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Issue 94 Alzheimer’s Insights by Curation Health 28 June 2016
Until news emerged from the annual meeting of the British Medical Association to the effect that doctors feel that dementia diagnosis without adequate support for patients is “pointless”, it looked like being a pretty positive week for news about Alzheimer’s. Questions need to be asked about who is there for whom when a person sits down with a doctor they need to trust. Can it be right that doctors, however well-meaning, can effectively withdraw a service if they cannot deliver the service they would prefer?
Most read stories this week
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After 190 Tries, Are We Any Closer to a Cure for Alzheimer’s?
AXON’s Pioneering Tau Vaccine against Alzheimer's Started Phase II
Dementia diagnosis 'pointless' if no help is on offer, say doctors
Annexon Gets $44M To See If Protecting Synapses Will Help Fight Alzheimer's
An Architectural Installation Shows How to Build for People with Dementia
Drugs & Clinical Trials
Diabetes and Alzheimer’s: links both ways
Evidence continues to mount that diabetes, increasingly recognised as a risk factor for developing Alzheimer’s, may also be a consequence of contracting the disease. Recent research published in the journal Diabetologia and reported widely, as here in the Pharmaceutical Journal, suggests that the cause and effect may work in both directions, and the effects of lifestyle factors on brain metabolism may be the culprit.

Scientists at Aberdeen University have been able to show that what causes the build-up in the brain of the toxic proteins that can lead to the development of Alzheimer’s symptoms can also lead to diabetic complications. Their research into new treatments designed to address symptoms of both diseases builds on research last year that showed significant improvement in cognitive function among mice subjects treated with the diabetes drug liraglutide. Spokespeople for the Alzheimer’s Society and Diabetes UK recognised the significance of this research but stress the need for further investigation, and the need to extend this study beyond mice into human subjects.

Talk about try, try, and try again
Kudos for the most startling, non-Brexit related headline of the week has to go to this piece on the Bloomberg website, asking if, “after 190 tries” we are any closer to a cure for Alzheimer’s. If the evidence is to be measured in the amount of funding being committed to pushing new treatments over the line, the answer has to be yes. The article provides a useful summary of efforts over recent decades generally, with the earlier emphasis on amyloid-based therapies slipping back slightly as more research is being done on tau-based treatments.

The market is vast, all the more so when no present treatment can claim to cure or reverse the disease. The rewards for anything that can go beyond managing symptoms will be vast, given that the international population of people with Alzheimer’s continues to grow. While research continues into both amyloid and tau – both functions of protein accumulation in the brain – we also expect to see increasing investment in promising treatments for affecting the course of the disease: more reliable diagnostics, increased research into genetics and nanotechnology for drug delivery systems, and more powerful scanning technologies allied to better software for reading those scans and the data they generate.
$4m grant boosts early onset research
Reflecting its established position as a world leader in research into early onset Alzheimer’s, the Washington University School of Medicine in St Louis, Missouri has been granted a further $4.3M to expand its research activities by the American Alzheimer’s Association. Bioscience Technology reports that the money will be used to accelerate the work of its successful “Dominantly Inherited Alzheimer Network Trials Unite (DIAN-TU), going global with many more clinical trial sites for drugs designed to prevent or slow the disease in people who are genetically disposed to developing the disease but who for now are not exhibiting symptoms.

Drugs & Clinical Trials
Medical Information
A dementia diagnosis cannot be “pointless”
Despite the advances made over recent years in the public understanding of dementia in general and, in particular, the significance of early diagnosis to all the people who must its challenges, doctors in the UK remain frustrated at the lack of support for people following a diagnosis. One of the most widely reported outcomes of this year’s annual meeting of the British Medical Association’s annual meeting, as noted here on the Care Home website, was the motion passed to the effect that a diagnosis in these circumstances is “pointless”.

While there is every reason to improve the services and information made available to anyone getting a serious diagnosis of anything, what critics of the BMA position describe as a paternalistic attitude to health care is tantamount to saying that if doctors cannot do everything they would like to do, they may as well do nothing. This would suggest that the doctor-patient relationship is primarily about doctors and what they want, rather than the patients for whom the benefits of diagnosis are only in part related to whatever their doctors may say or do. Do people without a diagnosis derive any benefit from being kept in the dark about a disease they still have whether or not their doctor has enlightened them? Should they in fact be looking for a doctor on whom they can actually rely?
Blood flow in the brain provides early clues
Researchers at the Montreal Neurological Institute have published the results of their work with the Alzheimer’s Disease Neuroimaging Initiative, showing that early changes to blood flow patterns in the brain can be detected even earlier than the build-up of the protein amyloid, and well before the appearance of symptoms such as serious memory loss. Their research was published in the journal Nature Communications, and publicised here on the Alzheimer’s Research UK website.

Latest Alzheimer's Medical Info
Depression, Stress & Coping
American FDA updates consumer notes on memory loss
The USA food and Drug Administration published an update last week to its notes on Coping with Memory Loss, including detailed lists on the primary causes and what can be done to prevent or delay it. The publication is timely, coming just a few days after one of last week’s big stories: MedicalNewsToday produced one of their more popular features in describing how memory loss in early Alzheimer’s can be reversed with a personal treatment plan that combines lifestyle changes, brain stimulation, and medication.

Depression, Stress & Coping with Alzheimer's
Care Advice
New thinking on caregiving millennials
In a week that saw Bob DeMarco ask on his Alzheimer’s Reading Room why caregivers still struggle with the creeping loneliness of being ghosted by friends and family, The Huffington Post looked specifically at the caregiving challenges within the millennial community. In this case, the focus was specifically on two African-American and Latino daughters of mothers diagnosed with early onset Alzheimer’s. It is something of a jolt to read that one in four American caregivers is a millennial (between the ages of 18 and 30), and the strains for these people are even greater when they are part of a community already dealing with any measure of language difficulty of problems with social exclusion.
Adorable toys don't have to be robots
INSIGHTS has been interested in following the development of “cuddly robots” as caregiving aids for people with dementia, whether in a private home and similar informal care settings or in residential care. It appears from a blogspot by acclaimed blogger Marie Marley on the Huffington Post website that similar therapeutic benefits can be realised even with non-computerised pets, such as the battery-operated companion cat featured in this blog. There is no interactivity involved but this doesn’t appear to matter to their new owners, who react to the toy as if it were a programmed robot — or indeed, the real miaowing deal.
Alzheimer’s Association conference: quick preview
The world’s largest Alzheimer’s conference (AAIC) is gearing up for its annual extravaganza, a showcase for the American Alzheimer’s Association but this year being staged in Toronto, Canada. Taking place between 24 and 28 July, the event will attract international clinical investigators, health professionals and care providers to share news and reflections on the latest research and discoveries. Special attention on the AAIC website should be directed to the scientific topics of Emerging Concepts and Scientific Sessions. Interested parties can sign up for the Association’s free weekly newsletter.

Alzheimer's Care Advice
Lifestyle Issues
Improv opens the mind to new realities
An article on the Huffington Post website underlines the liberating power of turning the forces of denial and “no” into acceptance and “yes” in facing up to the reality of Alzheimer’s – in the case of this particular blogger and caregiver, through getting into improvisational theatre workshops. The key enablers appear to combine a focus on finding new possibilities in the moment with the social pleasure of discovering and exploring these possibilities in the company of other people. Very often the person being cared for can be one of these other people which, as this blogger confirms, leads directly to a closer bonding with the caregiver.
“Losing Myself” sees architecture take on dementia
It’s not normally a primary objective of architectural drawings that they set out to be confusing and disorienting, but the Irish pavilion at this year’s Architectural Biennale set out to be just that. As a story on the Wired website explains, a series of films based upon architectural blueprints of the Alzheimer’s Respite Centre in Dublin was designed as a simulation of what it’s like to live with dementia. A video embedded in the Wired article conveys something of the flavour of the disorientation: it’s certainly effective, and imaginatively done.

Alzheimer's Lifestyle Issues
Medical Devices
IBM imaging is a sign of the times
Very much reflecting the exponential growth of stronger imaging technologies and more powerful data analytic capabilities, IBM last week announced the formation of a collaborative venture with more than a dozen American companies operating in the space where medical imaging and informatics converge with diagnostic and health professional services.

As explained on the eWeek website, the Watson Health medical imaging collaborative will deploy the increasingly powerful data-crunching and cognitive capabilities associated with the Watson name (famous now for beating human champions in chess and Jeopardy) in the services of humanity’s battles with cancer, diabetes, and diseases of the eye, brain, and heart.

Medical Devices & Alzheimer's
And Finally…
An innovation in the world of “graphic medicine”, the inventively named “Aliceheimer’s: Alzheimer’s Through the Looking Glass” is the feature of a fascinating blogspot in The New York Times. A medical anthropologist who was by profession well placed to be intrigued by her mother’s Alzheimer’s, Dana Walcraw refused to accept what she saw as the prevailing narrative of the “disease as horror story” when her mother Alice was diagnosed with the disease. Together, the two obviously creative women collaborated on the development and publication of an animated reflection on a life reframed, based more emphatically on living in the present and articulated in a language not consisting of words so much as an appreciation of gestures, looks, and touch.
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)
Appreciate @LundbeckUS addressing challenges to an #Alzheimers breakthrough! @sallybyoung
Cory Booker (@CoryBooker)
June is Alzheimers and Brain Awareness Month. What can you do to #EndAlzheimers?
Gus Bilirakis (@RepGusBilirakis)
#IGoPurpleFor all those w/ Alzheimers. Wear purple & RT to raise awareness for Alzheimer’s & Brain Awareness Month.
Sixty and Me (@sixtyandme)
Do you know the early signs and stages of Alzheimers?… @USPurpleAngel #Alzheimers @sixtyandme
Alzheimers Support (@SandyAlz)
Dementia Behind the Wheel : Dementia/driving do not go together - Alzheimers Support
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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
Tam is a communications professional with three decades of experience in health, hospitality, and financial services publishing. His interest in the human brain goes back to his studies in philosophy at university. His commitment to securing the best information about health matters goes back to his decade as a carer. In addition to his work with Alzheimer’s, Tam is engaged in online publishing projects relating to health innovation and investment, human and artificial intelligence, and diabetes.
Explain This!
Is there a good guideline for telling the difference between a symptom of Alzheimer’s and something that may appear like a symptom but is actually caused by something else, like fatigue or stress or depression?
Click here to find out
Looking ahead…
Issue 95 5 July 2016
What assistive technologies are there for caregivers and the people they care for? Where can people with dementia turn for advice on products that are specially designed with them in mind?
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