Doctors at Emory University will begin testing a vaccine designed to slow the accumulation of amyloid plaques in the brains of patients with Alzheimer's disease.
Alzheimer's affects more than 4.5 million Americans and is marked by gradual nerve cell death and a progressive loss of memory and mental functioning. All of the medications now available aim to improve the functioning of the nerve cells that remain alive.

Several still-experimental vaccines or immunotherapies take a different approach. They target beta-amyloid, a naturally occurring protein that clumps together and forms plaques in the brains of Alzheimer's patients. The clumps appear to damage brain cells.

The study's main purpose is to evaluate the vaccine's safety, possible side effects and how well it stimulates the immune system.

ATLANTA (January 16, 2008) — The latest medications can delay the onset of Alzheimer’s disease, but none are able to reverse its devastating effects. This limitation often makes early detection the key to Alzheimer’s patients maintaining a good quality of life for as long as possible.
Now, a new device developed by the Georgia Institute of Technology and Emory University may allow patients to take a brief, inexpensive test that could be administered as part of a routine yearly checkup at a doctor’s office to detect mild cognitive impairment (MCI) — often the earliest stage of Alzheimer’s. The device is expected to be commercialized later this year.

Current assessment tests capable of detecting early Alzheimer’s typically are taken with a pen and paper or at a computer terminal and last about an hour and a half. They must be given by a trained technician in a quiet environment, because any distractions can influence the patient’s score and reduce the test’s effectiveness. Because of their length and expense, the tests are not used as regular screening tools and typically are given only after there is obvious cognitive impairment such as forgetfulness or unsafe behavior.

Vernon Hills, IL December 18, 2007 – Applied NeuroSolutions, Inc. (OTC BB:APNS, www.appliedneurosolutions.com), a Company focused on the development of an integrated portfolio of products for the treatment and diagnosis of Alzheimer’s disease (AD), today reported that a peer-reviewed paper, "Multicenter assessment of CSF-phosphorylated tau for the prediction of conversion of MCI,” is highlighted as a featured study in the December 11, 2007 issue of  the print edition of Neurology.  APNS’s p-tau 231 biomarker (p-tau 231) was utilized in an international, multicenter study, led by Dr. Harald Hampel, and shown to be a significant predictor of conversion in the transition from mild cognitive impairment (MCI) to Alzheimer's disease in a relatively short and clinically relevant observation interval.

Mild cognitive impairment is a predementia risk state for the possible development of Alzheimer's disease. Research literature indicates that approximately 16% of individuals with MCI develop AD annually, however the conversion rate may be as high as 41% after one year and 64% after two years while some patients may never convert to Alzheimer's disease and some may return to normal.....

23-protein screen is highly accurate and first to be validated

INDIANAPOLIS -- Primary care physicians should focus on "dementia red flags" rather than routinely screening individuals with no dementia symptoms just because they've reached a certain age, writes Dr. Malaz Boustani of the Indiana University School of Medicine and the Regenstrief Institute, Inc. and colleagues from the University of Kent and the University of Cambridge in the United Kingdom in a commentary published in the Nov. 28 issue of the Journal of the American Medical Association.

"To screen without symptoms, unless there is a suspicion of a problem, either by the individual, caregivers or a physician, may led to negative consequences for the person and for society," says Boustani, who is a geriatrician.

"There currently is no accurate screening test, and we would be faced with an unacceptable number of false positives and false negatives. If we focus on dementia red flags, we will be identifying individuals who will have a very high probability of having dementia and be able to focus our resources, including diagnostic testing, on these people," Boustani says.....read more

• Did you notice a decline in physical abilities?
• Did your parent seem less stable on their feet or did they recently fall?
• Did you notice a decline in short-term memory?
• Were there stacks of unopened mail or cancellation notices triggered by unpaid bills?
• Did your parent or their home seem unusually unkempt?
• Is the refrigerator supplied with nutritious foods or evidence of their lack?
• Has your parent lost weight?
• Did you have any questions about your parent's medications?
• Did you question your parent's driving ability?

INDIANAPOLIS -- Primary care physicians should focus on "dementia red flags" rather than routinely screening individuals with no dementia symptoms just because they've reached a certain age, writes Dr. Malaz Boustani of the Indiana University School of Medicine and the Regenstrief Institute, Inc. and colleagues from the University of Kent and the University of Cambridge in the United Kingdom in a commentary published in the Nov. 28 issue of the Journal of the American Medical Association.

"To screen without symptoms, unless there is a suspicion of a problem, either by the individual, caregivers or a physician, may led to negative consequences for the person and for society," says Boustani, who is a geriatrician.

"There currently is no accurate screening test, and we would be faced with an unacceptable number of false positives and false negatives. If we focus on dementia red flags, we will be identifying individuals who will have a very high probability of having dementia and be able to focus our resources, including diagnostic testing, on these people," Boustani says.

Dementia red flags include medication adherence problems, more than seven prescribed medications, agitation, multiple falls, and more than two hospitalizations or emergency department visits in the past year. Boustani, who says the healthcare system in the United States misses between 60 percent and 80 percent of individuals with dementia, is currently testing ways to help physicians identify dementia red flags in their patients so these missed individuals can be helped.

Someone in the United States develops Alzheimer's disease every 72 seconds, according to the Alzheimer's Association. The average primary care physician sees 2,000 patients per year of whom 300 are aged 65 or older. Of these 24 will develop dementia.

Despite this burden of disease, the benefit-harm ratio of conducting general population-based screening has not yet reached the point where the benefit outweighs the harm, the commentary maintains. Potential harms include possible stigma, loss of long term care insurance, emotional dislocation for both the individual and family, and resources' shifting from other health problems.

Boustani is the author of a 2003 report evaluating the wisdom of routine screening for dementia in primary care settings. The report, prepared for the U.S Preventative Services Task Force, found that while two-thirds of dementia cases are undetected by the patient's primary care physician, insufficient data exists to indicate whether or not it is a good idea to administer dementia screening tests to patients who do not have symptoms of memory loss or confusion.

"Pressures to institute screening of unproven benefit could divert much needed resources from the health and social care systems and have an overall negative impact on care for patients with dementia and other illnesses, ultimately delaying the point when dementia screening becomes indicated," the commentary concludes. "The goal should continue to be the best possible care for the most patients, which currently does not include screening for dementia."

From Indiana University