News & Events
Penn Memory Center News
Jason Karlawish, M.D., Associate Director of the Penn Memory Center, is quoted in the December 10, 2013 issue of Scientific American. The article, How Brain Scans Might Change the Way Doctors Diagnose Alzheimer’s, discusses the development over the past 10 years of sophisticated brain scans that can estimate the amount of plaque in the brain, and an upcoming clinical trial that will investigate whether giving an experimental drug as soon as the scans detect the formation of plaques can slow or halt the development of Alzheimer’s. That trial, the A4 Study, aims to screen 3,000 healthy senior citizens to identify 1,000 amyloid-positive individuals who will receive either a drug therapy for Alzheimer’s called solanezumab or a placebo for three years. The Penn Memory Center is one of the 60 sites where the study will take place. To read the full Scientific American article, click here.
The online issue of Neurology®, the medical journal of the American Academy of Neurology, reports that speaking a second language may delay the onset of certain types of dementias.
The study found that people who spoke two languages developed dementia four and a half years later than people who only spoke one language.
“Our study is the first to report an advantage of speaking two languages in people who are unable to read, suggesting that a person’s level of education is not a sufficient explanation for this difference,” said study author Suvarna Alladi, DM, with Nizam’s Institute of Medical Sciences in Hyderabad, India.
“Speaking more than one language is thought to lead to better development of the areas of the brain that handle executive functions and attention tasks, which may help protect from the onset of dementia.”
Read more at Neurology®.
More evidence is mounting that engaging in physical exercise leads to a healthier brain. At the Society for Neuroscience meeting currently underway in San Diego, researchers are reporting that “physical exercise can ease depression, slow age-related memory loss and prevent Parkinson-like symptoms.”
If you’re just playing Sudoku or challenging yourself with a crossword puzzle, you may not be doing enough.
“We definitely have more evidence for exercise,” said Teresa Liu-Ambrose of the University of British Columbia. Liu-Ambrose moderated a panel of scientists who presented studies showing that physical activity offers a wide range of brain benefits.
One reason exercise provides mental benefits may be that it actually requires the brain to do a lot of work, Robin Callister of the University of Newcastle said. The brain is coordinating complex movements when you go on a run, she said. Team sports or group exercises also activate parts of the brain devoted to social interactions.
Read more at NPR.
The 7th Annual Penn Memory Center Thank You Breakfast drew a full house to the Inn at Penn’s Woodlands Ballroom on Saturday, October 26, 2013. The annual invitation-only breakfast is held each year to thank research participants for their contribution to Penn’s Alzheimer’s disease research.
Over 200 research participants, their family members, guests and PMC staff gathered to enjoy a full breakfast buffet before hearing presentations on the latest updates in Alzheimer’s disease and the results of Alzheimer’s disease research done at the Penn Memory Center.
John Trojanowski, MD, PhD, Director of Penn’s Alzheimer’s Disease Core Center; Steven E. Arnold, MD, Director of the Penn Memory Center; Jason Karlawish, MD, Associate Director of the Penn Memory Center; and Felicia Greenfield, Associate Director for Clinical and Research Operations at the Penn Memory Center, presented the latest results from their research studies as well as updates on Penn Memory Center programs and upcoming research opportunities.
The presentations concluded with an open question and answer session. Guests’ questions ranged from the current and future state of Alzheimer’s disease research to the effects of antihistamines on memory.
The Food and Drug Administration approved a radioactive imaging chemical from General Electric to help screen patients for Alzheimer’s disease and dementia. The drug, Vizamyl, is an injection of radioactive material designed to highlight abnormal brain plaque in medical imaging scans.
Vizamyl works by binding to the plaque and creating images that show up on PET scans of the brain. A negative scan means there is little plaque and the cause of dementia is probably not Alzheimer’s, according to an FDA release. A positive scan means the patient has at least some plaque, but does not mean they definitely have Alzheimer’s.
The injection is intended as one tool to help physicians identify the cause of patient’s cognitive decline.
Read the full Associated Press article here.
A new study published in JAMA Neurology suggests that older adults who don’t sleep well have more brain beta-amyloid plaques, which can be indicators of Alzheimer’s disease.
The finding doesn’t prove that not getting enough sleep causes the build-up of beta-amyloid plaques and leads to dementia rather than the other way around. But, the study’s lead author, Adam Spira from the Johns Hopkins Bloomberg School of Public Health said, “It’s exciting that our findings … may point to sleep disturbance as something that can be a modifiable risk factor that can be leveraged to prevent Alzheimer’s disease.”
“We’ve known for a long time that people with Alzheimer’s disease have really disturbed sleep patterns,” Spira told Reuters Health. “People have wondered, well, is it possible that poor sleep is actually leading to cognitive decline?” In the new study, “We were able to look under the hood and see what’s going on in the brain,” he said.
Read the full Reuters Health article here.
The BBC reported on the discovery of a chemical that prevents the death of brain tissue. In tests on mice, the Medical Research Council Toxicology Unit at the University of Leicester showed brain cell death from prion disease could be prevented.
Researchers used a compound to prevent the natural defense mechanisms that are built into brain cells from kicking in when a virus attacks the brain cell. The study, published in Science Translational Medicine, showed mice with prion disease developed severe memory and movement problems. Mice given the compound showed no sign of brain tissue wasting.
Lead researcher Prof Giovanna Mallucci said of the mice: “They were absolutely fine, it was extraordinary. What’s really exciting is a compound has completely prevented neurodegeneration and that’s a first. This isn’t the compound you would use in people, but it means we can do it and it’s a start.” The compound did show signs of side effects including an impact on the pancreas; the treated mice developed a mild form of diabetes and lost weight.
Jason Karlawish, M.D., Associate Director of the Penn Memory Center, cautioned that studies done on mice don’t necessarily translate into benefits for humans.
“Many studies of treatments in mice have been spectacular, only to fail in man. So, this finding is a bend in the road, but not a turning point,” Dr. Karlawish said.
To read the full BBC report, click here.
The Robert Wood Johnson Foundation Human Capital Blog features a post written by Dr. Jason Karlawish, Associate Director of the Penn Memory Center, exploring personalized medicine for the seemingly healthy brain that is at risk for neurodegenerative dementias.
“Prescribe the right drug to the right patient at the right time” is not a new medical practice, but when a biomarker—that is, a measure of disease pathophysiology—or a gene makes this decision, that is a radically new medical practice. The promise of personalized medicine is that biomarker and gene driven algorithms will do much of the work of medicine. By predicting patients’ future health and the outcomes of an intervention, they will guide what doctors recommend to their patients. Like the theory of evidence-based medicine, personalized medicine promises a more objective, efficient and precise medical practice.
Read the full blog post here
A leading group of Alzheimer’s researchers contends that, as biomarkers to detect signals of the disease improve at providing clinically meaningful information, researchers will need guidance on how to constructively disclose test results and track how disclosure impacts both patients and the data collected in research studies. A survey conducted by a group including experts from the Perelman School of Medicine at the University of Pennsylvania found that a majority of Alzheimer’s researchers supported disclosure of results to study participants. The study is published online in Neurology.
“While this is not a call to immediately tell subjects their biomarker results, it does show that the field is moving to a point where experts want to share valid and meaningful results with participants,” said co-senior author Jason Karlawish, MD, professor of Medicine and Medical Ethics and Health Policy and Associate Director of the Penn Memory Center. “As we gain more data on the predictive abilities of these measurements, we will need models and methods to effectively reveal results.”
Alan J. Lerner, MD’s editorial, Amyloid imaging – the court of public opinion, in the same issue of Neurology, stated that “human amyloid imaging is one of the great recent
translational medicine stories.” Lerner found that important issues were raised by the study’s findings.
“Revision of research disclosure policies in an age of expanded information access has to be considered, but should be weighed against protecting participants from harm from worrisome but incomplete prognostic information,” Lerner wrote. “Lay people often do not understand the meaning or context of disclosed information, so simple disclosure of data needs to be fashioned into usable information. Disclosing results of amyloid imaging may require skills that current clinicians lack, ” he continued.
The University of Pennsylvania was the site for a Pennsylvania Alzheimer’s Disease Planning Committee hearing on Thursday, August 15. The committee heard more than 3 hours of testimony from politicians, researchers, caregivers, advocates, and others affected by Alzheimer’s disease.
Alzheimer’s disease accounts for 50 percent to 70 percent of cases of dementia, said Steven Arnold, who directs the Penn Memory Center. Other common types are vascular, frontotemporal, and Lewy body dementia. People with Parkinson’s disease often develop a form of dementia. Arnold emphasized that a host of risk factors for dementia – poor education, head injuries, smoking, alcoholism, obesity, heart disease – are preventable and would be good targets for public health campaigns.
Jason Karlawish, Associate Director of the Penn Memory Center focused on the financial problems of older people with cognitive problems, since they are easy targets for fraud and abuse. He said that the state should strengthen laws meant to protect adults from exploitation and that the financial services industry knows it is on the “front lines” of identifying people with dementia. “They’re bothered about this and they want guidance,” he said.
Read the full Philadelphia Inquirer article here
Cognitively normal adults who learn that they are at high risk for developing Alzheimer’s disease do not, as some clinicians fear, spiral downward into depression, anxiety, or distress, investigators reported at the Alzheimer’s Association International Conference 2013.
An analysis of data from three randomized trials testing the effects of genetic testing disclosure found that that cognitively normal adults who learned that they were homozygous for the high-risk apolipoprotein E epsilon-4 allele (APOE epsilon-4) had a spike in test-specific distress score until about 6 months after learning the results but returned to levels similar to those of heterozygous carriers, reported Dr. Jason Karlawish, Associate Director of the Penn Memory Center, and his colleagues.
“While there is no question that learning that you’re at higher risk causes some test-specific distress, this further validates that there is no long-term, sustained psychological distress,” Dr. Karlawish said in an interview with Clinical Neurology News. Read more here
As we age, time often seems to pass more quickly than when we were young. But is this just a cognitive illusion? Richard A. Friedman, a professor of clinical psychiatry and the director of the psycho-pharmacology clinic at the Weill Cornell Medical College explored the concept of how we perceive the passage of time in an opinion piece, Fast Time and the Aging Mind, in the July 20, 2013 New York Times. Our perception of time is influenced by many factors, he says, including emotions, attention, and memory. And if you want to slow down time, he says, become a student again and learn something new or that necessitates real effort. Read more here
Dr. Steven Arnold, Director of the Penn Memory Center and Dr. Gary Landreth, Professor of Neurosciences and Neurology and Director, Alzheimer’s Research Laboratory, Case Western
Reserve University School of Medicine, will be guests on USAgainstAlzheimer’s Alzheimer’s Talks “Could we treat Alzheimer’s with existing drugs?” teleconference on Wednesday, July 24 from 3:00 – 4:00 pm EST.
Dr. Arnold is conducting research into drug repurposing with a diabetes drug and Dr. Landreth is researching alternate uses for an existing cancer drug. They will be introduced by Dr. Guy Eakin, Vice President of Scientific Affairs at BrightFocus Foundation, a nonprofit which funds research to eradicate diseases of mind and sight, including some of this research.
Alzheimer’s Talks is a free monthly teleconference series to help individuals better understand Alzheimer’s. This call is made possible by the generous support of Emanuel J. Friedman Philanthropies.
To register for Alzheimer’s Talks click here
The Alzheimer’s Association’s 2013 Alzheimer’s disease Facts and Figures report explains that older African Americans are probably about twice as likely to have Alzheimer’s and other dementias as older Caucasians. A new study presented at the Alzheimer’s Association International Conference in Boston says socioeconomic disparities account for the high Alzheimer’s prevalence in African Americans.
The study at the University of California, San Francisco and the San Francisco Veterans Affairs Medical Center surveyed about 3,000 black and white elderly people over a 12 year period. Though the black participants seemed to show more of a propensity to develop dementia, the researchers found the difference was not statistically significant after adjusting for patients’ income levels.
Dr. Kristine Yaffe, who led the study, said in a statement that the findings suggest researchers should better control for socioeconomic factors in future studies about demographics of aging populations.
These findings come on the tail of other recent research showing no genetic differences explaining the disease’s racial disparity.
Read the full story at The Boston Globe
On July 9, the Senate Labor, Health and Human Services, and Education, and Related Agencies Appropriations Subcommittee approved a fiscal year 2014 bill that includes funding for the National Institutes of Health (NIH) and, more specifically, for Alzheimer’s disease. The bill states that, “Without a medical breakthrough to prevent, slow, or stop [Alzheimer's disease], the total payments for healthcare, long-term care, and hospice for people with Alzheimer’s and other dementias are projected to rise from $203 billion in 2013 to a staggering $1.2 trillion in 2050. This bill includes an $84 million increase for the National Institute on Aging, the NIH Institute with the primary responsibility for preventing, treating, and curing Alzheimer’s disease. The bill also includes $20 million for a new Alzheimer’s Disease Initiative that will strengthen dementia-capable long-term services and supports, assist caregivers of individuals with Alzheimer’s disease, and train healthcare providers on how to recognize the signs and symptoms of Alzheimer’s and manage the disease.”
The full Senate Appropriations Committee will meet on July 11 to review the bill. For more information on the bill, click here
In a June 24, 2013 article, “Before Night Falls: Alzheimer’s researchers seek a new approach,” The New Yorker interviews Reisa Sperling, MD, director of the Alzheimer’s clinical research center at Bringham and Women’s Hospital and Massachusetts General Hospital in Boston. The article outlines a new study, the Anti-Amyloid Treatment in Asymptomatic Alzheimer’s Disease Trial (or A4 Trial), which Dr. Sperling and Paul Aisen, MD, of the University of California, San Diego will jointly oversee. The study, funded by the National Institutes of Health, aims at targeting beta-amyloid plaques in patients with pre-clinical Alzheimer’s disease in order to slow the accumulation of these plaques in the brain, and the symptoms of Alzheimer’s, before they start.
Read full article here
On June 17, 2013 the U.S. Department of Health and Human Services (HHS) released the 2013 Alzheimer’s disease plan update. The initial “National Plan to Address Alzheimer’s Disease” was released in May 2012 under the 2011 National Alzheimer’s Project Act (NAPA). President Obama signed the National Alzheimer’s Project Act to support Alzheimer’s research and help individuals and families affected by Alzheimer’s disease. The National Plan to Address Alzheimer’s disease was developed by experts in Alzheimer’s disease and aging to discover techniques to prevent and treat Alzheimer’s disease by 2025, improve care for patients, enhance public awareness, and increase support for caregivers. The 2013 update to the National Plan highlights completed goals over the past year in addition to recommendations for additional action steps.
Highlights in the fight against Alzheimer’s disease this past year include the National Institutes of Health organized the Alzheimer’s Disease Research Summit in May 2012 to bring together national and international experts, researchers, and advocacy groups to develop suggestions on how to best advance research. Several new Alzheimer’s research projects were funded in areas including clinical trails, genetic sequencing, and development of new cellular models for Alzheimer’s disease. These projects can be reviewed in the 2011-2012 Alzheimer’s Disease Progress Report. The U.S. Department of Health and Human Services launched a website, www.alzheimers.gov, to spread public awareness and provide information and resources to people with Alzheimer’s and their caregivers. This website reached a wide audience, with more than 200,000 visits in the first ten months.
The 2013 update to the National Plan addresses the various challenges presented by Alzheimer’s disease and the update identifies actions to overcome these challenges. Specific additional actions recommended in the update include a cohesive Alzheimer’s disease training curriculum for primary care providers, assistance for families and communities affected by Alzheimer’s disease through legal services, and improvement in dementia services within state and local health networks.
This week, a strategic roadmap to help to the nation’s health care system cope with the impending public health crisis caused Alzheimer’s disease and related dementia will be published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. The plan aims to link the latest scientific findings with clinical care and bring together patients, families, scientists, pharmaceutical companies, regulatory agencies, and advocacy organizations behind a common set of prioritized goals. The consensus document is the outcome of a June meeting of leading Alzheimer’s researchers, advocates and clinicians, who gathered as part of the Marian S. Ware Alzheimer Program at the University of Pennsylvania.
Today, 5.4 million people are living with the disease, and more than 15 million Americans are caring for persons with Alzheimer’s and other dementias, according to the Alzheimer’s Association. Alzheimer’s disease is the sixth-leading cause of death in the United States and the only cause of death among the top 10 in the United States that cannot be prevented, cured, or even slowed.
“Alzheimer’s is an enormous and complex disease, and we believe that creative thinking, repurposing of existing funds, vigilance in reducing waste, and a constant focus on cost effectiveness will help make these recommendations a much-needed reality,” said John Trojanowski, MD, PhD, senior author and director of the Penn Alzheimer’s Disease Core Center.
“The diverse perspectives collected in this report provide constructive, ethical, cost-effective guidance for policymakers,” said second author Jason Karlawish, MD, associate director of the Penn Memory Center. “The recommendations serve as a clear roadmap to bring caregivers, researchers, clinicians, and advocacy groups together and provide them much-needed support now and in the future.”
Medical historians may be familiar with the story of Dr. William Beaumont, but Jason Karlawish, MD, casts it in a new light in his novel, Open Wound: The Tragic Obsession of Dr. William Beaumont. The story is fascinating on many levels, but it is Karlawish’s portrayal of Beaumont’s unstoppable, desperate, and almost dangerous ambition that takes center stage in this engaging historical account.
As the Alzheimer’s disease (AD) field moves closer to using genetic and biomarker data to identify people at risk, researchers are urgently trying to tackle whether and how to disclose that information to people in both routine clinical care and research settings. This past February, the Alzheimer Research Forum, an online scientific knowledge base for Alzheimer’s disease, published a detailed account of the issues involved and ongoing studies aimed at these goals. At the 2012 Alzheimer’s Association International Conference in Vancouver, three of the featured researchers updated attendees on their projects at a plenary session dedicated to the topic.
One topic of discussion at the AAIC session was the questions of whether it is psychologically harmful to divulge ApoE4 carrier status, which is associated with a higher risk of Alzheimer’s disease, to cognitively normal people. Jason Karlawish, MD, explored perhaps an even more contentious issue of whether doctors or researchers should reveal plaque status to cognitively normal people, as research on whether cognitively normal people with plaque progress to Alzheimer’s disease is at an earlier stage. “We have great concern that it may cause despair,” said Dr. Karlawish.