Archive for July, 2012

How long does it take to develop Alzheimer’s disease? A study published in the New England Journal of Medicine (July 11, 2012) indicates that a rare and aggressive form of Alzheimer’s disease produces measurable changes 25 years before clinical symptoms appear. There is a rare form of familial Alzheimer’s disease where carriers of a gene mutation are afflicted with symptoms in their 30s and 40s (20s for some). This early onset (autosomal-dominant) form of Alzheimer’s disease is inherited in a pattern similar to Huntington’s chorea. We inherit pairs of genes (one of two possible from each parent). In early-onset Alzheimer’s disease one gene is normal and the other carries the program for the illness. In carrier families half of the children with develop the disease and half will not. Fortunately, most cases of Alzheimer’s disease are late-onset – we are […]


I had two discussions this last week about the distinction between delirium and dementia. The first was with a client who underwent major surgery several weeks ago. I have been following this client for several years and several evaluations demonstrating excellent memory. Subsequent to surgery, the client developed a delirium which has cleared. However, for the first time his evaluation scores have dropped. Second, the discussion during Minder’s Keepers at the Alzheimer’s Support Network turned to the same topic. So let me try to clarify the difference between a delirium and a dementia. By the dictionary a delirium is “an acute mental disturbance characterized by confused thinking and disrupted attention usually accompanied by disordered speech and hallucinations.” By the same dictionary dementia is “usually progressive condition marked by deteriorated cognitive functioning with emotional apathy.” The critical thing to know is […]


Depression in midlife and late life is associated with an increased risk for developing Alzheimer’s disease and/or vascular dementia. The most recent study was completed on 13,535 members of Kaiser Permanente (a not-for-profit health plan with its home in Oakland, CA) and published in the Archives of General Psychiatry (2012, 69, 493-498). The design of the study was retrospective and included any member who had a medical diagnosis of depression or neurological based diagnosis of Alzheimer’s disease or vascular dementia. Records were reviewed from 1964 to 1973 (midlife) and 1994 to 2000 (late life). Depressive symptoms were reported in about 14% of those in midlife and about 9% of those with depressive symptoms in late life. Those who were depressed at midlife had a 20% increased risk of dementia (either Alzheimer’s disease or vascular dementia). Those who were depressed in […]

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