Alzheimer Related News Items

News as of 11/09/03

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US OKs First Drug for Late-Stage AD - The Food and Drug Administration (FDA) on 10/17/03 approved Namenda (memantine), made by Forest Laboratories Inc., as the first medicine for the late stages of AD. The FDA said Namenda slowed the decline in awareness, reasoning and daily function experienced by patients with moderate to severe AD who were treated in clinical trials. In the studies, most patients’ mental and functional ability did deteriorate. But on average those given Namenda were better able to perform tasks such as feeding themselves or dialing a phone than those given a placebo, the FDA said. Forest said Namenda will address an important medical need because the moderate to severe stages of AD can last years and that the drug should be available in January 2004. This is the first drug to be approved for the most serious, late-stage symptoms of AD. Known as an N-methyl-D-asparate antagonist, it appears to block the action of the chemical glutamate, which has been shown to damage nerve cells. The drug was tested in a series of clinical trials in the United States and Latvia involving 800 patients. Those on memantine appeared to be better able to eat, dress, bathe, travel, shop and perform household chores than those on a non-medicinal placebo. In clinical trials, Namenda was used alone or with another AD treatment. Side effects were minor and included dizziness, headache and constipation, the FDA said. By Lisa Richwine Reuters 10/17/03 and HealthDayNews 10/17/03. FDA Press Release at http://www.fda.gov/bbs/topics/NEWS/2003/NEW00961.html

Study: Antibiotics May Help Stave Off AD - A combination of two common antibiotics may help delay symptoms of AD, researchers said on 10/9/03. In a 101 patient Canadian study, AD patients treated with antibiotics doxycycline and rifampin for three months had significantly less mental decline than those given dummy pills, said Dr. Mark Loeb, associate professor at McMaster University in Hamilton, Ontario, and the study’s lead author. “The antibiotic regimen might allow a person suffering from AD to remain home and avoid having to go to a nursing home or other institution, at least for a period of time,” said Dr. Loeb. The Alzheimer’s Association, however, cautioned against generalizing the results from the relatively small study. “There is not enough data ... to recommend antibiotic treatment to physicians, patients and families,” the association said in a statement. Loeb suggested the antibiotics may work by interfering with the buildup of plaques around neurons in the brain that are a hallmark of AD. It is also possible that the anti-inflammatory effects of the antibiotics are critical. More work needs to be done to determine an exact mechanism of action. “We would like other people to replicate this study and look into the mechanism of action,” Loeb said. He also warned that patients are at risk of becoming resistant to antibiotics given on a continual basis. Nevertheless, Loeb suggested that antibiotics may be an option for AD patients who are not doing well on standard therapy. “If I had a family member suffering from AD, I would show this study to the physician and see what they think,” he said. Results from the trial of patients with mild-to-moderate AD were presented in San Diego at a meeting of the Infectious Diseases Society of America. By Deena Beasley Reuters Health 10/9/03 Press release at http://www.idsociety.org/Template.cfm?Section=News_Releases1&CONTENTID=6739&TEMPLATE=/ContentManagement/ContentDisplay.cfm

Study: Gene May Set Age at Which Brain Diseases Hit - Researchers at at Duke University Medical Center and Harvard University reported on 10/21/03 they had found a gene that may help determine whether a patient gets AD or Parkinson’s disease late or early in life. Finding out more about the gene may help doctors devise a way to delay the two diseases, which may take decades to fully develop, the researchers said. The gene, called GSTO1 or glutathione S-transferase omega-1, was associated with the late onset of both AD and Parkinson’s, the team and other centers found. Duke AD expert Dr. Margaret Pericak-Vance and colleagues studied nearly 1,800 AD patients and 600 Parkinson's sufferers, as well as several hundred healthy people for comparison. Pericak-Vance’s team also reported in October, 2003, that they had found two other genetic regions associated with the age at which patients are diagnosed with AD -- one, on chromosome 2, strongly linked with early onset AD and another, on chromosome 15, with very late onset. Reuters 10/21/03 The study will appear in the Dec. 15 issue of Human Molecular Genetics

Panel: Use of OK'd Stem Cells Unethical - A medical ethics panel said Monday it would be unethical and risky to treat people with the embryonic stem cells approved by President Bush for federally funded research. The approved cell lines, created for possible future disease treatments, were initially grown on mouse cells. That could expose humans to an animal virus their immune systems couldn’t fight, the panel said. The experts said that safer stem cell lines now exist, but those would not be eligible for federal funding. The ethics panel announcement was the latest sign of the friction between stem cell scientists and Bush, who two years ago set limits on the controversial research which destroys human embryos. Earlier this year, the director of the National Institutes of Health called on the president to lift his restrictions. And a number of scientists note that research into stem cells is progressing overseas. There are currently only 11 cell lines available for research, instead of more than 70 thought to be available when Bush announced the restrictions, National Institutes of Health Director Elias Zerhouni said earlier this year when he called on Bush to ease his restrictions. By Foster Klug, AP Writer 11/10/03

U.S. Study Backs Exercise for AD Victims - The health of AD patients is improved by a exercise, along with training for their caregivers, a new study shows. The report from the University of Washington, Seattle, involved 153 patients living at home or elsewhere in the community who had not been institutionalized for the illness. For three months, the caregivers of the patients studied were given instruction either in routine medical care or a combination of training in exercise and behavioral problems. Two years later, the exercise/training group continued to have better physical activity than the other patients and its members were less likely to have been placed in an institution because of behavioral problems. Among patients with higher depression levels when the study started, those in the exercise and training group improved significantly more and maintained that improvement, the researchers said. “This study demonstrated that an integrated treatment program designed to train dementia patients and their caregivers in exercise and behavioral management techniques was successfully implemented in a community setting,” says the report . Reuters Health 10/14/03 Journal of the American Medical Association 2003 290 (15): 2015-2022 Oct. 15

New Marker for AD Found - A potential brain biologic marker for the diagnosis of AD has been identified by scientists at Berlex Pharmaceuticals. A receptor protein molecule called CCR1 that’s usually found on the surface of white blood cells is also present in the brains of people with AD, they say. They also found that increasing levels of CCR1 in the brain correlate with the progression of the disease. The finding may eventually help scientists develop a specific brain imaging biomarker for early diagnosis and tracking of disease progression. “Our research has demonstrated that CCR1 is evident in the brains of patients very early in the disease process, even in patients with mild cognitive impairment,” lead investigator Dr. Meredith Halks-Miller, head of Berlex pharmacopathology, said in a prepared statement. “CCR1 is present in swollen neuronal fibers that are associated with a molecule called amyloid beta 1-42, a sticky peptide that builds up and creates the ‘senile plaques’ that are the hallmark pathological sign of AD. As the disease progresses, the number of abnormal CCR1-containing neuronal fibers also increases,” Halks-Miller says. HealthDayNews 11/5/03 Annals of Neurology 2003 54(5)638-646

What Leads to Cognitive Decline - Mild cognitive impairment (MCI) experienced by the elderly may be associated with cerebrovascular disease, depression and racial factors.

People with MCI are at higher risk for developing dementia, especially AD. MCI is characterized by demonstrable cognitive impairment including memory problems but without dementia. Prevalence of MCI among the elderly increases with age. The researchers, led by Dr. Oscar L. Lopez of the University of Pittsburgh School of Medicine, studied thousands of people who took part in the Cardiovascular Health Study (CHS) Cognition Study who had magnetic resonance imaging (MRI) brain scans between 1991 and 1994. The overall prevalence of MCI among the study subjects was 19 percent (465 of 2,470 people still alive in 1998-99). The prevalence of MCI increases with age from 19 percent in people younger than 75 to 29 percent in people older than 85. The study also found MCI was associated with being black and having low levels of education. MCI was also associated with scores in tests that measure neuropsychological function, cortical atrophy (shrinkage of part of the brain), MRI-detected infarcts (tiny areas of brain damage caused by impaired circulation) and depression. “Twenty-two percent of the participants aged 75 years or older had MCI. Most of the participants with MCI had comorbid conditions [other health problems] that may affect their cognitive function,” the researchers write. HealthDayNews 10/20/03 Archives of Neurology 2003;60:1385-1389 and 1394-1399

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