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Issue 41 Alzheimer’s Insights by Curation Health 23 June 2015
What is the forecast for Alzheimer’s research? What are the challenges we face in converting research into results? It appears that the foundation for a successful future may well lie in the three Fs of facts, funding and focus.
Most read stories this week
Steady Progress On America's Most Terrifying Epidemic: Alzheimer's Disease
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Roche Twins study identifies blood protein that may predict Alzheimer’s disease
Alzheimer's Association Event, The Longest Day®, Honors Those Living With Alzheimer's And Their Caregivers
Mind and body exercise can help your brain — but not against dementia risk
Medical Information
Research efforts increase, not yet with enough focus
Co-ordination of efforts on a global scale is at the root of the challenge we face in addressing the enduring mystery of Alzheimer’s disease, as any review of the weekly output of articles and reports makes clear. This is particularly true in the USA this month, as June is being marked in that country as “Alzheimer’s and Brain Awareness Month” in an effort to focus the public’s attention on the disease and on the need for more study into its causes, effects and possible treatments.

Articles such as this one on the News Medical website and this more extensive review from Huffington Post make clear the scale of the problem and some of the efforts being made to address it. What is most startling is the expense associated with the disease today and how far the costs may escalate within a generation if the tide is not turned. In a report produced by the American Alzheimer’s Association and quoted in the Huffington Post story, two particular sets of statistics stand out:

First, in terms of costs today, it appears that Americans are now spending $226 billion annually on Alzheimer’s and, on current projections, this figure could more than triple by 2050, with the cumulative spending in combatting the disease amounting to more than $20 trillion. So far, so jaw-dropping.

Second, and offering a real incentive to those engaged in Alzheimer’s research, the achievement of the sort of disease-modifying treatment targeted for 2015 by the G8 leaders at their 2013 Summit would make a substantial and almost immediate impact on Alzheimer’s costs, lowering the annual American expenditure by $121 billion.

The size of the challenges in “getting our research act together” are generally pretty well-known. The pathology behind the disease, involving the most complicated and mysterious organ in the body, remains largely uncertain, although we know far more about the brain than we did a generation ago. Progress with bringing preventative or disease modifying drugs to market has been slow and expensive, with a mere handful of patents being awarded over the last dozen years.

Perhaps an even bigger inhibition to progress than the pathology has been the stigma associated with mental illness generally, and with the implications of an illness that remains identified with end-of-life care and a time when people retire into the relative privacy of their families where much of the costs and stress of living with the disease are absorbed privately and out of the public gaze.

While the past twelve months have seen another year passing without a research breakthrough, there has been a massive increase in awareness of the scale of the funding gap between Alzheimer’s and other diseases with much higher profiles. Much is made of the fact, for example, that Alzheimer’s research monies from the American government come in around the $600 million mark, a figure scarcely 10% of what is going into cancer research. What is perhaps even more alarming for the future trajectory of Alzheimer’s cost is the huge disparity between what care is costing as against the comparatively small monies being devoted to research.

As a recent report in The Guardian points out, the situation in the UK is little better, especially when measured against the situation in those other G8 countries. But things are getting better and, with the focus that should result from The Dementia Discovery Fund that was announced at about the same time as The Guardian story came out, we should see better application of the increased funds and more productive consolidation of the research wisdom that is acquired as a result.

Latest Alzheimer's Medical Info
Care Advice
Ice cream beats an argument every time
In an article in which the ever-thoughtful Bob DeMarco asks caregivers if Alzheimer’s is driving them crazy, he refers to an excellent article that appeared some months ago on his Alzheimer’s Reading Room. In addressing one of the most fundamental challenges of caregiving generally – how to get somebody to take their medication – he made some profound psychological points about non-verbal communication, positive behaviour reinforcement, and the power of gentle kindness.

In his experience of caring for his own mother, he discovered early on that long and tortuous explanations as to why any sort of behaviour was necessary proved fruitless, confusing and counter-productive. Actions spoke louder than words, and staying calm and focusing quietly on happy outcomes were far more useful. In the case of taking those pills, the happy announcement about, and delivery of, some ice cream established the right frame of mind as surely as any detailed lecture on the necessity of the pills would be pretty much guaranteed to kill the mood stone dead.

Alzheimer's Care Advice
Drugs & Clinical Trials
Funding boost for immune system research
Academics at the UK’s University of Southampton and researchers from MRC Technology have been given a half-million pound boost by the Dementia Consortium, a £3million drug discovery collaboration between Alzheimer’s Research UK, MRC and pharma companies Eli Lilly and Eisai. As reported on the News Medical website, this funding will assist in the coordination of academic and industry research into the immune system and the clues it offers in discovering new treatments for the disease.

Underlining the growing excitement about such collaborative ventures and the new hope that is being identified in the world of Alzheimer’s research, this short video from CNBC summarises stories from recent issues of INSIGHTS relating to developments at Lilly, Biogen and Axovant.

Drugs & Clinical Trials
Depression, Stress & Coping
Stress lowers “klotho”, affecting cognition
Researchers at the University of California, San Francisco have discovered that a hormone known as klotho – instrumental in regulating aging and affecting cognition – is shown to be diminished in clinical subjects who are depressed and stressed, even where the women involved were not showing symptoms of these problems. As published in the journal Translational Psychiatry and reported online at Financial Express, the report stressed that the research findings are so far correlative rather than causative, but added that if further research proves similarly positive, there may be hope for lifestyle interventions that could extend longevity and improve cognition.
Depression, Stress & Coping with Alzheimer's
Lifestyle Issues
Top story confuses dementia risk factor
One of the week’s Most Read stories risked spreading confusion if not downright alarm in reporting on a recent study reported originally in the online issue of Neurology. Normally a reliable source, at least when it comes to putting the right headline on a story, The Washington Post suggested that exercise can help the brain – “but not against dementia risk”. This is not what the Neurology study had reported.

As even the newspaper report recognised, the study had to do with imaging scans looking for “known markers of Alzheimer’s disease” – that is, physical changes within the brain itself. The headline on the story sees the disease and dementia, which is a descriptor for a wide range of symptoms, as the same thing. Not only are they not the same thing – as this week’s ExplainThis! Spot in INSIGHTS explains – but there is a wide and strongly established literature that makes clear that a lifestyle that includes regular exercise is indeed a preventative measure in defending against the onset of dementia.

And, it might be added, if the benefits of exercise are less clear in assessing risk factors for Alzheimer’s disease as one of the causes of dementia, this would have less to do with our understanding of exercise, and more to do with the continuing uncertainty over the precise causes of Alzheimer’s – something on which this particular story in The Washington Post has not done much to help.

Alzheimer's Lifestyle issues
And Finally…
A melding of music with community care achieved effective and moving results when the Bournemouth University Dementia Institute teamed up with that city’s Symphony Orchestra to bring professional musicians together with people with dementia and their caregivers. As reported in The Guardian, everyone got involved in some way and, with the musicians filling in the gaps, the reconstituted orchestra was able to put on a summer concert. From the former bass player who was coaxed back into enjoying his music to the couple who rediscovered their dancing shoes when the orchestra struck up Moon River, it was a powerful lesson in the power of music to inspire and nurture: reminding everyone who was there, and all of us, that we share a journey to “that same rainbow’s end…”
More Alzheimer’s Disease Feeds on CurationHealth
Depression, Stress & Coping with Alzheimer’s
Alzheimer’s Care Advice
Alzheimer’s Lifestyle Issues
Latest Alzheimer’s Medical Info
Drugs & Clinical Trials
Medical Devices & Alzheimer’s
Tweets of the week twitter logo
Ian Kremer (@LEAD_Coalition)
In #dementia/#Alzheimers science, care, support & policy, the status quo is unsustainable, intolerable, and immoral.
DementiaToday (@DementiaToday)
Poor Sleep Linked to Toxic Buildup of Alzheimer’s Protein, Memory Loss - # alzheimer #dementia
Dr. Rudy Tanzi (@RudyTanzi)
An article about my somewhat distracted life! CNN: Gene hunter by day, Aerosmith organist by night
DementiaToday (@DementiaToday)
Alzheimer’s Stages: How the Disease Progresses - # alzheimer #dementia
Alzheimer's Society (@alzheimerssoc)
We’ve launched Care & Cure, so we can help families like the Wilsons. Hear their story:
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About Alzheimer’s Insights
Alzheimer’s Insights is an online newsletter created for consumers -- primarily patients and carers -- who live with the challenge of Alzheimer’s disease. Based upon intelligent search algorithms that scour the Internet for the most read, relevant and useful stories from around the world, it is curated and published each Tuesday by a team of health and publishing experts.
Tam McDonald  
Tam McDonald Senior Curator
A publishing professional with three decades of experience in health, hospitality and financial services publishing. His interest in the human brain goes back to his university days of studying philosophy. His commitment to securing the very best information about health matters goes back to his decade as a carer.
Explain This!
Is there an easy way of explaining the difference between dementia and Alzheimer’s disease?
Click here to find out
Looking ahead…
Issue 42 30 June 2015
We look at improvements in the technologies for early diagnosis. From genetic testing to blood or eye examinations, from brain scans to cognition testing, how reliable are the means for spotting the early warning signs?
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