Alzheimer's Disease Research0

People with Alzheimer's disease and those with mild cognitive impairment, or even healthy people who want to help scientists test new treatments may be able to take part in clinical trials. Clinical trials are studies done with people to find out if a new drug or treatment is both safe and effective.
New therapies are tested on people only after laboratory and animal studies show that the therapy is safe and has promising results. The Food and Drug Administration sets strict rules to make sure that people who agree to be in the studies are treated as safely as possible.

People who take part in clinical trials say that the biggest benefit is having regular contact with experts who have lots of practical experience and a broad understanding about the disease. They also feel they are making a valuable contribution to knowledge that will help people who develop Alzheimer's in the future.

Scientists are testing a number of drugs in clinical trials to see if they prevent Alzheimer's disease, slow the disease, or help reduce behavioral symptoms. Many drugs and therapies are tested in clinical trials. Some ideas that seem promising turn out to have little or no benefit when they are carefully studied in a clinical trial.

There is evidence that inflammation in the brain may contribute to the damage caused by Alzheimer's disease. Some studies have suggested that drugs such as nonsteroidal anti-inflammatory drugs, or NSAIDs, might help slow the progression of Alzheimer's. So far, however, clinical trials have not shown a benefit from these drugs.

Research has suggested a link between Alzheimer's disease and factors that increase the risk for heart disease. Medicines already used to help reduce the risk of heart disease may help lower the chances of developing Alzheimer's disease or may slow its progression. Clinical trials of drugs known as statins, commonly used to lower cholesterol, have begun to see if they might help slow down the progression of Alzheimer's disease.

Studies have shown that people with Alzheimer's often have higher levels of an amino acid called homocysteine in their blood. High levels of homocysteine are known to increase the risk of heart disease. Folic acid and vitamins B6 and B12 can reduce levels of homocysteine in the blood, and scientists are conducting clinical trials to see whether these substances can also slow rates of mental decline.

Recently, scientists have focused on a type of memory change called mild cognitive impairment, or MCI. MCI is different from both Alzheimer's disease and age-related memory change. People with MCI have ongoing memory problems but do not have noticeable problems in other areas like confusion, attention problems, and difficulty with language.

Several years ago, a clinical trial showed that vitamin E slowed the progress of some consequences of Alzheimer's disease by about seven months. Other studies are considering whether antioxidants -- such as vitamin E and C -- can slow Alzheimer's. One clinical trial is examining whether vitamin E and/or selenium supplements can prevent Alzheimer's or stop mental decline. More studies on other antioxidants are ongoing or being planned.

Studies have linked keeping the brain active with a reduced risk of Alzheimer's disease. In a study of healthy older people and people with possible or probable Alzheimer's, scientists found that the healthy people had taken part in more mentally stimulating activities in their early and middle adulthood years than those who later developed Alzheimer's. The healthy group also spent more hours in these types of activities.

A growing body of research suggests that the more formal education a person has, the better his or her memory and learning ability will be, even if the brain turns out to have the type of plaques associated with Alzheimer's disease.

Some studies have suggested that estrogen used by women to treat the symptoms of menopause also protects the brain. Experts also wondered whether using estrogen could reduce the risk of Alzheimer's or slow the disease. However, clinical trials to test estrogen have not shown that it can slow the progression of Alzheimer's in women who have already been diagnosed with the disease. And one study found that women over the age of 65 who used estrogen with a progestin were at greater risk for dementia, including Alzheimer's. The study also showed that older women who used only estrogen could increase their risk of developing dementia. Scientists believe that more research is needed to find out if estrogen may play some role in Alzheimer's. They would like to know whether starting estrogen therapy around the time of menopause, rather than at age 65 or older, will protect memory or prevent Alzheimer's disease, and an NIH clinical trial is testing this possibility.

Early studies suggested that extracts from the leaves of the ginkgo biloba tree might be of some help in treating symptoms of Alzheimer's disease. There is no evidence yet that gingko biloba will cure or prevent Alzheimer's. Scientists are now trying to find out in a clinical trial whether ginkgo biloba can delay mental decline or prevent Alzheimer's disease or other types of dementia in older people.

Will a vaccine someday prevent Alzheimer's disease? Early vaccine studies in mice successfully reduced beta-amyloid plaques in the brain and improved the way mice performed on memory tests. But when the studies were conducted in humans, they had to be stopped because some participants experienced side effects. However, scientists are continuing to study variations of the vaccine approach in the hope that they will reduce beta-amyloid in the brain while minimizing harmful side effects.

Scientists have come a long way in their understanding of Alzheimer's disease. Findings from years of research have begun to clarify differences among age-related memory changes, mild cognitive impairment, and Alzheimer's disease. Scientists also have made great progress in defining the changes that take place in the Alzheimer's disease brain. This allows them to pinpoint possible targets for treatment.

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Alzheimer's Disease Treatments0

There is no known cure for Alzheimer's, but there are treatments that can prevent some symptoms from getting worse for a limited time. Ongoing research offers clues to the way Alzheimer's develops and the reasons it starts. It also offers hope that some day it may be possible to delay the onset of Alzheimer's, slow its progress, or even prevent it altogether. Alzheimer's disease develops slowly, starting with mild memory problems and ending in death. The course the disease takes and how fast changes occur vary from person to person. The time from diagnosis to end of life varies. It can be as little as 3 years if the person is over 80 when diagnosed. Or it may be as long as 10 years or more if the person is younger.

A person with Alzheimer's should be under a doctor's care and may see a neurologist, psychiatrist, family doctor, internist, or geriatrician -- a specialist who treats older adults. The doctor can treat the person's physical and behavioral problems and answer the many questions that the person or the family may have.

No treatment can stop Alzheimer's disease. However, for some people in the early and middle stages of the disease, the drugs Aricept®, Exelon® or Razadyne® -- previously known as Reminyl® -- may help prevent some symptoms from becoming worse for a limited time. Aricept® is also approved for severe symptoms of Alzheimer's. Another drug, Namenda®, is approved for use in moderate to severe forms of the disease, although it is also limited in its effects.

Also, some medicines may help control behavioral symptoms of Alzheimer's disease such as sleeplessness, agitation, wandering, anxiety, and depression. Treating these symptoms often makes patients more comfortable and makes their care easier for caregivers.

Family members and friends can assist people in the early stages of Alzheimer's in continuing their daily routines, physical activities, and social contacts. People with Alzheimer's should be kept up-to-date about the details of their lives, such as the time of day, where they live, and what is happening at home or in the world.

Memory aids may help in the day-to-day living of patients in the earlier stages of Alzheimer's. Some families find that a big calendar, a list of daily plans, notes about simple safety measures, and written directions describing how to use common household items are very useful aids.

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Alzheimer's Disease Diagnosis0

An early, accurate diagnosis of Alzheimer's disease helps patients and their families plan for the future. It gives them time to discuss care options while the patient can still take part in making decisions. And even though no drug can slow the onset or the progression of Alzheimer's, early diagnosis offers the best chance to treat the symptoms of the disease.
Today, the only definite way to diagnose Alzheimer's disease is to find out whether there are plaques and tangles in brain tissue. To look at brain tissue, doctors must wait until they do an autopsy, which is an examination of the body done after a person dies. Therefore, doctors can only make a diagnosis of "possible" or "probable" Alzheimer's disease while the person is still alive. At specialized centers, doctors can diagnose Alzheimer's disease correctly up to 90 percent of the time.

Doctors use several tools to diagnose "probable" Alzheimer's disease:

1. A complete medical history with questions about the person's general health, past medical problems, and any difficulties carrying out daily activities.
2. Medical tests, such as tests of blood, urine or spinal fluid.
3. Tests to measure memory, problem solving, attention, counting, and language.
4. Brain scans that allow the doctor to look at a picture of the brain to see if anything does not look normal.

Sometimes, these test results help the doctor find other possible causes of the person's symptoms. For example, thyroid problems, drug reactions, depression, brain tumors, and blood vessel disease in the brain can cause symptoms similar to those of Alzheimer's. Some of these other conditions can be treated successfully.

Recently, scientists have focused on a type of memory change called mild cognitive impairment, or MCI. MCI is different from both Alzheimer's disease and age-related memory change. People with MCI have ongoing memory problems but do not have noticeable problems in other areas like confusion, attention problems, and difficulty with language.

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Alzheimer's Disease Symptoms0

Alzheimer's disease begins slowly. At first, the only symptom may be mild forgetfulness. People in the early stage of Alzheimer's disease may have trouble remembering recent events, activities, or the names of familiar people or things. Simple math problems may become hard to solve. Such difficulties may be a bother, but usually they are not serious enough to cause alarm. However, as the disease goes on, forgetfulness begins to interfere with daily activities. People may forget the way home or find it hard to cope with daily life. Such symptoms are more easily noticed and become serious enough to cause people with Alzheimer's disease or their family members to seek medical help.

People in the middle stages of Alzheimer's disease may forget how to do basic tasks, like brushing their teeth or combing their hair. They can no longer think clearly. They begin to have problems speaking, understanding, reading, or writing. Later on, people with Alzheimer's disease may become anxious, agitated or aggressive, or wander away from home. Eventually, patients need total care.

Signs of mild Alzheimer's can include:

1.     memory loss
2.     confusion about the location of familiar places
3.     taking longer to accomplish normal daily tasks
4.     trouble handling money and paying bills
5.     poor judgment leading to bad decisions
6.     loss of spontaneity and sense of initiative
7.     mood and personality changes
8.     increased anxiety
9.     increasing memory loss and confusion
10.     shortened attention span
11.     problems recognizing friends and family members
12.     difficulty with language, including problems with reading and writing
13.     difficulty working with numbers
14.     difficulty organizing thoughts and thinking logically
15.     inability to learn new things or cope with new or unexpected situations
16.     restlessness, agitation, anxiety, tearfulness
17.     wandering -- especially in the late afternoon or at night
18.     repetitive statements or movement, occasional muscle twitches
19.     hallucinations and delusions, suspiciousness or paranoia, irritability
20.     loss of impulse control
21.     perceptual-motor problems

Symptoms of severe Alzheimer's include

1.     Inability to recognize family or loved ones
2.     Inability to communicate
3.     loss of sense of self
4.     weight loss
5.     seizures, skin infections, difficulty swallowing
6.     groaning, moaning, or grunting
7.     increased sleeping
8.     lack of bladder and bowel control
9.     total dependence on the caregive

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Alzheimer's Disease Causes0

Scientists do not yet fully understand what causes Alzheimer's disease. There probably is not one single cause, but several factors that affect each person differently. Age is the most important known risk factor for Alzheimer's disease. The number of people with the disease doubles every 5 years beyond age 65.
Family history is another risk factor. Scientists believe that genetics may play a role in the causes of Alzheimer's disease. For example, early-onset familial Alzheimer's disease, a rare form of Alzheimer's disease that occurs between the ages of 30 and 60, is inherited.

The more common form of Alzheimer's disease is known as late-onset. It occurs later in life, and no obvious family pattern is seen in most cases. One risk factor for this type of Alzheimer's disease is a gene that makes one form of a protein called apolipoprotein E, or apoE.

Everyone has apoE, which helps carry cholesterol in the blood. Only about 15 percent of people have the form that increases the risk of Alzheimer's. It is likely that other genes may also increase the risk of Alzheimer's or protect against it, but they remain to be discovered.

Scientists still need to learn a lot more about causes and risk factors. In addition to genetics and apoE, they are studying education, diet, environment, and molecular changes in the brain to learn what role they might play in the development of this disease.

Scientists are finding more clues that some of the risk factors for heart disease and stroke -- like high blood pressure, high cholesterol, and low levels of the vitamin folate -- may also increase the risk of Alzheimer's. Researchers are also investigating the possibility that physical, mental, and social activities may protect against Alzheimer's.

Studies have shown that keeping the brain active may be associated with a reduced risk of Alzheimer's. In a study with nuns, priests, and brothers known as the Religious Orders study, researchers asked more than 700 participants to describe the amount of time they spent in mentally stimulating activities.

These activities included listening to the radio, reading newspapers, playing puzzle games, and going to museums. After following the participants for four years, researchers found that the risk of developing Alzheimer's was 47 percent lower on average for those who did these mentally stimulating activities most frequently than for those who did them least frequently.

There are no treatments, drugs, or pills that can prevent Alzheimer's, but people can take some steps that may reduce their risk. These include:

1.     lowering cholesterol and homocysteine levels
2.     lowering high blood pressure levels
3.     controlling diabetes
4.     exercising regularly
5.     engaging in activities that stimulate the mind
6.     A healthy diet is important. Although no special diets or nutritional supplements have been found to prevent or reverse Alzheimer's disease, a balanced diet helps maintain overall good health.

Research has not shown that these steps will lower your risk for Alzheimer's, and studies designed to directly test their ability to do so are currently in progress. However, all of these things are good to do anyway because they lower the risk for other diseases and help maintain and improve your overall health and well-being.

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Alzheimer's Disease0

Dementia is a brain disorder that seriously affects a person's memory, thinking, and reasoning skills. People with dementia often have trouble thinking and speaking clearly, remembering recent events, and learning new things. Over time, it becomes hard for them to handle everyday activities and take care of themselves. There are many causes of dementia, but Alzheimer's disease is the most common cause of dementia in older persons. Scientists think that up to 4.5 million people in the United States suffer from Alzheimer's disease. The disease usually begins after age 65 and risk goes up with age. While younger people also may get Alzheimer's disease, it is much less common.

About 5 percent of men and women ages 65 to 74 have Alzheimer's disease, and nearly half of those age 85 and older may have the disease. It is important to note, however, that Alzheimer's disease is not a normal part of aging.

Alzheimer's disease is named after Dr. Alois Alzheimer, a German doctor. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. He found abnormal clumps and tangled bundles of fibers. The clumps are now called amyloid plaques and the tangles are called neurofibrillary tangles. Today, these plaques and tangles in the brain are considered signs of Alzheimer's disease.

Scientists also have found other brain changes in people with Alzheimer's disease. There is a loss of nerve cells and pathways in areas of the brain that are vital to memory and other mental abilities. There also are lower levels of some of the chemicals in the brain that carry complex messages back and forth between nerve cells.

Alzheimer's disease is characterized by the general atrophy (dying back) of the cerebral cortex with accumulation of proteins into neuritic (senile) plaques in the cortex and neurofibrillary tangles in the brain. The initial symptom of the disease is usually memory loss. Impairments in behavior and decline in daily living activities become more apparent as the neurodegeneration progresses. The most important risk factor for the disease is advancing age, but heredity also plays a significant role. Several different classes of medications are available to treat multiple aspects of mental impairment. These treatments do not slow the progression of the disease. Once dementia has set in, patients are usually in need of assistance with daily living or may be candidates for a skilled nursing facility. Although exercise, a healthy diet, and mentally stimulating activities are helpful to the patient, studies have shown they are not preventative. Research into the mechanisms of the disease has guided the search for new treatment. Some medications under investigation include anti-inflammatories, stem cells, and vaccines.

Alzheimer's disease may disrupt normal thinking and memory by blocking these messages between nerve cells.

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