Alzheimer’s disease research highlights prevalence, detection, treatment

Research presented at the Alzheimer’s Association International Conference 2014 in Copenhagen, Denmark, sheds light on the prevalence, detection and treatment of the disease. View all of the abstracts described and listed by title below—as well as additional abstracts—at https://www.alz.org/aaic/portal/overview.asp.

Two studies provide increasing evidence that those who have difficulty identifying odors may be developing cognitive impairment and Alzheimer’s disease.

• Search for “Olfactory identification and Alzheimer’s disease biomarkers in clinically normal elderly”
• See “Olfactory identification deficits predict the transition from MCI to AD in a multi-ethnic community sample”

Two studies reveal that tests of the retina or lens of the eye may help to detect Alzheimer’s.

• See “Retinal amyloid fluorescence imaging predicts cerebral amyloid burden and Alzheimer's disease”
• See “Detection of ligand bound to beta amyloid in the lenses of human eyes”

One study demonstrates the promise of new positron emission tomography scan technology to find abnormal tau proteins in the brain, one of the telltale characteristics of Alzheimer’s. The technology could be used to detect disease earlier and help identify potential research participants, the Alzheimer’s Association says.

• See “Imaging tau pathology in vivo in FTLD: initial experience with [18F] T807 PET”

A two-year randomized controlled clinical trial in Finland is the first to demonstrate that a structured program of multiple changes in lifestyle factors—related to nutrition, physical fitness, cognition, social engagement and heart health—can improve memory and thinking in older adults at risk for cognitive impairment and Alzheimer’s.

• See “A Multidomain Two-Year Randomized Controlled Trial to Prevent Cognitive Impairment ‒ the FINGER study”

A study of cognitively normal middle-aged adults in the United States with a genetic predisposition or parental family history of Alzheimer’s found that participating in mentally stimulating activities in middle age—reading books, visiting museums, and playing games such as puzzles and cards—may help protect against the development of Alzheimer’s disease and dementia later in life.

• See “Participation in cognitively-stimulating activities is associated with brain structure and cognitive function in preclinical Alzheimer's disease”

Two studies present evidence that regular physical activity may reduce the risk of Alzheimer’s and other dementias.

• See “Physical Exercise and the Outcome of Incident Dementia: The Mayo Clinic Study of Aging”
• See “Physical exercise in mid-life versus late life may have differential impact on the outcome of incident mild cognitive impairment: The Mayo Clinic Study of Aging”

Emerging evidence suggests that the association between hypertension and dementia risk changes over time. Hypertension during midlife may increase a person’s risk for Alzheimer’s or dementia, but hypertension may help protect against dementia in people aged 90 or more years.

• See “Age of onset of hypertension and risk of dementia in the oldest-old: The 90+ Study”
• See “The association between measured blood pressure and incident dementia in the oldest old: The 90+ Study”

A small clinical trial in the United States finds that cataract surgery in people with Alzheimer’s and other dementia not only improves vision but also can slow decline in cognition and improve quality of life for those with the disease and their caregivers.

• See “Visual and cognitive improvement following cataract surgery in subjects with dementia”

A randomized controlled trial in the United Kingdom found that a psychological support program for family caregivers of those with dementia significantly reduced caregivers’ anxiety and depression, and the effect lasted two years.

• See “The long term clinical effectiveness of START (STrAtegies for RelaTives), for family carers of people with dementia and the effects on cost of care”

A study of a large German database of people aged more than 60 years who did not have Alzheimer’s or another dementia found that long-term use of the drug pioglitazone, taken for diabetes, may reduce the incidence of dementia.

• See “The Effect of the Prescription of Pioglitazone on the Incidence of Dementia”

Researchers in a post-mortem study say that an abnormal protein, TDP-43, may play an important role in Alzheimer’s disease along with two previously identified proteins.

• See “TDP-43 amplifies memory loss and hippocampal atrophy in Alzheimer's disease”

Phase 2 clinical trials of crenezumab (Genentech) revealed that the drug did not meet its primary endpoints for cognition and activities of daily living, but there was a positive finding study participants with mild Alzheimer’s who received the drug intravenously. The trial, according to the Alzheimer’s Association, shows the importance of early treatment.

• See “A randomized, double-blind, placebo-controlled phase 2 study to evaluate the efficacy and safety of crenezumab in patients with mild to moderate Alzheimer's disease”

A retrospective study of sleep disturbance and dementia among 200,000 veterans aged 55 or more years, 96.5 percent of whom were male, found that veterans who had a diagnosis of non-specific sleep disturbance, apnea or insomnia at baseline had a 30 percent increased risk of dementia compared with other veterans. Also, the examination of eight years of medical records found that veterans with both post-traumatic stress disorder and sleep disturbance had an 80 percent increased risk of dementia.

• See “Sleep disturbance and risk of dementia among older veterans”

Recent trends in the United States, the Netherlands, Sweden and England suggest that the reduction and prevention of Alzheimer’s disease might be possible, but worldwide, the prevalence of Alzheimer’s disease is expected to increase.

• See “Is the Risk of Alzheimer's Disease Declining?: A Review of Evidence From Around the World”
• See “New global prevalence data on dementia”
• See “Temporal trends in Dementia Incidence in the Framingham Study”
• See “Prevalence estimates of dementia in Colombia (2005‒2020). Transitions and stage of disease”
• See “Short-term Trends in German Dementia Prevalence, Incidence, and Mortality”