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Updated 25 October 2006 Important Notice: The
Alzheimer Research Forum does not provide medical advice nor promote any
product or service. The contents are for informational purposes only and are not intended to substitute for professional medical advice, diagnosis or treatment. Always seek advice from a qualified physician or health care professional about any medical concern, and do not disregard professional medical advice because of anything you may read on this web site. The views of individuals quoted on this site are not necessarily those of the Alzheimer Research Forum.
What is your current research that is being conducted for
Alzheimer's?
A major focus of research today is to find genes that contribute to a
person's risk of developing Alzheimer disease. Genes that cause rare,
inherited forms of AD were discovered about 15 years ago. These genes
(APP, PS1, PS2) have mutations that cause a person who has the
mutation to always develop AD, typically at an early age (30-40 years
old). These are "autosomal dominant" mutations. Soon after, the gene for ApoE was
found to very strongly influence the risk of AD. People who have the
ε4 allele of ApoE have around a sevenfold increase in the risk of
developing late-onset AD. Geneticists think there are additional genes
that have weaker effects, based on the observation that a person who
has a first-degree relative with AD has a doubling of risk for AD.
However, these genes have such small effects that they are very
difficult to find. One would need to study 5,000+ people who have a
relative with AD and compare them with 5,000 people who do not have a
relative with AD, to start to see the effects of these genes.
This is why the Massachusetts General Hospital's Lars Bertram
collaborated with Alzforum to develop the AlzGene database. This database lists every published genetic
association study to help researchers compare results across multiple
studies on the same genes. So far, Dr. Bertram has found around 10
genes that have small effects. One would want to verify whether these
genes do indeed increase the risk of AD in a large, independent study.
How is this research helping with finding a cure or a better
understanding of Alzheimer's?
Knowing the risk genes would indicate which biological mechanisms are
involved in the disease, and might point to possible treatments.
However, this is not easy. Researchers have known for 15 years that
APP, PS1, PS2, and ApoE are very important, but they still don't
understand exactly how these genes are involved. We have quite a lot
of debates on the Alzforum about that.
How is this research being funded?
Nearly all funding comes from the National Institutes of Health,
mostly via the National Institute on Aging, National Institute on
Neurological Disease and Stroke, and the National Institute of Mental
Health. Charities such as the Alzheimer's Association, and
foundations, also fund the research. Research on drugs is funded
through biotechs and pharmaceutical companies.
What are the future prospects for finding a cure?
Researchers today are hoping to develop treatments that will slow down
the disease, rather than "cure" it. Alzheimer's develops undetected
over many years, and if it were possible to know who is on their way
to getting AD, it might be possible to give them a drug or other
treatment that will slow the disease process down enough to keep that
person from ever having AD (because the disease mainly affects those
who are older). There is optimism that such treatments will be
developed. Many scientists believe that successful treatments will
involve cocktails of drugs and supplements that together will have
protective effects.
My grandfather is 83 years old
and I think he's showing signs of senile dementia. He
has a lot of memory loss, likes to talk about the past,
throws valuable objects away, doesn't go to the bathroom
and will urinate anywhere in the house, becomes aggressive
(trying to hit somebody) and is disoriented. Are these
symptoms of Alzheimer disease? What kind of therapy
is available or what can be done to maintain control
of a patient with this behavior? -- L.C.
Your grandfather certainly appears to have symptoms of dementia, but he needs a proper neurological examination to confirm a diagnosis and to rule out other medical conditions, such as depression, thryoid disorders or reactions to medicines can cause similar behavior. Also, if he has dementia, a neurologist can determine whether it is of the Alzheimer's disease type or some other type. It's important to find out, because this will affect the treatment course and outlook for disease progression. The best place for your grandfather to be evaluated is at an Alzheimer Disease research center. For information about the one nearest to him, please consult the Alzheimer's Disease Education and Referral Center. Their URL is: http://www.alzheimers.org/
What are the most commonly used treatments for Alzheimer disease?
The most common medication prescribed for Alzheimer's disease is
Aricept (donepezil), which is moderately effective in some people who
have early or mid-stage AD. Exelon and Reminyl are similar to Aricept
and may be prescribed as an alternative. More recently, Namenda
(memantine), a drug that has a different mode of action, has been
approved for patients with more advanced AD. In addition, there are probably many patients taking Vitamin E or selenium, both of which are antioxidants believed to combat the damaging effects of oxygen radicals, and women taking estrogen, which has been shown to reduce the RISK of getting AD among elderly women. Nonsteroidal anti-inflammatory drugs are also of interest, because they may reduce inflammation in brain tissue, which is theorized to contribute to brain degeneration in AD. Whether antioxidants, estrogen or NSAIDs are helpful to patients who already have developed AD is not yet known, but this question is being addressed now in clinical trials. There are currently no medications or other treatments that are known to cure or prevent Alzheimer disease.
Our Treatments section includes a comprehensive list of approved and investigational therapies, and also discusses nonpharmacologic approaches to managing AD.
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