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THE DEMENTIA TSUNAMI

Rotarians Providing a Clearinghouse of Information on Cutting Edge Research and Family Support

Agenda

• Why Alzheimer’s disease as a focus?

• Organization of ADRAG

• Alzheimer’s basics and new findings

• How Rotary Members Can Help

Rotary-based Institutional Members (to-date):

• Coins for Alzheimer’s Research Trust – North Carolina

• Cure Alzheimer’s Fund – Boston, MA

• McCusker Alzheimer’s Research Foundation – Perth AUS

• Rotarians Easing the Pain of Dementia – England

• Alzheimer’s Disease International

Alzheimer’s is a cruel disease.

• PERSON: it destroys one’s history, mind, memories, sense of self, personal dignity and ultimately, life.

• FAMILIES: It creates the devastating pain of watching a loved one deteriorate; financial and physical burden of caretaking; potential health collapse of caretaker and bankruptcy of family.

• SOCIETY: It decreases overall productivity of patients and families lost to caregiving; potential to bankrupt social service agencies (Medicare/Medicaid in US).

Alzheimer’s Disease is the most common form of dementia in the elderly.

• Up to 80% of all Dementia is thought to be Alzheimer’s Disease.

• Up to ~50% of people over age 85 have AD of some kind. Approximately 12% of the persons over age 65 have Alzheimer’s

• Risk Factors:

• Current drugs (Aricept, Namenda, etc.) treat only the symptoms.

• Age • Family History • Gender • Head Injury

• Stress/Emotional Trauma/Loneliness • Stroke • Lack of deep sleep/

Sleep Apnea

Disastrous Impact of Alzheimer’s in the United States

• 6 million victims in the USA

• 3.5+ million deaths from Alzheimer’s in USA in past 10 years

• >13+ million family members impacted

• >15+ million unpaid caregivers

• Approximately 44,000,000 worldwide have Alzheimer’s >>100,000,000+ by 2040

6 Date source: Alzheimer’s Disease International

Alzheimer’s will disproportionately impact low and middle income countries, which are unprepared

to deal with the onslaught of dementia.

7 Date source: Alzheimer’s Disease International

0

20

40

60

80

100

120

2010 2020 2030 2040 2050

high income countries

low and middle income countries

Numbers of people with dementia (millions

Alzheimer’s Disease

Leading Causes of Death in Perspective

THE COST OF ALZHEIMER’S DISEASE IN U.S., 2015

Federal Government Costs for AD Care $171 billion

Total Medicare/Medicaid Budget $861 billion

NIH budget for AD research $600 million

9

In addition to the toll taken on families, AD has a disastrous impact on Country Finances

GLOBALLY Approximately 44 million people have Alzheimer’s/related Dementia.

Cost of Alzheimer’s and dementia estimated to be $605 billion or 1% of the entire world’s gross domestic product.

What is the new Alzheimer’s/Dementia Rotary Action Group, Inc.?

• Provide Rotarians updated information about medical developments, especially advances in research, and how to support them.

• Provide a forum for Rotary clubs to promote successful activities at the local level that address any form of dementia.

• Provide clubs that are looking to do something meaningful in this area to search a list of current effective club activities.

• Provide links to existing resources for patient’s families and caregivers.

• Source of co-funding for Alzheimer’s/Dementia Research

10

CEO

Dave Clifton

Patient & Family Support

Bill Parker

Communications & Outreach

Greg Garofolo

Finance & Administration

Dee Lander

Research Coordination

Mike Curren

Strategic Planning Committee

Board of Directors

• Club Liaison • Project Generation • Project Monitoring • Web content for

P&FS

• Website Management

• Social Media • Club Communication • Conferences

• Bank Account • Accounting • Foundation Finance • Audit • Systems & Reporting

• Grant Selection • Grant Monitoring • Science Web

Content

Alzheimer’s/Dementia Rotary Action Group

Science Advisory Committee

Alzheimer’s/Dementia Rotary Action Group, Inc. Co-chairs: Jeffrey Morby and David Clifton

Alzheimer’s/Dementia Rotary Action Group

• Approval by Rotary International: June, 2013

• Website: adrag.org

• Contribution information:

Minimum Contribution of $25.00 Online through the website or

Alzheimer's/Dementia Rotary Action Group, Inc. c/o Edgartown National Bank – Dee Lander, Treasurer P.O. Box 96, Edgartown, MA 02539

Fund research with the highest probability of preventing, slowing or reversing

Alzheimer’s disease through venture-based philanthropy.

“Plaques”

“Tangles”

Upon autopsy, Dr. Alzheimer described seeing “Plaques and Tangles” in the brain.

• Amyloid-beta Tangles & Nerve Cell Death

• Tangles Spread from nerve cell to nerve cell

• Brain inflammation is activated- kills many more nerve cells!

Tangles/Neuronal Loss Inflammation

b-Amyloid Pathology

CD33 HLA-DRB5 HLA-DRB1

MAPT GRN CHMP2B

VCP BIN1 SQSTM1

MS4A4A MS4A6E EPHA1

ABCA7 IGHV CR1

APP PSEN1 PSEN2 APOE CLU CD2AP

ATXN1 PICALM SORL1 ADAM10 CD33 ACE

TREM2 TREM1 TREM2L

?

Features of AD Pathology and some Associated Genes

Taking Control of Alzheimer’s Through Research—

The Roadmap to Therapies

17

Reducing Risk for Alzheimer’s

• PHYSICAL EXERCISE • At least 10,000 steps/day • Resistance training

• HEALTHY DIET - Mediterranean diet: Fruits/veggies/nuts, olive oil, less red meat, red wine.

• SUPPLEMENTS - Ashwagandha, cats claw

• SOCIAL ENGAGEMENT

• LEARN NEW THINGS - Better than brain games

• REDUCE EMOTIONAL STRESS and practice Meditation, Yoga

• GET EIGHT HOURS OF SLEEP PER NIGHT • Deep sleep consolidates memory: System back-up • Deep sleep clears debris from brain: “Mental floss”

• In the 50 years since the discovery of the Polio vaccine, 1.5 million lives have been saved worldwide.

• If a cure for Alzheimer’s disease is found in this decade, 100 million lives will be saved over the next 50 years.

Come Join with us together to fight this horrible disease

19

Introductions

Ms. Tiffany Ervin

Coins for Alzheimer’s Research Trust

Coins for Alzheimer’s Research Trust (CART)

www.cartfund.org

Coins for Alzheimer’s Research Trust (CART)

www.cartfund.org

• CART is in the Carolinas, Georgia, Tennessee, Virginia and parts of Texas, Florida, Idaho, Alabama, and Kentucky •As of May 2015, 29 grants made totaling $5.2 Million •CART Fund by-laws require that 100% of all donated funds must go to AD Research

CART Today

CART Brings Leverage

• 1999 Dr. Allan Levey received $100 K

- Research allowed $7.2 Million NIH Grant and a $25

Million Private Foundation Grant

• 2001 Dr. Gary Landreth received $250 K

- Research allowed $1 Million NIH Grant

- Findings allowed $200 Million follow-on Grant from

GlaxoSmithKline for drug trials

• 2009 Dr. Harry LeVine received $250 K

- Research allowed $22 Million NIH Grant

2015 ROTARY INTERNATIONAL CONVENTION

Who are we?

A network for Rotarians who believe that it is time to take direct action within our own communities to help support families who are coping alone with dementia.

The plight of the Carer

Dementia impacts on so many lives!

Memory Cafes

• Drop in sessions for people with dementia and their carers. • Volunteers organise entertainment and activities.

• Provides support for carers and the cared for.

The Memory Box

Reminiscence is a very powerful tool for people with dementia.

Simple objects from the past can unlock memories and inspire

a precious moment of clarity

Fidget Quilts

Simple, repetitive movements and sensory experiences become very soothing for people with late stage dementia

Using material with a variety of textures and extra accessories, fidget quilts provide comfort through the hands and eyes.

Lend a Hand! !

Rotarians offer their expertise to local families caring for a loved one with dementia. • Help around the house • Gardening • Shopping • Taxi service • Advice on form filling • Sympathetic ear

Forget-Me-Not Garden Project Rotary Clubs building community sensory gardens stocked with traditional

plants and garden tools.

Forget-Me-Not Gardens are designed to provide both a peaceful haven for carers and cared for, but also a chance to relax and reminiscence

Rotary Club of Market Harborough

Bridging the Generations

Project

Pupils from Princes Risborough College Interact Club at

Forget Me Not Café with Past RIBI President John Minhinick

A Dementia Friendly Community

Voluntary groups, businesses, traders,

emergency services, schools, transport workers, Doctors, community hospitals, libraries, councillors and faith groups, all

working together to improve the quality of life for people living with dementia in the

community

Johan Vos

Deputy Executive Director

Rotarian (Rotary Club of London)

About Alzheimer’s

Disease International (ADI)

• Established 1984

• The umbrella organisation of Alzheimer associations around the world

• 84 member associations

Aims to help establish and strengthen Alzheimer

associations throughout the world, and to raise global

awareness about Alzheimer's disease and all other

causes of dementia

30 years of ADI

Three decades of global collaboration

• ADI established in October 1984, grown from

4 to over 80 member associations

Strategic Plan

1. Making dementia a global public

health priority

2. Strengthening our member

associations

3. Raising awareness

4. Facilitating/encouraging research

Why global advocacy?

• Big societal problem: affecting people,

families and societies

• Care for today

• Cure for tomorrow

Estimated increase in dementia worldwide

Dementia worldwide

2013 2030 2050

Asia Pacific 22 40 72

Europe 11 15 21

The Americas 9 16 30

Africa 3 5 12

44 76 135

Dementia worldwide

US$604 billion in 2010

• Includes direct medical costs, direct non-medical costs and costs of informal (family) care

44

*Includes grants, contracts, and other funding mechanisms used across the National Institutes of Health.

**Includes heart disease ($1.38), coronary heart disease ($457M), cardiovascular disease ($2.14B), and stroke

($337M).

Sources: MetLife Foundation; National Institutes of Health

While AD Is the Second-Most Feared Health Condition

in the US, it Remains Poorly Funded

% People Who Fear it Most Annual Public Research Funding ($billions)*

AD AD

Advocate for dementia to be a global

health priority

• In consultative status with UN since August 2012

• Member of NGO committees on health, mental health and ageing

• Testified at UN meetings in New York and Geneva

• July 2014: review of NCD Summit – need to make clear steps to be taken to include AD and dementia

United Nations

A report developed jointly by

World Health Organization

and

Alzheimer's Disease International

Why dementia is a public health issue?

1. The world's population is ageing

The number of older persons has more than tripled since 1950; it will almost triple again by 2050

2. High burden and daunting costs: A major cause of disability in later life – accounting for 11.9% of years lived with disability

3. Extreme impact on caregivers, families, and societies

4. Lack of awareness and understanding of dementia at some level by all – often considered normal part of ageing

Dementia: a public health issue

Increase in numbers of people with dementia, by income group

And by region • Asia (46%) • Europe (31%) • Americas (16%) • Africa (7%)

Country preparedness for dementia required

• Countries must include dementia on their public health agendas.

• Sustained action and

coordination is required across multiple levels and with all stakeholders – at international, national, regional and local levels.

Dementia: call for action

Dr Margaret Chan, Director- General, WHO in the report's foreword:

• I call upon all stakeholders to make health and social care systems informed and responsive to this impending threat.

G8 Summit on Dementia

Envoy and Council

• World Dementia Envoy:

Dr Dennis Gillings

(Quintiles)

• World Dementia Council

• Agenda: 1) Finance

2) Research collaboration

3) Regulation and trials

4) Sharing knowledge

5) Health and Care

Mobilising NGO community

Global Alzheimer’s and Dementia Action Alliance

• Formed as a response to G7 commitment to “enhance global efforts to reduce stigma, exclusion and fear”

• ADI secretariat • Aimed at international NGOs • Website:www.globaldementia

alliance.org • 14 members now • Launched at WHO World

Health Assembly in May 2014 • Meetings July 2014 and March

2015

ADI reports

• Update global prevalence, incidence and cost data

• Will be launched at the beginning of September

• Women and Dementia report in June 2015

World Alzheimer Report 2015

World Alzheimer’s Month

• September is World Alzheimer’s Month

• 21 September is World Alzheimer’s Day

• International campaign to raise awareness globally

• 2014 theme: Dementia: Can we reduce the risk?

www.alz.co.uk/world-alzheimers-month

• New WHO ADI factsheet launched July 2014

• Reveals smoking can increase dementia risk by 45%

• 14% of dementia cases around the world potentially attributed to tobacco

• Urges governments to implement tobacco control measures and cessation services

Smoking and dementia

www.who.int/tobacco

Follow ADI on Twitter

https://twitter.com/alzdisint

Like us on Facebook

https://www.facebook.com/alzheimersdi

seaseinternational

Visit our website

http://www.alz.co.uk/

Thank you!

TITLE Diagnosis and Prevention of Alzheimer’s disease

Professor Ralph Martins AO

Emerging trends in AD statistics

4.6 million new cases every year

The number of people with dementia is expected

to double every 20 years - 81.1million patients

by 2040

43% of cases need significant care (equivalent to a

nursing home)

Ronald Reagan

(actor/President)

Rita Hayworth (actress)

Lorinda Klaric Hazel Hawke

$406

$471

$540

$604

$615

$924

$1340 GDP (Billion USD)

$96.4 Billion in direct costs related to medical

care (e.g. Hospital care, drugs, and

visits to clinics)

$255.7 Billion in direct social care costs from

formal services outside of the

medical care system (e.g. Home

care and transport)

$251.9 Billion in indirect costs (e.g. Unpaid care by

loved ones)

If Dementia were a Country, it would be the world’s 18th Largest Economy

Future trends in AD BURDEN

“any actual delay in the onset of dementia as a result, for example, of

dementia research and medical breakthroughs would have a dramatic

impact on the future number of cases and the real costs of dementia.”

– Access Economics 2005 Dementia Estimates and Projections -

Within two decades dementia will be the third greatest source of

health and residential aged care spending

– approximately 1% of GDP –

Spending on dementia will surpass any

other

health condition by the 2060s

Delay of Onset 2020 2040

5 Months $1.3 Billion $6.6 Billion

5 Years $13.5 Billion $67.5 Billion

Alzheimer’s Australia Access Economics report “Keeping dementia front of mind”, 2009

Alois Alzheimer Augusta D

Alzheimer’s Disease - Past

Congophilic Amyloid Angiopathy Neurofibrillary Tangles

Amyloid Plaque

ALZHEIMER’S DISEASE – PATHOLOGY

ROTARY STRATEGIC PLAN | 65

Beta Amyloid Protein (Aβ)

DAEFRHDSGYEVHHQKLVFFAEDVGSNKGAIIGLMVGGVVIAT

Aβ 1-40

Aβ 1-42

ROTARY STRATEGIC PLAN | 66

Antibodies are made and bind beta amyloid in the blood promoting its

rapid degradation in the liver thereby facilitating greater e-flux of Beta

amyloid out of the brain (Peripheral sink effect)

A vaccine made

from Beta

Amyloid found

in the brain

plaques is

injected into the

mouse’s muscle

ROTARY STRATEGIC PLAN | 67

IMMUNISATION with Ab42

Schenk D, Barbour R, Dunn W, et al. (1999) Immunization with amyloid-β attenuates

Alzheimer-disease-like pathology in the PDAPP mouse. Nature, 400: 173-177.

Vaccinated Unvaccinated

Sections of Mouse Brain

ROTARY STRATEGIC PLAN | 68

Normal Brain Alzheimer Brain

Brain - Gross Anatomy

ROTARY STRATEGIC PLAN | 69

Beta Amyloid

Changes in Hormone Levels: Oestrogen, Testosterone, Luteinizing

Hormone, Insulin

Defective Genes: Mutations in APP, PS1, PS2 < 3% of Cases

Lifestyle Factors: High Fat Diet,

Lack of Exercise

Genetic Risk Factors: APOE E4 > 50% of Cases

Responsible for >90% of all AD cases

Responsible for <3% of all AD cases

Interacts

ROTARY STRATEGIC PLAN | 70 Translating dementia research into practice

The Australian Imaging Biomarkers and Lifestyle Flagship Study of Ageing

Study is conducted between Perth (40%) and Melbourne (60%)

CSIRO P-Health* University of Melbourne*

Neurosciences Australia Ltd (NSA)* Edith Cowan University (ECU)*

Mental Health Research Institute (MHRI)* National Ageing Research Institute (NARI)

Austin Health University of WA (UWA)

CogState Ltd. Charles Gairdner Hospital radiology and nuclear medicine

*denotes signatories to the AIBL study contract

ROTARY STRATEGIC PLAN | 71

• Launched in November 2006; prospective longitudinal

study

• Aims to improve understanding of the causes and

diagnosis of AD, and help develop preventative strategies

Baseline 36 month 54 month 72 month Follow-up: 18 month

Current Status

The AIBL Study

ROTARY STRATEGIC PLAN | 72

29%64%

98%

HC MCI AD

PiB +ve or

“AD-like”

PiB - ve or

“HC-like”

29%64%

98%

HC MCI AD

PiB +ve or

“AD-like”

PiB - ve or

“HC-like”

Significant differences between the three groups (p<0.001)

Percentage of PiB + volunteers

ROTARY STRATEGIC PLAN | 73

Healthy controls: ApoE ε4 differences

In the HC subgroup, 49% of HC ApoE4+ were PiB+ve, compared to 21% of the HC ApoE4-ve group.

PiB +ve or “AD-like”

PiB -ve or “HC-like”

ε4+ ε4-

49%

21%

ROTARY STRATEGIC PLAN | 74

PiB SUVR cut-point 1.5

3 year clinical progression

HC (n=194)

6% 20% *

to MCI/AD to MCI/AD

Negative Ab Positive Ab

(n=134) (n=60)

Hazard Ratio 3.6 (OR 4)

*

MCI (n=92)

7% 66% *

to AD to AD

Negative Ab Positive Ab

(n=28) (n=64)

Hazard Ratio 11 (OR 25)

*

(p= 0.016) (p< 0.0001)

Corrected for age, gender, education

ROTARY STRATEGIC PLAN | 75

Ne

oco

rtic

al S

UV

Rcb

HC

-

MCI

+

AD

MCI-

HC+

*

1.0

1.5

2.0

2.5

3.0

Time (years)

Mean SUVR AD+

(2.33)

19.2 yr (95%CI 17-23 yrs)

Mean SUVR HC-

(1.17) 12.0 yr

(95%CI 10-15 yrs)

0 10 20 30 40

0.043 SUVR/yr (95%CI 0.037-0.049 SUVR/yr)

The natural history of Ab deposition

in sporadic AD

ROTARY STRATEGIC PLAN | 76

610 research groups granted access to AIBL@LONI through ADNI website

Includes access granted to the following companies:

Abbott Labs, Abiant, ADM diagnostics, Astra Zeneca, Avid, BioClinica, Biogen Idec, Bristol-Myers Squibb, Cogstate Cytokinetics, Eisai, Elan, Eli Lilly, GE Health Care, General Resonance, Genetech, Imorphics, Iris Biotechnologies, Janssen, Johnson Johnson, M and M Scientific, Merck & Co, Mimvista, Pentara Corp, Pfizer, Philips, Predixion software, Rancho Biosciences, Servier, Siemens, Soft team solutions, UCB, United Biosource Corp.

Canada USA Colombia Mexico Cuba Argentina

Belgium Netherlands Switzerland Poland Algeria Egypt Bulgaria Israel Turkey

China Taiwan Japan Hong Kong Korea Australia New Zealand

Finland Sweden

Denmark UK Ireland Germany France Spain Italy

India Pakistan Saudi Arabia Iran

Blood and Eye Biomarkers

ROTARY STRATEGIC PLAN | 78

Correlation With Brain Amyloid

ApoJ

r2= 0.53

p<0.0001

r2= 0.48

p<0.0001

r2= 0.24

p<0.0001

Antithrombin III intensity (isoform B:Aß) apoJ intensity (isoform E:Aß) Serum amyloid P (isoform B)

Discovery/Qualification

Retinal amyloid fluorescence imaging For Early Detection and Monitoring of Alzheimer’s Disease

Shaun Frost | PhD

15 July 2015

Nothing to Disclose Funders: Janssen Research & Development, LLC and NeuroVision Imaging, LLC

PREVENTATIVE HEALTH FLAGSHIP

ROTARY STRATEGIC PLAN | 80

Retinal amyloid fluorescence imaging

Masuda et al. Bioorg Med

Chem. 2011 Proprietary curcumin formulation with

scientifically tested and defined

chemical content and high-

bioavailability.

NeuroVision Imaging

Los Angeles, CA

Retinal amyloid fluorescence imaging | Shaun Frost

ROTARY STRATEGIC PLAN | 81

HC-

HC-

HC+

HC-

HC-

AD+

HC-HC-

AD+

HC-

HC-

HC+

AD+

AD+AD+

HC-

HC+

HC+

AD+

AD+

AD+

HC+

HC-

HC+

MCI+

MCI-

MCI+HC+

HC+

MCI-MCI-

MCI+

HC+

MCI+

MCI-

MCI+

MCI+

MCI+

HC+

R² = 0.586

0.5

1.0

1.5

2.0

2.5

3.0

3.5

0.5 1 1.5 2 2.5 3 3.5

Re

tin

al A

myl

oid

Ind

ex

Brain Neocortical SUVR

p < 0.0001

Results

No False Negatives

Retinal amyloid fluorescence imaging | Shaun Frost

Lifestyle Factors in Alzheimer’s

ROTARY STRATEGIC PLAN | 83

Lifestyle Programme

Aim: Identification of lifestyle and dietary modifications which prevent or delay onset of AD

ROTARY STRATEGIC PLAN | 84

HC > AD*

Fortified Wine Capsicum

White Wine Lettuce

Red Wine Avocado

Light Beer Spinach

Other Spirits Broccoli

Vegemite Yoghurt

Tofu Muesli

Nuts

AD > HC*

Sausages Ice Cream

Ham Margarine

Meat Pies

Cornflakes

Bran flakes

Tinned Fruit

Chips

Full Cream Milk

*Student’s unpaired t-test, p<0.05

Controlling for BMI, country of birth, gender, age and APOE allele status.

Food and Beverage Consumption: Classification Differences

ROTARY STRATEGIC PLAN | 85

Dietary patterns and Alzheimer’s disease

ROTARY STRATEGIC PLAN | 86

Constructed using an ‘a priori’ method • High intake of fruit and vegetables • Moderate to high fish intake • Moderate to high cereal intake • High unsaturated fatty acids • Low saturated fatty acids • Low to moderate dairy product intake • Low meat and poultry intake • Regular but moderate alcohol intake

Mediterranean Diet (MeDi)

ROTARY STRATEGIC PLAN | 87

Adherence to a healthy dietary pattern is important for reducing

risk of cognitive decline

EXECUTIVE and VISUOSPATIAL

function strongly impacted

Influence of genotype

ROTARY STRATEGIC PLAN | 88

Proposed Combination Nutritional

Supplement Therapies (varying mechanisms of action)

Normal Pathway

Amyloidogenic Pathway

Ab40/42 C99 (b-CTF)

sAPP-b

C83 (a-CTF)

sAPP-a

BACE

a-secretase

g-secretase

APP

N

C

Small Ab aggregates (Oligomers)

Amyloid Plaques

EGCG

Pomegranate Curcumin

Resveratrol

↓ Cognition

Lipoic acid

DHA

ROTARY STRATEGIC PLAN | 89

Physical activity data

ROTARY STRATEGIC PLAN | 90

General Benefits of Physical Activity

• Benefits of regular physical activity;

• Prevents cardiovascular disease

• Increases function and independence

• Reduces body weight

• Alleviation of depression

• MAINTAINS A HEALTHY BRAIN

ROTARY STRATEGIC PLAN | 91

Physical Activity and Brain Amyloid

Clinical Trials

ROTARY STRATEGIC PLAN | 93

Sex Hormone Levels and Ageing

Age Group

Ho

rmo

ne L

evels

Luteinizing

Hormone

Testosterone

Oestrogen

ROTARY STRATEGIC PLAN | 94

Relationship between Testosterone and Plasma Aβ40 Levels

ROTARY STRATEGIC PLAN | 95

Androgen regulation of Ab accumulation

Testosterone treatment lowers

CSF Aβ levels in a castrated

Guinea pig Model Wahjoepramono et al. (2008) J. Alz.

Disease.

subiculum

7 mo Sham 7 mo GDX +DHT 7 mo GDX

Androgens regulate Ab accumulation in 3xTg-AD mice Rosario et al. (2006) J

Neurosci

ROTARY STRATEGIC PLAN | 96

Aβ

TESTOSTERONE: Reducing Aβ load

Direct Effect on

Aβ production

Indirect Effect on

Aβ production

LH

Enhancing Aβ

Clearance

Insulin

Resistance Neprilysin Activity

ROTARY STRATEGIC PLAN | 97

Guinea Pigs Fed a Green Tea or Fish Oil Diet with High-Cholesterol

• 60 male GPs aged 8-10 wk (600 g) placed on a high-cholesterol diet +/- nutritional intervention for 8 weeks.

• Diets had the same macronutrient composition and cholesterol content (0.25%).

Green Tea group

– 50 mg/Kg B.W. Polyphenon 60

– 20 mg/Kg B.W. Piperine

Fish Oil group

– 50 mg/Kg B.W. DHA-enriched fish oil.

– DHA content ~40%

Values are mean SEM. Data was analysed with a one-way

ANOVA. * P < 0.05 vs. Control group, F(1,47) = 11.194,

p=.000

n=16 n=19 n=19

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

9.0

Control Green Tea Fish Oil S

eru

m C

ho

les

tero

l (m

mo

l/L

)

*

ROTARY STRATEGIC PLAN | 98

CSF and Brain Aβ40 Levels

0

5

10

15

20

25

Cortex Hippocampus Cerebellum

Aβ

40

ng

/ g

ram

we

t

tissu

e

n=13 n=16 n=19

3.0

3.2

3.4

3.6

3.8

4.0

4.2

4.4

Control Green Tea Fish Oil

CS

F A

β4

0 (

ng

/ml)

Control Green tea Fish Oil

Values are mean SEM. Data was analysed with a one-way ANOVA. * P < 0.05 vs. Control group

* *

*

ROTARY STRATEGIC PLAN | 99

200 PiB positive men,

Aged 60 years or over

Placebo injection

+ Placebo capsule

(n=40)

Testosterone injection

+ Placebo capsule

(n=80)

Testosterone injection

+ DHA capsule

(n=80)

Testosterone + DHA Clinical Trial

ROTARY STRATEGIC PLAN | 100

Curcumin and Alzheimer’s disease

Turmeric Plants in

India

Turmeric

Roots

Fresh Turmeric

Root

• Curcumin, active ingredient of the Indian curry spice Turmeric.

• Curcumin has shown promise as a neuroprotective agent in the

prevention of Alzheimer’s disease.

ROTARY STRATEGIC PLAN | 101

• Crosses the blood brain barrier and inhibits the formation of

Aβ

oligomers and fibrils, binds Aβ plaques (Ono et al, 2006;

Park et

al, 2008; Yang et al, 2005).

• Epidemiological studies have suggested curcumin is

protective

against cognitive decline (Ng et al, 2006).

• Clinically safe; no adverse effects reported with doses of up

to

8000 mg/day (Baum et al, 2007; Benny et al, 2009).

Curcumin as “Curecumin”

Plaque burden ↓33% Beta amyloid levels ↓85%

Aged Tg2576 mice with advanced amyloid accumulation, fed curcumin for 6 months (Yang et al, 2005).

ROTARY STRATEGIC PLAN | 102

ROTARY STRATEGIC PLAN | 103

Beta Amyloid

Factors Promoting Aβ Reduction

Recipe for lowering the risk of Alzheimer’s Disease

A Nutritional Diet

Physical Activity

Mental Stimulation

Social Engagement

Hormone Therapy

ROTARY STRATEGIC PLAN | 104

World Alzheimer’s Month

• September is World Alzheimer’s Month

• 21 September is World Alzheimer’s Day

• International campaign to raise awareness globally

• 2014 theme: Dementia: Can we reduce the risk?

www.alz.co.uk/world-alzheimers-month

ROTARY STRATEGIC PLAN | 105

Understanding Alzheimer’s

ROTARY STRATEGIC PLAN | 106

Alzheimer’s book

Chapters on diagnosis, genetics and modifiable risk factors.

A description of the important roles of diet, physical activity and mental exercise.

Current and potential future treatments for Alzheimer’s disease.

Caring for someone with dementia

McCusker Alzheimer’s Research Team

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Thank You

r.martins@ecu.edu.au www.alzheimers.com.au

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Telephone: 877-669-3239 Access Code: 665 253 262

McCusker Alzheimer’s Research Foundation Edith Cowan University

Sir James and Malcolm

McCusker