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Preventing Alzheimer's Easier than Treating it.

Dec. 10 (United States)  
Pevention Easier than Treatment?
Mayo Clinic Jacksonville researchers report evidence to suggest that prevention of amyloid beta (Abeta) deposition in the brain prior to Alzheimer's disease (AD) onset may be easier than curing established disease. An immunization strategy targeting Abeta42, or a second form of Abeta known as Abeta40, prevented onset of amyloid deposition in young, AD-prone mice. However, this strategy was not effective in altering Abeta deposition or clearance in mice with modest levels of preexisting Abeta deposits.

Current hypotheses suggest that it is the accumulation over time of amyloid beta peptide 1–42 (Abeta42) that triggers changes in the brain that lead to cognitive dysfunction in Alzheimer's disease. The reduction of amyloid levels is therefore a major therapeutic objective. Todd Golde and colleagues from the Mayo Clinic Jacksonville report evidence to suggest that prevention of amyloid deposition may be easier than curing established Alzheimer's disease. Their results will appear online on December 8 in advance of print publication in the January 2006 issue of the Journal of Clinical Investigation.

The authors use transgenic mice genetically predisposed to accumulate amyloid deposits in their brain to show that an immunization strategy targeting Abeta42, or a second form of Abeta known as Abeta40, prevents the onset of amyloid deposition in these mice at a young age. In contrast, the anti-Abeta42 or anti-Abeta40 monoclonal antibodies were not effective in altering Abeta deposition in mice with modest levels of preexisting Abeta deposits, nor were they capable of clearing existing deposits.

The results suggest that it may be easier to prevent Abeta deposition than to alter Abeta once deposited. This method may be an effective strategy to prevent amyloid deposition prior to the onset of Alzheimer's disease, but may have limited benefit in a therapeutic setting where amyloid deposits are already well established within the brain.


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Alzheimer's

Is there any treatment?

There is no cure for AD and no way to slow the progression of the disease. For some people in the early or middle stages of AD, medication such as tacrine (Cognex) may alleviate some cognitive symptoms. Donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl) may keep some symptoms from becoming worse for a limited time. A fifth drug, memantine (Namenda), was recently approved for use in the United States. Combining memantine with other AD drugs may be more effective than any single therapy. One controlled clinical trial found that patients receiving donepezil plus memantine had better cognition and other functions than patients receiving donepezil alone. Also, other medications may help control behavioral symptoms such as sleeplessness, agitation, wandering, anxiety, and depression. Prevention, through lifestyle changes and mental and physcial exercise, represents one of the best ways to reduce the likelihood of getting the disease, coupled with regular, systematic monitoring.  

What is the prognosis?

AD is a progressive disease, but its course can vary from 5 to 20 years. The most common cause of death in AD patients is infection.  As the population ages and other diseases are brought under control - Alzheimer's becomes a major risk.

What research is being done?


Scientists are currently studying or testing different types of drugs and other substances to determine if they can stop AD progression, including nonsteroidal anti-inflammatory drugs (NSAIDS), statins (such as those used for lowering cholesterol), folic acid, gingko biloba, huperzine, and vitamins E, B6, and B12. Studies in basic science are also exploring the potential of vaccines. Regular  'screenings' are being advocated by some - with the U.S. House of Representatives recently passing a bill in support of early memory check-ups.  All advocate a regimen of physical exercise and mental exercise. If you start an exercise regimen or just walking use MemCheck to track your progress.

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Source: NIH and Cognitive Advisors. For a qualified medical opinion or diagnosis, please see your healthcare provider.  

Famous People and Alzheimers: former President Ronald Reagan, Grambling University football coach Eddie Robinson, actor Charlton Heston, actor James Doohan.