Communion Of Dreams

It’s been seven and a half years since my mother-in-law passed away from Alzheimer’s. A couple years later, we published Her Final Year. Since then I have kept an eye on ongoing research concerning the disease, and have mentioned it here when I thought appropriate. This week, there are several new promising developments to come out of the Alzheimer’s Association International Conference in Washington, D.C.

First is a saliva test for metabolites which indicate brain changes associated with Alzheimer’s. From this CNN article:

Researchers from the University of Alberta in Canada analyzed saliva samples of fewer than 100 people, divided into three groups based on cognitive ability: 35 with normal aging cognition, 25 with mild cognitive impairment and 22 with Alzheimer’s disease.

Using protein analysis technology, researchers examined the saliva of each individual, analyzing nearly 6,000 metabolites, which are small molecules that are byproducts of chemical reactions in the brain.

The team then discovered specific biomarkers (or patterns of metabolites) in the groups with known Alzheimer’s or mild cognitive impairment, in comparison with the natural aging group, and tested the biomarkers as predictors of cognitive performance.

It’s a very small study, but if additional research into this area bares out the results, this could be a quick and inexpensive screening tool to help determine who may be at risk for Alzheimer’s. Because, as discussed in a very good segment on the Diane Rehm show this morning, early detection helps even though there are limited treatment options for Alzheimer’s (and other age-related dementias). That’s because there are things you can do to prepare for managing the disease: establish necessary legal protections (things like family trusts and durable power of attorney), educate family members and caregivers, investigate daycare and assisted living options, participate in drug and treatment trials, and similar.

Speaking of drug and treatment trials, the Alzheimer’s Association has a very useful online tool for Alzheimer’s patients, care-providers, and family members:

About Alzheimer’s Association TrialMatch^®

Alzheimer’s Association TrialMatch is a free, easy-to-use clinical studies matching service that connects individuals with Alzheimer’s, caregivers, healthy volunteers and physicians with current studies. Our continuously updated database of Alzheimer’s clinical trials includes more than 225 promising clinical studies being conducted at nearly 700 trials sites across the country.

This is just one of the new tools which have been made available since we cared for Martha Sr. Because in the last 7+ years, there has been a lot of research and a growing awareness that Alzheimer’s will touch nearly every family at some time.

One of the other pieces of information to come out of this week’s is that women seem to be more susceptible to the disease, and experience a faster decline in their mental abilities than men:

Study: Women with mild memory problem worsen faster than men

Older women with mild memory impairment worsened about twice as fast as men, researchers reported Tuesday, part of an effort to unravel why women are especially hard-hit by Alzheimer’s.

Nearly two-thirds of Americans with Alzheimer’s are women.

At age 65, seemingly healthy women have about a 1 in 6 chance of developing Alzheimer’s during the rest of their lives, compared with a 1 in 11 chance for men. Scientists once thought the disparity was just because women tend to live longer — but there’s increasing agreement that something else makes women more vulnerable.

There are a number of other factors which can have an impact on those numbers, of course. But even accounting for differences due to education, lifestyle, and social status, the discrepancy between men and women could not be accounted for. And having close family who had Alzheimer’s is a substantial risk factor, about doubling your chances of developing the disease. As is having any kind of major health crises requiring either hospitalization or surgery under general anesthesia.  In each and every case, men seem to fare better than women.

That may not seem to be a “promising development”, particularly if you are a woman in the high-risk category/categories. But it is, in the sense that scientists are now coming to understand the disease much, much better than they did just a decade ago. When we cared for Martha Sr, there really wasn’t a good diagnostic tool to determine whether or not someone had Alzheimer’s — it was a diagnosis confirmed postmortem. Now there are very good imaging tools available for amyloid plaque and tau protein, as detailed at the Alzheimer’s Disease Neuroimaging Initiative.

As I noted above, there are still very limited treatment and drug options, though even there some hopeful results have been reported at the Conference. But real progress has been made. Alzheimer’s no longer needs to be a devastating diagnosis, something to be feared and hidden. If you, or someone you love, is showing any signs of memory or cognitive impairment, seek help. It’s even possible that through participation in some of the clinical trials you can be part of the solution.

Jim Downey

PS: As noted previously, the Kindle edition of Her Final Year is available as a free download on the first of each month.