Saturday December 14, 2019

US Researchers Finding Ways to Treat Dementia

Researchers are looking for ways to treat or prevent dementia, and a promising clinical trial is underway in the US

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Dementia is a rapidly growing public health problem throughout the world. VOA

Dementia is a rapidly growing public health problem around the world. Fifty million people suffer from dementia, and in the next 30 years, that number is expected to triple. Researchers are looking for ways to treat or prevent dementia, and a promising clinical trial is underway in the U.S.

Dementia is not a normal part of aging, but age is a huge risk factor. Regular exercise, a healthy diet, maintaining healthy blood pressure, cholesterol, and blood sugar levels help stave off dementia as we grow older

As people around the world live longer, health agencies and researchers are looking for ways to prevent, stop or treat dementia, including Alzheimer’s disease, one of the most common types of dementia.

Promising clinical trial

David Shorr was diagnosed with Alzheimer’s at 56.He is about to undergo a new procedure that could treat early stage Alzheimer’s. He is with his doctor, Vibhor Krishna, a neurosurgeon at Ohio State Wexner Medical Center.

The procedure Shorr is about to have involves sound waves. Ultrasound waves target and open the blood-brain barrier — a protective layer that shields the brain from infections. But Krishna says the barrier also makes it hard to treat neurodegerative diseases like Alzheimer’s. “Opening the blood-brain barrier allows us to access more of the brain tissue and be able to increase the effectiveness or bioavailability of the therapeutics,” Krishna said.

Shorr and his wife, Kim, were willing to try any new treatment that might help with his dementia. Kim describes the couple’s reaction when they received a phone call inviting Shorr to participate in a clinical trial. “There’s this trial. Would you be interested?” she said, describing the call. “And without really knowing what it was, we said, Sure.’”

Ultrasound targets protein buildup

Shorr became one of 10 patients enrolled in the study. The trial tests MRI-guided imaging to target the part of the brain responsible for memory and cognition. Krishna explains that’s where Alzheimer’s patients have a buildup of toxic proteins called amyloid. “Higher deposition of amyloid goes hand in hand with loss of function in Alzheimer’s disease,” he said.

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FILE – Dr. William Burke goes over a PET brain scan, Aug. 14, 2018, at Banner Alzheimers Institute in Phoenix. VOA

Krishna says this procedure might allow a patient’s own immune system to clear some of the amyloid. In this procedure, ultrasound wave pulses cause microscopic bubbles to expand and contract in the brain. “The increase and decrease in size of these microbubbles mechanically opens the blood-brain barrier,” Krishna said. The patient is awake during the procedure.

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Study could help others

Opening the barrier may one day allow doctors to deliver medication straight to the site of the disease. Kim Shorr realizes her husband might not benefit from this treatment.

“We’re hopeful it can help him, but we also know maybe it will help somebody else,” she said. Shorr is glad to be part of a study that could help others who are in the early stages of Alzheimer’s, even if it doesn’t help him. (VOA)

Next Story

Research Finds That Drug Can Curb Dementia’s Delusions

About 8 million Americans have dementia, and studies suggest that up to 30% of them develop psychosis.

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Television actor Barbara Windsor and her husband Scott Mitchell talks about Drugs
Television actor Barbara Windsor and her husband Scott Mitchell pose with a placard in front of Downing Street ahead of a meeting with Britain's Prime Minister Boris Johnson in London, Britain. VOA

A drug that curbs delusions in Parkinson’s patients did the same for people with Alzheimer’s disease and other forms of dementia in a study that was stopped early because the benefit seemed clear.

If regulators agree, the drug could become the first treatment specifically for dementia-related psychosis and the first new medicine for Alzheimer’s in nearly two decades. It targets some of the most troubling symptoms that patients and caregivers face — hallucinations that often lead to anxiety, aggression, and physical and verbal abuse.

Results were disclosed Wednesday at a conference in San Diego.

Unmet need for treatment

“This would be a very important advance,” said one independent expert, Dr. Howard Fillit, chief science officer of the Alzheimer’s Drug Discovery Foundation.

Although the field is focused on finding a cure for dementia and preventing future cases, “there is a huge unmet need for better treatment” for those who have it now, said Maria Carrillo, the Alzheimer’s Association’s chief science officer.

The drug is pimavanserin, a daily pill sold as Nuplazid by Acadia Pharmaceuticals Inc. It was approved for Parkinson’s-related psychosis in 2016 and is thought to work by blocking a brain chemical that seems to spur delusions.

Dementia Drugs
Dementia is a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. Pixabay

About 8 million Americans have dementia, and studies suggest that up to 30% of them develop psychosis.

“It’s terrifying,” said Dr. Jeffrey Cummings of the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas. “You believe that people might be trying to hurt you. You believe that people are stealing from you. You believe that your spouse is unfaithful to you. Those are the three most common false beliefs.”

How the study worked

He consults for Acadia and helped lead the study, which included about 400 people with dementia and psychosis. All were given a low dose of the drug for three months, and those who seemed to respond or benefit were then split into two groups. Half continued on the drug and the others were given dummy pills for six months or until they had a relapse or worsening of symptoms. Neither the patients nor their doctors knew who was getting what.

Independent monitors stopped the study when they saw that those on dummy pills were more than twice as likely as those on the drug to relapse or worsen — 28% versus nearly 13%.

There were relatively few serious side effects — 5% in the drug group and 4% in the others. Headaches and urinary tract infections were more common among those on the drug. Two deaths occurred, but study leaders said neither was related to the drug.

The drug could become the first treatment for dementia
The drug could become the first treatment specifically for dementia-related psychosis. Pixabay

Carrillo said the study was small, but the drug’s effect seemed large, and it’s not known whether the federal Food and Drug Administration would want more evidence to approve a new use.

Risk of death

Current anti-psychotic medicines have some major drawbacks and are not approved for dementia patients.

“They’re often used off label because we have very few other options,” Fillit said.

ALSO READ: Researchers Associate Social Media Use to Eating Disorder in Adolescents

All carry warnings that they can raise the risk of death in elderly patients, as does Nuplazid.

Cost could be an issue — about $3,000 a month. What patients pay can vary depending on insurance coverage. (VOA)