WASHINGTON – That sticky gunk coating Alzheimer’s patients’ brains gets all the notoriety, but another culprit is gaining renewed attention: Protein tangles that clog brain cells and just might determine how fast patients go downhill.

Nobody knows what causes Alzheimer’s, although the disease’s hallmark plaque — that gooey stuff called beta-amyloid — is the main suspect. Yet repeated attempts at anti-amyloid treatments have failed, the latest disappointment last month when Eli Lilly & Co. abandoned an experimental drug that wound up doing harm, not good.

Now comes a different clue: A second protein called tau seems to signal how aggressive the mind-robbing disease will be. Researchers discovered that patients with mild Alzheimer’s and high levels of tau also harbored a genetic alteration that in turn predicted they would worsen faster.

That suggests if scientists could figure out how to lower tau levels, it might slow dementia, says senior researcher Alison Goate of Washington University in St. Louis.

More than 5 million Americans are estimated to be living with Alzheimer’s, as many as half in the disease’s early stages. The only available medications temporarily ease symptoms but don’t slow the disease.

How quickly a loved one will deteriorate is a big question for families struggling to plan for care — and Goate’s work is a first step at identifying genetic markers to help predict how long someone may function independently and when they might require a nursing home.

Don’t look for a genetic test for tau any time soon. This is first-step research that needs to be validated by other laboratories, and Goate says it’s likely just one genetic marker among many to be discovered.

Already, a handful of drug companies are focusing on the protein. Singapore-based TauRx Therapeutics tells The Associated Press it has begun planning an advanced research trial of its experimental anti-tau drug known as LMTX. It’s a second-generation version of a drug named Rember that generated excitement in early-stage testing a few years ago.

And the genetic finding promises to increase interest.

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SOURCE: http://news.yahoo.com/s/ap/20100920/ap_on_he_me/us_med_healthbeat_alzheimer_s_tangles

Not only do women live longer than men, on average, but a new study from the Mayo Clinic suggests they also may keep their cognitive function longer, too.

In a study of more than 2,000 adults 70 to 89 years old, researchers found that men were 1.5 times more likely to experience mild cognitive decline than their female counterparts.

Researchers tested elderly men and women in Olmstead County, Minn., for signs of mild cognitive impairment (MCI), a condition in which people have problems with memory or thinking beyond the decline seen because of normal aging. MCI can be a pre-cursor to Alzheimer’s disease or other forms of dementia.

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SOURCE: http://abcnews.go.com/Health/Alzheimers/male-brains-decline-sooner-female/story?id=11553164

Researchers led by Stephen Rao, director of the Schey Center for Cognitive Neuroimaging at the Cleveland Clinic report in the journal NeuroImage that physical activity helps the brain of at-risk individuals to build up a neural reserve of hyper-function that may hold off dementia and neurological decline. People who inherit a certain version of the ApoE gene, which regulates triglyceride metabolism, are at higher risk of developing Alzheimer’s—as much as a quarter of early onset cases might be due to this genetic variation. But previous studies had found that even among those with the riskier version of the gene, exercise could slow the first appearance of cognitive decline. Rao wanted to know how—was it the endorphins and other feel-good byproducts of exertion that were providing a temporary boost in intellectual operations of the brain, or was exercise providing some more fundamental benefit specific to neurons in memory-related areas?

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SOURCE: http://wellness.blogs.time.com/2010/09/07/exercise-protects-against-alzheimers/

A brief needle-in-the-back test could someday tell you, if you were inclined to know, whether you’re likely to suffer from neurological diseases such as Alzheimer’s or Parkinson’s, and how bad the condition will be in your case.

Researchers are using lumbar punctures, or spinal taps, to collect cerebrospinal fluid, or CSF, the liquid that bathes the brain and spinal cord. They think chemicals in the fluid may be key to predicting and understanding neurological disease. Some day these chemicals, called biomarkers by scientists, may help predict brain problems, just as high cholesterol can herald trouble in the heart.

“CSF, if you will, is a relatively ‘untapped’ reservoir for biomarkers that was sort of neglected for decades,” says Dr. Michael Schwarzschild, a neurologist and researcher at Massachusetts General Hospital in Boston.

Doctors already routinely use CSF to diagnose infections and multiple sclerosis. But in the past, they found few clues there relevant to the memory loss and dementia of Alzheimer’s or the tremors of Parkinson’s. Now, with newer technologies to identify CSF chemicals and promising results on the power of CSF from a large study of Alzheimer’s disease, scientists have renewed interest in spinal taps.

“It allows you to have a window into the biochemistry of the brain,” says Dr. Joy Snider, a neurologist at the Washington University School of Medicine in St. Louis.

Scientists collaborating in the Alzheimer’s Disease Neuroimaging Initiative, or ADNI, have found that certain CSF proteins go up and others down in people with the disease — and also in people who are likely to get it in the future. Now scientists studying Parkinson’s are looking to find similar markers in a project launched this year, funded by the Michael J. Fox Foundation for Parkinson’s Research. And in the case of Lou Gehrig’s disease, also called amyotrophic lateral sclerosis, scientists have found several CSF changes that might someday help them predict the severity of disease in a patient.

This is a spinal tap: Patients curl forward to stretch apart the bones in the back, and a doctor injects anesthetic to numb the lower back. The doctor then slides a needle into the lower spinal canal, just a bit deeper than anesthesiologists do for an epidural. It takes a few minutes for a bit of the clear, watery fluid to drain into a tube. Afterward, a person usually lies down for half an hour or so.

Although nobody likes the idea of a needle in the spine, a lumbar puncture is fairly safe, Schwarzschild says. “For most people, it’s not much different from giving blood.”

For diseases like Alzheimer’s, by the time a person has trouble with memory or dementia, many brain cells are already dead or dying. By late stages, “it’s hard to do much to arrest the disease or rescue the brain from the horrors of this awful disease,” says Leslie Shaw, a biomarkers researcher at the University of Pennsylvania Medical Center in Philadelphia.

There is an ongoing “quest,” Shaw says, to find ways to catch Alzheimer’s early. In 2004, several researchers banded together to start the $70-million ADNI project, hunting for predictive biomarkers in spinal fluid as well as telltale signs of early Alzheimer’s in brain scans.

In several studies, ADNI researchers and other scientists have found clear biomarkers in the CSF of people who have Alzheimer’s disease. The amount of a protein called amyloid-beta — the ingredient of the plaques that form in the brains of people with Alzheimer’s — drops as the disease worsens. Conversely, levels of another protein, called tau, go up. Tau forms abnormal, tangled structures that appear, along with plaques, in the Alzheimer’s brain.

The scientists found that this low-amyloid, high-tau signature appears not only in people with advanced Alzheimer’s disease but also in people who may be headed that way. In a 2009 paper in the Archives of Neurology, Snider and colleagues studied 49 people with mild thinking problems, which often lead to Alzheimer’s. They found that those in the group who advanced most quickly to Alzheimer’s were those who had low amyloid and the high tau in their CSF.

And in this month’s Archives of Neurology, the ADNI group reported that a person can have this CSF signature of Alzheimer’s without having any memory problems at all. They found, in fact, that one-third of healthy elderly people in their sample of 114 had low amyloid and high tau. It could be those people are in the early stages of Alzheimer’s, but the scientists are cautious about that interpretation.

“That doesn’t mean they’re going to get Alzheimer’s tomorrow or anything like that,” Shaw says. Just as high cholesterol isn’t a guarantee of a heart attack, some people with the CSF signature could be headed toward Alzheimer’s and some might not. Researchers do not yet have enough information, Shaw says, to use these biomarkers to predict if and when Alzheimer’s will arise in healthy people. ADNI will be following those people as long as possible, he adds, to see if they develop Alzheimer’s.

The success of ADNI inspired the Michael J. Fox Foundation to launch a similar study, the $40-million Parkinson’s Progression Markers Initiative, this year. Over its five-year course, doctors in the U.S. and Europe intend to examine CSF chemicals, among other samples, from 400 people with Parkinson’s disease.

Schwarzschild and his colleagues have already discovered one interesting chemical in the CSF of people with Parkinson’s: urate, an antioxidant that may protect brain cells. In 2009, the scientists reported that, on average, people with plenty of urate in the CSF and blood tend to have a slower progression of Parkinson’s than people with low urate levels.

That does not necessarily mean that urate levels are a direct cause or consequence of Parkinson’s, Schwarzschild notes, and it is too soon to use urate alone to predict the course of disease. But he is now treating people with urate supplements in a small clinical trial to see if the treatment is safe and if it boosts urate levels in the blood and CSF of people with Parkinson’s. If so, researchers will probably study whether urate supplements slow Parkinson’s.

In many cases, biomarkers may be most helpful in predicting severity, not diagnosing disease, says neuroscientist James Connor of the Penn State Hershey Medical Center. For example, neurologists don’t need much help diagnosing Lou Gehrig’s, he says. But telling those patients what to expect is harder. Many patients die within a few years, but others may survive for a decade or more. “It matters to the patient: Are you on the three-year plan or the 10-year plan?” he says.

Connor is working to find biomarkers that may help doctors make those kinds of predictions. In the journal Neurology, in 2009, he and colleagues reported that 11 proteins related to inflammation go up in the CSF of people with Lou Gehrig’s.

Researchers trying to understand disease and develop treatments also find clues in the CSF. For example, knowing that people with Lou Gehrig’s disease have inflammation in the spinal cord suggests scientists should consider inflammation as a process to target with drugs. And by tracking changes in the pattern of amyloid and tau in the CSF of people with Alzheimer’s, doctors might get a sense of whether an experimental drug treatment is working.

In the future, doctors might even screen elderly people for biomarkers for Alzheimer’s or Parkinson’s, and treat the disease early just as they do for people with high cholesterol — perhaps staving off or slowing diseases that, for now, are impossible to prevent.

“If we have a treatment that works even a little bit in people with the disease, it may work a lot better in people that do not yet exhibit signs of the disease,” Snider says.

health@latimes.com

SOURCE: www.latimes.com

A research team in Japan made the connection by examining 135 people with an average age of 67.

All of them were given several glucose tests to measure blood sugar levels.

They were also monitored for Alzheimer’s disease over the next 10 to 15 years.

Results of the study showed that 16 percent of participants developed Alzheimer’s disease, while 65 percent of them had plaques in the brain associated with Alzheimer’s.

Local experts said they’ve known how diabetes puts patients at risk for varying medical problems, but the study notes how those with insulin resistance or pre-diabetes are at risk.

“I think it’s an important warning sign and we need to be in better shape and we need to watch our lifestyle because, if we develop a pre-diabetes state, there certainly are consequences,” said Dr. Murray Gordon, of Allegheny General Hospital.

The next step for researches will be to try and determine if insulin resistance is the cause of the development of plaques associated with Alzheimer’s.

Gordon said there are steps everyone can take right now.

“Clearly, there is an epidemic of obesity. The No. 1 thing we can do is diet and exercise. We need to exercise more. We need to exercise vigorously three of four times a week. We need to keep our weight down and, hopefully, with a healthy lifestyle, we can help to prevent pre-diabetes and diabetes,” said Gordon.

Signs of pre-diabetes include being overweight and having high blood pressure and cholesterol.

SOURCE: http://www.thepittsburghchannel.com

Alzheimer’s advances in stages, progressing from mild forgetfulness and impairment to widespread loss of mental abilities. The time course of the disease varies by individual, ranging from five to 20 years. The most common cause of death is infection. Scientists have made significant progress in understanding the possible causes of Alzheimer’s disease, but there are still many questions to be answered.

Today, it is estimated that about 5 million Americans suffer from Alzheimer’s disease, and about 360,000 people are newly-diagnosed every year. Alzheimer’s affects about 10 percent of people ages 65 and up, and the prevalence doubles roughly every 10 years after age 65. The financial cost of caring for someone with Alzheimer’s disease is estimated to be about $50,000 per year in direct medical expenses.

TREATMENT: Alzheimer’s has no cure. There are a number of medicines available that may help improve the mental function of people with Alzheimer’s disease. If these drugs are given early enough in the course of the disease, they may enable people to carry out their daily activities and independent living for a longer period of time and may prolong the time that patients can be managed at home.

NEW CLINICAL TRIAL: The Georgetown Memory Disorders Program has recently conducted a study testing an immunotherapy called immune globulin (IGIV) for Alzheimer’s.

The therapy is approved by the Food and Drug Administration and has been used for more than 20 years to treat a variety of autoimmune and immunodeficiency diseases. However, it has not been approved to treat Alzheimer’s.

Two previous studies showed statistical improvement in cognition among patients. They also showed that the therapy reduced amyloid plaque levels in the brain, which are thought to contribute to Alzheimer’s development.

The treatment may be effective in destroying and removing plaques from the brain, according to Brigid Reynolds, NP, clinical coordinator at Georgetown University’s Memory Disorders Program. One interesting aspect of the study is that patients receive the intravenous treatments from home.

FOR MORE INFORMATION, PLEASE CONTACT:

Carolyn Ward
Program Coordinator
Georgetown University
(202) 784-6671
Cw2@georgetown.edu

SOURCE: http://abclocal.go.com

However, Dr. Richard Besser, ABC News Senior Health and Medical Editor, stated on Good Morning America, that “this test isn’t ready to be used on healthy, normal people.” The reason is because it may not be 100% accurate and we have no cure for Alzheimer’s. So, a person may be told they have the markers for Alzheimer’s and never actually develop the disease, and are left to stress and worry about it. Dr. Gary Kennedy, director of the Division of Geriatric Psychiatry at Montefiore Medical Center mentioned, “…there are still no successful anti-amyloid treatments available.”

At the present time, this test will help in confirming a diagnosis. It will also help springboard further research including research to determine if lowering amyloid proteins will actually improve Alzheimer’s which, as of yet, has not been proven.

More information can be read through an article presented by the Mayo Clinic:

http://www.mayoclinic.com/health/alzheimers-test/an01993
For those who have a loved one that already has Alzheimer’s, this test may be of little value. If you, yourself, are concerned about getting Alzheimer’s, take heart that research is on-going and every little breakthrough leads to another breakthrough. There are several on-line resources available that offer education and support for Alzheimer’s and other Cognitive Impairment disorders.

The Greater Ann Arbor Area has several support groups, sometimes you can find them through your local library or an area church. The University of Michigan Hospitals, Ann Arbor, MI, has a website where you can get more local information:

http://www.med.umich.edu/alzheimers
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SOURCE: http://www.examiner.com

A new study released by Swedish scientists has found that midlife stress in women can increase the risk of developing Alzheimer’s disease later in life. The Daily Mail reports that the research discovered that those who experience anxiety may be up to two times more likely to have the mental illness.

According to the news source, the study followed 1,415 women for 32 years, between 1968 and 2000. During the course of the study, the subjects were asked three times to assess their stress levels, which were defined as sensing nervousness, irritation, tension, anxiety, fear or sleeping problems.

While more research is needed, researcher Lena Johansson told the news provider that this may help doctors provide better Alzheimer’s care.

“Stress has previously been shown to increase the risk of cardiovascular diseases such as stroke, heart attack and hypertension,” Johansson told the news outlet. “This study could result in a better understanding of the risk factors for dementia.”

There are a number of ways for middle-aged and older adults to reduce their stress to minimize their risk for Alzheimer’s disease. MedicineNet.com recommends exercise, mediation and working on one’s time management skills as effective ways to reduce worry.

Read more: http://www.retirementhomes.com/library/senior-living/retirement-living/study-finds-stress-may-increase-alzheimer’s-risk-201008171328.html#ixzz0wuHcNdbT

SOURCE: www.retirementhomes.com

After studying a pool of subjects between the ages of 18 and 89, the researchers identified a portion of the brain called the perforant path. This collection of nerve tissue is believed to deteriorate with age and breakdown much more quickly for those with Alzheimer’s.

In a paper published in the Proceedings of the National Academy of Sciences, the research teams says that studying the perforant path could help diagnose Alzheimer’s earlier than ever before.

“The nice thing about this is we may be able to predict Alzheimer’s very early,” Craig Stark, associate professor of neurobiology & behavior at UC-Irvine, tells Science Daily.

He adds that the breakthrough could have implications for the development of Alzheimer’s treatments as well.

“Let’s say you’re a drug company, and you think you’ve got a potentially effective treatment for slowing Alzheimer’s. You want to try it on people in the most preliminary stages of that disease, not those just experiencing normal aging.”

by RTT Staff Writer

For comments and feedback: contact editorial@rttnews.com

SOURCE: www.rttnews.com

By LARA SALAHI, ABC News Medical Unit
Aug. 10, 2010

Researchers claimed to have identified markers for early Alzheimer’s disease in some patients by analyzing results of a spinal tap, according to an article published Monday in the Archives of Neurology. Their results, they claim, are nearly 100 percent accurate in predicting Alzheimer’s in some patients.

But many experts are quick to question how reliable these results may be.

“The test is an advance and has tremendous research potential. This is sure,” said Karl Herrup, chair of Cell Biology and Neuroscience at Rutgers University in Piscataway, N.J.

But, he added, “a dangerous, though unintended, consequence of the ‘100 percent accuracy’ descriptor is that people who may not be on the fast track to Alzheimer’s will end up frightened unnecessarily from a positive test result.”

“[T]he fear of [Alzheimer's disease] is so strong in our population that feeding it any way seems not in our best overall interest.”

And ABC News Senior Health and Medical Editor Dr. Richard Besser said the test is not yet ready for prime time.

“This test isn’t ready to be used on healthy, normal people,” Besser said on “Good Morning America.”

“It will be useful for research, doing drug trials in a group of people who may be at high likelihood to go on for Alzheimer’s disease.”

The researchers measured tracked results from a spinal tap from three groups of patients: those with Alzheimer’s, those who had been diagnosed with mild cognitive impairment (MCI), and those who were relatively healthy. Specifically, the researchers looked for patterns in the levels of two types of proteins, known as tau and amyloid, that appear to have a link to the chances of developing Alzheimer’s. The data suggested that patients who had Alzheimer’s or MCI had a combination of low levels of amyloid beta protein, known to form plaques in the brain, and high tau protein levels, which is known to build up dead nerve cells in the brain.

However, one-third of the study participants were identified as having levels of these proteins that suggested an Alzheimer’s diagnosis — even though they were cognitively normal. Herrup said that even if the test results are accurate, it may only mean that a patient could have a marker for the disease, but may never get the disease. He said for the moment, there is nothing a patient can do once they learn about the results of the test.

“People who take this test and are told the results are going to need a very high degree of medical sophistication in order to think about their results properly,” Herrup said.

Alzheimer’s Finding May Help Research, but Not Yet For Patients

While spinal fluid tests are often performed to screen for neurological infections such as meningitis or other types of brain or spinal cord damage, many experts agreed the results of this study only add to existing research for early Alzheimer’s diagnosis.

In fact, out of 29 Alzheimer’s disease experts who responded to a question posed by the ABC News Medical Unit, 22 said they viewed the study results as a continuation of Alzheimer’s research. Only two said they could see the tests as a screening method for Alzheimer’s diagnosis.

“A test won’t be beneficial for screening in a population if there are no current effective interventions (treatments) that can significantly affect the natural history of the condition for which one is screening, which is currently the case for Alzheimer’s disease,” said Dr. Ken Langa, co-director for the Center for Research and Education at the University of Michigan Health System, in an e-mail.

Dr. Clifford Saper, chairman of the department of neurology at Beth Israel Deaconess Medical Center, said until experts are able to successfully treat Alzheimer’s disease, there is no reason to perform this test on patients with MCI or Alzheimer’s disease.

“This test shows up positive in presymptomatic individuals, and Alzheimer’s disease is a common disorder,” said Saper. “The main value would be to detect [Alzheimer's disease] in atypical cases.”

What the Future Holds

There are more steps to take to besides researching whether the test works, according to the coinciding editorial published in Archive of Neurology. Less experienced physicians would need to get comfortable with the idea of taking the time to prepare and perform a spinal tap. Patients and physicians would need to understand the risk involved in taking the test, and understand what the results mean.

And, according to Dr. William Hu, assistant professor of neurology at Emory University School of Medicine, the question is not whether the test works to identify potential markers for the disease, but whether those who have these markers actually develop the disease in the long run.

“The key question remains whether some the cognitively normal subjects with the [Alzheimer's disease] signature will go on to develop clinical disease, have the signature because of shared risks for [Alzheimer's disease] as those who do have the disease, or are resistant to disease despite similar changes in the brain,” said Hu.

Dr. Gary Kennedy, director of the division of geriatric psychiatry at Montefiore Medical Center, said even if the test found that a higher amyloid protein may be a marker for Alzheimer’s disease, there are still no successful anti-amyloid treatments available. The relevance of this marker so far is limited to confirming the diagnosis, said Kennedy.

“The real impact of these findings will be in subsequent studies of anti-amyloid drugs where spinal fluid can be used to test their immediate effects,” said Kennedy. “Even so we still need to determine if lowering amyloid levels is associated with improved memory.”

“We have a long way to go,” he said.

SOURCE: http://abcnews.go.com