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June is Alzheimer’s and Brain Awareness Month, and it’s a great time to shed light on the impact of Alzheimer’s in our communities. About 6.5 million Americans age 65 years and older—or 1 in 9 people in this age group—live with Alzheimer’s dementia (i.e., dementia due to Alzheimer’s disease). This number is expected to grow as the baby-boom generation ages.  

Alzheimer’s is a progressive disease that causes problems with memory, thinking, and behavior in primarily older people. Average survival after diagnosis in people age 65 years and older is 4 to 8 years, but some individuals live up to 20 years with the disease. This takes a huge toll on both those living with Alzheimer’s and those who care for them. 

There are many ways to support people in your community who are dealing with the daily effects of Alzheimer’s disease: 

  • Learn about the risk factors and incidence rates of Alzheimer’s. Visit alz.org to read facts and figures, find resources for help, and learn about advocacy. 

  • “Go purple” in June to raise awareness. Wear purple, turn your Facebook page purple, and share your story on social media using the hashtags #ENDALZ and #GoPurple.  

  • Contribute your time or money to organizations that support people living with Alzheimer’s, like the Alzheimer’s Association, the Alzheimer’s Foundation of America, or a local group.  

For more information about what you can do in June to highlight Alzheimer’s disease, visit https://www.alz.org/abam/overview.asp.   

 

Looking for products to assess dementia or Alzheimer’s disease? Learn more. 

 

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More than 50 million people are living with Alzheimer’s disease and other dementias. Alzheimer’s disease is currently the only leading cause of death in the U.S. that cannot be prevented, cured, or slowed.  

 

What you should know about Alzheimer’s and other dementias 

  • Someone in the U.S. develops Alzheimer’s disease every 66 seconds. Estimates indicate this will increase to one every 33 seconds by 2050. 

  • Alzheimer’s is the most common cause of dementia among older adults. Most individuals with Alzheimer’s disease start exhibiting signs in their mid-60s. 

  • Just this month, the Food and Drug Administration approved the use of the drug aducanumab for Alzheimer’s patients, the first novel therapy to be approved since 2003. 

 

Ways you can show your support 

Raise awareness on social media. The Alzheimer’s Association makes it simple to update your Facebook profile with a frame in support of Alzheimer’s awareness. 

Share your story. Use hashtags #ENDALZ and #EndAlzheimers to share your story about how Alzheimer’s has touched your life and read more about how Alzheimer’s and other dementias have impacted people throughout the world.  

Wear purple. Show your support by wearing purple! You may even want to show your support by tying purple ribbons on your home or car to show your support. 

Raise funds through the Solstice Challenge. The longest day of the year—June 20—is a day dedicated to fighting against the darkness of Alzheimer’s. The Alzheimer’s Association offers suggestions on how you can participate, whether through games, parties, sports, or the arts! 

 

PAR offers a range of products designed to assess and monitor dementia. Learn more

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PAR has announced the recipient of its fifth-annual program to benefit worthy charities. “PAR has been incredibly fortunate as a company,” stated Kristin Greco, MBA, Chief Executive Officer. “Rather than sending our Customers an end-of-year gift, a few years ago, we decided to make a charitable contribution on behalf of our Customers to an organization chosen by those we serve. This is the fourth year we have done so, each year selecting a new charity to honor.”

In November, PAR mailed an end-of-year communication to select Customers, thanking them for their business and asking them to choose their favorite organization from a list as a way to acknowledge the important work they do throughout the year. Most PAR Customers are involved in psychological assessment, educational assessment, or mental health work.

Now that results have been tallied, PAR is proud to announce that on behalf of its Customers, a $5,000 donation will be made to the Alzheimer’s Foundation of America“We are so inspired by the work our Customers do, and the Alzheimer’s Foundation of America is doing work that is important to them,” said Greco. “It is an honor to be able to pay it forward to such a worthy organization.”

 

Scientists have found a way to replicate human brain cells for use in Alzheimer’s research, according to an article in the New York Times this week. Lead researcher Rudolph E. Tanzi of Massachusetts General Hospital in Boston and his colleagues were able, for the first time, to grow human brain cells in a petri dish, where the neurons formed networks as they do in an actual brain. Their study was published in the online version of the journal Nature.

The researchers have resolved a long-standing problem with Alzheimer’s research, the New York Times reports. Previously, drugs had to be tested in mice, which have a different form of the disease. With human brain cells grown in a gel, the cells form the same kinds of networks that they do in a real brain. After implanting the cells with Alzheimer’s genes, the researchers began to see plaques and tangles develop—the telltale signs of Alzheimer’s.

“It is a giant step forward for the field,” said Dr. P. Murali Doraiswamy, an Alzheimer’s researcher at Duke University, in a recent interview. “It could dramatically accelerate testing of new drug candidates.”

This discovery will allow researchers to quickly test drugs that could slow or stop the progression of the disease. In fact, Dr. Tanzi and his colleagues have started to test 1,200 drugs currently on the market as well as 5,000 experimental ones. This huge project would have been impossible using mice, but with the new petri dish system, says Dr. Tanzi, “we can test hundreds of thousands of drugs in a matter of months.”

The full text of Dr. Tanzi’s study, along with videos showing Alzheimer’s brain cells in the culture, can be found online in the current issue of Nature.

Editor’s Note: On Saturday, November 1, an enthusiastic team of PAR employees will be participating in the Walk to End Alzheimer’s here in Tampa, Florida—one of a series of walks to benefit the Alzheimer's Association, which is the largest voluntary health organization in Alzheimer’s care, support, and research. To find a walk near you, click on the link and visit their Web site today!
A recent study of 648 older adults in India suggests that those who were bilingual developed dementia more than four years later, on average, than those who spoke only one language—regardless of educational level.

Published recently in Neurology, the medical journal of the American Academy of Neurology (AAN), the study found that speaking two languages seems to have a protective effect against three types of dementia: Alzheimer’s disease, frontotemporal dementia, and vascular dementia.

“Speaking more than one language is thought to lead to better development of the areas of the brain that handle executive functions and attention tasks, which may help protect from the onset of dementia,” said study author Suvarna Alladi, DM, with Nizam’s Institute of Medical Sciences in Hyderabad, India, in a press release from the AAN.

The study subjects, all of whom were diagnosed with dementia, had an average age of 66. Approximately half spoke two or more languages; 14 percent were illiterate.

“These results offer strong evidence for the protective effect of bilingualism against dementia in a population very different from those studied so far in terms of its ethnicity, culture and patterns of language use,” Alladi said.

To learn more or to read the full article online, visit the Neurology Web site.
A remarkable transformation is taking place in nursing homes around the country as elderly patients are reconnecting with life through music. The brainchild of social worker Dan Cohen, a program called Music & Memory has created personalized iPod playlists for residents of elder care facilities, many of whom have Alzheimer's type dementia. The results have been truly life changing for patients as they are “reawakened” by the music of their youth.

Cohen is now working with renowned neuropsychologist Oliver Sacks (author of Musicophilia: Tales of Music and the Brain) on a documentary about Cohen’s program and the elderly patients who are responding so positively. In a clip from this documentary, a man reacts to hearing music from his past:

 

http://www.youtube.com/watch?v=fyZQf0p73QM

 

“Our approach is simple, elegant and effective,” says Cohen on his Music & Memory Web site. “We train elder care professionals how to set up personalized music playlists, delivered on iPods and other digital devices, for those in their care. These musical favorites tap deep memories not lost to dementia and can bring residents and clients back to life, enabling them to feel like themselves again, to converse, socialize and stay present.”

What do you think? Has music helped your clients with dementia to access memories and engage more positively in daily life? PAR wants to hear from you, so leave a comment and join the conversation!
In the search for more effective treatments for Alzheimer’s disease, a new clinical trial will test whether a prevention drug has any effect on patients who are genetically predisposed to develop the disease, but who don’t yet exhibit symptoms. In the study, scientists are focusing on members of a large, extended family in Medellín, Colombia, some of whom have a specific genetic mutation that is linked to early-onset dementia. The trial will be “the first to focus on people who are cognitively normal but at very high risk for Alzheimer’s disease,” said Dr. Francis S. Collins, director of the National Institutes of Health (NIH), in a May 15 interview with the New York Times.

Members of the Colombian family who have the genetic mutation begin showing cognitive impairment around age 45 and develop full dementia by age 51. Three hundred family members, some as young as age 30, will participate in the initial trial.

The five-year study is a collaboration between the NIH, the nonprofit Banner Alzheimer’s Institute, Genentech (maker of the drug crenezumab, which will be used in the trial), and the University of Antioquia in Medellín. The trial will help to test the amyloid theory of Alzheimer’s, which holds that the disease is caused by a steady buildup of the beta amyloid protein. Some results of the trial—specifically those that address whether the drug can delay memory decline—may be available in as little as two years, according to study leader Ken Kosik, codirector of the Neuroscience Research Institute at University of California, Santa Barbara.

Although only a small percentage of people with Alzheimer’s have the genetic early-onset form, researchers expect the trial to yield information that will help millions people who are affected more common forms of the disease. “It offers a tremendous opportunity for us to answer a large number of questions, while at the same time offering these people some significant clinical help that otherwise they never would have had,” said Dr. Steven T. DeKosky, an Alzheimer’s researcher from the University of Virginia School of Medicine, in the New York Times article.

To learn more about this and other ongoing studies of Alzheimer’s disease, visit the NIH’s National Institute on Aging Web site.
Broader Definition of the Disease Could Help Doctors with Early Diagnosis and Intervention

In April of this year, the National Institutes of Health and the Alzheimer’s Association announced significant changes in the clinical diagnostic criteria for Alzheimer’s disease dementia. These revisions—the first in 27 years—are intended to help diagnose patients in the very early stages of the disease, allowing doctors to prescribe medication when it is most effective; that is, before a patient’s memory becomes compromised.

The new guidelines recognize two early stages of the disease: preclinical Alzheimer's, in which biochemical and physiological changes caused by the disease have begun; and mild cognitive impairment, a stage marked by memory problems severe enough to be noticed and measured, but not severe enough to compromise a person’s independence. The new guidelines also reflect the increased knowledge scientists have about Alzheimer’s, including a better understanding of the biological changes that occur and the development of new tools that allow early diagnosis.

William H. Thies, chief scientific and medical officer of the Alzheimer’s Association, explains, “If we start 10 years earlier and could push off the appearance of dementia by, say, five years … that could cut the number of demented people in the U.S. by half” (Los Angeles Times, April 25, 2011).

For more information about the updated guidelines, as well as a list of journal articles and answers to frequently asked questions for clinicians, visit the National Institute on Aging Web site at http://www.nia.nih.gov/Alzheimers/Resources/diagnosticguidelines.htm.

What made you decide initially to develop the Mini-Mental® State Examination (MMSE)?


We developed the MMSE to solve a clinical problem on a geriatric psychiatric inpatient service. The diagnoses of patients on our unit included depression, dementia, delirium, and occasional late-life schizophrenia. We needed a practical quantitative cognitive exam in order to aide clinicians in determining the severity of cognitive impairment ranging from mild to severe and to document improvement or decline.

At the time, Susan was a psychiatry resident rotating on the geriatric psychiatric unit where I (Marshal) was a junior attending. Always a perfectionist, she was not happy when I repeatedly asked for cognitive information that she had not asked about. So she asked me to write down all the items that I wanted her to include.

What made you decide to update it and create the Mini-Mental® State Examination, Second Edition™ (MMSE®-2™)?


Over the years, students and other users made many suggestions about how to improve the MMSE. There was a need to clarify the instructions so that certain tasks were administered; there was a need for phrases that were more easily translated into other languages; and users requested multiple forms in order to minimize practice effects with serial administration. In addition, we had long wanted to develop a shorter version that could be given very quickly in busy clinical settings, and also a longer version that would eliminate ceiling effects. We wanted this longer version to be more sensitive than the original MMSE to disorders of executive function and to the kinds of memory impairment found in mild cognitive impairment.

What would you like to tell people about the MMSE-2 that they may not know?


The MMSE-2 Standard Version scores are equivalent to the original MMSE scores. We took care that subjects tested during development scored the same, regardless of whether they were given the original MMSE or the MMSE-2 Standard Version. Longitudinal studies currently underway can switch to the new version without any adjustment to scores. The original, unrevised MMSE is still available if users do not want to change to the revised versions.

How do you spend your free time?


Marshal takes flute lessons and is trying to improve his photography. Susan enjoys gardening and reading spy novels, biographies, Jane Austen, and Patrick O’Brian. She has a new job at the University of Miami School of Medicine with a joint appointment in psychiatry and in the Hussman Institute for Human Genomics. We both like to write and watch old movies.

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