Like Seeing A Light on a Distant Shore
Despite the fact that an estimated 5.4 million Americans have been diagnosed with Alzheimer’s (including some 50,000 Mississippians), a disease that robs the memory and eventually leads to death, there is still so much that we simply don’t know.
We do know that it kills more people than breast cancer and prostate cancer combined and that it is the only condition of the top 10 causes of death that thus far cannot be prevented, reversed or cured. But in Mississippi, we can be very proud to know that we have one of the nation’s leading research centers dedicated to unlocking the mysteries of Alzheimer’s disease by identifying its risk factors, developing better techniques for diagnosing and treating it, and hopefully, someday preventing it and the terrible toll it takes on our families, our communities and our society as a whole.
The MIND (Memory Impairment and Neurodegenerative Dementia) Center at the University of Mississippi Medical Center is on the forefront in the search to crack the code of Alzheimer’s disease. It is leading a collaborative study of Alzheimer’s risk factors with experts from four major academic medical centers including Johns Hopkins University, University of Minnesota, Wake Forest University and University of North Carolina – Chapel Hill, that is funded by a $26 million grant from the National Institutes of Health.
The MIND Center is under the leadership of Dr. Tom Mosley, a professor in geriatric medicine and neurology, and a nationally recognized leader in the study of cognitive decline. The Center is combining pioneering research, state-of-the-art brain imaging and powerful new genetic technologies to make discoveries about Alzheimer’s causes.
According to Dr. Mosley, when it comes to preventing or curing Alzheimer’s disease, the promise of recent research is “like seeing a light on a distant shore,” when he spoke last year at the 16th annual Conference on Alzheimer’s Disease and Psychiatric Disorders in Older Adults.
Mosley was quoting a colleague when he described the potential to exploit the latest breakthroughs.
Each step forward “provides hope,” said Mosley. “It’s a beacon to us, but it’s still a ways off.”
Among the promising conclusions of the research, is the discovery of a significant link between cardiovascular risk factors (such as hypertension and diabetes) and Alzheimer’s disease. This is important because determining who is most at risk for developing Alzheimer’s, as with cardiovascular disease, could lead to early intervention and someday, prevention.
In another vein of the research, new advances in brain imaging have accelerated our knowledge of Alzheimer’s by enabling researchers to more closely examine the brain, and uncover the presence of plaques, or abnormal buildup of protein, between the nerve cells – a condition believed to cause Alzheimer’s.
According to Mosley, improvements in genetic research also have been a boon to their efforts. Mosley also leads an international consortium of researchers with over 30 studies representing more than 100,000 research participants in the U.S. and Europe that is taking advantage of recent advances in genetics. This team has now identified new genetic regions related to memory loss and cognitive abilities in older adults. Identifying these genes and understanding their function could lead to the development of new treatments for memory loss.
In addition to the prestigious research arm of The MIND Center, there is also an outpatient clinic, which offers leading-edge diagnostic and clinical services for patients with memory loss and cognitive impairment such as Alzheimer’s disease. The MIND Center Clinic’s multidisciplinary team includes geriatricians and neurologists, nurse practitioners and social workers, all of whom are expert in caring for patients and families battling Alzheimer’s and dementia.
Netrali Patel, M.D., Director of The MIND Center Clinical Services, explains the multi-faceted process they use to diagnose Alzheimer’s disease.
“We do a 90-minute memory evaluation that includes a clinical assessment, comprehensive memory and cognitive evaluation, diagnostic labs and imaging studies including CT, MRI, and state-of-the-art brain PET scanning,” notes Dr. Patel. “First we must rule out medical and emotional conditions that could present similar symptoms. We look at blood count, electrolytes, kidney function, liver function, thyroid test and carefully review medications a patient is taking and any other factors (hearing loss) that could contribute to cognitive changes.”
“Once we have made a diagnosis of Alzheimer’s or another form of dementia,” adds Patel, “we work closely with the patient and caregiver to determine the best treatment options for them, such as using pharmacological and behavioral therapies, based on the detailed medical and cognitive evaluation.”
“Beyond the clinical aspects of our services, we help patients and caregivers manage the symptoms and side effects of the disease, and show caregivers how to care for themselves, as well as their loved ones. We also can give guidance on difficult issues such as assisted living, memory care, skilled nursing, home health or legal considerations,” Patel adds.
Dr. Patel stresses the importance of getting a diagnosis as soon as possible if a person is exhibiting signs and symptoms of memory loss.
“While Alzheimer’s is a disease without a cure, the sooner it is diagnosed, the more can be done to slow its progression,” Patel continues. “We can’t repair the damage to the brain once it has occurred, but we can intercede to extend quality of life for the patient and the caregiver and reduce the pace of future memory loss. By diagnosing Alzheimer’s disease early, we can not only begin treatment, but help the patient and family have time to prepare for legal and financial concerns and hopefully postpone loss of independence and nursing home placement.”
To serve patients outside the immediate Central Mississippi area, The MIND Center has collaborated with UMMC’s Center for Telehealth to launch an Alzheimer’s telemedicine program called “TeleMIND” to bring specialized dementia care to patients across Mississippi. This innovative program provides remote medical care, health education and public health services through secure audiovisual technology.
DID YOU KNOW?
What is the mission of The MIND Center? To discover the causes of Alzheimer’s disease, identify risk factors, improve diagnoses, develop more effective treatments and eventually prevent its onset.
Are there any breakthroughs in Alzheimer’s disease research to report? The most significant advances include: the discovery of the link between cardiovascular risk factors and Alzheimer’s disease; and the identification of specific genes that are related to memory, cognition and dementia. Electronic medical records that link big data systems so they are available to researchers and the “harmonizing” of genetic data on the same platforms have been significant to the collaboration of researchers from around the world.
Is Alzheimer’s disease on the rise and if so why? There are 35.6 million people living with dementia worldwide. Those numbers are expected to double by 2030 and triple by 2050. The simple answer to why is that we are living longer and more of our population, as a whole, is growing older. Beyond that, researchers are still searching for answers.
At what age can symptoms of Alzheimer’s disease begin? Symptoms for the majority of people who are diagnosed appear after the age of 70. About 5 percent develop symptoms before age 65, but early-onset Alzheimer’s has been known to develop as early as age 30 or 40, but that’s very uncommon.
Is Alzheimer’s disease hereditary? There is a strong genetic link for early onset disease. Genetics also play a role in late life dementia but genes do not explain the full story. Environmental and life style factors and how these interact with genes remains a major focus of research.
Is there anything we can do to improve or slow down the progression of memory loss?
1) Stimulate your senses – involve as many senses as possible: vision, sound, touch, smell and taste.
2) Write it down – make lists, keep calendars, follow a routine, maintain associations, repeat names, run through the alphabet.
3) Keep your body and brain active