Thursday, August 7, 2008

Family History May Add to Alzheimer's Puzzle

The gene most often associated with Alzheimer's disease doesn't provide a complete picture of overall risk, according to researchers who analyzed family histories of the disease.

Previous research has shown that people with the E4 variant of the APOE gene have a greater risk of developing Alzheimer's, but this new Duke University Medical Center-led study is one of only a few to examine the role of both APOE and family history together.

"We've learned that APOE genotype does not tell the whole genetic story. Other genes may be acting independently of APOE to influence someone's risk for developing the disease," lead investigator Kathleen A. Welsh-Bohmer, director of Duke's Bryan Alzheimer's Disease Research Center, said in a Duke news release.

The study included more than 5,000 people in Cache County, Utah, who were 65 and older when they were enrolled in the study in 1995. About 3,000 of the participants who provided DNA and details about their family history of Alzheimer's were grouped according to the family history of the disease and whether they had the APOE E4 variant.

"Over an average of seven and a half years of observation, the people who experienced the most significant cognitive decline had a family history of the disease and one or more copies of APOE E4," Kathleen M. Hayden, an assistant professor of geriatric psychiatry, said in the Duke news release.

"For this reason, researchers should focus not only on people at risk because of the APOE gene, but also those who have a family history of Alzheimer's disease. Conversely, studying those who survive to late old age without disease is important to discover genes that may offer protection against the disease."

The study was expected to be presented Tuesday at the Alzheimer's Association's International Conference on Alzheimer's Disease, in Chicago.

"These data provide further evidence that we must explore other genetic avenues to learn more about who is at risk for cognitive decline and dementia," Welsh-Bohmer said.

Friday, April 11, 2008

Treatment of Alzheimer's Disease

Four medications, tacrine (Cognex), donepezil (Aricept), rivastigmine tartrate (Exelon) and galantamine (Razadyne, formerly known as Reminyl), may slow the intellectual decline in some people with mild to moderate Alzheimer's disease. These drugs (called cholinesterase inhibitors) increase the brain's levels of acetylcholine, which helps to restore communication between brain cells. Another medication, memantine (Namenda), has been shown to stabilize memory in people with moderate to severe Alzheimer's disease. It is the first in a new class of medications called NMDA receptor antagonists.

Other strategies used to help people with Alzheimer's include psychotherapy techniques (reality orientation and memory retraining) and medications to relieve depression and calm agitated behavior.

As much as possible, you should follow a regular exercise routine, maintain normal social contacts with family and friends and continue intellectual activities. In addition to regularly scheduled doctor visits, patients and their families should take advantage of community resources and support groups. Discuss any safety concerns, especially driving, with the doctor.

Although several nonprescription products claim to improve mental function, the scientific evidence to support this claim is weak. Check with your doctor before taking any nonprescription medication, especially if you are taking a prescription medication for heart problems, diabetes, high blood pressure or mental illness or if you have problems with your heart or liver.

Saturday, February 16, 2008

Ten warning signs of Alzheimer's disease

The following list of warning signs was developed by the Alzheimer's Association. It includes common symptoms of Alzheimer's disease. Individuals who show several of these symptoms should seek medical advice for a complete evaluation.
1) Memory loss
2) Difficulty performing familiar tasks
3) Problems with language
4) Disorientation to time and place
5) Poor or decreased judgment
6) Problems with abstract thinking
7) Misplacing things
8) Changes in mood or behavior
9) Changes in personality
10) Loss of initiative