Talk:Alzheimer's disease

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[edit] Flouride as a cause?

Several internet sources have been claiming that flouride is a serious cause of alzhiemers. Is there and validity to that???

[edit] UCLA/VA Study on Curry - Can it Help Immune System Clear Amyloid Plaques?

Published in Oct. 9 - Journal of Alzheimer's Disease

Treating Alzheimer's disease by enhancing the immune system using curcumin? Curcumin is "known for its anti-inflammatory and anti-oxidant properties" "Curcumin improved ingestion of amyloid beta by immune cells in 50 percent of patients with Alzheimer's disease" http://www.newsroom.ucla.edu/page.asp?relnum=7366&

Any other studies/comments on this approach?

Other UCLA studies/news can be found by searching "Alzheimer's" at http://www.newsroom.ucla.edu/page.asp?menu=fullsearchresults

To better understand how to use curcumin and DHA: http://alzheimer.neurology.ucla.edu/diet.html

[edit] Citations

A lot of the causes/prevention methods of Alzheimer's were lacking citations. I don't think that the statements are incorrect but they do need to be cited.

I have a few of the citations from some review articles, but my office is packed up for a move right now. I would prefer to keep the list to things that have been proven in large observational studies and eliminate those that are only in animal models or cellular models. --Chrispounds 22:44, 2 January 2007 (UTC)

[edit] New Section

I just added a new section, "Statistics on AD". I think it is a nice to have some kind of a "trivia" bulletin section on AD. It gives you a quick over review of what AD is about.-Igoruha 19:59, 12 October 2006 (UTC)

I like this. Could we maybe make this into a box within the social issues section?--Ipeltan 04:53, 14 October 2006 (UTC)

I think it should be as a separate section. I noticed that when I want to find some statistical numbers related to disease (or whatever) I need to go and search for it in the text, which can be annoying. But like that anyone who comes to the page and looks in the "contents" can see right away the statistics, rather than wondering where it caN be. Although I acknonowledge that it belongs in "social issues" section. -Igoruha 18:39, 14 October 2006 (UTC)

I like the idea of having statistics grouped, but the proposed guideline suggests we should not be putting "trivia" into the article. Since we do not have that many images on the page, perhaps this would fit well into a box? --Chrispounds 00:53, 15 November 2006 (UTC)

[edit] Therapeutic targets

Since many noval approaches do not qualify for "Potential Treatments." How about creatings a new section called "Therapeutic Targets" where we can post different therateutic targets that comu up in sceintific (well cited) papers ? -Igoruha 12:57, 13 October 2006 (UTC)

the solution may be "Alzheimer's Research" where we put in what is in clinical development and people can add whatever and then summarize it into the Potential treatments. --Chrispounds 18:08, 13 October 2006 (UTC)

I've just discussed some of this above, but the problem lies in defining what data defines a potential treatment. Because the actual pathogenic mechanism remains unclear, biochemical (i.e. amyloid beta levels and aggregation) and pathological (i.e. amyloid plaque count) surrogate markers have such a poor correlation with Alzheimer's disease risk, severity/symptoms, and progression. If a compound blocked the fibrilization of hyperphosphorylated tau in solution, would we really want that listed as a potential treatment? I argue that potential treatments need to be one of the following: very strongly mechanistically indicated, already in popular use, have human trials data supporting efficacy, or be in Phase II+ trials.--Ipeltan 04:53, 14 October 2006 (UTC)

As for "Alzheimer's Research," although I'd support such intitiative, it appears to me that Wikipedia is not for this. Encylopedia is ussually for reference, not a research blog. -Igoruha 15:43, 14 October 2006 (UTS)

[edit] Suggestion

Due to increased misunderstading of what should be inlcuded in "Potentail Treatments" (understandablly so, since 'potential' means: possible, capable of being or becoming) I propose to rename "Potentail Treatments" section to avoid future (and present) confusion.

suggestion: "Possible Treatments for AD, that now are in Clinical Trals", if anybody can come with the title that underlines what section is for, are welcome. -Igoruha 19:12, 14 October 2006 (UTC)

[edit] Just added

I recently noticed that the evidences that we present for the amyloid hypotesis are inadequate. Therefore I decided to add a few more:

"It should be noted further that ApoE4, the major genetic risk factor for AD, leads to excess amyloid build up in the brain before AD symptoms arise. Thus, beta-amyloid deposition precedes clinical AD. Another strong support for the amyloid hypothesis, which looks at the beta-amyloid as the common initiating factor for the Alzheimer's disease, is that transgenic mice solely expressing a mutant human APP gene develop first diffuse and then fibrillar beta-amyloid plaques, associated with neuronal and microglial damage.

And yet another support for the amyloid hypothesis comes from the knowledge of other amyloid diseases. Humans get many amyloid diseases, generally referred to as amyloidosis. Blocking the production of the responsible amyloid protein ( e.g., beta-amyloid in AD) can successfully treat these diseases."

Is everyone ok with this addition ? Igoruha 13:59, 21 October 2006 (UTC)

Can you give a direct citation or a cluster of citations that shows this? --Chrispounds 23:05, 28 October 2006 (UTC)

I just included the citations you requested, but I do not know how corectly include them in the referance section. Can some one please correct them. Igoruha 20:30, 28 October 2006 (UTC)

check out how the citations were done--you will find it is not too much work. Also look at this as a tool to do a lot of the work for you. --Chrispounds 01:44, 2 November 2006 (UTC)

I edited the comparison equating SORL1 and APOE. Given that 70% of association papers don't reproduce, the single Nature Genetics paper associating SORL1 and AD does not equate to the 150 replications of APOE-e4 and AD.

[edit] Drug Attributes

The drug attributes section that has been added is interesting on a theoretical level, but I am not sure how it relates to compounds that have been tested in human subjects. It might be more relevant in the disease mechanism section, although from what I observed at ICAD in Madrid, the alpha secretase clinical stream seems to be well behind the other modalities. Let's discuss this. --Chrispounds 17:15, 31 October 2006 (UTC)

The topic is too controversial and definatly not adequate information is presented. For example, RIKEN, the biggest research institute in Japan, came out with the study in 2005 suggesting the combination of neprilasin (the AB degrading enzyme) gamma and beta secretase inhibitors (30% of each, to reduce side effects) will propably porduce a satisfying result of reducing AB levels by 63%. Again, this is just to illustarate that the topic if included should cover much more approaches, otherwise it would not satisfy the "complete" article we are trying to have. Can we do this, gather the approaches that are being taken by research initiatives, is a question. Igoruha 17:46, 31 October 2006 (UTC)

Furthermore, despite what is said, alpha-secretase is not attractive target for pharmaceutical intervention of AD, because the therapeutic upregulation of alpha-secretase poses greater logistic challenges than does the chemical inhibition of betta- and gamma- secretases. Igoruha 10:46, 3 November 2006 (UTC)

[edit] New Medicines in different phases of development

October's issue of "U.S. Pharmacist" has a section on AD. In it they say that curently there are 12 Phase I, 19 Phase II, and 11 Phase III new medicines in development for Alzheimer's Disease/Dementias. Alzheimer's article here mentions 3-4 drugs in development, while the magazine 42. There should be more than we mention, since AD in the most common type of dememntia. What's going on ? Igoruha 21:58, 5 November 2006 (UTC)

At the Fifth Annual Dementia Congress over the weekend exactly two compounds were mentioned to be in Phase 3 --Alzhemed and Flurizan. This came from Steven De Kosky who is on the FDA Advisory Board for Neurology products. Voyager stopped the trial for Memryte somewhat abruptly in October. I believe Xaliproden has results from their Phase 3s, but they have not been publicly announced. Other compounds may be products that have completed Phase 3 but stopped there. Also, approved compounds that do work in Alzheimer's might be counted at Phase 3. The TZD and statin trials might fit this. The author might be using PharmaProjects or a similar database to make this count. --Chrispounds 04:58, 6 November 2006 (UTC)

Why should Wikipedia only list FDA approved Phase 3 drugs? This isn't the "Wikipedia of America". 88.112.219.78 18:13, 13 November 2006 (UTC)

Great question! As it turns out, the Phase 3 compounds in the US also are in Phase 3 trials with the EMEA in Europe. Alzhemed and Flurizan are still enrolling in Europe, Xaliproden had US and European trials at the same time (results in the next year or so), and Voyager only had US enrollment going when they halted things. Japanese Phase 3 trials lag by 5-6 years. The economics of pharmaceutical development favor starting US trials ahead of Europe. Prices are about 15-20% higher in the US for products in this category. --Chrispounds 22:24, 13 November 2006 (UTC)

Thanks for clearing that up for me. It just puzzled me that everyone always speaks about drugs approved in the US here. Might have something to do with most editors being from the US (?) of course. The fact that the medicine prices are higher in the US surprises me. As far as I know, most products in other categories than medicine are cheaper in the US than Europe. 88.112.219.78 23:50, 13 November 2006 (UTC)

It might be surprising at first to someone not from U.S. I guess, but for those living in America it is even more surprising sometimes. Furthermore a lot of Americans see evil in all those "bloody" pharmaceutical companies charging all those “ridiculous” prices. Consider this: The United States has the most rigorous process in the world for new drug approvals. It takes 10 to 15 years for an experimental drug to become available to patients. It is estimated that only five in 5,000 compounds testing make it to human testing. And only one of those five is approved for manufacturing. It costs a company $802 million (Chrispounds can correct me if I am wrong) to get one new drug from laboratory to patients. R & D investment in new drugs in the U.S. by biotechnology and pharmaceutical companies was about $51.3 billion last year. The R&D investments far exceed those of the international pharmaceutical industry and the NIH. To say more, it can be said that Americans are "obsessed" with medical advances, and this in fact turned my country (U.S.) into the world's research laboratory. If you followed this year's Nobel Price announcements, you may have noticed that every scientific price went to an American. To be fare, all these do not mean that we (Americans) have the best drugs and/or the best medicines. |Igoruha 21:14, 13 November 2006 (UTC)

Average costs of $800 MM is about right from the Tufts research, but for a given compound it could be much less--like $100 MM to get it approved. It just takes many tries before you get one in the goal. I think 7-10 years is the typical timeline. The EMEA process is equally rigorous now, but in the past there was more leeway in Europe. If the cost of a therapy is more than the substitutes, then by all means, the substitute should be used. --Chrispounds 00:58, 15 November 2006 (UTC)

Good point, especially for some Alzheimer's "treatment." Expensive procedures - like some Alzheimer's treatments, some knee surgeries, and especially body scans - are often no more effective than basic ones. In other countries, I think, people have arrived at a better undertanding that health care necessarily involves economics triage - that $10,000 spent on quixotic care is &10,000 than can't be spent more usefully. And stastics proves that, as in the United States health care expenditure per person is bigger than in any other country in the world, but life expectancy at birth is in the U.S. is behind most countries in Europe, Canada, and Japan. Igoruha 22:42, 14 October 2006 (UTC)

Indeed, but that fact has nothing to do with medicine or the medical system. The life expectancy in US states which have fewer socioeconomic and illegal immigration problems compare very well to the rest of the world. If you take the US states which have the best life expectancy, like Hawaii, Minnasota, South Dakota, and Utah, you find that they compare very well with those of Japan in Iceland. They are as good as anywhere in the world-- yet there is nothing special about the US health care system present in these states. For example, male life expectancy at birth in Hawaii is 75.4 and for females it's 81.4. For Utah men it's 74.9 and for Minnisota women it's 80.8. These are due to cultural factors completely independent of doctors, hospitals and even insurance plans. And so they are also in Japan and Iceland, too, no doubt. In fact, I have little doubt that the fact that Hawaii beats all the other states in the US in lifespan is due in part to the Japanese Americans who live there. It's not that Hawaiian doctors or hospitals are amazing.

What drags things down in the US are places like Washington DC where males at birth can expect only 61.8 years and women 73.3. That gives an average of 67.5-- incredibly bad. Next is Louisiana at 72.7 and Mississippi at 72.6.

In short, if you have an ocean around you, or a big buffer-country to the South (like Canada) you can run a very fine tight health care system. Which would be immediately and totally destroyed if exposed to the population of New Orleans or the immigration problems of Arizona. Look at that life expectancy for Louisiana again.

A last point is that of course this has nothing to do with Alzheimer's disease treatment, except as a social argument about triaging resources between generations. The US has the best life expectancy AT AGE 65 of anyplace in the world. And yes, we waste a lot of money doing it. But it's not by doing PET scans to look for dementia. Rather, it's by NOT doing PET scans, and instead doing serial MRI scans (paid for by medicare) every time time elderly person with known dementia has some change in mental status. Which, in total, cost far more than a PET scan, and in total add very little to quality of health care, but a LOT to the cost of it. So in this case, the problem is not use of high-tech, it's use of the WRONG high-tech. S B H arris 21:58, 18 December 2006 (UTC)

Realizing that this discussion group should be about Alzheimer's article, I'd allow myself to make a few short remarks unrelated to AD, to respond to the last comment. Reports, that S B H[[User:Sbharris|arris] probably came across, neglect to mention that Hispanics (many of whom are immigrants) in general live slightly longer than Whites, even though Hispanics have very high rates of lacking health insurance and have very low per capita incomes and high poverty rates. Recent San Francisco news report slammed lower life expectancy for city blacks, but completely overlooked that at 80.2 years, city Latinos rank among the longest living of any group anywhere in the world. This evidence is counter to the common wisdom that the Japanese live longer. This is of course not disregard that life expectancy in parts of U.S. comparable to third world. Plus, US has the longest life expectancy if you're already 80. Although all this is supposed to change for the worst as NIH suggests: "Over the next few decades, life expectancy for the average American could decline by as much as 5 years unless aggressive efforts are made to slow rising rates of obesity ... The U.S. could be facing its first sustained drop in life expectancy in the modern era" Igoruha 15:33, 19 December 2006 (UTC)

[edit] Images

I am not sure that the histopathology picture is convincing. Where is the neurofibrilary tangle? It might be useful to show a brain scan or a photograph of a brain with increased sulci and reduced gyri (and perhaps a normal one for comparison). Snowman 23:29, 6 November 2006 (UTC)

[edit] Breakthrough in Diagnosing AD

New PET tracer compounds, developed to visualize the profile of accumulating pathology, visualize amyloid plaques and NFTs in the living brain - hallmarks of AD previously only detectable at autopsy. These molecular probes are labeled with positron emitting isotopes - when they bind to the hallmark lesions of AD, their distribution in the brain can be determined using PET scanning.The results accurately and effectively separated the AD patients from the control. group.http://www.loni.ucla.edu/~thompson/PDF/Thompson-AD-NYAS-v8-Jul24.pdf

For movies of disease progression copy and paste this link into your address box: http://www.loni.ucla.edu/~thompson/AD_4D/dynamic.html

Other videos about ADNI at: http://www.nia.nih.gov/Alzheimers/ResearchInformation/ClinicalTrials/ADNIVideoClips.htm Igoruha 10:28, 17 November 2006 (UTC)

[edit] Alternative Therapy

So I don't know much about Alzheimer's or the potential use of curry as a cure. But I do know that the section that mentions it in this article is extremely biased and inapropriate for this page. Although I certainly have my problems with drug companies I know better to discuss them on this very unrelated thread. So could someone please remove or edit that section so that it lives up to the standards of the rest of the page. 69.87.178.87 16:45, 13 December 2006 (UTC)

[edit] Lyme Disease

The Lyme disease linkage is novel, but it is very far from being accepted in the scientific literature. The 1987 reference has only 17 citations, and doing a search there have been letters that find zero evidence of the Borrelia involvement. There are only 14 citations in pubmed with borrelia and alzheimer's. There have been and continue to be discussions about viral causes of AD, but I think we should stick with the more prevalent theories for this treatment. Alzforum has some great notes on microbial involvement. --Chrispounds 12:16, 17 December 2006 (UTC)

[edit] Abeta normal role ?

Since Abeta peptide is produced in healthy brain as well as in diseased brain, does anyone know the normal role of this peptide ? And if it has neurotrophic role, would that mean that inhibition of beta and/or gamma sercetases would be bad ? Igoruha 10:03, 28 December 20006 (UTC)

Gamma secretase inhibition blocks Notch. See this for example. Notch is important in cell development, and side effects to Notch inhibition often show up in the form of gastro-intestinal problems. --Chrispounds 17:23, 29 December 2006 (UTC)

The question was meant to ask the following: if normal (non fibrilogenic) beta-amyloid peptide does something "good" for the brain, would brain continue to function normally if beta-amyloid production to be blocked ? Igoruha 12:33, 29 December 2006 (UTC)

[edit] Cerebral Health Website

As director of the cerebralhealth.com website, I would like to offer an appeal to the editors of this page to include a link to either the homepage at http://www.cerebralhealth.com or to the Brain Research and Information Network (B.R.A.I.N.) at http://www.cerebralhealth.com/neuroscienceresearch.php

Due to the rising profile of Wikipedia and the amount of extra traffic it can bring a site, there is a great temptation to use Wikipedia to advertise or promote links. This includes both commercial and non-commercial sites. You should avoid linking to a website that you own, maintain or represent, even if the guidelines otherwise imply that it should be linked. If the link is to a relevant and informative site that should otherwise be included, please consider mentioning it on the talk page and let neutral and independent Wikipedia editors decide whether to add it. This is in line with the conflict of interests guidelines. Shoessss 15:48, 29 December 2006 (UTC)

Just about all commercial sites will be removed. One exception will be for product specific sites where we have linked to the Product Insert. The Alzheimer's Store page that mentions news (the first of the external links) has also been an exception because it provides a really nice archive to news stories related to the disease without being terribly commercial in its delivery. I would invite other editors to have a look at this and other external links to see if it should be removed, but I would keep it. --Chrispounds 17:17, 29 December 2006 (UTC)

I took a quick look of two links. Neither of two are directly related to the Alzheimer's Disease. But I found some links on two pages (more on the second one) to be very informative and some are directly related to the disease. For that reason we can use some of the information from two sites to improve our article. Taken into account the great abundance of similar sites, I think that we (editors) should limit external links to sites which are specific to AD, as we have the article which is specific to AD. But I join Chrispounds in inviting other editors to express their opinions on the subject matter. --Igoruha 12:55, 29 December 2006 (UTC)

I appreciate your consideration.

[edit] Cause of Alzheimer's

While light metals has long been suggested to be a causal factor to Alzheimer, it is only recently that Dr. Rosanna Squitti has discovered a link between copper and Alzheimers.

The logic is quite simple, a metal interfers with the brains electro chemcial impulses.

Another light metal often assocated with Alzheimers has been Aluminum. The widespread use of aluminum cans and especially the use of alum flakes to be used as a nucleous for filtering water often results in high level of aluminium remaining in the water.

The lobbying efforts by the Aluminum industry and media relation efforts (ie S&H Incorporated) to dispell the connection are considered to be at play here.

--Son of Maryann Rosso and Arthur Natale Squitti 16:20, 4 January 2007 (UTC)

Interesting stuff, but folks might also say that copper is the cause of heart disease with electrical interference with the sino-atrial node. The study mentioned was in animals, and not humans. The discussions I have read like here are more skeptical. This is one of many research streams being studied but it has not shown a lot of evidence in humans. Can you point to other sources for us? --Chrispounds 19:22, 4 January 2007 (UTC)

Thanks for that observation. I regret I do not have the time to do the research you require for your article. As I suggested to Dr. Rosanna Squitti, Alzheimers may the result of more than one factor working half-truths together to create the disease. It appears your article suggests cholesterol.

Just one factor I have seen the proliferation of profit motivated research and truths, and have become quite cynical as to pure truths.

Perhaps I will have more time in the near future.

Ie source of contaminations...water, and water pipes. I did find some info into the fact that old lead pipes became coated, and released very littl lead into the water, on the contrary new copper pipes, and lead solder in those pipes was a concern.

Let us not ignore the history of lobbying efforts by the cigarette industry on the link between smoking and cancer.

--Son of Maryann Rosso and Arthur Natale Squitti 00:20, 5 January 2007 (UTC)

[edit] Fatality

In some parts of the article (for ex. statistics) AD is stated as a cause of death. But on the other hand, no where in the article it's not stated whether AD is fatal or not. It seems like it's fatal, but not clear why, the chances, and reason. It would be nice if there's some kind of info about fatality in the first section. iyigun 23:06, 16 January 2007 (UTC)

Many things are causes of death without being necessarily or immediately fatal to all people, immediately. Any kind of paralysis or coma, for example. These things cause such gigantic care problems for any person that the patient becomes practically impossible to keep alive for the long term. It comes down to a matter of money, ala Terri Schiavo or Christopher Reeve. The more money you have, the better you can do, but it's a losing game, and for people with no effective consciousness, usually one that nobody is willing to play. S B H arris 23:26, 16 January 2007 (UTC)

Since there is no "cure" for AD, everyone who has it will die with it, but not necessarily from it. It can cause death by shutting down brain function. I will get a source and description of that, but of course, "How we Die" by Sherwin Nuland is the classic. --Chrispounds 23:38, 16 January 2007 (UTC)

I do not think you'll find a case of anybody dying of Alheimer's which had progressed to the point of shutting down brain stem function and causing classical brain death. It just doesn't work that way. Nor would anybody allow the process to go on that long, even if it did. S B H arris 23:41, 16 January 2007 (UTC)

Just to make it clear: People who develop Alzheimer's can live from 2 to 20 years with the disease, but Alzheimer's disease is a terminal illness. Due to the deterioration in the brain and body, a person becomes more susceptible to various complications, such as infection, that can cause death. While infection may be the immediate cause of death, the underlying cause is the deterioration brought about by AD. In the brain with Alzheimer's disease neurons continue to die over time and eventually the body will shut down. However, people usually die of secondary infection. It is usually not the actual Alzheimer's that ends a person's life, but rather, any one of a number of side effects of the disease. Such as influenza or pneumonia brought on by compromised immune system. --Igoruha 23:34, 17 January 2007 (UTC)

Yes, and you can say just the same about being a high level quadruplegic. Potato, potahto. Aging itself is a terminal illness. Nobody has died of old age since 1955 when they outlawed it as a cause of death to put on death certificates. Since then, it's been putting down "complications" only. Doesn't change reality. S B H arris 04:41, 17 January 2007 (UTC)

Thanks for your reply Igoruha. I would like to see such an explanation in the article. iyigun 17:04, 20 January 2007 (UTC)

[edit] Ginkgo

The AAGP document states that ginkgo is no well studied enough to recommend it as a treatment. We mention it later and point to the long-term trial that is reviewing it. Other treatments have seen safety and efficacy studies. If the editors can point me to this, we can keep it in, else I would say we keep the current statement in. The 2004 conference paper seems to be well below the standard of other references. --Chrispounds 23:11, 30 January 2007 (UTC)

I am in the middle of locating more reliable sources (many exist), and I look forward to your comments after they appear. Kim99 00:44, 31 January 2007 (UTC)

There is a good paper titled "The use of herbal medicine in Alzheimer's disease-a systematic review."

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=17173107

As you pointed out there are many sources, here are some that I find reliable:

"Amyloid-beta-induced pathological behaviors are suppressed by Ginkgo biloba extract EGb 761 and ginkgolides in transgenic Caenorhabditis elegans." :http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=17167099

And another paper that supports same argument: "The GuidAge study: Methodological issues. A 5-year double-blind randomized trial of the efficacy of EGb 761(R) for prevention of Alzheimer disease in patients over 70 with a memory complaint."http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=17101932

Igoruha 19:52, 30 January 2007 (UTC)

I read a pretty well organized German meta-analysis too, and am trying to locate it. Kim99 04:50, 31 January 2007 (UTC)

In view of the number and results of studies on Ginkgo Biloba I suggest that the paragraph on "alternative treatments" be removed or modified (Intriguing studies on Curcumin exist but nothing to write home about quite yet, as far as I have discovered). Kim99 06:21, 1 February 2007 (UTC)

[edit] Notable cases: Emerson: Problem

Article says, "Notable cases of Alzheimer's disease have included ... Ralph Waldo Emerson ..." Article also says, "No medical tests are available to diagnose Alzheimer's disease conclusively pre-mortem. ... a definitive diagnosis of Alzheimer's disease must await microscopic examination of brain tissue, generally at autopsy." Also says, "In 1901, Dr. Alois Alzheimer, a German psychiatrist, interviewed a patient named Mrs. Auguste D. [who] ... would be the first patient to be identified with Alzheimer's disease." Ralph Waldo Emerson died in 1882. Alzheimer's disease can only be definitively diagnosed by post-mortem study. Emerson died twenty years before the disease was clinically defined. Therefore, it is speculation to say that Emerson died of Alzheimer's. Therefore, I'm deleting this reference from the article. If you wish to re-add it, please justify here. ---- Writtenonsand 02:35, 1 February 2007 (UTC)

the Shenk book describes Emerson's condition and together with the PBS miniseries http://www.pbs.org/theforgetting/experience/index.html both are pretty clear about Emerson's dementia. Let me double check what the JAMA review says. Yes, it is an ex-post diagnosis without "definitive" pathological evidence. A couple of the stories in it about Emerson are really sad. I can retrieve the book from a colleague to give you page numbers if you like. Note that the book is cited as the source for these first few names. --Chrispounds 05:04, 1 February 2007 (UTC)

We can diagnose DEMENTIA by symptoms alone, and therefore historically. But there are many causes of dementia, and AD is only one of them. About all we can say of Ralph Emerson is he got demented at the end, like Swift. It was probably AD, but it could just as well have been MID. Or a combo. We'll never know. S B H arris 06:03, 1 February 2007 (UTC)

JAMA says, "In some of the most publicized parts of the book, Shenk describes the dementia (not necessarily AD) of famous people, such as President Reagan and Frederick Law Olmsted, and of literary figures, such as Jonathan Swift, E. B. White, and Ralph Waldo Emerson. It is ironic that Shenk focuses in part on these literary figures with dementia, given the findings from Snowdon's longitudinal study of nuns1 that those with poorer literary skills and impoverished verbal output seemed to be at greater risk for developing AD." So, we do not have the medical confirmation of it. The delete is fine. --Chrispounds 14:53, 1 February 2007 (UTC)

[edit] Drugs in Clinical Trials

Alzheimer's Research Forum lists 55 drugs in current clinical development http://www.alzforum.org/drg/drc/default.asp. Why we only mention a few ?? -Igoruha 23:20, 2 February 2007 (UTC).

Are you interested in starting a new article that would go deeper into the clinical research? --JWSchmidt 04:53, 3 February 2007 (UTC)

I think it was back in October that we talked about what would be listed. Many products have failed in Phase 3 (Phenserine most recently), so unless something has reached late stage testing (Phase 3), they are not going to be listed. The vaccines were in Phase 2 back in 2002, but had a setback. Dimebon, PBT2 and the army of phase 1-2 compounds would make the article longer, and we already have a long article. If you want to summarize the research in alzheimer's disease into an article, I can give you a list of compounds to look at. Alzforum has not cleaned out some of the dead compounds from their list. --Chrispounds 16:54, 3 February 2007 (UTC)

[edit] New Table

I think it would be a good idea to add a table describing prevalence and costs associated with the disease among countries (or regions around the world), to give readers a better prospective on the impact of Alzheimer's (or dementia in whole). Before that I want to collect reliable references. If any one knows good statistics please post it. -Igoruha 9:42, 5 February 2007 (UTC).

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