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Alzheimer’s battlefield keeps changing, researchers find

PET scan of a human brain with Alzheimer's disease.

PET scan of a human brain with Alzheimer’s disease.

If by looking into a crystal ball you could learn whether your likelihood of developing Alzheimer’s disease is higher than others’, you probably wouldn’t want to know. After all, definitive cause and cure continue to elude researchers and medications may stabilize the illness, but won’t reverse it.

But what if you learned that your risk profile included elements that you did have control over and perhaps, just possibly, you could influence the outcome to some degree?

This is where Alzheimer’s research is going, learned those who braved the cutting chill to attend the Alzheimer Groupe’s annual awareness conference last month.

Dr. Serge Gauthier of the McGill Centre for Studies in Aging moderated the evening, ceding the spotlight to neurologists Hyman Schipper and Howard Chertkow of the Jewish General Hospital’s Lady Davis Research Institute.

Using imaging techniques other than crystal balls, but just as mysterious, the researchers informed the audience that changes, such as amyloid buildup, tangles and the shrinking of brain tissue indicative of Alzheimer’s disease can be seen in the living brain. However, there is a tiny percentage of people who exhibit these changes yet do not develop the illness.

Degeneration takes place over years, and the researchers are finding that it may begin before any symptoms are manifest. “It’s a cascade,” Gauthier said. “If you can stop the cascade, you can prevent dementia.”

Although symptoms we associate with “normal” aging such as short-term memory problems can be caused by several factors, there is a chance that when they are combined with physical changes in the brain they may indicate Mild Cognitive Impairment, Chertkow said. Of patients with MCI, 15 per cent do eventually develop dementia.

The hope is that with early diagnosis and intervention, through making these information tools available to doctors outside the research arena, the outcome of the disease may be mitigated or perhaps prevented. “Biomarkers can indicate signs of the disease five to 10 years earlier,” Chertkow said. “There are advances in diagnosis which are very exciting.”

The concept of “risk” is being refined as different kinds are being studied and researchers are targeting middle-aged rather than older individuals, said Schipper. “By delaying the onset, you cut the prevalence in half.”

Some risk, such as our genetic profile, cannot be controlled. However we can affect the metabolic, nutritional, cognitive and psychological factors within our environment that raise our risk, Schipper said. “Hypertension is turning out to be as important to dementia as it is to heart disease.” While hypertension in midlife may raise the chances of developing dementia, blood pressure medications may mitigate the illness in late life. As well, it appears that aerobic exercise in mid-life decreases dementia in late life. “A minimum of 30 minutes three times a week,” Schipper said. “You gotta do it.”

Schipper runs an Alzheimer Risk Assessment Clinic (ARAC) at the Jewish General Hospital for people between 40-65 who have concerns about their risk of contracting Alzheimer’s Disease. Info: 514-340-8222 ext 5849 or adrienne.liberman@mail.mcgill.ca.

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