The University Record, November 8, 1999

Study looks to drugs as preventive measure for Alzheimer’s disease

By Kara Gavin
Medical Center Public Relations

Could the simple act of taking a drug help keep a person with memory loss from disappearing into the thick fog of Alzheimer’s disease? No one yet knows, but a new study at the U-M and other sites across the nation is attempting to find out.

Scientists, including neurology professor Norman Foster believe that some of the same drugs already used to treat the 4 million Americans with Alzheimer’s might also keep relatively healthy people from developing this dreaded cause of dementia. This goal is more important than ever because experts predict that 10 million Americans—including a quarter million Michigan residents—will have Alzheimer’s by the year 2040.

The new study, the first of its kind, tests the preventive properties of promising drugs. It focuses on patients with a form of serious but not incapacitating memory loss that scientists call mild cognitive impairment (MCI).

All of us forget things as we grow older—where the car keys are, whether we’ve turned off the iron before leaving home. But somewhere between this normal forgetfulness and Alzheimer’s lies MCI. Millions of older Americans live with this condition, which leaves them with their wits intact but with much less ability to remember events, actions and information for very long. Studies have shown that it also increases by tenfold their risk of developing Alzheimer’s.

Says Foster, who co-directs the Michigan Alzheimer’s Disease Research Center, “One of the groups that’s at highest risk for Alzheimer’s are the people with significant memory problems, who perform at the lowest 5 percent for their age group in memory tests, but are otherwise able to perform all of their everyday activities. That’s who will take part in this study.”

The project, funded by the National Institute on Aging and a pharmaceutical company, will follow 720 55- to 90-year-old MCI patients for three years. Doctors at the University and other research centers will monitor their physical and mental condition as they take either a placebo, vitamin E—which has shown promise in slowing mild Alzheimer’s—or donepezil, which is one of two drugs approved by the FDA for the treatment of mild to moderate Alzheimer’s.

Those who wish to participate may call 1-888-455-0655 to be screened for inclusion in the study.

Alzheimer’s disease is a brain disorder that causes progressive loss of intellectual ability, known as dementia, and particularly memory loss. Thought to affect 5 percent of people 65 years of age and older, and 20 percent of people 80 years of age and older, it also can strike people as young as their late 30s.

Only 1 percent of healthy people 65 years of age and older develop Alzheimer’s each year, but that rises to 12 to 20 percent per year in people with MCI. Besides MCI, other risk factors that can increase a person’s chance of developing it are a family history of Alzheimer’s disease, increasing age and disorders like Down syndrome.

Just like MCI, Foster says, Alzheimer’s begins with memory problems. “They begin gradually, and can be hardly noticeable at first, but over time they progress to the point that they affect everyday activities,” he notes. “At this point, the problem is clearly different from normal aging. We’re beginning to look at Alzheimer’s disease earlier and earlier in its progression, and trying to identify patients who have the earliest symptoms because we think that we can have the most effect at altering the disease course then.”

Foster cites 10 warning signs that can be used to recognize Alzheimer’s:

  • Recent memory loss that affects job performance—for example, forgetting something and being unable to recall it later.

  • Difficulty performing familiar tasks, such as making coffee.

  • Problems with language, including forgetting simple words or using inappropriate words.

  • Disorientation of time and place, for example getting lost near home or even within the home.

  • Difficulty with judgement, for instance forgetting a child under their care.

  • Problems with abstract thinking, like numbers and how to use them.

  • Misplacing objects or putting them in the wrong place.

  • Changes in mood, such as going from calm to tears to anger in a few minutes.

  • Changes in behavior, like withdrawing from interaction with family and friends.

  • Personality changes, for instance becoming irritable, suspicious or fearful.

    “If patients have one or more of these warning signs, they should seek the advice of their physician,” Foster urges.

    MCI is trickier to diagnose, but physicians have recently developed a list of criteria: memory complaints, abnormal memory for the patient’s age, ability to carry out normal activities of daily life and normal cognitive function. For example, an MCI patient will forget important events repeatedly, or not be able to remember as many details of a short paragraph or picture as a person of the same age with normal memory. On the other hand, they will be able to shop, prepare meals and continue their hobbies.

    Facts about Mild Cognitive Impairment and Alzheimer’s Disease

  • More than 4 million Americans have Alzheimer’s disease, including 125,000 in Michigan. It is the most common form of dementia in adults.

  • By the year 2040, more than 10 million Americans will have Alzheimer’s, including more than a quarter million Michigan residents.

  • About 1 percent of healthy people 65 years of age and older develop Alzheimer’s each year, while 12 percent to 15 percent of people with MCI do.

  • More than 34 million people—13 percent of the total population of the United States—are age 65 and older. According to the U.S. Bureau of the Census, this percentage will climb to 18 percent by the year 2025.

  • The annual economic toll of Alzheimer’s disease in the United States in terms of health care expenses and lost wages of both patients and their caregivers is estimated at $80 billion to $100 billion.

    For more information, call TeleCare at

    1-800-742-2300, category 1010.