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New Discoveries

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It is frustrating and heartbreaking to see someone you care about slowly change and not be able to do anything about it. Researchers all over the world are working to find answers to help stop or slow dementia. What is hard to accept is that it takes time. It will take many discoveries, and as they build upon one another over time, there will be successful treatments.

The focus for current research on Alzheimer’s and other dementias is:

• the study of the brain and interaction of brain cells and their breakdown 

• methods for earlier detection and monitoring of disease progression

• drug development and other non-drug interventions along with human trials

• the study of potential health factors that may impact the risk for dementia

• examining lifestyle factors that could impact the risk for dementia

• work to bridge the gap between research discoveries and therapeutic development.

Every day new discoveries are made. The following are the most recent research advancements as of February 2024. 

Detection

Biomarker tests which help measure changes in the brain associated with the disease are widely used by researchers in the lab, such as the PET scan or blood tests. And a possible new way to detect Alzheimer’s Disease has been discovered by an international research team funded by Bright Focus Alzheimer’s Disease Research program. They recently developed an AI model to study and compare details in photos of the retina of the eye. It is an expectation that, one day, these tests will be used by doctors in a clinical setting. 

Drugs to Stop the Progress of Dementia 

The primary hallmarks of Alzheimer’s disease are: Amyloid plaques, Tau tangles, and Neurogeneration. A new category of drugs for the treatment of Alzheimer’s, known as monoclonal antibodies, have been developed which target the clumps of beta-amyloid in the brain and help remove these protein-based plaques which are known to kill healthy neurons in the brain. Some have had mixed test results, but one monoclonal drug has been shown to slow cognitive decline by 25%. Lequembi was granted full approval by the U.S. Food and Drug Administration to treat individuals with earlier stages of mild cognitive impairment or mild dementia. There can be some flu like reactions due to the infusion mode of administering the drug, and swelling or small bleeds in the brain have occurred in rare instances. Whether to to take the drug depends on your health background. The challenge now, for researchers, is to find a way to untangle the Tau tangles.

Treatment Cross-over 

Researchers are also looking into treatments and vaccines already in use for other diseases to see if they can be effective on dementia. There is evidence that brain health is closely related to heart and blood vessel health. The risk of developing dementia is seen to increase as a result of conditions that cause damage to the heart and arteries such as heart disease, high blood pressure and high cholesterol. Researchers are looking into whether medicines to treat these conditions may decrease the risk or slow the decline of memory associated with dementia. Insulin therapy and hormone replacement have not found success, but a study by a research team at Duke University Social Science Research Institute  shows promise. They investigated associations between pneumococcal vaccination and the risk of Alzheimer’s disease, and found that a vaccination between the ages of 65-75 reduced risk for developing the disease by 25-30%, adjusting for other factors. Lead researcher Svetlana Ukraintseva, Ph.D. said, “These data suggest that pneumococcal vaccine may be a promising candidate for personalized Alzheimer’s prevention.”

Exposome

 An area that has gained much interest in the research community is an environmental health approach to Alzheimer’s and dementias. Over the course of a person’s life, they are exposed to environmental factors such as the food and water they ingest, the air they breathe as well as social and psychological environments they experience. The totality of these environmental exposures that have a direct effect on human health is called the exposome. Environmental toxicants like air pollution, pesticides and metal toxins have been linked to several neurogenitive disorders including dementias and have been seen to disproportionately affect poorer communities. With the advancement of computing it is now possible to measure the aspects of the exposome and their relationship to human health. How they affect the risk for dementia is still being studied.

Genomics

Genomics has made a huge advancement, biomedical research in recent years. Studies of the genome has led to identifying the genetic basis of many complex diseases. Genome-wide Association Studies (GWAS) conducted as part of the Alzheimer’s Disease Sequencing Project (ADSP) were successful in identifying 70 regions of the genome associated with Alzheimer’s along with genetic variations that may play a role in the role of AD. As yet, how these genetic regions affect the function of molecules or cells in the body or confer risk for dementia is still unknown.

Individual Cells

The study of AD and dementia is set to expand to the analysis on the scale of individual cells. The techniques, advanced  by Brain Research Through Advancing Innovative Neurotechnologies (BRAIN) “can facilitate comparisons across cells” and “can help shed new light on disease dynamics.”

Final Thoughts

While we would like to see a speedy break-through discovery of a treatment that would eliminate the causes and continued impairment of the brain from Alzheimer’s and other dementias, know that this goal is also shared by scientists and researchers. What is key to the finding a treatment is cooperation and sharing between those who are involved in the research. An example of this is the consortium CPAD, formed under the direction of the National Institute on Aging to share data from clinical trials. Consortium partners include pharmaceutical companies, non-profit foundations and government advisors. 

The scientific and medical community now realizes there will probably be no one drug or therapy that will be successful for those who suffer with AD or dementia. In the near future, researchers expect a range of treatments and approaches tailored to each individual, similar to the way we treat cancer today.

Information obtained from:
National Institute on Aging  www.nia.nih.gov
Bright Focus Foundation www.brightfocus.org
Alzheimer’s Association  alz.org

A Reason For Hope

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In this time of increased political divisiveness and lack of confidence in our congressional representatives to work together and make effective decisions to run the country, finding evidence of compromise on an issue brings hope.

On September 28, 2018 a bill was signed into law that allocated $2.3 billion dollars to be included in the 2019 budget for Alzheimer’s and dementia research under the auspices of the National Institutes of health (NIH) . The congressional members who sponsored the bill included four Republicans, and four Democrats.

Alzheimer’s is indeed the most expensive disease in the country, costing an estimated $277 billion–including $186 billion in direct costs to medicare and medicaid–in 2018. As the number of those afflicted increases, so will the cost. There are 5 million Americans living with Alzheimer’s today; it is predicted this number will rise to 14 million by 2050. With the increase in funding, scientist are able to work at a faster pace to explore ways to reduce risks, develop drugs or other potential treatments to stop or slow the disease. 

In 2011 the National Alzheimer’s Project Act (NAPA) was passed which focused on the need for resources for research and the needs of family caregivers with a goal to find effective treatment of Alzheimers/dementia by 2025. Since that time, the federal government has continued to be supportive. The monies allocated to NIH from 2011 to the present have quadrupled, and continue to be spent on research and programs to help caregivers.

Among the many groups that keep congress aware of the need for funding for Alzheimer’s and dementia, one group stands out. Alzheimer’s Impact Movement (AIM), the advocacy arm of the Alzheimer’s Association. The group is very active in keeping our representatives aware of what is needed to help those afflicted with Alzheimer’s and those who care for them, as well and working with government agencies that oversee the research and programs that impact dementia and Alzheimer’s.
AIM federal goals are:

Increase the Commitment to Alzheimer’s Research

Build an Alzheimer’s Public Health Infrastructure

Educate Providers on Palliative and Hospice Care

State policy is also vital to the work that the Alzheimer’s Association is doing to meet the needs of individuals living with Alzheimer’s and their families. State officials determine regulatory and statutory standards for dementia training, control spending on state respite care dollars, designate spending for state long-term care services, and control Medicaid spending which can affect eligibility and scope of benefits – all of which can have a direct effect on families impacted by Alzheimer’s disease.
AIM state goals are:

Implement and update state Alzheimer’s disease plans

Improve dementia training

Increase early detection and diagnosis of Alzheimer’s

Educate the public about risk reduction

Preserve Medicaid

Aim was very active in the last election and seeks volunteers on a continuous basis to meet with local representatives, engage on social media, coordinate events, draft ‘letters to the editor’ or assist in other ways to bring awareness to the effects of Alzheimer’s.

To find out more about AIM or learn how you can volunteer go to alzimpact.org

 

Inside the Brain

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Only 1% of dementia cases can be cured with treatment. These types of dementia usually evolve as a side affect from conditions such as an operable brain tumor, vitamin B12 deficiency, thyroid disease, hydrocephalus, alcoholism or depression. All other types of dementia are rarely reversible.

Vascular dementia, which occurs in about 10% to 20% of cases, often results from a series of small strokes that destroy brain cells or from deposits of amyloid protein on blood vessels which cause them to rupture. Symptoms may include paralysis on one side, incontinence, and a mask like expression. This type of dementia is usually brought about by chronic high blood pressure, diabetes or coronary heart disease.

Lewy Body dementia accounts for 5% to 15% of cases and is caused by deposits of alpha-synuclein protein throughout the brain. Those with this type of dementia have memory loss symptoms the same as Alzheimer’s in addition to motor problems similar to Parkinson’s disease.

With Alzheimer’s disease, the most common type at 60% to 80% of the cases, the damage to the brain is more severe and ultimately affects larger regions. In the Alzheimer diseased brain,  nerve cells (neurons) stop functioning, lose connections with each other and ultimately die. The death of many neurons in key parts of the brain causes those areas to atrophy and shrink.

The strongest theory for the cause of Alzheimer’s disease is based on the presence of amyloid plaques and neurofibrillary tangles in the brain of patients. Researchers still can’t say, though, whether they are a cause or byproduct of the disease.

Amyloid plaques are a mixture of of abnormal proteins and nerve cell fragments that develop in the tissue between nerve cells., They are formed when the amyloid precursor protein which is part of the nerve cell membrane is broken down by enzymes when a nerve dies. One of the enzymes, beta-secretase, cuts the protein into a piece, the plaque, which is insoluble. This piece is toxic and eventually causes other nerve cells to die.

Neurofibrillary tangles are formed when a protein called tau becomes twisted. Tau plays an important part in the internal support structure of microtubules. In healthy neurons, microtubules act like railroad tracks carrying nutrients from cell to cell. When tau becomes twisted, it disturbs the function of the microtubules which, in turn, affects the communication within the nerve cells and leads to their death.

Another discovery characteristic to Alzheimer’s disease is the reduction of cholinergic neurons in the brain. These neurons, prolific in the hippocampus and cerebral cortex, produce acetylcholine, a neurotransmitter critical to memory and learning. As the disease progresses, acetylcholine levels drop dramatically and the dementia worsens. Levels of other neurotransmitters such as serotonin, norepinephrine also drop which have a direct affect on patient behavior. It is thought the reduction is due to brain cell death.

Alzheimer’s is named for the German physician who first identified it 1906

 

A Forum on Dementia

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Welcome to my new, redesigned blog space. Some of you might have followed my original blog about my mother and her journey through dementia. Others of you may have just discovered my site.

Since my mother’s death, and inspired by her, I have been working toward two goals. The first, at the urging of many, I have taken my blog writings and expanded them into a book. My purpose remains the same: to share my mother’s experience in the hope that it will help others. During the course of writing my blog, I spoke with others and received messages from people from all over the United States and even a few from other countries. Universally they had the same reaction “That sounds just like my mother(or whomever). I know what it’s like.” By offering my book on Amazon I hope to reach more people.

My second goal was to learn as much as I could about dementia and Alzheimer’s Disease. Public awareness of dementia has grown by leaps and bounds and medical researchers and other scientists are discovering more about it each day. Though I have gained much knowledge about it, my goal has become never ending.

My purpose for this site is to share some of what I have learned and information I have gathered from my study of dementia. There is a phethora of information out there on the web, and sifting through it all can be daunting. I don’t claim to be a medical professional or psychologist; I will leave the technical explanations up to them. What I will do is refer you to articles or web pages for more in depth knowledge. My plan is to write every two weeks about some aspect about dementia. In addition, I would like to see this web page as a place to share information and serve as a community forum for those whose lives are or have been touched by dementia. I will share names of organizations that are advocates for dementia or Alzheimers, as well as sites to go to for up-to-date information about the disease and help for caregivers. Anyone else who wishes to contribute something that others would find helpful will be encouraged to do so.