Is Alzheimer's Everywhere?

My name is Bob DeMarco, I am an Alzheimer's caregiver. My mother Dorothy, now 93 years old, lives with Alzheimer's disease.

Is Alzheimer's everywhere?

I don't get out much these days. But, I make an effort to take my mother out every Friday night. We always go to a place where we can easily interact with people. This is part of the effort to keep my mother socialized and in the "world".

Last night, we went to Vic and Angelo's in downtown Delray Beach, Florida. A really fantastic venue. If you click on the image to the left, you'll hear a nice rendition of a song you might recognize.

Bing Keyword Search - do i leave an alzheimer's person alone

A reader searched Bing with the following keyword search

do i leave an alzheimer's person alone

They then selected this headline from Bing

You Can't Leave a Person with Alzheimer's Alone

It took me a while to understand how my mother might be feeling when I went out and left her alone at home.

Are Alzheimer's and Dementia the Same Thing?

No. In a nutshell, dementia is a symptom, and Alzheimer's disease is the cause of the symptom.

 +Bob DeMarco 
+Alzheimer's Reading Room 

Urinary Tract Infections Can Hasten Memory Loss in Alzheimer's Patients

Researchers have found a link between common infections, such as a cold, stomach bug or urine infection and an increase in inflammation like reactions in the brain which lead to an increased rate of cognitive decline. Study results show that people who got an infection had twice the rate of memory loss as people without infections.

By Bob DeMarco 
Alzheimer's Reading Room 

Bob DeMarco

My name is Bob DeMarco, I am an Alzheimer's caregiver. My mother Dorothy lived with Alzheimer's disease.

This week my mother had her second urinary tract infection of the year. Urinary Tract infections are a problem faced by many Alzheimer's caregivers.

Urinary tract infections are particularly worrisome to me and they should be to most Alzheimer's caregivers.

There is research evidence indicating that infections can hasten memory loss in persons suffering from Alzheimer's. 

Jump to the Alzheimer's Reading Room to continue reading - Urinary Tract Infections Can Hasten Memory Loss in Alzheimer's Patients 

Alzheimer's Disease -- Finding Simple Solutions to Problems

I learned over time that keeping it simple works best.

Amplify’d from www.alzheimersreadingroom.com

If they don't know what to talk about with Dad, they can always pick up the memory book and share something he enjoys....

Alzheimer's caregivers find it difficult to deal with behaviors that come along with Alzheimer's disease.

Sometimes it is best to find a simple solution to an ongoing problem.

Original content Bob DeMarco, the Alzheimer's Disease -- Finding Simple Solutions to Problems

The Plan to End Alzheimer's Disease by 2020 (Podcast)

Click above to Listen. Please share this podcast with family, friends, support groups, and the Alzheimer's community.

If you don't see the podcast go here.

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Rudy Tanzi the Plan to End Alzheimer's Disease by 2020 (Podcast)

Omega 3 ‘Fish Oil’ Supplements Do Not Appear to Slow Cognitive, Functional Decline in Alzheimer’s Disease

URL:  http://www.alzheimersreadingroom.com/2010/11/omega-3-fi...

In summary, these results indicate that DHA supplementation (Omega 3) is not useful for the population of individuals with mild to moderate Alzheimer disease....

Original content Bob DeMarco, the Alzheimer's Reading Room

Alzheimer's Disease -- No One Understands -- Maria Shriver (Video)

In the video Maria Shriver says as she travels around the country women tell her over and over,

No One Understands

What is Alzheimer's Disease ?

URL:  http://www.alzheimersreadingroom.com/2010/01/what-is-al...

A comprehensive overview. Includes definition, symptoms, causes, risk factors, lifestyle issues, test and diagnosis, treatments and drugs.

Original content Bob DeMarco, the Alzheimer's Reading Room

The Estrogen Dilemma and Alzheimer's Disease Revisited

FYI

Amplify’d from www.alzheimersreadingroom.com

“Sixty-eight percent of all victims of Alzheimer’s are women. Is it just because they live longer? Let’s say it is, for purposes of discussion. Let’s say it’s just because these ladies get old. Do we just say, ‘Who cares?’ and move them into a nursing home? Or alternatively, maybe they are telling us something.” -- Dr. Roberta Diaz Brinton

“These women thought they were losing their minds,” Brizendine said, describing the 40-to-60-year-old patients she began seeing when she opened the Women’s Mood and Hormone Clinic at the university in 1994. “In 1994 we didn’t have words for it,” she said. “Now we do. It’s called perimenopausal depression.”

Facts about estrogen and Alzheimer's disease

Original content Bob DeMarco, the Alzheimer's Reading Room

Alzheimer's Disease, Urinary Tract Infections, Urinary Incontinence, Poop (8 Articles)

URL:  http://www.alzheimersreadingroom.com/2010/09/alzheimers...

Topics page leading to additional information

Original content Bob DeMarco, the Alzheimer's Reading Room

Jan's Story: A Love Lost to Alzheimer's (Video)

By Bob DeMarco

Finally, when her anger and confusion were slipping out of our control, I moved her into an assisted-living facility, where on each painful visit I see the changes as she disappears a little more.

A friend calls it grieving, like saying goodbye by going to the same funeral over and over again.

"It's really challenging to grieve someone that's sitting right in front of you," said Kallmyer. "It's really challenging to grieve someone that you've just helped take a bath and get them dressed."

"Because it's such a long process and a long road that a family travels down together, it changes family dynamics," said Pring. "And it takes away all our preconceived notions about how families should look and how they should function."

"I know that he will always be in my life," Jan said.

Alzheimer’s Disease--What is it?

Alzheimer's disease is the most common cause of a condition called dementia. It is named for the German doctor who first described it, Alois Alzheimer. What is it? Who gets it? What causes it?



The desciption below was taking from the Milton S. Hershey Medical Center website. This is useful to clear up some of the misunderstanding about the Alzherimer's Disease.

Alzheimer’s Disease

What is it?

Alzheimer's disease is the most common cause of a condition called dementia. Dementia is a general decline in mental ability, such as memory, language skills, judgment, and concentration. Alzheimer’s is a progressive disease, which means symptoms occur gradually and become worse over time. It is named for the German doctor who first described it, Alois Alzheimer.

Who gets it?

Alzheimer’s disease affects most commonly affects those over the age of 65, although it has been diagnosed in people in their 40s and 50s.

What causes it?

The degeneration of parts of the brain, which destroys brain cells, causes the symptoms of Alzheimer’s. However, at this time researchers are not sure what causes this degeneration. Those with a family history of Alzheimer’s are more likely to develop the disease as they age, so there is a gene abnormality that causes the disease in some people. Researchers are looking for links between Alzheimer’s disease and the environment, lifestyle, nutrition, and viruses.

What are the symptoms?

Alzheimer’s usually progresses in three stages, with each lasting anywhere from one to several years. The first symptom of Alzheimer’s disease is usually mild forgetfulness. Someone in the early stages may find him or herself unable to find the right word, recall where something was placed, or recall someone’s name. It may be difficult to concentrate. At this point, symptoms are so general that they do not signal a serious problem or have a great impact on day-to-day functioning. As the disease progresses to the second stage, the forgetfulness becomes worse, making it difficult to function at work, remember directions, or to even make it through the day without difficulty. The person may be restless and unable to sleep at night. His or her personality may change considerably, with increasing anxiety and decreasing emotions. By the late stages of Alzheimer’s, patients suffer from extreme confusion and memory loss. They are unable to recall the names of close friends and family or recent events, and cannot function socially or perform basic daily personal care. Late-stage Alzheimer’s patients may have hallucinations and delusions.

How is it diagnosed?

Alzheimer’s disease is diagnosed by taking a complete medical history and performing a thorough physical examination. Alzheimer’s is generally suspected when there is a gradual deterioration in mental ability. The doctor will perform tests, such as blood tests and brain scans, to rule out other possible causes of the symptoms. The doctor will also ask the patient a series of questions to test his or her mental status. One type of test of mental status is called neuropsychological testing, which is a standardized test of memory, concentration, and visual-spatial skills. Because a definite diagnosis can only be made by performing an autopsy after death, patients are diagnosed with “probable” Alzheimer’s. An autopsy of brain tissue, however, will show areas of abnormal tissue, called plaques, made up of abnormal proteins; a loss of nerve cells; and areas of tangles in the nerve cells that remain in patient’s with Alzheimer’s disease.

What is the treatment?

At this time, there is no cure for Alzheimer’s disease. Treatment focuses on maintaining the best possible quality of life for the patient by providing a supportive environment. Memory aids, such as calendars and other daily reminders of time and place, can help the patient feel more secure and reduce confusion. There are some medications that, when used in the early stages of this disease, can slow memory loss in some patients for a limited amount of time. However, these drugs are used with caution because of potential side effects. Other drugs may be prescribed to treat anxiety, sleeplessness, depression, and hallucinations, as necessary. In the early stages of Alzheimer’s, it is important to help the patient maintain as much independence as possible. As the disease progresses, it may be necessary to seek the help of a home healthcare aid, an adult daycare, or nursing home. While there is currently no treatment to prevent or stop the progression of Alzheimer’s, researchers are continuing to study this disease and test new drugs. There is a possibility that certain types of nonsteroidal anti-inflammatory drugs (NSAIDs) may slow the progression of Alzheimer’s.

Self-care tips

A diagnosis of probable Alzheimer’s is devastating for someone who has been accustomed to living an independent life. It is important to provide the patient with emotional and physical support as he or she adjusts to living with this disease. Keeping the daily routine consistent and as stress free as possible is helpful. Because depression is so common in the early stages of Alzheimer’s, you should be aware of the signs of depression and seek help for the patient as soon as possible. Caring for someone with Alzheimer’s can be demanding and discouraging, especially when the loved one does not remember who you are. Your doctor or local social services agency can direct you to support services to help make this time a little easier. Also seek legal advice so it is clear who has the power to make medical and financial decisions once your loved one is no longer able to do this for him or herself. If you have a family history of Alzheimer’s disease, see your doctor for regular checkups. An early diagnosis is important, especially as the medical community learns more about this disease and its treatment. While there is no way to prevent this disease, you can lower your risk and protect yourself from many illnesses by following a healthy diet that is high in fiber and antioxidants and low in saturated fat, and participating in regular physical exercise. Performing activities that stimulate your brain on a regular basis, such as crossword puzzles, word searches, or memory games, may also help maintain mental ability longer.


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This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. The health information written by our authors is intended to be a supplement to the care provided by your physician. It is not intended nor implied to be a substitute for professional medical advice.

The CareGiver Blog

Robert T DeMarco

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Big belly in middle age triples risk of dementia

My mother has visceral fat. At her age it could be life threatening. There is no doubt this is a contributing factor to her Alzheimer's. She is exercising but at the age of 91, and after many years of bad eating habits, it is very difficult to get her to lose weight.

clipped from www.breitbart.com Having a large belly in middle age nearly triples the risk of developing dementia, a study released Wednesday found Researchers measured the abdominal fat of 6,583 people age 40 to 45 in northern California and some 36 years later 16 percent had developed dementia, the study published in the journal Neurology found. Those who were overweight or obese but did not have a pot belly had an 80 percent increase in the risk of dementia compared to people with a normal body weight and abdominal fat level. The risk increase jumped to 230 percent among overweight people with a large belly and 360 percent among the obese with large abdomens. "Where one carries the weight -- especially in midlife -- appears to be an important predictor for dementia risk," Whitmer said. "These findings imply that the dangerous effects of abdominal obesity on the brain may start long before the signs of dementia appear."

New Alzheimer’s Study Underscores Importance of Sustaining Viable Medicaid System

“The long term care stakeholder community must work together in an intelligent, realistic manner to ensure the Medicaid safety net does not fray in the critical years ahead and that the rising numbers of Alzheimer’s patients are not relegated to a status unworthy of our great nation”

Long Term Care Facilities Predict Older, Sicker, Cognitively-Impaired Patient Population

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) today said that findings in a new study from the Alzheimer’s Association, which estimates ten million U.S. baby boomers will develop Alzheimer’s disease in their lifetime, underscores the urgent need for Congress and the Bush Administration to ensure Medicaid has both the future capacity and the financing necessary to compassionately and effectively treat what will be an older, sicker, cognitively-impaired patient population.

“This is a significant, disturbing and timely study from the Alzheimer’s Association because it demonstrates in stark definable terms why Medicaid must remain financially viable to ensure we have the ability to care for the influx of Baby Boomers who will require increasingly high levels of care,” stated Bruce Yarwood, President and CEO of AHCA/NCAL “The study also signals to our policy makers that critical Medicaid ‘reforms’ cannot lead us down a road that will further weaken the financial underpinnings of this already unstable program.”

Currently, at least 5.2 million Americans suffer from Alzheimer’s disease, including 200,000 to 250,000 people under age 65. The Alzheimer’s report estimates that by 2010, there will be 500,000 new cases of the disease each year and nearly one million new cases annually by 2050.

Yarwood reiterated AHCA/NCAL’s position on Medicaid reform proposals, stating that it is essential for Congress and the Administration to focus on how they would impact care capacity at the state level, and how simply eliminating revenue would decimate the ability to enhance staffing, improve quality, and bolster facility infrastructure and capacity as demand for more care and therapies is on the rise.

“The long term care stakeholder community must work together in an intelligent, realistic manner to ensure the Medicaid safety net does not fray in the critical years ahead and that the rising numbers of Alzheimer’s patients are not relegated to a status unworthy of our great nation,” concluded Yarwood.

The American Health Care Association represents nearly 11,000 non-profit and proprietary facilities dedicated to continuous improvement in the delivery of professional and compassionate care provided daily by millions of caring employees to 1.5 million of our nation's frail, elderly and disabled citizens who live in nursing facilities, assisted living residences, subacute centers and homes for persons with mental retardation and developmental disabilities. For more information, please visit www.ahca.org.

The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

What If It's Not Alzheimer's: A Caregiver's Guide to Dementia

One in Seven Older Adults Has Dementia

Approximately one in seven, or 3.4 million, Americans age 71 and older has dementia, and 2.4 million have Alzheimer's disease, according to a new analysis supported by the National Institutes of Health (NIH). It is the latest in a series of analyses attempting to assess the prevalence of dementia and Alzheimer's, the most common form of dementia.

One in Seven Older Adults Has Dementia

Approximately one in seven, or 3.4 million, Americans age 71 and older has dementia, and 2.4 million have Alzheimer's disease, according to a new analysis supported by the National Institutes of Health (NIH). It is the latest in a series of analyses attempting to assess the prevalence of dementia and Alzheimer's, the most common form of dementia.

The study is the first to estimate rates of dementia and Alzheimer's using a nationally representative sample of older adults across the United States.

Brenda Plassman, PhD, of Duke University Medical Center, in Durham, NC, worked with Kenneth Langa, MD, PhD, and David Weir, PhD, of the University of Michigan, in Ann Arbor; Robert Wallace, PhD, of the University of Iowa, in Iowa City; and others to conduct the analysis as part of the Aging, Demographics and Memory Study, which is a substudy of the Health and Retirement Study (HRS).

HRS is the leading resource for data on the combined health and economic circumstances of Americans over age 50. The substudy and HRS are sponsored by the National Institute on Aging (NIA) under a cooperative agreement with the University of Michigan.

The study highlights the nationwide reach of dementia, which affects not only those with the disease but their families and communities as well.

"As the population ages during the next few decades, the prevalence of Alzheimer's will increase several-fold unless effective interventions are discovered and implemented," said NIA director Richard Hodes, MD. "These data underscore the urgency of research in this area."

The study included 856 HRS participants age 71 and older from 42 states in 2001-2003. Duke researchers conducted home evaluations to gather information about each participant's cognitive and functional status and symptoms, neuropsychiatric symptoms, medications, medical history, and family history of memory problems. Prior neuroimaging and laboratory results also were obtained.

A team of clinicians reviewed the evaluation information and made a preliminary assessment of cognitive status. A consensus panel of medical experts used diagnostic criteria to determine if the participant had normal cognitive function, cognitive impairment without dementia, or dementia. The criteria also were used to discern the type of dementia, such as Alzheimer's or vascular dementia, the second most common cause of dementia in older adults.

Based on the experts' classifications, the researchers estimated the national prevalence and total numbers of people age 71 and older, by age group, with any dementia and with Alzheimer's or vascular dementia. They determined that 13.9 percent of Americans age 71 and older have some type of dementia, 9.7 percent of people in that age group have Alzheimer's, and 2.4 percent have vascular dementia. Alzheimer's accounted for about 70 percent of all dementia cases among people 71 and older.

The substudy analysis showed that the prevalence of dementia increases significantly with age: 5 percent for ages 71-79, 24.2 percent for ages 80-89, and 37.4 percent for 90 or older. The estimated rate of Alzheimer's also rose greatly with older age, from 2.3 percent for ages 71-79 to 18.1 percent for ages 80 to 89 and 29.7 percent for age 90 and older.

Fewer years of education and the presence of at least one APOE e4 allele, a genetic risk factor for Alzheimer's, were found to be strong predictors of dementia.

The substudy data will be valuable in assessing the impact of dementia, said Richard Suzman, PhD, director of the NIA Behavioral and Social Research Program, which jointly directs the HRS. The information about the health, economic and family resources of individuals in the study "will help us to characterize more fully the burden of dementia on individuals, caregivers and the nation's health care system."

Previous studies included lower age ranges than the substudy, broader characterizations of dementia, or participants in a specific community as a base for national extrapolations. A 1998 study combined data from four community-based studies, estimating that the national prevalence of Alzheimer's in individuals age 60 or older would rise from 2.3 million in 1997 to 8.6 million in 2047.2 Widely cited estimates based on the prevalence of Alzheimer's in a Chicago-based community and an earlier comparable study using data from East Boston forecast the number of those age 65 or older with Alzheimer's to be 5.1 million in 2010.3,4

References

1.Plassman, B.L., et al. (2007). Prevalence of dementia in the United States: The Aging, Demographics and Memory Study. Neuroepidemiology, 29: 125-32.

2.Brookmeyer, R., et al. (1998). Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset. American Journal of Public Health, 88: 1337-42.

3.Hebert, L.E., et al. (2003). Alzheimer disease in the U.S. population. Archives of Neurology, 60: 1119-22.

4.Evans, D.A., et al. (1990). Estimated prevalence of Alzheimer's disease in the United States. Milbank Quarterly, 68: 267-89.

Alzheimer's Activities: Hundreds of Activities for Men and Women With Alzheimer's Disease and Related Disorders

Dementia diagnosis brings relief, not depression

When it comes to a diagnosis of Alzheimer's disease, what you don't know may not kill you, but knowing the truth as soon as possible appears to be the better approach — one that may improve the emotional well-being of both patients and their caregivers, suggests new research from Washington University in St. Louis.

Medical advances have made it possible to diagnose Alzheimer's at very early stages, but a 2004 review of research found about half of all physicians were still reluctant to inform patients of an Alzheimer's diagnosis. While many physicians fear a dementia diagnosis would only further upset an already troubled patient, this follow-up study found quite the opposite.

"We undertook this study because we wanted there to be some data out there that addressed this question and that we could show to physicians and say, 'Most of the people don't get depressed, upset and suicidal. So, this fear that you have about telling them and disturbing them is probably not legitimate for most people,'" says Brian Carpenter, Ph.D., associate professor of psychology in Arts & Sciences at Washington University.

The study, published in the current Journal of the American Geriatrics Society, is co-authored by Carpenter and colleagues in the Division of Biostatistics, the Department of Neurology and the Alzheimer's Disease Research Center at the University's School of Medicine.

In their study, they followed 90 individuals and their caregivers as they came to the Alzheimer's Disease Research Center for an evaluation. Sixty-nine percent eventually got a diagnosis of Alzheimer's disease, but no significant changes in depression were noted and anxiety decreased substantially.

"The major finding is that both patients and their families feel relief, not increased anxiety, upon learning the diagnosis," says study co-author John C. Morris, M.D., the Harvey A. and Dorismae Hacker Friedman Distinguished Professor of Neurology and director of the Alzheimer's Disease Research Center.

"Nobody wants to hear the diagnosis of Alzheimer's disease, but even that is preferable to recognizing there's a problem and not knowing what it is. At least having the diagnosis allows people to make plans for the future, including treatment as appropriate."

One reason an Alzheimer's diagnosis can be comforting to both family members and patients, suggests Carpenter, is that it provides an explanation for what's been going on with the patient. Caregivers, he notes, are often quick to attribute symptoms of dementia to the person, rather than the disease, and patients wonder if they are going "crazy." This study confirms that most patients, regardless of their degree of impairment, tend to experience a sense of relief after getting their diagnosis.

Patients in this 2007 study came from the Alzheimer's Disease Research Center at Washington University. Individuals calling the Center were informed of the study and could choose to participate. Subjects were then interviewed prior to their appointment at the Center and questioned about their mood, family history and expectations for their upcoming exam. After extensive neurological examination, a diagnosis was delivered to the patients and their caregivers and videotaped for the purposes of the study.Patients and caregivers were then called two days after their appointment and asked the same questions about mood, anxiety, and the results of their diagnosis. This study is one of the first where caregivers have also been asked about mood and emotions."In this current study, we were interested in gauging psychological reactions shortly after receiving the diagnosis," Carpenter says. "That's why we did the follow-up phone call within a couple of days of their evaluation."Most clinical practice guidelines instruct physicians to tell patients when they suspect Alzheimer's or dementia.

"It's just taking awhile for the clinicians to catch up," says Carpenter.

Carpenter thinks that the number of physicians not telling their patients has gone down since the 2004 study due to a greater public awareness about Alzheimer's.

"We're probably where we were at 10 or 15 years ago with cancer. Years ago when people had cancer their doctors didn't tell them. But we know now that that's improper, and that everybody needs to know if they have cancer. We're going to get there with Alzheimer's disease. [People] are not aware that when you tell the person they're not going to have some sort of catastrophic emotional reaction. The word will get out eventually," says Carpenter.

And there is good reason to spread the word. Earlier diagnoses allow for earlier intervention to delay the effects of Alzheimer's and dementia. Medications currently on the market can delay symptoms in a minor way, in some patients, and may delay institutionalization.

"There are some real practical and financial advantages of even these small incremental gains that we're getting from the medications now. If you can get an extra three to six months in your own house before you have to go to a nursing home, that's a big deal," says Carpenter.

And perhaps more importantly, providing a diagnosis as early as possible gives people a chance to prepare for what is coming."They know that things are going to get worse rather than better and they know that there's going to come a time when they're not going to be able to do the things they can do now, says Carpenter. "They can get ready for what's coming and we can connect them to support services. We can get their family ready ...so they'll be better prepared."

The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

What If It's Not Alzheimer's: A Caregiver's Guide to Dementia

Life book to help Alzheimer's patients

clipped from www.craegmoor.co.uk A charity dedicated to Alzheimer's disease has dreamt up an innovative idea which could help to reassure sufferers and help them to remember. Alzheimer's Support, a charity in Trowbridge, has created the concept of a 'Life Book', which comprises both a photo album and a scrapbook to help patients remember important occasions and events in their life. The Alzheimer's charity helps patients to put the Life Book together themselves, picking out key pieces of information from their lives. "Being a carer for someone with Alzheimer's is extremely physically and mentally stressful. I have to be with Don at all times. If he is left on his own he suffers extreme anxiety and descends into a wild panic. At night he wanders around the house and looks through cupboards."It is devastating to have to deal with this and I am extremely grateful that I have Alzheimer's Support to help me. "We had a great time doing it and Don responded really well."

'Instant' Alzheimer's Drug Claim, Enbrel (Etanercept)

Ten minutes after the injection, the researchers reported that the patient was calmer, less frustrated and more attentive. He could correctly identify California as his home state, but incorrectly identified the current year. At two hours, the Montreal Cognitive Assessment had improved from seven out of a possible 30 to 15. The man's wife and son confirmed the improvements.


'Instant' Alzheimer's Drug Claim

A drug used for arthritis can reverse the symptoms of Alzheimer's 'in minutes'", the Daily Mail reported. Several newspapers covered the story of how an 81-year-old man with Alzheimer's disease improved within 10 minutes of being injected with a new drug, etanercept. The BBC reported that his wife described the effect on her husband as being "put back to where he was". His son said, "This was the single most remarkable thing I've seen".

Reports of success in single patients often herald the start of a new line of investigation into diseases and drugs. Though anecdotal evidence holds promise for patients, families and researchers, most of the news reports suggest that it is too soon to say if this drug will fulfil its potential. Larger, placebo controlled studies will be required to determine if this drug is safe or effective for this disease. The drug has the advantage that it has already been approved as safe for use in humans for treating arthritis, and this could speed up the process of testing its effectiveness in treating Alzheimer's.

Where did the story come from?

Dr Edward Tobnick from the Institute of Neurological Research and Dr Hyman Gross from the USC School of Medicine in Los Angeles carried out this research. The institute is a private medical group and there was no funding from outside sources. Competing interests were declared.

The study was published online in the Journal of Neuroinflammation.

What kind of scientific study was this?

This was a case study (a study in one person) that tested the short-term effects of the drug etanercept on a patient with Alzheimer's disease.

The researchers first obtained the written consent of the patient and his wife and explained the potential risks of the drug, which included infection and death. They then conducted a routine examination of the 81-year-old retired doctor followed by a range of tests for memory, attention and mathematical ability. The Montreal Cognitive Assessment (which assesses mild cognitive dysfunction) was used to give a numerical score for the degree of dementia. Prior to the injection the score was seven out of a possible 30 points, a number consistent with moderate to severe dementia.

The drug was then injected around the spinal cord at neck level, and the patient was placed with his head downwards, so that the drug would run to the head. The patient was re-examined after a 10 minute and two hour interval.

The drug etanercept belongs to a class of drugs called TNF-alpha blockers. These are increasingly used for the treatment of severe rheumatoid arthritis and other conditions caused by inflammation. This type of drug is usually administered by injection into muscle. It acts by deactivating a chemical involved in the early stages of generalised inflammation and in regulating immune cells - tumour necrosis factor (TNF). The researchers had already conducted a study that measured the drug's longer-term effects in 15 patients over a six month period and this study was aimed at assessing the rapid effects of the drug.

What were the results of the study?

Ten minutes after the injection, the researchers reported that the patient was calmer, less frustrated and more attentive. He could correctly identify California as his home state, but incorrectly identified the current year. At two hours, the Montreal Cognitive Assessment had improved from seven out of a possible 30 to 15. The man's wife and son confirmed the improvements.

What interpretations did the researchers draw from these results?

In their discussion of the results, the researchers describe the biological mechanisms providing the rationale for trying out this drug. They suggest it is a promising area for additional investigation and therapeutic intervention.

What does the NHS Knowledge Service make of this study?

As a case report of a single patient, this study represents very early evidence in the long journey from drug development to clinical use in patients. Disadvantages to this type of study include:

- the lack of any control patients against which the effect can be compared, meaning that it may be that some of the improvements, for example the lessened anxiety, could have occurred by sitting in the doctors office for long enough without being given any medication
- the lack of long term follow up means that it is not possible to know how long any suggested improvement may last
- the lack of results from other patients mean the effect may not be seen in other people

The drug has an advantage in that it is already approved for use in other conditions and therefore something is already known of its safety. The long and short term effects of drugs can be markedly different and this study may stimulate further research into the short term effects of etanercept for dementia.

While providing hope for those who suffer from Alzheimer's and their families, this case study should be regarded as a preliminary finding of this drug's use as a treatment for the disease. Further controlled studies of the drug's effects in a larger group of people would be required to test the drug's effectiveness properly.

Links to the science

Tobinick EL, Gross H. Rapid cognitive improvement in Alzheimer's disease following perispinal etanercept administration.J Neuroinflammation 2008; 5:2

This news comes from the National Health Service (NHS) of the UK.
http://www.nhs.uk/News/Pages/NewsIndex.aspx

Article URL: http://www.medicalnewstoday.com/articles/94072.php

Main News Category: Alzheimer's / Dementia

Also Appears In: Neurology / Neuroscience,

The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

What If It's Not Alzheimer's: A Caregiver's Guide to Dementia

Alzheimer's Drug Successful Test CTS-21166

clipped from www.omrf.org CoMentis, a California/Oklahoma City-based pharmaceutical company, is developing a beta-secretase inhibitor, CTS-21166, discovered by Dr. Tang and Dr. Arun Ghosh of Purdue University. Unlike the existing Alzheimer’s drugs that treat only the symptoms, CTS-21166 inhibits, or turns off, the mechanism believed to lead to disease progression. The Phase I clinical trial results showed CTS-21166 to be safe and well tolerated in humans at various dose levels. Following the administration of a single dose, CTS-21166 reduced the levels of plasma beta amyloid, a potential cause of progression of the disease, by as much as 60 percent. “CTS-21166 represents an entirely new approach to the treatment of Alzheimer’s disease by inhibiting beta-secretase, an enzyme critical in the production of potentially toxic amyloid beta,” said Henry Hsu, M.D., CoMentis Chief Medical Officer. “It has the potential to become the first-in-class disease-modifying therapeutic agent.”

Scientists have moved one step closer to developing a new type of drug to treat Alzheimer’s disease. An experimental drug based on discoveries made by Dr. Jordan Tang at the Oklahoma Medical Research Foundation has successfully completed the first phase of testing in human subjects.

CoMentis, a California/Oklahoma City-based pharmaceutical company, is developing a beta-secretase inhibitor, CTS-21166, discovered by Dr. Tang and Dr. Arun Ghosh of Purdue University. Unlike the existing Alzheimer’s drugs that treat only the symptoms, CTS-21166 inhibits, or turns off, the mechanism believed to lead to disease progression. The Phase I clinical trial results showed CTS-21166 to be safe and well tolerated in humans at various dose levels. Following the administration of a single dose, CTS-21166 reduced the levels of plasma beta amyloid, a potential cause of progression of the disease, by as much as 60 percent.

“CTS-21166 represents an entirely new approach to the treatment of Alzheimer’s disease by inhibiting beta-secretase, an enzyme critical in the production of potentially toxic amyloid beta,” said Henry Hsu, M.D., CoMentis Chief Medical Officer. “It has the potential to become the first-in-class disease-modifying therapeutic agent.”

Beta secretase, the enzyme thought responsible for causing Alzheimer’s, was first identified in 2000 by Tang and his colleagues at OMRF. They then developed an inhibitor to stop the enzyme’s action in a laboratory setting. Since that time, Tang and collaborator Arun Ghosh, Ph.D., of Purdue University have worked with CoMentis scientists to design and develop new inhibitors safe for use in humans.

“This is a significant milestone and an unquestionable success,” Tang said. “We are stepping onto uncharted paths in Alzheimer’s treatment and seeing wonderful results so far. Hopefully, this drug will make a real difference and help stop this disease one day.”

While the clinical trials continue, Tang and his colleagues will work on the next generation of drugs to combat Alzheimer’s. “This is not a one-shot deal. We will keep working to build an arsenal to fight this deadly disease.”

During the first phase of testing, the drug was administered by injections, Tang said. Another clinical study, using an oral version of CTS-21166 will likely begin in a few months, followed by a phase II study later this year, he said.

“As far as Phase I testing goes, we could not have expected better results for a new CNS (central nervous system) drug,” he said. “It not only proved the drug candidate is safe, it gave us a whole lot of information on efficacy.”

Tang said the significance of this drug is that it is designed to treat the disease itself rather than treating the symptoms, like all other available Alzheimer’s drugs.

“It would be great if people could take one pill a day and push the onset of the disease back indefinitely,” he said. “This is another milestone toward that goal.”

About Alzheimer’s Disease:
Alzheimer’s disease is a neurological disorder characterized by slow, progressive memory loss due to the gradual death of brain cells. According to the Alzheimer’s Association, the disease affects more than 4.5 million Americans, including 62,000 Oklahomans and nearly half the U.S. population over the age of 85.

About CoMentis:
CoMentis, Inc. (comentis.com) has its headquarters in South San Francisco, with research operations in both South San Francisco and Oklahoma City. The company is engaged in the discovery and development of small-molecule drugs to treat Alzheimer’s disease, age-related macular degeneration (AMD) and cognitive disorders.

About OMRF:
OMRF (omrf.org) is an independent, nonprofit biomedical research institute dedicated to understanding and developing more effective treatments for human disease. Its scientists focus on such critical research areas as Alzheimer’s disease, cancer, lupus and cardiovascular disease.

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