Science and Research Questions

Primidon (trade name: Primidone) is an antiepileptic agent currently only indicated for the treatment of seizures, seizure disorders, and essential tremor (such as is found in patients with Parkinson’s disease).

Unfortunately, there are no formal studies that have looked at the combined effects of these drugs on the treatment of AD or PD. This is mostly due to the fact that the patient population that could potentially benefit from the combined use of both of these drugs—i.e., patients having dementia associated with Parkinson’s disease—is relatively small compared to the larger general group of patients having Alzheimer’s disease, non-dementia-associated PD, and other neurodegenerative diseases and disorders.

Currently, there is no conclusive evidence linking the radio frequency electromagnetic radiation (RF-EMR) emitted from cell phones or from cell phone towers to Alzheimer’s disease. However, a longitudinal Swiss study published in January 2009 reported that the longer a person lived near a high power line (which emits electrical and magnetic fields), the greater their associated risk of developing Alzheimer’s disease.

Based on a finding such as this, one would have expected that people exposed to electrical or magnetic fields as part of their jobs (such as electric line workers and power plant operators) would also have a higher incidence of developing Alzheimer’s disease (AD). However, studies examining the effects of occupational exposure to electrical or magnetic fields on the development of neurodegenerative diseases have had conflicting results. For example, one study found that such exposure increases the risk for AD but not other neurological diseases (such as Parkinson’s disease (PD) or amyotrophic lateral sclerosis (ALS)), another found an increased risk of PD but not for AD, and yet another study found an increased risk for ALS but not for AD or PD. Thus, the literature is inconclusive regarding the use of cell phones (or exposure to electromagnetic radiation) on the increasing the risk for developing AD. Additional studies are necessary before any conclusions can be made.

Several independent research studies have reported an association between high cholesterol serum levels and Alzheimer’s disease. Consistent with these reports, other research findings also suggest that the best way to lower your risk of developing Alzheimer’s disease involves a combination of measures normally thought of as good for maintaining a healthy heart, such as eating a healthy diet low in saturated and trans-fats, exercising regularly, reducing stress, and of course, lowering serum cholesterol levels.

Though there are a few reported cases, it is extremely rare for people to develop Alzheimer’s disease in their thirties. Memory and speech problems could be caused by a number of things besides Alzheimer’s. Stress, depression, sleep disorders, interactions from medications, certain vitamin deficiencies, hormonal imbalances, head injuries and viral infections of the brain or central nervous system can all affect cognition and memory. And there are just as many other conditions and disorders that can affect speech.

So a good first step for you would be to have your primary care physician examine your symptoms. If after having been evaluated, your doctor cannot determine any other cause of your memory and speech impairments, and you still feel as though your symptoms may be related to Alzheimer’s disease, you can contact the Neurology or Neuroscience department of a research institution (such as a university or teaching hospital, etc.) located in your area and ask if they are in need of any young individuals with a family history of Alzheimer’s disease. Your physician may even know of some of these resources. Additionally, you can search for Alzheimer’s clinical trials in your area (which sometimes, depending on the study, may be interested in assessing various clinical measures in “pre-symptomatic” individuals with a family history of AD) using the “Search for Clinical Trials” link in the Resources section of our website.

In families afflicted by the heritable form of Alzheimer's disease (familial Alzheimer's disease (FAD), also known as early-onset AD) it is certainly possible to have half or more of the children affected by Alzheimer's disease if one of the parents carries an associated disease mutation. It is possible that in your great-grandmother (or your great-grandfather) passed an FAD-associated mutant gene on to their children. It is also possible that because all the siblings presumably grew up under the same environmental conditions, an environmental influence (such as exposure to toxins or other external factors) may have contributed to the high incidence of AD in this family. Except in cases of FAD, it is generally unusual to have more than half of the siblings in a family afflicted by Alzheimer's disease

Two studies published earlier this year in the journal of Neurology as part of the Women’s Health Initiative (WHI) report that women taking hormone replacement therapy (HRT), such as for treatment of menopausal symptoms, had slightly reduced brain volumes in areas of the brain associated with thinking and memory, the frontal cortex and the hippocampus. Previous studies had indicated that HRT carried a higher risk for women to have issues with cognition and memory later in life, which had been thought to be due to an increased incidence of mini-strokes leading to brain lesions. These new studies, however, found not lesions in the brains of women taking HRT, but smaller brain volumes. Brain shrinkage due to HRT therefore may put these women at an increased risk to develop dementia or Alzheimer's disease.

Although there have not been many formal studies examining the effects of HRT in Alzheimer's disease (AD) patients, based upon these newer findings it would appear that HRT could potentially hasten disease progression by further shrinking the brain areas known to be affected by AD—the frontal cortex and the hippocampus. In fact, a recently published review of the clinical databases found that overall, estrogen replacement therapy (ERT) or hormone replacement therapy (which includes estrogens combined with progestagen) in women with dementia was associated with worse performance on memory, skill and cognitive tasks. Further studies clearly need to be conducted in dementia patients to confirm or refute these findings.

For Alzheimer's disease research, there are numerous organizations and research groups that would graciously accept donation of a brain or brain tissue. A list of some of these groups is noted below. In addition, you can try contacting the neurology or neuroscience departments of research institutions or medical universities near you to see if they have any such programs in place. Please note that many of these institutions require that the donated brain be from a patient already enrolled in one of their research studies. Depending on your location in relation to the institution, it may be possible to participate in the research programs. You will have to contact them directly to find out additional details. Some programs accepting brain donations include:

• Baylor College of Medicine Brain Donation Autopsy Program
• Boston University Alzheimer's Disease Center
• Northwestern University Brain Endowment program
• University of Pennsylvania Center for Neurodegenerative Disease Research

Additionally, a list of brain banks in several states that can perform postmortem diagnosis of Alzheimer's disease and may accept brain tissue for donation has been compiled by the Alzheimer Research Forum.

Psychosis, paranoia and memory loss can occur in both schizophrenia and dementia, particularly as a patient ages and the associated risk of developing dementia increases. As you mentioned, there is a definite higher risk for schizophrenic patients to develop dementia later in life. Several studies have indicated, for example, that when schizophrenia develops late in life (>60 years), there is a higher likelihood that dementia will also be diagnosed.

Because of the overlapping nature of the diseases, research has focused on whether or not there are underlying causes in common, such as genetic or early environmental influences on the development of the brain. Scientists are also trying to determine if the same or similar genes are involved in psychiatric and neurological disorders, and also whether or not these genetic targets could be used either to develop new therapies or to provide better diagnostic techniques. Once researchers can determine the shared pathways that many of these neuropsychological diseases affect, it will only be a matter of time before new and better treatments are found.