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Issue 99 Alzheimer’s Insights by Curation Health Tuesday, August 2, 2016
The Alzheimer’s Association conference wrapped up in Toronto last week, with over 5,000 delegates gathering from around the world to hear news of research progress, share stories of best practice, and reflect on how much more needs doing on prevention and the pursuit of earlier diagnoses. Collaboration and community will be key words on all these fronts over the coming months, and it will be interesting to see what happens before the conference convenes again: next year, in London.
Most read stories this week
AAIC Meeting looks for silver linings
Alzheimer's Disease Patients Are The Last Casualties Of The Cold War
Treated Patients With Alzheimer's Disease Experience Increased Survival, Reduced Costs
What Are The Politicians Doing About Alzheimer's?
Best way to combat Alzheimer's is a healthy lifestyle, studies show
Global Alzheimer's Platform Foundation Announces GAP-Net
Care Advice
AAIC conference: goodbye Toronto, hello London
The world’s biggest Alzheimer’s conference and exhibition concluded last week in Toronto, Canada, prompting a tsunami of stories that pretty much tripled the quantity of material that normally goes through the Curation Health feeds in a week.

Among the 5,000+ delegates who gathered for all or part of the-five event staged by the Alzheimer’s Association, a global contingent of scientists, health researchers and care professionals were looking in particular for glimmers of realistic hope that a cure or disease-modifying treatment might emerge soon.

In this they were largely disappointed, although there were plenty of stories about bigger budgets for research, diagnostics and care; news of best practice in dementia awareness and community support from around the world; and a much greater focus on what can and must be done to boost prevention and increase quality of life for people with dementia and for their caregivers, in order to push the greater burden of care – and costs – further down life’s road.

Of the publications providing a summary of conference highlights, the review in the International Business Times was probably the best. Perhaps the two biggest stories or themes related to the fall-out from the results announced by TauRx of its LMTX drug, discussed in greater detail in Drugs & Clinical Trials, below; and how the political and funding situation might be affected in this, an American election year. (For more on this, see the story immediately below.)

One thing at least is certain: given how the Alzheimer’s landscape has changed since the 2015 AAIC conference in Washington, and given what is going to be happening – in Washington and elsewhere – over the next twelve months, the 2017 conference – announced for the ExCel Centre in London, England, will definitely be one to attend.
Tug of war over care costs: a Cold War issue?
Occurring just before, and then during the AAIC conference, the two American political conventions provided several talking points in Toronto on the future costs and funding of care – not just for Alzheimer’s but for America’s aging population generally. A brace of articles in Forbes Magazine made particularly interesting reading on health funding on the American election trail, and on “Obamacare” and the tug of war between the parties on what President Reagan long ago criticised as “socialised medicine”.

The first Forbes article asked “What About Health Care and Alzheimer’s, Hillary Clinton?”, noting that her acceptance speech ran a bit light on the subject. While it has been generally true that health care has not featured large in the American election so far – witness this piece in Pittsburgh’s TribLive website – Clinton’s VP nominee Tim Kaine has been an explicit champion of the Alzheimer’s cause. Moreover, Clinton herself has nothing to prove as a health advocate, her website is crystal clear on the subject of Alzheimer’s in particular, and the alternative to the Democrat ticket is a man who, as this piece in Healthcare IT News makes clear – is overtly hostile to Obamacare and appears to know very little about Alzheimer’s (and indeed about much else).

The second Forbes article led on a fascinating claim, that “Alzheimer’s Disease Patients Are The Last Casualties Of The Cold War”. Speaking from the perspective of a Toronto delegate reflecting on the colossal challenges being faced by society in accommodating the spiralling economic and social costs of the disease, the writer provides a thoughtful and detailed analysis of how generations of Americans reared on Cold War thinking have been playing out another tug of war, between a more free-wheeling capitalist approach to health and care issues, and a more community-oriented and yes, socialist perspective.

This argument will run and run, but what is clear after Toronto’s AAIC conference if it was not before, is that the challenges of Alzheimer’s and the solutions being demanded are not being played out in parallel universes. One world. One solution.
Early treatment lowers costs, improves survival rates
One of the more noteworthy presentations at the AAIC conference, in terms of the news stories it inspired, was reported in the American Journal of Managed Care. It told of a study of 6,553 individuals with Alzheimer’s who were either treated, or not, with an existing Alzheimer’s drug. Even though the underlying disease progression was unaffected for both categories, those who were being treated had higher survival rates, lower costs, and fewer co-morbidities than those who were untreated, prompting the comment from one industry professional that “early diagnosis and time to treatment should be a priority for policy makers, physicians, and the public.”
Lower need for anti-psychotics in care homes
Perhaps to show that not all news had to travel via the AAIC conference last week, the Australian website publicised a study out of the University of New South Wales suggesting that as many as 75% of nursing home residents who are prescribed anti-psychotic drugs to stay calm may not need them. It appears that better education on individual residents and their needs, and better training of care staff in spotting agitation triggers, makes all the difference.

Alzheimer's Care Advice
Lifestyle Issues
Get moving for a longer life
One of the more inevitable messages from the AAIC conference, especially given the disappointing data emerging on the clinical trials side, was the growing belief in a healthy lifestyle as key to preventing or forestalling the onset of dementia. Several studies making this point were cited in a report from USA Today, which leads bluntly with the claim that lifestyle is the best tool for prevention “according to another failed drug trial and a five-day-long international conference.”

Underlining the value of exercise among the lifestyle cocktail of diet, sleep, no smoking, and moderating stress, there were two articles that stood out over the course of the conference. A Californian study on the benefits of yoga was picked up by The Telegraph of India, claiming that yoga beats brain or computer training because it also helps with mood and with coping skills. But perhaps the boldest claim of the week in this context was the one picked up on PRNewsire: “There is No Cure for Alzheimer’s. Prevent it Through Ballroom Dance.”
Another lifestyle boost for red wine and chocolates
Devotees of either red wine or chocolate – or indeed both at the right kinds of tables – will get a hearty lifestyle boost from yet more research boosting the merits of resveratrol, the chemical found in red wine and dark chocolate and known to bolster the brain’s defence against brain inflammation that kills neurons. As reported just about everywhere, as here on the UK’s Telegraph website, the one possible downside is that the resveratrol dose mentioned in the study was the equivalent to the amount contained in 1,000 bottles of red wine, which some may see as an impediment. Or perhaps not.

Alzheimer's Lifestyle Issues
Drugs & Clinical Trials
TauRx story leads to dismay among researchers
Prize for the single biggest story out of the Toronto conference, at least so far as drugs and clinical trials are concerned, was the story of TauRx Pharmaceuticals and their somewhat selective presentation of trial data of their experimental drug LMTX. In short, no benefit was conferred upon trial participants who took the drug except for a small proportion (15%) who were on LMTX only, and showed less weakening of memory and cognitive skills.

Almost as interesting as an editorial phenomenon, the story was more than just another highly qualified “bad but good, good but bad” curate’s egg of a story blown along by wishful thinking. A lot depended on the choice of narrative through which the company’s PR would blow its story.

Is the Alzheimer’s research landscape so bleak that any news that is not wholly bad is somehow a bit good, in which case you get the sort of story that appeared in New Scientist or The Telegraph? Or is the dedication to the unvarnished data so fierce as to encourage the sort of treatment we got on the Reuters website or, even more starkly, on STAT News (“Reporting from the frontiers of health and medicine”)? Against the Telegraph’s “breakthrough”, we have STAT News’ “flop, crushing hopes”. Same planet, same data, different stories.

Making a decent stab at underpinning the confusion with some historical perspective, a short feature on the Exome website (“all the information, none of the junk”) describes how the research community gathered in Toronto worked hard to “take a page from the Silver Linings Playbook”.
Gene therapy offers huge promise for Alzheimer’s
Clinical advances in gene therapy may still be at an early stage, but it is possible to see how an AAIC conference in ten years’ time could focus as much on what is happening in genetics as we see now with the continuing emphasis on brain proteins. An article on the MedicalXpress website provides a powerful taster of what research is already underway into diseases of the central nervous system, including Alzheimer’s. Included within the story is a link to the same publication’s story from February of this year, asking a question which may well feature more in people’s thinking at next year’s AAIC conference in London: “Can gene therapy provide a breakthrough in Alzheimer’s disease?

Drugs & Clinical Trials
Medical Information
Global network of clinical trial initiatives launches
GAP-Net, described as a first-of-its-kind network of clinical trials site designed to streamline Alzheimer’s research and the development of new drugs, was possibly the best antidote to the lukewarm trials data presented at the AAIC conference. According to this release from PR Newswire, the new initiative is a promotion of the Global Alzheimer’s Platform Foundation and, although almost exclusively American at this stage, it has established bridgehead relationships with the European Prevention of Alzheimer’s Dementia Consortium (EPAD) and with the Canadian Consortium on Neurodegeneration in Aging (CCNA). Collaboration is seen as the key in reducing the time it will take to get any breakthrough cure or treatment through the trials process.
Round-up of early diagnostic innovations
Given the growing focus on prevention and on early diagnosis, it was inevitable that a series of stories would appear to coincide with last week’s AAIC conference. One of the more intriguing innovations was reported in the UK’s Telegraph, describing work underway at London’s Moorfields Eye Hospital and at Oxford University in measuring the thickness of a layer at the back of the eye. The idea is that a check that carried out by an optician might spot the early signs of neurodegeneration before any symptoms of cognitive impairment manifest themselves.

A story on the CNN website tells of a similarly inspired brace of studies at New York’s Columbia University but focused on smell; while slightly older stories have appeared on the Nature website regarding the possibility that tear proteins might serve as biomarkers for the disease, and on the Medical Daily website referencing research from earlier this year about a measurable difference in the smell of urine.

Latest Alzheimer's Medical Info
Medical Devices
Canadian diagnostic technology wins top prize
A tablet-based software programme that uses Artificial Intelligence to assess test subjects’ speech patterns as a means of identifying the early signs of dementia won the top prize in the AGE-WELL pitch competition that took place in Toronto in the week ahead of the AAIC conference. The Toronto-based technology team, whose innovative work as been featured before in INSIGHTS, has employed a wide range of variables such as pitch, tone, rhythm and rate of speaking to develop a predictive determination that works for aphasias, Parkinson’s and Alzheimer’s with a success rate in excess of 85%. Their story, picked up in the International Business Times, is indicative of advances being made in Artificial Intelligence and speech recognition.

Medical Devices & Alzheimer's
And Finally…
Another week, another icon shows us how the challenges of dementia can be faced. Thanks to this story on the website, we hear from Australian jazz great Don Burrows, now living in a Sydney home, that whether it’s Waltzing Matilda or Moonglow, the music lives on.
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Latest Alzheimer’s Medical Info
Drugs & Clinical Trials
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Tweets of the week twitter logo
The Associated Press (@AP)
Ad: What causes #Alzheimers? See what may be contributing in 360-degree #VR powered by @AMD
A Health Blog (@AHealthBlog)
#Exercise more important for those at risk of
Genentech (@genentech)
Our latest @CellReports paper offers new insights for anti-tau #immunotherapies in #alzheimers…
Mayo Clinic (@MayoClinic)
Q. How early can #Alzheimers be diagnosed? What are early symptoms? @RonPetersenMD replies.
Roche (@Roche)
DYK 1 person is diagnosed with #Alzheimers worldwide every 4 seconds. #AAIC16…
IMAGE (@neurosocialself)
Cognitive decline in Alzheimers reversed? Bobby Lazzara reviews a small study…
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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!
Memory loss is not necessarily a sign of Alzheimer’s but we understand that it can be, when it is persistent and begins to interfere with daily living. Determining a dividing line between the less worrying and the more worrying kinds of memory loss cannot be an easy thing to do, can it? Are there any online tests that can give a clue to a normal person?
Click here to find out
Looking ahead…
Issue 100 9 August 2016
Before stepping away for a short summer’s break, INSIGHTS will hit its century of issues with a look back over what has changed in the world of Alzheimer’s since our launch almost two years ago.
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