Un­der the mi­cro­scope

The Times Herald (Norristown, PA) - - LIVING -

other symp­toms. About onethird of peo­ple over 70 who show no think­ing prob­lems ac­tu­ally have brain signs that sug­gest Alzheimer’s, Jack said.

There is no cure — cur­rent medicines such as Ari­cept and Na­menda just tem­po­rar­ily ease symp­toms. Dozens of hoped-for treat­ments have failed, and doc­tors think one rea­son may be that the stud­ies en­rolled pa­tients af­ter too much brain dam­age had al­ready oc­curred.

“By the time that you have the di­ag­no­sis of the dis­ease, it’s very late,” said Dr. Eliezer Masliah, neu­ro­science chief at the In­sti­tute on Ag­ing.

“What we’ve re­al­ized is that you have to go ear­lier and ear- lier and ear­lier,” just as doc­tors found with treat­ing can­cer, he said.

An­other prob­lem: as many treat­ment might help, and the as 30 per­cent of peo­ple en- new def­i­ni­tion aims to im­prove rolled in Alzheimer’s stud­ies pa­tient se­lec­tion by us­ing brain based on symp­toms didn’t ac- scans and other tests. tu­ally have the dis­ease — they had other forms of de­men­tia or even other med­i­cal con­di­tions. That doesn’t give an ac­cu­rate pic­ture of whether a po­ten­tial


Many other dis­eases, such as di­a­betes, al­ready are de­fined by mea­sur­ing a biomarker, an ob­jec­tive in­di­ca­tor such as blood sugar. That wasn’t pos­si­ble for Alzheimer’s dis­ease un­til a few years ago, when brain scans and spinal fluid tests were de­vel­oped to do this.

They mea­sure cer­tain forms of two proteins — amy­loid and tau — that form plaques and tan­gles in the brain — and signs of nerve in­jury, de­gen­er­a­tion and brain shrink­age.

The guide­lines spell out use of these biomark­ers over a spec­trum of men­tal de­cline, start­ing with early brain changes, through mild im­pair­ment and Alzheimer’s de­men­tia.


Peo­ple may be wor­ried and want these tests for them­selves or a fam­ily mem­ber now, but Jack ad­vises: “Don’t bother. There’s no proven treat­ment yet.”

You might find a doc­tor will­ing to or­der them, but spinal fluid tests are some­what in­va­sive, and brain scans can cost up to $6,000. In­sur­ance usu­ally does not pay be­cause they’re con­sid­ered ex­per­i­men­tal out­side of re­search. A large study is un­der­way now to see whether Medi­care should cover them and when.

Any­one with symp­toms or fam­ily his­tory of de­men­tia, or even healthy peo­ple con­cerned about the risk can con­sider en­rolling in one of the many stud­ies un­der­way.

“We need more peo­ple in this pre-symp­to­matic stage” to see if treat­ments can help stave off de­cline, Masliah said. Mar­i­lynn Mar­chione can be fol­lowed on Twit­ter at http:// twit­ter.com/MMar­chioneAP The As­so­ci­ated Press Health & Sci­ence De­part­ment re­ceives sup­port from the Howard Hughes Med­i­cal In­sti­tute’s De­part­ment of Sci­ence Ed­u­ca­tion. The AP is solely re­spon­si­ble for all con­tent.


In this file photo, R. Scott Turner, Pro­fes­sor of Neu­rol­ogy and Di­rec­tor of the Mem­ory Dis­or­der Cen­ter at Ge­orge­town Univer­sity Hos­pi­tal, points to PET scan re­sults that are part of a study on Alzheimer’s dis­ease at Ge­orge­town Univer­sity Hos­pi­tal in Wash­ing­ton.


This photo shows slices of hu­man brains re­searchers at North­west­ern Univer­sity are us­ing to study Alzheimer’s dis­ease in Chicago.


This photo shows slices of hu­man brains re­searchers at North­west­ern Univer­sity are us­ing to study Alzheimer’s dis­ease in Chicago.

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