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Alzheimer Cover Page (Hard Cover)

May 29, 2018



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    Diana Vizoso

    Samantha Concepcion

    Melissa Sirolli

    Sean Faria

    William Lopez Jr.


    M & W 7:05pm

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    Alzheimers disease

    Diana Vizoso

    Samantha Concepcion

    Melissa Sirolli

    Sean Faria

    William Lopez Jr.


    M & W 7:05pm

    Professor Bidot

    December 07, 2009

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    The reason my group choose this topic for our research paper is for three reasons. One

    reason was the availability of information; it is easy to find information on the topic. Secondly

    was the topic seemed very interesting because from the research we have collected at least two

    people from this group will have Alzheimers disease as we age. Lastly was at least three of us

    from the group have relatives with this disease and would like to know what at least is going on

    so we may be some use to them. From this research paper we have learned a lot and this

    information we have learnt is irreplaceable.


    Alzheimers disease is a brain disorder named for German physician Alois Alzheimer,

    who first described it in 1906. Alzheimer's destroys brain cells, causing memory loss and

    problems with thinking and behavior severe enough to affect work, lifelong hobbies or social

    life. Alzheimers disease accounts for 50 to 70 percent of dementia cases. Other types of

    dementia include vascular dementia, mixed dementia, dementia with Lewy bodies and front

    temporal dementia. The brain has 100 billion nerve cells (neurons). Nerve cell networks have

    special jobs. In Alzheimers disease, as in other types of dementia, increasing numbers of brain

    cells deteriorate and die. Plaques build up between nerve cells. Tangles form inside dying cells.

    Scientists are not absolutely sure what role plaques and tangles play in Alzheimers disease.


    Scientists are still trying to fully understand the cause or causes of Alzheimers disease.

    In the meantime, its said to be helpful that we understand the hallmarks of Alzheimers plaques

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    and tangles and the risk factors that affect a persons likelihood of developing the disease.

    Alzheimer's disease is characterized by a build-up of proteins in the brain. Though this cannot be

    measured in a living person, extensive autopsy studies have revealed this circumstance. The

    build-up manifests in two ways. Plaques which are deposits of the protein beta-amyloid that

    accumulates in the spaces between nerve cells. Another way this build up can occur is through

    tangles, which are deposits of the protein tau that accumulate inside of nerve cells. Scientists are

    still studying how plaques and tangles are related to Alzheimers disease.

    One theory is that they block nerve cells ability to communicate with each other, making

    it difficult for the cells to survive. It is likely that the causes include genetic, environmental, and

    lifestyle factors, because people differ in their genetic make-up and lifestyle, the importance of

    these factors for preventing or delaying AD differs from person to person. Autopsies have shown

    that most people develop some plaques and tangles as they age, but people with Alzheimers

    develop far more than those who do not develop the disease.

    Scientists still dont know why some people develop so many compared to others.

    However, several risk factors for Alzheimers disease have been uncovered. Genetics play a role

    in some people with AD. A rare type of AD, called early-onset AD, affects people ages 30 to 60.

    Some cases of early-onset AD, called familial AD, are inherited. Familial AD is caused by

    mutations (permanent changes) in three genes. Offspring in the same generation have a 50-50

    chance of developing familial AD if one of their parents had it.

    Advancing age is the number one risk factor for developing Alzheimers disease. One out

    of eight people over the age of 65 have Alzheimers disease, and almost one out of every two

    people over the age of 85 has Alzheimers. Facts and studies show that the probability of being

    diagnosed with Alzheimers nearly doubles every five years after age 65. People who have a

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    parent or sibling that developed Alzheimers disease are two to three times more likely to

    develop the disease than those with no family history of Alzheimers. If more than one close

    relative has been affected, the risk increases even more.

    Scientists have identified two kinds of genes that are associated with this familial risk

    factor. The first is thought to be a risk gene, ApoE 4, that increases the likelihood of

    developing Alzheimers, but does not guarantee it. In addition to ApoE 4, scientists think there

    could be up to a dozen more risk genes yet to be discovered. The second kind of gene is a

    deterministic gene and is much rarer than risk genes. Deterministic genes are only found in a

    few hundred extended families around the world.

    If a deterministic gene is inherited, the person will undoubtedly develop Alzheimers, but

    probably at a much earlier age. Although age and family history are out of our control, scientists

    have also identified several lifestyle factors that can influence a persons risk of developing

    Alzheimers disease. A connection has been found between serious head injury and future

    development of Alzheimers, so those who practice safety measures such as wearing seat belts

    and not engaging in activities where there is a high risk of falling are at an advantage. Evidence

    states that there should be a greater promotion of exercise and a healthy diet, to help reduce

    Alzheimers risk.

    Avoiding tobacco, limiting alcohol consumption, staying socially active, and engaging in

    intellectually stimulating activities, have also been shown to have a protective effect against

    Alzheimers disease. Finally, there is a strong link between heart health and brain health. Those

    who are free of heart disease or related conditions are at a lower risk of developing Alzheimers

    or another kind of disease than those who have cardiovascular problems.

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    Signs and Symptoms of Alzheimers disease

    Alzheimers disease is the most common forms of Dementia. Alzheimers disease is a

    serious brain disorder that impacts daily living through memory loss and cognitive changes.

    Some common signs of Alzheimers disease can be mixed up with normal everyday normality of

    forgetfulness. Early stages of Alzheimers can be detected mainly by memory loss regarding

    recent conversations and events. It can start off as routinely placing important items in odd

    places, forgetting names of family members and common objects. It also is a result of, repeated

    questions, forgetting the way to get to a frequent visited place and even the inability to following

    simple directions for a recipe. This stage can usually last from 2-4 years.

    Moderate to middle stage Alzheimers disease is usually discovered when they can no

    longer cover up problems, have rambling speech, unusual reasoning, and have problems with

    places and times. Constant reminders are needed; assistance is needed with daily living activities,

    mood and behavioral changes start to occur and about 80% of patients show evidence of

    emotional and behavioral problems which are aggravated by stress and change that they are not

    used to. This Stage can last from 2-10 years.

    Severe to Late stage Alzheimers is the result of confusion of the past and present.

    Another sign is severe to total loss of verbal skills, they forget to speak or how to speak or write.

    The person becomes completely incapable to care for self. They become very high risk to falling

    due to gait dysfunction, and become bedridden. Patients begin to hallucinate, have severe mood

    swings and behavioral issues. They tend moan and cry when unable to express what they are

    feeling at the moment. They become totally dependent on others and need total support and care.

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    They can end up with issues such as the inability to swallow, incontinence, and illness. Illness is

    the result of the body systems shutting down usually resulting in death. To sum up the basic

    important information about Alzheimers disease one should the top ten basic signs to detect


    First Sign is memory loss. We all experience it one way or another; it is just a matter of

    knowing the difference between a slip-up and long-term forgetfulness. It is natural to forget an

    appointment and/or a persons name but to later remember it. Second basic sign of Alzheimers

    is challenges arising when planning or solving problems. We can easily make a mistake while

    balancing our check book every once in awhile but forgetting to pay monthly bills can be a sign

    to a serious condition. Third sign of possible Alzheimers disease is difficulty in completing

    familiar tasks at home. Of course we forget what button to press when wanting to TiVo

    something but forgetting the rules to your all time favorite board game, theres obviously a


    The fourth simple sign to detect Alzheimers disease is confusion time and place.

    Obviously we can occasionally forget what day of the week it is but we always remember in the

    end, whereas forgetting where we are and having no clue how we got there. These situations can

    be very stressful. The fifth sign of Alzheimers is trouble understanding. Alzheimers prospect

    begins having visual problems creating difficulty with reading. Over the years, with age, it is

    common to be diagnosed with cataracts, which at this time would be natural to have difficulty

    reading or seeing.

    The sixth sign of Alzheimers is having trouble with speech i.e. speaking and writing. It

    creates difficulty in joining in on conversations happening around them and or even while

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    theyre speaking they stop because they do not recall the subject of the conversation. We can be

    in the middle of a conversation and be distracted by something but as long as we are reminded by

    just a simple word. The seventh sign of Alzheimers is misplacing things and the inability to

    retrace ones steps to remember. Its normal for us to misplace the remote or even our car keys

    time to time but to place our common everyday items in awkward places is a little sign of


    The eighth sign of Alzheimers disease is decreased or poor judgment. It is normal for us

    to every once in a while make bad decisions and Alzheimers prospects pay less attention to their

    personal hygiene or can even pay people such as telemarketers large sum of money due to poor

    judgment with money. The ninth sign of Alzheimers disease is withdrawal from work or social

    activities. We are always at fault for feeling weary from work and wanting to be alone not having

    to go social gatherings or family gatherings from time to time. It is perfectly normal. An

    Alzheimers prospect will begin to withdraw from their favorite hobbies and forget how their

    favorite teams play. They can begin to feel that they dont want to participate in anything

    anymore and become lonely.

    The final sign of Alzheimers is the change in mood and/or personality. The prospect can

    become depressed, confused and even suspicious. We can usually create a routine of how we do

    things and when they get interrupted we can become irritated and frustrated and it is perfectly

    normal on occasion.

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    Alzheimers disease causes physical change in a persons brain that cannot be properly

    diagnosed until being closely examined. Physicians are able to diagnose Alzheimers with 90%

    accuracy due to thorough examination. Several of these medical examinations include the

    patients history, a mini-mental state exam, specific laboratory testing, and certain neuro-imaging

    examinations (Beers and Berkow). By gathering certain information from these exams, a doctor

    can identify if a patient suffers from Alzheimers and what stage of Alzheimers the patient is

    currently in.

    For further explanation, a doctor will ask a series of questions to compose a medical

    evaluation of the patient. The questions asked as part of the patients history includes information

    of the problem occurring, a history of current illnesses, and any family history in regards to the

    occurring problem. Physicians perform mini-mental exams that focus on the patients attention

    span, memory and other types of mental moods. For instances, the doctor performing the exam

    will try to interpret the different mood swings the patients undergoes. Another example would be

    the attitude, behavior and appearance towards other people. Specialists evaluate patients on the

    following statuses: Cognition, Insight judgment, Speech and language, Thought content, and

    Thought processes.

    After the physician has performed several mental tests, they usually send the patient to a

    laboratory to have blood work done. Even though there is not a specific lab test that can identify

    Alzheimers, the physician tries to rule out the possibility of other diseases by checking the

    levels of certain chemicals in the body. Specialist analyze the levels of Vitamin B12, TSH (for

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    the thyroids), CBC (for anemia), and HIV. Furthermore, depending on the conditions of the

    patient, the next step to evaluate if the patient has Alzheimer is to perform several neuro-imaging

    exams. One of the main exams that a patient undergoes is a CT scan. A CT scan takes multiple

    X-ray pictures of a certain body part to analyze any major changes. Patients with possible

    Alzheimers carry out a CT scan of the brain, where specialist can observe changes in the size of

    the brain. A size reduction of the brain may be a result of Alzheimers. Another imaging exam

    will be an MRI, which shows the functional changes of the brain. MRIs also rule out the

    possibility of Alzheimers by observing if any tumors are present (Kasper, Braunwald and

    Fauci). As stated previously, a patient cannot be properly diagnosed with Alzheimers until

    further studies are done after the patients death. These are some of the methods to determine the

    possibility of a patient suffering Alzheimers. There is only one method that has been recently

    discovered to diagnose Alzheimers at 100% accuracy which is an autopsy on the brain.


    Although no cure for Alzheimers disease is yet available, medical and behavioral

    treatments for the disease may ease symptoms for the individual with Alzheimer's. The

    symptoms that can be treated are the cognitive and behavioral symptoms. There is only three

    ways for treating symptoms of Alzheimers. They are the Standard Treatments, Sleep Treatments

    and lastly Alternative Therapy.

    Standard Treatments consist of two types of medications that have been approved by the

    U.S. Food and Drug Administration (FDA). The two types of drugs are cholinesterase inhibitors

    and Memanatine. Cholinesterase inhibitors are prescribed to treat symptoms related to memory,

    thinking, language, judgment and other thought processes. Three different cholinesterase

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    inhibitors are commonly prescribed. Donepezil also called Aricept, which is used to treat all

    stages of Alzheimers disease. Galantamine also called Razadyne, used to treat mild to moderate

    stages of Alzheimers. Rivastigmine also called Exelon, usually used to treat mild to moderate

    Alzheimers. Tacrine also called Cognex, the first cholinesterase inhibitor, was approved in 1993

    but is rarely prescribed today because of associated side effects, including possible liver damage.

    Cholinesterase inhibitors work by increasing the levels of a chemical messenger involved

    with memory, judgment and other thought processes called acetylcholine. There are certain cells

    in the brain that produce or release this chemical messenger acetylcholine, which in fact actually

    help communicate between other cells. Upon this messenger reaching the receiving cell various

    other chemicals as well as an enzyme called acetyl cholinesterase appear. This enzyme acetyl

    cholinesterase breaks down acetylcholine so it can be recycled.

    However Alzheimers disease damages or worst yet destroys the cells that produce or use

    acetylcholine. As a result of this process reduces the amount of acetylcholine to carry messages.

    Cholinesterase inhibitor is actually an enzyme created to slow down the process of breaking

    down the acetylcholine. Cholinesterase inhibitor accomplishes this by blocking the activity

    acetyl cholinesterase. This process saves some acetylcholine from being destroyed by the

    Alzheimers disease. These medications help the brain work better but it doesnt stop or reverse

    the destruction of the brain cells. Cholinesterase inhibitors do not prevent Alzheimers from

    getting worst this is just a method to slow the progression down.

    Cholinesterase inhibitors seem to offer other benefits, as well. For example,

    Galantamine appears to stimulate the release of acetylcholine and to strengthen the way certain

    message-receiving nerve cells respond to it. Rivastigmine may block the activity of another

    enzyme involved in breaking down acetylcholine. In contrast if side effects occur, they

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    commonly include nausea, vomiting, loss of appetite and increased frequency of bowel

    movements. It is strongly recommended that a physician who is experienced in using these

    medications monitor patients who are taking them, and that the recommended guidelines be

    strictly observed.

    Memantine also called Namenda is prescribed to improve memory, attention, reason,

    language and the ability to perform simple tasks. This was the first Alzheimer drug of the

    NMDA receptor antagonist type. Memanatine is used to treat moderate to severe Alzheimers


    Memantine works by regulating the activity of a chemical involved in information

    processing, storage and retrieval called glutamate. Perceptibly Glutamate triggers NMDA

    receptors to let a controlled amount of calcium into a nerve cell as a result of this process it

    significantly helps with learning and memory. The calcium helps creates the chemical

    environment required for information storage. In the same way Glutamate can be helpful it can

    be damaging. If there is excess Glutamate it over stimulates NMDA receptors so that they allow

    too much calcium into nerve cells. In a nut shell excess glutamate causes disruption and death of


    However Memantine may protect cells by partially blocking NMDA receptors. Adverse

    side effects include headache, constipation, confusion and dizziness. Scientists have made

    remarkable progress in understanding how Alzheimers affects the brain. Their insights point

    toward promising new treatments to slow or stop the disease. Ultimately, the path to effective

    therapies is through clinical studies.

    The second treatment to help Alzheimers is sleep treatment. This is a significant factor

    of Alzheimers because doctors have not found the exact reason why this happens. Many people

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    with Alzheimers experience changes in their sleep patterns. Similarly how Alzheimers affect

    memory and behavior, sleep changes also occur to Alzheimers patients. There have been cases

    of this in older adults without dementia who notice this as well. These conflicts occur more

    frequently and tend to be more brutal in Alzheimers patients. This is common in later stages of

    Alzheimers yet there have been reports and studies show to be found in the early stages as well.

    This seems hard to believe that such a thing as difficulty sleeping can be caused by

    Alzheimers. There are several patients with Alzheimers that wake up more often and stay

    awake longer during the night. Brain wave studies have shown to have a decrease in both

    dreaming and non-dreaming sleep stages. Sometimes those who cant sleep may be unable to lie

    still, or yell or call out, disturbing the sleep of their caregivers.

    Alzheimers patients have tendency for daytime napping and other shifts in the sleep-

    wake cycle. Individuals may feel very drowsy during the day and then be unable to sleep at

    night. Experts estimate that in late stages of Alzheimers, individuals spend about 40 percent of

    their time in bed at night awake and a significant part of their daytime sleeping. Patients should

    have a thorough medical examination to identify any treatable illnesses that may be contributing

    to the sleeplessness. Some conditions are Depression, Restless legs syndrome, Sleep apnea.

    Most doctors mostly try the non-drug treatment first due to the amount of medications

    patients usually are taking. This treatment aspires to build a sleep routine, to decrease daytime

    napping and to create the sleep environment necessary. The structure of this treatment consists of

    Maintaining a schedule for regular times for meals and for going to bed and getting up,

    Encourage regular daily exercise includes seeking morning sunlight exposure, Treat any pain,

    Avoid alcohol, caffeine and nicotine, If the person is taking a cholinesterase inhibitor avoid

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    giving the medicine before bed, Make sure the bedroom temperature is comfortable, If the person

    awakens, discourage staying in bed while awake; use the bed only for sleep, Discourage

    watching television during periods of wakefulness.

    The second Sleep treatment is obliviously medications. This is for the cases that non-

    drug fails help the sleeplessness. There is one rule for delivering sleep medications all experts

    agree on begin low and go slow. This rule came about because of the risk of sleep inducing

    medication on older adults who are cognitively impaired are significant. The risks are increased

    risk for falls and fractures, confusion, and a decline in the ability to care for oneself. However

    once a sleep pattern has been established patients are too slowly discontinue them.

    The most common used sleep medications are Tricyclic antidepressants, such as

    nortriptyline and trazodone. Another is Benzodiazepines which common names are lorazepam,

    oxazepam and temazepam. Sleeping pills also called zolpidem, zaleplon and chloral hydrate.

    Lastly are antipsychotics such as haloperidol, risperidone, onlanzapine and quetiapine.

    The final treatment is alternative therapy which consists of several herbal remedies,

    vitamins and other dietary supplements. The safety and capability of these products are based

    fundamentally on testimonials, tradition, and a rather small body of scientific research. The

    reason this is called alternative therapy is due to the unknown. The effectiveness, safety, purity

    are all unknown. The claims do not present enough evidence of effectiveness for FDA, as well as

    FDA has no authority over supplement production. The safety of this therapy is also not

    regulated. The safety precautions are actually given by healthcare professionals to the

    manufacturers. Not to mention the risk of these products can have serious or serve interactions

    with prescribed medications.

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    Vitamin E is used to treat Alzheimers because it is an antioxidant, a substance that may

    protect nerve cells from certain kinds of chemical wear and tear. There is one large federally

    funded study that shows that vitamin E can slightly slow down the loss of ability to carry out

    daily life. Patients should not take vitamin E to treat Alzheimers unless supervised by physician.

    The Vitamin E doses in these cases are relatively high. This high dose is why vitamin E should

    never been taken without proper supervision. Vitamin E can interact with other medications,

    including those prescribed to keep blood from clotting.

    Coenzyme Q10 or ubiquinone is another antioxidant that is used in Alzheimers patients.

    This usually naturally produced in the body and is necessary for ordinary cell reactions. There

    was a synthetic version of this compound called idebenone, which was studied with Alzheimers

    but produced complimentary results. There is also no information on an adequate dose to be

    taken and considered safe. Consequently there can be harmful effects due to the lack of study.

    Coral Calcium which is advertised as a cure for Alzheimers, cancer and other illnesses.

    This is a form of calcium carbonate that is derived from shells of formerly living organisms that

    made up coral reef. In June 2003, the Federal Trade Commission (FTC) and the Food and Drug

    Administration (FDA) filed a formal complaint against the promoters and distributors of coral

    calcium. Coral calcium differs from ordinary calcium supplements only in that it contains traces

    of some additional minerals incorporated into the shells by the metabolic processes of the

    animals that formed them. It contains no amazing health benefits.

    Ginkgo biloba is a plant extract containing several compounds. Ginkgo biloba is thought

    to have antioxidant and anti-inflammatory benefits that may have positive effects on cells within

    the brain and the body. However, multicenter Phase III study published in the Journal of the

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    American Medical Association (November 19, 2008) proved that gingko was acting as a

    placebo in delaying changes in memory, thinking and personality and had no impact on the

    development of Alzheimers.

    Huperzine-A is a moss extract usually used in traditional Chinese medicine. The

    properties of Huperzine-A is very similar to those of cholinesterase inhibitors. As a result, it is

    promoted as a treatment for Alzheimer's disease also may be comparable to approved drugs for

    Alzheimers. There was a study for this drug launched in spring 2004 by no results has been

    mentioned. This is also another drug that has been regulated as a dietary supplement with no

    uniform standards. It is recommended not to be taken with prescribed medication due its

    similarity to cholinesterase inhibitors and increase side effects of prescribed drug.

    Last form of alternative therapy is Omega-3 fatty acids. Omega-3 is a type of

    polyunsaturated fatty acid it has been more linked to heart disease and stroke than Alzheimers.

    There are only two types of Omega-3s qualified for use. Docosahexaenoic acid (DHA) and

    Eicosapentaenoic acid (EPA) recently added to 75% of prenatal vitamins for develop of brain in

    babies. This fatty acid cannot be made in the body this is fatty acid primarily use from fish oil or

    flax oil. The reason why this was linked to the reduction of brain decline was that DHA is the

    chief omega-3 in the brain. There are theories that Omega-3s are might influence dementia risk

    include their benefit for the heart and blood vessels, anti-inflammatory properties, and support

    while protecting the nerve cell membranes. These findings are still under study and are in the

    preliminary stage.

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    1. Alzheimers disease - a common form of dementia of unknown cause, usually beginningin late middle age, characterized by memory lapses, confusion, emotional instability, and

    progressive loss of mental ability. Named after Alois Alzheimer (18641915), German

    neurologist, who described it in 1907.

    2. Anti-inflammatory- acting to reduce certain signs of inflammation, as swelling,tenderness, fever, and pain.

    3. Antidepressants- of or pertaining to a substance that is used in the treatment of mooddisorders, as characterized by various manic or depressive affects.

    4. Autopsy- inspection and dissection of a body after death, as for determination of thecause of death; postmortem examination.

    5. Cholinesterase inhibitors- is an enzyme that increases the levels of a chemical messengerinvolved with memory, judgment and other thought processes called acetylcholine.

    6. Coenzyme Q10- a naturally occurring, fat-soluble, vitamin like enzyme found in a varietyof foods and synthesized in the body: sold as a dietary supplement for its antioxidant


    7. Confusion- lack of clearness or distinctness: a confusion in his mind between right andwrong.

    8. Coral Calcium- This is a form of calcium carbonate that is derived from shells offormerly living organisms that made up coral reef.

    9. Dementia- severe impairment or loss of intellectual capacity and personality integration,due to the loss of or damage to neurons in the brain.

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    10.Depression- condition of general emotional dejection and withdrawal; sadness greaterand more prolonged than that warranted by any objective reason.

    11.Diagnose- to determine the identity of (a disease, illness, etc.) by a medical examination:The doctor diagnosed the illness as influenza.

    12.Dietary supplement- product taken orally that contains one or more ingredients that areintended to supplement one's diet and are not considered food.

    13.Docosahexaenoic acid (DHA)- an omega-3 fatty acid found especially in cold-water fish.14.Eicosapentaenoic acid (EPA)-An omega-3 fatty acid found in fish oils.15.

    Federal Trade Commission (FTC)- A federal agency responsible for maintaining the

    competitive markets, thereby discouraging restraint of trade and monopoly. The clout and

    aggressiveness of the FTC vary greatly depending on its membership and the incumbent

    Presidential administration.

    16.Food and Drug Administration (FDA) - The FDA is responsible for protecting the publichealth by assuring the safety, efficacy, and security of human and veterinary drugs,

    biological products, medical devices, our nations food supply, cosmetics, and products

    that emit radiation.

    17.Fatty acid- any of a class of aliphatic acids, esp. palmitic, stearic, or oleic acid, consistingof a long hydrocarbon chain ending in a carboxyl group that bonds to glycerol to form a


    18.Ginkgo biloba- is a plant extract containing several compounds.19.herbal remedies- a plant or plant part or an extract or mixture of these used to prevent,

    alleviate, or cure disease called also herbal, herbal medicine.

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    20.Huperzine-A - is a moss extract usually used in traditional Chinese medicine. Theproperties of Huperzine-A is very similar to those of cholinesterase inhibitors.

    21.medical examinations- thorough physical examination; includes a variety of testsdepending on the age and sex and health of the person.

    22.Memory- the mental capacity or faculty of retaining and reviving facts, events,impressions, etc., or of recalling or recognizing previous experiences.

    23.mild stages of Alzheimers- progress from mild forgetfulness to widespread neurologicalimpairment and ultimately death.

    24.moderate stages of Alzheimers- progress from moderate forgetfulness to widespread

    neurological impairment and ultimately death.

    25.Omega-3 - a polyunsaturated fatty acid, essential for normal retinal function, thatinfluences various metabolic pathways, resulting in lowered cholesterol and triglyceride

    levels, inhibited platelet clotting, and reduced inflammatory and immune reactions.

    26.Polyunsaturated fatty acid - an unsaturated fatty acid whose carbon chain has more thanone double or triple valence bond per molecule; found chiefly in fish and corn and

    soybean oil and safflower oil.

    27.Restless legs syndrome- a nervous disorder of uncertain patho-physiology that ischaracterized by restlessness of the legs usually as evidenced by aching, crawling, or

    creeping sensations in them especially at night or when lying down and that is often

    accompanied by insomnia and by involuntary twitching of the legs during sleep called

    also restless legs.

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    28. Serve stages of Alzheimers- is the result of confusion of the past and present. Anothersign is severe to total loss of verbal skills, they forget to speak or how to speak or write.

    The person becomes completely incapable to care for self.

    29.Sleep apnea- a temporary suspension of breathing, occurring in some newborns (infantapnea)and in some adults during sleep

    30.Supplements- something added to complete a thing, supply a deficiency, or reinforce orextend a whole.

    31.Vitamin- any of a group of organic substances essential in small quantities to normalmetabolism, found in minute amounts in natural foodstuffs or sometimes produced

    synthetically: deficiencies of vitamins produce specific disorders.

    32.Vitamin E- a pale-yellow viscous fluid, abundant in vegetable oils, whole-grain cereals,butter, and eggs, and important as an antioxidant in the deactivation of free radicals and

    in maintenance of the body's cell membranes: deficiency is rare.


    y Alzheimers Association. Early Onset Dementia: A National Challenge, A Future Crisis.(Washington, D.C.: Alzheimers Association, June 2006) Accessible at

    y Alzheimers Association. Professionals & Researchers, Alzheimer's disease, TreatingAlzheimers: Cognitive Symptoms. Accessible at

    y Beers, Mark H. and Robert Berkow. "The Merck Manual of Diagnosis and Therapy, 17thEdition." Delirium and Dementia. Whitehouse Station, New Jersey: Merck Research

    Laboratories, 1999. Chapter 40.

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    y Lon S. Schneider MD, (University of Southern California) reflects in the Journal of theAmerican Medical Association (JAMA. 2008;300[19] Ginkgo Biloba and Alzheimer's

    Disease Online article accessible

    y Kasper, Dennis L., et al. "Harrison's Principles of Internal Medicine, 16th Edition." Bird,Thomas D. and Bruce L. Miller. Dementia. New York: McGraw-Hill Professional, 2004.

    Chapter 365.