Number Of Patients With Dementia On The Rise

At 81, Alberta Sabin’s mind is not as sharp as it used to be, and she knows it. She frequently misplaces common items, forgets names and appointments, some of the most frustrating aspects of memory loss, she says.

“I had been looking for my cell phone for three days and would you believe I found it laying on the counter in plain sight?,” Sabin says. “There it was and I thought why didn’t I see it before?”

It is that frustration that motivated Sabin to participate in U-M sponsored research designed to better diagnose and treat dementia before it escalates.

Sabin is one of millions of Americans who experience memory loss and may eventually be diagnosed with dementia.

“This is an explosive disease,” says Sid Gilman, M.D., director of the Alzheimer’s Disease Research Center at University of Michigan Health System, who conducts research with Sabin and others in her community. “It’s a horrible disease that robs people of their humanity. They forget their families and friends.”

Roughly 50 percent of people who reach 85 will become demented, according to studies conducted by investigators at Rush Medical Center in Chicago.

By age 100, the number spikes to 60 percent. Of those who develop dementia, roughly 60 percent will prove to have Alzheimer’s disease. It’s predicted that the current number of patients with Alzheimer’s disease in the United States is roughly 5 million. By the year 2050, it will grow to about 30 million, presenting a significant financial burden to the healthcare system.

Gilman and other researchers at the Michigan Alzheimer’s Disease Research Center (MADRC), have a keen interest in patients like Sabin. The center first received grant support from the National Institutes of Health in 1989 and has continued to receive funding since.

Researchers at the MADRC have so far studied 80 patients in a project that has been going on for four years on the diagnosis of Alzheimer's at the earliest sign of cognitive dysfunction. Researchers would ultimately like to evaluate 120.

One of the goals of the research is to determine the best tool for the early diagnosis of Alzheimer’s disease: PET scans or clinical evaluations. In addition to Alzheimer’s disease, there are other possible diagnoses with early onset cognitive impairment, including multiple strokes, frontotemporal dementia, corticobasal degeneration, and the cognitive disorder associated with Parkinson’s disease, which is termed dementia with Lewy bodies.

“The earliest possible treatment for Alzheimer’s disease would be to the patient’s greatest advantage,” Gilman says.

PET, or positron emission tomography, is an imaging study that allows doctors to evaluate the use of certain substances by the brain. Normally, the brain uses glucose as a fuel. Using PET scans, doctors can image the amount of glucose used by the brain to determine whether there’s a difference in brain use by the frontal lobe, temporal lobe or the parietal lobe.

PET gives the ability to make predictions as to those individuals who will go on from mild impairment of memory to developing Alzheimer’s disease. These patients may then qualify to participate in clinical trials for medications that treat Alzheimer’s. Studies with glucose are being supplemented by PET scans that can image beta-amyloid, one of the abnormal proteins in the brain in Alzheimer’s disease.

Sabin, whose mother and grandmother had dementia, is participating in U-M research that will help researchers diagnose and treat the illness earlier in life.

“I have trouble remembering names and the most frustrating is when they are names of people I know really well, I just can’t bring the name to the surface,” Sabin says.

“I felt I needed to do this because with my family history,” Sabin says. “I felt studies I was participating in would help other people so that they won’t have to go through what I did with my own relatives.”