May 25, 2007

Alzheimer’s tends to strike Hispanics at an earlier age

What role do fish have with Alzheimer’s?

Doctor’s Corner
By Dr. Eduardo Grunvald

What do fish have to do with Alzheimer’s disease? Researchers at UCSD (University of California, San Diego) are trying to figure that out.

Recently, they have identified a possible link between omega-3 fatty acids and slowing the progression of Alzheimer’s disease.

According to Dr. Michael Rafii, a UCSD investigator, observations have revealed that certain Scandinavian populations with low rates of Alzheimer’s disease also have increased levels of DHA, a type of omega-3 fatty acid. Omega-3 fatty acids are found in high levels in certain fish – primarily tuna and salmon - and are the main ingredients in many popular nutritional fish oil supplements. DHA is important in forming the essential fat containing material surrounding nerve cells - including those in the brain - necessary for their normal function. Further experiments in laboratories have provided evidence that DHA slows down some of the biochemical abnormalities found in the brains of Alzheimer’s patients.

The National Institute of Aging, one agency of the National Institutes of Health, is funding an extensive study throughout the United States to test this dietary substance on humans.

Alzheimer’s disease is a form of dementia afflicting approximately 4.5 million American adults. Affected individuals will exhibit progressive problems with poor memory, disorientation and getting lost easily, asking the same questions over again, inability to recognize familiar faces, problems with calculations, such as balancing finances or simple mathematics, and in advanced phases, even losing the ability to perform activities of daily living, such as dressing, cooking, or grooming.

Generally, there is no single test that can diagnose Alzheimer’s disease, and only a qualified doctor can provide the most likely diagnosis after a thorough evaluation.

Dr. Rafii, the principal investigator for this particular study at the UCSD site, known as the Alzheimer’s Disease Research Center (ADRC), is looking for volunteers 50 and older with mild to moderate Alzheimer’s disease. Those that are accepted into the trial would participate over the course of 18 months and would be randomly selected to receive either pills of DHA or placebo (an empty sugar pill that has no effect on the body).

Participation would require some blood tests and other studies, at no cost. Some participants may be paid for their time in the study.

We don’t know exactly what causes Alzheimer’s disease, but there are certain changes in the brain that are strongly associated with the disorder. It generally affects persons over the age of 60. It is estimated that approximately five percent of people between the ages of 65 and 74 suffer from this ailment, and up to half of those above 85 may have it. In contrast to mild memory loss associated with aging, it is a distinct disease and should not be considered a normal part of getting older.

In Hispanics, the disease tends to strike at an earlier age compared to non-Latino whites. According to a report released by the Alzheimer’s Association - at the current rate of population growth and incidence of the illness – it is estimated that the number of U.S. Hispanics affected with Alzheimer’s will grow from 200,000 currently to 1.3 million by the year 2050. There are probably multiple reasons explaining these projected statistics. Hispanics in the U.S. tend to have a higher incidence of risk factors for stroke and heart attacks – such as high blood pressure, diabetes, and high cholesterol – and social realities such as a lower rate of literacy and education, all attributes that have been linked to developing the disease. Combining these observations with the fact that Hispanics in this country have decreased access to health care, makes Alzheimer’s disease an important public health problem for this minority community.

As anyone can imagine, it is devastating to watch a loved one slowly lose their personality, memory, and intellectual capacities – essentially the loss of their identity. Sadly, the process is progressive. Although there are medications that can potentially slow down some of the deterioration, families can helplessly predict a gradual and downward course.

The Alzheimer’s Disease Research Center at UCSD provides excellent services for anyone concerned about memory or related problems, in both English and Spanish. To contact them, whether it may be to inquire about participating in the DHA trial or simply for a consultation, call (858) 622-5800, or visit their website at http://adrc.ucsd. edu. Participation in trials and receiving associated medications and tests requires no insurance or medical coverage. One of the objectives is to increase participation of Hispanic subjects and a bilingual nurse practitioner is available for Spanish speaking patients.

Scientific evidence has suggested fish oils may slow down the development of Alzheimer’s disease. It is now up to all of us to prove that this is also true in real patients. Perhaps you may one day stave off this devastating disease by simple dietary changes.

Dr. Grunvald is Associate Clinical Professor, Department of Medicine at the Perlman Internal Medicine Group, UCSD Medical Center.

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