Sherry C. on
Saturday, November 29th, 2014
Good news for Alzheimer’s prevention! At the 7th Annual International Conference on Clinical Trials for Alzheimer’s Disease (CTAD), a study was presented by Stephen Salloway, MD, MS, Director of Neurology and the Memory and Aging Program at Butler Hospital, Providence, RI, to evaluate amyloid PET imaging results. The study was initiated in order to evaluate the impact of Crenezumab on fibrillar amyloid in patients with mild-to-moderate Alzheimer’s disease. This topic was part of the mild to moderate Alzhiemer’s Prevention Clinical Research Initiative presented at this year’s annual conference.
The presenter discussed the latest clinical research findings on 2 different studies regarding an antibody called “crenezumab” which targets amyloid in the brain. The study evaluated several different methods of delivery of the antibody including: IV injections and subcutaneous (under the skin) administration. Three different tomography (PET) scans were taken during the trial to assess the change of amyloid level in the brain after the drug Crenezumab was given.
Another study that was discussed at the conference was presented by Presenters/Authors: R. Scott Turner, MD, Director, Memory Disorders Program, Georgetown University, Washington, DC. The study was conducted to evaluate whether Resveratrol was safe and well tolerated in mild to moderate Alzheimer’s disease (AD).
Resveratrol is a compound found in certain plants and in red wine that has antioxidant properties and has been investigated for possible ant- inflammatory and anti-cancer effects. This study shows some real promise that Resveratrol is well tolerated, passes through the blood-brain barrier, and may have a positive effect on some bio-markers of Alzheimer’s disease. Biomarkers are measurable substances whose presence may be an indication of a disease. Common biomarkers for AD include changes in cerebral spinal fluid and changes in tomography (PET) scans.
Sherry C. on
Tuesday, November 25th, 2014
First Category of Alzheimer’s Prevention Clinical Research Initiatives at the CTAD
The International Conference on Clinical Trials for Alzheimer’s Disease in Philadelphia, (also referred to as the CTAD) recently met to gather information regarding current research initiatives that indicate the highest level of promise for Alzheimer’s prevention and treatment.
PREVENTING ALZHEIMER’S BY TREATING EARLY
Presenters/Authors: Randall Bateman, MD, Charles F. and Joanne Knight Professor of Neurology, Washington University School of Medicine, St. Louis, MO presented information on a research project named, “The Collaboration for Alzheimer’s Prevention (CAP); Advancing the Evaluation of Alzheimer’s Prevention Therapies.”
This research project was established in order to ensure that the latest in cutting edge clinical trial information is available to the entire Alzheimer’s disease (AD) research field. CAP is sponsored by the Alzheimer’s Association and the Fidelity Biosciences Research Initiative. This project was launched in order to speed up the development of better and more effective AD treatments. Updates were provided on 4 AD prevention trials including: DIAN-TU, API, A4 and TOMMORROW-all trials test treatments that target a type of protein (called amyloid) that is deposited as plaque in the brain of those with AD.
Other Clinical Research Trials Presented at the CTAD
Philip Scheltens, MD, PhD, Professor of Cognitive Neurology and Director of the Alzheimer Center, VU University Medical Center in Amsterdam presented information on “Baseline Patient Characteristics from the Phase 3 SCarlet RoAD Trial, a Study of Gantenerumab in Patients with Prodromal AD.”
The SCarlet RoAD trial involving gantenerumab is a research project from the VU University Medical Center in Amsterdam. The trial was implemented in order to present initial clinical trial findings regarding 800 participants in the study with prodromal (early stage) AD who presented with memory loss and biomarker evidence of the disease (without any dementia).
Sherry C. on
Sunday, November 23rd, 2014
The International Conference on Clinical Trials for Alzheimer’s Disease in Philadelphia, (also referred to as the CTAD) recently met to gather information regarding current research initiatives showing the most promise for Alzheimer’s treatment and prevention.
The CTAD began in 2008 and since that time has continued its function to provide a platform for professional research experts from around the globe to come together in collaboration regarding research that may lead to new intervention and prevention modalities for AD. The disease effects 5.4 million people in American and nearly 36 million (with AD and related dementias) world-wide-and by the year 2050 that number is expected to grow to an astounding 115 million. In fact, if successful intervention is not achieved in the next 35 years, many experts project that Alzheimer’s disease may cost more than any other major illness in the healthcare industry-worldwide.
Top researchers around the globe came together for this year’s conference to discuss Alzheimer’s treatment and AD prevention and treatment clinical research trials that exhibit the most hope for the future. Other topics of discussion included-a strategy for new treatment alternatives for mild to moderate Alzheimer’s disease, as well as new drug treatment for some of the most disconcerting symptoms of the disease.
The conference was chaired by Paul Aisen, MD, University of California at San Diego; Bruno Vellas, MD, University of Toulouse; Jacques Touchon, MD, University of Montpellier; and Michael Weiner, MD, University of California at San Francisco.
According to the director of the Alzheimer’s Disease Cooperative Study (and Co-Organizer of the CTAD Conference), Paul Aisen, MD: “As evidenced by the research being presented this year, efforts to develop effective treatments for Alzheimer’s disease have been focused on the earliest stages of the disease, before symptoms are even apparent—but the needs of people already diagnosed have not been forgotten.”
The following topics discussed at the conference will be covered in subsequent blog entries:
Preventing Alzheimer’s By Treating Early
New Alzheimer’s Treatment Strategies for Mild to Moderate AD
Treating the most troubling symptoms in AD
Sherry C. on
Monday, July 14th, 2014
If you have read our blogs or books over the last several years, you have certainly seen our philosophy towards Alzheimer’s disease (AD) prevention. A new study presented at the 2014 Alzheimer’s Association International Conference (AAIC) today in Denmark shows for the first time that a cocktail of strategies (including exercise, dietary changes, socialization and cognitive activities) improves memory function after 2 years of the study, most solid evidence yet toward AD prevention.
This demonstrates the biological principal of synergy, meaning “1 + 1 = 3″ in terms of the additive effects of lifestyle interventions. It is important to note that there is no “magic pill” or “magic bullet” to prevent AD, but there are definitely ways people can reduce their risk. Dr. Richard Isaacson, Director of the Alzheimer’s Prevention Clinic, Weill Cornell Memory Disorders Program at NewYork-Presbyterian Hospital/Weill Cornell Medical Center firmly believes in the multi-modal approach, and cautions “there is no one-size-fits-all approach toward AD prevention, and in our AD Prevention Clinic, we offer personalized care and ongoing follow-up and monitoring of specific risk factors that can delay the onset of AD. These are exciting times in AD prevention research.”
Want to learn more about AD prevention, treatment, diagnosis and more? Visit Alzheimer’s Universe at www.AlzU.org and join for free today.
Interested in scheduling a consultation at the Alzheimer’s Prevention Clinic? Please call 212-746-0226 or visit cornellneurology.org/alz to learn more.
For easy to follow AD prevention information, focusing on nutrition, check out The Alzheimer’s Diet: A Step-by-Step Nutritional Approach to Memory Loss Prevention and Treatment, or visit www.TheADplan.com to learn more about Neurologist, Dr. Richard Isaacson’s cutting edge approach in the fight against AD in Alzheimer’s Treatment | Alzheimer’s Prevention: A Patient and Family Guide. Also, sign up for the newsletter to get the latest updates in AD treatment and prevention news.
Sherry C. on
Sunday, February 9th, 2014
We receive a lot of questions via email and Facebook. Here are some answers to the most common topics submitted. We hope to answer more in our next Newsletter (sign up in the box to the right), or on our Facebook page.
Topics below: Should everybody be doing things to prevent Alzheimers? / What are the stages of AD? / What are my chances to get AD? / Is there a test for AD? What is the lifespan for a person with AD?
Please note that these answers do not constitute medical advice. Please seek the help of a qualified medical professional in your area and do not make any changes without first discussing with and seeking approval from the treating physician.
Wishing you the best in the fight against AD! We are all in this together!
If AD starts 20 years before signs of memory loss, and if there are ‘prevention’ treatments, shouldn’t every human being be taking the prevention treatments? (submitted by one of our Newsletter subscribers)
Great question. When in comes to AD, evidence shows that the disease starts in the brain >20 years before the first symptom of memory loss. The difficult aspect about this question is that not everybody will develop AD, so it is currently impossible to know for sure who could best be served by risk reduction strategies. In summary, there are several “stages” of AD. Stage 0 means that AD has not yet started in the brain and there is no clear way to know for sure is that person will (or will not) develop it. Stage 1 (described in more detail below) means that AD has started in the brain, but there are no symptoms yet. When it comes to the topic of prevention, which includes evidence-based ways to possibly delay AD onset or reduce risk, it is currently unclear whether or not these should be started during Stage 0 or Stage 1, nor which interventions may “work” better in different patient types. This is an area of ongoing research and investigation. But, to answer the question more directly, many physicians would advocate for making brain-healthy changes as early as possible to help protect the brain (as well as the body). For people who are interested in being evaluated by a physician to discuss this further, learn more about the AD Prevention Clinic in NYC. Out-of-town visits are welcome, and video conferencing appointments are also available for people that live in NY and Florida.
Also, it is important to cover some basic terminology used in your question. The term “treatment” is a term that is used for a medication (for example, an antibiotic is used to treat a sinus infection, or one of the four FDA-approved drugs is prescribed by a doctor for Alzheimer’s disease). When it comes to AD prevention, the more accurate terms to use include “management options”, “strategies” etc, since it is less clear when these interventions should be best started and which ones may “work” better in different people.
Hi Docs – Can you tell me about the stages of Alzheimer’s? Ive read different things on different websites and im not sure where my Dad fits in? I heard there are new stages that doctors use but I dont understand these.
There are a variety of different types of Alzheimer’s “stages” that have been described. Sometimes, the exact definition of the stages differs from person to person, or website to website, or even from doctor to doctor.
From a medical perspective, the most recent criteria by the National Institutes of Aging describe Alzheimer’s disease as a spectrum of disease, starting many years before the first symptom of memory loss. Only recently did the medical community start to recognize that Alzheimer’s actually “starts” in the brain up to 20-30 years before it is diagnosed. The first “stage” using this criteria is called “pre-clinical Alzheimer’s” which means there are no symptoms yet, but the disease has started in the brain. The next “stage” is called “Mild cognitive impairment due to Alzheimer’s” and this means that memory loss has started yet it is relatively mild and not affected the “activities of daily living” (which means the person is still able to care for themselves, work, prepare meals, shop etc). The next “stage” is called “Alzheimer’s dementia” which means a person has memory loss and other cognitive symptoms that impact ones ability to completely care for themselves (e.g., activities of daily living are affected). Many doctors are now realizing that during the “pre-clinical” or pre-symptomatic stage of Alzheimer’s is the ideal time to suggest to people to make Brain-Healthy choices that can reduce Alzheimer’s risk and even delay its onset.
In the past, the medical community looked at Alzheimer’s as mild, moderate and severe, but sometimes the exact definition of mild vs. moderate vs. severe were inconsistent between healthcare professionals. Some would base the “stage” on a memory test score (like the Mini Mental Status Exam) and others would base this on how a person was doing in their everyday life. The newest diagnostic criteria are called the “DSM-5″ criteria, which were just released in May 2013. These use the terms “mild” and “major” neurocognitive disorder, instead of the word dementia. These refer to “mild” meaning just having symptoms of memory loss, and “major” as having additional cognitive complaints.
All in all, the various staging definitions can be quite confusing, so we hope this helps to clarify!
I have 3 family members with dementia, two with “Alzheimer’s” and my grandmom was diagnosed with “senile dementia” but not Alzheimer’s. What are my chances to get this terrible disease? I am so scared and dont know what to do. Thank you for taking the time to answer me
One of the most common questions that we get asked about Alzheimer’s disease (AD) is “If I have a family history, am I more likely to develop Alzheimer’s?” Before we answer this, let us clarify a few things. In general, Alzheimer’s is a very common condition regardless of whether a person has a family member with the disease. In fact, everyone’s risk of developing AD increases over time because the number-one risk factor is advancing age. That is why we all should start making changes in our lives to reduce this risk! Most especially, seeing a physician for an evaluation, as well as lifestyle and dietary changes.
That being said, there are specific genes that can be passed on from parents to children that may increase the likelihood of developing Alzheimer’s disease. The good news is that only 6 percent of AD cases are caused by the types of genes that can lead to early-onset Alzheimer’s disease (we will not get into technical detail here, but these genetic mutations include presenilin-1, presenilin-2, and amyloid precursor protein gene mutation). These genes may contribute to the development of AD in patients younger than age sixty, although many younger-onset patients do not end up having these genes.
There is another set of genes that are associated with older-age onset of AD, or late-onset Alzheimer’s disease. The most well studied of these genes is called apolipoprotein epsilon-4 (or commonly referred to as APOE4 [or APOε-4]). Briefly, we get one copy of the APOE gene from our mother and another copy from our father. There are three types of these genes, APOE2, APOE3, and APOE4. If a person has one or more of the APOE4s, the risk of developing AD will increase. However, genetic testing for APOE is not currently recommended. Knowing whether a person has one or more copies of APOE4 does not necessarily help a physician predict if or when a patient will develop AD. Conversely, having one or more copies of APOE2 confers a reduced risk of developing AD.
We still have a long way to go before using genetic testing to help with the pre-symptomatic diagnosis of AD. For these reasons, most doctors do not recommend genetic testing on family members of Alzheimer’s patients. Instead, based on the latest scientific research, doctors are now starting to suggest several options to family members at risk. As an example, Dr. Isaacson directs the Alzheimer’s Prevention Clinic in the Weill Cornell Memory Disorders Program at WCMC/NYP in NYC. He evaluates patients and gives each patient a focused and individualized plan to either reduce their risk, or help them improve their symptoms, that is balanced in safety and grounded in scientific evidence (to watch Dr. Isaacson lecture at a recent international conference on the topic of Alzheimer’s prevention, click here).
Keep in mind that there are some changes in thinking skills that occur normally with age. This condition is called age-associated cognitive impairment. Symptoms may include intermittent memory loss, word-finding difficulties, and slowing of the speed of thinking. When cognitive changes are isolated to difficulties with memory, this condition is sometimes referred to as age-related memory loss.
We do not yet have all the answers about what would be considered the “normal” or expected cognitive changes that occur with age. Scientists also have much work to do to more accurately determine whether a person will develop AD instead of conditions like normal age-related memory loss. This is an area where active research is currently being conducted.
Is there a test for Alzheimer’s disease? I am 43 and my mom is 68, she was diagnosed last year and I want to find out my chances.
At the present time, there is no 100% accurate test to determine whether or not a person is going to develop Alzheimer’s. However, some of the most progressive Alzheimer’s specialists and researchers believe that the future of AD care is dependent upon our ability to diagnose it at its earliest stages. The question becomes how do we identify these people? There have been rigorous research efforts to identify these at risk patients, in order to intervene before AD declares itself clinically. In addition, with the widespread availability of commercial genetic testing that commonly includes APOE status and with increased public awareness of AD, this question has been increasing in frequency in Dr. Isaacson’s clinic, which focuses on Alzheimer’s risk reduction and individualized preventative strategies based on a person current medical problems, family history, genetics, and dietary and lifestyle patterns. Eventually a screening test may be possible, just as we screen patients for cervical cancer, colon cancer and diabetes to prevent future negative outcomes. From a clinical perspective, interpretation of currently available biomarkers and genetic testing identifies asymptomatic patients with varying degrees of risk, and presents real-life diagnostic, therapeutic and ethical challenges.
Currently available studies to help diagnose Alzheimer’s
Our tools available today include persons subjective complaints, memory/cognitive testing (called neuropsychological testing), brain imaging, and a variety of lab tests. While there are a few subspecialists who are solely focused on Alzheimer’s and AD research who have the expertise and background necessary to be able to both order and interpret these tests, AD diagnostic tests (called biomarkers) are not currently at the fiscal or practical stage to warrant widespread use (due to the lack of definitive results and their complexity in interpretation). However, on occasions where diagnostic uncertainty exists, such as a younger age of onset in an individual without clear risk factors or family history, some clinicians have relied on a combination of several currently available diagnostic studies that would tend to still fall in the “research only” category. As such, it is important to note though that these tests are NOT typically recommended and only suggested in rare cases when ordered by Alzheimer’s specialists. There are many tests currently being studied and over the next several years, these new research finding should help advance the field considerably.
What is the average lifespan for someone with Alzheimer’s disease?
This answer depends on a variety of factors, including the age that a person is first diagnosed with dementia due to Alzheimer’s (meaning Stage 3 of AD) as well as the other medical problems that a person has. Most healthcare professionals would say that the average number of years is >10 years, some would say average is 8-12 years, but again, there is a lot of variability here. If a person with Alzheimer’s is generally very healthy, they will tend to live longer. If a person has several medical problems like high blood pressure, diabetes, or cancer, the lifespan may be shorter. With advances in medical care, the overall lifespan should continue to increase as time goes on.
Sherry C. on
Sunday, January 26th, 2014
There is a lot of discussion today about how (and which) Omega-3s can have positive effects on the brain and promote cognitive health. Specifically, these have been touted as a way to slow the onset of memory loss, and reduce risk for dementia, including Alzheimer’s disease. Does the truth live up to the hype? If so, what type of fish oil is best, and are supplements enough to help with Alzheimer’s?
From Confusion to Clarity
The #1 take home point with Omega’s 3s (also referred to as a “Omega 3 fatty acids”) is that not all of the different types are created equal in terms of potential for protecting brain health. As discussed in detail in The Alzheimer’s Diet book, there are several types of Omega-3s, with DHA having the most evidence for brain protection, followed by EPA. Another new study was recently published that again supports this. Another common form of Omega 3 is called ALA, but the problem with ALA is that only a very small percentage actually gets later converted in the body to the brain-boosting forms (DHA and EPA). Complicating things, a recent study showed an association between DHA and prostate cancer in men, yet the American Nutrition Association (as well as many experts) state that the overall benefits likely outweigh risk. Before considering any changes to ones diet or before considering starting a supplement, people should always discuss first and seek approval by their treating physician. For a specialized opinion, scheduling a consultation with the Alzheimer’s Prevention & Treatment Program at New York Presbyterian / Weill Cornell Medical Center in NYC is also an option.
Another important point that leads to a lot of confusion is that a lot of people use the terms “Fish Oil” and “Omega-3s” interchangeably. Fish oil comes from fish and can be supplemented in the diet in capsule form, but each capsule has different amounts of DHA, EPA, ALA etc. Many people also don’t realize that Omega 3 fatty acids are plentiful in certain types of fish, and the fish actually get these brain-healthy fatty acids from eating algae. There are even very specific types of Omega 3 supplements that are DIRECTLY from algae, rich in DHA, and have been studied specifically in patients with the earliest stages of AD. These studies showed slowing of cognitive decline and improvements in memory. To learn more about this topic, as well as which types of fish may be most beneficial, and to read an overview of all the evidence and other specific dietary choices for Alzheimer’s prevention and treatment, read The Alzheimer’s Diet book.
Research is being done regarding the effect of fish oil when it comes to the Alzheimer’s disease prevention and treatment. Read below for more details.
- Image Source: Friendseat.com
Sherry C. on
Friday, January 10th, 2014
Alzheimer’s disease doesn’t just affect the patient; it affects the entire family. Recently, the Alzheimer’s Prevention & Treatment Program (APTP) and Alzheimer’s Prevention Clinic (APC) at New York-Presbyterian / Weill Cornell Medical Center was founded by Neurologist Dr. Richard Isaacson, an Alzheimer’s specialist who has several family members with this disease. This specialized clinic and research program focuses on the latest treatments for patients, as well as cutting-edge strategies that may reduce a person’s risk for AD (or help to delay its onset), with an emphasis on nutritional approaches and comprehensive education for the entire family. Interested in scheduling a consultation? Please call 212-746-0226
Scientists now understand that AD starts in the brain 20 to 30 years before the onset of symptoms, giving physicians ample time to intervene in an individualized fashion for those as risk. There is no “magic pill” or “magic cure” for AD treatment or prevention; however, combining a variety of strategies based on strong science and safety may yield the best chance for benefit.
As a part of this initiative, individuals interested in lowering their risk for Alzheimer’s can be followed over time and receive a personalized plan based on a variety of elements, such as their risk factors, genes, past/present medical conditions, and the latest scientific research. Patients in the APTP and APC will be cared for over time using a sophisticated and interactive state-of-the-art research tool and database. This approach allows for ongoing monitoring and the development of personalized therapeutic options aimed at reducing Alzheimer’s disease risk and providing optimal care.
The approach is based on a collaborative care model for Alzheimer’s disease, while being firmly grounded in the latest scientific evidence-based therapies. This integrated approach to care aims to provide the most comprehensive therapies for patients with Alzheimer’s disease, mild cognitive impairment due to Alzheimer’s, “preclinical” Alzheimer’s, and patients who are at risk for the disease.
Click Here to Visit the Alzheimer’s Prevention & Treatment Program
at Weill Cornell Medical College website:
Or, Visit this Page to Learn More about the Personalized Approach at the APTP.
Sherry C. on
Saturday, December 21st, 2013
If you are a caregiver or family member of one of the 5.4 million individuals with Alzheimer’s disease, you may be wondering what the upcoming holiday season will bring, particularly if you have a family member with progressive cognitive decline or Alzheimer’s dementia. You may have many questions such as “how can I make a holiday meal that will promote the prevention of Alzheimer’s disease and ensure the food I serve is healthy enough for the Alzheimer’s diet?”
Image Source: Pinterest
There are many ways to ensure a safe and enjoyable holiday with your loved one who has dementia. Below are some tips on transforming a potentially stressful holiday season to an enjoyable and safe event for those who have a family member or close friend who suffers with dementia:
- Encourage the individual with dementia to follow their own instincts when it comes to setting limits on how much t social interaction they are able to engage in. Remind other family members that individuals with dementia may not be able to participate in every event.
- Encourage family members and friends to be sure to visit the person with dementia over the holiday season, even if it is difficult. Socialization is great for prevention of Alzheimer’s, but it is a good idea to limit the number of people who visit to only a few at a time to keep distractions at a minimum. Be sure that there is adequate time for rest between visitors if many family members are planning to visit.
- Keep the noise level low and avoid over stimulating the individual with Alzheimer’s by keeping lights low-avoid drastically change the intensity of light.
- Caregivers should take advantage of the holidays to visit family members and take a break from the day to day routing of caring for someone with dementia. Seek out help from other family members to cover for you if you need to. Continue reading…
Sherry C. on
Wednesday, December 11th, 2013
With the holidays approaching, it’s a great time to talk about healthy sweeteners-particularly for those who are following a diet for Prevention of Alzheimer’s disease (AD). One important aspect of an Alzheimer’s Prevention diet (based on scientific evidence that proves certain people can delay the onset of AD) is avoiding unhealthy foods high in sugar, fructose and high fructose corn syrup. These unhealthy sweeteners are present in many of the holiday treats that are available in abundance at this time of year.
Fructose is a natural ingredient in fruits and vegetables, however when it is extracted from natural foods, leaving it void of fiber, fructose becomes a sweetener that is high on the glycemic index chart (the higher the rating, the faster the food causes spikes in blood sugar). Fructose is processed the same in the body as sugar. Fructose is added to many types of processed sugar such as white table sugar and high fructose corn syrup.
Image Source; mindbodygreen.com
When it comes to sugar substitutes there are many different alternatives including; NutraSweet, aspartame, saccharine, Sweet-n- Low and more. Then there are the natural sweeteners such as; honey, maple syrup, agave syrup, coconut sugar and stevia. But with so many choices, which type of sweetener is best for prevention of Alzheimer’s disease?
Sherry C. on
Monday, December 2nd, 2013
There are some very exciting new clinical trials that have shown a new medical food therapy (available now in the US) may help some patients with Alzheimer’s disease (AD).
A recent study of the effectiveness of caprylic triglyceride (CT) – the active ingredient in a non-drug prescription called Axona, was conducted by Dr. Steven Douglas Maynard and Dr. Jeff Gelblum at Indiana University/Mount Sinai Medical Center. The research article was published in the Neuropsychiatric Disease and Treatment Journal in October 2013.
The primary reason for the study was to evaluate the effects of CT in those with mild to moderate AD in a routine clinical practice setting. The effect of CT was evaluated in the study by medical records reviews by the physicians, as well as reports from caregivers who were asked to answer questionnaires at specific intervals during the study period.
Image Source: Bestinfographics
The study included male and female participants age 50 and over, diagnosed with probable mild to moderate AD who had received this new prescription-only medical food for over 6 months.
The results of the study were encouraging. Of a total of 55 participants who took Axona in addition to medications for AD, 80 percent were stable or had improvement in cognition. This was after an average of over 18 months of taking Axona, where 36.9% of the participants in the study improved (and 80% of patients improved or remained stable).