Alzheimer's Disease and Other Dementias

by

Stanley G. McCracken

• LAST REVIEWED: 21 November 2012
• LAST MODIFIED: 21 November 2012
• DOI: 10.1093/obo/9780195389678-0115

Introduction

Prior to the last century dementia, referred to as senility, was seen as a normal and inevitable part of aging. About one hundred years ago Dr. Alois Alzheimer described the case of a woman with a complex set of symptoms including impaired memory and speech, disorientation, and hallucinations. After her death, Dr. Alzheimer conducted an autopsy and described the beta-amyloid (Aβ) plaques and neurofibrillary tangles that are the hallmarks of Alzheimer’s disease (AD). The prevalence of AD and other dementia is estimated at 5–7 percent in individuals sixty-five years old and at 25–50 percent in those over eighty-five (Agronin 2008; see Guidebooks). There were approximately 35 million adults over sixty-five in the United States in 2000, and that number is expected to double by 2050. When considered together, these figures explain why dementia is considered a growing national problem. Research on AD and other dementias has grown in the past thirty years and especially in the last decade. Advances in imaging and neuropsychological testing have improved the ability to recognize and distinguish between AD, frontotemporal, Lewy body, vascular, and Parkinson’s disease dementias. Knowledge has expanded particularly rapidly in understanding the changes associated with AD. For example, knowledge from multicenter projects is yielding insights into the pathophysiology of dementia, and information from large-scale genetic studies has revealed a number of potential gene candidates contributing to the risk of AD in older adults. Unfortunately, these basic science insights have yet to be translated into proven treatments to prevent or interrupt the disease process in AD or other dementias. There have been some advances in the treatment of dementia symptoms and associated conditions, such as development of medications designed to slow the progression of memory loss. While these medications provide some symptomatic relief, the effects have not been large, and use is often associated with unpleasant side effects. Many have looked to herbal remedies and dietary supplements to preserve cognitive functioning and slow progression of dementia, though these approaches too have shown minimal effect. Psychosocial approaches, often delivered by family members and other informal caregivers, are still considered the first line interventions to maintain the function of individuals with dementia and associated conditions. Because of the rapid growth of knowledge in AD and other dementias, most of the works cited in this bibliography will be recent systematic reviews and meta-analyses. This will provide a portal to current information and to authors or approaches that can be explored further.

General Overviews

One of the best ways to keep up with the rapid growth of knowledge on dementia is to regularly visit or sign up for updates from web-based dementia and aging resources for practitioners, researchers, clients, and family and other caregivers. These websites range from sites that specifically target dementia, like the National Institute on Aging’s Alzheimer’s Disease Education and Referral Center, the Alzheimer’s Research Forum, Alzheimer’s Disease International, the Alzheimer’s Association, and the Lewy Body Dementia Association to those that focus more broadly on aging in general such as the National Council on Aging. (See the Oxford Bibliographies article on Aging for additional links to general gerontological websites.) These web-based resources, associated with national, international, and governmental organizations, include a variety of educational materials including publications that can be downloaded or ordered as booklets, brochures, and fliers. Some of these educational materials are written for clients, families, and other caregivers, and others are more suitable for practitioners, students, teachers, and researchers. The first five dementia-specific sites post updates and news releases on dementia research including advances in assessment and treatment and changes in diagnostic criteria. They also provide links to other websites and treatment resources, and some provide information for people interested in participating as subjects in dementia research and clinical trials. While several of the sites list Alzheimer’s in their name, they also provide information on other types of dementia as well. Finally, the CSWE Gero-Ed Center and Lippincott Williams & Wilkins’s How to Try This provide gerontology teaching resources useful for training staff in health, mental health, substance abuse, and aging settings, as well as graduate and undergraduate level social work courses. These resources include teaching notes and online skill demonstrations of assessments and interventions.

• Alzheimer’s Association.

  Alzheimer’s Association is the largest private, nonprofit, funder of Alzheimer’s research. It promotes care and support for individuals with dementia through local chapters around the nation. This site provides links to a variety of resources including local chapters, online message boards, support groups, clinical trials, and educational activities and materials.

• Alzheimer’s Disease Education and Referral Center (ADEAR).

  Site for Alzheimer’s disease information with resources for teaching, staff training, and the public. Publications, including DVDs and videos, can be downloaded or ordered. One of the best is Alzheimer’s Disease: Unraveling the Mystery (2008), a primer on Alzheimer’s disease. Includes information about participating in clinical trials, other research.

• Alzheimer’s Disease International (ADI).

  ADI is an international federation of Alzheimer associations around the world, in official relations with the World Health Organization. ADI believes integrating global solutions and local knowledge is key to winning the fight against dementia. Site provides links to dementia information and resources, including contact information for Alzheimer’s Associations around the world.

• Alzheimer’s Research Forum.

  Alzheimer’s Research Forum posts current information and news on Alzheimer’s and dementia research including (national and international) conference presentations. People may post comments on articles, receive the weekly Alzheimer’s Research Forum Newsletter, view webinars, and download papers and presentations. Includes special section specific to familial (early onset) Alzheimer’s disease.

• CSWE Gero-Ed Center.

  Resources for infusing gero competencies and content in undergraduate and graduate teaching. Resources developed by participants in the Curriculum Development Institute Program, GeroRich, and SAGE-SW Projects; and other gerontological social work educators. Training modules addressing dementia and associated conditions found in several sections including mental health, health care, and caregiving.

• How to Try This. Lippincott’s NursingCenter.com.

  Teaching resource developed by nurses for nurses and nursing students but has many videos and articles on dementia suitable for training social work students and staff. Demonstrations include both the skill demonstration and a discussion of administration and interpretation of the information gathered from the discussion.

• Lewy Body Dementia Association (LBDA).

  LBDA is a nonprofit organization that promotes awareness of the Lewy body dementias (LBD), supports individuals with LBD and their families and caregivers, and promotes scientific advances in the understanding and treatment of LBD. The site provides resources and links both for families and for professionals who work with LBD.

• National Council on Aging.

  NCOA is a national, nonprofit service and advocacy organization bringing together nonprofit organizations, businesses, and government to develop solutions to help older adults remain in their homes, active in their communities, find jobs and benefits, and improve health. Links to events, advocacy, research, and programs that promote older adults’ well-being.