Improved Diagnosis for Alzheimer's on the Horizon
< Mar.
21, 2007 > -- In light of a new report
that shows a long-predicted increase in the number
of Americans with Alzheimer's disease, researchers
are reporting what could be a real advance in research
into the condition.
Any breakthrough in diagnosis
and treatment is important, experts say, especially
since a new report released this week finds that
more Americans than ever are now suffering from Alzheimer's.
According to new data released
this week by the Alzheimer's
Association, about 5 million Americans now
have the disease, up 10 percent from five years ago
and more than double the number in 1980.
One in every eight people over
the age of 65 has Alzheimer's disease, including
half of those over 85. Between 2000-2004, Alzheimer's-related
deaths rose 33 percent.
Scientists now project that some
7.7 million older Americans will have the brain-robbing
illness by 2030, the association said. By 2050, unless
new ways are found to prevent or treat the disease,
the total could climb to 16 million.
Younger people are also affected:
According to the report, between 200,000 and 500,000
Americans under the age of 65 now suffer from early-onset
Alzheimer's or some other form of dementia.
Scientists have used positron
emission tomography (PET) scans to distinguish living,
healthy brains from the brains of patients with Alzheimer's
disease.
Diagnosis of Alzheimer's is a
notoriously tricky affair and is never 100 percent
definite until an autopsy is performed.
"It's done with great difficulty," says
Alan Carpenter, vice president of business development
at Avid Radiopharmaceuticals in Philadelphia, which
licensed the compound used in the brain scan study. "Autopsy
is the only definitive means."
Many experts believe that Alzheimer's
is caused by a build-up of amyloid plaque proteins
in the brain. But, again, the protein can only be
detected through an autopsy.
The new brain scans relied on
a compound called AV-1, which binds to the beta-amyloid
proteins that build up in the brain and are the hallmark
of the disease.
Last week, scientists confirmed
that an imaging agent known as Pittsburgh Compound
B binds to beta-amyloid accumulations in the brain.
AV-1 was developed by a researcher
at the University of Pennsylvania and is licensed
exclusively by Avid. The current study was a joint
effort between Austin Health, the University of Melbourne
(Australia), Neuroscience Victoria (Australia), Avid,
the University of Pennsylvania, and Bayer Schering
Pharma.
The study involved five individuals
with mild Alzheimer's disease and six healthy controls,
all of whom underwent PET imaging over 3 hours after
injection with AV-1.
The PET imaging clearly distinguished
patients with Alzheimer's from healthy individuals.
"This is basically the proof-of-concept
stage," Carpenter says. "We will now need to go into
phase 2 and phase 3 trials before submission of data
to the FDA [US Food and
Drug Administration]."
"People with Alzheimer's had a
significant 'signal' in the brain in areas known
from autopsy where amyloid tends to deposit," confirms
Carpenter.
The results were presented earlier
this week at the 8th International Conference on
Alzheimer's Disease in Salzburg, Austria.
The results hold out the hope
that doctors will one day be able to better diagnose
the disease. Researchers might also use the technology
to judge the effectiveness of drugs that target the
amyloid beta protein.
But there is still a ways to go,
one expert says.
"This is another brick in the
yellow brick road, but it's not the end," says Dr.
Gary Kennedy, director of geriatric psychiatry at
Montefiore Medical Center in New York City. "We should
be excited that this is moving technology along,
but it's not ready for clinical application. Still,
the more studies like this we have, the closer we
get to it being useful to patients."
According to Dr. Kennedy, compounds
currently being tested, including this one, need
to be much more specific and more sensitive before
they can be considered reliable.
In addition, doctors need ways
to predict who will develop the disease, not just
distinguishing who currently has it versus who does
not, he adds.
Always consult your physician
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Alzheimer's
disease is a progressive, neurodegenerative
disease that occurs when nerve cells in the brain die. It
often results in the following:
- impaired memory, thinking, and
behavior
- confusion
- restlessness
- personality and behavior changes
- impaired judgment
- impaired communication
- inability to follow directions
- language deterioration
- impaired thought processes that
involve visual and spatial awareness
- emotional apathy
With Alzheimer's disease, motor function is often
preserved.
When Alzheimer's was first identified by German
physician, Alois Alzheimer, in 1906, it was considered a rare disorder.
Today, with one in eight persons over age 65 (and
nearly half of persons over age 85) affected, Alzheimer's disease
is recognized as the most common cause of dementia (a disorder in
which mental functions deteriorate and breakdown). It is estimated
that over 5 million Americans have Alzheimer's disease.
The rehabilitation program for persons with Alzheimer's
differs depending upon the symptoms, expression, and progression
of the disease, and the fact that making a diagnosis of Alzheimer's
is so difficult. These variables determine the amount and type of
assistance needed for the Alzheimer's individual and family.
With Alzheimer's rehabilitation, it is important
to remember that, although any skills lost will not be regained,
the caregiving team must keep in mind the following considerations:
- In managing the disease, physical
exercise and social activity are
important, as are proper nutrition
and health maintenance.
- Plan daily activities that help
to provide structure, meaning, and
accomplishment for the individual.
- As functions are lost, adapt activities
and routines to allow the individual
to participate as much as possible.
- Keep activities familiar and satisfying.
- Allow the individual to complete
as many things by himself/herself
as possible. The caregiver may need
to initiate an activity, but allow
the individual to complete it as
much as he/she can.
- Provide "cues" for
desired behavior (i.e., label drawers/cabinets/closets
according to their contents).
- Keep the individual out of harm's
way by removing all safety risks
(i.e., car keys, matches).
- As a caregiver (full-time or part-time),
it is important to understand your
own physical and emotional limitations.
Always consult your physician for more information.
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