Alzheimer Disease History

RI Hospital Part of Major National Alzheimer's Disease Research

Over the next five years, Rhode Island Hospital will participate in the next stage of a groundbreaking study on Alzheimer’s Disease. This study will be the first to focus on the initial biological signs of Alzheimer’s, before any of the symptoms appear, and therefore will be the first to focus on the prevention of the disease.  

“We think that Alzheimer’s starts maybe in middle age,” says Dr. Brian R. Ott, director of the Alzheimer's Disease & Memory Disorder Center at Rhode Island Hospital .  “If we understand early changes we will come up with ways to really effectively treat the disease,” he says, “Now we look at end stages, when the damage has been done. It’s too little too late.” 

Dr. Ott is leading the Rhode Island segment of ADNI2, or Alzheimer’s Disease Neuroimaging Initiative. The National Institutes of Health has allocated a grant of $40 million for the second phase of this study, which started in 2004. 

“The goal of that study was to define the optimum markers of Alzheimer’s Disease in order to recognize it before it becomes overt." says Dr. Ott. "That project was very successful and now we’re pushing back the diagnosis even further."

This second portion of the study will continue to define subtle changes that occur in the brains of older people, many years before clear signs of Alzheimer’s begins to appear. The study looks at pictures of the brain and measures of blood and spinal fluid.  

“The earliest biomarker we have found so far is beta-amyloid,” Dr. Ott says, “that starts to develop before you have any symptoms at all, about ten to twenty years before."

“But we are also collecting data on behavior and cognitive function that will pick up the latest change in the disease and symptoms,” he says. “Clearly, symptoms lag by years in the biological process. We need to find out the time course of these changes.” 

Participants' brains will be examined for any changes, in constitution or function, as people transition from normal cognitive aging to mild cognitive impairment to Alzheimer’s dementia. By examining people who are at risk for the disease and tracking its progression, the researchers hope that they can determine possible interventions.

Alzheimer's Disease – History, Etiology and Burden

Alzheimer is the most common cause of dementia.  It was first documented in 1906 by a German psychiatrist Alois Alzheimer, who observed the pathological hallmarks of the disease — atypical mass of protein (i.e., beta-amyloid plaques) and tangled bundles of protein fibers (i.e., neurofibrillary tangles) — in the brain of a female patient who had experienced memory loss, troubles, and unpredictable behavior.  An important breakthrough was the invention of the photomicrograph from the early 1900s by Solomon Carter Fuller, an African American psychiatrist; this crucial innovation provided a technique for taking images via the lens of a microscope allowing visualization of amyloid plaques and neurofibrillary tangles.

Since its first description, Alzheimer’s condition has gone from a seldom documented disorder to one of the most common disabling diseases among older adults. The growing proportion of older adults in the U.S. population reinforces the urgent need for prevention and treatment of all chronic diseases including Alzheimer’s disease. In most individuals, cognitive health and effectiveness remain stable over the lifetime, with only a gradual decline in short-term memory and processing speed. For others, on the other hand, the decline in cognitive effectiveness progresses to a far more serious state of cognitive impairment or into a variety of forms of dementia. Mild cognitive impairment is characterized by difficulties with memory, vocabulary, or other vital cognitive functions which are serious enough being noticed by other people and are reflected on cognitive tests, but aren't severe enough to interfere with daily life. Dementia is portrayed by progressive global deterioration of cognitive capabilities in multiple domains including memory and at least one additional area — learning, orientation, language, understanding, and judgment —severe enough to interfere with daily life.

The diagnosis of Alzheimer’s disease is difficult and usually imprecise, but its importance is without question. Relying on the diagnostic and pathologic standards employed, Alzheimer’s disease accounts for 60-80% of all dementia cases. As many as five million Americans may currently have the disorder, and the prevalence of mild cognitive disorder is even higher.

Alzheimer's disease, methods and protocols

Alzheimer's disease, a century of scientific and clinical research

Self, senility, and Alzheimer's disease in modern America, a history

Alzheimer's disease

The Everything Health Guide to Alzheimer's Disease, A Reassuring, Informative Guide for Families and Caregivers