coping and caring with alzheimer's disease and dementia: your action group in action
TRANSCRIPT
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THE DEMENTIA TSUNAMI
Rotarians Providing a Clearinghouse of Information on Cutting Edge Research and Family Support
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Agenda
• Why Alzheimer’s disease as a focus?
• Organization of ADRAG
• Alzheimer’s basics and new findings
• How Rotary Members Can Help
Rotary-based Institutional Members (to-date):
• Coins for Alzheimer’s Research Trust – North Carolina
• Cure Alzheimer’s Fund – Boston, MA
• McCusker Alzheimer’s Research Foundation – Perth AUS
• Rotarians Easing the Pain of Dementia – England
• Alzheimer’s Disease International
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Alzheimer’s is a cruel disease.
• PERSON: it destroys one’s history, mind, memories, sense of self, personal dignity and ultimately, life.
• FAMILIES: It creates the devastating pain of watching a loved one deteriorate; financial and physical burden of caretaking; potential health collapse of caretaker and bankruptcy of family.
• SOCIETY: It decreases overall productivity of patients and families lost to caregiving; potential to bankrupt social service agencies (Medicare/Medicaid in US).
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Alzheimer’s Disease is the most common form of dementia in the elderly.
• Up to 80% of all Dementia is thought to be Alzheimer’s Disease.
• Up to ~50% of people over age 85 have AD of some kind. Approximately 12% of the persons over age 65 have Alzheimer’s
• Risk Factors:
• Current drugs (Aricept, Namenda, etc.) treat only the symptoms.
• Age • Family History • Gender • Head Injury
• Stress/Emotional Trauma/Loneliness • Stroke • Lack of deep sleep/
Sleep Apnea
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Disastrous Impact of Alzheimer’s in the United States
• 6 million victims in the USA
• 3.5+ million deaths from Alzheimer’s in USA in past 10 years
• >13+ million family members impacted
• >15+ million unpaid caregivers
• Approximately 44,000,000 worldwide have Alzheimer’s >>100,000,000+ by 2040
6 Date source: Alzheimer’s Disease International
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Alzheimer’s will disproportionately impact low and middle income countries, which are unprepared
to deal with the onslaught of dementia.
7 Date source: Alzheimer’s Disease International
0
20
40
60
80
100
120
2010 2020 2030 2040 2050
high income countries
low and middle income countries
Numbers of people with dementia (millions
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Alzheimer’s Disease
Leading Causes of Death in Perspective
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THE COST OF ALZHEIMER’S DISEASE IN U.S., 2015
Federal Government Costs for AD Care $171 billion
Total Medicare/Medicaid Budget $861 billion
NIH budget for AD research $600 million
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In addition to the toll taken on families, AD has a disastrous impact on Country Finances
GLOBALLY Approximately 44 million people have Alzheimer’s/related Dementia.
Cost of Alzheimer’s and dementia estimated to be $605 billion or 1% of the entire world’s gross domestic product.
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What is the new Alzheimer’s/Dementia Rotary Action Group, Inc.?
• Provide Rotarians updated information about medical developments, especially advances in research, and how to support them.
• Provide a forum for Rotary clubs to promote successful activities at the local level that address any form of dementia.
• Provide clubs that are looking to do something meaningful in this area to search a list of current effective club activities.
• Provide links to existing resources for patient’s families and caregivers.
• Source of co-funding for Alzheimer’s/Dementia Research
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CEO
Dave Clifton
Patient & Family Support
Bill Parker
Communications & Outreach
Greg Garofolo
Finance & Administration
Dee Lander
Research Coordination
Mike Curren
Strategic Planning Committee
Board of Directors
• Club Liaison • Project Generation • Project Monitoring • Web content for
P&FS
• Website Management
• Social Media • Club Communication • Conferences
• Bank Account • Accounting • Foundation Finance • Audit • Systems & Reporting
• Grant Selection • Grant Monitoring • Science Web
Content
Alzheimer’s/Dementia Rotary Action Group
Science Advisory Committee
Alzheimer’s/Dementia Rotary Action Group, Inc. Co-chairs: Jeffrey Morby and David Clifton
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Alzheimer’s/Dementia Rotary Action Group
• Approval by Rotary International: June, 2013
• Website: adrag.org
• Contribution information:
Minimum Contribution of $25.00 Online through the website or
Alzheimer's/Dementia Rotary Action Group, Inc. c/o Edgartown National Bank – Dee Lander, Treasurer P.O. Box 96, Edgartown, MA 02539
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Fund research with the highest probability of preventing, slowing or reversing
Alzheimer’s disease through venture-based philanthropy.
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“Plaques”
“Tangles”
Upon autopsy, Dr. Alzheimer described seeing “Plaques and Tangles” in the brain.
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• Amyloid-beta Tangles & Nerve Cell Death
• Tangles Spread from nerve cell to nerve cell
• Brain inflammation is activated- kills many more nerve cells!
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Tangles/Neuronal Loss Inflammation
b-Amyloid Pathology
CD33 HLA-DRB5 HLA-DRB1
MAPT GRN CHMP2B
VCP BIN1 SQSTM1
MS4A4A MS4A6E EPHA1
ABCA7 IGHV CR1
APP PSEN1 PSEN2 APOE CLU CD2AP
ATXN1 PICALM SORL1 ADAM10 CD33 ACE
TREM2 TREM1 TREM2L
?
Features of AD Pathology and some Associated Genes
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Taking Control of Alzheimer’s Through Research—
The Roadmap to Therapies
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Reducing Risk for Alzheimer’s
• PHYSICAL EXERCISE • At least 10,000 steps/day • Resistance training
• HEALTHY DIET - Mediterranean diet: Fruits/veggies/nuts, olive oil, less red meat, red wine.
• SUPPLEMENTS - Ashwagandha, cats claw
• SOCIAL ENGAGEMENT
• LEARN NEW THINGS - Better than brain games
• REDUCE EMOTIONAL STRESS and practice Meditation, Yoga
• GET EIGHT HOURS OF SLEEP PER NIGHT • Deep sleep consolidates memory: System back-up • Deep sleep clears debris from brain: “Mental floss”
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• In the 50 years since the discovery of the Polio vaccine, 1.5 million lives have been saved worldwide.
• If a cure for Alzheimer’s disease is found in this decade, 100 million lives will be saved over the next 50 years.
Come Join with us together to fight this horrible disease
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Introductions
Ms. Tiffany Ervin
Coins for Alzheimer’s Research Trust
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Coins for Alzheimer’s Research Trust (CART)
www.cartfund.org
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Coins for Alzheimer’s Research Trust (CART)
www.cartfund.org
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• CART is in the Carolinas, Georgia, Tennessee, Virginia and parts of Texas, Florida, Idaho, Alabama, and Kentucky •As of May 2015, 29 grants made totaling $5.2 Million •CART Fund by-laws require that 100% of all donated funds must go to AD Research
CART Today
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CART Brings Leverage
• 1999 Dr. Allan Levey received $100 K
- Research allowed $7.2 Million NIH Grant and a $25
Million Private Foundation Grant
• 2001 Dr. Gary Landreth received $250 K
- Research allowed $1 Million NIH Grant
- Findings allowed $200 Million follow-on Grant from
GlaxoSmithKline for drug trials
• 2009 Dr. Harry LeVine received $250 K
- Research allowed $22 Million NIH Grant
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2015 ROTARY INTERNATIONAL CONVENTION
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Who are we?
A network for Rotarians who believe that it is time to take direct action within our own communities to help support families who are coping alone with dementia.
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The plight of the Carer
Dementia impacts on so many lives!
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Memory Cafes
• Drop in sessions for people with dementia and their carers. • Volunteers organise entertainment and activities.
• Provides support for carers and the cared for.
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The Memory Box
Reminiscence is a very powerful tool for people with dementia.
Simple objects from the past can unlock memories and inspire
a precious moment of clarity
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Fidget Quilts
Simple, repetitive movements and sensory experiences become very soothing for people with late stage dementia
Using material with a variety of textures and extra accessories, fidget quilts provide comfort through the hands and eyes.
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Lend a Hand! !
Rotarians offer their expertise to local families caring for a loved one with dementia. • Help around the house • Gardening • Shopping • Taxi service • Advice on form filling • Sympathetic ear
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Forget-Me-Not Garden Project Rotary Clubs building community sensory gardens stocked with traditional
plants and garden tools.
Forget-Me-Not Gardens are designed to provide both a peaceful haven for carers and cared for, but also a chance to relax and reminiscence
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Rotary Club of Market Harborough
Bridging the Generations
Project
Pupils from Princes Risborough College Interact Club at
Forget Me Not Café with Past RIBI President John Minhinick
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A Dementia Friendly Community
Voluntary groups, businesses, traders,
emergency services, schools, transport workers, Doctors, community hospitals, libraries, councillors and faith groups, all
working together to improve the quality of life for people living with dementia in the
community
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Johan Vos
Deputy Executive Director
Rotarian (Rotary Club of London)
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About Alzheimer’s
Disease International (ADI)
• Established 1984
• The umbrella organisation of Alzheimer associations around the world
• 84 member associations
Aims to help establish and strengthen Alzheimer
associations throughout the world, and to raise global
awareness about Alzheimer's disease and all other
causes of dementia
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30 years of ADI
Three decades of global collaboration
• ADI established in October 1984, grown from
4 to over 80 member associations
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Strategic Plan
1. Making dementia a global public
health priority
2. Strengthening our member
associations
3. Raising awareness
4. Facilitating/encouraging research
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Why global advocacy?
• Big societal problem: affecting people,
families and societies
• Care for today
• Cure for tomorrow
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Estimated increase in dementia worldwide
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Dementia worldwide
2013 2030 2050
Asia Pacific 22 40 72
Europe 11 15 21
The Americas 9 16 30
Africa 3 5 12
44 76 135
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Dementia worldwide
US$604 billion in 2010
• Includes direct medical costs, direct non-medical costs and costs of informal (family) care
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*Includes grants, contracts, and other funding mechanisms used across the National Institutes of Health.
**Includes heart disease ($1.38), coronary heart disease ($457M), cardiovascular disease ($2.14B), and stroke
($337M).
Sources: MetLife Foundation; National Institutes of Health
While AD Is the Second-Most Feared Health Condition
in the US, it Remains Poorly Funded
% People Who Fear it Most Annual Public Research Funding ($billions)*
AD AD
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Advocate for dementia to be a global
health priority
• In consultative status with UN since August 2012
• Member of NGO committees on health, mental health and ageing
• Testified at UN meetings in New York and Geneva
• July 2014: review of NCD Summit – need to make clear steps to be taken to include AD and dementia
United Nations
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A report developed jointly by
World Health Organization
and
Alzheimer's Disease International
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Why dementia is a public health issue?
1. The world's population is ageing
The number of older persons has more than tripled since 1950; it will almost triple again by 2050
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2. High burden and daunting costs: A major cause of disability in later life – accounting for 11.9% of years lived with disability
3. Extreme impact on caregivers, families, and societies
4. Lack of awareness and understanding of dementia at some level by all – often considered normal part of ageing
Dementia: a public health issue
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Increase in numbers of people with dementia, by income group
And by region • Asia (46%) • Europe (31%) • Americas (16%) • Africa (7%)
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Country preparedness for dementia required
• Countries must include dementia on their public health agendas.
• Sustained action and
coordination is required across multiple levels and with all stakeholders – at international, national, regional and local levels.
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Dementia: call for action
Dr Margaret Chan, Director- General, WHO in the report's foreword:
• I call upon all stakeholders to make health and social care systems informed and responsive to this impending threat.
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G8 Summit on Dementia
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Envoy and Council
• World Dementia Envoy:
Dr Dennis Gillings
(Quintiles)
• World Dementia Council
• Agenda: 1) Finance
2) Research collaboration
3) Regulation and trials
4) Sharing knowledge
5) Health and Care
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Mobilising NGO community
Global Alzheimer’s and Dementia Action Alliance
• Formed as a response to G7 commitment to “enhance global efforts to reduce stigma, exclusion and fear”
• ADI secretariat • Aimed at international NGOs • Website:www.globaldementia
alliance.org • 14 members now • Launched at WHO World
Health Assembly in May 2014 • Meetings July 2014 and March
2015
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ADI reports
• Update global prevalence, incidence and cost data
• Will be launched at the beginning of September
• Women and Dementia report in June 2015
World Alzheimer Report 2015
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World Alzheimer’s Month
• September is World Alzheimer’s Month
• 21 September is World Alzheimer’s Day
• International campaign to raise awareness globally
• 2014 theme: Dementia: Can we reduce the risk?
www.alz.co.uk/world-alzheimers-month
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• New WHO ADI factsheet launched July 2014
• Reveals smoking can increase dementia risk by 45%
• 14% of dementia cases around the world potentially attributed to tobacco
• Urges governments to implement tobacco control measures and cessation services
Smoking and dementia
www.who.int/tobacco
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Follow ADI on Twitter
https://twitter.com/alzdisint
Like us on Facebook
https://www.facebook.com/alzheimersdi
seaseinternational
Visit our website
http://www.alz.co.uk/
Thank you!
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TITLE Diagnosis and Prevention of Alzheimer’s disease
Professor Ralph Martins AO
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Emerging trends in AD statistics
4.6 million new cases every year
The number of people with dementia is expected
to double every 20 years - 81.1million patients
by 2040
43% of cases need significant care (equivalent to a
nursing home)
Ronald Reagan
(actor/President)
Rita Hayworth (actress)
Lorinda Klaric Hazel Hawke
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$406
$471
$540
$604
$615
$924
$1340 GDP (Billion USD)
$96.4 Billion in direct costs related to medical
care (e.g. Hospital care, drugs, and
visits to clinics)
$255.7 Billion in direct social care costs from
formal services outside of the
medical care system (e.g. Home
care and transport)
$251.9 Billion in indirect costs (e.g. Unpaid care by
loved ones)
If Dementia were a Country, it would be the world’s 18th Largest Economy
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Future trends in AD BURDEN
“any actual delay in the onset of dementia as a result, for example, of
dementia research and medical breakthroughs would have a dramatic
impact on the future number of cases and the real costs of dementia.”
– Access Economics 2005 Dementia Estimates and Projections -
Within two decades dementia will be the third greatest source of
health and residential aged care spending
– approximately 1% of GDP –
Spending on dementia will surpass any
other
health condition by the 2060s
Delay of Onset 2020 2040
5 Months $1.3 Billion $6.6 Billion
5 Years $13.5 Billion $67.5 Billion
Alzheimer’s Australia Access Economics report “Keeping dementia front of mind”, 2009
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Alois Alzheimer Augusta D
Alzheimer’s Disease - Past
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Congophilic Amyloid Angiopathy Neurofibrillary Tangles
Amyloid Plaque
ALZHEIMER’S DISEASE – PATHOLOGY
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ROTARY STRATEGIC PLAN | 65
Beta Amyloid Protein (Aβ)
DAEFRHDSGYEVHHQKLVFFAEDVGSNKGAIIGLMVGGVVIAT
Aβ 1-40
Aβ 1-42
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ROTARY STRATEGIC PLAN | 66
Antibodies are made and bind beta amyloid in the blood promoting its
rapid degradation in the liver thereby facilitating greater e-flux of Beta
amyloid out of the brain (Peripheral sink effect)
A vaccine made
from Beta
Amyloid found
in the brain
plaques is
injected into the
mouse’s muscle
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ROTARY STRATEGIC PLAN | 67
IMMUNISATION with Ab42
Schenk D, Barbour R, Dunn W, et al. (1999) Immunization with amyloid-β attenuates
Alzheimer-disease-like pathology in the PDAPP mouse. Nature, 400: 173-177.
Vaccinated Unvaccinated
Sections of Mouse Brain
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ROTARY STRATEGIC PLAN | 68
Normal Brain Alzheimer Brain
Brain - Gross Anatomy
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ROTARY STRATEGIC PLAN | 69
Beta Amyloid
Changes in Hormone Levels: Oestrogen, Testosterone, Luteinizing
Hormone, Insulin
Defective Genes: Mutations in APP, PS1, PS2 < 3% of Cases
Lifestyle Factors: High Fat Diet,
Lack of Exercise
Genetic Risk Factors: APOE E4 > 50% of Cases
Responsible for >90% of all AD cases
Responsible for <3% of all AD cases
Interacts
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ROTARY STRATEGIC PLAN | 70 Translating dementia research into practice
The Australian Imaging Biomarkers and Lifestyle Flagship Study of Ageing
Study is conducted between Perth (40%) and Melbourne (60%)
CSIRO P-Health* University of Melbourne*
Neurosciences Australia Ltd (NSA)* Edith Cowan University (ECU)*
Mental Health Research Institute (MHRI)* National Ageing Research Institute (NARI)
Austin Health University of WA (UWA)
CogState Ltd. Charles Gairdner Hospital radiology and nuclear medicine
*denotes signatories to the AIBL study contract
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ROTARY STRATEGIC PLAN | 71
• Launched in November 2006; prospective longitudinal
study
• Aims to improve understanding of the causes and
diagnosis of AD, and help develop preventative strategies
Baseline 36 month 54 month 72 month Follow-up: 18 month
Current Status
The AIBL Study
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ROTARY STRATEGIC PLAN | 72
29%64%
98%
HC MCI AD
PiB +ve or
“AD-like”
PiB - ve or
“HC-like”
29%64%
98%
HC MCI AD
PiB +ve or
“AD-like”
PiB - ve or
“HC-like”
Significant differences between the three groups (p<0.001)
Percentage of PiB + volunteers
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ROTARY STRATEGIC PLAN | 73
Healthy controls: ApoE ε4 differences
In the HC subgroup, 49% of HC ApoE4+ were PiB+ve, compared to 21% of the HC ApoE4-ve group.
PiB +ve or “AD-like”
PiB -ve or “HC-like”
ε4+ ε4-
49%
21%
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ROTARY STRATEGIC PLAN | 74
PiB SUVR cut-point 1.5
3 year clinical progression
HC (n=194)
6% 20% *
to MCI/AD to MCI/AD
Negative Ab Positive Ab
(n=134) (n=60)
Hazard Ratio 3.6 (OR 4)
*
MCI (n=92)
7% 66% *
to AD to AD
Negative Ab Positive Ab
(n=28) (n=64)
Hazard Ratio 11 (OR 25)
*
(p= 0.016) (p< 0.0001)
Corrected for age, gender, education
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ROTARY STRATEGIC PLAN | 75
Ne
oco
rtic
al S
UV
Rcb
HC
-
MCI
+
AD
MCI-
HC+
*
1.0
1.5
2.0
2.5
3.0
Time (years)
Mean SUVR AD+
(2.33)
19.2 yr (95%CI 17-23 yrs)
Mean SUVR HC-
(1.17) 12.0 yr
(95%CI 10-15 yrs)
0 10 20 30 40
0.043 SUVR/yr (95%CI 0.037-0.049 SUVR/yr)
The natural history of Ab deposition
in sporadic AD
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ROTARY STRATEGIC PLAN | 76
610 research groups granted access to AIBL@LONI through ADNI website
Includes access granted to the following companies:
Abbott Labs, Abiant, ADM diagnostics, Astra Zeneca, Avid, BioClinica, Biogen Idec, Bristol-Myers Squibb, Cogstate Cytokinetics, Eisai, Elan, Eli Lilly, GE Health Care, General Resonance, Genetech, Imorphics, Iris Biotechnologies, Janssen, Johnson Johnson, M and M Scientific, Merck & Co, Mimvista, Pentara Corp, Pfizer, Philips, Predixion software, Rancho Biosciences, Servier, Siemens, Soft team solutions, UCB, United Biosource Corp.
Canada USA Colombia Mexico Cuba Argentina
Belgium Netherlands Switzerland Poland Algeria Egypt Bulgaria Israel Turkey
China Taiwan Japan Hong Kong Korea Australia New Zealand
Finland Sweden
Denmark UK Ireland Germany France Spain Italy
India Pakistan Saudi Arabia Iran
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Blood and Eye Biomarkers
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ROTARY STRATEGIC PLAN | 78
Correlation With Brain Amyloid
ApoJ
r2= 0.53
p<0.0001
r2= 0.48
p<0.0001
r2= 0.24
p<0.0001
Antithrombin III intensity (isoform B:Aß) apoJ intensity (isoform E:Aß) Serum amyloid P (isoform B)
Discovery/Qualification
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Retinal amyloid fluorescence imaging For Early Detection and Monitoring of Alzheimer’s Disease
Shaun Frost | PhD
15 July 2015
Nothing to Disclose Funders: Janssen Research & Development, LLC and NeuroVision Imaging, LLC
PREVENTATIVE HEALTH FLAGSHIP
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ROTARY STRATEGIC PLAN | 80
Retinal amyloid fluorescence imaging
Masuda et al. Bioorg Med
Chem. 2011 Proprietary curcumin formulation with
scientifically tested and defined
chemical content and high-
bioavailability.
NeuroVision Imaging
Los Angeles, CA
Retinal amyloid fluorescence imaging | Shaun Frost
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ROTARY STRATEGIC PLAN | 81
HC-
HC-
HC+
HC-
HC-
AD+
HC-HC-
AD+
HC-
HC-
HC+
AD+
AD+AD+
HC-
HC+
HC+
AD+
AD+
AD+
HC+
HC-
HC+
MCI+
MCI-
MCI+HC+
HC+
MCI-MCI-
MCI+
HC+
MCI+
MCI-
MCI+
MCI+
MCI+
HC+
R² = 0.586
0.5
1.0
1.5
2.0
2.5
3.0
3.5
0.5 1 1.5 2 2.5 3 3.5
Re
tin
al A
myl
oid
Ind
ex
Brain Neocortical SUVR
p < 0.0001
Results
No False Negatives
Retinal amyloid fluorescence imaging | Shaun Frost
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Lifestyle Factors in Alzheimer’s
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ROTARY STRATEGIC PLAN | 83
Lifestyle Programme
Aim: Identification of lifestyle and dietary modifications which prevent or delay onset of AD
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ROTARY STRATEGIC PLAN | 84
HC > AD*
Fortified Wine Capsicum
White Wine Lettuce
Red Wine Avocado
Light Beer Spinach
Other Spirits Broccoli
Vegemite Yoghurt
Tofu Muesli
Nuts
AD > HC*
Sausages Ice Cream
Ham Margarine
Meat Pies
Cornflakes
Bran flakes
Tinned Fruit
Chips
Full Cream Milk
*Student’s unpaired t-test, p<0.05
Controlling for BMI, country of birth, gender, age and APOE allele status.
Food and Beverage Consumption: Classification Differences
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ROTARY STRATEGIC PLAN | 85
Dietary patterns and Alzheimer’s disease
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ROTARY STRATEGIC PLAN | 86
Constructed using an ‘a priori’ method • High intake of fruit and vegetables • Moderate to high fish intake • Moderate to high cereal intake • High unsaturated fatty acids • Low saturated fatty acids • Low to moderate dairy product intake • Low meat and poultry intake • Regular but moderate alcohol intake
Mediterranean Diet (MeDi)
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ROTARY STRATEGIC PLAN | 87
Adherence to a healthy dietary pattern is important for reducing
risk of cognitive decline
EXECUTIVE and VISUOSPATIAL
function strongly impacted
Influence of genotype
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ROTARY STRATEGIC PLAN | 88
Proposed Combination Nutritional
Supplement Therapies (varying mechanisms of action)
Normal Pathway
Amyloidogenic Pathway
Ab40/42 C99 (b-CTF)
sAPP-b
C83 (a-CTF)
sAPP-a
BACE
a-secretase
g-secretase
APP
N
C
Small Ab aggregates (Oligomers)
Amyloid Plaques
EGCG
Pomegranate Curcumin
Resveratrol
↓ Cognition
Lipoic acid
DHA
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ROTARY STRATEGIC PLAN | 89
Physical activity data
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ROTARY STRATEGIC PLAN | 90
General Benefits of Physical Activity
• Benefits of regular physical activity;
• Prevents cardiovascular disease
• Increases function and independence
• Reduces body weight
• Alleviation of depression
• MAINTAINS A HEALTHY BRAIN
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ROTARY STRATEGIC PLAN | 91
Physical Activity and Brain Amyloid
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Clinical Trials
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ROTARY STRATEGIC PLAN | 93
Sex Hormone Levels and Ageing
Age Group
Ho
rmo
ne L
evels
Luteinizing
Hormone
Testosterone
Oestrogen
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ROTARY STRATEGIC PLAN | 94
Relationship between Testosterone and Plasma Aβ40 Levels
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ROTARY STRATEGIC PLAN | 95
Androgen regulation of Ab accumulation
Testosterone treatment lowers
CSF Aβ levels in a castrated
Guinea pig Model Wahjoepramono et al. (2008) J. Alz.
Disease.
subiculum
7 mo Sham 7 mo GDX +DHT 7 mo GDX
Androgens regulate Ab accumulation in 3xTg-AD mice Rosario et al. (2006) J
Neurosci
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ROTARY STRATEGIC PLAN | 96
Aβ
TESTOSTERONE: Reducing Aβ load
Direct Effect on
Aβ production
Indirect Effect on
Aβ production
LH
Enhancing Aβ
Clearance
Insulin
Resistance Neprilysin Activity
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ROTARY STRATEGIC PLAN | 97
Guinea Pigs Fed a Green Tea or Fish Oil Diet with High-Cholesterol
• 60 male GPs aged 8-10 wk (600 g) placed on a high-cholesterol diet +/- nutritional intervention for 8 weeks.
• Diets had the same macronutrient composition and cholesterol content (0.25%).
Green Tea group
– 50 mg/Kg B.W. Polyphenon 60
– 20 mg/Kg B.W. Piperine
Fish Oil group
– 50 mg/Kg B.W. DHA-enriched fish oil.
– DHA content ~40%
Values are mean SEM. Data was analysed with a one-way
ANOVA. * P < 0.05 vs. Control group, F(1,47) = 11.194,
p=.000
n=16 n=19 n=19
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
Control Green Tea Fish Oil S
eru
m C
ho
les
tero
l (m
mo
l/L
)
*
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ROTARY STRATEGIC PLAN | 98
CSF and Brain Aβ40 Levels
0
5
10
15
20
25
Cortex Hippocampus Cerebellum
Aβ
40
ng
/ g
ram
we
t
tissu
e
n=13 n=16 n=19
3.0
3.2
3.4
3.6
3.8
4.0
4.2
4.4
Control Green Tea Fish Oil
CS
F A
β4
0 (
ng
/ml)
Control Green tea Fish Oil
Values are mean SEM. Data was analysed with a one-way ANOVA. * P < 0.05 vs. Control group
* *
*
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ROTARY STRATEGIC PLAN | 99
200 PiB positive men,
Aged 60 years or over
Placebo injection
+ Placebo capsule
(n=40)
Testosterone injection
+ Placebo capsule
(n=80)
Testosterone injection
+ DHA capsule
(n=80)
Testosterone + DHA Clinical Trial
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ROTARY STRATEGIC PLAN | 100
Curcumin and Alzheimer’s disease
Turmeric Plants in
India
Turmeric
Roots
Fresh Turmeric
Root
• Curcumin, active ingredient of the Indian curry spice Turmeric.
• Curcumin has shown promise as a neuroprotective agent in the
prevention of Alzheimer’s disease.
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ROTARY STRATEGIC PLAN | 101
• Crosses the blood brain barrier and inhibits the formation of
Aβ
oligomers and fibrils, binds Aβ plaques (Ono et al, 2006;
Park et
al, 2008; Yang et al, 2005).
• Epidemiological studies have suggested curcumin is
protective
against cognitive decline (Ng et al, 2006).
• Clinically safe; no adverse effects reported with doses of up
to
8000 mg/day (Baum et al, 2007; Benny et al, 2009).
Curcumin as “Curecumin”
Plaque burden ↓33% Beta amyloid levels ↓85%
Aged Tg2576 mice with advanced amyloid accumulation, fed curcumin for 6 months (Yang et al, 2005).
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ROTARY STRATEGIC PLAN | 102
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ROTARY STRATEGIC PLAN | 103
Beta Amyloid
Factors Promoting Aβ Reduction
Recipe for lowering the risk of Alzheimer’s Disease
A Nutritional Diet
Physical Activity
Mental Stimulation
Social Engagement
Hormone Therapy
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ROTARY STRATEGIC PLAN | 104
World Alzheimer’s Month
• September is World Alzheimer’s Month
• 21 September is World Alzheimer’s Day
• International campaign to raise awareness globally
• 2014 theme: Dementia: Can we reduce the risk?
www.alz.co.uk/world-alzheimers-month
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ROTARY STRATEGIC PLAN | 105
Understanding Alzheimer’s
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ROTARY STRATEGIC PLAN | 106
Alzheimer’s book
Chapters on diagnosis, genetics and modifiable risk factors.
A description of the important roles of diet, physical activity and mental exercise.
Current and potential future treatments for Alzheimer’s disease.
Caring for someone with dementia
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McCusker Alzheimer’s Research Team
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ROTARY STRATEGIC PLAN | 109
Telephone: 877-669-3239 Access Code: 665 253 262
McCusker Alzheimer’s Research Foundation Edith Cowan University
Sir James and Malcolm
McCusker