Lauren Miller Rogen on Alzheimer’s Caregivers

In an interview with WebMD, actress and Alzheimer’s disease advocate Lauren Miller Rogen praises the work of Alzheimer’s patient caregivers.

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Alzheimer’s in the brain,Alzheimer’s disease,Alzheimer’s symptoms,Alzheimer’s disease stages,caregiving,Maria Shriver,Alzheimer’s Association,Seth Rogen,Lauren Miller Rogen,#EndAlz,WebMD

Antibody helps detect protein implicated in Alzheimer’s, other diseases

May lead to novel ways to diagnose, monitor brain injury

by Tamara Bhandari•April 19, 2017

Researchers use mouse brains (above) to study ways to measure the brain protein tau, which plays a role in neurodegenerative diseases such as Alzheimer’s. A team led by scientists at Washington University School of Medicine in St. Louis has found a way to measure tau levels in the blood. The study, in mice and a small group of people, could be the first step toward a noninvasive test for tau

Damaging tangles of the protein tau dot the brains of people with Alzheimer’s and many other neurodegenerative diseases, including chronic traumatic encephalopathy, which plagues professional boxers and football players. Such tau-based diseases can lead to memory loss, confusion and, in some, aggressive behavior. But there is no easy way to determine whether people’s symptoms are linked to tau tangles in their brains.

Now, however, a team led by scientists at Washington University School of Medicine in St. Louis has found a way to measure tau levels in the blood. The method accurately reflects levels of tau in the brain that are of interest to scientists because they correlate with neurological damage. The study, in mice and a small group of people, could be the first step toward a noninvasive test for tau.

While further evaluation in people is necessary, such a test potentially could be used to quickly screen for tau-based diseases, monitor disease progression and measure the effectiveness of treatments designed to target tau.

The research is published April 19 in Science Translational Medicine.

“We showed that you can measure tau in the blood, and it provides insight into the status of tau in the fluid surrounding cells in the brain,” said senior author David Holtzman, MD, the Andrew B. and Gretchen P. Jones Professor and head of the Department of Neurology at Washington University School of Medicine in St. Louis.

Tau is a normal brain protein involved in maintaining the structure of neurons. But when tau forms tangles, it damages and kills nearby neurons.

“People with tau diseases have a wide range of symptoms because basically, wherever tau is aggregating, those parts of the brain are degenerating,” Holtzman said. “So if it’s in a memory area, you get memory problems. If it’s in a motor area, you get problems with movement.”

A blood-based screening test, likely years away, would be a relatively easy way to identify people whose symptoms may be due to problems with tau, without subjecting them to potentially invasive, expensive or complicated tests.

“We have no test that accurately reflects the status of tau in the brain that is quick and easy for patients,” Holtzman said. “There are brain scans to measure tau tangles, but they are not approved for use with patients yet. Tau levels can be measured in the cerebrospinal fluid that surrounds the brain and spinal cord, but in order to get to that fluid, you have to do a spinal tap, which is invasive.”

In the brain, most tau proteins are inside cells, some are in tangles, and the remainder float in the fluid between cells. Such fluid constantly is being washed out of the brain into the blood, and tau comes with it. However, the protein is cleared from the blood almost as soon as it gets there, so the levels, while detectable, typically remain very low.

Holtzman, postdoctoral researcher Kiran Yanamandra, PhD, and MD/PhD student Tirth Patel, along with colleagues from C2N Diagnostics, AbbVie, the University of California, San Francisco, and Texas Health Presbyterian Hospital, reasoned that if they could keep tau in the blood longer, the protein would accumulate to measurable levels. Allowing the protein to accumulate before measuring its levels would magnify – but not distort – differences between individuals, in the same way that enlarging a picture of a grain of sand alongside a grain of rice does not change the relative size of the two, but does make it easier to measure the difference between them.

The researchers injected a known amount of tau protein directly into the veins of mice and monitored how quickly the protein disappeared from the blood. The researchers showed that half the protein normally disappears in less than nine minutes. When they added an antibody that binds to tau, the half-life of tau was extended to 24 hours. The antibody was developed in the laboratories of Holtzman and Marc Diamond, MD, of the University of Texas Southwestern Medical Center, and is currently licensed to C2N Diagnostics, which is collaborating with the pharmaceutical company AbbVie in developing the technology.

To determine whether the antibody could amplify tau levels in an animal’s blood high enough to be measured easily, they injected the antibody into mice. Within two days, tau levels in the mice’s blood went up into the easily detectable range. The antibody acted like a magnifying glass, amplifying tau levels so that differences between individuals could be seen more easily.

Tau levels in people’s blood also rose dramatically in the presence of the antibody. The researchers administered the antibody to four people with a tau disease known as progressive supranuclear palsy. Their blood levels of tau rose 50- to 100-fold within 48 hours.

“It’s like a stress test,” Holtzman said. “We appear to be bringing out the ability to see what’s coming from the brain because the antibody amplifies differences by prolonging the time the protein stays in the blood.”

Measuring tau levels in the blood is only useful if it reflects tau levels in the brain, where the protein does its damage, the researchers said.

Both high and low levels of tau in the fluid that surrounds the brain could be a danger sign. Alzheimer’s and chronic traumatic encephalopathy both are associated with high levels of soluble tau, whereas progressive supranuclear palsy and other genetic tau diseases are thought to be associated with low levels.

To see whether elevated brain tau is reflected in the blood, the researchers treated mice with a chemical that injures neurons. The chemical causes tau to be released from the dying neurons, thereby raising tau levels in the fluid surrounding the cells. The scientists saw a corresponding increase of tau in the blood in the presence of the anti-tau antibody.

To lower tau levels, the researchers turned to genetically modified mice that, as they age, have less and less tau floating in their cerebrospinal fluid. Such mice at 9 months old had significantly lower tau levels in their blood than 3-month-old mice with the same genetic modification, again demonstrating the antibody’s ability to reflect levels of tau in the brain.

“It will be helpful in future studies to see if the measurement of tau in the blood following antibody treatment in humans reflects the state of tau in the brain,” Holtzman said.

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Yanamandra K, Patel TK, Jiang H, Schindler S, Ulrich JD, Boxer AL, Miller BL, Kerwin DR, Gallardo G, Stewart F, Finn MB, Cairns NJ, Verghese PB, Fogelman I, West T, Braunstein J, Robinson G, Keyser J, Roh J, Knapik SS, Hu Y, Holtzman DM. “Anti-tau antibody markedly increases plasma tau in mouse and man: Correlation with soluble brain tau.” Science Translational Medicine. April 19, 2017.

This work was supported by the National Institutes of Health (NIH), grant number NIH R01AG048678, C2N Diagnostics, the Tau Consortium and the JPB Foundation.

Holtzman and other authors on this paper developed the antibody used in this study and are inventors on a submitted patent “Antibodies to Tau” that is licensed by Washington University to C2N Diagnostics LLC. This patent subsequently was licensed to AbbVie. Yanamandra was a postdoctoral researcher at Washington University during the course of these studies and now is an employee at AbbVie.

Washington University School of Medicine‘s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked seventh in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

MEDIA CONTACT
Diane Duke Williams, Associate Director for Media Relations

314-286-0111
williamsdia@wustl.edu
WRITER
Tamara Bhandari, Senior Medical Sciences Writer

Tamara Bhandari covers pathology, immunology, medical microbiology, cell biology, neurology, and radiology. She holds a bachelor’s degree in molecular biophysics and biochemistry and in sociology from Yale University, a master’s in public health/infectious diseases from the University of California, Berkeley, and a PhD in infectious disease immunology from the University of California, San Diego.

P314-286-0122
tbhandari@wustl.edu


Republished with permission.  See original and other great articles here.

Slowly Silenced:  How Alzheimer’s Quiets Beautiful Minds

Most have been touched by the devastating effects of Alzheimer’s. We have lost family and friends to the disease that snuffs the light in bright minds.  For us, the first to lose their fight was a friend’s mom, way too young with a rapid onset.  Most recently, it was my wife’s dad, who went from being a Gifted and passionate performer to a man locked in motionless silence for years.  When he missed calling on her birthday, my wife knew his humorous attempts at covering his forgetfulness hid something deeper.  I knew when he no longer remembered the words to his own gold Records as he played at our daughter’s graduation party.

Alzheimer’s is a type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.  More than 5 million Americans are living with Alzheimer’s disease and over 15 million Americans are providing unpaid care and support.  Worldwide, 50 million people suffer from Alzheimer’s or other dementia.

These numbers are expected to triple by 2050 without significant breakthroughs.  And, while death from heart disease has decreased in the last few years, death from Alzheimer’s has increased by 123%.  It is the only Top 10 leading cause of death in the United States without a cure, prevention or even a truly promising way to slow progress.

ALZHEIMER’S AND DEMENTIA BASICS

Alzheimer’s is the most common form of dementia – a general term for memory loss and other decline in intellectual abilities serious enough to interfere with daily life. Alzheimer’s disease accounts for 60 to 80 percent of dementia cases.  It is the sixth leading cause of death in the US.

Alzheimer’s is not a normal part of aging, although the greatest known risk factor is increasing age, and the majority of people with Alzheimer’s are 65 and older. But Alzheimer’s is not just a disease of old age. Up to 5 percent of people with the disease have early onset Alzheimer’s (also known as younger-onset), which often appears when someone is in their 40s or 50s.

Alzheimer’s worsens over time. Alzheimer’s is a progressive disease, where dementia symptoms gradually worsen over a number of years. In its initial stages, memory loss is mild, but with late-stage Alzheimer’s, individuals lose the ability to carry on a conversation and respond to their environment. Those with Alzheimer’s live an average of eight years after their symptoms become noticeable to others, but survival can range from four to 20 years, depending on age and other health conditions.

Alzheimer’s has no current cure, but treatments for symptoms are available and research continues. Although current Alzheimer’s treatments cannot stop Alzheimer’s from progressing, they can temporarily slow the worsening of dementia symptoms and improve quality of life for those with Alzheimer’s and their caregivers. Today, there is a worldwide effort under way to find better ways to treat the disease, delay its onset, and prevent it from developing.

SYMPTOMS OF ALZHEIMER’S

The most common early symptom of Alzheimer’s is difficulty remembering newly learned information.

Just like the rest of our bodies, our brains change as we age. Most of us eventually notice some slowed thinking and occasional problems with remembering certain things. However, serious memory loss, confusion and other major changes in the way our minds work may be a sign that brain cells are failing.

The most common early symptom of Alzheimer’s is difficulty remembering newly learned information because Alzheimer’s changes typically begin in the part of the brain that affects learning. As Alzheimer’s advances through the brain it leads to increasingly severe symptoms, including disorientation, mood and behavior changes; deepening confusion about events, time and place; unfounded suspicions about family, friends and professional caregivers; more serious memory loss and behavior changes; and difficulty speaking, swallowing and walking.

10 WARNING SIGNS OF ALZHEIMER’S

Memory loss that disrupts daily life may be a symptom of Alzheimer’s or another dementia. Below are 10 warning signs and symptoms. Every individual may experience one or more of these signs in different degrees. If you notice any of them, please see a doctor.

MEMORY LOSS THAT DISRUPTS DAILY LIFE

One of the most common signs of Alzheimer’s is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over, increasingly needing to rely on memory aids (e.g. reminder notes or electronic devices) or family members for things they used to handle on their own.

A Typical Age-Related Change

Sometimes forgetting names or appointments but remembering them later.

 CHALLENGES IN PLANNING OR SOLVING PROBLEMS

Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.

A Typical Age-Related Change

Making occasional errors when balancing a checkbook.

DIFFICULTY COMPLETING FAMILIAR TASKS AT HOME, AT WORK OR AT LEISURE

People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.

A Typical Age-Related Change

Occasionally needing help to use the settings on a microwave or to record a television show.

CONFUSION WITH TIME OR PLACE

People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

A Typical Age-Related Change

Getting confused about the day of the week but figuring it out later.

TROUBLE UNDERSTANDING VISUAL IMAGES AND SPATIAL RELATIONSHIPS

For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and determining color or contrast, which may cause problems with driving.

A Typical Age-Related Change

Vision changes related to cataracts.

NEW PROBLEMS WITH WORDS IN SPEAKING OR WRITING

People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a “watch” a “hand-clock”).

A Typical Age-Related Change

Sometimes having trouble finding the right word.

 MISPLACING THINGS AND LOSING THE ABILITY TO RETRACE STEPS

A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.

A Typical Age-Related Change

Misplacing things from time to time and retracing steps to find them.

DECREASED OR POOR JUDGMENT

People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.

A Typical Age-Related Change

Making an unwise decision once in a while.

WITHDRAWAL FROM WORK OR SOCIAL ACTIVITIES

A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.

A Typical Age-Related Change

Sometimes feeling weary of work, family and social obligations.

CHANGES IN MOOD AND PERSONALITY

The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.

A Typical Age-Related Change

Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

If you notice any of the 10 Warning Signs of Alzheimer’s in yourself or someone you know, don’t ignore them. Schedule an appointment with your doctor.


RESEARCH AND PROGRESS

Today, Alzheimer’s is at the forefront of biomedical research.  Researchers are working to uncover as many aspects of Alzheimer’s disease and related dementias as possible. Ninety percent of what we know about Alzheimer’s has been discovered in the last 15 years. Some of the most remarkable progress has shed light on how Alzheimer’s affects the brain. The hope is this better understanding will lead to new treatments.

A worldwide quest is under way to find new treatments to stop, slow or even prevent Alzheimer’s. Because new drugs take years to produce from concept to market—and because drugs that seem promising in early-stage studies may not work as hoped in large-scale trials—it is critical that Alzheimer’s and related dementias research continue to accelerate. To ensure that the effort to find better treatments receives the focus it deserves, the Alzheimer’s Association funds researchers looking at new treatment strategies and advocates for more federal funding of Alzheimer’s research.

Currently, there are five FDA-approved Alzheimer’s drugs that treat the symptoms of Alzheimer’s, but these medications do not treat the underlying causes of Alzheimer’s. In contrast, many of the new drugs in development aim to modify the disease process itself, by impacting one or more of the many wide-ranging brain changes that Alzheimer’s causes. These changes offer potential “targets” for new drugs to stop or slow the progress of the disease.

Many researchers believe successful treatment will eventually involve a “cocktail” of medications aimed at several targets, similar to current state-of-the-art treatments for many cancers and AIDS.

WITH EARLY DETECTION, YOU CAN:

  • Get the maximum benefit from available treatments
  • Have more time to plan for the future
  • Participate in building the right care team and social support network
  • Locate care and support services for you and your loved ones

People with memory loss or other possible signs of Alzheimer’s may find it hard to recognize they have a problem. Signs of dementia may be more obvious to family members or friends. Anyone experiencing dementia-like symptoms should see a doctor as soon as possible. Early diagnosis and intervention methods are improving dramatically, and treatment options and sources of support can improve quality of life.

WHEN YOU SEE YOUR DOCTOR

If you need assistance finding a doctor with experience evaluating memory problems, your local Alzheimer’s Association chapter can help. Your doctor will evaluate your overall health and identify any conditions that could affect how well your mind is working. They may refer you to a specialist such as a:

  • Neurologist – specializes in diseases of the brain and nervous system
  • Psychiatrist – specializes in disorders that affect mood or the way the mind works
  • Psychologist – has special training in testing memory and other mental functions
  • Geriatrician – specializes in the care of older adults and Alzheimer’s disease

Everyday, there are physicians in the HealthLynked system ready to care for Alzheimer patients and support the caregivers who offer so much to help them live the best lives possible.  If someone you love is showing signs of memory loss beyond what might be considered normal for their age, go to HealthLynked.com to connect and collaborate with any number of specialists at the ready.

 

Ready to get Lynked and get help?  Go to HealthLynked.com today to register for free!

Sources:

ALZ.org

NYTimes.com

 

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