Icipating In Alzheimer’s Disease Clinical Trials
Everybody those with Alzheimers disease or MCI as well as healthy volunteers with or without a family history of Alzheimers may be able to take part in clinical trials and studies. Participants in Alzheimers clinical research help scientists learn how the brain changes in healthy aging and in Alzheimers. Currently, at least 270,000 volunteers are needed to participate in more than 250 active clinical trials and studies that are testing ways to understand, diagnose, treat, and prevent Alzheimers disease.
Volunteering for a clinical trial is one way to help in the fight against Alzheimers. Studies need participants of different ages, sexes, races, and ethnicities to ensure that results are meaningful for many people. To learn more about clinical trials, watch this video from NIH’s National Library of Medicine.
NIA leads the federal governments research efforts on Alzheimers. NIA-supported Alzheimers Disease Research Centers throughout the U.S. conduct a wide range of research, including studies of the causes, diagnosis, and management of the disease. NIA also sponsors the Alzheimers Clinical Trials Consortium, which is designed to accelerate and expand studies and therapies in Alzheimers and related dementias.
To learn more about Alzheimers clinical trials and studies:
- Talk to your health care provider about local studies that may be right for you.
Watch videos of participants in Alzheimers disease clinical trials talking about their experiences.
Causes Of Alzheimers Disease
Researchers are rapidly learning more about the chemical changes that damage brain cells in Alzheimers disease. Apart from the few with familial Alzheimers disease, it is not known why some people develop Alzheimers disease and others do not. It is likely that a number of factors contribute to development of the disease, including environmental, genetic and health factors.Alzheimers disease is characterised by specific changes in the brain that include the formation of amyloid plaques and neurofibrillary tangles . An abnormal build-up of a protein called beta-amyloid causes amyloid plaques to form outside the brain cells. Inside the brain cells, another protein called tau builds up and causes neurofibrillary tangles.These protein accumulations disrupt messages within the brain because they damage connections between brain cells. The brain cells eventually die and brain volume shrinks. These brain changes occur gradually and actually begin many years before the symptoms of Alzheimers disease occur. The brain is able to compensate for the early damage, but eventually the damage becomes too great and brain function is affected.
Genetic Testing For Alzheimer’s Disease
A blood test can identify which APOE alleles a person has, but results cannot predict who will or will not develop Alzheimer’s disease. Currently, APOE testing is used primarily in research settings to identify study participants who may have an increased risk of developing Alzheimer’s. This knowledge helps scientists look for early brain changes in participants and compare the effectiveness of possible treatments for people with different APOE profiles.
Genetic testing is also used by physicians to help diagnose early-onset Alzheimers disease and to test people with a strong family history of Alzheimers or a related brain disease.
Genetic testing for APOE or other genetic variants cannot determine an individuals likelihood of developing Alzheimers diseasejust which risk factor genes a person has. It is unlikely that genetic testing will ever be able to predict the disease with 100 percent accuracy, researchers believe, because too many other factors may influence its development and progression.
Some people learn their APOE status through consumer genetic testing or think about getting this kind of test. They may wish to consult a doctor or genetic counselor to better understand this type of test and their test results. General information about genetic testing can be found at:
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Do Genes Cause Diseases
Genetic mutations can cause diseases. If a person inherits a genetic mutation that causes a certain disease, then he or she will usually get the disease. Sickle cell anemia, cystic fibrosis, and some cases of early-onset Alzheimer’s disease are examples of inherited genetic disorders.
Other changes or differences in genes, called genetic variants, may increase or decrease a person’s risk of developing a particular disease. When a genetic variant increases disease risk but does not directly cause a disease, it is called a genetic risk factor.
Identifying genetic variants may help researchers find the most effective ways to treat or prevent diseases such as Alzheimer’s in an individual. This approach, called precision medicine, takes into account individual variability in genes, environment, and lifestyle for each person.
The expression of geneswhen they are switched on or offcan be affected, positively and negatively, by environmental and lifestyle factors, such as exercise, diet, chemicals, or smoking. The field of epigenetics is studying how such factors can alter a cell’s DNA in ways that affect gene activity.
Dementia Is The Umbrella Term For A Number Of Neurological Conditions Of Which The Major Symptom Includes A Global Decline In Brain Function
It is a condition that has been noted in people for hundreds of years.
Dementia was a relatively rare occurrence before the 20th century as fewer people lived to old age in pre-industrial society. It was not until the mid 1970s that dementia begun to be described as we know it today.
We now know dementia is a disease symptom, and not a normal part of ageing.
There are over 100 diseases that may cause dementia. The most common causes of dementia include Alzheimers disease, vascular dementia and dementia with Lewy bodies.
Although the risk of getting dementia increase as we age, people in their 40s and 50s can also have dementia. The term younger onset dementia is used to describe any form of dementia diagnosed in people under the age of 65. To find out more go to the younger onset dementia hub.
Visit the pages below to learn more about the causes of dementia:
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The Effects Of Alzheimers On The Brain
Damage to the brain begins years before symptoms appear. Abnormal protein deposits form plaques and tangles in the brain of someone with Alzheimers disease. Connections between cells are lost, and they begin to die. In advanced cases, the brain shows significant shrinkage.
Its impossible to diagnose Alzheimers with complete accuracy while a person is alive. The diagnosis can only be confirmed when the brain is examined under a microscope during an autopsy. However, specialists are able to make the correct diagnosis up to
- behavioral changes
- difficulty speaking, swallowing, or walking in advanced stages of the disease
Some types of dementia will share some of these symptoms, but they include or exclude other symptoms that can help make a differential diagnosis. Lewy body dementia , for example, has many of the same later symptoms as Alzheimers. However, people with LBD but are more likely to experience initial symptoms such as visual hallucinations, difficulties with balance, and sleep disturbances.
People with dementia due to Parkinsons or Huntingtons disease are more likely to experience involuntary movement in the early stages of the disease.
Treatment for dementia will depend on the exact cause and type of dementia, but many treatments for dementia and Alzheimers will overlap.
Stage : Subjective Memory Lossage Related Forgetfulness
Many people over the age of 65 complain of cognitive and/or functional difficulties. Elderly persons with these symptoms report that they can no longer remember names as easily as they could 5 or 10 years previously they can also have trouble recalling where they have recently placed things.
Various terms have been suggested for this condition, but subjective cognitive decline is presently the widely accepted terminology. These symptoms by definition, are not notable to intimates or other external observers of the person with subjective cognitive decline. Persons with these symptoms decline at higher rates than similarly aged persons and similarly healthy persons who are free of subjective complaints. Research has shown that this stage of subjective cognitive decline lasts 15 years in otherwise healthy persons.
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What Are Some Complications Of Alzheimers Disease
Alzheimers disease is an irreversible form of dementia. The rate of progression differs between people: some people have it only in the last 5 years of their life, while others may have it for as long as 20 years. Alzheimers disease eventually leads to complete dependence and increasing frailty. This means a secondary illness, such as pneumonia, may eventually cause death.
Other complications of Alzheimers disease may include:
- an inability to complete daily tasks such as planning meals and managing money
- a tendency to wander from home
- personality changes such as anxiety, depression and irritability that make relationships more difficult
- delusions and hallucinations in advanced stages of the disease
Stage : Moderate Dementia
Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.
While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.
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Stage : Age Associated Memory Impairment
This stage features occasional lapses of memory most frequently seen in:
- Forgetting where one has placed an object
- Forgetting names that were once very familiar
Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.
Down Syndrome And Alzheimers Disease
People with Down syndrome have a third copy of chromosome 21, instead of the usual two copies. This genetic change causes a collection of characteristics, including intellectual disability and some common physical traits.The APP gene that leads to the production of the beta-amyloid protein present in Alzheimers plaques is located on chromosome 21. This means that people with Down syndrome make one and a half times the amount of APP and, as a consequence, more beta-amyloid. This appears to be the cause of the earlier appearance of the brain changes typical of Alzheimers disease in people with Down syndrome.
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Beyond Memory Loss: How To Handle The Other Symptoms Of Alzheimer’s
There is a lot of talk about the emotional pain patients and caregivers suffer when a loved one loses memories to Alzheimers. But what about the other symptoms? Here are tips from a Johns Hopkins expert on what to watch for and how to manage.
#TomorrowsDiscoveries: From Dysfunctional Cells to Disease Dr. Rong Li
Can You Prevent Alzheimers Disease
There is no sure way to prevent Alzheimers disease. However, you can reduce the risk of Alzheimers disease by caring for your health:
- your heart whats good for your heart is good for your brain so stick to a healthy diet and dont smoke
- your body regular physical activity increases blood flow to the brain so maintain an active lifestyle
- your mind an active mind helps build brain cells and strengthens their connections so socialise, do things such as puzzles and crosswords, and learn new things, such as a language
Learn more about the risk factors associated with Alzheimers and other types of dementia, and what you can do to reduce your risk:
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What Are The Symptoms Of Early
For most people with early-onset Alzheimer disease, the symptoms closely mirror those of other forms of Alzheimer disease.
Withdrawal from work and social situations
Changes in mood and personality
Severe mood swings and behavior changes
Deepening confusion about time, place, and life events
Suspicions about friends, family, or caregivers
Trouble speaking, swallowing, or walking
Severe memory loss
The Seven Stages Of Dementia
One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.
Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.
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How Is Alzheimer’s Disease Diagnosed
There is currently no single test to identify Alzheimer’s disease. The diagnosis is made only after careful clinical consultation.
The clinical diagnosis might include:
- A detailed medical history
- Lumbar puncture for cerebral spinal fluid tests
- Medical imaging
These tests will help to eliminate other conditions with similar symptoms such as nutritional deficiencies or depression. After eliminating other causes, a clinical diagnosis of Alzheimer’s disease can be made with about 80% to 90% accuracy if the symptoms and signs are appropriate. The diagnosis can only be confirmed after death by examination of the brain tissue.
It is important to have an early and accurate diagnosis to determine whether a treatable condition other than Alzheimer’s disease, is causing the symptoms. If Alzheimer’s disease is diagnosed, medical treatment and other assistance can be discussed.
What Is Alzheimer’s Disease
Alzheimers disease is the most common form of dementia, affecting up to 70% of all people with dementia. It was first recorded in 1907 by Dr Alois Alzheimer. Dr Alzheimer reported the case of Auguste Deter, a middle-aged woman with dementia and specific changes in her brain. For the next 60 years Alzheimers disease was considered a rare condition that affected people under the age of 65. It was not until the 1970s that Dr Robert Katzman declared that “senile dementia” and Alzheimers disease were the same condition and that neither were a normal part of aging.
Alzheimers disease can be either sporadic or familial.
Sporadic Alzheimer’s disease can affect adults at any age, but usually occurs after age 65 and is the most common form of Alzheimer’s disease.
Familial Alzheimers disease is a very rare genetic condition, caused by a mutation in one of several genes. The presence of mutated genes means that the person will eventually develop Alzheimer’s disease, usually in their 40’s or 50’s.
The Healthy Human Brain
Behind the ears and temples are the temporal lobes of the brain. These regions process speech and working memory, and also higher emotions such as empathy, morality and regret. Beneath the forebrain are the more primitive brain regions such as the limbic system. The limbic system is a structure that is common to all mammals and processes our desires and many emotions. Also in the limbic system is the hippocampus a region that is vital for forming new memories.
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Where To Live With Dementia
Eventually, caregiving for someone with dementia wont be appropriate anymore. The needs of a person with progressive dementia become overwhelming, and moving into a full-time residence with trained staff becomes necessary. You should plan for this well before it becomes necessary, by visiting communities and asking the right questions.
Depending on your loved ones stage of illness, different living options are available:
Assisted Living in Early StagesAssisted living residences combine room and board with medical and personal care, and are often sufficient for someone in the early stages of Alzheimers disease or related dementia. Full-time supervision means residents are safe, with living units like private studios or apartments so someone with mild dementia can still feel a sense of independence.
Services offered in assisted living include meals, help with activities of daily living , social activities, and transportation to and from doctors appointments. Before moving in, the residence will assess your loved one to make sure its a good fit.
Memory care residences have physical designs that are appropriate for people with dementia. Someone with Alzheimers, for instance, may become upset when encountering a wall, so memory care buildings have circular hallways. Because people with dementia are prone to wander, memory care residences have increased security and supervision, and special locks on doors.
Did You Know?
Medications To Treat The Underlying Alzheimer’s Disease Process
Aducanumab is the first disease-modifying therapy approved by the FDA to treat Alzheimers disease. The medication helps to reduce amyloid deposits in the brain and may help slow the progression of Alzheimers, although it has not yet been shown to affect clinical outcomes such as progression of cognitive decline or dementia. A doctor or specialist will likely perform tests, such as a PET scan or analysis of cerebrospinal fluid, to look for evidence of amyloid plaques and help decide if the treatment is right for the patient.
Aducanumab was approved through the FDAs Accelerated Approval Program. This process requires an additional study after approval to confirm the anticipated clinical benefit. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug. Results of the phase 4 clinical trial for aducanumab are expected to be available by early 2030.
Several other disease-modifying medications are being tested in people with mild cognitive impairment or early Alzheimers as potential treatments.
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Conditions That Cause Similar Symptoms
It is also important to note that while Alzheimers is one of the most common causes of dementia, there are other conditions that can also result in similar symptoms. Other causes include dementia with Lewy bodies, frontotemporal dementia, HIV, Huntington’s disease, Parkinson’s disease, and traumatic brain injury.