Wednesday, May 4, 2016

Finding the Missing Link for Alzheimer's Patients

Alzheimer’s and dementia has had or will have some effect on a person in their lifetime. For me, it was watching both my grandparents slowly dwindle away and working with Alzheimer’s patients at my internship this summer. I have seen how this disease can take a person from a spritely, high functioning individual to someone who does not even know their own name. A very real testimony for those who have not encountered Alzheimer’s disease is featured in the New York Times following the story of Ms. Geri Taylor who is still battling Alzheimer’s and is actually in a clinical trial for a new Alzheimer’s drug. Hopefully, studies like Dr. Tamar Gefen’s look into SuperAgers, a demographic of elderly people whose cognitive abilities are as good as a 50 or 60 year old.
I have seen Alzheimer’s disease and dementia take its stronghold on a number of people in my life. Namely, my grandmother and grandfather on my mother’s side and currently my grandmother on my father’s side. However, nothing prepared me for an individual that I worked with at my internship at a local neurologist’s office last summer. During the summer, I would perform Mini Mental State Exams (MMSEs), a common test for memory and cognitive ability, on every Alzheimer’s patient that came into the office that day. Even though I only interned at the office for a few months, one particular gentleman sticks out in my mind. I remember that he was one of the first and last patients that I performed an MMSE on. The sharp decline that I saw in him in a few short months was shocking. He went from knowing a great majority of the answers to forgetting his daughter’s name. Seeing my grandparents was more of a gradual decline because I saw them almost every day. However, I did not know how fast this disease can take away a person. Ms. Taylors account shows the decline from a personal perspective. She talks about what aspects of her memory are slipping away at any certain point of her life. It also shows the perspective of her husband and children and what it is like for them being caretakers.
In the article, Ms. Taylor talks about how she is involved in a clinical trial for a new Alzheimer’s medicine. However, in order to be able to participate in the trial, she had to have significant beta-amyloid buildup and the gene ApoE 4, a gene specifically liked to Alzheimer’s. Having the ApoE 4 gene gives a person a higher risk to developing Alzheimer’s and is not a guarantee. Surprisingly, she had two copies meaning she inherited one from each parent and her son had inherited this gene, which she talks about how troubling it is for her to know that her son has a high risk of developing the disease that has taken over her life.
Dr. Gefan’s study on SuperAgers looked at the anterior cingulate gyrus in vivo and post mortem in SuperAgers, cognitively normal, and individuals with Alzheimer’s in the study. The findings supported the previous research that said the anterior cingulate gyrus was thicker in SuperAgers than the other two groups, in vivo and post mortem. Looking at the post mortem samples. SuperAgers showed lower Neurofibrillary Tangles (NFT) that are seen in Alzheimer’s patients. Also, more von economo neurons were seen in the anterior cingulate gyrus, most likely accounting for the thickness. Hopefully, more studies can be done in the future on SuperAgers to find out why they have more von economo neurons and less NFTs and will be able to put those into practice with patients with Alzheimer’s and other cognitive diseases.
Alzheimer’s is a disease that affects everyone at one point in their life, whether it be them or someone that they know. Hopefully, more medicines like Namenda and Aricept will be made in the future that will better combat the disease. One way that medicines like this could be made is looking into SuperAgers and how their brains and genes work. Dr. Gefan’s study is a good starting point to understand how the SuperAger brain is different and what we can take away from their brains to ultimately help people that suffer from Alzheimer’s and Dementia so the disease will no longer plague our loved ones.
Sources:
Gefen, T., Peterson, M., Papastefan, S. T., Martersteck, A., Whitney, K., Rademaker, A., . . . Geula, C. (2015). Morphometric and Histologic Substrates of Cingulate Integrity in Elders with Exceptional Memory Capacity. Journal of Neuroscience, 35(4), 1781-1791.
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