Geriatric Grand Rounds: Treatment for Alzheimer’s Disease “Inside & Outside The Box” Mark Brody, M.D. January 22, 2019

UAMS Disclosure Policy It is the policy of the University of Arkansas for Medical Sciences (UAMS) Office of Continuing Education to ensure balance, independence, objectivity, and scientific rigor in all directly or jointly provided educational activities. All individuals who are in a position to control the content of the educational activity (course/activity directors, planning committee members, staff, teachers, or authors of CE) must disclose all relevant financial relationships they have with any commercial interest(s) as well as the nature of the relationship. Financial relationships of the individual’s spouse or partner must also be disclosed, if the nature of the relationship could influence the objectivity of the individual in a position to control the content of the CE. The ACCME and ACPE describe relevant financial relationships as those in any amount occurring within the past 12 months that create a conflict of interest. Individuals who refuse to disclose will be disqualified from participation in the development, management, presentation, or evaluation of the CE activity. The following speakers have no business, personal, or financial relationships with commercial interests to disclose: Mark Brody, M.D. The planners of this RSS, Dr. Priya Mendiratta, Dr. Priya Priyambada, Dr. Gohar Azhar, and Candace Rolston, APN, and moderator Dr. Robin McAtee, have no financial relationships with commercial interests to disclose. The accreditation compliance reviewer, Courtney Bryant, has no financial relationships with commercial interests to disclose.

What is Alzheimer's disease? Video

Risks factors Aging High intake of saturated fat Presence of ApoE ε4 Allele Diabetes Mellitus Hypertension Stroke CHF Head Injury Atrial Fibrillation Menopause Hyperhomocysteinemia Lower Education Atherosclerosis Depression Smoking Sedentary Lifestyle Alcoholism Overweight

Hallmarks of AD

MCI progression to AD

Why consider clinical trials? Scenario: if you are diagnosed with an aggressive cancer and the only possible treatment lies on an experimental drug available 2K miles away from home, will you do it?

Why consider clinical trials? Benefits: You can play a more active role in your own health care. You can gain access to potential treatments before they are widely available. You can receive expert medical care at leading healthcare facilities — often free of cost — while participating in important medical research. You can help future generations — your children and grandchildren — by contributing to Alzheimer's research.

Why consider clinical trials? Available treatments approved by FDA: Donepezil – Aricept Galantamine – Razadyne Rivastigmine – Exelon Memantine – Namenda Effective Treatments or Bottles of Hope: “On average, the four approved AD drug’s are effective for about six-12 months for about half of the individuals who take them” – Alzheimer’s Association, Research Center, Science & Progress What We Know Today section. Current Alzheimer's Treatments. Available at http://www.alz.org/research/science/alzheimers_disease_treatments.asp. Accessed July 17, 2014. Current FDA-approved AD medications “may help some people” …but even for those it help, it is “only for months to a couple of years.” – NIH/NIA A primer on AD and the brain. NIH Alzheimer’s Disease Progress Report, 2011-2012.

How acetylcholinesterase inhibitors work

Questions?