Geriatrics doctor to receive an award

Colleague is working on clinical trial of an Alzheimer's drug

By Carrie Moore

Deseret News

Published: Friday, Feb. 20 2009 12:34 a.m. MST

As local advocates for patients with Alzheimer's disease prepare to honor a veteran care provider this weekend, one of his colleagues is recruiting patients for a clinical trial of a new drug that may help modify the symptoms of the dreaded disease.

Dr. Gerald Rothstein, who led the University of Utah Medical School's division of geriatrics for 19 years, will be honored Saturday with a lifetime achievement award by the Alzheimer's Association of Utah.

Known among local care providers as one who has taught many Utah doctors how to treat the disease, Rothstein said he's encouraged that the stigma associated with Alzheimer's and the education for patients and their families has improved dramatically in the past two decades.

Progress in treating the disease has evolved to the point where "we're in a relative investigative explosion of information right now," about how and why it occurs and how to best deal with it, he said.

Medications for treatment are no longer restricted "to the ones that deal with neurotransmitters (in the brain)." New drugs continue to be tested, including some that are designed to modify the progression of the disease.

His colleague, Dr. Edward Zamrini, is involved with in recruiting 10 Utah patients for a new clinical trial of a drug designed to block nerve damage and inflammation in the brain that can lead to the progressive memory loss and behavioral changes of Alzheimer's patients.

The drug is one of a handful of new drugs now being tested that are designed to be "disease modifying," which means it "works on multiple mechanisms," Zamrini said. Just as generals in a war attack the enemy on different fronts, this particular drug "reduces some of the inflammation that accompanies Alzheimer's" and also "attacks the amyloid beta (a protein in plaque deposits within the brains of Alzheimer's patients) itself, making it less toxic to nerve cells."

The 18-month trial will be conducted on some 400 patients at a few dozen locations nationwide. Those who participate must be 50 or older and have been diagnosed with Alzheimer's.

Rothstein said researchers now know more about the formation of the toxic amyloid beta protein than they ever have, and that new theories about the reasons for the brain modification that occurs with the disease are constantly being developed.

New research is also exploring mild cognitive impairment, focused on the deterioration of memory only, to determine whether that's a precursor to the disease, he said. If so, therapy to prevent the development of that condition could possibly be used in the future to delay or prevent the onset of Alzheimer's.

The Alzheimer's Association reports that there are as many as 5.2 million Americans now living with the disease, and that number could skyrocket to 16 million by 2050. The disease is not simply a normal part of aging. It gets worse over time, is ultimately fatal and is the sixth-leading cause of death in the United States. There is no known cure.

As more patients are diagnosed and their families affected, Rothstein foresees a time when tough decisions will have to be made about treatment and resources, particularly since a failing Medicaid system is often the funding source for elderly patients.

"I hope that will be done rationally," he said. "We need more public discourse."

Alzheimer's warning signs

Memory loss

Difficulty performing familiar tasks

Problems with language

Disorientation to time and place

Poor or decreased judgment

Problems with abstract thinking

Misplacing things

Changes in mood or behavior

Changes in personality

Loss of initiative

Source: Alzheimer's Association

Award being presented at fundraising auction Saturday

The Utah chapter of the Alzheimer's Association will honor Dr. Gerald Rothstein at its 25th annual fundraising auction, beginning at 5:30 p.m. Saturday at the downtown Marriott on West Temple. The event will feature will feature former Brigham Young University football coach LaVell Edwards as keynote speaker and former Utah anchorman Terry Wood as master of ceremonies.

Live auction items include a weeklong vacation in the Italian Alps; a personal performance for 30 people by vocalist Michael Ballam; dinner with University of Utah football coach Kyle Whittingham; a signed Utah Jazz basketball; and Jazz player Deron Williams' signed jersey.

For information, visit www.alz.org/utah or call 801-265-1944.

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