Alzheimer's Risks and Treatment

Testing for Alzheimer’s disease can be a long, costly, and tiresome process for patients, but researchers from Brigham and Women’s Hospital have been working to make the testing process easier on patients.

The group has developed a blood test that would evaluate the level of tau -- the leading protein in the brain associated with Alzheimer’s -- before a patient is even showing signs or symptoms of the disease.

“A blood test for Alzheimer’s disease could be administered easily and repeatedly, with patients going to their primary care office rather than having to go into a hospital,” said Dr. Dominic Walsh. “Ultimately, a blood-based test could replace cerebrospinal fluid testing and/or brain imaging. Our new test has the potential to do just that.”

Though the test is currently in the testing stages, Dr. Walsh is calling it a “transformative breakthrough” based on the early results.

How it works  

Tau is a protein in the brain that is most typically associated with Alzheimer’s. Though tau can develop through a number of different related molecules, the researchers were able to create a model that differentiates between the individual types of tau to ensure that the blood test comes up with the most accurate result.

The researchers have conducted two trials so far with participants from Harvard’s Aging Brain Study and the Institute of Neurology in London. The first group consisted of 65 participants and the second group had 86.

Everyone involved in the study donated samples of plasma and cerebrospinal fluid, which helped the researchers look at the breakdown of the tau protein and see exactly what was linked to Alzheimer’s.

In both tests, the researchers found one strand of tau -- NT1 -- that was effective in predicting and identifying cases of Alzheimer’s.

The next step for the researchers is to open the test up to larger groups of participants to further test its effectiveness on a wider sample. However, these early results proved to Dr. Walsh and his team that they could be on the right track.

“We’ve made our data and the tools needed to perform our test widely available because we want other research groups to put this to the test,” he said. “It’s important for others to validate our findings so that we can be certain this test will work across different populations.”

Fighting Alzheimer’s

While this blood test could potentially change the way doctors go about diagnosing Alzheimer’s, fellow researchers have made strides this year in an effort to better diagnose and treat the disease.

In late September, researchers from the Clinical Memory Research Unit at Lund University in Sweden developed a new brain imaging technique that would help doctors make the most accurate Alzheimer’s diagnoses.

The researchers used a PET scan to evaluate the level of tau in the brain by administering a marker for the protein before the test. The researchers found this new test to be more successful than traditional Alzheimer’s screening methods.

“If the patient has tau in certain parts of the brain, the marker will detect it,” said researcher Oskar Hansson. “The result -- whether Alzheimer tau is present or not -- is very clearly visible on the PET images.”

On the treatment front, researchers found success with a clinical trial for a drug being developed to treat Alzheimer’s.

Amyloid is another protein often found in the brain with Alzheimer’s, and researchers from Biogen and Eisai worked to develop BAN2401 -- an anti-amyloid drug. Though unsuccessful in initial tests, this new and improved version of the drug was found to slow the progression of Alzheimer’s in the study’s clinical trial.

The symptoms and risks associated with Alzheimer’s disease (AD) and dementia have been well-documented, and with over 5.5 million adults across the United States currently suffering, the medical community continues to look for ways to alleviate discomfort and make advancements.

A new study was recently published in the journal American Geriatrics Society that explores the effect exercise has on reducing the risk of falls among Alzheimer’s and dementia patients. The researchers note that over 60 percent of people with AD/dementia fall every year, and they are twice as likely to fall compared with people who don’t have AD/dementia.

More movement

The researchers’ primary goal was to see if AD/dementia patients with neuropsychiatric symptoms -- such as depression, anxiety, irritability, apathy, aggression, hallucinations, etc. -- had a reduced risk of falling when exercise was a regular part of their routines.

The researchers tested this by evaluating the FINALEX trial -- a study that includes a wide demographic of people with AD/dementia and neuropsychiatric symptoms. The study compared participants who had community care -- which didn’t include exercise -- with those who participated in group or home exercise.

The two groups were monitored by physiotherapists for one year and engaged in physical activity for one hour two times per week. The participants were evaluated based on endurance, strength, multitask training, and balance.

One of the biggest takeaways from the study was that the participants who had severe neuropsychiatric symptoms -- such as depression or anxiety -- were at a greater risk for falls, though the exercise proved to be a beneficial method. Additionally, those who had less severe symptoms -- but also didn’t exercise -- still had a high risk of falling.

Those in the exercise groups were found to be at less of a risk for falls, while the opposite was true for those who weren’t in the exercise groups.  

The researchers believe that incorporating exercise into a routine of AD/dementia patients will likely reduce the risk of falls, though more research will need to be done in this area to confirm the results.

Consistent findings

The findings from this study prove to be consistent with a study from earlier this year which found that exercise was linked to improved brain function and can even help prevent memory loss, cognitive function, and diseases like Alzheimer’s and dementia.

Conducted by researchers from UT Southwestern, the study found that keeping active caused nerve fibers in the brain to deteriorate at a much slower rate than for those who didn’t exercise as frequently.

“Evidence suggests that what is bad for your heart is bad for your brain,” said Dr. Rong Zhang of UT Southwestern. “We need studies like this to find out how the two are intertwined and hopefully find the right formula to help prevent Alzheimer’s disease.”

While researchers continue to look for the cause of Alzheimer’s disease, a new study published in Frontiers in Aging Neuroscience explores the connection between the development of the condition and the herpes virus.

Researcher Ruth Itzhaki has spent over two decades studying the relationship between herpes and Alzheimer’s, and in this most recent study she studied the effects that herpes flare ups have on neurons in the brain.

Exploring the connection  

Herpes never goes away entirely, with the condition often flaring up during times of stress or illness. The most severe form of herpes is Herpes Simplex Virus 1 (HSV1), and according to Itzhaki, this strand of the infection could account for “50 percent or more of Alzheimer’s disease cases.”

A key component of Itzhaki’s theory was testing an antiviral drug that could alleviate the risk of senile dementia in people that had herpes.

To get an accurate population sampling to test this theory, Itzhaki utilized data taken from Taiwan’s National Health Insurance Research Database, which documents information on disease and infections.

As nearly all of Taiwan’s population is enrolled in the Database, Itzhaki was able to evaluate three studies published between 2017 and 2018 that described the ways patients with HSV1 were treated by healthcare professionals; the data showed the evolution of those with senile dementia.

Itzhaki found that the antiviral drug was an effective course of treatment for those who were infected with HSV1 and then developed dementia. She also found that those who already have HSV1 areat a much greater risk of later developing senile dementia.

Itzhaki noted that this study focuses on those with the most severe cases of the infection, and future research would have to focus on dementia rates in those with more mild forms of herpes.

Despite this, Itzhaki was confident in the study’s results.

“Considering that over 150 publications strongly support an HSV1 role in Alzheimer’s, these Taiwan findings greatly justify usage of anti-herpes antivirals -- which are safe and well tolerated -- to treat Alzheimer’s disease,” said Itzhaki. “They also incentivize development of an HSV1 vaccine, which would likely be the most effective treatment.”

Recent Alzheimer’s breakthroughs

Alzheimer’s research continues to be a point of emphasis for the medical community, and researchers have made considerable contributions to the field in recent months.

Back in July, a major drug company reported positive results from a clinical trial for a new Alzheimer’s drug. The study involved nearly 900 participants in the early stages of Alzheimer’s, and after 18 months, the drug was found to be successful in slowing the progress of the disease.

Later in the summer, researchers at the University of Adelaide found a link between iron in our cells and a rare genetic mutation that causes Alzheimer’s.

Most recently, researchers from the Clinical Memory Research Unit at Lund University found a new brain imaging technique that would help doctors diagnose Alzheimer’s more accurately. The PET scan involved in the study proved to be more successful than traditional treatments that are currently used to diagnose Alzheimer’s, and the researchers are confident the method will gain popularity worldwide.