Talk:Alzheimer's disease/Archive 2

message: :Research ?
Years ago while studying a water option to get rid of a spring fed water supply in favor of a lake water source and alot of filtration it was noted that in Canada and the USA, they use Aluminum Sulfate to filter water.  Problem is this adds to the Aluminum in the water, from .02 mg to .32 mg/litre.
No problem in Canada no standards for Aluminum in drinking water; why ?
Have the lobby groups manipulated government ?
Months later I found this scientest on the Internet, a Dr. Squitti doing research on Alzheimers and Copper...well she told me that Aluminum was always suspected of contributing to Alzheimers.  
Well in Canada we got rid of glass pop bottles in favor of aluminum cans, and today Alcan Aluminum collects cans for Alzheimers Research; imagine that.
Remember the cigarette companies and how scientests preseted evidence to some grand jury that cigarettes did not cause cancer; well they lied.
--Son of Maryann Rosso and Arthur Natale Squitti 04:36, 20 August 2006 (UTC)
thread_title: Aluminum

message: I was informed about stem-cell therapy related to AD. Does anyone have information about it, or any name I could contact about this new research?
:No, this concerns Parkinson's, not Alzheimer's. There is no proof that stem ells would work in AD. JFW | T@lk 03:33, 23 Jan 2005 (UTC)
replies: text: I recently read something (a heading, yes, no time to read the article) on Google News that would disagree. It's recent, within a day or two, and says something about Brain Stemcells being used to combat Alzheimer's. --24.76.141.132 05:15, 23 Mar 2005 (UTC)

text: That's experimental, like most unproven theories mentioned in this article. Shall we concentrate on the present management? Stem cells are only used in bone marrow disorders, and the rest is all daydreaming out of therapeutic embarassment. JFW | T@lk 07:49, 23 Mar 2005 (UTC)
thread_title:  Stem Cells 

message: There is a danger in starting a rewrite from the medical profession's literature, because of the prevasive effect of drug company studies combined with the medical model's focus primarily on perscription drugs, and primarily after diagnosis.  The result is a subtle and pervasive bias in the medical journals' point of view, and adopting it uncritically would threaten to obscure the most useful information that a Wikipedia article can provide.  
The audience that Wikipedia's Alzheimer's Disease article serves may include a few merely curious souls who want to know the basics, but far more often information on Alzheimer's is sought by family members struggling with the news of diagnosis of a loved one, or concerned about their own fate in old age, and directly or indirectly perhaps by policy makers.  
There is a subtly slanted point of view pervasive in the medical literature, including the article on which it is suggested that this article be patterned.  Neurological literature is driven by publication of new research studies.  And the overwhelming majority of research studies are financed by drug companies hoping to promote costly proprietary treatments for Alzheimer's.  Lost in this torrent of publications is the fact that efforts to find a cure have so far proven to provide very modest value at best.  
Meanwhile, the large gains available in the way of prevention have so far been demonstrated in only a few studies, those for which financing was found with non-company money.  Impressive results have been observed with certain NSAIDs, vitamins C and E in combination, and exercise, among others.  But these important results have drowned in the flood of publications reported in the journals most consulted by neurologists, which discuss drug company studies of (largely ineffective post-diagnosis) drugs.  In reporting these studies, the medical journals adopt a pervasive POV focused on present and possible future profitable medicines.  This focus has effectively buried the story about prevention, which is the actual headline.  To the extent that medical doctors see their role as providing prescription rather than non-prescription remedies, and as acting only after diagnosis, rather than before, their POV conincides with that of the drug companies.  If information isn't about cure after diagnosis, it receives short schrift in the medical journals and in medical practices alike.  
But for families and individuals who need information on Alzheimer's, prevention and care are the information of greatest value.  Prevention and nursing care are salient for families (news they can use) and useful in framing public policy.  Information about the present, largely-ineffective proprietary treatements will be provided by almost any health-care professional consulted, and often adopted because not taking the (admittedly near-useless) patent medicines is presented as "doing nothing."  
Wikipedia should not allow the POV that focuses exclusively on these low-value / high-cost treatments to crowd out useful, practical NPOV information that patients and their families desperately need on diagnosis, prognosis, nursing care (whether family provided or otherwise), and especially prevention.  
Information about the gains in prevention is urgently needed in the debates by public policy makers.  As some recent comments point out, most people currently get Alzheimer's if they live long enough.  Most are cared for by female relatives, as one inestimable social cost.  The remaining nursing-care costs threaten to swamp the social safety net in developed countries, which all have aging populations.  Though few, the available studies show that cost-effective prevention works.  The information in these studies is more valuable and more important than the many re-hashing drug treatments that have but little effect.  
:The review I suggested is quite impartial, and does not "rehash drug company studies". Of course the social context should be firmly embedded in the article.  You may be shouting at a strawman. JFW | T@lk 22:22, 26 Mar 2005 (UTC)
thread_title:  Rewrite for those who need this article -- families, policy makers 

message: The gross image of the "Alzheimer's Brain" appears to be one of frontotemporal dementia, not Alzheimer's.  It is of course possible that this is Alzheimer's degeneration, but it would be an atypical case.  I would like to suggest replacing this image with one showing the more typical parietal and medial temporal atrophy pattern associated with Alzheimer's disease. sallison 02:53, 6 January 2006 (UTC)
replies: text: You're totally correct. I've fixed this accordingly. Semiconscious (talk · home) 07:30, 6 January 2006 (UTC)

text: I'm glad you caught my mistake, by the way. Thank you. :) Semiconscious (talk · home) 07:30, 6 January 2006 (UTC)
thread_title: Pathology photo

message: I have been reading a lot of material about nCJD being misdiagnosed as Alzheimers - supposedly indicating why cases of Alztheimers are doubling/tripling (?) recently.  Can anyone provide points of view on either side of this aurgument ? Thanks
:nCJD has a rather typical presentation of rapidly progressive diffuse mental deterioration and specific motor symptoms (such as myoclonic jerks). I think the increase in Alzheimer's is a result of people getting older in general and surviving other previously mortal diseases in particular. I think it would be immensely speculative to attribute this increase to CJD. JFW | T@lk 16:02, 16 February 2006 (UTC)
thread_title: Question

message: This article is probably quite accurate, but at the expense of accessibility.  Can't some of the jargon be taken out of the article, particularly the introduction? --Robert Merkel 22:37, 19 March 2006 (UTC)
replies: text: I've looked at the language in the intro and while bits of it are quite technical most of the terms are explained or a link is offered that explains the term.  This article has become rather untidy and could do with a complete review.  The introduction as it is now does present a number of advanced notions that perhaps could be discussed later on in the article.  I'll try to have a go at tidying it up, perhaps with the help of some of my colleagues.  I know JFW wanted to have a go at it, maybe we’ll do it soon. JASFonseca 20:37, 22 March 2006 (UTC)
replies: text: Good idea, I'll help out if I can. I agree with simplifying the language where it makes sense. -Ravedave 04:01, 23 March 2006 (UTC)
thread_title:  Language simplification... 

message: This article has fallen prey to individuals pushing fringe theories with respect to the pathogenesis and treatment of the disease, such as the sections on heavy metal administration to rabbits and therapeutic use of Indian spices (turmeric), which have now mercifully been deleted. I would request that other neurologists and neuroscientists specializing in Alzheimer's disease join me in providing surveillance of this page so that the lay public can find a concise presentation of well-substantiated and valid information on the subject. There is already far too much quackery and chicanery concerning Alzheimer's disease available on the internet, which does a huge disservice to family members searching for information that possibly could help their loved one(s). The clinical and research communities should work together to make Wikipedia a sound and reliable source on medical subjects for patients and family members.
-- Ve ri tas 22 April 2006
:You are welcome to participate. I agree that only very popular and notable remedies should be mentioned; this information is notoriously hard to verify. JFW | T@lk 10:50, 23 April 2006 (UTC)
thread_title:  CAVEAT LECTOR (Let the Reader Beware) 

message: So who are these people?
:You see, they were randomly inserted because people thought it would be interesting to know that their favourite historical personality had Alzheimer's. I think only the very most famous people should be listed here (Ronald Reagan comes to mind), and the rest either removed or forked to a different page. JFW | T@lk 20:28, 1 May 2006 (UTC)
thread_title:  What Considers As Famous? 

message: Do we really need an entire section with this title? I'll bet there are dozons of studies being done on nutritional aspects of Alzheimer's. Could we just merge a summary of this into 'treatment'? DJ Clayworth 14:27, 7 June 2006 (UTC)
thread_title: Drinking more than 2 cups of green tea a day could help prevent Alzheimer's

message: Just wanted to link this before I forgot. I'll try and add it if not someone else can... Alzheimer's Vaccine Shows Promise -Ravedave 15:22, 13 June 2006 (UTC)
thread_title:  Alzheimer's Vaccine Shows Promise  

message: In the Epidemiology section, there is mention that smoking and drinking reduce the risk.  What is the basis for this kind of conclusion?  Was it part of the same report from Duijin and Hofman?  
I could probably show that a healthy dose of radioactive uranium will keep people from getting Alzheimer's.  The people in the test will all be dead well before they could ever see the symptoms of Alzheimer's.  But something tells me that people would not be lining up at the airport with plane tickets to Chernobyl.  Before people read this article and start new smoking and drinking habits to prevent Alzheimer's, someone please show the scientific validity of such a conclusion.  jordan 19:05, 16 June 2006 (UTC)
thread_title:  Statistical indications 

message: There seem to be new Alzheimer's articles every week, so I am just going to start listing any I find here. Please feel free to add to the list.  
* Alzheimer's Vaccine Shows Promise
* Chinese Moss Extract Tested as Alzheimer's Drug
* Green tea could protect against Alzheimer's, (catechins).
* Antioxidant in Green tea may fight Alzheimer's, (EGCG).
* Alzheimer's Association International Conference 2006 overview. 
* A new drug, called PBT2, shows promise
:There are new Alzheimer's articles every week, which shouldn't come as a surprise. But please don't list them here, as that would be an entirely unacceptable use of a talk page. If you'd like to summarize these alternative therapies, pointing to peer-reviewed studies, noting the rampant pseudoscience and quackery, then by all means, feel free. But do not clutter this talk page with a mere list of links to news articles when only a vanishingly small subset of their authors have bothered to read and understand the study in the first place. --David Iberri (talk) 23:08, 6 July 2006 (UTC)
thread_title:  List of Alzheimer's articles 

message: I'm proposing a major revision of the later sections of this article which have become unwieldy at best.  As per the comments of Veritas and JFW above, data has been added non-selectively, described in excess detail and used to support overly broad clinical assertions.
I'd suggest the following components for a revision:
*Break off the list of "famous" disease sufferers to its own page, and include a sentence like this one somewhere in the article: "Famous Alzheimer's disease sufferers have included President Ronald Reagan, Ralph Waldo Emerson, and Rita Hayworth."
*Convert the prevention section to bullet point format, including only popular and/or validated treatments.  Where popular therapies have been called into question, include this information
*Limit external links to a few of the many available highly reliable sites. If we're going to offer links, they should be neither redundent nor POV nor self-promotional.
*Choose a consistent citation format for scientific and other articles (footnote or inline or PMID reference with or without full reference at the article's end).  I propose the new new Cite.php footnote format with full references.
Towards this end, I've combined the epidemiology and prevention sections and converted it to an annotated bullet point format.  I've based the information on prevention recommendations in Up-To-Date and the Cochrane databases.  It should be notable that I've removed references to such things as green tea and caloric restriction.  I've used the Cite.php format converted the only other two complete references as well.  (The molecular pathway "reference" moved to external links since it wasn't really a reference.)
Depending on feedback, I'll complete additional parts of this revision in the next few days.
—The preceding unsigned comment was added by Ipeltan (talk • contribs) .
:Sounds good! -Ravedave 15:11, 17 June 2006 (UTC)
replies: text: Bravo! Much needed. Ve ri tas 17:28, 18 June 2006 (UTC)
thread_title: Proposed major revision

message: Hi. I'm writing a page on reelin and stumbled upon this article about Reelin's role in Alzheimer's. I've included these facts in the reelin page. I thought you may be interested in this. --CopperKettle 15:25, 21 June 2006 (UTC)
thread_title: Role of glycoprotein Reelin in the disease

message: There was a question as to why the link to the Wash U. Alzheimer's site was deleted.  First, the page states at it's top that is a copy of material from the government's Alzheimer.org site.  The link should therefore go to that site and not the Wash U. site.  Second, and more importantly, the same statement dates the material to 2000, which is extremely outdated in the world of Alzheimers. Much of the information at that site is therefore likely outdated.  Third (and least important), the link is not formatted in the style now being used in this article. 
Other standards for external links include relevance and non-commercial/non-promotional.
--Ipeltan 17:36, 26 June 2006 (UTC)
thread_title: Standards for external links

message: Question.  Diagnosis section of article says "...a definitive diagnosis of Alzheimer's disease must await microscopic examination of brain tissue,generally at autopsy."  I'm looking at some pictures from www.alz.org/brain/overview.asp . Will a qualified doctor please look at pictures 8 and 9?  They seem to show a very obvious, visibile-to-the-naked-eye deterioration of the brain.  I was a bit shocked when I saw these because I had no idea that an Alzheimer's-afflicted brain looked so markedly different from a healthy brain--I thought the difference would be indiscernable to a layman.  According to these pictures, the brain of a person with advanced Alzheimer's actually looks shrunken and shriveled--macroscopically.  So, would the micronanalysis of brain tissue really be necessary other than to confirm the obvious?  Or, are the pictures exaggerated to make it more intuitively clear to the lay-viewer.  Does the Alzheimer's brain not really look this bad?  Seems to me it actually shrinks to a substantial degree.  Surely the tissue analysis is just to make it "official?"  Thanks in advance.  Colin.65.102.39.98 00:13, 27 June 2006 (UTC)
thread_title: Definitive diagnosis must await microscopic examination of brain tissue?

message: After review, I'm promoting this article to GA status, based on the qualifications. I think it is well written, and seems fairly up-to-date. However, I do have some suggestions for further improvement.
*The article needs more references. In fact, the references section is borderline. If I had chosen to fail the article, it would have been due to references. Things like statistics and the claims of the various theories of the disease pathophysiology really need references, so people can evaluate how up-to-date and valid the information is. I'd recommend sticking with the cite.php format, which is already in use for most of the references. Remember that external links can be cited in the same way, particularly if they are stable online documents, and not just a 'general site about the topic'. For FA status, people like to see at least one reference per paragraph, typically. Keep this in mind as a goal while improving.
*Continued expansion in the prevention and treatment sections would be nice. This is the part of the disease that is likely the most important to people, and should be very complete. It is good now, but would be a good place for more information.
*Some images would be good. It's not as critical for articles of this type, but a few images can do a lot of good. Do any universities release medical images under a free license? If not, are there some particularly illustrative ones that we could use under a good fair-use rationale?
Thanks for your hard work everyone. Keep working on the article, and keep your standards high. If you would like any clarification on my reasons for promoting this article, please leave me a message on my talk page. Phidauex 18:50, 3 July 2006 (UTC)
replies: text: Thanks Phidauex.  Just added a couple of images from the Wikimedia commons, but we could really use some amyloid plaque and tangle images. Are any researchers/doctors have their own pathology or research images they could upload? --Ipeltan 09:01, 7 July 2006 (UTC)
thread_title: This is a [[WP:GA|Good Article]]

message: I'd like to point out that the deposition of amyloid-beta into plaques is itself is not abnormal. Most people develop some plaques in their brain tissue as they age. However, the AD brain has many more plaques in certain brain regions.
|Igoruha 8:38, 24 July 2006 (UTC)
thread_title: More about amyloid plaques

message: I just posted a paragraph on "First Alzheimer patch" (in Potential Ttreatments section). I anyone wants to delete or move it, please discuss it first. --Igoruha 6:47, 12 August 2006 (UTC)
replies: text: This is not a "potential treatment" but merely a different form of administration for an already existing drug. Not only is the information in the wrong place, but there's no reason for this to deserve it's own paragraph, much less a long one.  The paragraph is longer than the entire paragraph on the entire class of drugs to which Rivestigmine belongs! A sentence in the section on acetylcholinesterase inhibitors would be appropriate, but no more.--Ipeltan 14:52, 13 August 2006 (UTC)

text: Thank you for providing an explanation before taking action. In a way I agree with you. But, I posted it in "potential treatment" because by potential treatments I understand some exiting progress in new therapies for AD. Such as: advances in adult stem cell research; advances in the earliest stages of drug discovery through post-marketing studies; and also advances that include: positive results from the first Alzheimer "patch". By potential treatments I understand not only drugs with new targets or a new mechanism of action, but also new methods of delivery. For these reasons I ask not to change it. --Igoruha 19:24, 13 August 2006 (UTC)
replies: text: I think he was trying to say that a new delivery system for a crappy drug, and indeed an entire crappy mode of thinking about drug treatment of this disease, is not that exciting. These people have brains full of dead or dying neurons. Dumping a little more of this or that neurotransmitter on them, a little nerve gas here or there by pill or by patch, is not an answer. We've spent decades now and billions for treatments that change things so little that it takes a big statistical study even to tell the difference between treatment and placebo. We've seeing changes of something like +1 in a score of 30 on the MMSE. For 6 months.  By contrast, the vaccine trials that you mention below in the next section, really is a new mode of thinking, and deserves some of the space you used (and shouldn't have used) for the patch.SBHarris 00:49, 27 August 2006 (UTC)

text: Is it time to cut down some of the talk page?  --Chrispounds 19:21, 28 August 2006 (UTC)
thread_title: Discuss it first

message: Why there is no mention about ADDLs ? Follow this link to find out more one ADDLs and their relationship to AD: http://alzheimers.about.com/od/research/a/ADDLs.htm
--Igoruha 21:00, 21 August 2006 (UTC)
replies: text: About.com is a secondary source. I'd prefer a peer-reviewed primary source on the utility of ADDLs in Alzheimer's. JFW | T@lk 08:26, 3 September 2006 (UTC)
thread_title: Question - ADDL 

message: This paper made headlines by suggesting that fruit juice intake may reduce incidence of AD by 75%. JFW | T@lk 08:25, 3 September 2006 (UTC)
thread_title:  Fruity 

message: Would anybody be interested representing the mechanism of AD as a schematic diagram ?
--Igoruha 22:38, 4 September (UTC)
: I can help out and might have a starting point from the amyloid hypothesis perspective.  I would say we will need to re-write the Disease Mechanism section to reflect the growing influence of amyloid and tau.  William Summers, the champion of tacrine, has said he favors the oxidative injury theory and that amyloid and tau might be "tombstones derived from cellular debris." (p 444)   Summers WK, "Tacrine, and Alzheimer's treatments" J Alzheimers Dis. 2006 Aug;9(3 Suppl):439-45    The Geriatrics and Aging article  has a nice diagram that we could start with.  If we include some of the details of gamma and beta secretase we might have a really cool image.  --Chrispounds 14:52, 5 September 2006 (UTC)
replies: text:   [Cummings, J. "Alzheimer's disease" NEJM 2004 2004 Jul 1;351(1):56-67.  ]  has a great picture of the disease. --Chrispounds 02:51, 12 September 2006 (UTC)
thread_title: Mechanism

message: I really like how the author shows that cholinesterase inhibitors are essentially ineffective.  I added another reference from the British Medical Journal 2005 that further supports this concept.  It's very important to get this point out there.  The pharmaceutical companies are making billions of dollars off patients who believe that these drugs slow the progression of the disease.  Not only is this false, but these drugs do next-to-nothing aside from causing diarrhea in 40% of the old folk who take them.  Thanks!E4043 04:33, 15 September 2006 (UTC)
thread_title: Cholinesterase Inhibitors

message: [Copied from: User talk:Nunquam Dormio
Dear Nunquam, I have introduced a link of a weblog that deals with a Centre for treatment of Alzheimer AlzheimUr CENTREand it has been removed.
Do you know the reasons?
Sincerely, jsmjsm User talk:Jsmjsm
:The short answer is No, I don't. I looked at your edit and decided it was on balance OK. User talk:Ipeltan obviously felt otherwise. I think, as the article currently stands, a blog about the design of a centre seems a little tangential. There's probably a whole wikipedia article to be written about design for Alzheimer's, both for architecture and for implements. I remember reading somewhere that certain colours of dining plate are useful for Alzheimer's sufferers as the contrast helps them see what they're eating. So probably the thing to do is to make it clearer how the link relates to the article. These are my thoughts so far. Nunquam Dormio 15:13, 22 September 2006 (UTC)
replies: text: It seems to me a blog about the ongoing development of a particular Alzheimer's disease "center" isn't appropriate for an encyclopedia article on Alzheimer's disease. There are hunderds if not thousands of centers, clinics etc. that provide Alzheimer's treatment that would also deserve mention.  Frankly, I wasn't able to understand exactly what the purpose of the blog, although this was not my reason for removing the link, where the AlzheimeUr Centre is located, nor what its purpose is going to be.  Is it a residence facility, a research center, a treatment clinic, or a day/respite service?  As Nunquam Dormio suggested, you might wish to a separate article on design for Alzheimer's.  You could also add some material to the treatment section about lifestyle/living accomdations for patients. The social impact section of the main article is extremely weak; you might be able to make a contribution to this section as well.  It also seems you have access to some great Alzheimer's histology images.  These would be a major addition to the article if you'd be willing to add them. --Ipeltan 23:19, 22 September 2006 (UTC)

text: "Our weblog emerges from the wish to offer an insight into the process of creating ideas for the AlzheimUr Centre. This centre is the reference for the region of Murcia (Spain) to provide a comprehensive attention to the illness of dementia. This weblog is an added tool to the project. Besides proofing the elaboration of different criteria that guide the development of the work, it tries to encourage interactivity with a system of commentaries. This is done in order to enrich the project with significant suggestions. Interdisciplinary collaboration is believed to be an essential part of the architect’s work. Working sessions every day are based on different programmes to develop specific contents and objectives. At the beginning of the first ten days the approach will be very intuitive. Then it will formulate the brief which, without being completely defined, suggests aims and important interests which the project will be based on." Quoted from the first post of the weblog.
I hope this answers your questions on purpose of the blog, location of the centre, etc. Definitely, the design for an Alzheimer Centre is something much more complex than deciding the colours of the dining plates. It requires the strong collaboration of architects, doctors, patients and families. There is not much information on it and this weblog is recollecting facts on this theme. It is a pity to remove information of Wikipedia under such misunderstandings, so I would appreciate if you reconsider your action or somebody more qualified gives an opinion.
Sincerely, jsmjsm User talk:Jsmjsm
I've started a Design for Alzheimer's section. Add to it as you will. Nunquam Dormio 11:05, 24 September 2006 (UTC)
thread_title:  AlzheimUr CENTRE 

message: I think we should add a section on the techniques (tests) used to determine the severity of AD's symtoms. Here is a list of a few that I found, if anybody can find them available online please provide a link:
 - Mini-Mental State Examination (MMSE)
 - Disability Assesement in Dememntia (DAD)
 - ADAS-Cog
 - Caregiver Stress scale (CSS)
 - Clinician's Global Impression of Change (CGI-C)
Igoruha 13:45, 22 September 2006 (UTC)
replies: text: Given the length of the article, we could mention the more common tests (MMSE, perhaps Clock drawing and ADAS-Cog) and then create a page of neuropsychiatric tests.  Some of these tests are Alzheimer's specific, but other tests are general neurological tests. Others I have heard of include the ADCS-Activities of Daily Living , Clinical Dementia Rating (CDR-Sum of Boxes), Neuropsychiatric Inventory Questionnaire (NPI), Brief Cognitive Rating Scale, Global Deterioriation Scale, and Clock Drawing. Some of these have been used in clinical settings to measure functional, cognitive or global changes.  A Medscape article looks at some of the tests in a diagnostic battery. --Chrispounds 22:42, 22 September 2006 (UTC)
thread_title:  Determining AD 

message: I found a newer source that gives some credit to Kraepelin, however the first cases in his own textbook are credited to Alois Alzheimer. This seems to be fairly convincing that he credited Alzheimer with the disease.--Chrispounds 01:36, 3 October 2006 (UTC)
replies: text: and now I have cited the reference. It was a busy morning when I added the text. --Chrispounds 23:07, 28 October 2006 (UTC)
thread_title: Kraepelin

message: Some articles with long lists of references use the syntax  to make two columns. Thought you might want to try it out. - Samsara (talk • contribs) 15:23, 11 October 2006 (UTC)
replies: text: I was thinking the same thing, implemented. -Ravedave (help name my baby) 15:38, 11 October 2006 (UTC)
replies: text: Very nice.  Makes the External links that much closer to the text. --Chrispounds 17:04, 11 October 2006 (UTC)
thread_title:  Reference section formatting