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Alzheimer’s Disease Researchers Switch Focus to Prevention Methods

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By Melinda Smith

Alzheimer's Disease Researchers Switch Focus to Prevention MethodsWhen scientists look back to the first quarter of the 21st century, they may marvel at what was accomplished in the treatment and prevention of Alzheimer’s Disease. Alzheimer’s is the most common form of dementia and is reaching global proportions. The World Health Organization says more than 35 million people now live with dementia and that number is projected to double by the year 2030.

As people live longer, there is growing pressure to develop a drug or vaccine that stops dementia.

Health and Human Services Secretary Kathleen Sebelius says setting priorities and coordinating research now will save time later.

“We’ve made the first historic investment of funds and a 15 year commitment to prevention and treatment,” she said.

In the past, the disease could be diagnosed only by doing an autopsy after the patient died.

Alzheimer’s researcher Ronald Petersen says new methods now can provide evidence while the patient is still alive.

“We use biomarkers, various imaging tests, blood tests, spinal fluid tests that are going to tell us that these are in fact indicators of what the disease is going to be,” he stated.

In images provided by the Banner Alzheimer’s Institute in Phoenix, Arizona, you can see the progression of the disease.

Inside the brain of an aging patient, the dark areas are formed by plaques – made up of the amyloid protein – and tangles – composed of another protein called tau. The result is a loss of brain cells and neurons responsible for memory and learning.

During a national summit last month on Alzheimer’s research, two promising clinical trials generated a lot of interest. In this trial, patients already showing signs of Alzheimer’s are given nasal syringes of insulin that push the drug into the neurons of the brain.

“Nearly three-quarters of participants showed improvement in memory over the four-month period, a 50 percent improvement,” said Dr. Suzanne Craft, who is in charge of the study..

But another study may promise earlier treatment to actually prevent the disease. Two years ago, New York Times reporter Pam Belluck and a photographer traveled to Colombia to visit an extended family afflicted by early onset Alzheimer’s. Approximately one-third carry a genetic mutation that brings on the disease while they in their ’30s and ’40s. Belluck says the healthier, older generation, often cares for younger victims.

“They may be bedridden. They need to be fed. They may need to be diapered. They’re also agitated,” Belluck spoke with VOA via Skype.

Early next year, a team of American scientists and Colombian doctors will begin a five-year clinical trial of more than 3,000 members of the family. Not all of the patients carry the genetic marker and some will get a placebo.

The head of the American team, Dr. Eric Reiman, says the immunization drug being tested is designed to clear the amyloid quickly from the brain.

“If we intervene sufficiently early before the disease has ravaged the brain, we think these treatments might have their best shot of having a profound effect,” he said.

Pam Belluck says the Colombian family members are anxious for something – or someone – to help them. Facing a grim future, many say they are willing to step forward if it will help them and future generations.

Source: http://www.voanews.com/content/alzheimers-disease-researchers-switch-focus-to-prevention-methods/1147372.html

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If You Knew Then What You Know Now: Hindsight for Caregivers

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They say hindsight is 20/20. If you could go back in time: what would you now as seasoned caregivers say to your novice self about how to be a caregiver?

 

If You Knew Then What You Know Now: Hindsight for CaregiversAs a seasoned caregiver of multiple elders, I can choose to torture myself with my perceived failures at being a perfect caregiver, or I can choose to forgive myself for being imperfect, and recognize that I did the best I could at the time. You have the same choice.

 

Much like an adult who realizes that he or she has a “wounded child” living inside – a child who suffers from unearned self-blame or low self-esteem because of life events – many adult caregivers carry the guilt from their “infant” caregiving years to their grave. They spend precious time thinking about how they should have understood someone’s needs better, could have been more patient, would have done any number of things better, if only they knew then what they know now.

 

The very people who take on caregiving roles are often the most sensitive to other’s needs. Many also tend to be overly sensitive in other ways. Let’s face it. Whatever we do as caregivers seems to be wrong in the eyes of some lookers-on, generally people without all of the facts, and often people who couldn’t do what we do no matter what. Still, we are sensitive to their judgment.

 

We can decide not to be bothered by criticism from the outside. The problem is, we often aren’t aware that we are judging ourselves even more harshly than outsiders may judge us. This is particularly true in retrospect. We look back and beat ourselves up for slips, real or imagined, because we were novices and didn’t know what we know now.

 

What tips would you give yourself if you were starting fresh? You’d do your research, of that I’m sure. Government websites such as the Administration on Aging, the National Institutes of Health, plus disease specific websites and support sites such as AgingCare.com, all offer a wealth of information. Also, you’d use your local resources for in person support. You’d call your community Alzheimer’s organization, your Area Agency on Aging and watch for educational workshops. You’d take advantage of help that is available.

 

What Comfort Would You Give Your Novice Self?

 

You went into caregiving out of love and didn’t have the education to cope with specific issues, so you made mistakes. Everyone makes mistakes. Move on.

 

Believe that if your care receiver could be the person he or she was before getting ill, you would be told, “job well done.”

 

Remember precious moments rather than perceived mistakes. Remember the intimate times – times that remind you that you were fulfilling an important calling. Remember that you made a difference. Write yourself reminders of those rewarding times and read the notes when you start criticizing your earliest caregiving blunders – or even later ones.

 

Understand that imperfection is human, and your best was – and still is – good enough.

 

Please forgive the suffering caregiver inside of you as you would a friend. Again, I say you did your best given what you knew. Give that novice caregiver a spiritual hug, and a pass for being imperfect. If you do, you’ll leave room for your brain to focus on loving moments with the people you took care of.

 

Move on from self-imposed blame and admire yourself for stepping into the difficult role of being a caregiver and seeing it through to the best of your ability. What’s important in not what you did wrong along the way, but in the end, what you got right.

 

If you could go back in time: what would you now as seasoned caregivers say to your novice self about how to be a caregiver?

 

Source: http://www.agingcare.com/Articles/about-caregiving-in-hindsight-147804.htm

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Latest Alzheimer’s Research Progress Report Released

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2010 Alzheimer’s Disease Progress Report: A Deeper Understanding2010 Alzheimer’s Disease Progress Report: A Deeper Understanding, the latest annual Alzheimer’s research report from the National Institutes of Health (NIH), is now available online. Prepared by the National Institute on Aging, which leads the NIH effort conducting and supporting research on age-related cognitive decline and Alzheimer’s disease, the report highlights important developments and directions in NIH-funded research, including:

  • risk for developing Alzheimer’s
  • genes that play a role in the disease
  • neuroimaging and biomarkers that detect and track the disease
  • research into new treatments
  • lifestyle factors that may worsen or protect against the disease
  • help for caregivers

Special features include animation showing the progression of Alzheimer’s in the brain and video interviews highlighting new insights into the disease.

Read online or download @ http://www.nia.nih.gov/alzheimers/publication/2010-alzheimers-disease-progress-report-deeper-understanding.

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Warning Sign? Disrupted Sleep Tied to Alzheimer’s

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By Stephanie Pappas, LiveScience Senior Writer

Warning Sign? Disrupted Sleep Tied to Alzheimer's

People who awaken more during the night are more likely than sound sleepers to have pre-clinical signs of Alzheimer's Disease.

Trouble sleeping in middle age could herald Alzheimer’s disease later in life, according to new research linking dementia and slumber.

The findings can’t yet prove whether disturbed sleep helps contribute to the brain changes that cause Alzheimer’s or whether some other factor links the two; but preliminary results suggest that treating sleep problems might be beneficial for the brain in the long run.

“If sleep is found to affect either the beginning or the progression of Alzheimer’s disease, especially in its early stages, then it’s really an attractive thing to try to manipulate, because getting more sleep or better sleep has really no risk,” said study researcher Yo-el Ju, an assistant professor of neurology at the Washington University School of Medicine in St. Louis.

Plaque in the brain

In 2009, Ju’s Washington University colleague David Holtzman published research in the journal Science reporting that depriving mice of sleep causes a 25 percent increase in the levels of a protein fragment called amyloid beta in the brain. Amyloid beta is the primary ingredient in the amyloid plaques that clog the brains of people with Alzheimer’s.

These mice were genetically engineered to accumulate amyloid beta, and mouse-brain chemistry may not always match that of humans. So Ju and her colleagues, including Holtzman, turned to a group of people enrolled in the Adult Children Study, so named because half of the volunteers in the study are children of parents with Alzheimer’s.

They recruited 100 volunteers ages 45 to 80, all of whom had been clinically tested and showed no signs of memory loss or cognitive decline. The volunteers wore a wristwatch-like device called an actigraph for two weeks. The device measures activity levels, which can then be translated into time asleep and time awake. [Top 10 Spooky Sleep Disorders]

“Other studies that have looked at the relationship between sleep and dementia have generally studied older individuals who are obviously at higher risk of dementia, so I think this study is important because we’re looking at a population that is much younger,” Ju said.

Sleep and dementia

The results revealed that people who spent more of their time in bed tossing and turning rather than sleeping were more likely to show abnormal levels of chemicals that indicate amyloid beta. These chemical markers show up 10 or 15 years before any sign of memory loss or decline, but almost everyone who has them will eventually develop Alzheimer’s if they don’t die of something else first. About 25 percent of the people in the study fell into this “preclinical Alzheimer’s” category.

People who woke up more than average — or more than five times every hour — were also more likely to show signs of amyloid beta accumulation. Participants didn’t necessarily remember these waking periods the next morning, Ju said.

Ju and her colleagues will present their results at the American Academy of Neurology’s 64th annual meeting in New Orleans, which begins April 21. The study has not yet been published in a peer-reviewed journal. In the meantime, they’re continuing the sleep studies on more volunteers. In the long term, Ju said, the researchers hope to find out what causes the troubled sleep in people with preclinical Alzheimer’s.

“These are pretty preliminary results, and although they are intriguing and promising, we really need to do longer-term studies to find out which direction this is going,” Ju said.

Source: http://www.livescience.com/18474-disrupted-sleep-alzheimers.html?utm_source=Newsletter&utm_medium=Email&utm_campaign=LS_02142012

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Overeating May Double Risk of Memory Loss

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By Steven Reinberg – HealthDay Reporter

Too many calories could lead to early signs of Alzheimer’s, preliminary research suggests.

Overeating May Double Risk of Memory LossOlder people who eat too much are at risk for memory impairment, a new study contends.

People 70 and older who eat between 2,100 and 6,000 calories a day may be at double the risk of these deficits in memory, which can be an early sign of Alzheimer’s disease, the study authors said.

“Excessive daily caloric consumption may not be brain-health friendly,” said lead researcher Dr. Yonas Geda, an associate professor of neurology and psychiatry at the Mayo Clinic in Scottsdale, Ariz.

“It may sound like a cliche, but we need to be mindful of our daily caloric consumption,” he said. “The bottom line is that eating in moderation, not in excess amount, may be good for your brain.”

The results of the study are due to be presented in April at the annual meeting of the American Academy of Neurology, in New Orleans. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

For the study, investigators collected data on more than 1,200 people, aged 70 to 89, living in Olmsted County, Minn. Among these people, 163 had been diagnosed with the memory deficits known as “mild cognitive impairment.”

Each person told the researchers how much they ate. One-third ate between 600 and 1,525 calories a day, one-third between 1,526 and 2,142 calories a day, and one-third ate between 2,143 and 6,000 calories a day.

Among those who ate the most, the odds of being diagnosed with the impaired-memory disorder was more than twice that of those who ate the least, the researchers found.

There was no significant increase in risk for memory problems among those in the middle group, the researchers added.

These findings remained the same after taking into account a history of stroke, diabetes, education and other risk factors for memory loss.

“We also looked at BMI and obesity,” Geda said. BMI, or body mass index, is a measurement based on height and weight. “But there was no significant difference between the normal [participants] and mild cognitive impairment when it comes to these two variables,” he said.

Why overeating affects the brain isn’t clear, but “excessive caloric intake may lead to oxidative damage leading to structural changes in the brain,” Geda suggested.

Commenting on the study, Dr. Neelum Aggarwal, an associate professor of neurological sciences at Rush University in Chicago, said that “as the population of the U.S. is aging at a rapid rate, in addition to becoming increasingly obese, physicians are being asked by their elderly patients about their risk for various diseases, specifically cognitive [mental] decline and dementia.”

These findings allow doctors to start the discussion about the links between common healthy living practices — eating a nutritious diet, limiting sugar — to overall brain function, he said.

“This study furthers the discussion of what the possible mechanisms are for the development of cognitive decline and offers strategies for disease prevention through nutrition and caloric restriction,” Aggarwal said.

Another expert, David Loewenstein, a professor of psychiatry and behavioral sciences at the University of Miami Miller School of Medicine, said that “this makes a lot of sense because increased caloric intake is associated with obesity and metabolic syndrome, so it is not at all surprising that increased calories are associated with increased cognitive impairment.” Metabolic syndrome is a group of risk factors linked to heart disease and other health problems.

“This study suggests that anything that’s good for the heart — like decreased calories — is good for the brain,” Loewenstein added.

While the study found an association between overeating and memory impairment, it did not prove a cause-and-effect relationship.

Source: http://consumer.healthday.com/Article.asp?AID=661692

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Skin Cancer Drug Reverses Alzheimer’s in Mice

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Skin cancer drug reverses Alzheimer's in miceScientists say they “serendipitously” discovered that a drug used to treat a type of cancer quickly reversed Alzheimer’s disease in mice. “I want to say as loudly and clearly as possible that this was a study in mice, not in humans,” he said. “We’ve fixed Alzheimer’s in mice lots of times, so we need to move forward expeditiously but cautiously.”
Via edition.cnn.com

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10 Warning Signs of Alzheimer’s

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10 Signs of Alzheimer'sMemory loss that disrupts daily life may be a symptom of Alzheimer’s, a fatal brain disease that causes a slow decline in memory, thinking and reasoning skills. There are 10 warning signs and symptoms of Alzheimer’s from the Alzheimer’s Association. Every individual may experience one or more of these signs in different degrees.

1. Memory loss that disrupts daily life

One of the most common signs of Alzheimer’s is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.

What’s a typical age-related change? Sometimes forgetting names or appointments, but remembering them later.
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2. Challenges in planning or solving problems
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Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.
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What’s a typical age-related change? Making occasional errors when balancing a checkbook.
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3. Difficulty completing familiar tasks at home, at work or at leisure
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People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.
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What’s a typical age-related change? Occasionally needing help to use the settings on a microwave or to record a television show.
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4. Confusion with time or place
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People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.
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What’s a typical age-related change? Getting confused about the day of the week but figuring it out later.
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5. Trouble understanding visual images and spatial relationships
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For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not realize they are the person in the mirror.
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What’s a typical age-related change? Vision changes related to cataracts.
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6. New problems with words in speaking or writing
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People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a “watch” a “hand-clock”).
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What’s a typical age-related change? Sometimes having trouble finding the right word.
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7. Misplacing things and losing the ability to retrace steps
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A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.
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What’s a typical age-related change? Misplacing things from time to time, such as a pair of glasses or the remote control.
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8. Decreased or poor judgment
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People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.
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What’s a typical age-related change? Making a bad decision once in a while.
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9. Withdrawal from work or social activities
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A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.
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What’s a typical age-related change? Sometimes feeling weary of work, family and social obligations.
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10. Changes in mood and personality
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The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.
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What’s a typical age-related change? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.
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New Alzheimer’s Criteria Would Change Diagnosis for Millions

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By: Rachael Rettner, MyHealthNewsDaily Staff Writer

New Alzheimer's Criteria Would Change Diagnosis for MillionsAlmost everyone currently diagnosed with a mild form of Alzheimer’s disease would be downgraded to not having the condition, if new proposed criteria for the diagnosis of cognitive problems were applied, a new study shows.

Instead, people diagnosed as having “very mild” and “mild” Alzheimer’s disease would be reclassified as having mild cognitive impairment (MCI), which is currently recognized as an intermittent stage between the normal loss of mental function that comes with age and the development of dementia.

The new criteria broaden the definition of mild cognitive impairment, and this will cause confusion when doctors try to diagnose MCI and Alzheimer’s, said study researcher Dr. John Morris, a professor of neurology at Washington University School of Medicine in St. Louis.

Moreover, the new criteria highlight the fallacy of thinking about MCI and Alzheimer’s as different entities, Morris said.

“[The] idea that there is an MCI stage, distinct from very early Alzheimer’s disease, is artificial,” Morris said. “It really is the same disease process.”

Instead of widening the criteria so more people are diagnosed with MCI, researchers should do the opposite — try to figure how to winnow down the group of patients with MCI to find those who will go on to develop Alzheimer’s disease, Morris said. In fact, if a patient’s memory and thinking troubles are due to early Alzheimer’s, and not due to depression or medication use, “We can just call it very early Alzheimer’s disease. There’s no need to have this distinction,” Morris said.

The report is published online today (Feb. 6) in the Archives of Neurology.

Alzheimer’s Continuum

Previously, mild cognitive impairment was defined as a decline in cognitive function — which could include memory and language problems — that do not interfere with everyday activities.

But the new criteria, proposed by the National Institute on Aging and the Alzheimer’s Association, state that people with MCI have “independence in functional activities.”

This could mean that, as long as a person can do everyday activities by themselves, they would be classified as having MCI, even if they had mild problems with activities such as shopping, paying bills and cooking, Morris said. (In fact, having mild problems with such activities is a criterion for dementia, Morris said.)

To assess what the impact of the new criteria would be on patients diagnosed with Alzheimer’s disease, Morris analyzed information from 17,535 people who had been classified as having normal cognition, MCI or Alzheimer’s disease. Participants were classified based on how well they could function performing a variety of activities, including preparing meals and taking mediation.

The results showed 99.8 percent of patients currently diagnosed with very mild Alzheimer’s disease, and 92.7 percent of those diagnosed with mild Alzheimer’s disease, would be reclassified as having MCI based on the revised criteria.

Considering about 2.5 million people have very mild Alzheimer’s disease, the findings suggest that, very roughly, about 2.2 million people could be reclassified as having MCI (although this calculation is speculative), Morris said.

Need for Biomarkers

William Thies, chief medical and scientific officer at the Alzheimer’s Association, said the proposed criteria for MCI are less than a year old, and experts will likely continue to discuss and tweak them in the years to come.

“We are really now working on trying to identify exactly where people will fit in the continuum of Alzheimer’s disease,” Thies said.

Thies agreed the disease is a continuous process, and said you could likely not tell the difference between someone with the most severe case of MCI and someone with the mildest case of Alzheimer’s disease.

But Thies said he does not think the new criteria will create much confusion. They are intended to be used by experts in the field, some of whom have already been thinking of MCI in the manner described by the new criteria. And others who are very conservative when it comes to diagnosing people with Alzheimer’s disease likely won’t change their ways, he said.

Thies also said the field should move toward identifying which patients with MCI are actually in the early stages of Alzheimer’s disease. This could be done once there are well defined biomarkers for the condition, Thies said.

While the field is moving toward this goal, it will likely be a while before biomarkers are routinely used by doctors to diagnose patients, he said.

Pass it on: Identification of biomarkers for Alzheimer’s disease will make it easier to diagnosis the condition in its early stages.

Source: http://www.myhealthnewsdaily.com/2204-alzhimers-disease-criteria-mild-cognitive-impairment.html

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Alzheimer’s Disease “Jumps” Across Brain Cells to Spread

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Alzheimer's disease "jumps" across brain cells to spreadAlzheimer’s disease spreads through the brain by jumping from one cell to another, according to a new study.

The study found that tau protein, which indicates the fibrous tangles found in the brains of Alzheimer’s patients, spreads along the brain’s neurons from one region to the other – resulting in severe dementia. The new clues to the neurodegenerative brain disorder might help scientists find a way to stop the disease from getting worse.

Read more…

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Alzheimer’s Caregivers: Sandwiched Between Parenting Your Kids and Your Parents

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Via Scoop.it – Healthcare Continuing Education

Caring for kids and a loved one with Alzheimer’s, too? Here’s how to make it easier — for everyone.
Via www.webmd.com

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