New Research Advances from the Alzheimer's Association International Conference on Alzheimer's Disease 2010
By Alzheimers Association, PRNETuesday, July 13, 2010
HONOLULU, July 14, 2010 - This week, nearly 4,000 scientists from around the world gathered to
report and discuss the latest advances in research on treatments, risk
factors, and diagnosis for the health epidemic of the 21st century -
Alzheimer's disease - at the Alzheimer's Association's 2010 International
Conference on Alzheimer's Disease (AAICAD 2010) in Honolulu.
"With an aging baby boomer generation, the Alzheimer's disease crisis
will continue to touch more lives and create an unsustainable fiscal toll on
the nation's healthcare system - particularly Medicare and Medicaid," said
William Thies, PhD, Chief Medical and Scientific Officer at the Alzheimer's
Association.
"This week we saw promising investigations being pursued on a variety of
fronts - avenues that could very well lead to significant changes in
Alzheimer diagnosis and treatment. However, the chronic underinvestment in
Alzheimer research continues to be the greatest obstacle to bringing new,
more effective therapies to people," Thies said.
"Every day, researchers go to work with the sole purpose of advancing our
understanding and knowledge about Alzheimer's, which is the defining disease
of the baby boomer generation. We need a government response that shows equal
commitment by providing the level of funding for research that will get us
better diagnostic tests, treatments, and a cure," Thies added.
Highlights from the AAICAD 2010 included:
- The Alzheimer's Association announced the launch of Alzheimer's
Association TrialMatch(TM), a confidential, free, and interactive tool
that provides comprehensive clinical trial information and an
individualized trial matching service for people with Alzheimer's
disease and related dementias. The Internet (www.alz.org/trialmatch)
and phone-based (800-272-3900) program provides a first-of-its-kind
service in Alzheimer's by delivering individualized matches to clinical
trials for people with Alzheimer's, their healthcare professionals,
caregivers, and healthy volunteers.
- The Dementia Demonstration Project (DDP), an interdisciplinary effort
led by the Geriatric Research, Education and Clinic Center at the
Minneapolis Veterans (VA) Medical Center, found that early detection,
diagnosis and care management for people newly diagnosed with cognitive
impairment and dementia can reduce outpatient costs by almost 30
percent. Veterans in the study who were diagnosed in the DDP clinics
saw their average outpatient healthcare costs decline by an average of
US$1,991 in the year after diagnosis of cognitive impairment compared
with the year before diagnosis. In the DDP clinics, following
evaluation, the dementia care team met with the patient and family to
review the results, discuss the diagnosis, and outline treatment
recommendations. Informational material, assistance in identifying
needed services, and direct support and training from team members was
provided, as needed.
- Evidence from three long-term, large-scale studies (Framingham Study,
Cardiovascular Health Study, NHANES III) supports the association of
physical activity and certain dietary elements (tea, vitamin D) with
possibly maintaining cognitive ability and reducing dementia risk in
older adults. Plus, a new study in an animal model of Alzheimer's
reported today at AAICAD 2010 suggests that an antioxidant-rich diet
with walnuts may benefit brain function. Research has pointed towards a
number of factors that may impact our risk of Alzheimer's and cognitive
decline, the strongest being reducing cardiovascular risk factors. The
Alzheimer's Association and others have repeatedly called for longer-
term, larger-scale research studies to clarify the roles that these
factors play in the health of the aging brain. These studies from
AAICAD 2010 are some of the first reports of this type in Alzheimer's,
and that is encouraging, but it is not yet definitive evidence.
- Scientists at AAICAD 2010 presented the first draft reports from three
workgroups - covering Alzheimer's disease dementia, mild cognitive
impairment (MCI) due to Alzheimer's disease, and preclinical
Alzheimer's disease - convened by the National Institute on Aging (NIA)
and the Alzheimer's Association to update the diagnostic criteria for
Alzheimer's disease for the first time in 25 years. The proposals would
change the existing criteria by better reflecting the various stages of
the disease and the inclusion of Alzheimer's disease biomarkers. While
the role of biomarkers differs in each of the three stages, much
remains to be understood concerning their reliability and validity in
diagnosis. This makes it critical that any new recommendations be
thoroughly tested. Further input will be solicited by the NIA and the
Association through a website launched immediately after the AAICAD
presentations at www.alz.org/research/diagnostic_criteria.
- The primary therapeutic target in Alzheimer's disease has been the beta
amyloid peptide, which clusters outside cells in the brain to form
sticky clumps known as plaques. Recently, more attention has been given
to the tau protein, which aggregates inside the brain cells of people
with Alzheimer's, forming neurofibrillary tangles. Four new, though
very preliminary, research studies reported at AAICAD 2010 described
experimental immunotherapies for Alzheimer's - two of which target tau
directly and two of which may reduce tau even though their primary
target was beta amyloid. Importantly, these studies teach us more not
only about tau-targeted therapies but also about the progression of
Alzheimer's disease. It may be that amyloid changes in the brain happen
early in Alzheimer's, and tau-related changes happen "downstream" where
they have a more direct effect on cognitive function. Thus,
immunotherapy treatments targeting amyloid may also alter
neurodegenerative processes that occur later in the disease. However,
this is still to be determined.
- In an early finding reported at AAICAD 2010, a gene known as FTO, which
appears to be correlated with obesity in humans, may also increase risk
of Alzheimer's disease and dementia. When a person has certain variants
of both FTO and a recognized Alzheimer's risk gene known as APOE, the
risk of Alzheimer's could be doubled. FTO has previously been shown to
affect body mass index (BMI) and the risk for diabetes. These vascular
risk factors have also been associated with risk of Alzheimer's
disease. However, the researchers found that the increased risk was
independent of these traits, suggesting that there is a different
mechanism by which FTO is associated with an increased risk for
Alzheimer's. We need to see these results confirmed by other
researchers. In fact, we need to know more, in general, about the
genetics and other causes of Alzheimer's so that we have additional
targets for therapies and preventions.
- Last minute scientific submissions to AAICAD 2010, known as "hot
topics," suggested that (1) a newly-discovered risk gene for
Alzheimer's may have early impact on memory skills and brain volume,
(2) intranasal insulin may be beneficial in Alzheimer's, and (3) beta
amyloid deposits in the brains of people with Alzheimer's disease may
take different shapes based on a known Alzheimer's risk gene.
-- Two studies reported at AAICAD 2010 give us more information about
the TOMM40 gene - a newly identified risk gene for Alzheimer's. They
found that healthy, middle aged people who have the high risk
version of TOMM40 (a) did worse on memory tests and (b) had reduced
brain volume in two regions affected early in Alzheimer's.
-- A short-term (4 months) clinical trial of intranasal insulin in
Alzheimer's and mild cognitive impairment (MCI) showed statistically
significant benefits on certain tests of memory and functioning, but
no changes on others. In those who showed benefits on memory tests,
there were also positive changes in Alzheimer's biomarkers in spinal
fluid. Larger, longer-term studies are planned.
-- Researchers using a new imaging tool suggest that there are
different shapes of beta amyloid deposits in the Alzheimer brain
based on which version a person has of a well-established
Alzheimer's risk gene, known as APOE. This may be especially
important because in some recent drug trials the therapy provided
benefits in people who had certain types of APOE but were less
effective or not effective in others.
- Two new studies from AAICAD 2010 suggest that having Alzheimer's
disease may increase the risk of getting other potentially disabling
health conditions, including seizures and anemia. Researchers in one
study found that that the rate of seizures, per 1,000 people per year,
in a study population that included 14,838 people with Alzheimer's aged
50 years or older and 14,838 randomly-selected, age- and sex-matched
people without Alzheimer's, was 9.1 among patients with Alzheimer's
compared with 1.4 for those without Alzheimer's - an incidence rate
that was 6.4 times higher. In a second study of 1,112 older adults (768
healthy controls, 133 MCI, 211 Alzheimer's), people with anemia were
found to have an increased risk of Alzheimer's (odds ratio: 2.56). And
people with Alzheimer's in the study were found to have an increased
risk of being anemic (odds ratio: 2.61). If Alzheimer's also increases
risk of other disabling conditions, then its impact may be more
devastating than we've envisioned as the global population ages and as
more countries become westernized in their habits and lifestyles.
- Racially and ethnically diverse older adults are one of the fastest
growing population segments in the United States. New research
presented at AAICAD 2010 revealed that older African-Americans and
Latinos with significant cognitive impairment have a lower likelihood
of nursing home placement and longer survival than White older adults
in the study. These results have significant implications for caregiver
burden and community resources. There is a greater than anticipated
need for culturally-appropriate dementia care resources and home and
community- based services for these populations.
-- These findings are particularly compelling since African-Americans
are about two times more likely and Latinos about one and one-half
times more likely to develop Alzheimer's and dementia than Whites,
according to the Alzheimer's Association's 2010 Alzheimer's Disease
Facts and Figures report.
-- Another study reported at AAICAD 2010 suggests that the bereavement
process and mourning experience for Alzheimer caregivers after the
death of their loved one varies greatly among different racial and
ethnic groups.
-- A third research report suggested that cultural and spiritual
beliefs of African-Americans, American Indians and Whites greatly
influence how long it takes for a family to seek a medical diagnosis
of Alzheimer's.
About AAICAD
The Alzheimer's Association International Conference on Alzheimer's
Disease (AAICAD) is the world's largest conference of its kind, bringing
together researchers from around the world to report and discuss
groundbreaking research and information on the cause, diagnosis, treatment
and prevention of Alzheimer's disease and related disorders. As a part of the
Alzheimer's Association's research program, AAICAD serves as a catalyst for
generating new knowledge about dementia and fostering a vital, collegial
research community.
About the Alzheimer's Association
The Alzheimer's Association is the leading voluntary health organization
in Alzheimer care, support and research. Our mission is to eliminate
Alzheimer's disease through the advancement of research, to provide and
enhance care and support for all affected, and to reduce the risk of dementia
through the promotion of brain health. Our vision is a world without
Alzheimer's. Visit www.alz.org or call +1-800-272-3900.
EMBARGOED FOR RELEASE UNTIL WEDNESDAY, JULY 14, 2010, 7:30 a.m. HST /
1:30 p.m. ET
Alzheimer's Association media line: +1-312-335-4078, media at alz.org, or ICAD 2010 press room, July 10-15: +1-808-792-6523
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