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Winter 2017 E-Newsletter

Winter 2017 UCLA Alzheimer's Research Center Newsletter

| Dear Doc | Alzheimer’s Awareness Day |
| New Additions to the Easton Center | Clinical Trials |

Dear Doc...
Five Questions with Verna Porter, MD, FANA, Director of Clinical Programs, Mary S. Easton Center for Alzheimer’s Disease Research at UCLA

Dr. Verna Porter as the new Clinical Program Director

Photo: Verna Porter, MD, FANA
Interviewed By: Monica Moore

1. What does a diagnosis for Alzheimer’s disease (AD) entail?
The first thing to know is that dementia itself is not truly a diagnosis, it’s more of a medical description that indicates that the patient’s cognitive symptoms are beyond what we would expect for normal aging and require a further diagnostic workup. Since everyone is unique, there isn’t one given workup that applies to all people. However, a general approach for most patients is to do a comprehensive assessment. Typical features of such assessments include neurocognitive testing, which is very detailed, in-depth, one-on-one pencil and paper memory testing that a patient would do with a neuropsychologist. The other thing that we would do would be magnetic resonance imaging (MRI) of the brain so that we can look at its structure; we would look for things like atrophy and vascular changes, any structural changes that may have bearing on memory or cognitive function. We may also use functional imaging, such as positron emission tomography (PET), to look for patterns of metabolism in the brain that would imply the presence of a neurodegenerative process, such as Alzheimer’s disease. Finally, we look at basic laboratory blood tests to screen for metabolic disturbances or abnormalities that may affect memory that we may even be able to fix, correct or reverse. A lumbar puncture, to obtain cerebrospinal fluid (CSF), is another example of a diagnostic tool that we have available. With this tool, we are looking for proteins that are present in the CSF at certain levels that would be indicative of a disease like Alzheimer’s. So, this type of testing is very specific for the diagnosis of AD, as opposed to other forms of dementia.

2. How long does this initial evaluation take?
The typical initial appointment that we do with patients is 60 minutes in duration, and we try to cover several different things during that time. We spend a good deal of time taking a thorough history, listening to the patient and the person who accompanies them to understand the patient’s strengths and weaknesses, what has changed, and whether these changes are affecting the patient’s ability to complete activities of daily living. As clinicians, we think about memory as one domain and we also think about other kinds of thinking skills such as executive function, which includes reasoning, judgment, higher integrative skills, and general fund of knowledge. After this initial evaluation, the neurologist will typically refer a patient to have further neurocognitive testing performed by a neuropsychologist, which can last 4-6 hours.

3. What can the patient do to help the physician?
dear doc take notes It would be of enormous benefit to physicians if patients came to these initial appointments with a written list of the difficulties that they have been experiencing, how they have changed, and what their greatest concerns are. Having a care partner (friend, spouse, adult child, etc.) accompany the patient to the visit is critically important to supply additional information – particularly for the details in a patient’s history that may be less apparent to the patient themselves. In addition, if the patient can send in any additional records, scans or radiology films prior to the initial visit would be extremely helpful.

4. Is this covered through insurance?
Most insurance will cover the core workup (the neurocognitive testing, MRI and laboratory work). PET imaging is a little more specific to the type of insurance, but we are finding more and more insurance plans that cover it. Perhaps they are realizing the value of this type of testing in determining what type of dementia a person may have, which ultimately determines the treatment course and next steps.

5. Who should perform this initial examination and evaluation?
What we provide through neurology is a high level of precision as to the diagnosis. We are trying to grasp what underlying process is affecting the brain, and secondarily, we want to understand how that process is going to affect mood, personality, behavior, memory, and general cognition. The way in which we differ from other medical practitioners is that we conduct a very high resolution evaluation of the patient to arrive at a very accurate diagnosis from which we can develop a plan for how to move forward with the patient’s care. In the process of arriving at a thorough diagnosis, a neurologist may refer patients to see other specialists, such as a neuropsychologist. Neurology complements the other medical specialties that care for patients with cognitive impairment and dementia by focusing on the determination of the root cause of the disease, which helps optimize the care plan and treatment options.

The UCLA Neurology Dementia and Memory Disorders Clinic is a component of Mary S. Easton Center for Alzheimer's Disease Research at UCLA (Easton Center) specializes in the evaluation and diagnosis of mild cognitive impairment (MCI), early Alzheimer's disease, frontotemporal dementia (FTD), and related disorders. An early diagnosis enables patients to take advantage of the most effective therapies and to maintain the highest level of functioning for the longest period of time. Callers can speak directly with the triage coordinator who will collect relevant medical information and, with input from expert clinicians, schedule patients or refer to the most appropriate UCLA clinic. For appointments or questions, please contact Barbara Dwyer at (310) 794-6039.

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Alzheimer’s Awareness Day: Center Branch of the Los Angeles Public Library

Written By: Monica Moore

250,000 people in Los Angeles County suffer from Alzheimer’s disease or other forms of dementia, and in response to this, the Central Branch of the Los Angeles Public Library and the UCLA-Easton Center were called into action to help and to spread the word about this terrible disease - what is being done and what the community can do about it. Experts from the three local California Alzheimer’s Disease Centers (UCLA, USC, and USC Rancho Los Amigos) came together on Saturday, January 28, 2017, to discuss the latest in research and care surrounding Alzheimer's disease.

Alzheiemr’s Awareness Day

Sarah Kremen, MD and Edmond Teng, MD, PhD were on hand from the UCLA-Easton Center, and spoke about the basics of Alzheimer’s disease and recent research findings. John Ringman, MD, MS from USC presented “What is My Risk for Developing Alzheimer’s Disease: New Perspectives on Genetics” to explain the role genetics has on Alzheimer’s. Following the informative lectures, a panel of experts in the Alzheimer’s field took the stage to answer questions from the audience. The panel featured Drs. Sarah Kremen, Edmond Teng, and John Ringman, as well as Freddi Segal-Gidan, PA, PhD (Director, USC - Rancho Los Amigos Alzheimer’s Disease Center), Donna Benton (Director, Los Angeles Caregiver Resource Center), and Petra Niles, MSG (Alzheimer’s Greater LA). The panel expressed the importance of research and clinical care to help those currently with Alzheimer’s disease and those who are at risk for developing the disease in the future, as well as the importance of advocating for increased funding for research and care through the state and federal government.

The day was complimented by a beautiful brain healthy lunch provided by Silverado Beverly Place, and a resource fair filled with information from a wide variety of senior agencies in Los Angeles. It was a wonderful day, and we are so thankful to those who attended, Central Branch of the Los Angeles Public Library, and of course the experts who gave their time to the community on a Saturday!

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New Additions to the Easton Center
Please join us in welcoming three new members to the Easton Center.

Lauren Garcia Photo: Lauren Garcia

Lauren joins the Mary S. Easton Center as the newest member of the Kagan Clinical Trials team. Lauren graduated from Santa Clara University with a B.S. in Biology and Minors in Bioengineering & Music. With a strong interest in Alzheimer's disease, Lauren started volunteering at the Center to learn more about the research that is going on. She is excited to officially be a part of UCLA and the Kagan Clinical Trials team as a Staff Research Associate!

Lina Lee Photo: Lina Lee

Lina has joined the Mary S. Easton Center as the newest member of the Cognitive Neuropsychology Lab. Her B.S. degree in Cognitive Neuroscience from UC San Diego has both interested and prepared her to step foot in the field of neurology and neuropsychology, and she is thrilled to join the lab to further explore the wonders of brain-behavior relationships. She comes to UCLA with a background of contribution to various research labs, ranging from interventional rehabilitative studies with incarcerated veterans who suffer from post-traumatic stress disorder and acquired brain injuries, to observational studies in the pediatric population with neurodevelopmental disorders. As she works toward her pursuit of a Ph.D. degree in clinical psychology, Lina looks forward to welcoming the opportunities and challenges to come at the Easton Center!

Lina Lee Photo: Michelle Torreliza

Michelle completed her associate degree in Medical Assisting in 2000 from Pasadena City College. She has been working as a Clinical Research Coordinator for the past 16 years in various indications such as, Ophthalmology, Musculoskeletal, Endocrinology, Gastroenterology, and Reproductive health. One of the reasons why Michelle enjoys being a coordinator is that she finds fulfillment in helping patients and getting to know them. She is eager to learn another indication in clinical trials, Alzheimer's disease, especially since her grandmother suffered from the disease. Michelle is very excited to be a part of the Kagan Clinical Trials team, and to learn more about Alzheimer’s disease as well as what kinds of research are being done to help individuals who suffer from the progressive disease.

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Clinical Research Opportunities

If you would like to advance Alzheimer's disease research, please consider participating at the Easton Center. Below are the current recruiting trials. For a complete list of enrolling studies, visit our website at www.eastonad.ucla.edu.

ENGAGE Study:

The ENGAGE study is a Phase III clinical trial sponsored by Biogen of the investigational drug aducadumab. Individuals aged 50-85 who are diagnosed with mild cognitive impairment may be eligible to participate in this trial. The goal of the study is to assess whether aducanumab, a drug that targets brain amyloid, can reduce brain amyloid levels and slow memory loss associated with amyloid build up. Participants will be randomized to receive active drug or placebo (inactive substance) via monthly infusions. The study lasts approximately 2 years, which includes an 8-week screening period and 4.5 month follow up period once the investigational drug/placebo phase is completed. To learn more, please call (310) 794-6191 or visit www.eastonad.ucla.edu.


The Anti-Amyloid Treatment in Asymptomatic Alzheimer’s Disease (A4) Study:

The Anti-Amyloid Treatment in Asymptomatic Alzheimer’s Disease (A4) Study is a clinical study for older individuals ages 65-85 who have normal thinking and memory function but who may be at risk for developing Alzheimer's disease (AD) memory loss sometime in the future. This study is sponsored by the National Institute on Aging, Eli Lilly, and the Alzheimer’s Therapeutic Research Institute. The purpose of the A4 study is to test whether a new investigational treatment can slow the memory loss associated with Alzheimer’s disease by decreasing amyloid levels in the brain. The A4 Study lasts for three years, and participants will be assigned at random to receive either the investigational drug or a placebo (inactive substance) via monthly infusions and will be regularly monitored over that period.

You may be eligible to join the A4 Study if you:

  • Are age 65 to 85 years
  • Have normal thinking and memory abilities
  • Have a study partner (someone who has weekly contact with you and is willing to answer questions once a year).

If you are interested in participating, please call (310) 794-6191 or visit www.eastonad.ucla.edu.


The CREAD Study: A Study of Crenezumab Versus Placebo to Evaluate the Efficacy and Safety in Participants with Prodromal to Mild Alzheimer’s Disease (AD):

The CREAD study is a Phase III clinical trial sponsored by Genentech/F. Hoffman-La Roche of the investigational drug, crenezumab, which is an anti-amyloid antibody. The goal of the study is to test whether monthly infusions of crenezumab, will slow down disease progression and memory loss by reducing brain amyloid levels. Participants will have a 50% chance of receiving active study drug versus placebo (an inactive substance). The study lasts approximately 2 years, with 26 infusion visits and the possibility of an open label extension upon completion. Individuals ages 50-85 with a diagnosis of mild cognitive impairment (prodromal Alzheimer’s disease) and mild dementia due to Alzheimer’s disease may be eligible to participate. To learn more, please call (310) 794-6191 or visit www.eastonad.ucla.edu.


Curcumin and Yoga Therapy for Those at Risk for Alzheimer’s Disease:

Physical exercise has proven to improve memory including in the elderly. Drugs developed to stop the underlying disease processes that cause Alzheimer's disease may not improve memory on their own without efforts to stimulate brain function. One purpose of the study is to test the clinical benefits of curcumin, a safe and effective compound isolated from the turmeric root (a component of Indian curry spices), which has been found to inhibit several potential disease pathways in Alzheimer's disease. Another purpose of this study is to determine how the addition of a physical exercise program in individuals with early memory problems may affect memory function or brain imaging and blood-based markers associated with Alzheimer's disease. To learn more, please call Mychica at (310) 478-3711 Ext. 42171 or send an email to This email address is being protected from spambots. You need JavaScript enabled to view it.. (PI: Sally Frautschy, Ph.D.; Location: VA Greater Los Angeles Medical Center, CA.)


Our mailing address is:
Mary S. Easton Center for Alzheimer's Disease Research at UCLA
710 Westwood Plaza, Room C-224
Los Angeles, CA 90095-1769
| http://www.eastonad.ucla.edu | Phone Number: (310) 794-3665 / Appointments: (310) 794-6039 |
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Copyright © 2017. Mary S. Easton Center for Alzheimer's Disease Research at UCLA. All rights reserved.

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