A dementia diagnosis naturally raises the frightening prospect of slowly losing one’s memory and personality – made all the worse by knowing that few effective treatments are available.
But at the UNM Memory & Aging Center, New Mexicans now have access to clinical trials that offer hope for treating this devastating condition. Patients can also participate in research funded by the National Institutes of Health that will help distinguish Alzheimer’s disease from other forms of dementia.
The center, based in UNM’s Domenici Hall, integrates state-of-the-art brain imaging and diagnostic capabilities with advanced clinical and research expertise, says center director Gary Rosenberg, MD, professor in Department of Neurology.
“In terms of having resources, I think we’re as good as anywhere in the world,” he says. “Having it in a convenient package in Domenici Hall is very nice for patients, because everything is done in one building.”
A multi-center phase 3 trial is testing whether wearing a nicotine patch might help people with early-stage memory loss, Rosenberg says. One type of FDA-approved medication works by blocking an enzyme that breaks down acetylcholine, a neurotransmitter involved in memory, he says, and nicotine has a similar effect. "The phase 2 data looked pretty good, so NIH is supporting this phase 3 trial,” he says.
UNM’s Memory & Aging Center is studying ways to improve the diagnosis of vascular cognitive impairment, Rosenberg says There is growing awareness that risk factors like hypertension, diabetes, increased lipids and sleep apnea may damage small blood vessels in the brain, depriving the tissue of oxygen.
Doctors have a hard time distinguishing vascular causes of dementia from Alzheimer’s and other forms of dementia because the symptoms tend to overlap. And some patients may be suffering from both Alzheimer’s and vascular cognitive impairment, he adds.
“At this stage, a lot of what we do – because we don’t have a treatment for everybody – is to get a more precise diagnosis,” Rosenberg says. “This will relieve anxiety due to an incorrect diagnosis and ultimately improve the chance of a drug having a beneficial effect. When patients go to their doctor and are told, ‘You have Alzheimer’s disease,’ there is about a 50 percent chance – maybe even less – of that being accurate.”
UNM is one of seven centers around the country that has been awarded a five-year, $5 million NIH grant to study the impact of vascular disease on Alzheimer’s disease. The consortium hopes to identify biomarkers from brain imaging and blood and cerebrospinal fluid that can be used to improve diagnosis and to follow the effects of treatment.
UNM doctors are plugging the biomarker data into a computer machine-learning program for precision diagnosis. “As more patients are entered into the computer, the build-up of accurate diagnostic information improves the ability of the machine to make a correct diagnosis,” Rosenberg says.
In addition to Rosenberg, the center’s dementia experts include neurologists Janice Knoefel, MD, and John Adair, MD, as well as nurse practitioner Elaine Stack. The team of physicians and nurses has greatly shortened the waiting time to be seen in the center.
Patients who are interested in participating in studies at the Memory & Aging Center need to be referred by their doctors through the UNM Clinical Neurosciences Center, Rosenberg says.