Drug Halts Decline In Alzheimer's Patients

ljw1004 writes "Alzheimer's researchers are divided on whether the disease is caused by 'beta amyloid' (a peptide found in Alzheimer brains) or by 'tau protein' (normally used for cellular scaffolding, but can aggregate out of control and destroy neurons). Today in Chicago a new drug has been announced that stops tau aggregation and appears to have halted Alzheimer's-related decline in 300 clinical trial patients. The drug is known as 'rember.' Do you have friends or family who appear to be on the road to dementia? Here is an online questionnaire, part of one used in the clinical trial to diagnose dementia. (Disclosure: I made the online questionnaire, and my father is one of the scientists behind the drug.)"

Comments

Rember

[StarfishOne]

"The drug is known as 'rember.' "

Is that a deliberate pun on 'remember'? :?

Re:Rember

[Nasajin]

I imagine they started writing remember, but forgot how far they'd gotten when committing it to paper.

Re:Rember

[StarfishOne]

For clarity and completeness I should add:

This is awesome news. My grandfather is suffering from an advanced state of this disease and it's horrible to see in what state he currently 'lives'.

He does not recognize me, or my brothers, or my parents (inc. his own son!).

Perhaps my first post (parent) sounded like I did not take this seriously. I guess it's more of a coping mechanism that got in action.

To all the scientists: please keep up this wonderful work! It'll probably be too late for my grandfather, but no-one should have to suffer like.

I hope that it won't be long before it helps to save many lives from being destroyed.

Re:Rember

[blahplusplus]

"He does not recognize me, or my brothers, or my parents (inc. his own son!)."

This just goes to show us how important our memory systems are in our intelligence and what an important role it plays in our lives.

Re:Rember

[Anonymous Coward]

On the list of things that should be remembered, I'd hope that "me" would be pretty high.

Re:Rember

[Anonymous Coward]

And I thought that it was bad that drug companies could direct market to people on tv. Now they've infiltrated /.

Re:Rember

[Smallpond]

Unless you recently fired a bunch of US Attorneys, in which case losing your memory can be extraordinarily helpful.

Re:Rember

[pitje]

you mean it's horrible for you to see how he's doing. He's probably past the stage where he knows that 'there is something wrong'.
That's the stage I had the most problems with when my grandfather had Alzheimers'.
When he got to the stage where he thought he was a little boy again, he was much more cheerful. Again, for the family it was no pleasure to see that, but he had the time of his life :)

Re:Rember

[the eric conspiracy]

That's probably the real reason Fermat never finished his last theorem.

Re:Rember

[Anonymous Coward]

suppose it could have been worse. When I get a bit frazzled I tend to repeat myself. We could of ended up with remememememember.

Re:Rember

[elrous0]

Shit, too late for me. And who are you people?

Re:Rember

[Anonymous Coward]

I don't mean to hurt your feelings, but I do work in health care, on a Memory Care Unit, specifically. The MCU is designed for people with many forms of dementia, our most common diagnosis being Alzheimer's. I am sure you know many of the ugly symptoms of this disease. Confusion, loss of memory, loss of fine motor skills, deteriorating ability to perform activities of daily living, eventual death, etc. This drug may sound like a godsend, but think about it for a moment.

If your loved one breaks down crying several times a day because he or she can't tell where everyone is or where they are, if he goes into violent rages because he thinks he is being held against his will, if he lives in a constant state of fear because he knows something is wrong but he can't figure out what it is, if he tries day after day to go home but his captors refuse to et him go, causing him to fear for his life... do you really want a drug that will keep him in that state, somewhat permanently?

At best, wait until the affected person progresses to a state of Alzheimer's that is more comfortable for him or her -- around stage 5 (out of 7 total) people forget that something is wrong and they happily live their lives in total confusion. Then start the drug therapy. But stalling people's progress in a state that makes them absolutely miserable is not a miracle drug's miracle cure. It's torture.

Check out http://www.iatbdementiacare.com/index2.html I worked with the guy who runs the site and wrote the book on Dementia Possible Care. He is crazy insightful and smart when it comes to caring for people with Alzheimer's. Trust me, the $20 for the book will serve you tremendously.

Re:Rember

[JamesP]

"The drug is known as 'rember.' "

Too bad even though it stops Alzheimers, it causes dyslexia...

Re:Rember

[Brandano]

Unless you are talking about Windows

Re:Rember

[StarfishOne]

He's probably past the stage where he knows that 'there is something wrong'.

First of all I understand completely what you're saying and to a certain extend that is true.

But on the other side, his body is starting to fail and he is suffering from that. "Gradually, minor and major bodily functions are lost" as Wikipedia describes it.

It's getting somewhat better now, but recently he could barely breath, general pain all over his body and basically unable to swallow, combined with a cough he developed. He could not even eat Apple mush when helped.

Every now and then he has a 'good moment' and suddenly he can say more than 5 words without falling asleep again, but the general condition is suffering for him.

I know this could sound weird to some, but every time he closes his eyes I just hope that he drifts away to a better place and stays there.

Re:Rember

[Talderas]

Think about it this way, if the drug halt further onset of Alzheimer's as they claim, the value of it as a first treatment before they reach the stage you describe is immeasurable.

It this is the miracle drug, the next step is early diagnosis before there is too much degeneration of the mind.

Re:Rember

[StarfishOne]

do you really want a drug that will keep him in that state, somewhat permanently?

No, definitely not. You raise a valid point and I understand it completely.

My parent post should be seen more in the light of 'progress IS finally being made'... perhaps one day we can label it a disease that can be prevented.

Not just for 'everyone out there', but I have to admit also from a slightly selfish perspective:

Researchers do not know the exact cause of Alzheimer's disease, but it is most likely due to a combination of a variety of genetic and other factors. Genetic research is concentrating on the role of heredity -- the transmission of qualities and illnesses from parents to children -- in determining risk for, and development of, Alzheimer's disease.

My grand father was a fish salesman for his entire life. All the Omega 3 fish oil he has ingested wasn't enough to prevent it.

Then there's my father. We (mother, brother, me) are not sure if it's his current stress level, but in the last few months he is less 'sharp' than he used to be and his memory does fail him every now and then.

He's 57 and the idea alone that he might be heading for the same road is very terrifying to say the least.

And my brother and I are also starting to fear that we might have inherited a genetic disposition for this disease.

Personally I love learning.. I'm an addicted to knowledge and I'll pick up a book in bed even if my body is almost robbing me of my consciousness by force.

The idea that 'everything that I am' might one day start to slowly degrade freaks me out. Euthanasia is a word that comes up in this context if this situation might start to become a reality in a (hopefully) very distant future.

Re:Rember

[SpcCowboy]

You make a valid point for patients who are already in the MCU, but your thinking is a bit shortsighted. If this drug works as advertised, it truly IS a godsend; not to those who have deteriorated to a state requiring constant care, but rather those patients who are diagnosed in the early stages of the disease. In this population, the drug could prevent them from ever progressing to the point that hospitalization is necessary.

Re:Rember

[Creepy]

Nice to point out there are many types of dementia other than Alzheimer's - my grandpa has stroke induced dementia caused by bleeding in the brain and doesn't seem capable of generating any new long term memories. Barring another stroke, it is unlikely he will ever change from his current stage (which happens to be about the anger and confusion stage, but I'm not sure if he has a specific ranking - my mom is a nurse and more on top of that sort of thing). The worst problem for him is he lost most of his memory before about 1956, so he doesn't remember any of his grandchildren (and often comments on how big his youngest son has gotten).

Re:Rember

[Urger]

suppose it could have been worse. When I get a bit frazzled I tend to repeat myself. We could of ended up with remememememember.

Re:Rember

[knavel]

I know this could sound weird to some, but every time he closes his eyes I just hope that he drifts away to a better place and stays there.

My grandfather suffered the same way, and I know exactly what you mean. It gets to a point where you think they (and you) would be better off once its over, as selfish as that may sound.

Re:Rember

[caramelcarrot]

Just having a look at the questionnaire, I'm not entirely sure if it's appropriate for diagnosis. Most of the questions are very leading and closed. Questions like "Do you feel sad, depressed or miserable?" and "Do you feel more tense or worried than usual?" are hard to answer truthfully, and it's far more effective for a doctor to diagnose someone with light chat about how they're living, rather than trying to suggest to them what's wrong. It's like diagnosing someone with psychosis, you don't just ask them if they think everyone's out to get them, you ask them if they've noticed anything odd lately as see what tangent they spin off on.

Re:Rember

[Anonymous Coward]

suppose it could have been worse. When I get a bit frazzled I tend to repeat myself.

suppose it could have been worse. When I get a bit frazzled I tend to repeat myself.

suppose it could have been worse. When I get a bit frazzled I tend to repeat myself.

suppose it could have been worse. When I get a bit frazzled I tend to repeat myself.

Re:Rember

[Chatsubo]

Sadly I understand.

My grandmother suffered extreme bursts of anger towards the family, it was horrible trying to deal with it. At times she believed that we were constantly trying to trick her by moving things around, lying to her about our identities, etc. When she passed away we were almost relieved, not having seen the worst of what was to come... I guess that goes a long way to describing how horrible this disease really is.

I cannot explain how relieved I am that I may never have to experience it myself, and hopefully not with my parents.

Re:Rember

[ljw1004]

I'm sorry to hear about your grandmother. It sounds heartbreaking. With our statistical analysis of the questionnaire results, what became clear was that alzheimers was a disease where (1) the sufferer lost their "personhood", and (2) the sufferer lots their cognitive faculties. You clearly experienced the first part. It's a shame that current FDA regulatory approval only take into account effectiveness for point (2).

Re:Rember

[jhfry]

Rember is a much better name than Member.

I always thought remember was a strange word... I don't member anything, so how can I possibly RE-member it?

Either way, I'm glad I don't have to worry about hearing my dear old grandfather say "hold on son I have to grab my member" when we are headed out of the house. And god forbid grandma tells the ladies in her bridge club that she loves member, she takes two at a time, and they are actually easy to swallow!

Here's to you, great pharmasutical drug namer, thank you for Rember, oh and thanks for Flomax and Boniva too... they always make me laugh!

Re:Rember

[will.perdikakis]

Mod parent UP! This is why I love this website.

Re:Rember

[Locutus]

Everyone knows these people are lying and it just makes a mockery of the legal system every time this happens. The iconic balancing scale should be replaced with some kind of game piece. IMO

LoB

Re:Rember

[ljw1004]

It's an awful calculation to make, isn't it?

TauRx does freeze progression of the disease, though, even before it's begun to manifest as a reduced MMSE score. You can catch people at this stage (Braak 1 or 2, equivalent to MMSE 28/29/30) before they've deteriorated much at all, and start administering the drug.

Re:Rember

[ljw1004]

You're right that the questions have leading phrasing. But for a standardised clinical trial, the questions have to be phrased exactly identically and administered in an identical way. The questions we use come from standardized vetted tests for alzheimers (MMSE, ADAS-COG, ADLS, ADFACS, CAMCOG, CAMDEX, ...). Half the questionnaires are done by interview with the carer, the other half by interview with the patient.

What we do is look at the questions and statistics as a black box. Ignore the semantic content of the questions. Look solely for statistical correlates between results on the questionnaires, and disease pathology (in terms of tangles in the brain, in people who died prematurely and we got their brains under a microscope.)

The statistical analysis lead to some interesting results! "Principal Component Analysis" is a technique for, more or less, "letting the data speak for itself". In this case the data told us that there are two completely separate areas of decline in the disease, one the loss of "personhood", one the loss of "cognition". They don't go hand in hand.

Actually, the loss of "personhood" starts FIRST in alzheimers disease.

And amongst all the questionnaires, the single question that was best correlated with the onset of the disease was, "and for how long have you been depressed?" !!

But you're right, the questions are leading and cosed. It was needed for a standardized clinical trial. But a true diagnosis is best made also with a doctor and light chat. Actually, this is standardized in a test called "CIBIC" -- Clinician Interview-Based Impression of Change -- and this CIBIC test was routinely administered in the Rember clinnical trial.

Re:Rember

[Anonymous Coward]

I don't work in health care, but I have seen my partner's father go through Alzheimer's; he died recently in a "care" home.

I have to say, I disagree with your notion that Alzheimer's patients reach some kind of comfortable plateau where they live "happily in a state of confusion".

In my father-in-law's case, as memory loss progressed, fear and increasingly anger set in. He became incapable of looking after himself; he disappeared on long walks and got lost. He forgot where he lived. He failed to recognise his family.

Eventually, he had to be looked after in an institution, where he was deeply unhappy and became ever more violent, so they often sedated him. He did not reach such a comfortable stage you describe. And frankly, I can't see why halting the disease at a point where the person can't look after themselves, recognize anyone, or do anything for themselves, would be desirable for anyone.

Re:Rember

[Anonymous Coward]

I always thought remember was a strange word... I don't member anything, so how can I possibly RE-member it?

The word comes from rememorari, which is re + memorari (Latin for "to be mindful (of)"). Rememorari is essentially "to be mindful (of) again".

Re:Rember

[compro01]

I think you're missing the point of this. The purpose is to start it at an early stage before you'd ever deal with them and prevent any of that from occurring or at the very least, keep it at bay for a number of years.

Also, it's progress. It's generally necessary to figure out how to stop something before figuring out how to reverse something.

Re:Rember

[Anonymous Coward]

I'm the AC you responded to. Alzheimer's progresses individually. Some people, like the relative you described, might never be in a stage where they are happily confused. Others can live fairly decently, with some help, even in late stages of dementia. It's all very individual. Some people die within 10 years of being diagnosed, some suffer for 30. Generally, the more intelligent and refined you were when you became ill, the harder and faster you fall.

Personally, I don't see much of a point to greatly extending the lives of those gravely ill either, but I'm not God or anyone's power of attorney, so I just do my job. That decision is not up to me. Personally, I've decided (like many others I know who work with dementia patients) to arrange my own insurance policy with a close relative. The kind that includes a large shot of insulin in my sleep. YMMV.

I realize that this new drug (if it passes trials) could halt people's progression at an early stage. The problem is that Alzheimer's is very difficult to diagnose in an early stage. There is no blood test. There is no skin biopsy. By the time Grandma or Grandpa shows obvious symptoms, (and believe me, he or she has probably known for YEARS that something is wrong, he was just too scared to tell anyone) the person may be halfway through the disease process.

Re:Rember

[curunir]

If your loved one breaks down crying several times a day because he or she can't tell where everyone is or where they are, if he goes into violent rages because he thinks he is being held against his will, if he lives in a constant state of fear because he knows something is wrong but he can't figure out what it is, if he tries day after day to go home but his captors refuse to [l]et him go, causing him to fear for his life... do you really want a drug that will keep him in that state, somewhat permanently?

I'm not sure if our case was atypical, but when my grandmother was diagnosed with Alzheimer's, she was nothing like you've described. The symptoms she had manifest to that point were all related to short-term memory and becoming easily confused when in public, but she was still living on her own and perfectly happy while at home. The initial response, which worked for a year and a half, was to have someone from her church come live with her. This worked well for everyone because the woman and her daughter were getting free room and board and my grandmother had someone to buy the food and take her on occasional walks to the beach (she lived 3 blocks away from the ocean).

It wasn't until 18 months after the diagnosis that she became too senile for this arrangement to work. From that point, my family had to endure the absolute hell of watching a loved one waste away from the inside out until what's left is a shell of a person who reminds you of your loved one but can't remember how to form sentences let alone tell you they've forgotten you (which had started happening shortly after she was moved to a medical facility). About 4 months ago, she stopped eating and finally died. This was almost a full 15 years after the initial diagnosis.

If we could have hit the pause button on her disease the day she was diagnosed, we would have had 15 years of visits where we got to see her face light up when she saw us, got to hear her stories that were still very much accessible in her long-term memory and gotten some measure of closure when whatever ailment finally took her life would have deprived us of someone we recognized. It's a bizarre form of loss to lose someone you love so much so little at a time. Until you've been through it, you don't realize how lucky people are to lose someone in a manner where one day you can talk to them and the next you can't. Those people get to grieve and move on. Families of Alzheimer's patients are robbed of that. And I can only imagine the fear and confusion of someone actually subjected to it as they lose themselves to the disease.

I guess what I'm trying to say is that your experience working in the facility you work in means that you're naturally being exposed to people who were diagnosed or had progressed further into the disease than others. Maybe for those patients it would make sense to wait until the disease had progressed to the point you mentioned. But there are patients who are diagnosed earlier on for whom this drug would be a godsend. And, since there's some indication that Alzheimer's is hereditary, if it could be determined to be safe enough for family members of people with diagnosed Alzheimer's to take to prevent themselves from ever reaching the point, that would be all the more useful.

Re:Rember

[moderatorrater]

My grandpa died of Alzheimer's related causes (starved to death, basically) and I can honestly say that when he finally decided it was Alzheimer's, taking the drug would have been a big help. He still knew who I was and could function in daily life, he just didn't have the short term memory that he used to have.

IMHO, I don't think that prolonging his childish state would be helpful to anyone involved. He was happy right up until the day that he died, but everyone who knew and loved him was hurting plenty the whole time.

Re:Rember

[MrNiceguy_KS]

I realize that this new drug (if it passes trials) could halt people's progression at an early stage. The problem is that Alzheimer's is very difficult to diagnose in an early stage. There is no blood test. There is no skin biopsy. By the time Grandma or Grandpa shows obvious symptoms, (and believe me, he or she has probably known for YEARS that something is wrong, he was just too scared to tell anyone) the person may be halfway through the disease process.

A major part of the fear of telling anyone is that, right now, Alzheimer's is basically a slow death sentence. People will probably be more willing to tell others about any symptoms if there is an effective treatment available.

Re:Rember

[Anonymous Coward]

diet can be extremely important in the fight to prevent or mitigate the impact of alzheimer's.

high dose, ultra refined epa/dha concentrates (fish oil) may be very beneficial in the treatment of alzheimer's patients.

Framingham Study: High DHA Levels Linked to Lower Dementia Risk
http://www.medscape.com/viewarticle/548076

http://www.research.va.gov/news/press_releases/fish-oil-032505.cfm

check ifos for a detailed list of 5 star rated fish oils:

http://www.nutrasource.ca/ifos_new/index.asp?section=ifosconsumer&ifossection=5%20Star%20Rating%20Reports

inflammation is linked to alzheimer's and a host of other chronic diseases (google inflammation and alzheimer's, if interested).

eicosanoids control inflammation and essential fatty acids (those provided by diet - omega 3 and omega 6) are the prime drivers of cellular inflammation.

following the newest dietary recommendations of harvard university's joslin diabetes center is a good place to start.

http://www.medscape.com/viewarticle/502699

a similar diet recently showed an 83% reduction in the incidence of diabetes over a 4 year time period.

http://www.reuters.com/article/healthNews/idUSL2979390020080530

these diets do better at controlling insulin and provide a better omega 3 to omega 6 fatty acid ratio, which, in turn, keeps cellular inflammation under much better control - including brain inflammation.

the SAD (standard american diet) is high in omega 6 (a substrate for inflammation production), high in carbohydrates (*huge* glycemic load, elevated insulin and delta-5-desaturase - which drives omega 6 into arachidonic acid - a precursor to pro inflammatory eicosanoids) and low in fish/fish oil (long chain omega 3 fatty acids that divert the production of inflammatory eicosanoids into anti-inflammatory eicosanoid production.

in other words, SAD is a pro chronic disease diet, including alzheimer's.

food is an incredibly powerful drug that will either drive you toward a state of wellness or a state of chronic disease.

where is your diet taking you today?

i'm on a diet similar to the one recommended by the joslin diabetes center and i love what i eat, i'm satiated and I'm leaner, feel better and have more energy than when i ran cross country in high school.

no pill could do that.

Re:Rember

[mazarin5]

Indeed; the three things that scare the shit out of me about getting old are the possibilities of:

1. Dementia
2. Paralysis
3. Incontinence

(In that order)

Re:Rember

[Hoi Polloi]

For me, after too many beers that order becomes:

1. Incontinence
2. Dementia
3. Paralysis

Re:Rember

[caramelcarrot]

Thanks, that explains things well. I also asked my dad (a GP), and he explained that you need to ask concrete questions so the patient can't avoid them with social chit-chat. Also, since the questionnaire is being administered by a doctor it makes more sense - I just couldn't see how I could answer it properly myself.

tested?

[Anonymous Coward]

Is this drug FDA (Or the British equivalent) approved yet?

Re:tested?

[DrDNA]

This drug is in the second of three phases which are required prior to FDA approval.

Phase 1: safety at various dosages
Phase 2: small test of efficacy and determining proper dosage
Phase 3: larger test of efficacy

It is still years away from the market. There was a screw-up in the formulation of the highest dose in this study, and the lowest dose had no effect, so only the middle of three doses tried had any effect. I found that out here

Re:tested?

[MrMr]

Except that in this case you can skip all that and do a little experimentation on your grandparents. This is not a new drug: it's plain old methylene blue, which has been used for all kinds of purposes for a century (from anti-malaria drug to aquarium antifungal)
See this

Re:tested?

[Zebraheaded]

Informative?? I think not.

Knowing what the API is != Knowing what the drug product is

Re:tested?

[steelfood]

From the wikipedia article:

Methylene blue was used at the end of the century as a successful treatment for malaria. It disappeared as an anti-malarial during the wars in Asia, as U.S. soldiers disliked its two inevitable, fully reversible side effects: green urine and blue sclera.

Am I the only one who thinks it'd be pretty cool to look like I'm on melange?

Re:tested?

[Anonymous Coward]

Not quite so easy... From your link

However, the formulation used was different from that commonly available as a medicine and caution has been expressed about use of methylene blue as a treatment for Alzheimer's.

Can it reverse dementia?

[BadAnalogyGuy]

While the article says that the disease was halted in 300 trial patients, it's not quite clear that the effects of the disease can be reversed. So those in the early stages have perhaps gotten their lucky break, but many who have already progressed down the road to lunacy are still without reprieve.

I'm glad to see such progress being made, and more importantly that aluminum cans and deodorant have been vindicated. Seriously though, I'm turning Japanese isn't just a song anymore, it's a long gone daddy in the USA. Where some patients may get a chance to return to normal lives, it's still a bit sad that those who have lost loved ones to the waking death of Alzheimer's will only feel a bitterness that this trial was conducted so long after they bore the brunt of it.

Your dad is doing good work. We need more people like him.

Have your thoughts slowed up?

[amnezick]

nope, they're high down there ... (I'm also not a native English speaker)

Wow, that's awesome

[oodaloop]

It's hard to think of a scarier disease than one where you slowly lose your mental faculties. I'd take almost any other disease over Alzheimer's.

Re:Wow, that's awesome

[BadAnalogyGuy]

It's hard to think of a scarier disease than one where you slowly lose your mental faculties.

Ebola

Re:Wow, that's awesome

[MR.Mic]

I'm sorry, but I'd rather bleed out from the insides than slowly forget who my friends and family are.

Re:Wow, that's awesome

[Anonymous Coward]

Agreed, and if you've experienced it in your family you know it's nothing to laugh at. It's a serious crippling disease. This is really cool news and I'm quite excited about this going to the FDA.

Re:Wow, that's awesome

[SirShmoopie]

Its nasty, I worked in Alzheimers care for years.

What's worse is the routine treatment of Alzheimers patients with anti psychotic drugs, Most of my time as a nurse in that field was spent undoing the damage caused by such ill advised prescribing of chemical straight jackets to deal with minor behavioural issues.
If this drug can stop Alzheimers from getting worse once diagnosed I'd be happy, both professionally, and selfishly (I want Pratchett on this stuff NOW).

Re:Wow, that's awesome

[hansraj]

Let me see: On one hand I have a disease that gives me a rather quick (even though painful) death, and on other I have something that slowly turns me into a vegetable. Tough choice? I think not.

If I was forced to pick one (without a hope for cure once I made my choice) I would pick Ebola any day of the week. Thank you very much.

Re:Wow, that's awesome

[loafula]

Locked in syndrome More condition than disease, but this is the worst thing I could imagine anyone ever experiencing.

Re:Wow, that's awesome

[Anonymous Coward]

Cool here's some cancer. Have fun!

Re:Wow, that's awesome

[StarfishOne]

I worked in Alzheimers care for years.

I've already posted in this topic anyway, but I wish there was a mod option that is something like 'very grateful and respect'.

I salute your and your colleagues SirShmoopie!

Re:Wow, that's awesome

[stranger_to_himself]

I agree with you entirely, we need to do more to learn how to deal with the emotional and communication issues caused by AD and other dementias that lead to behavioual problems. Treatment with anti-psychotics is disgraceful but it's easy to see how it happens.

These advances in treatment are great for those who will benefit (largely the younger onset cases) but will not prevent the majority of dementia that occurs in the very old without much relationship with tau-related disease. We will see in the future much more dementia caused by simple atrophy or ageing of the brain with very little associated disease.

Re:Wow, that's awesome

[Tsoat]

"After 5-7 days the person will die of "a million cuts." Yeah...Good luck with that.

Re:Wow, that's awesome

[Tim C]

Personally I'd still rather that, than not recognise my daughter. I'd also rather put my loved ones through a relatively swift and dramatic end to my life, than a very slow, gradual decline, in which I am effectively dead to them (as I don't know who they are) long before I stop breathing or moving around.

Re:Wow, that's awesome

[PakProtector]

Haemorrhagic Fevers are bad, but not as bad as the public seems to paint them. Films such as Outbreak, and books such as Richard Preston's Hot Zone have made it seem like Filoviruses and other haemorrhagic diseases kill you in a matter of hours and cause you to have to be buried in a water-tight plastic bag. This is about as accurate as saying cancer patients are going to mutant into something that looks like a Horta due to out-of-control cellular replication.

For Ebola in particular, there are methods of treatment, including a post-exposure vaccine that has shown to be 99% effective in monkeys. The only downside is that it must be administered very quickly, or there will be too much damage already done to the patient (within 4 days.)

I can thinking of many ways of dying that are far more agonising that Ebola. MS would be one. To be gradually robbed of my motor and mental skills would be a horrible and terrifying experience. As someone who recently lost a family member who suffered from senile dementia (and whose dementia was directly responsible for her death), I can say that it is definitely worse for the sufferer than for the family. As painful as your loved one not knowing who you are is, it is far more painful for them, and to watch them, come back to moments of lucidity, only to have to have where they are and what has happened explained to them yet again.

I think it is a sign of the times that people seem to think that physical agony can even begin to compare to psychological agony.

Re:Wow, that's awesome

[oodaloop]

I have not had to deal with it in my family yet, and I pray to FSM I never have to.

When studies showed a link between aluminum and Alzheimer's, that was enough to get me to stop drinking anything in an aluminum can and to stop wrapping my sandwiches in aluminum foil. I don't know if there's a real link, but it's not the kind of risk I'm going to take. Aluminum isn't good for you anyway, so it can't hurt to cut down your intake.

Re:Wow, that's awesome

[PakProtector]

Judging from the number of spelling errors in the above post, I think it's safe to say that I am already being gradually robbed of at least one of my cognitive functions.

Re:Wow, that's awesome

[rugatero]

I think it is a sign of the times that people seem to think that physical agony can even begin to compare to psychological agony.

On the contrary, I think it is only a recent development that we can see psychological pain as being as real or more real than physical pain. It is not so long ago that mental problems were casually dismissed by most as being 'just in your head'.

The point I'm trying to make is that modern society is improving in this regard, rather than degrading.

Re:Wow, that's awesome

[stranger_to_himself]

If you want to reduce your risk of dementia, the best advice is to simply live healthily and be socially and intellectually active. Just as much dementia is caused by vascular disease as is caused by classical Alzheimer's disease, and being active (probably, we're not totally sure yet) increases your brain reserve so you can sustain more damage to your brain while retaining high levels of function.

While this treatment appears to be an important breakthrough you can't rely on it for prevention since it will not do anything about the general age-related atrophy or vascular disease that many older people will suffer

Re:Wow, that's awesome

[Verteiron]

I'm sure Pratchett wants Pratchett on this stuff as well.

Re:Wow, that's awesome

[galoise]

For some reasson, i've always had this terrible fear of catching parkinson...

but alzheimer is creepier, specially for those around you.

Re:Wow, that's awesome

[PakProtector]

Apparently you've never talked to any one of the large number of men in America who saw combat in either World War II, Korea, Vietnam, or any of the other myriad police actions we've been involved in. I think the older generations are very well aware that there are things worse than painful death; being the one who didn't die can be a horrible, horrible experience.

Anyone who grew up in the 20's or 30's, or the 40's or 60's and 70's and saw the wounded who returned home, missing arms and legs, hands, eyes, or, worse still, their mental stability, knew that there are far worse things than death.

My generation and those younger than I have, on average, never experienced any sort of real hardship or suffering.

Re:Wow, that's awesome

[rugatero]

I'm perfectly aware of the horrific effect that such things had on people's minds. I am also aware of how callously they were treated. WWI soldiers suffering 'shell-shock' were branded as cowards and traitors. In WWII, the US military would use the euphemistic term 'exhaustion' to refer to psychiatric problems, rather than face the true impact on the soldier.

Re:Wow, that's awesome

[LordVader717]

There's way more scarier things in my opinion. By the time they experience severe issues, it seems they have lost the capability to realise the suffering.
Now losing your body's functions while still being mentally fully aware, and suffering from excrutiating pain, I find that scarier.

Re:Wow, that's awesome

[smellsofbikes]

Ebola has, what, a 40% mortality rate, and it's over one way or the other in less than two weeks.
Alzheimer's, in contrast, has (until now) a 100% mortality rate and takes *years* of horribleness.

I'll take Ebola, thanks.

Re:Wow, that's awesome

[TheLink]

Ebola doesn't scare me. Odds are you die in a few days. Painful sure. You'd probably hate it every moment, but I think the bright side is you know it'll be over _soon_.

Dementia is a pretty bad way to go. The end stage is probably not so bad for the person with it (just bad for everyone around who cares). But the months where you know you are malfunctioning bit by bit can be pretty depressing.

What scares me would be to not lose all my mental faculties but instead "just" be trapped without sight or sound or most of my other senses.

I believe a stroke could cause something like this.

Solitary confinement for the rest of my life. And modern medical technology could keep people alive for rather long.

Imagine that you are in darkness, you can't feel anything, you can't see anything, you can't hear anything, and this goes on, for not just for days. Worse of all you don't know how long it will go on for - it could go on for years.

I'll take ebola over that anytime.

On a related note - it's funny how so many people think that it would be great to be one of those Highlaner Immortals. It's all fun and games till one day you get stuck in a bad situation for "a long while".

Re:Wow, that's awesome

[TheLink]

Thing is, many people are not quite sure what happens after death.

If it just ends there, then sure there are far far worse things than death.

BUT if we have an immortal soul and we "kind of remain as we are", then eternity is a bit too long for an immortal but _imperfect_ person.

Hands up those of you who are perfect and can handle an eternity of existence.

Re:Wow, that's awesome

[TheLink]

"If you want to reduce your risk of dementia, the best advice is to simply live healthily"

Really? I thought if you really want to reduce your risk of dementia, you have supersize McD meals for every meal every day.

>99% of people sticking to this diet plan will never get dementia or cancer.

It works even better with Bacon.

Mmmmm. Bacon.

Of course the side effects might be a showstopper for you. :)

Re:Wow, that's awesome

[stranger_to_himself]

If your high salt sugar and fat diet leads to a stroke then you have at least a 1 in 3 chance of ending your days with dementia of some sort (high blood pressure and cholesterol cause strokes and mini-strokes and are also thought to directly lead to Alzheimer's disease). So not only will you die young, you're alse likely to die disabled and demented.

There is a serious message there. There's no point thinking 'I don't want to get old so I don't get dementia', because if your lifestyle is unhealthy you'll suffer all of the negative consequences of age too early.

Re:Wow, that's awesome

[Anonymous Coward]

How would you know if it's worse than painful death? You can't really ask those who have suffered such a fate.

I don't think you've expressed yourself well because . . . what, you'd rather be dead then lose a bodypart or two? I don't mean to trivialize such a loss but I think there are lots of people in the world happy that most of them is still alive.

Re:Wow, that's awesome

[Anonymous Coward]

If he picked both, then he could die quickly while not being aware of the pain! /poor taste

Re:Wow, that's awesome

[philspear]

I don't know if it's the best basis to compare terrible diseases, but with Altzheimers you have decades of life before the symptoms. With Lesch-Nyhan syndrome you don't. It has a few different symptoms like being prone to gout, but the symptom that really sets it up there is the constant urge to self-mutilating behavior that starts at the age of 2 or 3.

http://en.wikipedia.org/wiki/Lesch-Nyhan_syndrome

Re:Wow, that's awesome

[Anonymous Coward]

Just to note, ebola can cause brain haemorrhaging -> loss of mental faculties. Even if you recover you may be brain damaged.

Re:Wow, that's awesome

[steelfood]

Considering how contagious ebola is, you'd also be putting a swift and dramatic end to the lives of everyone else around you. We're only fortunate that we can't get it through airborne transmission. Monkeys can though, so it's only a matter of time.

Ebola is seriously not something to mess with. Give me alzheimers any day.

Re:Wow, that's awesome

[Randle_Revar]

A Pak Protector loosing some of it's cognitive functions? You must be *really* old for that to happen!

Re:Wow, that's awesome

[Muad'Dave]

At least in the US, your biggest biological exposure to aluminum may be via deodorants/antiperspirants. Many contain Aluminum Chlorohydrate which was rumored to contribute to Alzheimer's.

Re:Wow, that's awesome

[ShakaUVM]

>>I can thinking of many ways of dying that are far more agonising that Ebola. MS would be one. To be gradually robbed of my motor and mental skills would be a horrible and terrifying experience.

I hate MS Office as much as anyone, but isn't that a bit of hyperbole??

Re:Wow, that's awesome

[PakProtector]

You have no idea. I have to keep recalculating my age, adjusted for relativistic effects, just to keep myself from wanting to tell the Breeders to get off my damn lawn.

Re:Wow, that's awesome

[Anonymous Coward]

Just to let you know, you don't necessarily lose your mental and motor skills when you are diagnosed with MS. I have had MS for twelve years. I am just finishing up my M.Ed, I won on Jeopardy a few years back and I walk and do Pilates every morning.

I would take MS over Ebola any day.

Re:Wow, that's awesome

[TheLink]

"Even if you recover you may be brain damaged."

Just make sure you don't recover then ;).

Re:Wow, that's awesome

[Ol Olsoc]

My Mother and my mother in law passed away within a year of each other.

The difference was my mother was healthy until th eday she suffered a massive heart attack. It was over in a minute.

My Mother in law OTOH, was a dementia patient for 8 years, suffering a passel of indignities, and pain and suffering, until she just plain wore out. Don't think the drugs are all that great. Lots of them have nasty side effects. But people are often willing to try anything..

There is no question in my mind which path I'd prefer to take.

Obligatory

[Fear the Clam]

Now what's that drug called...?

Re:Obligatory

[Anonymous Coward]

"Member" or something. And it's blue. And it's for when people get older...

I'm pretty sure I used some last weekend, but whatever happened was a little confusing, and I was sore afterward.

Re:Obligatory

[amnezick]

rember, i think

Re:Obligatory

[eastlight_jim]

I thought it was quite easy to rember actually.

Yes but........

[Anonymous Coward]

is it in time to help the President!!!!!

Re:Yes but........

[Anonymous Coward]

Probably in time for Jemma.

Re:Yes but........

[Anonymous Coward]

Apparently it's too late for you, too. It's been years since Reagan was President.

Video games...

[Notquitecajun]

Odd thing about Gen-xers and the following generations...due to our proliferation in playing video games, there won't be as many of us with Alzheimer's, but EVERY one of us is going to wind up with carpal tunnel.

Thank your dad for his research for all of us - this is one of the worst ways to go.

Re:Video games...

[blahplusplus]

", but EVERY one of us is going to wind up with carpal tunnel."

From wikipedia:

"The term 'carpal tunnel' is also used quite commonly to refer to 'carpal tunnel syndrome' which is a condition where the median nerve is compressed within the tunnel and causes pain and/or numbness of the wrist/hand, never proven to be the result of repetitive motion such as painting or typing. It has been shown to be associated with obesity, hypothyroidism, diabetes, pregnancy, family history, rheumatoid arthritis and wrist shape."

Re:Video games...

[MobyDisk]

Can you post a link on the relationship between video games and Alzheimer's? Or do you mean we will all get fat and die of heart disease before we are old enough to get Alzheimer's?

Re:Video games...

[Seakip18]

So, expect blizzard to get hit with class action lawsuits for WoW?

Re:Video games...

[Culture20]

[Carpal Tunnel Syndrome] has been shown to be associated with obesity, hypothyroidism, diabetes, pregnancy, family history, rheumatoid arthritis and wrist shape.

So, expect blizzard to get hit with class action lawsuits for WoW?

WoW causes all that? *whistles*

Re:Video games...

[Seakip18]

WELL! My roommate is well into 3 of those(strangely enough, he'll prolly get a girl preggers via WoW-ness). I don't know but he'd probably lie about family history if it suited him.

Re:Video games...

[compro01]

I believe it's more a general link between prevention/delay of onset of Alzheimer's and regular general cognitive activity. There was a study a few years ago showing a link between regularly playing a musical instrument or other mentally demanding activities had a significantly lower risk of dementia than those who didn't or did so less often.

Got a NY times story on it http://query.nytimes.com/gst/fullpage.html?res=9C0DE6D7153BF937A15755C0A9659C8B63. study was in the New England Journal of Medicine in '03.

It's not too much of a stretch to extend that criteria to videogames where you need to think, such as RTS's, TBS's, RPG's, and strategic FPS's.

Dementia != Alzheimer's

[morgan_greywolf]

It's important to remember that Dementia != Alzheimer's. Alzheimer's can cause a form of dementia (Alzheimer's-related dementia), but dementia has many other causes, some are age-related and some are not.

my dad is smarter than your dad

[bjmoneyxxx]

(Disclosure: I made the online questionnaire, and my father is one of the scientists behind the drug.)

oh yeah, well my dad...

Oh dear

[Chrisq]

I answered the questionnaire.
I got the day of month wrong and occasionally feel depressed. It says I have minimal cognitive impairment.

Re:Oh dear

[MyLongNickName]

Yeah. And mine said I have no signs of dementia. Clearly this test is fubared!

(why do I have to wait 7 mintues between posts)?

Disclosure: I made the online questionnaire...

[will_die]

So let the complaints on the code begin.
BTW if you want to get into the fun stuff answer question 1 incorrect and question 2 correct and hit submit.
On the sad side if you answer questions 1 and 2 correct and then forget the rest of the questions you don't get hit with having some dementia and just a boring all is probably fine screen.

Re:Disclosure: I made the online questionnaire...

[ljw1004]

That's funny :)

On the serious side, we had a battery of several hundred questions that were administered to patients. Lots of the old ones just couldn't cope with sitting through an hour of questions. So we had to figure out statistical ways to make a diagnosis even when some of the questions aren't answered.

For the online version, I didn't display confidence intervals because I thought they'd be too confusing. But the statistical engine under the hood (if you answered 1 incorrect and 2 correct) says "the patient has somewhere between 0 dementia and FULL dementia, with a confidence level of 95%" ...

Rember is Methylene Blue

[Fallen Andy]

See here (a very well known biological stain) - so short term toxicity is probably well understood - long term? Who knows yet. At the very least it ought to open the way to a new class of drugs for this terrible condition

Andy

Re:Rember is Methylene Blue

[lisaparratt]

Ooh, will it stain my eyes blue? That'd be *awesome*. El Wiki suggests that it might.

How long til Rember gets nicknamed Spice?

Re:Rember is Methylene Blue

[jamesh]

long term? Who knows yet.

I was going to write "well... if I had been diagnosed with Alzheimer's, I'd love for 'long term' to be something I'd need to worry about", but thinking about it more, this is more a "stop you getting worse" drug than a "make you better" drug, so the earlier you start taking it the better. And if Alzheimer's can have it's roots 30-40 years in the past as the article suggests, maybe long term toxicity is something to consider...

Are the really early onset cases of Alzheimer's the same as those more associated with older people? I'm sure there will be no shortage of test subjects who would otherwise have another 50 years of life in front of them...

Re:Rember is Methylene Blue

[Anonymous Coward]

At my university, we use methylene blue to baptize the new students - so no Alzheimer here!

Re:Rember is Methylene Blue

[An dochasac]

Back when kids chemistry sets contained a few chemicals not found in mom's kitchen and no one was making crank with stuff which was in mom's kitchen, my skillkraft set had something I swear was called "methylethylene blue", but maybe the guy who typed the label stuttered at the keyboard.

I also vaguely remember that one practical use for medical grade methylene blue was as an antidote for carbon monoxide poisoning, since it's one of the few not-so-toxic substances which binds to hemoglobin more strongly than CO molecules.

Re:Rember is Methylene Blue

[ljw1004]

Toxicity is minimal, and methylene blue has been used for many many years. In fact it was used even before the FDA came in and standardized toxicity testing. That means that there's no "officially approved" toxicity data for the drug. The company's hope is to do Phase 3 trials concurrently with toxicity.

Re:Rember is Methylene Blue

[ljw1004]

Not your eyes, but the drug does stain your urine blue...

Re:Rember is Methylene Blue

[lisaparratt]

Hrm, the wiki page suggested that it also affects the sclera.

Re:Rember is Methylene Blue

[Jaysyn]

Seems much simpler / safer than this: http://damncoolpics.blogspot.com/2007/07/eye-tattoo.html

Thanks

[MyLongNickName]

I have nothing useful to add to this discussion except to send your father a Thanks for working on things like this. I love my job in IT, but my job will never have as big an impact on humanity as folks like your dad.

beta amyloid

[PHPNerd]

(I'm a PhD Neuroscience student) It seems like more and more scientists are moving away from the beta amyloid plaque buildup hypthesis. While it seemed like a great lead, people who die with no symptoms of dementia or Alzheimer's Disease can still have a buildup of beta amyloid plaque as massive as the person who did die of Alzheimer's. It could be that high levels of beta amyloid plaque buildup increases the risk of getting Alzheimer's, though. It's a hard disease to crack, that's for sure. If this new drug really does work, it'll save 5 million lives a year, and that's just in the past few years; as the Baby Boomers all get past 65 we're going to start seeing a massive increase in Alzheimer's Disease.

Re:beta amyloid

[PakProtector]

I am not a Doctor (for a couple more years), but...

I think that Alzheimer's is probably a confluence of different things instead of just a single disease. It could be that the plaque build up does not directly cause Alzheimer's, but that it creates an environment more conducive to the real disease agent's functioning. Or it could be that they are both expressions of an underlying pathology that as yet escapes us -- they're found together not because one causes the other but because they're both caused by the same thing.

I remember seeing some research a few months ago that showed that treating Alzheimer's patients with drugs to increase insulin sensitivity seemed to have some benefit, suggesting that the disease could be a third form of Diabetes.

I really do wonder if it should be Alzheimer's Syndrome instead of disease. It seems that there are several different causes of the condition, at least for the moment, which either contribute to the degeneration or could be the direct cause.

Re:beta amyloid

[stranger_to_himself]

I saw a talk by Peter St George Hyslop on this subject a couple of weeks ago. The current thinking is that the presence of smaller beta amyloid oligomers lead to the formation pathogenic form of tau. Whether it's the tau or the beta-amyloid itself that leads to the cognitive impairment is still debated, while this work suggests that the tau is most important, one of my students is presenting work at the same meeting that suggests soluble beta amyloid concentrations (rather than plaques) are key. Neither conclusion to my mind is completely satisfactory.

Re:beta amyloid

[daniel_newby]

It seems like more and more scientists are moving away from the beta amyloid plaque buildup hypthesis. While it seemed like a great lead, people who die with no symptoms of dementia or Alzheimer's Disease can still have a buildup of beta amyloid plaque as massive as the person who did die of Alzheimer's.

Recent research found that beta amyloid dimers were toxic in a laboratory model of Alzheimer's disease. Monomers, trimers, and larger aggregates, as well as plaque cores were not toxic.

Re:beta amyloid

[Intron]

A study I read on Donepezil (Aricept) suggested that it slowed impairment in a portion of Alzheimer's patients but had no effect in the rest, which suggests that there may be multiple conditions under the same name. I thought that autopsy results showed plaques as common to all cases, though.

rember ...

[sister bliss]

Rember v.0.3.4b Product Description: Rember is a front-end GUI to the 'memtest' command line memory testing program. This application will allow the user to select the number of test loops, as well as the amount of memory to test. This software is free, and is covered under the GNU GPL. Please read accompanying "COPYING" file for more info. damn ... they turned GPL'led software into a pill ... http://64.233.183.104/search?q=cache:YkUL5kuv8NIJ:www.kelleycomputing.net:16080/rember/+rember&hl=nl&ct=clnk&cd=1&gl=be&client=firefox-a

Error in quiz

[Anonymous Coward]

I got this error at the end of the questionare;

Python 2.5: /usr/local/bin/python
Wed Jul 30 08:58:26 2008

A problem occurred in a Python script. Here is the sequence of
function calls leading up to the error, in the order they occurred. /usr/wwws/users/wischik/tau/quiz/tacore.py in ()
1415 raise
1416 print
1417
1418
1419 index()
index = /usr/wwws/users/wischik/tau/quiz/tacore.py in index()
1400 answers[kv] = form[kv].value
1401 try:
1402 r = BraakDSMScore(answers)
1403 print "Status: 303 See Other"
1404 if len(r)==1: print "Location: unclear.html?tcog="+str(r['tcog'])
r undefined
global BraakDSMScore =
answers = {'age_correct': 'Y', 'deps_always': 'N', 'deps_diff_concentrate': 'Y', 'deps_diff_decisions': 'Y', 'deps_lost_energy': 'Y', 'deps_more_tense': 'Y', 'deps_prefer_alone': 'Y', 'deps_sad': 'Freq', 'deps_start': '22', 'deps_thoughts_slowed': 'Y', ...} /usr/wwws/users/wischik/tau/quiz/tacore.py in BraakDSMScore(answers={'age_correct': 'Y', 'deps_always': 'N', 'deps_diff_concentrate': 'Y', 'deps_diff_decisions': 'Y', 'deps_lost_energy': 'Y', 'deps_more_tense': 'Y', 'deps_prefer_alone': 'Y', 'deps_sad': 'Freq', 'deps_start': '22', 'deps_thoughts_slowed': 'Y', ...})
1344 def BraakDSMScore(answers):
1345 "Calculates Braak stage and DSM rating from a set of answers, using Damon2Score internally and a lookup table"
1346 tcog = Damon2Score(answers)['tcog']
1347 r = {'tcog':str(tcog.score)}
1348 #
tcog undefined
global Damon2Score =
answers = {'age_correct': 'Y', 'deps_always': 'N', 'deps_diff_concentrate': 'Y', 'deps_diff_decisions': 'Y', 'deps_lost_energy': 'Y', 'deps_more_tense': 'Y', 'deps_prefer_alone': 'Y', 'deps_sad': 'Freq', 'deps_start': '22', 'deps_thoughts_slowed': 'Y', ...} /usr/wwws/users/wischik/tau/quiz/tacore.py in Damon2Score(answers={'age_correct': 'Y', 'deps_always': 'N', 'deps_diff_concentrate': 'Y', 'deps_diff_decisions': 'Y', 'deps_lost_energy': 'Y', 'deps_more_tense': 'Y', 'deps_prefer_alone': 'Y', 'deps_sad': 'Freq', 'deps_start': '22', 'deps_thoughts_slowed': 'Y', ...})
1251 rtcog.score = tcog
1252 rtdem.score = tdem
1253 ll = loglik(dqsa)(tcog,tdem)
1254 dll = dloglik(dqsa)(tcog,tdem)
1255 d2ll = d2loglik(dqsa)(tcog,tdem)
ll undefined
global loglik =
dqsa = [Question(code='name_correct', criterion='Y', wcog=0.0, wdem=0.0, noise=0.0, score=-1), Question(code='dob_year_correct', criterion='', wcog=0.0, wdem=0.0, noise=0.0, score=-1), Question(code='dob_month_correct', criterion='', wcog=0.0, wdem=0.0, noise=0.0, score=-1), Question(code='dob_date_correct', criterion='', wcog=0.0, wdem=0.0, noise=0.0, score=-1), Question(code='dob_correct', criterion='Y', wcog=0.168022, wdem=0.0, noise=0.0, score=1), Question(code='age_correct', criterion='Y', wcog=0.498653, wdem=0.0, noise=0.0, score=1), Question(code='mem_difficulties', criterion='N', wcog=0.450583, wdem=0.0, noise=1.02701, score=-1), Question(code='forget_where_more', criterion='N', wcog=0.0, wdem=0.703223, noise=0.54606, score=0), Question(code='forget_came_on_suddenly', criteri...cog=0.717391, wdem=0.0, noise=1.279221, score=-1), Question(code='forget_got_worse', criterion='N', wcog=0.0, wdem=0.426788, noise=0.338265, score=-1), Question(code='mmse_year', criterion='Y', wcog=0.825942, wdem=0.0, noise=0.0, score=-1), Question(code='mmse_season', criterion='Y', wcog=0.403934, wdem=0.0, noise=0.0, score=-1), Question(code='mmse_month', criterion='Y', wcog=0.581528, wdem=0.0, noise=0.0, score=-1), Question(code='mmse_date', criterion='Y', wcog=1.664112, wdem=0.0, noise=0.0, score=-1), Question(code='mmse_dayweek', criterion='Y', wcog=0.

Re:Error in quiz

[ljw1004]

Thanks for the bug report.
I don't suppose you happen to remember how you answered the questions, do you? We don't keep any logs (because the data seems personal and confidential!) But I think I'll update the error-handling mechanism to show what answers the person gave, so I can reproduce bugs...

He suffers from Alzheimer's Disease. She has it!

[Frans Faase]

Although Alzheimer's Disease might seem a very scary disease, the reality is often that the family members suffer most. As a partner of someone with Alzheimer's Disease, I can affirm this. Although my wife is only in the early stages of the disease, the effects are already dramatic. She is no longer my equal and I often feel I have to treat her like a teenager, as she is showing similar kind of behaviour. Our teenager daughter is also suffering from not having a "normal" mom anymore.

Although most people with Alzheimer's Disease go through periodes of depression, they often appear to be rather happy with their condition, because they are no longer aware of what has happened to them. They forget that they forget.

First Post?

[crunch_ca]

I meant to get first post, but I forgot.

Maybe is is the Spice

[Frans Faase]

The Spice (from Frank Herbert's Dune) also gave you those blue in blue eyes. Made me wonder what it will to a "normal" person.

My grandma

[Wiarumas]

My grandma was a renown heart surgeon who gave many conference speeches (or so I'm told). She was a really intelligent person... and the only "imperfection" she had was a slight case of OCD (which I believe could be reasonable - being a germophobe - if you are in medicine). I'm afraid she now suffers from schizophrenia WITH alzheimers (or at least, thats what the doctor's say) which is quite the brutal combination.

Its terrible of how little grasp she has on the present let alone reality. There are times she recognizes me, there are times she confuses me with someone else, there are times she doesn't know me at all, and there are times she is completely out in lala land. The terrible thing is, you could think its a good day and she is completely with it, then she suddenly makes a turn for the worst by leaning over and whispering religious mumbo jumbo in your ear about your grandpa being some sort of demon and passing you junk mail she recieved with certain words highlighted in yellow, notes written all over it, and it being "proof" of some sort of conspiracy against her. Then she acts like it never happened and becomes normal again. The fascinating thing is, despite her dementia and retrograde amnesia, she is capable of watching all 3 Lord of the Rings in one sitting and completely knows exactly what is going on because she read all of the books when she was younger.

Another thank you...

[icebrain]

Thank you to your dad from here, too. My grandmother had a bad case of Alzheimer's before she died from a stroke; nobody should have to go through that.

And frankly, I'm worried on a personal level; with the family history of it, and the rather poor memory my dad and I have, I'm worried both of us may wind up with it.

Somebody get hold of Pratchett

[Bonker]

He was looking for a high-end brain specialist in neurochemistry at last report. Subby's dad fits the bill.

Re:Somebody get hold of Pratchett

[MrMr]

Here's your brain specialist:
My brain hurts

Re:Somebody get hold of Pratchett

[moosesocks]

I went to the library to do some research regarding a cure for Terry, but all I got was a banana.....

Other ways to prevent Alzheimer's

[Pedrito]

I've been working for years to prevent Alzheimer's with the medications currently available and it's working great for me!

Sad memories

[vorwerk]

My Great Aunt was the first female high school principal in the city in which I grew up. She was both witty and strong-willed, and achieved success in both her personal and professional lives.

She passed away from Alzheimer's, perhaps the most degrading, saddening, awful disease that I can imagine. In a sense, it is a fate worse than death -- it robs 'you' of *you*. It's torturous for the afflicted -- there was a period of a few weeks or months where my Great Aunt would wake up every day and have to be reminded that her parents had already passed away. It's equally unpleasant for friends or family of the patient.

The story of my Great Aunt probably isn't all that different from that of a family member that you may know. I imagine that anyone that has seen a loved one succumb to this illness would agree that this disease has to be stopped....

Wow proteins make up cell towers.

[t-maxx cowboy]

caused by 'beta amyloid' (a peptide found in Alzheimer brains) or by 'tau protein' (normally used for cellular scaffolding,

I never knew that protein was used to make cellular phone tower scaffolding.

ROFL

Scary

[WPIDalamar]

Alzheimer's is one of my worse fears in life, both for me and for loved ones.

Slowly losing your mind and not being able to do anything about it is terrifying. I guess the only solace one might have is after a certain point, you don't realize it's happening.

Is it patentable?

[Thelasko]

From TFA:

Methylthioninium chloride is more commonly used as a blue dye in laboratory experiments.

Wikipedia also notes:

Methylene blue was used at the end of the century as a successful treatment for malaria. It disappeared as an anti-malarial during the wars in Asia, as U.S. soldiers disliked its two inevitable, fully reversible side effects: green urine and blue sclera. Interest in its use has recently been revived,[1] especially because it is very cheap.

Which raises the question, is it patentable? TFA notes that the study was funded by a pharmaceutical company, but I am worried that the funding will end when the company discovers that the drug won't be profitable.

Re:Is it patentable?

[ljw1004]

Yes it is patentable, and TauRx holds several patents around the drug. It's not just the chemical itself. You can also patent the formulation, the test-tube tests, the "use of chemical for a specific purpose", the transgenic animal tests...

Re:Is it patentable?

[avandesande]

OMG! You think the company missed this little detail in their plans?

Re:Is it patentable?

[unikussituation]

definitely. sure, the substance may be well-known but application as a therapeutic will require new processes of manufacture, new standards of purity, &c. also depending on the mode of administration (peroral, intravenous or maybe even intrathecal) different varieties of the parent substance might have to be developed... and that is just before the "me-too drugs" will appear.

Re:Is it patentable?

[Anonymous Coward]

You can also patent the..."use of chemical for a specific purpose"...

In such a case, would other companies legally be able to sell it as "moisturizing cream", with "Warning: Ingesting this product may halt the onset of Alzheimer's" printed on the bottle?

Obviously not a totally serious situation, but if you patent something for a specific purpose, does that in any way prevent somebody else from selling it for no purpose whatsoever? I'm sure somebody with more time to think on it than I could work out some form of marketing to get it out there while bypassing the 'specific purpose' clause.

Re:Is it patentable?

[Hoi Polloi]

I would imagine the drug itself would still be relatively inexpensive since it didn't have to be formulated and its action was found by accident. I also imagine that this is cheap to make. The shear number of constant sales could keep this drug at a very affordable price.

Re:Is it patentable?

[magus_melchior]

It's cases like these that obviate the need for a nonprofit that funds unpatentable drug therapy research (Yo, Gates! I'm lookin' at you!), or the need to eliminate drug patents altogether. Surely, there's another way to make millions off of medications without denying those who most need them.

Time Machines Hillary Clinton And You

[Anonymous Coward]

Oh to have a working flux capacitor again. For if we did, we could ship some rember back to 1995 to help The Hildabeast remember some of those details about the Webster Hubbell and Castle Grande affairs.

Kant rember cow to pell

[snsr]

Sorry, couldn't help it. 'Rember' is actually a very well suited name.
From the BBC article:

Methylthioninium chloride is more commonly used as a blue dye in laboratory experiments.
Professor Wischik discovered it by accident 20 years ago, when a drop in a test tube led to the disappearance of the Tau protein he had been working on..

This is absolutely amazing, I applaud the work of all involved!

Terry Pratchett

[arkham6]

Terry Pratchett has early onset Alzheimer's. Can we sign him up for this treatment?

Does this mean fewer dupes?

[davidwr]

Too bad for the editors this won't be available for a few years.

Cue jokes about ...

[Asgerix]

Cue lots of silly jokes about ... what was the subject again?

Does this mean fewer dupes?

[davidwr]

Too bad for the editors this won't be available...

Oh sorry, did I say that already?

Probably has something funky done to it

[sirwired]

One of the toughest problems when developing drugs for the brain is crossing the "blood-brain barrier". For instance, neurotransmitters will not cross the barrier, so we can only prescribe drugs that affect them, as opposed to prescribing doses of neurotransmitters themselves.

I am 100% sure this is patentable, it is not as if nobody knows about methylene blue; and possibly they have patented a way of getting the drug directly into the brain.

But yes, unpatentable drugs are a real big problem. One of the drugs used to effective treat depression, a Reverse Monoamine Oxidase Inhibitor called Manerix is not available for sale in the U.S. because the company that bought the U.S. rights tried to use it to treat dementia, for which it does not work. By the time the trials failed, the patent was too close to running out to run the paperwork for using it to treat depression, for which it does work. Consequently, it is a safe, effective, drug, with nobody in the U.S. to sponsor it to get through the approval process.

SirWired

Re:Probably has something funky done to it

[TheSync]

But yes, unpatentable drugs are a real big problem. One of the drugs used to effective treat depression, a Reverse Monoamine Oxidase Inhibitor called Manerix is not available for sale in the U.S. because the company that bought the U.S. rights tried to use it to treat dementia, for which it does not work. By the time the trials failed, the patent was too close to running out to run the paperwork for using it to treat depression, for which it does work. Consequently, it is a safe, effective, drug, with nobody in the U.S. to sponsor it to get through the approval process.

The same thing happened to Domperidone, a drug used widely outside the United States for treatment of gastroparesis. It was proven safe in FDA trials, but was not found effective because it did not improve gastric emptying. As it turns out, it did a great job of reducing the disabling nausea of gastroparesis, but at this point no company wants to pay to take it back through FDA testing process again.

So they went on and held a big press conference...

[unikussituation]

...before publishing their data in a peer-reviewed scientific journal? At least on pubmed.gov no article on this clinical trial or even a proposal for a clinical trial could be found. I wouldn't quite call it "fishy", but a little overly eager to go public. So maybe somebody was in a hurry to stake out his claim. A drug that could halt the progress of or prevent, or even delay the onset of Alzheimer's would be worth quite a large sum. there is a number of papers on the principle of action of this drug in a number of prestigious journals, e.g. "Selective inhibition of Alzheimer disease-like tau aggregation by phenothiazines.", by Wischick CM et al. (PNAS 1996). Apparently the drug is based on dyes like methylene blue which are quite common around most medical or biological labs... so one wonders how they will or have changed the basic substance to make it patentable (and a potential cash cow).

Shame on you, funny people

[ggalvao]

Shame on you making jokes about this dreadful disease. Alzheimer is a disease which takes a heavy toll on those around the patient. There are some subjects which are better off without jokes involved. This exacerbated need for humour is a symptom of need of being oblivious to a harsh reality. Please, get your act together, folks. Let's show some more respect here.

Re:Shame on you, funny people

[Anonymous Coward]

If I cried every time something bad happened in the world, I'd never stop crying. Humor is the only way to actually cope with it all.

Re:Shame on you, funny people

[ggalvao]

That doesn't mean you'll laugh in front of people directly suffering the subject of the joke.

Re:Shame on you, funny people

[Anonymous Coward]

The Internet is SERIOUS B... er, what was I going to say? BEES? BEES!

Why would we want to stop progress?

[dkh2]

The way I read that headline - "Drug Halts Decline In Alzheimer's" it came across as we were making progress in reducing the number of Alzheimer's sufferers and this drug puts the spank on that.

Aging in general

[bindo]

QUESTION FOR THE AUTHOR: ljw1004

I used to think that aging was a very complex set of events. Most of the people here do as well, as you can see by reading other peoples comments. I actually still do. but the graph at the end of the explanation page has me at least curious:

http://www.tau-rx.com/quiz/tangles.html

Squarely 100% of the people are at stage 1 by 85. 50% are at stage 3 or higher.

Keeping in mind that: "correlation is not causation", and all appropriate memes for the case:

Do you feel that this could be a fundamental path (albeit not the only necessary one) to tackle aging or its just one in a miriad of problems?

BindO

Tau

[Anonymous Coward]

You just cant trust those Tau, they suck!
Thats why I always play Chaos or Necros =)

Online questionnaire issue

[RJFerret]

My father has alzheimers--his decline began years ago. Sadly, he would have passed your questionnaire handily (back when an early diagnosis might have helped certain legal and medical issues) as his lucidity would be "up" for any appointment. But go out for lunch afterward, and he wouldn't remember his food preferences, or know which way to go to get home, in his community of half a century.

It was fascinating how apparent his change of behavior and faculties was to any close to him, for such an extended time, while professional assessments couldn't discern such, or validate what was obvious to us.

Now obviously an insightful application of your questionnaire might help, especially if asked when he isn't "prepared", in the evening, at home instead of visiting an office, or perhaps with results compared to another instance of questioning, since his performance would be markedly different for the same questions on a different day.

That being said, I appreciate all the research, efforts, and hope we are on the cusp of medications to alleviate this dramatic condition.

Re:Online questionnaire issue

[hoosier_geek]

My mom (Parkinsonian dementia, as far as we can tell) is similar. I think adrenaline or some similar endocrine change temporarily affects the brain chemistry, skewing it toward normal. To me, this is interesting because it hints that her problem is chemical, not structural.

"Rember" is methylthioninium chloride?

[Futurepower(R)]

Interesting points.

The BBC article linked in the Slashdot story says, "Rember, or methylthioninium chloride, is the first treatment specifically designed to target the Tau tangles."

Note that, apparently:

1) They don't know what causes Alzheimer's disease. They have only found a chemical that modifies the course of the disease.

2) The smack-you-in-the-face marketing has already begun? They are calling the drug, "Rember"?

The "drug" is only a well-known synthetic dye. "Rember" is Methylene blue. The Free Dictionary says it is, "A basic aniline dye that forms a deep blue solution when dissolved in water and is used as a bacteriological stain and as an antidote for cyanide poisoning."

3) This is apparently just an example of trying every known chemical to see if it modifies every known disease. If it works, fine, but it is not an example of science; it is apparently only an example of somewhat blindly trying everything. How is that a "treatment specifically designed"?

My understanding is that it is common to have temporary remissions of the symptoms of Alzheimer's disease. In any short clinical trial, there will be some people who have improved.

4) "... the trial was funded by a pharmaceutical company..." according to the BBC article.

Re:"Rember" is methylthioninium chloride?

[bunratty]

This is apparently just an example of trying every known chemical to see if it modifies every known disease. If it works, fine, but it is not an example of science; it is apparently only an example of somewhat blindly trying everything. How is that a "treatment specifically designed"?

In what way is this not science? Hypothesis 1: Compound A is effective against disease X. Falsified. Hypothesis 2: Compound B is effective against disease Y. Falsified. Hypothesis 3: Compound C is effective against disease Z. Not falsified. Perform double-blind tests and find a dosage that is safe and effective. Sounds like science to me.

How would you conduct a search for safe and effective drugs? If you have a better way, I'm sure pharma companies would be all ears!

Re:"Rember" is methylthioninium chloride?

[vorpal22]

The basis of 20th century psychopharmacology was in the discovery that certain dyes affect the brain in profound ways, so this hardly seems like a stretch to me. (See "The Creation of Psychopharmacology" by Dr. David Healy if you're curious.)

Furthermore, as someone with a chronic, debilitating disease whose causes are not known (Crohn's Disease), I've learned to embrace new treatments where they're found, even if they make no sense in the context of the body of existing knowledge about the condition. Indeed, it seems that the successes of treatments often are quite formative to hypotheses as to the nature of my illness. Were it not for TNF-alpha inhibitors, I would probably be dead right now.

Re:"Rember" is methylthioninium chloride?

[QuantumRiff]

I completely agree. How many products did Edison try when developing the fillament of the lightbulb. I remember reading that it was a few thousand. Imagine if he didn't do that because it "wasn't scientific". Really, its the basis of all new drugs, Does the grandparent poster think that since we sequenced the human DNA, the super computers that the drug companies use just go "aha, this is it". No, they need supercomputers to try so many combinations to come up with the right one. Essentially, speeding up the trial and error by a few million times.

Re:"Rember" is methylthioninium chloride?

[Anonymous Coward]

4) "... the trial was funded by a pharmaceutical company..."

Show me a trial that WASN'T funded by a pharmaceutical company. No, really - show me a single clinical trial for a drug that was funded by some entity other than the pharm company that makes it, and I'll show you a drug that's not going to be approved by the FDA.

See, because the number and scope of clinical required to get a drug to market are very, VERY costly. And, with such a small percentage of drugs that get through the process, clinicals are usually a giant hole into which money gets thrown. So, if some company other than the maker is paying for the trial, you can bet that it's STILL tied to the maker in some way - or it's not a real clinical trial in the first place, but a sham to show some snake oil is "safe and effective".

Re:"Rember" is methylthioninium chloride?

[ljw1004]

I should say that Claude Wischik thinks he *does* know what causes Alzheimer's disease. He's sure that tau tangles cause it. He's spent the past twenty years accumulating evidence and trying to convince people of the fact, but it's been hard because of the entrenched scientific dogma that amyloid causes it. The success of this drug finally is a vindication.

You're absolutely right, though, it was a case of trying lots of chemicals. At least, the larger pharmeceutical companies have been trying hundreds of thousands of chemicals from their libraries. A smaller company like TauRx can only manage far fewer.

But what's needed is a test-tube test to judge whether your chemical works. Previous attempts have judged whether their test chemicals work to prevent Amyloid buildup, and so they skip right over the useful ones. Claude Wischik realised that the test-tube test should be judging whether a drug works on tau tangles. This test-tube assay was the first key invention.

After that, you need an animal test to judge whether the drug works in animals. The second key invention by TauRx is a transgenic mouse where you can make it selectively express tau aggregates. They created mice with alzheimers, watched them make their demented way around water-tanks looking for firm ground, and then showed that Rember improved their condition.

You're right to ask about the temporary remissions. The clinical trial lasted 19 months and had 321 patients -- not a short trial! The test results had a p-value of 0.2%, i.e. there's a 0.2% chance that the improvement was due to the common random fluctuation rather than the drug's effect.

Re:"Rember" is methylthioninium chloride?

[seven of five]

The "drug" is only a well-known [google.com] synthetic dye [wrongdiagnosis.com]. "Rember" is Methylene blue [thefreedictionary.com]. The Free Dictionary says it is, "A basic aniline dye that forms a deep blue solution when dissolved in water and is used as a bacteriological stain and as an antidote for cyanide poisoning."

"He who toys with the most dyes, wins."

Re:"Rember" is methylthioninium chloride?

[Muad'Dave]

No mod points to give, but nicely played!

Good news for me

[sxmjmae]

It seems that Alzheimer's appears to be in part hereditary. From the number of Alzheimer in my direct blood line I knew what potentially was in my future. Not that I care as I would forget everything anyways. It sounds like it is about 5-10 years out from reaching general usage. I know I will need it in about 20 years. Good job!

quite the opposite

[Anonymous Coward]

Actually, watching someone with advancing (but not yet devestating) Alzheimers can also show you how little memory is needed for intelligence. People can continue to cope in social situations for quite a while operating almost statelessly to guess at how they should behave. Only when you pay close attention do you realize the serious short-term memory deficit.

Re:quite the opposite

[ljw1004]

The late Sir Martin Roth, a leading UK psychiatrist, always used to insist: "Alzheimers is NOT a disease of cognition". It has two separate components: the loss of personhood, and the loss of memory/cognition. In the questionnaire, one of the questions that best correlates with the onset of the disease is "... and for how long have you been depressed?"

Re:quite the opposite

[blahplusplus]

"Actually, watching someone with advancing (but not yet devestating) Alzheimers can also show you how little memory is needed for intelligence."

I think you're missing the point, if you an function, that means the most important memory is intact, consider it the brain having multiple hard disks, with data stored on each one (different parts of the brain, different networks), if one hard disk dies, or gets disconnected (cable cut), the brain cannot access that information in that storage area that is now disabled.

Memory is absolutely crucial to intelligence, there is no intelligence without a place to store and analyze feedback, even briefly.

Good for presidential candidates.

[Anonymous Coward]

I recommend this for John McCain, he is borderline demented.

Chicago?

[Anonymous Coward]

[citation needed]

Chicago isn't mentioned in the article at all.

Re:Chicago?

[ljw1004]

The work was announced at the ICAD 2008 conference in Chicago.

Here's the ICAD press release that mentions Rember:
http://www.alz.org/icad/_release_icad_072908_130pm_trials.asp

Quick, John McCain

[Anonymous Coward]

...get on that list!

Terry Pratchett

[Anonymous Coward]

Quick, someone tell Terry Pratchett!

Who cares? It won't be free to everyone

[Kohath]

This is just another huge money grab for big pharmaceutical companies. Why should you guys get to make any money off of this? All you did was cure Alzheimer's disease. Why should rich people get to avoid dementia when the poorest can't afford it? Shouldn't everyone get dementia equally?

When are we going to stop these big rich drug companies from making these obscene profits for merely curing diseases and plagues?

[Evil socialism off]

I actually hope you guys succeed and make billions. If I get Alzheimer's disease someday, it's nice to know there might be a cure, even if I have to pay you for your effort to find it.

How is it administered?

[Anonymous Coward]

Does anyone know how this was administered to the patients in the study? Was it injected or oral? If injected, just anywhere or directly into the skull?

If we were to try it ourselves we'd want to do it right.

Re:How is it administered?

[ljw1004]

It was administered in pills. The world's supply of methylene blue largely comes from a factory in china, but TauRx wanted much higher purity for their drug, so they invented a new process for manufacturing it and oversaw production in a new factory. The methylene blue is put into pills and taken orally.

There were difficulties with formulation. It had to do with the problem of getting the right dose to the brain, and not having it get digested. Also there was a problem (I can't remember which way round) about acid/base conditions. Maybe it was that the stomach acid wanted to oxidise the drug, so it had to be mixed with a reducing agent so it lasted long enough to reach the brain? I'm afraid I worked on the questionnaire side, not on the chemistry....

Re:How is it administered?

[7bit]

65mg Tablets of Methylene Blue (Urolene Blue) {a round blue tablet} used to be commonly available and at a price of $19.99 for a bottle of 30 65mg tablets at www.drugstore.com. But for whatever reason these tablets seem to no longer be available in the U.S.

Here is an Info page from Merck which references that and much more about Methylene Blue (Tablets & Injection):

http://www.merck.com/mmpe/lexicomp/methylene%20blue.html

Administration: Oral

Administer after meals with a full glass of water. When given for the treatment of ifosfamide-induced encephalopathy, may be mixed with fruit juice to mask unpleasant taste.

Administration: I.V.

Administer undiluted by direct I.V. injection over several minutes. For the treatment of ifosfamide-induced encephalopathy, methylene blue may be administered either undiluted as a slow I.V. push over at least 5 minutes or diluted in 50 mL NS or D5W and infused over at least 5 minutes. Consider concomitant dextrose administration, especially in patients who are hypoglycemic, to ensure efficacy of methylene blue.

Dosage

Children: NADPH-methemoglobin reductase deficiency: Oral: 1-1.5 mg/kg/day (maximum: 300 mg/day) given with 5-8 mg/kg/day of ascorbic acid

Children and Adults: Methemoglobinemia: I.V.: 1-2 mg/kg or 25-50 mg/m2 over several minutes; may be repeated in 1 hour if necessary

Adults:

Genitourinary antiseptic: Oral: 65-130 mg 3 times/day with a full glass of water (maximum: 390 mg/day)

Ifosfamide-induced encephalopathy (unlabeled use): Oral, I.V.:

Prevention: 50 mg every 6-8 hours

Treatment: 50 mg as a single dose or every 4-8 hours until symptoms resolve

-
by the way: The (Ascorbic Acid) mentioned under dosage is (Vitamin C).
-

* Does anyone know where these tablets could be purchased now?

Re:How is it administered?

[Rich0]

Knowing a little about this stuff I figured I'd comment.

Quality is a big concern with pharmaceuticals. Even if the stuff coming from China was half-decent it probably couldn't be legally used to manufacture pills. For very good reason just about all modern nations require some variant of the GMPs ("Good Manufacturing Practices") to be followed when manufacturing drugs. The foundation of these principles are that everything is done following standardized processes, so that the first pill ever made and the pill that comes off the line 10 years later can be assured to be nearly identical in composition. That applies to the pills, and every ingredient that goes into them. Look up any common household item that can be bought with or without a "USP" (or EP/JP/BP/etc) designation - the latter will probably cost 3x as much but for the most part it is probably the same stuff. The difference is all the paperwork required to prove to regulatory inspectors that it is safe for use in people.

If that factory in China isn't a GMP facility then nobody could use it as a raw material for forumlating a pill. It isn't considered acceptable to just grab a random feedstock and test it - every step of the process has to be controlled. They may also have issues with impurities. Sometimes the best way to make a drug isn't the best way to make a chemical in general. The ideal manufacturing process for a non-drug might be prone to leaving impurities that are toxic, whereas a less-ideal process might have a lower yield but result in a product whose impurities are not toxic. Also - manufacturing processes might yield a salt or crystal form of a compound that varies in absorbtion or stability.

Pharmaceuticals that aren't stable in the stomach aren't uncommon - there are lots of common ways for handling these situations. Enteric coatings are fairly standard fare in the world of pharmaceutical manufacture.

All of these are well-understood problems in the pharmaceutical industry. They are solved probably 100 times for every drug that makes it to market (for every drug that makes it probably around 100 got as far as being formulated but were abandoned). It certainly costs money, but the real costs come later with the clinical trials.

Ch ch ch changes

[wombatmobile]

The idea that 'everything that I am' might one day start to slowly degrade freaks me out.

Everyone declines. Everyone dies. Nobody gets out alive. Such is life on Earth.

Re:Ch ch ch changes

[StarfishOne]

"Everyone declines. Everyone dies. "

Yes, true, true.

But there's quite a difference between what I shall call 'normal decline' and 'Alzheimer induced decline'.

It's normal that ones body will start to function less well... but also losing ones mental functions?

My grandfather is 86 now. His mother reached the high age of 96.. and she was sooo sharp. Definitely not one you could fool. Her son, now 10 years younger is just a shadow of who he was.

Headline halts decline...

[ryanscottjones]

... in ambiguous headlines.

So what's your point?

[Man On Pink Corner]

There are two schools of thought in drug research. One is to throw lots of stuff at the wall to see what sticks, and the other is "intelligent design," using extensive modelling and simulation to build molecules on spec. So far, the former school is ahead about ten thousand to one.

If you had syphilis in the early 1900s, would you balk at taking Salvarsan just because it contained arsenic, and because the guy who came up with it was on his 606th try? Well, we're in exactly the same boat now with respect to Alzheimer's.

4) "... the trial was funded by a pharmaceutical company..." according to the BBC article.

And they're getting results. What do you value more, your money or your sanity? If you get this particular disease, you (and your family) are going to be damned glad somebody came along and offered you the choice.

If you have a better process in mind, we're all ears. So far, the more-socialized European approach has given us, well, LSD.

Glad to read this

[Kibblet]

As someone who just started working in the field (long term care/hospice), this makes me happy. Not only because of the emotional aspects of it, of people remembering families and the like, but the very serious end stage problems, like forgetting how to eat. I don't think people realize how even the simplest tasks can be forgotten, and these effects can cause a further physical deterioration. It's also sad to see someone very upset because they can't find the elevator on a one story building, and they are going to miss their appointment, or wondering where their taxi is to take them from this hotel back home. All that stress makes the experience more draining on their bodies, and on the health of their caretakers (sometimes getting on in years themselves).

Rember is Methylene Blue? Methylene Blue is...

[Tetsujin]

Methylene Blue is PEOPLE! It's PEEEE-PULLLLL!!

Who are you people?

[AP31R0N]

And what the hell are you doing in my house? /obscure //not likely

Laughing is FORBIDDEN!

[Tetsujin]

Shame on you making jokes about this dreadful disease.

My dad seems to have Alzheimer's - he now lives in a veteran's home, often doesn't know who his kids are, or that he has any, who his wife is, etc. It seems like his greatest point of clarity is that he doesn't want to be in the home, so we have to make excuses every time we leave there without him. Plus he had some recent dental issues (all his upper teeth are falling apart) - my mom arranged for him to get dentures, but he had a habit of taking them out and now he's lost them. She won't be getting him more, and I can't blame her.

This from a guy who used to be very active in the Ham Radio community, a sometimes-tinkerer in programming and circuits, etc. One of the sadder stories, IMO, is of how one time after the onset of the disease (when he could still live at home but had degraded to the point where he couldn't track complicated discussions or follow instructions, etc.) someone from the ham radio community called him up looking to ask him a question - and I guess from the course of the discussion figured out what happened. That must be really sad.

So, yeah, when people post lame jokes like "I was going to post something here but I forgot what" - it's like I want to smack 'em up-side the head and be like, "do you know what this disease really does? It made this man paranoid that my visiting 7-year old cousin might constitute some mortal threat. It's not just about forgetting things."

But, you know what? I also hate this whole attitude of bitching out the "insensitive clods" of the world. Yes, "my dad has Alzheimer's you insensitive clod." But all the same I don't think anything should be considered outside the domain of a good joke. Let's have fun and laugh! :D

Re:Laughing is FORBIDDEN!

[ggalvao]

I agree with you on the level of the jokes. But to a good 90% all we see is the "I forgot" joke. The kind of attitude that makes me think that they're in severe need of attention and care like 'Look At Me, P-lease!".

Re:Laughing is FORBIDDEN!

[Tetsujin]

I agree with you on the level of the jokes. But to a good 90% all we see is the "I forgot" joke. The kind of attitude that makes me think that they're in severe need of attention and care like 'Look At Me, P-lease!".

So the fact that their jokes aren't very imaginative is a cry for help? :D

I dunno. I think sometimes you gotta go for the low-hanging fruit. Lots of people don't know all the eventualities of dementia - but just about everybody knows that Alzheimer's makes you forget things. Hence it's a lot easier to make an effective (and funny) Alzheimer's memory-loss joke than a real dementia joke...

I don't know, maybe people should look at this post as an open invitation - a challenge, even, to produce a good dementia-based joke, something that would be funny whether or not the person reading it is really familiar with dementia... I'm not sure how you do that, at least without crafting a fairly elaborate character and setting to frame it in...

Re:He suffers from Alzheimer's Disease. She has it

[ljw1004]

I'm very sorry about your wife. That sounds really awful. This idea, that it's the carers who suffer most, is something my father repeats all the time.

Someone contact Terry Pratchett

[roc97007]

Right away.

Re:So they went on and held a big press conference

[ljw1004]

What happened is that they went to present their results at the ICAD 2008 alzheimer conference in Chicago. The ICAD committee selected Rember as one of the "top presentations" at the conference, and organized all the PR and news briefings.

Pharma doesn't care!

[Anonymous Coward]

All pharma does anymore is make drugs that give old guys erections... or so i've been told around here again and again and again.

awesome

[Anonymous Coward]

This is good news for anyone that's watched a relative die from this horrible disease.

I hope it really works and isn't snake oil.

-AC

we middle age people worry about this

[peter303]

Its called "senior moment jokes". Many of us no longer have the photographic memories of a high school or college students. I could pretty much breeze through classes then or memorize technical manuals upon first read-thru. However, its not long term memory that goes first in Alzheimers, but short term memory. Like did you remember turn off the car lights, close the garage door etc.? One remedy is to develop rituals, e.g. morning wakeup routine, to make sure you've done everything. But surprises like a cat running across the driveway or a cellphone call can break your train of thought.

So does this apply to computer programming? When you are coding you need to keep several ideas in short term memory at time. With Alzheimers, I suspect that ability would go away. I use legal pads more to write down fleeting thoughts like a new feature or minor bug you want to return to in the future. Else you remember you are supposed to remember something, but forgot what it was :-) Computer programming itself might be a partial antidote against Alzheimers since you are constantly exercising your memory. The old cliche: use it, or lose it.

Insightful?

[Anonymous Coward]

How about offtopic?

most confusing headline ever

[Anonymous Coward]

That's all.

Re:most confusing headline ever

[Anonymous Coward]

This is Slashdot, just do what most users here do -- pretend you understand all of it and discuss it as such. Even use made-up jargon if you must, as long as it sounds kinda-sorta Latin-ish.

Re:Who cares? It won't be free to everyone

[TheSpoom]

And yet, even in an "evil socialist regime" where people don't directly pay for drugs they need, the makers still get their (possibly) billions of dollars. It's simply coming from one source, rather than many, and that source is funded by taxes.

It means that everyone can get cured of dementia equally, and that the makers and producers will still profit from their efforts.

It means no one is cut out from drugs that they need.

Do some research before you blindly accept the idea that universal healthcare is "evil".

Re:So they went on and held a big press conference

[unikussituation]

That does of course make quite a difference. Thanks for clearing this up.There are after all some scientists out there who like to bypass peer reviews and publish their "breakthroughs" by leaking them to conventional media, which are generally less critical of scientists' claims. No offense was intended to your fathers or his colleagues' work. that said, I am excited to see what will become of this. as I understand the idea has been around for more than 12 years and it will be interesting to see what large scale clinical trials will reveal.

Quiz

[Anonymous Coward]

Yikes! According to that quiz I'm already suffering "mild cognitive impairment" and I'm only 29.

Odd facts about the BBC article:

[Futurepower(R)]

You said, "I should say that Claude Wischik thinks he *does* know what causes Alzheimer's disease. He's sure that tau tangles cause it."

But what causes tau tangles?

Fraud? In my opinion, at the very least the BBC story is very badly written. In my opinion, there are elements of fraud. If I were the manager of "Emma Wilkinson, Health reporter, BBC News" I would review her work to try to discover if she has been taking money to advertise drugs. I would consider firing her, or at least re-assigning her to less demanding writing projects.

Quote from the BBC article: "Rember, or methylthioninium chloride, is the first treatment specifically designed to target the Tau tangles." There was no "design". The effect was discovered entirely because of a laboratory accident with a common laboratory chemical. Quote from the BBC article: "Methylthioninium chloride is more commonly used as a blue dye in laboratory experiments. Professor Wischik discovered it by accident 20 years ago, when a drop in a test tube led to the disappearance of the Tau protein he had been working on."

It seems a bit odd that, if Professor Wischik discovered the effect 20 years ago, there is an investigation of the effect only now. Why the delay? What happened?

Cancer? The BBC article should have mentioned that the laboratory chemical they are now calling "Rember" is an aniline dye, that aniline dyes cause cancer, and that has been known for a long time. Quote from that web page: "A group of chemicals called arylamines are known to cause bladder cancer. These chemicals have been banned in the UK for about 20 years. But it can take up to 25 years for a bladder cancer to develop. You may have been exposed to them a long time ago if you work in industries such as rubber or plastics manufacture. Arylamines that increase risk of bladder cancer include * Aniline dyes ...".

What that quote doesn't say is that direct chemical exposure can cause cancer immediately. How is it possible that "chemicals have been banned in the UK for about 20 years" can be given to people in the U.K. as a drug?

The title of the BBC article is NOT "Alzheimer's drug halts decline". It is "Alzheimer's drug 'halts' decline", but people with no professional writing experience will almost certainly miss the significance of the single quotes, which mean that a claim is merely being made, and the claim is not a verified fact.

The BBC article contains 539 words total. Of those, 243 words, more than half, are quotes. It seems that much of the article may have been taken from a PR release, with little or no critical thinking.

Calling the dye "Rember" encourages those with no scientific training in the field to believe that it will help them "Remember".

There are other odd aspects of the BBC article. The article says, "Trials of the drug, known as Rember, in 321 patients showed an 81% difference in rate of mental decline compared with those not taking the treatment." Does that mean there continues to be mental decline, but the decline is slower?

Later the article says, "Patients with mild to moderate Alzheimer's disease were given either 30, 60 or 100mg of the drug or a placebo. The 60mg dose produced the most pronounced effect - over 50 weeks there was a seven-point difference on a scale used to measure severity of dementia." How many points total are on the scale? Isn't that odd, that the 60 milligram dose worked better than a 100 milligram dose? How much better? Doesn't that say that there were really 3 trials, and one of the dosage levels was by chance statistically better than the others, so it was chosen to report the results?

The BBC article says, "At 19 months there was no significant decline in mental function in patients taking the drug, the researchers said."

Re:Odd facts about the BBC article:

[ljw1004]

20 years is just how long it's taken to go from the discovery of a chemical effect, on to gathering the brains of alzheimer's sufferers who have just died, developing reliable test-tube assays, developing models of the disease, developing transgenic animals, finding funding, seeking ethical and regulatory approval for clinical trials, running Phase1, and the same for Phase 2.

If you go to http://www.wischik.com/claude/pubs.html you'll see some 40 peer-reviewed publications spanning 20 years that document how slow and painstaking the research is.

There's no indication that MTC in particular causes cancer, and it's been prescribed for other conditions for many decades.

The reasons for the 100mg ineffecacy seemed to be related to how much of the chemical was reduced or absorbed in the intestines.

Analysing the data is hard in general. What's clear is that there was no statistically significant difference between the start state and end state of patients on the drug.

The trademark word "rember" is written with a lower-case initial letter.

But I agree with your concern about advertisments on slashdot.

Re:Odd facts about the BBC article:

[Anonymous Coward]

What that quote doesn't say is that direct chemical exposure can cause cancer immediately. How is it possible that "chemicals have been banned in the UK for about 20 years" can be given to people in the U.K. as a drug?

Hello, you sound like a complete idiot. Goodbye.

Alzheimer's Research even worse than mentioned....

[spectecjr]

What gets me is that 3 years ago, people found a direct link between HHV1 (Herpes Simplex 1 - the kind you get coldsores from), and Alzheimers; literally, the plaques are riddled with the virus.

Add into the mix the fact that new hi-res MRI devices show microbleeds all over the brain of most people, and that these break the blood/brain barrier in those areas, and it gives a very simple mechanism for the virus to get into the brain (even if it doesn't just travel up the neurons themselves).

Why are people focusing on the plaques and the tangles? We have a virus here that lives inside of neurons, which has been found and strongly correlated with the disease.

There are other classes of herpes virus which have similarly been implicated in brain cancer. This should be a big fat red X marks the spot. But most researchers are too specialized.

Re:Who cares? It won't be free to everyone

[Budenny]

You need to do some research into Aricept and similar drugs in the UK NHS. This is how it works under socialized medecine.

First the drug gets approved, or not, for safety and efficacy. This means it is legal to use in the UK. But it has not yet got into the NHS. So far its only in private practice.

Then it gets approved, or not, for use in the NHS by the Orwellian named NICE (National Institute for Clinical Excellence, aka the State Drug Rationing Agency).

Suppose it passes that hurdle (and Aricept did not at first), then you have to persuade your local Strategic Health Authority or maybe your Primary Care Trust, or maybe both, to let you actually have it. Whether you get it will depend among other things on the then state of their budget, where you live, what their policy is, whether they like you. Who knows, whether you are obese or a smoker perhaps. You have no RIGHT to any treatment whatever. You see, its free at the point of use, which is the Orwellian description of saying that you have paid for it out of taxes and have no right to any particular treatment for any particular condition.

They are operating a defined contribution, discretionary benefit, compulsory membership, HMO. Its called a lot of other fancy names, but this is what it is. What it does not do is treat, still less treat equally, Alzheimers patients. If it can possibly avoid it.

Universal health care is not evil, Europe does it very well. Don't however mistake what goes on in the UK for universal health care. Its socialized medecine. They are different.

More odd facts about the drug "Rember".

[Futurepower(R)]

Quote from the Chicago Sun-Times newspaper article: "In the study, 321 patients were given one of three doses of Rember or dummy capsules three times a day. The capsules containing the highest dose had a flaw in formulation that kept them from working, and the lowest dose was too weak to keep the disease from worsening, Wischik said. However, the middle dose helped, as measured by a widely used score of mental performance. 'The people on placebo lost an average of 7 percent of their brain function over six months whereas those on treatment didn't decline at all,' he said."

This seems to say that two-thirds of the results of the study of 321 people were thrown away, with excuses, and the one-third of the study that produced only 7 percent results was kept. How many people were in the one-third of the trial that produced 7 percent results? That's the true size of the trial.

Quote from the Sun-Times article: " 'This is suggestive data,' not proof, Wischik warned. The company is raising money now for another test of the drug to start next year." So, this is another Slashdot story that is in fact an investment opportunity.

The underlying facts don't seem funny.

[Futurepower(R)]

Funny comment. But the underlying facts about the name, and the drug, don't seem funny to me:

1) The person who submitted the story to Slashdot says, The trademark word "rember" is written with a lower-case initial letter. A trademark in a proper noun, and must be capitalized to show that it is not a common noun. The word seems to me to be chosen to confuse those who don't know how to think about drugs in a scientific way.

2) The "drug" is an aniline dye commonly used in laboratories. Aniline dyes have been known to cause cancer. See the comment about that, Odd facts about the BBC article, which I posted below.

3) The Slashdot story is an advertisement, apparently. The company is looking for money for more trials. See the comment More odd facts about the drug "Rember".

4) The above comment links to a Chicago Sun-Times newspaper article which says that two-thirds of the study produced no results and were ignored. The one-third of the study which is being considered produced only "7 percent" results.

5) The chemical in the drug is cheap and has been widely available for decades. Apparently to make it commercial, they are claiming they have a special formulation.

Re:Who cares? It won't be free to everyone

[Kohath]

Trying to gin up hatred and envy towards drug companies who develop disease cures is clearly evil. But people can advance their political agendas, so they do it.

Ook!

[znerk]

Ook ook!

Re:Alzheimer's Research even worse than mentioned.

[spectecjr]

Links:

HSV1 and Alzheimer's link:
http://www.sciencedaily.com/releases/2000/05/000512083302.htm and http://www.scienceblog.com/cms/cold-sore-virus-might-play-role-in-alzheimers-12283.html and http://www.ncbi.nlm.nih.gov/pubmed/18300070

Oh, and scratch that 3 years... make it 8, at least.

Re:Who cares? It won't be free to everyone

[jhylkema]

You need to do some research into Aricept and similar drugs in the UK NHS. This is how it works under socialized medecine.

First the drug gets approved, or not, for safety and efficacy. This means it is legal to use in the UK. But it has not yet got into the NHS. So far its only in private practice.

Then it gets approved, or not, for use in the NHS by the Orwellian named NICE (National Institute for Clinical Excellence, aka the State Drug Rationing Agency).

Suppose it passes that hurdle (and Aricept did not at first), then you have to persuade your local Strategic Health Authority or maybe your Primary Care Trust, or maybe both, to let you actually have it.

Sort of like how you have to persuade your HMO to let you have it? The difference is, under a universal health care regime, the CEO doesn't get a bigger yacht if he denies you your expensive, but lifesaving, procedure.

Besides, the fact is that a lot of "revolutionary new, lifesaving drugs" aren't. Many of them are very slight reformulations of existing drugs, but enough to get a new patent. See Celexa/Lexapro. And who paid for the research on the drug? Most likely some governmental organization like the NIH, but Big Pharma gets the patent. You can thank Alzheimer's Reagan for that one.

They are operating a defined contribution, discretionary benefit, compulsory membership, HMO. Its called a lot of other fancy names, but this is what it is. What it does not do is treat, still less treat equally, Alzheimers patients. If it can possibly avoid it.

Well, if Wikipedia is to be believed, the evidence of Aricept's effectiveness was somewhat shaky.

Now...

[XDirtypunkX]

... let's hope sufferers can rember to take the medication regularly.

Uh.....

[IHC Navistar]

"Drug Halts Decline In Alzheimer's Patients"

Um... isn't the point of treatment to INCREASE the decline in the number of patients?

Re:Who cares? It won't be free to everyone

[Kohath]

Here's your socialized medicine in action.

Oregon says: "We won't pay for your cancer drugs, but have you considered assisted suicide? We'll pay for that."

How could anyone describe something like that as evil?

Re:Who cares? It won't be free to everyone

[TheSpoom]

The evil there is in the corruption that's preventing people from getting the drugs they need, not the ideology of paying for them from one source.

If the state is evil, then the populace needs to elect / otherwise put in place a new state.

One example of a bad system does not make the idea itself unworkable, it simply means that that one example (Oregon, in this case) needs to fix their system.