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Alzheimer’s study raises hopes for onset delay

Medical officials hope a new University of Nevada School of Medicine study of Alzheimer’s disease will help detect cognitive changes in elderly people earlier and lead to an ability to delay the onset of the condition.

Alzheimer’s is still without a cure, but Dr. Charles Bernick, medical director of the Lou Ruvo Brain Institute in Las Vegas, said even impeding the condition would be huge to its potential sufferers.

"You don’t have to cure it, just delay it," Bernick said.

"We are trying to see if we can track a person’s mental functioning over a period of time and accurately. … If we can learn from this study and be able to delay the onset of Alzheimer’s, we can reduce by 50 percent the number of people who actually get it," he said.

From a public health standpoint, Bernick said, delaying Alzheimer’s would be enormous because the disease is costly, requiring around-the-clock care. Also, it isn’t covered by Medicare.

The direct and indirect costs of caring for individuals with the disease are estimated at $100 billion annually, according to the national Alzheimer’s Association.

The University of Nevada School of Medicine is enrolling mentally and physically healthy Nevadans age 75 and older into the Home-Based Assessment study. Bernick is the principal investigator for the study.

Slowing the progression of the degenerative brain disorder is no easy task considering that very little, if anything, is known about when or how it begins.

There are about 50 other medical schools and research centers across the country enrolling seniors in the study, which is funded by a grant from the National Institute of Aging through the Alzheimer’s Disease Cooperative Study.

It will try to detect changes in a person’s daily living activities and functional capabilities over time. The goal is to determine whether physicians can detect cognitive change in seniors from their homes better than they can in a clinical setting.

Current Alzheimer’s studies require participants to go periodically to a clinic or research center for evaluation, Bernick said. This study will gather the same information but by way of three different at-home methods.

They include answering questions by mail-in forms, telephone or a touch-screen computer system.

The volunteers will be studied for a four-year period, said Bernick, also a professor at the School of Medicine. The school is funded for 30 or more participants, he said.

Alise Moss Vetica, a spokeswoman for the Alzheimer’s Association of Northern California and Nevada, said monitoring seniors for Alzheimer’s in their homes is an excellent idea.

She said a recent survey of Reno residents about their health care needs found that they wanted to "age-in-place.”

"People want to age at home,” Vetica said.

Alzheimer’s usually begins with a gradual forgetfulness about recent events or familiar tasks. In later stages, the person has difficulty communicating, often struggling to find words, finish their thoughts or follow directions.

According to the Alzheimer’s Association in Nevada and its latest figures from 2000, roughly 21,000 people are living with the disease in the state. By year 2010, that number is expected to increase to 29,000, a 38 percent jump.

Vetica said there are roughly 71,000 Nevada caregivers providing 61 million hours a year in care to people with Alzheimer’s and dementia-related problems. The cost of that care is about $600 million a year.

"Millions of families have to leave the work force to care for their loved ones as this disease progresses,” she said. "Medicare doesn’t cover long-term care, and in order to qualify under Medicaid, you have to spend down. You can’t have any assets. This disease can quickly deplete a family of its assets.”

Bernick said another goal of the Home-Based Assessment study is to determine how well volunteers adhere to taking medications.

The study is also trying to involve more minorities in Alzheimer’s studies. Like the rest of the country, Bernick said there is often a barrier to understanding what’s really happening in a community because medical studies tend to be underrepresented by minorities.

He said there tends to be less public trust regarding medical trials among minorities.

"This mistrust is usually centered around people feeling like the medical field is just using them or that they are going to be guinea pigs,” he said.

Contact reporter Annette Wells at awells@reviewjournal.com or (702) 383-0283.

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