Still no cure for Alzheimer’s
Despite expectations that this would be the year in which the first disease modifying drug to treat Alzheimer’s would reach the market, that has not been the case. Just recently two widely anticipated drugs to treat Alzheimer’s failed clinical trials. That is according to the L.A. Times.
The leading theory on Alzheimer’s is that it is caused by the sticky protein, amyloid beta. This protein clumps together in the brain and form plaque that kills brain cells. With the failure of the latest drugs, it will be interesting to see if this theory continues to dominate research efforts.
At the same that efforts to find a cure are taking a setback, technology to detect Alzheimer’s is advancing rapidly. But there is no way to halt or reverse the disease. The five medicines currently available treat symptoms disease such as confusion and memory problems and not the disease. And their effect on the lives of Alzheimer’s victims is so minor that many find that the drugs are not worth the cost and side effects.
Despite these setbacks, some researchers remain hopeful that a cure will be found.
What’s the real deal about obesity and dementia?
Obesity increases your risk of coming down with any form of dementia by 40%, according to one report. It increases your risk of coming down with Alzheimer’s by 80%. There is also a risk with being underweight since being underweight increases your risk by 40% of coming down with any type of dementia.
Another report claims that obesity is not related to cognitive decline. This report claims that “lifestyle guidelines such as increasing cognitive activity, cardiorespiratory fitness, and dietary recommendations are more important than those that focus on weight loss alone.”
Obesity is defined as having a body mass index (BMI) of 30 or more. Being underweight is considered having a BMI of less than 18.5.
As with any research information, the results in these studies deal with percentages. For example, the data in one report shows that there is an overwhelming risk of coming down with Alzheimer’s if you are overweight. My mother, who was neither overweight, nor underweight, nevertheless came down with Alzheimer’s in her late 60s. The other report claims that keeping mentally active may delay mental decline. My mother was obsessed with crossword puzzles until Alzheimer’s made it impossible.
I obtained the info claiming there is a relationship between obesity and dementia from the June 9, 2008 Los Angeles Times Health section. That edition was devoted to weight loss and problems related to losing weight. That were other worthwhile articles in that edition including report on the status of research to develop a weight loss pill, new type of weight loss surgery, and several weight loss stories.
Alzheimer’s drug a bust
Excitement has soured over the new drug Flurizan designed to treat Alzheimer’s. Flurizan was the first drug to reach late stage testing that was designed to address amyloid buildup in the brain. Amyloid plaques in the brain is the leading theory used to explain Alzheimer’s so Flurizan’s failure may cast doubt on that theory as well as related theories.
Tests showed that Flurizan did not statistically improve thinking ability, and did not improve the ability of patients to participate in outside activities.
Existing drugs to treat Alzheimer’s treat symptons temporarily but do not stop the progression of the disease. Bad luck for those of us with loved ones suffering with Alzheimer’s.
Socializing may be the key to avoiding memory loss
In the NY Times today was an article on the new to be released study that shows that socializing may help to delay memory problems. The premise the researchers adopted is that socializing keeps us mentally engaged. Their study shows that individuals in their 50s and 60s who were most engaged displayed the fewest memory problems.
The socializing the report is referring to is not the kind where a relative or friends stops in to check on a loved one. The type of socializing necessary to make a difference is one in which individuals are fully integrated in a social network. It can be a network of friends, or family or involvement in community organizations, or a combination of any of these.
Although I’m an Obama admirer, one of the great things about the current political landscape is having the opportunity to observe the intellectual and physical vigor of both the mature Congressional figures and the mature presidential candidates. These leaders show that intellectual decline is not an inevitable part of aging.
That senior moment may be a good thing
Who among us haven’t had a senior moment? For that brief moment our mind freezes, and try as we might, we can’t remember the name of a person who at one time had been so important to us. A shiver runs through us and we can’t help but wonder if it is the beginning of the end, or even worse, a sign of early onset Alzheimer’s. For me, moments of forgetfulness often occurred during the middle of my lectures while I railed against one or another social injustice.
Far worse are those moments of stress when my mind freezes up. It is then I remember riding in the backseat of a car driven by a relative, my mother next to her. We’ve gotten the word that my mother’s granddaughter is dying for the third time, and we are on our way to the hospital to be with her and the family. The stress causes my mother’s short-term memory to desert her, and she talks about events that occurred in the distant past as if they are happening now. My niece survives only to die again and again until it becomes impossible to resuscitate her. My mother’s memory returns, only to desert her each time her granddaughter dies, until finally she could summon it no more.
I am cautiously optimistic. A the new report shows that moments of forgetfulness in older adults may signal a broad attention span. As people grow older their focus of attention widens which may make it difficult to latch onto one idea. Broad attention span may be an advantage in that older adults have more data that they can use to become better problem solvers.
Congressional hearings on problems affecting older Americans
This week was nursing home week. In connection with this event, the senate held a hearing on enforcement of federal quality of care standards for nursing homes. The hearing was broadcast by Cspan. Click here to watch the testimony if you missed it. You’ll find it under “Recent Programs.” As I wrote earlier, the Government Acccounability Office (GAO) found that nursing home inspectors are derelict in their duty of identifying and enforcing violations.
Also, the Senate Special Aging Cmte. held a hearing on breakthroughs and challenges in treating Alzheimer’s. If you didn’t get a chance to watch it, videotaped testimony by Fmr. Supreme Court Justice Sandra Day O’Connor about caring for a spouse with Alzheimer’s can be accessed on Cspan’s website. Along with her testimony is testimony from a patient, health care specialists and other caregivers. I read a wonderful article awhile back about O’Connor’s ability to value her Alzheimer’s husband great fortune to be able to find love a second time. Although they have been married since 1952, he no longer recognizes O’Connor and has fallen in love with a patient who lives at the same Alzheimer’s facility. It is a touching story. I believe I wrote something about it, but can’t remember if I posted it.
Adult day care can provide relief for caregivers
Caring for someone afflicted by Alzheimer’s can be overwhelming. To get relief some caregivers turn to adult day care. As the sole caregiver for my mother, that’s what I did. As my mother’s disease progressed, I found that she needed 24 hour care. It was overwhelming since her deterioration was accompanied for a long period by what I perceived to be unreasonable anger and constant demands to say nothing of the emotional pain she and I both experienced as the result of her gradual and profound loss. The changes were also accompanied by emotional abandonment as friends and loved ones slipped away.
Adult day care provided a way for her to connect with individuals that could offer her friendship. It provided her the opportunity to be the person that existed in her mind. In my mother’s case that person was someone who was young and alluring with childlike appeal. It provided me with a window of time that I could use to pursue my own dreams.
The care was free, offered by the local government. Along with the care came free transportation. Transportation was not always reliable – the drivers sometimes were late in picking up my mother, and on one or two occasions simply forgot about her. Still it was a tremendous help. This type of care is available in most communities. Although some places charge, there are others that are free. The best place to find out what’s available in your community is to check with your local government, with the local agency on aging, or with AARP.
Alzheimer’s effect on family relationships
As these remarks from the sethedaughter blog shows Alzheimer’s has a tremendous impact on family relations.
Judge not that ye be not judged
March 12, 2008
Alzheimer’s is a painful disease both for the caregiver and the victim. As my mother’s mind began to increasingly deteriorate from the effects of Alzheimer’s, there was a marked attempt on the part of some of my family to distance themselves from her. Visits tapered off until they were non existent. Phone calls became increasingly infrequent.
My mother was excruciatingly aware of what she was losing and she was terrified. During the stage of her disease when the loss seemed beyond her ability to bear, one of my siblings called to check on her. (This was before she ceased calling altogether). When I offered to let her speak to our mother, she found a reason to get off the phone. After our mother died, I made a conscious decision to forgive my sister, but it did not prevent me from continuing to judge her.
A few years before that a favorite niece died after a prolonged period of suffering. One day she went into the hospital vital and alert. The next day after surgery, she lost the ability to ever speak again, and was put into a nursing home with tubes down her throat. It was a dreary place filled with old people resigned to a fate of increasing irrelevance and eventual death. One visit was all I was able to manage. Her health deteriorated and for the last two years of her life, she was immobilized in a hospital bed in her mother’s living room. During that entire time, I never set foot in her mother’s house.
Research on Alzheimer’s not promising
Alzheimer’s was first recognized as a disease 101 year ago. As of now the government has spent more than $8 billion on Alzheimer research. Private industries have spent billions more. Even so, progress on this disease has been slow.
The drug industry’s heavy investment in Alzheimer’s research has to do with huge potential profits. With the aging of the large baby boomer population, and longer life expectancy, demand for products that offer a cure is expected to be enormous.
Things have not panned out the way the drug industry and other researchers expected. New drug candidates are failing trails, and old drugs are the subject of lawsuits as consumers charge the drug industry with caring more about profits and not enough about patient safety. To make matters worse for the drug companies, patents on old drugs are expiring.
Much of recent research has been directed at understanding the normal process by which brain cells break down. So far this has been the biggest obstacle. That is because there are many events involved in brain function, and breakdown can happen at any point in the process. Every point represents a possible point of intervention, but each intervention can cause a cascade of unintended changes. Although some researchers are optimistic that a cure will be found, others like Eric Karran, chief scientific officer at Eli Lilly are less optimistic.
What is exponential growth?
For any quantity that is growing exponentially, the larger the quantity, the faster the growth. A quantity is growing exponentially if it increases by the same percent in each year or other unit of time. Comparing it to the linear model will make it clearer.
Linear model: Let’s pretend that the number of people afflicted with Alzheimer’s is 10,000. If we assume that the number of afflicted increases by 500 each year, we’ll end up with the following:
After the 1st year, the number will be 10,000
After the 2nd year, the number will be 11,000
After the 3rd year, the number will be 11,500
Exponential model: We’ll use the same 10,000, but we will assume the number of afflicted will increase by 5 percent a year:
Since 5 percent of 10,000 is 500, we’ll still end up with 10,500 after the 1st year.
After the 2nd year, the increase will be 5 percent of 10,500, which is 525. That means we’ll end up with 11,025.
After the 3rd year, the increase will be 5 percent of 11,025 which is 551. That means we’ll end up with 11,576.
If we continue with this example, we’ll see the following:
Linear v. Exponential growth rate
30 years 20,000 40,000
40 years 30,000 80,000
The true number of individuals afflicted with Alzheimer’s is 5 million. Because growth is faster with larger quantities, and the number of afflicted is expected to grow exponentially, it is estimated that by 2010 Alzheimer’s related care will cost Medicare about $160 billion per year and by by 2050 the cost to Medicare will be $1 trillion dollars per year.
