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Promising New Alzheimer’s Research For Disease With Few Treatments

Michael Nystrom |
April 20, 2015 | 12:59 p.m. PDT

Editor-at-Large

Alzheimer’s patient Faye Farnsworth and her husband, who both passed away within 24 hours (Ashley London)
Alzheimer’s patient Faye Farnsworth and her husband, who both passed away within 24 hours (Ashley London)
Scientists at the University of Southern California have released groundbreaking new research on the correlation between an unbalanced immune system and Alzheimer’s disease. 

Published in the February edition of the scientific journal Neuron, a Keck School of Medicine study found the brain plaque that causes Alzheimer’s could be successfully removed in preclinical rodent models with immune cells. 

For a previously unsuccessful field of study, these finding are promising and urgently needed.

“There are over five million Americans with the disease and [Alzheimer’s] is the most common form of dementia,” said Terrence Town, a professor of physiology and biophysics and the study’s lead researcher at USC. “Instances are on the rise, largely due to advances in general medicine and longer life spans afforded by those advances.”

According to the Alzheimer’s Association, the disease is projected to affect 13.8 million people over age 65 by 2050.

Town and his team hypothesized that the immune system goes out of balance in a brain of an Alzheimer’s patient. They then demonstrated that by rebalancing the immune system, the effects of the disease could be reduced. 

“What we did was to genetically or pharmacologically block a molecule, interleukin-10, that mediates the DNA immune response,” said Town. “We looked at it from the DNA and RNA level to show that blocking this pathway was beneficial in terms of reducing Alzheimer’s pathology.”

The research represents preclinical findings—approval for clinical trials with human patients could take years. The process will not restore memory already lost, but it will stave off future degradation.

Alzheimer’s disease is a form of dementia, characterized by memory loss, mental capacity and changes in behavior. The disease is established when the body’s immune system fails to remove plaque built up in the brain.

Due to it’s complicated nature, there is a void in effective treatments for the disease.

“Alzheimer’s is a very complex disease so it’s a very difficult problem to solve, because of that there are no treatments available that are effective,” said Town. “There are some drugs prescribed for Alzheimer’s but they just don’t work that well.”

Most Alzheimer’s patients are currently treated with a combination of prescribed anti-psychotic medications and assisted living caregiving. Medications such as Aricept are used to treat mild dementia caused by Alzheimer’s disease, but are met with limited results. And, as the disease progresses, many drugs are ineffective and patients can no longer make responsible decisions or take care of themselves.

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Caring for a patient with Alzheimer’s can be difficult, especially for family members who are first-time caregivers. The disease not only affects the lives of the patient, but lives of their loved ones as well.

“I realized people weren’t being educated on how to make good medical decisions, and it’s really rather fixable,” said Viki Kind, a clinical bioethicist and author of “The Caregiver’s Path to Compassionate Decision Making.” She added,  “In bioethics we have these great tools that we can use to make respectful and compassionate decisions when taking care of another person who lacks mental capacity.”

These tools include stepping in and making tough decisions for the patient, but also keeping their perspective in mind. 

“It’s something called substituted judgment, and it comes from bioethics, where we think about the person’s perspective—what’s their religion, what’s their culture, their values, their preferences, who are they if they could tell us?” said Kind. “We try to do things that they would like. We should honor patient’s wishes. We should try to imagine what the person would say if they could still speak to us.”  

Ashley with her grandmother, Faye (Ashley London)
Ashley with her grandmother, Faye (Ashley London)
This approach is comforting to many caregivers, because instead of feeling the responsibility for the decision, it feels as though the patient is simply using the caregiver’s voice. The disease’s debilitating effects are tough for family, who physically see an unchanged person.

“The person is there and not there at the same time. This creates a lot of loss for the people in the family so the person that they knew, the person that they told jokes with, the person that used to nurture them is now the person that needs you to take care of them,” said Kind. “I tell a lot of people that they’re still there. You can still hold their hands, you can still sing to them or read to them or spend time with them and take them on an outing if they’re comfortable. There are all sorts of things we can do to improve their quality of life.”

In addition to the emotional cost, caring for Alzheimer’s patient is also expensive. According to the Alzheimer’s Association, costs range from $65 per day for adult day services, to $212 per day ($77,380 per year) for a semi-private room in a nursing home.

For Ashley London, 27, the reach of Alzheimer’s is all too familiar. Her grandmother, Faye Farnsworth, was diagnosed with Alzheimer’s disease, and London was one of her main caregivers—taking her to doctor appointments and staying overnight with her in the hospital.

“I found out when I was about 21 from my dad that she was diagnosed with Alzheimer's and that it would be tough to watch, and back then she wasn't so bad, just a little forgetful,” said London. “She had changed a lot over the years, it was about a five year span of watching the disease take over. It went from moments of forgetfulness to moments of rage because she forgot something, then to moments of terror because she would forget the people around her.”

Her grandmother was one of millions of Alzheimer’s patients who are taking ineffective medications to treat their disease. If Town’s research was available, her outcome may have been different. 

“She was given a medication from her doctor and would take it for years. Then in her last year she would refuse to take it, whatever the drug was really didn't seem to help,” said London. “To this day, if there was a more effective drug or vitamin out there I would definitely have tried it. We tried at different times to have her take vitamins that we had heard helped with Alzheimer's but because she was 78-80 years of age she was so stubborn that she wouldn't try anything. Maybe early on when she was diagnosed it would have been easier to give her something.”

People in London’s situation oftentimes need outside help and to feel connected to people who are experiencing the same feeling of loss associated with having a family member with Alzheimer’s disease. 

Alzheimer’s Association is a nationwide organization focused on Alzheimer’s care, support and research. There are local support factions in many areas and is available for both patients and caregivers to take advantage of. For a disease that doesn’t have any effective treatments, this is a valuable outlet for many in its reach. 

Dan Field, a support facilitator for the Alzheimer’s Association in Metro Los Angeles, works with male caregivers who have wives who suffer from Alzheimer’s and dementia. He also recognizes the lack of widespread treatment for the debilitating disease. 

“There doesn’t seem to be any effective treatment for especially the later stages of the disease,” said Field. “The fact is, this is such a complex and perplexing disease that what may work for someone may not work for another and sometimes these medications, people improve their function just a little bit, their memory, but then issues of major depressive disorder come out.”

Reach Editor-at-Large Michael Nystrom here. Follow him on Twitter here



 

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