The Alzheimer's Association 2009 International Conference on Alzheimer's Disease was held July 11 to 16 in Vienna, Austria. This year, nearly 3,800 international attendees were present at the conference, which focused on the latest research on the cause, diagnosis, treatment and prevention of Alzheimer's disease and related dementia disorders. These findings were reported in over 100 plenary and symposium sessions, as well as thousands of oral and poster presentations. Participants represented diverse professional settings, including academic; industry; institutional and hospital; private and independent research; and government and non-government organizations.
Colleen E. Jackson, of the University of Connecticut in Storrs, reported findings from an anonymous online survey showing that adults have little understanding of the link between Alzheimer's disease and heart health. A total of 690 adults (mean age 50 years, range: 30 to 85 years) participated, approximately three-quarters (76 percent) of whom were female. The vast majority (94 percent) of respondents were from the United States. The sample population self-reported being well-educated, with 87 percent having completed at least one to three years of college, and relatively wealthy (18 percent earning more than $200,000 at the peak of their career). The investigators used the survey to assess "dementia literacy", a measure of the knowledge and beliefs that could assist in the recognition, management, or prevention of Alzheimer's disease. Over half (64 percent) of the participants incorrectly responded that there was no association between obesity or high blood pressure and Alzheimer's disease. Further, two-thirds (66 percent) did not indicate that high stress is a risk factor for the development of dementia, nor did 34 percent correctly respond that physical exercise can protect against Alzheimer's disease. However, the majority (94 percent) did know that Alzheimer's disease was not part of the normal aging process, and that it is not a completely genetic-based disease.
In a statement, Jackson concluded, "American adults have limited knowledge and a poor understanding of factors that have been demonstrated to increase risk for Alzheimer's, such as obesity, high blood pressure, and other heart health risk factors." Jackson added that "we need more education programs and opportunities, across all demographic groups, focusing on behaviors that modify your risk for developing Alzheimer's disease."
Kristine Yaffe, M.D., of the University of California in San Francisco, presented the results of a study investigating a potential link between post-traumatic stress disorder (PTSD) and the development of dementia. A total of 181,093 veterans (aged 55 years and up) without dementia (127,938 without PTSD and 53,155 with PTSD) were followed from 2001 to 2007. Over the follow-up period, the rate of new dementia cases was higher in the group with PTSD compared with the group without PTSD (10.6 versus 6.6 percent). After adjusting for patient demographics and medical and physical comorbidities in multivariate models, the risk of developing dementia remained nearly two-fold higher among individuals with PTSD (hazard ratio, 1.8).
Based on these results, Yaffe said in a statement that "it is critical to follow patients with PTSD, and evaluate them early for dementia. Further research is needed to fully understand what links these two important disorders. With that knowledge we may be able to find ways to reduce the increased risk of dementia associated with PTSD."
Hanna Rosenmann, Ph.D., of the Hadassah Hebrew University Medical Center in Jerusalem, reported data from an investigation of a novel immunotherapy against tau tangles in a mouse model. Neurofibrillary tangle (NFT) mice were immunized with antigens comprising a mixture of three phosphorylated tau peptides. The immunization was considered successful, as anti-phosphorylated tau antibodies were detectable in the serum of the mice. Further, an approximately 40 percent reduction in the number of tau tangles present in the brains of these mice was demonstrated. Brain inflammation, a side effect previously noted with the use of a non-phosphorylated tau peptide antigen, was not observed in these mice.
"We believe that these results point to the therapeutic potential of phosphorylated-tau-immunotherapy in Alzheimer's," Rosenmann said in a statement. "We devoted significant effort to address not only the anti-tangle effect but also the safety of a phosphorylated-tau vaccine. This was done in order to identify early in the preclinical stage any potential hazard of this potential Alzheimer's therapy."
Scott Roberts, Ph.D., of the University of Michigan in Ann Arbor, reported the findings of a survey of members of the American Academy of Neurology (AAN) regarding the clinical utility of mild cognitive impairment (MCI) as a category of cognitive status between normal aging and Alzheimer's disease. A total of 420 clinicians, 88 percent of whom reported at least a monthly encounter with patients experiencing MCI, completed the survey. The majority of respondents (90 percent) recognized MCI as a clinical diagnosis. Further, when following patients with MCI, respondents reported routinely recommending monitoring and follow-up (88 percent), counseling patients on physical and mental exercise (78 and 75 percent, respectively), and communicating the risk of dementia to these patients (63 percent). Cholinesterase inhibitors or memantine, two drugs approved for Alzheimer's disease, were prescribed by 70 and 39 percent of the responding physicians, respectively. However, 23 percent of respondents indicated that the diagnosis of MCI was "too difficult to diagnose accurately or reliably."
"Our results show that neurologists regularly see and treat people with MCI, despite the fact that the medications they are prescribing are not FDA-approved for this particular diagnostic category," Roberts summarized in a statement. "Clinicians vary greatly in the education and support they provide or recommend for people with MCI, suggesting that there is a need for practice guidelines in this area."
This study was funded by the Alzheimer's Association.
Two studies were reported which demonstrated that the incidence of Alzheimer's disease and dementia continue to rise even in the oldest age groups. Ugo Lucca, of the Mario Negri Institute for Pharmacological Research in Milano, Italy, performed a prospective population-based study of 2,138 individuals 80 years of age and older. A total of 995 surviving participants who did not have evidence of dementia at baseline were reassessed after an average of three years. Prevalence of dementia was found to increase with increasing age (13.5, 30.8, 39.5, and 52.8 percent for age groups 80 to 84, 85 to 89, 90 to 94, and older than 94 years, respectively). In a separate systematic review, reported by Emma Reynish, M.D., of the Victoria Hospital in Kirkcaldy, Scotland, the age-specific prevalence of dementia was higher in the oldest female age groups than previously reported. The prevalence was greater than 50 percent in women in Europe older than 95 years.
ICAD: Investigational Drug Increases Amyloid-β
WEDNESDAY, July 15 (HealthDay News) -- In a surprising result, acute treatment with the drug dimebolin, currently in clinical development for Alzheimer's disease, increased excreted amyloid-β (Aβ) protein levels in a study presented at the 2009 International Conference on Alzheimer's Disease, held July 11 to 16 in Vienna, Austria.
ICAD: Antihypertension Diet Linked to Improved Cognition
TUESDAY, July 14 (HealthDay News) -- Eating a diet designed to lower blood pressure may be associated with a reduction in age-related cognitive decline, supporting a link between hypertension and dementia, according to research presented at the 2009 International Conference on Alzheimer's Disease, held July 11 to 16 in Vienna, Austria.
ICAD: Reduced Dementia Risk Linked to Alcohol Intake
MONDAY, July 13 (HealthDay News) -- Moderate alcohol intake reduces the risk of dementia in cognitively normal older adults by almost 40 percent, according to research presented at the 2009 International Conference on Alzheimer's Disease, held July 11 to 16 in Vienna, Austria.
ICAD: DHA May, May Not Be Helpful in Alzheimer's Disease
MONDAY, July 13 (HealthDay News) -- The jury is still out regarding the benefit of the omega-3 fatty acid docosahexaenoic acid (DHA) in Alzheimer's disease, according to two double-blind multicenter clinical studies presented at the 2009 International Conference on Alzheimer's Disease, held from July 11 to 16 in Vienna, Austria.
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