Alzheimer’s disease

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Working first with mice and later with humans, Lee Goldstein of Boston University’s Alzheimer’s Disease Center made an extraordinary discovery several years ago. He found, in the lens of the eye, the toxic protein that triggers Alzheimer’s—the first time the disease has been detected outside the brain. The discovery could change forever the way the disease is diagnosed and treated.

Thanks to research like Goldstein’s, there is new hope for an early Alzheimer’s test—one that could be given to people in their forties or younger, long before noticeable symptoms appear. In the long term, this might prove to be a lifesaver, if people can be diagnosed and treated before the disease has inflicted its cruel damage.

Goldstein and members of his team are conducting clinical trials of a diagnostic procedure they hope will yield an inexpensive, non-invasive test that doctors can administer in their offices when patients come for routine physicals. (Learn more about Goldstein’s research, and other Alzheimer’s-related studies, in BU Research 2009 and the Summer 2009 issue of Campus & Alumni News.)

Goldstein’s research is just one of many projects at Boston University School of Medicine pushing the boundaries of knowledge into the deadly disease of Alzheimer’s.

Reason to hope

Alzheimer’s disease elicits fear. It is a relentless, fatal disease that often goes undiagnosed until it is well advanced and beyond treatment. It strikes otherwise healthy individuals when they are preparing to enjoy the rewards of a long and productive life.

But the day may not be far off when Alzheimer’s no longer sparks feelings of dread. At the Boston University School of Medicine’s world renowned Alzheimer’s Disease Center, scientists are discovering the causes of Alzheimer’s. They are learning how to diagnose and treat it—and how to prevent it.

“There is so much reason for hope,” says Dr. Robert Stern, co-director of the center’s clinical program and professor of neurology and neurosurgery. “The new trials for drugs that can change the course of the disease are very promising. If the next one doesn’t work, the one after that might.”

Attacking the disease

Researchers at Boston University School of Medicine are approaching Alzheimer’s on multiple fronts. Some are exploring the basic biology of the disease. They are learning what happens at the cellular and molecular levels when Alzheimer’s attacks the brain.

Other researchers are working with animal models, gaining an understanding of the genetics of the disease. These scientists are developing and testing drugs that have the potential to disrupt the progress of Alzheimer’s.

One of the most promising areas of research involves identifying biomarkers—a substance in the body that indicates the presence of the disease. Non-invasive testing with biomarkers opens the possibility of early diagnosis, which would allow treatment before Alzheimer’s has a chance to damage the brain.

Boston University School of Medicine also is a leader in developing effective care for patients in advanced stages of Alzheimer’s disease. Programs designed by the medical school now are used in hospitals, nursing homes, and specialized Alzheimer’s care centers around the world.

A history of achievement

Founded in 1996, the Alzheimer’s Disease Center at BU medical school is one of 31 special Alzheimer’s research centers in the United States funded by the National Institute on Aging.

“For more than a decade and a half we have built a solid foundation as a national leader in Alzheimer’s research,” says center Director Neil Kowall, a professor in neurology and pathology.

The federally funded Alzheimer’s centers, located at major research institutions around the country, are working collaboratively on sweeping research projects, which have the potential to alter scientists’ understanding of the disease and to point the way to a cure.

One major study is following 800 of individuals, some of whom have Alzheimer’s, others who have mild cognitive impairment, and others who are normal. Subjects are given regular brain scans, as well as blood and spinal fluid tests, to track the progress of the disease over many years. This project holds great promise for developing ways to diagnose Alzheimer’s at an early stage.

Researchers at Boston University’s Alzheimer’s Disease Center collaborate with the university’s famed Framingham Heart Study, which revolutionized modern medicine’s approach to cardiovascular health.  By following individuals and families in a Boston suburb over many generations, the Framingham Heart Study discovered how diet, smoking, and exercise affect the risk of heart disease. Researchers at the Framingham study and the Alzheimer’s Center now are identifying risk factors for Alzheimer’s—information that could prevent many cases in the future.

Care for patients—and caregivers

While the race for a cure continues, researchers at the medical school are exploring how best to care for those who already have the disease. Boston University School of Medicine has a long affiliation with the Veterans Administration’s health care system. In the early 1990s, the medical school developed a model of care for late stage Alzheimer’s patients residing at the VA hospital in Bedford, Massachusetts. This palliative approach, designed to keep patients safe and comfortable, became the model for VA hospitals around the country and has been adopted by many private institutions.

Working with patients and caregivers, researchers also are crafting new strategies designed to promote emotional and physical health of those who care for Alzheimer’s patients.

In today’s health care system, the task of detecting Alzheimer’s cases usually falls to primary care physicians. Many of these doctors lack specialized geriatric training. Boston University of Medicine offers special classes and training for primary care physicians to help them to identify the signs of Alzheimer’s.

Untangling a mystery: Alzheimer’s and CTE

While researchers are still trying to find the precise cause of the Alzheimer’s, they have identified two of the disease’s hallmarks. One is the accumulation of beta-amyloid proteins, which interfere with brain cell activity. The second is the abnormal tangling and clumping of the tau protein, which is essential for the healthy brain function. Both of these hallmarks have the potential to kill brain cells.

Researchers at the Alzheimer’s Disease Center are exploring these two important characteristics of the disease and how one affects the other. In their investigations, researchers have discovered important similarities between Alzheimer’s disease and Chronic Traumatic Encephalopathy, which is caused by blows to the head and affects athletes and war veterans.

Accumulation of the tau protein is a key characteristic of CTE, according to the findings of scientists at the Alzheimer’s center. Further investigation into the role of the tau protein promises to offer a clearer understanding how Alzheimer’s develops and how best to limit the damage of chronic brain injury.

Toward an end to Alzheimer’s

Alzheimer’s disease devastates individuals and families. With the aging of the population, it threatens to overwhelm the nation’s health care system. Our best hope for preventing, treating, and ultimately curing Alzheimer’s is research.

The National Institute on Aging funds much of the basic Alzheimer’s research at Boston University School of Medicine. But philanthropic support is essential if researchers are finally to unravel the complexities of the disease.

Private donations allow researchers to conduct so-called high risk-high reward experiments, which have a higher rate of failure but can yield great advances if successful. Some of the most important scientific discoveries in the past have resulted from such highly speculative projects.

Philanthropic support also allows the center to hire additional faculty researchers and to recruit more graduate students and post-doctoral fellows.

A donation supporting Alzheimer’s research at Boston University School of Medicine will bring us closer to effective treatment, prevention, and a cure.

Sample giving opportunities

  • Create and name an endowed professorship for the faculty of the program: $1.25 million for an assistant professor, $2.5 million for a full professor
  • Endow a research fund: $100,000
  • Endow a scholarship for a BUSM student: $100,000
  • Endow a postdoctoral fellowship: $100,000
  • Create a current-use fellowship award: $10,000
  • Provide unrestricted support as a member of the BUSM Dean’s Club: $1,500 and above