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Forgetful?
Don't Assume It's Alzheimer's Disease
Alzheimer's Is the Culprit Less Than Half the
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By Peggy Peck
WebMD Medical News
Reviewed by Dr. Jacqueline Brooks
(Washington) -- Persons who consistently misplace
car keys or are "putting money in the sugar
bowl" have mild memory deficit, but probably
less than half of people with these symptoms actually
have early Alzheimer's disease, says a team of researchers
from Denmark. Gunhild Waldemar, MD, PhD, says, "Twenty
percent of these people have memory problems that
are caused by other conditions which can be treated
and thus reverse the memory deficit."
Waldemar says that among persons with reversible
memory problems, the most frequent cause is depression.
She tells WebMD that when people are depressed,
they have difficulty concentrating and that lack
of concentration leads to forgetfulness, which is
often alarming to the person experiencing it. She
adds that many people are reluctant to seek help
because they fear they are developing dementia.
This fear, she says, leads to unnecessary delays
in diagnosis.
Waldemar, reporting her findings at the World Alzheimer
Congress 2000 in Washington, says, "Some conditions
mimic Alzheimer's disease, and that is why it is
important that patients with memory deficits be
referred for a full evaluation by specialists."
Waldemar is director of the Memory Disorders Research
Unit of the Neuroscience Center at Copenhagen University
Hospital in Denmark. She says that patients referred
to the unit are given a systematic examination including
medical history, physical examination, blood tests,
and brain imaging.
Waldemar and colleagues reported on almost 800
patients who were referred over a 40-month period.
The average age of the patients was 64, but the
range was "from the 20s through the 90s."
She says that a typical group of 10 patients would
break down this way: About one and a half would
be "healthy, worried adults," two would
have a treatable condition like depression or thyroid
disease, and two would have memory disorders or
disorders of their ability to function that would
be considered stable but might progress to Alzheimer's
disease. And "four and a half have progressive
dementia," she says.
Additionally, about 35% of the Alzheimer's patients
also have depression or another disorder that can
make the symptoms of Alzheimer's more severe. She
says that among Alzheimer's patients, treating these
secondary conditions will improve the ability to
function.
Waldemar says that the "20%-reversible dementia
rate is very applicable worldwide."Bill Thies,
PhD, vice president for medical and scientific affairs
at the Alzheimer's Association, tells WebMD that
Waldemar is probably correct. He says that this
is the group they want to target for identification
and early treatment if the condition is indeed early
Alzheimer's, but that they also need to find those
people who have other conditions so they can be
treated. The problem, says Thies, is that many people
are reluctant to seek medical help for these symptoms.
Ronald C. Peterson, MD, PhD, also feels that Waldemar's
numbers are probably on target. He says that the
study is important in terms of reminding American
physicians that there are treatable causes of memory
loss. Peterson is professor of neurology at the
Mayo Medical School in Rochester, Minn.
In addition to depression as a reversible cause,
Waldemar says, "Thyroid disease and nutritional
problems were also identified as a cause of mild
memory disorders." Another cause was a problem
with brain-fluid circulation, which is corrected
by surgery. A small number of patients also had
alcohol dependence as a cause, she adds.
Waldemar says the current study was "just
an identification study. We have no data on the
effect of treatment." She says, however, that
she and her colleagues are now conducting a treatment
study.
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