When former president Ronald Reagan announced his affliction with Alzheimer's disease in November 1994, he de-stigmatized an oft-neglected disease and provided momentum for research for years to come.
In the early days of research, Duke University scientists competed to score the next major breakthrough, but a greater sense of collaboration now unites them. Using newly-developed genetic tools, scientists hope to find a reliable bio-marker that would enable early detection of Alzheimer's within the next two to three years.
In the meantime at Duke, a multifaceted approach to research focuses on three important phases of disease. The theory is to attack the disease from three angles: recognizing susceptibility, detecting the disease early and delaying its symptoms. Duke, with its cutting-edge research, is at the forefront of the field.
"In genetics, we are probably amongst the best, if not the best--same thing for neuro-imaging. [In regards to] treatment, a number of places have expertise, and we are one of them," said Murali Doraiswamy, associate professor of psychiatry and a lead investigator on several Alzheimer's studies.
Currently, Alzheimer's disease--a degenerative illness that steals both the mind and the body--is treated by delaying the onset of symptoms with drugs and improving the overall health of the body, allowing the patient to project the illusion of being asymptomatic for as long as possible.
Duke researchers, however, are not satisfied with current therapies and are leading the way in developing treatments and diagnostic tools for detection and postponement of Alzheimer's symptoms.
Margaret Pericak-Vance, James B. Duke professor of medicine and director of the Center for Human Genetics, studies the relationship between genes and the disease--she already had a major breakthrough in 1993 when she discovered apolipoprotein E, a protein that, when over-expressed, can interfere with the brain's ability to function. She is currently leading research to identify new related genes.
With no concrete idea of how Alzheimer's can be cured, however, researchers are trying a variety of other options ranging from developing a vaccine to testing the effectiveness of different drugs.
Many Alzheimer's patients do everything they can to aid in these studies--some people even participate in drug and treatment trials even though the data will most likely not be applied until the next generation.
Hoping to have a direct impact on the future treatment plans, Doraiswamy is involved with a number of treatment trials that look to find ways to diagnose Alzheimer's in older, non-afflicted individuals.
These researchers are working to develop a new type of brain MRI scan to catch the illness in the very early stages. They hope to provide a detection tool analogous to the treadmill for heart disease. A scan would show early markers that allow doctors to screen patients with high risk more regularly. If the disease is caught early, drugs can delay symptoms.
University scientists are even experimenting with improving these drugs. Dr. Donald Schmechel, professor of medicine and director of the Joseph and Kathleen Bryan Alzheimer's Disease Research Center, is researching risk factors for Alzheimer's associated with a high-cholesterol diet.
Alzheimer's affects almost half of the American population older than 85 and is the leading cause of dementia. This degeneration is especially noticeable when occurring in figures in the public eye.
"One of the saddest thing about Alzheimer's is that people gradually lose the ability to express oneself," said Lisa Gwyther, education director at the Bryan ADRC, noting Reagan's reputation as a powerful orator. "[Reagan's strength] mobilized people to recognize Alzheimer's as a public health problem, not an individual issue. We need to find an answer to this because so many people will be affected in the future."
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