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Ball, flag, tree. It's been a decade since I worked as a psychiatric research assistant and I can still recall these words. Recalling these words are part of a simple and quick cognitive test called the Mini Mental Status Exam. For some delayed recall is a problem. Some may shrug it off as memory loss associated with aging. But, for others the problem may be signs of Alzheimer's disease.

Alzheimer's is a fatal and progressive brain disease that affects five million Americans. While those who develop Alzheimer's disease are about 70 years of age, the disease can affect people decades earlier. Although age is a factor in the disease process some people living well past their 70s never get the disease.

What causes some and not others to get Alzheimer's disease?

Scientists have not pinpointed the exact cause of the disease. Early Alzheimer's disease is associated with a mutated gene that produces a protein called ABeta. In Alzheimer's cases where there is no gene mutation, the problem is attributed to an issue with the removal of this protein resulting in its buildup.

Studies have also shown that gender plays a role as well. Women are at a higher risk for developing the disease. In post-menopausal women with Alzheimer's disease, estrogen's role is being studied. The apoE4 gene is another risk factor. Interestingly, some people who have this gene may never develop the disease. This is why apoE4 is only a risk and not a definitive genetic link to the disease.

We know that a telltale sign of Alzheimer's disease is increasing loss of memory. But, there are many more signs and symptoms that differentiate the disease from the memory loss associated with normal aging. According to the Alzheimer's Association there are 10 warning signs:

1. Forgetfulness
2. Personality changes
3. Disorientation
4. Problems performing everyday tasks
5. Decline in expressing one's self
6. Losing things
7. Mood and behavioral changes
8. Inability to take initiative
9. Poor judgment
10. Problems with abstract thinking

There is no blood test for Alzheimer's disease. Diagnosing the problem requires the expertise of medical specialists. A complete medical work-up is warranted to rule out other possible medical problems that can cause memory deficits (e.g., Parkinson's disease, strokes, brain tumors). Once a diagnosis for Alzheimer's disease is confirmed doctors will prescribe medication to help slow down the effects of the disease. Treatment choices are prescribed based on the stage of the disease. Currently

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