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She is a 2013 graduate of Brooklyn Law School and is currently researching war on terror prosecutions for an upcoming book.","avatar":"https://secure.gravatar.com/avatar/c8b48ebc98e770640f3013c470d23f3e?s=600&d=blank&r=g","twitter":"amelscript","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"futureofyou","roles":["editor"]},{"site":"science","roles":["editor"]}],"headData":{"title":"Amel Ahmed | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/c8b48ebc98e770640f3013c470d23f3e?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/c8b48ebc98e770640f3013c470d23f3e?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/aahmed"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"futureofyou_445133":{"type":"posts","id":"futureofyou_445133","meta":{"index":"posts_1591205157","site":"futureofyou","id":"445133","score":null,"sort":[1540229203000]},"guestAuthors":[],"slug":"want-to-keep-your-brain-sharp-take-care-of-your-eyes-and-ears","title":"Want To Keep Your Brain Sharp? Take Care Of Your Eyes And Ears","publishDate":1540229203,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>By age 40, about 1 in 10 adults will experience some hearing loss. It happens so slowly and gradually, says audiologist Dina Rollins. \"You don't realize what you're missing.\" And even as it worsens, many people are in denial.\u003c/p>\n\u003cp>By the time someone is convinced they have a hearing problem, age-related memory loss may have already set in. But there's good news. Restoring hearing with hearing aids can help slow down cognitive decline.[contextly_sidebar id=\"6YAV50tRbgqwIJiI86NoTCI17lxry3wy\"]\u003c/p>\n\u003cp>Consider these findings: Researchers tracked about 2,000 older adults in the U.S. both before and after they started using hearing aids. The adults were participants in a big, national study called the \u003ca href=\"http://hrsonline.isr.umich.edu/\" target=\"_blank\" rel=\"noopener\">Health and Retirement Study\u003c/a>.\u003c/p>\n\u003cp>\"We found the rate of cognitive decline was slowed by 75 percent following the adoption of hearing aids,\" says \u003ca href=\"https://www.research.manchester.ac.uk/portal/asri.maharani.html\" target=\"_blank\" rel=\"noopener\">Asri Maharani\u003c/a>, a researcher at the University of Manchester in the division of neuroscience and experimental psychology and an author of the paper. \"It is a surprising result,\" Maharani says. The study was \u003ca href=\"https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.15363\" target=\"_blank\" rel=\"noopener\">published\u003c/a> this spring in the \u003cem>Journal of the American Geriatrics Society\u003c/em>.\u003c/p>\n\u003cp>To assess cognition over time, researchers performed a battery of face-to-face tests with participants. This was done every two years from 1996 to 2014. One test to assess memory required participants to recall a list of 10 words, both immediately after the words were read aloud and then again after the participants had been distracted by other tasks.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We weren't expecting that hearing aid use would eliminate cognitive decline. That's just not going to happen\" because age-related decline is inevitable, explains \u003ca href=\"https://www.research.manchester.ac.uk/portal/piers.dawes.html\" target=\"_blank\" rel=\"noopener\">Piers Dawes\u003c/a>, an experimental psychologist and another author of the study. \"But the reduction in the rate of change is quite substantial. It's a very intriguing finding.\"\u003c/p>\n\u003cp>To put the findings in context, consider that the slower rate of decline equates to remembering less than one more word on the 10-word recall test. So it's a small but measurable effect. And it adds to the evidence that hearing loss and cognitive decline are strongly linked.[contextly_sidebar id=\"AfcnhascoCNQ0xP8K2IKX6aiTBhqbp6H\"]\u003c/p>\n\u003cp>It makes sense, says Rollins. Consider what people are getting when their hearing is restored: \"Stimulating your ears stimulates the nerves that stimulate your brain.\"\u003c/p>\n\u003cp>When you get hearing aids, \"we're giving your ears back what they're missing, and giving your brain what it needs to make sense of what you're hearing,\" Rollins explains. And this can help you stay more stimulated and socially engaged. Rollins was not involved in the study. She's in practice in Silver Spring, Md.\u003c/p>\n\u003cp>Rollins says people who have hearing loss might decline faster than those with normal hearing due to the loss of social stimulation. \"Social isolation is a huge part of hearing loss, and people will notice their loved ones withdrawing from conversation, or not going to family or social functions like they used to.\"\u003c/p>\n\u003cp>Rollins fits a lot of people with hearing aids, and sometimes they come in only after their loved ones insist on it. \"No one \u003cem>wants \u003c/em>to wear a hearing aid,\" Rollins says. \"Typically, there's convincing that needs to be done.\" There's still a stigma attached to wearing hearing aids. People think: \"I don't want to look old!\" But Rollins says the technology has improved a lot in recent years. And often, hearing aids are a lot less noticeable and are covered up by hair.\u003c/p>\n\u003cp>Cost is another obstacle. With a price tag of $4,500 and upwards for high-end aids, they're not cheap. Less expensive options are available, but insurance plans typically don't cover the full cost. Some plans offer no benefit for hearing aids, and, in general, Medicare \u003ca href=\"https://www.npr.org/sections/health-shots/2018/04/11/600895543/can-you-hear-me-now-senate-bill-may-make-the-answer-yes\" target=\"_blank\" rel=\"noopener\">does not cover the cost\u003c/a>, either.\u003c/p>\n\u003cp>But when people decide to get fitted with hearing aids, this step can improve quality of life. This is the case with Rollins' patient Lucien Johnson, 92, who was fitted with hearing aids a few weeks back.\u003c/p>\n\u003cp>\"I was tired of screaming,\" his wife, Carrie Johnson, tells us. And it was frustrating for Lucien as well.\u003c/p>\n\u003cp>\"Sometimes she thought I was ignoring her,\" Lucien says. But, really, he just didn't hear her speaking.[contextly_sidebar id=\"I4AgglSmwy1bzyUdMoNKByGDxN5TnrXK\"]\u003c/p>\n\u003cp>The Johnsons say they're communicating better now. Lucien went in to see Rollins for an adjustment recently. \"I need some fine-tuning,\" he told her. \"But so far, so good.\"\u003c/p>\n\u003cp>Another common condition as we age is the deterioration of vision, often because of cataracts.\u003c/p>\n\u003cp>New evidence shows that restoring vision by having cataract surgery can also slow cognitive decline. A companion study carried out by the same researchers and \u003ca href=\"https://journals.plos.org/plosone/article/comments?id=10.1371/journal.pone.0204833\" target=\"_blank\" rel=\"noopener\">published\u003c/a> in the journal \u003cem>PLOS One\u003c/em> this month evaluated the outcomes of about 2,000 older adults who had cataract surgery. They were all participants in the \u003ca href=\"https://www.elsa-project.ac.uk/\" target=\"_blank\" rel=\"noopener\">English Longitudinal Study of Ageing,\u003c/a> which is carried out similarly to the U.S. Health and Retirement Survey. Participants are given periodic cognitive assessments.\u003c/p>\n\u003cp>\"We found the rate of cognitive decline was slowed by 50 percent following cataract surgery,\" explains Maharani. As with the outcome in the hearing aid study, restoring good vision can't eliminate cognitive decline, but this study suggests it can significantly slow the process.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So many factors influence healthy aging, including lifestyle habits such as diet and physical activity. But Maharani and her co-authors say it's important to know that steps to correct vision and hearing loss can play into the equation as well.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Want+To+Keep+Your+Brain+Sharp%3F+Take+Care+Of+Your+Eyes+And+Ears&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Two large studies show that age-related memory loss can be slowed significantly when older people promptly address hearing and vision loss.","status":"publish","parent":0,"modified":1540229331,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":923},"headData":{"title":"Want To Keep Your Brain Sharp? Take Care Of Your Eyes And Ears | KQED","description":"Two large studies show that age-related memory loss can be slowed significantly when older people promptly address hearing and vision loss.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Want To Keep Your Brain Sharp? Take Care Of Your Eyes And Ears","datePublished":"2018-10-22T17:26:43.000Z","dateModified":"2018-10-22T17:28:51.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"445133 https://ww2.kqed.org/futureofyou/?p=445133","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/22/want-to-keep-your-brain-sharp-take-care-of-your-eyes-and-ears/","disqusTitle":"Want To Keep Your Brain Sharp? Take Care Of Your Eyes And Ears","source":"DIY Health","nprByline":"Allison Aubrey, NPR","nprStoryId":"658810909","nprApiLink":"http://api.npr.org/query?id=658810909&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/10/22/658810909/can-t-hear-well-fixing-hearing-loss-can-keep-your-memory-sharper?ft=nprml&f=658810909","nprRetrievedStory":"1","nprPubDate":"Mon, 22 Oct 2018 11:37:00 -0400","nprStoryDate":"Mon, 22 Oct 2018 04:48:00 -0400","nprLastModifiedDate":"Mon, 22 Oct 2018 11:37:19 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/10/20181022_me_want_to_keep_your_brain_sharp_take_care_of_your_eyes_and_ears.mp3?orgId=1&topicId=1128&d=206&p=3&story=658810909&ft=nprml&f=658810909","nprAudioM3u":"http://api.npr.org/m3u/1659416513-0ba446.m3u?orgId=1&topicId=1128&d=206&p=3&story=658810909&ft=nprml&f=658810909","audioTrackLength":206,"path":"/futureofyou/445133/want-to-keep-your-brain-sharp-take-care-of-your-eyes-and-ears","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/10/20181022_me_want_to_keep_your_brain_sharp_take_care_of_your_eyes_and_ears.mp3?orgId=1&topicId=1128&d=206&p=3&story=658810909&ft=nprml&f=658810909","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>By age 40, about 1 in 10 adults will experience some hearing loss. It happens so slowly and gradually, says audiologist Dina Rollins. \"You don't realize what you're missing.\" And even as it worsens, many people are in denial.\u003c/p>\n\u003cp>By the time someone is convinced they have a hearing problem, age-related memory loss may have already set in. But there's good news. Restoring hearing with hearing aids can help slow down cognitive decline.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Consider these findings: Researchers tracked about 2,000 older adults in the U.S. both before and after they started using hearing aids. The adults were participants in a big, national study called the \u003ca href=\"http://hrsonline.isr.umich.edu/\" target=\"_blank\" rel=\"noopener\">Health and Retirement Study\u003c/a>.\u003c/p>\n\u003cp>\"We found the rate of cognitive decline was slowed by 75 percent following the adoption of hearing aids,\" says \u003ca href=\"https://www.research.manchester.ac.uk/portal/asri.maharani.html\" target=\"_blank\" rel=\"noopener\">Asri Maharani\u003c/a>, a researcher at the University of Manchester in the division of neuroscience and experimental psychology and an author of the paper. \"It is a surprising result,\" Maharani says. The study was \u003ca href=\"https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.15363\" target=\"_blank\" rel=\"noopener\">published\u003c/a> this spring in the \u003cem>Journal of the American Geriatrics Society\u003c/em>.\u003c/p>\n\u003cp>To assess cognition over time, researchers performed a battery of face-to-face tests with participants. This was done every two years from 1996 to 2014. One test to assess memory required participants to recall a list of 10 words, both immediately after the words were read aloud and then again after the participants had been distracted by other tasks.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We weren't expecting that hearing aid use would eliminate cognitive decline. That's just not going to happen\" because age-related decline is inevitable, explains \u003ca href=\"https://www.research.manchester.ac.uk/portal/piers.dawes.html\" target=\"_blank\" rel=\"noopener\">Piers Dawes\u003c/a>, an experimental psychologist and another author of the study. \"But the reduction in the rate of change is quite substantial. It's a very intriguing finding.\"\u003c/p>\n\u003cp>To put the findings in context, consider that the slower rate of decline equates to remembering less than one more word on the 10-word recall test. So it's a small but measurable effect. And it adds to the evidence that hearing loss and cognitive decline are strongly linked.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>It makes sense, says Rollins. Consider what people are getting when their hearing is restored: \"Stimulating your ears stimulates the nerves that stimulate your brain.\"\u003c/p>\n\u003cp>When you get hearing aids, \"we're giving your ears back what they're missing, and giving your brain what it needs to make sense of what you're hearing,\" Rollins explains. And this can help you stay more stimulated and socially engaged. Rollins was not involved in the study. She's in practice in Silver Spring, Md.\u003c/p>\n\u003cp>Rollins says people who have hearing loss might decline faster than those with normal hearing due to the loss of social stimulation. \"Social isolation is a huge part of hearing loss, and people will notice their loved ones withdrawing from conversation, or not going to family or social functions like they used to.\"\u003c/p>\n\u003cp>Rollins fits a lot of people with hearing aids, and sometimes they come in only after their loved ones insist on it. \"No one \u003cem>wants \u003c/em>to wear a hearing aid,\" Rollins says. \"Typically, there's convincing that needs to be done.\" There's still a stigma attached to wearing hearing aids. People think: \"I don't want to look old!\" But Rollins says the technology has improved a lot in recent years. And often, hearing aids are a lot less noticeable and are covered up by hair.\u003c/p>\n\u003cp>Cost is another obstacle. With a price tag of $4,500 and upwards for high-end aids, they're not cheap. Less expensive options are available, but insurance plans typically don't cover the full cost. Some plans offer no benefit for hearing aids, and, in general, Medicare \u003ca href=\"https://www.npr.org/sections/health-shots/2018/04/11/600895543/can-you-hear-me-now-senate-bill-may-make-the-answer-yes\" target=\"_blank\" rel=\"noopener\">does not cover the cost\u003c/a>, either.\u003c/p>\n\u003cp>But when people decide to get fitted with hearing aids, this step can improve quality of life. This is the case with Rollins' patient Lucien Johnson, 92, who was fitted with hearing aids a few weeks back.\u003c/p>\n\u003cp>\"I was tired of screaming,\" his wife, Carrie Johnson, tells us. And it was frustrating for Lucien as well.\u003c/p>\n\u003cp>\"Sometimes she thought I was ignoring her,\" Lucien says. But, really, he just didn't hear her speaking.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The Johnsons say they're communicating better now. Lucien went in to see Rollins for an adjustment recently. \"I need some fine-tuning,\" he told her. \"But so far, so good.\"\u003c/p>\n\u003cp>Another common condition as we age is the deterioration of vision, often because of cataracts.\u003c/p>\n\u003cp>New evidence shows that restoring vision by having cataract surgery can also slow cognitive decline. A companion study carried out by the same researchers and \u003ca href=\"https://journals.plos.org/plosone/article/comments?id=10.1371/journal.pone.0204833\" target=\"_blank\" rel=\"noopener\">published\u003c/a> in the journal \u003cem>PLOS One\u003c/em> this month evaluated the outcomes of about 2,000 older adults who had cataract surgery. They were all participants in the \u003ca href=\"https://www.elsa-project.ac.uk/\" target=\"_blank\" rel=\"noopener\">English Longitudinal Study of Ageing,\u003c/a> which is carried out similarly to the U.S. Health and Retirement Survey. Participants are given periodic cognitive assessments.\u003c/p>\n\u003cp>\"We found the rate of cognitive decline was slowed by 50 percent following cataract surgery,\" explains Maharani. As with the outcome in the hearing aid study, restoring good vision can't eliminate cognitive decline, but this study suggests it can significantly slow the process.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>So many factors influence healthy aging, including lifestyle habits such as diet and physical activity. But Maharani and her co-authors say it's important to know that steps to correct vision and hearing loss can play into the equation as well.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Want+To+Keep+Your+Brain+Sharp%3F+Take+Care+Of+Your+Eyes+And+Ears&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/445133/want-to-keep-your-brain-sharp-take-care-of-your-eyes-and-ears","authors":["byline_futureofyou_445133"],"categories":["futureofyou_1060","futureofyou_1"],"tags":["futureofyou_56","futureofyou_1023","futureofyou_61","futureofyou_398","futureofyou_1632"],"collections":["futureofyou_1093"],"featImg":"futureofyou_445136","label":"source_futureofyou_445133"},"futureofyou_444402":{"type":"posts","id":"futureofyou_444402","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444402","score":null,"sort":[1536615990000]},"guestAuthors":[],"slug":"germ-theory-of-alzheimers-may-trigger-a-seismic-shift-in-treatment","title":"'Germ Theory' of Alzheimer's May Trigger a Seismic Shift in Treatment","publishDate":1536615990,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Dr. Leslie Norins is willing to hand over $1 million of his own money to anyone who can clarify something: Is Alzheimer's disease, the most common form of dementia worldwide, caused by a germ?[contextly_sidebar id=\"MVU0oAlLJAOY5cRLFm8SgRXzH5ufmBIa\"]\u003c/p>\n\u003cp>By \"germ\" he means microbes like bacteria, viruses, fungi and parasites. In other words, Norins, a physician turned publisher, wants to know if Alzheimer's is infectious.\u003c/p>\n\u003cp>It's an idea that just a few years ago would've seemed to many an easy way to drain your research budget on bunk science. Money has poured into Alzheimer's research for years, but until very recently not much of it went toward investigating infection in causing dementia.\u003c/p>\n\u003cp>But this \"germ theory\" of Alzheimer's, as Norins calls it, has been fermenting in the literature for decades. Even early 20th century Czech physician Oskar Fischer — who, along with his German contemporary Dr. Alois Alzheimer, was integral in first describing the condition — noted a possible connection between the newly identified dementia and tuberculosis.\u003c/p>\n\u003cp>If the germ theory gets traction, even in some Alzheimer's patients, it could trigger a seismic shift in how doctors understand and treat the disease.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For instance, would we see a day when dementia is prevented with a vaccine, or treated with antibiotics and antiviral medications? Norins thinks it's worth looking into.\u003c/p>\n\u003cp>Norins received his medical degree from Duke in the early 1960s, and after a stint at the Centers for Disease Control and Prevention he fell into a lucrative career in medical publishing. He eventually settled in an admittedly aged community in Naples, Fla., where he took an interest in dementia and began reading up on the condition.[contextly_sidebar id=\"Xrb4XR0KXYySlI7ldjHh45GWXuqxKcIS\"]\u003c/p>\n\u003cp>After scouring the medical literature he noticed a pattern.\u003c/p>\n\u003cp>\"It appeared that many of the reported characteristics of Alzheimer's disease were compatible with an infectious process,\" Norins tells NPR. \"I thought for sure this must have already been investigated, because \u003ca href=\"http://act.alz.org/site/DocServer/2015_Appropriations_Fact_Sheet__FY16_.pdf?docID=3641\" target=\"_blank\" rel=\"noopener\">millions and millions of dollars\u003c/a> have been spent on Alzheimer's research.\"\u003c/p>\n\u003cp>But aside from scattered interest through the decades, this wasn't the case.\u003c/p>\n\u003cp>In 2017, Norins launched \u003ca href=\"https://alzgerm.org/about/\" target=\"_blank\" rel=\"noopener\">Alzheimer's Germ Quest Inc.\u003c/a>, a public benefit corporation he hopes will drive interest into the germ theory of Alzheimer's, and through which his prize will be distributed. A white paper he penned for the site reads: \"From a two-year review of the scientific literature, I believe it's now clear that just one germ — identity not yet specified, and possibly not yet discovered — causes most AD. I'm calling it the 'Alzheimer's Germ.' \"\u003c/p>\n\u003cp>Norins is quick to cite sources and studies supporting his claim, among them a 2010 study published in the \u003cem>Journal of Neurosurgery\u003c/em> showing that \u003ca href=\"http://thejns.org/doi/pdf/10.3171/2010.1.JNS091740\" target=\"_blank\" rel=\"noopener\">neurosurgeons die from Alzheimer's at a seven-fold higher rate\u003c/a> than they do from other disorders.\u003c/p>\n\u003cp>Another study from that same year, published in The \u003cem>Journal of the American Geriatric Society,\u003c/em> found that people whose \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20722820/\" target=\"_blank\" rel=\"noopener\">spouses have dementia are at a six-times greater risk\u003c/a> for the condition themselves.\u003c/p>\n\u003cp>Contagion does come to mind. And Norins isn't alone in his thinking.\u003c/p>\n\u003cp>In 2016, 32 researchers from universities around the world signed an editorial in the \u003cem>Journal of Alzheimer's Disease\u003c/em> calling for \"further research on the role of infectious agents in [Alzheimer's] causation.\" Based on much of the same evidence Norins encountered, the authors concluded that clinical trials with antimicrobial drugs in Alzheimer's are now justified.[contextly_sidebar id=\"TlULmPwfIfLNT30W6fAdCGOQeBCymn7e\"]\u003c/p>\n\u003cp>NPR reported on an intriguing \u003ca href=\"https://www.npr.org/sections/health-shots/2018/06/21/621908340/researchers-find-herpes-viruses-in-brains-marked-by-alzheimers-disease\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published in \u003cem>Neuron\u003c/em> in June that suggested that viral infection can influence the progression of Alzheimer's. Led by Mount Sinai genetics professor Joel Dudley, the work was intended to compare the genomes of healthy brain tissue with that affected by dementia.\u003c/p>\n\u003cp>But something kept getting in the way: herpes.\u003c/p>\n\u003cp>Dudley's team noticed an unexpectedly high level of viral DNA from two human herpes viruses, HHV-6 and HHV-7. The viruses are common and cause a rash called roseola in young children (not the sexually transmitted disease caused by other strains).\u003c/p>\n\u003cp>Some viruses have the ability to lie dormant in our neurons for decades by incorporating their genomes into our own. The classic example is chickenpox: A childhood viral infection resolves and lurks silently, returning years later as \u003ca href=\"https://www.cdc.gov/shingles/about/symptoms.html\" target=\"_blank\" rel=\"noopener\">shingles\u003c/a>, an excruciating rash. Like it or not, nearly all of us are chimeras with viral DNA speckling our genomes.\u003c/p>\n\u003cp>But having the herpes viruses alone doesn't mean inevitable brain decline. After all, up to 75 percent of us may \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11285567\" target=\"_blank\" rel=\"noopener\">harbor HHV-6\u003c/a> .\u003c/p>\n\u003cp>But Dudley also noticed that herpes appeared to interact with human genes known to increase Alzheimer's risk. Perhaps, he says, there is some toxic combination of genetic and infectious influence that results in the disease; a combination that sparks what some feel is the main contributor to the disease, an overactive immune system.\u003c/p>\n\u003cp>The hallmark pathology of Alzheimer's is accumulation of a protein called amyloid in the brain. Many researchers have assumed these aggregates, or plaques, are simply a byproduct of some other process at the core of the disease. Other scientists posit that the protein itself contributes to the condition in some way.\u003c/p>\n\u003cp>The theory that amyloid is the root cause of Alzheimer's is losing steam. But the protein may still contribute to the disease, even if it winds up being deemed infectious.[contextly_sidebar id=\"reNe9dG45Jm18II65oxyuE0ETmculfjN\"]\u003c/p>\n\u003cp>Work by Harvard neuroscientist Rudolph Tanzi suggests it might be a bit of both. Along with colleague Robert Moir, Tanzi has shown that amyloid is lethal to viruses and bacteria in the test tube, and also in mice. He now believes the protein is part of our ancient immune system that like antibodies, ramps up its activity to help fend off unwanted bugs.\u003c/p>\n\u003cp>So does that mean that the microbe is the cause of Alzheimer's, and amyloid a harmless reaction to it? According to Tanzi it's not that simple.\u003c/p>\n\u003cp>Tanzi believes that in many cases of Alzheimer's, microbes are probably the initial seed that sets off a toxic tumble of molecular dominoes. Early in the disease amyloid protein builds up to fight infection, yet too much of the protein begins to impair function of neurons in the brain. The excess amyloid then causes another protein, called tau, to form tangles, which further harm brain cells.\u003c/p>\n\u003cp>But as Tanzi explains, the ultimate neurological insult in Alzheimer's is the body's reaction to this neurotoxic mess. All the excess protein revs up the immune system, causing inflammation — and it's this inflammation that does the most damage to the Alzheimer's-afflicted brain.\u003c/p>\n\u003cp>So what does this say about the future of treatment? Possibly a lot. Tanzi envisions a day when people are screened at, say, 50 years old. \"If their brains are riddled with too much amyloid,\" he says, \"we knock it down a bit with antiviral medications. It's just like how you are prescribed preventative drugs if your cholesterol is too high.\"\u003c/p>\n\u003cp>Tanzi feels that microbes are just one possible seed for the complex pathology behind Alzheimer's. Genetics may also play a role, as certain genes produce a type of amyloid more prone to clumping up. He also feels environmental factors like pollution might contribute.\u003c/p>\n\u003cp>Dr. James Burke, professor of medicine and psychiatry at Duke University's Alzheimer's Disease Research Center, isn't willing to abandon the amyloid theory altogether, but agrees it's time for the field to move on. \"There may be many roads to developing Alzheimer's disease and it would be shortsighted to focus just on amyloid and tau,\" he says. \"A million-dollar prize is attention- getting, but the reward for identifying a treatable target to delay or prevent Alzheimer's disease is invaluable.\"[contextly_sidebar id=\"VDtvU3haNd1M74SuCUvVZuAz4hFEV5iO\"]\u003c/p>\n\u003cp>Any treatment that disrupts the cascade leading to amyloid, tau and inflammation could theoretically benefit an at-risk brain. The vast majority of Alzheimer's treatment trials have failed, including many targeting amyloid. But it could be that the patients included were too far along in their disease to reap any therapeutic benefit.\u003c/p>\n\u003cp>If a microbe is responsible for all or some cases of Alzheimer's, perhaps future treatments or preventive approaches will prevent toxin protein buildup in the first place. Both Tanzi and Norins believe Alzheimer's vaccines against viruses like herpes might one day become common practice.\u003c/p>\n\u003cp>In July of this year, in collaboration with Norins, the Infectious Diseases Society of America announced that they plan to offer two $50,000 grants supporting research into a microbial association with Alzheimer's. According to Norins, this is the first acknowledgement by a leading infectious disease group that Alzheimer's may be microbial in nature – or at least that it's worth exploring.\u003c/p>\n\u003cp>\"The important thing is not the amount of the money, which is a pittance compared with the $2 billion NIH spends on amyloid and tau research,\" says Norins, \"but rather the respectability and more mainstream status the grants confer on investigating of the infectious possibility. Remember when we thought ulcers were caused by stress?\"\u003c/p>\n\u003cp>Ulcers, we now know, are \u003ca href=\"https://www.nobelprize.org/prizes/medicine/2005/press-release/\" target=\"_blank\" rel=\"noopener\">caused by a germ\u003c/a>.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Bret Stetka is a writer based in New York and an editorial director at \u003c/em>\u003ca href=\"http://www.medscape.com/public/bios/bio-bretstetka\">Medscape\u003c/a>.\u003cem> His work has appeared in \u003c/em>Wired, Scientific American\u003cem> and on The Atlantic.com. He graduated from the University of Virginia School of Medicine. He's also on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/BretStetka\" target=\"_blank\" rel=\"noopener\">@BretStetka\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Infectious+Theory+Of+Alzheimer%27s+Disease+Draws+Fresh+Interest&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Money has poured into Alzheimer's research, but until very recently not much of it went toward investigating infection in causing dementia. A million dollar prize may lead more scientists to try.","status":"publish","parent":0,"modified":1536615990,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":38,"wordCount":1587},"headData":{"title":"'Germ Theory' of Alzheimer's May Trigger a Seismic Shift in Treatment | KQED","description":"Money has poured into Alzheimer's research, but until very recently not much of it went toward investigating infection in causing dementia. A million dollar prize may lead more scientists to try.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"'Germ Theory' of Alzheimer's May Trigger a Seismic Shift in Treatment","datePublished":"2018-09-10T21:46:30.000Z","dateModified":"2018-09-10T21:46:30.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"444402 https://ww2.kqed.org/futureofyou/?p=444402","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/09/10/germ-theory-of-alzheimers-may-trigger-a-seismic-shift-in-treatment/","disqusTitle":"'Germ Theory' of Alzheimer's May Trigger a Seismic Shift in Treatment","source":"Hope/Hype","nprByline":"Bret Stetka, NPR","nprImageAgency":"Ariel Davis for NPR","nprStoryId":"645629133","nprApiLink":"http://api.npr.org/query?id=645629133&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/09/09/645629133/infectious-theory-of-alzheimers-disease-draws-fresh-interest?ft=nprml&f=645629133","nprRetrievedStory":"1","nprPubDate":"Mon, 10 Sep 2018 11:20:00 -0400","nprStoryDate":"Sun, 09 Sep 2018 07:30:20 -0400","nprLastModifiedDate":"Mon, 10 Sep 2018 11:20:41 -0400","path":"/futureofyou/444402/germ-theory-of-alzheimers-may-trigger-a-seismic-shift-in-treatment","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Leslie Norins is willing to hand over $1 million of his own money to anyone who can clarify something: Is Alzheimer's disease, the most common form of dementia worldwide, caused by a germ?\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>By \"germ\" he means microbes like bacteria, viruses, fungi and parasites. In other words, Norins, a physician turned publisher, wants to know if Alzheimer's is infectious.\u003c/p>\n\u003cp>It's an idea that just a few years ago would've seemed to many an easy way to drain your research budget on bunk science. Money has poured into Alzheimer's research for years, but until very recently not much of it went toward investigating infection in causing dementia.\u003c/p>\n\u003cp>But this \"germ theory\" of Alzheimer's, as Norins calls it, has been fermenting in the literature for decades. Even early 20th century Czech physician Oskar Fischer — who, along with his German contemporary Dr. Alois Alzheimer, was integral in first describing the condition — noted a possible connection between the newly identified dementia and tuberculosis.\u003c/p>\n\u003cp>If the germ theory gets traction, even in some Alzheimer's patients, it could trigger a seismic shift in how doctors understand and treat the disease.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For instance, would we see a day when dementia is prevented with a vaccine, or treated with antibiotics and antiviral medications? Norins thinks it's worth looking into.\u003c/p>\n\u003cp>Norins received his medical degree from Duke in the early 1960s, and after a stint at the Centers for Disease Control and Prevention he fell into a lucrative career in medical publishing. He eventually settled in an admittedly aged community in Naples, Fla., where he took an interest in dementia and began reading up on the condition.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>After scouring the medical literature he noticed a pattern.\u003c/p>\n\u003cp>\"It appeared that many of the reported characteristics of Alzheimer's disease were compatible with an infectious process,\" Norins tells NPR. \"I thought for sure this must have already been investigated, because \u003ca href=\"http://act.alz.org/site/DocServer/2015_Appropriations_Fact_Sheet__FY16_.pdf?docID=3641\" target=\"_blank\" rel=\"noopener\">millions and millions of dollars\u003c/a> have been spent on Alzheimer's research.\"\u003c/p>\n\u003cp>But aside from scattered interest through the decades, this wasn't the case.\u003c/p>\n\u003cp>In 2017, Norins launched \u003ca href=\"https://alzgerm.org/about/\" target=\"_blank\" rel=\"noopener\">Alzheimer's Germ Quest Inc.\u003c/a>, a public benefit corporation he hopes will drive interest into the germ theory of Alzheimer's, and through which his prize will be distributed. A white paper he penned for the site reads: \"From a two-year review of the scientific literature, I believe it's now clear that just one germ — identity not yet specified, and possibly not yet discovered — causes most AD. I'm calling it the 'Alzheimer's Germ.' \"\u003c/p>\n\u003cp>Norins is quick to cite sources and studies supporting his claim, among them a 2010 study published in the \u003cem>Journal of Neurosurgery\u003c/em> showing that \u003ca href=\"http://thejns.org/doi/pdf/10.3171/2010.1.JNS091740\" target=\"_blank\" rel=\"noopener\">neurosurgeons die from Alzheimer's at a seven-fold higher rate\u003c/a> than they do from other disorders.\u003c/p>\n\u003cp>Another study from that same year, published in The \u003cem>Journal of the American Geriatric Society,\u003c/em> found that people whose \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20722820/\" target=\"_blank\" rel=\"noopener\">spouses have dementia are at a six-times greater risk\u003c/a> for the condition themselves.\u003c/p>\n\u003cp>Contagion does come to mind. And Norins isn't alone in his thinking.\u003c/p>\n\u003cp>In 2016, 32 researchers from universities around the world signed an editorial in the \u003cem>Journal of Alzheimer's Disease\u003c/em> calling for \"further research on the role of infectious agents in [Alzheimer's] causation.\" Based on much of the same evidence Norins encountered, the authors concluded that clinical trials with antimicrobial drugs in Alzheimer's are now justified.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>NPR reported on an intriguing \u003ca href=\"https://www.npr.org/sections/health-shots/2018/06/21/621908340/researchers-find-herpes-viruses-in-brains-marked-by-alzheimers-disease\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published in \u003cem>Neuron\u003c/em> in June that suggested that viral infection can influence the progression of Alzheimer's. Led by Mount Sinai genetics professor Joel Dudley, the work was intended to compare the genomes of healthy brain tissue with that affected by dementia.\u003c/p>\n\u003cp>But something kept getting in the way: herpes.\u003c/p>\n\u003cp>Dudley's team noticed an unexpectedly high level of viral DNA from two human herpes viruses, HHV-6 and HHV-7. The viruses are common and cause a rash called roseola in young children (not the sexually transmitted disease caused by other strains).\u003c/p>\n\u003cp>Some viruses have the ability to lie dormant in our neurons for decades by incorporating their genomes into our own. The classic example is chickenpox: A childhood viral infection resolves and lurks silently, returning years later as \u003ca href=\"https://www.cdc.gov/shingles/about/symptoms.html\" target=\"_blank\" rel=\"noopener\">shingles\u003c/a>, an excruciating rash. Like it or not, nearly all of us are chimeras with viral DNA speckling our genomes.\u003c/p>\n\u003cp>But having the herpes viruses alone doesn't mean inevitable brain decline. After all, up to 75 percent of us may \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11285567\" target=\"_blank\" rel=\"noopener\">harbor HHV-6\u003c/a> .\u003c/p>\n\u003cp>But Dudley also noticed that herpes appeared to interact with human genes known to increase Alzheimer's risk. Perhaps, he says, there is some toxic combination of genetic and infectious influence that results in the disease; a combination that sparks what some feel is the main contributor to the disease, an overactive immune system.\u003c/p>\n\u003cp>The hallmark pathology of Alzheimer's is accumulation of a protein called amyloid in the brain. Many researchers have assumed these aggregates, or plaques, are simply a byproduct of some other process at the core of the disease. Other scientists posit that the protein itself contributes to the condition in some way.\u003c/p>\n\u003cp>The theory that amyloid is the root cause of Alzheimer's is losing steam. But the protein may still contribute to the disease, even if it winds up being deemed infectious.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Work by Harvard neuroscientist Rudolph Tanzi suggests it might be a bit of both. Along with colleague Robert Moir, Tanzi has shown that amyloid is lethal to viruses and bacteria in the test tube, and also in mice. He now believes the protein is part of our ancient immune system that like antibodies, ramps up its activity to help fend off unwanted bugs.\u003c/p>\n\u003cp>So does that mean that the microbe is the cause of Alzheimer's, and amyloid a harmless reaction to it? According to Tanzi it's not that simple.\u003c/p>\n\u003cp>Tanzi believes that in many cases of Alzheimer's, microbes are probably the initial seed that sets off a toxic tumble of molecular dominoes. Early in the disease amyloid protein builds up to fight infection, yet too much of the protein begins to impair function of neurons in the brain. The excess amyloid then causes another protein, called tau, to form tangles, which further harm brain cells.\u003c/p>\n\u003cp>But as Tanzi explains, the ultimate neurological insult in Alzheimer's is the body's reaction to this neurotoxic mess. All the excess protein revs up the immune system, causing inflammation — and it's this inflammation that does the most damage to the Alzheimer's-afflicted brain.\u003c/p>\n\u003cp>So what does this say about the future of treatment? Possibly a lot. Tanzi envisions a day when people are screened at, say, 50 years old. \"If their brains are riddled with too much amyloid,\" he says, \"we knock it down a bit with antiviral medications. It's just like how you are prescribed preventative drugs if your cholesterol is too high.\"\u003c/p>\n\u003cp>Tanzi feels that microbes are just one possible seed for the complex pathology behind Alzheimer's. Genetics may also play a role, as certain genes produce a type of amyloid more prone to clumping up. He also feels environmental factors like pollution might contribute.\u003c/p>\n\u003cp>Dr. James Burke, professor of medicine and psychiatry at Duke University's Alzheimer's Disease Research Center, isn't willing to abandon the amyloid theory altogether, but agrees it's time for the field to move on. \"There may be many roads to developing Alzheimer's disease and it would be shortsighted to focus just on amyloid and tau,\" he says. \"A million-dollar prize is attention- getting, but the reward for identifying a treatable target to delay or prevent Alzheimer's disease is invaluable.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Any treatment that disrupts the cascade leading to amyloid, tau and inflammation could theoretically benefit an at-risk brain. The vast majority of Alzheimer's treatment trials have failed, including many targeting amyloid. But it could be that the patients included were too far along in their disease to reap any therapeutic benefit.\u003c/p>\n\u003cp>If a microbe is responsible for all or some cases of Alzheimer's, perhaps future treatments or preventive approaches will prevent toxin protein buildup in the first place. Both Tanzi and Norins believe Alzheimer's vaccines against viruses like herpes might one day become common practice.\u003c/p>\n\u003cp>In July of this year, in collaboration with Norins, the Infectious Diseases Society of America announced that they plan to offer two $50,000 grants supporting research into a microbial association with Alzheimer's. According to Norins, this is the first acknowledgement by a leading infectious disease group that Alzheimer's may be microbial in nature – or at least that it's worth exploring.\u003c/p>\n\u003cp>\"The important thing is not the amount of the money, which is a pittance compared with the $2 billion NIH spends on amyloid and tau research,\" says Norins, \"but rather the respectability and more mainstream status the grants confer on investigating of the infectious possibility. Remember when we thought ulcers were caused by stress?\"\u003c/p>\n\u003cp>Ulcers, we now know, are \u003ca href=\"https://www.nobelprize.org/prizes/medicine/2005/press-release/\" target=\"_blank\" rel=\"noopener\">caused by a germ\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Bret Stetka is a writer based in New York and an editorial director at \u003c/em>\u003ca href=\"http://www.medscape.com/public/bios/bio-bretstetka\">Medscape\u003c/a>.\u003cem> His work has appeared in \u003c/em>Wired, Scientific American\u003cem> and on The Atlantic.com. He graduated from the University of Virginia School of Medicine. He's also on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/BretStetka\" target=\"_blank\" rel=\"noopener\">@BretStetka\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Infectious+Theory+Of+Alzheimer%27s+Disease+Draws+Fresh+Interest&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444402/germ-theory-of-alzheimers-may-trigger-a-seismic-shift-in-treatment","authors":["byline_futureofyou_444402"],"categories":["futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_999","futureofyou_1023","futureofyou_61","futureofyou_1056"],"collections":["futureofyou_1093","futureofyou_1097"],"featImg":"futureofyou_444403","label":"source_futureofyou_444402"},"futureofyou_443668":{"type":"posts","id":"futureofyou_443668","meta":{"index":"posts_1591205157","site":"futureofyou","id":"443668","score":null,"sort":[1533070821000]},"guestAuthors":[],"slug":"alzheimers-study-sparks-new-debate-over-amyloid-hypothesis","title":"Alzheimer’s Study Sparks New Debate Over Amyloid Hypothesis","publishDate":1533070821,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>In the long-running debate over just what causes Alzheimer’s disease, one side looks to have scored a victory with \u003ca href=\"https://www.statnews.com/2018/07/25/experimental-alzheimers-drug-biogen-eisai/\" target=\"_blank\" rel=\"noopener\">new results with an in-development drug\u003c/a>. But there’s enough variation in the data to ensure that the squabbling factions of Alzheimer’s will have plenty to fight about.[contextly_sidebar id=\"A04l79ZF49Fepp9ayXq47IfI7cWrtD3j\"]\u003c/p>\n\u003cp>At issue is the so-called amyloid hypothesis, a decades-old theory claiming that Alzheimer’s gradual degradation of the brain is caused by the accumulation of sticky plaques. And the new drug is BAN2401, designed by Biogen and Eisai to prevent those amyloid plaques from clustering and attack the clumps that already have.\u003c/p>\n\u003cp>In data presented last week, one group of patients receiving BAN2401 saw their amyloid levels plummet, a result that was tied to a significant reduction in cognitive decline compared with placebo.\u003c/p>\n\u003cp>To the amyloid-inclined, like Dr. Howard Fillit of the Alzheimer’s Drug Discovery Foundation, that marks a clear affirmation of the linkage between plaques and mental fortitude.\u003c/p>\n\u003cp>“I mean if you asked me five or 10 years ago if we’re going to have a drug that can remove the plaques from the brain, I would have thought this was space technology,” Fillit said. “And there was definitely a signal, in my opinion, on clinical outcomes, which is what we’ve all been looking for.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But to skeptics, the trial was laden with confounding details that make it impossible to draw conclusions.\u003c/p>\n\u003cp>“These results are a mess,” wrote Baird biotech analyst Brian Skorney. “Not so much that they indicate an outright failure of the [amyloid] hypothesis, but they don’t really say anything informative at all.”\u003c/p>\n\u003cp>In the trial, every single tested dose had a significant effect on plaques as measured by a brain scan, and the more BAN2401 patients got, the less amyloid they had after 18 months. But looking at cognition, only the highest tested dose was significantly better than placebo at slowing down mental decline. And some of the patients who received lower doses actually declined faster than those who received no treatment at all.[contextly_sidebar id=\"TAyKNwsnIzWapwgWfQcwbB5f1ZW4XVH2\"]\u003c/p>\n\u003cp>If amyloid really is the driving factor behind Alzheimer’s, why didn’t each incremental reduction in plaques lead to a corresponding improvement in cognition?\u003c/p>\n\u003cp>Dr. Al Sandrock, Biogen’s chief scientific officer, said there is likely a threshold of amyloid reduction that must be reached before patients actually benefit. The low doses, despite their effect on plaques, might not have hit that threshold, Sandrock said, thus accounting for their poor performance on cognitive decline.\u003c/p>\n\u003cp>The divergence in the two curves is what gives Dr. Reisa Sperling, who was overall encouraged by the results, “the most pause.” But Sperling, director Center for Alzheimer Research and Treatment at Brigham and Women’s Hospital, noted that some of the study’s arms had small numbers of patients, making it difficult to draw conclusions. She said while there is a biological argument that could underpin the threshold hypothesis, she wanted to see more data from a larger trial with a more traditional design.\u003c/p>\n\u003cp>Even if Sandrock’s theory holds up, what happened to BAN2401 is not a new phenomenon. This year a drug from Merck, meant to shut off the production of plaques by blocking an enzyme called BACE, was successful in reducing amyloid but fared so dismally on cognitive measures that researchers terminated the trial early. A second BACE drug, from Biogen and Eisai, had similar results in miniature, hitting the mark on plaque reduction in a Phase 2 trial but failing to significantly outperform placebo on cognition.\u003c/p>\n\u003cp>The underlying issue, according Dr. Lon Schneider, director of the California Alzheimer’s Disease Center at the University of Southern California, is that “the plaques are not the target — those are biomarkers.”\u003c/p>\n\u003cp>“A target is something that, as a result of hitting it, there will be change downstream in behavior, cognition, and illness course,” Schneider said. “So, yeah we’re knocking down amyloid, but so far we’re not changing behavior much.”\u003c/p>\n\u003cp>Even BAN2401’s saving grace — that its highest dose appeared to both reduce amyloid and improve patient’s clinical results — has come under scrutiny.\u003c/p>\n\u003cp>In the BAN2401 trial, about 70 percent of patients getting placebo had a genetic mutation that triples the risk of Alzheimer’s. But in the high-dose BAN2401 group, just 30 percent of patients had the mutation, called APOE4.[contextly_sidebar id=\"tcdS8fDReoUFY02DP3vnBwSqYDEV9wHe\"]\u003c/p>\n\u003cp>That could explain why BAN2401 seemed to outperform a saline injection in the high-dose group, skeptics say, as past trials suggest that APOE4 carriers have more rapidly progressing Alzheimer’s than patients without the mutation.\u003c/p>\n\u003cp>And it could mean that the drug’s seeming promise is a mirage.\u003c/p>\n\u003cp>Dr. Paul Aisen, who runs the Alzheimer’s Therapeutic Research Institute at the University of Southern California, said the discrepancy “does create a potential bias.” But in trials where patients are confirmed to have amyloid in their brains at the outset, as was the case with BAN2401, “the impact of [APOE4] on progression is modest,” Aisen wrote in an email. “I don’t think this accounts for the apparent slowing of cognitive decline in the high-dose arm.”\u003c/p>\n\u003cp>Sperling agreed that she did not think the arms’ different populations skewed the data, in part because the group that received the second highest dose of the drug had a larger share of APOE4 carriers and saw results that were similar — though not as substantial — as the high dose group.\u003c/p>\n\u003cp>“It’s a similar pattern,” she said. “For me that partially mitigates that concern.”\u003c/p>\n\u003cp>Biogen and Eisai have promised to dig into the data and parse out the effect APOE4 had on whether patients responded to BAN2401, but those results likely won’t be ready for months.\u003c/p>\n\u003cp>In the meantime, companies are still queueing up to take cracks at amyloid.\u003c/p>\n\u003cp>Eli Lilly, which has spent billions on failed Alzheimer’s drugs in recent years, has designed a trial that will test the amyloid hypothesis “in the most definitive way possible,” said Mark Mintun, the company’s vice president of neurodegeneration.\u003c/p>\n\u003cp>The plan is to take a BACE inhibitor and pair it with an injected treatment that targets amyloid already in the brain. That should address the two major concerns with each approach, Mintun said: BACE inhibitors prevent amyloid but don’t address plaques that already exist, while amyloid-targeting therapies don’t stem the flow of new toxic clumps.\u003c/p>\n\u003cp>“I equate it to going down to your basement and finding three feet of water and there’s been a slow drip for four weeks,” Mintun said. “You can turn off the spigot, but it won’t feel like you’ve made much progress, so you’ve got to pump it out, too.”\u003c/p>\n\u003cp>That study is enrolling 375 patients into three groups, planning to study whether the combination can improve cognition compared with placebo over 18 months.\u003c/p>\n\u003cp>\u003cem>Andrew Joseph contributed reporting.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2018/07/30/alzheimers-amyloid-hypothesis/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"In data presented recently, one group of patients receiving an experimental drug saw their amyloid levels plummet, a result that was tied to a significant reduction in cognitive decline.","status":"publish","parent":0,"modified":1532989851,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":31,"wordCount":1250},"headData":{"title":"Alzheimer’s Study Sparks New Debate Over Amyloid Hypothesis | KQED","description":"In data presented recently, one group of patients receiving an experimental drug saw their amyloid levels plummet, a result that was tied to a significant reduction in cognitive decline.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Alzheimer’s Study Sparks New Debate Over Amyloid Hypothesis","datePublished":"2018-07-31T21:00:21.000Z","dateModified":"2018-07-30T22:30:51.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"443668 https://ww2.kqed.org/futureofyou/?p=443668","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/07/31/alzheimers-study-sparks-new-debate-over-amyloid-hypothesis/","disqusTitle":"Alzheimer’s Study Sparks New Debate Over Amyloid Hypothesis","source":"Hope/Hype","nprByline":"Damian Garde\u003cbr />STAT","path":"/futureofyou/443668/alzheimers-study-sparks-new-debate-over-amyloid-hypothesis","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In the long-running debate over just what causes Alzheimer’s disease, one side looks to have scored a victory with \u003ca href=\"https://www.statnews.com/2018/07/25/experimental-alzheimers-drug-biogen-eisai/\" target=\"_blank\" rel=\"noopener\">new results with an in-development drug\u003c/a>. But there’s enough variation in the data to ensure that the squabbling factions of Alzheimer’s will have plenty to fight about.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>At issue is the so-called amyloid hypothesis, a decades-old theory claiming that Alzheimer’s gradual degradation of the brain is caused by the accumulation of sticky plaques. And the new drug is BAN2401, designed by Biogen and Eisai to prevent those amyloid plaques from clustering and attack the clumps that already have.\u003c/p>\n\u003cp>In data presented last week, one group of patients receiving BAN2401 saw their amyloid levels plummet, a result that was tied to a significant reduction in cognitive decline compared with placebo.\u003c/p>\n\u003cp>To the amyloid-inclined, like Dr. Howard Fillit of the Alzheimer’s Drug Discovery Foundation, that marks a clear affirmation of the linkage between plaques and mental fortitude.\u003c/p>\n\u003cp>“I mean if you asked me five or 10 years ago if we’re going to have a drug that can remove the plaques from the brain, I would have thought this was space technology,” Fillit said. “And there was definitely a signal, in my opinion, on clinical outcomes, which is what we’ve all been looking for.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But to skeptics, the trial was laden with confounding details that make it impossible to draw conclusions.\u003c/p>\n\u003cp>“These results are a mess,” wrote Baird biotech analyst Brian Skorney. “Not so much that they indicate an outright failure of the [amyloid] hypothesis, but they don’t really say anything informative at all.”\u003c/p>\n\u003cp>In the trial, every single tested dose had a significant effect on plaques as measured by a brain scan, and the more BAN2401 patients got, the less amyloid they had after 18 months. But looking at cognition, only the highest tested dose was significantly better than placebo at slowing down mental decline. And some of the patients who received lower doses actually declined faster than those who received no treatment at all.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>If amyloid really is the driving factor behind Alzheimer’s, why didn’t each incremental reduction in plaques lead to a corresponding improvement in cognition?\u003c/p>\n\u003cp>Dr. Al Sandrock, Biogen’s chief scientific officer, said there is likely a threshold of amyloid reduction that must be reached before patients actually benefit. The low doses, despite their effect on plaques, might not have hit that threshold, Sandrock said, thus accounting for their poor performance on cognitive decline.\u003c/p>\n\u003cp>The divergence in the two curves is what gives Dr. Reisa Sperling, who was overall encouraged by the results, “the most pause.” But Sperling, director Center for Alzheimer Research and Treatment at Brigham and Women’s Hospital, noted that some of the study’s arms had small numbers of patients, making it difficult to draw conclusions. She said while there is a biological argument that could underpin the threshold hypothesis, she wanted to see more data from a larger trial with a more traditional design.\u003c/p>\n\u003cp>Even if Sandrock’s theory holds up, what happened to BAN2401 is not a new phenomenon. This year a drug from Merck, meant to shut off the production of plaques by blocking an enzyme called BACE, was successful in reducing amyloid but fared so dismally on cognitive measures that researchers terminated the trial early. A second BACE drug, from Biogen and Eisai, had similar results in miniature, hitting the mark on plaque reduction in a Phase 2 trial but failing to significantly outperform placebo on cognition.\u003c/p>\n\u003cp>The underlying issue, according Dr. Lon Schneider, director of the California Alzheimer’s Disease Center at the University of Southern California, is that “the plaques are not the target — those are biomarkers.”\u003c/p>\n\u003cp>“A target is something that, as a result of hitting it, there will be change downstream in behavior, cognition, and illness course,” Schneider said. “So, yeah we’re knocking down amyloid, but so far we’re not changing behavior much.”\u003c/p>\n\u003cp>Even BAN2401’s saving grace — that its highest dose appeared to both reduce amyloid and improve patient’s clinical results — has come under scrutiny.\u003c/p>\n\u003cp>In the BAN2401 trial, about 70 percent of patients getting placebo had a genetic mutation that triples the risk of Alzheimer’s. But in the high-dose BAN2401 group, just 30 percent of patients had the mutation, called APOE4.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That could explain why BAN2401 seemed to outperform a saline injection in the high-dose group, skeptics say, as past trials suggest that APOE4 carriers have more rapidly progressing Alzheimer’s than patients without the mutation.\u003c/p>\n\u003cp>And it could mean that the drug’s seeming promise is a mirage.\u003c/p>\n\u003cp>Dr. Paul Aisen, who runs the Alzheimer’s Therapeutic Research Institute at the University of Southern California, said the discrepancy “does create a potential bias.” But in trials where patients are confirmed to have amyloid in their brains at the outset, as was the case with BAN2401, “the impact of [APOE4] on progression is modest,” Aisen wrote in an email. “I don’t think this accounts for the apparent slowing of cognitive decline in the high-dose arm.”\u003c/p>\n\u003cp>Sperling agreed that she did not think the arms’ different populations skewed the data, in part because the group that received the second highest dose of the drug had a larger share of APOE4 carriers and saw results that were similar — though not as substantial — as the high dose group.\u003c/p>\n\u003cp>“It’s a similar pattern,” she said. “For me that partially mitigates that concern.”\u003c/p>\n\u003cp>Biogen and Eisai have promised to dig into the data and parse out the effect APOE4 had on whether patients responded to BAN2401, but those results likely won’t be ready for months.\u003c/p>\n\u003cp>In the meantime, companies are still queueing up to take cracks at amyloid.\u003c/p>\n\u003cp>Eli Lilly, which has spent billions on failed Alzheimer’s drugs in recent years, has designed a trial that will test the amyloid hypothesis “in the most definitive way possible,” said Mark Mintun, the company’s vice president of neurodegeneration.\u003c/p>\n\u003cp>The plan is to take a BACE inhibitor and pair it with an injected treatment that targets amyloid already in the brain. That should address the two major concerns with each approach, Mintun said: BACE inhibitors prevent amyloid but don’t address plaques that already exist, while amyloid-targeting therapies don’t stem the flow of new toxic clumps.\u003c/p>\n\u003cp>“I equate it to going down to your basement and finding three feet of water and there’s been a slow drip for four weeks,” Mintun said. “You can turn off the spigot, but it won’t feel like you’ve made much progress, so you’ve got to pump it out, too.”\u003c/p>\n\u003cp>That study is enrolling 375 patients into three groups, planning to study whether the combination can improve cognition compared with placebo over 18 months.\u003c/p>\n\u003cp>\u003cem>Andrew Joseph contributed reporting.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2018/07/30/alzheimers-amyloid-hypothesis/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/443668/alzheimers-study-sparks-new-debate-over-amyloid-hypothesis","authors":["byline_futureofyou_443668"],"categories":["futureofyou_1062","futureofyou_1","futureofyou_1064"],"tags":["futureofyou_999","futureofyou_673","futureofyou_1023","futureofyou_141","futureofyou_61"],"collections":["futureofyou_1097"],"featImg":"futureofyou_443671","label":"source_futureofyou_443668"},"futureofyou_443536":{"type":"posts","id":"futureofyou_443536","meta":{"index":"posts_1591205157","site":"futureofyou","id":"443536","score":null,"sort":[1532365245000]},"guestAuthors":[],"slug":"hormone-levels-likely-influence-a-womans-risk-of-alzheimers-but-exactly-how","title":"Hormone Levels Likely Influence A Woman's Risk Of Alzheimer's. But Exactly How?","publishDate":1532365245,"format":"standard","headTitle":"Women’s Health | KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>There's new evidence that a woman's levels of female sex hormones, including estrogen and progesterone, can influence her risk of Alzheimer's and other forms of dementia.[contextly_sidebar id=\"rPJOdHYPkIXQXRx2JEsrHPZVgzMtEJk7\"]\u003c/p>\n\u003cp>Women are less likely to develop dementia later in life if they begin to menstruate earlier, go through menopause later, and have more than one child, researchers \u003ca href=\"https://www.alz.org/aaic/pressroom.asp\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> Monday at the \u003ca href=\"https://www.alz.org/aaic/\" target=\"_blank\" rel=\"noopener\">Alzheimer's Association International Conference\u003c/a> in Chicago.\u003c/p>\n\u003cp>And recent studies offer hints that \u003ca href=\"https://medlineplus.gov/hormonereplacementtherapy.html\" target=\"_blank\" rel=\"noopener\">hormone replacement therapy\u003c/a>, which fell out of favor more than a decade ago, might offer a way to protect a woman's brain if it is given at the right time, the researchers said.\u003c/p>\n\u003cp>The findings could help explain why women make up nearly two-thirds of people in the U.S. with Alzheimer's, says \u003ca href=\"http://nationalacademies.org/hmd/Activities/Research/NeuroForum/Member%20Profiles/Maria%20Carrillo.aspx\" target=\"_blank\" rel=\"noopener\">Maria Carrillo\u003c/a>, the association's chief scientific officer.\u003c/p>\n\u003cp>\"It isn't just that women are living longer,\" Carrillo says. \"There is some biological underpinning. And because of the large numbers of women that are affected, it is important to find out [what it is].\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Scientists have long suspected that sex hormones such as estrogen and progesterone play a role in Alzheimer's. And two studies on dementia and what occurs during a women's reproductive years support that idea.[contextly_sidebar id=\"Wwp2fmV71pvuOzg04oa6uZxzPex1NtQ3\"]\u003c/p>\n\u003cp>One of the studies looked at nearly 15,000 women in California. And it found an association between a woman's reproductive history and her risk of memory problems later in life.\u003c/p>\n\u003cp>The risk of dementia for women who had three or more children was 12 percent lower than the risk for women who had one child, according to \u003ca href=\"https://divisionofresearch.kaiserpermanente.org/researchers/gilsanz-paola\" target=\"_blank\" rel=\"noopener\">Paola Gilsanz\u003c/a> of Kaiser Permanente Northern California Division of Research, and \u003ca href=\"https://profiles.ucsf.edu/rachel.whitmer\" target=\"_blank\" rel=\"noopener\">Rachel Whitmer\u003c/a> of the University of California, Davis.\u003c/p>\n\u003cp>Also, women who began to menstruate earlier and went through menopause later were less likely to develop dementia. Menopause at age 45 or younger seemed to increase the risk by 28 percent.\u003c/p>\n\u003cp>Another study of 133 elderly women in the U.K. found that the more months of pregnancy they experienced during their lives, the lower their risk of developing Alzheimer's.\u003c/p>\n\u003cp>The findings all suggest that female sex hormones — which rise at puberty and during pregnancy, then fall at menopause — are somehow affecting a woman's risk of developing Alzheimer's and other forms of dementia. The results also suggest that greater exposure to these hormones, through more pregnancies or more reproductive years, can reduce a woman's risk.\u003c/p>\n\u003cp>But it's still not clear whether the mere presence of female sex hormones is a reason that the frequency of Alzheimer's is greater in women than in men.\u003c/p>\n\u003cp>One possibility is that it's not female sex hormones on their own, but rapid changes in their levels that are a problem, says \u003ca href=\"https://crwg.uic.edu/crwg-home/crwg-staff/pauline-maki-phd/\" target=\"_blank\" rel=\"noopener\">Pauline Maki\u003c/a>, a professor of psychiatry and psychology at the University of Illinois at Chicago, who presented research at the Alzheimer's conference.[contextly_sidebar id=\"YEYwp8N3sM3v9aN2dUZdqE3yWweQzhJS\"]\u003c/p>\n\u003cp>\"Women experience these very dramatic hormonal transitions that in the long run can give rise to Alzheimer's disease,\" she says.\u003c/p>\n\u003cp>One way for women to minimize the dramatic hormonal changes that occur at menopause is to use hormone replacement therapy.\u003c/p>\n\u003cp>That approach fell out of favor more than a decade ago when a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/12771112\" target=\"_blank\" rel=\"noopener\">large study\u003c/a> found that women who took estrogen plus progestin after menopause were actually more likely to get some form of dementia. They also appeared to have a higher risk of heart disease and breast cancer.\u003c/p>\n\u003cp>But Maki says more recent studies suggest that hormone therapy — especially estrogen alone — really can be helpful if women get it at the right time.\u003c/p>\n\u003cp>\"The effects of hormone therapy depend on the timing of use,\" Maki says. \"Use later in life is detrimental, whereas use early in the menopausal transition could be beneficial.\"\u003c/p>\n\u003cp>An analysis presented at the Alzheimer's conference supports that idea.\u003c/p>\n\u003cp>It found that in two recent studies, women who started taking estrogen after age 65 were more likely to have trouble with thinking and memory. But women who started taking estrogen between 50 and 54 were not.\u003c/p>\n\u003cp>And estrogen may benefit the mental function of younger women because it reduces the hot flashes associated with menopause, Maki says.[contextly_sidebar id=\"v9bruUJ5zucWs4sZPfqccXVqvwa2qouD\"]\u003c/p>\n\u003cp>\"The more hot flashes a woman has, the worse her memory performance,\" Maki says, citing her own research. \"And when we intervene to address those hot flashes, her memory performance bounces back.\"\u003c/p>\n\u003cp>Findings like that are renewing interest in the idea that someday, it may be possible to use hormones around the time of menopause to prevent Alzheimer's and other forms of dementia later on, Maki says.\u003c/p>\n\u003cp>In the meantime, there's evidence that hormonal differences between men and women may affect their brains in ways that affect doctors' ability to accurately diagnose Alzheimer's, Maki says.\u003c/p>\n\u003cp>At the Alzheimer's conference, she presented research showing that women tend to have higher verbal memory skills than men, even when they are in the early stages of Alzheimer's. As a result, women are likely to be diagnosed with the disease later than men.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>It's unclear whether male hormones, such as testosterone, affect a man's risk of Alzheimer's.\u003c/p>\n\u003chr>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hormone+Levels+Likely+Influence+A+Woman%27s+Risk+Of+Alzheimer%27s.+But+Exactly+How%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Scientists are taking a second look at the idea that hormone replacement therapy could reduce a woman's risk of dementia. New research suggests the key may be in giving it at the right time.","status":"publish","parent":0,"modified":1532368619,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":28,"wordCount":886},"headData":{"title":"Hormone Levels Likely Influence A Woman's Risk Of Alzheimer's. But Exactly How? | KQED","description":"Scientists are taking a second look at the idea that hormone replacement therapy could reduce a woman's risk of dementia. New research suggests the key may be in giving it at the right time.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Hormone Levels Likely Influence A Woman's Risk Of Alzheimer's. But Exactly How?","datePublished":"2018-07-23T17:00:45.000Z","dateModified":"2018-07-23T17:56:59.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"443536 https://ww2.kqed.org/futureofyou/?p=443536","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/07/23/hormone-levels-likely-influence-a-womans-risk-of-alzheimers-but-exactly-how/","disqusTitle":"Hormone Levels Likely Influence A Woman's Risk Of Alzheimer's. But Exactly How?","source":"Health","nprImageCredit":"Ronnie Kaufman","nprByline":"Jon Hamilton, NPR","nprImageAgency":"Blend Images/Getty Images","nprStoryId":"630688342","nprApiLink":"http://api.npr.org/query?id=630688342&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/07/23/630688342/might-sex-hormones-help-protect-women-from-alzheimer-s-after-all-maybe?ft=nprml&f=630688342","nprRetrievedStory":"1","nprPubDate":"Mon, 23 Jul 2018 09:01:00 -0400","nprStoryDate":"Mon, 23 Jul 2018 09:01:17 -0400","nprLastModifiedDate":"Mon, 23 Jul 2018 09:01:17 -0400","path":"/futureofyou/443536/hormone-levels-likely-influence-a-womans-risk-of-alzheimers-but-exactly-how","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>There's new evidence that a woman's levels of female sex hormones, including estrogen and progesterone, can influence her risk of Alzheimer's and other forms of dementia.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Women are less likely to develop dementia later in life if they begin to menstruate earlier, go through menopause later, and have more than one child, researchers \u003ca href=\"https://www.alz.org/aaic/pressroom.asp\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> Monday at the \u003ca href=\"https://www.alz.org/aaic/\" target=\"_blank\" rel=\"noopener\">Alzheimer's Association International Conference\u003c/a> in Chicago.\u003c/p>\n\u003cp>And recent studies offer hints that \u003ca href=\"https://medlineplus.gov/hormonereplacementtherapy.html\" target=\"_blank\" rel=\"noopener\">hormone replacement therapy\u003c/a>, which fell out of favor more than a decade ago, might offer a way to protect a woman's brain if it is given at the right time, the researchers said.\u003c/p>\n\u003cp>The findings could help explain why women make up nearly two-thirds of people in the U.S. with Alzheimer's, says \u003ca href=\"http://nationalacademies.org/hmd/Activities/Research/NeuroForum/Member%20Profiles/Maria%20Carrillo.aspx\" target=\"_blank\" rel=\"noopener\">Maria Carrillo\u003c/a>, the association's chief scientific officer.\u003c/p>\n\u003cp>\"It isn't just that women are living longer,\" Carrillo says. \"There is some biological underpinning. And because of the large numbers of women that are affected, it is important to find out [what it is].\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Scientists have long suspected that sex hormones such as estrogen and progesterone play a role in Alzheimer's. And two studies on dementia and what occurs during a women's reproductive years support that idea.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>One of the studies looked at nearly 15,000 women in California. And it found an association between a woman's reproductive history and her risk of memory problems later in life.\u003c/p>\n\u003cp>The risk of dementia for women who had three or more children was 12 percent lower than the risk for women who had one child, according to \u003ca href=\"https://divisionofresearch.kaiserpermanente.org/researchers/gilsanz-paola\" target=\"_blank\" rel=\"noopener\">Paola Gilsanz\u003c/a> of Kaiser Permanente Northern California Division of Research, and \u003ca href=\"https://profiles.ucsf.edu/rachel.whitmer\" target=\"_blank\" rel=\"noopener\">Rachel Whitmer\u003c/a> of the University of California, Davis.\u003c/p>\n\u003cp>Also, women who began to menstruate earlier and went through menopause later were less likely to develop dementia. Menopause at age 45 or younger seemed to increase the risk by 28 percent.\u003c/p>\n\u003cp>Another study of 133 elderly women in the U.K. found that the more months of pregnancy they experienced during their lives, the lower their risk of developing Alzheimer's.\u003c/p>\n\u003cp>The findings all suggest that female sex hormones — which rise at puberty and during pregnancy, then fall at menopause — are somehow affecting a woman's risk of developing Alzheimer's and other forms of dementia. The results also suggest that greater exposure to these hormones, through more pregnancies or more reproductive years, can reduce a woman's risk.\u003c/p>\n\u003cp>But it's still not clear whether the mere presence of female sex hormones is a reason that the frequency of Alzheimer's is greater in women than in men.\u003c/p>\n\u003cp>One possibility is that it's not female sex hormones on their own, but rapid changes in their levels that are a problem, says \u003ca href=\"https://crwg.uic.edu/crwg-home/crwg-staff/pauline-maki-phd/\" target=\"_blank\" rel=\"noopener\">Pauline Maki\u003c/a>, a professor of psychiatry and psychology at the University of Illinois at Chicago, who presented research at the Alzheimer's conference.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Women experience these very dramatic hormonal transitions that in the long run can give rise to Alzheimer's disease,\" she says.\u003c/p>\n\u003cp>One way for women to minimize the dramatic hormonal changes that occur at menopause is to use hormone replacement therapy.\u003c/p>\n\u003cp>That approach fell out of favor more than a decade ago when a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/12771112\" target=\"_blank\" rel=\"noopener\">large study\u003c/a> found that women who took estrogen plus progestin after menopause were actually more likely to get some form of dementia. They also appeared to have a higher risk of heart disease and breast cancer.\u003c/p>\n\u003cp>But Maki says more recent studies suggest that hormone therapy — especially estrogen alone — really can be helpful if women get it at the right time.\u003c/p>\n\u003cp>\"The effects of hormone therapy depend on the timing of use,\" Maki says. \"Use later in life is detrimental, whereas use early in the menopausal transition could be beneficial.\"\u003c/p>\n\u003cp>An analysis presented at the Alzheimer's conference supports that idea.\u003c/p>\n\u003cp>It found that in two recent studies, women who started taking estrogen after age 65 were more likely to have trouble with thinking and memory. But women who started taking estrogen between 50 and 54 were not.\u003c/p>\n\u003cp>And estrogen may benefit the mental function of younger women because it reduces the hot flashes associated with menopause, Maki says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"The more hot flashes a woman has, the worse her memory performance,\" Maki says, citing her own research. \"And when we intervene to address those hot flashes, her memory performance bounces back.\"\u003c/p>\n\u003cp>Findings like that are renewing interest in the idea that someday, it may be possible to use hormones around the time of menopause to prevent Alzheimer's and other forms of dementia later on, Maki says.\u003c/p>\n\u003cp>In the meantime, there's evidence that hormonal differences between men and women may affect their brains in ways that affect doctors' ability to accurately diagnose Alzheimer's, Maki says.\u003c/p>\n\u003cp>At the Alzheimer's conference, she presented research showing that women tend to have higher verbal memory skills than men, even when they are in the early stages of Alzheimer's. As a result, women are likely to be diagnosed with the disease later than men.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>It's unclear whether male hormones, such as testosterone, affect a man's risk of Alzheimer's.\u003c/p>\n\u003chr>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hormone+Levels+Likely+Influence+A+Woman%27s+Risk+Of+Alzheimer%27s.+But+Exactly+How%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/443536/hormone-levels-likely-influence-a-womans-risk-of-alzheimers-but-exactly-how","authors":["byline_futureofyou_443536"],"series":["futureofyou_219"],"categories":["futureofyou_1060","futureofyou_1"],"tags":["futureofyou_999","futureofyou_1023","futureofyou_1008","futureofyou_61","futureofyou_80"],"collections":["futureofyou_1093"],"featImg":"futureofyou_443537","label":"source_futureofyou_443536"},"futureofyou_443398":{"type":"posts","id":"futureofyou_443398","meta":{"index":"posts_1591205157","site":"futureofyou","id":"443398","score":null,"sort":[1531843234000]},"guestAuthors":[],"slug":"worried-about-dementia-you-might-want-to-check-your-blood-pressure","title":"Worried About Dementia? You Might Want to Check Your Blood Pressure","publishDate":1531843234,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"term":1093,"site":"futureofyou"},"content":"\u003cp>Every day, \u003ca href=\"https://www.ninds.nih.gov/About-NINDS/Who-We-Are/Directors-Corner\" target=\"_blank\" rel=\"noopener\">Dr. Walter Koroshetz\u003c/a>, 65, takes a pill as part of his effort to help keep his brain healthy and sharp.[contextly_sidebar id=\"4qBhSsrstKRvTKQK6tvUcmCtY4bzQNtv\"]\u003c/p>\n\u003cp>The pill is his blood pressure medication. And Koroshetz, who directs the National Institute of Neurological Disorders and Stroke, says controlling high blood pressure helps him reduce his risk of dementia.\u003c/p>\n\u003cp>He also keeps his blood pressure down by exercising and paying attention to his weight and diet. \"I'm a believer,\" he says.\u003c/p>\n\u003cp>Koroshetz is urging other people with high blood pressure to follow his lead.\u003c/p>\n\u003cp>He is responsible for the institute's public health campaign called \u003ca href=\"https://mindyourrisks.nih.gov/\" target=\"_blank\" rel=\"noopener\">Mind Your Risks\u003c/a>. Its goal is to let people know that there is a link between high blood pressure, stroke and dementia.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When blood pressure rises, it strains the tiny blood vessels that keep brain cells alive, Koroshetz says.\u003c/p>\n\u003cp>\"With every pulse of your heart, you are pushing blood into these very small blood vessels in the brain,\" he says. And when the heart pushes too hard, as it does when blood pressure is elevated, it can cause damage that can lead to a stroke.[contextly_sidebar id=\"8eq71K4GS69glebb5gMvhBNDaKzdVXhl\"]\u003c/p>\n\u003cp>At least two large studies have revealed an alarming trend among stroke patients, Koroshetz says.\u003c/p>\n\u003cp>\"If you had a stroke, even a small stroke, your risk of dementia within the next two years was greatly magnified,\" he says. \"So there's something about having a stroke that drives a lot of the processes that give rise to dementia.\"\u003c/p>\n\u003cp>The evidence is clearest for a type of dementia called \u003ca href=\"https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/vascular-dementia\" target=\"_blank\" rel=\"noopener\">vascular dementia\u003c/a>. It occurs when something blocks or reduces the flow of blood to brain cells.\u003c/p>\n\u003cp>But high blood pressure also appears to increase a person's risk of developing Alzheimer's disease, which is associated with the accumulation of plaques and tangles in the brain.\u003c/p>\n\u003cp>If people knew about the link between dementia and high blood pressure, they might be more inclined to do something about it, Koroshetz says.\u003c/p>\n\u003cp>\"Only about 50 percent of people who have hypertension are actually treated,\" he says. \"So I think there's a lot to be said for trying to get high blood pressure under control.\"\u003c/p>\n\u003cp>Koroshetz's campaign is getting some help from the \u003ca href=\"https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/vascular-dementia\" target=\"_blank\" rel=\"noopener\">Alzheimer's Association\u003c/a>.\u003c/p>\n\u003cp>The group will present new research on blood pressure and Alzheimer's at its annual scientific \u003ca href=\"https://www.alz.org/aaic/about/chicago.asp\" target=\"_blank\" rel=\"noopener\">meeting\u003c/a> in Chicago, which starts July 22. And the group is encouraging people to control high blood pressure.\u003c/p>\n\u003cp>\"The good news is that we can control blood pressure now,\" says Maria Carrillo, the group's chief science officer. \"We can do that with exercise, with lifestyle, with healthy eating and also with medications.\"\u003c/p>\n\u003cp>Koroshetz is using all of these approaches. And he says other people with high blood pressure should follow his lead.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"When you get to be my age, you're going to be very grateful that you controlled your blood pressure and exercised,\" he says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Worried+About+Dementia%3F+You+Might+Want+to+Check+Your+Blood+Pressure&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"A new public health campaign says controlling high blood pressure is among the best ways to keep your brain sharp. The neurologist in charge aims to lead by example.","status":"publish","parent":0,"modified":1531812714,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":500},"headData":{"title":"Worried About Dementia? You Might Want to Check Your Blood Pressure | KQED","description":"A new public health campaign says controlling high blood pressure is among the best ways to keep your brain sharp. The neurologist in charge aims to lead by example.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Worried About Dementia? You Might Want to Check Your Blood Pressure","datePublished":"2018-07-17T16:00:34.000Z","dateModified":"2018-07-17T07:31:54.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"443398 https://ww2.kqed.org/futureofyou/?p=443398","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/07/17/worried-about-dementia-you-might-want-to-check-your-blood-pressure/","disqusTitle":"Worried About Dementia? You Might Want to Check Your Blood Pressure","nprImageCredit":"John Rensten","nprByline":"Jon Hamilton, NPR","nprImageAgency":"Getty Images","nprStoryId":"628156948","nprApiLink":"http://api.npr.org/query?id=628156948&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/07/16/628156948/worried-about-dementia-you-might-want-to-check-your-blood-pressure?ft=nprml&f=628156948","nprRetrievedStory":"1","nprPubDate":"Mon, 16 Jul 2018 13:56:00 -0400","nprStoryDate":"Mon, 16 Jul 2018 05:09:00 -0400","nprLastModifiedDate":"Mon, 16 Jul 2018 13:56:04 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/07/20180716_me_worried_about_dementia_you_might_want_to_check_your_blood_pressure.mp3?orgId=1&topicId=1128&d=150&p=3&story=628156948&ft=nprml&f=628156948","nprAudioM3u":"http://api.npr.org/m3u/1629362055-0937a2.m3u?orgId=1&topicId=1128&d=150&p=3&story=628156948&ft=nprml&f=628156948","path":"/futureofyou/443398/worried-about-dementia-you-might-want-to-check-your-blood-pressure","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/07/20180716_me_worried_about_dementia_you_might_want_to_check_your_blood_pressure.mp3?orgId=1&topicId=1128&d=150&p=3&story=628156948&ft=nprml&f=628156948","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Every day, \u003ca href=\"https://www.ninds.nih.gov/About-NINDS/Who-We-Are/Directors-Corner\" target=\"_blank\" rel=\"noopener\">Dr. Walter Koroshetz\u003c/a>, 65, takes a pill as part of his effort to help keep his brain healthy and sharp.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The pill is his blood pressure medication. And Koroshetz, who directs the National Institute of Neurological Disorders and Stroke, says controlling high blood pressure helps him reduce his risk of dementia.\u003c/p>\n\u003cp>He also keeps his blood pressure down by exercising and paying attention to his weight and diet. \"I'm a believer,\" he says.\u003c/p>\n\u003cp>Koroshetz is urging other people with high blood pressure to follow his lead.\u003c/p>\n\u003cp>He is responsible for the institute's public health campaign called \u003ca href=\"https://mindyourrisks.nih.gov/\" target=\"_blank\" rel=\"noopener\">Mind Your Risks\u003c/a>. Its goal is to let people know that there is a link between high blood pressure, stroke and dementia.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When blood pressure rises, it strains the tiny blood vessels that keep brain cells alive, Koroshetz says.\u003c/p>\n\u003cp>\"With every pulse of your heart, you are pushing blood into these very small blood vessels in the brain,\" he says. And when the heart pushes too hard, as it does when blood pressure is elevated, it can cause damage that can lead to a stroke.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>At least two large studies have revealed an alarming trend among stroke patients, Koroshetz says.\u003c/p>\n\u003cp>\"If you had a stroke, even a small stroke, your risk of dementia within the next two years was greatly magnified,\" he says. \"So there's something about having a stroke that drives a lot of the processes that give rise to dementia.\"\u003c/p>\n\u003cp>The evidence is clearest for a type of dementia called \u003ca href=\"https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/vascular-dementia\" target=\"_blank\" rel=\"noopener\">vascular dementia\u003c/a>. It occurs when something blocks or reduces the flow of blood to brain cells.\u003c/p>\n\u003cp>But high blood pressure also appears to increase a person's risk of developing Alzheimer's disease, which is associated with the accumulation of plaques and tangles in the brain.\u003c/p>\n\u003cp>If people knew about the link between dementia and high blood pressure, they might be more inclined to do something about it, Koroshetz says.\u003c/p>\n\u003cp>\"Only about 50 percent of people who have hypertension are actually treated,\" he says. \"So I think there's a lot to be said for trying to get high blood pressure under control.\"\u003c/p>\n\u003cp>Koroshetz's campaign is getting some help from the \u003ca href=\"https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/vascular-dementia\" target=\"_blank\" rel=\"noopener\">Alzheimer's Association\u003c/a>.\u003c/p>\n\u003cp>The group will present new research on blood pressure and Alzheimer's at its annual scientific \u003ca href=\"https://www.alz.org/aaic/about/chicago.asp\" target=\"_blank\" rel=\"noopener\">meeting\u003c/a> in Chicago, which starts July 22. And the group is encouraging people to control high blood pressure.\u003c/p>\n\u003cp>\"The good news is that we can control blood pressure now,\" says Maria Carrillo, the group's chief science officer. \"We can do that with exercise, with lifestyle, with healthy eating and also with medications.\"\u003c/p>\n\u003cp>Koroshetz is using all of these approaches. And he says other people with high blood pressure should follow his lead.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"When you get to be my age, you're going to be very grateful that you controlled your blood pressure and exercised,\" he says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Worried+About+Dementia%3F+You+Might+Want+to+Check+Your+Blood+Pressure&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/443398/worried-about-dementia-you-might-want-to-check-your-blood-pressure","authors":["byline_futureofyou_443398"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_1283","futureofyou_56","futureofyou_1023","futureofyou_61"],"collections":["futureofyou_1093"],"featImg":"futureofyou_443399","label":"futureofyou_1093"},"futureofyou_443236":{"type":"posts","id":"futureofyou_443236","meta":{"index":"posts_1591205157","site":"futureofyou","id":"443236","score":null,"sort":[1531162927000]},"guestAuthors":[],"slug":"family-caregivers-exchange-tips-share-stories-to-ease-alzheimers-losses","title":"Family Caregivers Exchange Tips, Share Stories To Ease Alzheimer's Losses","publishDate":1531162927,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Vicki Bartholomew started a support group for wives who are caring for a husband with Alzheimer's disease because she needed that sort of group herself.\u003c/p>\n\u003cp>They meet every month in a conference room at a new memory care facility in Nashville, Tenn., called \u003ca href=\"http://nashvillepublicradio.org/post/nashville-dementia-ward-aims-become-hub-memory-care-research#stream/0\" target=\"_blank\" rel=\"noopener\">Abe's Garden\u003c/a>, where Bartholomew's husband was one of the first residents — a Vietnam veteran and prominent attorney in Nashville.\u003c/p>\n\u003cp>\"My husband's still living, and now I'm in an even more difficult situation — I'm married, but I'm a widow,\" she says.\u003c/p>\n\u003cp>These women draw the shades and open up to each other in ways they can't with their lifelong friends.\u003c/p>\n\u003cp>\"They're still wonderful friends, but they didn't know how to handle this. It was hard for them, and as you all know, your friends don't come around as much as they used to,\" Bartholomew says. \"I was in bad shape. I didn't think I was — I did have health problems, and [now] I know I was depressed.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As the numbers of Americans afflicted with Alzheimer's disease continue to swell to an estimated 5.7 million, so do the legions of loved ones caring for friends and family members. The toll on Bartholomew's own mental health is one of the reasons the Alzheimer's Foundation of America focuses on the nation's estimated \u003ca href=\"https://www.alz.org/facts/\" target=\"_blank\" rel=\"noopener\">16 million unpaid caregivers\u003c/a>.\u003c/p>\n\u003cp>With no cure on the horizon, the foundation has been highlighting the necessity of better support for those caregivers through a \u003ca href=\"https://alzfdn.org/afa-educating-america-tour/\">national tour\u003c/a>. It stopped in Nashville earlier this spring, was in Tempe, Ariz., in June and heads to Fairfax, Va., in September; the tour includes at least six more cities in the fall.\u003c/p>\n\u003cp>At the live events, Alzheimer's researchers and clinicians offer guidance on a number of topics, including how to ensure safety for patients at home, care planning and even how to \u003ca href=\"https://alzfdn.org/event/afa-educating-america-tour-tempe/\" target=\"_blank\" rel=\"noopener\">entertain someone\u003c/a> with memory loss.\u003c/p>\n\u003cp>The organization promotes in-person and \u003ca href=\"https://alzfdn.org/alzheimers-foundation-americas-national-toll-free-helpline-expanding-seven-days-week/\" target=\"_blank\" rel=\"noopener\">telephone support groups\u003c/a>, since being a caregiver is often a barrier to getting out of the house alone. But even virtual support systems have shown some effectiveness at reducing loneliness, stress and depression \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4668714/\" target=\"_blank\" rel=\"noopener\">in a small 2014 study.\u003c/a>\u003c/p>\n\u003cp>\"We have to do everything we can to educate a caregiver, to provide them with the best practices on caring for somebody,\" says \u003ca href=\"https://alzfdn.org/team_member/charles-j-fuschillo-jr/\" target=\"_blank\" rel=\"noopener\">Charles J. Fuschillo Jr.,\u003c/a> the Alzheimer's Foundation of America's CEO.\u003c/p>\n\u003cp>For example, the AFA \u003ca href=\"https://alzfdn.org/caregiving-resources/fact-sheets-information/\" target=\"_blank\" rel=\"noopener\">recommends\u003c/a> that family members:\u003c/p>\n\u003cul>\n\u003cli>Feed Alzheimer's patients one food at a time. \"A busy plate can be confusing,\" the group says.\u003c/li>\n\u003cli>Mark rooms in the house with signs to avoid unnecessary confusion.\u003c/li>\n\u003cli>Remind a person with Alzheimer's to use the toilet; don't wait for them to ask.\u003c/li>\n\u003cli>When traveling, stick with familiar destinations.\u003c/li>\n\u003cli>Watch for a cough while eating; it can signal a swallowing disorder in people with dementia.\u003c/li>\n\u003cli>Schedule overnight stays at a memory-care facility so the caregiver gets some respite.\u003c/li>\n\u003c/ul>\n\u003cp>Just as important, Fuschillo says, \"We want to do everything we can to avoid caregiver burnout.\"\u003c/p>\n\u003cp>The breaking point sneaks up on even the most committed caregiver, say Alzheimer's advocates, especially as the nights grow more sleepless. Alzheimer's patients can tend to pace, or wake up their partner every few minutes. They can even become violent. Or, perhaps worse, they can leave the house.\u003c/p>\n\u003cp>\"And I've had some issues at night that I had to take care of alone,\" says Pam Hawkins, whose husband has Alzheimer's. \"But I'm not ready to have anyone there at night.\"\u003c/p>\n\u003cp>For now, she says, her husband usually sleeps all night. And if there's a problem, her son-in-law is 15 minutes away.\u003c/p>\n\u003cp>She's had to hire caregivers during the day. Knowing how to find and hire the right person is a shared concern by Alzheimer's family members that has inspired an entire\u003ca href=\"https://www.alz.org/national/documents/topicsheet_homehealth.pdf\" target=\"_blank\" rel=\"noopener\"> checklist\u003c/a> for navigating the process. The tips include these: Interview the aide in the home. Over-share information about the patient. Ask what kind of quality control a supervisor will provide.\u003c/p>\n\u003cp>Hawkins is adamant about keeping her husband at home, whatever the cost.\u003c/p>\n\u003cp>\"He's not going anywhere,\" she says. \"He's staying at our home until he moves to heaven. We made that decision a long time ago.\"\u003c/p>\n\u003cp>But many caregivers have no choice.\u003c/p>\n\u003cp>April Simpkins says tending to her husband became all consuming, and she's young enough that she still needs to keep her job; she works at a local university.\u003c/p>\n\u003cp>\"It was not possible for us to keep Joe at home,\" she says.\u003c/p>\n\u003cp>Simpkins found she'd often have to call her husband's siblings to settle him down over the phone. One night, she had to dial 911 when he kept yelling in the hallways of their condo building.\u003c/p>\n\u003cp>And yet she felt some societal pressure that she wasn't doing enough.\u003c/p>\n\u003cp>\"There's a lot of ... glory given to the whole idea of someone being long-suffering and staying at home and giving up their life, basically, to care for their loved one,\" Simpkins says. \"It makes it harder for people who can't do that.\"\u003c/p>\n\u003cp>Everyone around the table nods in agreement. Whatever stage of illness their loved one is experiencing, these caregivers understand the complicated existence that many have dubbed \"the long goodbye.\"\u003c/p>\n\u003cp>Along with sharing the sorrow, they find a way to share in the humor of it all — one woman says her husband wears a laundry-basket's-worth of shirts and pants because he forgets he's already gotten dressed. Even tips on how to reduce the odor from incontinence are offered with a loving laugh.\u003c/p>\n\u003cp>The support group ends with hugs. Some women head for the parking lot. Others buzz through the locked doors to see their husbands.\u003c/p>\n\u003cp>Simpkins sits down for lunch with Joe, who is a former state employee and a youthful-looking 66 years old. She drapes an arm around his slumping shoulders and assists him as he spears a cold strawberry with his fork.\u003c/p>\n\u003cp>\"You know, there are some days,\" she says, interrupted by a random reflection from Joe. \"Yeah, some days are clearer than others.\"\u003c/p>\n\u003cp>Simpkins tries to stop by to see her husband every day. But it's a wicked kind of blessing, she says, that when she misses a visit, Joe no longer notices.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's reporting partnership with Nashville Public Radio and Kaiser Health News.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Nashville Public Radio. To see more, visit \u003ca href=\"http://www.wpln.org/\" target=\"_blank\" rel=\"noopener\">Nashville Public Radio\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Family+Caregivers+Exchange+Tips%2C+Share+Stories+To+Ease+Alzheimer%27s+Losses&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"As the number of people with Alzheimer's climbs, so does the number of loved ones caring for them. The health of 16 million unpaid U.S. caregivers has become a focus for Alzheimer's advocacy groups.","status":"publish","parent":0,"modified":1531169663,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":33,"wordCount":1098},"headData":{"title":"Family Caregivers Exchange Tips, Share Stories To Ease Alzheimer's Losses | KQED","description":"As the number of people with Alzheimer's climbs, so does the number of loved ones caring for them. The health of 16 million unpaid U.S. caregivers has become a focus for Alzheimer's advocacy groups.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Family Caregivers Exchange Tips, Share Stories To Ease Alzheimer's Losses","datePublished":"2018-07-09T19:02:07.000Z","dateModified":"2018-07-09T20:54:23.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"443236 https://ww2.kqed.org/futureofyou/?p=443236","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/07/09/family-caregivers-exchange-tips-share-stories-to-ease-alzheimers-losses/","disqusTitle":"Family Caregivers Exchange Tips, Share Stories To Ease Alzheimer's Losses","source":"Health","nprImageCredit":"Tang Yau Hoong","nprByline":"Blake Farmer, NPR","nprImageAgency":"Ikon Images/Getty Images","nprStoryId":"621110042","nprApiLink":"http://api.npr.org/query?id=621110042&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/07/06/621110042/shared-tips-support-help-prevent-burnout-among-alzheimers-family-caregivers?ft=nprml&f=621110042","nprRetrievedStory":"1","nprPubDate":"Fri, 06 Jul 2018 13:18:00 -0400","nprStoryDate":"Fri, 06 Jul 2018 04:59:00 -0400","nprLastModifiedDate":"Fri, 06 Jul 2018 13:18:48 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/07/20180706_me_family_caregivers_exchange_tips_share_stories_to_ease_alzheimers_losses.mp3?orgId=577&topicId=1128&d=229&p=3&story=621110042&ft=nprml&f=621110042","nprAudioM3u":"http://api.npr.org/m3u/1626442145-cdcb9f.m3u?orgId=577&topicId=1128&d=229&p=3&story=621110042&ft=nprml&f=621110042","path":"/futureofyou/443236/family-caregivers-exchange-tips-share-stories-to-ease-alzheimers-losses","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/07/20180706_me_family_caregivers_exchange_tips_share_stories_to_ease_alzheimers_losses.mp3?orgId=577&topicId=1128&d=229&p=3&story=621110042&ft=nprml&f=621110042","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Vicki Bartholomew started a support group for wives who are caring for a husband with Alzheimer's disease because she needed that sort of group herself.\u003c/p>\n\u003cp>They meet every month in a conference room at a new memory care facility in Nashville, Tenn., called \u003ca href=\"http://nashvillepublicradio.org/post/nashville-dementia-ward-aims-become-hub-memory-care-research#stream/0\" target=\"_blank\" rel=\"noopener\">Abe's Garden\u003c/a>, where Bartholomew's husband was one of the first residents — a Vietnam veteran and prominent attorney in Nashville.\u003c/p>\n\u003cp>\"My husband's still living, and now I'm in an even more difficult situation — I'm married, but I'm a widow,\" she says.\u003c/p>\n\u003cp>These women draw the shades and open up to each other in ways they can't with their lifelong friends.\u003c/p>\n\u003cp>\"They're still wonderful friends, but they didn't know how to handle this. It was hard for them, and as you all know, your friends don't come around as much as they used to,\" Bartholomew says. \"I was in bad shape. I didn't think I was — I did have health problems, and [now] I know I was depressed.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As the numbers of Americans afflicted with Alzheimer's disease continue to swell to an estimated 5.7 million, so do the legions of loved ones caring for friends and family members. The toll on Bartholomew's own mental health is one of the reasons the Alzheimer's Foundation of America focuses on the nation's estimated \u003ca href=\"https://www.alz.org/facts/\" target=\"_blank\" rel=\"noopener\">16 million unpaid caregivers\u003c/a>.\u003c/p>\n\u003cp>With no cure on the horizon, the foundation has been highlighting the necessity of better support for those caregivers through a \u003ca href=\"https://alzfdn.org/afa-educating-america-tour/\">national tour\u003c/a>. It stopped in Nashville earlier this spring, was in Tempe, Ariz., in June and heads to Fairfax, Va., in September; the tour includes at least six more cities in the fall.\u003c/p>\n\u003cp>At the live events, Alzheimer's researchers and clinicians offer guidance on a number of topics, including how to ensure safety for patients at home, care planning and even how to \u003ca href=\"https://alzfdn.org/event/afa-educating-america-tour-tempe/\" target=\"_blank\" rel=\"noopener\">entertain someone\u003c/a> with memory loss.\u003c/p>\n\u003cp>The organization promotes in-person and \u003ca href=\"https://alzfdn.org/alzheimers-foundation-americas-national-toll-free-helpline-expanding-seven-days-week/\" target=\"_blank\" rel=\"noopener\">telephone support groups\u003c/a>, since being a caregiver is often a barrier to getting out of the house alone. But even virtual support systems have shown some effectiveness at reducing loneliness, stress and depression \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4668714/\" target=\"_blank\" rel=\"noopener\">in a small 2014 study.\u003c/a>\u003c/p>\n\u003cp>\"We have to do everything we can to educate a caregiver, to provide them with the best practices on caring for somebody,\" says \u003ca href=\"https://alzfdn.org/team_member/charles-j-fuschillo-jr/\" target=\"_blank\" rel=\"noopener\">Charles J. Fuschillo Jr.,\u003c/a> the Alzheimer's Foundation of America's CEO.\u003c/p>\n\u003cp>For example, the AFA \u003ca href=\"https://alzfdn.org/caregiving-resources/fact-sheets-information/\" target=\"_blank\" rel=\"noopener\">recommends\u003c/a> that family members:\u003c/p>\n\u003cul>\n\u003cli>Feed Alzheimer's patients one food at a time. \"A busy plate can be confusing,\" the group says.\u003c/li>\n\u003cli>Mark rooms in the house with signs to avoid unnecessary confusion.\u003c/li>\n\u003cli>Remind a person with Alzheimer's to use the toilet; don't wait for them to ask.\u003c/li>\n\u003cli>When traveling, stick with familiar destinations.\u003c/li>\n\u003cli>Watch for a cough while eating; it can signal a swallowing disorder in people with dementia.\u003c/li>\n\u003cli>Schedule overnight stays at a memory-care facility so the caregiver gets some respite.\u003c/li>\n\u003c/ul>\n\u003cp>Just as important, Fuschillo says, \"We want to do everything we can to avoid caregiver burnout.\"\u003c/p>\n\u003cp>The breaking point sneaks up on even the most committed caregiver, say Alzheimer's advocates, especially as the nights grow more sleepless. Alzheimer's patients can tend to pace, or wake up their partner every few minutes. They can even become violent. Or, perhaps worse, they can leave the house.\u003c/p>\n\u003cp>\"And I've had some issues at night that I had to take care of alone,\" says Pam Hawkins, whose husband has Alzheimer's. \"But I'm not ready to have anyone there at night.\"\u003c/p>\n\u003cp>For now, she says, her husband usually sleeps all night. And if there's a problem, her son-in-law is 15 minutes away.\u003c/p>\n\u003cp>She's had to hire caregivers during the day. Knowing how to find and hire the right person is a shared concern by Alzheimer's family members that has inspired an entire\u003ca href=\"https://www.alz.org/national/documents/topicsheet_homehealth.pdf\" target=\"_blank\" rel=\"noopener\"> checklist\u003c/a> for navigating the process. The tips include these: Interview the aide in the home. Over-share information about the patient. Ask what kind of quality control a supervisor will provide.\u003c/p>\n\u003cp>Hawkins is adamant about keeping her husband at home, whatever the cost.\u003c/p>\n\u003cp>\"He's not going anywhere,\" she says. \"He's staying at our home until he moves to heaven. We made that decision a long time ago.\"\u003c/p>\n\u003cp>But many caregivers have no choice.\u003c/p>\n\u003cp>April Simpkins says tending to her husband became all consuming, and she's young enough that she still needs to keep her job; she works at a local university.\u003c/p>\n\u003cp>\"It was not possible for us to keep Joe at home,\" she says.\u003c/p>\n\u003cp>Simpkins found she'd often have to call her husband's siblings to settle him down over the phone. One night, she had to dial 911 when he kept yelling in the hallways of their condo building.\u003c/p>\n\u003cp>And yet she felt some societal pressure that she wasn't doing enough.\u003c/p>\n\u003cp>\"There's a lot of ... glory given to the whole idea of someone being long-suffering and staying at home and giving up their life, basically, to care for their loved one,\" Simpkins says. \"It makes it harder for people who can't do that.\"\u003c/p>\n\u003cp>Everyone around the table nods in agreement. Whatever stage of illness their loved one is experiencing, these caregivers understand the complicated existence that many have dubbed \"the long goodbye.\"\u003c/p>\n\u003cp>Along with sharing the sorrow, they find a way to share in the humor of it all — one woman says her husband wears a laundry-basket's-worth of shirts and pants because he forgets he's already gotten dressed. Even tips on how to reduce the odor from incontinence are offered with a loving laugh.\u003c/p>\n\u003cp>The support group ends with hugs. Some women head for the parking lot. Others buzz through the locked doors to see their husbands.\u003c/p>\n\u003cp>Simpkins sits down for lunch with Joe, who is a former state employee and a youthful-looking 66 years old. She drapes an arm around his slumping shoulders and assists him as he spears a cold strawberry with his fork.\u003c/p>\n\u003cp>\"You know, there are some days,\" she says, interrupted by a random reflection from Joe. \"Yeah, some days are clearer than others.\"\u003c/p>\n\u003cp>Simpkins tries to stop by to see her husband every day. But it's a wicked kind of blessing, she says, that when she misses a visit, Joe no longer notices.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's reporting partnership with Nashville Public Radio and Kaiser Health News.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Nashville Public Radio. To see more, visit \u003ca href=\"http://www.wpln.org/\" target=\"_blank\" rel=\"noopener\">Nashville Public Radio\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Family+Caregivers+Exchange+Tips%2C+Share+Stories+To+Ease+Alzheimer%27s+Losses&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/443236/family-caregivers-exchange-tips-share-stories-to-ease-alzheimers-losses","authors":["byline_futureofyou_443236"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_999","futureofyou_56","futureofyou_1023","futureofyou_1008","futureofyou_61"],"collections":["futureofyou_1093"],"featImg":"futureofyou_443237","label":"source_futureofyou_443236"},"futureofyou_440728":{"type":"posts","id":"futureofyou_440728","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440728","score":null,"sort":[1523386836000]},"guestAuthors":[],"slug":"scientists-push-plan-to-change-how-researchers-define-alzheimers","title":"Scientists Push Plan To Change How Researchers Define Alzheimer's","publishDate":1523386836,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>An international coalition of brain researchers is suggesting a new way of looking at Alzheimer's.\u003c/p>\n\u003cp>Instead of defining the disease through symptoms like memory problems or fuzzy thinking, the scientists want to focus on biological changes in the brain associated with Alzheimer's. These include the plaques and tangles that build up in the brains of people with the disease.\u003c/p>\n\u003cp>But they say the new approach is intended only for research studies, and isn't yet ready for use by most doctors who treat Alzheimer's patients.[contextly_sidebar id=\"Zc2PdHyXHi6M2lDV49kQiFVNaKeIPoB0\"]\u003c/p>\n\u003cp>If the new approach is widely adopted, it would help researchers study patients whose brain function is still normal, but are likely to develop dementia caused by Alzheimer's.\u003c/p>\n\u003cp>\"There is a stage of the disease where there are no symptoms and we need to have some sort of a marker,\" says \u003ca href=\"https://www.nia.nih.gov/research/blog/2016/09/meet-director-division-neuroscience\">Eliezer Masliah\u003c/a>, who directs the Division of Neuroscience at the National Institute on Aging.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The new approach would be a dramatic departure from the traditional way of looking at Alzheimer's, says \u003ca href=\"http://www.mayo.edu/research/faculty/jack-clifford-r-jr-m-d/bio-00026247\" target=\"_blank\" rel=\"noopener\">Clifford Jack\u003c/a>, an Alzheimer's researcher at Mayo Clinic Rochester.\u003c/p>\n\u003cp>In the past, \"a person displayed a certain set of signs and symptoms and it was expected that they had Alzheimer's pathology,\" says Jack, who is the first author of the central paper describing the proposed new \"research framework.\"[contextly_sidebar id=\"cR0O5c7lGyXeCBcMlKvsHUcXDud9KX3K\"]\u003c/p>\n\u003cp>But researchers began to see the flaws in that approach when they took a close look at the brains of people receiving experimental drugs for the disease, Jack says. \"About 30 percent of people who met all the appropriate clinical criteria did not have Alzheimer's disease.\"\u003c/p>\n\u003cp>Their memory or thinking problems were being caused by something else.\u003c/p>\n\u003cp>So researchers have been looking for more reliable ways of determining whether someone really has Alzheimer's. And they've focused on the two best-known brain changes associated with the disease.\u003c/p>\n\u003cp>\"What we're seeing now is that Alzheimer's disease is defined by the presence of plaques and tangles in your brain,\" Jack says. And in this way of thinking, he says, \"symptoms become the result of the disease, not the definition of the disease.\"\u003c/p>\n\u003cp>Once it was virtually impossible to detect plaques and tangles in a living person. But over time, scientists have developed a number of ways to spot the abnormalities using special brain scans or tests of spinal fluid.[contextly_sidebar id=\"YZk4pmpKdzGmEy59QhebIBpZRwnapuqb\"]\u003c/p>\n\u003cp>These tests for what are known as biomarkers of Alzheimer's are allowing scientists to do experiments that would have been impossible relying on symptoms alone. \"One could, let's say, start preventive treatment five years before the onset of the symptoms,\" Masliah says.\u003c/p>\n\u003cp>The new approach has detractors, who argue that it's not yet a reliable replacement for clinical symptoms in research. And proponents have responded to these complaints by including symptom measures in their proposal, and acknowledging that biomarkers are still in an early stage of development.\u003c/p>\n\u003cp>Proponents have also stressed that the biomarker approach is not yet the right tool for most doctors who treat Alzheimer's patients.\u003c/p>\n\u003cp>\"It's a research framework meant to be tested, a tool for researchers, not for the doctor's office,\" says \u003ca href=\"https://www.alz.org/research/funding/advisory_council_alzheimers_association.asp\" target=\"_blank\" rel=\"noopener\">Maria Carrillo\u003c/a>, chief scientific officer of the Alzheimer's Association.\u003c/p>\n\u003cp>But Carrillo hopes that when drugs to prevent Alzheimer's finally arrive, biomarker tests can show who should get them.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The proposal, and several commentaries supporting it, appears Tuesday in the April 2018 issue of \u003ca href=\"http://www.alzheimersanddementia.com/\" target=\"_blank\" rel=\"noopener\">\u003cem>Alzheimer's & Dementia: The journal of the Alzheimer's Association\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Scientists+Push+Plan+To+Change+How+Researchers+Define+Alzheimer%27s+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"The new approach would be a dramatic departure from the traditional way of looking at Alzheimer's.","status":"publish","parent":0,"modified":1523383386,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":604},"headData":{"title":"Scientists Push Plan To Change How Researchers Define Alzheimer's | KQED","description":"The new approach would be a dramatic departure from the traditional way of looking at Alzheimer's.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Scientists Push Plan To Change How Researchers Define Alzheimer's","datePublished":"2018-04-10T19:00:36.000Z","dateModified":"2018-04-10T18:03:06.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440728 https://ww2.kqed.org/futureofyou/?p=440728","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/04/10/scientists-push-plan-to-change-how-researchers-define-alzheimers/","disqusTitle":"Scientists Push Plan To Change How Researchers Define Alzheimer's","source":"Health","nprImageCredit":"Cecil Fox","nprByline":"Jon Hamilton\u003cbr />NPR Shots","nprImageAgency":"Science Source","nprStoryId":"600944750","nprApiLink":"http://api.npr.org/query?id=600944750&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/04/10/600944750/scientists-push-plan-to-change-how-researchers-define-alzheimers?ft=nprml&f=600944750","nprRetrievedStory":"1","nprPubDate":"Tue, 10 Apr 2018 11:34:00 -0400","nprStoryDate":"Tue, 10 Apr 2018 05:04:00 -0400","nprLastModifiedDate":"Tue, 10 Apr 2018 05:50:56 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/04/20180410_me_scientists_push_plan_to_change_how_researchers_define_alzheimers_.mp3?orgId=1&topicId=1128&d=174&p=3&story=600944750&ft=nprml&f=600944750","nprAudioM3u":"http://api.npr.org/m3u/1601072306-f70dc6.m3u?orgId=1&topicId=1128&d=174&p=3&story=600944750&ft=nprml&f=600944750","path":"/futureofyou/440728/scientists-push-plan-to-change-how-researchers-define-alzheimers","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/04/20180410_me_scientists_push_plan_to_change_how_researchers_define_alzheimers_.mp3?orgId=1&topicId=1128&d=174&p=3&story=600944750&ft=nprml&f=600944750","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>An international coalition of brain researchers is suggesting a new way of looking at Alzheimer's.\u003c/p>\n\u003cp>Instead of defining the disease through symptoms like memory problems or fuzzy thinking, the scientists want to focus on biological changes in the brain associated with Alzheimer's. These include the plaques and tangles that build up in the brains of people with the disease.\u003c/p>\n\u003cp>But they say the new approach is intended only for research studies, and isn't yet ready for use by most doctors who treat Alzheimer's patients.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>If the new approach is widely adopted, it would help researchers study patients whose brain function is still normal, but are likely to develop dementia caused by Alzheimer's.\u003c/p>\n\u003cp>\"There is a stage of the disease where there are no symptoms and we need to have some sort of a marker,\" says \u003ca href=\"https://www.nia.nih.gov/research/blog/2016/09/meet-director-division-neuroscience\">Eliezer Masliah\u003c/a>, who directs the Division of Neuroscience at the National Institute on Aging.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new approach would be a dramatic departure from the traditional way of looking at Alzheimer's, says \u003ca href=\"http://www.mayo.edu/research/faculty/jack-clifford-r-jr-m-d/bio-00026247\" target=\"_blank\" rel=\"noopener\">Clifford Jack\u003c/a>, an Alzheimer's researcher at Mayo Clinic Rochester.\u003c/p>\n\u003cp>In the past, \"a person displayed a certain set of signs and symptoms and it was expected that they had Alzheimer's pathology,\" says Jack, who is the first author of the central paper describing the proposed new \"research framework.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But researchers began to see the flaws in that approach when they took a close look at the brains of people receiving experimental drugs for the disease, Jack says. \"About 30 percent of people who met all the appropriate clinical criteria did not have Alzheimer's disease.\"\u003c/p>\n\u003cp>Their memory or thinking problems were being caused by something else.\u003c/p>\n\u003cp>So researchers have been looking for more reliable ways of determining whether someone really has Alzheimer's. And they've focused on the two best-known brain changes associated with the disease.\u003c/p>\n\u003cp>\"What we're seeing now is that Alzheimer's disease is defined by the presence of plaques and tangles in your brain,\" Jack says. And in this way of thinking, he says, \"symptoms become the result of the disease, not the definition of the disease.\"\u003c/p>\n\u003cp>Once it was virtually impossible to detect plaques and tangles in a living person. But over time, scientists have developed a number of ways to spot the abnormalities using special brain scans or tests of spinal fluid.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>These tests for what are known as biomarkers of Alzheimer's are allowing scientists to do experiments that would have been impossible relying on symptoms alone. \"One could, let's say, start preventive treatment five years before the onset of the symptoms,\" Masliah says.\u003c/p>\n\u003cp>The new approach has detractors, who argue that it's not yet a reliable replacement for clinical symptoms in research. And proponents have responded to these complaints by including symptom measures in their proposal, and acknowledging that biomarkers are still in an early stage of development.\u003c/p>\n\u003cp>Proponents have also stressed that the biomarker approach is not yet the right tool for most doctors who treat Alzheimer's patients.\u003c/p>\n\u003cp>\"It's a research framework meant to be tested, a tool for researchers, not for the doctor's office,\" says \u003ca href=\"https://www.alz.org/research/funding/advisory_council_alzheimers_association.asp\" target=\"_blank\" rel=\"noopener\">Maria Carrillo\u003c/a>, chief scientific officer of the Alzheimer's Association.\u003c/p>\n\u003cp>But Carrillo hopes that when drugs to prevent Alzheimer's finally arrive, biomarker tests can show who should get them.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The proposal, and several commentaries supporting it, appears Tuesday in the April 2018 issue of \u003ca href=\"http://www.alzheimersanddementia.com/\" target=\"_blank\" rel=\"noopener\">\u003cem>Alzheimer's & Dementia: The journal of the Alzheimer's Association\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Scientists+Push+Plan+To+Change+How+Researchers+Define+Alzheimer%27s+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440728/scientists-push-plan-to-change-how-researchers-define-alzheimers","authors":["byline_futureofyou_440728"],"categories":["futureofyou_452","futureofyou_1"],"tags":["futureofyou_999","futureofyou_56","futureofyou_1023","futureofyou_141","futureofyou_61","futureofyou_1056"],"featImg":"futureofyou_440729","label":"source_futureofyou_440728"},"futureofyou_440380":{"type":"posts","id":"futureofyou_440380","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440380","score":null,"sort":[1521763255000]},"guestAuthors":[],"slug":"abnormal-heartbeat-theres-an-app-for-that-and-it-could-be-97-percent-accurate","title":"Abnormal Heartbeat? There's an App for That -- And it Could Be 97 Percent Accurate","publishDate":1521763255,"format":"standard","headTitle":"Heart health | Future of You | KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>A mobile app was able to detect irregular heart rhythms with 97 percent accuracy, a finding by UC San Francisco researchers that could lead to life-saving \u003ca href=\"https://www.kqed.org/futureofyou/266349/how-reliable-are-smartphones-and-wearables-for-monitoring-your-heart\" target=\"_blank\" rel=\"noopener\">preventative screenings.\u003c/a>\u003c/p>\n\u003cp>One in four adults over the age of 40 is at risk for a heart condition known as \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624\" target=\"_blank\" rel=\"noopener\">atrial fibrillation\u003c/a> (AF). It's one of the leading causes of stroke and often goes undetected until it's too late.\u003c/p>\n\u003cp>The study, which relied on an app specifically designed for the Apple Watch, is reportedly the first to use a smartwatch to detect abnormal heart rhythms.\u003c/p>\n\u003cp>“By identifying candidates for appropriate anti-coagulation treatment, we might ultimately leverage common wearable devices to reduce ... complications, even death,\" said Gregory Marcus, director of clinical research in the UCSF Division of Cardiology and lead author of the study.\u003c/p>\n\u003cp>AF occurs when electrical impulses in the the upper chambers of the heart become erratic, causing the atrium's walls to quiver as blood passes through, potentially triggering blood clots.[contextly_sidebar id=\"sQ9MJSaMtUHbSJHSKfj37aKsbqwOOxmZ\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Researchers say the findings, published in \u003ca href=\"https://jamanetwork.com/journals/jamacardiology/article-abstract/2675364?redirect=true\" target=\"_blank\" rel=\"noopener\">JAMA Cardiology\u003c/a>, could lead to the development of more effective screenings. And with nearly 6 million people in the U.S. estimated to develop AF by 2050, the app could prevent large numbers of strokes and death.\u003c/p>\n\u003cp>With a 97 percent accuracy rate, the app performed better than a competing \u003ca href=\"http://www.abstractsonline.com/pp8/#!/4496/presentation/41378\" target=\"_blank\" rel=\"noopener\">FDA-approved product sold as Kardia Band.\u003c/a>\u003c/p>\n\u003cp>The UCSF-tested app, designed by Cardiogram, relies on deep neural networks, a type of sophisticated machine-learning algorithm that provides a continuous stream of data. More than 139 million measurements of heart rates and step counts were collected from 9,750 participants. [contextly_sidebar id=\"C27bFTVwLpXMdavOJy6PlXm3e5jXCR7Q\"]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Researchers cited certain limitations to their study, including a number of participants who failed to link their Cardiogram accounts. In addition, researchers focused on those with known AF and did not look into the app's ability to identify undiagnosed conditions.\u003c/p>\n\n","blocks":[],"excerpt":"With one in four adults over 40 at risk for the heart condition, the app could be a life-saving tool.","status":"publish","parent":0,"modified":1521763324,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":11,"wordCount":327},"headData":{"title":"Abnormal Heartbeat? There's an App for That -- And it Could Be 97 Percent Accurate | KQED","description":"With one in four adults over 40 at risk for the heart condition, the app could be a life-saving tool.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Abnormal Heartbeat? There's an App for That -- And it Could Be 97 Percent Accurate","datePublished":"2018-03-23T00:00:55.000Z","dateModified":"2018-03-23T00:02:04.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440380 https://ww2.kqed.org/futureofyou/?p=440380","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/22/abnormal-heartbeat-theres-an-app-for-that-and-it-could-be-97-percent-accurate/","disqusTitle":"Abnormal Heartbeat? There's an App for That -- And it Could Be 97 Percent Accurate","source":"DIY Health","path":"/futureofyou/440380/abnormal-heartbeat-theres-an-app-for-that-and-it-could-be-97-percent-accurate","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A mobile app was able to detect irregular heart rhythms with 97 percent accuracy, a finding by UC San Francisco researchers that could lead to life-saving \u003ca href=\"https://www.kqed.org/futureofyou/266349/how-reliable-are-smartphones-and-wearables-for-monitoring-your-heart\" target=\"_blank\" rel=\"noopener\">preventative screenings.\u003c/a>\u003c/p>\n\u003cp>One in four adults over the age of 40 is at risk for a heart condition known as \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624\" target=\"_blank\" rel=\"noopener\">atrial fibrillation\u003c/a> (AF). It's one of the leading causes of stroke and often goes undetected until it's too late.\u003c/p>\n\u003cp>The study, which relied on an app specifically designed for the Apple Watch, is reportedly the first to use a smartwatch to detect abnormal heart rhythms.\u003c/p>\n\u003cp>“By identifying candidates for appropriate anti-coagulation treatment, we might ultimately leverage common wearable devices to reduce ... complications, even death,\" said Gregory Marcus, director of clinical research in the UCSF Division of Cardiology and lead author of the study.\u003c/p>\n\u003cp>AF occurs when electrical impulses in the the upper chambers of the heart become erratic, causing the atrium's walls to quiver as blood passes through, potentially triggering blood clots.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Researchers say the findings, published in \u003ca href=\"https://jamanetwork.com/journals/jamacardiology/article-abstract/2675364?redirect=true\" target=\"_blank\" rel=\"noopener\">JAMA Cardiology\u003c/a>, could lead to the development of more effective screenings. And with nearly 6 million people in the U.S. estimated to develop AF by 2050, the app could prevent large numbers of strokes and death.\u003c/p>\n\u003cp>With a 97 percent accuracy rate, the app performed better than a competing \u003ca href=\"http://www.abstractsonline.com/pp8/#!/4496/presentation/41378\" target=\"_blank\" rel=\"noopener\">FDA-approved product sold as Kardia Band.\u003c/a>\u003c/p>\n\u003cp>The UCSF-tested app, designed by Cardiogram, relies on deep neural networks, a type of sophisticated machine-learning algorithm that provides a continuous stream of data. More than 139 million measurements of heart rates and step counts were collected from 9,750 participants. \u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Researchers cited certain limitations to their study, including a number of participants who failed to link their Cardiogram accounts. In addition, researchers focused on those with known AF and did not look into the app's ability to identify undiagnosed conditions.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440380/abnormal-heartbeat-theres-an-app-for-that-and-it-could-be-97-percent-accurate","authors":["11428"],"programs":["futureofyou_54"],"series":["futureofyou_350"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_1023","futureofyou_1070","futureofyou_742","futureofyou_281","futureofyou_1451","futureofyou_35"],"collections":["futureofyou_1093"],"featImg":"futureofyou_440381","label":"source_futureofyou_440380"},"futureofyou_439274":{"type":"posts","id":"futureofyou_439274","meta":{"index":"posts_1591205157","site":"futureofyou","id":"439274","score":null,"sort":[1517950642000]},"guestAuthors":[],"slug":"risky-antipsychotic-drugs-still-overprescribed-in-nursing-homes","title":"Risky Antipsychotic Drugs Still Overprescribed In Nursing Homes","publishDate":1517950642,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"term":1093,"site":"futureofyou"},"content":"\u003cp>A \u003ca href=\"https://www.hrw.org/report/2018/02/05/they-want-docile/how-nursing-homes-united-states-overmedicate-people-dementia\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published Monday by \u003ca href=\"https://www.hrw.org/report/2018/02/05/they-want-docile/how-nursing-homes-united-states-overmedicate-people-dementia\" target=\"_blank\" rel=\"noopener\">Human Rights Watch\u003c/a> finds that about 179,000 nursing home residents are being given antipsychotic drugs, even though they don't have schizophrenia or other serious mental illnesses that those drugs are designed to treat.\u003c/p>\n\u003cp>Most of these residents have Alzheimer's disease or another form of dementia and \u003ca href=\"https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml#part_149866\" target=\"_blank\" rel=\"noopener\">antipsychotics\u003c/a> aren't approved for that. What's more, antipsychotic drugs come with a \"\u003ca href=\"https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020272s056,020588s044,021346s033,021444s03lbl.pdf\" target=\"_blank\" rel=\"noopener\">black box warning\u003c/a>\" from the FDA, stating that they increase the risk of death in older people with dementia.\u003c/p>\n\u003cp>The study concluded that antipsychotic drugs were often administered without informed consent and for the purpose of making dementia patients easier to handle in understaffed facilities.\u003c/p>\n\u003cp>Researchers focused on six states, including California and Texas, which have the most skilled nursing facilities. They used publicly available data, along with hundreds of interviews with residents, families and state ombudsmen, the officials who deal with complaints about long term care facilities.\u003c/p>\n\u003cp>In 2012, the federal government \u003ca href=\"https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/National-Partnership-to-Improve-Dementia-Care-in-Nursing-Homes.html\" target=\"_blank\" rel=\"noopener\">began a \u003c/a>program to reduce the use of antipsychotic drugs in nursing homes, in partnership with the nursing home industry, and advocacy organizations. \u003ca href=\"https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-10-02.html\" target=\"_blank\" rel=\"noopener\">Since then\u003c/a>, the use of the drugs has dropped by about a third nationwide, from 23.9 percent of residents in 2012 to 15.7 percent at the beginning of 2017. The Centers for Medicare and Medicaid Services have called for an additional 15 percent reduction by 2019 for those nursing homes that have lagged in curtailing their use of antipsychotics.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But the Human Rights Watch study contends that the federal government hasn't done nearly enough. It faults the government for failing to enforce \u003ca href=\"https://www.medicare.gov/what-medicare-covers/part-a/rights-in-snf.html\" target=\"_blank\" rel=\"noopener\">laws that exist to protect nursing home residents\u003c/a> from what are sometimes called \"chemical restraints.\"\u003c/p>\n\u003cp>An NPR investigation into the first few years of the government's program to reduce the use of antipsychotic drugs found that \u003ca href=\"https://www.npr.org/sections/health-shots/2014/12/09/368538773/nursing-homes-rarely-penalized-for-oversedating-patients\" target=\"_blank\" rel=\"noopener\">only 2 percent\u003c/a> of cases were deemed serious enough to trigger a fine.\u003c/p>\n\u003cp>The study also calls for the government to strengthen informed consent procedures and to establish minimum staffing levels, something that has long been opposed by the nursing home industry.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.ahcancal.org/Pages/Default.aspx\" target=\"_blank\" rel=\"noopener\">The American Health Care Association\u003c/a>, which represents most nursing homes, said in a \u003ca href=\"https://www.ahcancal.org/News/news_releases/Pages/AHCA-Responds-to-Human-Rights-Watch-Report.aspx\" target=\"_blank\" rel=\"noopener\">statement\u003c/a> that the report \"does little to highlight the effort launched by our profession in 2012 that has resulted in a dramatic decline in the use of these medications.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit \u003ca href=\"http://www.npr.org/\" target=\"_blank\" rel=\"noopener\">http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Risky+Antipsychotic+Drugs+Still+Overprescribed+In+Nursing+Homes&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Too many people with dementia are being given sedating drugs to make them easier to handle in understaffed facilities, a new study finds, despite federal warnings to stop the practice.","status":"publish","parent":0,"modified":1517950642,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":11,"wordCount":403},"headData":{"title":"Risky Antipsychotic Drugs Still Overprescribed In Nursing Homes | KQED","description":"Too many people with dementia are being given sedating drugs to make them easier to handle in understaffed facilities, a new study finds, despite federal warnings to stop the practice.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Risky Antipsychotic Drugs Still Overprescribed In Nursing Homes","datePublished":"2018-02-06T20:57:22.000Z","dateModified":"2018-02-06T20:57:22.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"439274 https://ww2.kqed.org/futureofyou/?p=439274","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/02/06/risky-antipsychotic-drugs-still-overprescribed-in-nursing-homes/","disqusTitle":"Risky Antipsychotic Drugs Still Overprescribed In Nursing Homes","nprImageCredit":"Bruno Ehrs","nprByline":"Ina Jaffe\u003cbr />NPR Shots","nprImageAgency":"Getty Images","nprStoryId":"583435517","nprApiLink":"http://api.npr.org/query?id=583435517&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/02/05/583435517/risky-antipsychotic-drugs-still-overprescribed-in-nursing-homes?ft=nprml&f=583435517","nprRetrievedStory":"1","nprPubDate":"Mon, 05 Feb 2018 20:51:00 -0500","nprStoryDate":"Mon, 05 Feb 2018 20:51:00 -0500","nprLastModifiedDate":"Mon, 05 Feb 2018 21:06:34 -0500","path":"/futureofyou/439274/risky-antipsychotic-drugs-still-overprescribed-in-nursing-homes","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A \u003ca href=\"https://www.hrw.org/report/2018/02/05/they-want-docile/how-nursing-homes-united-states-overmedicate-people-dementia\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published Monday by \u003ca href=\"https://www.hrw.org/report/2018/02/05/they-want-docile/how-nursing-homes-united-states-overmedicate-people-dementia\" target=\"_blank\" rel=\"noopener\">Human Rights Watch\u003c/a> finds that about 179,000 nursing home residents are being given antipsychotic drugs, even though they don't have schizophrenia or other serious mental illnesses that those drugs are designed to treat.\u003c/p>\n\u003cp>Most of these residents have Alzheimer's disease or another form of dementia and \u003ca href=\"https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml#part_149866\" target=\"_blank\" rel=\"noopener\">antipsychotics\u003c/a> aren't approved for that. What's more, antipsychotic drugs come with a \"\u003ca href=\"https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020272s056,020588s044,021346s033,021444s03lbl.pdf\" target=\"_blank\" rel=\"noopener\">black box warning\u003c/a>\" from the FDA, stating that they increase the risk of death in older people with dementia.\u003c/p>\n\u003cp>The study concluded that antipsychotic drugs were often administered without informed consent and for the purpose of making dementia patients easier to handle in understaffed facilities.\u003c/p>\n\u003cp>Researchers focused on six states, including California and Texas, which have the most skilled nursing facilities. They used publicly available data, along with hundreds of interviews with residents, families and state ombudsmen, the officials who deal with complaints about long term care facilities.\u003c/p>\n\u003cp>In 2012, the federal government \u003ca href=\"https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/National-Partnership-to-Improve-Dementia-Care-in-Nursing-Homes.html\" target=\"_blank\" rel=\"noopener\">began a \u003c/a>program to reduce the use of antipsychotic drugs in nursing homes, in partnership with the nursing home industry, and advocacy organizations. \u003ca href=\"https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-10-02.html\" target=\"_blank\" rel=\"noopener\">Since then\u003c/a>, the use of the drugs has dropped by about a third nationwide, from 23.9 percent of residents in 2012 to 15.7 percent at the beginning of 2017. The Centers for Medicare and Medicaid Services have called for an additional 15 percent reduction by 2019 for those nursing homes that have lagged in curtailing their use of antipsychotics.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But the Human Rights Watch study contends that the federal government hasn't done nearly enough. It faults the government for failing to enforce \u003ca href=\"https://www.medicare.gov/what-medicare-covers/part-a/rights-in-snf.html\" target=\"_blank\" rel=\"noopener\">laws that exist to protect nursing home residents\u003c/a> from what are sometimes called \"chemical restraints.\"\u003c/p>\n\u003cp>An NPR investigation into the first few years of the government's program to reduce the use of antipsychotic drugs found that \u003ca href=\"https://www.npr.org/sections/health-shots/2014/12/09/368538773/nursing-homes-rarely-penalized-for-oversedating-patients\" target=\"_blank\" rel=\"noopener\">only 2 percent\u003c/a> of cases were deemed serious enough to trigger a fine.\u003c/p>\n\u003cp>The study also calls for the government to strengthen informed consent procedures and to establish minimum staffing levels, something that has long been opposed by the nursing home industry.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.ahcancal.org/Pages/Default.aspx\" target=\"_blank\" rel=\"noopener\">The American Health Care Association\u003c/a>, which represents most nursing homes, said in a \u003ca href=\"https://www.ahcancal.org/News/news_releases/Pages/AHCA-Responds-to-Human-Rights-Watch-Report.aspx\" target=\"_blank\" rel=\"noopener\">statement\u003c/a> that the report \"does little to highlight the effort launched by our profession in 2012 that has resulted in a dramatic decline in the use of these medications.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit \u003ca href=\"http://www.npr.org/\" target=\"_blank\" rel=\"noopener\">http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Risky+Antipsychotic+Drugs+Still+Overprescribed+In+Nursing+Homes&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/439274/risky-antipsychotic-drugs-still-overprescribed-in-nursing-homes","authors":["byline_futureofyou_439274"],"categories":["futureofyou_1"],"tags":["futureofyou_1023","futureofyou_952","futureofyou_1008","futureofyou_61","futureofyou_23"],"collections":["futureofyou_1093"],"featImg":"futureofyou_439275","label":"futureofyou_1093"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg","imageAlt":"On Our Watch from NPR and KQED","officialWebsiteLink":"/podcasts/onourwatch","meta":{"site":"news","source":"kqed","order":"1"},"link":"/podcasts/onourwatch","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1567098962","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw","npr":"https://rpb3r.app.goo.gl/onourwatch","spotify":"https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x","tuneIn":"https://tunein.com/radio/On-Our-Watch-p1436229/","stitcher":"https://www.stitcher.com/show/on-our-watch","rss":"https://feeds.npr.org/510360/podcast.xml"}},"on-the-media":{"id":"on-the-media","title":"On The Media","info":"Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. 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