Philadelphia Magazine's Treatment Guide featured the Hospital of the University of Pennsylvania (HUP) one of the top hospitals for Alzheimer's disease care and research. The breadth and magnitude of senior services at the University of Pennsylvania Health System (UPHS) earned it 21st place in the nation for geriatrics in the most recent U.S. News & World Report rankings.
Download the PDF | Read the article (links open in a new window)
Use of Alzheimer Disease Biomarkers: Potentially Yes for Clinical Trials but Not Yet for Clinical Practice, an editorial in the Journal of the American Medical Association, co-written by Dr. John Trojanowski
Ronald C. Petersen, PhD, MD, and John Q. Trojanowski, MD, PhD, co-wrote an editorial in the July 22/29, 2009, issue of the Journal of the American Medical Association (JAMA). It discusses an article in the same issue by Mattsson et al., entitled "CSF Biomarkers and Incipient Alzheimer Disease in Patients with Mild Cognitive Impairment."
Per Petersen and Trojanowski's editorial, "The investigators from the Swedish Brainpower CSF Initiative enrolled individuals with mild cognitive impairment (MCI) from 12 centers in Europe as well as healthy individuals as controls and those with mild AD for comparison. They identified 750 individuals as having MCI and followed them for at least 2 years to determine whether the CSF profile at baseline of AB42, total tau (T-tau), and phosphorylated tau (P-tau) predicted the ultimate clinical course. They found that CSF AB42,T-tau, and P-tau could be used to predict outcomes and thus suggest that these markers may be useful in identifying patients for clinical trials and possibly screening tests in memory clinics." They go on to discuss the key challenges that need to be addressed before CSF markers are ready for broad clinical applications.
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The Boston/New England chapter of the National Academy of Television Arts & Sciences has awarded Alzheimer's Disease: Facing the Facts an Emmy® for Documentary Program. Narrated by Emmy and Tony award-winning actor Edward Hermann, this one-hour documentary, airing on PBS affiliates nationwide, features Penn's Dr. John Trojanowski, along with other prominent AD researchers across the country. Patients and their families are also featured, including some who participate in research here at Penn.
The executive producer and writer of Facing the Facts, Carol Edwards, is the associate director of the Penn Memory Center's Education and Information Transfer Core. Along with her long-time friend and colleague Glenn Orkin, co-owner of Motion, Inc., in Hartford, CT, they wrote, edited, and produced this film.
Click here for the list of Emmy® winners, or here for the video of the awards show (Carol, Glenn, and Dr. Trojanowski can be seen on part 8, at about 20 minutes and 45 seconds in)
Carol Edwards with Glenn Orkin (left) and Dr. John Trojanowski
photo by Dr. Glenn Schreiber
An editorial by Ewbank & Arnold in the May 2009 issue of the New England Journal of Medicine comments on Savva et al.’s finding, published in the same issue, that in the oldest old, the strength of the association between clinical dementia and the pathological features of AD diminished. These findings highlight the complexity of the relationship between cognition and pathology. The authors put forth several possible explanations of why some of the oldest old with a high density of lesions did not show clinical symptoms of dementia. They hypothesize that certain protective factors could be at work in these individuals, such as a slower accumulation of pathology. Another proposed explanation is that factors that can affect cognition but that studies often fail to account for, such as comorbidity and stress, complicate the effect of AD pathology on cognition.
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A test capable of confirming or ruling out Alzheimer's disease has been validated and standardized by researchers at the University of Pennsylvania School of Medicine. By measuring cerebrospinal fluid (CSF) concentrations of two of the disease's biochemical hallmarks – amyloid beta42 peptide and tau protein – the test also predicted whether a person's mild cognitive impairment would convert to Alzheimer's disease over time.
Read the article in Science Daily
U.S. News & World Report recently ranked the University of Pennsylvania Health System (UPHS) 21st in the nation for geriatrics, as reported by Philadelphia Magazine. The Penn Memory Center is “the only Alzheimer’s disease center in Philadelphia that’s supported by the National Institute on Aging,” making it a valuable resource for the geriatric population. Also mentioned is the Ralston Penn Center, which includes board-certified geriatric physicians delivering health care in problems to which the elderly are especially prone.
Read the article in Philadelphia Magazine
Henry Gustav Molaison, one of the most remembered patients in the history of brain science, died on December 2, 2008, at the age of 82. Better known as H.M., he challenged scientists with his inability to form new memories—each time he did an activity, it was a completely new experience. During his lifetime, H.M. helped scientists understand learning and memory.
"The contribution of HM to the study of both normal memory function and diseases which produce disorders of memory, including Alzheimer’s Disease, is invaluable. In particular, modern notions of memory systems and their neural underpinnings which serve as a framework for all subsequent memory research directly relate to the study of HM. The story of HM also speaks to the enormous value to medical science of patient participation in research endeavors and this particular man’s altruism."
--Dr. David Wolk, assistant professor, Department of Neurology
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Although ginkgo biloba is considered one of the top natural products used by Americans, a study published by the Journal of the American Medical Association show that the supplement has no benefit in reducing the development of dementia. The Ginkgo Evaluation of Memory (GEM) study was over 8 years, making it the largest clinical trial ever to evaluate ginkgo’s effect on dementia.
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Dr. Jason Karlawish was one of the featured guests on WHYY Philadelphia’s November 4, 2008, segment on mental disability and voting access. People with varying degrees of cognitive impairment are underrepresented in the polls, and Dr. Karlawish, along with Penn psychologist Mark Salzer, are pressing on to allow our fundamental right to vote available to everybody, not just the cognitively sound.
Read the article and listen
Dr. Steven E. Arnold, director of the PENN Memory Center, and Dr. Christopher M. Clark, director of the Center of Excellence for Research on Neurodegenerative Diseases, were quoted in a October 20, 2008, article in The New York Times, titled "More Alzheimer's Risk for Hispanics, Studies Find." The article discusses that Hispanics are at high risk for developing Alzheimer's disease, and a significant number are being diagnosed in their late 50s and early 60s. They are not necessarily genetically predisposed; rather, "several factors [...] may put Hispanics at a greater risk for dementia, including higher rates of diabetes, obesity, cardiovascular disease, stroke and possibly hypertension." Furthermore, the symptoms for Alzheimer's are often mistaken for normal signs of aging, which delays diagnosis and treatment.
Read the article
Dr. Jason Karlawish was the keynote speaker for an October 10, 2008, conference sponsored by the University of Virginia Institute on Aging and organized by Law School Professor Richard Bonnie. Karlawish spoke on the election system needing reform to protect residents of long-term care facilities, such as nursing homes and assisted-living facilities, of voter fraud and political disenfranchisement. Many residents would like to vote, but the difficulty of obtaining either an absentee ballot or traveling to a polling place prevents them from exercising their right. Paired with the possibility of fraud, “people in long term-care facilities suffer doubly,” says Karlawish.
Listen: Streaming | MP3
The July 14, 2008, edition of the AARP Bulletin Today describes Jason Karlawish’s recent efforts to establish and test mobile polling sites in the United States. Mobile polling would allow “teams of local election workers or trained, nonpartisan volunteers [to] visit assisted living facilities, nursing homes and other such settings to help residents register to vote.” Already implemented in Germany and Australia, mobile polling can make it especially easier for those with cognitive disabilities the opportunity to exercise their right to vote—a right not so readily permitted in nursing homes and assisted living facilities throughout the country.
Read more in “Mobile Polling—For Those Who Simply Can’t Get to a Voting Booth”.
- AD Research Participation: Informed Consent Complicates Trials
Jason Karlawish, MD, is quoted in two Alzforum.com articles discussing decisional capacity for people with Alzheimer’s Disease who have cognitive impairment. The first part looks at the challenges of enrolling patients into clinical trials for Alzheimer’s Disease and the need for clear guidelines on who is allowed to make decisions about research participation on behalf of adults whose disease prevents them from being able to do so themselves. The second part highlights a study by Dr. Karlawish, published in the American Journal of Geriatric Psychiatry earlier this year, which confirms previous work showing that, in general, AD patients and their caregivers supported the use of proxy consent in situations where participants are incapable of giving their own consent to research participation.
Alzforum Part 1
Alzforum Part 2
- Rember as a treatment for Alzheimer's Disease?
The Penn Memory Center has been receiving many calls about experimental medicines for dementia that are being described at this year’s International Conference on Alzheimer’s Disease (ICAD) in Chicago. ICAD is one of the foremost forums for researchers to present new and potentially important scientific and therapeutic findings in the field of Alzheimer’s disease and other neurodegenerative diseases.
Among the therapies being reported are novel anti-amyloid drugs, some of which are in clinical trials here at the Penn Memory Center, various nutritional and herbal remedies, as well as established and FDA-approved medicines already in use for other illnesses that are being re-investigated for their potential to help Alzheimer’s disease.
One of these older medicines is methylthioninium chloride (also known as methylene blue), which has been used for over a century for malaria, urinary infections, and some rare blood diseases. Under the name “Rember,” a new company in England (TauRx Therapeutics) has conducted a Phase II trial in people with Alzheimer’s disease and reported that over the two years of the study, Rember significantly delayed disease progression. The unpublished data has not yet been through the peer review process, and so it is hard for us to judge this old medicine’s new promise. A Phase III trial is reportedly being planned and it is only after confirming the medicine’s benefit and safety with better evidence that we can feel comfortable recommending it.
- “American voters getting older”
On January 31, 2008, Jason Karlawish, MD, testified to the Senate Committee on Aging at a hearing titled "Older Voters: Opportunities and Challenges for the 2008 Election" chaired by Chairman Herb Kohl (D-WI).
Click below to:
- Annual Marian S. Ware Neurodegenerative Diseases Research Retreat. November 9, 2007.
Oh better drugs where art thou?
In the wake of the first failed Phase 3 trial of a supposedly amyloid-lowering drug, leaders of Alzheimer disease programs at several major pharmaceutical companies came together to discuss drug development at the invitation of Virginia Lee and John Trojanowski.
Click here for to read
Pat McCaffrey’s roundup from the Alzheimer Research Forum web site.
- PENN Neurodegenerative Disease Research - In the Spirit of Benjamin Franklin
“Penn Neurodegenerative Disease Research - In the Spirit of Benjamin Franklin” by John Q. Trojanowski (Neurosignals 2008) showcases the strengths of a large and diverse "slice" of neurodegenerative disease research at PENN.
Click here for more information from Penn Medicine News.
Click here to read the abstract on Pubmed.gov.
- A Vaccine for Alzheimer's
A promising Phase II study is now underway at Penn that is helping pave the way for an Alzheimer’s vaccine by eliminating small proteins from coming together to form plaque. Scientists are also researching a protein in the spinal fluid that might be a predictor for the disease.
Please note, we are not presently recruiting for this study.
ABC 6 Action News' HealthCheck with Anita Brikman aired interviews from the Ralston Center with Dr. Clark and patient Mrs. Josephine Feige about the Lilly-Immuno vaccine trial.
Click here to watch the ABC news video
According to CBS 3 medical reporter Stephanie Stahl — “It could be one of the biggest scientific breakthroughs ever, a way to treat, maybe even prevent Alzheimer's disease and it's being tested in Philadelphia.” She interviewed Dr. Clark and study participant Ada English on February 5, 2007.
Click here to read the CBS 3 story.
Click here to link to the CBS3 news video.
- Home Visits Improve Willingness to Participate in Alzheimer's Clinical Trials
Jason Karlawish, M.D., associate professor of medicine and associate
director of the PENN Memory Center, and his colleagues at the University of
Pennsylvania recently completed a study addressing the challenges of
recruiting and retaining study participants for Alzheimer's clinical
trials. They tested whether redesigned clinical trials might improve
caregivers' willingness to participate in Alzheimer's trials by analyzing
the value of four possible alterations in the study. June 2007
Click here to read more.
- When Informed Consent is Impossible.. an opinion by Jason Karlawish, M.D. on ABCnews.com
Is research that enrolls patients with Alzheimer's Disease ethical?...an opinion by Jason Karlawish, M.D. on ABC News Health online, January 29, 2007
By definition, Alzheimer's patients have trouble with memory, concentration and attention. They may not be competent to give an informed consent. Without the patient's informed consent, how do we ethically enroll patients with Alzheimer's disease in research?
Click here to connect to ABCnews.com to read the article.
Bob Moore, diagnosed with Alzheimer's Disease, donated his brain for autopsy to help doctors learn more about causes and prevention of the disease.
Read the article online. ($2.95 fee to view archived articles.)