How Quickly Does Alzheimer's Progress?
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What We Know
Research has shown that memory and cognition decline at varying rates in people with Alzheimer’s.
- 1/3 do not experience a noticeable decline in the first five years
- 1/3 decline at a moderate rate during the first five years after diagnosis
- 1/3 decline quickly during the first five years.
- On average, patients with AD live for 8 to 10 years after they are diagnosed. However, some people live as long as 20 years.
Related Insights:
- Women with Alzheimer’s tend to live longer than men.
- Americans with Alzheimer’s survived about half as long as those of similar age who did not have the disease.
- Older age, the presence of other health problems, waiting longer till diagnosis, and the level of care one receives are also associated with shorter life expectancy.
What Researchers Are Working On
Johns Hopkins researchers are working on a reliable way to predict how quickly any specific patient will lose their memory and cognition. Being able to tell which of the above groups an individual falls into can help families, caregivers and doctors to provide better treatment and support.
The researchers are looking into measuring the ratios of two lipids, or fatty compounds, in a patient’s blood. Michelle Mielke, Ph.D., is an adjunct assistant professor of psychiatry at the Johns Hopkins University School of Medicine and lead author of an article about this research, which is published in the Journal of Alzheimer’s Disease. She said,
““We’re confident there’s a relationship between these lipids and AD (Alzheimer’s disease) progression, but this work is not yet ready to be used clinically.”
In analyzing information about the fats found in over 100 people who were diagnosed with probable Alzheimer’s over a two-year period, researchers found a consistent pattern. They looked at two types of fat, sphingomyelin and ceramide. These fats are present throughout the body The higher the level of plasma sphingomyelins and the lower the level of ceramide, the more slowly the dementia of Alzheimer’s progressed.
The researchers speculated that this might have something to do with the connection between ceramides, inflammation and cell death. Fewer ceramides, fewer brain cells die. That would explain the slower progress of Alzheimer’s.
Dr. Mielke already demonstrated a similar association in an earlier study on MCI (mild cognitive impairment). In that case, higher ceramide levels went together with more brain shrinkage in the parts of the brain having to do with memory. Other research has demonstrated that ceramide levels are linked to the levels of beta-amyloid that make up Alzheimer’s plaques.
Extra Benefits
There is far greater potential in this research than calculating the rate of decline in Alzheimer’s. One very real possibility is finding ways to control the levels of these fats to fight Alzheimer’s. For instance, there is an enzyme called sphingomyelinase. Sphingomyelinase metabolizes sphingomyelins into ceramides. So, a sphingomyelinase inhibitor should inhibit, or block, this process. This, in turn, could well interrupt the progress of Alzheimer’s.
Dr. Mielke feels there is potential here to change the entire course of Alzheimer’s. She says,
“None of the other compounds in clinical trials to date are showing any benefits. Perhaps we need to shift our focus. The answers could be in these lipids, which can be measured in the blood.”
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More Information
Other Hopkins researchers contributing to this work include Norman J. Haughey, Ph.D.; Vera Venkata Ratnam Bandaru, Ph.D.; and Constantine G. Lyketsos, M.D.
For more information:
http://www.hopkinsmedicine.org/psychiatry/specialty_areas/memory_center/
Source:
- Johns Hopkins Medicine
- Survival after Initial Diagnosis of Alzheimer’s Disease
- Dementia, Prognosis, and the Needs of Patients and Caregivers
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