Factors that may increase risk

Four factors are associated with an increased risk for Alzheimer's disease and cognitive decline. They are not necessarily causes, but science has noticed some meaningful connection between these things and an increased risk for Alzheimer's and cognitive decline. They are:
* diabetes,
* the gene variation ApoE,
* current smoking, and
* depression.

Evidence is not as strong for a connection between estrogens or nonsteroidal anti-inflammatory drugs and an increased risk for Alzheimer's, and there's no evidence of a connection between estrogens or NSAIDS and cognitive decline.

There is also not a consistent association involving cholesterol-lowering medicine, obesity, high blood pressure or blood homocysteine levels for either Alzheimer's or cognitive decline.

Download the 21-page "Preventing Alzheimer's Disease and Cognitive Decline"

state-of-the-science conference statement

What is the hippocampus? And why should we care?

My Dad was dating the woman he would marry when the Lancet published research in 1985 about how "the decline of all higher cognitive functions in senile dementia of the Alzheimer type is attributable to histopathological changes in the hippocampal formation."

Twenty-three years later, the year his wife got him settled into Silverado Senior Living, research still focused on the hippocampus, deep in the brain. It seems a larger hippocampus may protect people from the effects of Alzheimer's disease-related brain changes, "an exciting area of research," according to Professor Clive Ballard, director of research for the Alzheimer's Society in London.

It's not that any of this knowledge or experimentation could help my Dad now, or even back in 1985, that I find myself wondering about this structure, this region, this whatever-it-is piece of the brain. It's the purple area in this drawing provided by Dr. Jim Phelps, an Oregon psychiatrist. This is a slice image, looking deep in the temporal lobe, which is above and infront of the ear on either side of the head.

He explains that the hippocampus--part of the innermost fold of the temporal lobe--is instrumental in helping us store memories. And, he gives three reasons why we should care about it:

1. This part of the brain appears to be absolutely necessary for making new memories. Alzheimer's disease affects the hippocampus first and severely, which is why memory (or the ability to make new ones) is usually the first thing to start to falter in Alzheimer's.

2. The hippocampus appears to shrink in severe mental illnesses, including severe depression and schizophrenia.

3. Estrogen has a direct effect on the hippocampus. Research on the role of estrogen in preventing Alzheimer's is underway.

So this is what we know now. We can only imagine what we'll know another 23 years from now.

ScienceDaily report from 2006 on the size of the hippocampus as it relates to Alzheimer's disease

What is FTD?

We had never heard of FTD before (other than the flower delivery service) when a doctor gave our family the diagnosis for our patriarch of frontotemporal lobe dementia. He said it was like Alzheimer's disease in some respects. But it was its own disease.

FTD actually refers to a group of rare neurological disorders that affect the frontal and temporal lobes of the brain, which control personality and social behavior, reasoning, movement, language, and some aspects of memory.

It often strikes people earlier than does Alzheimer's, developing as early as 35, (but most are diagnosed in their 50s and 60s.)

Doctors say that FTD makes up about 3 percent of all dementia cases.

The FTD Support Forum lists some of the diseases that get classified as FTD include Pick's Disease, FEDP-17, Supranuclear Palsy, Primary Progressive Aphasia and Corticobasal Degeneration.

It's not Alzheimer's

Frontotemporal dementia (frontotemporal lobar degeneration) is an umbrella term for a diverse group of uncommon disorders that primarily affect the frontal and temporal lobes of the brain, the areas generally associated with personality, behavior and language, according to the Mayo Clinic definition page.

Here's what else it says:

In frontotemporal dementia, portions of the frontal and temporal lobes atrophy, or shrink. Signs and symptoms vary, depending upon the portion of the brain affected.

Some people with frontotemporal dementia undergo dramatic changes in their personality and become socially inappropriate, impulsive or emotionally blunted, while others lose the ability to use and understand language.

Frontotemporal dementia is often misdiagnosed as a psychiatric problem or as Alzheimer's disease. But frontotemporal dementia tends to occur at a younger age than does Alzheimer's disease, typically between the ages of 40 and 70.