INSIGHT Newsletter of the USC Alzheimer Disease

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1 INSIGHT Newsletter of the USC Alzheimer Disease Consortium USC Alzheimer Consortium Alzheimer Disease Research Center USC Alzheimer Research Center of California /Rancho USC Alzheimer Research Center of California/Health Sciences Campus USC Awarded New Funding The Alzheimer Disease Research Center (ADRC) at the University of Southern California (USC) was approved by the National Institute of Aging for a five-year grant renewal to continue its study of memory and aging. The grant runs from April 1, 2004 through March 31, Now in its 21st year, the USC ADRC achieved a high rating based on competitive scoring. The USC ADRC will continue as one of 29 Alzheimer Disease Centers across the United States. The renewed grant makes it possible for physicians and scientists at the USC ADRC to continue their investigations which focus on reducing the cognitive and behavioral impact of Alzheimer disease, cerebrovascular dementia, and related disorders of the aging. In addition to its current research continued on page 2 Spring 2004 Inside this issue: Nationwide Genetics Initiative Spanish Speaking Satellite USC ADRC Longitudinal Study Research Corner Clinical Trials 6 Memory Walk & Lecture Series 7 The USC Alzheimer Disease Research Center congratulates the Mission Lodge Alzheimer/Dementia Center of San Gabriel on its 100th anniversary of service to the elderly. The USC ADRC received a $7,000 gift from Mission Lodge which held a silent auction as part of their anniversary activities last November. Pictured from left to right are Peggy Franklin and Carol De Marco of Mission Lodge receiving a plaque from Helena Chui, M.D., and Linda Clark, Ph.D., of the USC ADRC. We are studying how memory changes as people age... in order to help people age better.

2 Page 2 INSIGHT Spring 2004 Funding continued from page 1 The USC ADRC received a high rating and will continue as one of 29 Alzheimer Disease Centers in the U.S. programs, the USC ADRC plans to undertake new projects such as the Nationwide Genetics Initiative (see the article on page 3.) Under the leadership of Helena Chui, M.D., the ADRC is building upon its relationships within the Los Angeles community. Los Angeles presents a unique cross-section of people because of its great ethnic diversity. This makes it a prime location for carrying out cuttingedge research. The USC ADRC continually looks to the residents of the greater Los Angeles area as the source of volunteers for its many research programs. Collaborative efforts with other Alzheimer Disease Centers and the Alzheimer s Association of Greater Los Angeles, Riverside and San Bernardino counties will expand during this renewed funding cycle. Current collaborations among physicians and scientists within the USC research community include clinical trials, memory studies and in-depth research on the brain. With the financial support of this federal grant, the USC ADRC continues its quest for greater insight and acquired knowledge during the next five years. These efforts support the overall goal of improving diagnosis and care for individuals while searching for cures and ways to prevent Alzheimer disease and other illnesses which lead to dementia in older adults. Longitudinal Study Enters 21st Year The USC Alzheimer Disease Research Center Longitudinal Study is coordinated by Linda Clark, Ph.D. For more information see her article on page 5. As part of the longitudinal study, graduate students in psychology are supervised by neuropsychologist, Carol McCleary, Ph.D. (third from left). The graduate students conduct the memory tests for study participants. From left to right they are Kristen Eddy, Lisa Mitchell and Makoto Ono (far right).

3 Newsletter of the Alzheimer Disease Consortium at USC Page 3 USC Part of Nationwide Genetics Initiative As we approach the entrance of the baby-boomer generation into the 65+ age group, it is expected that the number of people with Alzheimer s disease (AD) will skyrocket. The Baby Boomers are those born from 1946 through In 2011, the front-edge of the boomers will turn 65. The elderly population, which numbered 30 million in 1988, will reach 40 million in 2011, and then will reach 50 million in only 8 more years (2019). By 2030, 1 in 5 U.S. citizens will be elderly. Recent estimates indicate that by 2050 there could well be 13 million elderly people in the United States with AD. Scientists are eager to speed research efforts to understand the causes and risk factors for AD in order to develop ways to treat it and hopefully prevent the disease. There is a nationwide effort funded by the National Institute on Aging (NIA). Eighteen NIA-funded Alzheimer Disease Research centers are working to identify 1,000 families with at least two siblings who have been diagnosed at 60 years of age or older with late-onset AD. Researchers across the country have joined efforts to identify families with multiple members affected with the condition in order to study the underlying disease process of AD and identify areas for new research and drug therapy. At the University of Southern California Alzheimer Disease Research Center, The National Genetics Initiative is being coordinated by Arousiak Varpetian, M.D. At present, there are four known genes associated with AD. Three of these genes are linked with the early-onset form of the disease. Early-onset AD is inherited in an autosomal dominant pattern, meaning that the disease develops in family members in multiple generations. Mutations, or changes, in these genes, known as presenilin 1 (PS1), presenilin 2 (PS2) and amyloid precursor protein (AAP) are rare and are not associated with the much more common late-onset form of AD. The fourth gene associated with Alzheimer Disease is the apolipoprotein E (APOE) which is referred to as a risk-factor or susceptibility gene. The e4 variant is associated with an increased risk of developing late onset AD. AD genes, as well as the genes for other human diseases, have been located by studying families with multiple cases of the disease in question. It is very difficult to locate one risk factor gene out of the 30,000 or so genes that are contained within the human cell. Researchers believe that there are other risk factor genes for AD. They have identified regions in the human genome where these genes lie, but they have not been able to pinpoint exactly what the genes are and where they are located. The further collection of data and analysis of families with multiple affected individuals will help identify these risk factor genes more clearly. You Could Help Find Answers You may be a key to finding the answers we seek to treat or prevent Alzheimer disease. To be eligible to participate in the study, families must have at least 3 living members who can donate blood, including: 2 siblings (brothers or sisters) who developed AD after age 60 AND Another family member over age 50 who may have memory loss OR a family member over age 60 who does not have any memory loss. If a family member is no longer living, but there is frozen autopsy tissue available, then the family may Continued on page 4

4 Page 4 INSIGHT Spring 2004 Genetics Initiative continued from page 3 still be eligible. Participation involves a neurological examination with cognitive testing or collection of medical records and the donation of a blood sample, which will be made into a cell line (a family of cells grown in the laboratory). This enables the participant's DNA to be available to qualified researchers over many years. The cell lines and DNA are stored at the National Cell Repository for AD (NCRAD), a centralized repository at Indiana University. Medical, demographic, and family history information is also collected. There is no cost for those who join the study. All genetic information collected is strictly confidential. Identifying information, such as names and dates of birth are removed from all materials. To participate in the study, families should contact NCRAD at its toll free number, , or by at alzstudy@iupui.edu. Further information about the study is available through the website at Information about the Genetics Initiative at USC can be obtained by calling Benjamin Anderson at (323) or ing him at beanders@usc.edu, or contacting Dr. Varpetian at varpetia@usc.edu. Spanish Speaking Satellite at Rancho Center Xavier Salazar The population of Los Angeles County is highly diverse with respect to racial and ethnic backgrounds. According to the 2000 U.S. Census, Latinos have surpassed Anglo-Americans as the major ethnic/racial group in the County. Thus, the USC Alzheimer Disease Research Center Spanish-Speaking Satellite (SSS), serves a population that is both growing in number and showing differences in dementia rates according to surveys in several U.S. communities. Managed by its program director, Xavier Salazar, Psy.D., the SSS is based at Rancho Los Amigos National Rehabilitation Center in Downey, and focuses on the recruitment, evaluation, and diagnosis of Spanish-speaking subjects with mild cognitive impairment and dementia due to Alzheimer disease and ischemic-vascular disease; as well as appropriate age-matched normal controls. The SSS is also an essential resource for obtaining autopsy tissue and brain imaging data for this population. Since the founding of the SSS in 1986, 338 subjects have been enrolled and 47 subjects have consented to an autopsy. Over the course of the project, 12 autopsies have been performed, and 30 individuals have completed testing for ApoE, which is a gene associated with Alzheimer disease. For more information regarding programs of the Spanish-Speaking Satellite please call:

5 Newsletter of the Alzheimer Disease Consortium at USC Page 5 Volunteers Help Find The Answers To Memory Loss by Linda Clark, Ph.D. they are proud that they are helping make the future brighter for all of us. Longitudinal studies examine how a process changes over time and may contact participants at intervals over many years. The Longitudinal study at the USC ADRC offers free comprehensive memory testing annually or biannually depending on age. Some of our participants have been valued partners in this study for over 20 years. Families can benefit in many ways. The testing reports provide very helpful objective information to families who wonder how the fluctuations they see daily relate to an overall change. We provide expert comprehensive evaluation and consultation with teams of the top authorities in their fields. We can complete the testing at your home, and our satellite office in Downey offers testing in Spanish. Our research relies on comparing what we learn about people with dementia (the target group) with a normal control group. Many of our normal volunteers tell us how reassuring it is to have annual verification that they are aging normally in regards to their memory and thinking abilities. They also find it comforting to know they will receive early diagnosis and quick treatment, if any problem develops. Of course, they are proud that they are helping researchers learn the answers that may make the future brighter for all of us. (Do you need help with directions to USC or parking questions? Please call for assistance. We look forward to seeing you.) RESEARCH CORNER Margaret Gatz, Ph.D., serves as the Director of the Education, Information and Transfer Core for the USC Alzheimer Disease Research Center. Dr. Gatz brings to this position her research interests which include agerelated change in depressive symptoms, risk and protective factors for Alzheimer disease, and evaluation of the effects of interventions. Her work includes an international perspective on aging research as she is the Director of the Study of Dementia in Swedish Twins, a large longitudinal investigation of genetic and environmental factors in Alzheimer disease. Professor Nancy L. Pedersen from the Department of Medical Epidemiology and Biostatistics at the Karolinkska Institute in Stockholm Sweden with Margaret Gatz, Professor of Psychology, Gerontology and Preventive Medicine at USC.

6 Page 6 INSIGHT Spring 2004 Opportunities to Participate in Clinical Trials The Geriatric Studies Center at the USC Keck School of Medicine is staffed by specialists in the diagnosis and treatment of Alzheimer disease and age-related memory loss. The Center provides evaluation, diagnosis and treatment recommendations, referral to caregiver services and support groups, and the opportunity to participate in clinical drug trials of the most recent advances in medications for memory problems. The Center also provides evaluation for those who are experiencing the normal memory loss that occurs with age and may not have Alzheimer disease. If patients are eligible for a trial, they receive medical evaluations, tests and treatments at no cost. The following studies are currently taking place on the USC Health Sciences campus: Condition being studied Slowing of agitation and behavioral problems in Alzheimer disease Persons with Alzheimer disease and major depression Slowing of cognitive decline in Alzheimer patients Persons with Alzheimer disease or suspected memory problems Medication being tested valproate - Subjects are allowed to continue on other memory medications sertraline - Subjects are allowed to continue on other memory medications xaliproden - Subjects are allowed to continue on other memory medications evaluation, diagnosis, recommendations, family conferencing and long term follow up Memory loss with Alzheimer disease and normal cholesterol levels Improving cognitive function in patients with Alzheimer disease Slowing of cognitive decline in Alzheimer patients simvastatin - Subjects are allowed to continue on other memory medications huperzine A - Subjects can not be on other memory medications (however, namenda/ memantine is allowed) homocysteine reduction - Subjects are allowed to continue on other memory medications For additional information, or an appointment please contact: Margaret Villa, R.N. Randall Sanabria Amber Watts, M.A. Telephone (323) Fax Visit the Geriatric Studies Center website for a current list of medication trials and studies: psychiatry_behavioralsciences/research/gsc/

7 Newsletter of the Alzheimer Disease Consortium at USC Page 7 Alzheimer s Association Memory Walk The USC Alzheimer Disease Research Center participated in the Taking Steps to End Alzheimer s Disease Memory Walk last October 4. The event was held in conjunction with The Los Angeles Times Festival of Health & Fitness/Weekend of Wellness at USC. Nine walkers represented the USC ADRC, and a total of $1,990 was raised by the ADRC team, which was donated to the Alzheimer s Association of Los Angeles, Riverside and San Bernardino Counties. The 2003 Memory Walk provided over $505,000 in donated funds for the Alzheimer s Association. As part of the weekend activities, the USC ADRC also co-hosted a booth with the Los Angeles Caregivers Resource Center at the LA Times Festival of Health and Fitness. Lecture Series The USC Alzheimer Research Center of California/Health Sciences Campus hosts luncheon lectures, which are open to healthcare practitioners, allied health staff, consumers and interested community members. These bimonthly lectures are presented by faculty from USC and other regional institutions, and are held on Thursdays from 11:30 am 1:00 pm at the USC University Hospital located at 1500 San Pablo Street, Los Angeles, CA There is no charge for the lecture, and lunch is provided. Bioethical Issues of End of Life Care in Dementia June 10, 2004 Karen Josephson, M.D. Director of Geriatric Services, Department of Family Medicine, USC Keck School of Medicine USC University of Hospital Cardinal room, 1 st fl A Word of Thanks, We deeply appreciate all who have made generous donations to the USC Alzheimer Disease Research Center. These gifts in memory of loved ones, or in lieu of flowers, greatly serve to further the work of the USC ADRC. Again we offer our sincere thanks.

8 Phone: Fax: USC Alzheimer Disease Research Center Visit our web-site: USC research nurses Margaret Villa (center) and Liberty Teodoro (right) at the LA Times Festival of Health and Wellness on the USC campus Andrus Gerontology Center University of Southern California 3715 McClintock Avenue Los Angeles, CA Non-Profit Organization U.S. Postage Paid FORWARDING SERVICE REQUESTED