Alzheimer’s Disease Prevention Initiative Primary Secondary Prevention Prevention Treatment Pre- Mild Normal symptomatic Cognitive AD AD Impairment No Disease, Early Brain Mild Memory Mild, Moderate No Symptoms Changes, Loss and Severe No Symptoms Impairment Disease Progression Risk of Developing Alzheimer’s Disease in Persons with MCI Survival curve of persons characterized as having a mild cognitive impairment for 6 years. Approximately 80% have converted to dementia during this time. Peterson RC, et al., Arch Neurol. 58:1985-1992, 2001. Volume of Hippocampus and Rate of Shrinkage Predicts Crossover from MCI to AD Percent Annual Decline in Hippocampal Volume 4 Normal, 3.5 75 years old 3 2.5 Stable 2 Decliner 1.5 1 0.5 0 Alzheimer’s disease, Control MCI AD 75 years old De Leon MJ, 1999 Jack CR, et al, Neurology 55: 484-489, 2000 PET Imaging of Amyloid Deposits in Alzheimer’s Disease vs Normal Controls PET imaging with a novel tracer, Pittsburgh Compound-B (PIB), can provide quantitative information on amyloid deposits in living subjects. Source: Klunk, et al. Ann Neurol 2004: 55:306-319. Current Drug Treatments for AD • Acetylcholinesterase inhibitors for mild to moderate AD − Tacrine (Cognex) − Denepezil (Aricept) − Rivastigmine (Exelon) − Galantamine (Reminyl) • Neuroprotective agent for moderate to severe AD − Memantine (Namenda) Funded AD Prevention and Selected Treatment Trials Vitamin E, C, B6, B12, Folate, B-Carotene Vitamins E, Aricept Aspirin, Vitamin E Estrogen B-Carotene, Vit. E, C Celecoxib, Naproxen Ginkgo Biloba Vitamin E, Selenium Simvastatin 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 April 2002 Complementary & Alternative Therapies for AD • Ginkgo Evaluation of Memory (GEM) study • Clinical trial of huperzine • Traditional Asian medicines • High intensity light therapy REACH II Intervention The REACH II intervention is a multi-component intervention designed to address five areas linked to caregiver risk profile: • Safety • Social Support • CR Problem Behaviors • Emotional well-being • Self-care and Health Behaviors
"Risk of Developing Alzheimer’s Disease"