News reports of research into Alzheimer's disease Jan - June 2004

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There's a glossary of terms used in Alzheimer's research.

Disclaimer:
This section began as an offshoot of my gathering of news items about memory. I am not a medical expert. My background is in psychology. The information I have gathered here should not be taken as providing any advice.

June

Doubt over effectiveness of cholinesterase inhibitors for treatment of Alzheimer's

A study involving 565 Alzheimer’s patients has found that while donepezil did improve tests of mental and functional ability over the first 2 years of treatment, the improvement was slight, and there was no significant delay in institutionalization or progression of disability. There were also no differences between donepezil and placebo in behavioral and psychological symptoms, formal care costs, unpaid caregiver time, adverse events or deaths, or between the two doses of donepezil used in the study.
The study was reported in the 26 June issue of The Lancet. Full reference
http://www.eurekalert.org/pub_releases/2004-06/l-doe062304.htm

Why stroke and hypertension may increase risk of Alzheimer's

New findings of the presence of beta amyloid in the brain of a mouse that overproduces a protein called p25 may help explain the occurrence of sporadic Alzheimer's (the more common form of the disease) and also why stroke and high blood pressure increase the likelihood of developing Alzheimer's. Researchers are now testing potential compounds to halt, or even prevent, the complex cascade of events caused by the presence of p25 that lead to neurodegeneration. The work may also suggest an intervention after stroke to lower or prevent additional risk of Alzheimer's.
The report was presented on June 15 at the annual meeting of the American Society for Biochemistry and Molecular Biology (ASBMB)/8th International Union of Biochemistry and Molecular Biology Conference (IUBMB) in Boston.
http://www.eurekalert.org/pub_releases/2004-06/foas-api060304.htm

Antibody detection in Alzheimer's may improve diagnosis, treatment

A study has found that people with Alzheimer’s disease have three to four times more antibodies to RAGE (receptor for advanced glycation end products) and beta amyloid — both major players in Alzheimer’s — than their healthy counterparts. The ability to measure these specific antibody levels could lead to a method for very early diagnosis. The finding may also point to a new treatment approach. The study supports the theory that autoimmunity and resulting inflammation play a big role in Alzheimer’s.
The report is scheduled for publication in the September issue of Neurobiology of Aging. Full reference
http://www.eurekalert.org/pub_releases/2004-06/mcog-adi060204.htm

Progress on Alzheimer's vaccine

Efforts to create a vaccine for Alzheimer’s have been hindered by potential side effects — some human participants in an earlier trial developed severe inflammation in the brain. A mouse study has now substantially increased the safety of the vaccine by including a tetanus toxin to alter the immune response. Future studies are planned using the herpes virus.
The work was published on-line June 25 in Neurobiology of Aging. Reference
http://www.eurekalert.org/pub_releases/2004-06/uorm-hta062904.htm

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May

Diabetics at significantly higher risk for Alzheimer's disease

New findings from the Religious Orders Study add to research suggesting a link between diabetes mellitus and an increased risk of developing Alzheimer's disease. Some aspects of cognitive function appear to be affected differently than others, in particular perceptual speed declined significantly faster in those with diabetes.
The study appeared in the May issue of the Archives of Neurology. Full reference
http://www.eurekalert.org/pub_releases/2004-05/rpsl-das051204.htm

Enhanced counseling eases depression among caregivers

A new report from of the NYU Spouse-Caregiver Intervention Study shows that a six-session counseling and long-term support program substantially eases the depression of people caring for a loved one with Alzheimer’s, and that the mental health benefits apparently are long lasting. The study involved 406 caregivers, half of whom received the usual counseling--sessions provided on an ad-hoc basis upon request (control group). The other half was given three additional types of counseling: two sessions of individual counseling, four sessions of counseling with their family, and then weekly meetings with a support group of fellow caregivers. After one year, some 45% of the control group had symptoms of clinical depression, compared with 30% of those who had received special counseling. This group still showed fewer symptoms of depression on average than those in the control group three years later. There was no difference after five years. It was suggested that key factors in the enhanced treatment program were having the same counselor for all sessions, the use of multiple types of coordinated therapy, and counseling tailored to the particular coping challenges that each of the caregivers and their families were dealing with.
The study was published in the May 1 issue of the American Journal of Psychiatry. Full reference
http://www.eurekalert.org/pub_releases/2004-05/nyum-ece042704.htm

Protein found that dissolves amyloid fibers

Amyloid plaque is extremely tough — so tough researchers have been unable to find a means to attack them. A new study suggests that yeast may be the means. Oddly, the yeast protein seems to be involved both in making amyloid fibers, and in dissolving them. The yeast protein Sup35 sometimes forms amyloid fibers in yeast cells — this is part of the cell's normal biology, changing the types of proteins that the cell makes. Another protein — Hsp104 — appears to affect Sup35's ability to form amyloid fibers. When a yeast cell contained either high amounts of Hsp104 or none at all, amyloid fibers never formed. But when Hsp104 levels were small, the fibers flourished. In the latest study, researchers found that small amounts of Hsp104 catalyzed the formation of amyloid fibers, but large levels of the protein actually caused the fibers to dissolve. Interestingly, Hsp104 belongs to a class of proteins that sometimes are influenced by environmental factors.
The study was published online 20 May in Science.
http://www.eurekalert.org/pub_releases/2004-05/wifb-rdp052004.htm

New reliable test for Alzheimer's

A new test for Alzheimer’s promises a reliable means ofdiagnosing Alzheimer’s in a living patient. Combined with clinical assessment, testing blood flow in a specific region of the brain may boost the degree of diagnostic certainty in difficult cases from 90% to almost 100%. The test involves use of single-photon emission computed tomography (SPECT) — a radioisotope test that produces a three-dimensional picture of the amount of blood flowing in certain regions of the brain — to identify a characteristic sign of Alzheimer's disease (reduced blood flow in the posterior cingulate cortex) and distinguish it from a group of illnesses known as frontotemporal diseases, which comprise the second-leading cause of dementia in the elderly. The test did fail to identify Alzheimer’s patients with an atypical form of Alzheimer’s known as tangle-predominant AD. This form of Alzheimer’s also appears to be resistant to drugs currently used to help treat Alzheimer’s. Evidence of shrinkage in brain structures such as the hippocampus and parietal cortex is also central to diagnosing Alzheimer's. This atrophy can be seen on a standard MRI.
The study appeared in the May edition of the Journal of Nuclear Medicine. Full reference http://www.eurekalert.org/pub_releases/2004-05/uots-rin050404.htm
http://www.eurekalert.org/pub_releases/2004-05/sonm-sis050504.htm

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April

Inactivation of Alzheimer's genes in mice causes dementia and brain degeneration

Mutations in two related genes known as presenilins are the major cause of early onset, inherited forms of Alzheimer's disease, but how these mutations cause the disease has not been clear. Since presenilins are involved in the production of amyloid peptides (the major components of amyloid plaques), it was thought that such mutations might cause Alzheimer’s by increasing brain levels of amyloid peptides. Accordingly, much effort has gone into identifying compounds that could block presenilin function. Now, however, genetic engineering in mice has revealed that deletion of these genes causes memory loss and gradual death of nerve cells in the mouse brain, demonstrating that the protein products of these genes are essential for normal learning, memory and nerve cell survival.
The study appeared in the April 8 issue of Neuron. Full reference
http://www.eurekalert.org/pub_releases/2004-04/cp-ioa032904.htm

Patients' medications eases caregiver distress

In a new analysis of an earlier study, researchers have discovered that the drugs currently used to alleviate the symptoms of Alzheimer’s not only help confusion and memory loss, but also alleviates or delays symptoms like agitation, depression, and psychosis, and thus have flow-on effects of alleviating the burden on caregivers. For patients not already exhibiting behavioral problems, treatment with galantamine delayed their symptoms for more than three years on average. This is added impetus to treat patients with dementia with cholinesterase inhibitors as early as possible.
The report appeared in the March issue of the American Journal of Psychiatry. Full reference http://www.eurekalert.org/pub_releases/2004-04/uorm-crt040504.htm

Rate of brain volume loss predicts dementia

A new study has found that rates of total brain volume loss may help identify patients with mild cognitive impairment who are at high risk of developing dementia. The study followed 55 people over 14 years, and found that loss of volume in the hippocampus predicted which mildly cognitively impaired individuals would stay stable and which would decline to Alzheimer's with 70% accuracy, while the rate of total brain volume loss was 62% accurate in predicting cognitive outcome. Combining both variables produced the strongest model: 75% accuracy. The discovery could help doctors plan early treatment strategies and prevention studies.
The study was presented at the 56th annual meeting of the American Academy of Neurology in San Francisco.
http://www.eurekalert.org/pub_releases/2004-04/ohs-osr042804.htm

Preliminary results promising in Alzheimer's gene therapy trial

A small, preliminary study has had some success in delaying brain cell loss in early Alzheimer’s patients through the surgical placement of genetically modified tissue directly into their brains.
The study was reported on April 27 at the American Academy of Neurology meeting in San Francisco.
http://www.eurekalert.org/pub_releases/2004-04/uoc--pra042204.htm

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March

New PET technique improves accuracy of early diagnosis of Alzheimer's

A new study identifies a new Positron Emission Tomography (PET) scanning technique that may increase the already high accuracy of PET in diagnosing Alzheimer’s at a very early stage. Altered brain connections between the entorhinal cortex and both hemispheres of the brain can be clearly identified with 18F-FDG PET. The entorhinal cortex is a critical site for learning and memory. It now appears that most of its connections to the neocortex in both hemispheres are destroyed at a very early stage of Alzheimer’s.
The study appeared in the March issue of The Journal of Nuclear Medicine. Full reference
http://www.eurekalert.org/pub_releases/2004-03/sonm-nss031104.htm

A new hypothesis about Alzheimer's

A new theory about the cause of Alzheimer's disease has been proposed. According to this theory, Alzheimer’s arises as a consequence of inflammation, which creates abnormal metabolites out of normal brain molecules. These abnormal metabolites then modify "amyloid beta" proteins in the brain and cause them to misfold, thus accumulating into the fibrils and plaques characteristic of the disease. The inflammation process that creates these metabolites can be triggered by numerous stimuli, including infections that precede the onset of Alzheimer's disease by a significant amount of time — perhaps years. Traumatic head injuries, for example, are a major risk factor for later developing Alzheimer's disease. Inflammation is increasingly seen as playing a role in neurodegenerative diseases.
The theory was published online March 19 in Proceedings of the National Academy of Sciences. Full reference
http://www.eurekalert.org/pub_releases/2004-03/sri-anh031504.htm

Loss of smell linked to key protein in Alzheimer's disease

Loss of smell is one of the first clinical signs of Alzheimer’s and Parkinson’s disease. Now researchers have linked smell loss in genetically altered mice with excessive levels of a key protein associated with these diseases. If smell function declines as the levels of this protein increase in brain regions associated with smelling, the research could validate the use of smell tests for diagnosing Alzheimer's disease.
Their findings appear in the March 12th issue of Brain Research, the commemorative volume 1000. Full reference
http://www.eurekalert.org/pub_releases/2004-03/uopm-los030304.htm

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February

Genes influence memory in families with Alzheimer's disease

A study of 1,036 people from 266 families, most of whom had more than one person living with Alzheimer's in the extended family, found that about half of the variation in memory performance among individuals was due to genetics. The influence of genetics was not as strong in the areas of attention, abstract reasoning, language and visual-spatial ability. The genetic influence seemed to have little to do with the gene apolipoprotein E, known to increase the risk of developing Alzheimer's. It should be noted, however, that participants in the study had an average of only six years of education.
The study was published in the February 10 issue of Neurology. Full reference
http://www.eurekalert.org/pub_releases/2004-02/aaon-gim020304.htm

Research clarifies how Alzheimer's medicines work

New research clarifies how cholinesterase inhibitors alleviate mild-to-moderate Alzheimer's. When scientists chemically blocked receptors for an important neurotransmitter called acetylcholine, even healthy young people found it significantly harder to learn and remember – especially in the face of interference. Cholinesterase inhibitors slow the breakdown of acetylcholine. The finding also helps explain why Parkinson's disease, dementia due to multiple strokes, multiple sclerosis and schizophrenia, are all also associated with memory problems — all these conditions, like Alzheimer’s, are associated with lower levels of acetylcholine in the brain.
The study appeared in the February issue of Behavioral Neuroscience. Full reference
(Full text of the article is available at http://www.apa.org/journals/bne/press_releases/february_2004/bne1181223.html )
http://www.eurekalert.org/pub_releases/2004-02/apa-rch020904.htm

Why diet, hormones, exercise might delay Alzheimer’s

A theory that changes in fat metabolism in the membranes of nerve cells play a role in Alzheimer's has been supported in a recent study. The study found significantly higher levels of ceramide and cholesterol in the middle frontal gyrus of Alzheimer's patients. The researchers suggest that alterations in fats (especially cholesterol and ceramide) may contribute to a "neurodegenerative cascade" that destroys neurons in Alzheimer's, and that the accumulation of ceramide and cholesterol is triggered by the oxidative stress brought on by the presence of the toxic beta amyloid peptide. The study also suggests a reason for why antioxidants such as vitamin E might delay the onset of Alzheimer's: treatment with Vitamin E reduced the levels of ceramide and cholesterol, resulting in "a significant decrease in the number of neurons killed by the beta amyloid and oxidative stress.
The study was published in the February 17 issue of Proceedings of the National Academy of Sciences. Full reference
http://www.eurekalert.org/pub_releases/2004-02/aaft-nsm021004.htm

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January

New drug approved for moderate to severe Alzheimer's

The FDA recently approved memantine for treatment of moderate to severe Alzheimer’s. The drug has been used for some 20 years in Germany. While memantine significantly improved performance in Alzheimer’s sufferers in studies, the effect, as with all Alzheimer’s drugs currently in use, is small.
The report appeared in the 21 January issue of the Journal of the American Medical Association. Full reference
http://www.eurekalert.org/pub_releases/2004-01/uorm-jsc012004.htm

http://www.eurekalert.org/pub_releases/2004-01/jaaj-ndi011504.htm

Gene targeting prevents memory loss in Alzheimer's disease model

A new mouse study presents new evidence that beta-amyloid is directly responsible for causing the memory loss seen in Alzheimer's, and provides compelling evidence for the therapeutic potential of inhibiting an enzyme, beta-secretase (BACE1), required for the production of beta-amyloid. The mice were genetically engineered to lack the enzyme.
The study was published in the January 8 issue of Neuron. Full reference
http://www.eurekalert.org/pub_releases/2004-01/nu-gtp010504.htm

More sensitive test norms better predict who might develop Alzheimer's disease

Early diagnosis of Alzheimer's is becoming more important with new medical and psychological interventions that can slow (but not stop) the course of the disease. Given this, it is suggested that more sensitive testing may be necessary for highly intelligent people, who, on average, show clinical signs of Alzheimer's later than the general population. Once they show such signs, they decline much faster. A study of 42 older people with IQ's of 120 or more, used two different test norms to forecast problems: the standard norm, derived from a large cross-section of the population, or an adjusted high-IQ norm that measured changes against the individual's higher ability level. The raised cutoffs predicted that 11 of the 42 individuals were at risk for future decline – compared with standard cutoffs, which indicated they were normal. True to the former prediction, three and a half years later, nine of those 11 people had declined. Six of those went on to develop mild cognitive impairment (MCI), a transitional illness from normal aging to a dementia (of which one type is Alzheimer's). Five of these individuals have since received a diagnosis of Alzheimer's disease, two years after this study was submitted. It is also suggested that, at the other end of the scale, those with below-average intelligence have the potential for being misdiagnosed as 'demented' when they are not, and the norms should be adjusted downwards accordingly.
This finding is reported in the January issue of Neuropsychology. Full reference
http://www.eurekalert.org/pub_releases/2004-01/apa-mst122903.htm

New technique allows sight of amyloid plaque in living brains

The first human study has now been completed of a compound that, through PET scanning, enables researchers to see the amyloid plaque deposits in the brains of Alzheimer’s sufferers. The compound has been dubbed Pittsburgh Compound B (PIB), and should be a very useful new tool in Alzheimer’s research.
The study was reported in the March issue of Annals of Neurology. Full reference
http://www.eurekalert.org/pub_releases/2004-01/uopm-uop012104.htm

New method of distinguishing Alzheimer's from Lewy body dementia

Looking at specific changes in alertness and cognition may provide a reliable method for distinguishing Alzheimer's from dementia with Lewy bodies (DLB) and normal aging. Four characteristics significantly distinguished patients with DLB from persons with Alzheimer’s and normal elderly controls: daytime drowsiness and lethargy despite getting enough sleep the night before; falling asleep two or more hours during the day; staring into space for long periods and episodes of disorganized speech. "For the normal elderly control group, one or two of these behaviors was found in only 11 percent of the group. For the patients with AD, one or two of these behaviors were not uncommon, but over 63% of the patients with DLB had three or four of these behaviors.” DLB accounts for as much as 20 to 35% of the dementia seen in the United States.
The study appeared in the January 27 issue of Neurology. Full reference
http://www.eurekalert.org/pub_releases/2004-01/ama-nmo010804.htm

Using vitamin E and C supplements together may reduce risk of Alzheimer disease

A study involving 4,740 elderly (65 years or older) found the greatest reduction in both prevalence and incidence of Alzheimer's in those who used individual vitamin E and C supplements in combination, with or without an additional multivitamin. There was no significant benefit in using vitamin C alone, vitamin E alone, or vitamin C and multivitamins in combination.
The study appeared in the January issue of the Archives of Neurology. Full reference
http://www.eurekalert.org/pub_releases/2004-01/jaaj-uve011404.htm

Low free testosterone levels linked to Alzheimer's disease in older men

A study evaluating the testosterone levels of 574 men, ages 32 to 87, who participated in the Baltimore Longitudinal Study of Aging (BLSA), found that older men with lower levels of free, or unbound, testosterone circulating in their bloodstreams were apparently at higher risk of developing Alzheimer's than their peers. This is believed to be the first study to associate low circulating blood levels of free testosterone with Alzheimer’s years before diagnosis. Previously, the same researchers had found that older men with high levels of circulating free testosterone have better visual and verbal memory and perform spatial tasks more adeptly than their peers.
The study appeared in the January 27 issue of Neurology. Full reference
http://www.eurekalert.org/pub_releases/2004-01/naos-lft012804.htm

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