Prevalence of Alzheimer’s Rises 10% in 5 Years

New York Times: News Source



March 21, 2007

Prevalence of Alzheimer’s Rises 10% in 5 Years

By JANE GROSS

More than five million Americans have Alzheimer’s disease, a 10 percent increase from the last official tally five years ago, and a number expected to more than triple by 2050, absent a cure, as the 85-and-over population soars and the baby boomers move into their late 60s and 70s.

The updated estimates, based on the rising occurrences of the disease with age, not new disease research, were released yesterday by the Alzheimer’s Association, along with a compilation of other information about a progressive brain disease that afflicts 13 percent, or one in eight people 65 and over, and 42 percent of those past 85.

Much of the report is a synthesis of existing research on the prevalence and costs of the disease. But the report includes the startling finding that 200,000 to 500,000 people younger than 65 have some form of early onset form of dementia, including a rare form of Alzheimer’s disease that strikes people in their 30s and 40s.

Mary Mittelman, an Alzheimer’s researcher at New York University, had mixed feelings about disproportionate attention to early onset Alzheimer’s disease. On the one hand, Dr. Mittelman said, these cases are such a small minority that she fears will take focus and resources “from the majority who are much older.” On the other, she said, "because of the ageism of this society” far too many people still believe dementia to be part of normal aging and attention to this younger group will clarify that it is a "real disease.”

Apart from early onset cases, the primary risk factor for Alzheimer’s disease is age.

Alzheimer’s disease, the most common form of dementia, affects memory, reasoning and communication. In the advanced stage, people need help dressing, using the bathroom and eating. In the final stages, they cannot speak or recognize family members. The disease is ultimately fatal.

Currently, there are five drugs approved by the Food and Drug Administration that slow the disease’s symptoms for 6 to 12 months in half the individuals who take them. Nine other drugs are in late-stage trials.

Yesterday’s report was released at a hearing in Washington, where Congress is considering a bipartisan bill to increase research money.

The report itemizes the cost to the federal government in Medicare spending. Care for a patient with dementia costs three times as much as care for the average beneficiary — $13,207 a year vs. $2,454 — and overall dementia-related Medicare costs are expected to more than double, to $189 billion, by 2015.

Other costs include the value of unpaid care provided by family and friends to the vast majority of Alzheimer’s patients who live at home.

Estimates were based on research by the Rush Alzheimer’s Disease Center in Chicago, which analyzed incidence of the disease locally. That incidence information was then extrapolated to national prevalence using census population figures and census projections.

Copyright 2007 The New York Times Company

Currently, there are five drugs approved by the Food and Drug Administration that slow the disease’s symptoms for 6 to 12 months in half the individuals who take them. Nine other drugs are in late-stage trials.

I wonder if cannabis is one of those? It seems insane that something that has proven to be of value could be tossed aside just because of drug war rhetoric.

Click HERE to rent this MEDICINES advertising spot to support LongeCity (this will replace the google ad above).

I wonder if cannabis is one of those?

I highly doubt it.

If anything, cannabis is probably a culprit of inducing alzheimers.

If anything, cannabis is probably a culprit of inducing alzheimers.

First fluoride aversion, now this. Will you please back up your claims with some science? Cannabis has actually been projected to PROTECT AGAINST Alzheimer's and increase neuroplasticity due to its anti-inflammatory mechanisms upon the brain, just take a look at these studies reported by the BBC.

Another person who has yet to attain the ability to properly duduce the meaning of statements.

If you notice, I said at the beginning the words "if anything" preceded by the word "probably".


In the scientific community, I guess you could conclude that as being a hypothesis.

No where did I state that as a factual statement.


Where did I say "not" to use flouride? Did I say flouride was a negative to human health in any of my statements? If I told you that I drink soy milk (which I do not), would you take that as me being anti-dairy?

Please refrain yourself from further embarrassment.

Semantics games are the best.

Another person who has yet to attain the ability to properly duduce the meaning of statements. 

If you notice, I said at the beginning the words "if anything" preceded by the word "probably".


In the scientific community, I guess you could conclude that as being a hypothesis.

No where did I state that as a factual statement.


Where did I say "not" to use flouride?  Did I say flouride was a negative to human health in any of my statements?  If I told you that I drink soy milk (which I do not), would you take that as me being anti-dairy? 

Please refrain yourself from further embarrassment.

Clean up your act, or go join an internet community where your kind of bullshit actually flies. Shape up, shut up, or get out. You made a statement and someone called you on it. Go use the search function, find the study which has already been listed on these forums, and paste it instead of whining about how you're not really making factual statements.

I think you need to re-read the study. The study was done on rats. Although other drugs have worked the same for humans as in rats, not all have. It has yet to be tested in humans! People such as yourself jump prematurely to conclusions of these studies. Also, it was based at slowing down the progression of alzheimer's disease. They hypothesize that it may help prevent the disease but don't know for sure.

There is no bullshit here. If only this were a study done with humans. Ohhh only if.

Also, you are still acting very immature. I've read over a few of your posts, and the vast majority of them are of no benefit whatsoever to this community. They are very negative in nature. Do you always have a chip on your shoulder?

The study was done on rats.  Although other drugs have worked the same for humans as in rats, not all have.  It has yet to be tested in humans!  People such as yourself jump prematurely to conclusions of these studies.  Also, it was based at slowing down the progression of alzheimer's disease.  They hypothesize that it may help prevent the disease but don't know for sure.

My info was attained from here:

http://www.medscape....warticle/546336



Can you say for certainty that marijuana will benefit alzheimer's patients addison? Do you believe everything that you hear? If this is so, you are not very scientifically inclined in nature. Don't try to be something you aren't.



I am through with this nonsense. Why not cool it with the language also. Act like an adult, and you shall be treated like an adult.

More than five million Americans have Alzheimer�s disease, a 10 percent increase from the last official tally five years ago, and a number expected to more than triple by 2050, absent a cure, as the 85-and-over population soars and the baby boomers move into their late 60s and 70s. [/b]

The best prevention seems to be tobacco smoking:

Apolipoprotein E genotype and association between smoking and early onset Alzheimer's disease

van Duijn CM, Havekes LM, Van Broeckhoven C, de Knijff P, Hofman A.
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, Netherlands.

OBJECTIVE--To investigate the hypothesis that differential survival between smokers and non-smokers leading to a decrease in the frequency of the e4 allele of the apolipoprotein E gene may explain the inverse relation between smoking history and early onset Alzheimer's disease.
DESIGN--A population based case-control study.
SETTING--The four northern provinces of the Netherlands and metropolitan Rotterdam.
SUBJECTS--175 patients with early onset Alzheimer's disease and two independent control groups of 159 and 457 subjects. MAIN OUTCOME MEASURES--Frequencies of the apolipoprotein e4 allele and relative risk of early onset Alzheimer's disease.

RESULTS--The inverse association between smoking history and early onset Alzheimer's disease could not be explained by a decrease in the frequency of the apolipoprotein e4 allele. Among carriers of this allele with a family history of dementia subjects with a history of smoking had a strongly reduced risk of early onset Alzheimer's disease (odds ratio 0.10 (95% confidence interval 0.01 to 0.87)).
CONCLUSIONS--The results suggest that the inverse relation between smoking history and early onset Alzheimer's disease cannot be explained by an increased mortality in carriers of the apolipoprotein e4 allele who smoke. The association is strongly modified by the presence of the apolipoprotein e4 allele as well as by a family history of dementia.


I haven't seen any other drug or natural remedy which can reduce the Alzheimer's rates tenfold, or even close to it. Smoking also reduces risk of schizophrenia and Parkinson's by factors 2 to 3, possibly due to a very strong (by factor 2 vs nonsmokers) MAO B inhibition observed in long term smokers (which is unrelated to nicotine and its upregulation of acetylcholine by factor 2). Note that selegiline (deprenyl) has very similar MAO B inhibition properties to tobacco smoke and is used in smoking cessation pharmaceuticals as well as for treatment of Parkinson's and Alzheimer's. { Curiosly, over 90% of schizophrenics smoke (they are mostly chain smokers, since it relieves their symptoms), yet at any age they have 30-50% lower rates of lung cancer as well as many other cancers, compared to general population which has 20-30% smokers and who smoke less cigarettes per smoker than schizophrenics. }

Another possible mechanism behind this dramatic protective effect, especially relevant for ApoE4 allele carriers (who have increased risk for early onset Alzheimer's and who were studied above) is the upregulation of glutathione by tobacco smoke (80% higher in smokers). Since glutathione is the master antioxidant and detox enzyme in human body, especially significant in removal of mercury and aluminum (via bile), while ApoE4 carriers have reduced rates of mercury removal from brain, it may be that the near doubling of glutathione in smokers helps ApoE4 carriers against the chronic mercury toxicity (e.g. from amalgams, seafood) which produces damage to neurons indistinguishable from that seen in Alzheimer's patients.

The decline in smoking, due to the intense antismoking social engineering results in millions more Alzheimer's, Parkinson's and schizophrenia patients. The pharmaceutical industry, which profits enormously from these extra millions of AD, Parkinson's and schizophrenia patients who need expensive pharmaceuticals for years or decades, purely accidentally I suppose, happens to be the principal sponsor of antismoking "research", "grass roots" antismoking organizations, antismoking legislations and regulations.

Edited by nightlight, 23 March 2007 - 05:01 PM.

[sarcasm] My HIGHLY regarded scientific opinion : [/sarcasm]

I believe that Alzheimers is most directly related to diet. In my family, my great uncle suffered from a case of Alzheimer's disease, and although he was the most intellectual one of his family group, he undoubtedly had the worst diet. My own grandfather, who embraces quite a healthy life style is still alive and shows no trace of a mental disorder. He grows and eats vegetables from his garden. I think its the vegetables, to be honest.

I doubt anyone here will have a problem (even if it runs in your family) if you embrace a healthy lifestyle -- which I assume most of you do.

News Source: The New York Times




Image Credit: Sally Ryan for The New York Times
Lawrence Goldstein, center, and Mollie Simon on the Culture Bus, a Chicago Alzheimer's support group.

March 29, 2007

Living With Alzheimer’s Before a Window Closes

By JANE GROSS

Mary Blake Carver gazes from the cover of a neurology magazine this month, under the headline “I’m Still Here!” She often feels like shouting the message to her friends, her children, her husband.

Ms. Carver, 55, is among the growing ranks of people in the early stages of Alzheimer’s disease, when short-term memory is patchy, organizational skills fail, attention wanders and initiative comes and goes. But there is still a window of opportunity — maybe one year, maybe five — to reason, communicate and go about her life with a bit of help from those around her.

Yet Ms. Carver is often lonely and bored. Her husband leaves her out of many dinner table conversations, both say, because she cannot keep up with the normal patter. He insists on buttoning her coat when she fumbles at the task. She was fired as a massage therapist because she lost track of time. So Ms. Carver fills her days by walking her neighborhood on the Upper West Side of Manhattan, always with her dog, so she looks like “an ordinary person,” she said, not someone with “nothing better to do.”

Five million people in the United States have Alzheimer’s disease, according to a study last week by the Alzheimer’s Association. About half, 2.5 million, are at the early stages of the disease, other studies have found, struggling to pass for normal.

They are impaired but not helpless or demented, and now a growing number are speaking out about how it feels to be them: Silenced prematurely or excluded from decision making. Bristling at well-meaning loved ones who boss them around. Seeking meaningful activities to fill their days.

Out of their individual frustrations, these patients are creating a grass-roots movement to improve services and change public perceptions. And they are making a mark.

Early stage patients like Ms. Carver, telling their own stories, have become popular speakers at national conferences and persuasive lobbyists with state and federal lawmakers. Closer to home, they are pushing for more patient support groups, creating social networks and taking part in couples counseling to restructure their marriages after diagnosis.

Rarely have ill spouses and well spouses participated in joint support groups because of the widespread belief that their fears and frustrations are very different and that Alzheimer’s patients were too far gone to benefit. Historically, social service agencies have focused on the needs of caregivers. But that, too, is changing. “We’ve given wide attention to the caregivers and ignored the psychological and relational aspects of the lives of people with the disease,” said Peter V. Rabins, a professor of psychiatry at the Johns Hopkins University and a co-author of “The 36-Hour Day,” a guidebook for caretakers. “So these are important steps toward redressing this imbalance.”

Ms. Carver’s husband, Stephen, an electrician at a Broadway theater, is mindful that spouses — fearful and overwhelmed — can be insensitive and impatient as their mates’ abilities decline.

“They can’t always follow what’s going on if there’s too much input,” Mr. Carver said. “Their brains have to work so much harder, which tires them out, and their logic isn’t always linear, so there’s a tendency to think they don’t comprehend. I’m not a patient person by nature, and Mary’s losing her mental capabilities. So I have to slow down and adapt. And I have to remind myself that she still has feelings and perceptions. She still has an emotional life.”

Absent a cure, or more effective drugs, Alzheimer’s disease is a march to oblivion. But the process can unfold over two decades. Patients at the front end, said Paulette Michaud, manager of early stage services at the New York City Alzheimer’s Association chapter, “lose the sense of independence and control much more quickly than they need to because everyone focuses on their deficits.”

“These are still viable people,” Ms. Michaud continued. “What are they supposed to do for the next three, four, five years of life?”

Some answers are emerging, as patients request and help design new programs at academic medical centers and social service agencies. Among them is a speakers’ bureau at the New York City chapter of the Alzheimer Association that grew out of complaints of boredom.

Ms. Carver is among the most popular speakers. She flushes with accomplishment when she is on the podium at a conference but recalls none of it moments after leaving the stage. Ms. Carver sobs at the extent of her short-term memory loss. Her support group friends comfort her, reminding her that their memories may be better, but their speech or concentration is worse.

At the Alzheimer’s clinic at Northwestern University Medical School, support group participants told Darby Morhardt, the facilitator, that they yearned to spend more time together. As a result, in partnership with the Council for the Jewish Elderly in Chicago, Ms. Morhardt’s support group takes regular bus trips to historical and cultural sites of their choosing like an African-American art museum, a glass blower’s studio and a Hindu temple.

Social groups are also springing up for couples. In San Anselmo, Calif., Peter and Judy Hebert regularly entertain new friends from Mr. Hebert’s two support groups, each with different deficits but all relatively high-functioning.

Mr. Hebert, once an official at the General Services Administration, is 67 and retains his short-term memory, but his speech and motor skills are deteriorating five years after diagnosis, and he cannot reassemble a sandwich should one piece of bread fall off. But he can maintain a busy schedule visiting assisted-living centers and nursing homes to exhibit his landscape photography, and sometimes his speech flows.

“It feels like I’m working,” Mr. Hebert said.

His wife accompanies him, struggling not to fill in the blanks in his halting sentences. “We all have that tendency to take over,” she said.

How much hovering is too much has been a common topic in couples counseling sessions at New York University that are part of a research study by Dr. Mary S. Mittelman.

The study, in which couples receive six counseling sessions together, was to have included 200 couples, but 16 have signed up, an indication, some of Dr. Mittelman’s colleagues said, that many couples still do not welcome frankness.

At the sessions, a counselor with expertise in Alzheimer’s disease can guide the conversation, slow everything down and offer enough encouragement so the ill spouse can participate. In reviewing early results, Dr. Mittelman said, the patients with dementia said they enjoyed being included, and their spouses said they learned ways to make that happen.

Months later, the patients remembered the counselor and were happy to be back, though the content of the sessions had disappeared from memory and they veered between confusion and understanding.

“What am I doing now?” asked John McCrosky, 75, directing the question at his wife, Corinne Samios.

The counselor intervened, asking, “Are you the same John as when I saw you last?”

“No, I’m not the same,” he said, slyly setting up the punch line to his own joke. “Now I can’t remember to flush.”

The second study involving couples, led by Carol J. Whitlatch of the Cleveland Institute, compared the expectations of the ill spouse and the caregiver spouse, with an eye toward planning for the future.

Both began the counseling assuming that all needs would be met by the well spouse but quickly saw that this was unfair and together sought areas where care could be delegated.

A result, Dr. Whitlock said, was that patients felt involved in the decision making and caregivers felt relieved at having more options than they had imagined, sometimes even the acknowledgment of the ill spouse that a nursing home might someday be necessary.

The groundwork for the current self-help movement is the 20-year-old work of Robyn Yale, a social worker in Northern California, who ran patient support groups when most Alzheimer’s agencies considered them incapable of benefiting. Ms. Yale is now organizing groups for early stage patients in assisted-living centers and nursing homes.

“It’s been a long process of changing stereotypes,” Ms. Yale said. “But we’re finally hearing their voices, and we need to respond to that.”

One frustration among innovators in the field is creating volunteer opportunities for people who are too forgetful or confused to do many jobs. An agency tried that in California, pairing a cognitively intact volunteer with a second volunteer with mild dementia, but, over time, the labor-intensive project could not be sustained.

Last year, the national office of the Alzheimer’s Association declared early stage services a priority. The association now has an advisory board made up of patients, most whom have a rare early onset form of the disease, which sometimes runs in families.

People struck with dementia of various sorts in the prime of life — 200,000 to 500,000, according to last week’s study — have been the most aggressive advocates, experts say. They have not settled into retirement or been slowed by other infirmities, and they also came of age in an era of activism.

“This younger group, we’re mouthy,” said Chuck Jackson, 53, one of the board members, a former outplacement counselor for loggers who left his job upon diagnosis, wanting to “enjoy daily life” as long as possible.

“I know where I’m going to end up,” Mr. Jackson said.

So do John Carpenter and Mary Carver, but they are not there yet.

Mr. Carpenter, who once performed in Broadway musicals, was determined to perform again after his illness was diagnosed recently at age 82. One of his “big hurts,” Mr. Carpenter said, “is not knowing what I’m going to do tomorrow or the next day or the day after that.” His wife, Milly, “doesn’t talk to me like she used to,” he said.

“And,” he added, “when people say, ‘Tell me what you did,’ it’s gone, just gone. I want to be who I was.”

So he petitioned the Alzheimer’s Association to let him star in a play about the disease. And he and Ms. Carver, a former singer, told Ms. Michaud, the group leader, that they would enjoy performing together. Could she help them find an adult day care center where they could entertain? She can, and she will.

Copyright 2007 The New York Times Company

News Source: Philly.com



The Associated Press

WASHINGTON - More than 26 million people worldwide have Alzheimer's disease, and a new forecast says the number will quadruple by 2050. At that rate, one in 85 people will have the brain-destroying disease in 40 years, researchers from Johns Hopkins University conclude .

The new estimates, being presented Sunday at an Alzheimer's Association conference in Washington, are not very different from previous projections of the looming global dementia epidemic with the graying of the world's population.

But they serve as a sobering reminder of the toll to come if scientists cannot find better ways to battle Alzheimer's and protect aging brains.

"If we can make even modest advances in preventing Alzheimer's disease, or delay its progression, we could have a huge global public health impact," said Johns Hopkins public health specialist Ron Brookmeyer, who led the new study.

The biggest jump is projected for densely populated Asia, home of almost half of today's Alzheimer's cases, 12.6 million. By 2050, Asia will have 62.8 million of the world's 106 million Alzheimer's patients, the study projects.

A recent U.S. study estimated that this nation's Alzheimer's toll will reach 16 million by 2050, compared with more than 5 million today. The new estimate is significantly lower, suggesting only 3.1 million North American cases today and 8.8 million by 2050.

Among the estimates for other regions are:

,Africa, 1.3 million today and 6.3 million in 2050.

,Europe, 7.2 million and 16.5 million.

,Latin America and the Caribbean, 2 million and 10.8 million.

,Oceania, 200,00 and 800,000.

The project was funded by Elan Pharmaceuticals and Wyeth Pharmaceuticals.
,,,

On the Net:

Alzheimer's Association: http://www.alz.org/
 
Find this article at:
http://www.philly.co...th/7922587.html 

Does anybody else stay up at night worrying about the statistical probabilities of losing mind before losing life?

Here's to participating in the life extension and nootropic movement of today to prevent a forgetful us of tomorrow.

The average age of the U.S. population is going up (and there are a lot of people with crappy diets). It makes sense then that alzheiners cases are rising.

It appears there are four new drugs that may bring a "new era of hope" to treat Alzheimer's disease:

News Source: Medical News Today



Four Alzheimer's Drug Trials Bring New Era Of Hope

12 Jun 2007 

Results from a series of trials on four drugs to treat Alzheimer's appear to bring a new era of hope to patients with the disease, according to scientists reporting their findings to the 2nd Alzheimer's Association International Conference on Prevention of Dementia in Washington, DC yesterday. The conference brings together over 1,000 dementia experts from around the world.

The four drugs are an anti-amyloid (Alzhemed), an inhibitor of brain cell death (Dimebon), an "Alzheimer's vaccine" (Immunotherapy Treatment AN1792), and a drug normally used to treat diabetes (Avandia).

Alzheimer's disease is thought to be caused by build up of a protein called amyloid beta which forms plaques and tangles in the brain, kills off brain cells and interferes with neuron to neuron signalling.

Approved treatments for Alzheimer's currently only relieve symptoms for a couple of years and make little impact on the amyloid beta build up and the progress of the disease. Vice president for Medical and Scientific Relations at the Alzheimer's Association, Dr William Thies said that:

"Amyloid as a cause for Alzheimer's and a primary target for therapies and preventions must be thoroughly tested."

"We need an answer to this question so that we can then sharpen our focus on attacking amyloid and creating better treatments, or change the focus to other areas if the theory is wrong," he added.

Dr Sam Gandy, chair of the Alzheimer's Association's Medical and Scientific Advisory Council said they were very pleased to see so many drugs make it to clinical trials, and was optimistic that:

"The odds are quite good that we'll have more effective new treatments for Alzheimer's in the near future."

Developing a new drug is a lengthy and expensive process that takes up to 15 years and on average costs 800 million US dollars. According to the Alzheimer's Association, only 5 out of 10,000 compounds investigated make it to clinical trials, and of those, only one makes it through to approval for treatment. And, in the case of Alzheimer's, there are added challenges; for example, the only definitive diagnosis at the moment involves sampling brain tissue.

Anti-Amyloid: Alzhemed

Tramiprosate, brand name Alzhemed (made by Neurochem) is an orally-administered amyloid beta antagonist that is currently in Phase III clinical trials to assess its safety, efficacy and disease modifying effects in patients with mild to moderate Alzheimer's.

Alzhemed binds to amyloid beta protein and interferes with its ability to build plaque and poison brain cells.

Dr Paul Aisen, Professor of Neurology and Medicine, and Director of the Memory Disorders Program at the Georgetown University Medical Center, Washington DC , and lead author presented the conference with an update of the trial.

The key points were:

o The randomized, double-blind, placebo controlled trial enrolled 1,052 patients from several medical centres in the US and Canada.
o All patients were taking doses of acetylcholinesterase inhibitors, with or without memantine.
o Patients took either the active drug or a placebo twice a day for 18 months and were assessed every three months.
o Assessments included tests of cognitive function, disability, clinical efficacy, and volumetric MRI to assess effect of the disease on brain volume.

Unfortunately Aisen was unable to present any conclusions because there is a lot of complex data that is still being processed. Apparently there are significant unexpected differences in the data coming from the various sites and these need to be accounted for before the results can be finalized.

Gandy said that while the results of the Alzhemed Phase III clinical trial were not available, there was a positive note:

"We have learned important lessons about how to do these types of very complex, long-term, large-scale Alzheimer's trials, which in itself is very important because there are now so many promising Alzheimer's therapies in the pipeline," he explained.

Brain Cell Death Inhibitor: Dimebon

Dimebon (made by Medivation) is an orally-administered drug that has shown ability to stop brain cell death in preclinical testing for Alzheimer's and Huntington's.

Dimebon appears to offer brain cells protection from amyloid build up by blocking something that targets their mitochondria. Mitochondria supply cells with energy and are also involved in programmed cell death (apoptosis) which is associated with neurodegenerative diseases like Alzheimer's and ageing.

Dr Rachel Doody, Effie Marie Cain Chair in Alzheimer's Disease Research and Professor of Neurology at Baylor College of Medicine, Houston, Texas reported the 12 month results of a small trial, which was already reported at the six-month stage:

o The trial took place in Russia and enrolled 183 patients with mild to moderate Alzheimer's.
o The patients were randomized to receive Dimebon or placebo three times a day for six months.
o They were then offered to continue in a double blind trial extension for another six months.
o No other anti-dementia medication was allowed.
o Assessments included a battery of cognitive and other tests of behaviour and daily functioning (ADAS-cog was the primary endpoint) performed at baseline and then roughly every 3 months.
o The results showed that patients improved significantly compared to baseline on all measures and the drug was well tolerated.

According to Dr William Thies, vice president of medical and scientific affairs at the Alzheimer's Association, Dimebon limits symptoms in a similar way to glutamate antagonists (also used to treat Alzheimer's) and anticholinesterases such as Aricept.

Adverse events included dry mouth and sweating and over 30 per cent of the patients dropped out of the trial. This high drop out rate could raise some concerns, said some critics, although the results are promising.

Medivation will be seeking approval for Dimebon in 2010.

"Alzheimer's Vaccine": Immunotherapy Treatment AN1792

AN1792 is a synthetic form of the amyloid beta protein (made by Elan and Wyeth) which was used in an immunotherapeutic clinical trial that was stopped because 6 per cent of the patients began to suffer from inflammation of the brain (encephalitis).

However, the researchers followed the patients after the trial.

Dr Michael Grundman, Senior Director of Clinical Development in the Alzheimer's Disease Program at Elan Pharmaceuticals presented their findings to the conference. These showed that 4.5 years after immunization with AN1792, patients who had developed antibodies to amyloid beta continued to show detectable levels of antibodies and slower decline in daily living compared with patients treated with placebo.

The key points of their findings were:

o 159 patient/caregiver pairs took part in the follow-up (30 placebo patients and 129 patients on AN1792).
o Of the 129 AN1792 patients, 25 were classed "antibody responders".
o Compared to the placebo group, the antibody responders showed significant favourable results in: ability to look after themselves and pursue leisure activities; dependency on caregivers; and memory and thinking skills.
o After the first year, brain volume changes in antibody responders and placebo patients were similar.
o No further cases of encephalitis were observed.

"The favorable results on Activities of Daily Living among the antibody responders in this study support the hypothesis that amyloid beta immunotherapy may have long-term benefits for patients with mild to moderate Alzheimer's and their caregivers," said Grundman.

Diabetes drug: Avandia

Rosiglitazone, brand name Avandia (made by GlaxoSmithKline) is already approved for treatment of type 2 diabetes (but not for Alzheimer's). It lowers blood sugar by helping cells use insulin more effectively.

Scientists have speculated that Avandia may also be able to help Alzheimer's patients because of its effect on brain inflammation and other processes associated with neurodegenerative diseases.

However, in recent months, Avandia has been in the spotlight because a recent study that reviewed the available published research suggested that diabetes patients on Avandia were at increased risk of heart attack and death from cardiovascular causes.

Researchers studied the effect of an extended release form of Avandia (Rosiglitazone XR) on Alzheimer's patients for 12 months. This was a follow up open lable extension to a randomized controlled trial.

The results suggested that Avandia may help some Alzheimer's patients depending on their genetic make up. Patients that were "APOE e4 negative" did benefit from the treatment, they showed some improvement. But patients who were "APOE e4 positive" either did not improve or continued to decline.

The key points of the study were:

o 337 patients with mild to moderate Alzheimer's enrolled in the study and 82 per cent of them completed it.
o 7 per cent pulled out because of adverse events.
o 48 per cent had one or more adverse events (mostly peripheral oedema, or fluid accumulation, in the legs or sacral region, nasopharyngitis or inflammatioon of the nasal passages and pharynx).
o 9 per cent had one or more severe adverse events, each of which occurred in 1 per cent or less of the patients (except for fractures, 2 per cent).
o Few patients had clinically significant changes in heart rate (less than 1 per cent) or abnormal ECG readings (2 per cent).
o Insulin and glycemic control measures were within the range expected for older people with low insulin resistance.

Although there is controversy surrounding the use of Avandia as a type 2 diabetes drug because of the link with elevated heart problem risks, these risks could be outweighed by the potential benefits when considering the benefit-risk profile of person with Alzheimer's.

Global Clinical Vice President, Neurology, at GlaxoSmithKline, Dr Michael Gold said that Avandia appeared to have a safety profile similar to that already seen in diabetes type 2 patients. He added that:

"Rosiglitazone XR (Avandia) appeared to be generally well tolerated in subjects with Alzheimer's for up to 72 weeks."

Thies said: "There is value in continuing to study rosiglitazone in Alzheimer's. We need to attack the disease through multiple mechanisms, and the only way we can learn with certainty about issues of safety and efficacy in Alzheimer's is through clinical trials."

"There are risks involved in clinical studies, and we do need to ensure that all risks are thoroughly described and explained to study participants and family members. That's why we have informed consent, and why the process is so important," he added.

Click here for the Alzheimer's Association (US).
http://www.alz.org/

Click here for more articles on Alzheimer's research (Medical News Today).
http://www.medicalne...ons/alzheimers/

Written by: Catharine Paddock
Writer: Medical News Today
Copyright: Medical News Today
Article URL: http://www.medicalne...hp?newsid=73899


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http://www.aan.com/membersearch/

Print Resources

The Academy publishes several brochures on neurology which are used by members for patient information. The Patient Information Guide for Neurology lists organizations which can supply information and materials on specific diseases. The publication, Neurologist, describes what a neurologist is and does. Serial publications: Neurology (journal), monthly; AANews (newsletter), monthly.

A potentially related story:

The American Academy of Neurology: News Source



EMBARGOED FOR RELEASE UNTIL 4 PM ET, JUNE 27, 2007

Media Contacts: Angela Babb, (651) 695-2789, ababb@aan.com or Robin Stinnett, (651) 695-2763, rstinnett@aan.com.

Frequent Brain Stimulation in Old Age Reduces Risk of Alzheimer’s Disease

ST. PAUL, Minn – EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, WEDNESDAY, JUNE 27, 2007 Media Contacts: Angela Babb, ababb@aan.com, (651) 695-2789 Robin Stinnett, rstinnett@aan.com, (651) 695-2763

Frequent Brain Stimulation in Old Age Reduces Risk of Alzheimer’s Disease

ST. PAUL, Minn – How often old people read a newspaper, play chess, or engage in other mentally stimulating activities is related to risk of developing Alzheimer’s disease, according to a study published June 27, 2007, in the online edition of Neurology®, the medical journal of the American Academy of Neurology.

For the study, more than 700 people in Chicago, IL, with an average age of 80 underwent yearly cognitive testing for up to five years. Participants were part of the Rush Memory and Aging Project, a longitudinal study of more than 1,200 older people. Of the participants, 90 developed Alzheimer’s disease. Researchers also performed a brain autopsy on the 102 participants who died.

The study found a cognitively active person in old age was 2.6 times less likely to develop dementia and Alzheimer’s disease than a cognitively inactive person in old age. This association remained after controlling for past cognitive activity, lifetime socioeconomic status, and current social and physical activity.

Researchers say the findings may be used to help prevent Alzheimer’s disease.

“Alzheimer’s disease is among the most feared consequences of old age,” said study author Robert S. Wilson, PhD, with the Rush Alzheimer’s Disease Center at Rush University Medical Center in Chicago. “The enormous public health problems posed by the disease are expected to increase during the coming decades as the proportion of old people in the United States increases. This underscores the urgent need for strategies to prevent the disease or delay its onset.” Wilson says the study also found frequent cognitive activity during old age, such as visiting a library or attending a play, was associated with reduced risk of mild cognitive impairment, a transitional stage between normal aging and dementia, and less rapid decline in cognitive function.

The study was supported by grants from the National Institute on Aging and the Illinois Department of Public Health.

The American Academy of Neurology, an association of more than 20,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer’s disease, epilepsy, Parkinson’s disease, and multiple sclerosis. For more information about the American Academy of Neurology, visit www.aan.com.

Also of interest may be the following topics:

1. Marijuana may stave off Alzheimer's - U.S. Study

2. Rat study shows how marijuana may ease Alzheimer's

Take care.

[sarcasm] My HIGHLY regarded scientific opinion : [/sarcasm]

I believe that Alzheimers is most directly related to diet. In my family, my great uncle suffered from a case of Alzheimer's disease, and although he was the most intellectual one of his family group, he undoubtedly had the worst diet. My own grandfather, who embraces quite a healthy life style is still alive and shows no trace of a mental disorder. He grows and eats vegetables from his garden. I think its the vegetables, to be honest.

I doubt anyone here will have a problem (even if it runs in your family) if you embrace a healthy lifestyle -- which I assume most of you do.

what exactly do you mean by bad diet? this can mean many things to many people, so what exactly was your great uncle's diet approx ?

An update, I guess -- on new research on what appears to be one of the most popular Alzheimer's drugs on the market:

Here's some introductory information regarding the primary source of evidence: The American Academy of Neurology - AAN -- from the U.S. Department of Health and Human Services:

American Academy of Neurology - AAN

Organization URL(s)

memberservices@aan.com
www.aan.com

Other Contact Information

1080 Montreal Avenue
St. Paul, MN 55116

800-879-1960 (Voice - Toll-free)
651-695-2717 (Voice)
651-695-2791 (FAX)

Description

The American Academy of Neurology (AAN) is a professional society composed of neurologists and professionals in related fields who share a common goal of continued growth and development of the neurological sciences.

Online Resources

Find a Neurologist
http://www.aan.com/membersearch/

Print Resources

The Academy publishes several brochures on neurology which are used by members for patient information. The Patient Information Guide for Neurology lists organizations which can supply information and materials on specific diseases. The publication, Neurologist, describes what a neurologist is and does. Serial publications: Neurology (journal), monthly; AANews (newsletter), monthly.

Here is some info from wikipedia on AAN:

The American Academy of Neurology (AAN) is a professional society for neurologists and neuroscientists. As a medical specialty society it was established in 1949 to advance the art and science of neurology, and thereby promote the best possible care for patients with neurological disorders.

Annual Meeting The annual meeting of the AAN is attended by more than 15,000 neurologists and neuroscientists from the US and abroad. The 2007 meeting will be in Boston featuring scientific presentations and educational courses. Plenary presentations on three days will highlight cutting edge clinical, translational and basic research. The annual "Future of Neuroscience" conference is titled "Therapies of Genetic Disorders" and will feature talks on enzyme replacement, gene therapy, siRNA, and stem cells ([1]).

Here is the study abstract:

Link to study abstract

NEUROLOGY 2007;69:459-469
© 2007 American Academy of Neurology

Donepezil preserves cognition and global function in patients with severe Alzheimer disease

S. E. Black, MD, R. Doody, MD, H. Li, PhD, T. McRae, MD, K. M. Jambor, MA, Y. Xu, PhD, Y. Sun, PhD, C. A. Perdomo, MS and S. Richardson, PhD

From the Division of Neurology (S.E.B.), Department of Medicine and Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Alzheimer's Disease and Memory Disorders Center (R.D.), Baylor College of Medicine, Houston, TX; Eisai Inc. (H.L., Y.S., S.R.), Teaneck, NJ; Worldwide Neurosciences, Pfizer Global Pharmaceuticals (T.M.), Pfizer Inc. (Y.X.), New York, NY; PPSI (K.M.J.), Stamford, CT; and Biostatistics (C.A.P.), Eisai Medical Research Inc., Ridgefield Park, NJ.

Address correspondence and reprint requests to Dr. Sandra Black, LC Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Room A421, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada sandra.black@sunnybrook.ca

Objective: To evaluate the efficacy and safety of donepezil for severe Alzheimer disease (AD).

Methods: Patients with severe AD (Mini-Mental State Examination [MMSE] scores 1 to 12 and Functional Assessment Staging [FAST] scores 6) were enrolled in this multinational, double-blind, placebo-controlled trial at 98 sites. Patients were randomized to donepezil 10 mg daily or placebo for 24 weeks. Primary endpoints were the Severe Impairment Battery (SIB) and Clinician's Interview-Based Impression of Change-Plus caregiver input (CIBIC-Plus). Secondary endpoints included the MMSE, the Alzheimer Disease Cooperative Study-Activities of Daily Living-severe version (ADCS-ADL-sev), the Neuropsychiatric Inventory (NPI), the Caregiver Burden Questionnaire (CBQ), and the Resource Utilization for Severe Alzheimer Disease Patients (RUSP). Efficacy analyses were performed in the intent-to-treat (ITT) population using last post-baseline observation carried forward (LOCF). Safety assessments were performed for patients receiving 1 dose of donepezil or placebo.

Results: Patients were randomized to donepezil (n = 176) or placebo (n = 167). Donepezil was superior to placebo on SIB score change from baseline to endpoint (least squares mean difference 5.32; p = 0.0001). CIBIC-Plus and MMSE scores favored donepezil at endpoint (p = 0.0473 and p = 0.0267). Donepezil was not significantly different from placebo on the ADCS-ADL-sev, NPI, CBQ, or RUSP. Adverse events reported were consistent with the known cholinergic effects of donepezil and with the safety profile in patients with mild to moderate AD.

Conclusion: Patients with severe AD demonstrated greater efficacy compared to placebo on measures of cognition and global function.

Supplemental data at www.neurology.org

Supported by Eisai Inc. and Pfizer Inc.

Disclosure: Sandra Black, MD, reports receiving contract research grants not reported in this article in excess of $10,000 per year and receiving honoraria for ad hoc consulting and CME in excess of $10,000 per year during the course of the study. Rachelle Doody, MD, reports receiving contract research grants not reported in this article in excess of $10,000 per year. Honglan Li, PhD, reports being a current employee of the sponsor. Thomas McRae, MD, reports being a current employee of the sponsor. Kyle Marie Jambor, MA, reports being funded by the sponsors to provide editorial support in the preparation of the manuscript. Yikang Xu, PhD, reports having equity or ownership interest in the sponsor in excess of $10,000 per year and is a current employee of the sponsor. Yijun Sun, PhD, reports being a current employee of the sponsor. Carlos Perdomo, MS, reports being a current employee of the sponsor. Sharon Richardson, PhD, reports being a current employee of the sponsor.

Received September 16, 2006. Accepted in final form March 2, 2007.

For a "mainstream" version of this story, please click here to read: "Health Day News: Aricept Eases Symptoms of Severe Alzheimer's Study finds the drug works, just as it does in milder cases."

... -- FYI:

The tests run on patients (severe AD (Mini-Mental State Examination [MMSE] scores 1 to 12 and Functional Assessment Staging [FAST] scores 6))

At the "primary endpoints" the following tests were run:

1. Severe Impairment Battery (SIB)

More information on SIB:

Vol. 51 No. 1, January 1994
ARTICLE

Severe impairment battery. A neuropsychological test for severely demented patients

M. Panisset, M. Roudier, J. Saxton and F. Boller

McGill Center for Studies on Aging, St-Mary's Hospital, Montreal, Quebec.

OBJECTIVE: Patients with progressive dementia invariably evolve to a stage where they can no longer be tested by standard neuropsychological tests. We studied the use of the Severe Impairment Battery (SIB) in such patients. DESIGN: Case series. SETTING: Geriatric long-term facility. PATIENTS: Sixty-nine patients who met the criteria of the Diagnostic and Statistical Manual for Mental Disorders, Revised Third Edition, for dementia were selected. The diagnosis of probable Alzheimer's disease was established according to the guidelines suggested by the National Institute of Neurologic and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association. There were 18 men and 51 women. The mean age of the population was 82.99 +/- 5.66 years. The mean Mini-Mental State Examination (MMSE) score was 10.71 +/- 6.14. MAIN OUTCOME MEASURE: To characterize the cognitive profile and evolution of severely demented patients by means of the SIB. RESULTS: The mean score on the SIB was 92.52 +/- 31.92, with a possible maximum of 133 points. Subgroups of patients with the most severe degree of dementia (MMSE scores of 0 to 5 and 6 to 11) showed significant differences in their scores on the SIB. In contrast, no differences were found between subgroups with MMSE scores of 6 to 11, 12 to 17, and greater than 17. Fifteen patients who had MMSE scores of less than 6 had SIB scores ranging from 7 to 81. All cognitive domains showed a deterioration across the four severity groups as determined by the MMSE scores and also during a longitudinal study performed on 26 patients. CONCLUSION: Our study indicates that the SIB is useful for the neuropsychological evaluation of severely demented patients and for their follow-up.

2. Clinician's Interview-Based Impression of Change-Plus caregiver input (CIBIC-Plus)

Information regarding Clinician's Interview-Based Impression of Change-Plus caregiver input (CIBIC-Plus):

Vol. 23, No. 2, 2007 

Original Research Article

Reliability Study on the Japanese Version of the Clinician's Interview-Based Impression of Change
Analysis of Subscale Items and 'Clinician's Impression'
Yu Nakamuraa, Akira Hommab, Shinichi Kobunec, Yosuke Tachibanad, Keizo Satohd, Isao Takamic, Shinji Nagaid, Masanao Sakaie, Hiroshi Fukutaf, Hiroaki Matsudag, Hideaki Hashimotoh, Tadashi Kusunokii, the SKETCH Study Group

aKagawa University, Kita-gun, and
bTokyo Metropolitan Institute of Gerontology,
cNovartis Pharma K.K.,
dAstellas Pharma Inc.,
eDaiichi Asubio Pharma Co. Ltd.,
fDaiichi Pharmaceutical Co. Ltd.,
gNippon Boehringer Ingelheim Co. Ltd.,
hJanssen Pharmaceutical K.K., and
iJapanese Society for Pharmacoepidemiology, Tokyo, Japan

Address of Corresponding Author

Dementia and Geriatric Cognitive Disorders 2007;23:104-115 (DOI: 10.1159/000097596)

Abstract

Background/Aims: The Japanese version of the Clinician's Interview-Based Impression of Change plus Caregiver Input (CIBIC-plus J) consists of 3 subscales: Disability Assessment of Dementia Scale (DAD), Behavioral Pathology in Alzheimer's Disease Rating Scale (Behave-AD), and Mental Function Impairment Scale (MENFIS), as well as the Clinician's Global Impression of Change (CGIC). While the interrater reliability of CGIC has already been reported, that of the 3 subscales has not. The aim of the present report was to examine the reliabilities of the subscale items and investigate their relationships with CGIC. Methods: Eleven raters who were clinical physicians watched videotapes of 20 patients with Alzheimer's disease, completed the CIBIC-plus J assessment form, and assigned a CGIC score to the patients. Reliability was assessed using the kappa coefficient. Results: The kappa coefficient of the subscale items was in most instances higher than that of CGIC (0.453) and substantial reliability was observed. The Spearman rank correlation that was calculated between CGIC and the total score change of items was very high for MENFIS (0.990) and DAD (0.910), and moderate for Behave-AD items (0.576). The incidence of comments by the raters was highest for MENFIS (89%), followed by DAD (70%). The incidence was low for Behave-AD items (48%). Conclusion: Based on the results, it is concluded that DAD, Behave-AD, and MENFIS are necessary constituents of CIBIC-plus J, and indispensable for the reliability of CGIC.

Copyright © 2007 S. Karger AG, Basel

Yu Nakamura, MD, PhD
Department of Neuropsychiatry, Kagawa University School of Medicine
1750-1 Ikenobe, Miki-cho
Kita-gun, Kagawa 761-0793 (Japan)
Tel. +81 87 891 2167, Fax +81 87 891 2168, E-Mail yunaka@med.kagawa-u.ac.jp

Accepted: September 6, 2006
Published online: November 28, 2006
Number of Print Pages : 12
Number of Figures : 2, Number of Tables : 4, Number of References : 15

At "secondary endpoints" the following tests were run:
1. The MMSE (Mini Mental State Examination)

Click here for more information on MMSE

2. The Alzheimer Disease Cooperative Study-Activities of Daily Living-severe version (ADCS-ADL-sev)

(I can't find any reliable online info on this, can anyone else?)

3. The Neuropsychiatric Inventory (NPI)

Click here for more information on NPI

4. The Caregiver Burden Questionnaire (CBQ)

I can't seem to find much info online regarding CBQ, can anyone else?

5. The Resource Utilization for Severe Alzheimer Disease Patients (RUSP)

(I can't find any reliable online info on this, can anyone else?)

Thoughts or comments?

Take care.

"Fast Food" and Alzheimer's

Mice that were fed a diet rich in fat, sugar and cholesterol for nine months developed a preliminary stage of the morbid irregularities that form in the brains of Alzheimer’s patients.

“We now suspect that a high intake of fat and cholesterol in combination with genetic factors, such as apoE4, can adversely affect several brain substances, which can be a contributory factor in the development of Alzheimer’s,” says Susanne Akterin.

I am pulling my hair out right now - and you know I don't have much hair. How come they always finger the fat as the bad actor and NEVER, NEVER, EVER THE SUGAR!!!!???

Click HERE to rent this MEDICINES advertising spot to support LongeCity (this will replace the google ad above).

Not just sugar, but all excitotoxins. I would not be surprised to learn that they were the biggest culprit in alzheimers and perhaps other disorders like ADD.