Risk of Developing Alzheimer’s Disease in Persons with MCI

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Presentation transcript:

Risk of Developing Alzheimer’s Disease in Persons with MCI Survival curve of persons characterized as having a mild cognitive impairment for 6 years. Approximately 80% have converted to dementia during this time. Peterson RC, et al., Arch Neurol. 58:1985-1992, 2001.

Volume of Hippocampus and Rate of Shrinkage Predicts Crossover from MCI to AD Normal, 75 years old Alzheimer’s disease, 75 years old De Leon MJ, 1999 Jack CR, et al, Neurology 55: 484-489, 2000

PET Imaging of Amyloid Deposits in Alzheimer’s Disease vs Normal Controls Figure 4. PIB standardized uptake value (SUV) images demonstrate a marked difference between PIB retention in Alzheimer's disease (AD) patients and healthy control (HC) subjects. PET images of a 67-year-old HC subject (left) and a 79-year-old AD patient (AD6; MMSE = 21; right). (top) SUV PIB images summed over 40 to 60 minutes; (bottom)18FDG rCMRglc images ( mol/min/100ml). The left column shows lack of PIB retention in the entire gray matter of the HC subject (top left) and normal 18FDG uptake (bottom left). Nonspecific PIB retention is seen in the white matter (top left). The right column shows high PIB retention in the frontal and temporoparietal cortices of the AD patient (top right) and a typical pattern of 18FDG hypometabolism present in the temporoparietal cortex (arrows; bottom right) along with preserved metabolic rate in the frontal cortex. PIB and 18FDG scans were obtained within 3 days of each other. PET imaging with a novel tracer, Pittsburgh Compound-B (PIB), can provide quantitative information on amyloid deposits in living subjects. Source: Klunk, et al. Ann Neurol 2004: 55:306-319.

Current Drug Treatments for AD Acetylcholinesterase inhibitors for mild to moderate AD Tacrine (Cognex) Denepezil (Aricept) Rivastigmine (Exelon) Galantamine (Reminyl) Neuroprotective agent for moderate to severe AD Memantine (Namenda)

Funded AD Prevention and Selected Treatment Trials April 2002

Complementary & Alternative Therapies for AD Ginkgo Evaluation of Memory (GEM) study Clinical trial of huperzine Traditional Asian medicines High intensity light therapy

REACH II Intervention Safety Social Support CR Problem Behaviors The REACH II intervention is a multi-component intervention designed to address five areas linked to caregiver risk profile: Safety Social Support CR Problem Behaviors Emotional well-being Self-care and Health Behaviors