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| NOVEMBER: NATIONAL ALZHEIMER'S AWARENESS MONTH |
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| Twenty-five years ago, the U.S. government designated November as National Alzheimer’s Disease Awareness Month. Back then, less than 2 million Americans had Alzheimer’s, compared with more than 5.2 million today. “There’s still much we don’t know about Alzheimer’s disease, but a great deal of progress has been made,” said Eric Reiman, M.D., director of the Arizona Alzheimer’s Consortium. “Having November designated as a special month to raise Alzheimer’s awareness indicates the importance of continuing work to make breakthroughs in diagnosis, prevention, treatments, and eventually, a cure.” During and around the month of November, the Alzheimer’s Association and a number of AAC member institutions are sponsoring or participating in activities to educate the public and bolster support in the fight against this fatal disease. For example, on October 18, more than 25 volunteers from Sun Health Research Institute (SHRI) participated in the Alzheimer’s Association Memory Walk, the nation’s largest event to raise awareness and funds for Alzheimer’s care, support, and research. SHRI walkers of all ages took to the event with enthusiasm, treading a one to three mile course that began at Beardsley Recreation Center in Sun City West. Since 1989, the Memory Walk has raised more than $230 million to aid in the fight against Alzheimer’s. |
Above and below: Just a few of the Sun Health Research Institute team members who participated in the Alzheimer’s Association Memory Walk on October 18.  |
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| The AAC and our member institutions will continue to work with the Alzheimer’s Association and other organizations on many Alzheimer’s related events to continue educating the public and seeking a cure for the disease. To view upcoming events, visit the Alzheimer’s Association www.alzdsw.org or the Arizona Alzheimer’s Consortium www.azalz.org. |
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| PERFORMANCE PRESSURE? WORKING TO PREVENT MEMORY DISORDERS DURING THE MOST IMPORTANT YEARS OF A WOMAN'S LIFE |
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| “Memory is the key to life,” says Leslie Baxter, Ph.D. “It contains the very essence, the fabric, of who you are.” Dr. Baxter, a clinical neuropsychologist at Barrow Neurological Institute, the neurological division of St. Joseph’s Hospital and Medical Center, studies cognitive functions in order to learn how the brain affects behavior. And there’s one group in particular that’s attracted her interest. “A lot of women who are starting menopause complain about memory problems,” Dr. Baxter explains, “and yet there’s hardly any research focused on this problem.” Given the unprecedented number of women in today’s workforce, this niche area may now be more of a hot spot than ever before. “Women have come a long way in the past two or three decades,” notes Dr. Baxter. “They have high-powered jobs while still taking care of their kids and their parents. And yet, around age 50—when they’re at the peak of their careers, needing to multitask and work at maximum capacity—perimenopause happens, and memory problems can set in.” Of course, commonplace forgetfulness and clinically significant memory impairment are two very different things. But especially in the wake of the women’s health initiative that discourages the use of estrogen or hormone replacement therapy, Dr. Baxter is concerned that the lack of using estrogen in post-menopausal women may be contributing to some cognitive decline. “In some ways, [by discouraging hormone replacement therapy] we may have made a blanket decision about a complex situation,” she says. How so? Today, both men and women enjoy longer life spans than at any point in history, and physicians generally regard it as “normal” for estrogen levels to decline in women during menopause. “While a decline in estrogen levels may be normal,” Dr. Baxter says, “in general, women didn’t used to live long enough to experience the decline! So the question of whether estrogen reduction contributes to memory problems is really unanswered. In reality, it may be abnormal for the female brain to operate without estrogen.” Working under this hypothesis, Dr. Baxter is currently engaged in research that assesses basic cognitive functions in aging women to identify whether changing hormone levels are truly related to memory impairment. “There may be a direct and an indirect cause [of memory impairment],” says Dr. Baxter. For example, women who begin menopause often experience hot flashes and don’t sleep well. The resulting sleep deprivation can affect memory in a complete different way from lack of estrogen. “If we can find out what kind of memory problems women generally experience, we can figure out how to treat them,” she says. To this end, Dr. Baxter and her team are conducting brain structure and function studies in perimenopausal women—research that gathers information about what the brain looks like and how it works. Study participants undergo a brain scan while being presented with different types of information known to trigger various memory systems and functions. The scan records brain activity patterns as each system or function is triggered. “We’re looking for patterns of brain activity, and particularly for the pattern differences between women who have memory problems and people who don’t,” Dr. Baxter explains. The scans are conducted using very advanced, non-invasive methods such as magnetic resonance imaging (MRI) that can reveal detailed structures and identify very subtle changes in brain activity patterns. “We assume that if memory problems are due to one particular memory system, we’ll see a certain type of brain activation pattern,” Dr. Baxter explains. Results from studies like Dr. Baxter’s—which delve deep into the normal aging process—may eventually help to keep women at their utmost performance level throughout their life. |
Dr. Leslie Baxter, Ph.D., is using novel imaging techniques to track brain activity patterns and identify those patterns that are unique to people who eventually develop Alzheimer’s disease.
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| Dr. Baxter and her colleagues are also involved in another promising imaging study: Developing a way to detect Alzheimer’s disease in patients before the onset of the disease. “Right now we don’t have a good idea of who those people are, so we have no way to target them for treatment or prevention therapies,” Dr. Baxter explains. But if people at high risk of developing Alzheimer’s disease can be identified early enough—before the disease is advanced—scientists will be better positioned to develop therapies that can slow the disease enough so that people can continue to live perfectly normal lives. “Remember, this is a disease of aging,” Dr. Baxter explains. “At some point, other health problems will eventually catch up to them. But if we can effectively delay the disease onset or progression, it becomes a null issue.” Such work holds the promise of keeping life’s fabric—memory—intact. |
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| INTERNATIONAL TEAM FINDS LINK BETWEEN BRAIN PROTEIN AND ALZHEIMER'S DISEASE Investigators at the Translational Genomics Research Institute (TGen) have announced a link between the brain protein KIBRA and Alzheimer’s disease—a discovery that could lead to promising new treatments. The new discovery builds on a previous TGen-led study published in the journal Science, which showed a genetic link between KIBRA and memory in healthy adults. In that study, healthy adults with the KIBRA gene performed better on memory tests than those without the gene. In the new study, TGen researchers found that carriers of a memory-enhancing flavor of the KIBRA gene had a 25 percent lower risk of developing Alzheimer’s disease. “This research suggests that KIBRA, and possibly some of the proteins with which it interacts, may play a role in Alzheimer’s disease,” said Matthew J. Huentelman, Ph.D., an investigator in TGen’s Neurogenomics Division and the study’s senior investigator. The critical difference found in KIBRA, a protein so named because it is commonly found in the kidneys and brain, was that those individuals with the T-allele gene were less likely to develop Alzheimer’s than those with the C-allele. Alleles are genetic markers (labeled as A, C, G, or T) that determine such inherited traits as eye and hair color, as well as susceptibility to disease. “We are now beginning to dig deeper regarding the genetic sequence of KIBRA in individuals carrying—and not carrying—the T-allele. We believe this variation causes a potential lifelong difference in the total levels of KIBRA in the brain, and that this may influence one’s risk for Alzheimer’s,” said Dr. Huentelman, who led a team that worked with several Arizona institutions, as well as other national and international universities and research organizations. According to Eric Reiman, M.D., clinical director of TGen’s Neurogenomics Division and executive director of Banner Alzheimer’s Institute and the Arizona Alzheimer’s Consortium, and who was a contributor to the study, “This study suggests a link between the inherited genes involved in normal human memory and the predisposition to Alzheimer’s disease. It provides promising new targets at which to aim new treatments to stave off Alzheimer’s and improve memory.” Dr. Huentelman’s team confirmed a link between KIBRA and Alzheimer’s in three different ways: |
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| Gene expression study results The gene expression study examined tissues from six regions of the brain among 47 deceased individuals. The brain tissue samples were provided by three Alzheimer’s disease centers: Washington University in St. Louis, Mo., Duke University in Durham, N.C., and Sun Health Research Institute in Sun City, Ariz. KIBRA and a subset of other molecules directly interacting with it were significantly altered in regions of the brain involved in Alzheimer’s disease pathology. The regions investigated included the hippocampus, entorhinal cortex, posterior cingulate cortex, middle temporal gyrus, and superior frontal gyrus. However, they were not altered in a region of the brain typically unaffected by the disease—the primary visual cortex. PET scan results PET scans of 69 carriers and 67 non-carriers of the KIBRA T-allele—all with close relatives diagnosed with AD—showed that non-carriers exhibited, on average, similar alterations in the metabolic activity of key brain regions known to be altered in the earliest stages of the disease. All 136 individuals were mentally normal, late-middle-aged Phoenix area volunteers solicited from newspaper advertisements. They ranged in age from 47 to 68, with an average age of 55. Scans showed that individuals without the KIBRA T-allele (those with only KIBRA C-alleles from their mother and father) had less metabolic brain activity when compared to those individuals carrying the T-allele (from either mother or father or both). These differences were found in the precuneus and posterior cingulate regions of the brain affected in the earliest stages of Alzheimer’s. Previous work led by Dr. Reiman illustrated a similar finding when individuals were grouped according to whether they carried the most powerful genetic indicator for Alzheimer’s—the epsilon 4 allelee of apolipoprotein E. In the current study, the effects of this allele were controlled for, yet similar observations were made. This suggests that KIBRA may play a role in a convergent biological risk pathway for the disease. |
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| BARROW SCIENTISTS WORK THEIR MAGIC |
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| Two neuroscientists at Barrow Neurological Institute at St. Joseph’s Hospital and Medical Center are turning magic tricks into science. Stephen Macknik, Ph.D., director of the Laboratory of Behavioral Neurophysiology, and Susana Martinez-Conde, Ph.D., director of the Laboratory of Visual Neuroscience, are working with world-famous magicians to discover the brain’s mechanisms underlying attention and awareness. The collaboration between the magicians and scientists in a recent study have led to new insights and may benefit the fields of education and medical rehabilitation by using magic techniques to help treat attention deficit hyperactivity disorder (ADHD), Alzheimer’s disease and brain trauma. “Magicians have developed powerful cognitive principles and intuitions about attention and awareness that are not understood scientifically,” says Dr. Martinez-Conde. “We’ve been able to learn more about cognition from magicians who have developed illusions that trick audiences.” The scientists have studied how magicians mix humor into their performances because a laughing audience is unable to pay attention to the magician’s hand. The study also determined that there are various levels of misdirection that magicians use to trick an audience. These insights, which were previously unknown to scientists, suggest that humor and misdirection can help manipulate levels of attention. The magicians working with Drs. Macknik and Martinez-Conde include James Randi (The Amazing Randi), Teller (of Penn & Teller), Apollo Robbins, Mac King and John Thomson (The Great Tomsoni). “The collaboration on this project has led to many exciting insights to help us understand the brain’s underlying cognition,” says Dr. Martinez-Conde. |
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| REGISTER NOW FOR DECEMBER 2008 CAREGIVER AND DIVERSITY CONFERENCE |
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| On December 6, Barrow Neurological Institute at St. Joseph’s Hospital and Medical Center will host its 4th annual Caregiver & Diversity Conference, designed to provide current information and practical solutions for people who care for loved ones with Alzheimer’s disease and other dementias. |
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| When: Where: Register: |
Saturday, December 6, 2008, 7:15 a.m. – 2:40 p.m. St. Joseph’s Hospital and Medical Center Leonard Goldman Auditorium Phoenix, AZ Download the registration form here (PDF), email lindsay.kerby@chw.edu, or call (602) 406-3067. Registration is $10. |