Top AD Experts Debating New Targeted Biomarkers and Therapeutic Approaches in a New Era

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June
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Top AD Experts Debating New Targeted Biomarkers and Therapeutic Approaches in a New Era

Post by June »

Hi all - Found this fascinating 10-part new short video series on Neurology Live with top AD medical experts
Richard Isaacson, MD (moderator)
Sharon Cohen, MD
Marwan Sabbagh, MD

who discussed and debated the criticality of early intervention and evolving treatment strategies surrounding Alzheimer’s disease. Thrilled to hear their voice of HOPE for near-term breakthroughs in AD treatment(#9 pipeline), early diagnosis and future outlook. A lot of attention on E4/4 genotype. Enjoy 8-)

Neurology Live

Preparing for a New Era in Alzheimer's Disease: Debating New Targeted Biomarkers and Therapeutic Approaches

My personal favorites:
EP. 1: Apolipoprotein E4 in Alzheimer’s Disease

EP. 2: Importance of Early Diagnosis of Alzheimer’s Disease

EP. 4: Amyloid Cascade Hypothesis of Alzheimer’s Disease

EP. 5: Contribution of Multiple Pathways to the Development of Alzheimer’s Disease

EP. 7: CSF Testing and Blood-based Biomarkers in Alzheimer’s Disease

EP. 8: Utilization of APOE4 Genotype in Management of Alzheimer’s Disease

EP. 9: Alzheimer’s Disease Pipeline
(Alzheon's ALZ-801 was highlighted as a promising phase 3 candidate)

EP. 10: The Future Outlook for Alzheimer’s Disease

For those of us feeling crushed and hopeless by the 5/6/24 Fortea Nature Medicine paper, or the discovery of 4/4 or 4/3 status, I highly recommend listening to this series with cutting-edge research updates and a lot of HOPE for us all :!: :idea:

Let us know who are planning to attend this annual conference and share what you find out about the latest:
Alzheimer’s Association International Conference | July 28 – Aug. 1, 2024 | Philadelphia, USA, and Online

Cheers!
June 4/4 yet hopeful
Former biotech executive
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Chicagogirl
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Re: Top AD Experts Debating New Targeted Biomarkers and Therapeutic Approaches in a New Era

Post by Chicagogirl »

June wrote: Mon Jun 17, 2024 11:50 pm Hi all - Found this fascinating 10-part new short video series on Neurology Live with top AD medical experts
Richard Isaacson, MD (moderator)
Sharon Cohen, MD
Marwan Sabbagh, MD

who discussed and debated the criticality of early intervention and evolving treatment strategies surrounding Alzheimer’s disease. Thrilled to hear their voice of HOPE for near-term breakthroughs in AD treatment(#9 pipeline), early diagnosis and future outlook. A lot of attention on E4/4 genotype. Enjoy 8-)

Neurology Live

Preparing for a New Era in Alzheimer's Disease: Debating New Targeted Biomarkers and Therapeutic Approaches

My personal favorites:
EP. 1: Apolipoprotein E4 in Alzheimer’s Disease

EP. 2: Importance of Early Diagnosis of Alzheimer’s Disease

EP. 4: Amyloid Cascade Hypothesis of Alzheimer’s Disease

EP. 5: Contribution of Multiple Pathways to the Development of Alzheimer’s Disease

EP. 7: CSF Testing and Blood-based Biomarkers in Alzheimer’s Disease

EP. 8: Utilization of APOE4 Genotype in Management of Alzheimer’s Disease

EP. 9: Alzheimer’s Disease Pipeline
(Alzheon's ALZ-801 was highlighted as a promising phase 3 candidate)

EP. 10: The Future Outlook for Alzheimer’s Disease

For those of us feeling crushed and hopeless by the 5/6/24 Fortea Nature Medicine paper, or the discovery of 4/4 or 4/3 status, I highly recommend listening to this series with cutting-edge research updates and a lot of HOPE for us all :!: :idea:

Let us know who are planning to attend this annual conference and share what you find out about the latest:
Alzheimer’s Association International Conference | July 28 – Aug. 1, 2024 | Philadelphia, USA, and Online

Cheers!



June

Thanks so much for posting this information and the link to the series. I've watched the first episode and intend to watch the rest. I was impressed with the credentials of the presenters and their presentations about current information on Alzheimer's and APOE4 gene.

Chicagogirl
;) 4/4 “Choose to be optimistic. It feels better.” Dalai Lama
June
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Re: Top AD Experts Debating New Targeted Biomarkers and Therapeutic Approaches in a New Era

Post by June »

Chicagogirl wrote: Tue Jul 02, 2024 8:46 am
June wrote: Mon Jun 17, 2024 11:50 pm Hi all - Found this fascinating 10-part new short video series on Neurology Live with top AD medical experts
Richard Isaacson, MD (moderator)
Sharon Cohen, MD
Marwan Sabbagh, MD

who discussed and debated the criticality of early intervention and evolving treatment strategies surrounding Alzheimer’s disease. Thrilled to hear their voice of HOPE for near-term breakthroughs in AD treatment(#9 pipeline), early diagnosis and future outlook. A lot of attention on E4/4 genotype. Enjoy 8-)

Neurology Live

Preparing for a New Era in Alzheimer's Disease: Debating New Targeted Biomarkers and Therapeutic Approaches

My personal favorites:
EP. 1: Apolipoprotein E4 in Alzheimer’s Disease

EP. 2: Importance of Early Diagnosis of Alzheimer’s Disease

EP. 4: Amyloid Cascade Hypothesis of Alzheimer’s Disease

EP. 5: Contribution of Multiple Pathways to the Development of Alzheimer’s Disease

EP. 7: CSF Testing and Blood-based Biomarkers in Alzheimer’s Disease

EP. 8: Utilization of APOE4 Genotype in Management of Alzheimer’s Disease

EP. 9: Alzheimer’s Disease Pipeline
(Alzheon's ALZ-801 was highlighted as a promising phase 3 candidate)

EP. 10: The Future Outlook for Alzheimer’s Disease

For those of us feeling crushed and hopeless by the 5/6/24 Fortea Nature Medicine paper, or the discovery of 4/4 or 4/3 status, I highly recommend listening to this series with cutting-edge research updates and a lot of HOPE for us all :!: :idea:

Let us know who are planning to attend this annual conference and share what you find out about the latest:
Alzheimer’s Association International Conference | July 28 – Aug. 1, 2024 | Philadelphia, USA, and Online

Cheers!



June

Thanks so much for posting this information and the link to the series. I've watched the first episode and intend to watch the rest. I was impressed with the credentials of the presenters and their presentations about current information on Alzheimer's and APOE4 gene.

Chicagogirl
Thanks Chicagogirl,glad you're enjoying the series, its gets better as you watch comments on new developments!
June 4/4 yet hopeful
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Re: Top AD Experts Debating New Targeted Biomarkers and Therapeutic Approaches in a New Era

Post by KathleenC »

June wrote: Mon Jun 17, 2024 11:50 pm Hi all - Found this fascinating 10-part new short video series on Neurology Live with top AD medical experts
Richard Isaacson, MD (moderator)
Sharon Cohen, MD
Marwan Sabbagh, MD

who discussed and debated the criticality of early intervention and evolving treatment strategies surrounding Alzheimer’s disease. Thrilled to hear their voice of HOPE for near-term breakthroughs in AD treatment(#9 pipeline), early diagnosis and future outlook. A lot of attention on E4/4 genotype. Enjoy 8-)

Neurology Live

Preparing for a New Era in Alzheimer's Disease: Debating New Targeted Biomarkers and Therapeutic Approaches
Thanks so much for sharing this, June. I found it fascinating as well. The drug development pipeline discussion left me feeling optimistic. Fingers crossed new solutions will arrive in time to help all of us!

Kathleen
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Re: Top AD Experts Debating New Targeted Biomarkers and Therapeutic Approaches in a New Era

Post by rubyd0g 3/4 »

Thank you. This was so helpful. I am a 3/4 with no symptoms and 76. My mother and grandmother died of Alzheimer’s. I need help now. I have a large family of 10 and so far sisters are apoe4 carriers and one sister, age 73, is symptomatic with noticeable memory loss and has had a Ct scan and recently a csf results that her doctor ran through Mayo Clinic. She is treated at univ of Rochester . Her doctor told her that results were not consistent with Alzheimer’s but has ordered a MRI to look at other causes. I do not understand the csf results which indicate she has high ptau. Her doctor says this is puzzling. Can someone help me . My sister is soooo happy and has decided that she can relax on diet and lifestyle changes. She believes that she does not have Alzheimer’s despite her 4/4 status and family history . I think she needs to get a second opinion. These are her numbers:
P-tau/abets-42 ratio. .028
Abeta42- 854
Total tau- 261. High
Phospho tau- 24.3 high

Her doctor says tau protein is so close to normal, she is not sure it holds any meaning. Might be some tau based damage of uncertain significance going on or normal aging Will get mri and then monitor in office every 6months.
This seems inconsistent with what the presenters explained. “Any amyloid is Alzheimer’s biologically, but with ptau also, this is significant and you don’t wait at all.
I am reading as much as I can but was put off by the results from Mayo Clinic and cut offs used for the ratio . My sisters ct scan also showed “mild parenchyma atrophy and chronic microangiopathy, the ventricles and cortical sulcus are globally and proportionately enlarged. Cerebral parenchyma shows areas of decreased attenuation within the white matter compatible with mild chronic microangiopathy. . No other regions of abnormal density to suggest acute hemorrhage, focal infarction or mass elision. I think this is also consistent with Alzheimer’s.
Any insight - please. I cared for both my mom and gm with this. I do not want to loose my sisters to this desease. We are testing our children and so far one is a 4/4 and only 30.
Thank you
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Re: Top AD Experts Debating New Targeted Biomarkers and Therapeutic Approaches in a New Era

Post by NF52 »

rubyd0g 3/4 wrote: Thu Jul 04, 2024 8:05 pm Any insight - please. I cared for both my mom and gm with this. I do not want to loose my sisters to this desease. We are testing our children and so far one is a 4/4 and only 30.
Thank you
I'm so sorry that your sister is experiencing noticeable memory changes, yet she is lucky to have a "big sister" who is so caring and persistent in seeking to understand what is going on now and what it means for the future. [As an aside, you and I are close in age (I'm 72) and my mother was the 10th of 11 kids, born a couple miles from the University of Rochester. Growing up in Rochester with about 20 cousins, lots of aunts and uncles and eventually cousins 'spouses and kids, I thought it strange when people didn't walk around with a genealogy chart in their heads to keep everyone straight! ] I'm taking the liberty of "quoting" sections of your post so I can touch on what MAY be the thinking of her UR neurologist. [FWIW, the UR is a site of lots of Alzheimer's research and a member of the Alzheimer's Clinical Trial Consortium. Doesn't mean everyone there is perfect, but I would trust my sister who still lives in Rochester to them.]
These are her numbers:
P-tau/abets-42 ratio. .028
Abeta42- 854
Total tau- 261. High
Phospho tau- 24.3 high
Her doctor says tau protein is so close to normal, she is not sure it holds any meaning. Might be some tau based damage of uncertain significance going on or normal aging
My non-scientist understanding is that values is CSF vary based on the test used, but this reference from 2021 seems to have values similar to your sisters in the group with mild cognitive impairment (MCI) that I circled.
Image 7-5-24 at 6.22 PM.jpeg
But it's entirely possible that the Mayo Clinic is using levels based on the particular tests they performed. It might be possible to ask her UR neurologist if he can order the PrecivityAD 2 blood test, which as of June 24 is available through Mayo Clinic providers to aid in diagnosis of Alzheimer's disease: https://precivityad.com/news/c2ns-preci ... boratories P-tau/Aβ42 and Aβ42/40 ratios in CSF are equally predictive of amyloid PET status
My sisters ct scan also showed “mild parenchyma atrophy and chronic microangiopathy, the ventricles and cortical sulcus are globally and proportionately enlarged. Cerebral parenchyma shows areas of decreased attenuation within the white matter compatible with mild chronic microangiopathy. . No other regions of abnormal density to suggest acute hemorrhage, focal infarction or mass elision. I think this is also consistent with Alzheimer’s.
As a bystander, but with two friends who have had similar results on MRIs, I think the term "mild chronic microangiopathy" means she has changes to the blood vessels in her brain that may be a contributing, or even the primary cause of her memory issues. Here's a source from April 2024: Cerebral small vessel disease:
Cerebral small vessel disease, also known as cerebral microangiopathy, is an umbrella term for lesions in the brain attributed to pathology of small arteries, arterioles, capillaries, venules, or small veins. It is the most common cause of vascular dementia/cognitive impairment and is a major cause of ischemic and hemorrhagic strokes.
The VERY good news is that she has not had ischemic (clotting) or hemorrhagic (brain bleeds) strokes! Although I hesitate to offer my two sisters any advice ;) you may want to share this article with her once she's had an MRI and talked with her doctor. https://www.healthline.com/health/micro ... ic-disease She doesn't have to turn her life upside down, but may want to think about her values and preferences and find some enjoyable exercise, even if it's walking with friends.

Finally, you haven't mentioned any neuropsychological testing, which covers thinking, reasoning, memory, attention and questionnaires about everyday activities. I take these tests as part of the AHEAD 45 study in people with elevated amyloid and normal cognition. While they can be frustrating at times, I remind myself that they are simply data points to help tease out where my thinking may be stable and where it may be changing--and therefore need some add-ons to support me. Neuropsychologists are not MDs; they're psychologists--and usually very attuned to supporting people who are nervous!

We cannot make others, even those we love, do what we think is best for them. We can just make ourselves ready to support and help smooth their journey as much as possible. If you're near Rochester, I'd say that includes having some concord grapes this fall!

Nancy
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4/4 and still an optimist!
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Re: Top AD Experts Debating New Targeted Biomarkers and Therapeutic Approaches in a New Era

Post by rubyd0g 3/4 »

Thank you so much for your thoughts. I am still in Rochester area I am apoe4 /3. Wondering what treatment if any you have used as a 4/4. Do you follow a modified keto type diet?? Do you know of any good functional medicine doctors in area that can order some initial testing? I am struggling with diet as can’t seem to get into ketosis when not using coconut or MCT oils (made my lipid panel worse). Can’t believe how well you sound after many years!!
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Re: Top AD Experts Debating New Targeted Biomarkers and Therapeutic Approaches in a New Era

Post by NF52 »

rubyd0g 3/4 wrote: Sat Jul 06, 2024 11:15 am Thank you so much for your thoughts. I am still in Rochester area I am apoe4 /3. Wondering what treatment if any you have used as a 4/4. Do you follow a modified keto type diet?? Do you know of any good functional medicine doctors in area that can order some initial testing? I am struggling with diet as can’t seem to get into ketosis when not using coconut or MCT oils (made my lipid panel worse). Can’t believe how well you sound after many years!!
I'm not an outlier in having ApoE 4/4 and doing well in my 70's and far from perfect either in my mid-life or now. We have members on this forum in their 70's and early 80's with ApoE 4/4, and I personally know several others who lead adventurous lives--and are even still employed in high-level professions. The most recent work on prevalence of Alzheimer's dementia or MCI among people with ApoE 4/4 using cohorts enriched for family history suggests only a 60% likelihood of diagnosis by the age of 85--although the risk is definitely higher in our 70's than for those with one copy.

My diet is closer to a Mediterranean diet, but each of us finds what works best for our specific purposes. I'm sure I also owe some thanks to ancestors who lived well into their 90's, and I was fortunate enough to have early-life advantages like education that continue to allow me to have cognitive challenges and keep my brain happy.

Dr. Stavia's Primer was a great source of support and information when I first found this forum, and her list of Biomarkers to check helped me use sites like Life Extension and Lab Corp to get Direct-to-Consumer tests to monitor myself over time--and share with my doctor, who appreciates that insurance won't cover many of these. I also got a coronary artery scan (small cost; big relief to find I wasn't where my dad was at 67) and a carotid artery scan. Most helpful to me personally, I believe, was deciding to enroll in patient registries like TrialMatch, AlzMatch and the online "games" in APT Webstudy. I was connected with the AHEAD study and also hear about other smaller studies, often looking for people with normal cognition and one or two copies of ApoE4--because the growing consensus is that (as with other diseases) prevention and early diagnosis of risk factors is how Alzheimer's is going to be beaten.

I don't personally know functional medicine doctors in Rochester, but Dr. Lesely James (#27) is listed on our Wiki: ApoE4-Aware Healthcare Practitioners. Best wishes to you, your sister and your extended family!

Nancy
4/4 and still an optimist!
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