Can changes in the eyes help diagnose Alzheimer’s Disease?

Diagnosing someone with Alzheimer’s disease can be a long and complicated process.  In addition to reviewing a patient’s full medical history, doctors must also subject individuals to expensive brain scans or invasive surgical procedures in order to be fully certain of the disease’s presence.

But now, there may be an easier way to spot the brain-wasting condition.  Researchers from Georgetown University Medical Center (GUMC) and the University of Hong Kong have found that it may be possible to diagnose Alzheimer's simply by screening for changes in two very important organs: the eyes.

In a new study presented at the Neuroscience 2013 conference, the scientists detailed how the thickness of a particular layer of retinal cells may serve as an indication of Alzheimer’s progression.

“We’re looking for biomarkers for early disease [recognition], partly for our new clinical studies focusing more on prevention of Alzheimer’s… and to test new drugs,” study author Dr. R. Scott Turner, director of the Memory Disorder Program at GUMC, told FoxNews.com.  “We’re hoping to incorporate this as a new biomarker for drug trials and potentially for screening and prognosis.”

Currently, there are two leading biomarkers that physicians can utilize to diagnose Alzheimer’s.  One is the buildup of beta-amyloid plaques in the brain, which can be observed through positron emission tomography (PET) or computed tomography (CT) scans.  The other involves measuring changes in protein levels of the cerebrospinal fluid – the liquid surrounding the brain and spinal cord.

However, brain imaging scans can be expensive for patients, and in order collect samples of the cerebrospinal fluid, doctors must administer a spinal tap, which can be a very invasive procedure.

Hoping to find a simpler biomarker, Turner and his colleagues decided to analyze the relationship between the eyes and dementia.  According to Turner, the retina serves as a direct extension of a person’s brain.

“The retinas have neurons themselves that send projections straight into the brain,” Turner said. “…Those nerve cells are directly connected to the brain via the optic nerve….So when looking at the retina, it’s the easiest place to see the brain and its neurons.”

Turner also noted that there has been an established association between glaucoma and Alzheimer’s, though the mechanisms behind the relationship remain unclear.  Most studies examining this connection have revolved around the retinal ganglion cell layer, which is responsible for transmitting visual information through the optic nerve.  However, this cell layer relies on information it receives from another layer in the retina called the inner nuclear layer, which had never before been studied in relation to dementia.

With this knowledge in mind, the researchers analyzed a group of mice that had been genetically engineered to develop Alzheimer’s disease, observing the thicknesses of the six layers in their retinas. They found that there was significant loss in thickness to both the inner nuclear layer, which experienced an average 37 percent loss of neurons, and the retinal ganglion cell layer, which experienced an average 49 percent loss.

According to Turner, these two retinal layers may be most vulnerable to neuron loss because they are larger than the other layers.

“The larger the neuron, the more vulnerable it seems to be to injury,” Turner said.  “We looked at some of the other [smaller] neurons, and they didn’t lose much because they were presumably less vulnerable. So we think whatever is killing neurons in the brain is killing the bigger nerve cells in the retina.”

The next step, Turner said, is to see if this biomarker translates to humans with Alzheimer’s.  If similar changes in retinal thickness occur in people, then a simple, noninvasive procedure known as optical coherence tomography (OCT) can be used to measure loss of neurons in these layers.

“If this holds true with humans and seems to be predicative, it could be used for screening, diagnosis, prognosis, but probably more immediately, a research tool to test new drugs,” Turner said. “…But we should probably be looking at the retinal thickness of our Alzheimer’s patients.”

Care of: http://www.foxnews.com/health/2013/11/13/can-changes-in-eyes-help-diagnose-alzheimers-disease/

Study Seeks Super Agers' Secrets To Brain Health

CHICAGO (AP) — They're called "super agers" — men and women who are in their 80s and 90s, but with brains and memories that seem far younger.

Researchers are looking at this rare group in the hope that they may find ways to help protect others from memory loss. And they've had some tantalizing findings: Imaging tests have found unusually low amounts of age-related plaques along with more brain mass related to attention and memory in these elite seniors.

"We're living long but we're not necessarily living well in our older years and so we hope that the SuperAging study can find factors that are modifiable and that we'll be able to use those to help people live long and live well," said study leader Emily Rogalski, a neuroscientist at Northwestern University's cognitive neurology and Alzheimer's disease center in Chicago.

The study is still seeking volunteers, but chances are you don't qualify: Fewer than 10 percent of would-be participants have met study criteria.

"We've screened over 400 people at this point and only about 35 of them have been eligible for this study, so it really represents a rare portion of the population," Rogalski said.

They include an octogenarian attorney, a 96-year-old retired neuroscientist, a 92-year-old Holocaust survivor and an 81-year-old pack-a-day smoker who drinks a nightly martini.

To qualify, would-be participants have to undergo a battery of mental tests. Once enrolled, they undergo periodic imaging scans and other medical tests. They also must be willing to donate their brains after death.

The memory tests include lists of about 15 words. "Super agers can remember at least nine of them 30 minutes later, which is really impressive because often older adults in their 80s can only remember just a couple," Rogalski said.

Special MRI scans have yielded other remarkable clues, Rogalski said. They show that in super agers, the brain's cortex, or outer layer, responsible for many mental functions including memory, is thicker than in typical 80- and 90-year-olds. And deep within the brain, a small region called the anterior cingulate, important for attention, is bigger than even in many 50- and 60-year-olds.

The super agers aren't just different on the inside; they have more energy than most people their age and share a positive, inquisitive outlook. Rogalski said the researchers are looking into whether those traits contribute to brain health.

Other research has linked a positive attitude with overall health. And some studies have suggested that people who are "cognitively active and socially engaged" have a reduced chance of developing Alzheimer's disease, but which comes first — a healthy brain or a great attitude — isn't known, said Heather Snyder, director of medical and scientific operations for the Alzheimer's Association.

Snyder said the SuperAging study is an important effort that may help provide some answers.

Edith Stern is among the super agers. The petite woman looks far younger than her 92 years, and is a vibrant presence at her Chicago retirement home, where she acts as a sort of room mother, volunteering in the gift shop, helping residents settle in and making sure their needs are met.

Stern lost most of her family in the Holocaust and takes her work seriously.

"What I couldn't do for my parents, I try to do for the residents in the home," she said, her voice still thick with the accent of her native Czechoslovakia.

Stern acknowledges she's different from most people at the home, even many younger residents.

"I am young — inside. And I think that's the difference," she said.

"I grasp fast," she adds. "If people say something, they don't have to tell me twice. I don't forget it."

She's different in other ways, too.

"When you get old, people are mainly interested in themselves. They talk about the doctor, what hurts," she said. "You are not so important that you just concentrate on yourself. You have to think about other people."

Study participant Don Tenbrunsel has a similar mindset. The 85-year-old retired businessman doesn't think of himself as a super ager. "Neither do my children," he says, chuckling.

But Tenbrunsel says his memory has been sharp "from the time I was born. My mother used to say, 'Donald, come sing with me — not because I had a good voice, but because I always knew the words," he said. "I think I'm just lucky, not only with respect to my memory, but I'm able to get around very well; I walk a lot and I have a pretty good attitude toward life itself."

Tenbrunsel volunteers several hours a week at a food pantry run by the Chicago church where he is a parishioner. One recent morning in the sun-filled rectory kitchen, he nimbly packaged ham and cheese sandwiches, set out bags of chips and cans of soda, and cheerfully greeted a steady stream of customers.

"Good morning, good to see you," he said, standing at the pantry's bright red door. He gave everyone their choice of chips — a small gesture but important, he said, because it gives them some sense of control over their hard-luck lives.

"I enjoy doing it. I probably get more out of it than I give," Tenbrunsel said.

Ken Zwiener, of Deerfield, Ill., is another super ager. He had "more than an inkling" he might qualify for the study, and his kids encouraged him to enroll.

"They said, 'Dad, your brain is the best thing about you,'" the 81-year-old retired businessman recalled.

He's a golfer and Broadway musical "nut" who created a 300-plus-page computer database of shows. Zwiener uses an iPad, recently went hot-air ballooning and is trying to learn Spanish.

He also pours himself a vodka martini every night and is a pack-a-day cigarette smoker, but says he doesn't think his habits have made much difference. His healthy brain, he says, may be due to heredity and genes, but Zwiener said he hopes the study comes up with more "scientific insights".

"My dad lived into his middle 90s and was pretty sharp right up until the day he died," Zwiener said.

Zwiener's motivation for joining the study was simple: The best man at his wedding died of Alzheimer's disease before age 50.

"To lose a mind ... is just a terrible way to go," he said.

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Online:

SuperAging study: http://tinyurl.com/lo75t7b

Alzheimer's Association: http://www.alz.org

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

Is Long-Term Use of Ginkgo Biloba Effective for Alzheimer’s Disease?

An estimated 5.1 million adults in the United States have Alzheimer’s disease, according to the National Institute on Aging. A common form of dementia, Alzheimer’s disease affects cognitive and behavioral function.

In the later stages of the disease, Alzheimer’s disease significantly affects memory and cognition, resulting in patients being unable to recognize their family members and understand language.

Because of the serious effects of the disease, research has investigated new treatment possibilities. Currently, there is no cure for Alzheimer’s disease.

The U.S. Food and Drug Administration have approved four medications for Alzheimer’s disease: donepezil, rivastigmine, galantamine and memantine.

Rivastigmine and galantamine are for mild to moderate Alzheimer’s disease, while memantine is for moderate to severe Alzheimer’s. Donepezil is used for mild to moderate as well as severe Alzheimer’s.

Some patients have looked into alternative treatments to help with the symptoms of Alzheimer’s disease. One such alternative treatment is ginkgo biloba. The herb contains two components thought to have medicinal effects: flavonoids and terpenoids.

The University of Maryland Medical Center noted that in Europe, ginkgo biloba is used for the treatment of dementia, with the original rationale being that the herbal medicine improved flow of blood to the brain. Currently, it is thought that it protects cells in the brain that are damaged by Alzheimer’s disease.

Possible benefits of ginkgo biloba include improvements in cognitive function, social behavior and activities of daily living, according to the University of Maryland Medical Center.

However, long-term use of ginkgo biloba may not protect users’ Alzheimer’s disease from progressing. A randomized double-blind study investigated the effects of gingko biloba on Alzheimer’s disease progression over five years.

The study included 2,854 participants, who were divided into two groups: a group that received at least one ginkgo biloba extract dose (1,406 individuals), and a group that received at least one placebo dose (1,414 participants).

Article care of:  http://www.empowher.com/alzheimer039s-disease/content/long-term-use-ginkgo-biloba-effective-alzheimer-s-disease