Alzheimer's News and Events

The NonProfit Times recognizes the Alzheimer's Association for translating awareness into action

Alzheimer's Association — 2009-10-30

The NonProfit Times recognizes the Alzheimer's Association for translating awareness into action
- The NonProfit Times

Diabetes and Alzheimer's connection unclear

Alzheimer's Association — 2009-10-28

In a surprising finding, a new study suggests that people with Alzheimer's and diabetes have slower loss of memory skills than those without diabetes.
- HealthDay

The Alzheimer's Association and Eisai Inc. honor Richmond pharmacist with 2009 C.A.R.E. (Commitment to Alzheimer's. Recognition of Excellence.) Pharmacy Award

Alzheimer's Association — 2009-10-28

The Alzheimer's Association and Eisai Inc. announce today that Heather Greene, PharmD, is the recipient of the 2009 C.A.R.E. Pharmacy Award. Dr. Greene is being recognized for the critical role she has played in helping patients and caregivers fight Alzheimer's disease.
- Alzheimer's Association

Physical toll of dementia sometimes overlooked

Alzheimer's Association — 2009-10-26

A new study suggests that family members of someone with Alzheimer’s or a related dementia would be far less likely to subject their loved ones to aggressive treatments if they understood how the disease shuts down the body as well as the mind.
- The New York Times

Panel discusses "Lovely, Still" at AARP conference

Alzheimer's Association — 2009-10-23

At the AARP Vegas@50+ event in Las Vegas, the Alzheimer's Association participated in a panel on the film "Lovely, Still," which features a plot centered around Alzheimer's disease.
- Alzheimer's Association

Monitoring patients' comfort zone

Alzheimer's Association — 2009-10-22

Alzheimer's Association ComfortZone is a location management system that aims to give caregiver and people with Alzheimer's peace of mind.
- ABC World News Tonight

Alzheimer's Association launches ComfortZone

Alzheimer's Association — 2009-10-22

Alzheimer's Association Comfort Zone, powered by Omnilink, is the first comprehensive location management system designed specifically for Alzheimer's, giving people with the disease more freedom and independence in their community while providing their family some peace of mind.
- Alzheimer's Association

Vision problems may precede Alzheimer's

Alzheimer's Association — 2009-10-19

The ability to perceive relationships between objects (visuospatial skills) may decline years before a person is diagnosed with Alzheimer's disease, a new study suggests.
- HealthDay

Senate Finance Committee Passes Health Care Reform legislation

Alzheimer's Association — 2009-10-13

The Alzheimer's Association applauds the Senate Finance Committee, under the leadership of Sen. Max Baucus (D-Mont.), for passing health care reform legislation in a vote of 14-9.
- Alzheimer's Association

Dementia Risk Seen in Players in N.F.L. Study

Alzheimer's Association — 2009-09-30

A study commissioned by the National Football League reports that Alzheimer's disease or similar memory-related diseases appear to have been diagnosed in the league's former players vastly more often than in the national population — including a rate of 19 times the normal rate for men ages 30 through 49.

The N.F.L. has long denied the existence of reliable data about cognitive decline among its players. These numbers would become the league's first public affirmation of any connection, though the league pointed to limitations of this study.

The findings could ring loud at the youth and college levels, which often take cues from the N.F.L. on safety policies and whose players emulate the pros. Hundreds of on-field concussions are sustained at every level each week, with many going undiagnosed and untreated.

A detailed summary of the N.F.L. study, which was conducted by the University of Michigan's Institute for Social Research, was distributed to league officials this month.

The study has not been peer-reviewed, but the findings fall into step with several recent independent studies regarding N.F.L. players and the effects of their occupational head injuries.

"This is a game-changer — the whole debate, the ball's now in the N.F.L.'s court," said Dr. Julian Bailes, the chairman of the department of neurosurgery at the West Virginia University School of Medicine, and a former team physician for the Pittsburgh Steelers whose research found similar links four years ago. "They always say, 'We're going to do our own studies.' And now they have."

Sean Morey, an Arizona Cardinals player who has been vocal in supporting research in this area, said: "This is about more than us — it's about the high school kid in 2011 who might not die on the field because he ignored the risks of concussions."

An N.F.L. spokesman, Greg Aiello, said in an e-mail message that the study did not formally diagnose dementia, that it was subject to shortcomings of telephone surveys and that "there are thousands of retired players who do not have memory problems."

"Memory disorders affect many people who never played football or other sports," Mr. Aiello said. "We are trying to understand it as it relates to our retired players."

As scrutiny of brain injuries in football players has escalated the past three years, with prominent professionals reporting cognitive problems and academic studies supporting a link more generally, the N.F.L. and its medical committee on concussions have steadfastly denied the existence of reliable data on the issue. The league pledged to pursue its own studies, including the one at the University of Michigan.

Dr. Ira Casson, a co-chairman of the concussions committee who has been the league's primary voice denying any evidence connecting N.F.L. football and dementia, said: "What I take from this report is there's a need for further studies to see whether or not this finding is going to pan out, if it's really there or not. I can see that the respondents believe they have been diagnosed. But the next step is to determine whether that is so."

The N.F.L. is conducting its own rigorous study of 120 retired players, with results expected within a few years. All neurological examinations are being conducted by Dr. Casson.

According to a 37-page synopsis of the study furnished to the league, the Michigan researchers conducted a phone survey in late 2008 in which 1,063 retired players — those who participated from an original random list of 1,625 — were asked questions on a variety of health topics. Players had to have played at least three or four seasons to qualify. Questions were derived from the standard National Health Interview Survey so rates could be compared with those previously collected from the general population, the report said.

Some health issues were reported by N.F.L. retirees at normal rates (kidney and prostate problems), while others were higher (sleep apnea and elevated cholesterol) and others lower (heart attacks and ulcers), the summary said.

The researchers also asked players — or a caregiver for those who could not answer — if they had ever been diagnosed with "dementia, Alzheimer's disease, or other memory-related disease."

The Michigan researchers found that 6.1 percent of players age 50 and above reported that they had received a dementia-related diagnosis, five times higher than the cited national average, 1.2 percent. Players ages 30 through 49 showed a rate of 1.9 percent, or 19 times that of the national average, 0.1 percent.

The paper itself questioned the reliability of using phone surveys to assess prevalence rates of diagnosed dementia, as did several experts in telephone interviews. For example, some of those affected may not be reachable; then again, N.F.L. players may have greater access to doctors to make the diagnosis. The lead researcher, David R. Weir, said in an interview that proxies might have been handled differently in past studies.
- The New York Times

Celebrities vie for "Who Wears Purple Best?" title to raise awareness of new global prevalence on World Alzheimer's Day: 35 million people worldwide are now living with Alzheimer's and dementia

Alzheimer's Association — 2009-09-15

Today, on World Alzheimer's Day, new data released estimates 35 million people worldwide – a 10% increase over 2005 – are living with Alzheimer's and dementia, highlighting the urgent need for action and response.

Celebrities committed to the cause – Vote for "Who Wears Purple Best?" Doing their part, eight Alzheimer's Association celebrity Champions are having a friendly "Who Wears Purple Best?" competition. Bradley Cooper ("The Hangover"), Seth Rogen ("Knocked-Up"), Soleil Moon Frye ("Punky Brewster"/Entrepreneur), Natalie Morales ("TODAY"), Terrell Owens (Buffalo Bills), Melina Kanakaredes ("CSI New York"), Elisabeth Hasselbeck ("The View") and David Hyde Pierce ("Frasier," "Curtains") are all vying for the title of "Who Wears Purple Best?" Fans can cast their vote here when polls open today through Wednesday, September 30.

By voting, fans also become Alzheimer's Association Champions and can take action by learning more about Alzheimer's disease, becoming advocates, making donations. They can also share the purple competition Web site with family and friends via e-mail, Facebook and Twitter to campaign for their favorite Alzheimer's Association celebrity Champion.

"While I hope to be a favorite in the World Alzheimer's Day 'Who Wears Purple Best?' competition, my goal is for people to learn more about Alzheimer's and take action," said Melina Kanakaredes, actress and Alzheimer's Association Champion. "People do not realize that Alzheimer's is not old age. It is a progressive and fatal disease and staggering amounts of people develop Alzheimer's every day."

Global devastation of Alzheimer's disease – We must act now
With 77 million American baby boomers reaching the age of greatest risk, it is clear that the crisis of dementia and Alzheimer's cannot be ignored. Left unchecked, dementia and Alzheimer's will impose enormous burdens on individuals, families, health care infrastructures and the worldwide economy.

According to the 2009 World Alzheimer Report, newly released today from Alzheimer's Disease International (ADI), a London-based nonprofit, international federation of 71 national Alzheimer organizations including the Alzheimer's Association, the number of people with Alzheimer's or another dementia, currently 35 million, is expected to nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050.

"Today on World Alzheimer's Day, with 35 million people worldwide and as many as 5.3 Americans living with Alzheimer's disease, we should commit to focusing on Alzheimer's throughout the year," said David Hyde Pierce, actor and Honorary Alzheimer Association National Board Member. "Our government should commit to making this a health care priority, and the next step is to pass the Alzheimer's Breakthrough Act."

Worldwide, the economic cost of dementia has been estimated as $315 billion annually. The total annual costs per person with dementia have been estimated as $1,521 in a low income country, rising to $4,588 in middle income countries, and $17,964 in high income countries. (Anders Wimo, et al. "An Estimate of the Total Worldwide Societal Costs of Dementia in 2005." Alzheimer's & Dementia: The Journal of the Alzheimer's Association. Volume 3, Issue 2, April 2007.)

"The number of people affected by Alzheimer's is growing at a rapid rate, and the increasing personal costs will have significant impact on the world's economies and health care systems. We must make the fight against Alzheimer's a priority here in the United States and worldwide," said Harry Johns, President and CEO of the Alzheimer's Association. "Just like our celebrity Champions, we must take action against Alzheimer's now."

In addition to new prevalence estimates, the report outlines eight global recommendations.

More than 60 celebrities from entertainment, sports and media are committed to being Alzheimer's Association Champions and encouraging people to help raise awareness and funds.The extensive roster of celebrities includes Bradley Cooper, Soleil Moon Frye, Melina Kanakaredes, Seth Rogen, Peter Gallagher, Elisabeth Hasselbeck, Bryant Gumbel, Olympia Dukakis, Terrell Owens, Kyle Chandler, David Hyde Pierce, Victor Garber, Kyle Chandler and more.

What you can to do to help end Alzheimer's
On World Alzheimer's Day and throughout the year, you can take action in the fight against this devastating disease:
* Sign up and be counted as an Alzheimer Champion
* Advocate on behalf of individuals and their families
* Write Congress and tell lawmakers to increase Alzheimer research funding
* Donate today
* Participate in Memory Walk by joining or forming a team
- Alzheimer's Association

"The Alzheimer's Project" wins two Creative Arts Emmys

Alzheimer's Association — 2009-09-15

Two installments of the multi-part HBO documentary "The Alzheimer's Project," produced with help from the Alzheimer's Association and others, won Creative Arts Emmy awards. "The Memory Loss Tapes" was honored for Exceptional Merit in Nonfiction Filmmaking, while "Grandpa, Do You Know Who I Am? with Maria Shriver" won for Outstanding Children's Nonfiction Program.
- Emmys.com

Tune in Sept. 15 to PBS: "Living with Alzheimer's" - Segment part of PBS "Retirement Revolution: The New Reality"

Alzheimer's Association — 2009-09-14

Segment is part of PBS "Retirement Revolution: The New Reality" with Paula Zahn

On Tuesday, Sept. 15, PBS will air "Retirement Revolution: The New Reality." This eight-topic program hosted by Paula Zahn looks at the stories of everyday people who have found ways not only to survive but thrive in retirement after the recession.

The "Living with Alzheimer's" segment features interviews with Alzheimer's Association experts Dr. Bill Thies and Beth Kallmyer, as well as Early-Stage Advisors Mimi Steffen and Gary Shelton. The segment also shares information about current research and the benefits of early diagnosis.

You can find local listings, additional show information and videos at the Retirement Revolution Web site: http://www.pbs.org/wttw/retirementrevolution/.
- Alzheimer's Association

Scientists discover three more genes with links to Alzheimer's

Alzheimer's Association — 2009-09-10

Two European research teams have identified three genes that affect a person's risk of developing Alzheimer's disease, the most common cause of dementia in the elderly.

The new genes appear to have at least as big a role as four others discovered in the last 15 years that are known to play a role in Alzheimer's.

"The message here is that genes are important in Alzheimer's disease . . . and there may be multiple ways of reducing the risk that the genes produce," said Julie Williams, a neuroscientist at Cardiff University in Wales who helped lead one of the teams.

All so-called Alzheimer genes have normal roles in brain physiology; they don't exist solely to cause dementia. Instead, small variations in their DNA alter their function and, through processes only now being uncovered, increase or reduce a person's risk of developing the disease.

Two of the genes described in the new research may be involved in determining the brain's capacity to clear itself of toxic "amyloid" proteins that collect outside neurons, eventually poisoning them.

The most important previously known Alzheimer gene promoted overproduction of amyloid. The new findings suggest that at least two processes -- production of amyloid and its removal -- are involved in the disease.

At least 5 million Americans have Alzheimer's disease. By one estimate, one in seven people age 72 and older has dementia, with Alzheimer's the most common form.

The new findings, reported Sunday in the journal Nature Genetics, will have no immediate consequence in either diagnosis or treatment of the disease. However, they will help illuminate a process that goes on for years or even decades before memory loss, the cardinal symptom of the disease, becomes apparent.

The genes were found through "genome-wide association studies," in which long stretches of DNA are examined for small differences between individuals.

With the advent of cheap and fast DNA sequencing in the last five years, the studies have become a powerful way to uncover genes that make small contributions -- along with environmental influences and personal choice -- to a person's overall risk for such chronic ailments as diabetes, coronary heart disease and depression.

Neuroscientists believe 60 percent to 80 percent of a person's risk of developing Alzheimer's disease is attributable to genes. Knowing which they are and what they do may provide targets for drugs and other interventions.

"Hopefully they will point us to parts of a physiological pathway where we can do some tweaking," said Stephen Snyder, deputy director of the National Institute on Aging, who was not involved in the studies.
- The Washington Post

Workplace fraught with worry for people with early-onset dementia

Alzheimer's Association — 2009-09-10

When Diane Thornton first realized she was having trouble keeping track of appointments, she would write herself reminder notes. When she got lost on her way to the office, she'd call her secretary and ask for directions. On days she had trouble speaking or remembering words, she would avoid answering her phone.

But when in her psychotherapist practice she could not remember her patients' names, could not recognize the notes she had written in their files, could not understand the mounting paperwork it took to handle their claims, and could not trust herself not to say inappropriate things -- she knew there would be no quick fix, no easy cover up.

She would have to quit, and face the fact that at age 52 she had dementia.

Though she admits she has "no reference for time" and difficulty "remembering when things happened," she remembers one date in particular.

"August 15, 2006. That date really sticks on the brain. That's when I left my job. That's the day I lost my identity," Thornton said.

Thornton, now 55, is one of the 200,000 Americans under age 65 estimated to be living with early onset dementia or Alzheimer's disease. Dementia, and its often attendant cause Alzheimer's, is marked by memory loss and declines in language and cognitive function. While it typically affects people in the final years of life, early onset dementia sometimes strikes people in their prime.

For a retiree with adult children, dementia is a frightening prospect. But for a middle-aged person with a mortgage and children who never anticipated early retirement, figuring out how to balance their diagnosis with their job adds another layer of anxiety to an already dire situation.

"I would forget the patient I was seeing. I'd look at my notes and at the patient's chart and I wouldn't recognize my own handwriting. After the HIPAA [privacy] laws changed there was all this new paperwork and I just could not keep track," Thornton told ABC News from her home in Memphis.

After months of seeing doctors, one of whom suggested she was just a "stressed-out soccer mom," Thornton received her diagnosis from a physician who "couldn't have looked more unhappy that I didn't have a brain tumor."
- ABC News

"The Doctors" discuss growing prevalence of Alzheimer's and the difficulties of caregiving

Alzheimer's Association — 2009-09-03

Alzheimer's Association Champion Coach Broyles and Alzheimer's Association Science Advisor Zaven Khachaturian appeared on the popular television talk show "The Doctors" to speak about Alzheimer's disease.
- www.thedoctorstv.com

Alzheimer's Association statement on Sen. Kennedy's death

Alzheimer's Association — 2009-08-27

The Alzheimer's Association was saddened to learn of the death of Sen. Edward "Ted" Kennedy (D-Mass.), a true healthcare champion who has left an indelible mark on the American political landscape. For nearly a half century, he helped to worked tirelessly to improve the lives of Americans. In no arena was this more greatly felt than his efforts in working to provide access to health care all Americans.

As head of the Senate Health, Education, Labor and Pensions (HELP) Committee, Sen. Kennedy understood the importance of developing comprehensive strategies and policies that address the needs of aging Americans who suffer from chronic conditions, including Alzheimer's disease. As it stands today, our current long-term care system is dangerously unprepared and ill-equipped to meet the needs of an aging baby boomer population, and Sen. Kennedy valiantly led the charge that the nation's long-term care crisis must be addressed now, before 78 million baby boomers need long-term services.

According to the Alzheimer's Association's 2009 Alzheimer's Disease Facts and Figures, today there are more than 5 million Americans with Alzheimer's disease and this number is expected to grow to as many as 16 million by mid-century. People with Alzheimer's disease and other dementias are high users of health and long-term care services. Few Alzheimer families can afford to pay for long-term care services for the duration needed and most families exhaust their own resources to pay for their loved ones' care. By championing the Community Living Assistance Supports and Services (CLASS) Act (S. 697/H.R. 1721), Sen. Kennedy exhibited his unique understanding of how important is it to explore other revenue streams and financing mechanisms that make long-term care affordable in order to lessen the overwhelming pressure and financial burden on families and safety-net programs, especially Medicaid.

Individuals who are cognitively impaired must have access to the critical long-term care services and supports to allow them to maintain their independence and keep them at home with their families for as long as possible. Sen. Kennedy understood that steps must also be taken to ensure individuals don't have to impoverish themselves to qualify for much needed assistance.

With his unmatched and distinguished history of public service, Sen. Kennedy's absence will be felt by all. His significant contributions to the nation will continue to benefit all Americans, including those with Alzheimer's disease, for years to come.
- Alzheimer's Association

MRI pictures of brain activation may predict Alzheimer risk

Alzheimer's Association — 2009-08-26

One of the many tragedies of Alzheimer's disease is that patients don't know until it's too late that they actually have the condition. By the time the first signs of forgetfulness and confusion set in, experts believe, the disease has already been ravaging the brain for a decade or more, causing irreversible damage.

But researchers at the Cleveland Clinic report that they may have found a way to identify those most at risk of developing the neurological disorder long before symptoms develop — simply by asking them whether they recognize celebrities such as Britney Spears and Johnny Carson. It turns out that when people who are at highest risk of Alzheimer's try to recognize a famous name, their brains activate in very different ways from those of people who aren't at risk. And scientists can actually see this difference using functional magnetic resonance imaging, or fMRI.

In the journal Neurology, a team led by Stephen Rao, a brain-imaging specialist, describes a study of 69 healthy men and women aged 65 to 85. The researchers divided the group into three: those who had no risk factors for Alzheimer's, those who had a family history of the disease but no genetic indicators of it themselves and those who had both family members with Alzheimer's as well as a version of a gene for a protein called apolipoprotein E4 (ApoE4) that has been linked to the condition. They slid all of the subjects into an fMRI machine, and while the volunteers were there, they saw names of both famous and not-so-famous people flashed in front of them.

Rao's team found that when volunteers saw names such as Britney Spears, George Clooney, Albert Einstein and Marilyn Monroe, those who were at the highest risk of developing Alzheimer's — those with both the genetic makeup and a family history — showed high levels of activity in the hippocampus, posterior cingulate and regions of the frontal cortex, all areas involved in memory. The control group showed the opposite pattern. Their brains became more excited when they saw unfamiliar names, which included Irma Jacoby, Joyce O'Neil and Virginia Warfield.

That could mean that the at-risk people were working harder to recognize the well-known celebrities, compensating for already damaged or destroyed neurons that were no longer functioning, while the control group had to struggle only when trying to place the names of noncelebrities, recruiting more nerve cells and connections, racking their memory banks and recall centers. Significantly, in neither group did pictures of the brain designed to pick up structural changes associated with dementia, like signs of atrophy and dead neurons, show any differences — at least not yet.

"This pushes the envelope further in attempting to detect dysfunction in the brain at a stage earlier than any detectable clinical measurement of cognitive decline," says Dr. Ralph Nixon, a psychiatrist at New York University and vice chair of the medical and scientific advisory council of the Alzheimer's Association. "We all know that the brain is changing metabolically at a very early stage of the disease, well before clinical symptoms. This type of technique validates that concept."

While doctors can now test for the presence of ApoE4, you have to have two copies of a particular form of the gene to be at real risk of Alzheimer's. If you do have them, your chances of developing the disease increase 10- to 20-fold. So far, the Alzheimer's Association does not recommend widespread screening for the gene, even among those with a family history of Alzheimer's, since most people who have the risky version of ApoE4 don't have the necessary gene copies. But looking more closely at people who have a family history of the disease by adding an fMRI scan such as the one Rao conducted to the genetic screen could help doctors select those who do seem to be in the greatest danger of being claimed by the disorder.

The idea is not necessarily to diagnose Alzheimer's earlier, says Rao. But imaging studies can help to identify those most vulnerable to cognitive decline so they can participate in clinical trials of new drugs designed to postpone or reduce symptoms. "If we can delay the onset of Alzheimer's by five years," he says, "by some estimates we can cut the incidence of Alzheimer's in half. If we can delay the disease by 10 years, we could almost eliminate it because people would die from other conditions first."
- Time

High blood pressure linked to memory loss

Alzheimer's Association — 2009-08-26

High blood pressure may contribute to memory loss and other declines in brain function in people 45 and older, according to a study. The higher the reading, the more likely the individuals were to show impairment.

With each 10-point increase in diastolic blood pressure, the odds of cognitive difficulties grew by 7 percent, according to the report published today in the journal Neurology. This measurement is the force exerted on arteries when the heart is at rest.

The study builds on previous research probing the connection between blood pressure and brain function. The research thus far has yielded conflicting results, said Georgios Tsivgoulis, an assistant professor of neurology at the University of Alabama in Birmingham, and a lead study author, in an e-mail today. The study is noteworthy because it analyzed more than 19,000 participants, Maria C. Carrillo, senior director of medical and scientific relations for the Alzheimer's Association in Chicago, said today in a telephone interview.

"It lends further support to what we had already really thought was the case," said Carrillo. "That is that high blood pressure, and certainly cerebrovascular diseases, do contribute to increased risk of Alzheimer's disease."

When diastolic blood pressure rises, it can cause arterial walls in the brain to thicken faster than they do naturally with age, which may lead to reduced blood flow and tissue death, according to the report. Systolic blood pressure, the force on arteries when the heart beats, didn't show a connection to brain function.

Study Details

The research, funded by the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health, included 19,836 participants ages 45 and older. It used data from a national evaluation of stroke risk, called Reasons for Geographic and Racial Differences in Stroke, which tested participants' blood pressure and assessed their brain function.

More research is needed on risk factors of declining brain function and Alzheimer's disease, Carrillo said. More than 5.3 million people in the U.S. have Alzheimer's, with one person developing the disease every 70 seconds, the Alzheimer's Association says on its Web site. It was the sixth-leading cause of deaths in 2007, overtaking diabetes.

High blood pressure is defined as more than 90 millimeters of mercury (mm Hg) diastolic pressure or more than 140 mm Hg systolic pressure, according to the American Heart Association.

"It's never too late to change your lifestyle habits, and it's never too late to change the trajectory of cognitive decline," Carrillo said. "Research has shown us that even late in life -- exercise, eat healthy -- you can actually give yourself years of health."

While the cause of high blood pressure is unknown in more than 90 percent of cases, doctors recommend it may be controlled by reducing fat and salt intake and not smoking, the association says on its Web site.
- Bloomberg

Generation B: When you're your mother's keeper

Alzheimer's Association — 2009-08-26

When Suzanne Cooper's elderly mother moved in three years ago, her Alzheimer's was in an early stage. The 84-year-old was still fairly lucid, so Mrs. Cooper could leave her home, while picking up her son, Griffin, from nursery school or going food shopping.

But in time, the mother turned more inward, having long conversations with herself at the kitchen table or just staring. "She goes into the other world and you try to pull her back, but it gets harder," Mrs. Cooper said. She would come home with Griffin, 5, and find her mother sitting by the back door holding her blanket and looking lost.

Soon, the 49-year-old Mrs. Cooper couldn't leave her alone and the days became logistical brainteasers, as she tried to balance the needs of her son and those of her mother.

If she had errands, it could take three hours to get her mother fed, groomed, bathed, dressed and out the door. "Mom can still brush her teeth," Mrs. Cooper said, "but I have to put the toothpaste on the brush."

"In fall and spring I could take her on errands and she was content to sit in the car," Mrs. Cooper said. "There's no law against leaving an 84-year-old woman in the car with the windows down. But summer and winter, I can't do that — I'm tied to the house."

Mother and daughter were sitting on the back deck recently, when Mrs. Cooper jumped up and said, "I need to check on Griffin." He was supposed to be playing a computer reading game inside. "Sometimes, he finds his way onto the Internet," she said. "I'll be back." Her day is all back and forth: Comfort her mother, mumbling and sobbing at the kitchen table; stop Griffin from biting the sofa cushions.

While she was inside, her mother, Irma Stitz, a retired nurse, carried on a conversation with herself: "God bless you, but you know that. There will be a tomorrow. Yes, because of your hate, hate, hate."

When Mrs. Cooper returned, her mother said, "The people all may be changing."

"Mom, can I get you to come in the house and have some soup?" said Mrs. Cooper, moving to help her up.

Mrs. Stitz shooed her away. "I can do it myself," she said, and she walked into the kitchen and ate her soup.

Mrs. Cooper's mantra had been, "I want to be a stay-at-home mom, and a stay-at-home daughter," though for a long time she worried she did neither well. She spent 20 years building a career, rising to become a corporate vice president, and was finally ready to be home. Married late, at 43, to Peter Cooper, an architect, she felt blessed to become pregnant right away. Mr. Cooper was also caring for his parents — now deceased.

They loved this about each other. "Family loyalty," Mr. Cooper, 55, said. "Other women said, 'Oh, he's never married, caring for his parents.' Suzanne found that appealing." About 20 percent of baby boomers — 14 million — take care of an aging loved one, according to a Natural Marketing Institute report done for the AARP, and as the Coopers know, it can be a struggle.

Mrs. Cooper was determined not to put her mother in a nursing home. "I don't want someone else to be there when Griffin scrapes his knees and I felt the same about my mother as she comes to the end."

"I was sure I could do this myself," she said. The remodeled house — on a cul-de-sac in an upscale suburb — provides Mrs. Stitz with her own bedroom, bathroom, laundry room and living room.

A widow for 30 years, she had been independent, hard-working and proud, taking care of herself in her Pennsylvania home. It was a long time before the daughter realized the mother had been masking the disease. If the mother came for a visit, she would leave the next morning, before anyone could notice lapses. During one stretch, she and her dog repeatedly had the stomach flu; Mrs. Cooper figured out they were eating spoiled meat. When Mrs. Cooper made stuffed artichokes, a favorite family dish, her mother couldn't remember how to eat one.

Mrs. Cooper loved her mother's sense of wonder and her laugh, but this last year, the joy kept contracting. They used to go to the beauty parlor together, but the other day, Mrs. Cooper couldn't get her mother to their appointment. "Where are we going?" Mrs. Stitz asked. "How will we get there?" She sat back and closed her eyes.

"That's when I back off," Mrs. Cooper said.

The less the mother would do, the less the family could do.

"We became increasingly isolated, it was unbearable," Mr. Cooper said. Nor did the economy help; Mr. Cooper's firm went from three employees to one. He worked long days and often had night meetings.
- The New York Times

Researchers determine toxicity levels of Alzheimer clusters

Alzheimer's Association — 2009-08-20

Scientists have long suspected that Alzheimer's disease is caused by plaques formed when the small protein amyloid-beta (Aβ) binds to itself in clusters and undergoes a chemical change, creating protein deposits in the brain.

However, recent studies have suggested it is not the plaques that cause Alzheimer's but the small, grape-like clusters of Aβ. The clusters vary in size, and the relationship between cluster size and toxicity — the ability to kill nerve cells — has never been determined accurately.

Now, by creating various sizes of Aβ clusters in the laboratory that exactly match what forms in the brains of Alzheimer's patients, UCLA neurologists have determined that toxicity increases dramatically as the clusters increase in size from two to three to four Aβ proteins. The researchers also report that although larger clusters are more toxic than smaller ones, large formations are relatively rare; smaller formations are more numerous and are thus an inviting target for the development of new therapeutic drugs.

In addition, said senior author and UCLA neurology professor David Teplow, developing the ability to make Aβ clusters in a very pure and precise way that duplicates what forms in the Alzheimer's brain will enable scientists to make detailed studies of their structures, aiding future drug development.

The research is currently available in the early online edition of Proceedings of the National Academy of Sciences.

Alzheimer's is the most common form of late-life dementia. More then 5 million Americans have been diagnosed with the disease and 24 million people worldwide — a number that is expected to reach 81 million by the year 2040.

"We now have the best understanding yet of what types of toxic Aβ structures we should target with new classes of therapeutic drugs," Teplow said.

While researchers found that the larger the Aβ cluster, the greater the toxicity, they also discovered that the increase in toxicity with these clusters is not linear.

"Clusters that contain two Aβ molecules are more toxic than a single Aβ molecule, and those with three molecules are more toxic that those with two," Teplow said. But clusters of the Aβ molecule known as dimers (two Aβ molecules forming a cluster) are three times more toxic than simple monomer compounds; trimers (three Aβ molecules) and tetramers (four) are more than 10 times more toxic than monomers, he said.

This suggests that larger, more toxic clusters should be the target for scientists trying to stop the disease. But in the brains of Alzheimer's patients, the larger clusters are relatively rare, Teplow said, and because smaller clusters are found in far greater amounts, they are, taken in total, more toxic to the brain than larger ones.

"Think of the molecules being wrapped in very weak Velcro," Teplow said. "A number of molecules can bind together to form large clusters, but they break apart very easily."

Having developed a process in the lab to make pure forms of these Aβ clusters of specific sizes will enable detailed study of their structures to show where every atom is.

"This will make development of drugs much easier and, likely, more successful," Teplow said.

Other authors included Kenjiro Ono, of UCLA and Japan's Kanazawa University School of Medicine, and Margaret M. Condrona, of UCLA.

Funding was provided by the Japan Human Science Foundation, a Pergolide Fellowship from Eli Lilly Japan, the Mochida Memorial Foundation for Medical and Pharmaceutical Research, the National Institutes of Health, the Alzheimer's Association and the Jim Easton Consortium for Alzheimer's Drug Discovery and Biomarkers at UCLA.

The UCLA Department of Neurology encompasses more than a dozen research, clinical and teaching programs that cover brain mapping and neuroimaging, movement disorders, Alzheimer's disease, multiple sclerosis, neurogenetics, nerve and muscle disorders, epilepsy, neuro-oncology, neurotology, neuropsychology, headaches and migraines, neurorehabilitation, and neurovascular disorders. The department ranks first among its peers nationwide in National Institutes of Health funding.
- UCLA Newsroom

Study: Mediterranean diet cuts Alzheimer risk

Alzheimer's Association — 2009-08-11

A Health Alert report discusses the Mediterranean diet, which a study suggests can reduce the risk of Alzheimer's by 40 percent.
- The Today Show

Alzheimer's Association statement on Senate confirming new National Institutes of Health Director

Alzheimer's Association — 2009-08-10

The Alzheimer's Association is pleased that the Senate has confirmed Dr. Francis Collins as the new Director of the National Institutes of Health (NIH). As one of the world's foremost leaders in human genetics, Collins will bring to this new role a wealth of expertise and knowledge and a comprehensive understanding of the importance of investing in science and research.

For the more than 5 million people living with Alzheimer's disease today and the projected 16 million who may have it by mid-century, the Association is pleased to have Collins at the helm of NIH. Alzheimer's disease poses tremendous human, social and economic burdens on the nation as a whole and is a challenge to us all. The Alzheimer's Study Group, an independent group of national leaders led by co-chairs Former House Speaker Newt Gingrich and former Nebraska Senator Bob Kerrey, revealed in their report, "A National Alzheimer's Strategic Plan," that the government in on track to spend nearly $20 trillion on Alzheimer's between today and the middle of the century. As an individual who has contributed so much to science by revolutionizing the field of genetics, Collins brings a unique understanding of how the necessary investment in science can yield significant breakthroughs.

Recently at the Alzheimer's Association's International Conference on Alzheimer's Disease (ICAD), hundreds of studies were presented about advances in scientific research on a variety of fronts – from drugs in the earliest stages of investigations, to findings in early detection, to diagnostic tools. Results from landmark projects like the Alzheimer's Disease Neuroimaging Initiative (ADNI), a $60 million, 5-year; public-private partnership for identifying Alzheimer biomarkers, continue to produce rich, robust clinical data and imaging information. This year's ICAD was a clear indication of the real scientific progress being made but how fast we get to a world without Alzheimer's depends completely on investment in research and Collins knows this all too well.

Over the last 6 years, federal funding for Alzheimer research has been stagnant. In no way has the funding investment matched the tremendous current and future impact of the disease poised to strike 10 million baby boomers. The personal and economic impact of Alzheimer's is so large that no one entity can solve the problem alone. It will require all levels of government and the private sector working together to diminish the human and economic cost of Alzheimer's disease. Encouraged by the commitment and dedication to science and research Collins has exhibited in his long and distinguished career thus far, the Alzheimer's Association looks forward to working with him in his leadership role at NIH in making a world without Alzheimer's.
- Alzheimer's Association

High cholesterol linked to Alzheimer's

Alzheimer's Association — 2009-08-06

Adults who had just slightly elevated blood cholesterol when they were in their early 40s were at greater risk of developing dementia decades later, compared with those whose cholesterol was at optimal levels, a new study has found.

The findings, which analyzed data from almost 10,000 health care plan members followed for four decades, surprised the investigators.

While earlier studies have shown an association between high cholesterol in midlife and an elevated risk of Alzheimer's disease, "we were surprised to see the association with borderline levels," said Rachel A. Whitmer, an epidemiologist with the Kaiser Permanente Division of Research and the paper's senior author.

The study followed 9,844 members of the Kaiser Permanente Northern California Medical Group who had blood work done between 1964 and 1973, when they were 40 to 45 years old. All had remained members of the plan until at least 1994, when computerized outpatient diagnoses of dementia were made available.

Some 598 of the original participants were diagnosed with Alzheimer's disease or vascular dementia, a less common form of dementia, between 1994 and 2007, when they were between 61 and 88 years old.

Those whose total blood cholesterol had been high - over 240 milligrams per deciliter - were 57 percent more likely to have developed Alzheimer's disease than those with optimal levels. Those who had borderline cholesterol values - between 200 and 239 milligrams per deciliter - were at 50 percent greater risk of developing vascular dementia.

"What's good for the heart is good for the brain," Dr. Whitmer said, adding, "Midlife is not too soon to be thinking about risk factors for dementia. This is a modifiable risk factor. This is something you can change."

The study is being published online this week in the journal Dementia & Geriatric Cognitive Disorders.
- The New York Times

200,000 Americans living with early Alzheimer's

Alzheimer's Association — 2009-08-03

At the age of 46, Jay Jones started to change.

The owner of a $20 million yacht dealership and married for only two years to his wife, Laura, Jones noticed subtle differences. His wife began noticing them, too.

"The beginning was the personality changes," Laura Jones said. "He was more agitated. He was more nervous and then getting lost."

What the couple would find out was that he had developed an early-onset form of Alzheimer's, which was slowly robbing him of an otherwise healthy life and the ability to form and retrieve new memories. He is only 52.

Jay Jones is not the typical face of an Alzheimer's patient -- but one that is younger and growing in numbers.

With his wife by his side and her notes in his hands, Jay Jones read aloud what it is like to live with Alzheimer's disease at a Social Security Administration hearing in Chicago last week.

He is fighting for change and a better chance for survival.

The government hearing sought to bring more Social Security disability benefits to those in their 40s and 50s suffering from Alzheimer's disease -- with less red tape -- and to fast-track the disability benefit claiming process.

A new report released by the Alzheimer's Association shows that Jay Jones is among many others suffering from the disease at the prime of their life.

The report says that an estimated 200,000 Americans under the age of 65 now have early on-set Alzheimer's, and it accounts for 60 to 80 percent of dementia cases.

This attempt to receive benefits from midlife adults comes as a surprise since Alzheimer's affects 5.1 million people age 65 and older, according to the Alzheimer's Association.

"[S]uddenly all things you know become unfamiliar," Jones said. "It was hard for me because people see a healthy, young 52-year-old man who is physically fit ... yet this disease invades your mind."

Laura Jones recalled that little things, such as his commute home from work, changed. He would turn right instead of left. That led to a visit to the family physician.

The doctor, however, dismissed it as job-related stress. Over the next three years, Jay Jones' symptoms grew more severe and more frequent. Finally, at age 49, he saw a neurologist who made the diagnosis: Alzheimer's disease.
- ABC News

"The Alzheimer's Project" wins Television Critics Association award

Alzheimer's Association — 2009-08-03

HBO's "The Alzheimer's Project" won a Television Critics Association award for Outstanding Achievement in News and Information.
- TV by the Numbers

SSA considers adding Alzheimer's to Compassionate Allowances list

Alzheimer's Association — 2009-07-29

Today there are an estimated 5.3 million Americans with Alzheimer's disease. Although the majority of Alzheimer cases are individuals age 65 and older, there is still a significant number of individuals under age 65 impacted by this fatal disease that has no cure. For people under age 65 with Alzheimer's disease or a related dementia, their cognitive impairment can quickly reach a point where they can no longer maintain gainful employment. The Alzheimer's Association applauds the Social Security Administration (SSA) for holding a hearing today to examine whether these individuals with younger-onset Alzheimer's disease or related dementias should be included in its Compassionate Allowances Initiative.

"Alzheimer's and other neurodegenerative dementias are progressive and currently there aren't any effective treatments to delay onset or progression. These individuals affected are unable to work and eventually they get Social Security disability — sometimes after a long, difficult process and many appeals," says Harry Johns, president and CEO of the Alzheimer's Association. "Through the Compassionate Allowances process, Social Security can avoid the extra costs to the agency of numerous appeals, and families can avoid the financial and emotional toll of going through a long decision process."

Under the Compassionate Allowances initiative, there is a recognized class of medical conditions and diseases that are severely debilitating or life-threatening which prevent individuals from being able to work for at least 12 months. Social Security's proactive efforts to "fast track" certain conditions will help to reduce the backlog of disability claims and, more importantly, ensure those claims that fall under this initiative will be decided within days instead of months or years.

Currently, many people with younger-onset Alzheimer's or other dementias face multiple challenges when applying for Social Security Disability benefits (SSDI), including a long decision process and multiple appeals. If the SSA decides to include Alzheimer's disease on the list of "Compassionate Allowances" conditions, it would simplify and streamline the SSDI application process and decrease the wait time for benefits. It would also ensure individuals with younger-onset Alzheimer's and related dementias would not have to endure the associated unnecessary, emotionally and financially draining effects of having to wait an extended period of time for a disability determination.

"The very diagnosis of Alzheimer's indicates significant enough cognitive impairment to interfere with daily living activities, including the ability to work," says Johns.

The Alzheimer's Association believes today's Social Security hearing is a significant step in considering individuals with younger-onset Alzheimer's and related dementias for the Compassionate Allowance list. It provides an opportunity for individuals with Alzheimer's to testify and share their personal experience navigating the Social Security disability process before Social Security officials. The Alzheimer's Association remains committed to working with the agency to ensure the needs of individuals with dementia related illnesses continue to be considered and included.
- Alzheimer's Association

Social Security Administration hosts younger-onset hearing

Alzheimer's Association — 2009-07-27

On Wednesday, July 29, the Social Security Administration (SSA) will hold a hearing examining whether people with younger-onset Alzheimer's disease and related dementias (under age 65) should be included in SSA's Compassionate Allowances Initiative for Social Security benefits.

The Compassionate Allowances Initiative is an effort to improve and expedite the Social Security disability (SSDI) determination process for a recognized class of medical conditions and diseases that are severely debilitating and/or life threatening that prevent individuals from being able to work for at least 12 months.

The hearing will feature testimony from five panels, including experts in the field as well as those directly affected by Alzheimer's and related dementias. Alzheimer's Association panelists include Harry Johns, president and CEO; Jay Jones, early-stage advisor, Southeast Florida Chapter; Laura Jones, Southeast Florida Chapter; and Joyce Simons, early-stage advisor, New York City Chapter.

SSA is broadcasting a live webcast on July 29 from 9 a.m.-4:30 p.m. Central. You can view the webcast at http://www.ssa.gov.

For people under age 65 with Alzheimer's disease and related dementias, their diminished cognitive impairment can quickly reach a point where they can no longer maintain gainful employment. Currently, many people with younger-onset Alzheimer's disease and related dementias face multiple challenges when applying for SSDI, including a lengthy decision process and multiple appeals.

If SSA decides to include younger-onset Alzheimer's disease and related dementias on the list of Compassionate Allowances, it would simplify and streamline the SSDI application process, decrease the wait time for benefits and help people access the assistance they need. The hearing will provide SSA with an opportunity to be briefed and introduced to the broad range of issues concerning those with younger-onset Alzheimer's and other dementias.

An official Alzheimer's Association statement will be posted on July 29. The hearing recording and written testimony will be available on July 30.

Questions? Contact info@alz.org.
- Alzheimer's Association

Alzheimer's Association response to introduction of the Alzheimer's Breakthrough Act

Alzheimer's Association — 2009-07-24

For the more than 5 million people living with Alzheimer's disease today and the projected 16 million who may have it by mid-century, The Alzheimer's Breakthrough Act of 2009 (S. 1492 & H.R. 3286) is a tremendous step in the fight against Alzheimer's. The bipartisan legislation, offered in the Senate by Sens. Barbara Mikulski (D-Md.) and Christopher Bond (R-Mo.) and by Reps. Edward Markey (D-Mass.) and Christopher Smith (R-N.J.) in the House, offers great promise for someday having a world without Alzheimer's disease.

With an aging baby boomer population at the epicenter of an escalating Alzheimer crisis, the disease is quickly becoming the country's biggest, broadest and most expensive problem — to individuals, families and the healthcare system. According to the Alzheimer's Association's 2009 Alzheimer's Disease Facts and Figures report, total healthcare costs are more than three times higher for people with Alzheimer's and other dementias than for other people the same age without the disease. For the last six years, federal funding for Alzheimer research has declined in real terms. In fact, for every dollar the government spends on the costs of Alzheimer care, it invests less than a penny in research to find a cure. This is all while the loss of lives and costs to Medicare and Medicaid continue to soar.

By calling for a significant increase of funding for Alzheimer's at the National Institutes of Health (NIH) to $2 billion, this legislation authorizes the necessary resources to restore momentum in the pursuit of better diagnosis, prevention and treatment. Advances and progress in the various areas of Alzheimer research have the potential to save millions of lives and save billions of dollars to the nation's public health programs. The Alzheimer's Association enthusiastically supports this legislation and sees it as a necessary vehicle to change the paradigm as we know it today.

Equally important as investing in the research that can yield breakthroughs in the near future, is helping the nearly 10 million Alzheimer caregivers today who wrestle with the financial and emotional challenges of caring for a loved one with this disease. The Alzheimer's Breakthrough Act seeks to provide them with vital resources and tools to assist them in this demanding role. It also calls for a National Summit on Alzheimer's to look at promising research avenues and programs that are important in fighting this disease and supporting those who are struggling with it.

Alzheimer's disease poses tremendous human, social and economic burdens on the nation as a whole and is a challenge to us all. The Alzheimer's Study Group, an independent group of national leaders led by co-chairs former House Speaker Newt Gingrich and former Nebraska Sen. Bob Kerrey, revealed in its report, A National Alzheimer's Strategic Plan, that the government in on track to spend nearly $20 trillion on Alzheimer's between today and the middle of the century. The co-sponsors of this legislation understand there must be a commitment to ending Alzheimer's that matches the magnitude of the disease.

The Alzheimer's Association commends the following congressional members for their leadership in championing this bill: Sen. Susan Collins (R-Maine), Robert Menendez (D-N.J.), Richard Burr (R-N.C.), and Kristen Gillibrand (D-N.Y.). In the House, we thank Reps. Gene Green (D-Texas), Steven LaTourette (R-Ohio), Henry Waxman (D-Calif.), Todd Platts (R-Pa.), Ron Kind (D-Wis.), Frank LoBiondo (R-N.J.), Christopher Murphy (D-Conn.), Betty Sutton (D-Ohio), Russ Carnahan (D-Mo.), Zoe Lofgren (D-Calif.), Nick Rahall (D-W.Va.), Bobby Rush (D-Ill.), Jan Schakowsky (D-Ill.), Louise Slaughter (D-N.Y.), John Tierney (D-Mass.), Robert Wexler (D-Fla.) and John Yarmuth (D-Ky.).

The Association urges all members of Congress to support and pass this meaningful legislation.
- Alzheimer's Association

"The Alzheimer's Project" receives Emmy nods

Alzheimer's Association — 2009-07-16

HBO's "The Alzheimer's Project" was nominated for Outstanding Nonfiction Special ("Momentum in Science"), Exceptional Merit in Nonfiction Filmmaking ("The Memory Loss Tapes") and Outstanding Children's Nonfiction Program ("Grandpa, Do You Know Who I Am? with Maria Shriver"). The Emmy broadcast airs Sept. 20 on CBS.
- Academy of Television Arts & Sciences

DASH Diet Combats Mental Decline

Alzheimer's Association — 2009-07-15

The low-fat, high-fiber diet recommended for lowering blood pressure may help prevent memory loss and sharpen mental skills.

Known as the Dietary Approaches to Stop Hypertension ( DASH) diet, the plan emphasizes fruits and vegetables, nuts and legumes, whole grains, and low-fat dairy products. Sodium, sweets, and red meats are to be consumed sparingly.

In a new study, the greater a person's adherence to the DASH diet, the slower the rate of mental decline, reports Heidi Wengreen, PhD, RD, assistant professor of nutrition at Utah State University in Logan, and colleagues.

It's not surprising that the diet worked: The DASH eating plan has been proven to lower blood pressure, and high blood pressure is a known risk factor for Alzheimer's disease and dementia, says Ron Munger, PhD, a professor of nutrition at Utah State who also worked on the study.

"Over the years, researchers have tried to slow cognitive decline using single nutrients and supplements, with mixed results. [That's because] the total diet is greater than the sum of its parts," he tells WebMD.

Vegetables, Nuts, Whole Grains Help

The study involved 3,831 people 65 and older with no signs of dementia.

At the start of the study, they filled out a 142-item food questionnaire asking what they ate and how often they ate it. Based on their adherence to the components of the DASH diet, the participants were divided into five groups, or quintiles.

A standard test that measures overall cognitive function, including memory, attention span, and problem solving, was given at the outset and four other times over an 11-year period.

The researchers found that those in the highest quintile had the best cognitive functioning at the beginning of the study and the least decline in mental skills over time.

The best foods at curbing mental decline: vegetables, whole grains, low-fat dairy products, and nuts and legumes, Munger says.

The findings were presented at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease.

Not Easy to Follow

The DASH diet isn't easy to follow, he acknowledges. It calls for a total of eight to 10 servings of fruits and vegetables a day, for example, and "only about 25% of Americans eat even five servings a day," Munger says.

"The good news is there's lots of room for improvement," he says.

Also, the study doesn't prove that the diet slows mental decline. It could be the diet itself or some other lifestyle factor shared by people who eat well that is responsible for the protective effect.

On the other hand, DASH is proven safe and effective and lowers blood pressure, so there's no reason not to follow it, Munger says.

Each day that you follow the eating plan "helps you to preserve a little bit of cognitive function that otherwise would have been lost," says Maria Carrillo, PhD, director of medical and scientific relations at the Alzheimer's Association.

"And it's cumulative, so ultimately there's a big difference," she tells WebMD.
- WebMD

Promising Alzheimer's drug boosts toxic protein

Alzheimer's Association — 2009-07-14

* Dimebon increased amyloid levels in mouse brains

* Result raises new questions about anti-amyloid drugs

By Julie Steenhuysen

CHICAGO, July 15 (Reuters) - Dimebon, Medivation Inc's (MDVN.O) promising experimental Alzheimer's drug, significantly raised levels of a toxic protein in the brains of mice, yet has been shown to delay thinking problems in human dementia patients, U.S. researchers said on Wednesday.

"This is an unexpected result," said Dr. Samuel Gandy, a researcher at Mount Sinai School of Medicine in New York, whose findings were presented at an Alzheimer's meeting in Vienna.

The study raises new questions about how the drug works and new worries about drugs meant to remove telltale clumps of a protein called beta amyloid from the brain as a way to reverse Alzheimer's disease.

Researchers are not sure whether amyloid is a cause or a symptom of Alzheimer's but, either way, getting rid of it had appeared to be a good thing.

"We think we want amyloid levels to go down," Gandy said in a telephone interview. "Here is this compound that is looking very promising clinically that is making amyloid levels go up."

Dimebon, first sold in Russia as an antihistamine, is being developed jointly with Pfizer Inc (PFE.N), maker of the Alzheimer's drug Aricept.

Researchers see Dimebon as the best hope for a new treatment for the incurable, mind-robbing disease that affects 26 million people globally.

Now in late-stage testing, Dimebon seems to delay thinking problems in people but it is not clear how.

"We wanted to know what Dimebon was doing to amyloid," Gandy said.

His team tested mice genetically engineered to have a human form of Alzheimer's. The drug increased amyloid outside nerve cells.

OTHER ROUTES

"It certainly means this medicine is not acting by an acute amyloid-lowering effect, which is what we were looking for in the lab," Gandy said.

Separately, Israeli researchers reported promising results from a study in mice that takes aim at a less-studied brain protein called tau, which is strongly associated with dementia in Alzheimer's disease.

Hanna Rosenmann of Hadassah University Hospital in Jerusalem and colleagues found that injecting mice with tau-fighting antibodies reduced the number of tangles in the brain by 40 percent and produced tau antibodies in the blood.

"That looks to me like a viable therapeutic avenue," said Dr. Gary Kennedy of Montefiore Medical Center in New York.

The "amyloid hypothesis" has already produced some stunning failures in large, late-stage trials. They include a drug by Canadian biotech Bellus Health (BLU.TO), formerly known as Neurochem Inc, and one last year with Flurizan, dealing a blow to its backers Myriad Genetics (MYGN.O) and Lundbeck (LUN.CO).

"You have to wonder if maybe we have been thinking about this wrong," Gandy said.

And he wonders about bapineuzumab, a highly watched drug for Alzheimer's being developed by Wyeth (WYE.N) and Irish drugmaker Elan Corp (ELN.I) and Johnson & Johnson (JNJ.N). Last year, the drug failed to meet its primary goal in a mid-stage trial and caused brain swelling at higher doses.

Gandy said Dimebon could be making nerve cells more efficient at excreting the toxic protein. Or perhaps the drug has such a powerful effect that it overrides any harm being done to the brain by beta amyloid. (Editing by Maggie Fox and John O'Callaghan)
- Reuters

An Alzheimer's Drug Mystery

Alzheimer's Association — 2009-07-14

Medivation's dimebon may help Alzheimer's patients--but scientists aren't sure how.

One of the most promising drugs in Alzheimer's disease research just got a little more mysterious.

Dimebon, a Russian antihistamine being developed by San Francisco-based Medivation ( MDVN - news - people ) in partnership with Pfizer ( PFE - news - people ), has shocked scientists with its apparent efficacy. But in cell cultures and in mice, the drug actually seems to increase concentrations of a chemical many experts believe may be a culprit in the disease, according to experiments presented today at the International Conference on Alzheimer's Disease (ICAD 2009) in Vienna.

"There's certainly more questions than answers," says Sam E. Gandy, the professor at Mt. Sinai Medical Center in New York who led the team that conducted the experiments.

More than 5 million Americans are living with Alzheimer's, according to the U.S. Alzheimer's Association, and there are no good treatments to prevent the dementia and memory loss caused by the disease. Scientists don't really understand what goes wrong to cause it.

In a clinical trial conducted in Russia, dimebon improved the ability of patients with Alzheimer's disease on a standardized test used to measure disease severity. The results were published a year ago in The Lancet.

"The published paper from Lancet is the best thing anyone's ever seen in Alzheimer's. No one's ever seen an improvement with sustained benefit for a year, and lots of people, myself included, initially said, 'This is too good to be true,' " says Gandy.

His early skepticism has given way to hope. Reputable American clinical trialists have staked their reputations on the validity of the Russian trials. And Pfizer has dropped $225 million--plus the promise of milestone payments--for rights to co-market the drug. Medivation shares are up 75% over the past 12 months.

Studies that could confirm dimebon's effectiveness are now underway. If it does work, Gandy asks, exactly what could it be doing? Medivation believes that dimebon helps brain cells work better by improving the function of cellular energy factories called mitochondria.

Gandy decided to look at another reputed culprit in Alzheimer's called beta amyloid. Beta amyloid is a protein fragment that collects in clumps inside the brains of Alzheimer's patients. Some experimental anti-Alzheimer's drugs aim to arrest the disease by blocking amyloid buildup. The most advanced of these is a treatment being developed by Elan Pharmaceuticals ( ELN - news - people ) and Wyeth ( WYE - news - people ). Johnson & Johnson ( JNJ - news - people ) recently invested $1 billion in Elan to acquire a quarter of the rights to this drug. Pfizer and Eli Lilly ( LLY - news - people ) also have amyloid-blocking programs.

But dimebon didn't decrease the amount of amyloid produced by mouse brain cells in a dish. It actually caused the mouse cells to churn out twice as much of the protein. If beta amyloid is the key to stopping Alzheimer's, dimebon shouldn't work at all. Animal results frequently don't translate to humans.

A mid-stage study of the Elan-Wyeth amyloid-blocker did not show a statistically significant benefit, although some subsets of patients did better. Patients were at higher risk for a vasogenic edema, a buildup of fluid in the brain.

"In the presence of the disease, there has been little evidence that amyloid makes a difference," says Mary Sano, a psychiatrist at Mount Sinai Medical Center. She is a co-author of both Gandy's study and Russian dimebon study, and serves on scientific advisory boards to both Medivation and Elan.

A lot more will be known when current late-stage studies of dimebon wrap up. Says Lynn Seely, Medivation's chief medical officer: "One of the great things about a new drug that has clinical effect is that it can teach us more about the disease."
- Forbes

A Phase III Alzheimer's Drug Increases Levels Of Beta Amyloid In The Brain – But Still Provides Benefits

Alzheimer's Association — 2009-07-15

Immunotherapy Targets Alzheimer's Tau Tangles - More Doctors Diagnosing and Treating Mild Cognitive Impairment

Vienna, July 15, 2009 – New insights into how a Phase III Alzheimer's drug might work were among the advances in potential therapies targeting two abnormal brain proteins – beta amyloid and phosphorylated tau – that were reported today at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD 2009) in Vienna.

Scientists also reported on how clinicians view and treat mild cognitive impairment (MCI), a research category used to define the state between normal aging and Alzheimer's, that is now being used widely in clinical practice.

"There are now more than 5 million people living with Alzheimer's disease in the United States. The cost of caring for people who now have Alzheimer's, and those who will get it in the next few years, will bankrupt the healthcare system and devastate Medicare and Medicaid," said Ralph Nixon, PhD, MD, vice chair of the Alzheimer's Association Medical & Scientific Advisory Council.

"But, as these studies and many hundreds more reported at ICAD 2009 show, there is hope. There are currently dozens of drugs in Phase II and III clinical trials for Alzheimer's. This, combined with advancements in diagnostic tools, has the potential to change the landscape of Alzheimer's in our lifetime. How fast we get there depends completely on the investment in research. We need more government and private dollars for Alzheimer's research now to capitalize on the progress we've made in the last decade," Nixon added.

Surprisingly, Dimebolin Increases Brain Beta Amyloid in Alzheimer's Mouse Models

Recent evidence suggests that dimebolin (Dimebon®, Medivation) may improve cognitive function in aged rodents and in people suffering from mild to moderate Alzheimer's, but how the drug produces these benefits remains unclear.

Samuel Gandy, MD, PhD, Mount Sinai Professor in Alzheimer's Disease Research; Professor of Neurology and Psychiatry; and Associate Director, Alzheimer's Disease Research Center at the Mount Sinai School of Medicine, New York, and colleagues John Cirrito PhD, and David M. Holtzman, MD, Professor and Chairman of the Department of Neurology at Washington University in St. Louis, MO, conducted a series of experiments in cells and in Alzheimer's mouse models to assess the effects of dimebolin on beta amyloid and other brain proteins known to be related to Alzheimer's disease.

Beta amyloid is a protein that is the main constituent of amyloid plaques found in the brains of people with Alzheimer's disease. It is widely considered a key player in the development and progression of Alzheimer's. The goal of anti-amyloid drugs that are currently in clinical trials is to reduce beta amyloid levels in the brain.

In a surprising result, the researchers at Washington University in St. Louis found that treatment with dimebolin caused an acute increase in brain beta amyloid levels in the animal models.

"This result is highly unexpected in what may prove to be a clinically beneficial Alzheimer's drug," Gandy said. "We need more research to further clarify how dimebolin affects beta amyloid levels in the brain."

"A number of ideas need to be pursued. It may turn out that the drug works by getting toxic amyloid out of brain nerve cells. Or, the effects of dimebolin on other brain systems may override its effect on increasing beta amyloid. Finally, the drug's beneficial actions might have nothing to do with amyloid, which, if true, indicates the existence of important therapeutic targets independent of beta amyloid," Gandy added.

The researchers note that so far they only studied acute systems, and it is conceivable that the chronic effect of dimebolin could be amyloid-lowering.

Immunotherapy Against Tau Tangles in Alzheimer's Mouse Models

Immunotherapy (treatment by inducing, enhancing, or suppressing an immune response) targeting beta amyloid is being researched widely by companies and academics as a therapeutic option for Alzheimer's disease. Earlier, late stage, anti-amyloid immunotherapy trials in people were complicated, and eventually stopped, when about six percent of participants developed brain inflammation. Current trials in this area are working in a variety of ways to eliminate this side effect.

Tau tangles, the other major Alzheimer's brain pathology, are now also receiving attention as a target for immunotherapy. Also known as neurofibrillary tangles (NFTs), these lesions consist of an abnormal folded protein (phosphorylated tau), and research shows their accumulation in the brain is more closely associated with the progression of Alzheimer's symptoms than amyloid.

Building on previous studies using this approach (for example, Asuni et al. (2007)), Hanna Rosenmann, Ph.D., head of the Laboratory of Molecular Neurogenetics, Department of Neurology, Hadassah University Hospital, Ein Kerem, and an Investigator (Associate-Senior Lecturer) at the Hebrew University Hadassah School of Medicine, Jerusalem, Israel, and colleagues performed immunization studies against tau tangle pathology by immunizing NFT mice with a mixture of three phosphorylated-tau peptides (shortened versions of the full length tau protein that are phosphorylated like the NFTs). Previous experiments by this lab with non-phosphorylated full length tau caused brain inflammation in the animal models.

The researchers observed a robust decrease in the number of tau tangles in the brains of the mice immunized with the phosphorylated tau-peptides (~40%; p<0.001), and detected anti-phosphorylated-tau antibodies in mouse serum. They found no evidence or symptoms of brain inflammation in the immunized mice.

According to Rosenmann, the decrease in tau tangles observed by her team is in accord with previous findings by Asuni's group, though Asuni immunized with a different phosphorylated tau peptide and immunization protocol.

"We believe that these results point to the therapeutic potential of phosphorylated-tau-immunotherapy in Alzheimer's," Rosenmann said. "We devoted significant effort to address not only the anti-tangle effect but also safety of a phosphorylated-tau vaccine. This was done in order to identify early in the preclinical stage any potential hazard of this potential Alzheimer's therapy."

Neurologists Views MCI as a Useful Clinical Diagnosis – Practice Guidelines Are Needed

Mild cognitive impairment (MCI) is a category of cognitive status that is used in research to define the state between normal aging and Alzheimer's, and it is now entering clinical practice. Little is known about how it is being used by clinicians or how they view the benefits and limitations of MCI as a clinical category.

In MCI, a person has problems with memory, language, or another mental function severe enough to be noticeable to other people and to show up on tests, but not serious enough to interfere with their daily life. Because the problems do not interfere with daily activities, the person is not diagnosed with Alzheimer's or another dementia. The best-studied type of MCI involves a memory problem and is called "amnestic MCI."

Research has shown that people with MCI have an increased risk of developing Alzheimer's over the next few years, especially when their main problem is memory. However, not everyone diagnosed with MCI goes on to develop Alzheimer's. There is currently no treatment for MCI approved by the FDA. Numerous clinical trials are investigating treatments to delay or prevent Alzheimer's in MCI populations.

Scott Roberts, PhD, Assistant Professor of Health Behavior & Health Education at the University of Michigan's School of Public Health; Jason Karlawish, MD, Associate Professor of Medicine and Medical Ethics with tenure, Senior Fellow of the Center for Bioethics and the Leonard Davis Institute of Health Economics, and Associate Scholar at the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania; and colleagues sought to assess how neurologists are diagnosing and treating patients with mild cognitive symptoms and how they view MCI as a clinical diagnosis. They surveyed members of the American Academy of Neurology (AAN) who had indicated a clinical practice focus on aging/dementia or behavioral neurology in a recent AAN Member Census using mail, fax and the Internet.

420 clinicians (response rate=48%) completed the survey. 88% reported at least monthly encounters with patients experiencing mild cognitive symptoms. Most respondents recognize MCI as a clinical diagnosis (90%) and use its diagnostic code for billing purposes (70%). When seeing this population, most respondents report routinely making recommendations for monitoring and follow-up (88%), counseling patients on physical (78%) and mental exercise (75%), and communicating about risk of dementia (63%).

Most respondents (70%) prescribe cholinesterase inhibitors at least sometimes for this population, with memantine (39%) and "other" agents (e.g., vitamin E, gingko) prescribed less frequently. Cholinesterase inhibitors and memantine are FDA-approved drugs for Alzheimer's. Relatively few respondents routinely provide information on support services (27%) or a written summary of findings (15%).

Respondents endorsed several benefits of making a clinical diagnosis of MCI:

1 Labeling the problem is helpful (91%)

2 Involving the patient in planning for the future (87%)

3 Motivating the patient's risk reduction activities (85%)

4 Helping the family with financial planning (72%)

5Prescribing medications useful for treating MCI (65%)

Some respondents noted potential drawbacks of MCI as a clinical diagnosis, including:

1 It is too difficult to diagnose accurately or reliably (23%)

2 It is usually better described as early AD (21%)

3 A diagnosis can cause unnecessary worry (20%)

"Our results show that neurologists regularly see and treat people with MCI, despite the fact that the medications they are prescribing are not FDA-approved for this particular diagnostic category," Roberts said. "Clinicians vary greatly in the education and support they provide or recommend for people with MCI, suggesting that there is a need for practice guidelines in this area. Millions of people can be classified as having MCI, and these numbers are expected to rise in coming years. It is important to establish professional consensus about appropriate care for this population."

According to Roberts, the AAN is currently engaged in an evidence-based medicine review of the literature to develop a new practice parameter for MCI.
- Alzheimer's Association

Results From Drug Trials And New Risk Factors Announced At International Alzheimer's Conference

Alzheimer's Association — 2009-07-15

Vienna, July 16, 2009 – This week, more than 3,000 leading scientists convened to report and discuss the latest advances in research on treatments, risk factors, diagnosis and causes for the health epidemic of the 21st century – Alzheimer's disease – at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD 2009) in Vienna, Austria.

"The cost of caring for people who have Alzheimer's, and those who will get it, will bankrupt the healthcare system and devastate Medicare and Medicaid," said William Thies, PhD, Chief Medical and Scientific Officer at the Alzheimer's Association. "Fortunately, the field is progressing and we may soon see changes in the landscape of Alzheimer's diagnosis, care, treatment, and prevention. How fast we get there depends completely on investment in research. We must capitalize on the advances made in the last decade."

Highlights from ICAD 2009 include:

DHA Drug Trials

Results from two large studies using DHA, an omega 3 fatty acid, were reported at ICAD 2009. DHA (docosahexaenoic acid) is the most abundant omega 3 fatty acid in the brain. An 18-month study in people with mild to moderate Alzheimer's by the Alzheimer's Disease Cooperative Study (ADCS) supported by the U.S. National Institute on Aging (NIA) showed no evidence for benefit in the studied population. The results do not support the routine use of DHA for people with Alzheimer's.

A six month study was conducted by Martek Biosciences Corporation in healthy older people to see DHA's effect on "age related cognitive decline." This trial showed a positive result on one test of memory and learning. The results need confirmation. Both studies used Martek's algal DHA.

These two studies – and other recent Alzheimer's therapy trials – raise the possibility that treatments must be given early in Alzheimer's process for them to be truly effective. For that to happen, we need to get much better at early detection and diagnosis of Alzheimer's.

Phase III Alzheimer's Drug Raises Level of a Toxic Protein

Recent evidence suggests that the drug Dimebon may improve cognitive function in people with mild to moderate Alzheimer's, but how the drug produces these benefits remains unclear. In a surprising result from ICAD 2009, researchers found that treatment with Dimebon caused an increase in a brain protein, known as beta amyloid, in animal models of Alzheimer's. Beta amyloid is a protein that is the main constituent of plaques found in the brains of people with Alzheimer's. It is thought to be a key player in the development and progression of Alzheimer's. This result is highly unexpected as most Alzheimer's drugs are tested for how much they can lower beta amyloid levels.

News Cases of Alzheimer's and Dementia Continue to Rise, Even Past Age 90

The number of people with Alzheimer's and dementia – both new cases and total numbers with the disease – continues to rise among the very oldest segments of the population, according to research reported at the Alzheimer's Association International Conference. This age group is the fastest growing segment of the population in western countries. This is different from past research results. Previous studies have suggested that the number of people with Alzheimer's and dementia begins to level off and perhaps even go down a bit in people age 90 and above.

Post Traumatic Stress Disorder May Raise Alzheimer's Risk; Moderate Alcohol May Lower It

Two studies from ICAD 2009 looked at how post traumatic stress disorder (PTSD) and alcohol consumption may affect risk levels.

A study of more than 181,000 veterans aged 55 and older without dementia showed that there may be nearly two times higher Alzheimer's risk in veterans with post-traumatic stress disorder (PTSD) than those without it. Further research is needed to fully understand what links these two important disorders. With that knowledge we may be able to find ways to reduce the increased risk of dementia associated with PTSD.

A second study suggests lower Alzheimer's risk among adults who consume moderate amounts of alcohol (1 or 2 drinks per day), versus those who do not drink or who are heavy drinkers. However, this does not appear to be true for those who already have mild cognitive impairment.

The good news is that we now know there's a lot you can do to help keep your brain healthier as you age. These steps might also reduce your risk of developing Alzheimer's disease or another dementia. Find out more by visiting the Alzheimer's Association at www.alz.org.

Heart Healthy Diet and Ongoing Moderate Exercise May Reduce Risk of Cognitive Decline

Scientists at ICAD 2009 reported that following the Dietary Approaches to Stop Hypertension diet – or DASH diet – was associated with higher scores for cognitive functioning. The researchers found that four food categories from the diet plan – whole grains, vegetables, low-fat dairy foods, and nuts and beans – may offer benefits for cognition in late life. We need more research before we can confidently say how much of these foods to include in your diet to experience some benefit.

Two studies from ICAD 2009 looked at physical activity and mental performance as we age.

One study found that maintaining or increasing physical activity throughout life may slow cognitive decline as we age. Older adults who were sedentary throughout the study had the lowest levels of cognitive function at the beginning and had the fastest rate of decline.

A second study in post-menopausal women found that moderate long-term physical activity may improve late life cognition; while long-term strenuous activity may actually increase risk of cognitive impairment.

Neurologists Surveyed on Diagnosing and Treating Mild Cognitive Impairment (MCI)

Scientists at ICAD 2009 reported on how clinicians view and treat mild cognitive impairment (MCI), a research category used to define the state between normal aging and Alzheimer's, that is now being used widely in clinical practice. Millions of people can be classified as having MCI, and these numbers are expected to rise in coming years. Researchers found that neurologists regularly see and treat people with MCI, despite the fact that the medications they are prescribing are not FDA-approved for MCI. They also found that clinicians vary greatly in the education and support they provide or recommend for people with MCI, suggesting that there is a need for practice guidelines.

There are now more than 26 million people living with dementia around the world. The cost of caring for these people, and those who will get it in the next few years, have potential to bankrupt the world's healthcare systems. But, as these studies and many hundreds more reported at ICAD 2009 show, there is hope.

Successful Recruiting Strategies for Alzheimer's Clinical Trials

Several studies at ICAD 2009 investigated the most effective method of recruiting people for Alzheimer's clinical studies. Researchers in one study found that successful Alzheimer's trials promote volunteerism and study participation by conducting community educational events, and actively partnering with local physicians. Surprisingly, in this study, patient registries and Internet recruiting were found to be much less successful recruitment strategies.

In a study looking specifically at recruiting African Americans for Alzheimer's genetics studies, researchers found that having a relative with the disease, use of minority study personnel, and monetary compensation were the most powerful incentives for participation in research. The researchers found that large percentages of African Americans are willing participants for Alzheimer's genetic studies, if culturally sensitive techniques are used to recruit them.

Recruiting participants for clinical studies is the second greatest barrier to developing better treatments for Alzheimer's disease, behind inadequate funding. The Alzheimer's Association has initiated a Clinical Studies Initiative to begin to address this problem. Find out more at 1-800-272-3900 or www.alz.org.
- Alzheimer's Association

Statin Drugs May Cut Dementia Risk

Alzheimer's Association — 2009-07-14

The popular cholesterol-lowering statin drugs taken by millions to help prevent heart attacks and strokes may also protect against the development of dementia.

In a study of more than 17,000 people 60 and older, use of statin drugs appeared to cut the risk of developing dementia by more than half.

The study does not prove that statins prevent cognitive decline, and no one should start taking them as a dementia preventive, doctors stress. But the findings are compelling enough to justify further study, says Alina Solomon, MD, a researcher in the department of neurology at the University of Kuopio in Finland.

The study was presented at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease.

Other studies have had conflicting results on the ability of statins to protect against memory loss, dementia, and Alzheimer's disease, but this study is one of the largest to date. The trial included Finnish people enrolled in a larger, ongoing study examining risk factors for heart disease and stroke.

The current analysis involved 17,257 participants 60 and older who had not been diagnosed with dementia or Alzheimer's disease in 1995. Over the next 12 years, 1,551 of them were diagnosed with dementia. Of those, 281, or 18%, had taken statins for at least one year prior to the diagnosis.

One advantage of the current study is that data about statin use was obtained from a drug reimbursement registry, Solomon tells WebMD. Some of the previous trials relied on patients to self-report use of cholesterol-lowering drugs, which can be especially problematic when working with people with dementia, she explains.

After adjusting for risk factors for dementia, including age, sex, education level, place of residence, body mass index, blood pressure, and cholesterol levels, the researchers found that people who took statin drugs were 58% less likely to develop dementia than those who did not.

Statins and Insulin Levels in Brain

Statins help protect against heart attacks and strokes by lowering low-density lipoprotein ( LDL), or "bad" cholesterol. But since the current analysis was adjusted for participants' cholesterol levels, that action alone does not fully explain statins' apparent punch against dementia, Solomon says.

So what is going on? A risk factor for dementia is high insulin; one theory is that statins may lower the high insulin levels in the brain. Statins have also been shown to reduce levels of C-reactive protein (CRP), a marker of inflammation that has been linked to the pathology that can lead to dementia, researchers say.

"There's a lot more work to be done," Solomon says. The next step for her team: determining whether the type of statin drug, dosage, or duration of treatment affects the results. "Two other studies didn't show that the type of statin made a difference, but we're checking that," she says.

Ronald Petersen, MD, PhD, professor of neurology at the Mayo Clinic in Rochester, Minn., and chair of the Alzheimer's Association Medical & Scientific Advisory Council, notes that two large studies showed that statins do not appear to prevent Alzheimer's disease.

But dementia develops before Alzheimer's, and it could be that it "was a matter of too little too late. More and more research suggests you have to give interventions early to have an impact on Alzheimer's disease," he tells WebMD.

The best way to settle the issue, doctors agree, is a primary prevention trial in which half of people take statins and half don't. Then, they are followed over time to see how many in each group develop dementia or Alzheimer's. "That's the gold standard," Solomon says.
- WebMD

"Heart healthy" diet and ongoing, moderate physical activity may protect against cognitive decline

Alzheimer's Association — 2009-07-14

A "Heart Healthy" Diet and Ongoing, Moderate Physical Activity May Protect Against Cognitive Decline As We Age

Vienna, July 14, 2009 – Eating a "heart healthy" diet and maintaining or increasing participation in moderate physical activity may help preserve our memory and thinking abilities as we age, according to new research reported today at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD 2009) in Vienna.

"We can't do anything about aging or family history, but research continues to show us that there are lifestyle decisions we all can make to keep our brains healthier, and that also may lower our risk of memory decline as we age," said William Thies, PhD, Chief Medical & Scientific Officer at the Alzheimer's Association.

Dietary Approaches to Stop Hypertension (DASH) Eating Pattern May Reduce Age-Related Cognitive Decline

The Dietary Approaches to Stop Hypertension (DASH) diet is often recommended by physicians to people with high blood pressure or pre-hypertension. The DASH diet eating plan has been proven to lower blood pressure in studies sponsored by the National Institutes of Health. High blood pressure is considered a risk factor for Alzheimer's and dementia.

Heidi Wengreen, RD, PhD, Assistant Professor of Nutrition at Utah State University, and colleagues examined associations between how closely people adhered to the DASH diet and risk of cognitive decline and dementia among older participants in the Cache County Study on Memory, Health and Aging.

In 1995, 3,831 study participants 65 years of age or older completed a survey that included a food frequency questionnaire and cognitive assessment. Cognitive function was checked again during four assessments over 11 years using the Modified Mini-Mental State examination (3MS), which is graded on a 100 point scale. A DASH diet adherence score was created based on consumption levels of nine food-group/nutrient components -- fruit, vegetables, nut/legumes, whole grains, low-fat dairy, sodium, sweets, non-fish meat, and fish. Participants were ranked by DASH score into five groups, or quintiles.

The researchers found that higher DASH scores were associated with higher scores for cognitive functioning at the beginning of the study and over time. Those in the highest quintile scored 1.42 points higher at baseline and 1.81 points higher after 11 years on the 3MS than did those in the lowest quintile of the DASH score (p-values <0.001).

They also found that four of the nine food-group/nutrient components used to create the DASH score were independently associated with 3MS scores -- vegetables, whole grains, low-fat dairy, nut/legumes. The scientists created a diet adherence score based on just these four components which they then tested for association with changes in cognitive abilities on the 3MS. Those in the highest quintile scored 1.72 points higher at baseline and 3.73 points higher after 11 years than did those in the lowest quintile of the four-component score (p-values <0.001).

"Our results suggest that including whole grains, vegetables, low-fat dairy foods, and nuts in one's diet may offer benefits for cognition in late life," Wengreen said. "However, we need more research before we can confidently say how much of these foods to include in your diet to experience some benefit."

Maintaining or Increasing Activity Levels May Slow Cognitive Decline in Elderly

Studies have found that older adults who are physically active may experience slower rates of cognitive decline. Less is known about the impact of changes in physical activity levels on rate of cognitive decline.

Deborah E. Barnes, PhD, MPH, Assistant Professor of Psychiatry at the University of California, San Francisco, and a geriatrics researcher at the San Francisco VA Medical Center, and colleagues studied changes in levels of both physical activity and cognitive function over seven years in 3,075 white and black elders aged 70-79 years in the Health, Aging and Body Composition Study. Physical activity was assessed based on self-reported number of minutes walked per week at the beginning of the study and after two, four, and seven years of follow-up. Participants were classified at each time point as sedentary (0 minutes per week), low (less than 150 minutes per week) or high (150 minutes per week or more). Changes over time were classified as consistently sedentary, maintaining (low or high), decreasing, or increasing/fluctuating. Cognitive function was assessed using the 3MS.

The researchers found that 21% of study participants were consistently sedentary, 12% maintained their activity levels, 26% had declining levels, and 41% had increasing or fluctuating levels. After adjustment for age, sex, race, education, study site, diabetes, hypertension, smoking, alcohol consumption and baseline 3MS score, they found that the mean rate of decline in 3MS scores was 0.62 points/year in those who were consistently sedentary, 0.54 points/year (p=0.30) in those with declining activity levels, 0.44 points/year (p=0.01) in those with increasing/fluctuating activity levels, and 0.40 points/year (p=0.04) in those who maintained their activity levels.

"We found that older adults who were sedentary throughout the study had the lowest levels of cognitive function at the beginning and experienced the fastest rate of cognitive decline," Barnes said. "Cognitive decline also was faster in those whose physical activity levels consistently declined during the study period."

According to the researchers, sedentary elders who began new aerobic exercise programs experienced improvements in cognitive function, especially the ability to process complex information quickly. "Sedentary individuals should be encouraged to engage in physical activity at least occasionally," Barnes said. "People who are currently active should be encouraged to maintain or increase their activity levels."

Moderate Long-Term Physical Activity May Improve Late Life Cognition; Long-Term Strenuous Activity May Increase Risk of Cognitive Impairment

Long-term strenuous physical activity has been shown to decrease lifetime exposure to ovarian hormones in women and has been found to play a protective role against breast cancer. However reduction in ovarian hormone exposure has been associated with increased risk of cognitive impairment. At the same time, long-term physical activity is associated with improved cognition but the intensity required to preserve cognition is not known

Mary C. Tierney, PhD, CPsych, Professor of Family and Community Medicine at the University of Toronto, and Senior Scientist and Director, Geriatric Research Unit, Brain Sciences Program at Sunnybrook Health Sciences Centre, and colleagues sought to examine the associations between both long-term strenuous and moderate activity levels and cognition in recently postmenopausal women.

Study participants were 90 women aged 50-63 years, one to 10 years post natural menopause, with no history of breast cancer, HRT use, psychiatric disorder, dementia or other neurological condition. Participants gave details on the amount of their strenuous and moderate physical recreational activities from high school to menopause. Eight memory and brain function tests were administered to all participants.

After adjusting for age, education, reproductive years, cigarette smoking, alcohol consumption, parity, and periods of amenorrhea, the researchers found that long-term strenuous activity was consistently associated with poorer performance on all eight of the tests; with statistically significant results on tests of semantic memory, working memory, delayed verbal recall, and sustained attention (p <0.05). Moderate physical activity was consistently associated with better performance on all eight of the tests, with statistically significant results on cognitive flexibility, working memory, and sustained attention (p <0.05).

"Our results suggest that long-term strenuous activity may increase the risk of cognitive impairment in recently postmenopausal women," Tierney said. "On the other hand, moderate long-term physical activity may improve later life cognition. These preliminary findings have important implications for women's health and support the need for large-scale studies including both women and men."

Alzheimer's Risk Gene May Reduce Benefits of Physical Activity to Cognitive Ability

While the relationship of physical activity with cognitive performance as we age is a subject of considerable research, much less is known about how this relationship is impacted by the Alzheimer's risk gene Apolipoprotein E (APOE). The APOE gene comes in three types, or alleles, known as e2, e3, and e4. Each person gets one type of APOE from each parent, making the possible combinations: e2/e2, e2/e3, e2/e4, e3/e3, e3/e4, e4/e4. Having two copies of e4 conveys the highest risk for Alzheimer's; having one e4 also raises one's risk. E3 is the most common type. E2, though rare, is thought to be protective.

Thomas Obisesan, MD, MPH, FAAFP, Chief of the Division of Geriatrics at Howard University Hospital and professor of medicine at Howard University College of Medicine, Washington, D.C., and colleagues examined this issue using data from The Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994). They identified 1,799 men and women age 60 and older who had data on levels of aerobic-related physical activity (AR-PA), such as walking, jogging, bicycling or swimming; mental status test scores; and APOE genotype.

In their analysis, the researchers found that physical activity was associated with enhanced cognitive function, and that this relationship was differentially influenced by the person's APOE genotype: non-E4 carriers and people with one copy of E4 performed better than people with two copies of E4. After adjusting for age, ethnicity, severe chronic medical illness, lean body mass, and education, aerobic physical activity continued to show a statistically significant association with cognitive function in non-E4 carriers but not in people with E4 (any combination)

"In our nationally representative sample, persons who reported higher levels of aerobic physical activity had better memory than those who reported no such activity. This was especially true in those people who didn't have the APOE-e4 Alzheimer's risk gene," Obisesan said.

"Because physical activity is a low-cost, low-risk, readily available intervention, it may prove to be an important public health strategy to reduce or prevent memory loss and other symptoms of mental decline in the elderly. Future rigorous clinical trials are needed to confirm these findings," Obisesan added.
- Alzheimer's Association

New tests may help spot early-stage Alzheimer's

Alzheimer's Association — 2009-07-14

CHICAGO (Reuters) - New tests assessing brain changes and body chemistry are showing promise at diagnosing Alzheimer's disease in its earliest stages, aiding the search for new drugs, researchers said on Tuesday.

In one study, Irish researchers found scans measuring brain volume and a combination of memory tests accurately identified nearly 95 percent of people who had progressed from mild cognitive impairment to early Alzheimer's disease.

In another study, U.S. researchers found that a type of brain scan that measures glucose combined with low scores on memory tests was a strong predictor of disease progression.

The findings, presented at an Alzheimer's Association meeting in Vienna, Austria, are some of the first from a five-year, $60 million study aimed at identifying brain changes that signal the advance of Alzheimer's disease.

"The idea is if there could be biological markers identified that tracked what was going on in the brain, this would give you a better idea of whether a drug was having a biological effect," Neil Buckholtz, who heads the U.S. National Institute on Aging's Alzheimer's Disease Neuroimaging Initiative, or ADNI, said in a telephone interview.

The study, which is funded with U.S. government and industry funds, involves more than 800 people looking at brain structure and biological changes such as in spinal fluids that could signal disease progression.

Despite decades of research, doctors still have few effective treatments for Alzheimer's disease, a mind-robbing form of dementia that affects more than 26 million people globally and is expected to reach 100 million by 2050.

CHEAPER TRIALS

Only an autopsy revealing the disease's hallmark plaques and tangles in the brain can offer a definitive Alzheimer's diagnosis. Short of that, doctors use neurological and memory tests. Because they are subjective, drug companies must run large, costly trials to show their drugs work.

Biomarkers may lead to cheaper trials, Buckholtz said.

In the Irish study, Michael Ewers of Trinity College Dublin and colleagues studied 345 participants in the ADNI study with mild cognitive impairment, a precursor to Alzheimer's.

They looked at an array of tests and found three memory tests plus MRI measurements of brain volume in the left hippocampus -- a region closely linked to memory -- were most predictive of disease progression.

In a separate study, Susan Landau of the University of California, Berkeley used data on 85 patients and found positron emission tomography scans that measure glucose in the brain and poor memory recall were strong predictors. People who did poorly on these measures were 15 times more likely to progress to Alzheimer's within two years.

Buckholtz expects many more studies to come from the ADNI study. "The idea is we are trying to define the best biomarkers or combination of biomarkers that will allow us to assess progress," he said.

In another study presented at the meeting, a team at Duke University in North Carolina led by Dr. Allen Roses found that a gene called TOMM40 raises Alzheimer's risk.

The gene predicted the age of Alzheimer's development within a five- to seven-year window in people over 60. It is closely linked to another Alzheimer's gene called ApoE4.

"It now looks fairly clear that there are two major genes -- APOE4 and TOMM40 -- and together they account an estimated 85-90 percent of the genetic effect," Roses said.
- Reuters

Brain imaging and proteins in spinal fluid may improve Alzheimer's prediction and diagnosis

Alzheimer's Association — 2009-07-14

New Results from ADNI Data Bring Us Closer to Earlier Detection of Alzheimer's

Vienna, July 14, 2009 – Changes in the brain measured with MRI and PET scans, combined with memory tests and detection of risk proteins in body fluids, may lead to earlier and more accurate diagnosis of Alzheimer's, according to new research reported today at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD 2009) in Vienna.

The National Institute on Aging's (NIA) Alzheimer's Disease Neuroimaging Initiative (ADNI), data from which forms the basis of these three studies, is a $60 million, 5-year, public-private partnership to test whether imaging technologies (such as MRI and PET), other biomarkers, and clinical and neuropsychological assessment can be combined to measure progression toward Alzheimer's. ADNI is the first study to examine a number of candidate Alzheimer's biomarkers in the same individuals. The study is expected to be a landmark for identifying Alzheimer's biomarkers, with data widely available to researchers. ADNI is primarily funded by NIA, part of the National Institutes of Health (NIH), with private sector support through the Foundation for NIH. The Alzheimer's Association is one of the ADNI sponsors.*

A biomarker is a substance or characteristic that can be objectively measured and evaluated as an indicator of normal body processes, disease processes, or the body's response(s) to therapy. For example, blood pressure is a biomarker that indicates risk of cardiovascular disease.

"With the continued aging of the population and the growing epidemic of Alzheimer's, early detection of the disease is crucial for risk assessment, testing new therapies, and eventual early intervention with better drugs, once they are developed," said Ronald Petersen, PhD, MD, chair or the Alzheimer's Association Medical & Scientific Advisory Council.

"It is widely believed that Alzheimer's disease brain changes, including amyloid plaques and neurofibrillary tangles, begin many years before we see symptoms. It is critical to identify affected individuals while they are still relatively cognitively healthy so that future therapies can preserve healthy memory and thinking function. And, in order to develop those new therapies, we need to identify 'at risk' individuals now in order to steer them to clinical trials," Petersen added.

Petersen is Professor of Neurology; Cora Kanow Professor of Alzheimer's Disease Research; and Director, Mayo Alzheimer's Disease Research Center, Mayo Clinic College of Medicine, Rochester, MN. He is one of the Principal Investigators of ADNI.

Memory Tests and Hippocampal Volume May Accurately Diagnose Early Alzheimer's

Researchers led by Michael Ewers, PhD, senior research fellow at Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland, and Harald Hampel, MD, MSc, Chair of Psychiatry, Trinity College Dublin, identified 345 ADNI participants (81 with Alzheimer's, 163 with amnestic MCI; 101 elderly healthy controls) on whom there was available data including (a) cerebrospinal fluid (CSF) concentration and ratios of Alzheimer's related proteins: total tau, phosphorylated tau (p-tau181), and beta-amyloid (Aβ1-42), (b) MRI volume measures of certain sections of the brain, including the left and right hippocampus, entorhinal cortex, and medial temporal lobe, and (c) scores on certain standard memory, learning and brain function tests, including the Rey Auditory Verbal Learning test (RAVL) and the Alzheimer's Disease Assessment Scale (ADAS).

From this data they used statistical methods to identify the best set of predictors that correctly identified (a) healthy people versus those with Alzheimer's, and (b) people with mild cognitive impairment (MCI) who progressed to Alzheimer's (of which there were 50 people in the study who converted over the next year and a half).

"The clinical symptoms of MCI alone are not enough to allow for early diagnosis of Alzheimer's," Ewers said. "In fact, a substantial proportion of people with MCI may revert back to normal or may not develop Alzheimer's for years. Thus, the challenging task is to discern which of people with MCI have the Alzheimer's brain changes that may be responsible for their initial memory and thinking problems and their eventual progression to Alzheimer's, so that they can be targeted for Alzheimer's-specific treatments."

The researchers found that results of three subunits of the memory tests could be combined to reach a classification accuracy of 89.9% for distinguishing people who progressed from MCI to Alzheimer's versus healthy people. They found that by adding in results from MRI volume measurements of the left hippocampus – a brain region closely linked to memory and Alzheimer's – they could increase classification accuracy to 94%. When, as a means to validate the findings, the same set of tests and measures was applied to distinguish the healthy people from those with Alzheimer's, classification accuracy was 95.7%.

When the researchers also included measures of tau and beta amyloid in CSF and presence or absence of a known Alzheimer's risk genotype (ApoE-e4), they could correctly identify people with MCI who progressed to Alzheimer's within 1.5 years with 95.6% accuracy, but the model including only memory tests plus hippocampus was the most robust predictor set.

"Our results show that a relatively simple prediction model, including the combination of hippocampus volume measured by MRI with memory tests, may be able to accurately diagnose Alzheimer's at a very early stage in the disease," Ewers said. "We believe this is the first large-scale, multi-center study to use this variety of biomarker candidates in MCI and Alzheimer's. This diagnostic model needs to be validated in autopsy-confirmed Alzheimer's cases."

Poor Results on PET Brain Measurements and Memory Test Scores Increase Alzheimer's Risk 15 Times for People with MCI. Susan M. Landau, PhD, of the Helen Wills Neuroscience Institute at the University of California, Berkeley, and colleagues used data from 85 ADNI participants with MCI (ages 55–90) to compare the utility of a variety of baseline measurements for predicting decline in MCI and conversion from MCI to Alzheimer's over a two-year period.

Candidate predictors of decline included hippocampal volume measured with MRI; relative rates of glucose metabolism in certain, prespecified brain regions measured with FDG-PET scans; number of apolipoprotein E4 (ApoE4) alleles, which is an Alzheimer's risk gene; CSF measurement of Alzheimer's related proteins, including beta amyloid (Aβ1-42), total tau (t-Tau), and tau phosphorylated in the 181 threonine position (p-tau181); and a test of memory recall ability (AVLT). Participants were evaluated at approximately 6 month intervals to determine whether decline to Alzheimer's had occurred. Approximately 17% (1 in 6) MCI patients converted to Alzheimer's disease per year in this study.

The researchers found that low baseline FDG-PET measurements and poor memory recall in people with MCI reliably predicted progression to Alzheimer's over the two year follow up period of the study.

"The novel finding of our analysis is that when we directly compared all the potential predictors to one another, we found that the amount of glucose metabolism, as measured by FDG-PET, and memory recall ability, measured by AVLT total recall, were the most predictive of conversion from MCI to Alzheimer's," Landau said. "People who did poorly on those two measurements – that is, low glucose metabolism combined with poor memory performance – were 15 times more likely to convert to Alzheimer's compared to individuals who were normal on those measurements."

"When the measurements are considered individually, p-tau (a CSF protein) and hippocampal volume also significantly predict conversion from MCI to Alzheimer's. Specifically, MCI patients in our study who were low on these measures had a 2 to 4 times higher risk of progressing to Alzheimer's," Landau added.

Additionally, all measurements (ApoE4 status, hippocampal volume, FDG-PET, CSF biomarkers, and memory recall ability) played a role in predicting cognitive decline, regardless of whether the patients converted to Alzheimer's or not. P-tau181 had the strongest value in predicting subsequent cognitive decline.

According to the researchers, the selection of a biomarker, or set of biomarkers, will be critical in research to select participants who are most likely to experience Alzheimer's over time, and enable these individuals to participate meaningfully in clinical studies, such as those for Alzheimer's drug treatments.

PET Measurements of the Hippocampus May Improve Alzheimer's Diagnosis

According to Dawn Matthews, Chief Executive Officer and President of Abiant, Inc., and colleagues at New York University School of Medicine, declines in regional cerebral glucose metabolism (rCMglc) in the brain as measured with Positron Emission Tomography (PET) imaging have been demonstrated to correlate to the progression of Alzheimer's, and to differentiate between dementias. Recent studies have shown that the accuracy of Alzheimer's diagnosis may be improved by including measurement of rCMglc in the hippocampus (HIP), a region of the brain that is critical to the formation of new memories. However, according to the researchers, HIP rCMglc cannot be accurately and practically sampled in broad populations using conventional techniques. This is because the hippocampus has an irregular shape and undergoes varying degrees of shrinkage during aging and when affected by disease, such as Alzheimer's. Conventional analysis techniques rely on the ability to align images of each patient's brain to a template brain map, and there is loss of sensitivity and precision due to the difficulty of aligning this irregular shape.

Lisa Mosconi, PhD, and colleagues in the Center for Brain Health at New York University (NYU) School of Medicine, directed by Mony de Leon, PhD, developed and tested an automated method that achieves accurate, rapid sampling of many brain regions, including the hippocampus. Matthews and her team collaborated with NYU to apply the automated method to 250 subjects from the ADNI database (78 female/172 male, age 59-88; 79 healthy, 111 MCI, 60 Alzheimer's). Using the automated approach, rCMglc was measured by PET in 32 brain regions. Participants were divided into seven subgroups across normal, MCI, and AD categories, based upon their initial diagnosis and results of subsequent memory and thinking tests up to 3 years after the scan.

The researchers observed a significant correlation between rCMglc in several brain regions and the progression from "stable normal" to "normal with subsequent clinical decline", to subcategories of MCI and Alzheimer's. They also found that HIP rCMglc was a sensitive predictor of decline and discriminator between disease stages. As compared to people considered "stable normal," HIP rCMglc was reduced by 5% in "normal with subsequent clinical decline", 12% in "stable MCI," 14% in "MCI with subsequent clinical decline" (p<0.05), and 24% in Alzheimer's (p<0.001).

"We found that glucose metabolism levels were highest in the healthy participants who did not decline to MCI, lower in healthy people who later declined, and progressively lower in people with MCI who remained MCI, lower in MCI patients who declined to AD, and lowest in those with Alzheimer's," Matthews said. "These results demonstrate the feasibility of achieving highly specific diagnosis by incorporating glucose metabolism measurements from the hippocampus."
- Alzheimer's Association

Booze for the Brain

Alzheimer's Association — 2009-07-13

You've probably heard a glass of wine is good for the heart, and now a new study shows drinking may also help stave off dementia as well.

Researchers at Wake Forest University School of Medicine in North Carolina asked senior citizens how often they drank alcoholic beverages. After following the 3,069 study subjects for six years, the researchers found that those who had a drink or two a day were 40 percent less likely to develop Alzheimer's disease and other forms of dementia compared to senior citizens who didn't drink at all or drank more than an average of two drinks a day. It didn't matter what type of alcohol the senior citizens drank.

"We were excited to see that even in older adults, moderate alcohol intake decreases the risk of dementia," said Dr. Kaycee Sink, a geriatrician and senior author of the paper, which is being presented Monday in Vienna at an Alzheimer's Association conference. "As of yet, we still have no cure for Alzheimer's disease and other dementias, so it is important to look for things that might help people prevent the disease."

Drinking, however, was harmful for the senior citizens who started the study with mild cognitive impairment. For this group, consumption of alcohol in any amount was associated with faster rates of cognitive decline.

Dr. Laurel Coleman, a geriatrician in Maine and a member of the Board of Directors of the Alzheimer's Association, who was not involved in the research, said the study is significant.

"A 40 percent lower risk of dementia is a meaningful change," Coleman said. "This is really big." She added more research needs to be done to determine why alcohol might stave off dementia.
- CNN Newsroom

Alzheimer's studies tackle omega threes and alcohol

Alzheimer's Association — 2009-07-13

"Good Morning America" medical editor Dr. Tim Johnson has broken down brand new studies on Alzheimer's disease. and wants you to know what they mean.

Find out his thoughts on the new research below.

Alzheimer's and Omega Three Fatty Acids

The findings from an 18-month, government-backed study suggest taking supplements of docosahexenoic acid, or DHA -- an omega-3 fatty acid -- does not arrest Alzheimer's in people who have already developed the mind-robbing disease.

DHA is an omega three fatty acids that you get from eating certain fish like salmon and tuna, or from certain plants or supplements that include fish oil. In the past there have been some suggestions that this particular fatty acid might reduce the risk for Alzheimer's or even help treat it.

The research looked at 400 randomized patients. One group got a two gram dose of fatty acid every day. The other group got a placebo for 18 months. The results showed no difference in outcome between the two groups.

This is the best study done on Alzheimer's and DHA far and away.

Alzheimer's and Alcohol Intake

Experts at Wake Forest University School of Medicine in North Carolina examined and interviewed 3,069 people aged 75 or older -- most with no memory problems -- about their drinking habits and whether they drank beer, wine or spirits.

It looked for a correlation between people who drank one to two alcoholic beverages a day. Those people had a 40 percent less chance of developing dementia compared to abstainers.

The study, which was presented at the Alzheimer's Association 2009 International Conference, also found that those who had a mild impairment did not benefit from moderate alcohol consumption, and the impairment got worse with alcohol.

There are other benefits from moderate drinking. You can reduce your risk for heart disease, for example. But you shouldn't start drinking if you don't. Ten percent of people who start drinking become alcoholics. And more than one to two drinks daily can damage your brain and heart tissue.

Researchers looked at 50,000 veterans who were diagnosed with post traumatic stress disorder and 125,000 vets who were not diagnosed with PTSD.

The study, which was reported at the Alzheimer's Association 2009 International Conference on Alzheimer's disease, followed the veterans for seven years.

Vets who had been diagnosed with PTSD had a 1.8 times greater risk of developing Alzheimer's than those who did not have PTSD.

That's just one more reason to monitor these people carefully.
- ABC News

A daily tipple cuts dementia risk for healthy elderly

Alzheimer's Association — 2009-07-13

July 13 (Bloomberg) -- One or two alcoholic beverages a day may reduce an elderly person's risk of developing dementia by almost 40 percent, a study presented at the International Conference on Alzheimer's Disease in Vienna found.

The results show people aged 75 years and older reap the same benefits from alcohol as their middle-aged counterparts, the researchers said. They asked more than 3,000 adults how often they drank and examined them every six months for up to six years for signs of memory loss or mental decline.

The findings aren't a free pass for drinking among the elderly, the results showed. People who were already showing signs of memory problems deteriorated significantly faster if they drank alcohol, and the more they consumed the worse the symptoms became. Heavy drinkers, defined as those consuming more than 14 drinks a week, were almost twice as likely to develop dementia, researchers said.

"If you're already drinking, you don't need to cut back if you're cognitively healthy, but we don't have enough information to recommend you start drinking," Kaycee Sink, assistant professor of medicine at Wake Forest University School of Medicine in Winston-Salem, North Carolina, said during a press conference. "The benefits increase as people move from mild to moderate levels of drinking, and then start to decline."

Range of Benefits

Alcohol has a range of benefits, such as boosting good cholesterol, preventing blood platelets from clotting and prompting the production of chemicals that help memory, Sink said. When older people show signs of dementia, the benefits may be outweighed by the toxic effects of drinking, she said, emphasizing that the theory is unproven. Heavy drinking is associated with a range of problems, including smaller brain volumes and vitamin deficiencies, she said.

The study divided the group into four categories: those who abstained, light drinkers who had one to seven beverages a week, moderate drinkers at eight to 14 weekly drinks and heavy consumers who had more than 14 every week.

The participants had an average age of almost 80 years and most, 43 percent, didn't drink at all. One-third took a drink a few times a week, while the rest were moderate or heavy drinkers.

The moderate drinkers were most likely to benefit from their alcohol habits, with the risk of developing dementia lowered by 37 percent, according to the study.

"It's a nuanced message, and we need to take some care with that, especially given the large number of people with mild cognitive impairment that remain undiagnosed," William Thies, chief medical and scientific officer of the Alzheimer's Association, said in an interview. "Still, people are comforted by the fact that a drink or two a day is ok."
- Bloomberg

PTSD Associated with Higher Alzheimer's/Dementia Risk; Moderate Alcohol Consumption May Lower It

Alzheimer's Association — 2009-07-13

Also, Survey Shows Adults Don't Know Heart Risk & Alzheimer's Risk Are Related

Vienna, July 13, 2009 – Though discoveries about Alzheimer's disease risk factors are often in the news, adults do not know about the relationship between Alzheimer's disease risk and heart health, nor that physical activity can be protective against dementia, according to new research reported today at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD 2009) in Vienna.

Two additional studies reported at ICAD 2009 show higher Alzheimer's risk in veterans with post-traumatic stress disorder (PTSD), and lower Alzheimer's risk among adults who consume moderate amounts of alcohol.

"Your brain plays a critical role in almost everything you do: thinking, feeling, remembering, working, and playing – even sleeping," said Maria Carrillo, PhD, Director of Medical & Scientific Relations at the Alzheimer's Association. "The good news is that we now know there's a lot you can do to help keep your brain healthier as you age. These steps might also reduce your risk of developing Alzheimer's disease or another dementia."

"There's a strong and credible association between heart health and brain health. If people learn about and do some simple lifestyle modifications, such as being more physically active and eating a brain healthy diet, it could have an enormous impact on our nation's public health and the cost of healthcare," Carrillo added.

Adults Show a Poor Understanding of Alzheimer's Link to Heart Health Risk Factors

Colleen E. Jackson, M.S., a doctoral student in Clinical Psychology at the University of Connecticut, and colleagues conducted an anonymous online survey of 690 adults to measure "dementia literacy," that is, their knowledge and beliefs that may assist in the recognition, management, or prevention of Alzheimer's.

Mean age of the population was 50 years, the range was 30-85 years; 76% of respondents were female. Ninety-four percent (94%) of participants were from the United States, with the remaining 6% from other English-speaking countries. The sample was relatively wealthy, with 18% of respondents making more than $200,000 per year at the peak of their careers, and well-educated, with 87% of respondents having completed at least 1-3 years of college.

The researchers found that 64% of study participants incorrectly indicated no association between Alzheimer's and obesity or high blood pressure. Sixty-six percent (66%) did not know that high stress is a risk factor for dementia, and 34% did not know that physical exercise is a protective factor.

On the positive side, nearly all study participants (94%) correctly indicated that Alzheimer's is not normal aging, and is not completely based on genetics.

"Our data suggest that American adults have limited knowledge and a poor understanding of factors that have been demonstrated to increase risk for Alzheimer's, such as obesity, high blood pressure, and other heart health risk factors," Jackson said. "They also didn't know much about protective factors against Alzheimer's, such as physical exercise, relative to the strength of the available research evidence."

"We need more education programs and opportunities, across all demographic groups, focusing on behaviors that modify your risk for developing Alzheimer's disease," Jackson added.
- Alzheimer's Association

Vets with post-traumatic stress are at high risk of dementia

Alzheimer's Association — 2009-07-12

Veterans diagnosed with post-traumatic stress disorder (PTSD) have a significantly higher risk of developing dementia compared with veterans who don't have the disorder, a study reports today.

Using data from the Department of Veterans Affairs National Patient Care Database, scientists from the University of California-San Francisco analyzed files of 181,093 veterans ages 55 and older without dementia from 1997 to 2000. The mean age at the start of the study was 68, and 97% were male.

During the follow-up period from 2001 to 2007, the researchers learned that 53,155 veterans were diagnosed with dementia or cognitive impairment. Veterans who had post-traumatic stress developed dementia at a rate of 10.6% over seven years, while those who didn't have the disorder had a rate of 6.6%, the researchers reported.

The researchers reported their findings at the International Conference on Alzheimer's Disease in Vienna.

"The results are not surprising," says Robert Wilson, neuropsychologist in the Alzheimer's Disease Center at Rush University Medical Center. "Our thinking is that things like PTSD or chronic anxiety or depression don't cause dementia themselves but may make us more vulnerable to it."

Other research presented Sunday and today at the Alzheimer's conference:

Two separate studies evaluate the influence of DHA, an omega 3 fatty acid, supplements on brain health. The first study, which was government-funded, looks at DHA supplementation in patients with mild to moderate Alzheimer's and finds that the supplements offered no cognitive benefits to patients. The other, sponsored by a DHA maker, Martek Biosciences Corp., suggests supplements may help in healthy older adults who have mild memory loss.

Wake Forest University School of Medicine scientists find that moderate alcohol intake (one to two drinks a day) is linked to a 37% lower risk of dementia in patients with normal cognition at baseline, not those who already have cognitive impairment.

University of Connecticut scientists report that in an online study of 676 adults, many don't know the risk factors for dementia: 61% incorrectly believe there is no link between dementia and the cardiovascular risk factors obesity and high blood pressure; 66% do not know high stress is a risk factor; and 38% are unaware exercise protects against dementia.

The number of people who have Alzheimer's disease and dementia is increasing among the "oldest old," those over 80, Italian researchers report. The finding contradicts observational studies that suggested the number of people with dementia levels off and perhaps drops late in life.
- USA TODAY

New Cases of Alzheimer's and Dementia Continue to Rise, Even in the "Oldest Old"

Alzheimer's Association — 2009-07-13

New Research Shows that the Proportion of People with Alzheimer's and Dementia also Rises in the Oldest Age Groups

Vienna, July 13, 2009 – The number of people with Alzheimer's and dementia – both new cases and total numbers with the disease – continues to rise among the very oldest segments of the population in contradiction of the conventional wisdom, according to research reported today at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD 2009) in Vienna.

Previous epidemiological studies have suggested that the number of people with Alzheimer's and dementia begins to level off and perhaps even go down a bit in people age 90 and above, known as the "oldest old." This is the fastest growing segment of the population in western countries.

"The number of people affected by Alzheimer's and dementia is growing at an epidemic pace, and the skyrocketing financial and personal costs will devastate the world's economies and healthcare systems, and far too many families," said William Thies, Ph.D., Chief Medical & Scientific Officer at the Alzheimer's Association. "We must make the fight against Alzheimer's a priority before it's too late."

"However there is hope. There are many drugs in late stage clinical trials for Alzheimer's that show promise to slow or stop the progression of the disease. This, combined with advancements in early detection, has the potential to change the landscape of Alzheimer's in our lifetimes. But we need more funding for research to see these possibilities through to completion," Thies said.

The research reported at ICAD 2009 includes a study of more than 2,100 individuals age 80 years or older in eight municipalities of Varese province, Italy, and a systematic review and collaborative analysis of studies reporting the prevalence of dementia in Europe.

The Monzino 80-plus Study – Dementia Risk Continues to Rise in the "Oldest Old"

Ugo Lucca, head of the Laboratory of Geriatric Neuropsychiatry at the Mario Negri Institute for Pharmacological Research in Milano, Italy, and colleagues conducted a prospective, door-to-door, population-based study of all people age 80 years or older in eight municipalities of Varese province, Italy, roughly 30 kilometers (20 miles) north of Milan (known as the Monzino 80-plus Study). Their goal was to estimate the prevalence (total number with the disease) and incidence (new cases of the disease) of dementia in this population.
- Alzheimer's Association

Six Scientists Receive Awards for Contributions to Alzheimer's Disease Research

Alzheimer's Association — 2009-07-13

Vienna, July 13, 2009 – The Alzheimer's Association recognized four scientists for their extraordinary achievements in advancing Alzheimer's research at its 2009 International Conference on Alzheimer's Disease (ICAD 2009) in Vienna, Austria. Two top papers on neuroimaging were also recognized.

"We are beginning to reap the benefits of Alzheimer's scientific advancements made in the last two decades, including a robust pipeline of anti-dementia drug therapies and advances in early detection," said William Thies, PhD, Chief Medical & Scientific Officer at the Alzheimer's Association. "The contributions of these leading researchers will help us defeat Alzheimer's, solve the health epidemic of the 21st century, and save future generations from this progressive and fatal disease."

Lifetime Achievement Awards in Alzheimer's Disease Research

Henry Wisniewski, MD, PhD, Khalid Iqbal, PhD, and Bengt Winblad, MD, PhD, were the founders of ICAD in 1988. Lifetime Achievement Awards named in their honor are given to three outstanding scientists who have dedicated their careers to helping millions around the world through their research.

At ICAD 2009, the 2009 Henry Wisniewski Lifetime Achievement Award was presented to Richard Mayeux, M.D., M.S., Gertrude H. Sergievsky Professor of Neurology, Psychiatry and Epidemiology and Director of the Gertrude H. Sergievsky Center at Columbia University in New York City. The Center is devoted to the epidemiologic investigation of neurological diseases. Mayeux is also the Co-Director of The Taub Institute for Research on Alzheimer's Disease and the Aging Brain. For nearly 20 years, Mayeux has led studies that have provided the most current information on the rates of Alzheimer's and other age-related disorders among African–American, Caribbean Hispanic and Caucasian elderly. His research focuses on Alzheimer's disease causes and risk factors, and their often complex interactions, with special emphasis on diverse communities.

The 2009 Khalid Iqbal Lifetime Achievement Award was awarded to Virginia M.-Y. Lee, Ph.D., M.B.A., director of the Center for Neurodegenerative Disease Research at the University of Pennsylvania, School of Medicine. Dr. Lee's research focus includes determining the genesis and roles of various normal and abnormal brain proteins (amyloid, tau, etc.) thought to be the keys to the cause and progression of numerous brain diseases, including Alzheimer's.

The 2009 Bengt Winblad Lifetime Achievement Award was awarded to Martin Rossor, M.D., head of the Division of Neurology and Director of the Dementia Research Centre at the UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London. Dr Rossor's research includes studying familial Alzheimer's disease and familial frontotemporal lobar degeneration. Longitudinal studies of at risk individuals from affected families has helped identify the first clinical and imaging changes that signal the onset of disease.

Zaven Khachaturian Award

At ICAD 2009, William R. Markesbery, M.D., was recipient of the 2009 Zaven Khachaturian Award. This award, named in honor of Zaven Khachaturian, PhD, consultant, lecturer and author, recognizes an individual whose compelling vision, selfless dedication and extraordinary achievement has significantly advanced the field of Alzheimer science.

Dr. Markesbery is professor of Pathology and Neurology at the University of Kentucky, College of Medicine, and director of the Sanders-Brown Center on Aging. He has been a leader in uncovering the step by step development of Alzheimer's and the chain of events that leads to the disease. His research also includes studies of free radicals and other oxidative damage in Alzheimer's, and the various changes that happen in the brain in normal aging, mild cognitive impairment, and Alzheimer's.

Best Paper in Alzheimer's Disease Neuroimaging Awards

At ICAD 2009, Brian Bacskai, PhD, of Massachusetts General Hospital in Charleston is the winner of the 2009 Best Paper in Alzheimer's Disease Neuroimaging Award for his article entitled Ab Plaques Lead to Aberrant Regulation of Calcium Homeostasis In Vivo Resulting in Structural and Functional Disruption of Neuronal Networks. Dr. Backsai will receive $5,000.

Jennifer Whitwell, PhD, of the Mayo Clinic in Rochester, Minnesota is the winner of the 2009 Best Paper in Alzheimer's Disease Neuroimaging: New Investigator award for her paper entitled MRI correlates of Neurofibrillary tangle pathology at autopsy: a voxel-based Morphometry Study. Dr. Whitwell will receive $1,000.

For more information about Alzheimer's disease, ICAD or these awardees, please visit www.alz.org.
- Alzheimer's Association

Omega-3 fatty acid falls short in Alzheimer's trials

Alzheimer's Association — 2009-07-12

No significant benefits seen with DHA, either in terms of prevention or treatment

SUNDAY, July 12 (HealthDay News) -- Two trials that looked at whether the omega-3 fatty acid DHA might treat or prevent Alzheimer's disease have produced mixed results.

The studies were done because of "a long history of epidemiological studies that related fish consumption to cognitive function," explained Bill Thies, chief medical and scientific officer of the Alzheimer's Association. Fish is rich in DHA, but the research scheduled to be presented Sunday at the association's annual meeting in Vienna, Austria, used DHA derived from algae.

An 18-month study of people with mild to moderate Alzheimer's disease "did not show treatment benefit in the study population as a whole, and does not support use of DHA for treatment of Alzheimer's disease," said study author Dr. Joseph Quinn, an associate professor of neurology at Oregon Health and Science University.

However, Quinn added that there was "an encouraging analysis of a subpopulation of the larger study," showing a slower rate of decline in mental function among those who did not have the e4 version of the APOE gene. That version is known to increase the risk of developing Alzheimer's disease. Between 70 percent and 80 percent of people have that gene version, Quinn estimated.

Still, "we're not prepared to conclude that e4-negative people should be on DHA," Quinn said. "We don't know a mechanism that would account for a benefit in e4-negative people and we don't know if our exploratory analysis would be confirmed in future trials."

His study, funded by the U.S. National Institute on Aging, included 402 people, average age 76, with a daily dietary intake of less than 200 milligrams a day. Some took 2,000-milligram DHA supplements while others took a placebo. All underwent standard tests of mental function over the 18-month trial. The slower rate of decline seen in e4-deficient participants did not reach statistical significance.

The second study was a six-month trial of 900 milligrams a day of DHA in 485 people, average age 70, who did not have Alzheimer's disease but had mild complaints about memory loss. Those taking the supplement made fewer errors on one memory test.

That trial was funded by the Martek Biosciences Corp., which markets the DHA used in both studies.

The results indicate that DHA supplements are appropriate for "people who have very mild memory complaints, which applies to a large percentage of the population at this age," said Karin Yurko-Mauro, associate director of clinical research at Martek Biosciences. "We're not talking about a disease stage here."

The company is "looking at the potential for more trials," but is still evaluating data from the completed study, Yurko-Mauro said.

"The results are certainly interesting," Thies said. "There was some improvement in memory. Then you can get into a debate about what the real-world benefit would be of that improvement in memory."

What is needed, Thies said, is a major trial for people with no Alzheimer's disease but some memory problems. "DHA is a great candidate for such a trial because it is a food supplement that is currently available," he said.

Meanwhile, Thies said, "it is too early" to make a recommendation about use of DHA supplements to prevent loss of mental function. "You would want to see more information in normal people before you make a recommendation," Thies said. "In high doses, DHA does have side effects, so you would want to see a benefit to justify the risk you are taking. We need more work for that."
- HealthDay

Doctors Talk Frankly About What Encourages And Impedes Early Diagnosis Of Alzheimer's

Alzheimer's Association — 2009-07-12

Vienna, July 12, 2009 – A doctor's positive attitude to Alzheimer's diagnosis and their trusting, personal relationships with local dementia support service providers are powerful enablers for early diagnosis of Alzheimer's, according to new research reported today at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD 2009) in Vienna.

Current data suggests that less than 35 percent of people with Alzheimer's disease or other dementias have a diagnosis of the condition in their medical record (Boise et al., 2004; Boustani et al., 2005; Ganguli et al., 2004; Valcour et al. 2000). While there is currently no cure for Alzheimer's, early detection and diagnosis is critical to ensuring that people living with Alzheimer's have the power to plan their own healthcare and future, according to the Alzheimer's Association.

"By getting diagnosed late in the progression of the disease, opportunities are missed to make key decisions about treatment, care and, future planning. Being diagnosed early is vital to receiving the best help and care possible, living one's life to the fullest, and capitalizing on opportunities such as participating in clinical studies," said William Thies, PhD, Chief Medical & Scientific Officer at the Alzheimer's Association.

Dr. Nerida Paterson, Senior Lecturer in the Discipline of General Practice at the University of Newcastle, Australia, and colleagues are interviewing more than 100 general practitioners (GPs) from four Australian research sites, taping and transcribing the interviews, and analyzing the content for themes and insights that can improve the diagnostic process.

"Increasing evidence suggests that early diagnosis of Alzheimer's and timely intervention is beneficial, both for people with the disease and their caregivers," Paterson said. "Because doctors are the primary entry way to healthcare services for the elderly and the usual point of contact with the health system for individuals with dementia and their caregivers, there remains a need to overcome their attitudes of 'therapeutic nihilism' surrounding dementia."

According to Paterson, "therapeutic nihilism" is a belief that there is no recognized cure or effective treatment for an illness, and therefore treatment or intervention in any form is not important.

At ICAD 2009, Paterson reported an interim analysis including interviews with 25 GPs.

The most cited enabler to early Alzheimer's diagnosis is a doctor's positive attitude to the diagnosis and treatment of dementia. In addition, GPs reported that having a trusting, personal relationship with individuals who provide dementia support services is a powerful enabler for dementia diagnosis and management. Most of the GPs reported that referral to support services for legal and financial planning, patient education, and caregiver support is an important part of disease management.

Additional factors that encourage early Alzheimer's diagnosis include: support from relatives and caregivers, belief in the patient's right to know, and the desire of GPs to be honest and open with their patients.

According to the researchers, the most frequently cited barriers to diagnosis of dementia in this study are that patients and GPs have differing health priorities, GPs are largely dependent on being alerted by either the patient or a relative about symptoms of memory loss, and GPs' challenges with properly timing referral to support services. Also reported by GPs was fear of damaging the doctor-patient relationship, especially around the issue of declaring the patient's inability to drive safely.

"Older patients frequently have complex and overlapping illnesses involving multiple body systems. Often these diseases are having a bigger impact on their day to day lives than mild cognitive impairment. As a result, when they see the doctor, their priority is to have their non-cognitive health needs addressed," Paterson said.

According to the study, this is especially true if the person is also a caregiver. GPs reported that caregivers tend to downplay their own needs and behave as though they cannot afford to become ill and give up their caregiving role. They reported that caregivers spend most of their appointments discussing the person for whom they are a caring, and not their own health needs.

If a patient appeared to be functioning well, GPs in this study were less likely to suspect cognitive impairment. GPs reported that a cognitive deficit is more often brought to their attention by a relative or caregiver than by the patient; an informant is seen as vital for early diagnosis.

GPs also identified that they find it difficult to remember to re-offer referral to Alzheimer's support services to patients and caregivers. GPs generally suggest these services soon after the diagnosis is made. However, patients and caregivers are still adjusting to the diagnosis at this time and may be suffering from denial, anger and guilt and often reject the referral. When they are ready to accept support, the GP is often unaware that their attitude has changed.

The researchers recommend that doctors should be educated to have a higher level of suspicion for symptoms of cognitive decline, especially in caregivers and people with complex, multi-system diseases, and that GPs should offer referrals to support services for people with dementia and caregivers on multiple occasions during the diagnostic and treatment process.

A literature review on early diagnosis of dementia and diagnostic disclosure in primary care conducted by the same researchers and also presented at ICAD 2009, reinforced these themes and suggested that the involvement of practice and community nurses in the diagnostic process may overcome some of the barriers and improve detection rates.
- Alzheimer's Association

DHA supplements get mixed results in memory studies

Alzheimer's Association — 2009-07-12

Taking DHA, an omega-3 fatty acid, does not appear to benefit people with mild and moderate Alzheimer's disease, according to new government-funded research presented today. However, another study by a supplement maker in healthy older adults suggests DHA supplementation might be helpful.

On Sunday, at the International Conference on Alzheimer's Disease, in Vienna, scientists presented studies which examined whether there is a benefit to memory from taking DHA, docosahexaenoic acid, a fatty acid which occurs naturally in the body in small amounts and is abundant in fatty fish.

Previous animal and observationalstudies have suggested DHA improves memory, and because it's safe to take, scientists have been investigating its impact in Alzheimer's and aging patients, says William Thies, chief medical and scientific officer at the Alzheimer's Association.

The Alzheimer's Disease Cooperative Study (ADCS), supported by the National Institute on Aging, was an 18-month trial conducted on Alzheimer's patients with mild to moderate disease in which patients took supplements of a microalgae rich in DHA. The double-blind, randomized, placebo-controlled trial included 402 participants.

At the study's start, all of the participants had a dietary DHA intake of less than 200 mg per day. Over a year-and-a-half period, subjects either received a daily 2,000 mg dose of the DHA supplement or a placebo.

The results showed no cognitive benefit in the Alzheimer's patients: no differences were seen on three dementia tests that included evaluation of behavioral symptoms and the ability to perform daily living tasks.

In the second DHA study, also presented Sunday at the conference, DHA maker Martek Biosciences Corporation, who made the supplement used in both studies, said 485 healthy older adults with mild memory issues, not people with Alzheimer's or any other form of dementia, took 900 mg of the supplement every day for six months.

The researchers report that after six months, the participants who took the supplement made significantly fewer errors on memory tests than those who took a placebo.

"In our study, healthy people with memory complaints who took algal DHA capsules for six months had almost double the reduction in errors on a test that measures learning and memory performance versus those who took the placebo," says researcher Karin Yurko-Mauro, associate director of clinical research at Martek. She says the benefit is equal to having the learning and memory skills of someone three years younger.

A notable drop in heart rate was also observed in the DHA group.
- USA TODAY

Omega-3 no match for Alzheimer's, study finds

Alzheimer's Association — 2009-07-12

CHICAGO, July 12 (Reuters) - Omega-3 fatty acid supplements did nothing to slow memory declines in people with mild to moderate Alzheimer's disease, but a study in healthy people with slight memory complaints did show promise, U.S. researchers said on Sunday.

"These trial results do not support the routine use of DHA for patients with Alzheimer's," Dr Joseph Quinn of Oregon Health and Sciences University in Portland, who led the study, said in a statement.

But a six-month company study that looked at people whose memory was slipping just a bit found Martek Biosciences Corp's (MATK.O) DHA supplements helped restore some of the mental acuity they had lost.

"The benefit is roughly equivalent to having the learning and memory skills of someone three years younger," Martek researcher Karin Yurko-Mauro said in a telephone interview.

Both studies, which are being presented at an international Alzheimer's Association meeting in Vienna, Austria, show the difficulty of treating Alzheimer's disease, which causes memory loss, confusion, the inability to care for oneself and eventually death. It affects 26 million people globally.

Taken together, the findings along with other studies suggest treating Alzheimer's must begin early in the disease process, before sticky amyloid plaques begin forming toxic clumps in the brain.

"It may be that ... by the time you have Alzheimer's disease, it is too late," Dr Ronald Petersen, director of Alzheimer's research at the Mayo Clinic in Rochester, Minnesota, said in a telephone interview.

HIGH HOPES

Plenty of studies in both mice and people had suggested that a diet rich in DHA -- an omega-3 fatty acid found in fatty cold-water fish -- could dramatically slow Alzheimer's disease, and hopes were high for DHA as a possible new treatment.

DHA is naturally found in the body in small amounts, and is the most abundant omega-3 fatty acid in the brain.

In the Alzheimer's study supported by the National Institute on Aging, Quinn and colleagues compared Martek's DHA supplements to a placebo in 402 people with mild to moderate Alzheimer's. Although blood levels of DHA increased, the team saw no change in two widely accepted Alzheimer's tests.

But the study did suggest some benefit in people with Alzheimer's who do not have the ApoE4 gene, which raises their Alzheimer's disease risk. Quinn called the finding "intriguing" because other trials have shown different response rates based on this gene, and said future studies should look at this.

In the six-month Martek study, researchers looked at the effects of a 900 mg daily dose of DHA on 485 healthy people with an average age of 70 who had a mild memory complaint. People in this study were tested using a computer memory test.

At the end of six months, those who took DHA made far fewer mistakes than those in the placebo group. The effect was "almost double," Yurko-Mauro said.

Petersen, a former vice chairman of the Alzheimer's Association, said the study was promising, but needs to be confirmed before healthy people start taking DHA supplements.

"The association is not recommending normal elderly people take DHA based on this study," he said.
- Reuters

Results From Trials of DHA In Alzheimer's Disease And Age-Related Cognitive Decline

Alzheimer's Association — 2009-07-12

Results from two large studies using DHA, an omega 3 fatty acid, were reported today at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD 2009) in Vienna. One trial was in people with mild to moderate Alzheimer's disease, the other in healthy older adults who were experiencing mild memory problems.
- Alzheimer's Association

Three New Studies Give Clear Guidance On How To Better Recruit Volunteers For Alzheimer's Clinical Studies

Alzheimer's Association — 2009-07-12

Partnering with local physicians, working with local clinics, and conducting educational seminars and health fairs were found to be the most effective tools in recruiting people for Alzheimer's clinical studies, according to new research reported today at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD 2009) in Vienna.
- Alzheimer's Association

Language skills may guard against Alzheimer's

Alzheimer's Association — 2009-07-09

Women with greater language abilities in early adulthood were less likely to have Alzheimer's disease later in life, even when autopsies revealed the clear brain changes that are hallmarks of the disease.

Also, the brains of women without symptoms of Alzheimer's housed bigger neurons, according to a study appearing in the July 9 online edition of Neurology.

"We noticed that the neurons in this group of people are larger and we also know that the same group of people we call asymptomatic also had higher language skills during their 20s," said study author Dr. Diego Iacono, a research fellow in neuropathology at Johns Hopkins University in Baltimore.

It's possible that the larger neurons compensated for the brain plaques and tangles that are usually indicative of Alzheimer's, the authors stated.

The findings could also mean that language abilities in the early 20s can predict the risk of developing dementia several decades later.

A previous study, this one in men, also found larger neurons in individuals who had plaques and tangles but no clinical evidence of Alzheimer's.

For the current study, researchers examined the brains of 38 deceased Catholic nuns, part of the ongoing Nun Study.

Women were divided into two groups: those with symptoms of memory loss along with plaques and tangles and those with no memory loss whether or not they had plaques or tangles.

Essays written by the women when they first entered the convent in their late teens or early 20s were analyzed for richness of language skills, including how many ideas were expressed per 10 words, number of verbs and adjectives in one sentence and more.

Women without memory problems scored 20 percent higher on language tests (though not grammar tests) than did women with memory issues. "We think this percentage could be higher if we could increase the sample size of the subjects to examine. We are working on that," Iacono said.

"The novelty is that these people were normal [cognitively] but they have Alzheimer's disease pathology like the people with dementia," Iacono said. "It's amazing that, even though you have a certain amount of pathology in your brain, you are not demented. You have some protective mechanism."

It's not clear whether that protection comes from genetic factors or from more studying during the first two decades of life, although it does fit with the "cognitive reserve" theory.

"The idea is that we have a sort of cognitive reserve that we start to increase during our second and third decades of life, and you can spend this reserve when you get older," Iacono explained. "In this way, you can avoid the manifestation of dementia even if you have some pathology. This is something we didn't expect."

"This is the second independent sample with the same result. We're back to the metaphor of the brain as a computer and a muscle," said Dr. Gary J. Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City. "In volunteers who had no signs of Alzheimer's but did have the plaques and tangles, the neurons were actually larger and more functional with more connections."

The paper also showed an increased risk for cognitive impairment in people with the APOE4 gene and a protective effect in those with the APOE2 gene.

The authors are now investigating to see if they can show a connection between the language skills and these particular genes.
- HealthDay

Living alone increases odds of developing dementia

Alzheimer's Association — 2009-07-06

Middle-aged adults who live alone are twice as likely to develop dementia or Alzheimer's disease later in life compared to those who are married or live with a partner. And the risk is three times higher among those who are divorced or widowed, according to a new study by Swedish and Finnish researchers.

The study included 2,000 men and women in Finland who were initially surveyed when they were about 50 years old and again 21 years later.

In addition to looking at the association between marital status and dementia, the researchers also examined the link between living alone and being a carrier of the apolipoprotein E e4 gene variant, a known risk factor for Alzheimer's disease.

The study found the highest risk of developing Alzheimer's disease among people with the gene variant who live alone after losing their partner.

The findings add to a growing body of evidence that shows that social factors play an important role in brain health, and indicate that "supportive intervention for individuals who have lost a partner might be a promising strategy in preventive health care," according to Dr. Miia Kivipelto, of the Karolinska Institute in Sweden, and colleagues.

The study, which appears online July 2 in the BMJ, is one of the first to examine mid-life marital status and dementia risk.

In an accompanying editorial, epidemiologist Dr. Catherine Helmer of Victor Segalen University in Bordeaux, France, noted that the study strengthens the theory that cognitive impairment and dementia are affected by various factors throughout life and develop over a long period of time.

The findings could lead to preventive strategies that encourage unmarried people to boost their social involvement by taking part in community, cultural and sporting activities, Helmer said.
- HealthDay

Longtime music executive passes away with Alzheimer's

Alzheimer's Association — 2009-07-06

Allen Klein, a music executive who managed the business affairs of Sam Cooke, the Rolling Stones and, for a short time, the Beatles, and who was both admired and feared for his reputation as a fierce negotiator, died on Saturday in Manhattan, where he lived. He was 77.

The cause was complications from Alzheimer's disease, said Bob Merlis, a spokesman for Mr. Klein's company, Abkco Music and Records.

Mr. Klein rose from humble origins to become a powerful figure in the music business. Born in Newark, he spent much of his childhood in an orphanage, and graduated from Upsala College in East Orange, N.J., with a degree in accounting and a keen appreciation of the value of a dollar. At the invitation of one of his college friends, Don Kirshner — who would go on to become a successful music publisher and record executive — Mr. Klein began to work in the music business. He gained a reputation early on as an effective sleuth who could root through record companies' books on behalf of artists and find thousands of dollars in unpaid royalties.

In the early 1960s, he performed those miracles of accounting for Bobby Darin and Cooke. He also became Cooke's manager, negotiating an usually favorable deal with RCA Records that gave the singer a strong royalty rate and the rights to his own recordings. By the height of the British Invasion of the mid-1960s, Mr. Klein was rapidly acquiring clients in England, among them Mickie Most, who was the producer of the Animals, Herman's Hermits and many other groups.

In 1965, Mr. Klein was hired by the Rolling Stones' young manager, Andrew Loog Oldham, to handle the band's business affairs. With his working-class New Jersey accent and aggressive, direct negotiating style, Mr. Klein convinced the Stones, as he would many other musicians, that he would be a powerful advocate.

"Andrew sold him to us as a gangster figure, someone outside the establishment. We found that rather attractive," Mick Jagger was quoted as saying in Stephen Davis's 2001 book, "Old Gods Almost Dead: The 40-Year Odyssey of the Rolling Stones."

For the Stones and others, though, Mr. Klein was sometimes also an adversary. He negotiated a new deal for the band with Decca, its label at the time, but soon bought the rights to both the band's recordings and its publishing. The band would later sue for their return, without success. (The Stones settled with Mr. Klein in 1984.) Through Abkco, Mr. Klein retained control of the band's music before 1971, when the group formed its own record company, Rolling Stones Records.

In 1969, Mr. Klein began to work with the Beatles, as that band was beginning to splinter apart. According to some accounts, he urged John Lennon not to announce that he wanted to quit because it would jeopardize Mr. Klein's negotiations with E.M.I. over royalties. A highly favorable royalty rate was achieved, and shortly afterward, the Beatles broke up, although Mr. Klein continued to work with Lennon and, for a time, George Harrison. He was a producer of the concerts for Bangladesh, with Harrison, Bob Dylan, Eric Clapton and others, at Madison Square Garden in 1971.

Mr. Klein was convicted of tax fraud in 1979 and served two months in prison for failing to report income from sales of promotional records, according to the Associated Press.

Abkco owns the rights to many recordings by the Stones, Cooke and others, and administers many more. Mr. Klein also worked as a producer on the films "The Holy Mountain" in 1973 and "The Greek Tycoon" in 1978, as well as on a number of Italian spaghetti Westerns.

Mr. Klein is survived by his sister, Naomi; his longtime companion, Iris Keitel; his wife, Betty, with whom he had not lived with for many years; two daughters, Robin and Beth; a son, Jody; and four grandchildren.
- New York Times

Cognitive tests a "first step" to Alzheimer diagnosis

Alzheimer's Association — 2009-06-30

The sooner someone is diagnosed with dementia, the better.

Increasingly, that's the mantra of experts in Alzheimer's disease, a condition that robs people of their memories and ability to think.

The Alzheimer's Association is highlighting the message in a new media campaign that began last month on television and is continuing with print ads in local markets.

How does this work? And why deliver a diagnosis of Alzheimer's, an incurable condition that many older people fear, sooner rather than later?

If a family member is becoming confused and forgetful much more often, experts recommend a brief test that can suggest potential dementia. (For 10 possible warning signs of dementia, go to the Alzheimer's Association Web site, alz.org.)

The most common is the Mini Mental State Exam, which asks takers to name several objects, identify the year, date and season, and count backward, among other tasks.

Limitations of the exam include its length and relatively poor ability to identify people with mild cognitive impairment, explained William Thies, chief medical office for the Alzheimer's Association. Mild cognitive impairment is often a precursor to dementia.

A new test by researchers in Britain, called Test Your Memory, may become an alternative. In a recent article in the British Medical Journal, researchers reported the five-minute, self-administered exam detected 93 percent of patients with Alzheimer's.

These brief cognitive tests are "a first step," said Dr. Raj Shah, an Alzheimer's expert at Rush University Medical Center in Chicago. Further evaluation involves ruling out other conditions that can compromise memory, such as stroke or depression, and taking a thorough history with the person and a family member.

Often, more extensive cognitive testing will also be ordered. "It's unrealistic to expect a very brief test to discriminate between normal aging and mild cognitive impairment," said Dr. Ronald Petersen, head of the Mayo Clinic's Alzheimer's Disease Research Center.

What's the value of a diagnosis?

People with mild cognitive impairment or early-stage Alzheimer's can make lifestyle changes -- exercise more, eat diets rich in vegetables and fish, engage in cognitively stimulating activities -- that may improve their quality of life, Shah said.

Also, people who receive diagnoses early can participate in decisions about their treatment and connect with community resources. For instance, those newly diagnosed could put their financial affairs in order or get counseling for depression.

It's important to note that the Food and Drug Administration hasn't approved any medications for use in people with mild cognitive impairment. Researchers have tested drugs commonly used to treat Alzheimer's in these patients, but results are inconclusive, Petersen noted.

With Alzheimer's disease, the medications produce a slight benefit -- a relief of some symptoms for 6 to 12 months for about half of people who take them. No medication has been shown to alter the disease's progression.

For all the emphasis on early detection, many people may not want to know they're at risk for Alzheimer's disease. Indeed, almost two-thirds of people with dementia haven't received a diagnosis, the Alzheimer's Association reports. Currently, 5.3 million Americans are living with Alzheimer's disease.
- Chicago Tribune

Do I want to know if I have Alzheimer's?

Alzheimer's Association — 2009-05-27

The answer is "yes." An estimated 5.3 million Americans suffer from Alzheimer's Disease, the majority - 5.1 million - over the age of sixty five. Research suggests that less than 35 percent of people with Alzheimer's or other dementias are properly diagnosed. Early diagnosis is crucial for many reasons, including:

1) There are medications available today that can reduce symptoms in many people - at least temporarily - and improve the daily lives of patients. There are also trials of new drugs that researchers hope will slow or stop the underlying processes that cause Alzheimer's in the first place.

2) Knowing what's going on can lessen anxiety and allow for planning - not only for patients but for their families, friends, and caregivers.

3) Although Alzheimer's causes 60-80 percent of dementia in patients over 65, there are other causes that need to be considered, especially potentially reversible ones due to medications, alcohol, low thyroid, low B12, depression, and infections. Dementia can also be caused by tumors, increased pressure, blood clots and other abnormalities within the head itself that can be detected by a CT or MRI of the brain. And patients with "vascular dementia" due to problems such as multiple small strokes (that may not have caused any other symptoms) can be treated with measures that include medications and lifestyle adjustments to lower their cardiovascular risk.

The Alzheimer's Association is a terrific resource for information about Alzheimer's and other forms of dementia. Its website includes ten warning signs for Alzheimer's Disease.
- CBS News

Early Alzheimer diagnosis reduces costs

Alzheimer's Association — 2009-05-27

The way to fight Alzheimer's disease is to intervene decades before someone demonstrates symptoms, U.S. researchers suggest.

"The future of this disease is to intervene decades before someone becomes symptomatic. This analysis says you can save literally billions of dollars in long-term care costs if you can intervene at an earlier stage," study co-author David Weimer of the La Follette School of Public Affairs said in a statement. "What you don't know costs a lot of money when it comes to this disease."

The researchers analyzed two types of interventions following diagnosis -- patient drug treatment and caregiver-support programs.

The study, published in the Alzheimer's & Dementia: The Journal of the Alzheimer's Association, found each intervention provides positive net savings, with the greatest benefits achieved using a combination of both.

Currently, Medicare does not support caregiver-intervention programs and even accounting for implementation costs, the analysis suggests it would result in net savings to governments by reducing the care burden on medical systems.

The Wisconsin Medicaid program spends almost $500 million each year on nursing home care for 11,000 dementia patients -- a tiny fraction of the estimated 160,000 affected people in the state, but caregiver support is sparse, Mark Sager of the University of Wisconsin-Madison School of Medicine and Public Health said.
- United Press International

Alzheimer's impact on families

Alzheimer's Association — 2009-05-22

Misplacing things and having lapses in judgment may indicate Alzheimer's, says Dr. Jennifer Ashton, who talks to Julie Chen about the disease's impact on families.- CBS Early Show

Related information: Know the 10 Signs >>

Recognizing Alzheimer's

Alzheimer's Association — 2009-05-20

Dr. Jennifer Ashton talks to Julie Chen about the outward warning signs of Alzheimer's disease and takes a look inside a brain suffering from the disease.- CBS Early Show

Related information: Know the 10 Signs >>

Warning signs of Alzheimer's

Alzheimer's Association — 2009-05-18

Harry Smith spoke with Dr. Jennifer Ashton about easy-to-spot early warning signs of Alzheimer's disease.- CBS Early Show

Alzheimer's Association launches new Know the 10 Signs: Early Detection Matters education campaign

Alzheimer's Association — 2009-05-17

The Alzheimer's Association has kicked off its Know the 10 Signs: Early Detection Matters campaign, a multi-faceted national education effort to increase awareness of the 10 warning signs of Alzheimer's and the benefits of early detection and early diagnosis. Early detection, diagnosis and intervention are vital because they provide individuals the best opportunities for treatment, support and planning for their future.

Updated warning signs help with early detection
As part of its public education effort, the Alzheimer's Association has worked with a wide range group of experts to update its 10 warning signs of Alzheimer's to make them more current and user-friendly. The comprehensive review process included feedback from health professionals, clinicians, scientists and people with dementia.

See new print ads by going to: http://www.alz.org/news_and_events_16726.asp

The Alzheimer's Association
The Alzheimer's Association is the leading voluntary health organization in Alzheimer care, support and research. Our mission is to eliminate Alzheimer's disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer's. For more information, visit www.alz.org.- Alzheimer's Association

Alzheimer's Association statement on care coordination

Alzheimer's Association — 2009-05-13

As the leading research and advocacy organization for Alzheimer's disease, the Alzheimer's Association commends Sens. Blanche Lincoln (D-Ark.) and Susan Collins (R-Maine) and Rep. Gene Green (D-Texas) for their leadership in offering the Reaching Elders with Assessment and Chronic Care Management and Coordination Act (S. 1004 and H.R. 2307), which seeks to improve the coordination of care for the growing elderly population with multiple chronic conditions.

This legislation is especially significant for people with Alzheimer's disease and other dementias because most have one or more other serious medical conditions and as a result incur high healthcare costs.

As the current Medicare program focuses primarily on treatment of acute episodes of illness and one specific disease or condition at a time, it doesn't adequately meet the needs of beneficiaries who have dementia and other multiple chronic conditions. With an aging baby boomer generation at greater risk for developing Alzheimer's disease, it is important to address this issue now before these numbers climb higher.

This legislation is a tremendous first step in substantially improving the healthcare delivery system while lowering costs for Medicare beneficiaries with multiple chronic conditions by providing much needed assessment and care coordination necessary for these expanding populations.

According to the Alzheimer's Association's 2009 Alzheimer's Disease Facts and Figures report, there are 5.3 million Americans living with Alzheimer's disease today and most have other chronic conditions. For example, in 2004, 26 percent of Medicare beneficiaries aged 65 and older with Alzheimer's and other dementias also had coronary heart disease; 23 percent also had diabetes; 16 percent also had congestive heart failure; and 13 percent also had cancer.

Cognitive impairment caused by Alzheimer's and other dementias greatly complicates the management of these other conditions, resulting in more hospitalizations, longer hospital stays and higher costs than those with these same conditions but no Alzheimer's disease.

The 2009 Facts and Figures report also highlights Medicare claims data that illustrates the results of combined dementia and co-morbid medical conditions. In 2006, for example, Medicare beneficiaries with diabetes plus Alzheimer's or another dementia had 64 percent more hospital stays than those with diabetes and no Alzheimer's, and their average per-person costs were $20,655, compared to $12,979 for beneficiaries with diabetes but no Alzheimer's or dementia.

The Alzheimer's Association urges congressional members to co-sponsor and eventually pass this important legislation.

The psychological toll of early-onset Alzheimer's

Alzheimer's Association — 2009-05-13

Lisa Carbo knew something was wrong. The former registered nurse from Metairie, La., began experiencing difficulty in remembering how to perform various functions at her job. Multitasking became harder. Eventually she was written up for poor performance, prompting her to seek medical help.

Carbo was diagnosed with early onset Alzheimer's disease in November 2007, at the age of 53.

Before her Alzheimer's diagnosis, Carbo had plans for her golden years. "I hoped to semi-retire, spend the rest of [my] life with someone, continue to be productive, travel," she said. "I love animals, I had planned to do a lot more volunteering with animal shelters."

Her diagnosis changed everything: She lost her job and her boyfriend left her. "All those hopes and dreams are smashed. They're all gone. It's like everything that you planned on for your life is gone."

Fortunately for Carbo, she was able to find help to deal with the depression brought about by her diagnosis. She began taking antidepressants and started seeing a therapist.
- Abcnews.com

Alzheimer's Association statement on the Medicare Trustees Report

Alzheimer's Association — 2009-05-13

The Medicare Trustees Report makes it clear that we must act quickly to stave off unsustainable costs to Medicare. We must take the necessary steps now to protect Medicare for future generations. In just two short years, the first wave of baby boomers becomes eligible for Medicare. According to the recent Alzheimer's Association's 2009 Facts and Figures Report, Medicare currently spends three times more for people with Alzheimer's and other dementias than for other Americans age 65 and older.

Today there are 5.3 million Americans living with Alzheimer's and as many as 16 million will have the disease by mid-century. As the nation's lawmakers contend with the best way to reform the country's health care system – Medicare is front and center. With an emerging baby boomer generation at higher risk for developing the disease, there is no clearer public health crisis or threat to Medicare than Alzheimer's disease.

Connecting the dots is simple. Controlling soaring Medicare costs is fundamental to getting the nation's fiscal health back on track. The impact of growing number of people with Alzheimer's on these costs is a clear obstacle to this objective. The nation is facing unprecedented economic challenges. The potential insolvency of Medicare in just eight years makes finding effective treatments to end or delay the progression of Alzheimer's even more urgent - especially with 10 million baby boomers at risk to develop the disease.

The most significant way to reduce Medicare costs now and in the future is to immediately increase the investment in federally-funded medical Alzheimer research. For the last several years, government funding for Alzheimer research has been woefully inadequate, especially considering the ballooning impact the disease will continue to have on Medicare.

Accelerating research would be a most prudent investment of federal dollars – for millions of retiring baby boomers, and for the viability of Medicare trust funds. Effective treatments for Alzheimer's can save millions of lives and billions of dollars for Medicare and the latest Medicare Trustees Report underscores the fact that we must act today.
- Alzheimer's Association

Maria Shriver on Larry King

Alzheimer's Association — 2009-05-08

Maria Shriver talks to CNN's Larry King about her upcoming documentary, "The Alzheimer's Project."
- CNN

The disease that steals yourself

Alzheimer's Association — 2009-05-08

The 10 warning signs listed online by the Alzheimer's Association include not recognizing oneself in the mirror and giving large amounts of money to telemarketers. Also, Cognitivelabs.com offers free instant memory tests, but the scoring system at the end can be confusing. These tips are offered here because it is almost impossible to watch even a portion of "The Alzheimer's Project" on HBO without worrying. Many viewers will be tempted to search the Internet or call 877-IS IT ALZ in a sudden panic over blank spells: "Did I already take my Lipitor?" and "That funny blond actress, you know, the one in that old movie about Washington with the guy who was in 'Picnic'?" (Judy Holliday, "Born Yesterday," William Holden.)

Memory loss is a terrifying prospect, and "The Alzheimer's Project," a sober, deeply affecting four-documentary series on HBO that begins on Sunday, seeks to comfort and encourage those whose worst fears turn out to be true.

The project was made in collaboration with the National Institute on Aging of the National Institutes of Health, which provided scientific information and guidance, but the filmmakers had the final word on editing. And HBO chose as its marketing motto "HOPELESS," printed with a big purple X over the "LESS." The message conveyed by "The Alzheimer's Project" is that a breakthrough — in prevention and treatment, and even possibly a cure — is at hand.

In interviews some of the most eminent scientists in the field exude enthusiasm and optimism. Dr. Paul Aisen, a neuroscientist who heads the Alzheimer's Disease Cooperative Study at the University of California, San Diego, says, "There's a sense of excitement in the field of drug development for Alzheimer's disease that I think is beyond anything else in health care now."

Neither he nor the filmmakers deliver many caveats about the long, bumpy road from clinical trial to prescription pad. At times the collective exuberance is so persuasive that viewers have to remind themselves that there is as yet no way to prevent the disease or even slow its progress.

And that's a problem. It suggests that "The Alzheimer's Project" comes with an implicit agenda of morale boosting — and fund-raising — that could compromise a balanced understanding of this frightening and complicated disease.

HBO has undertaken public-service programming before in documentary projects like "Addiction" and "Cancer: Evolution to Revolution." This one is the most ambitious to date, a multiplatform event with offshoots on all the HBO channels as well as Facebook and YouTube; the project's Internet site (hbo.com/alzheimers) also offers 15 short films, culled from material that was edited out of the main documentaries, and PublicAffairs published a companion book, "The Alzheimer's Project: Momentum in Science," in May.

The documentary series itself is made up of four separate films by different directors and producers. "The Memory Loss Tapes," "Grandpa, Do You Know Who I Am?" and "Caregivers" focus on patients and their families, while the two-part "Momentum in Science" explains the advances in scientific research.

One likely reason the project's creators were so intent on a sunny view of Alzheimer's in the future is that the portraits of the disease as it is lived now are so harrowing. In "The Memory Loss Tapes," on Sunday, Joe Potocny, 63, a retired computer programmer in California, seems to be doing O.K. under the circumstances. He writes a blog about living with Alzheimer's, has a supportive wife and a sense of humor, and seems to be holding onto his identity, even though, as he puts it, "I used to be a genius, and now I'm not." His mind is slowly falling away, however, "in slices." In one scene he tells his doctor that he won't let himself succumb completely.

"I told Lynn and the kids when it gets to the point to where I — I feel that I'm stepping over the line, going to become totally a different person, that they would all be — be given a hug and a kiss and said goodbye to, and I will leave," he says defiantly. "There'll be no way to save me. There'll be no gun, there's other ways to do it that are 100 percent sure within seconds."

Joe isn't typical, because no case is typical. The men and women who are showcased in the film are very different in age, background, attitude and degree of infirmity. The film begins with a cheerful, energetic 87-year-old woman in Wisconsin who is only beginning to lose track of her thoughts and closes with a 79-year-old man, a former magician and host of a local children's television show, on his death bed.

The Institutes of Health estimate that as many as five million Americans may have Alzheimer's, but that number doesn't reflect the families, friends and health care professionals who live with the disease as well. The film examines in depth the sacrifices made by patients' families.
- The New York Times

Review: "The Alzheimer's Project"

Alzheimer's Association — 2009-05-08

"The Alzheimer's Project" is an ambitious, disturbing, emotionally fraught and carefully optimistic four-part documentary exploring virtually every angle of Alzheimer's disease that can be explored on television. Interviewed and filmed by the same team that produced HBO's "Addiction" project, patients and their families, scientists and doctors, caregivers and advocates are all given an opportunity to speak, often with heartbreaking details of their lives and the impact Alzheimer's has had on them.

That this will resonate with millions of viewers is indisputable -- as many as 5 million Americans have Alzheimer's, and as the baby boomers age, some predict that number could more than double. That much of the documentary is difficult to watch is equally so, particularly the first part, which debuts on Sunday.

In "The Memory Loss Tapes," we meet seven people in various stages of the disease. Though 87-year-old Bessie Knapmiller is becoming increasingly forgetful, she is still feisty and active. Yolanda Santamartino, 75, is in a far darker place. Her closest friend in the resident facility in which she lives is her own reflection -- whom she berates for never coming to visit. Plagued by visions of snakes, surrounded by other similarly beset patients, she declares, in a rare moment of clarity, that "this is no life."

So while it's heart-wrenching, it's not surprising that at 63, Joe Potocny, who was diagnosed two years ago, plans to kill himself when he feels he has become someone he no longer recognizes. In one scene, he shows his wife the box which he has chosen to contain his ashes.

For those who have only a theoretical understanding of the illness, "The Memory Loss Tapes" provides a spine-straightening revelation. For those who have lost someone, either physically or mentally, to Alzheimer's or dementia, it may be excruciating to watch.

Certainly there are moments of beauty and grace: Once a painter, Josephine Mickow, 77, composes visual vignettes that her daughter photographs in what may be their final form of real communication; endlessly cheerful, Woody Geist, 78, does not remember his wife yet he can still sing all the old songs.

But there is no Michael J. Fox of Alzheimer's, no Christopher Reeve to showcase the conquering human spirit. While even the most tragic physical limitations can leave a person essentially intact, Alzheimer's strips away precisely what makes a human body a person, until there is nothing left but an empty outline where your mother or brother once was.

In "Grandpa, Do You Know Who I Am?," which airs on Monday, Maria Shriver, one of the more sugar-coating-averse individuals of our time, gets straight to the point: How does one handle having a parent or grandparent who is no longer the person they were? Her own father, the indomitable Sargent Shriver, was diagnosed years ago and the first lady of California long ago dedicated herself to raising awareness of the disease, including serving as executive producer of "The Alzheimer's Project."

In this segment, children express their sense of loss, their guilt over not wanting to visit a vacant and belligerent grandparent, and the stalwart optimism in believing that somehow just their presence will help. Frankly, if this doesn't send everyone racing for a checkbook and a list of Alzheimer's research projects, nothing will.

It is a relief then to learn that many scientists believe they are very close to understanding what causes the disease. The two-part "Momentum in Science," which begins Monday night as well, provides a near-perfect balance of scientific explanation and narrative accessibility -- even a non-scientifically inclined television critic can follow the conversation.

The final installment is "Caregivers," and here are the stories of hope and transcendence, here is the heartbreaking and at times nearly impossible task that is being undertaken by ordinary people each and every day.

As anyone who has been touched by this disease knows, it is hard to let a loved one go, even when they want to go and even when they have been gone for a long, long time.
- The Los Angeles Times

"The Alzheimer's Project": An unflinching look at a brain stealer

Alzheimer's Association — 2009-05-08

Someday, when we can look back at Alzheimer's disease and say we finally beat it, we'll probably admit that as we explored it and realized its full devastating impact, things got harder before we saw the rays of hope.

The same can be said for "The Alzheimer's Project," a four-part series that kicks off Sunday night on HBO with the ambitious goal of changing the way we look at a disease that steals our minds.

Sunday's opening production, "The Memory Loss Tapes," is like a primer on Alzheimer's. We know generally what it is, but by watching people who have it, we get an unblinking and chilling snapshot of its insidious effects.

The subjects in "Memory Loss" are in progressively advanced stages, so the impact keeps building.

The first woman sometimes forgets people she has recently met. The second has to surrender her driver's license, a step she fears will take away her independence.

A man in a middle stage still blogs about it, hoping to connect with and help others. He talks about feeling its impact, sensing every day that another thin layer of his brain and memory have been shaved away. When he feels himself going over the edge, he vows, he will check out. No guns. Pills.

From there, we move to a woman in a nursing home. She doesn't recognize her son. She is terrified of going to her room because she sees snakes coming from the ceiling.

If you're looking for an easy Sunday night watch, in other words, click back to "Desperate Housewives." But the producers here clearly felt we needed to see the unsoftened effect of the enemy if we're going to understand it.

Monday night's second episode (at 7:30) shifts to the first person as Maria Shriver, the driving force behind the series, hosts "Grandpa, Do You Know Who I Am?"

As Shriver talks with children in Alzheimer's families, this part feels like group therapy, offering the comfort of shared stories and the reassurance that families aren't as alone as they might sometimes feel.

The rays of hope get a little brighter in the last two parts, "Momentum in Science" and "Caregivers."

While scientists don't claim to be on the brink of a cure, they report progress. They have helped some patients already and with 91 drugs now in testing stages, there is hope of further inroads.

"Caregivers" finishes it off by focusing on the ordinary people who change their own lives and make the sacrifices necessary to provide whatever comfort they can to a family member or friend they know they will lose.

It's the most selfless side of our species.

Even on that defiant note, "The Alzheimer's Project" is hard to watch. It's just not as hard as the disease it examines.
- The New York Daily News

"The Alzheimer's Project" a learning tool for Shriver

Alzheimer's Association — 2009-05-08

In "The Alzheimer's Project," executive producer Maria Shriver shares on camera that her father, Sargent Shriver, 93, no longer recognizes her.

"You want them to be that person you looked up to who knew the answer to everything," Shriver, 52, said during a conference call last week. She added that she takes cues from her children to deal with the pain and frustration.

"My children will always be like, 'Just talk to Grandpa, just go with whatever he is saying, don't try to correct him, don't get mad, it's not him. Just laugh with him or just accept him, or be patient with him.'"

Shriver, California's first lady, was promoting the HBO series that premieres this weekend. Her answers below are edited for length and clarity.

Q: In the last few years, there have been some advances in research toward Alzheimer's, including predictive genetic testing. Through your experience with your father, has it led you to take such a test?

A: No. I have not taken a test in particular to see if I have Alzheimer's or I'm predisposed to it. I try to follow some of the recommendations to keep myself mentally active. I think one of the things that comes out of this "Alzheimer's Project" is that your cardiovascular health is directly related to your brain health and if anything comes out of this, I hope it will also be to Baby Boomers to not just focus on keeping your body in shape, but you can keep your brain in shape by how you keep your body in shape. It's just not just about crossword puzzles.

But I think there is really nothing that is going to help us unless we find a cure. I think that's where I'm going to concentrate my efforts. My efforts have been in writing a book, being the executive producer of the special, testifying in front of the Congress, and trying to work with the Alzheimer's Study Group to perhaps bring attention and a sense of urgency to the research in funding Alzheimer's. I find that that might be a better use of my time than to go and get this test and find out if I might get Alzheimer's because that would really scare the daylights out of me. And I don't know what really productive, frankly, would come of it.

Q: How do you think this will impact Baby Boomers?

A: As Baby Boomers age they become more susceptible to getting Alzheimer's, and so many Baby Boomers I know are having to quit jobs, having to move home to care for their own parents. That's why I think that this is the Baby Boomer epidemic. This is an epidemic that Baby Boomers have to realize is their epidemic, to try to find a cure for. Otherwise it's going to ravage the Baby Boomer generation. Not only mentally but physically, spiritually, financially, and that's why I think that it used to be five or six years ago that people just looked at Alzheimer's and said that's an old person's disease, it's not about me, it's not going to happen to me.

Q: Can you talk about what you have learned from children with how they approach Alzheimer's? Their perspective?

A: I've learned from my own children to be much more in the moment, to accept the person for who they are, not for who they want them to be or who you remember them to be. My own children have taught me a lot about just trying to - let me just say also they obviously don't have all the emotional entanglements that a child has when it's a parent, so they can address it in a different way - but I think you can learn from them that to accept the person that's sitting in front of you as opposed to wanting that person to be the person they used to be. I think many children, and I say children whether you be 50, 40 or whatever, you are still a child of that person, you want that person to be the parent that they used to be.

Q: As a former journalist, how was it different for you to report on a topic that is so close to home and so personal for you?

A: Well, no different, believe it or not. In many of the stories that I covered, I felt I had some kind of understanding of the subject. Being an executive producer was a different role for me, from being the reporter and the writer and being involved in the editing and all that sort of stuff.

But I didn't feel like, oh, maybe I'm not objective - I didn't feel any of that. I was really interested because there was a lot of the science that I did not know. I didn't know the depth of the clinical trials, the breadth of the clinical trials. I didn't know all the doctors that have been working so tirelessly for so long. I knew a lot about what it's like to live with someone with Alzheimer's and I knew a lot about caretaking. One of the things I love so much about being a reporter is that even if you think you know something, you're constantly learning what you don't know. So for me the big difference here wasn't in the subject matter, it was in the role, actually.
- The San Francisco Chronicle

Maria Shriver raising awareness about Alzheimer's

Alzheimer's Association — 2009-05-08

Maria Shriver is the executive producer of the groundbreaking four-part documentary series "THE ALZHEIMER'S PROJECT" airing May 10, 11 and 12 on HBO. Shriver narrates "Grandpa, Do You Know Who I Am?" which is geared towards children and young teens coping with a grandparent's Alzheimer's. The film is based on her book, "What's Happening to Grandpa?" Her father, Sargent Shriver, has Alzheimer's disease.

What's Happening to Grandpa? by Maria Shriver

Maria Shriver has generously given copies of her children's book – "What's Happening to Grandpa" – to the Alzheimer's Association. This heartwarming book is about a grandparent with Alzheimer's, and is a great resource for explaining the disease to kids. Book sales benefit the Association and helps support our mission. Buy the book now.
- Alzheimer's Association

"The Alzheimer's Project" gives inside look at the disease

Alzheimer's Association — 2009-05-07

When her father was diagnosed six years ago with Alzheimer's disease, California first lady Maria Shriver learned firsthand just how devastating it can be.

"At the age of 93, my dad still goes to Mass every day. And believe it or not, he still remembers the Hail Mary. But he doesn't remember me, Maria. I'd be lying if I didn't admit that still makes me cry. "

Shriver has become so passionate about the issue that she even testified before congress. Afterward, she said her office was inundated with letters from people who could relate to what's happening to her family and her father, Sargent Shriver.

Now, the author and journalist is giving others the opportunity to get the same look at the disease with her documentary "The Alzheimer's Project."
- ABC News

Shriver spotlights Alzheimer's in HBO documentary

Alzheimer's Association — 2009-05-07

THE ALZHEIMER'S PROJECT. 9 p.m. Sunday, 7:30 p.m. and 8 p.m. Monday, 8 p.m. and 7 and 8 p.m. Tuesday, HBO.

MARIA SHRIVER would like to "remarket" Alzheimer's.

And it's her own generation she's selling to.

"This is an epidemic that baby boomers have to realize is their epidemic," the former NBC News anchor told reporters in a conference call last week to talk about HBO's "The Alzheimer's Project," a documentary series she helped produce that will begin airing Sunday.

Not only are many of Shriver's contemporaries caring for parents with the most common form of dementia - Shriver's own father, former Peace Corps director Sargent Shriver, 93, suffers from Alzheimer's - but if a cure isn't found, "it's going to ravage the baby boomer generation," she said.

"Five or six years ago . . . people just looked at Alzheimer's, I think, and said, 'That's an old person's disease, it's not about me, it's not going to happen to me,' " said Shriver, 53.

"Now, I think baby boomers have got to look at that and say, 'Oh, my God, if we don't do something about that, that's going to be me,' " she said.

In 2004, Shriver, who has four children with her husband, Calif. Gov. Arnold Schwarzenegger, published a children's book, "What's Happening to Grandpa?"

She first approached HBO "to do just a piece on talking to children about Alzheimer's when my book came out and they weren't interested in doing it. And I think in hindsight, that was really probably the right decision," she said.

But then came HBO's "The Addiction Project," a look at the problem of addiction that was made available on multiple platforms, and to people who didn't even subscribe to HBO. After that, Shriver said, the cable network's documentary chief, Sheila Nevins, "called me and said, 'We want to actually go back now and do that program on children, but we actually want to try to do more.' "

More, they've done.

"Grandpa, Do You Know Who I Am?" (7:30 p.m. Monday) is the one piece in which Shriver appears onscreen, and focuses both on talking to children and learning from them.

"What I've learned from my own children . . . is to be much more in the moment, to accept the person for who they are, not for who you want them to be or who you remember them to be," Shriver said.

First, though, there's Sunday's "The Memory Loss Tapes," a moving look at what that loss means to seven different patients, some in the early stages of Alzheimer's, some more advanced.

Following Shriver's piece on Monday is the first installment of "Momentum in Science," a two-part film that's probably the one must-see piece of "The Alzheimer's Project," focusing as it does on both the search for more effective treatments and on the research that suggests what's good for our hearts is probably good for our brains, too. (And vice versa.)

On Tuesday at 7, the project will also look at "Caregivers," followed by the second half of "Momentum."

Shriver, who said she sees no point in being tested for possible predisposition to a disease that can't yet be cured, added that she does "try to follow some of the recommendations to keep myself mentally active," noting that given the links between high cholesterol and blood sugar and Alzheimer's, "it's not just about crossword puzzles."

And as with its addiction series, "The Alzheimer's Project" isn't just about television.

Besides a companion book to be published Tuesday, "The Alzheimer's Project: Momentum in Science" (Public Affairs Books/$25.95), there's a Web site, hbo.com/alzheimers, where users can stream any part of the series, including 15 supplemental films. The project will also be offered for free to non-HBO customers through some providers, including Comcast, which will be allowing all its digital cable customers to see the programs for free on HBO On Demand from Sunday through Tuesday, according to a Comcast spokesman.

As for what she hopes viewers will take away from all this, Shriver said she'd like them to "recognize the connection between their cardiovascular health, their heart health, and their brain health, one. And they'd get involved in trying to get this government, this president, this Congress, to allocate the funds to find a cure."

This isn't like cancer, "where we're constantly surrounded by stories of survivor and remission and people working and doing well," she said.

"With Alzheimer's, there's no remission, there are no survivors, there is nobody doing well." *
- The Philadelphia Inquirer

HBO puts Alzheimer's under the microscope

Alzheimer's Association — 2009-05-04

HBO, the pay-cable home to blood-sucking 173-year-olds, polygamous Mormons and stressed-out, therapy-seeking C.E.O.'s, is not the usual place for explanations of amyloid plaques, computer-rendered brain-imaging scans or distressing tales of a woman told she can never drive again. But as it does every few years, HBO will soon intrude on its largely fiction-oriented lineup of series and second-run Hollywood movies to deliver five prime hours of a multimillion-dollar public service health campaign. Starting May 10, in its most far-reaching initiative yet, HBO tackles Alzheimer's disease.

As with the previous "Addiction" and "Cancer: Evolution to Revolution," "The Alzheimer's Project" is a curious hybrid of science and emotional stories about patients, their families and caretakers. It started, as many HBO documentary projects do, with a personal fascination of Sheila Nevins, HBO's president of documentary. "We were all getting older," Ms. Nevins said. "The whole idea of what was real-forgetting, aging-forgetting and Alzheimer's-forgetting was obsessing me."

Like many of Ms. Nevins's other obsessions, the initiative will get a lot of attention. HBO is opening the program to all cable subscribers, helping with grass-roots screenings of the four prime-time films and flooding digital outlets (like Facebook and YouTube) with content. From video that didn't make the cut, HBO has made 15 short films for digital outlets and another 18 for Alzforum.org, a site for researchers. There will be a companion book, "The Alzheimer's Project: Momentum in Science," published by Public Affairs in May.

Aside from the personal interests of Ms. Nevins, HBO executives seeking out projects look for diseases that affect a broad swath of people and instances in which medical progress has been underreported. Alzheimer's "kept coming up as having been this recent surge of advances," said John Hoffman, the series producer. He added, "There seems to be some hope in an area where previously there had been little or none."

It is estimated that as many as five million Americans suffer from Alzheimer's, a relatively small number compared with the 23 million who were estimated in 2007 to be fighting addiction. And there are other afflictions that affect more people. But as a public health concern, Alzheimer's — the seventh-leading cause of death in 2006, according to the National Center for Health Statistics — is a growing worry because of its already high cost of care and the likelihood that the numbers of those with the disease will grow markedly as the population ages. With cancer and heart disease, "there is a greater understanding that there is a problem," said Richard J. Hodes, director of the National Institute on Aging (part of the National Institutes of Health), which is presenting the series with HBO. By contrast, just a couple of decades ago, he said, Alzheimer's wasn't even recognized as a distinct disease, and had a stigma.

Despite President Ronald Reagan's openness in discussing his Alzheimer's diagnosis, for many the disease is one of "fear, guilt, shame and confusion," said Maria Shriver, whose father, Robert Sargent Shriver, the founding director of the Peace Corps, received a diagnosis of the disease in 2003. Ms. Shriver, an executive producer of the HBO series, said there is guilt and shame in dealing with caregiving, coupled with a "fear that I am looking into my own future." The goal of the project, she added, "is to give people realistic hope."

That goal initially made National Institute on Aging officials wary when HBO asked it to collaborate, Dr. Hodes said. "We were unsure what the focus was likely to be," he said, noting the need to provide a balance between hope and scientific advances without raising "the promise of false expectations." But ultimately, the institute signed on as a full co-presenter, the first time it has consented to such deep involvement in a project. The institute's role was to ensure that all the science content was accurate; HBO retained editorial control.

Dr. Hodes said the two worked extensively "to understand and respect one another's position," but the tricky balance in outlook — hope or despair? — is evident in separate forewords to the companion book. Dr. Hodes writes that "research has yet to achieve success, as defined by the ability to prevent Alzheimer's disease, or, if it develops, to slow its progression." Mr. Hoffman writes that through producing the program, "I lost my fear of developing the disease" that killed his father. His optimism, he writes, stems from learning that late-onset Alzheimer's "is not completely determined by inheritance" and that lifestyle choices may make a difference.

Unlike in "Addiction," the science and the emotional issues around Alzheimer's are dealt with in separate films, which Ms. Nevins said was done for creative reasons. But the effect is to send viewers on an emotional roller coaster as they confront the anguish of a current diagnosis and the potential better news for future generations.

Nearly 25 million viewers watched "Addiction" on HBO TV channels alone in 2007. But if "Addiction" is an indication, the impact of "The Alzheimer's Project" will reach far beyond the personal. Patricia Taylor, executive director of Faces and Voices of Recovery, credits "Addiction" with playing an important role in her group's lobbying for the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, passed last year to end insurance discrimination against people with mental illness. "The HBO addiction show was really instrumental in laying the groundwork, obviously with other activities, to educate the public," she said.

Robert Meyers, professor emeritus at the University of New Mexico, where the Center on Alcoholism, Substance Abuse and Addictions is based, said that HBO's spotlight on his protocol for getting addicts to go to treatment led to numerous training requests from other researchers. "Some people learned the new system because of HBO," he said.

In July the Army Center for Substance Abuse Programs plans to distribute DVDs of "Addiction," as well as training curriculums, for use at Army installations worldwide, Hank Minitrez, an Army spokesman, wrote in an e-mail message.

Dr. Hodes said he hopes "The Alzheimer's Project" "will allow people to make a better judgment of how they think research ought to be supported," whether through government financing (although the National Institutes of Health doesn't lobby) or by participating in clinical research as a human subject.

Ms. Shriver, California's first lady and a former NBC News correspondent, already took the program to Capitol Hill in March when she testified before the Senate Committee on Aging. Her office in Sacramento told her that it "generated the most mail feedback of anything I had done in the last five years," she said.

For Ms. Shriver, the program has had professional repercussions. After pitching Ms. Nevins projects for years and getting rejected, this proved to be the right moment for the two to work together. She said she's happy that the series has a solid focus on caregivers, her personal interest.

Ms. Shriver appears in the second film, an adaptation of her 2004 children's book, "What's Happening to Grandpa?" Children ask questions and speak directly about their sadness; tears well up in the eyes of 11-year-old Ashanti when her grandmother snaps at her to "go home." "It's emotional television," Ms. Shriver admits, but she said that only one other time have her own four children watched something she did and, craving more, said, "That's it?"
- The New York Times

Anti-inflammatory drugs may raise Alzheimer risk

Alzheimer's Association — 2009-04-27

Millions of people who use non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen and ibuprofen, shouldn't bank on the drugs helping them ward off dementia.

A study in this week's Neurology suggests that NSAID users do not have lower rates of dementia and that increased use of the pain relievers may actually raise the risk of cognitive decline.

"We had high hopes that these non-steroidal arthritis drugs might play a role, in part because other studies had been promising," says study author Eric Larson, executive director of Group Health Center for Health Studies, a Seattle-based HMO.

Researchers followed 2,736 members of Group Health who were an average age of 75 at the study's start. Participants were tracked for 12 years to see if they developed dementia, including Alzheimer's disease. Participants' pharmacy records were evaluated for use of prescription and over-the-counter pain relievers, and they were questioned about their NSAID use as well.

Results showed 351 people had a history of heavy NSAID use at the study's start, while 107 people became heavy users during the follow-up period. Heavy users took at least one NSAID a day for at least 16 months of a two-year period.

During the study, 476 people developed dementia, and heavy NSAID users had a 66% higher risk of developing the condition than those with low or no use.

Larson says he was surprised at the outcome because inflammation is thought to play a role in dementia and because other studies suggested anti-inflammatory pills lowered dementia risk.

"We have years and years of drug exposure data that was extremely accurate. We did not expect these findings," Larson says.

Duke aging expert Murali Doraiswamy says that the latest results aren't a revelation to him and that previous trials evaluating Vioxx, aspirin and prednisone, among other anti-inflammatory medications, did not show reduced risks cognitive decline. "Any benefits noted in prior studies were likely due to an epiphenomenon — the people taking NSAIDS were younger, healthier and better educated, all of which biased the results."

The study doesn't disprove the theory that inflammation is a factor in Alzheimer's, though, says Jason Karlawish, associate director of the Penn Memory Center at the University of Pennsylvania. "Negative studies like this that fail to prove the hypothesis leave thousands of questions to be answered," Karlawish says.

The new data highlight the need for early detection and better biomarkers, says Alzheimer's Association vice president Bill Thies. "If you could tell who's going to need dementia drugs at age 40 and study them, you may have a totally different result."
- USA TODAY

Teams join race to fight Alzheimer's

Alzheimer's Association — 2009-04-20

DOWNTOWN SAN DIEGO — With 26 clues and 2½ hours to solve them, 30 teams – including one headed by actor Seth Rogen – set out on a mad dash around the Gaslamp Quarter yesterday to raise money and awareness for people with Alzheimer's disease.

The teams were tasked with raising at least $200 each for the Alzheimer's Association event, called QUASH, but many brought in more. The 100-plus participants raised an estimated $25,000, said Brad Makaiau, a spokesman for the Alzheimer's Association of San Diego.

Racing against each other, teams used clues to reach destinations where they earned points by tackling challenges. Some required contestants to answer a series of questions. Others were more physical, such as verbally guiding a blindfolded teammate through an obstacle course.

Teams could hail a cab or take a bus as they moved from task to task, but personal cars were a no-no. They were allowed to reach out to friends, use their cell phone's Internet access and ask for help.

"We called friends, asked people on the streets and basically used our brain and our brawn," said Reed Bermingham, 26, an investment adviser who lives downtown.

Bermingham's group of four, the Complete Stimulus Package, dressed alike in white, knee-high socks; head and wrist sweatbands; aviator glasses; and fake mustaches. They raised $4,100 and won the award for best costume.

"Oh, we're definitely doing it again next year," Bermingham said as he sipped a beer after the event.

Don't Know Jack, a mother-daughter-best-friend team of three who wore homemade, pâpier-maché Jack in the Box heads, won the overall award for most points, taking home a trophy.

The downtown odyssey started at 10:10 a.m. at Embarcadero Park South, when teams tore into sealed envelopes of clues and were told to return by 12:40 p.m.

Teams with names like Grandma's Girls, 4get Me Nots and State of Mind ran, took cabs or rode pedicabs from the Star of India to the Children's Museum to obscure places such as the former site of an oyster bar frequented by Wyatt Earp. That spot is the Louis Bank of Commerce building at 837 Fifth Ave. The challenge: What year was the building erected? Answer: 1888.

A member of Rogen's team, Daniel Miller, won the award for most money raised: $4,500. Rogen said his team, The Memory Finders, did well with the clues considering that no one knew downtown San Diego.

"I think we got almost all of them," Rogen, who lives in Los Angeles, said after the race. "We went to the Marriott and talked to the concierge, which is allowed. We got a map. We didn't even have a map."

Rogen hesitated to discuss his connection with Alzheimer's. When asked if he knows someone affected by the disease, he said he does "in a tangential way."

"It affects a lot of people," Rogen said. "Everybody knows someone."

Makaiau said QUASH helps get the word out about Alzheimer's, particularly among younger people. More than 50,000 San Diegans, and up to 5.2 million people nationwide, are living with Alzheimer's. The national figure is expected to grow to 16 million by 2050.

Leticia Campuzano, 49, of Paradise Hills volunteered yesterday instead of participating to see how she liked it. She vowed to form a team next year.

"It's a challenge every day," said Campuzano, who cares for her 85-year-old mother, Micaela Campuzano. "These events really help."
- San Diego Union-Tribune

Training fellowship awarded to Alzheimer researcher

Alzheimer's Association — 2009-04-16

The American Academy of Neurology (AAN) Foundation and the Alzheimer's Association awarded the 2009 Robert Katzman, M.D., Clinical Research Training Fellowship to Joshua Shulman, M.D., Ph.D., a senior neurology resident at the Brigham and Women's Hospital and the Massachusetts General Hospital, for his work investigating genes that influence risk for Alzheimer's disease. The two-year, $130,000 fellowship will be formally presented during the American Academy of Neurology's 61st Annual Meeting in Seattle, held April 25 through May 2.

The Robert Katzman, M.D., Clinical Research Training Fellowship is designed to encourage Alzheimer's disease clinical research with the goal of providing better treatment, prevention or cure of the disease. Shulman's research is designed to identify genes that influence risk for Alzheimer's disease.

"Common genetic variation influences susceptibility to Alzheimer's disease and age-related cognitive decline," said Shulman. "This research may facilitate early diagnosis and highlight new targets for future therapies. I am honored and deeply grateful to the AAN Foundation and the Alzheimer's Association for supporting my further research training and career development in this important field of neurology."

The fellowship includes tuition reimbursement for education in clinical research methodology.

The American Academy of Neurology
An association of more than 21,000 neurologists and neuroscience professionals, the American Academy of Neurology is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke. For more information about the American Academy of Neurology Foundation, visit www.aan.com/foundation.
- Alzheimer's Association

Low blood sugar a dementia risk for diabetics

Alzheimer's Association — 2009-04-15

CHICAGO (Reuters) - Older diabetics whose blood sugar drops to dangerously low levels have a higher risk of developing dementia, U.S. researchers said on Tuesday.

The study by researchers at Kaiser Permanente in Oakland, California, suggests that aggressive blood sugar control resulting in blood sugar so low it requires a trip to the hospital may increase dementia risks in older adults with type 2 diabetes.

"We know that having blood sugar that is too high is not good," Rachel Whitmer, a Kaiser research scientist whose study appears in the Journal of the American Medical Association, said in a telephone interview.

"You want to keep that blood sugar at a good level, but you don't want to go too low," she said.

Several studies have found that diabetics have a higher risk of developing Alzheimer's disease -- the most common form of dementia -- than do the general population. And others have shown that diabetics who take insulin and pills to help control their disease have a lower Alzheimer's risk.

"The very current issue here is balance of blood sugar control," Whitmer said. Read more>>
- Reuters

Memories slip, but golf is forever

Alzheimer's Association — 2009-04-08

Millions of golf enthusiasts who will watch the Masters Tournament this weekend have waxed endlessly about the game's mystical power and its hold on the human mind. A handful of people with Alzheimer's disease, no longer able to dress or nourish themselves without assistance, are proving them right.

A little after 9 a.m. last week, Wardell Johnston declared he wanted to be left alone. Confused and annoyed by the activities and tasks confronting him, the 87-year-old Alzheimer's sufferer shut his door at the Silverado Senior Living home in Belmont, Calif.

ust hours later, Mr. Johnston was measuring the uphill, right-to-left break on a 12-foot putt and knocking his ball into the hole. Then the former civil engineer, who played the game regularly as a younger man, ambled over to the driving range. He grabbed a six iron and practiced chipping with the sort of easy, stress-free swing duffers half his age could learn something from.

"I quit," he said with a cocky grin after each successful shot. Then he deftly cradled another ball with his club, moving it into position for the next stroke. "I haven't played a lot lately," he added. "I should, though. I've still got all the strokes."

Anyone who has dealt with people suffering from mid- to late-stage Alzheimer's knows how difficult it can be to transport someone from fear and confusion to contentment and lucidity. But at Silverado, caregivers have stumbled onto a technique that works nearly every time -- a golf outing. They run through a series of putting drills, knocking the ball around with the wonder of small children playing the game for the first time, which is how many of them experience it each week. For those who played the game when they were younger, swinging a club often sparks a startling transformation, however fleeting, that can make them seem like regular old folks again.

Experts in Alzheimer's say these weekly golf outings illustrate an individualized method of an increasingly popular treatment known as behavioral therapy. Behavioral therapy has been around for more than a decade, but personalizing the treatment to a patient's interests is less common. Rather than providing the same series of experiences to every patient, caregivers have begun to search for activities patients enjoyed when they were younger, and to allow the patients to experience them again.

"This is motor memory for these people, and usually you don't lose that," said Carl Cotman, a professor of neurology at the University of California at Irvine. Dr. Cotman, who has done research on treatment programs at assisted-living facilities throughout the country, said structured, individually focused experiences, especially ones that include off-site exercise like the golf outing, are rare. "It needs to be more common," he said.

Silverado and other assisted-living facilities often use activities like dancing or playing music to stimulate their residents. Like golf, such activities have proved helpful in both making people with dementia feel competent and generating periods of lucidity.

The problem is that personalizing activities for each Alzheimer's patient can be expensive. And playing sports has usually been deemed too difficult, since it often requires a level of balance and coordination -- think of riding a bicycle or hitting a tennis ball -- that people in the later stages of dementia no longer possess. Read more>>
- The Wall Street Journal

When should people with Alzheimer's stop driving?

Alzheimer's Association — 2009-04-08

WASHINGTON (AP) — Scientists are creating tests to show when it's time for people with early Alzheimer's disease to stop driving. It's one of a family's most wrenching decisions, and as Alzheimer's increasingly is diagnosed in its earliest stages, it can be hard to tell when a loved one is poised to become a danger.

Factor in that much of the country lacks public transportation, and quitting too soon restricts independence for someone who otherwise may function well for several years.

"That's a real cost to the individual and family and society," says Jeffrey Dawson of the University of Iowa. "You have to have some sort of trade-off between the individual's independence along with the safety of the driver and with other people on the road."

Typically, specialists say, patients gradually scale back their driving, avoiding busy freeways or night trips or left-turn intersections. Alzheimer's Association adviser Sue Pinder, 58, recently gave up big-city driving even though it meant fewer visits to a daughter in Dallas.

Shortly after Pinder's diagnosis in 2004, she signed a form designating her husband to decide when she'll quit driving altogether. He gave her a GPS system for her last birthday. It helped Pinder navigate unfamiliar streets when, to be near another daughter, the couple recently moved to West Monroe, La., from a nearby town.

"That's helped a lot where I don't have to worry, I can concentrate on my driving and not the directions," Pinder says.

Working on ways to help similar patients, Dawson's team in Iowa developed an intricate behind-the-wheel exam: A 35-mile drive through rural, residential and urban streets in a tricked-out Ford Taurus able to record just about every action the driver takes, much like an airplane "black box" does. Lipstick-size video cameras were positioned to show oncoming traffic, too.

Researchers recruited 40 people with early-stage Alzheimer's who still had their driver's licenses to take the road test, and compared how 115 older drivers without dementia handled the same trip.

The results, reported in the journal Neurology, are striking. On average, the Alzheimer's drivers committed 42 safety mistakes, compared with 33 for the other drivers.

Lane violations, such as swerving or hugging the center line as another car approaches, were the biggest problem for the Alzheimer's drivers. They performed 50 percent worse.

Overall errors rose with increasing age whether or not the driver had Alzheimer's, an extra 2 1/2 mistakes for every five years of age.

But some Alzheimer's patients drove just as well as their healthier counterparts, stresses Dawson, a biostatistics professor. Here's the key: Researchers also checked whether any of a battery of neuropsychological tests given beforehand accurately predicted who would drive worse — and some did.

Flunking simple memory tests didn't make a difference. Standard neurologic tests of multitasking abilities did, ones that assess if people's cognitive, visual and motor skills work together in a way to make quick decisions. Examples include showing patients geometric figures for a few seconds and having them draw the shape from memory, or drawing paths between a sequence of numbers and letters.

Alzheimer's patients who scored average or better on those types of written tests were likewise no worse behind the wheel than other older drivers — but those who scored worse than average tended to commit about 50 percent more errors on the road, Dawson says.

More research is needed but the ultimate goal is an easy doctor's-office exam to help guide when patients should give up the keys.

About 600,000 elderly adults stop driving for some health reason every year, according to the National Institute on Aging. But there's little clear guidance for the roughly 2 million people estimated to be in Alzheimer's early stages, and the disease is poised to skyrocket in two decades as the population grays.

States have varying laws on when aging drivers must pass a road test for a license renewal, but they seldom address specific diseases; California requires reporting of Alzheimer's diagnoses so driving can be assessed. The Alzheimer's Association tells families warning signs of unsafe driving.

But as Alzheimer's worsens, patients often vehemently deny that they're a hazard, says Dr. Gary Kennedy, geriatric psychiatry chief at New York's Montefiore Medical Center.

"I can be the bad guy," he tells families, sometimes reporting patients to the Department of Motor Vehicles for a driving test or advising relatives to disable the car.

"Giving up the car is not like going into the nursing home," Kennedy counsels patients, trying to recruit relatives or friends to schedule rides. "If as a society we recognize this as a danger, we need to help them compensate."
- Associated Press

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Response to introduction of the Medicare two-year wait bill

Alzheimer's Association — 2009-04-07

The Alzheimer's Association commends Sen. Jeff Bingaman (D-N.M.) and Rep. Gene Green (D-Texas) for their important legislation phasing out the two-year wait period for Medicare for those under age 65 who qualify for Social Security Disability Insurance (SSDI). We also appreciate the original co-sponsors of the legislation — Sens. Susan Collins (R-Maine) and Sherrod Brown (D-Ohio) and Rep. Lee Terry (R-Neb.) — for their support.

There are more than 5 million Americans living with Alzheimer's disease, and up to a half million of these individuals are under age 65 and have younger-onset Alzheimer's or a related dementia. After working full-time and paying into Medicare like all other employed Americans, many of these individuals lose their jobs and with it their employer-based health coverage. As these individuals grapple with the challenges an Alzheimer diagnosis brings to their lives, they also discover that federal law requires them to wait two additional years after their disability determination to become eligible for Medicare benefits.

The Alzheimer's Association urges members of Congress to cosponsor the Ending the Medicare Disability Waiting Period Act of 2009 (S. 700 and H.R. 1708). Phasing out the waiting period for Medicare benefits for people disabled by Alzheimer's disease would reduce the problem of lack of health insurance and high out-of-pocket expenditures for this vulnerable population. It would ensure access to critical healthcare services that can help to manage the disease and help to maintain independence.

There are more than 1.5 million people with disabling conditions suffering through two long years for much needed Medicare coverage. Nearly 40 percent of these individuals are without health insurance coverage at some point during their wait for Medicare and 24 percent have no health insurance during this entire period. These are important gaps in the healthcare system that can no longer be ignored.

Alzheimer's disease poses tremendous burdens on individuals and families, burdens made worse by lack of healthcare coverage. The Alzheimer's Association is grateful for the leadership of Sen. Bingaman and Rep. Green and urges bipartisan support and swift enactment of this important legislation that provides invaluable health coverage and peace of mind for those with Alzheimer's and other disabling, fatal diseases.

Brain cells give new clues to Alzheimer's

Alzheimer's Association — 2009-04-06

THURSDAY, April 2 (HealthDay News) -- By uncovering a mechanism that causes damage to brain synapses during Alzheimer's disease, researchers might have found a key to reducing or preventing nerve degeneration for these patients.

According to a report in the April 3 issue of Science, researchers at the U.S.-based Burnham Institute for Medical Research have shown that beta-amyloid protein "multimers" create excessive nitric oxide. This free radical then reacts with the protein Drp1, causing the fragmentation of mitochondria -- the cell's energy storehouses -- in the brain, a violent process that causes the neurodegeneration linked to Alzheimer's disease.

When mitochondria break apart, the reaction damages synapses leading to nerve cell death. As brain synapses are vital for learning and memory, any damage or malfunction of these message-carrying connections can lead to Alzheimer's and dementia. Multimers had also been previously linked to Alzheimer's disease.

"By identifying Drp1 as the protein responsible for synaptic injury, we now have a new target for developing drugs that may slow or stop the progression of Alzheimer's," study leader Dr. Stuart A. Lipton, director of the Del E. Webb Center for Neuroscience, Aging and Stem Cell Research, said in a news release issued by the Burnham Institute.
- HealthDay

Drug makers stop top dosage in Alzheimer trial

Alzheimer's Association — 2009-04-02

The developers of an experimental new treatment for Alzheimer's disease, and Wyeth, announced Thursday they have stopped the top dosage because trial patients are suffering from an increased risk of brain inflammation from water retention.

The companies said the setback would not affect their ongoing, advanced trials to win approval for bapineuzumab, a drug designed to combat Alzheimer's, an incurable disease that destroys the brain.

Elan ( ELN - news - people ) President Carlos Paya said an independent Safety Monitoring Committee overseeing the Elan-Wyeth trials detected a higher level of vasogenic edema - water accumulating in brain tissue - in trial patients taking the highest dose, 2 milligrams. He said the committee had found no health risks in patients receiving lower doses of bapineuzumab.

"Our review of the safety data and the feedback from the Safety Monitoring Committee made it clear that continued development of the highest dose was not advisable. The decision to remove the highest dose from development reduces risk to patients, and it also helps to reduce risk to the overall development effort," Paya said.

Shares in Dublin-headquartered Elan slumped on the news. Elan shares fell 5.8 percent to euro4.75 ($6.38) in afternoon trading on a broadly positive Irish Stock Exchange.

Elan said several hundred patients who had been receiving or scheduled to receive the highest dose will be removed from the trials or switched to lower doses, either 1 milligram or 0.5 milligrams. It said the problem was detected early using MRI scans on the brains of patients, who were not displaying symptoms associated with water-inflamed brains.

Elan and Wyeth began third-level trials on Alzheimer's sufferers in December 2007. This is the first time they have halted treatment on any category of patients. The trials involve four groups, two of which included patients taking the highest dose.

The companies said they now expected approximately 3,600 patients worldwide to participate in the trials, down from their original plan for 4,100.

More than a dozen pharmaceutical and biotechnology companies are competing to develop the first viable treatment to suppress or reverse the brain-wasting effects of Alzheimer's, which affects tens of millions worldwide.

Response to release of Alzheimer's Study Group report

Alzheimer's Association — 2009-03-25

The Alzheimer's Association commends the independent Alzheimer's Study Group (ASG) on their report released today, "A National Alzheimer's Strategic Plan: The Report of the Alzheimer's Study Group". The report explains the looming national crisis created by Alzheimer's disease and offers real solutions for the nation.
- Alzheimer's Association

New report says Alzheimer's disease and dementia triple healthcare costs for Americans age 65 and older

Alzheimer's Association — 2009-03-24

Total healthcare costs are more than three times higher for people with Alzheimer's and other dementias than for other people age 65 and older, according to the Alzheimer's Association's 2009 Alzheimer's Disease Facts and Figures, released today.
- Alzheimer's Association

Report: Alzheimer's rate accelerating
- NBC Nightly News

Alzheimer's costs rising
- ABC Good Morning America Health

Rising cost of caring for Alzheimer's
- ABC News

Watch Association President and CEO Harry Johns discuss Facts and Figures on C-SPAN
- C-SPAN

Maria Shriver highlights Alzheimer's awareness
- The Hill

Group says 5.3 million in U.S. have Alzheimer's
- Reuters

Alzheimer's cost triple that of other elderly
- Associated Press

Alzheimer's on a relentless upward trajectory
- USA Today

With Alzheimer's, health-care costs could triple
- HealthDay News

Alzheimer's Disease International conference to be held March 25-28

Alzheimer's Association — 2009-03-17

The 24th Conference of Alzheimer's Disease International (ADI) will be held March 25-28 at the Suntec Singapore International Convention  Centre, Suntec City, Singapore.
- Alzheimer's Disease International

Sen. Warner joins Alzheimer task force as co-chair

Alzheimer's Association — 2009-03-11

The Alzheimer's Association is pleased that Sen. Mark R. Warner (D-Va.) will contribute his own significant knowledge of Alzheimer issues as a co-chair of the bipartisan Congressional Task Force on Alzheimer's Disease.
- Alzheimer's Association

Obesity, diabetes and heart disease may speed dementia

Alzheimer's Association — 2009-03-10

Obesity and its common companions – diabetes and heart disease – can work together to speed dementia and other brain ills, new studies show.
- HealthDay

Related information:
Adopt a brain-healthy diet

Obama overturns Bush policy on stem cells

Alzheimer's Association — 2009-03-09

President Obama has cleared the way for a significant increase in federal dollars for embryonic stem cell research.
- Yahoo

Newt Gingrich talks about Alzheimer's Study Group

Alzheimer's Association — 2009-03-06

Former Speaker of the House Newt Gingrich, co-chair of the Alzheimer's Study Group (ASG), appeared on the "Today Show" to talk about the state of health care in America and his participation in the ASG.
- Alzheimer's Association