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ALZHEIMER’S DISEASE

Cover Story: The Latest Developments in Alzheimer’s Disease

Continued from page 1 include disproportionate hippocampal the most promising is immunotherapy physically and mentally active lifestyle to
not realistic in patients. atrophy seen on high resolution MRI using anti-amyloid antibodies to break boost brain health and overall well-
We can improve diagnosis by a careful scans and bi-hemispheric loss of cerebral up cerebral plaques and tangles. being.
history and examination, neuropsycho- metabolism seen on FDG-PET scans. Preliminary data is promising, indicating Caregivers need education and sup-
logical testing, and regular follow-up to Currently, the only FDA-approved that the immunotherapy appears able to port to maintain their health and reduce
look for progressive cognitive loss, but treatments for Alzheimer’s disease reduce amyloid plaque burden and pos- the burden and cost of caregiving.
too few patients actually receive such include four cognitive enhancing agents sibly slow down cognitive decline. Volunteers are needed for research stud-
comprehensive assessment. that provide modest symptomatic Despite these advances, a true cure is ies. Excellent care will at least improve
There is good news, however. Ongoing improvement. The three medications not yet in reach. One of the major chal- the lives of those afflicted with
research has led to an increased under- donepezil, rivastigmine and galantamine lenges stems from the fact that this dis- Alzheimer’s disease, even as we continue
standing of how the pathology of boost levels of acetylcholine – the key ease begins years if not decades before our search for a cure.
Alzheimer’s disease is linked to the extra- neurotransmitter in the brain for learn- symptoms appear, meaning that the
cellular build-up of insoluble beta-amy- ing and memory. Another medication most effective intervention must occur Dr. Marc Agronin is a geriatric psychi-
loid protein in cerebral neuritic plaques called memantine reduces the neurode- before widespread brain damage is in atrist and the vice president for
and the intracellular build-up of hyper- generative effects of overactive gluta- place. Behavioral Health and Clinical Research
phosporylated tau protein in neurofibril- mate activity in the brain. Current research with high-risk fami- at Miami Jewish Health. He is the author
lary tangles. State-of-the-art therapy combines one lies with known Alzheimer’s disease pro- of "The Dementia Caregiver: A Guide to
Being able to detect the elevated pres- of the acetylcholinesterase inhibitors ducing genetic mutations will tell us in Caring for Someone with Alzheimer’s
ence of these two toxic elements has rev- with memantine in hopes of improving the next few years whether this early- Disease and Other Neurocognitive
olutionized our approaches to diagnosis symptoms, even though this approach intervention approach is the key. Disorders."
and treatment. For example, we can now does not appear to slow the actual course In the meantime, we must adhere to
detect the elevated presence of amyloid of the disease. Based on the amyloid and several basic principles of care. Early For more information on clinical services
and tau through a characteristic ratio in tau hypothesis, however, numerous diagnosis via comprehensive assessment or current research studies at the Memory
cerebrospinal fluid, or in an amyloid or experimental agents are being studied to with an expert in Alzheimer’s disease is Center at Miami Jewish Health,
tau-based PET scan. Other biomarkers modify the disease itself or at least to critical. The use of cognitive enhancing call (305) 514-8710.
that can improve accurate diagnosis mitigate its impact on the brain. One of medications should be combined with a

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24 September 2017 southfloridahospitalnews.com South Florida Hospital News