Alzheimer Related News Items
News as of 3/10/02
For more info on these abstracts write/call Ed Cabic (edcabic@comcast.net or 410-992-7197)
NOTE - e-mail address change to new address
For more AD information, see Alzheimer Information athttp://www.connext.net/~seniors/infoad.htm
Copies of these reports are posted there
This web page was started at the Florence Bain Senior Center in Columbia MD
Top Items
AD Vaccine Permanently Shelved - A once-promising experimental AD vaccine, AN1792,
has been permanently withdrawn from human testing. The vaccine, under development by the
Irish pharmaceutical company Elan in conjunction with Wyeth-Ayerst Laboratories, a division of
American Home Products Corp. of Madison, N.J., had raised unusually high hopes after it had
halted and even reversed an AD-like condition in mice. It had passed initial safety studies in
Britain and was being tested in about 300 people in four European countries and 11 U.S. medical
centers. Ivan Lieberburg, Elan's chief scientific and medical officer, said 3/1/02 that the 15
people who had experienced brain inflammation problems were all alive and that most of them
were responding to treatment. He said it is still not clear why they developed the complications,
which had characteristics of encephalitis (inflammation of the brain) and meningitis
(inflammation of the membranes surrounding the brain). No such symptoms had been seen in the
earlier animal or human studies. "We never saw a hint of this," Lieberburg said. "It came as a
total shock to Elan." Experts familiar with the vaccine have theorized in recent days that the
vaccine may have stimulated too powerful an immune reaction in the brain. Lieberburg theorized
that some people may be genetically more susceptible to such an overreaction. One possible way
around that problem, he and others said, would be to inject precise doses of beta amyloid
antibodies into the body, instead of leaving it up to the body's immune system to produce those
antibodies. "It may be the end of this particular product, but not for this immunological approach
overall," said William Thies, vice president of medical and scientific affairs at the Alzheimer's
Association. By Rick Weiss Washington Post 3/2/02
New Drug Could Help Slow AD, Study Finds - An experimental drug, Memantine, that works to calm brain activity could help patients with moderate to severe AD just as they lose the ability to care for themselves, researchers said on 2/26/02. The drug slows over-excited brain cell signaling that is associated not only with AD but with other brain diseases, including Parkinson's. In doing so, it slows the progression of the disease, which gradually robs patients of their ability to remember, to find their way around, and to bathe and dress themselves, researchers told a meeting of the American Association for Geriatric Psychiatry in Orlando, Florida. "(Memantine) is the first efficacious treatment for moderate to severe AD, which is a big chunk of the disease," Dr. Barry Reisberg, a psychiatrist and AD specialist at New York University School of Medicine who led the study, said in a telephone interview. Reisberg's team tested Memantine on 252 patients at this stage of the disease. Half got the drug and half got a placebo. Researchers, who did know which patients got the drug, watched and recorded their progress. "The Memantine was very, very well-tolerated," Reisberg said. "There was a marked slowing of the functional problems of the patient. Cognitively we saw something very similar." Depending on the test used, the drug either slowed deterioration entirely for six months, or cut the rate in half. The drug is an NMDA antagonist. It blocks the transmission of NMDA, one of the brain's messenger chemicals that becomes overactive in diseases such as AD and Parkinson's. The next step is to see how long the slowing lasts, and then to test the drug in earlier- and later-stage AD patients. Forest Laboratories, Inc. is applying for U.S. Food and Drug Administration approval of the drug this year. Danish pharmaceuticals group Lundbeck, which holds some rights to the drug in Europe, Canada, Australia and South Africa, said last week the drug was recommended for approval by a European Union committee. By Maggie Fox, Reuters Health and Science Correspondent 2/26/02
Genes & Genetic Issues
Prenatal AD Test Succeeds - In what is believed to be a medical first, a woman with a gene that
is all but certain to cause AD by her 40s gave birth to a baby free of the defect after having her
eggs screened and selected in the laboratory. Experts said it appears to be the first time
preimplantation genetic diagnosis, or PGD, has been used for early-onset AD. There is no similar
test for the more typical form of AD, which strikes the elderly. PGD, which can also involve the
testing of early embryos, has been used to screen for other devastating diseases such as
Tay-Sachs and sickle-cell anemia, which strike in early childhood. It is less commonly used to
detect diseases that strike adults. Medical ethicists say the latest milestone raises troubling issues,
among them the rights of parents with disabling diseases to have children. The patient, a
33-year-old married geneticist who had the procedure about two years ago, desperately wanted
children, even though AD will probably steal her mind long before her daughter grows up. By
Lindsey Tanner, AP Medical Writer 2/26/02 Journal of the American Medical Assn. 2002;
287:1018-1021
Britain Gives Green Light to Human Embryo Cloning - Britain's scientists won a green light on 2/27/02 to pioneer the cloning of human embryos for research and set up the world's first embryo cell bank. An influential House of Lords committee ruled that embryo cloning -- which federally funded academics in the United States are barred from carrying out -- should be allowed to proceed under strict conditions. Committee chairman Richard Harries said the cells taken from embryos within two weeks of fertilization could be crucial for research into finding a cure for debilitating diseases such as Parkinson's and AD. "We conclude that for this to be fully realized, no avenue of research should be blocked off at this stage," Harries told a news conference. The British Medical Association said it strongly supported the verdict. "This research offers real hope to the millions of patients with conditions like AD, Parkinson's and diabetes," it said in a statement. By Dominic Evans Reuters 2/27/002
US Study Ties Gene to Memory Loss in Healthy Adults - A gene already linked to AD and heart disease can also cause everyday memory loss in healthy people as they age, researchers at Duke University said 2/26/02. A study of people 55 and older found that the nerve cell activity in the front of the brain declined three times faster among those who had a gene variation called APOE4 when compared to those who did not have the gene. The findings, presented at the American Association for Geriatric Psychiatry in Orlando, could allow researchers to understand why some people age faster than others, and design drugs to slow the process. "This gene appears to be very closely related to how a nerve cell can repair itself or survive after different types of insults," Dr. P. Murali Doraiswamy of Duke University in North Carolina said in a telephone interview. "If you carry this gene, your nerve cells appear less capable of repairing themselves." In the study brain activity declined 28% in people who had active copies of APOE4 gene compared to 9% in people who did not have the gene. APOE4 is found in 25% of the population and has been linked to higher levels of AD, cardiovascular disease and memory loss. Doraiswamy said even though the discovery of APOE4 could lead to the development of drugs to slow the aging process, more experiments must be done to find what this gene does to cause the brain to age faster. "But we have a ways to go and clearly this finding is not going to have any clinical applications right away in people," he added. A separate study published by Duke researchers has identified the average age at which people begin to develop memory loss. AD affects people beginning at 72.8 years old and Parkinson's at 60.1, researchers found. The study, published in the American Journal of Human Genetics, studied 449 families with a history of AD and 174 with multiple cases of Parkinson's disease. By Christopher Doering Reuters 2/27/02 The study by Doraiswamy is published at J. Neuropsychiatry Clin Neurosci 2002 Winter;14(1):58-63 The average age at onset study is at Am. J. Hum. Genet., 70:985-993, 2002
Gene Linked to Nerve Degeneration, Infertility - Scientists have linked mutations in a gene associated with regeneration in damaged spinal cells with nerve degeneration and male infertility in mice. They say the findings could eventually aid in the understanding and treatment of neurodegenerative disorders and infertility in humans. The investigators also point to a surprising link between regeneration and destruction in nerve cells. Dr. Jian Zuo of St. Jude Children's Research Hospital in Memphis, Tennessee, and his colleagues studied mutant mice that have been known for years to develop nerve degeneration that hinders their movement, sight and sense of smell. Zuo's team was able to zero in on a gene known as Nna1, which is expressed in several types of body tissue, including the brain and sperm-producing testes. This gene, which has a human counterpart, is known to be activated when spine nerve cells are damaged. But the researchers found that mutations in Nna1 were associated with the nerve degeneration and infertility seen in these mutant mice. Zuo told Reuters Health that identifying the gene could open up new possibilities in treating infertility and degenerative conditions. And if the gene is involved in degenerative conditions with more complex underlying causes, such as AD, studying its functioning further could identify new drug targets for these disorders. But for now, "this is all speculation," Zuo stressed. He said further research will, among other things, look into the "pathway" in which Nna1 operates to identify molecules that could be potential drug targets. By Amy Norton Reuters Health 3/7/02 Science 2002;295:1904-1906
Caregivers
Unreported Abuse Found at Nursing Homes - Physical and sexual abuse of nursing home
residents is not being promptly reported to local authorities and is rarely prosecuted, federal
investigators say. In a new study, the General Accounting Office, an investigative arm of
Congress, says, "Nursing home residents have suffered serious injuries or, in some cases, have
died as a result of abuse." Existing safeguards are clearly inadequate, the report says, since more
than 30 percent of the nation's nursing homes have been cited by state inspectors for violations
that harmed residents or placed them in immediate jeopardy. The report says workers who abuse
patients in one state can often be hired by "unsuspecting nursing homes" in other states because
the states do not exchange information and there is no national list of workers who have abused
patients. The inspector general of the Department of Health and Human Services recommended
such a national registry in 1998. Medicare officials are still studying the feasibility of the idea,
the report said. About 1.6 million people live in 17,000 nursing homes nationwide. Medicaid and
Medicare help pay for three-fourths of the patients and spent $58 billion for their care last year.The General Accounting Office found that "alleged physical and sexual abuse of nursing home
residents is frequently not reported in a timely manner," and that "few allegations of abuse are
ultimately prosecuted." By Robert Pear NY Times 3/2/02 The 45 page report is available in PDF
by going to http://www.gao.gov and clicking on "GAO Reports" on left side column. Then click
on "Find GAO Reports" and in the "Find reports by report number" window type GAO-02-312
for the 45 page report and GAO-02-448T for 16 page Testimony before Senate hearing.
U.S. to Weigh Computer Chip Implant - Applied Digital Solutions, based in Palm Beach, Fla., is preparing to seek government approval for a computer ID chip (their "VeriChip") that would be implanted inside the body and could be used to store everything from secret codes to sensitive medical information. The company also is developing another implant device that would work in conjunction with the VeriChip to allow satellite tracking of an individual's every movement. The tracker is already attracting interest across the globe for tasks like foiling kidnappings, the company says. The company will soon begin the process of getting FDA approval for the VeriChip, and intends to limit its marketing to companies that ensure its human use is voluntary. "The use of the VeriChip would always be voluntarily," said Keith Bolton, chief technology officer and a vice president at Applied Digital. "We would never provide it to a company that intended to coerce people to use it." The makers of the chip also foresee it being used to help emergency workers, for instance, diagnose a lost AD patient or access an unconscious patient's medical history. To obtain the implant a person or company buys the chip from Applied Digital for about $200 and the company encodes it with the desired information. The person seeking the implant takes the tiny device -- about the size of a grain of rice, to their doctor, who can insert it with a large needle device. The doctor monitors the device for several weeks to make sure it doesn't move and that no infection develops. The device has no power supply, rather it contains a millimeter-long magnetic coil that is activated when a scanning device is run across the skin above it. A tiny transmitter on the chip sends out the data. Without a scanner, the chip cannot be read. Applied Digital plans to give away chip readers to hospitals and ambulance companies, in hopes they'll become standard equipment. By Christopher Newton AP 2/27/02 The Applied Digital Solutions web site discusses the VeriChip at http://adsx.com/prodservpart/verichip.html
Assistive Technology: This PDA's To-Do Lists Can Be a Lifeline - In an interview with Suzanne Robatille at BusinessWeek Online published 2/20/02 Randy Dayle, president of Cogent Systems in Orlando, discussed ISAAC, a battery-powered device he invented that allows people to take vital information with them wherever they go. ISAAC is about the size of a Walkman, and it can be carried in a bag or worn around the waist. It weighs just under 1.5 pounds including batteries, case, and carrier. The screen needs to be big enough so that it's useful for people with the most severe cognitive disabilities. The system costs around $2,600. Then a rehabilitation expert provides services, such as programming and content updates, at the rate the expert charges for the service. These services are often handled as a package, where the practitioner is paid a fee to implement treatment, and since ISAAC is part of an individual's treatment or rehabilitation plan, usually there are no additional costs for the patient. The information programmed could be medical history which would be useful in an emergency. You could put in doctors' orders, or instructions for performing tasks at work or chores at home. You can tell ISAAC to read aloud a grocery-shopping list. It can be used to remind people about such mundane tasks as bathing and dressing. These are normal activities to you and me, but for someone with a cognitive disability, they can be difficult to remember. The content can be changed as the user adapts to his or her tasks. To obtain ISAAC the user is first evaluated by a rehabilitation practitioner to see if he or she would make a good candidate. The device is then purchased for the client by a doctor or other rehabilitation professional through Cogent Systems. The device isn't covered yet by health insurers, so Cogent works with practitioners to obtain funding through private and public venues, such as government agencies and insurance companies. For more information, e-mail info@cosys.com
UK to Study Alternatives to 'Chemical Cosh' - Britain's Alzheimer's Society said on 2/21/002 it was launching a major research project to find an alternative to the widespread use of tranquillizers and other "chemical coshes" in people with dementia. The charity says it has received numerous complaints about the use of tranquillizers and anti-psychotic drugs to sedate patients whose dementia is coupled with severe behavioral problems. Dr. Richard Harvey, director of research, said drugs were used outside their licensed indications as a "chemical cosh" or "chemical straightjacket." He told Reuters Health: "Essentially, these drugs are being used to get the side effects. Quite often, they are given covertly, mixed with food. The level of complaints suggests that probably most care homes have at least some people with dementia who are being treated with anti-psychotics or tranquillizers." In a statement, the society said that anti-psychotics such as chlorpromazine, haloperidol and thioridazine, and newer agents such as risperidone and olanzapine, were highly effective for treating hallucinations and delusions but there was only limited evidence to show they improved behavioral symptoms. By Richard Woodman Reuters Health 2/21/02
Prevention
More Evidence That Folate Cuts AD Risk - A new study in mice adds to growing evidence
that low levels of folic acid may increase the risk of AD. The findings complement a recently
published study linking elevated levels of the amino acid homocysteine with an increased risk of
the degenerative disease, since folic acid is known to reduce homocysteine levels. Assuming that
the connection between low levels of folate and AD holds true in human studies, eating more
folate-rich foods may help stave off the disease, researchers say. "Maintaining a sufficient
daily intake of folic acid will keep brain cells healthy and may protect against AD," Dr. Mark P.
Mattson, of the National Institute on Aging Gerontology Research Center in Baltimore, MD.,
told Reuters Health. Mattson is the lead author of the folic acid study. People with AD tend to
have below-average levels of folic acid, but the cause of this deficiency is uncertain. Low levels
of folic acid could stem from the disease itself or may be caused by malnutrition. Based on the
findings, the researchers speculate that too little folic acid and too much homocysteine make
neurons vulnerable to the development of AD-related protein bits called amyloid beta peptides.
To get enough folic acid, he recommended eating plenty of folate-rich foods such as green, leafy
vegetables, citrus fruits and juices, whole wheat bread and dried beans. An alternative approach
is to take a daily supplement containing 400 micrograms of folic acid, according to Mattson.
"People with elevated levels of homocysteine in their blood are at increased risk of AD,"
according to Mattson. "Because homocysteine levels can be decreased through folic acid
supplementation and other dietary changes including reducing one's calorie intake, it is therefore
useful to know one's homocysteine level." Blood homocysteine levels between 5 and 15
micromoles per liter are considered normal, noted Mattson, who added that it is "desirable" to
keep homocysteine below 7 micromoles per liter. Just as reducing cholesterol levels can lower
the risk of cardiovascular disease, "reducing levels of homocysteine can reduce risk of AD,"
Mattson said. By Merritt McKinney Reuters Health 3/01/02 Journal of Neuroscience
2002;22:1752-1762
Amino Acid Ups AD Risk; Folate May Help - High levels of the amino acid homocysteine may increase the risk of developing AD, researchers report. In a new study, the risk of AD was nearly doubled in people with high levels of the amino acid. The study raises the possibility of staving off dementia by consuming more folic acid and vitamins B6 and B12, which can lower homocysteine levels. But the study's first author emphasized that the research does not prove that lowering homocysteine levels will prevent AD. Still, Dr. Sudha Seshadri of Boston University School of Medicine in Massachusetts told Reuters Health that eating a low-fat, nutrient-rich diet is always a good idea. "Our study is observational and cannot be used as a basis for treatment recommendations," she said. But the results should encourage future trials to study the effects of vitamin supplements and lowering homocysteine levels on the development of dementia, she said. By Merritt McKinney Reuters Health 2/13/02
Cholesterol-Lowering Drugs May Ward Off Dementia - A Canadian study adds to a growing body of evidence that a commonly prescribed class of cholesterol-lowering drugs known as statins may help prevent AD and other forms of dementia. But unlike previous research that focused on statins, the new study also found that other cholesterol-lowering drugs appear to offer protection as well. In the study of 1,315 people aged 65 or older enrolled in the nationwide Canadian Study of Health and Aging from 1991 to 1996, use of any cholesterol-lowering medication was associated with a nearly 75% reduction in the risk of dementia. The preventive effect, however, was seen only in people under age 80. One possible reason is that the eldest study participants began using the drugs after dementia had already begun to take hold and it was too late, said study author Dr. Kenneth Rockwood of Dalhousie University in Halifax, Nova Scotia. While the new results are encouraging, there is still not enough evidence to recommend that at-risk people, such as those with a family history of dementia, take these drugs in an effort to preserve their mental function, Rockwood told Reuters Health. "Any widespread use for this purpose would be premature," he said. Just how these drugs might ward off dementia is unclear. Animal research has suggested that statins help prevent the build-up of beta-amyloid proteins that is seen in the brains of AD patients, Rockwood said. Another theory is that cholesterol-lowering drugs help prevent AD by reducing inflammation in the brain, he said. They also might stave off other types of dementia, such as that caused by restricted blood flow to the brain, by keeping arteries clear. By Jacqueline Stenson Reuters Health 2/211/02 Archives of Neurology 2002;59:223-227
Challenging the Mind May Save It From AD - Participating in ordinary tasks such as reading, listening to the radio and playing games like checkers and cards on a daily basis may stave off the memory-robbing illness AD, researchers reported 2/12/02. These findings are from a study of more than 800 Catholic nuns, priests and brothers 65 and older who are participating in the ongoing US-based Religious Orders Study. Dr. Robert S. Wilson of the Rush Alzheimer's Disease Center in Chicago, Illinois and colleagues found that people who participated most often in mentally challenging activities had a 47% lower risk of AD. Those who participated a moderate amount had a 28% lower risk of the ailment compared with those who rarely participated. The researchers looked at 7 common activities, including watching television; listening to the radio; reading newspapers, magazines and books; playing games, such as cards, checkers or crosswords or other puzzles; and going to museums. The amount of time study participants spent doing each activity was measured on a five-point scale with the lowest level of activity (rated a "1") for participating in an activity once a year or less, and the highest (rated a "5") signifying daily or "about every day" participation. The researchers found that a person's risk for developing AD decreased by 33% for each one-point increase on the participation scale. Reuters Health 2/12/02 Journal of the American Medical Association 2002;287:742-748.
Brain Training May Help Fortify Memory in Elderly - Dr. Randy Buckner of Washington University in St. Louis believes older people could strengthen their memory skills with certain types of rehabilitation and training exercises. They also provide the first evidence that memory loss is not due to destruction of the parts of the brain responsible for storing memories, he added. Buckner and colleagues used a technique called BOLD-contrast fMRI to view the brains of a group of adults as they tried to memorize words. None of them had AD or any other type of dementia. Adults in their mid-70s and older, they found, showed a different pattern of brain activation than younger people. What may be happening, Buckner suggests, is that the older person's brain loses the ability to call on and control the parts of the left cortex that are most useful for memory storage. When the older adults were given a strategy for remembering the words that required them to think more deeply about their meaning, they were able to bring the left frontal cortex region "on-line" nearly as efficiently as the younger adults, Buckner reported. But the activity in the other parts of their brain continued, and was actually more pronounced after the older adults were given the "support strategy." This involves asking them to decide whether a word fell into one semantic category or another -- was it abstract or concrete. You have to think about the meaning of the word to do it. It worked. In the older adults whose frontal regions stayed quiet when they tried to learn, the regions suddenly lit up when they used the trick. Older people, Buckner said, may have a more difficult time coming up with such "support strategies" on their own. What's encouraging about the findings, Buckner said, is that they suggest some age-related loss of memory function can be reversed with coaching and support. "Our work probably only suggests the potential," Buckner told Reuters Health. "This sets the stage for cognitive rehabilitation and training strategies." His team wants to see if AD patients have an exaggerated version of the less-focused brain activation he and his colleagues saw in healthy older individuals. By Anne Harding Reuters Health 2/19/02 and by Maggie Fox, Health and Science Correspondent Reuters 2/16/02 Neuron Vol 33,827-840, Feb. 2002 Free copy of the 14 page PDF article at http://www.neuron.org in the Feb. 28, 2002 issue
Other Items
Not Too Late to Learn New Tricks, Study Shows - Scientists at the Salk Institute for
Biological Studies in California have shown that physically active adult mice can create new
fully functional brain cells. The new cells were generated in the hippocampus, an area of the
brain important for learning and memory, which is found in all mammals. "This is the first
demonstration of this phenomenon ... that there was neurogenesis going on in the adult brain that
is generating cells that are functional and maturing over a long period of time," said Fred Gage,
who led the study. Gage and his team had already shown that mice stimulated by physical activity
in large cages and toys produced more brain cells than bored mice in smaller cages. They have
now proven that the new cells mature over a long period of time into functional neurons in the
adult brain, a finding that offers new insights into how brain cells are formed in animals and
humans, even as adults. "The advantage of having the same structure exist in all these different
species is that you know that neurogenesis is occurring in both mouse and man and you can study
the mouse as a model of what is going on in man," Gage said in an interview. The impact of the
findings on neurodegenerative diseases such as AD is still uncertain. The new cells may replace
dying brain cells or allow the adult brain to remain adaptable. Gage and his team believe it is
crucial to determine the function of the newly generated cells in the adult brain and why they are
only created in certain areas. By Patricia Reaney Reuters 2/27/02 Nature 415, 1030-1034(2002)
Reagans Mark Golden Anniversary - As Ronald and Nancy Reagan celebrate their 50th wedding anniversary 3/4/02, they are still inseparable after years together in Hollywood, the White House and finally, in the shadows of AD. This year, Mrs. Reagan laments, she will miss the traditional anniversary letter from her now-91-year-old husband. "(It's) one of the days that I most looked forward to every year, since I always knew I would receive a special letter from Ronnie," she writes in the paperback edition of the book "I Love You, Ronnie," being released 3/4/02. The book, first released in fall 2000, is a compilation of his letters to her that exposed the depth of passion for Reagan's beloved wife. Whenever asked about the nation's 40th chief executive, Mrs. Reagan and his chief of staff Joanne Drake say he's doing fine and leave it at that. By Jeff Wilson AP 3/4/02
'Iris' Receives Three Oscar Nominations - The movie "Iris," the tale of the descent of British writer Iris Murdoch into AD, received three Oscar nominations. Former Oscar winner Dame Judi Dench was nominated for her role as the aging Murdoch, while "Titanic" star Kate Winslet, who plays the writer as a young woman, won a nomination for best supporting actress. Jim Broadbent, who plays Murdoch's husband John Bayley, was nominated for best supporting actor. Hugh Bonneville plays Bayley as a young man. Reuters 2/12/02
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