International Conference on Alzheimer's Disease (ICAD) Highlights -- Drug Trials, Advances, New Risk Factors
Posted Jul 15 2009 6:56pm
This week, more than 3,000 leading scientists convened to report and discuss the latest advances in research on treatments, risk factors, diagnosis and causes for the health epidemic of the 21st century – Alzheimer's disease – at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD 2009) in Vienna, Austria.
“The cost of caring for people who have Alzheimer's, and those who will get it, will bankrupt the healthcare system and devastate Medicare and Medicaid,” said William Thies, PhD, Chief Medical and Scientific Officer at the Alzheimer's Association. “Fortunately, the field is progressing and we may soon see changes in the landscape of Alzheimer's diagnosis, care, treatment, and prevention. How fast we get there depends completely on investment in research. We must capitalize on the advances made in the last decade.”
Results from two large studies using DHA, an omega 3 fatty acid, were reported at ICAD 2009. DHA (docosahexaenoic acid) is the most abundant omega 3 fatty acid in the brain. An 18-month study in people with mild to moderate Alzheimer's by the Alzheimer's Disease Cooperative Study (ADCS) supported by the U.S. National Institute on Aging (NIA) showed no evidence for benefit in the studied population. The results do not support the routine use of DHA for people with Alzheimer's. A six month study was conducted by Martek Biosciences Corporation in healthy older people to see DHA's effect on “age related cognitive decline.” This trial showed a positive result on one test of memory and learning. The results need confirmation. Both studies used Martek's algal DHA.
These two studies – and other recent Alzheimer's therapy trials – raise the possibility that treatments must be given early in Alzheimer's process for them to be truly effective. For that to happen, we need to get much better at early detection and diagnosis of Alzheimer's.
Recent evidence suggests that the drug Dimebon may improve cognitive function in people with mild to moderate Alzheimer's, but how the drug produces these benefits remains unclear. In a surprising result from ICAD 2009, researchers found that treatment with Dimebon caused an increase in a brain protein, known as beta amyloid, in animal models of Alzheimer's. Beta amyloid is a protein that is the main constituent of plaques found in the brains of people with Alzheimer's. It is thought to be a key player in the development and progression of Alzheimer's. This result is highly unexpected as most Alzheimer's drugs are tested for how much they can lower beta amyloid levels.
The number of people with Alzheimer's and dementia – both new cases and total numbers with the disease – continues to rise among the very oldest segments of the population, according to research reported at the Alzheimer's Association International Conference. This age group is the fastest growing segment of the population in western countries. This is different from past research results. Previous studies have suggested that the number of people with Alzheimer's and dementia begins to level off and perhaps even go down a bit in people age 90 and above.
Two studies from ICAD 2009 looked at how post traumatic stress disorder (PTSD) and alcohol consumption may affect risk levels.
A study of more than 181,000 veterans aged 55 and older without dementia showed that there may be nearly two times higher Alzheimer's risk in veterans with post-traumatic stress disorder (PTSD) than those without it. Further research is needed to fully understand what links these two important disorders. With that knowledge we may be able to find ways to reduce the increased risk of dementia associated with PTSD. A second study suggests lower Alzheimer's risk among adults who consume moderate amounts of alcohol (1 or 2 drinks per day), versus those who do not drink or who are heavy drinkers. However, this does not appear to be true for those who already have mild cognitive impairment.
The good news is that we now know there's a lot you can do to help keep your brain healthier as you age. These steps might also reduce your risk of developing Alzheimer's disease or another dementia. Find out more by visiting the Alzheimer's Association at www.alz.org.
Scientists at ICAD 2009 reported that following the Dietary Approaches to Stop Hypertension diet – or DASH diet – was associated with higher scores for cognitive functioning. The researchers found that four food categories from the diet plan – whole grains, vegetables, low-fat dairy foods, and nuts and beans – may offer benefits for cognition in late life. We need more research before we can confidently say how much of these foods to include in your diet to experience some benefit.
One study found that maintaining or increasing physical activity throughout life may slow cognitive decline as we age. Older adults who were sedentary throughout the study had the lowest levels of cognitive function at the beginning and had the fastest rate of decline.
A second study in post-menopausal women found that moderate long-term physical activity may improve late life cognition; while long-term strenuous activity may actually increase risk of cognitive impairment.
Scientists at ICAD 2009 reported on how clinicians view and treat mild cognitive impairment (MCI), a research category used to define the state between normal aging and Alzheimer's, that is now being used widely in clinical practice. Millions of people can be classified as having MCI, and these numbers are expected to rise in coming years. Researchers found that neurologists regularly see and treat people with MCI, despite the fact that the medications they are prescribing are not FDA-approved for MCI. They also found that clinicians vary greatly in the education and support they provide or recommend for people with MCI, suggesting that there is a need for practice guidelines.
There are now more than 26 million people living with dementia around the world. The cost of caring for these people, and those who will get it in the next few years, have potential to bankrupt the world's healthcare systems. But, as these studies and many hundreds more reported at ICAD 2009 show, there is hope.
Several studies at ICAD 2009 investigated the most effective method of recruiting people for Alzheimer's clinical studies. Researchers in one study found that successful Alzheimer's trials promote volunteerism and study participation by conducting community educational events, and actively partnering with local physicians. Surprisingly, in this study, patient registries and Internet recruiting were found to be much less successful recruitment strategies.
In a study looking specifically at recruiting African Americans for Alzheimer's genetics studies, researchers found that having a relative with the disease, use of minority study personnel, and monetary compensation were the most powerful incentives for participation in research. The researchers found that large percentages of African Americans are willing participants for Alzheimer's genetic studies, if culturally sensitive techniques are used to recruit them.
Recruiting participants for clinical studies is the second greatest barrier to developing better treatments for Alzheimer's disease, behind inadequate funding. The Alzheimer's Association has initiated a Clinical Studies Initiative to begin to address this problem. Find out more at 1-800-272-3900 or www.alz.org.
About ICAD 2009 The 2009 Alzheimer's Association International Conference on Alzheimer's Disease (ICAD 2009) brings together more than 5,000 researchers from 60 countries to share groundbreaking research and information on the cause, diagnosis, treatment and prevention of Alzheimer's disease and related disorders. As a part of the Association's research program, ICAD 2009 serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community. ICAD 2009 will be held in Vienna, Austria at Messe Wien Exhibition and Congress Center from July 11–16.
About the Alzheimer's Association The Alzheimer's Association is the leading voluntary health organization in Alzheimer care, support and research. Our mission is to eliminate Alzheimer's disease through the advancement of research, to provide and enhance care and support for all affected, and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer's. For more information, visit www.alz.org.
Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for advice and insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 700 articles with more than 18,000 links on the Internet. Bob resides in Delray Beach, FL.