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- Talking to a Loved One With Alzheimer’s
- 10 Powerful Ways to Commemorate Alzheimer’s Awareness Month
- Making the Most of Mealtimes for People With Alzheimer’s
- Family Members Provide 100 Hours a Month of Unpaid Care for Alzheimer’s
- Alzheimer’s Caregivers Should Be Screened for Depression
- Alzheimer’s Care Costs Far More Than Heart Disease or Cancer Care
- Obesity at Midlife May Speed Alzheimer’s Onset
- Hello from my mom
- Easing the Behavior Problems of Alzheimer’s Without Drugs
- When Alzheimer’s Leads to Legal Wrangles
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- High Blood Sugar Tied to Memory Decline
- Blood Test for Alzheimer’s Gets Closer
- Worried About Your Memory? Alzheimer’s May Not Be to Blame
- Brain Changes of Menopause May Promote Alzheimer’s
- Predicting Who Will Get Alzheimer’s
- Personality Changes Are Not the Earliest Sign of Alzheimer’s
- Midlife Heart Problems Raise Alzheimer’s Risk
- Anemia Tied to Mild Cognitive Impairment Risk
- Being Too Thin Late in Life Tied to Increased Alzheimer’s Risk
- A Sniff Test for Alzheimer’s Getting Closer
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- Experimental Alzheimer’s Drug, Intepirdine, Disappoints in Study
- An Eye Scan for Alzheimer’s?
- Drug to treat Alzheimer’s is Ranked Highest
- Patients Often Fail to Adhere to Alzheimer’s Drug Schedules
- Could Treatments for Diabetes Help Treat Alzheimer’s?
- Pharmacists Can Aid in Alzheimer’s Care
- Two-Drug Combo May Ease the Agitation of Alzheimer’s
- Are New, More Effective Alzheimer’s Drugs on the Horizon?
- Insulin Nasal Spray Shows Promise as Alzheimer’s Treatment
- Inflammation Holds Clues to Alzheimer’s Progression, and Possible Treatment
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- Fitness in Midlife Tied to Lower Dementia Risk in Old Age
- Doctor’s Orders: Exercise for the Sake of Your Brain
- Positive Beliefs About Aging May Help Fend Off Alzheimer’s
- Brain Training May Help to Ward Off Dementia
- How Art Can Aid People With Alzheimer’s
- Music Can Be a Balm for People With Alzheimer’s Disease
- Crossword Puzzles May Help Keep the Brain Young
- 7 Steps for Optimal Brain Health
- Men, Women and Alzheimer’s Risk
- Exercise Vigorously and Often to Boost Brain Health
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- Combining Care Program With Medication Reduces Alzheimer’s Symptoms By 750%
- Fisher Center Scientists make two new Significant Discoveries in the battle against Alzheimer’s
- Dementia Rates Are Slowing, but Alzheimer’s Cases Continue to Rise
- Fisher Center Scientists Create a Novel Imaging Technology Allowing the 3D Visualization of Brain Defects That Cause Alzheimer’s Disease
- Negative Beliefs About Aging Could Prime the Brain for Alzheimer’s
- Recognizing Faces Is a Challenge for Those With Alzheimer’s
- Fisher Center Scientists Discover Pathway That may Lead to Alzheimer’s Disease
- Brain Scans Move Closer to Early Alzheimer’s Diagnosis
- Can Vitamin E Slow Alzheimer’s Decline?
- World Alzheimer’s Month
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- The Fisher Center for Alzheimer’s Research Foundation Earns Coveted 4-Star Rating from Charity Navigator for the 7th Consecutive Year
- Hear Kent Karosen, President and CEO of the Fisher Center for Alzheimer’s Research Foundation, describe his new book and the power of art therapy
- Fisher Center Scientists link a Mutation That Protects Against the Development of Alzheimer’s Disease
- Newly Inducted Into the Basketball Hall of Fame, Shaquille O’Neal, Joins the Fisher Center for Alzheimer’s Research Foundation to Raise Funds for Groundbreaking Research in the Quest for a Cure
- Pat Summitt, legendary women’s basketball coach, dies at 64
- Celebrating the life of Nancy Reagan for her Impact on the Fight to end Alzheimer’s
- WRNN Interview
- Fisher Center’s 20th Anniversary Celebration and recent activities
- Featured on NASDAQ’s Billboard
- Online Chat on Reddit.com with Nobel Laureate Dr. Paul Greengard
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The Decades-Long Slide of Alzheimer’s
Memory loss and personality changes are clear signs of Alzheimer’s, though scientists have become increasingly aware of subtle changes in the brain and body that appear years before the disease is diagnosed. Now researchers have mapped out a sequence of events that precedes overt Alzheimer’s, with some appearing decades before symptoms become obvious.
“A series of changes begins in the brain decades before the symptoms of Alzheimer’s disease are noticed by patients or families, and this cascade of events may provide a timeline for symptomatic onset,” said lead author Dr. Randall Bateman of Washington University School of Medicine in St. Louis. “As we learn more about the origins of Alzheimer’s to plan preventive treatments, this Alzheimer’s timeline will be invaluable for successful drug trials.”
Scientists hope that treating Alzheimer’s early, before the disease has damaged the brain extensively, may offer the most promise for slowing or halting the disease’s progress, or even preventing it in the first place. Current Alzheimer’s drugs can provide modest benefits for a time, but do not stop the progression of Alzheimer’s.
For the study, published online in the New England Journal of Medicine, researchers closely followed 128 men and women who lived in families that were genetically predisposed to the form of Alzheimer’s that strikes people at a relatively young age. They had a 50 percent chance of inheriting one of the genes that causes early-onset Alzheimer’s.
Even though most people who get Alzheimer’s have the far more common late-onset form which strikes in a person’s 60s, 70s or older, the scientists believe that studying this early-onset group, who tend to get overt Alzheimer’s in their 40s or even younger, will provide vital clues about how the disease progresses.
The study participants, most in their 30s and 40s, were given extensive memory and thinking tests, as well as brain scans and blood and spinal fluid tests to look for markers of Alzheimer’s, over a period of several years. Fifty-one of them carried an early-onset gene for Alzheimer’s (either presenilin 1, presenilin 2, or a gene called APP), which guarantees that they would get the disease.
The researchers also took detailed family histories to determine when parents developed Alzheimer’s. In this group, early-onset disease had been diagnosed among parents around age 45.
From these tests, the researchers ran statistical analyses to estimate when changes signaling Alzheimer’s disease first became evident. They found that in spinal fluid tests, drops in levels of beta-amyloid, a toxic protein linked to Alzheimer’s, occurred up to 25 years before Alzheimer’s was likely to become evident to patients and family members.
They also found that beta-amyloid brain plaques, a hallmark of Alzheimer’s, began to appear up to 15 years before disease became apparent. The researchers are planning follow-up studies to see whether new drugs that are designed to block or remove plaques in the brain, even before symptoms become disabling, may help slow or halt progression of the disease.
The researchers also found that 15 years before Alzheimer’s symptoms became apparent, parts of the brain critical for memory began to shrink. Spinal fluid levels of tau, a protein that forms tangled clumps in the brains of those with Alzheimer’s, also began to rise.
A decade before disease onset, the brain was less able to take up glucose, or blood sugar, an indication of a slowing brain. Those who were destined to get Alzheimer’s also had slight impairments in episodic memory, critical for remembering times, places and other contextual knowledge, though the changes would be too subtle to be recognized by family members or friends.
“These exciting findings are the first to confirm what we have long suspected, that disease onset begins years before the first sign of cognitive decline or memory loss,” said Laurie Ryan, clinical trials program director at the National Institute on Aging, which funded the study. “And while [these] participants are at risk for the rare, genetic form of the disease, insights gained from the study will greatly inform our understanding of late-onset Alzheimer’s disease.”
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: R. J. Bateman, C. Xiong, T.L.S. Benzinger, et. al. Clinical and Biomarker Changes in Dominantly Inherited Alzheimer’s Disease. The New England Journal of Medicine, July 11, 2012.