Alvaro Fernandez has a good no-nonsense article on healthy brain aging up on SribD.
Marcel Brasey has been awarded the 2010 "Coup de Coeur" prize by the Swiss Alzheimer's Association of Geneva. Marcel received the prize for his courage and determination in facing Alzheimer's and for creating his French-language site, "Survivre avec un diagnostic de maladie d'Alzheimer, The prize was also awarded to the Memory Clinic of Geneva, represented by Anne-Claude Juillerat Van der Linden, for supporting Marcel's efforts. Congratulations Marcel and Anne-Claude!
Summary: The New York University Caregiver Intervention lessens caregiver depression, reduces caregiver concern about behavioral symptoms and delays institutionalization. The program may be coming soon to a community center near you.
In my last post, I wrote about the evidence that a program of caregiver education and support lessens caregiver depression and lengthens the time a person with dementia can be cared for at home, rather than in an institution. One such program has been studied extensively by Mary Mittelman and her colleagues. Dr. Mittelman is Director of Psychosocial Research and Support, Center of Excellence on Brain Aging and Research Professor Department of Psychiatry at New York University. She is also co- author of Counseling the Alzheimer’s Caregiver: A Resource for Health Care Professionals.
In a clinical trial ranging over 23 years and involving more than 400 caregivers of spouses diagnosed with Alzheimer’s, Dr. Mittelman and her colleagues (including Bill Haley at the University of South Florida) compared caregivers receiving intensive education and support to those receiving “usual care.”
Summary: A systematic review of clinical trials of nondrug treatments for Alzheimer’s disease found good evidence that a program of caregiver education and support lengthens the time a person with dementia can be cared for at home, rather than in an institution. The same review found evidence (although not from large, well-designed trials) that some nondrug treatments for people with dementia and their caregivers may improve patients’ memory, mood, behavior and functionality as well as improve caregivers’ mood, psychological well-being and quality of life. More research is needed to investigate the costs and benefits of nondrug treatments.
Research on drugs to treat memory loss dominates the headlines, but some researchers think nondrug treatments may be just as effective. Sometimes called “nonpharmacological therapies” or “psychosocial interventions,” these nondrug treatments include physical exercise, caregiver education, cognitive stimulation, counseling, music therapy, reminiscence therapy and training on completing “activities of daily living” (ADLs). Unlike drug-based treatments, these treatments are often for caregivers, as well as for people with memory loss.
On Monday, I'll be on my friend Kim Linder's radio show, The Caregiver Hour. Kim and I will be talking about living with memory loss, along with Bill Haley, a psychologist and Professor at USF's School of Aging Studies and George Hanna from 1st Choice Pharmacy.
Tune in to 1250 WHNZ (or listen through the station's web site) at 11 AM Eastern time to hear the discussion!
The New York Times has published a much-needed correction to its article on a spinal fluid test that "can be 100 percent accurate" in predicting which patients with memory loss would go on to develop Alzheimer's.
You’ve probably seen recent media reports on the proposed changes to the guidelines for diagnosing Alzheimer’s, along with an article claiming that “a spinal fluid test can be 100 percent accurate in identifying patients with significant memory loss who are on their way to developing Alzheimer’s disease.” Today’s headlines include a story about a blood test for predicting whether you’ll develop Alzheimer’s.
Although most professionals are careful to say the proposed guidelines and tests aren’t ready for widespread use, public expectations seem very high. On a flight last month, I sat next to a man in his 20s whose stepfather is showing signs of memory loss. My seatmate wasn’t terribly concerned about his stepfather, he said, because he had seen the recent reports of progress in Alzheimer’s research and believed that a cure is around the corner.
Expecting Improved Diagnosis and Treatment
Two of my friends diagnosed with young onset dementia also have high expectations. They sent me their thoughts supporting the proposed guidelines for diagnosis, particularly the guidelines for a diagnosis of “preclinical Alzheimer’s.” Their strong support is based on the long and difficult process each went through to get diagnosis and treatment, and the relative success of treatments in stabilizing their conditions. It’s also based on their assumption that they would have been diagnosed with some form of Alzheimer’s if the proposed guidelines were used when they first sought answers about their symptoms.
“Consider me,” wrote Mary Kay Baum, who has a strong family history of dementia. “I am a 63 year-old woman who was a lawyer and pastor with two graduate degrees, thirty years of public service, and ten years of cognitive challenges. The old Alzheimer’s disease criteria ignored me. It did not have a vocabulary for my issues. Doctors did not know what to do with me! The criteria from 25 years ago did not advise practitioners to help me prevent the dementia we had seen in my mother and my aunt while in their mid-fifties. Most research excluded me…. Many in my situation fear we won’t be treated until we are really demented.”
There’s been a lot of optimistic headlines about diagnosing, treating and curing Alzheimer’s lately. It seems some financial and industry analysts are not so optimistic.
MarketWatch reports that the September issue of Neuroinvestment contains an extremely gloomy assessment of prospects for new Alzheimer’s drugs, and suggests that all research efforts need a “reset.”
I’ve written before about how bleeding in the brain is more common than previously thought, especially for people diagnosed with Alzheimer’s. Bleeding in the brain (which can be detected by a type of MRI) may be a sign of the cerebral amyloid angiopathy my father had, and is linked to memory loss.
A new study suggests that if you’ve already had bleeding in your brain, aspirin may increase the risk of further bleeding. This adds to the evidence that you should check with your doctor before taking aspirin on an ongoing basis.
Much of the current research on neurodegenerative diseases focuses on a handful of proteins that tend to form hard clumps in the brain, including:
Dr. Kenyon’s lab focuses on the study of aging in a microscopic roundworm called C. elegans. These roundworms are much simpler than humans or even mice. In a series of experiments using C. elegans, the researchers found there are actually hundreds of proteins that form hard clumps as roundworms age. “Our study shows that in worms, inherent protein aggregation is linked to the aging process,” says Della David, first author of the paper.
Eli Lilly has stopped its Phase III trial of semagacestat, a potential Alzheimer's treatment. Memory and thinking in trial participants receiving treatment declined faster than those receiving placebo, and semagacestat was associated with an increased risk of skin cancer.
Another failure of a treatment targeting beta amyloid is sure to further intensify the controversy about whether that protein causes Alzheimer's.
Marta Cortes-Canteli, Ph.D.
In the last few years, many Alzheimer’s researchers have been working under the assumption that beta amyloid, the protein that makes up Alzheimer’s plaques, damages brain cells. Other scientists, however, argue that Alzheimer’s is really due to blood vessel or vascular disease that reduces blood flow to brain cells. Maybe both are right -- people with dementia tend to have multiple pathologies in their brains, and these pathologies seem to interact to increase the risk for and severity of dementia.A new paper from researchers at The Rockefeller University suggests that a protein called fibrinogen might be involved in this interaction. Postdoctoral fellow Marta Cortes-Canteli and her colleagues focused specifically on the role of fibrinogen and beta amyloid in the presence of abnormal blood clots and the cerebral amyloid angiopathy (CAA) my father’s autopsy showed.