Tuesday, July 24, 2012

Alzheimer's Disease: Negative Bapineuzumab Findings in Phase III Trial

Critical reading for those interested in Alzheimer's clinical trials: first results from the BAP Phase III program. The link includes additional links to a New York Times article and a company press release.

From FierceBiotech:

UPDATED: Pfizer, J&J Alzheimer's drug bapineuzumab flunks out in big PhIII
July 23, 2012
By John Carroll

Read the full article

Examine media reports this week for these results and accompanying analysis and commentary. Those who have been following this clinical-trial program should examine the corporate press release for additional details about the other three Phase III trials in this program (which were not part of today's results).

Sunday, July 22, 2012

Neuropsychology Abstract of the Day: Alzheimer's Disease

Does pharmacological treatment of neuropsychiatric symptoms in Alzheimer's disease relieve caregiver burden?
Drugs Aging. 2012 Mar 1;29(3):167-179
Levy K, Lanctôt KL, Farber SB, Li A, Herrmann N

Abstract

Caregiving for patients with Alzheimer's disease (AD) is associated with negative outcomes for the caregiver such as depression, anxiety, medical illness, poorer general health and mortality, which further translate into adverse outcomes for the patient. The burden experienced by caregivers of AD patients, both professional and informal, has been found to be positively related to the presence and severity of the patients' neuropsychiatric symptoms, also referred to as the behavioural and psychological symptoms of dementia (BPSD). As such, management of BPSD may help in alleviating caregiver burden. The purpose of this review is to summarize the current literature on the effects of pharmacological interventions for BPSD on the burden of AD patient caregivers. A literature review was conducted, using keywords related to dementia, drug treatment, caregiving and BPSD. Studies were included if they were a randomized controlled trial of a currently marketed drug in AD patients, and included a measure of caregiver burden and BPSD. Twenty-four articles met the eligibility criteria for this review. Cognitive enhancers (cholinesterase inhibitors, memantine) were associated with decreased caregiver burden in some studies, though it is unclear whether the improvements were related to changes in BPSD or cognition and function. Antipsychotics have been associated with decreased caregiver burden in some studies, though variability may be related to disease severity. Other drug treatments, including antidepressants, have also been shown to have inconsistent effects on caregiver burden. Besides the small number of clinical trials that included a measure of caregiver burden, there is large variability in the literature due to differing conceptualizations of caregiver burden and the lack of a recognized gold standard for caregiving burden assessment. It is therefore difficult to draw strong conclusions about whether the pharmacological management of BPSD relieves caregiver burden. Given the importance of caregiver burden and its negative consequences for the caregiver and the patient, future clinical trials should pay more attention to this crucial outcome.

PMID: 22350526 [PubMed - indexed for MEDLINE]

Wednesday, July 18, 2012

Alzheimer's Disease: Phase II Gammagard Findings

A report from the Alzheimer's Association International Conference (AAIC) in Vancouver:

Alzheimer's drug IVIg could halt sufferers' decline
Trial involving 16 patients excites scientists by suggesting treatment prevented deterioration of memory and cognitive skills
Alexandra Topping and agencies
The Guardian
Wednesday 18 July 2012 10.21 BST

[snip]

"A new treatment for Alzheimer's could halt deterioration in people with early symptoms of the disease, a limited human trial has shown. The treatment, called the "most exciting drug in development" by scientists, is currently prescribed to people with immune system problems but could have a significant impact on the quality of life of Alzheimer's sufferers, the trial suggests.

"The drug, intravenous immunoglobulin (IVIg), prevented the decline in cognitive skills, memory and the ability to live independently, among patients with mild to moderate symptoms of Alzheimer's. Those who took a placebo continued to decline. The small number of patients who took the highest dose of the drug for three years showed no decline in memory."

[snip]

Read the full article

===

Here is the AAIC press release: Read the AAIC press release


Monday, July 16, 2012

Dr. Alan Baddeley Awarded

Lifetime Award goes to memory expert
The British Psychological Society
13/07/2012

[snip]

"Professor Alan Baddeley FRS CBE from the University of York has received this year’s Lifetime Achievement Award from the [British Psychoogical] Society’s Research Board."

[snip]

Read article

Friday, July 13, 2012

Alzheimer's Association International Conference (AAIC) 2012: Overview

Here is a link to the official AAIC Overview document: www.alz.org/aaic/downloads/aaic12_overview.pdf

Here is the current schedule of press briefings (Pacific Time) for the conference, as cited on the conference website:

Sunday, July 15
7:30 a.m. Gait disturbances and Alzheimer's disease risk/early detection

Monday, July 16
7:30 a.m. Irregular sleep patterns affect cognitive function and dementia risk

Tuesday, July 17
7:30 a.m. Alzheimer's therapies update

Wednesday, July 18
7:30 a.m. AAIC 2012 Developing Topics - including several clinical trials

If you are not attending the conference, you might anticipate being able to access media reports on these topics along this schedule, in addition to overall media coverage of the event.

Thursday, July 12, 2012

Forthcoming: Important Alzheimer's AAIC Conference Begins this Weekend in Vancouver

Beginning on the 14th, the Alzheimer's Association International Conference (AAIC) in Vancouver. Visit the website for all information: www.alz.org/aaic/.

All eyes and ears will be on clinical trials findings!

However, even if you are a student, this is an excellent annual conference to attend and you will find great interactions with others. Enjoy!

Wednesday, July 11, 2012

Alzheimer's Disease

In Preventing Alzheimer’s, Mutation May Aid Drug Quest
The New York Times
By GINA KOLATA
11 July 2012

[snip]

Two decades ago, researchers began discovering rare gene mutations that cause Alzheimer’s disease in all who inherit them. Now, they have found the opposite: a mutation that prevents the devastating brain disorder. The protective mutation also is very rare — it is not the reason most people do not develop Alzheimer’s disease. But what intrigues researchers is how it protects the brain. It does the reverse of what the mutations that cause Alzheimer’s do. Those mutations lead to excessive amounts of a normal substance, beta amyloid, in the brain. The protective mutation slows beta amyloid production, so people make much less.

[snip]

Read the full article

Tuesday, July 10, 2012

Neuropsychology Abstract of the Day: Alzheimer's Disease

GOOD or BAD responder? Behavioural and neuroanatomical markers of clinical response to donepezil in dementia. Behav Neurol. 2012;25(2):61-72 Authors: Bottini G, Berlingeri M, Basilico S, Passoni S, Danelli L, Colombo N, Sberna M, Franceschi M, Sterzi R, Paulesu E

Abstract

We explored the neuropsychological and neuromorphometrical differences between probable Alzheimer's disease patients showing a good or a bad response to nine months treatment with donepezil. Before treatment, the neuropsychological profile of the two patient groups was perfectly matched. By the ninth month after treatment, the BAD-responders showed a decline of the MMSE score together with a progressive impairment of executive functions. A voxel-based morphometry investigation (VBM), at the time of the second neuropsychological assessment, showed that the BAD-responders had larger grey and white matter atrophies involving the substantia innominata of Meynert bilaterally, the ventral part of caudate nuclei and the left uncinate fasciculus, brain areas belonging to the cholinergic pathways. A more widespread degeneration of the central cholinergic pathways may explain the lack of donepezil efficacy in those patients not responding to a treatment that operates on the grounds that some degree of endogeneous release of acetylcholine is still available.

PMID: 22530263 [PubMed - indexed for MEDLINE]

Thursday, July 05, 2012

Neuropsychology Abstract of the Day: Assessment

Variability in performance: Identifying early signs of future cognitive impairment. Neuropsychology. 2012 Jul;26(4):534-540. Authors: Gamaldo AA, An Y, Allaire JC, Kitner-Triolo MH, Zonderman AB.

Abstract

Objective: The current study examined whether year-to-year variability in cognitive performance differ between individuals cognitively unimpaired and individuals who subsequently develop dementia. Method: Analyses included a case-control sample of Baltimore Longitudinal Study of Aging (BLSA; mean [M] age = 69.90, standard deviation [SD] = 8.92) participants. One hundred and 35 clinically diagnosed demented participants were matched with 135 nondemented participants based on age at initial testing and sex. Cognitive performance was examined using measures of memory, executive function, attention, language, and global mental status performance. Cognitive performance was examined from baseline to 5 years before cognitive impairment (M, assessments = 3.03, SD = 2.80). Results: As compared with unimpaired individuals, individuals diagnosed with dementia had greater variability on measures of attention, executive function, language, and semantic memory at least 5 years before the estimated onset of cognitive impairment, which may be indicative of maladaptive cognitive functioning. The dementia cases, however, had less variability on visual memory than the unimpaired group, which may suggest that these cases had more difficulty learning. Conclusions: These results demonstrate that performance variability indexed over annual or biennial visits may be useful in identifying early signs of subsequent cognitive impairment. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

PMID: 22746310 [PubMed - in process]