The encyclopedia of alzheimer’s disease second edition The encyclopedia of alzheimer’s disease second edition carol Turkington and deborah mitchell foreword by James e. Galvin, m.d., m.p.h. Disclaimer: This book is intended to provide helpful information on the subject matter covered herein. It is sold with the understanding that the authors and the publisher are not engaged in rendering professional medical, health, or any other kind of personal professional services via this book. If the reader wants or needs personal advice or guidance, he or she should seek an in-person consultation with a competent medical professional. Furthermore, the reader should consult his or her medical, health, or other competent professional before adopting any of the suggestions in the book or drawing inferences from information that is included herein. The authors and publisher specifcally disclaim any responsibility for any liability, loss, or risk, whether personal or otherwise, that someone may incur as a consequence direct, or indirect, of the use and application of any contents of this book. In no way does reading this book replace evaluation by a physician. Also, the full responsibility for any adverse effects that result from the use of information in this book rests solely with the reader. The Encyclopedia of Alzheimer’s Disease, Second Edition Copyright © 2010, 2003 by the Estate of Carol Turkington All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage or retrieval systems, without permission in writing from the publisher. For information contact: Facts On File, Inc. An imprint of Infobase Publishing, Inc. 132 West 31st Street New York NY 10001 Library of Congress Cataloging-in-Publication Data Turkington, Carol. The encyclopedia of Alzheimer’s disease / Carol Turkington with Deborah Mitchell ; foreword by James E. Galvin.—2nd ed. p. cm. Includes bibliographical references and index. ISBN-13: 978-0-8160-7766-3 (hardcover : alk. paper) ISBN-10: 0-8160-7766-5 (hardcover : alk. paper) ISBN: 978-1-4381-2858-0 (e-book) 1. Alzheimer’s disease— Encyclopedias. I. Mitchell, Deborah R. II. Title. [DNLM: 1. Alzheimer Disease—Encyclopedias—English. WT 13 T939e 2009] RC523.T87 2009 616.8'31003—dc22 2009006661 Facts On File books are available at special discounts when purchased in bulk quantities for businesses, associations, institutions, or sales promotions. Please call our Special Sales Department in New York at (212) 967-8800 or (800) 322-8755. You can fnd Facts On File on the World Wide Web at http://www.factsonfle.com Text and cover design by Cathy Rincon Composition by Hermitage Publishing Services Cover printed by Sheridan Books, Ann Arbor, MI Book printed and bound by Sheridan Books, Ann Arbor, MI Date printed: March 2010 Printed in the United States of America 10 9 8 7 6 5 4 3 2 1 This book is printed on acid-free paper. LHL-Alzheimer-FNL.indd 4 4/2/10 10:52:39 AM To my wife, Doris, and my sons, Chris, Jake, and Conor. They are my source of inspiration and strength. —J. E. G. h conTenTs foreword ix acknowledgments xiii introduction xv entries a–z 1 appendixes appendix i: alzheimer’s disease resources 222 appendix ii: alzheimer’s disease centers 232 appendix iii: area agencies on aging 236 appendix iV: international alzheimer’s disease associations 241 appendix V: legal/financial issues 248 appendix Vi: read more about it 254 appendix Vii: alzheimer’s disease clinical Trials 256 Glossary 261 Bibliography 264 index 285 foreword ew words evoke more fear or uncertainty than dementing disorder, increases with age for every Fdementia. Dementia comes from the Latin de- decade after 65. It is currently estimated that there “apart, away” and mens, “mind,” but for millions are more than 5 million Americans with AD, up to of people the word indicates a thief that has stolen half of whom may be undiagnosed. away a loved one’s personality, memory, language, About one in 10 individuals over the age of and knowledge. The transformation typically is 65 and half of everyone over age 85 will develop gradual, a slow decline in abilities that eventually dementia. In addition to AD, other common leaves behind a victim who is uncommunicative, causes of dementia are cerebrovascular disease and uncomprehending, and unresponsive. I use the Parkinson’s disease. The annual direct and indirect term victim deliberately, because anyone who has costs of Alzheimer’s and other dementias to Medi- seen a loved one changed by the progression of care, Medicaid, and businesses amount to more these relentless disorders knows this image is apt. than $148 billion. Dementia is clearly a challenge I say disorders because dementia is not a single that affects many sectors of society. disease but, rather, a symptom of many conditions Overt clinical dementia is not the only cogni- that cause brain dysfunction. Dementia is associ- tive/memory defcit that affects so many older ated with a wide range of symptoms, modes of individuals. Terms such as mild cognitive impairment onset, clinical courses, and therapeutic responses. and age-associated memory impairment have been Perhaps the one positive thing that can be said proposed to characterize people who have some about this condition is that the diverse background memory challenges but who have relative preser- of clinical symptoms provides researchers with vation of other cognitive abilities and functions of fertile grounds for developing theories and insights daily life. It has been diffcult to reach consensus, into the basic inner workings of the brain and of however, on how and when these entities should the mind. be diagnosed. Moreover, because the prevalence of Over the years, I have often looked upon my dementia increases with age, and because there is patients with sorrow because I am all too aware of wide variation in test performance among normal the changes that will occur in their lives. I am in older adults, the boundaries between age-related awe of the inner strength and resolve of so many cognitive decline and very early dementia are caregivers who strive to provide their loved ones sometimes uncertain, both to the patients and to with the care they deserve. I watch as they look the physicians who treat them. for answers and for hope. In the early part of the 20th century, Dr. Alois Dementia is a common problem. There is a good Alzheimer described his frst patient (Auguste D) chance that everyone who opens this book will with the disorder that would come to bear his know someone who has dementia. The prevalence name. A psychiatrist, Dr. Alzheimer examined of Alzheimer’s disease (AD), the most common Auguste D in an institutionalized setting after she ix