New Research Explores Cure for Alzheimer’s
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As scientists look for causes as well as preventative measures for this form of dementia, they are examining not just physical factors but also “social,” such as age of retirement and an individual’s own concerns about memory. Click here to view article.
Although Alzheimer’s disease is the focus of much research, the bottom line is that there is still no cure. Nor are scientists sure what causes this form of dementia, though several workable theories exist.
Most recently, a study by the French government agency INSERM found that people who delay retirement have less risk of developing Alzheimer’s disease or other types of dementia. The study of half a million people in France, the largest study of this kind to date, backs the general theory of aging that says” if you don’t use it, you lose it,” referring both to physical and cognitive function. In this case, working longer seems to keep people more mentally challenged as well as socially active.
Along those same lines of cognitive function, it was reported at the Alzheimer’s Association conference in Boston in July that people with certain types of cognitive concerns were more likely to have Alzheimer’s pathology in their brains and develop dementia than those who had no such complaints, leaving the conclusion that health care workers should listen to patients’ own sense of their health. For example, people with more concerns about memory and organizing ability were more likely to have amyloid, a key Alzheimer’s-related protein, in their brains. For this reason, leading Alzheimer’s researchers are identifying a new category called “subjective cognitive decline,” which is people’s own sense that their memory and thinking skills are slipping even before others have noticed (“Dementia’s Signs May Come Early,” July 17, 2013, New York Times).
A Growing Problem
Alzheimer’s is a serious problem, not just for the individual, but for society as a whole. More than 5 million Americans live with Alzheimer’s disease, and 15.4 million friends and family members provide care, according to the Alzheimer’s Association.
Compounding the human toll, Alzheimer’s is now the most expensive disease in the U.S., topping cancer and heart disease, according to a new study by the nonprofit RAND Corp. (“Costs of Alzheimer’s disease could bankrupt Medicare,”wcbv.com).
Researchers are still trying to fully understand the illness’s process and how to prevent or stop the disease, which robs people of their memory and the ability to function. Although scientists can’t be sure about which factors determine Alzheimer’s disease, the Alzheimer’s Association lists these hallmarks:
- Plaques, microscopic clumps of a protein called beta-amyloid peptide.
- Tangles, twisted microscopic strands of the protein tau (rhymes with “wow”).
- Loss of connections among brain cells responsible for memory, learning and communication. These connections, or synapses, transmit information from cell to cell.
- Inflammation resulting from the brain’s effort to fend off the lethal effects of the other changes underway.
- Eventual death of brain cells and severe tissue shrinkage.
Research Path
Research is taking several paths (“Alzheimer’s Treatments: What’s on the Horizon?” Mayo Clinic).
Plaques: Two strategies aimed at beta-amyloid are immunizing the body against it and blocking its production. An early Alzheimer’s vaccine to reach clinical trials mobilized a person’s own immune system to attack beta-amyloid. However, researchers stopped this study when some participants developed acute brain inflammation.
The second approach blocks the production of plaques either through intravenous (IV) infusions of a product from donated blood, which contains naturally occurring anti-amyloid antibodies from the donors; or by reducing the amount of beta-amyloid formed in the brain.
Tau: Researchers are looking at a way to prevent tau from forming tangles.
Inflammation: Researchers are studying nonsteroidal anti-inflammatory drugs, which have had varying results.
Insulin resistance: Researchers are looking to see if insulin changes in the brain may be related to Alzheimer’s. A trial is testing an insulin nasal spray to determine if it slows Alzheimer’s progression.
Heart-head connection: The risk of developing Alzheimer’s appears to increase after due to conditions that damage the heart or arteries, including high blood pressure, heart disease, stroke, diabetes and high cholesterol. To counteract this, researchers are looking at whether drugs used to treat those conditions may also help people with Alzheimer’s or reduce the risk of developing the disease. They are also interested in whether healthy living with known heart benefits, such as exercising and a heart-healthy diet, may help prevent Alzheimer’s disease or delay its onset.
In fact, one study reported that up to half of Alzheimer’s cases worldwide could be prevented through lifestyle changes and treatment of chronic medical conditions such as diabetes, as reported at the Alzheimer’s Association International Conference in July 2011 in Paris. Modest reduction in seven risk factors for dementia, including smoking, obesity, sedentary lifestyles and midlife high blood pressure, could have a huge impact, said Deborah Barnes, an associate professor of psychiatry at the University of California, San Francisco (“Researchers Say Reduction in Risk Factors Could Lower Rate of Alzheimer’s Disease,” July 19, 2011, WebMD Health News).
Cognitive and social activities: Researchers are looking at whether cognitive activities such as memory training or social interaction may help prevent or delay Alzheimer’s.
Current Therapy Options
Several different medications are used to treat Alzheimer’s symptoms such as memory loss, problems with thinking and reasoning, and issues with sleep (“Alzheimer’s Disease Therapy Options, WebMD).
These treatments boost performance of brain chemicals that carry information from one brain cell to another. Although these treatments don’t stop the underlying decline and death of brain cells, they can slow the progression of symptoms for a few months or even years. All of these medications can have side effects, which can be pronounced in older people.
The U.S. Food and Drug Administration has approved two types of medications to treat Alzheimer’s — cholinesterase inhibitors (Aricept, Exelon, Razadyne, Cognex) for the early to moderate stages of Alzheimer’s; and memantine (Namenda) to treat the cognitive symptoms (memory loss, confusion and problems with thinking and reasoning) for moderate to severe stages. Both medications have side effects.
Evidence indicates that sensory treatments such as music therapy and art therapy can improve Alzheimer’s patients’ mood, behavior and day-to-day function. By stimulating the senses, these treatments may help trigger memory recall and enable Alzheimer’s patients to reconnect with the world around them.
Similarly, storytelling can be therapeutic for people who don’t communicate well, according to research that reported people became more engaged and alert, happier and better able to communicate in general. At least two studies found that writing memoirs has therapeutic effects for those suffering from dementia, calming them down and increasing self-esteem.
Beyond that, individuals can take steps to help Alzheimer’s patients (see sidebar, “Tips for Coping.”)
Tips for Coping:
Caretakers can take simple steps to make life easier for a person with Alzheimer’s disease.
- Monitor personal comfort. Check for pain, hunger, thirst, constipation, full bladder, fatigue, infections and skin irritation. Maintain a comfortable room temperature.
- Avoid being confrontational or arguing about facts. For example, if a person expresses a wish to visit a parent who died years ago, don’t point out that the parent is dead. Instead, say, “Your mother is a wonderful person. I would like to see her too.”
- Redirect the person’s attention. Try to remain flexible, patient and supportive by responding to the emotion, not the behavior.
- Create a calm environment. Avoid noise, glare and too much background distraction, including television.
- Allow adequate rest between stimulating events.
- Acknowledge requests and respond to them.
- Look for reasons behind each behavior. Consult a physician to identify any causes related to medications or illness.
- Don’t take comments or unkind remarks personally and remember that talking about your experiences with others can be therapeutic and lead to helpful insight and needed encouragement.
- Contact the Alzheimer’s Association for support and information; 24/7 helpline: 1-800-272-3900
Source: Adapated from Alzheimer’s Association
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