Alzheimer's Disease - New Findings Hold Promise

PET scan of a human brain with Alzheimer's disease. By US National Institute on Aging, Alzheimer's Disease Education and Referral Center, via Wikimedia Commons.

As the world's elderly population grows, the incidence of Alzheimer's disease is expected to skyrocket. The recent admission by 59-year-old University of Tennessee women's basketball coach Pat Summitt that she has early onset dementia has no doubt got many people in her age group worried.

Fortunately, there have been some new findings that are pointing to possible causes of and detection strategies for the disease. Things are very preliminary at this point, so scientists are cautioning people not to get their hopes up yet, but some of the research looks promising.

* Researchers in San Francisco have identified and ranked seven risk factors that can be linked to at least half of all cases of Alzheimer's disease. Worldwide, lack of education is the main cause; in the U.S., leading a sedentary lifestyle leads the way. See this L.A. Times story for more details.

In the U.S., the study says, lack of exercise was the main risk factor, accounting for 21% of risk. Depression was the next highest factor (15%), followed by smoking (11%), hypertension (8%), obesity (7%), low education (7%),  and diabetes (3%).

* It may be possible to detect some signs of Alzheimer's disease as long as 20 years before the onset of symptoms by examining a person's cerebrospinal fluid (CSF), say new findings from the Washington University College of Medicine in St. Louis. The research concerns a specific type of the disease called dominantly inherited Alzheimer's, which passes from one generation to the next.

This form of Alzheimer's is rare (only about 1% of all cases of the disease), but researchers hope that some of the information they gain from these findings will be applicable to the broader population of patients. 

* Can a simple smell test detect Alzheimer's? A team of Australian researchers is working on a test based on the fact that "people who have memory loss and other signs of mental decline that can lead to Alzheimer's may have trouble discriminating between smells."

In the test, a person is asked to sniff three sticks, two of which contain the same odor. If the person identifies the wrong stick, the test is repeated with sticks featuring a higher concentration of the odor.  The test showed that people in the study who had trouble telling the smells apart at the start of the study "were more likely to shows signs of mental decline."

* In addition, simple eye tests may be able to detect the presence of Alzheimer's disease before symptoms develop. One looks for changes in the retina, another looks for the presence of amyloid-beta, a protein found in Alzheimer's plaque, in the lens of the eye.

These are all early findings, but they may represent advances that may lead to simple and affordable detection methods.

Geraldine Ferraro Dies of Multiple Myeloma - What is This Blood Cancer?

CT scan of the head of a man with multiple myeloma. There is a lesion in the left temporal bone (red arrows) consistent with multiple myeloma. Green arrows show a normal facial nerve canal. Photo: radpod.org

Geraldine Ferraro, the first woman to be U.S. vice presidential candidate for a major party, died March 27th of complications from multiple myeloma, a type of incurable blood cancer. If you haven't heard of multiple myeloma, you're not alone: many news reports have simply said that Ferraro died of blood cancer without specifying the specific disorder. If she had died of leukemia, the most common cancer of the blood, they certainly would have mentioned it because that's a disease most people are familiar with.

Although multiple myeloma is not as well known as leukemia, it starts in the same place: plasma cells, which become white blood cells. In multiple myeloma abnormal plasma cells form and multiply, accumulating in the bone marrow and crowding out normal cells. The myeloma may collect in the marrow of a number of different bones, which is what the "multiple" part of the disease's name means. In addition, myeloma cells may collect in organs of the body.

Geraldine Ferraro, who was 75, died at Massachusetts General Hospital in Boston, where she was receiving treatment. She was Walter Mondale's vice presidential nominee in 1984, and had suffered from multiple myeloma for 12 years. She was involved in campaigning for greater funding and new treatments for the disease, and was an honorary board member of the Multiple Myeloma Research Foundation (MMRF). Before being named VP candidate, Ferraro had been a member of the U.S. Congress from New York City and had served as a criminal prosecutor in Queens.

Find out more about multiple myeloma at the Medicine.net article here or at MayoClinic.org (both written for the lay reader).

H.S. Basketball Player Wes Leonard is Latest Young Athlete to Die of Cardiomyopathy

Above: Gross pathology of the heart showing idiopathic cardiomyopathy, which is similar to dilated cardiomyopathy. The opened left ventricle of heart shows a thickened, dilated left ventricle with subendocardial fibrosis manifested as increased whiteness of endocardium.

Sixteen-year-old basketball player Wes Leonard died of cardiac arrest caused by dilated cardiomyopathy (an enlarged heart), according to a Michigan medical examiner. Leonard collapsed during the post-game celebration for his Fennville High School team the other after scoring the winning basket near the end of the overtime game.

Cardiomyopathy is a condition in which the heart muscle becomes enlarged or thickened and weakened, making it unable to pump blood effectively. The heart, like any other muscle, increases in mass when it is exercised, and it is not unusual for athletes such as basketball players and distance runners to have enlarged hearts, or even cardiomyopathy. But to some people, cardiomyopathy can be harmful or even deadly.

Dilated cardiomyopathy is the most common form of cardiomyopathy according to the U.S. National Institutes of Health. It can be caused by a genetic disorder or by a variety of other problems including heart rhythm disturbances, infection, drug or alcohol abuse, medications, or even high blood pressure.

Unfortunately, Wes Leonard is only the latest high-profile athlete to die because of cardiomyopathy, which often causes no symptoms. In many cases, the person doesn't know anything is wrong until he or she collapses during or after a practice or game. The lucky ones survive the first incident and get treatment to prevent reoccurrence.

American distance runner Ryan Shay died suddenly in 2007 while running the U.S. Olympic half marathon trials in New York City. His father said that Shay had an enlarged heart that was first diagnosed when the runner was 14. Shay's death was attributed to "cardiac arrhythmia due to cardiac hypertrophy with patchy fibrosis." Hypertrophy is a thickening of the heart muscle.

After Shay's death, a number of medical experts said that an enlarged heart was "the biggest cause of sudden death among young athletes."

Athletes and former athletes who have died of hypertrophic cardiomyopathy include Reggie Lewis of the Boston Celtics, Loyola Marymount University basketball player Hank Gathers, and Maggie Dixon, coach of the Army women's basketball team, who was a former college player. All were under the age of 30 when they died.

After Dixon's death, the Maggie Dixon Foundation was set up to raise awareness of and screening for heart arrhythmia and sudden cardiac death in young people. Each December the Maggie Dixon Classic features four of the nation's top women's college basketball team playing a doubleheader in New York's Madison Square Garden to promote the cause and screen attendees for heart problems.

It's hoped that the death of Wes Leonard will bring more attention to cardiomyopathy and other heart conditions in young people, and make athletes, coaches, and parents more aware of the problem.