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Issue 96 Alzheimer’s Insights by Curation Health Tuesday, July 12, 2016
A mixture of common themes and innovative therapies dominate the news feeds this week, with the mainstays focusing on diagnosis. Why should it be as early as possible, and what can be done to plan for life afterwards. Among the innovations, special regard must go to work with artificial intelligence, virtual reality, vaccines and transdermal patches. We really are starting to throw everything at Alzheimer’s.
Most read stories this week
Unique Alzheimer's Disease Vaccines Show Great Potential in Pre-Clinical Studies
Being diagnosed with dementia 'is not the end'
Should Drugmakers Be Allowed To Avoid Taxes On Their Profits From An Alzheimer's Drug?
Alzheimer’s risk genes may impact the brain in early adulthood
AI assists in Alzheimer’s diagnosis
Medical Information
AI boost for Alzheimer’s diagnosis
Artificial Intelligence (AI) is making its way into the world of diagnosing Alzheimer’s at a much earlier stage, according to a study published online in the journal Radiology, and reported in several media outlets including here on the Laboratory Equipment website. Machine learning techniques – software that effectively “learns by doing” rather than being programmed to carry out a specific task – have been successful in reviewing thousands of MRI scans of a highly specialist nature, measuring the amount of blood that is being delivered to various regions of the brain.

Pattern recognition capabilities far beyond what the human eye can achieve enable the software to distinguish between miniscule variations in blood perfusion, predicting which study patients were going to go on to develop Alzheimer’s to rates of accuracy in excess of 80%. As with any device that can reliably assist in achieving an early diagnosis, the combination of powerful scanning technologies with smart predictive software should prove to be an invaluable ally in enabling people to act early in the progression of their disease and reap the benefits of early interventions and more sensitive care.
Genetic research has a place in prevention
We are still in the early days of understanding the genetic basis of Alzheimer’s disease and how our genes interact with the environment in bringing us closer to a diagnosis, but recent research at Massachusetts General Hospital has been able to show a link between a selection of genetic risk factors and particular effects on the brain before any symptoms of dementia present themselves. In a study published in the journal Neurology and reported widely – possibly most reliably here on the Alzheimer’s Research UK website – the researchers took data from two large studies and determined a method for calculating an overall genetic risk for an individual.

Pattern Applying their risk index to the patients in the study, they were able to show after three years which patients were more likely to present with mild cognitive impairment. The variation in risk was very small but still measurable and, while further study will be necessary, we can say that progress has been made in understanding the potential that genetic research has in meeting the challenges of early diagnosis.
Vaccine hope with earlier diagnosis
Researchers in California believe they are achieving something of a breakthrough with a new vaccine formulation that they believe can succeed where earlier attempts have failed in tackling the problematic proteins that accumulate in the brains of people with Alzheimer’s disease. In a study published in the Nature Publishing Group journal of Scientific Reports, and reported on the Bloomberg website, a collaborative team based at The Institute of Molecular Medicine and the University of California at Irvine used an “inulin-based adjuvant” as an immunotherapy in tackling the protein. In brief, this is a naturally occurring energy source designed to work with the body’s immune system before protein deposition in the brain has had time to do its damage. The science makes this a slow read but the efficacy of the treatment is confirmed in the team’s moving to secure the science with patents.

Latest Alzheimer's Medical Info
Medical Devices
jDome lets you cycle inside your memories
Virtual reality continues to make inroads on dementia, with a story on the website reporting on a Swedish initiative that lets people with dementia cycle back into their own past, thanks to a collaboration by makers jDome BikeAround with Google Maps. The subject sits on a bicycle in front of a projected image of a familiar setting, ideally accompanied by a caregiver with whom a conversation can get started. The activity is something of a triple whammy activity – social, mental and physical – which apparently diminishes restlessness, decreases the need for medication, and improves sleep.
Low-level light therapy is not to be sniffed at
It seems awfully early days to be saying much about this particular initiative, but this story on the pharmaphorum website is so incredibly innovative that it deserves a look: how about “photobiomodulation” as a therapy designed to treat dementia by inserting a probe up a person’s nose and shining infra-red light onto the brain? A Toronto-based company called Vielight is doing just that, claiming to have improved attention, mood and working memory with 19 patients over the course of a 12-week, randomised and placebo-controlled trial. The pharmaphorum story has an embedded video that explains low-level light therapy and its effects beyond what Vielight is doing.
Disease patch enters a lucrative market
A transdermal patch that can be applied to the skin to deliver the active ingredient in Pfizer’s widely used Aricept product could be available within two years, according to this story on in-Pharma Technologist. Produced by Corium International, the patch would be only the second such product in the market, joining Novartis’ Exelon product, which achieved $900 million in sales last year. The news is good for Corium because it saves them huge development costs, and good for patients who cannot take medicines orally for whatever reason, or who endure side effects that do not occur when the product is delivered transdermally.

Medical Devices & Alzheimer's
Care Advice
Diagnosis is not an end point
Over the course of the almost-two years since INSIGHTS was launched, the name Kate Swaffer has turned up in the content channels as much as anyone’s. It has been good this week to see her inspiring her own feature: this profile on the Australian website is fittingly entitled “Dementia diagnosis is not the end, advocate for human rights says.” Too right.

Among the many good points she makes is the vital importance of getting whole communities on board, a point long reflected in the UK with the initiative championed by the Alzheimer’s Society. Kate Swaffer turned her moment of diagnosis into a launchpad to raise her game and her profile as a champion of human rights: she now tours the world, speaking at dementia conferences about her human right not to be retired to the sidelines, to carry on planning for as active a future as possible.

This approach is now the rule rather than the exception in writing about what to do after a diagnosis of dementia. Even this rather more conventional article this past week in Market Watch, follows its more conventional line in taking a proactive interest in getting financial matters sorted out, with its two concluding paragraphs focused squarely on the importance of staying as active as possible for as long as possible.

And here’s a great fact to finish off with: it seems that a review of 429,000 French workers revealed that “the likelihood of getting dementia seemed to decline for each additional year they worked.”
Best books for that moment
Kate Swaffer’s book (see story above) is fittingly entitled “What the hell happened to my brain?: Living Beyond Dementia”. Its focus is strongly on how best to ensure an optimal quality of life for people following their diagnosis.

Three other books that have impressed over these past couple of years are:
  • June Andrews’ “Dementia – The One-Stop Guide” is precisely that, rendered in positive and accessible prose that conveys its advice clearly and common-sensibly.
  • A Dignified Life: The Best Friends Approach to Alzheimer’s Care, A Guide for Family Caregivers”, by Virginia Bell and David Troxel; and
  • Sum it Up” written by Pat Summit, last week’s subject of an INSIGHTS profile. This book would get into any Best-Of list just on attitude, fighting spirit and a great sub-title: “A Thousand and Ninety-Eight Victories, a Couple of Irrelevant Losses, and a Life in Perspective”.

Alzheimer's Care Advice
Drugs & Clinical Trials
Two drugs with – perhaps – a common purpose
Possibly the most inspiring feature of the week was a contribution to the Huffington Post website provided by the executive director and chief science officer of the American Alzheimer’s Drug Discovery Foundation (ADDF). Dr Howard Fillit asks if cancer drugs might work against Alzheimer’s and not only answers with a more-than-just hopeful yes, but explains a few of the initiatives that the ADDF has been backing to open up this area of research. His starting point is that both diseases feature aging as their greatest risk factor, and the biology of aging is central to the development of each. We will be hearing much more about the re-purposing of an expanding variety of cancer treatments to augment research into Alzheimer’s.
Biohaven secures FDA approval for Phase 3
Human trials may commence for the glutamate-modulating drug BHV-4157, produced by Biohaven, a privately held biopharmaceutical company. Approval by the American Food and Drug Administration, reported on the Pharmabiz website, brings Biohaven one significant step closer to the development of new therapies for a variety of disease states in which glutamate dysfunction is implicated, including major depressive disorders, dementia generally, and Alzheimer’s in particular.

Should pharma avoid taxes on breakthrough drugs?
Certainly not is the short answer from a senior contributor at Forbes Magazine, tackling head-on the suggestion that is inspiring a bill going before the American Congress. The bill proposes that profits from the sale of particular Alzheimer’s drugs might be tax-free for seven years. The writer provides seven reasons why this is a bad idea. One of these reasons is highly debatable – he claims that “Alzheimer’s is far from the nation’s biggest health problem”. The temptation here is to suggest he think about what he means by “biggest”, as biggest is what it most certainly is. However, the other six reasons bear thinking about, and societies everywhere might well keep their conscience and their chequebooks under control when throwing profit incentives around.

Drugs & Clinical Trials
Depression, Stress & Coping
Neuroimaging is exposing depression
Reinforcing the point of this week’s lead story, a report on Psychiatry Advisor’s website reflects on the May meeting of the American Psychiatric Association, talking about the lessons that modern neuroscience and enhanced neuroimaging techniques are providing on the anatomical basis of depression. In other words, this most common of brain disorders appears to be more than just a psychiatric illness and is actually revealing itself as a biological disease. Given the correlations between depression and a wide spectrum of brain disorders, including dementia, what seems to be emerging is a new horizon of potential treatments extending well beyond the traditional range of varyingly successful and invariably expensive anti-depressants.

Depression, Stress & Coping with Alzheimer's
And Finally…
One of the more famous American professors of law has added his name to the list of distinguished people who have found themselves diagnosed with Alzheimer’s disease. Harvard professor Charles Ogletree, who counts Barack and Michelle Obama among his ex-students, was typically forthright in announcing the news in The Boston Globe, declaring that “You have to fight it.” He recognises his potential as a spokesperson for a disease that disproportionately affects black people, by a factor of roughly 2:1 compared with white people according to the American Alzheimer’s Association. “Tree”, as he is known to friends and colleagues, is a lifelong activist and is addressing his new challenge as just another cause that “needs to be addressed”. He will not be easing up on his busy schedule and says “My sense is that I have to keep moving forward. Those are my favourite words.”
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
WeillCornellMedicine (@WeillCornell)
Risk for developing #Alzheimers may be detectable earlier than expected @JacqEHoward for @cnnhealth #AlzU
Nautilus (@NautilusMag)
"I am fearful of the day when I put my hands on they keyboard and don't know what to do." #Alzheimers up close:
Ian Kremer (@LEAD_Coalition)
If only #doctors, #nurses, #caregivers, and people living with #dementia/#Alzheimers always worked as a team! #Hope
DementiaToday (@DementiaToday)
Tips on Boosting Spirits in Alzheimers Caregiving #EndAlz, #caregiving
Ireland AM (@IrelandAMTV3)
Kathy's two sons Andrew and Matthew created a moving video explaining life with their mum's alzheimers #IrlAM
Alzheimer's Assoc. (@alzassociation)
Find activities that build on remaining skills & talents of your loved one with #Alzheimers. Get ideas here:
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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.
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Looking ahead…
Issue 97 19 July 2015
Where does a caregiver look to get news on best practice in keeping the care environment safe? What devices are available for assisting in monitoring living spaces and keeping a person with dementia safe during those times when they are alone?
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