produces as Alzheimer’s disease progresses. Even-
tually acetylcholine production drops below the
level at which extending its presence is useful,
however, making these medications most effective
in the early to middle stages of the disease.
There is some evidence that GINKGO BILOBA, a
botanical supplement, improves the cognitive and
memory symptoms of early to middle Alzheimer’s
disease in some people. Ginkgo biloba has no
known effect on neurotransmitters directly; its
action appears to be that it improves the circula-
tion of BLOODthroughout the brain. This possibly
broadens the areas of the brain that participate in
cognitive functions. However, ginkgo biloba also
affects COAGULATION (the processes of clotting).
People who take anticoagulant medications,
including daily ASPIRIN THERAPY, should not take
ginkgo biloba unless their doctors approve and
determine there are no interactions likely with
prescribed medications.
Other treatments for Alzheimer’s disease are
primarily supportive and may include OCCUPA-
TIONAL THERAPYto provide methods for maintaining
cognitive function and memory for as long as pos-
sible. Activities that use these functions, such as
crossword puzzles and reading, seem helpful.
Some studies show that daily physical exercise,
such as walking, slows the progression of
Alzheimer’s disease, though the mechanisms
through which it may do so remain unknown.
Alzheimer’s disease is challenging and emotion-
ally draining for family members and friends who
participate in caregiving. Most people want to
maintain their loved ones at home for as long as
possible, such that it often takes a traumatic event
to force the recognition that the person requires
more extensive care. Specialized Alzheimer’s care
facilities provide the staffing and environment to
keep the person with Alzheimer’s disease safe.
SUPPORT GROUPSfor family members and caregivers
provide forums for sharing information and
understanding. Because Alzheimer’s disease is
progressive and incurable, it is important for fami-
lies to discuss key END OF LIFE CONCERNSwith the
person before impairment becomes significant.
Most people prefer to make decisions about their
own care and are more comfortable when they
can feel confident their desires will shape the care
they receive.
Risk Factors and Preventive Measures
Age is the primary risk factor for Alzheimer’s dis-
ease. Though researchers have investigated
numerous apparent correlations between environ-
mental exposures (such as to aluminum) and
Alzheimer’s disease, they have not been able to
substantiate them. Genetic factors are likely signif-
icant contributors. Except for early-onset
Alzheimer’s disease, however, the role of the
genetic component of Alzheimer’s disease remains
uncertain. Researchers discovered in the early
2000s that people taking statin medications (such
as lovastatin) to lower blood cholesterol levels
have a much lower rate of Alzheimer’s disease
than people who do not take these medications,
and they continue to investigate what correlations
may exist.
At present, however, there are no measures
known to prevent Alzheimer’s disease. Because
environmental factors such as overall personal
health, nutrition, and lifestyle likely contribute in
some fashion to conditions that allow Alzheimer’s
disease to develop, health experts encourage
nutritious EATING HABITS, daily physical activity, and
other lifestyle measures to maintain optimal
health.
See also AGING, NEUROLOGIC CHANGES THAT OCCUR
WITH; COGNITIVE FUNCTION AND DYSFUNCTION; LIFESTYLE
AND HEALTH; MEMORY AND MEMORY IMPAIRMENT.amnesia See MEMORY AND MEMORY IMPAIRMENT.amyotrophic lateral sclerosis (ALS) A progres-
sive, degenerative disorder in which motor neu-
rons (NERVE cells in the SPINAL CORD that are
responsible for movement) die, resulting in loss of
voluntary MUSCLE function. ALS does not affect
involuntary muscle function or other neurologic
structures. Other names for ALS include Lou
Gehrig’s disease, Charcot’s disease, and motor NEU-
RONdisease. ALS affects half again as many men as
women and typically appears in people who are
between the ages of 40 and 60.
Though ALS ultimately affects all voluntary
muscle function, it typically begins in one of the
three types of motor neurons:- upper motor neurons, which regulate volun-
tary muscle function in the upper extremities
amyotrophic lateral sclerosis (ALS) 223