By Juhi Yajnik,The Monterey County Herald

MONTEREY, Calif. – Ann Todd was shocked when she first realized something was wrong with her husband, Ronald.

“He called the sheriff’s office to report that some of his tools had been stolen,” she said. “And when I came home from work he told me about it. I realized he had forgotten that he had given them to our son.”

That day marked the beginning of the couple’s nine-year struggle with Alzheimer’s disease. Ronald died last year.

Like many Alzheimer’s patients, Ronald Todd had high cholesterol. But the side effects of the cholesterol-lowering drug he was taking forced him to quit the medication.

Since then, Ann Todd, a registered nurse, said she has read about studies that found similar drugs might actually slow the progression of the disease.

“That’s hopeful,” she said.

Now, several California universities are participating in a nationwide study of 400 patients to determine whether a drug commonly prescribed to reduce cholesterol can, in fact, slow the progression of Alzheimer’s disease.

The large-scale study, which began in December 2002, is specifically focused on the drug simvastatin, commonly known as Zocor. Universities including Stanford and University of California campuses at Davis, Irvine, Los Angeles and San Diego recruited Alzheimer’s patients to participate. Each of the 40 universities involved in the study chose 10 to 15 patients who had normal cholesterol levels and no signs of stroke or head injuries.

Unless a physician dissects a patient’s brain, however, there is no way to confirm whether he or she has Alzheimer’s disease. By ruling out all the other known causes of dementia and memory loss, physicians are about 90 percent accurate when diagnosing Alzheimer’s disease.

Every patient in the study must also have a study partner to observe their progress, report any problems and make sure they are taking the medication.

Physicians monitor the patients’ progress periodically and keep in regular contact with the study partner. They evaluate the patients by talking to them and by giving them tests. For example, patients can be tested to see if they can remember names, keep track of where they are or draw something specific.

When designing this study, scientists at the National Institute of Aging said they wanted to test a cholesterol-lowering drug that was commonly prescribed, relatively inexpensive and could cross the blood-brain barrier to gain access to the brains of Alzheimer’s patients. They chose Zocor, which, according to manufacturer Merck & Co., was prescribed more than 200 million times over the past 12 years in the United States.

Merck holds patents on the drug but did not sponsor the study, which is one of many being funded by the federal government. This year, Alzheimer’s disease research received about $647 million from the federal government.

Some scientists believe that lowering cholesterol levels in the body changes chemical reactions in the brain and slows the progression of Alzheimer’s disease. Already, studies have shown that controlling blood pressure, cholesterol and weight can help reduce the risk of the disease.

Previously, small-scale studies with 20 to 50 patients have shown that cholesterol-lowering drugs, such as Lipitor and Zocor, may slow the progression of Alzheimer’s disease.

The disease, sometimes referred to as “the long goodbye,” attacks the minds of the elderly over the course of decades. Alzheimer’s patients typically begin by losing their memory. Eventually dementia takes over. As their minds degenerate, Alzheimer’s patients can regress to the point of babbling like a baby and being unable to stand or swallow.

Alzheimer’s disease has been studied for nearly a century.

As Germany was enjoying an industrial boom before World War I, Alois Alzheimer, a neurologist in Munich, first identified the disease. He interviewed a woman who was losing her memory and spatial skills. Before she died a few years later, the woman had started hallucinating and had lost the ability to write.

Alzheimer performed an autopsy on her brain in 1906. He found protein plaques, clumps of tiny biological molecules, and also found that parts of the nerve cells in her brain had become tangled. Those clumps and tangles have come to define Alzheimer’s disease.

Like Alzheimer, scientists today still do not know what causes the disease. Some believe the clumps and tangles are a result of Alzheimer’s, not its cause. But many studies have shown that the clumps and tangles cause brain decay. Alzheimer’s research is therefore often aimed at reducing the number of clumps in the brain.

There is no cure for Alzheimer’s disease, nor is there a way to stop it from progressing. The few drugs that are available mostly help ease some symptoms of the disease, such as insomnia, anxiety and depression. The nationwide study now under way aims to determine whether lowering the cholesterol in Alzheimer’s patients is enough to slow the progress of the disease by slowing the accumulation of clumps in the brain.

(EDITORS: STORY CAN END HERE)

The clumps are formed from the biological molecules, called beta-amyloid particles, that float around in the brain. Because the particles are slightly sticky, they eventually start clinging to each other. Studies have shown that high levels of cholesterol can trigger the brain to produce lots of beta-amyloid particles, which occur naturally in the brain but become dangerous when clumped together – “Like when you are cooking spaghetti and it all sticks together,” said William Seavey, a geriatrician and internist at the University of Califoria-Davis who has also been involved in the nationwide study.

But at this point, Seavey said, “I wouldn’t go out and take a cholesterol-lowering drug simply to prevent Alzheimer’s disease. But I think there is a lot of reason to take care of your brain and your heart to avoid Alzheimer’s.”

Copy the Story Link