Alzheimer's and Dementia - Prevention and Research

SEATTLE, WASH.

Can Alzheimer's be prevented? It's a question that continues to fuel new research.

There are no clear cut answers yet—partially due to the need for more large-scale studies—but promising research is under way. The Alzheimer's Association continues to fund studies exploring the influence of mental fitness, physical fitness, diet and environment. As the number of people affected by Alzheimer's rises, the effort to find prevention strategies continues to gain momentum.

Most experts believe that the majority of Alzheimer's disease occurs as a result of complex interactions among genes and other risk factors. Age, family history and heredity are all risk factors we can’t change. Now, research is continuing to reveal clues about other risk factors we may be able to influence through general lifestyle and wellness choices and effective management of other health conditions.

• Heart-head connection: Growing evidence links brain health to heart health. Your brain is nourished by one of your body’s richest networks of blood vessels. Every heartbeat pumps about 20 to 25 percent of your blood to your head, where brain cells use at least 20 percent of the food and oxygen your blood carries.

The risk of developing Alzheimer’s or vascular dementia appears to be increased by many conditions that damage the heart or blood vessels. These include high blood pressure, heart disease, stroke, diabetes and high cholesterol. Work with your doctor to monitor your heart health and treat any problems that arise.

Studies of donated brain tissue provide additional evidence for the heart-head connection. These studies suggest that plaques and tangles are more likely to cause Alzheimer's symptoms if strokes or damage to the brain’s blood vessels are also present.

• General healthy aging: Other lines of evidence suggest that strategies for overall healthy aging may help keep your brain as well as your body fit. These strategies may even offer some protection against developing Alzheimer’s or related disorders:

o Try to keep your weight within recommended guidelines

o Avoid tobacco and excess alcohol

o Stay socially connected

o Exercise both your body and mind

o Sign up for Alzheimer’s ENews at alzwa.org and stay informed on research investigating lifestyle factors and the risk of cognitive impairment

• Head trauma: There may be a strong link between serious head injury and future risk of Alzheimer’s, especially when trauma occurs repeatedly or involves loss of consciousness. Protect your brain by buckling your seat belt, wearing your helmet when participating in sports, and “fall-proofing” your home.

Research Updates: The latest and most promising Alzheimer’s and related dementias research

New studies reported at the Alzheimer’s Association International Conference 2013 (AAIC® 2013) in Boston this past July covered the spectrum of Alzheimer’s disease and dementia research, including novel treatment and prevention strategies, possible new risk factors, advances in early detection and diagnosis, and an updated model of disease progression.

Alzheimer’s Disease Therapies Update

• Scientists at Zinfandel and Takeda Pharmaceuticals International, Inc. are initiating an international Phase 3 trial of low dose pioglitazone, a medication which at higher doses is approved for treatment of type 2 diabetes, as a therapy to delay onset of mild cognitive impairment (MCI) due to Alzheimer’s.

• It has been suggested that amyloid plaques can stimulate microglia, the brain’s first-line immune cells, to produce inflammatory compounds that cause brain cell damage in Alzheimer’s patients. The experimental compound CHF5074 (Chiesi Pharmaceuticals), which is designed to inhibit inflammation by modifying microglial action, has been shown to prevent formation of brain plaques and reduce deficits in mouse models of Alzheimer’s.

• Researchers reported results of an early-stage, randomized, double-blind, placebo-controlled, multiple-dose study of the experimental medication MK- 8931 (Merck), which inhibits beta secretase − one of two enzymes that produce beta-amyloid − in people with mild-to-moderate Alzheimer’s.

• Allopregnanolone, also known as Allo, is a neurosteroid found in the brain and bloodstream. In previous studies, it has shown promise as a potential regenerative therapy to promote brain cell creation and improve cognitive function in older animals and animal models of Alzheimer’s disease.

Alzheimer’s Disease Detection and Diagnosis

• A panel of Canadian experts – including geriatricians, human-computer interaction specialists, neuropsychologists and neuroethicists – reviewed 16 freely accessible online tests for Alzheimer’s disease, and found that the tests scored poorly on scales of overall scientific validity, reliability and ethical factors.

• Four studies supported increasing evidence that subjective cognitive decline (SCD) — the self-reported perception of memory or cognition problems — is a potentially valid early clinical marker of brain and cognitive changes that may indicate Alzheimer’s disease. Also at AAIC 2013, an international group of Alzheimer’s researchers announced the formation of the Subjective Cognitive Decline Initiative (SCD-I) to develop a new research framework for SCD, with a focus on preclinical Alzheimer’s.

Potential Alzheimer’s Disease Risk Factors

• An analysis of health and insurance records of more than 429,000 self-employed workers in France found that retirement at older age is associated with a reduced risk of dementia, with a lower risk for each added year of working longer. The researchers suggested that professional activity may contribute to higher levels of intellectual stimulation and mental engagement, which may be protective against dementia, though more research is needed in this area.

• A study of the health records of 3.5 million U.S. veterans indicated that most kinds of cancer are associated with a significantly decreased risk of Alzheimer’s disease. Results suggested that chemotherapy treatment for almost all of those cancers conferred an additional decrease in Alzheimer’s risk.

• Type 2 diabetes may double the risk of dementia. However, in a study of nearly 15,000 type 2 diabetes patients age 55 and older, patients who started on metformin, an insulin sensitizer, had a significantly reduced risk of developing dementia compared with patients who started other standard diabetes therapies.

For expanded information on the research items listed, visit alz.org/aaic/

This article is courtesy of the Alzheimer's Association, Western and Central Washington State Chapter, alzwa.org | 206-363-5500