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Dr. Paul Greengard, Karolinska Institutet's Bicentennial Gold Medal Recipient
 Dr. Paul Greengard, a Nobel Prize-winning neurobiologist and director of the Fisher Center for Alzheimer's Disease Research at The Rockefeller University, will receive the Karolinska Institutet's Bicentennial Gold Medal on September 23rd, 2010. This medal is the highest award conferred by Karolinska Institutet during its 200th anniversary celebrations, and recognizes the work of an individual not permanently located at the Karolinska Institutet, who has contributed to the esteemed Swedish university's activities. Since 1901, the Nobel Assembly at Karolinska Institutet has selected the Nobel laureates in Physiology or Medicine.
"Dr. Greengard is one of the most prominent scientists of this century." says Harriet Wallberg-Henriksson, President of Karolinska Institutet. "His seminal work has revealed several of the mechanisms behind psychiatric diseases. He has been a mentor for generations of Karolinska Institutet scientists, who have been inspired by his scientific leadership and by his extraordinary capacity to reveal the biological meaning and medical implications of a series of unexpected observations from the laboratory."
Dr. Greengard has authored over 1,000 major scientific publications, and on September 2, 2010, he published an article in the scientific journal Nature that has been lauded as a potential paradigm shift in how Alzheimer's will be studied, and possibly treated, in the future. The article, entitled "Gamma-secretase Activating Protein is a Therapeutic Target for Alzheimer's Disease," outlines the discovery of a protein in the brain that stimulates the production of beta-amyloid, a protein in the brain believed to be one of the biological causes of Alzheimer's disease.
Dr. Greengard is a member of the National Academy of Sciences and has received more than 50 awards and honors. In 2000, Dr. Paul Greengard, together with his wife, the renowned sculptor, Ursula von Rydingsvard, used his Nobel Prize honorarium to fund the Pearl Meister Greengard Prize, an award for women scientists named in honor of Greengard's mother, Pearl Meister Greengard, who died giving birth to him. The award is to combat discrimination against women in science, since, as Greengard observed, "Women are not yet receiving awards and honors at a level commensurate with their achievements."
The Karolinska Institutet's Gold Medal will be presented to Greengard on September 23rd at the residence of the Swedish ambassador to the United States in Washington, D.C.
Mr. Kent L. Karosen, President and CEO of the Fisher Center for Alzheimer's Research Foundation adds, "On behalf of the Fisher Center Foundation, I want to congratulate Dr. Greengard on this very prestigious award. Dr. Greengard's contribution to Alzheimer's research has shaped the course of modern investigation into the causes and possible treatment of the disease, and his recent findings continue to open new avenues of study. We are honored to have such a world prominent scientist directing the work of our research center."
The Fisher Center for Alzheimer's Research Foundation is a leading source of funding for Alzheimer's research and education. We serve Alzheimer's patients and their families by seeking to understand the causes of, discover a cure for, and improve the lives of people with Alzheimer's disease. Nobel laureate Dr. Paul Greengard directs the Foundation's team of internationally renowned scientists. Of the money raised by the Foundation, only 8 cents out of every dollar is used for overhead and administrative purposes. For more information about the Fisher Center for Alzheimer's Research Foundation, visit www.ALZinfo.org
Contact:
Betsey Odell: betsey@alzinfo.org, 646-381-5148 |
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A test that measures proteins in the spinal fluid was accurate in detecting which people with memory problems would go on to develop Alzheimer's disease. The findings could lead to a safe and accurate way to test for Alzheimer's disease at its earliest stages, before memory loss and other symptoms become evident and when treatment may be most effective.
Experts now believe that Alzheimer's begins 10 years or more before memory loss and thinking and personality problems become prominent. Currently, the only way to diagnose Alzheimer's with certainty is after death, with autopsy of the brain. Still, many people continue to be diagnosed with the disease based on memory tests, brain scans and other methods.
Detecting the disease at a very early stage, before the brain has suffered a lot of damage, may mean that treatments can be developed to stop the progression of disease. Current medications for Alzheimer's, which are typically prescribed once memory impairment becomes obvious, may ease symptoms for a time but do nothing to stop the underlying disease.
In the study, which was published in the Archives of Internal Medicine, researchers looked at 102 older men and women who met clinical criteria for Alzheimer's. They also studied 200 with mild cognitive impairment, a form of memory loss that sometimes progresses to Alzheimer's, and 144 who were mentally alert and free of serious memory problems.
The researchers looked at a trio of three proteins, or biomarkers, that formed a "signature" pattern in the spinal fluid, the liquid that bathes the brain and spinal cord. The three proteins are known as cerebrospinal fluid beta-amyloid protein 1-42, total CSF tau protein, and CSF phosphorylated tau 181P.
They found that the characteristic proteins were found in 90 percent of those with Alzheimer's disease, and 72 percent of those with mild cognitive impairment. Even some of the seniors who were mentally sharp had the protein pattern: the proteins were found in 36 percent of the seniors who were still cognitively healthy.
The spinal fluid test proved remarkably effectively in predicting who would progress to Alzheimer's disease. When they followed 57 of the patients with mild cognitive impairment for five years, they found that 100 percent of those who had the characteristic protein markers went on to develop full-blown Alzheimer's.
The researchers suspect that many of the "healthy" seniors with the proteins in their spinal fluid would eventually also develop signs of Alzheimer's. “The unexpected presence of the Alzheimer’s disease signature in more than one-third of cognitively normal subjects suggests that Alzheimer’s disease pathology is active and detectable earlier than has heretofore been envisioned,” they wrote.
In an editorial accompanying the study, doctors noted that, "To date, cerebrospinal fluid analyses have not been a routine component of assessment and care for patients with cognitive impairments and suspected Alzheimer’s disease in the United States. There is now ample evidence that these measurements have value; physicians need to formulate when and how to incorporate cerebrospinal fluid measurements into their practice,” they wrote.
Challenges remain. The findings must be confirmed with additional studies, and easy-to-implement versions of the test would need to be made available. The procedure requires a spinal tap, which is not currently a routine part of doctor office visits. In addition, many people who are at risk for Alzheimer's disease may not want to know that they are very likely to develop a disease for which there is currently no effective treatment or cure.
But hundreds of drugs are under testing as possible treatments for Alzheimer's, and some may be most effective when given at the earliest hints of the disease. “Gazing into the future, when there are neuroprotective medications for Alzheimer’s disease, we can envision a recommendation that cerebrospinal fluid analyses be implemented as a screening test to identify clinically healthy individuals at risk for mild cognitive impairment and Alzheimer’s disease," wrote the doctors in the accompanying editorial. "The information gained would enable early application of treatments to delay onset of symptoms or slow progression of cognitive impairments.”
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University
Sources:
Gyungah Jun; Adam C. Naj; Gary W. Beecham; et al: "Meta-analysis Confirms CR1, CLU, and PICALM as Alzheimer Disease Risk Loci and Reveals Interactions With APOE Genotypes." Archives of Neurology, Vol. 67 (No. 8), August, 2010,
A. Zara Herskovits, MD, PhD; John H. Growdon, MD: "Sharpen That Needle" (editorial). Archives of Neurology, August 2010,.2010;67(8):918-920. doi:10.1001/archneurol.2010.151 |
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Up to 90 percent of people in the advanced stages of Alzheimer's disease must be cared for in a nursing home at some point during their lives, and many of those are prone to serious infections like pneumonia. A new study in the Archives of Internal Medicine looked at the antibiotic treatment that Alzheimer's patients with pneumonia received. Researchers found that while the drugs can prolong life, in many cases it could prolong suffering.
The findings underline the importance of proper end-of-life care for people with Alzheimer's, a disease that takes its toll not just on the brain but on the whole body. Indeed, Alzheimer's is the seventh leading cause of death in the United States, accounting for nearly 75,000 deaths yearly and exceeding the deaths caused by diabetes or pneumonia and flu.
The researchers, from Rush Medical Center in Chicago, studied patients with advanced Alzheimer's and other forms of dementia in 22 nursing homes in the Boston area. Over 40 percent of the patients had at least one bout of pneumonia during the 18-month study period. Antibiotics did prolong survival in patients with pneumonia. But overall, it did not make patients feel more comfortable, and in many cases increased discomfort.
Antibiotics can cause well-known adverse effects like allergic reactions and severe digestive upset. But patients who received antibiotics also tended to suffer more pain, for a variety of reasons. In many cases, patients had to be transferred to hospitals for intensive treatment. There, antibiotics often had to be administered intravenously, leading to painful skin infections. The procedure might have to be repeated multiple times, as agitated patients tore drug lines out of their arms and the I.V. tubes had to put back in again and again.
In a commentary accompanying the study, Dr. Anna Chang and Dr. Louise Walter of the University of California, San Francisco, and the Veteran Affairs Medical Center in San Francisco note that patients and their families should carefully consider what it means "to treat pneumonia." While most of us would not hesitate to pop an antibiotic if we got pneumonia, that may not be the best option for a frail and disoriented person in the final days of their life.
They call for greater awareness of all end-of-life issues for those with late-stage Alzheimer's. They note that nursing home staff are not adequately educated about the fatal course of Alzheimer's, which is the seventh leading cause of death overall. In one study, for example, only 1 percent of nursing home staff believed that residents with advanced dementia had a life expectancy of less than six months, when more than 70 percent actually die within that time frame.
They further note that in many cases, patient and family wishes about end-of-life care is not well understood or followed by medical staff, aggressive treatments like tube feeding are overused, and medical problems like pain, bedsores and aspiration of food is not properly managed. Less than a third of nursing home residents who die of advanced dementia receive hospice care, which manages pain and usually makes patients more comfortable in their final months.
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University
Source: Jane L. Givens, Richard N. Jones, Michele L. Shaffer, Dan K. Kiely, and Susan L. Mitchell: "Survival and Comfort After Treatment of Pneumonia in Advanced Dementia." Archives of Internal Medicine, July 12. 2010; Vol. 170(13): pages 1102-1107.
Anna Chang, M.D., Louise C. Walter, M.D.: "Recognizing Dementia as a Terminal Illness in Nursing Home Residents: Comment on “Survival and Comfort After Treatment of Pneumonia in Advanced Dementia.” Archives of Internal Medicine, July 12, 2010. Vol. 170(13): pages 1107-1109. |
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Researchers have noted that extra years of schooling during youth can reduce the risk of Alzheimer’s in old age. As a group, for example, those with a college degree are less likely to develop Alzheimer’s than those with only an elementary school education. But scientists are not sure why education may help ward off Alzheimer’s.
Now, a large European study that looked at data spanning 20 years suggests a reason for the apparent brain-boosting benefits of formal schooling. Researchers from the U.K. and Finland looked at the brains of 872 people who had been part of three large aging studies. All had completed questionnaires about their education before they died, and their medical and cognitive histories were well known.
Confirming results of earlier studies, the researchers found that the more education someone had, the less likely they were to show the memory loss and thinking problems of Alzheimer’s and other forms of dementia. For each additional year of education, the study found, there was an 11 percent decrease in risk of developing dementia.
But microscopic examination of the brains of those who had died showed an interesting finding. Many of those studied had brains that were clogged with the hallmark plaques and tangles of Alzheimer’s disease. But when the scientists compared the brains of those who showed similar degrees of damage, or pathology, they found that those who were highly educated had fewer symptoms of Alzheimer’s when they died than those with fewer years of schooling.
“Previous research has shown that there is not a one-to-one relationship between being diagnosed with dementia during life and changes seen in the brain at death,” said study co-author Dr. Hannah Keage of the University of Cambridge in England. “One person may show lots of pathology in their brain, while another shows very little, yet both may have had dementia. Our study shows education in early life appears to enable some people to cope with a lot of changes in their brain before showing dementia symptoms.”
The results are observational, so you can’t draw a direct connection between staying in school and avoiding Alzheimer’s in old age. People with more education tend to be wealthier than those with little education, and they may tend to live healthier lifestyles, eating healthier foods and going to the gym more often, for example. Those factors may be more important than education per se in fighting off Alzheimer’s onset.
But the findings help support the theory of brain reserve, which holds that richer connections between brain cells help compensate for the degradation caused by Alzheimer’s disease. Education may be one way to help build up the brain’s capacity early in life. Later, as some brain cells die from the buildup of plaques and tangles of Alzheimer’s, enough healthy cells remain to keep the mind and memory intact.
The theory also helps explain why many experts recommend life-long learning and stimulation to help keep the brain young. Word games and crossword puzzles, for example, may act similarly to help build up brain reserve. Read a book or learn a new language or musical instrument, the theory goes, to further stimulate and maintain the brain.
At the least, such activities will enhance your quality of life. And they may do that for years to come.
By ALZinfo.org. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Carol Brayne, et al: “Education, the brain and dementia: neuroprotection or compensation,” Brain, July 26, 2010. |
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