Archive for April, 2010

Blanchette Rockefeller Neurosciences Institute

Today there are no reliable tests to determine conclusively if a person has Alzheimer’s disease (AD). However, there are several breakthrough tests on the horizon that have us hopeful that soon we may have an accurate test to diagnose Alzheimer’s disease. That’s a good thing. On an emotional level, though, sometimes I wonder if I really want to know. I prefer to not know and simply do all that I can to prevent it. (Click here for examples). There are several institutions and companies working on breakthrough tests and in this post I will cover what’s happening at the Blanchette Rockefeller Neurosciences Institute (BRNI) at West Virginia University and Inverness Medical Innovations.

At the Blanchette Rockefeller Neurosciences Institute (BRNI), the only non-profit independent institution in the world dedicated to the study of human memory and memory disorders, they located a biomarker that can be tested witout the invasive procedures previously required.  A biomarker is an objective, biological measure that is used to assess health or make a diagnosis of disease. The BRNI biomarker had a 98 percent level of accuracy in detecting AD. With the prick of a finger, it detects defective enzymes involved with memory function that are found in both brain and skin cells.

What is really exciting is that researchers discovered that low doses of the chemotherapy drug, bryostatin, reactivates the defective enzymes. It can actually rewire broken connections in the brain and restore memory! This means that it could be used to reverse the brain diseases. Clinical trials in people will start this year.

Center for Molecular and Behavioral Neuroscience

The Center for Neuroscience at Rutgers University – Newark publishes a wonderful newsletter, Memory Loss and the Brain. In the Winter 2010 issue, one of the articles is on Parkinson’s disease. Although Parkinson’s is known as a movement disorder which affects how they walk  — slowly with a stiff gait — as well as possibly producing tremors, it also affects memory, learning, and behavior. Alzheimer’s disease and Parkinson’s disease have similarities such as:

  • Both develop slowly over many years
  • Both tend to develop later in life
  • Both are currently incurable
  • Both affect the brain

As a neurological disorder, Parkinson’s disease affects the part of the brain that controls muscle movement. The neurons that make dopamine, a chemical that helps your body coordinate movements, die. As a neurotransmitter, dopamine is essential for the central nervous system to function. Medications are prescribed that increase the amount and effectiveness of dopamine in the brain. However, medications can cause serious cognitive side effects and even possibly addictions such as gambling and overeating.

Unlike Parkinson’s, the cause of Alzheimer’s disease is not as specific. It may be a composite of causes. Medications are available as mentioned in a previous post, but they only work temporarily to slow down the disease and they don’t address the underlying causes. It is difficult to develop effective treatments when the exact cause is not known.

In both cases, lifestyle choice might make a difference. There is growing evidence that aerobic exercise improves memory and various other brain functions … even modest exercise. Click here to see an amazing video of a Parkinson’s patient riding the bicycle. Besides exercise, a healthy diet — one low in “lousy” cholesterol (LDL) and high in fruits, vegetables, and fatty fish — can help possibly prevent dementia. Mental activities that you enjoy and challenge you is possibly another preventive.

We all hope that cures for Alzheimer’s disease and Parkinson’s disease will be found. In the meantime, we can only do what the evidence tells us might possibly help.

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I recently had a chance to have lunch with a couple who had just had a month of caregiver duties for her mom to give her sister (primary caregiver) some time off. Steve put his engineering background to work and devised an ingenious contraption which I asked him to share. He wrote this delightful piece which shows caregiver creativity in caring for his mother-in-law with Alzheimer’s disease.

The more we talk to fellow Alzheimer’s family caregivers, the more we hear about sleep challenges.  Successfully managing those challenges has, of course, two-fold benefits — if your patient sleeps well, they do better during the day, and so do you.

We live those challenges when we take care of my mother-in-law, normally for only a month at a time.  Admittedly, that’s not a major load.  BUT you have to understand how important sleep is to my wife.  Nighttime interruptions are the snails on the cabbage of slumbering bliss.

For Mom’s recent visits, her first week or two of nights were disorienting, compounded by an inability to tell the time (either digital or hands on a clock).  And since nearly all activities such as reading and TV watching are not favored, the only activity she believed she could engage in was eating.  So, after an unsupervised 2:00 a.m. gustatory session with half a pound of corned beef (which gives cream-colored carpet lovely splotchy foot-applied tattoos), it was time to take preemptive action instead of spending an hour every morning spot cleaning.

My solution was to catch her in the act and rely on her fortunate good nature to be convinced it was not time to rise and shine and dine.  It was a bit like trying to defeat squirrels at a bird feeder … if at first I didn’t succeed, I wasn’t worth my salt as an engineer.  The solution evolved to clamping a $35 outside motion detector to the top of the vacuum cleaner, positioning it outside Mom’s bedroom door, and plugging the bell alarm within my earshot (but out of my wife’s dream-addled earshot).  When the motion alarm goes off, downstairs I shoot and one glance at me sends her back to bed without much argument.  Eventually, she learned that when the lights are not on, an undeniably under-dressed man will not appear and she would do better to go back to sleep.

For the last two weeks of her visits, we are all lucky enough to sleep soundly.  But then, didn’t somebody once say, “Luck is the residue of good planning”?

When one is diagnosed with Alzheimer’s disease, the medical care provider may prescribe medication. Unfortunately, there is not yet a cure. The treatment medication may slow down the disease, but like other prescription medications, there are always potential side effects. It may work for a few years or it may work for just a few months. There are only four treatment medications currently being used for Alzheimer’s disease that are approved by the U.S. Food and Drug Administration .

From the Fischer Center for Alzheimer’s Research Foundation, the four treatment medications are:

Brand Name Generic Name When Approved More Information
Namenda® memantine 2003 Fact sheet
Razadyne, Reminyl® galantamine 2001 Fact sheet
Exelon® rivastigmine 2000 Fact sheet
Aricept® donepezil 1996 Fact sheet
*Cognex® tacrine 1993 Fact sheet

* Cognex is rarely prescribed due to serious side effects, including possible liver damage.

Excelon and Aricept are used for the early stages of Alzheimer’s disease, whereas Namenda and Razadyne/Reminyl are prescribed for moderate to severe Alzheimer’s disease. In each case, the treatment medications it will not halt the disease in the long term.