Improved Diagnosis for Alzheimer's on the Horizon

< Mar. 21, 2007 > -- In light of a new report that shows a long-predicted increase in the number of Americans with Alzheimer's disease, researchers are reporting what could be a real advance in research into the condition.

Any breakthrough in diagnosis and treatment is important, experts say, especially since a new report released this week finds that more Americans than ever are now suffering from Alzheimer's.

According to new data released this week by the Alzheimer's Association, about 5 million Americans now have the disease, up 10 percent from five years ago and more than double the number in 1980.

One in every eight people over the age of 65 has Alzheimer's disease, including half of those over 85. Between 2000-2004, Alzheimer's-related deaths rose 33 percent.

Scientists now project that some 7.7 million older Americans will have the brain-robbing illness by 2030, the association said. By 2050, unless new ways are found to prevent or treat the disease, the total could climb to 16 million.

Younger people are also affected: According to the report, between 200,000 and 500,000 Americans under the age of 65 now suffer from early-onset Alzheimer's or some other form of dementia.

Alzheimer's Diagnosis Difficult to Obtain

Scientists have used positron emission tomography (PET) scans to distinguish living, healthy brains from the brains of patients with Alzheimer's disease.

Diagnosis of Alzheimer's is a notoriously tricky affair and is never 100 percent definite until an autopsy is performed.

"It's done with great difficulty," says Alan Carpenter, vice president of business development at Avid Radiopharmaceuticals in Philadelphia, which licensed the compound used in the brain scan study. "Autopsy is the only definitive means."

Many experts believe that Alzheimer's is caused by a build-up of amyloid plaque proteins in the brain. But, again, the protein can only be detected through an autopsy.

New Brain Scan May Aid Diagnosis

The new brain scans relied on a compound called AV-1, which binds to the beta-amyloid proteins that build up in the brain and are the hallmark of the disease.

Last week, scientists confirmed that an imaging agent known as Pittsburgh Compound B binds to beta-amyloid accumulations in the brain.

AV-1 was developed by a researcher at the University of Pennsylvania and is licensed exclusively by Avid. The current study was a joint effort between Austin Health, the University of Melbourne (Australia), Neuroscience Victoria (Australia), Avid, the University of Pennsylvania, and Bayer Schering Pharma.

The study involved five individuals with mild Alzheimer's disease and six healthy controls, all of whom underwent PET imaging over 3 hours after injection with AV-1.

The PET imaging clearly distinguished patients with Alzheimer's from healthy individuals.

"This is basically the proof-of-concept stage," Carpenter says. "We will now need to go into phase 2 and phase 3 trials before submission of data to the FDA [US Food and Drug Administration]."

"People with Alzheimer's had a significant 'signal' in the brain in areas known from autopsy where amyloid tends to deposit," confirms Carpenter.

The results were presented earlier this week at the 8th International Conference on Alzheimer's Disease in Salzburg, Austria.

The results hold out the hope that doctors will one day be able to better diagnose the disease. Researchers might also use the technology to judge the effectiveness of drugs that target the amyloid beta protein.

More Work Needs to be Done

But there is still a ways to go, one expert says.

"This is another brick in the yellow brick road, but it's not the end," says Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City. "We should be excited that this is moving technology along, but it's not ready for clinical application. Still, the more studies like this we have, the closer we get to it being useful to patients."

According to Dr. Kennedy, compounds currently being tested, including this one, need to be much more specific and more sensitive before they can be considered reliable.

In addition, doctors need ways to predict who will develop the disease, not just distinguishing who currently has it versus who does not, he adds.

Always consult your physician for more information.

More About Alzheimer's

Alzheimer's disease is a progressive, neurodegenerative disease that occurs when nerve cells in the brain die. It often results in the following:

• impaired memory, thinking, and behavior

• confusion

• restlessness

• personality and behavior changes

• impaired judgment

• impaired communication

• inability to follow directions

• language deterioration

• impaired thought processes that involve visual and spatial awareness

• emotional apathy

With Alzheimer's disease, motor function is often preserved.

When Alzheimer's was first identified by German physician, Alois Alzheimer, in 1906, it was considered a rare disorder.

Today, with one in eight persons over age 65 (and nearly half of persons over age 85) affected, Alzheimer's disease is recognized as the most common cause of dementia (a disorder in which mental functions deteriorate and breakdown). It is estimated that over 5 million Americans have Alzheimer's disease.

The rehabilitation program for persons with Alzheimer's differs depending upon the symptoms, expression, and progression of the disease, and the fact that making a diagnosis of Alzheimer's is so difficult. These variables determine the amount and type of assistance needed for the Alzheimer's individual and family.

With Alzheimer's rehabilitation, it is important to remember that, although any skills lost will not be regained, the caregiving team must keep in mind the following considerations:

• In managing the disease, physical exercise and social activity are important, as are proper nutrition and health maintenance.

• Plan daily activities that help to provide structure, meaning, and accomplishment for the individual.

• As functions are lost, adapt activities and routines to allow the individual to participate as much as possible.

• Keep activities familiar and satisfying.

• Allow the individual to complete as many things by himself/herself as possible. The caregiver may need to initiate an activity, but allow the individual to complete it as much as he/she can.

• Provide "cues" for desired behavior (i.e., label drawers/cabinets/closets according to their contents).

• Keep the individual out of harm's way by removing all safety risks (i.e., car keys, matches).

• As a caregiver (full-time or part-time), it is important to understand your own physical and emotional limitations.

Always consult your physician for more information.