Thursday, September 28, 2023

update trials of Alzheimers

 The best part of the day is when I have a bowel movement.  

Recently started Miralax. I found MOM too harsh.

Pacing helps but I get exhausted. I walk about 3,000 steps a day.

Water important also.

I am curious how they deal with a floor full of AZ.  

This morning I stopped making the bed because I got short of breath.

Last week I got short of breath shaving. 

I was hoping exercise would help but I am not so sure.

With protein supplement drink for breakfast and lunch I have lost weight.

I am down to 181 pounds.  I stopped Ozempic.


Thursday, June 29, 2023

Dx of AZ in Dec .2017

I was diagnosed with Alzheimers in 2017 which means I have had it for 6.5 years. I can tell I am get worse mentally. I am content because I don't have pain and I pass the time with TV and movies. I have a wonderful dog, a Newfoundland about 8 years old. A perfect dog for an older couple. My wife and I watch a lot of movies and she helps me keep track of the characters. We finished the sixth season of Shetland. In July a promising new drug is comimg out for AZ. It is for early dementia. Might be too late for me but I look forward to taking it. I have read some books. A 4 book series of fantasy books by Chris Paolini. A 3 book series about Scotand by Peter May. I have enjoyed these books. My goal is to back to being able to walk around my block which is one mile long. Constipation become a challenge for me. I hope walking will halp. My coke floats help, I still take all the Recode suppliments that Bredesen advises in his book.

Update on weight and Alzheimers

https://meandgin.blogspot.com/2021/11/i-finally-broke-through-my-weight.html link I stay at 204 lbs. I don't eat much. Yet I don't lose weight. I drink two protein drinks a and am doing some ribbon exercise Perhaps due to Ozempic 1 cc a week. I can go up to 2 mg Ozempic a week. Get better glucose control. My fasting glucose this a AM was 135 on Invokana and long acting Insulin 25 units I bought a fit bit to increase my walking.

Thursday, November 3, 2022

Starting Insulin today

 Good news yesterday from my endocrine Doctor.

He said starting insulin may improve my energy level. 

I hope to exercise more

Lab result;


Wednesday, October 26, 2022

I had a "very bad day" yesterday was it from the COVID shot or a busy day for me?

On Oct 24 I had a very busy day.  I usually just rusticate in my basement man cave due to my usual of lack of energy.


I had an appointment for eye exam to get Px. glasses. 

We went to Cold Stone for Ice cream which was a big treat since we never do it. 

I guess I overdid it because my fasting glucose was 437 ketones zero on Oct. 26.

My ketones are always at least 0.5.  

Then we went to get our Covid vaccine. 

Ginger said I was walking well all this time. 

On Oct 25 I started being very unsteady on my feet and Ginger my confusion was much worse.  

On Oct 26 Ginger said I returned to my baseline. She thinks it was due to my Covid shot.

I think I was recovering from a big active day.

My arm was sore when I went to sleep.

My glucose today at 1:30 PM today fell to 380 thanks to my Invokana.  



Sunday, October 2, 2022

New drug for AZ

 Earlier this week, the pharmaceutical companies Biogen and Eisai announced encouraging results from a clinical trial for patients with Alzheimer’s disease: a monoclonal antibody treatment, called lecanemab, reduced cognitive decline by 27% in people with early-stage Alzheimer’s compared with those on a placebo after a year and a half. Outside observers say the trial could offer hope to some of the millions of people afflicted worldwide, who are largely bereft of treatments.

Amid the excitement, however, many questions linger, including why this treatment shows promise when others based on a similar strategy have failed. For years, researchers have tried to target a signature feature of the illness: a buildup of amyloid plaques in the brain, clumps of protein that disrupt neurons and other cells. But drugs that break down or otherwise inhibit these plaques haven’t clearly subdued symptoms. The new treatment is, apparently, the first to do so.

The field has been roiled in controversy: Another Biogen drug, aducanemab, was approved by the Food and Drug Administration (FDA) last year over concerns that, despite clearing away amyloid plaques, the evidence it alleviates patients’ symptoms was unconvincing. No other approved Alzheimer’s treatment targets the disease’s presumed roots, only its symptoms. Before aducanumab, U.S. officials hadn’t greenlighted an Alzheimer’s drug for almost 20 years.

Science spoke with Alzheimer’s experts about this week’s announcement and what’s next for lecanemab and the field.

What did the clinical trial find?

In a press release, Biogen and Eisai shared outcomes of their study, which included 1795 people with early-stage Alzheimer’s disease. The participants were randomly assigned to either receive lecanemab or a placebo, given via an intravenous infusion every other week for 18 months. The primary test was comparing cognitive decline between the two groups, based on a classic dementia scale called Clinical Dementia Rating-Sum of Boxes (CDR-SB). “I grew up using it and love it,” says Joy Snider, a neurologist at Washington University in St. Louis, of the assessment tool, which was developed at her institution. She heads the Knight Alzheimer’s Disease Research Center Clinical Trials Unit there, which enrolled nine patients in the lecanemab study. One advantage of this assessment, Snider says, is that it includes information from family members on how patients are faring, along with other measures.

In the study, people getting lecanemab still had cognitive decline, but it progressed 27% slower than in those on a placebo. That translates to 0.45 points on the 18-point CDR-SB. Although the difference is modest, it’s spawning hope. “This does make us feel a little better. These drugs do work,” Snider says.

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Lecanemab had side effects, most notably certain brain abnormalities seen with other antiamyloid therapies, including swelling and small hemorrhages in the brain. Neuroimaging turned up these concerns in about 21% of patients on lecanemab, and 9% of those on the placebo. Although these abnormalities often produce no symptoms, about 3% of those getting lecanemab did have symptoms from them.

Doctors aren’t sure how the apparently gentler slope of cognitive decline would be perceived by patients and their families. “Does that mean that grandma is going to have a few better days, a few better months, a few better years?” asks Jonathan Jackson, a cognitive neuroscientist at Massachusetts General Hospital (MGH). “It’s still an open question.” He and others hesitate to make grand pronouncements, especially after last year’s flameout of aducanemab. “We’re all feeling a sense of wariness and caution,” Jackson says. “We want to dig into the data before we make any large conclusions.”

Why did this drug meet its goals, whereas others failed?

No one knows for sure, but there are some theories. One is that lecanemab works a bit differently from other antiamyloid drugs. Some “try to bind or remove amyloid once it has aggregated into these large plaques,” Jackson says. Aducanemab, for example, primarily binds to amyloid protein after it has clumped together. Lecanemab, on the other hand, swoops in at an earlier stage, targeting “protofibrils,” strands that will consolidate into plaques but haven’t yet. Evidence across many trials and other research suggests the earlier in the disease process one goes after amyloid plaques, the better. For that reason, says Jackson—who describes himself as an amyloid skeptic—lecanemab “has always been one we had a lot of hope for,” even years ago when it was in early development.

The length of the lecanemab trial also made it easier to detect differences between patients not getting the experimental treatment and those who were. Assuming an Alzheimer’s drug works, the effect “will be bigger the longer your trial happens,” says Bart De Strooper, director of the UK Dementia Research Institute at University College London. And indeed, Biogen and Eisai noted that lecanemab failed to show a meaningful impact on cognition after 12 months, but did at 18 months.

The trial also included only people who had evidence of amyloid in the brain—something that’s been true of more recent trials but not older ones studying antiamyloid therapies, De Strooper says.

Does a diverse trial population matter?

One notable feature of the lecanemab trial was that about 25% of its participants were either Black or Hispanic, a relatively high number in the world of clinical trials, where marginalized groups are woefully underrepresented. “We’d like to think that people have equal access to our science,” says Jason Karlawish, co-director of the Penn Memory Center at the University of Pennsylvania, but practically speaking, they often don’t.

Furthermore, these populations also have a higher risk of Alzheimer’s disease than non-Hispanic white people, for reasons researchers don’t fully understand. “We want a drug that works in everybody,” Snider says, another reason trial diversity is so important.

For Jackson, who studies the impact of diversity and inclusion in human subjects research and directs the Community Access, Recruitment, and Engagement Research Center at MGH and Harvard Medical School, the new trial’s population presents an opportunity to research this disparity. According to one theory, dementia risk might be greater in Black and Hispanic people because they have higher rates of diabetes and cardiovascular disease, which can impact the brain, he explains. Probing how well lecanemab—“an antiamyloid therapy which really focuses on a pure presentation of Alzheimer’s disease”—worked in Black and Hispanic participants could offer biological insights into their illness. “I think this is going to be the first opportunity for us to have enough data on ethnic and racial minorities” in an Alzheimer’s trial to tease apart that information, Jackson says.

What will be the impact on the Alzheimer’s field?

Lecanemab is “not a cure, it doesn’t make people better,” Snider cautions. But she’s excited that it’s targeting known disease pathology and has some effectiveness in patients. (Still, scientists caution that especially after the aducanumab experience, they’ll feel more comfortable once the companies release more complete trial data.)

Other antiamyloid antibodies are in trials, and De Strooper says he’d love to see the development of small molecule drugs that can be swallowed instead of injected. Lecanemab’s impact on patients so far appears modest, but Jackson hopes emerging therapies “out in 3 or 4 years may be much more significant shots on goal.” Superior performance could come from researchers learning how to build better and safer antiamyloid therapies, he says, as well as determining who is best suited to receive them.

That said, “I still think we can’t just focus on amyloid,” Snider says. Future antiamyloid treatments may be an improvement over this one—or they may not. “This drug may be just as good as we can do” with that strategy on its own, she says, especially in people who already have symptoms. “We don’t treat cancer with one drug, we have a cocktail,” she says. Physicians need a similarly diverse toolkit for Alzheimer’s disease, where inflammation and other factors are also key drivers.

What questions remain?

A lot! First, researchers want to see more data from the lecanemab trial, which the companies say they’re planning to release in late November. Biogen and Eisai have applied for accelerated FDA approval. If it’s granted, there’s much interest—and some trepidation—about how the rollout of lecanemab will proceed in the real world. Snider wonders whether people on anticoagulant drugs, which reduce blood clots and which many older people take, may be at higher risk of brain bleeding from lecanemab. “That’s going to be a big question,” she says.

Karlawish wants more information on how patients fare long-term. Right now, assuming the companies’ announcement aligns with their trial data, the therapy seems “worth taking” or at least considering by those for whom it’s designed. But, “What haunts you in clinical practice is how long does the drug work and how long should you continue it.” He and others also worry that Alzheimer’s clinics aren’t equipped to handle a therapy like this, which requires infusions for potentially many patients and likely imaging to look for side effects. Karlawish would love to see a registry that tracks people on the treatment in order to help guide doctors and families facing difficult choices. “We don’t have an adequate workforce to roll this drug or a drug like it out into clinical practice,” where patients have enough trouble just getting a diagnosis, he says. 

Lecanemab is now being tested in people with evidence of amyloidsand, often, familial or genetic risk factors—but without symptoms. A burning question is whether the therapy can stave off dementia. At least a decade before glaring symptoms, there must be subtle signs of disease, De Strooper says. Preventing them from worsening is another frontier.

Friday, September 23, 2022

Green tea

Based on an article referenced by @dalebrendesen I stared Green tea today. 

Tuesday, September 13, 2022

AZ and feeling c0ld

Human beings have a system within the core of their brain called autoregulation, which regulates core blood flow, blood flow into the periphery, and other important physical tasks. As dementia attacks the brain and causes chemical and physical changes, it also affects the person’s autoregulation system. In addition, as human beings age, they lose subcutaneous fat, which is the padding under the skin of a person’s extremities, such as arms and legs. When this happens, the blood vessels are now right below the surface of their skin, and therefore more exposed to outside temperatures. Now, imagine a person living with dementia sitting in a room at maybe 74 degrees Fahrenheit, which is below the normal human body’s temperature of around 98.6 degrees. With the person’s autoregulation system having been damaged by dementia, the brain now tries to protect the body’s core by constricting the blood vessels of the person’s extremities, such as their hands, feet, or up to their knees or elbows. It’s going to make those areas colder to keep This, in turn, will make their hands and feet feel cold, which makes the person feel like they need to warm up. Your person living with dementia may feel like they need another layer of clothing when, in reality, the coldness is in their extremities. So, putting on another shirt, sweater, or pair of pants will not solve the issue and can cause overheating of the core as the autoregulation system is damaged and no longer expands the blood flow out to the hands and feet. Why being notoriously cold can cause further harm Heat can be very dangerous to the elderly. It can be serious and lead to almost immediate consequences when not quickly addressed. But how about the cold? Can it lead to further damage if not properly addressed? The unfortunate answer is yes.While less risky than heat, when a person living with dementia is frequently cold, they’ll be less likely to .In addition, as human beings age, they lose subcutaneous fat, which is the padding under the skin of a person’s extremities, such as arms and legs. When this happens, the blood vessels are now right below the surface of their skin, and therefore more exposed to outside temperatures. What you can do to help When a person living with dementia feels cold even though the room is a commonly considered to be at a comfortable temperature, adding gentle warmth to their extremities can help. Something like a gently warmed rice or bean sock or offering a warm cup might help. By providing warmth to the hands and feet, the blood vessels will start to relax and the blood will start to flow more openly into those areas. As some of the blood begins to circulate back from the core into the arms and legs, it’ll help the person feel more comfortable again.Unfortunately, this warmth isn’t going to last, so you may want to consider offering things episodically that are warm, can be held, and can be manipulated. However, make sure to always follow safety precautions and follow temperature checks. Be extremely cautious about using things like a heating pad that could get too hot, as an older person’s loss of the fat layer below the skin of their extremities makes them highly vulnerable to injury. Similar to how you’d heat-check an item for an infant, consider laying the object on yourself for a while to better determine whether this item could get too hot.Consider warming a towel in the dryer and, when not too hot anymore, laying it across the person’s feet. You might be able to watch the person relax as the warmth sets in, as it is giving them that much-needed circulation.

Wednesday, August 17, 2022

I decided to drop out of the scientific trial I was participating in after almost 5 years.

I am having a good morning. I feel alert and less confused. Thus I surprised my wife when I told her I didn't want to go to my trials MRI this afternoon. I wanted to drop out of the trial completely. I quess it is not very altruistic of me but I was told the study would last only 5 years. I get virtually no feed back from them. I had an MRI after my subarchnoid bleed. I want to use what little energy I have toward getting back to walking.

Tuesday, August 16, 2022

My worse day after 4 years of Alzheimers

One might think my worst day was when I fell on my face and had a subdural hematoma. Or when I was flown to get an MRI after falling down and hitting my head on the glass down and found to have a subarachnoid bleed. Today I woke up a little more confused than usual. I don't know why. Today was dreadful for me not because I had to start the prep for my colonoscopy but because I was not allowed to eat anything. I have been having a snack every hour because it comforts me. Not having those snacks made me feel miserable. The fasting did result in dropping my morning glucose from 220 to 170.

Can Ozempic help with Alzheimer's?
The drugs, which belong to a class of medications called glucagon-like peptide 1 (GLP-1) agonists, work by altering the metabolic system and lowering inflammation throughout the body. Scientists suspect this could help slow the progression of neurodegenerative diseases like Alzheimer's disease and Parkinson's disease.May 12, 2023

Monday, July 25, 2022

I gain hope with this article (excerpt below)






 My diagnosis of Alzheimers was diagnosed in Dec 2017.
Now about 4.5 years after I don't want to travel anymore.  
It's just too stressful for me.
Stress makes me feel depressed.

Ginger left for Greece on July 8, 2022
My wife will be home by 2 AM on Tues. July 26,  2022
 from cruise to Spain and Portugal.  

Total 16 days away.

Routine helps me do well on my own 
Keeps me content.
Ginger insists on having a housekeeper come twice a week.
She is also paying for a geriatric homecare visit 2- 3 times a week just to check on me.
My routine:

Sleep (very important)
1-I sleep a with CPAP machine from 9 PM till 8 or 9 AM. 
I take some sleep supplements. 
2-Melatonin to keep sleep times consistent.
3-Ashwaganda link
I try to sleep till 9AM.

Daily Routine
Morning TV. I have an 85 inch tv screen.
I like Morning Joe.  I "tape" it.
It's 2 hours long and I speed through the commericals. 

The 'Smart' TV is a boone as well as a bane
The boone part is that the picture on the screen is wonderful. 
The bane part is when I misplace the remotes.

After watching about 3 hours of TV while looking at my computer writing twitters and blog entries I develop some mild anxiety.

I then swtich to entertainment TV.
I own many DVD's.
I am 8 seasons into the series VIKINGS.

Meals
I have coffee and diet pepsi to put off breakfast as long as possible.  I fill my 8 cup water pitcher which I have no trouble drinking it all because of all the pills I take.  
I take my prescription pills first thing in the morning.



I start to make a Salmon sandwich for breakfast/lunch. 








update trials of Alzheimers

 The best part of the day is when I have a bowel movement.   Recently started Miralax. I found MOM too harsh. Pacing helps but I get exhaust...