Amyloid proteins gum up the transmission between nerve cells, while tau proteins form inside the cells and create neurofibrillary tangles, which affect cellular metabolism and function.
“If you have someone who has full-blown aggressive Alzheimer’s, they’ll have this intercellular protein (amyloid) that is impairing the ability for cells to send signals or talk to one another, and then you have this other protein (tau) that is causing the cells individually to become massively impaired,” Lacey said.
The other factor that causes Alzheimer’s is a lack of acetycholine, a neurotransmitter in the brain. All current Alzheimer’s medicines on the market deal with supplementing or retaining acetycholine, not replacing the two proteins that actually cause it and other forms of dementia.
Because of this, diagnosing Alzheimer’s early is crucial to how well modern medicine can help combat it.
“Right now, there are not very many highly reliable predictive tests for Alzheimer’s,” Lacey said. “There is one type of scan called the beta amyloid scan, which is incredibly accurate if you have beta amyloid there.”
The problem is these scans are typically not covered by insurance and can cost from $8,000 to $10,000.
Other forms of testing can help give a general idea if further testing is necessary, the easiest being the Mini-Mental State Examination (MMSE). It’s a 30-point questionnaire that measures cognitive impairment, and Dr. Lacey recommended giving it to a spouse, parent or grandparent if there’s reason to suspect some stage of Alzheimer’s.
Patti Eilbacher has Alzheimer's. AJC reporter Zachary Hansen demonstrates a simple test that can indicate a cognitive disease. (BOB ANDRES/AJC)
“The most common (signs of Alzheimer’s) that we see early on are tasks that before would have been second nature to somebody start to fall through the cracks,” Lacey said.
‘Am I going to be a blob?’
In a quaint house in Acworth live the Eilbachers, Leo and Patti. Patti was diagnosed with Alzheimer’s approximately two years ago — the disease her mother suffered from before she passed.
Patti is 76 years old, but when first asked about her age she incorrectly recollected that she was 79, having to be corrected by her husband, Leo. They’ve been married for over 50 years.
“It’s a disease that’s so frightening to people,” Patti said. “It’s a scary thing to go through, and you think, ‘Oh my God. What’s going to happen to me? What am I going to be? Am I going to be a blob for the rest of my life?’ ”
Patti definitely isn't a blob, though. She's is a retired schoolteacher with 27 years of teaching under her belt, including teaching at Kennesaw State University.
Leo constantly brought up his wife’s high intelligence and how he began to see the early signs of Alzheimer’s when her short-term memory began to waver.
“It started off (with short-term memory lapses), and I didn’t pay that much attention since I was the same way,” Leo, 80, said. “I would go up, stand in a room and think, ‘What the heck am I doing here?’ But (her) short-term memory started to go, and it started to worry me to the point where she was repeating herself an awful lot.”
Leo and their son, Todd, eventually were worried enough to get her tested for Alzheimer’s, and she was diagnosed as in the early stages of Alzheimer’s.
“We found out first of all that there’s no cure, unfortunately,” Leo said.
Leo, who played baseball with the Baltimore Orioles from 1955-1958, fought and won a bout with prostate cancer. He said his wife has handled Alzheimer’s beautifully, and they do everything possible to raise awareness for the disease.
The fight for a cure
NeuroTrials Research is conducting clinical trials on three medications that show promise for treating Alzheimer’s and dementia. All three studies focus on stimulating the brain to produce more acetylcholine, which slows the degradation of brain tissue.
The trial is in phase three, which means it’s being tested on a larger population recruited in multiple areas and states. The main purpose is to see if the medication does what it purports to do, is safe and what dosages are effective.
The Federal Drug Administration hasn’t approved a new medicine for Alzheimer’s in more than 12 years.
“The answer, at least for the foreseeable future, is going to involve using different medications with different mechanisms of action simply because a lot of times we won’t see somebody until they’re pretty far along,” Lacey said.
Once someone is diagnosed, Dr. Lacey said, “The first thing we look at is what are the things that you can control, because there’s a long list of things you can’t.” You inform them of risk factors, “and then you discuss the person’s routine, and what do they do to take care of themselves.”
He cited physical exercise and eating healthy as two important lifestyle choices that will not only improve overall health, but help combat Alzheimer’s or one’s chance of Alzheimer’s.
Dr. Lacey also heavily emphasized the importance of mental stimulation and keeping your mind active, by tasks such as completing Sudoku or crossword puzzles.
“Keep a wary eye on yourself. If you see something starting to happen, particularly if you feel like you’re losing ground in a somewhat progressive fashion, you need to get checked,” Lacey said. “The sooner (you) identify the problem, the more impact we’re going to have on minimizing how bad it may get and or how rapidly it deteriorates.”