Spring 2016 E-Newsletter

Spring 2016 UCLA Alzheimer's Research Center Newsletter

| The iDEAS-Study | Registry for a Potential Subject Pool |
| Dementia and Driving | Clinical Trials | CDPH Updates |

The Imaging Dementia – Evidence for Amyloid Scanning (iDEAS) Study.

The iDEAS-StudyBy: Sarah Kremen, M.D.

The neurologists at the Mary S. Easton Center for Alzheimer’s Disease Research at UCLA, along with their colleagues in the Departments of Psychiatry and Geriatrics, will soon be enrolling eligible participants in the largest brain amyloid scanning research study in the U.S. The IDEAS (Imaging Dementia – Evidence for Amyloid Scanning) Study is being led by the Alzheimer’s Association, and managed by the American College of Radiology (ACR) and the American College of Radiology Imaging Network (ACRIN). The goal of the study is to determine the clinical value of brain amyloid positron emission tomography (PET) scans in the diagnosis and management of patients over the age of 65, in whom the cause of mild cognitive impairment (MCI) or dementia remains uncertain. Amyloid PET scans can detect brain amyloid accumulation, a hallmark of Alzheimer’s disease, and have been used primarily as a diagnostic tool in research studies. Although these scans are the closest tool physicians have to be able to detect brain amyloid in living people, these scans are not covered by health insurance, limiting their clinical use. The IDEAS study aims to provide the evidence needed to demonstrate the utility of amyloid PET imaging in the clinical setting where the diagnosis of MCI and dementia is uncertain, and for future decision making about insurance coverage for this diagnostic tool. The study hopes to show that by enabling early and accurate diagnosis, amyloid PET imaging can improve health outcomes, such as reducing unnecessary hospitalizations and emergency room visits, and improving prescribing practices of medications used to treat cognitive impairment and dementia.

The IDEAS study will enroll over 18,000 Medicare beneficiaries over the age of 65 who are referred by a dementia specialist. For this study, a dementia specialist is defined as a board certified neurologist, geriatrician, or psychiatrist who spends greater than or equal to 25% of his or her time evaluating and treating patients with acquired cognitive impairment or dementia. At UCLA, participating dementia specialists see patients in the Dementia and Memory Disorders Clinic (Department of Neurology), the Memory Evaluation Program (Department of Geriatrics), and the Neuropsychiatric and Behavioral Health Clinic (Department of Psychiatry). Patients evaluated by our specialists and who meet the IDEAS study eligibility criteria will be able to enroll in the study, and will be referred for an amyloid PET scan that will be partially or completely covered by Medicare. The Amyloid PET scans will be performed and interpreted by a nuclear medicine physician. The amyloid PET scan results will be provided to the ordering dementia specialist, who in turn will disclose this result to the patient. This information will be used to help guide discussion between the dementia specialist and the patient regarding diagnosis, treatment, and other non-pharmacological management strategies, as well as care planning.

For more information regarding this study, please contact Nancy Osuch at 310-794-3665 or Barbara Dwyer, 310-794-6039.


Volunteering for Alzheimer's Disease Research.

Brain Health Registry for a Potential Subject PoolBy: Edmond Teng, M.D., Ph.D.

Amongst the most challenging hurdles in developing new treatments for Alzheimer’s disease is the successful completion of the large, pivotal clinical trials required by the U.S. Food and Drug Administration for approval. These trials are typically long, expensive, and increasingly complex in their design. However, perhaps the most difficult aspect of such trials is enrollment- finding the right potential research participants and matching them to the right study.

The Kagan Alzheimer's Disease Treatment Program is seeking to address this issue by teaming up with the Brain Health Registry and other research institutions to grow a registry of potential Alzheimer’s disease clinical trial participants to help speed the discovery of novel treatments for this debilitating condition. The Brain Health Registry, which was established by Dr. Michael Weiner from the University of California, San Francisco (UCSF), is an internet-based program that makes it easier for potential participants to express their interest in research studies and easier for researchers to identify potential participants that are the best fit for their clinical trials. Since current and upcoming studies are targeting the earliest stages of Alzheimer’s disease, they include individuals with intact memory and thinking as well as those with early signs of memory loss. Therefore, the Brain Health Initiative’s internet-based approach is designed to reach out to a broad spectrum of older adults.

Registration for this program is free at www.brainhealthregistry.org. Those who sign up will be asked to answer a questionnaire that collects basic information about demographics (i.e. date of birth, ethnicity, marital status, etc.) as well as more in-depth information regarding general health, lifestyle, and medical history. Additionally, they will be given the opportunity to play on-line games that test their memory, attention, and ability to process and organize new information. The information collected through this process contributes to a valuable database of individuals with different levels of cognitive performance that are interested in being contacted about new clinical trials as they become available.

The Brain Health Registry was started two years ago, with the initial rollout driven by Dr. Weiner and his team at UCSF. Since that time, over 40,000 people from across the country have joined the database; more than 25% percent of these individuals hail from the San Francisco Bay Area. Our goal in working with the Brain Health Registry is to replicate this success in Los Angeles, which would facilitate Alzheimer’s disease clinical trial enrollment at UCLA and other research centers throughout the region. You can help. By joining the Brain Health Registry and encouraging others to do so, you will play an important role in finding better treatments for Alzheimer's disease. Register today at www.brainhealthregistry.org.


Dementia and Driving: When Is It No Longer Safe?

Dementia and Driving: When is it no longer safe?By: Monica Moore, M.S.G.

When a diagnosis of Alzheimer's disease or a related form of dementia is made, it inevitably brings up concerns about driving. Most of us tie our sense of independence into our ability to get where we need to be, and for most of us, this is our ability to drive there. Many families delay having a discussion about driving for as long as possible due to the awkward nature of the topic, yet driving can become a safety issue even early in dementia. Driving is a very complex activity, requiring quick thinking, instant reactions, timing, coordination, and good visual and spatial perception. However, some or all of these areas of cognition can be compromised or affected when someone has dementia. Friends and family members can help determine that someone can no longer drive safely by reviewing the following signs of unsafe driving, courtesy of the Alzheimer’s Association:

  • Forgetting how to locate familiar places
  • Failing to observe traffic signs
  • Making slow or poor decisions in traffic
  • Driving at inappropriate speeds
  • Becoming angry or confused while driving
  • Hitting curbs
  • Using poor lane control
  • Making errors at intersections
  • Confusing the brake and gas pedals
  • Returning from routine drives later than usual
  • Forgetting the destination they are driving to during the trip

Family and friends are the first ones who may notice that their loved one is no longer safe to drive, but enlisting the aid of the diagnosing physician is an avenue which may make the conversation easier. California state law (California’s Health & Safety Code [Section 103900]) requires physicians to submit a confidential report to the county health department when an individual is diagnosed as having Alzheimer's disease or related disorders, severe enough to impair a person's ability to operate a motor vehicle. This information is then sent to the DMV, which is authorized to take action against the driving privileges of any individual who is unable to safely operate a motor vehicle.

The key to having a successful discussion about driving is to allow everyone to speak, focus on safety and ability (not age), and to plan ahead. For more information on driving and dementia please visit www.alz.org or www.dmv.ca.gov.


Clinical Research Opportunities

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

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

The 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. The A4 study is for people without any outward signs of Alzheimer's disease, and is designed to evaluate the effectiveness, safety and tolerability of an investigational drug for AD. The purpose of the Anti-Amyloid Treatment in Asymptomatic Alzheimer's study (the "A4 study" for short) is to test whether a new investigational treatment can slow the memory loss caused by Alzheimer’s disease. The overall goal of the A4 study is to test whether decreasing amyloid with antibody investigational treatment can help slow the memory loss associated with amyloid buildup in some people. The A4 Study lasts for three years, and participants will be assigned at random to receive either the investigational drug or a placebo and will be monitored over that period.

In general, you may be eligible to join the A4 Study if you:

  • Are 65 to 85 years old
  • 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.

Study of A Beta Secretase Inhibitor in Prodromal Alzheimer's Disease:

The Easton Center is currently participating in a Phase III clinical trial sponsored by Merck & Co of the investigational drug MK-8931. MK-8931 reduces levels of the beta amyloid protein by inhibiting the activity of an enzyme called beta secretase. MK-8931 is an oral medication taken daily. The study is approximately two years long, with roughly 12 study visits. Participants will be randomly assigned to the active study medication (MK-8931) or placebo. A placebo is a pill that looks just like the active medication but has no biological activity. Participants will have a 66% chance of receiving the active study medication. Individuals age 50-85 who have a memory problem are potentially eligible for this study. If you are interested in participating, please call (310) 794-6191 or visit www.eastonad.ucla.edu.

FYN Kinase (CONNECT) Study:

The CONNECT study will test whether an oral, experimental drug, AZD0530 (saracatinib), will slow progression in mild-stage Alzheimer’s disease (AD). Although the cause of AD is unknown, several lines of evidence suggest that a peptide known as beta-amyloid plays a central role. Convergent evidence in recent years has yielded a refinement of the “amyloid hypothesis”, suggesting that neurotoxicity of beta-amyloid oligomers leads to Alzheimer’s disease. The protein Fyn kinase, a member of the Src family kinases, may play a fundamental role in the pathway by which beta-amyloid oligomers damage neurons. AZD0530 is a selective inhibitor of Src family kinases that was previously developed as a cancer therapy but may hold greater promise as a treatment for AD. Researchers will use PET imaging to evaluate whether the drug is effective in slowing decline in brain metabolism and will also determine whether it is safe and well tolerated in patients with AD. Screening will occur over six weeks followed by a 52-week treatment period. The study requires a minimum of four visits during the screening and 13 to 14 visits during the course of the treatment. To learn more, please call (310) 794-6191 or visit www.eastonad.ucla.edu


CDPH Updates

The Healthy Brain Initiative – Patient and Caregiver Educational Materials

Promoting Brain Health – Physical Activity [PDF]

An educational infographic flyer for patients and caregivers that focuses on prevention (risk factors and the benefits of physical activity) for a healthy brain.

Promoting Brain Health – Nutrition [PDF]

An educational infographic flyer for patients and caregivers that focuses on nutrition for a healthy brain.

Caregiver Support and Resources Roadmap [PDF]

An infographic roadmap of support services and resources for caregivers of individuals living with dementia.

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 © 2016. Mary S. Easton Center for Alzheimer's Disease Research at UCLA. All rights reserved.


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