Client Education

Memory Issues

The Research

By: Denise Hamilton, Special to AccentCare

While much remains unknown about how to arrest or prevent memory loss, scientists are exploring chemicals, hormones, vitamins and therapies that hold promise for people with age-related memory loss, Mild Cognitive Impairment and Alzheimer? disease.

There is still no magic bullet. And scientists caution that the brain is a complex organ that can be affected by genetic, environmental and other conditions we haven? even discovered.

Nonetheless, there are intriguing advances. There is evidence, for instance, that post-menopausal women who take estrogen-replacement therapy are less likely to develop Alzheimer?. The verdict is still out, however, since a more recent small, short-term study found that women with Alzheimer? disease showed no reduction of symptoms after 16 weeks of estrogen therapy.

Still, estrogen is a really hot topic among scientists who study memory loss. "Figuring that what? good for the goose may also work for the gander, studies are now under way using testosterone to treat men with memory disorders," says Dr. Michael Mega, director of the UCLA Memory Disorders and Alzheimer? Clinic.

At the federally funded National Institute on Aging, studies are under way to determine whether certain non-steroidal anti-inflammatory drugs known as NSAIDS will slow cognitive and clinical decline in Alzheimer? patients. The major risk of NSAID therapy is upper-gastrointestinal toxicity, ranging from mild stomach upset to bleeding gastric ulcers or perforation.

On another front, a recent study reported in the New England Journal of Medicine found that 2,000 IUs of vitamin E twice a day might slow the progression of the disease. This is because vitamin E is a neuroprotective agent that can safeguard neurotransmitters and affect production of the chemical acetylcholine in the brain, which is thought to play a role in Alzheimer?.

The NIA is also testing the usefulness of vitamin E and a drug called donepezil to stop or slow the progression of Mild Cognitive Impairment to Alzheimer? disease. Other vitamin E studies are also under way, but meanwhile doctors do not recommend high doses because of side effects that can include internal bleeding. Many homeopathic and natural medicine advocates recommend the herb gingko biloba as a palliative for memory loss. Studies are also under way with this herb, although "there's no real evidence that gingko biloba provides any relief," Mega says.

And scientists are doing experimental trials giving patients hormones and chemicals that are naturally secreted by nerve cells in the brain but which are present in lower levels among Alzheimer's patients.

For instance, the two main drugs approved by the Federal Drug Administration for treatment of Alzheimer's disease are tacrine and donepezil, which keeps certain neurotransmitters firing.

Likewise, many neuroscientists believe that abnormal synthesis of a chemical called amyloid—commonly found in the brains of Alzheimer's patients—plays a role in the disease. While amyloid? exact role remains a mystery, a drug that would slow its production in the brain might forestall the disease, Mega says. In addition to drug therapy, scientists are also using high-tech machines to detect and study the brain changes associated with memory loss. A study discussed in the April 2000 issue of Annals of Neurology found that structural magnetic resonance imaging (MRI) may be able to note and diagnose evidence of Alzheimer? disease in its early stages, before clinical signs appear.

This study found that scientists could fairly accurately predict people with MCI who would develop Alzheimer? by measuring the volume of certain brain areas. The volume for those areas was 37 percent less in people who developed Alzheimer?, probably reflecting the loss of brain cells.

Scientists say that pinpointing these people and treating them before they develop symptoms could arrest or reverse the progress of Alzheimer?.