Doctor helps search for cure

Wednesday, October 30, 2002

SIKESTON -- Over four million Americans have been diagnosed with Alzheimer's disease, and new data projects the currently irreversible disease could reach up to 16 million Americans by 2050 if no cure is found.

For this reason and many others, Dr. Abhilash Desai, geriatric psychiatrist and medical director of Senior Lifestyles at Missouri Delta Medical Center, is helping others in the medical field search for answers about treatment for the disease. Desai is also a member of Saint Louis University's medical faculty in the psychology department.

"You can't prevent it. You can't reverse it. We can only try to slow it down," Desai said about the disease.

Studies at institutions across the country and as near as St. Louis take place every day.

"The most exciting find is the 'Pittsburgh Compound B', or 'PIB,'" Desai said. "PIB can scan the brains of Alzheimer's patients and spot the amyloid plaques, which destroy brain cells. If the plaques are present, they light up during the scan, and it means the patient has Alzheimer's."

The PIB, which is labeled with an extremely short-lived radioisotope, is injected into patients, who are then scanned using positron emission tomography, or PET, imaging, Desai explained.

"The Pittsburgh compound can highlight amyloid plaques in the brains of individuals in the early stages of Alzheimer's disease," Desai said. "Ability to quantify amyloid disposition in the brain will have a profound impact on our ability to monitor the progression as well as gauge the effectiveness of the treatment."

One in 10 persons over 65 and nearly half of those over 85 have Alzheimer's, according to the Alzheimer's Association. A small percentage of people as young as their 30s and 40s get the disease.

"Today tests are only about 90 percent accurate when diagnosing Alzheimer's. The only way to be 100 percent accurate is by looking at brain tissue under a microscope -- and the only way to get that tissue is after death. This is why PIB is so important," Desai explained.

Another hope for Alzheimer patients and their families is memantine, a drug that appears to protect the brain's nerve cells against glutamate, a messenger chemical released in excess amounts by cells damaged by Alzheimer's disease or other neurological disorders.

Memantine has been used in Europe for over 10 years and is currently under study in St. Louis at Saint Louis University and Washington University. It would slow the progression of the disease in patients, Desai said.

"People are very fearful of Alzheimer's, but that shouldn't prevent them from seeking help," Desai advised. "Even treatment delay by six months can never be caught up. You do harm by delaying the current medication."

Brain shunt surgery is another potential treatment for Alzheimer's, Desai said. The theory of the shunt is that poor circulation of the spinal fluid is contributing to Alzheimer's by allowing toxins to build up. A shunt is implanted into the brain where it empties fluid into the abdomen, clearing the toxins out, he explained.

Currently, there are only four symptomatic Alzheimer's drugs that are approved by the Federal Drug Administration. A study on an Alzheimer's vaccine was recently halted as some of the participants experienced brain inflammation. Desai believes a refined vaccine still shows promise in the future.

"Research also suggests that what's good for the heart may be good for the brain," Desai noted.

This basically means with good eating habits, regular exercise, low stress, cholesterol and blood pressure and no smoking, there's a less likelihood of developing Alzheimer's. Food rich in vitamin E, but not pills with vitamin E may also prevent AD, Desai added.

"A lot is in our own hands," Desai said. "Even if you have a family history of the disease, there's still a lot you can do on your own."

November is National Alzheimer's Disease Awareness Month. To commemorate the occasion, Desai is one of four speakers at the St. Louis Chapter of the Alzheimer's Association's Research Update 2002, which is scheduled for Nov. 2 at the University Center Ballroom on the campus of Southeast Missouri State University in Cape Girardeau.

Program topics include dementia care, updated research and family care and support will be discussed. The event is free and open to the public, but reservations are required. For more information, call the Alzheimer's Association at 800-980-9080.

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