Panel moderator, Dr. Sapna Parikh; Panelists, Dr. Sam Gandy, Dr. Effie Mitsis and Dr. Ralph Nixon; Chapter President and CEO, Lou-Ellen Barkan; Chapter Executive VP, Director of Programs and Services, Jed Levine
By Francine Russo
In the battle against Alzheimer’s, there are many grounds for hope, but everyone should bring a skeptical eye to news stories trumpeting a treatment just around the corner. Hope, not hype. That was the theme of the NYC Chapter’s annual scientific meeting held at the Times Center on October 18th, and titled “Alzheimer’s Research: What’s Behind the Headlines.”
“We are so grateful to our friends in the media,” Chapter President & CEO Lou-Ellen Barkan said. “They’ve helped us keep the story alive. But we worry that some of these hyped-up headlines will frustrate people when they learn that a prescription is not yet available. It can be heartbreaking.”
The lively panel discussion among three leading Alzheimer’s researchers—a new format for the Annual Meeting— was moderated by Sapna Parikh, ABC News medical correspondent. “Do you think a disease modifying drug is likely in the near future?” Parikh posed this tough question to the three scientists: Sam Gandy, M.D., Ph.D., an Alzheimer’s professor at Mount Sinai, Effie M. Mitsis, Ph.D., an assistant professor of psychiatry at Mount Sinai, and Ralph A. Nixon, M.D., Ph.D., Professor; Director of Silberstein Institute, NYU Langone Medical Center. Responding to this, Dr. Gandy counseled that research and testing take time. “Even the best idea may be five to 15 years away,” he cautioned. Nevertheless, all three researchers stressed, progress is happening on many fronts. Each is working on a diff erent approach to understanding the disease, preventing it, and treating it. And all of these avenues show tremendous promise.
The direction of Dr. Gandy’s research, for example, has led him to study amyloid, the sticky substance that clumps in the brain of people with Alzheimer’s. Recently, he’s studied how nerve cell communication regulates the generation of amyloid and he’s uncovered a promising link between diabetes and Alzheimer’s: a particular gene that controls the risk for both Type-2 diabetes and Alzheimer’s. “If people have this gene,” he said, “they’re at risk for both types of illness. Now we have a single molecule that’s a way into the process.”
Tackling Alzheimer’s from a completely different direction, Dr. Mitsis is using brain imaging to study combat veterans from Iraq and Afghanistan who’ve suffered traumatic brain injury (TBI) as a result of blast exposure. “These young men,” she reported, “have memory problems and depression. And we know that traumatic brain injuries (in boxers, for example) are a risk factor for Alzheimer’s.” Another group at high risk for Alzheimer’s, she noted, are those with Mild Cognitive Impairment. So, through imaging, she will study those who have Mild Cognitive Impairment with and without a history of TBI to determine whether a brain marker, like amyloid plaques, can be identified in those who have this history and whether any change in the marker predicts who will develop Alzheimer’s. By using imaging at different time points, she can track whether there is any change in the amyloid over time and whether that results in worse outcomes. Her goal is to be able to detect the onset of Alzheimer’s disease early on. For Dr. Nixon, the path to understanding and treating Alzheimer’s may be through what he calls the “trash recycling systems” of brain cells. Throughout our lives, he explained, our cells produce waste but have a way of digesting it, a process called autophagy or “selfeating.” When we age, this system breaks down. One exciting development is the discovery that mutations of presenilin, a gene required for this recycling process, are associated with early-onset Alzheimer’s. There’s also been a related and equally exciting discovery. Drugs that extend life span in experimental animals all have the ability to promote autophagy. “These new drugs are very promising,” Dr. Nixon reported, “and some large pharmaceutical companies are working on this right now.”
To learn what such developments really mean, the panelists stressed, don’t rely on the headlines. For every study reported, Dr. Nixon said, “Your local Alzheimer’s Association Chapter is likely to give you sage judgment on what’s smoke and mirrors and which have something to them.” Also check the website of one of the Alzheimer’s Disease Research Centers, added Dr. Gandy. And whatever the source, Dr. Mitsis suggested; don’t forget to maintain a critical eye. Ask questions like, “Who were in the sample? Were they representative?” For the present, Dr. Gandy said, the greatest hope for Alzheimer’s may lie in prevention. For example, using imaging to identify people early to see who’s building amyloid. Even though amyloid-lowering drugs don’t help those who already have the disease, he said, these drugs may help those who have not yet developed signifi cant amyloid in their brains. As for current treatments, Dr. Gandy said, “Only physical exercise has been proven in clinical trials to slow the progression of the disease.” Can exercise help prevent Alzheimer’s? It sure can’t hurt, the panelists suggested. “You have a hedge on delaying the onset of Alzheimer’s,” Dr. Nixon said, “if you keep your weight and fat-intake low, and control diabetes and hypertension.” The real answer to all these questions is research and more research, and we all need to support it in every way possible, urged Lou-Ellen Barkan. “Funding for Alzheimer’s research is in jeopardy now,” she said. “We need more dollars, and we need more subjects for clinical trials.” She herself has enrolled in a study, she told the group, and the Association has created a wonderful new tool to make it easy for everyone—with or without the disease—to enroll. It’s called the Alzheimer’s Association TrialMatch™. “To participate, just click on ‘TrialMatch™’ on our website,” Barkan said, “or call our 24-hour Helpline at 800-272-3900.”
In this spirit of hope, Director of Programs & Services Jed Levine recognized this year’s Research Award Grantees. Their scientific work could be the key to fi nally unlocking Alzheimer’s. We know such work takes years, Levine acknowledged, then, with a mix of gravity and levity, begged, “Please hurry it up a little.”
Francine Russo, author of They’re Your Parents, Too!, is a keynote speaker at conferences, hospitals, senior living communities, banks, and other groups serving boomers and the elderly.