>> on the cover
Memory Loss from page 11
tion, we make ourselves available 24/7
so that anyone needing help can talk to a
person.
"Although we can't stop Alzheimer's
from happening, with medication we can
manage a person's ability to function until
there's nothing left to improve she said.
"At that point, we can help the families
with counseling and programs, whether
the patient is in the early or late stages of
Alzheimer's:'
Often a patient is referred to the Speech
and Language Pathology Department at
Beaumont Hospital in Royal Oak because
they have problems speaking, although
they haven't been labeled with dementia.
"We include patients
and their families in
our 10-week program
to show them how they
can cope with their
problem:' said Michael
Rolnick, Ph.D., director
of the department at
Dr. Michael
Beaumont. "We work
Rolnick
on their speech and
show them how to live
a healthy lifestyle with good nutrition and
exercise. Often we inform families that a
patient should be re-evaluated for AD:'
Treatments And Research
An important discovery in 2012 was the
identification of a genetic mutation that
protects people from developing AD.
The mutation in the Amyloid Precursor
Protein (APP) significantly decreases the
amount of beta-amyloid a person makes,
improving a resistance to developing AD.
Research continues. (See sidebar below.)
Treatments today work by temporarily
improving symptoms of memory loss and
problems with thinking and reasoning.
The medications tend to boost perfor-
mance of specialized biochemicals that
carry information from one brain cell
to another. However, they don't stop the
underlying decline and death of brain
cells. As more cells die, Alzheimer's con-
tinues to progress.
One immunization strategy had to be
stopped recently because some partici-
pants developed acute brain inflammation.
Another medication under investigation is
taken as a nasal spray to impede the pro-
tein tau from forming tangles. Researchers
also are trying to develop drugs that focus
on the specific inflammatory processes.
Others are researching the heart-head con-
nection, evaluating how current drugs for
heart disease may reduce risk factors for
Alzheimer's. Still other studies are exploring
how much lifestyle choices may prevent AD
or at least delay its onset.
According to research presented at the
American Academy of Neurology's meet-
ing in March 2012, patients taking beta
blockers for hypertension may be less
likely to have brain changes associated
with Alzheimer's disease and other forms
Local Research Delves
Into Alzheimer's
percent accuracy in live patients.
Loeffler explains that AD is a "diagno-
sis of exclusion"; when all other causes of
dementia that can be tested for are ruled
he Alzheimer's research pro-
out, then a clinical diagnosis of "prob-
gram at Beaumont Hospital's
able dementia-Alzheimer type" is made.
Neurology Research Laboratory
But, he says, a diagnosis based
is headed by Dr. David
upon clinical findings is only
Loeffler, who also serves on
about 85-90 percent accurate
the Medical and Scientific
because using neuropatho-
Advisory Board of the Greater
logical findings (postmortem
Michigan Chapter of the
brain examination) is the "gold
Alzheimer's Association.
standard:'
Since 1984, he said, physi-
"Alzheimer's is the most
cians have diagnosed possible
common form of dementia,
Alzheimer's disease using clin-
but other disorders also can
ical tests. They evaluate how
cause dementia: Loeffler said.
patients perform on tests of
Dr. David Loeffler
"Efforts to improve the early
cognitive function and other
diagnosis of AD have moved
neuropsychological examina-
forward in recent years.
tions. By the time clinical tests
Researchers now test several chemical
indicate Alzheimer's disease, the patients
have probably experienced years, or even and physical markers, hoping to improve
the accuracy of diagnosis and to get ear-
decades, of Alzheimer's-related brain
lier diagnoses:'
pathology. To date, there are no valid
Though early detection may some-
biomarkers, chemical or mechanical tests
day lead to breakthroughs in treat-
that can diagnose Alzheimer's with 100
Louis Finkelman
Special to the Jewish News
T
12
April 18 • 2013
JN
of dementia such as Parkinson's dementia.
The study findings are preliminary but
promising. They emphasize the importance
of maintaining healthy cardiovascular and
cerebro-vascular systems through diet and
exercise and regular medical attention.
If you're looking for ways to stimulate
the growth of new brain cells, research
published in the Oct. 15, 2012, issue of
Nuerolmage suggest that learning a foreign
language in a condensed course may be the
perfect strategy.
New research also suggests that sweets and
fatty foods are not only bad for your body,
but they also are very bad for your mind. The
theory has to do with higher levels of LDL,
the bad cholesterol, because it has a negative
effect on blood vessels and reduces the flow
of oxygen to the brain. On the other hand, a
Mediterranean-style diet provides nutrients
that are beneficial to the brain.
Start exercising. The online, October
2012 issue of Archives of Neurology, report-
ed that a study of elderly people showed
that the worse participants did on physical
tests, the more likely they were to have
dementia.
The first Alzheimer's patient in the
United States received a pacemaker
implanted in her brain last October at the
Ohio State University Wexner Medical
Center. The patient was enrolled in an
FDA-approved study to determine if using a
brain pacemaker can improve cognitive and
behavioral functioning in patients with AD.
ment, Loeffler said, "Unfortunately, at
the moment, an earlier diagnosis of
Alzheimer's does not increase the chances
of successfully treating the disorder:'
However, having these biomarker tests
would be a blessing and a curse. If AD is
discovered in apparently healthy patients,
researchers could experiment on earlier
intervention, but until effective treatment
is developed, this news could be tragic
for the patients.
"If there were a predictive test for
Alzheimer's disease, would you want to
know?" Loeffler asked.
Furthermore, as Dr. Kostas Lyketsos
of Johns Hopkins University has pointed
out, tests for pre-clinical Alzheimer's
will also detect the disease in millions of
people who have no symptoms, doubling
or tripling health care costs, without, as
yet, any clear benefits to the patients.
Pathologists can look through a micro-
scope for signs of Alzheimer's disease on
brain tissue. They can see extracellular
plaques of amyloid-beta proteins; and
inside neurons, they can see tiny tangles
of twisted tau proteins. The plaques and
tangles are accompanied by brain inflam-
mation and, to varying extents, with
dementia.
A great deal of research has gone into
preventing or reversing the amyloid beta
build-up that leads to plaques in the
More research is needed.
Although no drug therapy or treatment
regimen has been found that will prevent
Alzheimer's disease, medical authorities
agree that lifestyle choices make a big dif-
ference for reducing the risk of developing
AD as you age.
Dr. Gary Small, author of The Alzheimer's
Prevention Program, says it's never too
early to begin making healthy choices.
Alterations in the brain associated with
Alzheimer's usually start decades before
symptoms appear. Small advises thinking
about prevention in your 30s and 40s. He
recommends concentrating on five areas:
• Nutritional eating and a diet low in
saturated fat.
• Staying physically active with aerobic
exercise and strength training.
• Maintaining a healthy weight and
avoiding diabetes, if possible.
• Staying mentally active by reading,
socializing.
• Limiting stress.
"If we take charge of our everyday life-
style choices, we can push back the age
at which Alzheimer's symptoms might
begin, perhaps by several years, which, in
some cases, can mean for the rest of our
lives:' Small said. "Even if scientists one day
come up with a miracle drug that can cure
dementia, it will always be easier to protect
healthy brain cells than to try to repair dam-
aged ones. For now, prevention is the key to
protecting our brains:'
❑
Alzheimer's brain. Unfortunately, treat-
ments that work well in mouse models
have not helped Alzheimer's patients in
clinical trials. In humans, plaque counts
correlate poorly with the extent of men-
tal impairment; some people have the
plaques and lose cognitive functions, but
others with plaques continue to function
well.
Other researchers have been work-
ing on targeting the tau protein within
tangles. Beaumont's Neurology Research
Laboratory is currently studying an
immunotherapy approach to prevent the
development of toxic conformations of
tau in the Alzheimer's brain. Researchers
refer to the dispute between those who
see more hope in work on plaques and
those who see more hope in work on tan-
gles as an argument between the BAPtists
(Beta Amyloid Protein researchers) and
the TAUists.
Researchers also would like to dis-
cover the mechanism or mechanisms
of Alzheimer's disease. In less than 1
percent of cases, Alzheimer's appears
in patients younger than 55 years; this
early-onset Alzheimer's has a large hered-
itary component due to well-defined
gene mutations and is called "familial
Alzheimer's." Heredity plays a lesser role
in the more prevalent "sporadic" form
of the disease, which shows up in older