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Influential Discoveries on Alzheimer's in 2014

已有 142 次阅读2017-11-15 12:06 |个人分类:medicine



Influential Discoveries on Alzheimer's in 2014


Alzheimer’s Awareness Month: Influential Discoveries of 2014

http://blog.braininstitute.ca/alzheimers-awareness-monthinfluential-discoveries-2014/

By Bryan Jenkins, OBI Intern, Research Programs 

At the end of 2014, many of us – with the help of certain social media websites – were reflecting upon the past year of our lives. It was a big year for neuroscience and brain health, following from our proclaimed ‘Year of the Brain’. In this post for Alzheimer’s Awareness month we will reflect upon some of the most influential discoveries of 2014 related to Alzheimer’s research, and from this assess the current and future state of this ever-progressing field. If you’re interested in learning more about Alzheimer’s disease, tune in to the Facebook chat we are hosting with the Ontario Science Centre from 12:00-1:00 pm on January 20, 2015.

This past year, Roche Pharmaceuticals announced that they have developed a method to bring larger drugs – including many that target damage associated with Alzheimer’s disease – into the brain through the blood brain barrier: A network of blood vessels that regulates the flow of chemicals into and out of the brain. This barrier may be likened to a sentry standing guard against invaders. However, helpful drug compounds may be seen as potential invaders and thus a paradox exists.  While this barrier is there to keep the brain healthy, it may also prevent modern medicine from working. For this novel technique, scientists attached their drug of choice to a protein that naturally crosses the blood-brain-barrier, and were happy to report that their experimental drug was transported into the brain and had beneficial effects. Although successful treatment still depends on the effectiveness of the drug used, this new delivery method pioneered by Roche has provided a simple way around a common problem in clinical drug trials.

2014 saw the pharmaceutical industry abuzz with a variety of clinical trials for therapeutic compounds, all at different stages of testing. One discovery in the race to find a treatment for Alzheimer’s disease was the announcement that collaborating labs in Sweden have bioengineered stem cells to become neurons. Not really all that new, you say? Well, these cells have the EXACT same degeneration as that seen in Alzheimer’s disease. This discovery will allow for a variety of experimental Alzheimer’s drugs and drugs already on the market to be tested with ease.

Early-detection measures have also been on the forefront of the battle against Alzheimer’s disease in the past year. One of the most exciting discoveries of 2014 must have been the development of a new imaging technology that was able to accurately diagnose the occurrence of Alzheimer’s disease, based upon the amount of protein measured in ones’ retina. It was presented at the Alzheimer’s Association International Conference in July, and the authors claim that the technique is 100% effective at detecting cases 15-20 years before clinical diagnosis. The authors are now working to optimize the technology for clinical use. This new technique may allow for researchers to directly assess the influence of lifestyle on the development and progression of Alzheimer’s disease, which is an area that also received special interest this past year.

Scientists and healthcare professionals around the world concluded in 2014 that an active lifestyle can slow down or even prevent the progression of dementias and age-related cognitive disorders. In 2013, The Ontario Brain Institute produced a report examining the role of exercise in the prevention and management of Alzheimer’s disease. It showed that one out seven cases of Alzheimer’s could be prevented if everyone who is currently inactive were to become physically active. Based on the report OBI and its partners released the Physical activity and Alzheimer’s disease toolkit to encourage older adults to get active.

Taking a step back from individual discoveries of 2014, there was – and continues to be – a shift in the way that brain-health advocates are working: institutions around the world have really begun looking at new ways of collaborating to achieve a common goal.  Much like initiatives fostered by the OBI, many of these advancements mentioned above were born out of collaborations between a variety of institutions, research initiatives, and professional disciplines. This will be the future of science, where patient-care communities, clinicians, researchers, and industry professionals all work together and inform one another.

Advancements in the field of Alzheimer’s research made in 2014 cannot be mentioned without making note of the enormous contribution that patient advocacy and patient care groups have made and continue to make. Initiatives tackling brain health have been announced all around the world, from the BRAIN Initiative in the US to the Year of the Brain in Europe and prominent public figures are acknowledging the prevalence and impending social impact of an aging global population. Most importantly, efforts made by societies, associations, and organizations established around the world continue to improve the quality of life for individuals living with Alzheimer’s disease. Awareness campaigns like the Alzheimer’s Society: Walk for Memories raise financial contributions that fund areas of scientific research making advancements in our understanding of the disease as a whole. From this, clinicians and healthcare/industry professionals are able to turn these discoveries into tangible, reproducible, and marketable therapies. Dedicated individuals have proved and continue to prove that with innovation and cooperation, we can turn the tides on Alzheimer’s disease.

Physical activity protects us from losing brain function

http://blog.braininstitute.ca/physical-activity-protects-us-from-losing-brain-function/

By Shaalee Sone, Outreach Intern, Ontario Brain Institute

As our population ages, Canadians are looking for ways to prevent dementia. As of 2010, there are 136 000 Ontarians living with a confirmed diagnosis of dementia. In addition to the impact on individuals and their families, the direct cost to the Ontario health care system is eight times higher for an individual living with dementia than it is for the average Ontarian.

The most common form of dementia is Alzheimer’s disease, a progressive loss of brain function that causes memory impairment, changes in thinking and behaviour, and difficulty performing everyday activities. While drugs can treat the symptoms of Alzheimer’s disease, there is currently no cure.

A report by the Ontario Brain Institute (OBI) shows that more than one in seven cases of Alzheimer’s disease could be prevented by moderate physical activity.

“Age and genetics are two of the biggest known risk factors for Alzheimer’s disease,” says Chris Ardern, report co-author and an Associate Professor in the Faculty of Health at York University. “Unfortunately, those are two things we can’t change.  But there is evidence to show that other, modifiable lifestyle factors  things like tobacco use, diet and exercise  may contribute to the prevalence of Alzheimer’s disease and hold the key to minimizing its effects.”

OBI’s report, The Role of Physical Activity in the Prevention and Management of Alzheimer’s Disease – Implications for Ontario, builds on a 2008 review by the Cochrane Collaboration, compiling and analyzing new findings from nearly 50 international studies.

Perhaps most significantly, the OBI report suggests that as few as five 30-minute walks per week can prevent up to 16% of Alzheimer’s disease cases. This is a wake-up call – only 20% of Canadians currently meet the 150 minutes of exercise per week advised in the Canadian Physical Activity Guidelines. This report shows that in just two and a half hours every week, you can significantly improve your chances of maintaining a healthy brain into your old age.

“With our population of older adults growing rapidly in Ontario, these findings could have significant meaning for our health-care system and our caregivers,” says Michael Rotondi, report co-author and an Assistant Professor in the Faculty of Health at York University. “Estimates show that if even 20 per cent of inactive people took part in moderate physical activity, we could save up to $170 million in health-care costs and significantly reduce the burden of care required by people with Alzheimer’s disease.”

The report also shows that physical activity can contribute to managing Alzheimer’s disease symptoms by increasing a patient’s independence, improving their overall quality of life and effectively mitigating depression – a condition that is up to ten times more common in people with Alzheimer’s disease than in the general population.

“We know that lifestyle interventions can prevent one third of all cases of dementia, and we need to identify what other factors are critical so that we can help the other two thirds,” says Dr. Tom Mikkelsen, OBI’s President & Scientific Director. “Our ONDRI program is working to identify biomarkers in individuals living with Alzheimer’s disease and other forms of dementia earlier so that we can monitor the factors that influence their development and progression in order to develop new treatments.”

Ready to act on this advice?

OBI has also put together a toolkit to help you plan physical activity. In it you can learn the evidence-based benefits of physical activity for older adults, and get suggestions for how to include physical activity into your daily life and safety tips for being active. There is also a planning calendar to write down your physical activity goals and motivations. You can fill out a weekly calendar for planned activities, and get advice on what to do if your physical activity plans change.

Exercise as medicine

http://blog.braininstitute.ca/exercise-medicine/

As you leave the doctor’s office you look down at the prescription pad and notice that instead of a drug your doctor has prescribed a dose of… exercise? This should really come as no surprise considering that by combining all the benefits discussed previously, aerobic exercise acts like a ‘cocktail therapy’ to improve brain health. There is little doubt that a dose of exercise is foundational for brain health, but did you know exercise can also be used as medicine to prevent, treat or recover from several brain disorders? Here are some examples:

Epilepsy

Recent clinical data has revealed that exercise actually has a protective effect by limiting the number of seizures, and decreasing depression, anxiety, and improving overall quality of life. Despite this, many individuals afflicted with epilepsy tend to avoid physical activity and lead less active lifestyles because of an erroneous belief that being overly active may actually cause seizures. In the last decade, this attitude is beginning to change and a task force created by the International League Against Epilepsy (ILAE) has begun to develop strategies to encourage participation in physical activity and remove existing barriers to exercise.

Alzheimer’s disease

The recent knowledge synthesis report released by the OBI shows that being physically active for 150 minutes a week or more decreases the chances of an individual developing Alzheimer’s disease by nearly 40%. The same report also shows that even in individuals with early stage Alzheimer’s disease, physical activity protects against depression, allows the individual to be more independent i.e grooming, feeding and dressing, and improves the overall quality of life. Read a more in depth discussion of the report and the results here.

Depression

Exercise appears to improve depressive symptoms and elevate moods in people with a diagnosis of depression. The actual clinical evidence is building, but most people will agree that you feel better after moving around for a bit than you would just sitting on the couch.

Stroke

The potential benefits of utilizing exercise after stroke are impressive given the wide ranging benefits. This low cost and accessible activity helps with brain repair, improving physical and cognitive function, as well as improving heart and vascular health which lessens the risk of subsequent strokes. All together, exercise helps to restore the independence of the individual and maximizes rehabilitation.

Cerebral Palsy

Maintaining movement is major concern in children afflicted with cerebral palsy, particularly since problems with walking tend to increase with age. From a young age, efforts are being made to encourage children with cerebral palsy to become more active in their daily lives by participating in sports or other forms of movement-based activities. Read more about an innovative and interactive new gaming platform being used to get children with cerebral palsy moving.

ADHD

The benefits of exercise are especially pronounced in children where even 20 minutes of aerobic activity can improve focus and attention. For children diagnosed with attention deficit hyperactivity disorder  studies are currently exploring the possibility that aerobic exercise can lessen some of the behavioural challenges, improve focus and enhance concentration.

With thanks, great ideas contributed by:

Dr. Dale Corbett, University of Ottawa

Dr. Ricardo Arida, University of Sao Paulo

Dr. William McIlroy, University of Waterloo and Toronto Rehab

Astrid Balemans MSc, Leontien van Wely MSc, Annet Dallmeijer PhD and Jules Becher MD PhD. Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, EMGO Institute for Health and Care Research, VU University Medical Center


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