AC/DC Founder Rocked By Brain Disease

Malcolm Young Leaves Band Because Of Dementia

The family of founding AC/DC guitarist Malcolm Young has confirmed the illness that forced the 61-year-old to quit the band because of dementia symptoms.

“Malcolm is suffering from dementia and the family thanks you for respecting their privacy,” they said in a statement, according to People magazine.

malcolm young AC/DC dementia

The group had previously announced in April that Young would be taking a break from the band and that it would be recording a new record without him. When AC/DC announced that it would be putting out the record, “Rock or Bust,” this fall, they confirmed that Young would not be returning to the band, “due to the nature of Malcolm’s condition.” They did not go into the specifics of the illness.

Young’s nephew, Stevie Young, played rhythm guitar in Malcolm’s stead on “Rock or Bust.” He will also be filling in for the elder Young on the group’s upcoming world tour in 2015. According to a family friend, the guitarist could no longer remember how to play AC/DC songs.

“If you were in the room with Malcolm and walked out, then came back in one minute later, he wouldn’t remember you. He has a complete loss of short-term memory,” according to an unnamed source.

Scottish-born brothers Malcolm and Angus Young formed AC/DC in 1973. The Australian band sold more than 200 million albums, with their 1980 record Back in Black their biggest-selling hit.

“We miss Malcolm, obviously,” AC/DC frontman Brian Johnson told Classic Rock in July at a time when the band was optimistic about the guitarist’s return. “He’s a fighter. He’s in the hospital, but he’s a fighter. We’ve got our fingers crossed that he’ll get strong again. … Stevie, Malcolm’s nephew, was magnificent, but when you’re recording with this thing hanging over you and your work mate isn’t well, it’s difficult. But I’m sure (Malcolm) was rooting for us.”


Alzheimer's disease treatment


Eye Test Might Detect Alzheimer’s Disease

Diagnosing Dementia With Ocular Examination

Two novel, noninvasive, and relatively simple eye tests show promise as potential screening tools for early Alzheimer’s disease (AD).

Preliminary results from 2 studies presented here at the Alzheimer’s Association International Conference (AAIC) 2014 show that beta-amyloid detected in the eyes significantly correlated with the burden of beta-amyloid in the brain, allowing investigators to accurately identify individuals with AD.

Alzheimer's disease treatment

In the first study, researchers at the Commonwealth Scientific and Industrial Research Organization (CSIRO), Australia’s national science agency, used curcumin fluorescence imaging to highlight beta-amyloid in the retina and correlated these results using Pittsburgh compound B (PiB) positron emission tomography (PET) imaging findings in the brain.

“Every single person who tested positive with high levels of plaque in the brain tested positive to the retinal test as well, so we had 100% sensitivity and no false negatives, which is a crucial component on a screen for Alzheimer’s disease because we don’t want to leave anyone behind when it comes to the early signs,” lead investigator Sean Frost said at a press briefing here.

The investigators note that although AD-related pathology in the brain is well documented, the disease has also been reported to affect the retina, a developmental outgrowth of the brain that is more accessible for imaging.

The primary substance in the Asian spice turmeric, curcumin has several properties that make it a good contrast medium ― it binds with high affinity to beta-amyloid, and it has fluorescent properties that enable amyloid plaques to be imaged in the retina. In addition, said Frost, it is safe.

Alzheimer's disease treatment

Study participants included individuals with AD, individuals with mild cognitive impairment, and healthy control participants from the Australian Imaging, Biomarker and Lifestyle Flagship Study of Aging (AIBL) study.

In addition to undergoing PiB PET imaging, participants made 2 visits for retinal fluorescence imaging. During the first visit, they drank a proprietary curcumin supplement. On the second visit, they underwent retinal amyloid imaging (RAI).

Preliminary data from the first 40 participants showed that amyloid levels detected in the retina were significantly correlated with brain amyloid levels, as shown by PiB PET imaging. In addition, RAI differentiated participants with AD from those without AD with 100% sensitivity and 80.6% specificity.

Furthermore, said Frost, longitudinal data showed an average increase of 3.5% in retinal amyloid during a 3.5-month period, suggesting that the technique may be used as a means of monitoring response to therapy.

If these early findings bear out, Frost said, this technology could be used as an initial screen for AD that could potentially be part of regular eye examinations.

“One day we hope there’s going to be better treatments available, and this will definitely provide a frontline screening tool to detect it in the early stages, before cognitive decline, and hopefully change the course of Alzheimer’s disease,” he said.

The full study is expected to be completed later this year.

treat Alzheimer's disease

In the second study, investigators from Cognoptix Inc, in Acton, Massachusetts, reported findings showing that a novel fluorescent ligand eye scanning (FLES) system that detects beta-amyloid in the lens of the eye also accurately detects amyloid burden and correlates with florbetapir PET brain imaging.

This phase 2 study included 20 individuals with probable mild to moderate AD and 20 healthy, age-matched control participants.

For the study, participants had a small molecule applied to the eye in the form of a sterile ophthalmic ointment. The compound is left to diffuse into the eye overnight; the next day, the eye is scanned with the laser and results are computed.

All 40 participants also underwent PET amyloid brain imaging.

According to Paul D. Hartung, president and CEO of Cognoptix Inc, who presented the findings, the study showed that the test was able to differentiate individuals with Alzheimer’s from healthy control participants with 85% sensitivity and 95% specificity (< .001). In addition, amyloid levels in the lens significantly correlated with PET imaging results.

Hartung pointed out that at approximately $300, the test is about 10 times less expensive than PET imaging and much less invasive than cerebrospinal fluid testing.

In addition, he said, a single scan takes less than a second, and the instrument can compute a score, known as a fluorescence uptake value, in less than 5 minutes.

Furthermore, he said, the technology requires minimal training and has the potential to be used by general practitioners, nurses, and other healthcare practitioners in clinics and offices. It is also safe and could be administered on a regular basis to track disease progression and to monitor treatment.

“Early detection is critical. We are hoping the treatments that are being developed will be more effective if they are administered earlier, and we need something that can be made accessible to doctors everywhere,” he said.

With principal investigator Pierre Tariot, MD, director of the Banner Alzheimer’s Institute, Phoenix, Arizona, Hartung said the investigators are currently conducting a pivotal phase 3, multicenter, US-based study to support US Food and Drug Administration approval of the FLES system as an aid in the diagnosis of probable AD.

Commenting on the studies for Medscape Medical News, David Knopman, MD, professor of neurology at the Mayo Clinic College of Medicine, consultant in neurology at the Mayo Clinic in Rochester, Minnesota, and a member of the Alzheimer’s Association Medical and Scientific Advisory Council, who moderated a press conference on this topic, said he was “very impressed” by both papers and particularly the retina paper.

“I thought the data were very interesting, and if it is the case that the amyloid in the retina parallels the amyloid in the brain ― and that’s what they were showing ― that’s really an exciting finding.

“I think that brain amyloid imaging at this point has been of tremendous scientific value in allowing us to understand who is either at risk, or who actually has the pathology of Alzheimer’s disease in life, but it’s so expensive. At my institution, to do an Amyvid [Avid Radiopharmaceuticals, Inc] scan is somewhere between $5000 and $7000.

“The Center for Medicare and Medicaid Services doesn’t pay for amyloid imaging. We’re looking into that for research purposes, but if this actually could substitute for that, say, in clinical trials or under appropriate circumstances if there were therapies to identify people who would benefit from the therapies, that would be a tremendous advance.”

Unfortunately, said Dr. Knopman, at this point, the Alzheimer’s field lacks a powerful therapy to prevent the disease or stop it in its tracks.

“At this point, we understand that, but the kind of approaches described here are the kind of approaches we need to have in place when we have those effective therapies,” he said.

Alzheimer’s Association International Conference (AAIC) 2014. Abstracts O2-05-05 and O3-13-01. Presented July 13, 2014.


Visual Test Can Distinguish Alzheimer’s Disease from Normal Aging

Visual Cognition Key To Early Diagnosis

Researchers have developed a new cognitive test that can better determine whether memory impairments are due to very mild Alzheimer’s disease or the normal aging process. The simple test asks subjects to determine if circles containing certain designs match each other, which exercises the hippocampus portion of their brain.

Alzheimer's disease treatment

Memory impairments and other early symptoms of Alzheimer’s are often difficult to differentiate from the effects of normal aging, which makes it hard for doctors to recommend treatment for those affected until the disease has progressed substantially.

Previous studies have shown that a part of the brain called the hippocampus is important to relational memory – the “ability to bind together various items of an event,” said Jim Monti, a University of Illinois postdoctoral research associate who led the work with psychology professor Neal Cohen, who is affiliated with the Beckman Institute at Illinois.

Being able to connect a person’s name with his or her face is one example of relational memory. These two pieces of information are stored in different parts of the brain, but the hippocampus “binds” them so that the next time you see that person, you remember his or her name, Monti said.

Previous research has shown that people with Alzheimer’s disease often have impairments in hippocampal function. So the team designed a task that tested the relational memory abilities of the participants, according to their study report in the journal Neuropsychologia.

Participants were shown a circle divided into three parts, each having a unique design. Similar to the process of name-and-face binding, the hippocampus works to bind these three pieces of the circle together. After the participants studied a circle, they would pick its exact match from a series of 10 circles, presented one at a time.

People with very mild Alzheimer’s disease did worse overall on the task than those in the healthy aging group, who, in turn, did worse than a group of young adults.

The test also revealed an additional memory impairment unique to those with very mild Alzheimer’s disease, indicating the changes in cognition that result from Alzheimer’s are qualitatively different than healthy aging. This unique impairment allows researchers to statistically differentiate between those who did and those who did not have Alzheimer’s more accurately than some of the classical tests used for Alzheimer’s diagnosis, Monti said.“That was illuminating and will serve to inform future work aimed at understanding and detecting the earliest cognitive manifestations of Alzheimer’s disease,” Monti said.

Although this new tool could eventually be used in clinical practice, more studies need to be done to refine the test, he said.

“We’d like to eventually study populations with fewer impairments and bring in neuroimaging techniques to better understand the initial changes in brain and cognition that are due to Alzheimer’s disease,” Monti said.

The Alzheimer’s Association estimates that the number of Americans living with Alzheimer’s disease will increase from 5 million in 2014 to as many as 16 million by 2050.


Does Marijuana Help Prevent Alzheimer’s Disease

Active Ingredient A Brain Stimulant

A paper published by the British Journal of Pharmacology suggests that the chemical compounds in marijuana likely prevent the onset of Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, and age-related dementia. Chronic brain inflammation, oxidative stress, and intra-cellular dysfunction are the primary reasons why people develop these debilitating neurological diseases. The study found that both THC and CBD (the primary chemical compounds found in marijuana) positively affect nerve cell function in consumers, significantly reducing these harmful neurological conditions.

Alzheimer's disease treatment

THC and CBD (called cannabinoids) tap into a primal, chemical signaling system in cells called “the endocannabinoid system.” The paper shows cannabinoids dampen inflammation, protect cells from oxidative damage, and promote cell health on a number of levels.

This paper echoes claims made in January by Gary Wenk, professor of neuroscience, immunology, and medical genetics at Ohio State University, that “if you do anything, such as smoke a bunch of marijuana in your 20s and 30s, you may wipe out all of the inflammation in your brain and then things start over again. And you simply die of old age before inflammation becomes an issue for you.”

The implications of marijuana’s medicinal effects on our brains are monumental, from not just a health perspective, but a financial one as well, for more than five million Americans with Alzheimer’s.

prevent Alzheimer’s disease with marijuana

One in three seniors will die with Alzheimer’s or another form of dementia, and Alzheimer’s is the sixth leading cause of death in the nation, costing the country about $203 billion in 2013.


Alzheimer’s Test Raises Ethical Issues

Many Don’t Want Test If Alzheimer’s Treatment Not Available

By Peter Jaret, AARP Bulletin

When researchers recently announced a promising new blood test for Alzheimer’s disease — one that could be as simple to perform as a standard cholesterol test — reactions were mixed. While some experts heralded the news, others worried that, until effective treatments are available, learning that you’re likely to develop Alzheimer’s disease could cause more harm than good.

Alzheimer's disease treatment

Experts say that developing a test for Alzheimer’s allows for the possibility of more effective treatment. “The main problem with treating Alzheimer’s disease today is that the medicines are probably given too late to do much good,” says Howard Federoff, M.D., professor of neurology at Georgetown University Medical Center, who was part of the team that developed the test. “Our research reports a biomarker that will allow us to select patients who have very early disease, and we can determine if medicines are more effective when given earlier.

There’s already good evidence that simple lifestyle changes can help slow the likelihood of developing dementia, says Jason Karlawish, M.D., professor of medicine at the University of Pennsylvania, who was not involved in developing the test. “A heart-healthy diet, physical activity, and social and cognitive stimulation can help preserve cognitive function,” he says. People who learn that they are at high risk of developing Alzheimer’s may be more motivated to make healthy changes.

In addition, early detection would allow people to make informed decisions about their care before the symptoms of Alzheimer’s get in the way — one reason both the Alzheimer’s Association and the Alzheimer’s Foundation of America support early diagnosis.

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But there are worries. “A positive result on a test like this could be devastating,” says Craig Klugman, a bioethicist who chairs the Department of Health Sciences at DePaul University. “It could change people’s outlook on life, making them anxious, depressed and withdrawn. Suddenly you find yourself living with this sense of doom that can affect every dimension of your life.”

People who test positive might also suffer the added burden of feeling stigmatized or ashamed, experts warn. The stress of learning that you are likely to develop Alzheimer’s disease could even worsen the symptoms of forgetfulness and confusion.

“What was a simple momentary lapse of memory before now becomes a terrifying symptom of this dreaded disease,” says Klugman.

Indeed, a recent study looked at the effect of telling people that they carry a genotype that puts them at high risk of developing Alzheimer’s. Those who learn that they tested positive judge their memories more critically and perform worse on memory tests than those who are not told.

And there’s another worry. Like almost all tests, the new blood test isn’t perfect. The 90 percent accuracy rate means that some people would be told they will likely develop Alzheimer’s over the next several years when, in fact, they won’t. “That would mean someone’s life was turned upside down for nothing,” says Klugman.

The flurry of headlines that greeted the announcement of a new blood test gave the impression that it was just around the corner. It isn’t. The preliminary results must first be confirmed by other independent research teams. Even then, says Mark Mapstone, an associate professor of neurology at the University of Rochester Medical Center and another member of the team that developed the blood test, it “would likely be used in high-risk individuals” — people with a family history of Alzheimer’s, for instance.

By that time, researchers say, they are likely to know much more about Alzheimer’s disease and even how to slow its progress. The blood test already offers important clues, according to Federoff. The changes that have been observed in the blood are believed to result from the breakdown of brain cell membranes in people destined to develop the disease. The researchers are continuing to look at other molecules in the blood that would give a more detailed glimpse into what goes wrong in people at risk.

In other research, scientists are recruiting volunteers for a program called the A4 Study, which will test an experimental drug that could slow cognitive decline in people who are at risk of memory loss because of Alzheimer’s. Researchers at Harvard Medical School recently announced that a naturally occurring protein may protect against the development of Alzheimer’s disease and age-related dementia — and these findings could open up a new area of treatment.

treat Alzheimer's disease

“As long as there is no effective treatment, there’s a real question about whether to offer a test,” says Klugman. “But once we have ways to slow or stop the disease, there are many fewer reasons against testing.”


Alzheimer’s Disease Third-Leading Cause Of Death

Alzheimer’s Disease Often Undiagnosed, Misdiagnosed

Alzheimer’s disease likely plays a much larger role in the deaths of older citizens than is reported, according to a new study that says the disease may be the third-leading cause of death in the United States. The Centers for Disease Control and Prevention lists Alzheimer’s as the sixth-leading cause of death, far below heart disease and cancer. But the new report, published Wednesday in the medical journal of the American Academy of Neurology, suggests that the current system of relying on death certificates for causes misses the complexity of dying for many older people and underestimates the impact of Alzheimer’s.

Alzheimer's disease treatment

While the CDC attributed about 84,000 deaths in 2010 to Alzheimer’s, the report estimated that number to be 503,400 among people 75 and older. That puts it in a close third place, behind heart disease and cancer, and well above chronic lung disease, stroke and accidents, which rank third, fourth and fifth.

Alzheimer’s is somewhat of a sleeping giant compared with other leading killers that have received more funding over the years. While deaths from these diseases have been going down thanks to better treatment and prevention, the number of people suffering from Alzheimer’s is quickly rising and the disease is always fatal.

More than 5 million people in the United States are estimated to have Alzheimer’s (44 million globally). With the aging of the baby-boom generation, this number is expected to nearly triple by 2050 if there are no significant medical breakthroughs, according to the Alzheimer’s Association. The disease cost the nation $210 billion last year; that rate is expected to rise to $1.2 trillion by 2050.

Alzheimer’s Disease Research, Treatment Underfunded

“Scientists told us we need $2 billion a year over the coming 10 years” to see significant advancement in treatment and prevention, said Keith Fargo, director of Scientific Programs and Outreach at the Alzheimer’s Association. Funding by the National Institutes of Health for Alzheimer’s in 2012 was about $500 million, far below funding for heart disease and cancers. The estimated funding in 2013 was $484 million.

Alzheimer's disease infectious disease

“We would like to see a response that is commensurate with the problem,” Fargo said. “Alzheimer’s disease is a serious disease and it needs to be taken seriously, and if we have the right kind of investment as a country, then we will be able to make strides similar to what we’ve made in heart disease, HIV and cancer.”

For the study, researchers at Rush Alzheimer’s Disease Center in Chicago followed 2,566 people 65 and older for an average of eight years, testing them annually for Alzheimer’s-type dementia and observing the risk of death in those who did and did not receive a clinical diagnosis of the disease.

But death certificates for many with Alzheimer’s often listed a more immediate reason for death, leading to a severe underreporting of the disease as an underlying cause, said Bryan James, the report’s lead author and an epidemiologist at the center. The study was funded by the National Institute on Aging and the Illinois Department of Public Health.

“Death certificates may not be the best way to measure how many people die from something that takes up to 10 years” to break down a person’s system, he said, adding that the disease leaves people more vulnerable to dying from infections and other problems. “We’re not saying they didn’t die of those things; we’re just saying, ‘Well, what put them in the hospital with that condition?’ ”

For example, if Alzheimer’s compromises one’s ability to swallow and results in food repeatedly going down the windpipe, that can leave a person more vulnerable to dying of pneumonia, he said.

“Trying to identify a single cause of death in elderly people is often not reflective of the real situation,” James said.

The idea that Alzheimer’s causes many more deaths is not new among experts, but the scope of the undercount is striking, said Dallas Anderson, science administrator for population studies of Alzheimer’s at the National Institute on Aging.

“Anybody who has somewhat of a knowledge of the disease registration system in the U.S. would not be surprised that there was an undercount; the surprising thing is how much of an undercount,” he said, adding that while earlier studies have had similar findings, this is the first peer-reviewed study to produce them.

caregivers Alzheimer's disease

“It’s shocking,” he said, “and it’ll be interesting to see how it plays out. . . . It would be nice if we could actually improve our death registration system.”

President Obama’s budget for fiscal 2015 included $100 million for an initiative to map the human brain to better understand diseases including Alzheimer’s. But many in the field think Alzheimer’s should receive more funding.

“The disease is still very underfunded in comparison to other diseases,” James said. “Cancer has about 10 times the amount of funding, and only about three times as many people have cancer.”

Alzheimer’s is not always taken as seriously as other diseases, which may contribute to the historical lack of funding, Fargo said. “There are many people who still think of Alzheimer’s disease as just a memory problem — you forgot where you left your keys. But currently, Alzheimer’s is a universally fatal brain disease that has kind of fallen by the radar.”


Alzheimer’s Disease Test Crashes University Website

Editor’s Note: The following article and the high demand for answers is very interesting. Last year, an expert panel told the Alzheimer’s Association International that 16 freely accessible online tests for the disease scored poorly on overall scientific validity, reliability and ethical factors. Ironically, doctors also are playing a game of pin-the-tail-on-the-donkey when declaring a diagnosis for Alzheimer’s. At least 20 percent of Alzheimer’s victims are “misdiagnosed” cases of Creutzfeldt-Jakob disease (CJD). CJD is very aggressive, fatal and highly contagious. Our new e-Book is packed with information that can save lives and curb the global epidemic.

Alzheimer's disease treatment

Alzheimer’s Disease Diagnosis Research

A new website that helps determine whether someone might have Alzheimer’s disease or dementia is so popular that the site crashed when it debuted. Ohio State University’s website says its Self-Administered Gerocognitive Exam (SAGE) is a test that can be done in your own home with a paper and pencil. Questions and tests include:

  • How many nickels are there in 60 cents?
  • What is today’s date? (no cheating)
  • Draw a large face of a clock and place in the numbers for a specific time of day.

When researchers visited 45 community events where they asked people to take the simple test, they found that of the 1,047 who did it, 28 percent were identified with cognitive impairment, test developer Dr. Douglas Scharre of Ohio State and his team reported Monday in The Journal of Neuropsychiatry and Clinical Neurosciences.

Researchers in Ohio say the SAGE test has been shown to be effective in spotting the early signs of cognitive decline, (Ohio State University Wexner Medical Center). Participants were told the test represented their baseline level, which doctors could use for future comparisons during re-screening.

“What we found was that this SAGE self-administered test correlated very well with detailed cognitive testing,” Scharre said in a release. “If we catch this cognitive change really early, then we can start potential treatments much earlier than without having this test.”

The Alzheimer Society of Canada says early diagnosis can help with planning, care and support. CBC health commentator and physician assistant Maureen Taylor said while she supports patient knowledge, there aren’t great treatments to turn back the course of the disease.

“My worry is that some people will do it and there may be other reasons why they’re having memory issues and can’t complete this test that have nothing to do with dementia or Alzheimer’s disease,” Taylor said. “It just underscores that you need to talk to your doctor if you have concerns.”

treat Alzheimer's disease

10 Warning Signs of Alzheimer’s Disease 

  • Memory loss affecting day-to-day abilities — forgetting things often or struggling to retain new information.
  • Difficulty performing familiar tasks — forgetting how to do something you’ve been doing your whole life, such as preparing toast or getting dressed.
  • Problems with language — forgetting words or substituting words that don’t fit the context.
  • Disorientation in time and space — not knowing what day of the week it is or getting lost in a familiar place.
  • Impaired judgment — not recognizing a medical problem that needs attention or wearing light clothing on a cold day.
  • Problems with abstract thinking — not understanding what numbers signify on a calculator, for example.
  • Misplacing things — putting things in strange places, like an iron in the freezer or a wristwatch in the sugar bowl.
  • Changes in mood and behavior — exhibiting severe mood swings from being easy-going to quick-tempered.
  • Changes in personality — behaving out of character such as feeling paranoid or threatened.
  • Loss of initiative  — losing interest in friends, family and favorite activities.


When Should You Be Tested for Alzheimer’s Disease?

Alzheimer’s Disease Diagnosis Not Precise

By Richard C. Senelick, M.D. via Huffington Post

Alzheimer’s disease (AD), the most common form of dementia, is defined by progressive memory loss and the loss of other intellectual abilities that are serious enough to interfere with daily life. It is a common problem, and your chance of developing AD doubles every five years after the age of 65. Inside your brain, a protein called amyloid beta peptide accumulates around the nerve cells inside your brain — as early as 10 or 20 years before you have symptoms — and causes them to malfunction and die.

Alzheimer's disease treatment

A great deal of research is directed toward identifying the amyloid protein in the brain and toward treatments to both prevent its deposition and remove amyloid that has already been deposited in the brain. This is important, because when the day arrives that we have effective methods to both prevent and treat Alzheimer’s disease, we will want to be able to identify, as early as possible, which individuals are going to develop AD.

As we age, memory loss is common and our concerns over developing Alzheimer’s disease (AD) are right up there with cancer. It may seem like we are desperate for a test to identify Alzheimer’s disease. A recent study, for example, claimed the distance from which you could smell peanut butter was a predictor of Alzheimer’s disease. They didn’t specify crunchy vs. smooth! The website “23 and Me” offers to not only tell you who your ancestors were, but for $99 they will also test your DNA and tell you if you are at risk for Alzheimer’s disease.

In addition, the FDA recently approved Vizamyl, a second radioactive diagnostic drug for “use with positron emission tomography (PET) imaging of the brain in adults being evaluated for Alzheimer’s disease and dementia.” The question is whether these tests are ready for “prime time” and use by physicians and the general public. CMS (The Centers for Medicare and Medicaid) has already denied payment (that is, access) to the first PET radioactive compound, Amyvid, on the basis that PET scans for Alzheimer’s disease will only be approved in a research setting and do not currently improve health outcomes. They may be right.

Who would want to be tested for Alzheimer’s disease? There is the woman whose mother and father both died of Alzheimer’s disease and who wants to know if she is at a high risk to develop the disease. A 65-year-old man may be worried about whether his memory loss is just a part of normal aging or whether he has early Alzheimer’s disease. He would like an answer so he can better plan his future. Do the current tests provide accurate information to assist these two individuals and their physicians to make intelligent predictions?

caregivers Alzheimer's disease

The PET Scan

A PET scan is different than an MRI scan. A radioactive “tracer” is injected in a vein, and, depending on the tracer, the scan looks at different ways in which the brain works. It may look at how the brain consumes oxygen or glucose, or how blood flows to the different parts of the brain. When testing for Alzheimer’s disease, the PET scan uses a tracer (Amyvid, Vizamyl) that identifies amyloid in the brain. The radioactive material attaches to the amyloid and the PET scanner produces elegant, full-color pictures of the brain. But, what does it mean if you have amyloid in your brain? Does it mean that you already have or that you will get Alzheimer’s disease?

The problem is that PET scans in older people routinely find amyloid protein in 30-40 percent of cognitively intact older people. Even if you already have mild cognitive impairment (MCI) there is only a 60 percent chance that you will have amyloid in your brain, and even if you do, that does not guarantee that you will go on to get Alzheimer’s disease. The good news — a negative scan means that there are few or no amyloid deposits in your brain and the likelihood of cognitive impairment is low. That is of course good news, but again doesn’t guarantee that you will not develop AD. The problem is that if you are cognitively normal, but still test positive for amyloid in your brain, we do not know how to accurately determine your risk of developing Alzheimer’s disease. The scan may provide you with information that will cause you to worry unnecessarily. It is for these reasons that CMS has restricted routine reimbursement for research studies. An amyloid PET scan alone just doesn’t help either of our two anxious patients.

Genetic Causes Some Cases

What about genetic testing? Should you order a kit online and send a swab that not only tells you how many of your relatives came from Scotland, but claims to tell you your risk of getting dementia? The role of genetics in AD is complicated and involves the new and exciting field of epigenetics. In brief, epigenetics is the analysis of how factors in the environment, like food, chemicals, or where you spent your childhood may interact with our genes to cause a disease. Two people may have the same gene, but only one, because of this interaction, may go on to develop a disease like Alzheimer’s.

treat Alzheimer's disease

There are different genes that are associated with the risk of developing AD. Some (PSEN1, PSEN2, APP) are associated with early-onset AD, before the age of 65 years, while the more common form of late onset AD is associated with the APOE4 gene. This is the gene that commercial companies most commonly test. The problem is, if you do test positive for the APOE4 gene, you may be more likely to get AD, but no one can tell you how much more likely or if you will get the disease. The results of the testing can be confusing and do not really supply you with any useful information on how to plan your future. Genetic testing will get there, but it isn’t there yet. Although there are healthcare professionals would argue that testing is at a point where it can help confirm AD, I believe that testing for Alzheimer’s has not reached a point where it should be routinely used by the average practicing physician or their patients. You are just as likely to get information that will confuse or worry you rather than help you make an intelligent decision about your future. We need to continue to perform research on testing because it will be every important when we have drugs that capable of preventing or modifying the course of AD.

So, what can you do if you are worried about your cognitive abilities or chances of developing AD? There are numerous articles, books, and blog posts that claim to have the answers on how to prevent or improve cognitive decline. For reasons noted in the post by Carol Steinberg, the president of the Alzheimer’s Foundation of America, it is important to know if you have AD, but scans and genetic testing ahead of your diagnosis are still not the answer. The jury is still out on all these approaches and we are still awaiting a medication or approach that will modify the course of Alzheimer’s disease. I can already hear the outcry from those who support one approach or another, but I await the science to support their claims.

What we do know is that, “if it is good for the heart, then it is good for the brain.” Follow a healthy diet, exercise, control your cholesterol and blood pressure, don’t smoke, and stay cognitively and socially involved with your environment. Alzheimer’s is still a clinical diagnosis and not one that can be made solely on the basis of scans and genetic testing. The tests supply useful information to the informed physician. For now, seek out the help of a neurologist who is interested in dementia. He should be able to rule out other causes of cognitive decline like depression, medications, sleep and vascular causes, while guiding you through the maze of potential. With all this information in hand, together you can plot a course of action. Alzheimer’s disease is not a diagnosis that is made all at once, but instead is more likely to become apparent over time.


Alzheimer’s Drug Sales To Triple In Next Decade

Alzheimer’s Disease Drugs In High Demand

Editor’s Note: This bold prediction about the growing demand for Alzheimer’s disease treatments further confirms the growth of the epidemic and the desperate search for preventions, cures, and treatments. Unfortunately, very few drugs make an impact on treatment in everyone and no drug is available today that prevents or cures Alzheimer’s. 

The market for Alzheimer’s disease therapies is set to nearly triple between 2012 and 2022, despite increasing generic sales and the fact that few new product launches are expected during this time, according to new forecasts.

Alzheimer's disease treatment

The key driver of growth in the AD market will be Eli Lilly’s anti-beta-amyloid monoclonal antibody solanezumab, the first potentially disease-modifying therapy (DMT) to launch for AD, according to the study, from Decision Resources. It reports that solanezumab is expected to launch in the seven major pharmaceutical markets – the US, France, Germany, Italy, Spain, the UK and Japan – starting in 2018 and that, by 2022, the drug is forecast to attain sales in excess of $5 billion in these markets.

More than 85% of solanezumab’s projected total use in 2022 will be in the mild AD market – the population in which the drug is currently being tested – followed by the pre-AD 1-2 years market segment, says the firm, which defines this latter population as those patients who will go on to develop overt AD within the next one to two years.

Though leaders who were interviewed by Decision Resources for the study say they believe that DMTs will offer the greatest therapeutic benefit in the earlier stages of the disease; as a result, uptake in the moderate and severe AD segments is likely to be minimal.

Furthermore, the report goes on to forecast that reimbursement authorities across the major markets will scrutinize the value of these therapies closely, and that they will impose restrictions that limit the use of such agents to specific patient subsets – who are most to be likely those patients in the mildest stages of the disease.

treat Alzheimer's disease

This scrutiny will stem from the anticipated premium pricing for emerging DMTs and their as-yet unproven cost/benefit ratio, coupled with the growing AD patient population, it says.

“AD patients have unique therapeutic needs depending on the disease severity, many of which are suboptimally met with current medication,” comments Georgiana Kuhlman, senior business analyst at Decision Resources.

“Late-stage emerging DMTs are largely focused on slowing cognitive decline, an advance that will predominantly benefit mild AD and pre-AD patients. In the absence of novel agents that specifically target the later stages of the disease, the moderate-to-severe AD population will likely remain underserved throughout the forecast period,” Ms Kuhlman forecasts.


Alzheimer’s Therapy Possible In Insulin Regulator

Alzheimer’s Disease Connected To Diabetes

Humanin is an amino acid known to play many roles in the human body. Alzheimer’s defense may be one of those roles. Humanin is a potential therapeutic agent for Alzheimer’s disease, and its derivative, S14 G-humanin, is much stronger in its neuroprotective effect against Alzheimer’s disease-relevant insults. Although effective, the detailed molecular mechanism through which S14 G-humanin exerts its effects remains unclear.

Alzheimer's disease treatment

A recent study by Xue Li and colleagues from Henan Provincial People’s Hospital, China investigated the inhibitory effects of S14G-humanin on amyloid-beta protein-induced hippocampal neuronal injury, and data from this study showed that fibrillar amyloid-beta 40 disturbed cellular homeostasis through the cell membrane, increasing intracellular calcium, generating reactive oxygen species, and decreasing the mitochondrial membrane potential. S14G-humanin blocked the effects of amyloid-beta 40 on the neuronal cell membrane, and restored the disturbed cellular homeostasis, thereby exhibiting a potential and effective treatment for Alzheimer’s disease.

These findings were published in the Neural Regeneration Research (Vol. 8, No. 27, 2013).