IN THE NEWS ‘Gold Standard’ for Recognizing Alzheimer’s in the Brain

Hippocampal protocol a powerful new tool for research, treatment

From Friends of the Semel Institute: After six years of painstaking research, a UCLA team has helped create a new “gold standard” method for recognizing signs of Alzheimer’s disease in the brain. Led by by Dr. Liana Apostolova, director of the neuroimaging laboratory at the Mary S. Easton Center for Alzheimer’s Disease Research, the researchers confirmed the effectiveness of MRI measurements of atrophy in the hippocampus to track the pathologic changes that are hallmarks of the disease — the progressive development of amyloid plaques and neurofibrillary tangles in the brain. “This hippocampal protocol … will serve as a powerful tool in clinical trials for measuring the efficacy of new drugs in slowing or halting disease progression,” said Apostolova. Learn more in this UCLA Newsroom story.

 

Advertisements

Study Suggests That Seniors With Declining Memory Aren’t Visiting Physicians

From Psychiatric News Alert: More than half of seniors–55 %–with dementia had no history of cognitive evaluations, reports a new study in Neurology led by researchers at the University of Michigan.

smiling senior woman and doctor with tablet pc

Good Physical Health can contribute to Good Mental Health. Image (c) Syda Productions | DPC

If these data were applied to the broader population, they suggest that around 1.8 million Americans over the age of 70 with dementia have not seen a physician about their memory problems, giving them no opportunity to receive interventions that may slow down their cognitive decline.

The study evaluated 856 seniors 70 and older, and identified 297 participants who met the criteria for dementia. Of those, only 45 percent had seen a physician about their memory problems. In addition, just 5 percent of seniors with mild memory and cognition problems had been tested by a physician for those issues, while 1 percent of seniors with normal memory had undergone cognitive testing.

The researchers tested various clinical and social predictors, and married status was the only demographic that increased the odds of getting a cognitive evaluation; race, income, and proximity of children did not influence cognitive testing.

The study authors said that this research does not answer the question of why seniors aren’t seeking help, but suggested that it likely involves a combination of factors involving physicians, patients, and the nature of our health care system. For example, the study data were collected before the initiation of Medicare’s free annual wellness exams for seniors, which may improve these discouraging numbers.

Alzheimer’s Research Spending vs. Annual Care Costs

Alzheimer’s disease affects more than 5 million Americans. It’s the fifth leading cause of death in the United States overall, and care costs for Alzheimer’s patients exceed $200 billion. But somehow the government hasn’t made research into this disease a top priority. 

Alzheimer’s Facts

In a year’s time, Alzheimer’s affects more people than cancer, heart disease and AIDS combined. As the infographic shows, only heart disease, the country’s number one cause of death, tops it in terms of annual care costs. (Heart disease costs are $264 billion; Alzheimer’s are $203 billion.)

Alzheimer’s falls not only among the top 10 causes of death in the country, but it’s the fifth leading cause of death for people aged 65 and over. In fact, one in every three seniors dies with Alzheimer’s or another form of dementia.

Over the next decade, cases of Alzheimer’s are projected to increase by 40 percent, barring a medical breakthrough. Yet the U.S. government spends less than one percent of its budget onAlzheimer’s research.

If research dollars remain unavailable, Alzheimer’s will affect nearly 14 million seniors by the year 2050, nearly triple the number of people it affects today.

Alzheimer’s Compared to Other Major Diseases

Between 2000 and 2010, death rates from Alzheimer’s disease increased 68 percent, as the infographic illustrates. However, deaths from other major diseases (cancer, heart disease and AIDS) decreased during that time.

Unfortunately, Alzheimer’s is unique in that it has no cure and no way to slow its progression.

Government Costs for Alzheimer’s

Nearly 30 percent of people with Alzheimer’s and other forms of dementia are on Medicare and Medicaid, compared to 11 percent of people not suffering from these diseases. Per-person Medicare costs for Alzheimer’s and dementia patients are triple that of people without Alzheimer’s. Per-person Medicaid costs are 19 times higher.

It’s clear that research into treatment and prevention could help lower costs for the country. That’s just speaking in financial terms.

Alzheimer’s Caregiver Costs

Family caregivers often give their time for no pay. In 2012, over 15 million caregivers provided more than 17 billion hours of care for no money. Those caregiving hours were valued at $216 billion.

And caregivers often suffer ill health as a result of their caregiving duties. According to theCaregiver Action Network, stress associated with caring for a person with dementia increases a caregiver’s chances of developing a chronic illness. They don’t go to the doctor when they should, tend to have poor eating habits and exercise less than they did before becoming caregivers.

Investing More in Alzheimer’s Research

Alzheimer’s is mysterious. We don’t know what causes it, and we can’t stop it. Some suggest that if it doesn’t affect a family, the family assumes it’s not their problem.

But a recent article in USA Today explains why this isn’t true. Those high Medicare and Medicaid costs affect anyone who pays federal taxes. If that isn’t enough, the statistics indicate that this disease will soon touch a far greater number of families in the near future.

Advocacy and involvement with the Alzheimer’s Association and similar groups can help lead to achievements in research. Until members of congress make Alzheimer’s a priority, however, chances are strong that the costs to the nation will continue to soar.

Making phone calls, writing letters, visiting with congress people and sharing personal stories would be a good step toward drawing attention to the need for Alzheimer’s research funding. It won’t be easy or immediate. Nonetheless, showing politicians the personal side of Alzheimer’s can inspire them to make it a top priority.

Article by Jennifer Wegerer from Alzheimers.net (http://www.alzheimers.net/2013-12-19/research-spending-vs-annual-care-costs/

Jennifer Wegerer is a writer and editor living in the Pacific Northwest. Originally from the Midwest, Jennifer graduated from the University of Illinois at Urbana-Champaign with a degree in English and later earned a Certificate in Project Management from Portland State University. She’s worked as a writer in the technical communications and marketing fields for over 15 years, taking a short break along the way to have twins. Along with writing, she enjoys movies, yoga, beach trips, wine tasting, and the chance to relax with friends and family.

Psychotic Symptoms, Rather than Antipsychotic Meds, Linked to Alzheimer Patient Death & Institutionalization

It is the presence of psychiatric symptoms, including psychosis and agitation, not the use of antipsychotic medications that appears to raise the risk for institutionalization or death among patients with Alzheimer’s disease (AD), according to a new study published in AJP in Advance.

Researchers at several institutions, led by Oscar Lopez, M.D., of the University of Pittsburgh, examined time to nursing home admission and time to death in nearly 1,000 patients with a diagnosis of probable AD, taking into account a range of variables, including dementia severity, physical illnesses, extrapyramidal signs, depression, psychosis, aggression, agitation, and dementia medication use. A total of 241 patients (25 percent) were exposed to antipsychotics at some time during follow-up. A higher proportion of patients exposed to antipsychotic medications, especially conventional antipsychotics, were admitted to a nursing home or died compared with those who never took these medications, but the association was no longer significant after adjustment for psychiatric symptoms. Psychosis was strongly associated with nursing home admission and time to death, but neither conventional nor atypical antipsychotics were associated with time to death.

“This observational study does not support the association between mortality and antipsychotic use that has been reported in institutionalized elderly patients,” the researchers stated.

Geriatric psychiatrist and immediate past APA President Dilip Jeste, M.D., who reviewed the study, called it “an important contribution to the literature on mortality related to psychosis and antipsychotics in persons with Alzheimer’s disease.”

“The results from various published studies have often been at variance with one another. The present study’s finding that psychosis itself is associated with increased mortality is consistent with several other reports, suggesting the need to treat these symptoms. Although there are no FDA-approved safe and effective treatments for psychosis in dementia, a number of pharmacological and psychosocial approaches are available. The treating clinician needs to take into account the risk-benefit ratios for various treatments as well as no specific treatment.”

For more information about AD, see American Psychiatric Publishing’s Clinical Manual of Alzheimer Disease and Other Dementias here and Psychiatric News here.