Alzheimer’s Research Update 2019
Alzheimer’s disease (AD), named for neuropathologist Aloysius Alzheimer, who first identified the disorder in 1901, is the most common form of dementia, currently affecting 5.8 million Americans, a number projected to reach 14 million by 2050.
The “markers” for AD — sticky plaques that accumulate in the brain from abnormally folded proteins, causing inflammation and cellular damage — can only be positively identified on autopsy. Thus, doctors generally make an Alzheimer’s diagnosis by testing for and eliminating other possibilities.
10 Early Warning Signs of Alzheimer’s Disease
- Memory loss. While all of us forget information from time to time or misplace keys or eyeglasses, someone in the early stages of Alzheimer’s may forget new information, lose track of important dates, names, and events, or rely heavily on posted reminders for everyday information.
- Visual changes. It becomes harder to read words on a page, judge distances, and tell colors apart. These changes can make driving more dangerous for someone in the early stages of Alzheimer’s.
- Conversational misfires. Struggling to find the right word, calling objects by the wrong name, repeating a story in the same conversation, or suddenly pausing in the middle of a conversation because they don’t know what to say.
- Difficulty handling money and paying bills. Mismanaging money can be a sign of Alzheimer’s disease. If calculating a tip or balancing the checkbook start to become challenging, make sure the problem is not visual impairment unrelated to cognitive decline.
- Confusing time and place. Disorientation, wandering or becoming easily lost.
- Loss of initiative. It becomes harder to make decisions or to act spontaneously.
- Poor judgment. Giving money to telemarketers or phone scammers, forgetting to shower, or dressing inappropriately for the weather.
- Trouble planning and problem-solving. Following an old recipe is suddenly difficult, or the senior forgets the rules of a favorite game.
- Social withdrawal. Instead of meeting a friend for lunch, someone with early Alzheimer’s wants to stay in and watch TV.
- Personality changes. A mild-mannered mother acting out
or showing signs of paranoia.
What Are the 7 Stages of Alzheimer’s?
Dr. Barry Reisberg, a geriatric psychiatrist with New York University’s Langone Health, a premier academic medical center, breaks the progression of Alzheimer’s disease into seven distinct stages. The Alzheimer’s Association has adopted Dr. Reisberg’s framework, which is currently the standard used by most dementia healthcare providers.
Stage 1: No Impairment
At this stage, Alzheimer’s is undetectable.
Stage 2: Very Mild Decline
The senior may notice minor memory problems, indistinguishable from normal age-related memory loss. Neither physicians nor loved ones are likely to suspect Alzheimer’s yet.
Stage 3: Mild Decline
At this stage, family members begin to notice the senior’s cognitive problems, such as finding the right word in a conversation, difficulties in organizing and planning, and losing personal possessions.
Stage 4: Moderate Decline
In stage four, symptoms of Alzheimer’s are readily apparent. These include poor short-term memory, inability to manage finances, and forgetting details about their own life history.
Stage 5: Moderately Severe Decline
During the fifth stage of Alzheimer’s, people begin to need help with many activities of daily living. They may be significantly confused, unable to recall basic details such as their phone number, yet are still able to identify family members and handle their own hygiene.
Stage 6: Severe Decline
People in stage six require constant supervision, which frequently means professional care. Symptoms include confusion or lack of awareness of their environment, inability to recognize anyone except immediate family and close friends, personality changes, and potential behavior problems.
Stage 7: Very Severe Decline
Stage seven is the final stage of Alzheimer’s. Because the disease is terminal, people in stage seven are nearing death. They have lost the ability to communicate or respond to their environment, and need assistance with all activities of daily living.
How the Alzheimer’s Association Helps
Founded in 1980 by a group of family caregivers, the Alzheimer’s Association began with the goal of taking a disease that was shrouded in silence and creating a global conversation. Today, Alz.org is the leading voluntary health organization in Alzheimer’s care, support, and research.
The Association funds research aimed at accelerating the global process of new treatments, prevention, and ultimately a cure. In 2018, the Alzheimer’s Association made its largest-ever research investment, with grants of over $30 million to 131 scientific investigations.
Committed to leading through innovation, the Alzheimer’s Association seeks partnerships throughout the scientific community, bringing together government, industry, and academia to increase funding and accelerate discovery. These include:
- Worldwide Alzheimer’s Disease Neuroimaging Initiative
- Amyloid Imaging Task Force
- Biomarker Consortium
- Global Alzheimer’s Association Interactive Network
- International Alzheimer’s Disease Research Portfolio
- Alzheimer’s Association Business Consortia
The Future of Alzheimer’s: Research and Breakthroughs
The Alzheimer’s Association supports clinical trials designed to test new interventions or drugs to prevent, detect or treat Alzheimer’s disease. Their TrialMatch program helps connect candidates with appropriate research opportunities.
Although some Alzheimer’s treatments have failed in recent clinical trials, the research frontier promises earlier detection — and possible prevention.
It turns out that oral hygiene and sleep each play a major role in whether someone will develop Alzheimer’s disease, and an ophthalmologist (eye doctor) may be the first person to detect the disease in its very early stages.
1. Gum Disease and Your Brain
Mothers and dentists have long exhorted children to brush and floss thoroughly, but rarely has anyone added, “Good dental health will keep your brain healthy as you grow old.”
New research findings show how “bacteria involved in gum disease travel throughout the body, exuding toxins connected with Alzheimer’s disease, rheumatoid arthritis and aspiration pneumonia.” The same bacterium that causes the most serious form of gum disease has been found in the brain tissue of Alzheimer’s patients, offering the strongest evidence yet that lifelong oral hygiene is key to good mental health as we age.
An experimental drug that blocks the main oral toxins, known as gingipains, is currently in Phase 1 clinical trials for Alzheimer’s disease. Researchers are working on other compounds that block enzymes important to the gum bacteria in hopes of interrupting their role in advancing Alzheimer’s and other diseases.
2. The Importance of A Good Night’s Sleep
Like dental health, a good night’s sleep is the watchword of parents everywhere. As adults, we make our own sleep schedule, and the majority of people today are chronically sleep deprived, in no small measure due to the digital revolution that precludes natural downtime, not to mention replacing natural light with digital blue light, which makes it harder to fall asleep.
Because today’s seniors are digitally adept, these behaviors apply to retirees who may be well into their 60s, 70s, 80s and beyond. How does poor sleep affect the brain?
People with Alzheimer’s disease have a buildup of the two key proteins that distinguish this disorder: amyloid beta and tau tangles in the brain. Previous studies in healthy animals and humans have reported higher levels of amyloid beta after just one night of sleep deprivation.
While quality sleep seems to be able to help the body clear excess proteins, “the question remains whether sleep disruption aggravates [Alzheimer’s disease] symptoms and augments disease progression, or if sleep disruption actually initiates the cascade of [Alzheimer’s disease] development,” say researchers.
3. The Eyes Have It
Diagnosing and starting treatment for Alzheimer’s disease before symptoms appear is key to managing the disease. In a new study using eye fluid from 80 patients who were previously scheduled for eye surgery, researchers found that low levels of amyloid beta and tau proteins in eye fluid were significantly associated with low cognitive scores.
“This is a major step in discovering the eye’s potential role in diagnosing preclinical Alzheimer’s disease,” said study ophthalmologists.
In a separate but related study, researchers found that reduced blood capillaries in the back of the eye may be a new, noninvasive way to diagnose early cognitive impairment, the precursor to Alzheimer’s disease.
4. Brain Scans Impact Alzheimer’s Diagnosis and Treatment
Along with ophthalmological detection of early changes in the brain, a form of brain imaging known as positron emission tomography (PET) scans can also identify amyloid plaques very early on. In a first of its kind national study of more than 11,000 Medicare beneficiaries, researchers reviewed PET scans, and the results changed medical management in nearly two-thirds of the cases.
“Amyloid PET imaging can be a powerful tool to improve the accuracy of Alzheimer’s diagnosis and lead to better medical management, especially in difficult-to-diagnose cases,” said Maria C. Carrillo, Ph.D., Alzheimer’s Association chief science officer and a co-author of the study. “It is important that amyloid PET imaging be more broadly accessible to those who need it.”
At The Kensington Falls Church, we partner with you in providing full-spectrum memory care for your loved one. We invite you to visit us and see The Kensington difference, and how we fulfill our promise to love and care for your family as we do our own.