Introduction

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Alzheimer’s disease is an age-related brain disorder that gradually destroys a person’s ability to remember, think, learn, and carry out even the simplest of tasks. Alzheimer’s is a type of dementia, a broad term for diseases and conditions that damage brain cells and, over time, impair brain function. Alzheimer’s causes once-healthy brain cells, or neurons, to lose their ability to function and communicate with each other. Eventually, they die.

Typically diagnosed in people age 60 and older, in extremely rare cases the disease occurs in people in their 30s, 40s, and 50s. The first symptoms of Alzheimer’s disease typically include memory loss or other cognitive problems, such as trouble with language or decisionmaking. As cognition continues to decline, people may experience disturbing changes in personality and behavior. In the final stage of Alzheimer’s dementia, people lose the ability to recognize family and friends and become totally dependent on others for daily care. Ultimately, Alzheimer’s disease is a terminal illness.

Research shows that Alzheimer’s causes changes in the brain years and even decades before the first symptoms appear, so even those who seem free of the disease today may be at risk. The fight against Alzheimer’s is urgent because, without new ways to prevent or more effectively treat this age-related disease, it will become increasingly prevalent in our aging population.

This report from the National Institutes of Health (NIH) focuses on research findings reported and projects funded in 2011 and the first half of 2012. These highlights, prepared by NIH’s National Institute on Aging (NIA), the lead institute within NIH for Alzheimer’s research, covers work by an active scientific community. This work aims to elucidate the basic mechanisms and risk factors of Alzheimer’s disease, then apply this knowledge to the development and testing of new interventions to treat or prevent Alzheimer’s disease.

The efforts of researchers and clinicians—made possible by the many people who volunteer for clinical studies and trials—may one day lead to a future free of this devastating disorder. This report details some of the recent progress toward that goal.


View a short video of NIA Director Dr. Richard J. Hodes introducing the 2011-12 Alzheimer’s Disease Progress Report:


A Looming Public Health Crisis

Published research studies estimate that 2.4 million to 5.1 million people in the United States may have Alzheimer’s disease. While estimates vary, few would dispute the urgent need to find ways to prevent, delay, and treat this age-related disease—especially in light of America’s aging population. The U.S. Census Bureau estimates that the 65-and-older population will double to about 72 million during the next 20 years. In fact, the United States reached a significant milepost in 2011 when the oldest “baby boomers” turned 65. This population aging is accompanied by a sobering reality: The number of people with Alzheimer’s doubles for every 5-year interval past age 65, studies show. And the ranks of the very elderly—those 85 years and older and at the highest risk for Alzheimer’s—are expected to triple by 2050.

To fully appreciate the impact of Alzheimer’s disease in America and around the world, one must understand its enormous personal and societal costs. Family, friends, and caregivers of people with Alzheimer’s experience emotional, physical, and financial stress as loved ones become increasingly forgetful, frustrated, confused, and lost during the course of the disease. Families struggle to provide care at home but often face difficult decisions about daily, short-term, and long-term care. Frequently, people with Alzheimer’s disease make multiple transitions between home, assisted living facilities, nursing homes, and hospitals as their families seek appropriate care and support.

Unless more effective interventions are developed, the number of people living with the disease could escalate significantly, along with the need to support them and their caregivers. That is why researchers and clinicians are devoting their time and talent to developing the interventions needed to help people with Alzheimer’s, those at risk for the disease, and the many caregivers on the frontlines of support.


NIH-Supported Research on Alzheimer’s Disease

Dr. Alois Alzheimer first described Alzheimer’s disease more than 100 years ago. But it was not until the 1970s that researchers began to question the commonly held belief that dementia—or senility, as it was then known—was a normal part of aging. Since then, the scientists and clinicians who have dedicated their lives to finding the causes of and possible treatments for Alzheimer’s disease have greatly advanced our understanding of the disorder.

NIH funds and oversees a productive research program into the basic biology of Alzheimer’s disease and the factors that influence its development and progression. The NIH research portfolio covers a broad array of scientific disciplines and seeks to answer complex questions: What are the causes of Alzheimer’s disease? How can the disease be diagnosed early and accurately? How might it be treated? How could it be delayed or even prevented? During the past quarter century, scientific advances have deepened our insights into this complex disease.

While we have much to learn, it is notable that the pace of translational research—which takes laboratory knowledge into the clinical arena—is accelerating. International collaborations are also leading to important discoveries as scientists collect and share the data needed to tease out the genetic variants that may play a role in developing Alzheimer’s, and identify and standardize imaging and biomarker measures to better understand the disease’s earliest brain changes.


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