We found a very interesting perspective on Alzheimer's in Yahoo! News that we wanted to tell you about. It seems signficant differences exist in the perception of memory loss depending on one's country of origin and cultural perspective. This reminds us of an experience we had last week as we were leaving Chicago and a meeting at the Alzheimer's Association, we were doing some work at the gate before our flight departed on our laptop. Since my battery was low I grabbed a seat on the floor and plugged in to one of those outlets that the crew at the airport use to power their industrial strength vacuums around the time that you are waiting for your redeye to depart, and if you are beginning to doze off, jolt you back to wakefulness.

A Sikh gentleman came up and asked if he could share my outlet - I said "of course," and he proceeded to open his very impressive titanium notebook. I noticed he was looking over at my open page while he worked on a Word document in Urdu. Soon he said, "What is that you are working on?" I told him I was making some changes to our web site, and I showed him our applications. "Ah, I see, that is very useful. You should make it in Urdu, that way the people would be more comfortable with it." I thanked him for his good wishes. Now to the article...

Britons differ from other Europeans and ignore early signs of Alzheimer's disease and put off seeing a doctor longer than their European neighbors, according to a poll on Wednesday.

Germans wait about 10 months from the start of symptoms such as memory problems or disorientation until they seek advice and are diagnosed with the degenerative brain disease.

It takes about 14 months in Italy, slightly longer in Spain and up to two years in France. But in Britain many people are not diagnosed until about 32 months after the first signs.

"Traditional British stoicism is a public health problem in terms of Alzheimer's disease," said Dr David Wilkinson, a psychiatrist at the Moorgreen Hospital in Southampton, southern England.

Britons seem to be more reluctant than their European neighbors to make a fuss about symptoms and to seek help.

"Older people feel their symptoms are not a legitimate medical need," said Wilkinson, who was commenting on the poll that was released at a medical meeting in Rome.

"We have got to get the message across that this is a common problem in the elderly -- but it is not part of normal aging."

An estimated 12 million people worldwide suffer from Alzheimer's, which is the leading cause of dementia in the elderly.

There is no cure for a condition that robs people of their memory and mental ability but drugs have been approved to alleviate symptoms.

The survey, conducted by the global research agency Millward Brown, included 2,550 interviews with doctors, spouses, caregivers and patients.

In Britain, 72 percent of caregivers said fear about Alzheimer's was the main reason people delayed seeing their doctors.

Elizabeth Rimmer, executive director of Alzheimer's Disease International, encouraged elderly people who may be experiencing signs of the illness to seek help.

"Throughout the world dementia is surrounded by stigma and myth which prevents people from coming forward if they are concerned about the early symptoms, which are often ignored or just attributed to aging," Rimmer added in a statement.


The many fronts in the Alzheimer's war

Scientists are experimenting with various approaches to turn back the progress of Alzheimer's Disease, some involving naturally occurring compounds such as Vitamin E, others involving experimental pharmaceuticals, while some are investigating the impact of exercise. All of these potential aids in treating memory loss and Alzheimer's can be employed to increase the likelihood of success.

By SUSAN ASCHOFF, Times Staff Writer
Published June 27, 2004

Some researchers suspect no silver bullet exists to stop this complex disease, so research is being carried out in areas as diverse as drugs, vaccines and stem cells.

The former first lady has always had a bare-knuckled determination to take care of her man. So a month before Ronald Reagan's death from Alzheimer's disease, Nancy Reagan spoke publicly for the first time in favor of stem cell research, breaking ranks with many in her husband's political party, including President Bush.

Scientists want no avenue of research closed to them. But many believe the answers to the devastating brain disease will come from other directions.

More than 50 drugs are in the pipeline. And in laboratories from Tampa to Reagan's home state, California, work proceeds on potential vaccines, chemical blockers and clues provided by genetically altered mice.

Almost a dozen "mechanistically distinct approaches" are under way, says David Morgan, Ph.D., a professor of pharmacology at the University of South Florida College of Medicine.

"I don't think cell therapy is going to be (the first) treatment to slow progress of Alzheimer's disease," Morgan says, and others agree. "I think any of these others are going to be developed in the next five years." Alzheimer's disease compromises the brain's function as computer and chemical factory. Connections between cells are lost, neurons die, and a protein called amyloid builds up between cells while other protein tangles within them. The resultant mess is daunting, but its complexity provides multiple targets for intervention. >>more>>


Today's Story - from Newsday

Helen Lenetsky's weathered hands guided her paintbrush, leaving behind gentle, intertwining strokes of purple, pink and green. Her eyes glanced around the room taking inspiration - if only subconsciously - from her surroundings in her retirement home.

Having painted for less than a year, Lenetsky's artistic goals are not fame or acclaim. In fact, she often paints with nothing particular in mind and no immediate thoughts about her work's meaning.

But none of that has stopped Lenetsky, 88, from being noticed.

One of her works, "Fall Reflections," was on display in the U.S. Senate in an exhibit held by the American Art Therapy Association. The show, which ended June 19, showcased 105 works by elderly citizens from around the country.

Lenetsky, a resident of the Bristal Assisted Living Community in North Woodmere, has been attending group art therapy sessions for months. Her piece was one of eight in her class to be displayed in the Senate. Trudy Alpern, Sylvia Berman, Ceil Chason, Bea Garver, Doris Hiller (two works) and Claire Korin also had paintings displayed in the show.

Two paintings chosen

Lenetsky's work, however, was one of two paintings plucked from the exhibit - and the only one from Long Island - to become part of the permanent collection of the Administration on Aging, a division of the federal Department of Health and Human Services.

"I was very, very surprised," she said of the honor. "Very thrilled. The artwork just came to me naturally."

The "natural" manner of creation that Lenetsky employed is precisely the point of art therapy - to draw from the subconscious - said Arlene Esgar, an American Art Therapy Association board-certified art therapist working at Bristal. Esgar's class attempts to create a window into the subconscious of her students by analyzing the symbols in their art. Over time, Esgar said, she is able to examine emotional issues by interpreting a person's artwork.

"I can see aspects of their personalities; if they're depressed, if they're happy. I can see changes in their everyday lives by what they are making."

Lenetsky is no exception.

A twice-widowed native Manhattanite who lived in Boca Raton, Fla., for many years, Lenetsky recently came to Bristal to be closer to her family, said her daughter Sandy Kaye, of East Rockaway.

"Fall Reflections," which depicts a row of autumnal trees reflected onto a pool of water, is an expression of the increased self-confidence, self- examination and optimism Lenetsky has acquired since being at Bristal, Esgar said. A quote of Lenetsky's that accompanied her piece at the exhibit read, "In the fall of my years I am getting better and better."

While art therapy has been used with people of all ages, it has proven particularly effective in alleviating many conditions that can affect the elderly, such as Alzheimer's disease, dementia and disorientation, as well as helping to preserve and improve general cognition, Esgar said.

In many cases, it is the physical act of painting that leads to medical improvement. "Sometimes seniors are having difficulty with fine motor skills, and using certain art materials may help with that," said Beth Gonzalez-Dolginko, also a board-certified art therapist and psychoanalyst in Huntington Hospital's Acute Psychiatric Unit. "It helps not only to increase coordination but to help them feel a sense of confidence and mastery over things they are losing capacity with."

Gonzalez-Dolginko said she has seen significant results while working with post-stroke patients who were able to communicate through their artwork after they had lost the ability to speak coherently.

Despite success stories such as these, art therapy remains largely under-recognized, members of the association said.

"It's definitely a new-ish field," said Megan Robb, curator of the therapy association show, and the group's liaison for its Governmental Affairs Committee. "We definitely are growing and raising awareness. Hopefully, every year people will learn more and more about it."

Meanwhile, Lenetsky and her friends at Bristal continue to pour their hearts onto blank canvases every week. For Lenetsky, the value of art therapy is real. She said, "I feel like I'm accomplishing something."


What is the critical indicator of detecting Alzheimer's? Perhaps it is the degree of change over time, indicated at our study at Stanford and now also the claim resulting from a study done at the Mayo Clinic in Scottsdale, AZ tracking people who possess a so-called 'genetic marker' for the disease (the APOE e4 gene), just published in the most recent issue of the journal Neurology.

Alzheimer's symptoms show early as 50s - Signs unrecognized, Mayo study finds.

Kate Nolan
The Arizona Republic
Jun. 26, 2004 12:00 AM

Just as baby boomers suspected.

You can have symptoms of Alzheimer's disease in your 50s and not even know it, says a new study.

But it's not as simple as misplacing your keys or enduring some other so-called senior moment, says Dr. Richard Caselli, co-author of the study and head of the department of neurology at Mayo Clinic in Scottsdale.

"We all misplace our keys sometime. What's key in diagnosing Alzheimer's is a pattern of forgetfulness that is worsening," Caselli said. And, often, the presence of a genetic marker, the APOE e4 gene, at least in the late onset version of the disease.

As part of the Arizona Alzheimer's Disease Consortium, Caselli and Mayo are studying people in their 50s who have the gene.

Most people who develop late-onset Alzheimer's disease are typically around age 70 when it is diagnosed.

Scientists have studied their mental declines after diagnosis. But until now, little data existed on how or when the symptoms first arise.

Caselli and fellow researchers wanted to find out, and decided to study younger people who had no symptoms.

The results appear in a paper, co-written by Caselli, in the June 8 edition of Neurology, the journal of the American Academy of Neurology.

In the study, more than a hundred men and women, ages 50 to 59, were tested for certain mental abilities over time. Some had the gene marker; some didn't. All were healthy; most were related to someone who'd had the disease.

At intervals over six years, various tests were given to assess mental skills. In one test, participants heard a list of 15 words and then were asked to recall them. In another, they looked at a complicated picture and later had to draw it. Ten minutes later they were asked to draw it again.

"The importance of the tests was measuring changes," Caselli said. Based on performance, it wasn't clear who did or didn't have the gene. It was the degree of change from one test to the next, he said.

On tests, decline in memory was much more pronounced among people who had the gene. But the loss was not evident in everyday life. Researchers also saw a rise in depression and feelings of paranoia - characteristics of some Alzheimer's patients - in those with the gene.

Caselli concludes that neurological degeneration may start many years before the symptoms are noticed.

A new study published in the British Medical journal Lancet today and widely quoted in the media over the past 24 hours suggests that some current Alzheimer's treatments may not be as effective as initial studies had indicated. However, proponents for the pharmaceutical under investigation by British researchers claim that additional studies are needed. Regardless of the impact of any one vector of treatment, early identification is critical.

Study: Drug doesn't hold off Alzheimer's
British researchers say that Aricept fails to prevent patients' need for nursing care.

By Denise Grady
The New York Times
June 25, 2004

The most widely prescribed drug for Alzheimer's disease, Aricept, does not delay the onset of disability or the need for a nursing home, British researchers are reporting today.

The researchers say that the drug has "disappointingly little overall benefit" and is not cost-effective, and that better treatments are needed.

Experts in the United States are already divided over the usefulness of Aricept and related drugs, and the study is unlikely to end the debate.

Most studies have shown that the drugs can produce small improvements in patients' scores on mental tests, but it is not clear whether those gains translate into anything helpful in real life. Even the drugs' staunchest advocates say that they offer only modest benefits at best, affording perhaps a short delay in a patient's decline. But when small changes in a patient's functioning occur, it may be hard to tell whether they are caused by the drug or to the ups and downs of the disease itself.

The new report, being published in today's edition of The Lancet, the British medical journal, is based on a study of 565 patients with mild to moderate Alzheimer's disease who were assigned at random to receive either Aricept or a placebo and were then followed for up to three years.

Although the patients taking the drug did have slightly higher scores on mental tests, after three years they did not differ from the placebo group in their rates of being put in a nursing home or becoming disabled.


Does Estrogen increase the risk of Alzheimer's in Women? That question is being put to the test by researchers. A new study conducted in the Chicago area reports that there appears to be a link...

CHICAGO - Estrogen pills appear to slightly increase the risk of Alzheimer's disease and other forms of dementia in postmenopausal women, a study found.


First, a message to all of you who are Fathers and have Fathers and Husbands: Happy Father's Day. Enjoy the day with friends and family. Meanwhile, the discussion over stem cells continues.

Even if stem cell research could lead to a treatment for Alzheimer's disease, its supporters face a number of political hurdles. Some of the most promising stem cells -- cells that can "learn" to become any type of cell in the human body -- come from human embryos. In this audio story, NPR analyzes the issue which can lead to strong discussion and debate, depending on one's convictions.

This file is in Real Audio or Windows Media. You probably have both on your computer, pick an option and listen to the story.

What do you think? Please send us your thoughts.


Often Alzheimer's brings with it a host of choices for those providing care. Coming to our site, many of you have generously shared your own personal experiences with family members or your concerns for the future. We will share some of those here. It shows the necessity of preventative action, if possible.

Difficult decisions for Alzheimer's sufferers' families

By Gina Kolata, NEW YORK TIMES

Macie Mull was 82 and had suffered from Alzheimer's disease for more than a decade when she developed pneumonia. Her nursing home rushed her to the hospital where she spent the night, receiving intravenous antibiotics. The next day she was back at the nursing home, more confused than ever.

Now she was choking on her pureed food; eating was becoming impossible. And so, one Sunday afternoon, the administrators of her nursing home in Hickory, N.C., asked Mull's daughter what to do: Did she want a feeding tube inserted? At that point, Mull muttered only a few random words and could no longer recognize her daughter. The feeding tube would almost certainly prolong her life, but was it worth it?

The question of how aggressive to be in treating late-stage Alzheimer's patients is one of the most wrenching and contentious issues in medicine. For every patient who, like Mull, reaches the final stage of the disease, there typically are about five or six family members faced with decisions about whether to authorize medical treatments for patients whose bodies live on though their minds are gone.

New research has found that Alzheimer's patients at the end of their lives often receive everything that medicine has to offer.


SOURCE: Cognitive Labs (Preview - Monday wire service)

Cognitive Labs Announces MemCheck Service in Support of Early Detection and Tracking of Cognitive Decline

IRVINE, CA - June 21, 2004 Cognitive Labs, a developer of Internet technologies for screening and monitoring cognitive performance, today announced that it had administered its 20 millionth keystroke response.

"Achieving such a vast number of data responses is a key milestone for our company," said Managing Director Michael Addicott, "we believe no other company in our field has accomplished this goal or developed this level of trust with consumers, clinical researchers and licensees. Today, we are fortunate to be regarded as a leader in our industry, based on our success in administering our services to a global customer base."

Coupled with this milestone, the company recently announced the general availability of MemCheck (TM) a suite of user-friendly applications incorporating proprietary and patented technologies that enable users to screen and monitor their memory and mental performance and stay alert for the onset of conditions such as Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD); conditions that experts predict will affect up to 15 million people in the U.S. within a few years, and up to 40 million people worldwide.

Visitors to cognitivecare.com, the company's test-administration site can purchase an annual subscription to MemCheck and access all services for $69.95 per year. For $9.95 per month, subscribers get MemCheck and MemWatch, helping them perform periodic check-ups of their memory while comparing their results to a baseline of scores from an ever-increasing number of users, approaching 60,000 while since inception the company has attracted more than 1 million members.

About Cognitive Labs

Cognitive Labs (CL), a privately held company, develops, licenses, and markets software-based services including MemCheck and MemWatch for screening, monitoring, and averting conditions that affect human cognition and motor performance. The company offers subscriptions and software licenses, and tools for efficacy monitoring for individuals, media, government, healthcare, special education, and industrial clients. The company has been awarded U.S. patents on its technology and method, administered nearly a million tests since its inception, and been subject to numerous validity studies on its technology at world-class universities.


Cognitive Labs
2102 Business Center Drive
Irvine, CA 92612


Link to CognitiveCare? We asked that question and the response has been overwhelming. So we'll do it. Tell a friend about CognitiveCare. If your friend signs up and continues their membership for 6 months, we'll send you a check for $10. Help your friends, and get paid.

Power User: If you have a web site, link to CognitiveCare and receive 15% when a friend (or anyone) referred by your web site, blog, or email signs up for CognitiveCare. You bring a wonderful service to people and help the cause, and are compensated for your loyalty!

Link: http://www.cognitivecare.com

If you are one of the growing number of Internet users who read weblogs to collect information that's important to you, you can set your reader to this link and get automatic updates from MemCheck - Memory News - our channel or just read it on our site. Here, we bring you a personalized view of the news relating to memory loss and sort through all the noise to find and present what's really important.

Thanks for being a member!

Lapses Must Be Major to indicate Alzheimer's - Dr. Paul Donohue

QUESTION: My 78-year-old father lives by himself and manages pretty well. I am worried that he might be in the early stages of Alzheimer's disease. He has become quite forgetful. Is there a test for it, and is there any medicine to treat it?

ANSWER: No test establishes the diagnosis of Alzheimer's disease with certitude. A microscopic examination of the brain is the only absolute proof of the illness.

However, mental aptitude and memory tests can provide good evidence that a person's forgetfulness comes from Alzheimer's and is not the kind of forgetfulness that comes with aging.

Misplacing keys and temporarily forgetting a name are common memory lapses. When the keys are located or when the name is supplied, the person remembers clearly why he or she put the keys where they were found, or is fully aware of the person whose name was forgotten.

There are more significant memory lapses that point to Alzheimer's. If a person forgets how to perform a routine, familiar task, that is an indication that Alzheimer's might be the cause. Being unable to work a dishwasher is such an example. If a person is lost in a well-known neighborhood, that can be a sign of trouble. Poor judgment, like wearing a heavy sweater on a hot day, or difficulty in writing a check or balancing the checkbook are other Alzheimer signs.


Great news today from Washington, D.C., as a bi-partisan effort led by Senators Barbara Mikulski of Maryland (D) and Christopher Bond of Missouri (R) aims to double the level of funding to the National Institutes of Health (NIH)to combat Alzheimer's Disease to $1.4 billion. The news was hailed by Sheldon Goldenberg, CEO of the Alzheimer's Association.

"Today, Alzheimer's disease is the biggest health threat facing Baby Boomers as they approach retirement. Currently, approximately 4.5 million Americans have Alzheimer's disease, and that number is expected to increase by 70% to 7.7 million by 2030. The cost to Medicare will rise 55 percent to $50 billion a year in less than 10 years, and the cost to Medicaid will soar by 80 percent to $33 billion. The cost to families will increase even more. What greater tribute to President Reagan can there be than to join together to create a world without Alzheimer's? This legislation for research and caregivers is a major step toward that goal."

We heartily agree. One wonders what can be done from our vantage point here in the Golden State, where Governor Schwarzenegger and Maria Shriver have also taken a proactive and caring approach towards the challenge facing all of us. We are looking forward greatly to the Stanford Innovation Summit in July to rub elbows with FCC Chairman Michael Powell, Howard Dean's former campaign manager Joe Trippi as well as folks like former 49er All-Pro Ronnie Lott plus usual cast of digerati, sponsored by tech media mogul Tony Perkins and his Always On Network. Rest assured Cognitivecare will be there representing your interests and seeing how we can best fight back against Alzheimer's through the power of technology.


Alzheimer's: Beyond Stem Cells

From Wired Jun. 11, 2004 PT

Despite the high profile that Nancy Reagan and others have given the idea of using embryonic stem cells to treat Alzheimer's disease, advances are likely to come faster from other approaches.

Experts cite other more promising efforts that in five to 10 years may be used to fight the disease that led to President Reagan's death. "I just think everybody feels there are higher priorities for seeking effective treatments for Alzheimer's disease and for identifying preventive strategies," said Marilyn Albert, a Johns Hopkins University researcher who chairs the Medical and Scientific Advisory Council of the Alzheimer's Association.

Stem cells from human embryos can form all types of cells, and the hope is that they one day could be used to replace cells damaged from such conditions as diabetes, spinal cord injury or Parkinson's disease. But experts say Alzheimer's, by the very nature of how it attacks the brain, would pose a far more daunting challenge to that approach.

"There's an awful lot going on right now that perhaps holds a little bit more immediate promise for trying to slow the disease, or even cut off its development," said Marcelle Morrison-Bogorad, associate director of the National Institute on Aging's neuroscience and neuropsychology of aging program.

She and Albert cited, for example, efforts to attack the buildup of clumps of protein called amyloid in the brain, and methods for spotting the disease early. That research will probably pay off in five or 10 years, earlier than any expected advances from stem cells, Albert said, because so much has to be learned about how to make stem cells useful against the disease.

"All the more reason we should start (stem cell efforts) now, because it's going to take a long time," she said.

About 4.5 million Americans have Alzheimer's, a progressive brain disorder that gradually destroys memory and ability to learn, reason, communicate and do everyday activities. Patients die on average eight years after symptoms appear, although the disease can linger for 20 years.

"What you're dealing with here is a mind in disarray," Morrison-Bogorad said. Connections between brain cells are being lost, neurons are dying and becoming dysfunctional, the amyloid plaques are building up between brain cells, and protein tangles are showing up within cells. And there's inflammation.

"It's just a mess in there," she said. "But the mess means there are so many targets for intervention."

The amyloid plaques have emerged as a favorite target, and scientists and drug companies around the world are studying ways to prevent or destroy them.

One high-profile approach is a vaccine that primes the body to attack amyloid. Studies on animals were encouraging, but in 2002 a study on people was halted when several vaccine recipients developed brain inflammation. Last year, researchers reported that the vaccine did appear to reduce the accumulation of plaques in one study participant.

Work is continuing now on a safer vaccine, because the available evidence suggests "this is an important avenue to pursue," Albert said.

Another popular approach seeks to keep the brain from making the abnormal form of amyloid that creates the plaques. It's a high priority at "every major drug company," Albert said.

The overall focus on amyloid makes her optimistic.

"Everybody's working on it," she said. "What we've learned from the past is that if everybody works really hard at something that is sensible, they're likely to make a lot of progress. So there's just enormous optimism that in five years, or certainly 10 years, we'll have much more effective treatments."

Another key research area is finding a way to predict who will get Alzheimer's before symptoms appear. Because the disease develops over many years, much damage has been done by the time it's diagnosed. So scientists want to identify people at an earlier stage for the day when more effective treatments become available.

In the same vein, scientists want to find ways to track the progress of the disease in people being treated, so they can quickly tell if the treatment is helping.

So researchers are doing long-term studies to see if different kinds of brain scans, mental tests and spinal or blood tests can predict development or progression of the disease.

Lifestyle factors too, such as taking anti-inflammatory drugs and vitamins like E and C, are being studied to see if they can help prevent Alzheimer's or delay it.

Researchers are also exploring the use of cholesterol-lowering drugs. A relatively recent idea, Albert said, is that things like keeping cholesterol and blood pressure low and staying physically active may help. Those steps are well-known for countering heart disease, she noted.

But it's becoming clearer, she said, that "if you do things that are good for your heart, they'll be good for your brain."


You can now read more information about the company behind the service, cognitivelabs, over at one of our other sites. The goal of our service is simply to provide a cost effective, fast, and easy way for people to check their memory over time, and also to provide a community for people to come together to talk about the issue; plus a standardized way of monitoring memory using the worldwide network we have come to depend on for news, weather, and entertainment-and eventually, tap into it from any kind of device. Taking a look at the post from the Chicago Tribune today (below), scientists are now saying that the cause of Alzheimer's may be pushed back even into childhood or the teen years. Feel free to comment and add your information, it's your community and only together can we conquer the unknown.

New research shows that Alzheimer's starts early.
Alzheimer's can have origin early in life, research suggests

Chicago Tribune

CHICAGO - (KRT) - Ronald Reagan's death, caused in part by Alzheimer's disease, comes as researchers are beginning to discover that the illness likely has its start long before old age, possibly even in childhood.

As scientists uncover the roots of the brain-destroying malady, which affects 4.5 million Americans and is expected to reach three times that number by mid-century, they also are pointing the way to new opportunities to prevent or greatly delay the disease's onset.

"The picture that's emerging is that there are a lot of environmental factors that contribute to your risk of getting dementia later in life," said Dr. Robert Wilson of Rush University Medical Center's Alzheimer's Disease Center in Chicago. "We're focusing on mental activity and its protective effect, but we're also finding that physical activity and social activity seem to be somewhat protective."

Many of the lifestyle changes and medical treatments that reduce the risk of heart attack and stroke - lowering cholesterol, exercise, weight loss, anti-inflammatory drugs - also may work to control Alzheimer's.

"We need to shift the thinking away from treating Alzheimer's disease as a disease of late life," said neuropsychologist Paul Nussbaum of the University of Pittsburgh School of Medicine.

Alzheimer's appears to follow a pattern similar to that of heart disease, he said. In heart disease, bad diet, lack of exercise and unhealthy lifestyles can lead to the formation of deposits in the arteries of youngsters, which may grow over time until they cause chest pains or heart attacks in middle age or beyond.

Bad lifestyles also can set the stage for Alzheimer's very early, especially in young people who have a genetic predisposition to the disorder, Nussbaum said. Cholesterol deposits in brain arteries, for example, can trigger inflammation and other biological processes that have been linked to Alzheimer's.

"Alzheimer's is a childhood disorder," Nussbaum said. "It's an invasion of our brain very early in life and across our life span, and it tends to show up clinically late in life."

Preliminary evidence appears to support the early-onset hypothesis. Autopsy studies of people who died young and who were mentally intact found that many already had the characteristic plaques and tangles and dead brain cells characteristic of Alzheimer's. Some of the signs showed up in people in their 20s and 30s.

Until now, autopsies were the only way to definitely show a person's brain was riddled by amyloid plaques and neurofibrillary tangles, the two hallmarks of Alzheimer's. But research teams at the Mayo Clinic and the University of Pittsburgh have developed techniques that for the first time may make it possible to accurately diagnose Alzheimer's disease early in living patients. Currently, a presumptive diagnosis is made based on a patient's behavior.

"A simple (magnetic resonance imaging) evaluation for Alzheimer's disease would ease the suffering of so many families and, hopefully, vastly improve patient care options," said the Mayo's Dr. Joseph Poduslo.

By giving patients special compounds that stick to amyloid plaques, Mayo and Pittsburgh scientists use MRI and positron emission tomography (PET) scans to identify amyloid deposits in the brain, possibly enabling doctors to detect the disease early and to monitor how anti-Alzheimer's drugs are working to eliminate amyloid plaques.

"We're learning more about how to help the brain help itself," said Marcelle Morrison-Bogorad, associate director of the National Institute on Aging's neuroscience and neuropsychology of aging program.

"A huge amount of research has moved from late-stage Alzheimer's disease to earlier and earlier stages where protective measures are more likely to be effective," she said.

The institute and drug companies are testing at least 30 compounds for their ability to delay or prevent the onslaught of dementia. A recent study showed that using two drugs in tandem - donepezil, which increases levels of the memory-enhancing chemical acetylcholine, and memantine, which prevents a deadly overproduction of another neurotransmitter - significantly slows the progress of Alzheimer's.

Another new study found that people who regularly take vitamins E and C, potent antioxidants, have a significantly reduced risk of developing Alzheimer's disease. Antioxidants neutralize free radicals, destructive molecular residue from metabolism and disease processes, which are thought to destroy brain cells.

Much more effective drugs are expected to become available within 10 years.

In recent years, former First Lady Nancy Reagan has been campaigning for embryonic stem cell research as a potential scientific avenue leading to cures for such illnesses as Alzheimer's. Such studies are generally opposed by conservatives and anti-abortion groups because they involve the destruction of human embryos.

In the meantime, researchers say there is much people can do on their own.

There's a growing conviction among scientists that a lifestyle that is good for your heart and your overall health can also considerably reduce your risk of Alzheimer's, said Bill Thies, vice president for medical and scientific affairs of the Chicago-based Alzheimer's Association. Among them are:

Know your medical numbers - blood pressure, cholesterol and blood sugar - and get them treated. All three have been linked to an increased risk of dementia. Diabetes may increase the risk of Alzheimer's by 65 percent, according to a recent study.

Get some physical exercise. Studies show that active older people have a lower risk of Alzheimer's. A University of California, Los Angeles, study found that walking about 1 mile a day cut the risk of cognitive decline by 13 percent. The Canadian Health Study also found that regular walking reduced the risk of cognitive decline and dementia.

Eat a diet that favors fish and vegetables and avoids fats. Martha Clare Morris of Rush University Medical Center found that people who eat more fish and vitamin E-rich foods have a lower chance of developing cognitive impairment and dementia.

Stay connected to society. This is a particular problem for older people who have lost relatives and friends. Their risk of dementia increases.

Stay mentally active. A recent study in the New England Journal of Medicine found that people 75 years and older who read, danced or played board games or musical instruments had a reduced risk of dementia. Crossword puzzles also appear to help.

Avoid toxins, such as cigarette smoke and excessive alcohol.

Keep your weight within normal limits. Studies show that overweight people are more prone to Alzheimer's.

Reduce psychological distress, especially depression, through exercise, meditation or medication. Rush's Wilson found that depression may be an Alzheimer's risk factor.

"All of these things will be good for your health, no matter what," Thies said. "My grandfather retired at 65, and like everyone else he just sat around because the next thing you did was die.

"People who are 65 now are saying, `Well, I'm ready to start my next career.' The only way you're going to be able to do that is if you remain functional, and that's a combination of the mental and physical abilities that you've preserved."

People who live to be 100 and older usually don't have Alzheimer's, heart disease or any of the other chronic disorders associated with aging, said Dr. Thomas Perls of the Boston University School of Medicine and director of the New England Centenarian Study.

They have really good genes in addition to healthy lifestyles, he said.

"There's a lot of evidence to show that for the rest of us, we have an average set of genes to get us to our mid- to late 80s in very good health," Perls said.

"The reason that many of us develop age-related diseases at younger ages has much to do with what we do with our bodies," he said. "We live on average about 10 years less in this country than what our genes are capable of achieving for us."

Brainteasers may be one of the most potent weapons against Alzheimer's. Growing evidence indicates that mental gymnastics that stimulate the construction of new connections between brain cells may buffer the destructive effects of the disease.

Muscles grow stronger through physical exercise, but the brain's exercise is learning, which sparks the construction of new connections, said Pittsburgh's Nussbaum.

Scientists refer to the formation of new synaptic connections as building "brain reserves." The idea is that as brain reserves increase, they make many more connections than a person can afford to lose to disease before memory loss occurs.

The gradual destruction of connections and the subsequent death of brain cells mark Alzheimer's.

"Learning things that are a challenge can certainly delay the onset of Alzheimer's disease by years," Nussbaum said. "You can slow the course once it's started, and it's never too late to start. The final question is going to be how much of an impact will this have in maybe stopping it altogether. We don't know that yet."


There are more tools today to combat memory loss and Alzheimer's than ever before, offering the possibility of early detection. If what is available today in diagnostic screening had been available in the 1980's, former president Ronald Reagan's early signs of Alzheimer's might have been detected and treated with pharmaceuticals which can slow down the progression of the disease. The widely available memory screen is MemCheck, now the world's most popular memory checking service, offered at CognitiveCare.com by Cognitive Labs.

Advances in Alzheimer's treatment
Diagnosis propelled research


June 6, 2004

A year after leaving the presidency, Ronald Reagan had his first series of tests to diagnose Alzheimer's disease. Four years later, in 1994, the Reagan family went public with the news that he was suffering from the debilitating brain disease that robs people of memory and the ability to carry out simple tasks.

Since then, the former president's name and his condition have led to a robust interest in Alzheimer's disease, and the research findings in the field have been staggering. When Reagan was first diagnosed, there were no drugs to treat the condition. Today, a handful of federally approved drugs offer modest help in restoring some aspects of memory and dozens of drugs in the research pipeline are being developed to stall the disease.

"The field is moving so fast," said Huntington Potter, an Alzheimer's researcher at the University of South Florida in Tampa. "We can't cure anyone yet, but the promise is there."

Roughly 4 million Americans suffer from Alzheimer's disease, according to the Alzheimer's Association, and the numbers will grow as people live longer. Most scientists estimate that more than 20 percent of those over 80 will develop symptoms of Alzheimer's, which can begin with mild forgetfulness and end with a person unable to carry out simple tasks.

When Reagan was diagnosed, there were no genes linked to the disease. Today, several genes have been identified for early-onset and late-onset disease. Particular forms of other genes have been found to increase the risk of Alzheimer's. Early gene therapy trials are under way.

"Ten years ago, the prospect of targeting treatment or preventing it would have been laughed at," said Zaven Khachaturian, director of research for the Ronald and Nancy Reagan Research Institute, a think tank directed by the Alzheimer's Association in Chicago. Khachaturian spearheaded research on Alzheimer's at the National Institute on Aging in the 1980s and left to develop the Reagan Institute. The presence of certain genes will not explain most Alzheimer's cases and scientists are hard at work trying to find environmental triggers.

Alzheimer's memory loss and behavior changes have been linked to brain damage, starting in the brain's hippocampus and gradually spreading throughout many brain regions. At death, the brains of patients are riddled with sticky plaques in the hippocampus and nearby regions, and neurofibrillary tangles are found inside brain cells themselves. It is thought that the plaques, made up of a substance called beta-amyloid, lead to the death of brain cells, called neurons.

The disease was first diagnosed in 1906 by Germany psychiatrist Alois Alzheimer, who described his first puzzling case of a 52-year-old woman with a bizarre assortment of behavior changes. Her behavior and memory grew progressively worse until she died nearly five years later.

Alzheimer paid careful attention at the autopsy to the atrophy in her brain: It would be the first time any doctor had characterized a brain pathology that was specifically linked to behavior changes. Alzheimer called the disease "pre-senile dementia," and it was actually Dr. Emil Kraepelin, author of the first diagnostic texts classifying mental illnesses, who named the disease after Alzheimer in 1910.

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