As research continues on how to best treat Alzheimer’s disease, it is becoming clearer that identifying the disease in its earliest stages, or even before symptoms start, is key to preventing or slowing the progression.
Dr. Rachelle Doody, professor of neurology and director of the Alzheimer’s Disease and Memory Disorders Center at Baylor College of Medicine, shared this message at her annual “Update on Alzheimer’s” lecture held at the Museum of Natural Science and co-hosted by the Alzheimer’s Association Houston and Southeast Texas Chapter.
To identify the earliest stages, she discussed the importance of understanding the differences between normal aging and abnormal aging when it comes to brain function.
“Normal aging does not cause memory loss but it may take longer for some people to recall a name or certain words. It becomes abnormal when people become repetitive with their stories, they lose track of time – perhaps thinking an event took place recently when it actually happened years ago, or they forget how to accomplish day-to-day tasks like how to use a blender,” Doody said.
While this may be noticeable to others, the person affected may not realize what is happening or does not accept it, so family and friends should be supportive and encourage them to see a doctor to intervene sooner rather than later.
Doody discussed the many factors involved in making the diagnosis of Alzheimer’s disease. Recent innovations have made biomarkers more widely available for diagnostic purposes. Despite their promise in improving diagnostic precision, they cannot stand alone.
“Not everyone has positive amyloid or spinal tap results but they still might go on to develop Alzheimer’s,” she said. “Diagnosis is a complex interaction between biomarkers, behavioral and psychological symptoms and risk factors throughout a person’s life.”
Some risk factors include genetics (less than 3 percent of cases are caused solely by genetics), illnesses that cause prolonged inflammation, diabetes, head injuries or concussions with loss of consciousness, family history and age.
Doody also discussed the many research trials currently underway, many of which focus on prevention and early detection. This discussion outlined the process of developing potential interventions and conducting clinical trials.
“To conduct a trial there are many steps to go through, including designing the study to include many influencing factors to the disease and showing efficacy and safety,” she said. “Sometimes the results might not be positive. However, there is always something to learn.”
Even if the outcome was not as hoped, the results could provide useful information, such as ruling out a therapeutic target or suggesting a more specific target, allowing future studies to focus on other areas, populations or treatments.
She closed her lecture by posing the question, “What can you do today to help prevent Alzheimer’s in the future?”
Her answer was to encourage people to take part in research trials. There are many options for those who have the disease, including the NOURISH Alzheimer’s Disease Study that looks at the use of a nutritional supplement to help the body produce ketones and SNIFF, the study of nasal insulin to fight forgetfulness.
Research studies also exist to evaluate people without a dementia diagnosis. Prevention studies include the TOMMORROW study, which evaluates a medication to see if the first symptoms of the disease can be delayed, and the A4 study, which evaluates whether the drug solanezumab can help rid the brain of amyloid plaques. The Health Aging Control Study was started to gain a better understanding of memory function in healthy elderly people. Another is titled Establishing a Database for Future Alzheimer’s Disease Prevention Trials which is creating a registry of people who may be interested in participating in studies that test the effectiveness of treatments to delay the onset of memory and thinking problems associated with Alzheimer’s disease and dementia. Those who sign up for the database might be called upon if their information matches criteria for future studies.
The lecture was supported in part by the Moselle and Milton Pollack Endowed Fund for Alzheimer’s Education in the Alzheimer’s Disease and Memory Disorders Center at Baylor.
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