Every June I like to share what I learned at the Maryland Gerontological Association's annual spring conference. MGA's 32nd conference, held June 4 at Charlestown, in Catonsville, with the theme "Outlooks on Aging: Renew, Redefine and Reform," and prominent speakers in the field of aging, provided a wealth of information. Vendors lined the meeting room with handouts featuring details on their businesses and services related to aging.
The first panel, "Alzheimer's Disease: The Case for Early Intervention," was presented by Marilyn Albert, PhD, director of the Division of Cognitive Neuroscience in the Department of Neurology at Johns Hopkins University School of Medicine and director of the Johns Hopkins Alzheimer's Disease Research Center; and Bill Benson, managing partner, Health Benefits ABCs and consultant to Healthy Aging Program, Center for Disease Control.
Albert related how Alzheimer's Disease was first described. It was Alois Alzheimer, in 1906, who thought the decline in mental ability applied to people age 68 and older. He looked at diseased brain tissue under a microscope and called what he saw "plaque and tangles." These terms are still used today.
When there is evidence of cognitive impairment, both memory and language need to be looked at in a clinical approach. The first step is to determine the presence of the syndrome, a progressive decline in cognition; and the second, the etiology (manner of causation) of the syndrome, ruling out other causes. Albert said that for years the disease has been treated with a number of different medications, but the disease still progresses. The development of drugs and their use have not been successful. She said that we have been trying to treat patients too late in the disease and that researchers have started looking at mild cognitive impairment in its earliest stage in an effort to stop or delay progression.
Albert stated that a vast amount of research is being done with respect to amyloid inhibitors and the removal of plaques. According to the Alzheimer's Association, plaques form when protein pieces called beta-amyloid clump together in the brain. Nutrients can't travel through the nerve cells of the brain and the cells eventually die.
Albert said that 20-30 percent of people who are cognitively normal have plaque and tangles at death but show no nerve cell loss. The Alzheimer's Association displays on its website the inside of the brain and the differences between a normal and diseased brain. Go to alz.org/braintour.
According to Albert, current priorities are to develop better medications for Alzheimer's, concentrating on the amyloid/tau accumulation; and to improve early diagnosis. Amyloid imaging is available now and drug trials are in development.
Bill Benson discussed "The Healthy Brain Initiative," an effort to bring Public Health into the fight against Alzheimer's. This collaboration of the Alzheimer's Association and the Center for Disease Control provided a road map on how state and local aging and public health agencies need to work together to promote cognitive functioning. He said 5.2 million Americans have Alzheimer's, which is the most expensive malady in America, $203 billion a year, and the sixth leading cause of death. It is predicted that by 2050, there will be 16 million Americans with Alzheimer's and the cost will be $1.2 trillion a year.
Benson also discussed the Behavioral Risk Factor Surveillance System used by Public Health. It is the world's largest approach to gathering information about public health. The cognitive impairment module was released in 2013 to 22 states, with state-specific fact sheets, including one titled "Cognitive Decline in Maryland." The data from the 2011 BRFSS fact sheet states that 86 percent of Marylanders with memory problems have not talked to a health care provider. Check details at alz.org/documents_custom/public-health/Maryland.pdf.
There are lifestyle risk factors that relate to Alzheimer's and four primary ways to help combat these risk factors: keep mentally active; keep physically active; stay engaged socially; and control vascular risks (overweight, cholesterol, high blood pressure). Benson recommended that older adults get involved in clinical trials and health studies, which will lead to more information on aging and hopefully cures for diseases such as Alzheimer's.
Other conference topics will have to be covered in future Senior Circles columns.