Keeping Time with Alzheimer's Revisited

I started the Alzheimer's Reading Room in 2007. This is post 653. I decided to go back and review some of the articles on this blog.

Early on, I posted the words of Persis Knobbe. Perris was writing about her journey with her late husband through his Alzheimer's disease. I think about what she wrote often. It had a major impact on me at the time.

Perris' words gave me a glimpse into my own future with my mother. Even though I had never met Perris in person, I could visualize this little piece of her journey as if I was experiencing it on my own.

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Hanging on like the mom of a new kindergartner, I watch my husband from the social worker's glass cubicle. He is facing the piano player, the shrunken woman on one side of him, and on the other, falling asleep, the guy they call the Major. Ben -- of all people -- in that circle, a little dazed, being good, going along with the group, his new group. I can go home now and be alone for six hours. No TV, no one trailing after me. Shadowing, it's called. He doesn't always do it. Not yet.

He nods his head in time to the blues, then Gershwin suddenly returns someone's smile. It's beginning to look like a good bet. Senior Access, it's called, adult day care. This branch is in Novato, the best game in town as far as I know. I checked out every possibility that had a few men on the scene, not just a roomful of elderly ladies. Each time I took one look and said, "Never. Never Ben." So how did never become now?

Here is a moment, and for a change I recognize it. I will have a permanent memory of him joining the circle, lowering himself into the chair, eyes fixed on the piano, head bobbing immediately with the rhythm of the blues, then patting his knee as if he is soothing it. He knows he's in the right place before I do. He's one of them, not as far along on the Alzheimer's road as some, still dapper in his crisp shirt and clean Dockers. But he is one of them.

There is no going back to where he was, doing what passed for functioning at home, where he could still propel himself through the day with TV and frequent naps. He is ready; I'm the one not quite ready. From here in the cubicle, for the first time I see what "down the road" means: squeezing out every ounce of making it work at a level you can live with and then stepping down to the next level. Step, step, stepping along.

This is a good thing, I say to myself on the drive home, and I shouldn't turn it into dross because it's a gift. It's as close to what he needs, what we both need, as anything I could find, stimulation for him, a little freedom for me, twice-a-week freedom. Maybe we can work up to three days, who knows? And what will I do with the time and life this offers me? Catch up with two years of unfinished business? The house, the desk, the roses? Give way to a free-flowing all-out depression?

There is a Costco just off the freeway and the car veers off to the nearest exit on its own. "What am I doing?" I ask myself, as I push a huge cart with three items in it: two plants for the garden and a polo shirt for him. "What am I doing, killing a morning like this, wasting it on shopping?" Guilt approaching panic is making my heart beat faster. I will barely get home and have to go back for him.

Setting the plants near the front door with a thud that loosens the soil, I head for my desk. Checkbook and bank statement to my left, Italian class assignment to my right, I study the space between them until the phone rings. Sandra from the Caregiver's Group. "Would I have time for a few brief questions?" I already had time for a few brief questions. She asks about my family. Are they helping me? Am I being good to myself? Answer on a spectrum of "Always" to "Never." I answer with "Always" or "Never," nothing in between. Sandra says she'll call back another time.

When guilt catches up with me, I am on the bike path above the creek, ducks swimming along beside me. Guilt rolls off our backs like you know what. Alone at last, I walk at my own pace. Fast. Fast is what Ben can no longer do -- and fast is slow compared with the woman coming toward me as I near the marsh. She is wearing shorts and earphones. She smiles and I smile back. What a good idea this is, walking out in the sun and cold. What could produce better clarity? I don't have to work it out the first day. I don't have to do it right the first time.

By the time I go back for Ben, I'm capable of being quite pleasant. I don't ask him how it went. He still looks dazed, but he smiles when he sees me. We drive home, have dinner and rent a movie. A musical. We love musicals, the older, sweeter ones and the biting, jaded shows like tonight's. At least we used to. Neither of us is crazy about this one. I try to pry a critique out of him and he gets as far as "It was ..."

Then he opens his mouth wide, an expression of alarm in his eyes, his arms waving frantically. Abruptly he drops the pose. "It was ..." he says again and waits. "Boffo?" I ask. He doesn't answer. It is hard to engage him. "You mean every number was a showstopper? Over the top? Like Liza Minnelli?" He nods, slowly at first, then with mounting pleasure as I elaborate on the word "boffo" and I know one thing: He's not all gone. Not yet.

Persis Knobbe, Special to The SanFrancisco Chronicle
Wednesday, December 27, 2006
Source The SanFrancisco Chronicle

Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 600 articles with more than 11,000 links on the Internet. Bob resides in Delray Beach, FL.

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A memoir of a daughter, her parents and the Beast named – Alzheimers

Deborah Ann Tornillo chronicles the time spent taking care of her mother and father, both of whom were diagnosed with Alzheimer’s in February 2006.

36 Days Apart: A memoir of a daughter, her parents and the Beast named – Alzheimer’s: A story of Life, Love and Death

“I didn’t know when I would tell this story, I just knew I would,” Tornillo writes. “Both my mother and father had Alzheimer’s. My Mom was further along in the disease process than my Dad. It was an incredible journey spending the last year and a half of their life with them, slowly watching the disease take its toll.”

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36 Days Apart recounts this painful, enlightening journey, and Tornillo writes candidly about the struggles and fears she faced as her parents’ caregiver. When the diagnosis came in 2006, Tornillo bravely faced the reality that she would need to take care of them full-time. At first, this entailed monthly flights back and forth to her home state, but it quickly became apparent that the Alzheimer’s was progressing in both parents much more quickly than first anticipated.

As their disease progressed, Tornillo was faced with the difficult task of learning how to be a parent to her own parents. Through the year and a half of caring for them she extensively researched Alzheimer’s in order to provide the best care possible, all the while knowing that the disease would eventually win in the end. She found herself saying goodbye to her father first, but little did she know that her mother would pass away just 36 days later.

36 Days Apart gives an honest, unflinching look at the realities of caring for and losing loved ones to Alzheimer’s. Tornillo gives the reader an inside look into the day-to-day life she faced during her heartbreaking, difficult time. “The two most important things I learned from my parents as we traveled this road together was how to stay strong in faith and never lose compassion for others or myself,” she writes. “I was blessed to have learned from them their wisdom of life and death. I have faith that as you read my parent’s story you will gain the strength and wisdom needed to guide you.”

Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 600 articles with more than 11,000 links on the Internet. Bob resides in Delray Beach, FL.

More from the Alzheimer's Reading Room

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• Dimebon Clinical Trial?
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• 2009 Alzheimer's Disease Facts and Figures
Flavanol-rich Cocoa Consumption Improves Blood Flow to the Brain

Alzheimer's Read May 28

Alzheimer’s, Aging and the Brain

Alzheimer’s is a disease of the very old: While only 5% of people between 65 and 74 have the disease, nearly half of those who are over 85 have it.


Medivation prices 2.75 mln shares at $21

Medivation (MDVN) plans to use the funds for general purposes, including developing its lead product candidate, Dimebon, targeted at Alzheimer's disease, and another candidate, MDV3100, for prostate cancer.

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Exercise Works -- Alzheimer's in the Nursing Home Enviroment

I can attest, exercise makes a difference. My mother now has the tendency to sit around all day. On those days when I can get her to go to Gold's Gym with me she is a completely different person. The look on her face, from dull to smiling, is more than enough to tell me that exercise works to her benefit.

You should note. My mother suffers from Alzheimer's disease. She is 92 years old. And, I am talking about the effect of exercise in a single day.

Nursing home residents with Alzheimer's disease who participate in a moderate exercise program have a significantly slower deterioration than those who receive routine medical care.

At the end of the 12 month study, the average activities-of-daily-living score was significantly more improved in the exercise group than in the routine medical care group.

In addition, average walking speed improved significantly more in the exercise group than in the routine medical care group at 6 months and 12 months.

The patients were 83 years old on average and assigned to one of two groups. One group was assigned to the exercise program, which focused on walking, strength, balance and flexibility training. The other group received routine medical care for 12 months.

Source -- Journal of the American Geriatrics Society

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Alzheimer's Disease -- Advice and Insight

• What’s the Difference Between Alzheimer’s Disease and Dementia?
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Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 2,255 articles with more than 272,100 links on the Internet. Bob resides in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room

Flavanol Rich Cocoa Consumption Improves Blood Flow to the Brain

Cocoa flavanols, the unique compounds found naturally in cocoa, may increase blood flow to the brain, according to research published in the Neuropsychiatric Disease and Treatment journal.

The researchers suggest that long-term improvements in brain blood flow could impact cognitive behavior, offering future potential for debilitating brain conditions including dementia and stroke.

In a scientific study of healthy, older adults ages 59 to 83, Harvard medical scientists found that study participants who regularly drank a cocoa flavanol-rich beverage, had an eight percent increase in brain blood flow after one week, and 10 percent increase after two weeks.

This information should be of interest to Alzheimer's caregivers, and is certainly worth considering.

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Eli Lilly Launches Two Late Stage Clinical Trials for Alzheimer's (LY2062430)

LY2062430 is now known as solanezumab (i).

These new clinical trials being offered by Eli Lilly are open to those suffering from Alzheimer's disease. The study intends to enroll 2,000 participants.

The good news here is that there is no upper age limit (anyone older than 55 could qualify), and the clinical trial locations are likely to cover most of the United States. The goal of enrolling 2,000 participants is very ambitious and good news to those suffering from Alzheimer's.

"Current therapies available to treat Alzheimer's disease may help with symptoms, but they haven't been proven to change the disease progression," said Eric Siemers M.D., Medical Director, Alzheimer's disease research for Eli Lilly and Company. "Biomarker results from a Phase II solanezumab trial give us hope that Lilly is on a path toward a treatment that may slow the rate of progression of Alzheimer's disease."

Eli Lilly and Company (NYSE: LLY) announced it will begin enrolling patients this month in two separate but identical Phase III clinical trials of solanezumab(i), previously referred to as LY2062430, an anti-amyloid beta monoclonal antibody being investigated as a potential treatment to delay the progression of mild to moderate Alzheimer's disease. The trials are called EXPEDITION and EXPEDITION 2.

EXPEDITION 2 is now recruiting new participants. To find out all the details about the phase III clinical trial go here.

EXPEDITION is not yet open, but you can get all the details by following this link.

Does Walking Help Ward Off Alzheimer's Disease

Here is a little known fact that might get your attention.

In a study published in the Journal of the American Medical Association, researchers asked 2,257 men (ages 71–93 and with no signs of dementia) how far they walked each day.

Cognitive assessments performed four to eight years later showed that the men who walked less than a quarter mile a day were nearly twice as likely to have developed dementia as those who walked two miles or more each day.

Source: John Hopkins, Guarding Your Memory

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Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 2,200 articles with more than 272,000 links on the Internet. Bob resides in Delray Beach, FL.

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Another Dimebon Phase III Clinical Trial

Editor Note: All Dimebon Clinical Trials into Alzheimer's disease with the exception of the Concert Study have been canceled.

If you are taking cholinesterase inhibitors and/or memantine you will not qualify for the Dimebon Connection study. However, there is another Dimebon clinical trial that has these inclusion criteria:

• Diagnosis of Alzheimer's Disease.
• MMSE 12-26 inclusive.
• If on existing anti-dementia therapy, have been on a stable dose of anti-dementia therapy (cholinesterase inhibitors and/or memantine) for at least 60 days prior to dosing in study.
  
• If not taking existing anti-dementia therapy, have not received therapy with cholinesterase inhibitors and/or memantine within 60 days prior to dosing in this study.

The study is currently recruiting new participants. For all the specifics including locations go here.

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Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. The Alzheimer's Reading Room is the number one website on the Internet for news, advice, and insight into Alzheimer's disease. Bob has written more than 800 articles with more than 18,000 links on the Internet. Bob resides in Delray Beach, FL.

Original content Bob DeMarco, Alzheimer's Reading Room

Dimebon might alter Alzheimer's Care

Dimebon is an orally-available, small molecule that has been shown to inhibit brain cell death in preclinical models relevant to Alzheimer’s. Dimebon is a potential treatment for Alzheimer's and other neurodegenerative diseases. Based on clinical and preclinical data generated to date, Medivation believes that Dimebon works through a novel mechanism of action improving mitochondria function. 

David Hung, the CEO of Medivation, said on Friday that the experimental drug Dimebon has the potential to transform care for Alzheimer's. The company believes that when the drug achieves FDA approval, it will experience blockbuster sales. The size of the market for Alzheimer's drug sales, now dominated by Aricept, is currently estimated at $5 billion annually.

"If we can get a drug out onto the market that is really effective and safe, that will probably increase the incentive of doctors to diagnose Alzheimer's early on and to treat it," Hung said.

Medivation is currently conducting a Phase III clinical trial for Dimebon. The study  referred to as the Connection Study is currently recruiting new participants.

People who can answer “yes” to the following questions may be able to join the Connection Study:

• Do you have Alzheimer’s disease?
  
• Are you not taking any Alzheimer’s prescription medicines?
  
• Do you have a caregiver who can come with you to doctor visits at the study site?
• To check the available locations go here.

If you believe you qualify, you can call this number for additional information --877-888-6386.

One note of caution. One of our readers emailed me and told me the Connection Study has not returned his phone call and it has been a month. 

The Connection Study is ongoing in the United States and Europe.

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Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 600 articles with more than 11,000 links on the Internet. Bob resides in Delray Beach, FL.

Alzheimer's Advocacy Health Care Reform

By Bob DeMarco
Alzheimer's Reading Room

I received the following email from the Alzheimer's Association. It is complete with the links.

If you have time please get involved. Use the links.

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Thyroid and Alzheimer's, Rose's Real Life Story

Last week, I wrote about the Thyroid and Alzheimer's. I was trying to make these points.

• Hypothyroidism often presents as Alzheimer's or dementia in older people.
  
• The importance of getting the Thyroid checked if you feel sluggish or depressed.
• The importance of selecting a personal care physician that is very familiar with Alzheimer's, dementia, and other diseases that can be mistaken for Alzheimer's in older people.

Our reader Rose Lamatt, wrote and told me about her experience with Alzheimer's and the Thyroid. I wanted to make sure that everyone had a chance to read about Rose's real life experience.

Important Note to Subscribers Alzheimer's Reading Room

You might be seeing lots of glitches especially with the email Subscribers list.

I use Google Feedburner for this service. Someone emailed me and told me they saw a bald headed guy on the email logo instead of the Alzheimer's Reading Room logo.

You might also find glitches on the Blog. I use Google Blogger.

Google is in the process of integrating all their services and the craziness is happening all over the place.

I have no direct control over these technical issues. So, I hope you will bear with us.

I had 4 unsubscribes from the email list already today. This is more than I had in the last year. This tells me there are multiple problems. 

To make matters worse the email from Feedburner is telling us they are unsubscribing from a name other than the Alzheimer's Reading Room. Nevertheless, they are gone.

In defense of Google, they offer great services that I appreciate. I guess I'll just have to grin and bear it. I hope you can also.

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Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 600 articles with more than 11,000 links on the Internet. Bob resides in Delray Beach, FL.

Detecting The Signs Of Alzheimer's Early -- Video

This video is short and contains some very good information.

I would take issue with Dr. Jennifer Ashton when she says, 90 percent of physicians are good at diagnosing dementia and Alzheimer's. There are several studies that show the opposite.

Personal care physicans are not good at diagnosing Alzheimer's, and the majority of them have little or no training in this area.

Dr. Ashton did go on to talk about neurologists. So perhaps she meant to say that 90 percent of neurologist are good at diagnosing dementia.

The problem I see  is that personal care physicians don't see or recognize the problem. This was the case with my mother, and I have seen the same problem over and over with others here in Delray Beach.

If you suspect Alzheimer's or dementia you need to be adamant with your personal care physician that you want a specialist and the appropriate testing. If they refuse, pickup the phone and call your health care provider and register your complaint.

Source CBS Video

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Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 600 articles with more than 11,000 links on the Internet. Bob resides in Delray Beach, FL.

Is Alzheimer's Disease in Your Future?

To me, this is an important development. I believe you can take steps to help delay the onset of Alzheimer's disease, and I have written about them often on the Alzheimer's Reading Room.

Delaying the onset of Alzheimer's means a better chance for the baby boom generation to benefit from a new treatment or cure.

This new risk index could be important for research...It could be used to identify people at high risk for dementia...The tool could also identify people who have no signs of dementia but should be monitored closely, allowing them to begin treatment as soon as possible, and potentially helping them maintain their thinking and memory skills and quality of life longer -- Deborah E. Barnes

To develop the index, researchers in the Cardiovascular Health Study examined 3,375 people with an average age of 76 and no evidence of dementia and followed them for six years. During that time, 480 of the people, or 14 percent, developed dementia.

The statistics caught my attention because they are similar to the statistics for the general population. Seems like a very good study group.

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A new tool can help predict whether people age 65 and older have a high risk of developing Alzheimer’s disease.

Research on the tool is published in the online issue of Neurology®, the medical journal of the American Academy of Neurology.

“This new risk index could be very important both for research and for people at risk of developing dementia and their families,” said study author Deborah E. Barnes, PhD, MPH, of the University of California, San Francisco, San Francisco Veterans Affairs Medical Center and member of the American Academy of Neurology.

“It could be used to identify people at high risk for dementia for studies on new drugs or prevention methods. The tool could also identify people who have no signs of dementia but should be monitored closely, allowing them to begin treatment as soon as possible, and potentially helping them maintain their thinking and memory skills and quality of life longer.”

The risk index is a 15-point scale. People who score eight or more points on the scale are at high risk of developing dementia in the next six years. Several of the items on the scale are well-known risk factors for Alzheimer’s disease, such as older age, low scores on tests of thinking skills, and having a gene that has been linked to the disease.

Other factors predicting dementia risk were more surprising: People who are underweight, do not drink alcohol, have had coronary bypass surgery, or are slow at performing physical tasks such as buttoning a shirt are more likely to develop dementia than people who do not have these risk factors.

To develop the index, researchers in the Cardiovascular Health Study examined 3,375 people with an average age of 76 and no evidence of dementia and followed them for six years. During that time, 480 of the people, or 14 percent, developed dementia.

The researchers then determined which factors best predicted who would develop dementia and created the point index.

A total of 56 percent of those with high scores on the index developed dementia, compared to 23 percent of those with moderate scores and four percent of those with low scores. Overall, the index correctly classified 88 percent of the participants.

Barnes said the risk index will need to be validated with other studies, and she and her colleagues are evaluating whether a shorter, more simplified index could be as accurate as this index.

Source American Academy of Neurology

Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 600 articles with more than 11,000 links on the Internet. Bob resides in Delray Beach, FL.

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Clincal Trial -- Evolution of Memory Related Activity (MCI, Alzheimer's)

This clinical trial is seeking 160 participant and is now actively recruiting. The study is seeking participants with mild cognitive impairment and Alzheimer's disease.

Recently, there has been a lot of focus on biomarkers and the possibility of treatments for Alzheimer's disease. If you have seen the use of fMri and how this relates to neural activity and loss of memory, you know that this is exciting research.

Detailed Description:

The development of biomarkers is now especially critical, as there are a number of promising disease-modifying therapies entering early phase clinical trials, with additional novel therapeutic strategies in development. It is essential to develop biomarkers that can detect a "signal of efficacy" over a relatively short time frame for use in Phase II trials.

Ideally biomarkers are needed that can reliably detect the earliest brain alterations due to Alzheimer's Disease pathology, perhaps at a point when there is synaptic dysfunction but not yet widespread neuronal loss.

Functional neuroimaging, in particular functional MRI (fMRI), has significant potential, having already shown promise in detecting regionally specific pharmacological effects on memory related neural activity, and as a sensitive marker of very early cognitive impairment.

This study, a parallel ancillary study of the Alzheimer's Disease Neuroimaging Initiative (ADNI), will first examine reproducibility of fMRI activation, using a face-name associative memory paradigm, and then the alterations in memory-related activation that occur over the course of MCI and mild AD.

The study will also examine the relationship of fMRI activation to clinical variables, memory task performance, genotype, and other imaging techniques cross-sectionally and longitudinally, sampling at multiple time points over a 3-year period.

So far, the only announced locations are in the Boston area. The research is being sponsored by the National Institute on Aging (NIA).

For all the details follow the link -- Evolution of Memory Related Activity

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Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 600 articles with more than 11,000 links on the Internet. Bob resides in Delray Beach, FL.

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Alzheimer's Bubble Bath

I posted this on another site and got a few good responses.

I am considering trying to give my mother bubble baths. I know this is a bit off the wall, but I wanted to get the reaction of subscribers.

I am interested in finding out if anyone is using baths and more about their experience. I am also looking for tips and advice.

Thanks in advance.

Please use the comments box, down under this article

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Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 600 articles with more than 11,000 links on the Internet. Bob resides in Delray Beach, FL.

The Alzheimer's Project DVD

Thyroid and Alzheimer's Disease

Articles on Alzheimer's and the Thyroid are some of the most frequently read on this website.

By Bob DeMarco

In the book The Alzheimer's Action Plan: The Experts' Guide to the Best Diagnosis and Treatment for Memory Problems the authors discuss in detail physical problems that can effect memory. As part of that discussion, they point out that hypothyroidism can present as Alzheimer's, dementia, or depression

While I don't want to hold out false hope, I often recommend to people I meet that they get the thyroid checked if they suspect, or are receiving a diagnosis of dementia or depression.

I first read that hypothyroidism could present as dementia or Alzheimer's a couple of years ago. As a a result, I decided to get my mother's thyroid checked. Sure enough, she was suffering from hypothyroidism. It did not cure her Alzheimer's.

The medication did have an unintended positive effect -- she started smiling and laughing for the first time in years.

I suggest you share this information with others.

Here is the original article that I wrote on this topic.

The Mental Activity and eXercise Trial for Seniors (MAX)

Those of you that have been here for a while know that I write often about the importance of exercise and the positive effect it has on my mother --she suffers from Alzheimer's disease.

This clinical trial caught my attention.

The primary objective of this study is to conduct a randomized, controlled trial to determine whether engaging in mental activity or exercise, either alone or in combination, improves cognitive function in non-demented, inactive older adults who self-report a recent decline in memory or thinking.

In addition, we, the researchers at the University of California, San Francisco, plan to seek funding to follow subjects over time to determine whether these interventions are associated with changes in rate of cognitive decline or risk of dementia after the intervention period has ended.

This study indirectly addresses an issue that is on the mind of many on this list, and the growing number of people related to someone suffering from Alzheimer's -- what can I do to ward off dementia or Alzheimer's.

The test are designed to see if exercise and mental activity improve memory in older people.

Right now, the only testing location is in San Francisco, Ca (University of California, San Francisco).

The researchers are seeking additional funds to lengthen the research period and expand the study. Detailed Description:

SPECIFIC AIMS AND HYPOTHESES

• Aim 1: To determine whether a 12-week, computer-based mental activity program improves cognitive function in non-demented, inactive elders.
  

We hypothesize that this mental activity program will improve cognitive function—especially visuospatial function—in non-demented, inactive elders.

• Aim 2: To determine whether a 12-week exercise program improves cognitive function in non-demented, inactive elders.
  

We hypothesize that this exercise program will improve cognitive function—especially executive function—in non-demented, inactive elders.

• Aim 3: To determine whether the effects of mental activity and exercise are additive or are more or less than the sum of their parts.
  

We hypothesize that the effects of these mental activity and exercise interventions will be additive.

• Aim 4: To determine whether mental activity and/or exercise may slow cognitive decline or lower risk of dementia in non-demented, inactive elders.
  

We hypothesize that both mental activity and exercise will slow cognitive decline and lower risk of dementia, and that the effects will be greatest when mental activity and exercise are combined.

You must be 65 years or older to apply for inclusion in the clinical trial.

More information and contact information. The Mental Activity and eXercise Trial for Seniors

Principal Investigator: Deborah E Barnes, PhD, MPH
University of California, San Francisco and San Francisco VA Medical Center

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Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 600 articles with more than 11,000 links on the Internet. Bob resides in Delray Beach, FL.

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FAQ about Rember and TauRx Therapeutics (TRx0014)

Last summer, there was an enormous buzz when TauRx Therapeutics reported on Rember at the annual Alzheimer's conference (ICAD, 2008).

Also see, Rember (Methylene Blue) For Alzheimer's, the Hype Continues.

With the release of The Alzheimer's Project, I am sure many are wondering, What happened?

So far TauRx Therapeutics has not announced a Phase III study.

New research findings point to a new treatment that appears to slow the progress of Alzheimer's by 81% over a year. The product - remberTM - is the first drug to act to arrest the progression of Alzheimer's disease by targeting the tangles which are highly correlated with the disease.

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Here is a revisit of my previous articles on Rember and TauRx Therapeutics.

Rember is a new version of an existing chemical substance, but modified to be used as a drug for the treatment and prevention of Alzheimer’s. The chemical, called MTC, has been used in the past to treat urinary tract infections and other conditions.

TauRx Therapeutics Ltd claims that rember acts by 'disrupting and dissolving' the abnormal build-up of Tau protein in brain cells, thus breaking down (and possibly preventing) tangles.

How is rember different from existing drugs for Alzheimer's disease?

Existing drugs for Alzheimer's disease, such as Aricept, work to lessen the symptoms of the illness. However, these drugs do not stop the death of the nerve cells in the long run. Aricept is a treament for Alzheimer's, not a cure.

It is claimed that rember could prevent the death of nerve cells.
Is rember a cure for Alzheimer's Disease?

While the results are very promising, it is important to consider the following:

• these results are from a trial of 321 people, from Aberdeen, Birmingham and Singapore, over a period of less than 2 years (note : an open label study with these patients is on-going),
• a Phase 3 trial is necessary to determine whether the drug will be well tolerated and show continued effectiveness,
• the findings of the Phase 2 trial are yet to be published in an academic journal.

Can I get rember from my family physician?

No. The drug is still in clinical trials and there are no licensing arrangements in place for the existing drug.

Can I buy rember over the internet?

It can be extremely dangerous to buy any drug over the internet or from other sources. Rember is still being developed and tested, this potential treatment for Alzheimer's disease cannot be purchased online.

How can I get involved in the rember Phase 3 trial?

Right now the Phase 3 clinical trial has not been scheduled. We will continue to monitor the situation at the Alzheimer's Reading Room and keep you posted.

When will rember be available on prescription?

If the trials are successful and the drug is licensed, the earliest it is likely to be available is 2012.

TauRx Therapeutics Ltd

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Caregivers -- The Alzheimer's Project on HBO

Caregivers is a collection of five portraits, each of which highlights the sacrifices and successes of people experiencing their loved one's gradual descent into dementia.

If you can't watch it on HBO, you can catch Caregivers on -- streaming video.

Tonight's questions:

• What did you learn from the presentation?
• What are the rewards of caregiving?

The comments box is located down the page, under Related Articles (scroll down the page).

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Caregiver Committment and the Clinical Trial -- Is it for you?

I often receive emails asking me questions about clinical trials. Caregivers are often surprised to learn that enrollment of their loved one into a clinical trial also means a major commitment on their part.

Here is a short list of things you should consider before searching for a clinical trial.

• The amount or number of expected visits you will need to make to the clinic location. This can be weekly, monthly, quarterly, or any combination of these. For sure, you will be making a big investment of your own time if you decide to enroll your loved one in a clinical trial. And, the trial managers won't seriously consider your loved one for enrollment if they are not convinced you can and will make this commitment.



• A second important consideration is the ability to convince the managers of the clinical trial that the patient will have someone monitoring them to insure all medications are taken correctly and as prescribed. If you can't convince the managers of this, you won't get in the trial.



• Most clinical trials have two groups: the treatment group and the control group. If your loved one lands in the control group they will not receive the experimental medication. They will receive an inactive pill, liquid, or powder that has no treatment value. In other words, while they are in the clinical trial they won't receive the benefits of the experiment drug.



• Generally speaking 33-50 percent of the participants in a clinical trial are in the control group. This means the odds of receiving the experimental drug can be as low as the flip of a coin. Patients are selected randomly for each group.



• You need to consider all of the above. If you try for a Phase III clinical trial and get accepted, it is likely that you will be making a 12-18 month commitment.
  

Note: Some clinical trials do offer an open label feature. This means that if the patient lands in the control group, the can still expect to receive the drug once their participation in the clinical trials ends. However, this is usually limited to drugs that are already approved by the FDA, and are being tested for new uses or in combination with other existing drugs.

Previously I wrote: What is a clinical Trial?

Soon I'll write -- How to find a Clinical Trial and What to Ask

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Bob DeMarco is a Caregiver. In addition to being an experienced writer he taught at the University of Georgia , was an Associate Director and Limited Partner at Bear Stearns, the CEO of IP Group, and a mentor. Bob currently resides in Delray Beach, FL where he cares for his mother, Dorothy, who suffers from Alzheimer's disease. He has written more than 600 articles with more than 11,000 links to his work on the Internet.

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• 2009 Alzheimer's Disease Facts and Figures
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Alzheimer's Momentum in Science

HBOs Alzheimer's Momentum in Science airs tonight at 8 PM eastern time.

Tonight's Question:

• Can you describe in your own words what Alzheimer's disease is?
  

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GrandPa Do You Know Who I AM? with Maria Shriver Tonight

GrandPa Do you know who I am airs tonight on HBO at 7:30 PM eastern time.

The question for subscribers and visitor to the Alzheimer's Reading Room.

• What did you think and feel when Grandma and Grandpa talked to Genevieve, Liam, and Margaret?
• Can you imagine yourself being part of a conversation like this?
• What do you think we should be doing to help other grown ups and kids to understand Alzheimer's disease?
  

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The Memory Loss Tapes --Comments and Reactions Wanted

Once you have viewed the Memory Loss Tapes feel free to enter your comments and reactions.

If you would like me to put your question up as a separate post -- send it to me via email and I will.

Feel free to share the link to this article with friends, family, and other interested parties -- http://www.alzheimersreadingroom.com/2009/05/memory-loss-tapes-comments-and.html

Personally, I could write quite a bit but I don't want to taint the conversation.

I will say, I believe the first part of the documentary was excellent. It was tastefully done. It was not the horror show that I thought it might be reading the early reviews. If it frightened anyone, so be it.

I found myself chuckling a few times. I found myself shaking my head up and down a few times. Been there, experienced that. But mostly, I found myself breathing harder than usual. I often had tears rolling out of the corners of my eyes. I felt a wide range of emotions. It felt both good and bad to have that kind of reactions.

What I saw was a lot of wonderful people. Really courageous and caring.

And like always, it reminded me -- I am not alone. There are millions of us --we are the ones.