We are excited about the first annual meeting of the Alzheimer’s Association International Conference on Alzheimer’s Disease (ICAD). Held in Vienna, Austria, in July 2009, this was the third largest ICAD on record in terms of attendance, and the second largest in a non-U.S. location, drawing nearly 3800 scientists from 74 countries. More than 1500 abstracts were submitted, illustrating that the field of Alzheimer’s disease (AD) research is at a most exciting and productive time. In fact, between 2000 and 2008, scientific abstract submissions to ICAD nearly doubled. These exciting, pre-publication reports contain the incremental advances, learnings, and major breakthroughs that will advance the field toward better diagnosis, treatment, and prevention.

Abstract: The quality of care provided by primary-care physicians for patients with dementia remains poor, in part because physicians do not provide counseling and education. Local Alzheimer’s Association chapters have the potential to improve the quality of care provided for dementia, but are hampered by a lack of referrals from primary-care physicians. Many physicians remain unaware of the services available through Alzheimer’s Association chapters, but recognize the need to provide support to families, ensure patient safety, and manage behavioral problems. At present, systems to promote referrals and communication with local chapters are lacking. Practice redesign may facilitate linkages between practices and Alzheimer’s Association chapters. However, if these linkages are to be adopted and sustained, they must demonstrate a relative advantage to physicians beyond the care they currently provide, and must be compatible with how care is currently delivered in their practices.

Abstract: Background: Brief cognitive screening measures are valuable tools for both research and clinical applications. The most widely used instrument, the Mini-Mental State Examination (MMSE), is limited in that it must be administered face-to-face, cannot be used in participants with visual or motor impairments, and is protected by copyright. Screening instruments such as the Telephone Interview for Cognitive Status (TICS) were developed to provide a valid alternative, with comparable cut-point scores to rate global cognitive function.Methods: The MMSE, TICS-30, and TICS-40 scores from 746 community-dwelling elders who participated in the Aging, Demographics, and Memory Study (ADAMS) were analyzed with equipercentile equating, a statistical process of determining comparable scores based on percentile equivalents for different forms of an examination.Results: Scores from the MMSE and TICS-30 and TICS-40 corresponded well, and clinically relevant cut-point scores were determined. For example, an MMSE score of 23 is equivalent to 17 and 20 on the TICS-30 and TICS-40, respectively.Conclusions: These findings indicate that TICS and MMSE scores can be linked directly. Clinically relevant and important MMSE cut points and the respective ADAMS TICS-30 and TICS-40 cut-point scores are included, to identify the degree of cognitive impairment among respondents with any type of cognitive disorder. These results will help in the widespread application of TICS in both research and clinical practice.

Abstract: The past 30 years have seen multiple attempts at demonstrating the safety and efficacy of drugs for Alzheimer’s disease (AD), predominantly to improve symptoms. Only five drugs (tacrine, donepezil, rivastigmine, galantamine, memantine) have obtained regulatory approval in most countries. Their cost-effectiveness from a societal perspective has not been universally recognized, and anybody who thinks these drugs are useful for individual patients will have to agree that the improvement above the starting point of treatment is moderate. Most of the benefit has been in slowing down progression of symptoms rather than a readily detectable improvement above baseline. There have also been attempts at arresting progression of AD, but all have failed until now. Should we change our approach to developing new drugs for AD so as to move forward? This review will highlight some options to consider in the development of future drugs for AD, with emphasis on strategies to prevent AD or arrest its progression.

Abstract: The Everyday Technologies for Alzheimer’s Care initiative was launched by the Alzheimer’s Association and Intel Corporation in 2003 to identify and fund promising research in the use of technology—especially information and communication technologies—for monitoring, diagnosing, and treating Alzheimer’s disease. At the last two progress meetings, scientific leaders of the two partners, together with aging health technology academic scientists, met to review the most recent research and discuss how current and developing technologies can address growing needs in Alzheimer care.

Abstract: Background: The objective of this study was to evaluate the existence of cognitive plateaus in some individuals during the course of Alzheimer’s disease (AD).Methods: Data came from the historical patient group collected via the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD, Duke University, 1988–1996). Data reduction was performed by using principal components analysis to derive a single cognitive measure (F1), followed by application of a novel plateau-searching algorithm to individual patient data, looking for stable periods of 3 years or longer. To evaluate the time dependence of F1, we fitted a linear mixed model to the group and to individual data points.Results: Twenty-two percent of AD subjects (54/243) and 98% of healthy control subjects (253/258) exhibited a plateau. Within the AD plateau group, the most common pattern was a single plateau (mean, 3.6 years; range, 3 to 7 years) that extended for the entire measurement period (28/54 subjects). Briefer plateau durations were seen at the beginning or end of the measurement period. Initial cognitive function (F1) was slightly higher in the plateau group, which was also slightly older and less well-educated. Men and women were equally represented.Conclusions: In a patient sample predating the widespread use of cholinesterase inhibitors, we found that approximately one fifth of individuals with AD demonstrated periods of prolonged cognitive stability. This significant interindividual variability must be considered when providing prognostic information to families and when assessing individual patient responses to pharmacotherapy. We advise caution when assessing results of potentially disease-modifying agents at the individual patient level.