Pasadena Magazine is the bi-monthly magazine of Pasadena and its surrounding areas – the diverse, historically rich and culturally vibrant region that includes Glendale, the Eastside of Los Angeles and the San Gabriel Valley all the way to Claremont.
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of Alzheimer's disease, at last discovering the mysteries of how Alzheimer's progresses in patients. One in three senior citizens age 65 and older die with Alzheimer's or another dementia. Today, it is the sixth leading cause of death in the US, with 5.5 million people currently living with the disease. The earliest general symptoms of Alzheimer's are problems with memory—episodic memory in particu- lar—with long-term memories of childhood generally spared. Among other symptoms, unknowingly repeating oneself, losing things, lack of attention, challenges with driving and problems with direction, are common. Approaching an Elusive Disease: Often patients and their families are left with many concerns after an Alzheimer's diagnosis. Such as "What options do I have? Which medications are available? Is there ever a point where intervention is limited—or even unattainable?" Judy Pa, assistant professor at the Institute for Neuroimaging and Informatics at Keck School of Medicine at USC helps to answer these questions. "I think it depends on what the goals are at different stages," Pa says. "When they are no longer able to take care of themselves, pay bills, cook, and when they really lose their instrumental activities of daily living like dressing themselves, brushing their teeth, feeding themselves- basic human behaviors- even at those stages goals just change. Early on you want to preserve cognition. You want Mom to remember her kids and grandchildren, but once an individual gets to that [severely impaired] stage, it changes. So, you want to maintain quality of life. You want to reduce agitation and anxiety." A common misconception is that you can't do anything about Alzheimer's disease, according to Pa. Her current five-year study, LEARNIt (Lifestyle Enriching Activities for Research in Neuroscience Intervention Trial) is considering how physical and cognitive activity affect brain pathology in older adults with elevated risk of Alzheimer's. LEARNIt randomly selects its participants to commit to 150 minutes per week of either physical activity—light aerobic exercise, or cognitive activity—reading about lifestyle factors that are important for aging, for a full six months. Pa then compares the differences of how the two types of intervention strategies affect brain health, cognition and physical function. Now, two years into the study, she is seeing how these lifestyle factors influence the probability of developing Alzheimer's disease or increase cognitive decline in those already living with the disease. Pa also considers lack of social engage- ment as another factor that can influence Alzheimer's disease. "One of the problems with older adults is, as they age, they become more socially isolated. Friends start to die. Their children have moved away. They may spend eight hours watching TV and living a sedentary lifestyle. Not going out and taking a walk, or going downstairs to play bridge or cards can affect this...and so we know that socialization is definitely a risk factor as well." Natural Memory Loss versus Alzheimer's Disease: It should be noted that with natural aging comes moderate memory loss. It's important to consider the difference between dementia and Alzheimer's. "Dementia and Alzheimer's are two related but distinct concepts. Dementia is not a spe- cific diagnosis. It's a description of the problem. It occurs in typically elderly people and to a degree, impacts the activities of daily living. Dementia has many causes…Alzheimer's is the most common cause," says Professor of Clinical Neurology at Keck School of Medicine John Ringman. Ringman specializes in Alzheimer's and has devoted much of his career studying families of the rare early onset Alzheimer's disease Jalisco, a gene-mutation affecting 1 percent of individuals from mostly Mexico and Puerto Rico. This gene mutation affects adults as early "We have great new tools for studying the earliest molecular changes of Alzheimer's disease," says Senior Author and Director of USC Alzheimer's Therapeutic Research Institute at Keck School of Medicine Paul Aisen. As the leading figure in Alzheimer's research for more than two decades, Aisen helped develop the earliest Alzheimer's medications patients still use today. SEPTEMBER 2017 57