Number of gene variants linked to Alzheimer’s disease doubles

Scientists have discovered 11 new genes that may be tied to the late-onset form of Alzheimer’s disease, a new study shows. Eleven gene variants had previously been linked to late-onset Alzheimer’s, including the APOE-e4 gene that appeared to have the strongest impact on risk. This latest research doubles the known Alzheimer’s disease gene variants. The Alzheimer’s Association co-funded the formation of the International Genomics of Alzheimer’s Disease Project (IGAP) that conducted this study.

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11 New Gene Variants Linked to Late-Onset Alzheimer’s Discovered

The International Genomics of Alzheimer’s Project (IGAP), the largest international Alzheimer’s disease genetics collaboration to date, has found 11 new genetic “areas of interest” that may contribute to late-onset Alzheimer’s disease. This doubles the number of potential genetics-based therapeutic targets to investigate in Alzheimer’s. The study was published online by Nature Genetics on Sunday, October 27.

In 2011, IGAP was formed to discover and map the genes that contribute to Alzheimer’s disease. The formation of this landmark international collaboration was funded by the Alzheimer’s Association and the Fondation Plan Alzheimer. The collaborative effort, spanning universities and research centers from both Europe and the United States, combines the knowledge, staff and resources of four consortia that conduct research on Alzheimer’s disease genetics.

The new genetic findings expand the scope of our understanding of Alzheimer’s to new areas, including the immune system, where a genetic overlap was identified with other neurodegenerative diseases such as multiple sclerosis and Parkinson’s disease.

This is extremely important research in taking our ability to detect and treat Alzheimer’s disease to the next level. Identification of genes that contribute to Alzheimer’s risk and influence the progression of disease may:

• Help lead us to the cause of the disease.
• Identify proteins and other new targets for drug development.
• Provide genetic methods for determining which people are at greatest risk for Alzheimer’s when preventative measures become available.

Alzheimer’s Association Involvement

The Alzheimer’s Association is pleased to fund this project that brings together four well-established and highly regarded research groups to enable an unprecedented sharing and analysis of Alzheimer’s disease genetic data. These results would not be possible without large-scale collaborative efforts, such as IGAP, which bring larger study populations and increased resources to solving the problem of Alzheimer’s disease. Only by working together can they amass a large enough group of participants to accelerate gene discovery. For example, in the newly published study, pooling resources through IGAP, the collaborative team was able to collect 74,076 participants (including people with Alzheimer’s and controls) from 15 countries.

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Map out a plan to approach Alzheimer’s diseases

The Alzheimer’s Association is here to support those facing Alzheimer’s disease. Through each stage of the disease, as families face decisions, plan for future care and build a team for support, we’re here to help.
With a vast amount of information available, it can be difficult to know where to begin. Personalized help starts with Alzheimer’s Association Alzheimer’s Navigator®, an easy-to-use online tool that guides people through the disease. If you or someone you know needs our help, we’ve made it easy.
Here’s how it works: http://www.alz.org/dm/fy14/alznav/alznav.html 

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Poor sleep may be tied to Alzheimer’s-like brain changes

In a newly published research article, older adults in the study who experienced difficulty sleeping had more of the brain plaques that are hallmarks of Alzheimer’s disease. The results of this small study don’t yet prove that trouble sleeping leads to dementia. More research is needed to determine if the brain changes cause the lack of sleep or the other way around.

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Study suggests lack of evidence for or against cognitive screening

A study published in the Annals of Internal Medicine found no substantial evidence for or against cognitive impairment screening. However, no one should misconstrue this study to think that these tests are harmful. The Alzheimer’s Association supports early detection and diagnosis of Alzheimer’s by trained professionals in a medical setting.

Alzheimer’s Association statement on screening for cognitive impairment in older adults

It is estimated that as many as 50 percent of people with Alzheimer’s disease or another form of dementia do not receive a formal diagnosis. In addition, when a diagnosis is received, it is often after the dementia has progressed significantly.

The Alzheimer’s Association supports efforts that increase early detection and diagnosis of Alzheimer’s by trained professionals in a medical setting — such as through the Medicare Annual Wellness Visit. The Alzheimer’s Association supports initial cognitive evaluation and regular follow-up assessment in a medical setting to establish a baseline and track change over time, which may reveal cognitive decline that would not be detected by a one-time screen. Routine cognitive assessments are not screening, but are a way to detect change over time that could indicate underlying pathology.

The Alzheimer’s Association does not support one-time memory and/or dementia screening in non-medical settings, such as shopping malls or health fairs. Screening generally refers to a one-time action, such as administration of a brief test that gives a score that may or may not accurately indicate the presence/absence of a disease or the need for further evaluation. Often these brief tests result in “false positives” and “false negatives.”

• “False positives” occur when a person fails or scores poorly on a screening test but does not have Alzheimer’s disease or another dementia.
• “False negatives” occur when a person scores well on a screening test but actually has Alzheimer’s disease or another dementia.

As the USPSTF reconsiders its current (2003) recommendation regarding screening for cognitive impairment, we urge it to consider this distinction and support establishment of a cognitive baseline for older adults in a medical setting, such as through the Medicare Annual Wellness Visit, and regular ongoing surveillance of individuals’ cognitive abilities.

It is important to point out that, in general, the Annals of Internal Medicinearticle did not find substantial evidence for or against screening for cognitive impairment, it found that there was no evidence available at all (i.e., no relevant studies) based on its inclusion criteria.

• “We found no trials that directly assessed whether screening for cognitive impairment in primary care could affect decision-making, patient or caregiver, or societal outcomes.”
• “No studies directly addressed the adverse psychological effects of screening or adverse effects from false-positive or false-negative test results.”
• “We found no studies to substantiate or refute concerns about harms of screening.”

No one should misconstrue this study to imply that there are no benefits to regular cognitive evaluations, or that regular evaluations are harmful.

As is made apparent by the findings of the Annals of Internal Medicinearticle, more research is needed to develop better and simpler diagnostic tools, verify the NIA/Alzheimer’s Association new diagnostic criteria for Alzheimer’s disease, and confirm what experts are already telling us — that early detection leads to better outcomes and reduced costs.

With the support of the Alzheimer’s Association and the Alzheimer’s community, the United States has created its first National Alzheimer’s Plan. The National Alzheimer’s Plan includes the critical goal of effectively treating and preventing Alzheimer’s by 2025. But more resources are needed to help us reach that goal. We need Congress to support the implementation of the U.S. National Alzheimer’s Plan with an additional $100 million commitment for the coming fiscal year for Alzheimer’s research, education, and community support. For more information, and to get involved, please visit www.alz.org.

The Alzheimer’s Association is working on many fronts to educate all stakeholders — individuals, families, physicians and policymakers — about the importance of early detection and early diagnosis and has developed a list of 10 Warning Signs of Alzheimer’s Disease to assist with that effort. If individuals have experienced any of the warning signs, it’s important to seek a comprehensive diagnostic evaluation from a physician who is experienced in diagnosing and treating Alzheimer’s. For more information, visit alz.org/10signs.

Alzheimer’s Association
The Alzheimer’s Association is the world’s leading voluntary health organization in Alzheimer care, support and research. Our mission is to eliminate Alzheimer’s disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer’s. For more information, visit www.alz.org.

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