According to psychiatrist Angela Scicutella, MD, PhD, associate professor of psychiatry and behavioral sciences at Albert Einstein College of Medicine, in the Bronx, New York, and a member of the American Academy of Neurology, one reason Alzheimer’s patients respond to music might be that the part of the brain that understands music is not the first target of the disease.

“The processing of music is thought to involve frontal subcortical circuits,” said Dr. Scicutella. “The orbitofrontal cortex is important in social interactions, and the medial prefrontal cortex is important in attention and motivation of human behavior. These areas, which are more involved in the emotional aspects of human behavior, are usually preserved until later in the course of Alzheimer’s dementia, as opposed to the hippocampus and entorhinal cortex, which are involved in factual memory and are the first areas to be affected by the pathology of Alzheimer’s disease. Therefore, these cortical/subcortical circuits, which tap into brain areas that are relatively preserved, can serve as another route for learning.”

While the study group was small, the findings have potentially big implications regarding the benefits of music therapy for AD patients. 

To read the full story, please click on this link:  http://www.medscape.com/viewarticle/761572

Part of the problem is that people with AD usually have at least one other serious health problem.  The mental impairment of AD patients makes treating their other ailments significantly more challenging, and costly, making AD a ‘cost multiplier’ on the healthcare system.

According to a story recently posted in the Philadelphia Inquirer, national leaders in Alzheimer’s care say the cost of doing nothing to find a cure, or at least ways to slow the progression of the disease, will significantly outpace the amount we currently spend to care for AD patients.  It is a crisis that will overwhelm an already overburdened healthcare system if more is not done to tackle this illness.  For example, a senior with diabetes and Alzheimer’s cost Medicare 81% more than with diabetes alone.

Harry Johns, the president and CEO of the Alzheimer’s Association recommends committing $2 billion to research for a cure…that is just one percent of the current cost for treating AD patients today.  To read the full article, click on this link:

http://www.philly.com/philly/health/HealthDay662557_20120308_Alzheimer_s__Dementia_Care_to_Cost_U_S___200_Billion_This_Year.html

In another recent article, this one from the Huffington Post, Michael Hodin, the executive director of the Global Coalition on Aging, reported from London in March at the Alzheimer’s Disease International Global Meeting, that Alzheimer’s Disease is indeed a global crisis.  Dr. Peter Piot, of the London School of Hygiene and Tropical Medicine, gave an impassioned speech to set an agenda to shape the global health priorities for decades to come.  Dr. Piot called AD a ‘time bomb” and warned that “…due to the tragic and cruel torture it inflicts on its victims, AD also demanded, on ethical grounds, to be elevated to a human rights issue.” 

Dr. Piot led the United Nation’s UNAIDS organization which played a profound role in transforming AIDS from a certain death sentence to a manageable illness.  The call for increased spending was made with an alarming comparison of AD research funding compared to other non-communicable diseases.  For example, cancer gets 10 times the funding that AD does, cardiovascular disease gets five times the spending, and diabetes gets double.  It’s not surprising that AD-related deaths have jumped by 66 percent in the last ten years, while other NCDs have fallen by 20 percent. 

The worldwide price tag for the disease is currently $604 billion annually; fully one percent of the global GDP.  As people live longer, the explosive trajectory of this spending is clear.  The risk for people getting AD is one in eight for people 65 and older and one in 2.5 for those over 85.  “What a cruel twist it would be if, due to lack of basic research and prevention, the ‘miracle’ of longevity became a curse.”

For the full story, click on this link: http://www.huffingtonpost.com/michael-hodin/alzheimers_b_1347320.html

Investigators from the Perelman School of Medicine at the University of Pennsylvania administered EpoD to aged mice that had memory deficits and inclusions within their brains that resemble the tangles caused by tau protein that is the hallmark of Alzheimer’s.  Normally, tau proteins stabilize structures called microtubules.  These structures are like molecular railroad tracks that transports cellular cargo.  When tangles develop, the ability of the microtubules to transport information is compromised, and this leads to damage to the nerve cells. 

EpoD stabilizes the microtubules in the same way as the FDA-approved cancer drug paclitaxel (Taxol™).  Both of these drugs prevent cancer cells from multiplying by over-stabilizing specialized microtubules responsible for separating chromosomes during cell division.  The advantage of EpoD is that it, unlike paciltaxel, easily enters the brain and it stays there longer than it stays in the blood.  As a result, researchers suspect that low doses of EpoD might have a therapeutic benefit in early-stage Alheimer’s patients.

After three months of receiving EpoD, additional tau clumps (or tangles) did not form in the test mice, and nerve-cell function increased compared to the AD mice that did not receive the drug.  The test mice also showed improvements in learning and memory.

Because EpoD was so readily absorbed by the brain, lower doses that produced no side-effects, were found to be effective.  This is particularly significant as other drugs in this class have been shown to suppress the immune system and cause peripheral nerve damage.

Click on this link for the full story:  http://www.cbs42.com/content/localnews/story/New-Drug-Slows-Alzheimers/D8m3tjqnA0qeoHQU6HnYjA.cspx.

Please post a comment about EpoD and Alzheimer’s, or send a question.  The staff at Accredited Health Services will be happy to help find answers to your questions.

For the majority of Americans, exercise is one of the most important steps one can take to prevent TBI because it promotes strength, agility, coordination and balance.  Making the home safer by removing tripping hazards, improving lighting and making the activities of daily life easier to navigate are key safeguards.  Checking medications is also important to do regularly in order to ensure that dosages are appropriate and there are no contraindications that might cause dizziness or drowsiness that could lead to a fall.  Finally, vision checks are essential to make sure eyeglass prescriptions are correct and there are no sight-limiting conditions like glaucoma or cataracts.    

In the event of a fall, making sure caregivers and family members recognize the symptoms of brain injury associated with TBI and know how to respond can literally be a life-saver.*  The most common symptoms are headaches, nausea and vomiting, convulsions, memory problems, slow speech, confusion, fatigue and weakness, dilated pupils, moodiness, and loss of balance.  Recognizing these symptoms and getting immediate medical attention can minimize the damage of TBI, and improve the outcome of rehabilitation efforts.

The care given when the patient goes home from the hospital or rehabilitation facility is crucial to achieving the best possible recovery.  Whether the caregiver is a family member or trained homecare aide, it is vital that they are well-trained in working with TBI patients.  AHS’ certified home health aides (CHHAs) and nurses are specially trained to help TBI patients continue the plan of care received in the rehab hospital to promote more complete healing at home.  AHS has earned accreditation from the Commission on Accreditation for Home Care (CAHC) and the Community Health Accreditation Program (CHAP).  This distinction demands a higher level of training in caring for patients who have had a TBI, as well as those who have had a stroke or are suffering from dementia and/or Alzheimer’s. 

AHS goes beyond the training demanded for accreditation and continues to instruct aides throughout their tenure with the agency to work with patients, and their families, to effectively deal with the functional impairments caused by TBI.  The effects of these brain injuries frequently cause frustration, anger, sadness, and/or despair for all involved.  Accredited Health Services’ CHHAs who deal with patients who have suffered a TBI receive extensive education on specific difficult-symptom management.  The training for the “A-Team” of CHHAs includes role playing, response training and team care that involves supervision from field nurses.  The result of this highly-trained at-home care is improved healing and rehabilitation for the patient, and greater resources to help families of patients who’ve suffered TBI.

“Providing the highest level of training for our caregivers sets us apart in homecare,” said Melissa Eschert, president of AHS.  “That training not only builds on the momentum achieved for patients coming out of rehabilitation hospitals, but is also a part of the education we offer to family members to enable them to cope with the after-effects of brain trauma suffered by a loved one.  It’s proven to be a formula that works particularly well with TBI patients, and their families.”

“There are so many exciting developments in Alzheimer’s research and we know our clients are hungry for information that provides hope and offers help for people suffering with the disease,” explained Ken Paster, VP/Chief Marketing Officer of National Home Health Care, the parent of AHS.  “We created ‘The Alzheimer’s News’ page to serve as a frequently updated source of news and information for people impacted by this disease.”

Recent posts to the AHS Alzheimer’s page includes:

• A story about Targretin, a drug indicated for liver and skin cancer, that has been shown to reverse Alzheimer’s in mice
• A story about surprising research findings that suggests Alzheimer’s may progress much like a virus spreads from cell to cell. 
• A report about deep brain stimulation with implanted electrodes that shows promise for not only stopping the advance of the disease, but has actually reversed it in one test patient.

Paster said he hopes the Alzheimer’s News page on the AHS website also becomes an online community where individuals, and their families, can compare experiences, share coping techniques, and connect with others who truly understand what it means to live with Alzheimer’s.  “The emotional toll Alzheimer’s takes on those afflicted with the disease, and their families, is enormous.  We hope to offer a source of comfort and support, as well as information and insight for people dealing with Alzheimer’s,” explained Paster.

Please check out the Alzheimer’s News page and make it a regular online destination as news is updated frequently.  Comments are welcome.  Please also feel free to request more information, or a consultation with AHS staff who specialize in addressing the needs of Alzheimer’s patients and their families.

Dr. Andres Lozano, the architect of the DBS study, describes the brain like the electrical grid to a city. For Alzheimer’s patients, the portion of the brain that controls memory is dark, as though this area has a power outage, while the rest of the ‘city’ (brain) is functioning and lit up. The DBS study was designed to see if physicians would get the power turned back on in the affected part of the brain.

This initial study resulted in improvement for one patient, stabilization for two patients, and no change for three patients. Doctors suspect that this treatment is most effective for Alzheimer’s patients that have been recently diagnosed with the disease. These patients have enough healthy brain tissue to respond positively to the electronic stimulation.

Robert Linton, the patient who saw improvement says, “I think it is the answer to Alzheimers…100 percent!”

Mr. Linton has early-stage Alzheimer’s and, in his case, the memory area of the brain that usually shrinks as the disease progresses is actually growing.

Doctors are awaiting approval to conduct a Stage 2 level study with 40-50 Alzheimer’s patients. They anticipate getting approval by May.

For more information about the story, and an online discussion with the doctors involved in the research, please click on the links below.

Link to news story about patient involved in electronic brain stimulation to treat Alzheimer’s Disease:
http://www.ctv.ca/CTVNews/TopStories/20120306/alzheimers-deep-brain-stimulation-120306/#.T1eb1f_RC9w.email

Link to discussion with doctors involved in brain electrode research for Alzheimer’s: http://www.ctv.ca/CTVNews/Health/20120307/alzheimers-brain-stimulation-chat-120307/

Seniors are the most ‘at-risk’ population for TBI; Americans aged 75 and older account for the highest percentage
of TBI-related hospitalizations and deaths each year. Of the estimated 1.7 million Americans who suffer a TBI
each year, the primary cause is a fall. This makes it critical for older Americans, and those who care for them, to
recognize symptoms of brain injury associated with TBI and know how to respond. Getting immediate attention
can minimize the damage of TBI, and improve the outcome of rehabilitation efforts.

Here’s what you should know:

Symptoms of TBI
• Persistent headache
• Nausea and vomiting
• Convulsions/seizures
• Problems with memory, concentration, organization and/or problem solving
• Slowness in thinking, reading, speaking and acting
• Fatigue and weakness
• Change in sleep patterns
• Dilation in pupils
• Mood changes
• Loss of balance/impaired coordination/light-headedness
• Confusion, restlessness, agitation

Ways to Prevent TBI
• EXERCISE — Regular exercise is the most important preventive measure older Americans can take to
avoid taking a fall which is the most common cause of TBI. It increases strength, agility, balance and
coordination.
• MAKING THE HOME SAFER — The Center for Disease Control recommends the following to safeguard the
home for seniors:
• Removing things from floors and stairs that could pose a tripping hazard
• Using double sided tape to keep area rugs firmly in place
• Placing frequently-used items used within easy reach so a step-stool is not needed
• Installing grab bars next to the toilet and in the tub and shower
• Putting non-stick mats in the bath and shower
• Improving the lighting in the home
• Making sure there are handrails and lights in stairwells
• Outfitting older adults with shoes that offer good support and have thin, non-slip soles (avoid
wearing slippers and socks or going shoeless)
• REVIEW MEDICATIONS regularly by health care providers. As people age, the way a drug works in the
body can change. Sometimes, those changes cause light-headedness or drowsiness that can lead to a fall.
• VISION CHECKS are also critical to ensure that prescription eyeglasses are correct and there are no
conditions that limit vision like glaucoma or cataracts.
Sources: Center for Disease Control and Prevention.

If you have questions or concerns about TBI, how to treat it and how to avoid it, post a comment here or call
Accredited Health Services at 201.432-8844.

Targretin was used in mice with brains engineered to show Alzheimer’s symptoms such as forgetfulness and rapid cell death. Immediately after taking the drug, the mice in the study performed better in tests and displayed better memory retention and sociability.  Mice also recovered their sense of smell which is commonly lost in Alzheimer’s patients.  The reason for the amazing results is that the drug stimulates the removal of beta-amyloid, a brain substance (similar to plaque) that can lead to Alzheimer’s.

Patients and their families are desperately trying to get the drug (which costs $1,200/month and is not expected to be covered by insurance), but researchers warn against humans trying Targretin ‘off-label’ until conclusive studies can be done on humans.  A four-month safety-trial of the drug is being tested on human’s with Alzheimer’s starting in March which will reveal very preliminary findings in human use, but getting FDA approval for use in Alzheimer’s patients could take years.

Given the vast number of Alzheimer’s sufferers and the destructive nature of the disease, do you think:
(a) The FDA should accelerate trials of Targretin in the hopes of getting FDA approval for use in humans?
(b) Should health insurance providers change their coverage rules to make this potentially transformational treatment available to insured patients?
(c) If you had recently been diagnosed with Alzheimer’s, would you be likely to volunteer to participate in a clinical trial in humans for a drug like Targretin that showed promise for Alzheimer’s patients?

Read the full story from The Daily Mail by clicking on:  (http://www.dailymail.co.uk/news/article-2099937/Families-Alzheimers-sufferers-clamor-cancer-drug-reverses-effects-incurable-disease-mice.html).

These independent studies in mice (conducted by researchers from Columbia and Harvard) suggest that Alzheimer’s disease seems to spread like an infection from brain cell to brain cell.  Instead of viruses or bacteria, what is being spread is a distorted protein called ‘tau.’  The exciting news is that these studies show that it may be possible to stop the progression of Alzheimer’s disease by preventing the cell-to-cell transmission with an antibody that blocks ‘tau.’  While it will take years to further test these findings, and develop a treatment plan based on this research, it is igniting excitement among researchers and hope among patients and their families.

Researchers have known that dying, tau-filled cells first show up in a small area of the brain where memories are made and stored, and then the disease slowly spreads to other areas of the brain.  Prior to the release of these surprising study findings, experts believed Alzheimer’s was spread from neuron to neuron, perhaps along the same paths that nerve cells use to communicate with one another.  Another school of thought held that some brain areas were simply more resilient to the disease than others.  These recent studies disprove both of these hypotheses.  To read the full story reported in The New York Times click on this link: http://www.nytimes.com/2012/02/02/health/research/alzheimers-spreads-like-a-virus-in-the-brain-studies-find.ht
ml?_r=1&emc=eta1)

In addition to further expanding the size of Accredited’s nursing and care giving staff, the acquisition of these assets provides AHS with entry into the market of private-duty nursing.  The impetus for the acquisition came from client requests to provide nursing that offers an advanced level of care.  AHS will now have the ability to care for individuals of all ages needing complex medical care such as wound care, ventilator and tracheotomy care, medication administration, nutritional support via a gastrostomy tube, and education.  Adding the private-duty component to AHS’ service gives patients the full continuum of care that enables them to stay in the comfort of their homes longer.

“This acquisition not only lets us offer greater continuity of care as patients’ needs change over time, but it also makes it possible to keep patients living at home longer, instead of moving to a skilled nursing facility as healthcare demands increase,” explained Melissa Eschert, President of Accredited Health Services.  “It is a strategic move that directly addresses the needs of our patients and their families while minimizing pressure on the strained healthcare infrastructure that is prevalent from coast to coast and is certainly evident in New Jersey.”

As part of the acquisition, Midpoint’s  regional director, Irma Camaligan, RN, is joining the AHS senior management team as Vice President in charge of among other things, private-duty nursing.  “We are all excited about joining the AHS team,” said Camaligan.  “Together, we can meet the full continuum of home care needs in New Jersey with greater efficiency and efficacy.  It’s a match that serves patients, and their families, and the caregiving staff of AHS and Midpoint well.”