Research key to Alzheimer’s fight

Earlier this month, the Obama administration pledged to push for approximately $156 million in increased funding for Alzheimer’s research. The move is part of the administration’s development of the first National Alzheimer’s Plan, to combine research toward better treatments – the goal is to have some by 2025 – along with steps to help overwhelmed families better cope today.

This is a most timely investment. In a recent survey, Alzheimer’s disease came out as the second-most feared disease behind cancer. And while all chronic diseases exact a toll on families, arguably Alzheimer’s and related dementia conditions have the greatest impact.

According to the Alzheimer’s Association, the current NIH investment in Alzheimer’s research of approximately $500 million pales in comparison with funding for other major diseases such as AIDS ($3 billion), heart disease ($4.4 billion) and cancer ($5.8 billion).

Most of the increased funding for Alzheimer’s research is expected to go to support early disease detection and treatment. That is a sound strategy. Currently, Alzheimer’s is not detected until the disease has progressed, and no medicines on the market can stop or reverse the decline in memory and everyday function.

There are, however, promising initiatives that are being investigated by researchers, including several that have been developed at Washington State University. For example, Professors Joe Harding and Jay Wright have developed compounds that have restored neural connections to the hippocampus that are destroyed by dementia in animal models. These drugs involve angiotensin, a peptide normally involved in regulating blood pressure.

This work is ripe for funding so it can reach the next step of toxicity trials and human testing.

Other work at WSU would undoubtedly also benefit from additional Alzheimer’s research funding. This includes work by Diane Cook and Maureen Schmitter-Edgecombe, who focus on creating “smart environments,” which can monitor and detect functioning in persons with dementia and can be modified to support them so they can live independently for as long as possible.

While most of the increased funding understandably would support the science of Alzheimer’s research and drug discovery, it was most gratifying also to see an acknowledgment that families and caregivers need help coping with the Alzheimer avalanche.

Schmitter-Edgecombe and I, with funding from the Alzheimer’s Association, are currently conducting a three-year study in Eastern Washington to implement and test an education and support intervention that we developed. It combines memory support tools for persons with mild cognitive impairment (MCI) with education and social connections for individuals with MCI and their care partners.

The memory tools are designed to help persons with fading memories function better in their everyday lives, with external aids, technological prompts and problem-solving strategies.

The main cognitive remediation tool is a memory notebook that consists of a daily log section, including an hourly log and to-do-today list. During each session, individuals with MCI and their care partner (a “care-dyad”) learn new strategies for using the memory notebook and develop plans for implementing the strategies into their everyday lives. The goal of the new strategies is to help patients maintain independence for as long as possible and to increase positive quality-of-life behaviors.

Education and support is provided in a multifamily group format that brings together a number of MCI patients and their care partners. This approach was adapted from previous successful research on schizophrenia and traumatic brain injury. The multifamily group is led by two clinicians who understand dementia and its practical day-to-day management, both from the perspective of the person with the disability and that of the spouse or other family caregiver. The clinicians also are educators and facilitate the development of a social network where families learn to solve practical problems from one another.

The early results from this work are extremely promising both for people with MCI and their care partners.

With at least some of the additional federal research funding directed toward the implementation of caregiver support systems, there is reason to be hopeful about our ability both to find cures and to help caregivers cope with the very human day-to-day struggles that are an intrinsic part of dealing with Alzheimer’s disease.