Alzheimer’s Disease: How to Treat it: A Work in Progress

1. Alzheimer’s Disease: How to Treat it: A Work in Progress NeekaParker, Department of Biological Sciences, College of Arts and Sciences, Honors College Faculty Mentor: Susan Eve, Ph. D., Department of Sociology, College of Public Affairs and Community Service and Honors College ABSTRACT LITERATURE REVIEW METHODS Alzheimer’s disease typically affects people age 65 and older, although it can affect younger people. The cause is still unknown and there is no cure With life expectancies increasing, more and more people are affected by this disease each year. Since Alzheimer’s affects memory and basic function, it also impacts the families and caretakers of patients.. There are, however, various treatments, some of which are more effective than others. My research on the effectiveness of various treatments in improving cognition will help determine the main cause of Alzheimer’s. I will do a meta-analysis on the data about available treatments to see which one is the most effective in alleviating or reversing the symptoms. This will enable us to see what the effective treatments do and give a direction for research into the cause. • I. STUDY RESULTS • Ginkgo biloba is not very helpful • Three possible treatments were stopped during their trials after the results were lower than expected • Two studies involving statins • One showed no difference in AD incidence • One showed 50% less incidence in those using statins • B vitamin supplements seem to have no effect • Massachusetts General Hospital Memory Disorders Unit study involving comparison of patients taking no AD drugs to patients taking one drug to patients taking two drugs • Last group had the slowest decline in memory and was less dependent on others • Keeping physically active helps almost as much as the drugs do • Among patients with similar levels of amyloid plaque those with higher education have better cognitive function • Cholinesterase inhibitors involved in preventing the breakdown of acetylcholine usually do not help • Studies with ergoloid mesylates are inconclusive • Nicotine can be beneficial to some patients • Some investigational drugs do not improve all aspects of AD • Replacement estrogen restores neural synapses in animals • Vitamin E and selegiline work better alone than together and delay functional decline by seven months • NSAIDs give a patient 50 percent less chance of developing AD • II. GENETIC FACTORS • Mutations on specific chromosomes • Apolipoprotein E gene on chromosome 19 • III. AMYLOID PLAQUES • May not be the right target • Two people whose brains were almost cleared of plaque had severe dementia before they died • The right target may be small amyloid fragments • At 300 K the predominant configuration of β-amyloid dimers was one with parallel N-terminals • This form also has the lowest energy • The location of minimum fluctuations of backbone atoms was an important binding site for inhibitors I will compile all of the available data and do a meta-analysis. In my analysis I will look at the effectiveness of individual treatments as well as any combined treatments that are available. I will try to focus my analysis on studies that are not specific to gender or ethnicity. I will look at the studies that are specific to gender or ethnicity as part of my background information. SYMPTOMS • Stage 1 • Less energy • Minor memory loss • Mood swings • Slow to react • Shy from anything new, prefer the familiar • Confused • Get lost easily • Poor judgment • Stage 2 • Perform tasks independently, may need assistance with complicated activities • Speech and understanding slower, lose train of thought mid-sentence • Get lost while traveling, forget to pay bills • Become depressed, irritable, restless • Recall distant past, cannot remember recent events • Do not know location, day, time • Caregivers must give clear instructions, repeat often • May not recognize familiar faces • Stage 3 • No ability to chew or swallow • Memory is poor • Recognize nobody • Lose bowel and bladder control • Need constant care • Vulnerable to pneumonia, infection, other illnesses • Respiratory problems worsen, especially if bedridden ACKNOWLEDGMENTS I would like to thank Dr. Eve for teaching the Introduction to Research class. I would also like to thank Dr. Cox for everything that she does for the Honors College. REFERENCE LIST 2009. Failed efforts to thwart Alzheimer's disease raise questions. Harvard Mental Health Letter 25, no. 8: 1-3, https://libproxy.library.unt.edu:9443/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=36138582&site=ehost-live&scope=site (accessed March 2, 2009). Anand, Priya, Fateh S. Nandel, and Ulrich H. E. Hansmann. 2008. The Alzheimer β-amyloid (Aβ1–39) dimer in an implicit solvent. Journal of Chemical Physics 129, no. 19: N.PAG, https://libproxy.library.unt.edu:9443/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=35514148&site=ehost-live&scope=site (accessed March 2, 2009). Pithadia, Anand. 2008. Pathophysiology and pharmacotherapy of Alzheimer's disease (AD). Internet Journal of Pharmacology 6, no. 1: 1-1, https://libproxy.library.unt.edu:9443/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=34252420&site=ehost-live&scope=site (accessed March 2, 2009). Image References Joshi, Mohit .Scientists unveil potential Alzheimer's disease drug target. TopNews Health. http://www.topnews.in/health/scientists-unveil-potential-alzheimers-disease-drug-target-21492 (accessed March 9, 2009). New Insights on Pathogenesis of Alzheimer’s Disease. Science News Digest for Physicians and Scientists. http://www.bioscience.org/news/scientis/alzheim1.htm (accessed March 9, 2009). Pande, Vijay. Folding@home Diseases Studied FAQ. Stanford University. http://folding.stanford.edu/Japanese/FAQ-Diseases (accessed March 9, 2009).