Preface: Over the past few decades, Alzheimer's disease has emerged from obscurity. Once considered a rare disorder, it is now seen as a major public health problem that has a severe impact on millions of older Americans and their families. Research on Alzheimer's disease has grown accordingly. The small group of pioneers who conducted research on the disease in the 1970s has expanded to thousands of scientists in laboratories and institutions all over the world.

The lead agency for Alzheimer's research at the National Institutes of Health (NIH) is the National Institute on Aging (NIA), which launched its Alzheimer's disease program in 1978. Since then, the study of this disease has become one of NIA's top priorities. Several other NIH institutes also conduct and sponsor studies on Alzheimer's disease, including the National Institute of Neurological Disorders and Stroke, the National Institute of Mental Health, and the National Institute of Nursing Research.

In the private sector, the Alzheimer's Association, other voluntary organizations, and private industry are also working to combat this disease. They fund research, contribute to public policy decisions, inform and educate the public, and provide critical services to people with Alzheimer's disease and their families. Their support for research is critical in the effort to understand and defeat this disorder.

Thanks to these many groups, the study of Alzheimer's disease is moving ahead rapidly. This booklet explains what Alzheimer's disease is, describes what we have learned to date, and provides a glimpse into future directions for research.

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National Institute on Aging, National Institutes of Health.

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"Often, Mary was afraid, a nameless, shapeless fear. Her impaired mind could not put a name or an explanation to her fear. People came, memories came, and then they slipped away. She could not tell what was reality and what was memory of people past. The bathroom was not where it was yesterday. Dressing became an insurmountable ordeal....Mary gradually lost the ability to make sense out of what her eyes and ears told her....She worried about her things: a chair, and the china that had belonged to her mother. They said they had told her over and over, but she could not remember where her things had gone. Perhaps someone had stolen them. She had lost so much.... Mary was glad when her family came to visit. Sometimes she remembered their names; more often she did not. She never remembered that they had come last week, so she regularly scolded them for abandoning her....She was glad when they didn't try to remind her of what she had just said or that they had come last week, or ask her if she remembered this person or that one. She liked it best when they just held her and loved her."

This excerpt from The 36-Hour Day, a book for families and caregivers of people with Alzheimer's disease (AD) and other similar diseases, gives a glimpse into what an Alzheimer's patient might be thinking and feeling. The gradual slipping away of mind and memory is frightening and frustrating, both for the person with the disease and for family and friends. Not so long ago, we couldn't do much for Mary or others like her. Happily, that situation is changing. Thousands of scientists, voluntary organizations, health care professionals, and families are working hard to learn more about Alzheimer's. They are also finding ways to manage, treat, and eventually perhaps, prevent this terrible disease.

Alzheimer's is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, eventually even the ability to carry out the simplest tasks. Although the risk of developing AD increases with age — in most people with AD, symptoms first appear after age 60 — AD is not a part of normal aging. It is caused by a disease that affects the brain. In the absence of disease, the human brain often can function well into the tenth decade of life.

(From Introduction)

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