USA2 SPOTLIGHT

A July 24, 2018 BioSpace article reported from the AAIC conference in Chicago this week. Despite the prevailing mood of optimism about the 25 Alzheimer’s drugs in Phase III testing, most failures occur in Phase III because positive effects of drugs seen in smaller groups don’t always work in larger groups, or despite decreasing or slowing the accumulation of beta-amyloid, there aren’t improvements in cognition and memory. According to UsAgainstAlzheimer’s Acting President Drew Holzapfel, “Often times we talk about trials as failed trials. They’re not failed trials, they’re advancing our knowledge of the science. We are learning from past trials and learning how to attack the disease.”

MUST READS

A July 24, 2018 Reuters article spotlighted the buzz surrounding Eisai and Biogen’s full results on their BAN2401 Alzheimer’s disease drug, to be presented tomorrow in Chicago at AAIC. The drugmakers plan to pursue accelerated approvals in Europe, the U.S. and Japan. According to the article, “The companies said after 18 months of treatment, patients who received the highest dose of BAN2401 saw a statistically significant improvement in cognitive and biological measures of Alzheimer’s versus placebo. That was a welcome surprise as the drug did not appear to be working at the 12-month mark.”

A July 24, 2018 Globe Newswire article reported that a study shows that a specific brain exercise, computerized training on iPads, can increase the production of the acetylcholine brain chemical, a neuromodulator critical to memory and learning. The study from McGill University and Posit Science represents the first time this phenomena has been shown in humans. According to Dr. Michael Merzenich of Posit Science, “This is the first confirmation in humans that this more organic strategy can work, leading to higher levels of acetylcholine even in a resting state. Now, we need to perform larger studies in at-risk, pre-dementia, and dementia populations.”

A July 23, 2018 Medscape article highlighted the newly released clinical practice guidelines, previewed at AAIC in Chicago this week, to evaluate cognitive impairment suspected as a result of Alzheimer's disease and related dementias, in both primary care and specialty care settings. According to Alireza Atri, MD, PhD of Brigham and Women's Hospital and Harvard Medical School, “These recommendations really involve good practice of medicine, but unfortunately the data doesn't support this being done. When you read the guidelines, they look like common sense, but there is data to show that upwards of half the people who end up in nursing homes that are in later stages of dementia actually have never been given a formal diagnosis. That's not right.” Also covered by MD Magazine.

SEX MATTERS

According to a July 23, 2018 NPR Wisconsin Public Radio segment, taking hormone replacement therapy does not increase the risk for Alzheimer’s disease, especially in healthy women in the beginning of menopause, but it also doesn’t provide any benefits to the brain. Women using estrodial, a natural form of estrogen, have lower levels of brain markers linked to AD. "We know in short term that there’s no cognitive downside to a woman who is healthy taking estrogen for menopausal symptoms. There do appear to be some mood benefits, which are important of course. We do know that at menopause women are at increased risk for depression,” said Neuropsychologist Carey Gleason of the University of Wisconsin-Madison.

CAREGIVING CORNER

A July 18, 2018 Reuters article looked to the China Health and Retirement Longitudinal Study, which concludes that caregiving for a spouse who is “severely dependent” likely leads to health declines in the caregiver. The study also found that caregivers with longstanding health problems seemed more resilient. According to the article, “Noting that low-intensity caregivers were included in the analysis, Kiecolt-Glaser [Ohio State University in Columbus] said in a phone interview that helping a loved one dress and groom can be difficult, but caregiving for spouses with dementia, or incontinence “is a lot bigger deal.”