Treatment for Alzheimer's Disease: Brief summaries of research reports

Estrogen

For women over 65, Combined Hormone

Therapy increases risk of dementia

Much to the researchers’ surprise and disappointment, a four-year experiment involving 4,532 women at 39 medical centers, has found that combined hormone therapy (involving both estrogen and progestin) doubles the risk of Alzheimer's disease and other types of dementia in women who began the treatment at age 65 or older, although the risk is still small : for every 10,000 women 65 and older who take hormones, 23 of the predicted 45 cases of dementia a year, will be attributable to the hormones. The study also found that the combined hormone therapy produced no improvement in general cognitive function, and in fact had adverse effects on cognition among some women. This supports an earlier study suggesting that, while estrogen is helpful to cognitive function in postmenopausal women, the benefits can be cancelled out by progestin / progesterone. The study also confirmed previous research showing that the combination therapy increased the risk of stroke - previous research has indicated that risk factors for stroke are also risk factors for cognitive decline.
The study was published in the May 28 issue of the Journal of the American Medical Association. Full reference 2 3
http://www.eurekalert.org/pub_releases/2003-05/wfub-chr052203.htm

Animal studies suggest why estrogen can't help after dementia has developed

Research with rats suggests that nerve cells in the brain called cholinergic neurons are needed for estrogen to help learning and memory. This suggests why starting estrogen after dementia has developed is ineffective.
The report appeared in the November issue of Hormones and Behavior. Full reference
http://www.eurekalert.org/pub_releases/2002-11/uopm-asp110502.htm

October 2002

Long-term ERT in postmenopausal women with Alzheimer's may worsen memory

A study using female rats investigated the interaction of two conditions known to exist within the brains of female Alzheimer's patients: 1) the presence of chronic neuroinflammation, and 2) having too much or not enough estrogen. They found that rats who had their ovaries removed (to model the condition of post-menopausal women) performed more poorly on a water maze task when they had chronic brain inflammation OR long-term estrogen replacement therapy. Most significantly, those who had both conditions performed much more poorly – beyond what would be expected by either condition alone. That such results extend to postmenopausal women is supported by a 2000 study involving a long term, placebo-controlled study that examined the effects of estrogen replacement therapy on cognitive function in women with mild to moderate Alzheimer's. The effects of ERT were initially beneficial, but the performance of women receiving sustained ERT declined more than that of women receiving the placebo treatment. The results of these studies suggest that postmenopausal women with Alzheimer's disease who undergo long-term estrogen replacement therapy may make their memory loss worse.
The study was reported in the October issue of Behavioral Neuroscience.Full reference
http://www.eurekalert.org/pub_releases/2002-10/apa-lei102202.htm
Full text of the article is available at http://www.apa.org/journals/bne/press_releases/october_2002/bne1165902.html.

August 2001

Estrogen patch may improve memory for women with Alzheimer's

A new study suggests that an estrogen skin patch given to women with mild to moderate Alzheimer's disease can improve their memory and attention skills. The study involved only 20 women for eight weeks, and the results will need to be confirmed by a larger-scale study. Research to date has been equivocal about the effects of estrogen on women with Alzheimer's, with some finding a memory-enhancing effect, and others finding no effect. It is speculated that the type of estrogen might be critical. The present study used estradiol, a type of estrogen that has been shown to have an effect on the brain.
The study was published in the August 28 issue of Neurology, the journal of the American Academy of Neurology.
http://www.eurekalert.org/pub_releases/2001-08/aaon-epm082001.htm

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Supplements

October 2006

Omega-3 fatty acids may slow cognitive decline in some patients with very mild Alzheimer's disease

Several studies have shown that eating fish, which is high in omega-3 fatty acids, may protect against Alzheimer's disease. A Swedish study has now tested whether supplements could have similar effects. Patients with mild-to-moderate Alzheimer’s who took 1.7 grams of DHA and .6g of EPA showed the same rate of cognitive decline as those taking a placebo, however, among a subgroup of 32 patients with very mild cognitive impairment, those who took the fatty acids experienced less decline in six months compared with those who took placebo. It may be that anti-inflammatory effects are an important reason for the benefit, potentially explaining why effects were seen only in those with very early-stage disease, when levels of inflammation seem to be higher.
The study was published in the October issue of Archives of Neurology. Full reference
http://www.eurekalert.org/pub_releases/2006-10/jaaj-ofa100506.htm

April 2006

Dietary supplements offer new hope for Alzheimer's patients

A "cocktail" of dietary supplements (omega-3 fatty acids, uridine and choline) has been found to dramatically increase the amount of membranes that form brain cell synapses in gerbils. The treatment is now in human clinical trials. It is hoped that such treatment may significantly delay Alzheimer's disease. The treatment offers a different approach from the traditional tactic of targeting amyloid plaques and tangles. Choline can be found in meats, nuts and eggs, and omega-3 fatty acids are found in a variety of sources, including fish, eggs, flaxseed and meat from grass-fed animals. Uridine, which is found in RNA and produced by the liver and kidney, is not obtained from the diet, although it is found in human breast milk.
The study appears in the May 9 issue of Brain Research. Full reference
http://www.eurekalert.org/pub_releases/2006-04/miot-mro042706.htm

November 2005

Compound in wine reduces levels of Alzheimer's disease-causing peptides

In cell studies, resveratrol has been found to lower levels of amyloid-beta peptides. Resveratrol is a natural compound occurring in abundance in grapes, berries and peanuts. The highest concentration has been reported in wines prepared from Pinot Noir grapes. The anti-amyloidogenic effect of resveratrol observed in cell cultures does not however necessarily mean that the beneficial effect can result simply from eating grapes or drinking wine. Further research aims to develop more active and more stable compounds.
The study was published in the November 11 issue of the Journal of Biological Chemistry. Full reference
http://www.eurekalert.org/pub_releases/2005-11/asfb-ciw110305.htm
http://www.sciam.com/article.cfm?chanID=sa003&articleID=000581B2-EE9B-136B-AE9B83414B7F0000

April 2005

Clinical diagnosis of Alzheimer's may be delayed with donepezil

In a study of people with mild cognitive impairment, those who took the drug donepezil were at reduced risk of progressing to a diagnosis of Alzheimer's during the first years of the trial, but by the end of the 3-year study there was no benefit from the drug. Of the 769 participants, 212 developed possible or probable Alzheimer’s within the 3-year study period; the donepezil group's risk of progression to a diagnosis of Alzheimer’s was reduced by 58% one year into the study, and 36% at 2 years, but no risk reduction at the end of three years. Vitamin E was also tested in the study and was found to have no effect at any point in the study.
The findings were reported in the April 14 online issue of The New England Journal of Medicine, and will appear in the June 9 print issue. Full reference
http://www.eurekalert.org/pub_releases/2005-04/nioa-cdo041205.htm
http://www.eurekalert.org/pub_releases/2005-04/mc-dia041105.htm

December 2004

Pilot study points to healing power of turmeric

A study using genetically engineered mice has found that those mice on a diet rich in curcumin (the yellow pigment in the curry spice turmeric) developed 85% few Alzheimer’s plaques then the control group. Curcumin has antioxidant, anti-inflammatory, and cholesterol lowering properties, and has long been used in India as treatment for a variety of ailments. A human trial involving 33 Alzheimer's patients will soon commence.
The study was reported online December 7 in the Journal of Biological Chemistry. Full reference
A copy of the full paper can be found on the Journal of Biological Chemistry Web site athttp://tinyurl.com/5bzbs
http://www.eurekalert.org/pub_releases/2004-12/potn-usn122804.htm
http://www.sciencentral.com/articles/view.htm3?article_id=218392455

November 2003

Dietary supplement helps Alzheimer’s

A three-month study of 55 elderly patients with mild or moderate Alzheimer’s found that those given EV-1, a dietary supplement containing, among other things, the putative antioxidant ingredient of red wine, showed no deterioration during the trial. The supplement is designed to interfere with a defective mitochondrial cycle thought to contribute to the metabolic disturbances associated with late onset Alzheimer’s. The Krebs tricarboxylic acid cycle is fuelled by glucose and regulates levels of reactive oxygen species in the body. EV-1 contains glucose, a compound called malate that primes or maintains the Krebs cycle, and resveratrol - the antioxidant component of red wine that is thought to soak up reactive oxygen species. More studies are needed to confirm this result.
The findings were presented in November at the annual meeting of the Society for Neuroscience (SFN) in New Orleans.
http://gateways.bmn.com/news/story?day=031121&story=1

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