Presentation delivered November 30, 2012 by Dr. Susan Landau at the P

1. Early detection of Alzheimer’s disease
Susan Landau
Helen Wills Neuroscience Institute
University of California, Berkeley
Lawrence Berkeley National Lab

2. Definitions
Dementia
A global, progressive loss of cognitive ability
that ultimately impairs independent function
Alzheimer’s disease
The most common cause of dementia
Begins with subtle memory loss
Characteristic brain pathology

3. Risk Factors/Protective Factors
Increased Risk
Age
Genetics/family history
Head Injury
Decreased Risk
Education
Cognitive Engagement
Physical Exercise

4. Neuropathology of Alzheimer’s disease:
Neuritic Plaques (amyloid) and
Neurofibrillary Tangles (tau)
neuro-
fibrillary
tangle
(tau)
amyloid (Ab)
plaque

5. Amyloid Imaging with
Positron Emission Tomography (PET)
Fibrillar Ab
Amyloid Plaques
PET Imaging

6. Amyloid Imaging with
Positron Emission Tomography (PET)
Fibrillar Ab
PET Imaging

7. Amyloid PET Imaging in Aging
Alzheimer’s Disease
Normal Aging (Amyloid Negative)
Normal Aging (Amyloid Positive)
30% of normal older
people are amyloid
positive

8. Amyloid is associated with cognitive decline over time
Cognitive function (worse )
Individuals without amyloid
Cognitive function (worse )
Individuals with amyloid
Time (years)

9. Lifestyle factors and Alzheimer’s disease risk
Lifestyle practices Improved cognitive function
Less Decreased AD risk
Cognitive, physical, social,
occupational engagement amyloid ? Slower decline

10. Lifetime cognitive activity and amyloid
Figure 2
a b
2.0
Cortical PiB uptake
Amyloid deposition
1.5
1.0
0.5
Lowest Moderate Highest
cognitive cognitive cognitive
activity activity activity
Alzheimer’s Older Young
patients controls controls
Landau et al. Arch Neurol 2012

11. Brain atrophy in Alzheimer’s Disease
Normal
Hippocampus
(involved in
Mild Cognitive memory
Impairment function) is
particularly
affected in AD
Alzheimer’s
Disease
(Hippocampal
Atrophy)

12. FDG-PET: Hypometabolism in Alzheimer’s
vs Normal Aging

13. The Amyloid Hypothesis of Alzheimer’s
Disease
Amyloid
Cognitive Decline
and
Dementia
neural function
atrophy

14. Early detection of amyloid
Amyloid PET imaging is an important tool in research and clinical
trials -- but is currently not appropriate for routine clinical
screening in cognitively normal people
Amyloid is linked to future cognitive decline, but :
Decline may occur >10 yrs after amyloid appears
Some individuals may not decline
Interventions or preventative treatment may only be effective early,
since loss of cognitive and neural function may be irreversible

15. Resources and volunteer opportunities
• Alzheimer’s Disease Neuroimaging Initiative (ADNI)
• National Institute on Aging

16. Thank you
University of California, Berkeley
William Jagust Robert Wilson
Elizabeth Mormino Gil Rabinovici ADNI participants and staff
Hwamee Oh Shawn Marks Avid Radiopharmaceuticals
Alzheimer’s Disease Neuroimaging Initiative
Michael Weiner
Bob Koeppe Ronald Petersen
Danielle Harvey Paul Aisen
Laurel Beckett Michael Donohue
Leslie Shaw Anthony Gamst
John Trojanowski Art Toga
Clifford Jack Karen Crawford
Chester Mathis Eric Reiman
Andrew Saykin Kewei Chen
Norman Foster