Alzheimer’s disease

Alzheimer's disease is a progressive, neurodegenerative disease that occurs when nerve cells in the brain die.

The Litwin-Zucker Research Center is a state-of-the-art facility that conducts clinical research in Alzheimer’s disease. Established by the late Peter Davies, PhD, a luminary in Alzheimer’s disease research, the center sits within the Feinstein Institutes’ Institute of Molecular Medicine and focuses on discovering treatments for Alzheimer’s disease and the behavioral impairments that commonly accompany it.

Jeremy Koppel, MD, associate professor, co-directs the center with Philippe Marambaud, PhD, professor. Together, they work with their team of researchers and support staff to pursue cutting-edge translational research in the search for a cure for Alzheimer’s disease, and oversee the production and distribution of Dr. Davies’ gold-standard tau antibodies to the scientific community.

Ongoing studies include novel neurocognitive and neurobehavioral investigations, new applications of the advanced neuroimaging, identification of biomarkers of disease, and integration of precision medicine informed by genetics and genomics in treatment strategies. In addition, basic science research programs at the center promote discoveries that inform clinical research directions, with a focus on tau pathology and the molecular biology of tau proteins and antibodies, the inflammatory and vascular component of Alzheimer’s disease pathogenesis and the role of monoaminergic neurotransmission in disease pathophysiology and symptomatology.

Call (516) 562-3492 or email [email protected] to contact the Litwin-Zucker Research Center and learn more about current clinical trials. To view our clinical trials, click here and search Alzheimer. To learn more about our researchers, click here.

Each individual may experience symptoms differently. Symptoms may include:

• Memory loss that affects job skills, especially short-term memory loss
• Difficulty performing familiar tasks
• Problems with language
• Disorientation to time and place
• Poor or decreased judgment
• Problems with abstract thinking
• Misplacing things
• Changes in mood or behavior
• Changes in personality
• Loss of initiative
• Lack of self-care and an ultimate decline in overall bodily functions
• Loss of ability to recognize who people are, even people well known to the individual, such as his or her child or spouse, when the disease progresses to a severe stage

The symptoms of Alzheimer's disease may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

Although intense investigation has been underway for many years, the causes of Alzheimer's disease are not entirely known. Suspected causes may include the following:

• Age and family history
• Certain genes
• Abnormal protein deposits in the brain
• Other risk and environmental factors
• Immune system problems

When Alzheimer's was first identified by German doctor Alois Alzheimer in 1906, it was considered a rare disorder. Today Alzheimer's disease is recognized as the most common cause of dementia (a disorder in which mental functions deteriorate and break down). An estimated 5.3 million Americans have Alzheimer's disease. According to the Alzheimer's Association, this number includes 5.1 million people over the age of 65, as well as 200,000 to 500,000 people younger than 65 who have early-onset Alzheimer's and other types of dementias.

There is not a single, comprehensive test for diagnosing Alzheimer's disease. By ruling out other conditions through a process of elimination, doctors, or other specialists, can obtain a diagnosis of probable Alzheimer's disease with approximately 90 percent accuracy. However, the only way to confirm a diagnosis of Alzheimer's disease is through autopsy.

Examination and evaluation are essential in determining whether the dementia is the result of a treatable illness. In addition to a complete medical history and extensive neurological motor and sensory exam (this is a brief and simple test of memory and some other common cognitive or thinking skills; it is usually part of a complete neurological exam), diagnostic procedures for Alzheimer's disease may include the following:

• Neuropsychological testing
• Blood tests
• Lumbar puncture (spinal tap)—A procedure performed by inserting a hollow needle into the lower back (lumbar spine).
• Urinalysis—Laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection or excessive protein.
• Chest X-ray—A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
• Electroencephalogram (EEG)—A procedure that records the brain's continuous electrical activity by means of electrodes attached to the scalp.
• Computed tomography scan (also called a CT or CAT scan)—A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body.
• Magnetic resonance imaging (MRI)—A diagnostic procedure that uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body.
• Genetic testing—Some genetic testing is available, especially in some research settings. Because there is no cure or effective treatment for Alzheimer's, the decision to undergo genetic testing is one that requires careful consideration and counseling with a specialist in genetics.

Specific treatment for Alzheimer's disease will be determined by your doctor based on:

• Your age, overall health and medical history
• Extent of the disease
• Your tolerance for specific medications, procedures or therapies
• Expectations for the course of the disease
• Your opinion or preference

At this time, there is no cure for Alzheimer's, no way of slowing down the progression of this disease and no treatment available to reverse the deterioration of Alzheimer's disease. New research findings give reason for hope, and several drugs are being studied in clinical trials to determine if they can slow the progress of the disease or improve memory for a period of time. There are some medications available to assist in managing some of the most troubling symptoms of Alzheimer's disease, including depression, behavioral disturbance and sleeplessness.

In managing the disease, physical exercise and social activity are important, as are proper nutrition, health maintenance, and a calm and well-structured environment. The rehabilitation program for people with Alzheimer's differs depending on the symptoms, expression and progression of the disease, and the fact that making a diagnosis of Alzheimer's is so difficult. These variables determine the amount and type of assistance needed for the Alzheimer's individual and family.

With Alzheimer's rehabilitation, it is important to remember that, although any skills lost will not be regained, the caregiving team must keep in mind the following considerations:

• To manage the disease, plan a balanced program of physical exercise, social activity, proper nutrition and health maintenance activities.
• Plan daily activities that help to provide structure, meaning and accomplishment for the individual.
• As functions are lost, adapt activities and routines to allow the individual to participate as much as possible.
• Keep activities familiar and satisfying.
• Allow the individual to complete as many things by himself or herself as possible. The caregiver may need to initiate an activity, but allow the individual to complete it as much as he or she can.
• Provide "cues" for desired behavior (for example, label drawers, cabinets and closets according to their contents).
• Keep the individual out of harm's way by removing all safety risks (for example, car keys and matches).
• As a caregiver (full-time or part-time), understand your own physical and emotional limitations.