American Medical Association Family Medical Guide - American Medical Association [433]
Studies are under way to determine if herbal therapies such as ginkgo biloba (see page 90) can slow the development of dementia or reduce the rate of cognitive loss from aging. Some doctors prescribe vitamin E supplements (400 IUs daily) to their patients to possibly reduce the risk of Alzheimer’s disease. Vitamin E is an antioxidant that can help neutralize the cell damage caused by molecules in the body called free radicals; this cell damage can cause inflammation in the brain, which has been linked to Alzheimer’s disease.
Anti-inflammatory drugs such as ibuprofen also may provide some protection against Alzheimer’s disease, based on the observation that people who take anti-inflammatory medications for chronic conditions such as arthritis or other immune disorders seem to have lower rates of Alzheimer’s disease. Drugs called statins, which are used to lower cholesterol, may also have some benefit; cholesterol in the brain contributes to the formation of waxy buildups called amyloid plaques, which are linked to Alzheimer’s disease.
Keep in mind that none of these therapies has yet been scientifically proven to be effective in preventing Alzheimer’s disease, and many doctors are waiting for further evidence before recommending them to patients. Always talk to your doctor before you consider taking any kind of drug, including herbal or vitamin supplements.
Parkinson’s Disease
Parkinson’s disease is a gradual, progressive deterioration of the nerve centers in the brain that coordinate movement. Changes in these nerve centers upset the delicate balance between two chemicals in the brain, dopamine and acetylcholine, which are essential for controlling the transmission of impulses from the brain to the motor nerves in the spinal cord that control muscle movement. This chemical imbalance disrupts the nerve impulses, affecting muscle control and coordination.
In most cases, the cause of Parkinson’s disease is unknown. The disease is thought to result from a combination of factors including environmental toxins, genetic predisposition, accelerated aging, and damage from free radicals (molecules in the body that can damage cells). In some cases, Parkinson’s disease may result from a brain infection such as encephalitis (see page 694), strokes (see page 669), hydrocephalus (see page 400), a chemical imbalance in the body, or high doses of medications prescribed to treat a mental disorder such as schizophrenia (see page 728). In rare cases, Parkinson’s disease may result from carbon monoxide poisoning or high levels of certain metals in body tissues. Parkinson’s disease usually develops in late middle age or later and affects men and women in equal numbers.
Symptoms
Early symptoms of Parkinson’s disease are subtle and appear gradually. The first symptom may be a slight rhythmic trembling (tremor) of the hands and feet that occurs at rest. Eventually, the arms, legs, and head may also tremble. Gradually, speech may become quiet, slow, and halting, and the person’s handwriting may become very small. Movement is slow, and walking becomes increasingly difficult. Falls may become frequent because of impaired balance and coordination. The trembling is worse during times of stress. Other possible symptoms include drooling, abdominal cramps, a flat facial expression, and, later in the disease, problems with memory and thought processes. The person may have difficulty sleeping and may become depressed.
Diagnosis
A diagnosis of Parkinson’s disease is usually based on the symptoms and the results of a complete neurological examination that includes tests to evaluate the functioning of the nervous system, such as vision, reflexes, hearing, sensation, movement, and balance and coordination. The doctor may order a CT scan (see page 112) or MRI (see page 113) to rule out