The trouble started for Myriam Marquez in March of 2009. One evening while driving home from Mount Vernon where she worked as an attorney, Marquez came to the same four-way stop she always crossed in Stanwood, at Woodland Road and 70th Avenue. Only this time things were different. The roads looked unfamiliar. She was lost despite having driven this way home almost daily.
“I came to that stop and all of the sudden I didn’t know where I was,” Marquez remembers. “I panicked. I picked up my cell phone and called my daughter. But as I was talking to her I realized where I was and said, ‘Never mind. I know where I am,’ and I made the right and went home.”
Marquez always knew Alzheimer’s disease was common in her family, but since most of her relatives started showing signs in their 40s, she thought she was safe, having reached her 60s.
The following week would prove to be a relief. She went to her doctor and underwent a variety of tests — PET scans, MRI, memory tests, and blood work. Her doctor informed her that, according to the tests, nothing appeared to be amiss.
But over time, Marquez would find herself more and more often in unfamiliar territory. Things finally came to a head at a family Thanksgiving. While getting ready to leave her daughter’s house, Marquez went to grab the doorknob when suddenly her whereabouts escaped her again.
“The next week I went to my doctor and I said ‘I know I’ve got it,’ ” Marquez said.
Subsequent DNA testing would confirm what she suspected: In April 2010, when she was 62 years old, Myriam Marquez was diagnosed with younger-onset Alzheimer’s.
Younger-onset Alzheimer’s distinguishes itself from traditional Alzheimer's in that symptoms of dementia start to manifest before a person reaches 65. It is quite rare, affecting only 5 to 10 percent of all Alzheimer’s cases. Yet nearly half of all younger-onset Alzheimer's is familial, in that a family member is genetically predisposed to it.
And in the Marquez family, it is common. Marquez's father was one of 13 siblings, six of whom died with symptoms of AD, and two of Myriam’s cousins are currently in the late stages of the disease. Marquez possesses the Puerto Rican mutation of the Presenilin 1 gene, one of the four genes that are known to cause AD with clusters found predominately in Puerto Rico, New York, and Hawaii.
The causes of Alzheimer’s disease (AD) are still unknown. But doctors and pathologists now understand that deposits of a fibrous protein called amyloids build up in sections of brain tissue forming plaques throughout memory centers. Over time, the buildup becomes more and more widespread, resulting in things like memory loss, aphasia, and mood swings. Eventually, normal bodily functions are lost as the brain shuts down completely, resulting in death.
“AD is a complex disease,” says Dr. Suman Jayadev, assistant professor of neurology at the University of Washington. “Some people have the rare form of Alzheimer's disease caused by a mutation in just one gene. But most people have the form of AD that is likely a consequence of the interactions of many genes and our environment.
“Fortunately we know a lot more about AD than we did 25 years ago when we were starting to identify the key players from a protein and gene standpoint.”
According to the Western and Central Washington chapter of the Alzheimer’s Association, there are 150,000 individuals over the age of 65 living with the disease in Washington. (The figures on younger-onset AD are not yet available.) Countrywide, some 5.4 million are living with it, with those numbers expected to double by 2025 as baby boomers age. As of March 2012, Alzheimer’s annual costs to Medicare and Medicaid totals $140 billion and by 2050 could reach $1.1 trillion.
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