The East Central Florida Memory Clinic Newsletter

National Institute on Aging
Alzheimer’s Disease Progress Report

Alzheimer’s Disease remains the most common cause of dementia amongst the population age 65 and older. It is estimated that more than 4 million people are currently afflicted with this disease in the United States alone. Its impact is far-reaching and widespread, involving individuals, their families, the health care system, and society in general. Today, about $100 billion is spent nationally to care for Alzheimer’s patients. If a preventive treatment or cure is not found, it is estimated that by 2050, over 14 million Americans will be living with the disease.

Current research in the United States is examining cause/risk factors, diagnosis, and treatment and care. Researchers are trying to determine why some nerve cells die while others do not, to see what causes Alzheimer’s, and to develop better diagnostic techniques in its earliest stage. Many clinical trials are underway to develop and improve drugs that can slow the progression of the disease or minimize its symptoms.
Other researchers are developing better ways to help patients and their families cope with the mental decline that accompanies this disease.

With Alzheimer’s, neurons in the brain shrink, especially those in areas that are important to new learning, memory, planning, and other complex mental activities.
Neuro-fibrillary tangles and amyloid plaques develop, and inflammation of the brain is common. Amyloid plaques are “dense, mostly insoluble deposits of protein and cellular material outside and around the neurons,” while tangles are “insoluble clumps of twisted fibers that build up inside the neurons.” It is not known whether plaques are by-products of or the cause of the disease. This research is currently being conducted at the Mayo Clinic. It has been determined that 21 of 25 individuals whose brains were examined at the Washington University School of Medicine and who had previously been diagnosed with mild cognitive impairment had brain damage similra to those with Alzheimer’s disease at the time of their deaths. Researchers have therefore concluded that those with mild cognitive impairment are at much greater risk of developing Alzheimer’s than cognitively healthy individuals. Neuroimaging has proven to be a useful tool in determining what brain structures are affected by Alzheimer’s. It has been shown that shrinkage of the hippocampus is closely correlated with the disease.

Other research has found a strong correlation between elevated HDL cholesterol levels and increases in amyloid plaques and neuro-fibrillary tangles. In another study, individuals with Type 2 diabetes and the APOE-e4 allele were found to be at higher risk of Alzheimer’s disease than those with neither risk factor. In a study conducted in
New York City, it was found that African Americans (10.5%) and Hispanics (9.8%) developed Alzheimer’s more frequently than Caucasians (5.4%). In addition, individuals with mutations of particular genes on chromosomes 1, 14 and/or 21 virtually always develop early-onset Alzheimer’s disease.

Current research is focused on whether daily doses of Vitamin E or Aricept™, when given over a three year period of time can delay or prevent the development of Alzheimer’s disease in those already diagnosed with mild cognitive impairment. Results for this study are expected soon. Another study is assessing the relationship between estrogen, memory, and cognitive functioning, while yet another is examining whether Zocor™, a cholesterol-lowering drug, can slow the progression of Alzheimer’s. Results for these studies are expected late in 2005. A final study is assessing whether or not non-steroidal anti-inflammatory drugs, such as naproxen or ibuprofen, can prevent Alzheimer’s in those who are at risk but have yet to show symptoms.

Comparing the Past to the Present:

Then – Fifteen years ago it was unknown whether or not genetics played a role in Alzheimer’s disease.

Now – Three major genes are known for early-onset of the disease and one is known for late-onset of the disease.

Then – Ten years ago Alzheimer’s could not be modeled in animals.

Now – Transgenic mice are invaluable in the research regarding Alzheimer’s, as they serve as a model for amyloid plaques.

Then – Five years ago there was no way to identify people at high risk for the disease.

Now – Research is being conducted using brain imaging, neuropsychological testing, and structured clinical interviews to determine whether an individual has mild cognitive impairment.

Then –Two years ago it was unknown how plaques and tangles related to each other.

Now – As a result of the development of double transgenic mice that possess both plaques and tangles, it is now known that plaques can influence the development of tangles.

For more information, the National Institute on Aging’s (NIA) has several booklets available from the NIA’s Alzheimer’s Disease Education and Referral (ADEAR) Center at www.alzheimers.org or by calling 1-800-438-4380. Ask for Alzheimer’s Disease: Unraveling the Mystery (NIH Pub. No. 02-3782), October 2002; Alzheimer’s Disease: Progress Report (NIH Pub. No. 03-5333), July 2003; or 2003 Progress Report on Alzheimer’s Disease (NIH Pub. No. 04-5570), October 2004. These booklets have been written for the lay person and offer valuable information about ongoing research as well as caregiver support.
Gina Salisbury, 7/15/2004

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East Central Florida Memory Clinic
3661 S. Babcock Street; Melbourne, FL 32901
Phone (321) 768-9575 Fax (321) 725-1998
info@ecfmdc.org