Alzheimer's Alternatives: Specialists are examining the role of particulate pollution, the positive impact of healthy lifestyle choices, and testing drugs to prevent the disease in at-risk individuals who are not showing any symptoms.

• Author: Hopper, Leigh
• Position: MEDICINE & HEALTH

SCIENTISTS at the University of Southern California are researching measures that might reduce the risk of developing Alzheimer's disease. Specialists are examining the role of fine particle pollution, the positive impact of healthy lifestyle choices, and testing drugs to prevent disease in at-risk individuals who are not showing any symptoms.

"We do not yet know how to prevent or cure Alzheimer's disease, although we know that genetics, lifestyle, and environmental exposures all contribute," says Margaret Gatz, professor of psychology, gerontology, and preventive medicine. "Nonetheless, there are things that can be done to reduce people's risk--regular physical exercise, controlling blood pressure and diabetes, and keeping one's brain active and engaged."

Gatz is studying twins where one member of the pair has developed Alzheimer's disease while the other has not, to better understand risk factors to which the affected twin was uniquely exposed and protective factors in the life of the unaffected twin.

Could a drug started before problems arise prevent Alzheimer's? Paul Aisen, a professor of neurology and director of the Alzheimer's Therapeutic Research Institute at the School of Medicine, indicates that a true Alzheimer's prevention trial would be difficult to do because it would require thousands of healthy, asymptomatic participants followed for many years to compare the rate of occurrence of Alzheimer's in individuals treated with a drug or placebo.

The next best thing, though, is underway. "It's a very early treatment trial, sometimes called a 'secondary prevention trial,' that enrolls individuals who have evidence amyloid in the brain but no Alzheimer's symptoms and tracks the rate of subtle cognitive decline across treatment arms. This is the design of the A4 trial now in progress."

Tatyana Gurvich, a certified geriatric pharmacist and assistant professor in the School of Pharmacy, looks at Alzheimer's a litde differently; she is interested in figuring out the problems that may mimic Alzheimer's.

"Before diagnosing Alzheimer's disease, it is very important to rule out other conditions. Sometimes depression, anxiety, insomnia, poor thyroid function, or a simple vitamin deficiency can contribute to worsening memory and confusion. Fixing those problems will lead to improved...