Alzheimer Related News Items

News as of 8/07/99
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Top Item
Old Age Carries Less Risk for AD - At advanced ages, the risk of developing AD actually decreases, report researchers from the Johns Hopkins School of Public Health in Baltimore. The finding challenges the conventional view that the chances of acquiring the dementia-causing ailment rise steadily with age. Earlier studies of AD patients point to the importance of a gene called apolipoprotein-E (APOE) in the onset of the disease. Individuals who carry a variant of the gene called APOE-4 tend to develop AD at an earlier age, according to Dr. John Breitner.Genetic analysis of 5,092 elderly people in Cache County, Utah, of whom 230 has AD, combined with knowledge about the onset of the disease revealed that people with two copies of the APOE-4 gene, one from each parent, after turning 80 had less risk of acquiring AD with each year. People with one copy of the gene saw their risk decline after age 89 and people without the variant had a lower risk after 95. The message is that AD is not inevitable. The study confirmed that carrying the APOE-4 gene variant raised the overall risk for developing AD, but only half of the population is doomed to develop the ailment. "If you can get past the critical age, then you see less and less AD." The researchers believe that APOE acts as a timing gene, interacting with the genes responsible for AD during a "window of opportunity when people are susceptible" to the disease. "The study really shows how we really don't understand what APOE is doing in the brain," said Neil Buckholtz, who directs AD research at the National Institute on Aging (NIA) in Bethesda, Md., which funded the research. "We're really waiting to find out what these genes do biologically," said Buckholtz, before new treatments for AD can be developed. The large number of people participating in the study enabled the researchers to tease out the genetic effects of APOE-4. Without looking at the genes, they would have only seen steady numbers of AD cases, validating the older view that the disease is inevitable. By Dan Vergano Medical Tribune News Service 7/23/99 Neurology (1999;53:321-331)

Drugs
Investigational Drug Being Studied for AD - Approximately 45 percent of patients suffering from memory loss -- so called Mild Cognitive Impairment (MCI) -- will have AD within three years. There are 45 centers nationwide evaluating an investigational medication manufactured by Merck & Co., Inc., to determine if it can treat MCI and possibly prevent AD. People interested in learning more about the PRAISE (Prevention of Alzheimer's In Society's Elderly) clinical research study should call 1-800-65-STUDY. More than 2.7 million Americans suffer from MCI, a memory problem characterized by increasing forgetfulness and memory difficulties such as not remembering a regularly scheduled appointment or items from a grocery list. Although MCI initially may not interfere with normal daily activities, patients with MCI are at a high risk of developing AD. In fact, approximately 10 percent to 15 percent of patients with MCI develop AD each year, compared with less than one percent to two percent of patients without MCI. While the exact cause of AD has not yet been confirmed, recent studies demonstrate that memory loss is typically the first evidence of the disease. Mild cognitive impairment is a transitional state between normal aging and AD. People with MCI struggle to remember familiar tasks and recent events that normally would be recalled with ease. Investigators believe that if we can identify MCI and treat it, the hope is that we can potentially prevent AD. PR 8/5/99

Snowdrops Are Hope For AD Patients - Sanochemia's medication Galanthamine is an alkaloid found only in Caucasian snowdrops. It has a dual-effect mechanism in that it raises the distribution of acetylcholine -- a messenger substance for chemical conduction in the nervous system -- and also slows down the breakdown of these substances in the human brain that are required for memory function. Sanochemia hopes to get the nod next year from U.S. and European authorities to sell Galanthamine on the market. The drug is so far only available in Austria. If granted, Galanthamine could become a major competitor to Eisai/Pfizer's Aricept and Novartis's Exelon. "Unlike the other two, Galanthamine has a very favorable efficacy/side effect ratio. The body actually gets used to the side effects and the symptoms disappear," said the chief executive of Sanochemia. They have made the chemical synthetically and have obtained a patent on the process. By Julia Ferguson Reuters 7/6/99

Tosk, Inc. Licenses Key Gene Therapy, Neuroscience, and Stem Cell Technologies From Stanford University - Tosk, Inc., a leading provider of innovative drug screening services, announced 8/2/99 the execution of an exclusive worldwide license with Stanford University for three platform technologies. One of the them Adult onset neurodegeneration (AON) technology, is an innovative, in-animal high throughput screening system for anti-adult onset neurodegenerative drugs. Positive drugs are identified based entirely on efficacious results in our patent-pending system. This system has been validated by positively identifying several drugs that either show positive clinical data or are available as a prescription for AD, Parkinson's disease, or stroke. PR 8/2/99

Roberts Pharma, Shire Set To Merge-Source - Roberts Pharmaceutical Corp of the United States is expected to announce 7/26/99 it will merge with Britain's Shire Pharmaceuticals Group Plc, creating the fourth largest UK drug firm, a U.S. industry source told Reuters. The enlarged group would also have five drugs in the developmental stage: galantamine for AD, Lambda for hyperphosphatemia, Dirame for analgesia, Emitasol for nausea and RL0903 for prostratic cancer. By Arindam Nag Reuters 7/26/99

Merck Widens Neurology Focus With Sibia Deal - Merck & Co Inc. said on 8/2/99 it would widen its focus on central nervous system drugs by buying California biotech company Sibia Neurosciences Inc. Sibia, founded in 1981, specializes in discovery and development of synthetic "small molecule" drugs for treatment of central nervous system (CNS) disorders. It is conducting a variety of clinical trials, including of experimental medicines for treatment of Parkinson's disease and AD. Analysts speculate that although the brain is a very complex organ and has proven harder to understand, growing strides in genetics and sequencing of DNA could help drug companies improve the odds of finding effective drugs for neurological diseases such as depression, Parkinson's and AD. By Ransdell Pierson Reuters 8/2/99

Genes & Genetic Issues
Gene May Predict Memory Loss, AD - The risk of accelerated memory loss appears to be higher in individuals who carry two copies of the apolipoprotein E-4 (apoE-4) gene, according to researchers. The apoE-4 gene has been long associated with increased risks for AD. "Normal memory loss that occurs in all people as they age starts earlier for people with two copies of the apoE-4 gene compared to those of the same age with one or no copies of the gene," explained study lead author Dr. Richard Caselli of the Mayo Clinic Scottsdale, Arizona. The researchers conducted genetic and memory-recall tests on 100 healthy, normal adults between 49 to 69 years of age. Fifty did not carry the apoE-4 gene, while the rest carried either one copy of the gene (25 subjects) or two copies (25 subjects). The researchers report that the members of the 'two-copy' group showed "significant negative" declines in immediate and long-term memory function, which appeared to increase with advancing age. In contrast, members of the 'non-carrier' group displayed "no significant correlations" between age and memory loss, while the memory scores of those with just one copy of the apoE-4 gene actually "improved with age rather than declined," according to the authors. In a statement from the American Academy of Neurology, Caselli said the findings "provide clues for identifying the age in which AD may actually begin.'' He explained that "if we can identify AD before it starts, in the future we may be able to develop preventative measures to fight the disease." Should middle-aged and elderly persons be tested for apoE-4? Not yet, according to Caselli. "Currently, there is no cure or preventative therapy for AD that necessitates testing for the apoE-4 gene," he said. "And even if a person has two copies of the apoE-4 gene (that) doesn't mean he or she is destined to get the disease." Reuters Health Neurology 1999;53:201-207.

NICHD Researchers Discover Gene For Major Brain Structure - Researchers at the National Institute of Child Health and Human Development (NICHD) have discovered a gene that controls the development of the hippocampus, a brain structure crucial for learning and memory. The work was performed by Yangu Zhao, Ph.D., and his colleagues, of NICHD's Laboratory of Mammalian Genes and Development. "This work describes the function of a gene that controls the assembly of a brain structure crucial for high order mental functions," said NICHD Director Duane Alexander, M.D. "The discovery provides crucial insight into understanding the complex molecular basis of hippocampus development. Efforts of this nature may one day lead to treatments of hereditary brain disorders that affect the hippocampus." PR and Science 5/14/99

Caregivers
Aquarium Fish Soothe AD Patients-US Study - AD patients are calmer, sharper and have better appetites when exposed to tanks of colorful, gliding fish. The researchers believe the combination of movement, color and sounds provides a stimulating experience for the patients. The study used two 5-foot-high by 3-foot-wide aquariums, each containing six to 10 silver and gold fish, in three Indiana nursing homes housing 60 AD patients. The researchers found when the patients were in close proximity to an aquarium, episodes of wandering, pacing and physical aggression associated with AD decreased and the patients' food consumption was up 17 percent. "Feeding is a terrible problem, because the patients are either running up and down the hall, or they're so lethargic that they can't stay awake to eat,'' said Nancy Edwards, a nursing professor at Purdue University. "But now they're watching the fish, they're not moving, they're awake and they're eating." By Denise Santos Reuters 7/27/99 study will be submitted to the Journal of Gerontology.

Staff Training Key in Caring for AD Patients - When it comes to selecting a long-term care facility for an AD patient, the extent of staff training in caring for such patients should play a key role, according to information presented at the Eighth National AD Education Conference in Long Beach, California. It is very important for all staff to be trained in dementia care. The most
effective staff training is given by dementia care specialists and consists of role playing and other interpersonal activities that help caregivers understand what it is like to have AD. Simple actions such as making eye contact with the patient during a conversation or taking the time to comfort an upset patient can make an enormous difference in how dementia patients react to their surroundings. Reuters Health 7/19/99

Predictors of Mortality in AD Patients in Long-term Care Facilities Identified - The SAGE Study Group reports that the strongest factors associated with mortality in nursing home AD patients appear to be increased age, male sex, limits in physical functioning, and malnutrition.
Factors associated with mortality in AD patients in long-term care facilities with  moderate cognitive deficits included hearing and vision problems and urinary incontinence. Caucasians in this patient population were more apt to die than African Americans and other minorities. A diagnosis of depression seemed to be a stronger predictor among patients with severe AD at baseline. Reuters 7/05/99 J Neurol Neurosurg Psychiatry 1999;67:59-65.

Report Pegs Johns Hopkins as Top U.S. Hospital - U.S. News & World Report has released its tenth annual ranking of the best hospitals in the United States and, for the ninth consecutive year, Johns Hopkins Hospital in Baltimore topped the chart. The Mayo Clinic was second, followed by Massachusetts General. To make the elite list, hospitals had to "demonstrate unusual competence" in at least six of 16 specialties, according to the magazine's web site. CNN 7/9/99

Loc8.net Provides Pager Location Through the Web to Enhance Personal Safety - Loc8.net announced 6/18/99 a new wireless Internet location service that will revolutionize how people manage personal safety. The Loc8.net pager will give users access to emergency services at the touch of a button wherever ReFLEX wireless network coverage exists; it currently covers 90 percent of the U.S. population. It's also designed to give designated users the ability to quickly and easily find the location of a pager -- to street address range accuracy -- from a location empowered Web site that offers high resolution Internet map displays. The service is designed to take advantage of the ReFLEX network for two-way paging to ease the worries of concerned parents and give people, young and old, a pocket-sized panic button that immediately alerts emergency officials. PR 6/18/99

Sunrise Assisted Living to Acquire Constellation's Senior Living Assets - Sunrise Assisted Living, Inc. a leading, national provider of assisted living for seniors, announced 8/2/99 it has entered into a definitive agreement to acquire most of the senior living assets of Constellation Health Services, Inc. (Constellation), a Columbia, Maryland-based assisted and independent living provider. The 12 existing facilities in the purchase agreement include assisted and independent living communities located in Annapolis, Ellicott City, Frederick, Linthicum, Lutherville, Odenton, Pasadena, Severna Park and Silver Spring, Maryland, Fredricksburg and Richmond, Virginia, and Cary, North Carolina. The communities have a total of 796 units and a resident capacity of 893. The three facilities under construction are located in Bowie and Easton, Maryland and Bloomfield, Connecticut and have a total of 142 units and a resident capacity of 165. Sunrise offers a full range of personalized assisted living services, from help with activities such as eating, bathing, dressing and medication management, to a specially designed program for residents with AD and other forms of memory impairment. PR 8/2/99

Testing
New Imaging Method in Development to Show AD Progression - A team of chemists at the Harvard Institutes of Medicine is at work on a non-invasive method to show images of plaque deposits in the brains of AD patients as the disease progresses. Currently, the only way to definitively diagnose both the plaque formation and the disease is to examine the patient's brain after death. The strategy involves coupling an isotope of the element technetium to large organic molecules that are known to have an affinity for amyloid of the type that characterizes the AD brain. The imaging is then done with single-photon computed tomography (SPECT) that relies on the detection of gamma particles emitted by the trace amounts of radioactive technetium probe. The researchers envision a time when individuals who may be at risk to develop AD because of a family history, the presence of a susceptibility genetic marker, or an epidemiological risk will routinely be imaged using the new technology. This would allow definitive diagnosis and therapy faster than is now possible. PR 8/5/99 Journal of Medicinal Chemistry 7/29/99

CSF Beta-amyloid(1-42) a Sensitive and Specific Marker for AD - Data from a prospective 20-month follow-up study confirm two prior reports that beta-amyloid-(1-42) in cerebrospinal fluid (CSF) is a diagnostic marker for AD. The latest findings on this marker come from a Swedish team led by Dr. Niels Andreasen of Pitea River Valley Hospital in Pitea. Using a sensitive enzyme-linked immunosorbent assay, Dr. Andreasen's team found that CSF beta-amyloid-(1-42) is significantly decreased in the majority of patients with AD compared with healthy age-matched elderly controls. Ninety-two percent of subjects with AD had CSF-beta-amyloid-(1-42) below 1,130 pg/mL while 95% of controls had levels exceeding this cutoff. This data implies that CSF [beta]-amyloid-(1-42) retains its diagnostic utility in mildly demented patients and can be used to support early diagnosis. The CSF beta-amyloid-(1-42) may prove useful in the early diagnosis of AD and especially to discriminate between incipient AD and normal aging. Reuters 6/15/99 Arch Neurol 1999;56:655-656,673-680

Urine May Be Used to Diagnose AD - A new urine test that can assist in the diagnosis of AD has been developed, according to researchers at the 51st annual meeting of the American Association for Clinical Chemistry in New Orleans. The AD7C neural thread protein urine test measures urine concentrations of the protein, which is elevated in patients with AD. Dr. Michael Munzar at Nymox Pharmaceutical Corp. of Montreal, Canada, in an interview said that the test has been accurately picking up AD in about 80% of cases and has been correctly negative about 90% of the time. The test has been made available commercially with samples being sent to their reference laboratory in Kensington, Maryland. Munzar added that "it's not a predictive test... it's a state marker, a biochemical marker." He said that preliminary evidence indicates a correlation between level of elevation of neural thread protein and severity of AD, "but we're very cautious about that." Nymox is in the process of developing a 7C assay, which is a quicker, more advanced test compared with AD7C. It can be turned into a kit for direct use by physicians, without having to go through their reference laboratory. Reuters Health 8/2/99

Prevention
Most Elderly Stay Lucid, U.S. Study Says - Most older people remain lucid, but those who don't often suffer from clogged arteries, diabetes or possibly the early stages of AD, according to a study at the University of California at Davis. The researchers concluded that treating atherosclerosis and diabetes might slow memory loss and cognitive decline in older people. The study of nearly 6,000 elderly people tracked their cardiovascular health and tested their cognitive function by asking them to do tasks such as naming parts of the anatomy and folding a piece of paper in half. It also checked to see if they carried the ApoE4 gene associated with AD. Seventy percent of individuals evaluated in this study showed no significant decline in cognitive function over the study period. Individuals whose cognitive ability remained constant during the study had two factors in common: They did not carry any of the (ApoE4) genes, which is often associated with AD, and they had little or no signs of diabetes or atherosclerosis. Those with atherosclerosis alone were three times more likely than healthy individuals to show a loss of function. Those with the ApoE4 gene and either atherosclerosis or diabetes were eight times more likely to suffer a loss of mental faculties. Reuters JAMA 1999;282:40-45

Walks Help Boost Memory, Judgment - A new study suggests that taking an invigorating walk gives older people's brains a good workout, boosting memory and sharpening judgment. Anaerobic exercise - stretching and weightlifting - did not produce similar cognitive improvements. The experiment was conducted at the University of Illinois. The mental benefits of walking were especially significant, researchers said, because the senior citizens had not exercised regularly before joining the study. "People who have chosen a lifetime of relative inactivity can benefit mentally from improved aerobic fitness," said the study's lead author, cognitive neuroscientist Arthur Kramer. "It's never too late." Previous studies have shown that regular exercise may reduce the risk of developing AD later in life, possibly because exercise enhances the production of certain hormones and other protective compounds in the brain. But those studies involved only people with long-term exercise habits. And AD involves the death of brain cells, which is different from more generalized memory lapses that frequently accompany aging. Experts who reviewed the Illinois study said it is not clear how walking might stimulate memory and planning ability. In the next second phase which is just beginning researchers are taking magnetic resonance images of participants' brains to see if there is enhanced blood flow in their executive control centers, and if it corresponds to the walkers' improved test performance. By Joseph B. Verrengia AP Science Writer Nature 7/29/99.

Ancient Chinese Remedy: New Hope for AD? - Huperzine A (HupA), a compound isolated from a Chinese herbal remedy, is under investigation by US physicians and researchers as a treatment for AD. In a small study of people with AD, more than half seemed to show improvement in mental status after taking HupA, says researcher Alan Mazurek, MD. "The results are preliminary, but there are indications it may help people with benign short-term memory loss as well," he says. Clinical trials are just getting started. HupA may work by guarding the brain's supply of the neurotransmitter acetylcholine against breakdown. Chinese studies have shown a significant improvement in cognitive function in 60% of the people with AD who took the Chinese remedy, says Alan Kozikowski, PhD, director of the drug discovery program at the Institute for Cognitive and Computational Sciences at Georgetown University Medical Center in Washington, DC. Dr. Kozikowski first synthesized HupA in 1991 and is the inventor of several huperzine patents. Both doctors think HupA, available as a dietary supplement, is worth a try, especially for improving symptoms of AD. By Sara Altshul O'Donnell Prevention June 1999 v51i6 p44.

Learning Shrinks Your Brain - Education can shrink your brain. The higher the level of education, the more your brain is likely to shrink as you get older. However, while better-educated seniors have smaller brains, they are less likely to suffer from memory loss and age-related impairments or dementias. The research shows that education exerts a protective effect. The study used magnetic resonance imaging (MRI) to measure the cerebrospinal fluid in the brains in about 300 seniors aged between 66 to 90. As the brain shrinks, the space is filled with cerebrospinal fluid. The study found that each year of education leads to approximately one third of a teaspoon (1.77 ml) more cerebrospinal fluid. Seniors with 16 years of education had approximately 10 percent more cerebrospinal fluid (and correspondingly smaller brains) than those with only four years of education. Wired News 7/13/99 Neurology 7/99.

Low-Fat Diet, Dementia Linked - Researchers studying dementia say they have uncovered a
possible health benefit to the relatively fatty Western diet, but they caution against changing eating habits based on the finding. The study found that a diet high in animal fat and protein may protect against the onset of dementia in people who have suffered a stroke. The findings are the latest from an ongoing study of cardiovascular disease that began in 1965 and initially involved more than 8,000 Japanese-American men living in Hawaii. They found that those who preferred a Western diet - higher in animal fat and protein and lower in complex carbohydrates than a traditional Asian diet - were roughly 57 percent less likely to develop dementia after a stroke. They also found a lower incidence of stroke-related dementia in people who took vitamin E supplements.  "This shouldn't be interpreted as advice to go and get in line at the Burger King or McDonald's," said one of the principal investigators since the study did not determine exactly what foods and nutrients in the Western diet may be most important in preventing dementia after a stroke. Future research will attempt to do that. By Jean Christensen AP July 22 issue of the journal Neurology.

A Chocolate a Day Might Keep the Doctor Away - Chocolate -- particularly dark chocolate -- contains high levels of antioxidants, suggesting that the much-maligned sweet might actually be good for you. In a new study, chocolate was found to have four times the level of catechins, a type of antioxidant, compared with black tea. Some studies have suggested that tea-drinkers have a lower risk of cardiovascular disease and possibly cancer -- though the link is not conclusive. However, if the protective health effect is due to the catechins in tea, the health benefit may extend to chocolate as well, according to researchers in the Netherlands. The Dutch researchers analyzed the amount of six different catechins and found that dark chocolate contained the highest level, at 53.5 milligrams of catechins per 100 grams. Milk chocolate contained 15.9 milligrams per 100 grams, and black tea contained 13.9 milligrams per 100 milliliters. They found that tea was the most important source of the antioxidants, making up 55% of total intake of the antioxidants by Dutch citizens. However, chocolate was an important source too, making up 20% of the total intake in this population. The findings have important implications for studies of the health effects of tea, the investigators note, which should take into account other sources of catechins, such as chocolate. Reuters Health 8/06/99 The Lancet 1999;354:488.

Anemia Linked to Vascular Dementia - Australian investigators report evidence for an association between anemia and vascular dementia, a type of deterioration in mental functioning caused by multiple areas of reduced blood supply to the brain. "Analysis of community-dwelling elderly subjects characterized for different dementias failed to confirm a previously reported association of anemia with AD," the team reports, "but revealed instead a significant association with vascular dementia (VAD)." The article suggest that anemia may worsen existing ischemia (inadequate blood supply) in portions of the brain and thereby precipitate or amplify VAD symptoms in elderly subjects who have blood vessel disease. The investigators are hopeful that their findings will stimulate larger community-based investigations of the associations between anemia and dementia. Reuters Health NeuroReport 1999;10:2377-2381.

Other Items
Leading Causes of Death - Leading causes of death in 1997 and the number of Americans who died from each, according to the National Center for Health Statistics. The data are based on an annual review of death certificates. They are: 1. Heart disease, 725,790; 2. Cancer, 537,390; 3. Stroke, 159,877; 4. Lung disease, 110,637; 5. Accidents, 92,191; 6. Pneumonia and influenza, 88,383; 7. Diabetes, 62,332; 8. Suicide, 29,725; 9. Kidney disease, 25,570; 10. Liver disease, 24,765; 11. Blood poisoning, 22,604; 12. AD, 22,527; 13. Homicide, 18,774; 14. HIV and AIDS, 16,685; 15. Hardening of the arteries, 15,884; and all other causes, 361,635. AP 7/28/99

Reagan Declines Due To AD - Doctor - Former U.S. President Ronald Reagan is gradually losing his mental functions because of AD, as often happens among people with the illness. Dr. Ronald Petersen of the Mayo Clinic told CNN's "Larry King Live" 7/13/99 that he visited the 88-year-old Reagan in March and determined that the former president's condition "is gradually declining with respect to various functions." Reagan told Americans in a letter in 1994 that he suffered from the early stages of AD. He has since lived in virtual seclusion at his home in California. "As you know, this is a progressive disorder,'' Petersen told CNN. Reagan is "having the difficulties that many patients have with AD." Reuters 7/14/99

Director Renny Harlin Reels in Hit with "Deep Blue Sea" - The action thriller, color, R, 1:45 has a plot line where one of the three test sharks being used by marine biologist Dr. Susan McAlester (Saffron Burrows), in her dubious experiment to wipe out AD, has somehow compromised her facility's security. McAlester's aim is to harvest protein from the brains of the test sharks, being fed a steady, rich diet of other sharks. Somehow, the protein -- when deposited onto AD-infected cells - quells the disease. The new picture will reel in serious and sustained box office at home and, especially, abroad. By Robert Koehler Variety 7/25/99

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