Reprinted by Alexei Koudinov for scholar academic purpose and wide information base of new and open ideas in Alzheimer's research
Memory Minute: Drug failure casts doubt on Alzheimer’s theory
by Dr. Bill E. Beckwith, Community Contributor, Naplesnews.com
Posted August 25, 2010 at 1 p.m.
Dr. Beckwith is a neuropsychologist, speaker and author of “Managing Your Memory: Practical Solutions for Forgetting.” He has an office in Naples and can be reached at memoryseminars@aol.com or (239) 851-1968. Visit Dr. Beckwith on Facebook at the Life and Memory Center or at www.lifeandmemorycenter.com.
Alex Koudinov note: I enjoyed reading this article and ask you to navigate to Dr.Beckwith web site and original publication as a thank you visit
Do we really have a breakthrough in diagnosis and treatment of Alzheimer’s disease? In our desperation for a cure, we have gotten ahead of biology and cast all of our hopes on the amyloid hypothesis ignoring the complexity of Alzheimer’s disease.
The amyloid hypothesis drives a multitude of clinical trials currently underway by pharmaceutical companies to find the cure for Alzheimer’s disease. Simply stated, the hypothesis proposes that build up of beta amyloid, an abnormal protein in the brain, is the cause of Alzheimer’s disease. Hence, treatments are sought that either stop or reverse the production of amyloid proteins in the brain. One of the medications under investigation was semagacestat, a drug developed by Lilly Pharmaceuticals.
The trials had advanced to the point where there were 2,600 patients enrolled in the clinical trials comparing semagacestat with a placebo. This medication attacks the abnormal amyloid. In theory, this is a good thing. However, the trials were terminated because the results indicated (1) that the medication did not slow the disease as expected, (2) the medication made cognition worse, and (3) the medication made treated patients less able to care for their personal needs. This led to many commentaries defending the amyloid hypothesis despite this important failure. This is a natural reaction to information that goes contrary to one’s beliefs. We regroup and find new ways to support our belief and minimize or ignore contrary evidence.
But in this case, the failure of semagacestat should cast doubt on the amyloid theory. We need to pursue the science behind this theory and its failure but we need to be careful in moving ahead with a single minded theory. This could be a costly blind alley. As discussed in an earlier article, the amyloid hypothesis has a number of other problems. For example, there are other data from clinical trials with amyloid drugs that reverse the buildup of beta amyloid but have no clinical benefit. Furthermore, a substantial number of people develop enough plaques as they age that they meet the pathological criteria for Alzheimer’s disease on autopsy but have no symptoms of the disease.
There is a strong push to add expensive (e.g., brain scans to see the amyloids) and invasive (e.g., spinal taps to assay the amyloids) tests as routine diagnostic assessment for Alzheimer’s disease. The failure of the Lilly drug makes me concerned about the path we are taking. We still don’t know whether the abnormal amyloids are the cause or the effect of the disease. These tests belong in the research lab, not in the clinic.
Until we better understand the biology and can safely modify the disease, rigorous and sequential memory testing and direct treatment of memory should be as routine as annual physicals. If you are going to develop Alzheimer’s disease, you must learn to implement memory and coping skills before your short-term memory fades too far to learn them.
Dr. Beckwith is a neuropsychologist, speaker and author of “Managing Your Memory: Practical Solutions for Forgetting.” He has an office in Naples and can be reached at memoryseminars@aol.com or (239) 851-1968. Visit Dr. Beckwith on Facebook at the Life and Memory Center or at www.lifeandmemorycenter.com.
2010/09/02
2010/08/31
Surgery can increase one's chances to get Alzheimer's disease?
Patients who undergo major hospital operations could be at greater risk of developing Alzheimer's disease, scientists believe.
Laura Donnelly (28 Aug 2010) Alzheimer's risk 'could be increased by surgery' Telegraph.co.uk
Alexei Koudinov: interesting article! Reprinted for scholar information. Dear reader, please follow this link to visit original publication and read a number of thoughful comments, and thus appreciate this interesting article!
Tests carried out on mice have revealed changes in their brains, similar to those observed in humans with dementia, when the animals are operated on.
The researchers suspect the same effect could occur in humans after surgical procedures and are now to start a new study to further explore the theory.
Many doctors already suspect there may be a link between surgery and the onset of Alzheimer's.
Previous studies have suggested that between 10 and 30 per cent of elderly people who undergo surgery suffer memory problems afterwards, but it has not been established whether these are a short-term response to physical trauma, or the beginnings of dementia.
Cognitive problems, ranging from memory loss to delirium, have been found most commonly when elderly people have undergone heart surgery, but also following other operations.
It is not known if the procedures themselves, or the body's response to major trauma, spark changes in the brain.
The latest research, conducted at Imperial College London and due to be published in the journal Critical Care Medicine next month, shows that the brains of mice who underwent a surgical procedure showed the presence of protein "tangles" in the brain which are associated with Alzheimer's disease in humans.
Because normal mice do not develop Alzheimer's disease, the new two-year study, also being led by Imperial College, will examine genetically modified mice, in an attempt to see whether the tangles – clusters of protein that form in nerve cells – which are present after surgery go on to trigger the onset of dementia.
The study will also examine whether the use of certain drugs – such as statins, used to protect against heart disease – and the active ingredient of a herbal remedy called Celastrol, could reduce the risks for those undergoing surgery.
In the recent study on mice, Celastrol was seen to reduce inflammation in the brain.
Researchers said if either drug appeared to lower the risks of dementia in modified mice undergoing surgery, further trials would be required to see if this worked in humans, and also to see if it could protect the brains of the wider population, not just those undergoing operations.
Dr Daqing Ma, the lead investigator on the research said: "The data has shown for some time that some elderly people who undergo surgery, especially heart surgery, can develop cognitive dysfunction, which can mean memory loss, and a loss of focus but it isn't clear how much of that is short-term, and how much long-term.
"Some people go on develop dementia, which can damage lives and mean an early death, but we don't know if there is a link with the cognitive dysfunction suffered post-surgery."
Previous studies had examined the extent of dementia within groups who had experienced surgery.
But given that an increasing number of elderly people now undergo operations, it has so far proved impossible to demonstrate that the procedures themselves triggered the dementia.
Anecdotally, many doctors believe they have seen cases which might have been triggered by surgery, said Dr Ma.
Doctor Suzanne Sorensen, head of research at the Alzheimer's Society, which is sponsoring the research along with the Bupa Foundation, said the study was important, because of the high numbers of elderly people who undergo one sort of surgery or another.
She said: "We know from what previous studies have shown that between 10 and 30 per cent of elderly people suffer some kind of cognitive problems after surgery, and the numbers are highest in the most elderly people.
"The problem is all the evidence is anecdotal, we know of people who went in for a hip operation, and went home with dementia, but we cannot prove the link."
Alzheimer's disease is the most common form of dementia and affects around 500,000 people in Britain.
This is expected to double by 2050 as the population ages and many have warned that the NHS will not be able to cope with the nursing needs of so many patients unless better medicines are developed.
Laura Donnelly (28 Aug 2010) Alzheimer's risk 'could be increased by surgery' Telegraph.co.uk
Alexei Koudinov: interesting article! Reprinted for scholar information. Dear reader, please follow this link to visit original publication and read a number of thoughful comments, and thus appreciate this interesting article!
Tests carried out on mice have revealed changes in their brains, similar to those observed in humans with dementia, when the animals are operated on.
The researchers suspect the same effect could occur in humans after surgical procedures and are now to start a new study to further explore the theory.
Many doctors already suspect there may be a link between surgery and the onset of Alzheimer's.
Previous studies have suggested that between 10 and 30 per cent of elderly people who undergo surgery suffer memory problems afterwards, but it has not been established whether these are a short-term response to physical trauma, or the beginnings of dementia.
Cognitive problems, ranging from memory loss to delirium, have been found most commonly when elderly people have undergone heart surgery, but also following other operations.
It is not known if the procedures themselves, or the body's response to major trauma, spark changes in the brain.
The latest research, conducted at Imperial College London and due to be published in the journal Critical Care Medicine next month, shows that the brains of mice who underwent a surgical procedure showed the presence of protein "tangles" in the brain which are associated with Alzheimer's disease in humans.
Because normal mice do not develop Alzheimer's disease, the new two-year study, also being led by Imperial College, will examine genetically modified mice, in an attempt to see whether the tangles – clusters of protein that form in nerve cells – which are present after surgery go on to trigger the onset of dementia.
The study will also examine whether the use of certain drugs – such as statins, used to protect against heart disease – and the active ingredient of a herbal remedy called Celastrol, could reduce the risks for those undergoing surgery.
In the recent study on mice, Celastrol was seen to reduce inflammation in the brain.
Researchers said if either drug appeared to lower the risks of dementia in modified mice undergoing surgery, further trials would be required to see if this worked in humans, and also to see if it could protect the brains of the wider population, not just those undergoing operations.
Dr Daqing Ma, the lead investigator on the research said: "The data has shown for some time that some elderly people who undergo surgery, especially heart surgery, can develop cognitive dysfunction, which can mean memory loss, and a loss of focus but it isn't clear how much of that is short-term, and how much long-term.
"Some people go on develop dementia, which can damage lives and mean an early death, but we don't know if there is a link with the cognitive dysfunction suffered post-surgery."
Previous studies had examined the extent of dementia within groups who had experienced surgery.
But given that an increasing number of elderly people now undergo operations, it has so far proved impossible to demonstrate that the procedures themselves triggered the dementia.
Anecdotally, many doctors believe they have seen cases which might have been triggered by surgery, said Dr Ma.
He cited the example of former US President Ronald Reagan, who underwent several surgical operations in the course of his life, including emergency brain surgery in 1989, after falling from a horse, five years before he was diagnosed with Alzheimer's.
His wife Nancy has said she believes the incident hastened the onset of the disease. Mr Reagan also underwent emergency surgery following an assassination attempt in 1981, and several surgical procedures for cancer.
Doctor Suzanne Sorensen, head of research at the Alzheimer's Society, which is sponsoring the research along with the Bupa Foundation, said the study was important, because of the high numbers of elderly people who undergo one sort of surgery or another.
She said: "We know from what previous studies have shown that between 10 and 30 per cent of elderly people suffer some kind of cognitive problems after surgery, and the numbers are highest in the most elderly people.
"The problem is all the evidence is anecdotal, we know of people who went in for a hip operation, and went home with dementia, but we cannot prove the link."
Alzheimer's disease is the most common form of dementia and affects around 500,000 people in Britain.
This is expected to double by 2050 as the population ages and many have warned that the NHS will not be able to cope with the nursing needs of so many patients unless better medicines are developed.
2010/08/30
No Success of Alzheimer's Research field debated by a Major Clinical Journal Lancet
Please visit original publication at: Debating The Success Of Alzheimer's Research, medicalnewstoday.com (29 Aug 2010)
Excerpt: An editorial in the journal Lancet debates the problems of drug development for Alzheimer's disease.
The feature questions why so many trials are failing at the phase 3 clinical trial stage and asks whether the animal models used prior to this are the most effective way to test the drugs. It also suggests treatments should perhaps start to focus more on the changes in the brain that happen before symptoms like memory loss start to appear. However, it notes that these are difficult to replicate in animal models.
Alzheimer's Society comment:
'Scientific research is essential in the search for a cure and treatments for Alzheimer's disease and we must not be too disheartened that many drug trials fall at the final hurdle. The fact only one in five clinical trials across all diseases will be successful highlights the need for more investment so we can defeat dementia.'
'Every day scientists are learning more about the early stages of Alzheimer's disease and this is an important area for further study and development. '
Dr Susanne Sorensen
Head of Research
Source: Alzheimer's Society
Excerpt: An editorial in the journal Lancet debates the problems of drug development for Alzheimer's disease.
The feature questions why so many trials are failing at the phase 3 clinical trial stage and asks whether the animal models used prior to this are the most effective way to test the drugs. It also suggests treatments should perhaps start to focus more on the changes in the brain that happen before symptoms like memory loss start to appear. However, it notes that these are difficult to replicate in animal models.
Alzheimer's Society comment:
'Scientific research is essential in the search for a cure and treatments for Alzheimer's disease and we must not be too disheartened that many drug trials fall at the final hurdle. The fact only one in five clinical trials across all diseases will be successful highlights the need for more investment so we can defeat dementia.'
'Every day scientists are learning more about the early stages of Alzheimer's disease and this is an important area for further study and development. '
Dr Susanne Sorensen
Head of Research
Source: Alzheimer's Society
2010/08/29
Full Article: Looking for Alzheimer Answers in All the Wrong Places
As seen 2010-08-28 pm time at huffingtonpost.com.
Reprinted for scholar and public information only.
Alex Koudinov: Dear reader, please make a visit to the web site of original publication, so, this interesting article original web page gets proper recognition, thanks!
*****
The news about Alzheimer's is dismal. A new Eli Lilly drug to treat Alzheimer's has failed big-time. After investing hundreds of millions of dollars in the drug, Semagacestat, the company announced it made patients worse.
And the latest idea from an elite circle of Alzheimer's researchers is to torture us with diagnostic spinal taps and brain scans, so we can know ten years in advance if we are heading lickety split into Alzheimer's even though specialists admit they have no treatment to stop it and are even losing faith in their long-held theories of what causes it. "This is a time of major soul-searching in the field," lamented Duke University researcher, Dr. P. Murali Doraiswamy, in the New York Times.
As a person who carries the major gene, ApoE4 for Alzheimer's, I am intensely tuned into and disturbed by this public conversation. The gene triples my risk of ending up with Alzheimer's. Some 77 million other Americans also carry ApoE4 (25 percent of the population), but few know it, and doctors are reluctant to test and tell, supposedly because they don't want to scare us. I accidentally discovered my gene via a blood test for cholesterol factors several years ago, and I'm glad I did, because it energized me to search for answers other than those from Big Pharma and its philosophical collaborators.
I have discovered a large contingent of Alzheimer's researchers who are extremely positive about prevention and not counting on an elusive drug to stymie the growing Alzheimer's epidemic of aging baby boomers. Investigators Gregory Cole and Sally Frautschy at UCLA's Center for Alzheimer's Research and Gary W.Arendash, PhD, at the Florida Alzheimer's Research Center, for example, are all focusing on prevention. There is a plethora of upbeat dialogue in the scientific community that does not grab headlines because it's not about big money and a magic cure. It's primarily about what people can do to change their own trajectory toward Alzheimer's.
Contrast the recent disturbing headlines in the New York Times about Alzheimer's drugs and diagnosis with the June, 2010 issue of the Journal of Alzheimer's Disease. It is a special issue devoted to finding ways to prevent Alzheimer's. Editors in chief George Perry, University of Texas at San Antonio and Mark A. Smith, Case Western Reserve, (who predicted the failure of Lilly's drug and others like it,) and guest editor, Jack de la Torre at the Center for Alzheimer's Research, Banner Sun Health Research Institute in Arizona all endorse the science showing how this disease can be cut off at the pass earlier in life.
Dr. de la Torre boldly asserts that finding a cure for Alzheimer's is a delusionary quest unlikely to happen in a hundred years and most probably, never. He argues that even if you could replace dead neuronal networks, bringing a shrunken Alzheimer's brain back to life, the persona and intellect of the individual would be so altered as to create a different personality. "Alzheimer's is incurable, but it is preventable," he says. "We need to identify and lower Alzheimer's risk factors in people when they are still cognitively normal and long before irreversible symptoms appear."
While the search for a pharmaceutical cure plays front and center, quietly in the background countless neuroscientists worldwide have concluded that Alzheimer's, as well as memory decline and other age-related dementias are actually slow-developing chronic diseases, like heart disease and cancer, partly dependent on lifestyle and other treatable diseases.
De la Torre, for example, is convinced that Alzheimer's and dementia are particularly tied to cardiovascular factors, notably, constricted blood flow to brain cells, and that midlife screening to detect and correct such heart-related deficits would help prevent much brain degeneration during aging. The special journal issue produced by de la Torre, called "Basics of Alzheimer's Disease Prevention," also included new research on the relationship between Alzheimer's and diabetes, high blood pressure, triglycerides, cholesterol and cholesterol- lowering drugs, (statins), a Mediterranean diet, exercise, fish oil, B vitamins and antioxidants.
This special issue of JAD is but the latest example of a shifting paradigm toward prevention. Other leading medical journals are full of studies, often funded by your tax dollars, filtered through the National Institutes of Health, revealing the dangers of alcohol, smoking, toxic chemicals, head injuries, infections, certain forms of anesthesia, excess copper, low vitamin B, excess calories, obesity, diabetes, thyroid problems, sleep deprivation, and depression in raising your risk of dementia and Alzheimer's.
The wisdom of Alzheimer's prevention, derived from the famous Nun Study at the University of Minnesota, and the Religious Orders Study, at Rush University in Chicago, has been piling up for a decade or two, but is rarely put into practice. Comparing brains at autopsy with lifestyle and cognitive status allows investigators to proclaim the value of mental, social and physical stimulation in building a brain more resistant to Alzheimer's. Best time to start: when you are young, but even activity in old age can make a huge difference.
Prolific research from the U.S. Department of Agriculture, UCLA, Tufts University and Columbia University College of Physicians and Surgeons, as well as dozens of other institutions, reveals a reduced Alzheimer's risk from consuming berries, nuts, curry powder, fruits and vegetables, fatty fish, olive oil and the Mediterranean diet, and various supplements, including folic acid, alpha lipoic acid, Vitamin B12, multivitamins and vitamin D.
We are missing the boat when we allow a small fragment of the scientific conversation about Alzheimer's, centered on ineffective pharmaceuticals and frightening diagnostic methods, drown out the momentous message coming from another research perspective: that we can take action right now to delay the progression and onset of Alzheimer's which happens over decades. The good news is that we know now how to detect and lessen many midlife lifestyle problems that may otherwise lead to irreversible dementia. The approach is much the same, Dr. De la Torre points out, as we now use extensively to prevent heart disease, cancer, diabetes and other chronic diseases of aging.
Obviously, this doesn't mean we should stop searching for treatments for the underlying causes and symptoms of Alzheimer's and other dementias or spare funding to relieve those already suffering.
But it is urgent that we have a vigorous dialogue about how to rescue the multitudes now racing at breakneck speed toward Alzheimer's. Unless we intervene, Alzheimer's cases in the United States will nearly triple. A May Alzheimer's Association report, "Changing the Trajectory of Alzheimer's Disease," predicts that cases will jump from 5.1 million to 13.5 million by 2050 with costs during that period exceeding $20 trillion in today's dollars.
If we could delay the onset of Alzheimer's by only five years, according to the report, some 1.6 million Americans expected to get Alzheimer's by 2015 and nearly 6 million scheduled to get it by 2050 would remain free of it while Medicare savings would be $33 billion in 2020 and $283 billion by mid century.
The only way to make that happen is to start talking as loudly about preventing Alzheimer's -- and listening to the researchers who can tell us how to do that -- as we do about trying to cure it.
Jean Carper is the author of 100 Simple Things You Can Do to Prevent Alzheimer's and Age-Related Memory Loss (Little, Brown & Company, September 2010).
Reprinted for scholar and public information only.
Alex Koudinov: Dear reader, please make a visit to the web site of original publication, so, this interesting article original web page gets proper recognition, thanks!
*****
The news about Alzheimer's is dismal. A new Eli Lilly drug to treat Alzheimer's has failed big-time. After investing hundreds of millions of dollars in the drug, Semagacestat, the company announced it made patients worse.
And the latest idea from an elite circle of Alzheimer's researchers is to torture us with diagnostic spinal taps and brain scans, so we can know ten years in advance if we are heading lickety split into Alzheimer's even though specialists admit they have no treatment to stop it and are even losing faith in their long-held theories of what causes it. "This is a time of major soul-searching in the field," lamented Duke University researcher, Dr. P. Murali Doraiswamy, in the New York Times.
As a person who carries the major gene, ApoE4 for Alzheimer's, I am intensely tuned into and disturbed by this public conversation. The gene triples my risk of ending up with Alzheimer's. Some 77 million other Americans also carry ApoE4 (25 percent of the population), but few know it, and doctors are reluctant to test and tell, supposedly because they don't want to scare us. I accidentally discovered my gene via a blood test for cholesterol factors several years ago, and I'm glad I did, because it energized me to search for answers other than those from Big Pharma and its philosophical collaborators.
I have discovered a large contingent of Alzheimer's researchers who are extremely positive about prevention and not counting on an elusive drug to stymie the growing Alzheimer's epidemic of aging baby boomers. Investigators Gregory Cole and Sally Frautschy at UCLA's Center for Alzheimer's Research and Gary W.Arendash, PhD, at the Florida Alzheimer's Research Center, for example, are all focusing on prevention. There is a plethora of upbeat dialogue in the scientific community that does not grab headlines because it's not about big money and a magic cure. It's primarily about what people can do to change their own trajectory toward Alzheimer's.
Contrast the recent disturbing headlines in the New York Times about Alzheimer's drugs and diagnosis with the June, 2010 issue of the Journal of Alzheimer's Disease. It is a special issue devoted to finding ways to prevent Alzheimer's. Editors in chief George Perry, University of Texas at San Antonio and Mark A. Smith, Case Western Reserve, (who predicted the failure of Lilly's drug and others like it,) and guest editor, Jack de la Torre at the Center for Alzheimer's Research, Banner Sun Health Research Institute in Arizona all endorse the science showing how this disease can be cut off at the pass earlier in life.
Dr. de la Torre boldly asserts that finding a cure for Alzheimer's is a delusionary quest unlikely to happen in a hundred years and most probably, never. He argues that even if you could replace dead neuronal networks, bringing a shrunken Alzheimer's brain back to life, the persona and intellect of the individual would be so altered as to create a different personality. "Alzheimer's is incurable, but it is preventable," he says. "We need to identify and lower Alzheimer's risk factors in people when they are still cognitively normal and long before irreversible symptoms appear."
While the search for a pharmaceutical cure plays front and center, quietly in the background countless neuroscientists worldwide have concluded that Alzheimer's, as well as memory decline and other age-related dementias are actually slow-developing chronic diseases, like heart disease and cancer, partly dependent on lifestyle and other treatable diseases.
De la Torre, for example, is convinced that Alzheimer's and dementia are particularly tied to cardiovascular factors, notably, constricted blood flow to brain cells, and that midlife screening to detect and correct such heart-related deficits would help prevent much brain degeneration during aging. The special journal issue produced by de la Torre, called "Basics of Alzheimer's Disease Prevention," also included new research on the relationship between Alzheimer's and diabetes, high blood pressure, triglycerides, cholesterol and cholesterol- lowering drugs, (statins), a Mediterranean diet, exercise, fish oil, B vitamins and antioxidants.
This special issue of JAD is but the latest example of a shifting paradigm toward prevention. Other leading medical journals are full of studies, often funded by your tax dollars, filtered through the National Institutes of Health, revealing the dangers of alcohol, smoking, toxic chemicals, head injuries, infections, certain forms of anesthesia, excess copper, low vitamin B, excess calories, obesity, diabetes, thyroid problems, sleep deprivation, and depression in raising your risk of dementia and Alzheimer's.
The wisdom of Alzheimer's prevention, derived from the famous Nun Study at the University of Minnesota, and the Religious Orders Study, at Rush University in Chicago, has been piling up for a decade or two, but is rarely put into practice. Comparing brains at autopsy with lifestyle and cognitive status allows investigators to proclaim the value of mental, social and physical stimulation in building a brain more resistant to Alzheimer's. Best time to start: when you are young, but even activity in old age can make a huge difference.
Prolific research from the U.S. Department of Agriculture, UCLA, Tufts University and Columbia University College of Physicians and Surgeons, as well as dozens of other institutions, reveals a reduced Alzheimer's risk from consuming berries, nuts, curry powder, fruits and vegetables, fatty fish, olive oil and the Mediterranean diet, and various supplements, including folic acid, alpha lipoic acid, Vitamin B12, multivitamins and vitamin D.
We are missing the boat when we allow a small fragment of the scientific conversation about Alzheimer's, centered on ineffective pharmaceuticals and frightening diagnostic methods, drown out the momentous message coming from another research perspective: that we can take action right now to delay the progression and onset of Alzheimer's which happens over decades. The good news is that we know now how to detect and lessen many midlife lifestyle problems that may otherwise lead to irreversible dementia. The approach is much the same, Dr. De la Torre points out, as we now use extensively to prevent heart disease, cancer, diabetes and other chronic diseases of aging.
Obviously, this doesn't mean we should stop searching for treatments for the underlying causes and symptoms of Alzheimer's and other dementias or spare funding to relieve those already suffering.
But it is urgent that we have a vigorous dialogue about how to rescue the multitudes now racing at breakneck speed toward Alzheimer's. Unless we intervene, Alzheimer's cases in the United States will nearly triple. A May Alzheimer's Association report, "Changing the Trajectory of Alzheimer's Disease," predicts that cases will jump from 5.1 million to 13.5 million by 2050 with costs during that period exceeding $20 trillion in today's dollars.
If we could delay the onset of Alzheimer's by only five years, according to the report, some 1.6 million Americans expected to get Alzheimer's by 2015 and nearly 6 million scheduled to get it by 2050 would remain free of it while Medicare savings would be $33 billion in 2020 and $283 billion by mid century.
The only way to make that happen is to start talking as loudly about preventing Alzheimer's -- and listening to the researchers who can tell us how to do that -- as we do about trying to cure it.
Jean Carper is the author of 100 Simple Things You Can Do to Prevent Alzheimer's and Age-Related Memory Loss (Little, Brown & Company, September 2010).
2010/08/28
New book review: Renoved scientist calls for a change in Alzheimer's disese direction
Press release: A Call For Major Reform In The Direction Of Alzheimer's Treatment And Patient Care As The Boomer Generation Ages:
New Book review: The Alzheimer's solution: How today's care is failing millions - and how we can do better (Prometheus Books, $19)
Article Date: 28 Aug 2010 - 1:00 PDT
by Kenneth S. Kosik, MD (Santa Barbara, CA)
Although a new surge of scientific research has uncovered telltale signs of Alzheimer's disease that show up in brain scans and spinal taps, many questions remain unanswered about the clinical value of early testing and the overall direction of patient care, according to Dr. Kenneth S. Kosik, Harriman Professor of Neuroscience Research at the University of California and co-director of UCSB's Neuroscience Research Institute.
Kosik, also formerly a longtime neurologist at the Brigham and Women's Hospital memory clinic in Boston, cautioned that such "biomarker" tests for Alzheimer's do not address the most devastating issues presented by the disease. Indeed, he said, without substantial reforms in the treatment of Alzheimer's, the advent of early testing may only increase the anxiety of patients and their families.
"Suppose you test positive, then what?" Kosik said in a recent interview. "The test doesn't tell you when you might be likely to get the disease, for example. Patients and families will inevitably have many questions about what lies ahead. Unfortunately, the medical system is not set up to answer them."
In his new book, THE ALZHEIMER'S SOLUTION: HOW TODAY'S CARE IS FAILING MILLIONS - AND HOW WE CAN DO BETTER (Prometheus Books, $19) Kosik and co-author Ellen Clegg, a former journalist and science communication specialist at the Broad Institute of MIT and Harvard, provide a bold vision for reforming Alzheimer's disease treatment, and outline an array of simple preventive measures that patients can take to delay the onset of symptoms.
The average time from diagnosis to death in patients with Alzheimer's disease is ten years, Kosik said, a time when interest in the patient's welfare by the medical establishment wanes rapidly. Patients and their families are left in a desperate search for information about treatment, experimental leads and clinical trials, and basic support.
While recent news reports have highlighted stepped-up collaboration among scientists in government agencies, universities, and private industry to develop new Alzheimer's drugs, there is certainly no cure on the immediate horizon. Indeed, the drugs currently on the market are not effective as the disease takes its devastating course. "We have no satisfactory treatment for Alzheimer's disease," Kosik said. "If you have a problem for which neither surgery nor pills will work, then the medical system is really more of an obstacle than a help." He explained that people don't generally know this and they think that if they have a medical problem, they should seek help within the medical system. "It need not work that way," he said.
New ethical guidelines are needed to address how testing is handled and for end-of-life care, Kosik argues. The authors recommend clear discussion of medical wishes at the earliest possible stage among patients, families, and physicians. In his clinical work, Kosik found that many patients say they would rather not go on living than accept an illness that will rob their life of dignity.
The time to act is now, the authors write in THE ALZHEIMER'S SOLUTION. With the aging of nearly 80 million baby boomers, Alzheimer's disease is an impending epidemic. To meet this challenge, Kosik and Clegg propose that a network of one-stop centers should be established to provide expertise and reliable information on a range of topics, including diet, physical and cognitive exercise programs that may help reduce the risk for dementia, and palliative measures to reduce suffering. The centers they describe would take a family-oriented, personalized approach to care and prevention, creating an atmosphere conducive to adult learning, and facilitating personal growth in areas that patients have enjoyed over a lifetime, including the arts, dance, socializing, and a host of other possibilities.
Kosik recently launched a pilot clinic in Santa Barbara called The Center for Cognitive Fitness and Innovative Therapies (CFIT) to put these preventive measures into practice.
About the Co-Authors:
Kenneth S. Kosik, MD (Santa Barbara, CA), is the Harriman Chair in Neurosciences, co-director of the Neuroscience Research Institute, and professor in the Department of Molecular, Cellular and Developmental Biology at the University of California, Santa Barbara. Previously, Dr. Kosik was professor of neurology and neuroscience at Harvard Medical School. Ellen Clegg (Boston, MA) is Managing Editor for Communications Platforms at the Broad Institute of MIT and Harvard, a genetic research center in Cambridge, Massachusetts. Previously, she was Deputy Managing Editor/News Operations of the Boston Globe. Her prior positions at the Globe include Sunday editor and health and science editor. She is the author of "ChemoBrain: How Cancer Therapies Can Affect Your Mind".
Source:
Jill Maxick
Prometheus Books
as seen at medicalnewstoday 2010/08/28
New Book review: The Alzheimer's solution: How today's care is failing millions - and how we can do better (Prometheus Books, $19)
Article Date: 28 Aug 2010 - 1:00 PDT
by Kenneth S. Kosik, MD (Santa Barbara, CA)
Although a new surge of scientific research has uncovered telltale signs of Alzheimer's disease that show up in brain scans and spinal taps, many questions remain unanswered about the clinical value of early testing and the overall direction of patient care, according to Dr. Kenneth S. Kosik, Harriman Professor of Neuroscience Research at the University of California and co-director of UCSB's Neuroscience Research Institute.
Kosik, also formerly a longtime neurologist at the Brigham and Women's Hospital memory clinic in Boston, cautioned that such "biomarker" tests for Alzheimer's do not address the most devastating issues presented by the disease. Indeed, he said, without substantial reforms in the treatment of Alzheimer's, the advent of early testing may only increase the anxiety of patients and their families.
"Suppose you test positive, then what?" Kosik said in a recent interview. "The test doesn't tell you when you might be likely to get the disease, for example. Patients and families will inevitably have many questions about what lies ahead. Unfortunately, the medical system is not set up to answer them."
In his new book, THE ALZHEIMER'S SOLUTION: HOW TODAY'S CARE IS FAILING MILLIONS - AND HOW WE CAN DO BETTER (Prometheus Books, $19) Kosik and co-author Ellen Clegg, a former journalist and science communication specialist at the Broad Institute of MIT and Harvard, provide a bold vision for reforming Alzheimer's disease treatment, and outline an array of simple preventive measures that patients can take to delay the onset of symptoms.
The average time from diagnosis to death in patients with Alzheimer's disease is ten years, Kosik said, a time when interest in the patient's welfare by the medical establishment wanes rapidly. Patients and their families are left in a desperate search for information about treatment, experimental leads and clinical trials, and basic support.
While recent news reports have highlighted stepped-up collaboration among scientists in government agencies, universities, and private industry to develop new Alzheimer's drugs, there is certainly no cure on the immediate horizon. Indeed, the drugs currently on the market are not effective as the disease takes its devastating course. "We have no satisfactory treatment for Alzheimer's disease," Kosik said. "If you have a problem for which neither surgery nor pills will work, then the medical system is really more of an obstacle than a help." He explained that people don't generally know this and they think that if they have a medical problem, they should seek help within the medical system. "It need not work that way," he said.
New ethical guidelines are needed to address how testing is handled and for end-of-life care, Kosik argues. The authors recommend clear discussion of medical wishes at the earliest possible stage among patients, families, and physicians. In his clinical work, Kosik found that many patients say they would rather not go on living than accept an illness that will rob their life of dignity.
The time to act is now, the authors write in THE ALZHEIMER'S SOLUTION. With the aging of nearly 80 million baby boomers, Alzheimer's disease is an impending epidemic. To meet this challenge, Kosik and Clegg propose that a network of one-stop centers should be established to provide expertise and reliable information on a range of topics, including diet, physical and cognitive exercise programs that may help reduce the risk for dementia, and palliative measures to reduce suffering. The centers they describe would take a family-oriented, personalized approach to care and prevention, creating an atmosphere conducive to adult learning, and facilitating personal growth in areas that patients have enjoyed over a lifetime, including the arts, dance, socializing, and a host of other possibilities.
Kosik recently launched a pilot clinic in Santa Barbara called The Center for Cognitive Fitness and Innovative Therapies (CFIT) to put these preventive measures into practice.
About the Co-Authors:
Kenneth S. Kosik, MD (Santa Barbara, CA), is the Harriman Chair in Neurosciences, co-director of the Neuroscience Research Institute, and professor in the Department of Molecular, Cellular and Developmental Biology at the University of California, Santa Barbara. Previously, Dr. Kosik was professor of neurology and neuroscience at Harvard Medical School. Ellen Clegg (Boston, MA) is Managing Editor for Communications Platforms at the Broad Institute of MIT and Harvard, a genetic research center in Cambridge, Massachusetts. Previously, she was Deputy Managing Editor/News Operations of the Boston Globe. Her prior positions at the Globe include Sunday editor and health and science editor. She is the author of "ChemoBrain: How Cancer Therapies Can Affect Your Mind".
Source:
Jill Maxick
Prometheus Books
as seen at medicalnewstoday 2010/08/28
2010/08/24
Star Tribune: Aging boomers will strain families, State
Aging boomers will strain families, state
There will be fewer people to care for the aged, and tax-supported nursing home costs will bust budgets.
By WARREN WOLFE, Star Tribune Last update: August 21, 2010 - 11:08 PM
Excerpt:
Lynn and Steve Halverson saved taxpayers about $175 yesterday -- the cost of a nursing home room -- and they'll do it again today as they start their third year of caring for Lynn's 80-year-old mother in their Apple Valley home.
"It's what you do -- you take care of family," said Steve Halverson, who was laid off as a Schwan's manager the same month that an increasingly frail Joan Anderson moved to their house from Eau Claire, Wis.
"We get by, but some days it's not easy," he said. "It's about caring -- loving, I guess you'd say.''
Across Minnesota about 650,000 caregivers -- one in five adults -- are deeply involved with the joys and frustrations of helping aging relatives. Many help with chores, arrange doctor visits, shop for groceries or simply check in by phone every day. But for others, the care is far more intense and intimate -- feeding, bathing, dressing, monitoring chronic diseases and answering a million repeated questions.
The need for that sort of help -- whether from paid staff or families -- is about to explode. About 680,000 Minnesotans are 65 and older now. That number will soar to 950,000 in a decade, then to 1.3 million by 2030, when baby boomers start turning 85.
It's an amazing success story in longevity, but it's tempered by a worrying problem: There are far fewer young people behind them to provide care -- or finance it -- as this "silver tsunami" gains force. One measure, the age dependency ratio, shows that compared to people of working age, the proportion of seniors will almost double over the next 20 years -- from 21 per 100 workers to 39.
That will be offset slightly by a drop in the ratio of children to working-age people -- but caring for children is cheaper than caring for the frail aged.
...Continue reading at Star Tribune
There will be fewer people to care for the aged, and tax-supported nursing home costs will bust budgets.
By WARREN WOLFE, Star Tribune Last update: August 21, 2010 - 11:08 PM
Excerpt:
Lynn and Steve Halverson saved taxpayers about $175 yesterday -- the cost of a nursing home room -- and they'll do it again today as they start their third year of caring for Lynn's 80-year-old mother in their Apple Valley home.
"It's what you do -- you take care of family," said Steve Halverson, who was laid off as a Schwan's manager the same month that an increasingly frail Joan Anderson moved to their house from Eau Claire, Wis.
"We get by, but some days it's not easy," he said. "It's about caring -- loving, I guess you'd say.''
Across Minnesota about 650,000 caregivers -- one in five adults -- are deeply involved with the joys and frustrations of helping aging relatives. Many help with chores, arrange doctor visits, shop for groceries or simply check in by phone every day. But for others, the care is far more intense and intimate -- feeding, bathing, dressing, monitoring chronic diseases and answering a million repeated questions.
The need for that sort of help -- whether from paid staff or families -- is about to explode. About 680,000 Minnesotans are 65 and older now. That number will soar to 950,000 in a decade, then to 1.3 million by 2030, when baby boomers start turning 85.
It's an amazing success story in longevity, but it's tempered by a worrying problem: There are far fewer young people behind them to provide care -- or finance it -- as this "silver tsunami" gains force. One measure, the age dependency ratio, shows that compared to people of working age, the proportion of seniors will almost double over the next 20 years -- from 21 per 100 workers to 39.
That will be offset slightly by a drop in the ratio of children to working-age people -- but caring for children is cheaper than caring for the frail aged.
...Continue reading at Star Tribune
2010/08/22
A New Look At Alzheimer's, Forbes says. Well, long overdue, Dr.Koudinov adds!
Robert Langreth. A New Look At Alzheimer's (09.16.09, 06:00 PM EDT) Forbes Magazine Dated October 05, 2009
Have researchers been barking up the wrong tree?
Excerpt: "...Alzheimer's disease is a bit like a murder mystery with numerous possible culprits and only a few vague clues. For years the prime suspect has been a protein fragment called beta-amyloid, which forms clumps inside the brains of dementia patients. Big drug companies since the 1990s have bet heavily on the concept that amyloid poisons brain cells and that blocking it will halt a patient's devastating decline.
But even as their drugs move into final human trials, the evidence implicating amyloid is starting to look a little shaky. An amyloid-lowering drug from Myriad Genetics ( MYGN - news - people ) did nothing in a giant trial. Wyeth ( WYE - news - people ) and Elan ( ELN - news - people )'s amyloid-clearing antibody, called bapineuzumab, showed mixed results in a midstage human trial last year. It clearly helped only a subset of patients who lacked a certain gene mutation, and it had side effects such as fluid leakage in the brain.
Stranger yet, this summer researchers from the Mount Sinai School of Medicine in New York City examined an old allergy drug from Russia that recently showed promising results in Alzheimer's victims. They wanted to know whether it lowered amyloid. To their surprise, it boosted short-term amyloid levels in animal and lab experiments, according to results reported at a big Alzheimer's conference. Pfizer ( PFE - news - people ) licensed comarketing rights for the Russian antihistamine from the biotech company Medivation ( MDVN - news - people ) in 2008 for $225 million plus milestone payments, and the companies are conducting large trials. Results are due next year.
All of this has some scientists wondering if they are targeting the wrong chemical. "People inside and outside the amyloid field are trying to think what are we doing wrong. Either we are treating the wrong thing or using the wrong drug or treating it in the wrong way," says Mount Sinai's Samuel Gandy, who led the research into the Russian drug and still thinks amyloid is involved. Adds Merck ( MRK - news - people ) Vice President Richard Hargreaves: "There has been a sort of a narrow-minded approach to Alzheimer's disease. Amyloid deposition is only one of the features."
Some go much further. "I think amyloid is a complete nothing," says University of Aberdeen (Scotland) researcher Claude Wischik. "One day someone has to write a book about how a whole field can get suckered into this for so long." ...read on full article at forbes.com
Alex Koudinov-Sheffer note: Well... www.alclub.org is all about shoing the public, not just field insiders, ethically corrupted for one reason (stock shares) or another (grant support for amyloid theory or a need to support amyloid because of tenure promotion)))
Have researchers been barking up the wrong tree?
Excerpt: "...Alzheimer's disease is a bit like a murder mystery with numerous possible culprits and only a few vague clues. For years the prime suspect has been a protein fragment called beta-amyloid, which forms clumps inside the brains of dementia patients. Big drug companies since the 1990s have bet heavily on the concept that amyloid poisons brain cells and that blocking it will halt a patient's devastating decline.
But even as their drugs move into final human trials, the evidence implicating amyloid is starting to look a little shaky. An amyloid-lowering drug from Myriad Genetics ( MYGN - news - people ) did nothing in a giant trial. Wyeth ( WYE - news - people ) and Elan ( ELN - news - people )'s amyloid-clearing antibody, called bapineuzumab, showed mixed results in a midstage human trial last year. It clearly helped only a subset of patients who lacked a certain gene mutation, and it had side effects such as fluid leakage in the brain.
Stranger yet, this summer researchers from the Mount Sinai School of Medicine in New York City examined an old allergy drug from Russia that recently showed promising results in Alzheimer's victims. They wanted to know whether it lowered amyloid. To their surprise, it boosted short-term amyloid levels in animal and lab experiments, according to results reported at a big Alzheimer's conference. Pfizer ( PFE - news - people ) licensed comarketing rights for the Russian antihistamine from the biotech company Medivation ( MDVN - news - people ) in 2008 for $225 million plus milestone payments, and the companies are conducting large trials. Results are due next year.
All of this has some scientists wondering if they are targeting the wrong chemical. "People inside and outside the amyloid field are trying to think what are we doing wrong. Either we are treating the wrong thing or using the wrong drug or treating it in the wrong way," says Mount Sinai's Samuel Gandy, who led the research into the Russian drug and still thinks amyloid is involved. Adds Merck ( MRK - news - people ) Vice President Richard Hargreaves: "There has been a sort of a narrow-minded approach to Alzheimer's disease. Amyloid deposition is only one of the features."
Some go much further. "I think amyloid is a complete nothing," says University of Aberdeen (Scotland) researcher Claude Wischik. "One day someone has to write a book about how a whole field can get suckered into this for so long." ...read on full article at forbes.com
Alex Koudinov-Sheffer note: Well... www.alclub.org is all about shoing the public, not just field insiders, ethically corrupted for one reason (stock shares) or another (grant support for amyloid theory or a need to support amyloid because of tenure promotion)))
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