All things Alzheimer’s: This week’s news on the most common form of dementia

While the start of Spring may not have brought on the warmer weather that we were all hoping for, it certainly brought in a wave of attention for Alzheimer’s disease (AD). There seemed to be no shortage of exciting and thought-provoking AD news this week so the IOA decided to highlight some of the top stories here.

| 2015 Alzheimer’s Disease Facts and Figures Report

First up, the Alzheimer’s Association recently released their official 2015 Screen Shot 2015-03-26 at 11.58.48 AMAlzheimer’s Disease Facts and Figures Report, a statistical resource for the most current knowledge on all aspects of Alzheimer’s disease. This report includes information on Alzheimer’s prevalence, mortality and morbidity, caregiving, and costs. In addition, this year’s report includes special coverage on disclosing the diagnosis of AD to patients and their family members, which is an issue that has sparked quite a bit of conversation this week as well.

| Disclosing the Diagnosis of Alzheimer’s Disease

According to new findings from research conducted by the Alzheimer’s Association, an estimated 55% of Alzheimer’s patients do not know their diagnosis. They are typically treated without being told their condition until the disease has progressed to a much more advanced stage. Representatives from the Alzheimer’s Association explain that the biggest problem with this, other than overriding a patient’s general right to be in-the-know, is that it is taking away the patient’s ability to make certain life decisions and plan for their future or to choose to participate in potentially beneficial clinical trials while they still can.

“Doctors commonly cite fear of causing emotional distress as one of the main reason they fail to disclose an Alzheimer’s diagnosis,” quoted the recent CBS News article covering the story, which also listed “uncertainty about their diagnosis, insufficient time to fully discuss treatment options and support services, a lack of support services, and the general stigma that surrounds Alzheimer’s,” as the other reasons given by doctors for not disclosing the diagnosis.

For the full CBS News article, click here.

| New clinical trial raises hope for possible treatment of Alzheimer’s Disease

Recent news of a “game changing” clinical trial for Alzheimer’s treatment highlights the ongoing A4 Study that is testing whether the drug Solanezumab can slow the progression or even prevent Alzheimer’s disease.

Screen Shot 2015-03-26 at 2.53.24 PMThe clinical trial, which is being offered at several different sites across the country including the University of Pennsylvania, is targeting patients who have not yet experienced symptoms related to AD, but whose brain scans indicate they will likely develop the disease in the future. The scans reveal that these patients have a buildup of amyloid plaque, which is one of the proteins believed to cause Alzheimer’s disease, in addition to tau tangles. The hope is that this drug will kill the amyloid before the amyloid can kill the brain cells, resulting in the disease.

For the full CBS News article, click here.

For more information on the A4 Study, click here.

| In other news…

While not directly related to Alzheimer’s disease, the coverage on the A4 Study also brings up the conversation about another recent breakthrough in the realm of neurodegenerative diseases right here at the University of Pennsylvania. Penn Medicine researcher, Corey McMillan, research assistant professor of Neurology in the Penn Frontotemporal Degeneration Center, and his colleagues, have identified a new potential drug target to protect against Amyotrophic Lateral Sclerosis (ALS) and Frontotemporal Degeneration (FTD). They have found that hypermethylation, the epigenetic ability to turn down or turn off a bad gene implicated in 10 to 30 percent of all patients with ALS and FTD, can serve as a protective barrier preventing the development of these diseases.

For the full Penn Medicine News Release, click here.

Geriatrics: From Bedside to Bench to Policy – Singing a Single Song in Separate Keys ft. Neil Resnick, MD

NeilResnickPicEarlier this week, the IOA welcomed Visiting Scholar, Neil Resnick, MD to discuss Geriatrics: From Bedside to Bench to Policy – Singing a Single Song in Separate Keys. Dr. Resnick, Thomas Detre Professor of Medicine; Chief, Division of Geriatric Medicine; Associate Director, Aging Institute of University of Pittsburgh Medical Center (UPMC) Senior Services and University of Pittsburg; and Director, Hartford Center of Excellence in Geriatrics, focused his talk mainly around his research on urinary incontinence in older adults and the myths surrounding this geriatric syndrome.

Myth #1: Urinary incontinence is a normal consequence of aging.

Myth #2: Urinary incontinence is inevitable in the demented, frail, and elderly.

Myth #3: Urinary incontinence is less treatable in the elderly.

During a brief interview, Dr. Resnick addressed these myths and explains how he and his colleagues work to treat, and ultimately cure, the burden of urinary incontinence in older adults.

Dr. Resnick explains that, according to his years of research, incontinence is never normal, regardless of age, even in those with conditions such as Alzheimer’s disease and other dementias. Aging does not cause the symptoms, but merely predisposes the individual and makes them more vulnerable to this syndrome. Therefore, it is not untreatable, as long as you can determine what is setting the stage for the development of incontinence. In younger people, the cause of incontinence is almost always due to the diseased organ, however, in older people this is rarely the case. Instead, the reason can be as simple as a medication or an injury or issue unrelated to the urinary tract.

Another important facet of his research is the realization that this treatment approach can be applied to a variety of other areas in geriatrics such as memory impairment, syncope, fall risks, and depression among others. The idea behind this unified approach is that, regardless of the condition, to properly treat or cure it you must detect any and all outside issues or factors such as medication, other diseased organs, or functional and sensory impairment, rule them out as the cause, and then proceed by addressing the organ-specific issues if still necessary.

 

Still Alice and the Hidden Tolls of Early-Onset Alzheimer’s Disease

still_aliceIn Still Alice, Julianne Moore plays a college professor struggling with her diagnosis of a genetic form of early-onset Alzheimer’s disease. Moore has already won two awards, a Golden Globe and a SAG Award, and is now nominated for an Oscar for Best Actress in a Leading Role.

While her performance is clearly nothing short of noteworthy, the biggest takeaway from this film in the increase in awareness of Alzheimer’s disease, particularly early-onset. Still Alice has gained a reputation as an outlet for highlighting the “hidden tolls” and its “shockingly accurate” depiction of this neurodegenerative condition.

With this in mind, Penn Medicine’s Steven E. Arnold, MD, director of the Penn Memory Center, sat down with us to weigh in on the topic with his expert opinion.

Spoiler Alert: This video may contain spoilers for Still Alice.

The Penn Memory Center is a National Institute on Aging-designated Alzheimer’s Disease Center (ADC). Their team consists of board-certified, experienced physicians specializing in cognitive neurology, geriatric psychiatry, and geriatric medicine, and clinical professionals from disciplines including neuropsychology, psychometrics, nursing, psychotherapy, social work, and research management. They provide clinical care including evaluation, diagnosis, treatment, and research opportunities for patients experiencing symptoms related to Alzheimer’s disease and mild cognitive impairment and related disorders, as well as providing support and resources to caregivers and family members.

For more information on the Penn Memory Center, visit: pennadc.org

Find more facts on the hidden tolls of Alzheimer’s disease that are highlighted in Still Alice, in the related NY Daily News article here.

Debunking the Common Myths of Aging ft. Sarah H. Kagan, PhD, RN

DrKaganBlogPicAccording to Sarah H. Kagan, PhD, RN, the idea of aging is not simply to live longer, but to live happier and healthier as well. As a Lucy Walker Honorary Term Professor of Gerontological Nursing at the University of Pennsylvania’s School of Nursing, her goal is to help the aging community to do just that.

During her recent presentation on “Debunking the Common Myths of Aging” at a lunchtime workshop offered to Penn faculty and staff, Dr. Kagan explained that one way to live longer, happier, and healthier lives is to change the way that we think about aging. We must discredit the stigma that our age defines who we are, how we act, and what we are capable of. There is a common misconception that “the older you get the more invisible you get,” however, this notion is quickly taking a positive turn for older Americans in this recent longevity revolution. With the still-evolving science around what is “normal aging,” we are finding that many conditions and behaviors that we associate with getting older may actually be epigenetic diseases rather than aging-related diseases.

Epigenetic diseases are those that are influenced by a variety of non-genetic factors such as geographic location, personal habits, and other environmental factors. For example, an individual does not necessarily lose their ability to hear simply because of their age, but rather due to a variety or combination of other factors in their life such as frequent attendance at rock concerts or years of working around heavy machinery. Aging also often takes all of the stereotypical blame for wrinkles and grey hair when the true culprits such as UV exposure and a variety of genetic factors actually play major roles in these physical changes.

Dr. Kagan also explained how ageism, the stereotyping of individuals based on their age, is the same as any other form of discrimination. Not every senior becomes frail, experiences memory loss or needs a caregiver but society often forgets that. However, it is not only the younger generations that are guilty of this. Self-stereotyping is a huge issue as well. Older individuals need to stray away from the “I’m too old for that” mindset. After all, an individual’s aging experience is significantly influenced by how they think about it.

ageism

With that said, Dr. Kagam shared that for the most part, the aging community is actually a generally happy on despite the “old and grumpy” stereotype. She explained it as a “U-shaped curve.” Our level of happiness is very high at a young age, decreases around midlife, and increases again as we enter the “last half” of our lives. This level of happiness tends to be higher in those who maintain healthy social relationships, and at a population level, those with closer relationships tend to live longer.

Find more information on Dr. Kagan here.

Follow Dr. Kagan on Twitter here.

 

2014 Vincent J. Cristofalo Annual Lectureship ft. Alfred L. Goldberg, PhD

GoldbergCircleOn Wednesday, February 4, 2015, the Institute on Aging hosted its 2014 Vincent J. Cristofalo Annual Lectureship (originally scheduled for December 11, 2014). This year’s keynote speaker was Alfred L. Goldberg, PhD, professor of Cell Biology, Harvard Medical School. During his lecture on “New Insights into Proteasome Function: From Destroying Misfolded Proteins to Disease Therapy,” Dr. Goldberg discussed his lab’s new advances in the elimination of damaged proteins that cause Alzheimer’s disease and other dementias, as well as the new developments that suggest new approaches to treating such diseases.

The lectureship began with a tribute to Dr. Vincent J. Cristofalo, a pioneer in aging research and the founder of the Center for the Study of Aging (now the IOA) at the University of Pennsylvania, by Robert J. Pignolo, MD, PhD, associate profess of medicine, Division of Geriatric Medicine, Hospital of the University of Pennsylvania and the Presbyterian Medical Center of Philadelphia. Immediately following the lecture and Q&A session, guests were invited to stay and enjoy light refreshments at the lectureship’s reception.

 

“This annual tribute to Vincent J. Cristofalo is to acknowledge in perpetuity his contributions to aging research, his critical scientific thinking, as well as his commitment to mentees, colleagues, friends, and family.” – Robert J. Pignolo, MD, PhD

View more photos from the event here.

Learn more about the IOA’s Vincent J. Cristofalo Annual Lectureship here.

Does lifespan extension equate to healthspan extension? ft. Brian K. Kennedy, PhD

On Thursday, January 15, 2015, Brian K. Kennedy, PhD visited Penn’s Institute on Aging to discuss his work in aging research. Dr. Kennedy, President and CEO of the Buck Institute for Research on Aging, presented a lecture on “Drugs that Forestall Aging – Extending Healthspan.” His most recent work, which you can learn more about in the video interview below, is based around studying the “TOR pathway,” or the target of rapamycin, and this drug’s recently discovered ability to extend lifespan in mice. One of Dr. Kennedy’s goals is to determine whether pathways like TOR can be regulated to treat aging-related diseases, specifically focusing on cardiovascular disease and metabolic syndrome like type II diabetes.

Find more information on Dr. Kennedy and his research here and in the video below.

 

 

Tom Montine, MD, PhD visits Penn to discuss “Precision Medicine for the Molecular and Clinical Complexity of Dementia”

MONTINEcircleLast Thursday, January 8, 2015, the Institute on Aging (IOA) hosted our first Visiting Scholars Series event of the new year. Tom Montine, MD, PhD, Professor and Chair, Department of Pathology, University of Washington, presented his lecture on “Precision Medicine for the Molecular and Clinical Complexity of Dementia.”

Dr. Montine is no stranger to Penn. He directs both the Alzheimer’s Disease Research Center (ADRC) and the Pacific Northwest Udall Parkinson’s Disease Center at the University of Washington and has been a long time collaborator with the related centers here as well. He has worked extensively with many Penn researchers especially John Trojanowski, MD, PhD, Director, Penn’s Institute on Aging, Penn’s Alzheimer’s Disease Core Center (ADCC), and Penn’s Udall Center for Parkinson’s Disease Research, Virginia, M.-Y. Lee, PhD, MBA, Director, Penn’s Center for Neurodegenerative Disease Research, Gerry Schellenberg, PhD, Professor, Pathology and Laboratory Medicine, University of Pennsylvania, Penn ADCC collaborator via Alzheimer’s Disease Genetics Consortium, and Li-San Wang, PhD, Associate Professor, Pathology and Laboratory Medicine, University of Pennsylvania, Penn ADCC collaborate via National Institute of Aging Genetics of Alzheimer’s Disease Data Storage Site (NIAGADS), just to name a few.

His work with Drs. Schellenberg and Wang focuses mainly on molecular drivers in disease and genetic risk related to endophenotypes in Alzheimer’s disease as well as using pathologic data instead of simply clinical diagnosis.

View a list of the IOA’s upcoming Visiting Scholars Series lectures here.