Early Onset Alzheimers Disease
Although age is the main risk factor for Alzheimers disease, this is not just a condition that affects older adults.
According to the Alzheimers Association, early onset Alzheimers disease affects around 200,000 U.S. adults under the age of 65 years. Many people with this condition are in their 40s or 50s.
In many cases, doctors do not know why younger people develop this condition. Several rare genes can cause the condition. When there is a genetic cause, it is known as familial Alzheimers disease.
An Alzheimers Love Story: The First Day Of The Rest Of My Life
For many couples and families living with Alzheimers, life changes dramatically with the onset of symptoms, again with the diagnosis, and sometimes with the admission into an assisted living facility. John is a loving husband who chronicles the day he moved his wife Kerry into a home. Silverado Care is the care facility behind the video, equal parts heartwarming and sad a feeling many caregivers know well.
Treatment For Moderate To Severe Alzheimers
A medication known as memantine, an N-methyl D-aspartate antagonist, is prescribed to treat moderate to severe Alzheimers disease. This drugs main effect is to decrease symptoms, which could enable some people to maintain certain daily functions a little longer than they would without the medication. For example, memantine may help a person in the later stages of the disease maintain his or her ability to use the bathroom independently for several more months, a benefit for both the person with Alzheimer’s and caregivers.
Memantine is believed to work by regulating glutamate, an important brain chemical. When produced in excessive amounts, glutamate may lead to brain cell death. Because NMDA antagonists work differently from cholinesterase inhibitors, the two types of drugs can be prescribed in combination.
The FDA has also approved donepezil, the rivastigmine patch, and a combination medication of memantine and donepezil for the treatment of moderate to severe Alzheimers.
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Treatment Of Secondary Symptoms
A variety of behavioral and pharmacologic interventions can alleviate clinical manifestations of AD, such as anxiety, agitation, depression, psychotic behavior, and sleep problems. The effectiveness of such interventions ranges from modest and temporary to excellent and prolonged. No specific agent or dose of individual agents is unanimously accepted for the wide array of clinical manifestations. At present, the FDA has not approved any psychotropic agent for the treatment of AD.
Alzheimers Is Difficult To Diagnose
Alzheimers symptoms can mimic those of many other diseases, and the condition cannot be definitively diagnosed with any single lab test, scan or exam. Instead, doctors generally rely on evaluation of symptoms of the disease, and are increasingly using imaging tests, particularly in research. However, non-imaging biomarkers are needed to advance our capabilities to more easily monitor disease progression and response to treatment as well as improve the rigor and efficiency of clinical trials.
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What Are The Symptoms Of Alzheimers Disease
Symptoms of Alzheimers disease vary from person to person and worsen over time. Symptoms of the disease include:
- Memory loss. This is usually one of the first symptoms of Alzheimers disease.
- Putting objects in odd places
- Confusion about events, time and place
- Repeating questions
For more information on the stage of disease, click here.
What Is The Theory Behind Coconut Oil
Researchers think the brain cells in the brains of people with dementia have problems with the way they make energy from glucose which led to the theory that coconut oil could make up for this.
Insulin, the hormone responsible for regulating blood sugar and glucose, has been linked to changes in the brain associated with Alzheimer’s disease. However, it is not clear yet exactly what role insulin has in the disease. We are funding research in this area and hoping to find out whether drugs that stimulate the insulin system could help slow down dementia. Researchers dont know whether the problem brain cells seem to have with making energy is a cause of the disease or the result of other disease-related processes.
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Treatment Of Moderate To Severe Disease
The partial N-methyl-D-aspartate antagonist memantine is believed to work by improving the signal-to-noise ratio of glutamatergic transmission at the NMDA receptor. Blockade of NMDA receptors by memantine is thought to slow the intracellular calcium accumulation and thereby help prevent further nerve damage. This agent is approved by the FDA for treating moderate and severe AD.
Several studies have demonstrated that memantine can be safely used in combination with ChEIs. The combination of memantine with a ChEI has been shown to significantly delay institutionalization in AD patients. Studies suggest that the use of memantine with donepezil affects cognition in moderate to severe AD but not in mild to moderate AD. A once-daily, fixed-dose combination of memantine extended-release and donepezil was approved by the FDA in 2014. Dizziness, headache, and confusion are some of the most common side effects of memantine.
In June 2013, the FDA approved rivastigmine transdermal for severe AD. Approval was based on the ACTION study, in which a higher dose of the drug demonstrated statistically significant improvement in overall cognition and function compared with a lower dose .
With Alzheimers Research At A Crossroads Ai Might Point The Way Forward
To be sure, NIH did fund some Alzheimers research that did not focus on amyloid. In a sea of amyloid-focused grants, there are tiny islands of research on oxidative stress, neuroinflammation, and, especially, a protein called tau. But Neves NINDS program officer, she said, told me that I should at least collaborate with the amyloid people or I wouldnt get any more NINDS grants.
A decade after her APP discovery, a disillusioned Neve left Alzheimers research, building a distinguished career in gene editing. Today, she said, she is sick about the millions of people who have needlessly died from the disease.
Dr. Daniel Alkon, a longtime NIH neuroscientist who started a company to develop an Alzheimers treatment, is even more emphatic: If it werent for the near-total dominance of the idea that amyloid is the only appropriate drug target, he said, we would be 10 or 15 years ahead of where we are now.
Making it worse is that the empirical support for the amyloid hypothesis has always been shaky. There were numerous red flags over the decades that targeting amyloid alone might not slow or reverse Alzheimers.
I dont think there was a purposeful attempt to scuttle other approaches, Selkoe added. Or as Aisen put it last week on the sidelines of the Aspen Ideas Festival, I dont think Im part of a cabal.
And here I thought research should be judged on its own merits, Itzhaki said.
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A Marriage To Remember
The New York Times presents this video documentary of Pam White and her family. Created by her son, filmmaker Banker White, the video is a diary of Pams Alzheimers progression. Youll hear Pam, in her own words, describe her childhood and life before the disease took over. Youll also hear her story from her husband, Ed and her son. For people with Alzheimers in their life, the story will be familiar. It may be heart wrenching. But theres a message of hope the disease has revealed the strength of Pam and Eds marriage.
Common Essential Oils Used With Alzheimers And Dementia
The essential oils that appear in the research literature the most are Melissa , lavender , rosemary , and sweet orange . These oils may help with improving sleep, decreasing anxiety and agitation, and improving some cognitive function, but other oils may also help, even though they have yet to be considered for formal medical research looking specifically at neurodegenerative diseases. Some essential oils may also remind people of prior events in their lives, supporting quality of life in other ways, making them appropriate for the specific individual for whom they are intended.
Schwan recommends considering Maslows hierarchy of needs when selecting an essential oil for a specific need. In this holistic philosophy, the whole person is considered, and needs everywhere from sleep disturbances, to anxiety, to confusion, to self-esteem can be addressed.
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Ronit Shapira, a PhD student TAUs Faculty of Life Sciences and the principal investigator of the study said the research has serious clinical implications.
Hyperbaric oxygen treatment is a well-tolerated and safe therapy used in clinics around the world for various medical conditions, including neurological disorders. Although further research is needed to elucidate the underlying beneficial mechanisms of the therapy and to evaluate its beneficial effects in various Alzheimer patient populations, it holds great potential for the treatment of Alzheimers disease, she said.
Evidence Grows For Inflammation As A Critical Drug Target
The ADDF believes that aging is the leading risk factor for Alzheimers. As we age, our inflammatory response increases. New findings reported in 2016 added to the evidence that increases in inflammation were associated with a faster pace of cognitive decline in people with Alzheimers disease. We also know that inflammation in the brain damages and destroys neurons, contributing to Alzheimers. The ADDF was an early funder of drugs targeting inflammation, and today its the second largest area of our portfolio. Our funded researchers are developing new drugs to combat neuroinflammation and repurposing approved drugs that target systemic inflammation in other diseases. Several have already reached clinical trials, including etanercept, being tested by Dr. Clive Holmes at the University of Southampton in the UK in a phase 2 trial. And in Boston, Dr. Phillip Haydon and his colleagues at the biotech Gliacure completed a successful phase 1 trial of GC021109. In 2017, we expect other drugs targeting inflammation to enter clinical trials, including an exciting program from Cleveland Clinic spin-off NeuroTherapia.
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Treatment For Mild To Moderate Alzheimers
Treating the symptoms of Alzheimers can provide people with comfort, dignity, and independence for a longer period of time and can encourage and assist their caregivers as well. Galantamine, rivastigmine, and donepezil are cholinesterase inhibitors that are prescribed for mild to moderate Alzheimers symptoms. These drugs may help reduce or control some cognitive and behavioral symptoms.
Scientists do not yet fully understand how cholinesterase inhibitors work to treat Alzheimers disease, but research indicates that they prevent the breakdown of acetylcholine, a brain chemical believed to be important for memory and thinking. As Alzheimers progresses, the brain produces less and less acetylcholine, so these medicines may eventually lose their effect. Because cholinesterase inhibitors work in a similar way, switching from one to another may not produce significantly different results, but a person living with Alzheimers may respond better to one drug versus another.
Before prescribing aducanumab, doctors may require PET scans or an analysis of cerebrospinal fluid to evaluate whether amyloid deposits are present in the brain. This can help doctors make an accurate diagnosis of Alzheimers before prescribing the medication. Once a person is on aducanumab, their doctor or specialist may require routine MRIs to monitor for side effects such as brain swelling or bleeding in the brain.
Ketogenic Diets And Cholesterol Levels
In the keto diet, carbohydrates are strictly limited and replaced by high fat intakes, forcing the body to use fat as a primary energy source. This is a similar idea behind the Atkins diet.Coconut oil is used to allow a slightly higher level of carbohydrate intake, making the very strict diet slightly easier to follow, but still preventing the body using sugar from carbohydrates as the main energy source. This works only because the body is forced to metabolise fats.The ketogenic diet must be incredibly strict because the body will always preferentially use glucose for metabolism instead of fats. This means that simply adding coconut oil to the diet would not provide brain cells with an alternative energy source. The keto diet is also linked to very high cholesterol levels, which is known to increase risk factors for stroke, heart disease and dementia.In fact, the NHS and World Health Organisation advise against consuming large amount of coconut oil as it contains high levels of saturated fat which can lead to high cholesterol levels.
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An Ancient Cure For Alzheimers
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In 2011, Ben Trumble emerged from the Bolivian jungle with a backpack containing hundreds of vials of saliva. He had spent six weeks following indigenous men as they tramped through the wilderness, shooting arrows at wild pigs. The men belonged to the Tsimane people, who live as our ancestors did thousands of years ago hunting, foraging and farming small plots of land. Dr. Trumble had asked the men to spit into vials a few times a day so that he could map their testosterone levels. In return, he carried their kills and helped them field-dress their meat a sort of roadie to the hunters.
Dr. Trumble wanted to find out whether the hunters who successfully shot an animal would be rewarded with a spike in testosterone. As a researcher with the Tsimane Health and Life History Project, he had joined a long-running investigation into human well-being and aging in the absence of industrialization. That day when he left the jungle, he stumbled across a new and more urgent question about human health. He dropped his backpack, called his mom and heard some terrible news: His 64-year-old uncle had learned he had dementia, probably Alzheimers.
But this approach has led to failure in humans. Even when drugs can clear the plaques in patients brains, the disease continues to wreak damage.
Goal : Prevent And Effectively Treat Alzheimer’s Disease And Related Dementia By 2025
Research continues to expand our understanding of the causes of, treatments for, and prevention of AD/ADRD. Goal 1 seeks to develop effective prevention and treatment modalities by 2025. Ongoing research and clinical inquiry can inform our ability to delay onset of AD/ADRD, minimize its symptoms, and delay its progression. Under this goal, HHS will prioritize and accelerate the pace of scientific research and ensure that as evidence-based solutions are identified and quickly translated, put into practice, and brought to scale so that individuals with AD/ADRD can benefit from increases in scientific knowledge. HHS will identify interim milestones and set ambitious deadlines for achieving these milestones in order to meet this goal.
In 2016/2017, Goal 1 showed substantial progress across a spectrum of research areas, thanks to the continued support from our national leadership and the American public, the dedication of study volunteers and their families and caregivers, and the valued work of clinicians and scientists.
The NIH will continue to prepare these estimates through FY 2025. Only two other areas of biomedical research have previously been the subject of this special budget approach: cancer and HIV/AIDS.
Planning for the annual bypass budget and NIH’s current AD/ADRD research portfolio are informed by research implementation milestones based on recommendations for AD/ADRD developed at a series of the NIH-convened research summits .
For more information, see:
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People With Alzheimers Tell Us Memories They Never Want To Forget
Another notable Alzheimers video from Cut, this one offers a glimpse into a disappearing world the memories of people with Alzheimers disease. Their childhood memories are mostly clear as they describe the weather and people around them. But when asked about a recent memory, they struggle. This video will certainly have you reaching for tissues, but will also leave you feeling richer for hearing their stories.
Fdas Accelerated Approval Program
Aducanumab was approved through the FDAs Accelerated Approval Program, which provides a path for earlier approval of drugs that treat certain serious conditions. This helps people living with the disease gain earlier access to the treatment. The approval of aducanumab was based on the ability of the drug to reduce amyloid in the brain. When using the accelerated approval pathway, drug companies are required to conduct additional studies to determine whether there is in fact clinical benefit after the drug is approved. 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.
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Using Essential Oils To Support Neurodegenerative Diseases
The various studies considered in the Forrester et al. meta-analysis looked at both inhaled and topically applied essential oils of Melissa and lavender . There were positive effects for reducing agitation found in the two trials included in this data set.
Several studies have used lavender and other essential oils as inhalants. Lin et al. found that inhaling lavender reduced agitation in dementia patients with no side effects. A small 2009 study used diffusers with patients with various forms of dementia, including Alzheimers, and found diffused essential oils to have some positive effects, with potential to improve cognitive function in patients with moderate Alzheimers disease . Diffusers ran for two hours every morning and every evening. In the mornings, the diffusers emitted a blend of lemon and rosemary, and in the evenings the blend was a combination of lavender and orange. Li et al. showed that diffused lavender has the potential to ease agitation in those suffering from dementia. Mitchell found a decrease in difficult behavior when patients were exposed to lavender and Melissa aromas over a period of time.