Do we really have a breakthrough in diagnosis and treatment of Alzheimer’s disease? In our desperation for a cure, we have gotten ahead of biology and cast all of our hopes on the amyloid hypothesis ignoring the complexity of Alzheimer’s disease. The amyloid hypothesis drives a multitude of clinical trials currently underway by pharmaceutical companies to find the cure for Alzheimer’s disease. Simply stated, the hypothesis proposes that build up of beta amyloid, an abnormal protein in the brain, is the cause of Alzheimer’s disease. Hence, treatments are sought that either stop or reverse the production of amyloid proteins in the brain. One of the medications under investigation was semagacestat, a drug developed by Lilly Pharmaceuticals. The trials had advanced to the point where there were 2600 patients enrolled in the clinical trials comparing semagacestat with a placebo. This medication […]
Archive for August, 2010
I was recently confronted with a situation that has caused me to again rethink the use and abuse of the power that we have as professionals- especially those with the title of “doctor.” In my line of work, I am often confronted with difficult and emotional decisions that involve personal rights and freedoms. I provide opinions regarding the capacity of persons to drive, manage finances, and live independently. Most of the cases I am involved with involve various degrees of memory loss, sometimes to the point of impairment known as dementia. Dementia presents as an irreversible loss of ability and coping skills. Depending on the severity of the dementia, rights such as the freedom to come and go as one pleases must be removed for safety. These are often gut wrenching for both the afflicted individual and those who love […]
A new study in the journal Neurology asserts that a spinal tap can accurately detect the development of Alzheimer’s disease before symptoms appear. As quoted in The New Republic, “The unexpected presence of the AD signature in more than one-third of cognitively normal subjects suggests that Alzheimer’s pathology is active and detectable earlier than has heretofore been envisioned.” The “AD signature” is the presence of a protein called beta-amyloid in the spinal fluid. The implication is that people can be accurately diagnosed with Alzheimer’s disease years before they develop symptoms. This all sounds so neat and clean like genetic testing for neurological diseases such as Huntington’s chorea. As technologies like spinal taps and brain scans become more available outside of research settings, there seems to be increased interest in using them as diagnostic tools. But I feel we are getting […]
What Improve Your Memory When Monday, August 16, 2010 12:00pm – 12:00pm to 1:30pm – All Ages Where FGSU Renaissance Academy (map) 10501 FGCU Blvd. South Fort Myers, FL 33965-6565 Other InfoDo you spend too much time looking for your glasses? Do names escape you? Dr. Bill E. Beckwith will provide you with effective, easy to use and practical techniques to improve your memory. Dr. Beckwith will present a lecture, Improve Your Memory, for the Renaissance Academy in Fort Myers, Florida. The talk will be given on August 16, 2010 from 12:00-1:30 PM. Please call 425-3276 for reservations and directions. « Back to the calendar
We get so focused on Alzheimer’s disease that we often forget that there are many other possible causes of progressive cognitive decline and dementia. One such disease that merits attention is Parkinson’s disease which is the third most common progressive neurodegenerative disorder behind Alzheimer’s and Lewy body disease. There are an estimated one million people diagnosed with Parkinson’s disease and 50,000 new cases each year. Parkinson’s disease is more common in men than women by a factor of about 2:1. Age is the only known risk factor as the average age of onset is 60 and most cases of Parkinson’s disease occur in those 50 and older. Family history does not appear to be a significant risk factor for developing Parkinson’s disease. “Parkinsonism” is associated with a variety of causes including viral encephalitis, use of anti-psychotic medications, carbon monoxide poisoning, […]
There are four FDA approved medications available for treatment of Alzheimer’s disease: Aricept, Exelon, Razadyne, and Namenda. The first three are in a class of medications known as cholinesterase inhibitors and the other, Namenda, is an NMDA receptor antagonist. In simple terms, the cholinesterase inhibitors increase the amount of a neurotransmitter called acetylcholine whereas Namenda decreases the amount of a different neurotransmitter, glutamate. Often Namenda is used together with one of the cholinesterase inhibitors as the combination appears to be more effective to boost cognition in moderate to severe Alzheimer’s disease than either medication used alone. The news of the week is that the FDA has approved the use of a higher dose of Aricept for those with moderate to severe Alzheimer’s disease as indicated by a score of 20 or fewer of 30 possible points on the Mini-Mental State […]
I often get asked two very important questions. How do I know when I should seek a memory evaluation and who do I see? This is a more complicated question than it sounds. If you have concerns early in the stages of memory decline you will easily pass all of the brief screening tests now in use and be told that you are fine. I have interviewed hundreds of clients worried about their memory and I have a set of questions that I ask. If you answer yes to one of more of these issues listed below, seek further evaluation no matter what you score on screening tests. Frequently repetitive Trouble remembering recent conversations Trouble remembering recent events Trouble remembering appointments Frequently misplace objects Trouble performing tasks that require many steps such as balancing a checkbook, cooking a meal, using […]
There is a new concern arising as “boomers” are now dealing with cognitive decline in their aging parents. They are now asking “What about me?” This is to say that boomers are concerned about dealing with one possible outcome of their own aging – dementia. As always I suggest getting a plan in place before you need it. We don’t wait until we are in our 70s to plan for financial needs in retirement – we purchase IRAs or 401Ks earlier in life. We don’t wait until we have cancer to act – we undergo cancer screenings from middle age. We don’t wait for medical problems to emerge – we have annual physicals. We are proactive about so many issues in life but remain reactive with our memory. There are several possible reasons for this. First, we treat decline in […]
There is a flurry of articles appearing in both the medical and popular press as many experts are attempting to change the criteria for diagnosing Alzheimer’s disease. The new criteria are based on the “amyloid hypothesis.’ Amyloid is brain protein that sometimes goes awry and is associated with the formation of plaques on neurons. The theory is based on the belief that abnormal amyloids cause Alzheimer’s disease. If this is so, the theory suggests that treatment strategies should be based on arresting or reversing the creation of amyloid plaques. Most current clinical trials of medications for Alzheimer’s disease are based on this hypothesis. By the newly proposed criteria, finding plaque on a PET scan or in cerebrospinal fluids would be cause to diagnose Alzheimer’s disease in persons without memory loss or other symptoms. If adopted, many would be told either […]
