Recent medical research has produced good news about a new test for Alzheimer's Disease and some bad news about the effectiveness of some drugs used to treat some of its symptoms.
As we age, our bodies change, and so do our brains. Many older people suffer memory loss and a decline in other cognitive functions. At one time, this was labeled senility and was considered a normal part of aging. Today, doctors recognize the condition as dementia, most often caused by Alzheimer's Disease.
The Alzheimer's Association, a research and advocacy group, estimates that half of everyone over age 85 has the disease. Both doctors and researches have been frustrated because there is no certain way of diagnosing Alzheimer's short of examining the brain after death. But that may be changing.
Scientists at Northwestern University in Chicago reported [Jan.31] a new way to examine spinal fluid to detect a toxic protein called ADDL, which is associated with Alzheimer's disease. "We've discovered that there's a toxin that builds up in the brain of Alzheimer's patients that attacks their synapses, targets those synapses, disrupts them, blocks memory mechanisms," said Dr. William Klein, who, with his colleagues, described their findings in the Proceedings of the National Academy of Sciences.The new test requires taking a sample of a patient's cerebral-spinal fluid (CSF) and running it through some very sophisticated diagnostic technology. "We increased the sensitivity a million-fold," he said. "And with this new technology we now show that the ADDLs are present in CSF -- and on top of that, greatly elevated in the CSF -- of Alzheimer's patients."
Taking a sample of a patient's spinal fluid is not a trivial exercise. Which is why Dr. David Katz of Yale University's School of Medicine said the new test will likely be used initially in research, rather than for treatment.
"The clearest implication of this right now is that this should be used as a research tool...we really have to complete the research," he said. "One of the frustrations for the public is that science always proceeds incrementally. One step leads to the next. The next step after this study is to study this and see: can we use this assay [to] monitor progress and identify better treatments? There will be better treatments for Alzheimer's. They can be given earlier. And as a result, some day we'll be able to prevent the memory impairment from occurring."
Despite its limitations, Dr. Katz labeled the new test an "important breakthrough." He spoke on NBC-TV's Today show.
The symptoms of dementia, whether caused by Alzheimer's or some other condition, include a loss of memory and other brain functions. Behavioral symptoms -- including aggression, hallucinations, wandering and agitation -- can make life miserable for caregivers and family members. Doctors often prescribe medicines to alleviate these symptoms. But a new study suggests that, not only do these drugs do little if any good, their side effects could make matters worse.
"Surprisingly, what we found was that most drugs in use are not very effective," says KayCee Sink, who conducted the study. Dr. Sink is an assistant professor and gerontologist - or specialist in aging - at Wake Forest University Baptist Medical Center in North Carolina. She says that one class of drugs, known as atypical anti-psychotics, may be of some use, "but even these drugs are only modestly effective and have side effects that must be balanced with any potential benefit." Side effects include an increased risk of stroke.
Dr. Sink says many doctors prescribe drugs for dementia patients to make it easier for family members or other caregivers to deal with them. But she says there are other approaches that don't involve medicine. "I think the most important thing to keep in mind, because none of the drug therapies are very effective, is that we should really be starting as first-line treatment with non-pharmacologic approaches," she says. "and, specifically, focusing on educating caregivers about the behaviors and things that they can do, short of giving drugs, to try to calm a patient down or keep them from wandering."
In addition, other studies have indicated that approaches like pet therapy and music therapy may be helpful in easing these dementia symptoms.