International Conference on Alzheimer’s Disease Concludes

Almost 5,400 participants convened in Chicago for the International Conference on Alzheimer's Disease (ICAD) 2008 which began on Saturday July 26th and concluded on Thursday July 31. We at Health News have been following the events and would like to provide you with highlights of the daily presentations.

During opening announcements, conference founders Khalid Iqbal and Bengt Winblad presented Harry Johns, President and CEO of the Alzheimer's Association, with a commemorative collection of images, highlights and breakthroughs from 1988 to 2008 in the fight against Alzheimer's disease. Johns also announced that the conference will now be an annual event, with the 2009 meeting to take place in Vienna, Austria from July 11-16.

On July 27, scientists reported having captured images of brain lesions similar to those found in Alzheimer's disease using conventional MRI in an animal model of the disease. These lesions, known as amyloid plaques, have previously been identified using very high power MRI scanners that are only used on animals and also with PET scans combined with specialized marker chemical, but this is the first time they have been captured using conventional, clinical strength MRI. Two other studies reported at the conference also used MRI and advanced computer analysis to identify markers of Alzheimer's, perhaps even before symptoms become evident. One uses an algorithm that extracts atrophy information from an individual patient's three-dimensional MRI scan that identifies neurofibrillary tangles, another lesion associated with Alzheimer's. The other uses images to analyze Alzheimer's-like patterns of brain atrophy. "As we search for ways to identify Alzheimer's early, these MRI studies shows that researchers are moving closer to accurate early detection of the disease, and that we may soon be able to use this technology to determine who is at greater risk," said William Thies, PhD, vice president of Medical and Scientific Relations at the Alzheimer's Association.

Also on the 27th, new research was presented showing that people with better physical fitness have less brain atrophy in key brain areas associated with memory. This is the first time that MRI brain imaging has been used to identify the connection between cardiorespiratory fitness and Alzheimer's-related brain changes in the hippocampus, an area of the brain important for memory and spatial navigation. In Alzheimer's, the hippocampus is one of the first regions of the brain to suffer damage. Another report showed that a home-based exercise program could reduce falls, improve balance, and maintain independence and quality of life in people with dementia. "These studies reinforce the need for increased awareness and education about the importance of living a brain-healthy lifestyle, including staying physically active," said Dr. Thies. "Growing evidence shows that physical exercise does not have to be strenuous or require a major time commitment. It is most effective when done regularly, and in combination with a brain-healthy diet, mental activity and social interaction."

On the 28th, researchers highlighted the correlation between the way staff and families communicate with the patient and the subsequent resistance to care. One study focused on nursing home staff and the other on family members, but both concluded that maintaining normalcy and respectful communication improves the quality of care for the Alzheimer's patient. "The style of communication that we use with people with Alzheimer's influences how they feel about themselves and how well they respond to those providing care," said Sam Fazio, PhD, Director, Medical and Scientific Relations at the Alzheimer's Association. "With the growing prevalence of Alzheimer's, it will be increasingly important for healthcare providers, caregivers, and families to understand the effect Alzheimer's has on communication and, perhaps more importantly, the impact their communication may have on the individual's quality of life."

The 29th was a big day at the conference. Reports on four studies of potential new treatments were discussed, including the Phase II trial of Rember, a tau "tangles" inhibitor. There was also data on a 12 week, Phase II trial of PBT2, which reduces the toxic form of amyloid by preventing the interaction of amyloid with copper and zinc in the brain and a proof of concept clinical trial of a "medical food" product that encourages the formation of brain synapses and may reduce beta amyloid. There was also disappointing news of a Phase III trial of tarenflurbil, an anti-amyloid therapy, that failed to achieve its primary endpoints. While currently approved treatment options for Alzheimer's offer some relief of symptoms for perhaps a year or two, they do not change the underlying course of the disease. Scientists hope that the next generation of therapies will be disease modifying; that they will slow or stop the brain cell death and loss of function caused by Alzheimer's. "We can't leave any stone unturned if we hope to aid the 5 million people currently living with Alzheimer's and the millions more that will be devastated by this epidemic," said Samuel Gandy, MD, PhD, chair of the Alzheimer's Association's Medical and Scientific Advisory Council.

Also on the 29th, results of four studies that show promise for early detection of Alzheimer's through advances in biomarkers were presented. A biomarker is a substance or characteristic that can be objectively measured and evaluated as an indicator of normal body processes, disease processes, or the body's response to a therapeutic intervention. One study was on a blood test that detects a cell cycle defect in lymphocytes of people with Alzheimer's. The second study was for identifying and tracking brain amyloid through a spinal fluid marker. The third study focused on a brain enzyme called BACE1 and the fourth study gave information on a recent advance in PET tomography using a tracer that when injected into the patient "lights up" on the image captured by the scanner.

On the 30th, a new study was presented that suggests that those who are unmarried or not living with a partner in midlife could have an increased risk of developing Alzheimer's disease. Additional research indicates that people who repeatedly think about their problems may be less likely to develop the disease, while people with metabolic syndrome (a combination of cardiovascular health related symptoms) are at higher risk. And, finally, a large analysis of nine European risk factor surveys confirmed a well recognized group of Alzheimer risk factors, which include memory complaint, severe head trauma, diabetes, stroke, and low education. "We may not be able to do anything about aging, genetics or family history, but research shows us that there are lifestyle decisions we all can make to keep our brains healthier as we age, and that also may lower our risk of developing Alzheimer's disease," said Dr. Thies.

Also, in correlation with the conference was a powerful and dramatic art exhibit called "Portraits from the Mind: The Works of William Utermohlen 1955-2000." The exhibit chronicles the life of William Utermohlen and includes a series of self-portraits that document the course of his disease from his diagnosis in 1995 to 2000. "The Utermohlen exhibition is a compelling portrayal of the life of a gifted artist both before and after his diagnosis of Alzheimer's," said Harry Johns. "Mr. Utermohlen's art visually demonstrates the progression of this devastating disease. Today, there are an estimated 5.2 million Americans currently living with Alzheimer's in the United States. Unless we find effective treatments, this figure is estimated to grow to as many as 16 million by 2050."