Alzheimer’s research shifting from treatment to prevention
Sherry Sheppard is trying to stay ahead of the game, and based on a recent paradigm shift among researchers of Alzheimer’s disease, she’s on the right track.
If you go
What: 14th annual Thrivent Financial Race for The ARK 5K Run and 1-mile run/walk
When: Saturday, 5K starts at 7:45 a.m.; 1-mile at 8:45 a.m.
Where: St. Luke’s Lutheran Church, 206 Central Ave., Summerville
Cost: $20-$25 today and Friday; $30 before event Saturday
Benefits: The ARK, which provides programs for families and other caregivers of people living with Alzheimer’s disease.
more info: http://thearkofsc.org/special-events/14th-annual-race-for-the-ark/
The 46-year-old’s mother, Brenda, was diagnosed with Alzheimer’s at the relatively young age of 62 on May 1, 2011, and the disease has advanced quickly since then. Sheppard’s maternal grandmother and aunt both died from the disease when they were in their 60s.
And while Sheppard juggles caring for her mother with continuing to work, she knows that her chances of developing the disease are high, and she is taking steps now to either delay or prevent its onset.
“It (the experience) has been a wake-up call for me,” says Sheppard of Summerville.
Among the changes, which are increasingly being confirmed by research to be effective at lowering risks, Sheppard has adopted a vegan diet, is engaging her mind beyond the realm of her job and is trying to lose weight.
The latter has been hampered by recent knee surgeries, which has limited her ability to exercise.
“I’m about 15 pounds overweight, but I’m determined to lose it,” says Sheppard, who recently helped raise $10,000 along with her employer, Thrivent Financial, to support this Saturday’s 14th annual Race for the ARK in Summerville.
About 5 percent of men and women, ages 65 to 74, have Alzheimer’s disease, and it is estimated that nearly half of those age 85 and older may have the disease, according to the U.S. Centers for Disease Control and Prevention. Among the known factors that contribute to the disease are age and genetics.
Increasingly, scientists also think that high blood pressure, high cholesterol and diabetes may increase risk.
Longtime, locally based Alzheimer’s researcher Jacob Mintzer attended the Alzheimer’s Association International Conference, held July 13-18 in Boston, and says research presented represented “a major shift” in the approach to the disease.
Mintzer says studies underscore a switch from efforts to treat the disease to targeting individuals and preventing it in them, using both lifestyle and drugs.
“It’s a big deal,” says Mintzer, who is the director of the new Roper St. Francis Clinical Biotechnology Research Institute and the director of the institute’s Alzheimer’s Research Center.
“During the last few years, Alzheimer’s disease researchers learned that with the help of novelty biomarkers, which are biological predictors of disease, they could predict the onset of symptoms with some degree of certainty, up to 10 years before the disease is clinically expressed,” says Mintzer.
These new biomarkers, he says, led researchers to start developing parameters that will allow for the pre-clinical diagnosis of the disease.
One study, in fact, suggests if someone perceives having memory problems, it is a reliable predictor that a physician will detect mild cognitive impairment that is symptomatic to Alzheimer’s. In fact, people who noticed changes in their memory were twice as likely to be diagnosed with mild cognitive impairment or symptomatic Alzheimer’s disease within the following nine years.
“These findings have started a strong movement to educate the public on the importance of a healthy lifestyle to decrease the risk of developing Alzheimer’s disease,” says Mintzer.
Meanwhile, government agencies and pharmaceutical companies have started programs looking at compounds that can act on the basic lesions of Alzheimer’s disease in patients at high risk, he says.
Type 3 diabetes?
Along the same lines of healthy lifestyle, a new study co-written by a researcher at the Medical University of South Carolina recently linked high-fat diets to the development of Alzheimer’s disease.
Type 3 diabetes?
Researchers Dr. Narayan Bhat of the MUSC neurosciences department and Lakshmi Thirumangalakudi of the Columbia University’s psychiatry department published the study in the current issue of the “Journal of Alzheimer’s Disease.”
Bhat says that genetic mutations causing Alzheimer’s disease are rare, but that lifestyle issues that result in disorders, such as Type 2 diabetes and atherosclerosis, are being linked to Alzheimer’s disease via common cardiovascular risk factors.
In fact, Bhat says some researchers now describe Alzheimer’s as “Type 3 diabetes” because it is a similar, diabetes-like consequence of insulin deficiency and resistance.
Therefore, treatments to improve insulin sensitivity could target Alzheimer’s.
More specifically, one of the consequences of dysfunctional insulin processes is the addition of phosphate to a brain protein, known as tau, which then loses its normal function and becomes toxic in the Alzheimer’s brain.
The process was demonstrated in a study in which mice were fed a high-fat, high-cholesterol diet and experienced altered insulin signals and brain changes, due to the phosphate in tau.
The hypothesis for the link between vascular disorders and Alzheimer’s disease — due to a high-fat, high-cholesterol diet — is that it causes inflammation and dysfunction in the brain’s vascular system. In turn, that causes damage on a cellular and metabolic level, similar to what occurs in a brain with Alzheimer’s disease.
Similarly, a new University of Arizona study, published in the journal “Neurology,” suggests another lifestyle-related link, elevated blood sugar levels, and the risk for developing Alzheimer’s.
Although the link between diabetes and Alzheimer’s has been studied, Arizona researchers wondered if elevated blood sugar levels in nondiabetic individuals also might indicate a higher risk for developing Alzheimer’s disease.
“There have been studies that have linked diabetes to Alzheimer’s disease as a risk factor,” says Arizona psychology professor Alfred Kaszniak, a co-author of the study, in a recent release from the university.
“What was not known when we began this work is whether that risk was only at levels of blood sugar that qualify for diagnoses of diabetes, or in the borderline or pre-diabetic range, or would we also see a relationship across the so-called normal range of blood glucose.”
The researchers used a medical imaging technique that produces three-dimensional images of metabolic activity in the brain. Fasting serum glucose levels, or blood sugar levels taken following several hours of not eating, are routinely examined as part of the imaging protocol.
In a nutshell, lead study author Christine Burns says the study demonstrated a link between high blood sugar and reduced metabolism in certain brain regions, typical of Alzheimer’s disease patients, in otherwise cognitively healthy adults.
The researchers studied data on 124 cognitively normal, nondiabetic adults with a family history of Alzheimer’s disease. The individuals, who ranged in age from 47 to 68, were among participants in a larger study.
In addition to suggesting a link between elevated blood sugar levels and Alzheimer’s risk in nondiabetic individuals, the study also shows promise for the use of brain imaging techniques in identifying Alzheimer’s risk and developing early preventive interventions, researchers say.
“Right now, if you want to develop a drug or evaluate some other kind of a preventive measure for Alzheimer’s disease, the labor and expense is prohibitive,” Kaszniak says. “If you recruit people who may be at some risk but are 20 years away from developing signs of the illness, what drug company or governmental agency is going to fund research that follows people for 20 years to see whether something is effective in prevention?”
“However, if you have a biologic marker, it suggests what areas you should really focus on in those very expensive longitudinal studies,” he says.
The Arizona researchers hope the findings will inform ongoing work designed to help develop early Alzheimer’s intervention that can be implemented as early as middle age.
Reach David Quick at 937-5516 or dquick@postand courier.com.