Health Editor’s Note: June is Alzheimer’s and brain awareness month. Alzheimer’s is a neurodegenerative disease which robs a person of his or her memory, individual behavior, and the ability to think. Someone in the grips of Alzheimer’s will not be able to recognize a spouse he or she has been married to for 50 years. Children will become strangers. One will not be able to put on a shirt or comb his or her hair. Will not be able to remember what was eaten for breakfast or that breakfast was even eaten. Symptoms develop slowly, usually with family members or close friends recognizing changes, but become severe enough to stop a person from being able to completely take care of him or herself. Alzheimer’s robs a person of the essence of who he or she is.
According to the Alzheimer’s Association, Alzheimer’s disease makes up 60 to 80 percent of dementia cases. The largest risk factor is aging (which we all are destined to do) although this is not a disease of old age and worsens over time as the person moves through several stages. Alzheimer’s is the sixth leading cause of death in the U.S. with the average length of time after diagnosis being eight years, but can range between four and 20 years before death.
Currently there is no cure, but there are treatments to lessen or delay symptoms, and ongoing research. What is being realized during this research, is that genetics and environmental issues are large factors. Since our genetic backgrounds vary and we live in various environmental situations, prevention and treatments will need to be individualize in order to be successful in stopping this very insidious and sinister disease….Carol
Alzheimer’s: Rethinking the ‘One-Size-Fits-All’ Approach
NIH conference emphasizes tailored prevention and treatment
by Judy George, Contributing Writer, MedPage Today
Precision medicine in Alzheimer’s disease — tailoring prevention and treatment to a patient’s unique risk profile — surfaced as a key theme at the NIH National Institute on Aging (NIA) 2018 Alzheimer’s Disease Research Summit.
“Alzheimer’s disease is a heterogeneous disorder. We are learning more about genetic and environmental risk factors, and we need to start differentiating Alzheimer’s patients based on genetics, environmental exposure, and clinical history,” Eliezer Masliah, MD, head of the NIA neuroscience division, told MedPage Today.”This might be more effective than a one-size-fits-all type of approach, which is where we are right now.”
At the summit, experts from government, academic institutions, industry, and non-profit organizations proposed recommendations to guide future research in Alzheimer’s disease and related dementias, building on previous frameworks that had been developed in 2012 and 2015.
“This is a critical time in Alzheimer’s research, with new opportunities to build upon what we have learned,” said Richard J. Hodes, MD, NIA director, in a statement. “We must continue to foster creative approaches that leverage emerging scientific and technological advances, establish robust translational infrastructure for rapid and broad sharing of data and research tools, and work with funding partners and other stakeholders to cultivate and sustain an open science research ecosystem.”
The summit emphasized a “big push to understand people with Alzheimer’s in a multidimensional way” and focused on research to develop new therapeutic targets, Masliah said. “There’s been an overemphasis in the past on targeting amyloid beta protein and tau. Now we are funding research in a gamut of targets in 140 Alzheimer’s clinical trials.”
At the meeting, experts discussed research about neurotrophic growth factor (NGF), brain-derived neurotrophic factor (BDNF) gene therapy, the neuroprotective effects of allopregnanolone, the brain-gut microbiota axis in Alzheimer’s, and research about the MIND diet and cognitive decline, as well as the EXERT trial of exercise in people with mild memory problems.
Researchers also examined new research about the environment and neurotoxicants. “For a long time we have been hearing about heavy metals, but now there is more evidence that shows air pollution may be linked to increased risk of cognitive impairment,” Masliah said.
The summit recommendations have been adopted by the National Advisory Council on Aging, and will be used to update milestones in the National Plan to Address Alzheimer’s Disease. The recommendations included developing a better understanding of Alzheimer’s causes, enabling precision medicine research, improving the research infrastructure, supporting novel therapeutics, and building a new research ecosystem based on open science.
The key to developing precision medicine in Alzheimer’s disease will be data sharing, Masliah noted. To understand Alzheimer’s in a multidimensional way requires more than “one person working in isolation
in a lab,” he said. “We need tremendous sharing of data among many, many different groups according to precision medicine ideals. Open access is a very important component.”
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