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process often destroys the brain centers responsible for self-awareness, including the patient's own
awareness of decline in intellectual capacity. Nonetheless, some family members refuse to accept
that the patient indeed has a brain disease and get upset when he or she behaves in an irrational
fashion. Coming to terms with the changing personality of the person they once knew is never an
easy task.

Later stages of the illness are characterized by confusion and disorientation, inability to recognize
family members, breakdown in the ability to manage bodily functions, and incontinence of urine.
Some patients become mute, and psychosis and behavioral changes like agitation and aggression
may occur. Managing patients in the final stages is virtually impossible at home, and admission to a
nursing home or similar long-term care facility becomes necessary. For family members and close
friends, the most disturbing turning point seems to be when the patient can no longer recognize them
and has ceased to be the person whom they once knew and loved.

Potential Therapies

Caring for and treating patients with Alzheimer's disease costs over $100 billion annually in the
United States alone. The introduction of FDA-approved cholinesterase inhibitors for treatment, and
their potential utility in treating memory loss due to the aging process, has given rise to new hope
that we are on the way to meaningful therapies for this terrible illness. There are suggestions that
vitamin E, ginkgo biloba, estrogens, and anti-inflammatory agents may slow the progression of
Alzheimer's disease, but some of these agents may be even more useful in preventing memory loss
due to the aging process. I will discuss these therapies in the next major section in this book.

Other Dementias
TEAMFLY
Vascular Dementia

After Alzheimer's disease, the second most common form of dementia is vascular dementia, which is
a direct result of multiple strokes destroying large portions of brain tissue (discussed in chapter 12).

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Team-Fly