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Hope. Courage. Progress. Alzheimer’S Disease: What’S It All About? Where Do We Stand in the Search for a Cure?

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Hope. Courage. Progress. Alzheimer’S Disease: What’S It All About? Where Do We Stand in the Search for a Cure? Alzheimer’s disease: What’s it all about? Where do we stand in the search for a cure? hope. courage. progress. Alzheimer’s disease: What’s it all about? Where do we stand in the search for a cure? This report describes the state of our knowledge about Alzheimer’s disease as it stands today, and does so in a way that people without a lot of knowledge of science or medicine can understand. – DR. Jack DIAMOND, FORMER SCIENTIFIC DIrector EMERITUS, ASC OctoBER 2011 Dr. Jack Diamond Dr. Jack Diamond is the former Scientific Director University in Hamilton, Ontario, and is currently Emeritus of the Alzheimer Society of Canada. For the Professor Emeritus in the Department of Psychiatry and past few years, he has been giving presentations on Behavioral Neurosciences, where he continues to run Alzheimer’s disease to various, largely lay, audiences his laboratory research program with a special focus across Canada and internationally. This report was on the apoE4 risk factor for Alzheimer’s disease. Dr. created in the light of these presentations and takes into Diamond was formerly Associate Director for Scientific account questions often asked by audience members. Affairs at the Montreal Neurological Institute at McGill Dr. Diamond received his PhD and subsequently his University. He was a longstanding member of the grant medical degree at the University of London, in England, review committees of the Juvenile Diabetes Research after which he did two years of post-doctoral research at Foundation International, and he also served on the Harvard Medical School, returning to a faculty position Scientific Committees of the ALS Society of Canada and at University College London. He was the founding chair the Spinal Cord Society. He is widely published, having of the original Department of Neurosciences when written more than 75 papers in refereed journals, and the new medical school was established at McMaster 15 book chapters. 2 Alzheimer Society summary cause the characteristic shrinkage of the brain. Following this is a discussion of some of the important discoveries about Alzheimer’s disease: inflammation of the brain, “oxidative stress” and the role of antioxidants, why mitochondria and glial cells are so important and why their sickness is so threatening, as is the impairment of calcium regulation. The next section includes an examination of why some people get Alzheimer’s disease and others not, what the differences are between the genetic and sporadic type of the disease and the roles of both genetic risk factors and genetic protective factors. Genes and gene variants are explained, as is familial Alzheimer’s disease (FAD) and its relation to animal models. The section on the causes of Alzheimer’s disease includes the amyloid or amyloid cascade hypothesis. Following that is a discussion about the risk factors for Alzheimer’s disease, including aging, genetics, The future is hopeful. We have a t has been just over 100 years since the ApoE4 gene variant, diabetes, and many others. There is also a discussion of how to much greater understanding of Dr. Alois Alzheimer identified the disease that now bears his name. reduce known risks for the disease, through Alzheimer’s disease today than Since that time, there have been many diet, exercise, intellectual activity and so on. discoveries about the nature of the disease, its we did 100 years ago, and we now I Then is a discussion about diagnosing causes and risk factors, and even treatments know several ways to reduce the Alzheimer’s disease, including the first signs to slow its progression. At the same time, there typically observed, testing, how diagnosis chances of getting the disease. is much to be learned. This report describes is made, and the importance of early the state of our knowledge about Alzheimer’s diagnosis. The section on treatments for disease as it stands today, and does so in a Alzheimer’s disease looks at drugs used to way that people without a lot of knowledge help, though not cure, the disease. Finally is a of science or medicine can understand. look at promising findings that could make The first section addresses some questions a difference in the next five to seven years. people commonly ask. Is Alzheimer’s disease These include, among others, vaccines; statins different from dementia? Why do people talk and secretases (drugs); anti-diabetic drugs; of “early” and “late” onset Alzheimer’s disease? animal studies and the recovery of long-term And, originally called “senile dementia,” now memories. it’s Alzheimer’s disease: why? The future is hopeful. We have a much greater An understanding of Alzheimer’s disease understanding of Alzheimer’s disease today requires a fairly detailed look at the role of than we did 100 years ago, and we now the “plaques and tangles” in the brain, and an know several ways to reduce the chances of awareness of the loss of nerve cells. This report getting the disease. As well, much research is examines how plaques are formed, the nature underway to help answer the many questions of tangles and why they are so dangerous, that remain, including the best strategies to and the sickness and death of nerve cells that halt and even reverse the disease process. Lay Report 3 contents Summary .........................................................3 Background .......................................................5 Common questions about Alzheimer’s disease ..................6 A new look at Alzheimer’s plaques, tangles, and loss of nerve cells .............................................8 Some important discoveries since Dr. Alzheimer’s time .........10 Why do some people get Alzheimer’s disease and others not?. .12 What causes Alzheimer’s disease? ...............................14 Risk factors for Alzheimer’s disease and, when known, 10 how do they work? ..............................................15 How can we reduce the risk of developing Alzheimer’s disease?. 21 How is Alzheimer’s disease diagnosed? .........................25 17 Treatments for Alzheimer’s disease ..............................28 The future: Ten findings that could make a difference in the next five to seven years ........................30 19 25 Conclusion .......................................................36 List of abbreviations .............................................36 Research reports on Alzheimer’s disease ........................36 The role of the Alzheimer Society of Canada ....................36 References. 37 28 32 4 Alzheimer Society background The report provides an overview The Alzheimer Society “Young Investigators” beginning their of our current understanding of professional careers—the Alzheimer Society of Canada of Canada (ASC) has become a leading funder Alzheimer’s disease. What are its The Alzheimer Society is the leading of Alzheimer research and research training origins and likely causes? Can it nationwide health charity for people living in Canada, distributing (with our partners) up be prevented? What treatments with Alzheimer’s disease and other dementias. to about $3 million each year. The funding for the research program comes from provincial are available and what are their Active in more than 150 communities across Canada, the Society: and local Alzheimer Societies across Canada, limitations? And finally, how close and from the generosity of individuals • Offers information, support and and corporations. The ASC administers the are our researchers to finding a education programs for people with research program. Research applications cure, making it possible not only dementia and their families and received for the annual competition are caregivers to halt the progress of the disease, reviewed through an extensive peer review but to reverse its effects and even • Funds research to find a cure and process, and funding is provided both for restore lost memories? improve the care of people with biomedical and quality of life fields. ASC seeks dementia out partnerships to enhance the impact of its research funding. • Promotes public education and awareness of Alzheimer’s disease and The Alzheimer Society Research Program other dementias to ensure that people supports biomedical research projects in know where to turn for help essentially all the areas discussed in this research report. • Influences policy and decision-making to address the needs of people with dementia and their caregivers. Use of Information The contents of this document are provided for Alzheimer Society information purposes only and do not represent Research Program advice, an endorsement, or a recommendation with respect to any product, service or Canadian scientists rank among the top enterprise, and/or the claims and properties Alzheimer scientists in the world. To support thereof, by the Alzheimer Society of Canada. these scientists— trainees (doctoral students The information contained in this report was and post-doctoral fellows), and promising current in October 2011. Lay Report 5 common questions about alzheimer’s disease The first three sections deal with frequently asked questions about the general nature of Alzheimer’s disease: how does it differ from dementia and why was senile dementia renamed Alzheimer’s disease? What’s meant by “early onset” and “late onset” Alzheimer’s disease? How can we recognise the disease (memory loss is not always first) and why is it fatal? Finally comes the reason why Alzheimer’s discovery of the “plaques and tangles” was so important – it identified the condition as a disease, not just an inevitable consequence of aging.
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