According to the Alzheimer’s Association’s report, an estimated 6.9 million Americans are living with Alzheimer’s disease in 2024, and this number is expected to continue to grow as the population of Americans age 65 or older is also increasing. June is a month dedicated to raising awareness about Alzheimer’s disease and to promoting brain health. In this article, we will focus on the following topics: 

• The latest research on early signs of Alzheimer’s disease 
• The influence of modern lifestyle on the disease 
• Advances in diagnosis: amyloid PET 
• Non-invasive devices to detect biomarkers 
• Hope in promising new drugs

 

The latest research on early signs of Alzheimer’s 

Before examining the latest advancements in Alzheimer’s disease, understanding how a brain with Alzheimer’s disease works is essential. 

With aging, the brain undergoes certain changes: 

• Both the brain’s weight and volume decrease. In fact, the main change associated with aging is not so much the loss of neurons, as a decrease in their size and number of connections. 
• The brain regions linked to learning, memory, processing speed, or planning capacity are the most affected by aging. 

 

A healthy older person may experience a certain decline in the ability to learn new things or have difficulty retrieving certain information, but in a brain with Alzheimer's disease, significant neuronal loss occurs, mainly related to the accumulation of: 

• Beta-amyloid protein plaques
• Tau protein neurofibrillary tangles 

 

These plaques and tangles affect the functioning and survival of neurons. In addition to generating toxicity processes, they interrupt the ability of neurons to communicate with each other, inevitably leading to their death. 

Beta-amyloid plaques begin to form decades before the first symptoms appear, which makes research on the early signs of Alzheimer’s disease crucial because it can lead to more efficient prevention. A recent large-scale study of posterior cortical atrophy completed by an international team suggests this condition may predict Alzheimer’s. Early identification of these visual symptoms, which normally appear around 59 years of age, may have important implications for Alzheimer’s treatment, as patients with posterior cortical atrophy may be candidates for anti-amyloid therapies, like lecanemab or donanemab.

The influence of modern lifestyle on the disease 

According to research carried out by the University of Southern California and published in the Journal of Alzheimer’s Disease, Alzheimer’s disease and related dementias are closely related to modern environments and lifestyles, as medical texts from 2,500 years ago rarely mention them. Researchers not only studied ancient medical writings from ancient Greeks and Romans, but they also turned to an Indigenous people of the Bolivian Amazon, the Tsimane, who have a physically active, pre-industrial lifestyle. These people show minimal dementia, which suggests that environmental factors such as pollution and sedentary behavior may be important determinants of dementia risk.

Latest advances in diagnosis: amyloid PET 

Early diagnosis of Alzheimer’s disease is essential to initiate treatment and slow down the cognitive decline. Despite the increasing use of positron emission tomography (PET) to measure the abnormal accumulation of amyloid beta protein plaques, evidence for its utility and cost-benefit ratio was limited, but for the first time there has been a randomized controlled clinical trial carried out to confirm the clinical utility of amyloid PET, says Juan Domingo Gispert, head of the BBRC Neuroimaging Research Group, who has led the center's participation in AMYPAD. 

The findings demonstrated that performing amyloid PET early in the diagnostic workup (within 1 month) allowed 40% of memory clinic patients to receive an etiological diagnosis with very high diagnostic confidence after only 3 months. This is relevant because, as the trial concludes, a timely high-confidence diagnosis is critical to the success of disease-modifying therapies, especially anti-amyloid drugs, whose efficacy might decrease with advancing disease progression.

Noninvasive devices to detect biomarkers 

In an effort to find noninvasive detection methods for degenerative brain disease, an international team of researchers has developed a non-invasive device that can detect biomarkers for Alzheimer's and Parkinson's diseases. The detection of three important amyloids is reported: 

• Amyloid beta (Aβ) 
• Tau (τ) 
• α-Synuclein (αS) 

 

Although the results of these experiments are promising, the challenges of brain-derived amyloid protein detection directly via bodily fluids are also acknowledged and research in this field has to continue.

Hope in promising new drugs 

Anti-amyloid drugs represent a significant advance in Alzheimer’s research. 

Immunotherapies 

Immunotherapies are already used in medicine, for example in the treatment of some cancers. They target amyloid plaques in the brains of people with Alzheimer’s to help them break them down. 

• The pharmaceutical companies Biogen and Eisai presented the results of the phase III study of their drug lecanemab during the Congress of Clinical Trials on Alzheimer's (CTAD). The study confirms that lecanemab reduces amyloid markers and has managed to slow down cognitive decline by 27% in patients in the early stages of the disease. It is therefore the first drug that would succeed in slowing cognitive decline, so it represents a significant advance in Alzheimer's research 
• Donanemab made headlines with the release of the full results from a large final-stage trial in July 2023, which showed the drug successfully leads to the removal of amyloid from the brain. In the study, donanemab cleared amyloid plaques better than aducanumab (Aduhelm) and lecanemab (Leqembi), also newly emerging monoclonal antibodies, and reduced blood tau concentrations, but not in a key area of the brain 
• Remternetug is the third of these promising amyloid immunotherapy drugs and is also made by Eli Lilly, who makes donanemab. It has been described as a second-generation immunotherapy because it is hoped to perform better than donanemab. The method of administration used in the trial, injections under the skin, is more practical and effective than intravenous drip. In this way, patients could use pens similar to the ones used with insulin and have it administered at home. 

 

Hope lies in the mentioned advances in research, with the help of artificial intelligence to analyze the large quantities of data generated. 

Caregivers and their challenges are certainly the other crucial part of Alzheimer’s. Caring for a person with this disease involves a team of specialized professionals but also loved ones who will need support and resources as the patient’s health declines. It’s important for caregivers to prioritize care of themselves and stay strong physically and emotionally.

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. 

 

An Interpretive Report for the Dementia Rating Scale–2™ (DRS-2™) is now available on PARiConnect. The DRS-2 measures mental status in adults with cognitive impairment and assesses an individual’s overall level of cognitive functioning.

The DRS-2 Interpretive Report provides:

• Age-corrected subscale scores, an age- and education-corrected DRS-2 Total Score, and percentile subscale scores.
• Interpretive text that describes the client’s overall performance and subtest performance.
• A graphic profile of the client’s performance.

Save money and valuable clinical time by letting PARiConnect handle scoring and interpretation of your DRS-2 administrations without the investment of purchasing the entire software program.

Don’t have a PARiConnect account? It’s easy to sign up—plus you get three free administrations and three free reports! Learn more.

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. 

February 14-21 is Alzheimer’s and Dementia Staff Education Week. This week brings awareness to the importance of properly training individuals from a variety of fields. Whether you are a health care provider, 911 operator, first responder, clergy member, elder care attorney, or have another role working with the elderly, this week focuses on the importance of comprehensive dementia education. 

Beyond educating individuals beyond those in mental and physical health care about the importance of dementia education, the week also shines a spotlight on caregivers supporting individuals with these diagnoses. 

 

Some resources for Alzheimer’s disease and dementia care 

The National Institute on Aging is the primary government agency conducting research on Alzheimer’s disease. 

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support, and research. The association’s website offers resources for caregivers as well as those living with Alzheimer’s. 

The National Council of Certified Dementia Practitioners (NCCDP) provides resources, including seminars and training. NCCDP members may download a free Alzheimer’s and Dementia Staff Education Week toolkit from their website. 

 

Need help assessing for neurocognitive impairment? 

Patients with neurocognitive impairment such as dementia are often unreliable reporters of their symptoms. An observer—such as a family member, friend, or home health care nurse—can often provide valuable insight into an individual’s functioning. The Older Adult Cognitive Screener™ (OACS™) is a quick informant rating scale that helps provide information on a patient’s mental status and determine if there is a need for more in-depth testing. Learn more about the OACS. 

The Dementia Rating Scale–2™ (DRS-2™) measures mental status in individuals with cognitive impairment. It assesses an individual’s mental status over time. 

 

Dementia is one of the most devastating diagnoses a patient and family can receive. It is a major cause of disability and dependency among older people worldwide, and nearly 10 million new cases are diagnosed globally each year. Early screening of dementia symptoms in older adults is critical to ensure timely treatment and intervention—and to minimize the impact on the patient and family.

PAR’s new neuropsychological assessment instrument, the Older Adult Cognitive Screener (OACS), will help you serve your older patients and their families with quicker answers. An all-digital informant rating scale, the OACS is designed for early screening of dementia symptoms for patients ages 55–90 years and will assist with follow-up determinations, including initiating or referring your clients for comprehensive diagnostic testing. Results are based on the observations and knowledge of a reliable caregiver, family member, or friend (e.g., spouse or home health care worker).

How does the OACS help you screen for neurocognitive impairments? 

1. Administration and scoring are rapid and reliable.

Raters can complete the items in only 5–10 minutes online, and scoring is instant via PARiConnect. Change Reports are available to help you track change over time.

2. The OACS is entirely digital, ideal for telehealth and social distancing.

Another significant advantage of the OACS is its digital format, which aligns well with today’s telehealth models and enables you to continue testing even when social distancing is required. Plus, because the OACS is administered through PARiConnect, data are easily exported into an electronic medical record (EMR) system.

Related article: SPEAKING MORE THAN ONE LANGUAGE MAY DELAY ONSET OF DEMENTIA

3. Items map onto DSM-5 domains.

The OACS is the only neurocognitive screener with items that map directly onto the six principal domains of neurocognitive function identified in the DSM-5®: executive function, complex attention, language, perceptual–motor, social cognition, and learning and memory. An additional item addresses activities of daily living (ADLs) to help you determine how the patient performs common physical tasks.

Why should I use the OACS?

Designed to be used in medical settings by primary care and specialty physicians, the OACS can also be administered and scored appropriately by nursing staff and properly trained clerical staff. It is also useful for clinical psychologists, neuropsychologists, and others who treat older adults on a clinical basis in a variety of mental health settings, including nursing homes and community mental health centers.

It was developed by trusted authors Cecil R. Reynolds, PhD, and Erin D. Bigler, PhD, to provide a rapid, cost-effective, and valid means of screening older adults for cognitive dysfunction.

To learn more or to order, visit parinc.com/OACS or call PAR Customer Support at 1.800.331.8378.

This fall, PAR will add a new neuropsychological assessment instrument to our lineup: the Older Adult Cognitive Screener (OACS), an all-digital informant rating scale that enables you to make quick decisions about your older clients’ (ages 55 to 90 years) mental status. The OACS is designed for early screening of dementia symptoms and will assist with follow-up determinations, including initiating or referring your clients for comprehensive diagnostic testing. Administration and scoring take only 10 minutes.

Working with authors Cecil R. Reynolds, PhD, and Erin D. Bigler, PhD, our goal as we’ve developed the OACS was to provide a rapid, cost-effective, and valid means of screening older adults for cognitive dysfunction based on the observations and knowledge of a reliable caregiver, family member, or friend (e.g., spouse or home health care worker).

Unlike on similar measures, OACS items map directly onto the six principal domains of neurocognitive function identified in the DSM-5®: executive function, complex attention, language, perceptual–motor, social cognition, and learning and memory. Activities of daily living (ADLs) are also assessed.

Related article: TICS: ASSESS FOR COGNITIVE IMPAIRMENT REMOTELY

Another significant advantage of the OACS is its digital format, which aligns well with today’s telehealth models and enables you to continue testing even when social distancing is required. Plus, because the OACS is administered through PARiConnect, data are easily exported into an electronic medical record (EMR) system.

The OACS is designed to be used in medical settings by primary care and specialty physicians and can be administered and scored appropriately by nursing staff and properly trained clerical staff. It is also useful for clinical psychologists, neuropsychologists, and others who treat older adults on a clinical basis in a variety of mental health settings, including nursing homes and community mental health centers.

The OACS will be released this fall. For more information, or to preorder, visit parinc.com/OACS.

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!

One of the world’s most popular and trusted assessments of cognitive impairment is now available as a convenient app for smartphones and tablets. Like the paper-and-pencil version, the app can be used to screen for cognitive impairment, to select patients for clinical trials research in dementia treatment, or to track patients’ progress over time.

The MMSE/MMSE-2 app includes a brief instructional video that walks users through the features of the app. In addition to the original MMSE, both standard and brief versions of the MMSE-2 are available, enabling health care providers to choose the version that will suit each client. Scoring is done automatically, and patient records can be uploaded directly to an electronic medical records (EMR) system or e-mailed to appropriate personnel. Equivalent, alternate forms of the MMSE-2 decrease the possibility of practice effects that can occur over serial examinations. The app also includes norms for the MMSE and the MMSE-2, by age and education level.

The MMSE/MMSE-2 app is available to qualified health care professionals from the Apple® App Store^SM (for the iPhone® or iPad®) and from Google Play (for Android™ devices). The app is free—users pay only for administrations, which start at $1.25 each.