Alzheimer Related News Items
News as of 12/08/00
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Top Items
Critical Enzyme in AD Identified - Scientists have identified a key enzyme responsible for the production of amyloid, a protein that makes up plaques found in the brains of AD patients. The enzyme is called beta-site amyloid precursor protein-cleaving enzyme (BACE). While researchers have known for some time that enzymes are responsible for helping manufacture the amyloid protein in the brain, it has not been clear if one enzyme in particular (i.e. BACE1 or BACE2) plays a greater role. "Our research shows that when mice were genetically engineered to lack one version of the enzyme so they were unable to make the key enzyme, BACE1, these mice do not produce the amyloid protein in nerve cells," Dr. Philip C. Wong at Johns Hopkins University in Baltimore, Maryland told Reuters Health. "This mechanism may be the best target for a drug that would stop BACE1 production." This will allow drug companies to focus their efforts to develop a drug that could specifically block the action of the enzyme, and hopefully halt the process that leads to neurological degeneration. In addition, Wong noted that "from the mice studies (we conducted) there is no clear evidence that inhibiting BACE1 inhibits other critical cell functions," suggesting that there may be minimal side effects from such a treatment. By Keith Mulvihill Reuters Health 11/9/00

Penn Researchers Find New Marker for AD - Researchers at the University of Pennsylvania Medical Center have determined that a form of isoprostane found in urine could help chart the course of AD in victims, allowing doctors to diagnose the disease earlier and treat it more accurately. The isoprostane is one of a family of molecules formed from fat and lipids when they are attacked by free radicals. The amount of isoprostane increases dramatically in the presence of AD and corresponds directly with another well-known AD marker, the tau protein. While an important indicator for AD, the tau protein is only found in the cerebrospinal fluid (CSF), which can only be measured by a lumbar puncture, commonly called a spinal tap. Isoprostanes, however, can be measured in CSF, blood, and urine. Unlike a spinal tap, a urine test is simple to do and provides a painless and noninvasive way of assessing the situation, said Domenico Praticòò, MD, at the University of Pennsylvania School of Medicine and lead author of the study. "The advantages are clear: with an easier test, doctors can diagnose the disease sooner, chart its progress more accurately and, in turn, prepare a better course of treatment." The researchers said that one hypothesis is that, in AD, healthy brain tissue is damaged by the local formation of large amounts of free radicals. Isoprostanes are the byproducts of fats in the human body that were warped by free radical attack. They then accumulate in CSF, blood, and urine as the body works to get rid of them. PR 11/29/00 Annals of Neurology 2000;48:809-812

Drugs
Study Shows AD Drug Galantamine Is Safe, Effective - A new treatment for AD, called galantamine, appears to slow the progression of the neuro-degenerative condition, according to researchers at the Janssen Research Foundation in Beerse, Belgium. Previous reports have suggested that this drug improves intellectual ability and delays the progression of the debilitating mental illness. In the current study, researchers evaluated the efficacy and safety of the drug and found galantamine is effective and well tolerated in AD. As galantamine slowed the decline of functional ability, as well as cognition, its effects are likely to be clinically relevant the researchers said. Galantamine works by inhibiting the production of acetylcholinesterase, which is thought to be linked to the memory loss in AD. It also enhances the brain response to acetylcholine, which plays a role in cognition. "Galantamine has a second mode of action. It increases the release of the chemical messenger acetylcholine as well. It helps the brain cells produce more," lead author Gordon K. Wilcock told Reuters in a telephone interview. He stressed the drug is not a cure for AD, but relieves the symptoms of the illness. "To halt the disease, you have to stop the brain cells being killed. What these drugs do is they improve the symptoms and make up for the loss of brain cells in other ways," Wilcock added. Reuters Health 12/08/00 British Medical Journal 2000;321:1445 (9 December) Free copy of full text at http://www.bmj.com/cgi/content/full/321/7274/1445

Drug May Halt AD Delusions - An antipsychotic drug, olanzapine, used to treat schizo-phrenia and other ailments may be helpful in preventing delusions and hallucinations in AD patients, according to the drug's manufacturer. In a study of 206 nursing home patients, about 8% of patients taking the drug olanzapine had hallucinations or delusions compared with 25% of patients taking a placebo (inactive drug). The patients, aged 61 to 97, had symptoms that suggested possible or probable AD, including agitation, aggression, hallucinations or delusions. The findings were presented by Dr. W. Scott Clark at a meeting of the Gerontological Society of America. Clark is a researcher at Eli Lilly and Company, the Indianapolis, Indiana-based maker of olanzapine. "Olanzapine is a safe and well-tolerated antipsychotic that may prove to be beneficial in the prevention of hallucinations, and possibly delusions, in patients with AD,'" Clark and colleagues concluded. The most significant side effects of the medication were sleepiness and abnormal gait. Others included pain, anorexia, bruising and fever. Overall, olanzapine had a favorable safety profile, the researchers said. Reuters Health 11/22/00

Experimental Drug Reverses Mental Impairment - An experimental drug, GT 715, may restore lost brain function, results of an animal study suggest. Researchers hope that the drug will be used to treat AD. The drug acts on the same cell-signaling pathway as nitroglycerin, which is used to treat heart disease, explained Dr. James N. Reynolds, of Queen's University in Ontario, Canada. But the drug's action is targeted more towards the brain rather than the cardiovascular system, he said. The drug increases the activity of a substance called guanylyl cyclase (sGC) in the brain, which, along with other brain chemicals, is important for new learning and memory. Activation of sGC is believed to be impaired in the brains of AD patients. This study provides the first evidence to show that activating sGC in the brain may improve mental performance, the authors note. "The results of this study therefore suggest that stimulation of cerebral sGC activity may be an effective strategy to improve learning and memory performance in individuals in whom cognitive abilities are impaired by injury, disease or aging," Reynolds and his colleagues write. The researchers' goal, according to Reynolds, is to develop a drug that not only relieves symptoms of neurological diseases like AD, but also prevents further impairment. The next step, Reynolds pointed out, is to test the safety of the drugs in people. Depending on funding for the research, such a study will hopefully begin within the next year or so, he said. By Merritt McKinney Reuters Health 12/07/00 NeuroReport 2000;11:3883-3886

SFVAMC/UCSF Researchers Develop Lead for a New AD Drug - a Fragment of a Brain Growth Protein - The fragment is derived from a protein called Nerve Growth Factor (NGF), which maintains the health of many types of brain cells, including those damaged by AD; it also helps strengthen the connections between cells. But NGF can't be used as a treatment because the molecule is too large to get past the filtering mechanisms that protect the brain from bacteria and other agents in the blood that might damage it. Researchers at San Francisco Veterans Affairs Medical Center (SFVAMC) and University of California, San Francisco have isolated a protein fragment that acts through the same mechanisms as its larger parent protein. However, a drug based on the fragment would be small enough to pass from the bloodstream into the brain, the researchers said. Their studies offer the first demonstration that a small molecule mimicking a specific part of the NGF protein can activate the same key mechanisms in neurons that are activated by NGF, and in doing so prevent death of these neurons. The next step in developing these fragments into drugs that might slow AD. Chemicals that closely match the shapes and structures in the NGF fragments will be gathered for further testing in nerve cell cultures. The most potent of these will then be tested in mouse models of AD. PR 11/8/00

Genes & Genetic Issues
Molecular Clue to AD Mystery Found - Researchers of the University of Maryland Biotechnology Institute report "strong evidence" that a molecule called ubiquilin controls levels of certain proteins that are central to the early development of AD. They believe the discovery may provide an important way to control the activity of proteins called presenilins. Previous studies showed that mutations in genes coding for presenilins cause early onset of AD. They found ubiquilin to be "highly expressed" in neurons of human brain and associated with tangles and plaques in neurons of brains that are afflicted with AD and Parkinson's diseases, respect-ively. They believe ubiquilin is the first molecule that has been found to increase presenilin levels in cells. Now, they want to see how ubiquilin regulates presenilin proteins carrying AD mutations. This is an important step in understanding presenilins and may lead to eventual treatments or cures for the neuropathological diseases. Molecular genetic studies previously linked early-onset AD to mutations in three genes: amyloid precursor protein, presenilin-1 and presenilin-2. However, the biological reasons why mutations in the genes cause AD has not yet been fully resolved. In their research they found that ubiquilin is localized in both the nucleus and cytoplasm in cells. Modulation of presenilin levels by ubiquilin may have important consequences to many cellular functions, because presenilins have been linked to various biological processes, including calcium regulation, apoptosis (programmed cell death), cell cycle regulation, and other cellular developmental functions. PR 11/13/00 Journal of Cell Biology 151(4):847-862 (11/13/00)

Brain Repair Companies Sharpen Their Drills - A local anesthetic, a small drill-hole in the skull and a syringe full of new cells may one day be all it takes to repair brain damage. That, at least, is the hope of scientists pioneering a new kind of "brain repair kit" using implants of mass-produced cells to patch up damaged gray matter. The daring approach offers hope to those incapacitated by stroke or degenerative diseases such as AD or Parkinson's. However, experts say it will take years before it is proven to be safe and effective. Reuters 11/10/00

deCODE genetics' New Gene Move - Iceland-based deCODE genetics announced formation of a pharmacogenomics unit to use gene expression data to better predict drug effect and response. In discussing the company in general deCODE said it believes that its access to genealogical records for Iceland's homogenous population give it a competitive advantage in learning what roles genes play in which conditions. In part proof, deCODE over the past months has provided stroke, AD, osteoporosis, and schizophrenia gene information to Swiss partner Roche Holdings as part of their $200 million alliance. And CEO Dr. Kari Stefannson reinforces that "Mapping genes that influence responsiveness to a drug is basically the same task as mapping disease genes." By Tom Jacobs MotleyFool.com 11/30/00

IBM Invests in Company That Maps Protein Structures - International Business Machines Corp. announced 11/29/00 its acquisition of a minority stake in San Diego-based Structural Bioinformatics Inc. which is a company that aims to accelerate drug discovery through faster modeling of proteins. Structural Bioinformatics produces advanced three-dimensional protein models that are used by pharmaceutical researchers to design and develop disease-fighting drugs faster and at lower cost. "The human genome has been sequenced, but the second stage -- understanding how genes produce proteins -- is much more complex," said Ann-Marie Derouault, director of business development for IBM Life Sciences. There are about 100,000 human genes and scientists have so far discovered about 2,000 of the estimated one million proteins found in the human body, the IBM executive said. "The IT challenge for processing this data is tremendous, Derouault said. Proteins regulate the structure and function of cells, tissues and organs. They also play a key role in triggering and de-activating genetically-linked diseases such as cancer, AIDS, AD, and diabetes. IBM will provide hardware and software and the two companies will collaborate to make the content of SBI's databases of protein structural information more readily accessible to researchers worldwide via the Internet on a subscription basis. Joint marketing efforts are also planned. Reuters 11/29/00

Caregivers
Family Caregivers of Dementia Patients May Be More Vulnerable to Illness - In a study of the response of caregivers to the pneumonia vaccine a bacterial pneumonia vaccine was given to 52 elderly study. Eleven participants were currently caring for spouses with dementia, 13 were former caregivers whose spouses had died approximately two years before, and 28 were non-caregivers. Immediately after the vaccination the researchers saw no difference between the groups, but over the next six months, the immune responses of the caregivers declined, while those of former and non-caregivers remained stable. Chronic stress may have led to a reduction in the number of immune cells in the caregivers or an impairment in the functioning of these cells the researchers suggest. According to the researchers, the poor response of caregivers to the pneumonia vaccine suggests these individuals may also have difficulty protecting themselves from illnesses such as the flu. The researchers had shown previously a similar impact of caregiving on individuals' response to the influenza vaccine. "These findings are of particular concern since the elderly already experience reductions in immune response as a normal part of aging" said Glaser. "Pneumonia and influenza are together the fourth leading cause of death among individuals 75 or older." The researches noted dementia caregiving can be quite taxing, and family members must cope with severe behavioral problems including incontinence, wandering and the inability to communicate or recognize familiar people. These findings add to growing evidence regarding the negative effects of caregiving on immune response according to the study. PR 11/30/00 Psychosomatic Medicine 2000;62(6): 804-807

Household Hazards Are Not, as Commonly Believed, the Leading Cause of Falls by the Elderly - Slippery showers, loose throw rugs, obstructed pathways and other environmental hazards are not the leading cause of falls by the elderly living at home, a study by Yale researchers shows. "We found, surprisingly, no relationship between potential hazards in the home and the occurrence of falls," said Thomas Gill, M.D., associate professor of medicine and geriatrics at the Yale School of Medicine. "It's been common wisdom that these conditions do cause falls. That's why they are called hazards. But there is actually very little evidence to support that linkage." Gill, said the significance of the results is that money spent making homes of the elderly safer probably could be better utilized. "Home safety assessments have been promoted as an important mechanism to prevent falls by the elderly," he said. "Our study suggests that if you have a set amount of money, it would be better to target areas we already know are effective in preventing falls by the elderly, things like increasing muscle strength, improving gait and balance, proper use of assistive devices, correct footwear, and monitoring of medications." PR 11/30/00

Driving Test Helps AD Patients - Driving is often a touchy issue for those with AD, as patients insist on keeping the keys when it may not be safe. Researchers at The Ohio State University have developed a simple test that can settle the issue before anyone gets hurt. Dr. Douglass Sharre, the neurologist who developed the test, said that actually putting patients in a car and retesting them on the road can be time-consuming, expensive and possibly dangerous. So he came up with an alternative: a test on foot in the office. "The course consists of four turns," Sharre said. "There are two left turns and two right turns, and afterwards, we have the patients do the course by themselves." With that, doctors can read volumes into a patient's ability to understand directions and visual cues. To prove it, Sharre put his patients through both kinds of test, and he found that most of the time, if they failed the simple walking or four-turn test in his office, they'd do the same on the road. "Seventy-eight percent of the people that failed the driving test also failed the four-turn test," Sharre said. "Eighty-two percent of the people that passed the driving test passed the four-turn test." YahooNews 11/23/00

Tai Chi Could Keep Elderly from Taking Dangerous Spills - Doctors already know the more hours the elderly spend on the move and off their seats, the less likely they are to break a hip. Now researchers are looking to an ancient Chinese exercise -- tai chi -- to see if it can help prevent falls and a number of other problems in the aging. "Hip fractures are the seventh leading cause of death among older individuals" said Steven Wolf, of Emory University in Atlanta. "If we can delay the occurrence of these even by ten percent ... from an economic point of view, that's over $1 billion dollars a year in savings." Studies have already shown that tai chi can cut the risk of falls by almost 50 percent in healthy, robust seniors. The series of postures and slow movements, developed in China as a system of self-defense and to aid meditation, can also lower blood pressure, improve balance and give people an overall sense of well-being. Now, researchers in a National Institutes of Health funded study will look to see if tai chi can also protect frail seniors from dangerous falls. CNN 11/20/00

Early Planning Urged for Dementia Patients - Because the progression of dementia can be so unpredictable, people diagnosed with AD or similar ailments need to make plans for end-of-life care while they can still make a meaningful contribution to that planning, researchers suggest. Among its devastating effects, dementia destroys the ability to communicate one's wishes for care, according to Dr. Ann Hurley and associates from EN Rogers Memorial Veterans Hospital in Bedford, Massachusetts. In a letter published in The Journal of the American Medical Association, Hurley and colleagues make several recommendations for improving end-of-life care in persons with dementia. (1) provide care that assures comfort even before the person is eligible for hospice programs; (2) support end-of-life care for people with dementia at all levels of the healthcare, from HMO to assisted-living to nursing home; (3) expand programs that provide comprehensive outpatient care to include patients who have no caregivers; (4) begin end-of-life planning as soon as dementia is diagnosed; and (5) spread the word about the need for specialized end-of-life care for persons with advanced dementia. "Because persons dying with AD or related dementia are vulnerable and depend on others to meet their needs," the authors conclude, "the US healthcare system must attend to these unique needs and develop policies to promote compassionate high-quality care." Reuters Health 11/24/00 The Journal of the American Medical Association 2000;284:2449-50 free full pdf copy at http://jama.ama-assn.org/issues/v284n19/fpdf/jlt1115.pdf

Report: Alterra Aged Facilities Under Scrutiny - Alterra Healthcare Corp. which operates hundreds of assisted living residences for the aged and for sufferers of AD, is under scrutiny by state regulators for the quality of care and safety conditions at some of its centers, The New York Times reported on 11/26/00. Regulators in at least five states have reported over the last year that Alterra facilities have inadequate or untrained staffs, they have failed to give elderly residents drugs and nutritional supplements, or failed to protect their safety, the Times said. Reuters 11/26/00 New York Times article http://www.nytimes.com/2000/11/26/business/26AGED.html

The Magic of Melody - If you've ever come home from a bad day at work and popped your favorite CD into the stereo to feel better, you've practiced a form of music therapy. Music makes people relax, energizes them, decreases depression, reduces pain and even helps babies gain weight, according to a recent presentation to the American Psychiatric Association's meeting in Philadelphia. "Music therapy is really coming into its own in the medical arena. It's really gaining acceptance through research," says Joanne Loewy, a board-certified music therapist at Beth Israel Medical Center in New York City. "Music therapy is being used in special education, AD treatment, depression and virtually every aspect of medicine," she says. For more information on music therapy, check American Music Therapy Association or the University of Exeter's music therapy page.  By Serena Gordon HealthScout Reporter 11/9/00

Testing
Telomere Length Linked to Dementia Risk - Reading a cellular biological clock could one day help identify people at risk of developing dementia and other conditions decades before they reach old age, according to German scientists at Evangelische Geriatriezentrum Berlin. What's more, the researchers believe that antioxidants may prevent this age-related deterioration. The clock in question is based on the telomere, a snippet of genetic material found at the end of the chromosome. Each time that a cell divides, a portion of the telomere is lost. When the telomere reaches a certain length, it triggers a cell-suicide program and the cell dies. The investigators measured the telomeres in white blood cells collected from 186 people. Individuals with shorter telomeres in their blood cells were three times more likely to have vascular dementia, but those with longer telomeres were 100 times less likely to have vascular dementia. Telomeres generally get shorter with age. People with AD, as well as those with blood vessel disease but no dementia, did not have short telomeres. The researchers suggest that telomere length is a marker for a person's ability to withstand oxidative stress, a process in which byproducts of normal metabolism damage cells and DNA. Oxidative stress plays a major role in the aging process. In human cells, the investigators found, the rate at which telomeres shortened correlated with the cells' ability to withstand oxidative damage. Cells that were more vulnerable to oxidative damage had telomeres that shortened more quickly, while cells that were more able to resist this damage had a slower rate of telomere shortening. There is currently no way to predict who will develop vascular dementia, the second leading cause of dementia in the developed world after AD. However, the researchers suggest that telomere length could one day be used to identify people at risk of this condition. The logical strategy for prevention they added, would be long-term therapy with antioxidants. They cautioned that much more research is needed to confirm these findings. By Anne Harding Reuters Health 11/23/00 Laboratory Investigation 2000;80:1739-1747

Prevention
Low Doses of Aspirin-Like Drugs Cut AD Risk - Even at low doses, aspirin and other anti-inflammatory drugs may stave off AD in the elderly researchers at the University of Sydney have found. Mounting evidence suggests that common anti-inflammatory drugs such as aspirin and ibuprofen may cut AD risk, but the necessary dose has been unclear. Now, results of a study of more than 600 men and women age 75 and older suggest even low doses of the drugs can ward off AD. Using high doses is dangerous since the drugs can trigger gastrointestinal bleeding or damage the liver. But high doses do not appear necessary to combat AD, the current findings suggest. Most study participants were taking anti-inflammatories only at the low doses necessary to protect their hearts. Still, anti-inflammatory use was linked to a lower prevalence of AD, but not other forms of dementia. Exactly why aspirin and similar drugs might protect against AD is unclear. Although the natural assumption might be that they reduce inflammation in the brain, research has not borne this idea out, Dr. G. Anthony Broe writes. Instead, the drugs' heart benefits may offer an explanation. Aspirin and similar drugs improve blood flow to the heart by reducing the 'stickiness' of platelets, cells that help the blood clot. And the drugs may improve the function of cells lining blood vessels, Broe and his colleagues speculate. Reuters Health 11/20/00 Archives of Neurology 2000;57:1586-1591

Vitamin E May Help Ward Off AD - Vitamin E may help protect against AD, but only in some patients, according to researchers at the New England Research Institutes in Watertown, Massachusetts. The supplements did not appear to help people with a version of the apolipoprotein E (Apo E) gene associated with the memory-robbing illness. People with the e4 version of the gene are at greater risk of developing AD than those who have either e2 or e3. The investigators found that out of the 127 women tested aged 60 and older those women who said they took vitamin E had memory and learning test scores 3.6 points higher on one test and 0.8 points higher on another test. This was true only in those women who did not have the e4 version of the Apo E gene. Overall, women who used vitamin E were less likely to score below the age- and education-specific cutoff points on two or more tests compared with those who did not use vitamin E. The reason that the e4 allele mitigates vitamin E's effect is unclear, Dr. Julie Dunn said in an interview with Reuters Health. And she cautioned that the results are preliminary and need to be confirmed in a larger study. But, should these results hold up under scrutiny, "they could explain the inconsistent results of previous studies" that attempted to show that vitamin E was protective against AD, she said. Reuters Health 11/21/00 report presented at the annual meeting of the Gerontological Society of America

OHSU Researchers Test Ginkgo Biloba as Possible Agent to Prevent or DelayAD - Research ers at Oregon Health Sciences University are beginning a four-year study with people 85 years and older to determine whether the herb ginkgo biloba could delay or prevent the early stages of AD in older people. The research is funded by the National Center for Complementary and Alternative Medicine. This group was chosen because they have the highest risk for developing mild cognitive impairment, a precursor to AD. The scientists are looking for a total of 200 subjects who do not display signs of mental impairment. Each volunteer will receive regular checkups. Written and verbal tests will be used to determine whether there has been any significant cognitive degeneration during the span of the clinical trial. In addition, MRI testing will help detect changes in brain structure. The researchers want to understand the benefits and risks of ginkgo for persons who may develop mild cognitive impairment. PR 11/6/00

Learning From an Old Dog's New Tricks - Antioxidants may be able to reverse some of the aging process, contends new research at the University of Toronto. The claim stems from what happens to dogs fed a diet enriched with antioxidants: They learn more quickly, say the research-ers. "Antioxidants could prevent or slow down the rate at which brain cells deteriorate or die off," says lead researcher William Milgram . "To some extent, we can improve the cognition of these animals."  By Julia McNamee Neenan HealthScout Reporter  11/27/00

Other Items
Scientists Identify Molecule That Whisks Away Toxic Protein Found in AD -  Scientists at the University of Rochester Medical Center have discovered how mice normally sweep away the protein that forms the plaques in brain tissue that are a hallmark of AD. The findings point to blood circulation in the brain as playing a key role in the prevention of the beta amyloid plaques that speckle the brains of AD patients, and should help scientists better understand how the plaques accumulate and perhaps how to prevent them. They found that blood vessels are responsible for removing the beta amyloid protein in healthy brain tissue and that the endothelial cells that line the blood vessels are key to the process. In particular, a protein known as LRP-1 (low density lipoprotein receptor-related protein), a molecule that plays a role in the transport and metabolism of lipids such as cholesterol, rapidly shuttles beta amyloid out of the brain and across the blood-brain barrier to the body, which breaks it down into harmless waste products. When LRP-1 was blocked in mice and amyloid peptide was injected into their brains the removal of amyloid from the brain slowed dramatically. They also showed that healthy middle-aged mice 9 to 12 months old had fewer LRP-1 molecules in their blood vessels, and that these mice shuttled amyloid out of their brains at only half the rate as young mice. Blood vessels routinely supply nutrients like oxygen and sugar to the brain, and they remove waste products like carbon dioxide. The researchers suspect that the blood is also involved in removing toxic plaques from the brain. Healthy young people normally can handle the load of removing amyloid, but plaques can occur when the LRP-1 system becomes less efficient and the body faces other challenges related to aging, such as decreased circulation. It's also possible that the protein begins accumulating more quickly, overwhelming the removal system. LRP-1 plays an important role in the metabolism of lipids and supplies fat to neurons, which need it to keep healthy and to send electrical impulses along the nerves they form. The team found that LRP-1, part of the family of proteins that handle "bad cholesterol," seems to work closely with two other proteins, alpha-2-macrolglobulin and apolipoprotein E (apoE), a protein known to be involved in some forms of AD. PR 11/10/00

'Senior Moments' Truly Know No Age - You're trying to think of that word for what King Edward VIII did with the crown of England so he could marry Wallis Warfield Simpson. You almost have it, but it just won't come to you. Psychologists call this a "tip-of-the-tongue" experience. It's annoying, embarrassing and, for older people worried about dementia, downright alarming. It's also quite normal, says Deborah M. Burke, a psychologist at Pomona College and co-author of new research on the brain's role in these tip-of-the-tongue experiences. And it appears to happen to young and old alike, she says. In her study the participants could come up with the hard-to-remember word in most cases  after they had heard other words that were similar. Burke calls this "phonological priming." The sounds prime the memory, she says, so that it can make phonological, or sound-like, connections to remember an unusual word. Although the senior citizens who participated in the study had more tip-of-the-tongue moments, they occurred in the same pattern as for the younger adults, the researchers say. And 95 percent of the time, the participants found the word they were looking for. "Normal tip-of-the-tongue experiences involve rarely used words," Burke says. People with AD, on the other hand, "start losing very high frequency words," she says. "They'll forget words like 'fork' or 'spoon.'" Susan J. Kemper, a University of Kansas professor who studies language and aging, acknowledges that "even healthy adults will sometimes get unduly concerned about these lapses." "The catch-phrase is 'a senior moment,'" Kemper says. "These kinds of moments are the butt of a lot of jokes, but they are so common." "What this work seems to show is you need a lot of phonological priming to keep these connections alive," Kemper says. "For a young person, that happens in ordinary life. You are constantly exposed to lots and lots of [language and words]. That helps keep alive all these phonological connections." "But as people get older, we know social networks decline" she says. "Older adults tend to have a smaller diet of TV and radio, and it's usually repetitive." Cerebral game shows like "Jeopardy" and even "Wheel of Fortune" provide more of this priming than, say, a shopping channel, Kemper says. Even situation comedies can provide it, she says. Burke adds that crossword puzzles and word games like Scrabble would offer more priming than bingo, for instance. Keep your vocabulary fresh with lots of conversation, social interaction, crossword puzzles and word games, experts advise. By Anne Haddad HealthScout Reporter 11/10/00 Journal of Experimental Psychology  2000; 26(6):1378-91

Low Childhood IQ Linked to Dementia in Old Age - People who develop AD or other types of dementia in old age tend to have had lower childhood IQs compared with their peers, researchers at Aberdeen University in Scotland report. But the findings raise a "chicken or the egg"-type question. Which comes first, lower intelligence or the predisposition towards the dementia of AD? In the study the scores from tests taken in 1932, while the test-takers were 11 years old were compared to the scores of people with dementia and with the scores of their healthy, same-age peers. The investigators found that people with late-onset dementia--memory problems that developed after age 64--had a lower average childhood intelligence score than people without dementia. But contrary to what the researchers expected, there was no link between childhood intelligence scores and early-onset dementia, or dementia starting before age 64. The researchers point out that the study has several limitations. The researchers were not able to distinguish between cases of dementia caused by AD and those caused by clogged vessels that reduce blood flow to the brain. They also noted that more intelligent people may be more likely to make healthier lifestyle choices, such as not smoking or eating a healthy diet, which could affect their risk of dementia. Assuming that AD develops over a lifetime, then a low childhood intelligence score may reflect the earliest effects of the disease, according to Dr. Richard Mayeux, of Columbia University College of Physicians and Surgeons in New York. Another possibility, however, is that less intelligent people are more vulnerable to AD in old age, he notes in an editorial accompanying the study. Reuters Health 11/27/00 Neurology 2000;55:1428-1429, 1455-1459.

Researchers Use Unique Imaging Technology to Study Changes in the Brain That Lead to Dementia Following Stroke - Researchers at Rush-Presbyterian-St. Luke's Medical Center, Chicago are enrolling 110 participants in a $3 million National Institutes of Health supported 5 year study to determine why 30 percent of those who experience a stroke have cognitive problems while the others are able to function more normally. Most strokes occur when a blood clot blocks an artery that carries oxygenated blood to the brain. A new technology using quantitative MRI analysis as well as diffusion tensor imaging will help identify risk markers in the brain. The researchers are focusing on two areas: the hippocampus, which is the section of the brain responsible for short-term memory, and the entorhinal cortex, which takes in information to other parts of the brain, including the hippocampus. Looking at special MRIs of these areas, Rush scientists will be able to tell whether these two key areas of the brain were deteriorating before the stroke occurred, providing a key glimpse into possible risk factors for stroke. If the deterioration in the hippocampus or entorhinal cortex was present before stroke, it may serve as a warning sign that individuals are at greater risk for post-stroke dementia and AD or other cognitive disorders. Researchers believe they may find that risk factors for diseases like stroke are also risk factors for AD and be able to design preventive strategies for both. PR 11/27/00

Gulf War Symptoms Linked to Brain Damage - Symptoms such as memory loss and dizziness suffered by US veterans with Gulf War syndrome can be correlated to specific areas of the brain where cells have died, probably from chemical exposure, researchers at the University of Texas Southwestern Medical Center in Dallas reported 11/27/00. In 1999, these doctors reported that brain scans performed on people with symptoms of Gulf War syndrome showed depleted cells in three areas of their brains. This year they show that brain cell losses from specific areas of the brain correlate with different symptoms and abnormalities.The Texas researchers have found the amount of brain cell loss in the Gulf War veterans to be comparable to that of patients with brain diseases like amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), multiple sclerosis, dementia and other degenerative neurological disorders, although the brain areas affected are different. Veterans with damage to the right basal ganglia appeared to share symptoms such as impaired sense of direction, memory lapses and depression. Brain cell losses on the left side appeared to cause more general confusion, including difficulty in understanding instructions, reading, solving problems and making decisions. Left side damage also appeared to correlate with elevated levels of dopamine, a neurotransmitter involved in movement and emotion. Reuters 11/27/00