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HOME > PAST ISSUE > May-June 2013 > Article Detail

FEATURE ARTICLE

Alzheimer’s Disease: The Great Morbidity of the 21st Century

Neuroangiogenesis (NAG) provides a vascular basis for understanding Alzheimer’s disease, senile dementias and cognitive decline with aging

Charles T. Ambrose

Alzheimer’s disease bids to become in its own way as devastating in the foreseeable future as any of the great plagues of the past. The Black Death (bubonic plague of the 14th century) was also called the Great Mortality because it killed many of those infected within a week or two of its onset. By analogy but in contrast, Alzheimer’s disease could be termed the Great Morbidity, because it sends affected persons down a fading mental spiral for decades before their death from other causes.

2013-05AmbroseF1.jpgClick to Enlarge ImageIn the United States at present, Alzheimer’s disease (AD) afflicts 13 percent of people age 65 and older and 43 percent of those 85 and older, or in total, an estimated 5.4 million—equivalent to the current population of Minnesota. AD is the fourth leading cause of death in the United States today. By 2030 the number of persons in the country with AD is expected to reach 7.7 million and by 2050 will approach 11 to 16 million—think of Ohio, Illinois or Pennsylvania. The impending economic and social impact from AD will compromise American life immensely during the coming decades … “unless preventative strategies are found,” as urged by numerous Alzheimer researchers.

Relevant in this discussion is the condition senile dementia (SD), which some regard as distinct from AD but others employ as a generic term encompassing it also. Throughout the greater world, senile dementia affects 5 to 7 percent of people over age 60. This number is expected to double in the next 20 years and reach 100 million by 2050.

2013-05AmbroseF2.jpgClick to Enlarge ImageIn the literature are several other terms for progressively impaired mental states—for example, adult onset dementia, cognitive decline with aging, vascular dementia, and frontal temporal dementia. Each has a particular meaning, which need not be explained here. AD accounts for 50 to 70 percent of all dementias. I link all the above mental conditions together because they may have a common basis—that is, diminished cerebral capillaries. This essay is a shortened version of a longer paper in the Journal of Alzheimer’s Disease, 2012, which presents in more detail the NAG hypothesis to explain these conditions.




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