New clues about why people get Alzheimer's and how to fight it

Jul. 20--After many exhausting nights of finding his wife getting dressed or becoming agitated, Abe Rappaport, 83, said he finally gave in to the Alzheimer's diagnosis and moved her into a memory care facility. Now, Rappaport, of Boca Raton, is desperately looking for medical trials or new medication that might stop the disease's progression in his wife of 56 years.

"I am hoping something new might be out there," Rappaport said.

This week, scientists from around the world met in Los Angeles at the Alzheimer's Association International Conference to reveal research that offers new clues into who gets Alzheimer's and why -- and how to prevent or attack it.

Answers can't come soon enough for Rappaport and the 560,000 Floridians living with the disease, or the 14 million Americans projected to have Alzheimer's by 2050.

Lots of research on brain health and Alzheimer's is in varying stages, and scientists worldwide are identifying possible risks and solutions as well as diagnosis and treatments. Sixty to 80 percent of people with dementia have Alzheimer's disease, the most common form of it.

"It will take a collective effort to slow the progression," said Keith Gibson, director of program services for the Alzheimer's Association Southeast Florida Chapter. This week's conference brought researchers worldwide together and encouraged them to share data.

Research findings revealed this week are beginning to offer clues.

Risks and solutions

Risk: Women may be more likely than men to develop Alzheimer's disease because it spreads differently in women's brains.

Solution: Get a job. Don't drink to excess or smoke.

New research found earning a living staved off memory decline. Women who worked between early adulthood and middle age showed slower rates of memory decline in late-life compared with those who did not work for pay.

Studies also found women who were alcoholics significantly increased their risk of dementia later in life, and smoking appears to be associated with cognitive impairment, even at mid-life.

Risk: Some people have genetic makeup that puts them at high risk for memory and thinking problems associated with Alzheimer's disease. Pollution may also be a factor.

Solution: Researchers revealed study results that show exercise, a healthy diet, not smoking and mental stimulation may decrease memory decline and dementia to protect people who have a genetic risk. A study of 2,340 individuals found those who followed at least four healthy lifestyle habits had a 60 percent lower risk of Alzheimer's dementia.

Risk: Infectious agents such as the herpes virus, a bacterial infection in the brain or the bacteria that causes chronic progressive degenerative gum disease could contribute to Alzheimer's disease.

Solution: Give attention to overall good health. Also, drug therapies that target toxic proteins released in the brain by bacterium may slow or halt the progression of Alzheimer's. An international study of 570 people for a drug that targets these toxic proteins is under way.

Risk: Poor sleep habits in mid- and late-life may increase the risk for developing dementia.

Solution: Avoid regularly taking sleep medications, which in some cases could increase dementia risk. Instead, look for a personalized program to reset bedtime and wake time, combined with physical activity to improve sleep quality.

Risk: Visual or hearing impairment in older adults increases the risk of developing dementia, and impairment in both senses further increases the odds.

Solution: Regular testing for changes in hearing and vision. Willa D. Brenowitz, a researcher at the University of California, San Francisco, said some forms of hearing and vision loss can be treated or corrected, which could allow for intervention and reduce risk for dementia.

Diagnosis and treatments

There is no cure for Alzheimer's disease.

Gibson, who attended the conference, said most clinical trials for new drugs and therapies are aimed at preventing or slowing the progression of the disease, rather than for treating or curing it in late stages. "That's why it's important to catch cognitive decline early, and start managing it," he said.

At this year's conference, scientists submitted 229 abstracts that describe or provide results from Alzheimer's clinical trials or studies. Seven researchers from Florida presented their findings.

A few highlighted therapies show significant promise.

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Diagnosis: Scientists are closer to a blood test for Alzheimer's. The availability of such as test could help with a diagnosis earlier in the disease process, allowing for improved and earlier care and planning. It could also help test the effect of therapies in clinical trials.

Treatments: Anti-amyloid drugs that target plaque in the brain have not proven effective. Clinical trials are under way for new, more innovative treatments. Hundreds of drugs are in trial stages, including some intended for other illnesses.

-- An intranasal device that delivers insulin into the central nervous system led to benefits for memory and thinking in a small study of 289 people. A larger study is now under way.

-- Anti-inflammatory drugs already in existence -- intended for asthma or cancer -- may target brain inflammation before plaque builds. Researchers have found that in some studies, targeting brain inflammation killed the bulk of the nerve cells that led to dementia. A 600-patient trial is under way with results expected within the next year.

Cindy Krischer Goodman can be reached at cgoodman@sunsentinel.com, 954-356-4661, Twitter and Instagram @cindykgoodman

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