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My bet is on Clostridium difficile as the cause because the use of antibiotics affects the progression of the disease and aluminum does not cause amyloid plaques or inflammation which C. difficile does. Diabetics progress to Alzheimer's and C. difficile shuts down the signaling cascade that trips the release of insulin from the pancreas.

Title: IDSA: Antibiotics May Temporarily Stave Off Alzheimer's Disease Symptoms

"IDSA: Antibiotics May Temporarily Stave Off Alzheimer's Disease Symptoms"

By Maury M. Breecher, PhD, MPH SAN DIEGO, CA -- October 15, 2003 -- Results from a small multi-center trial suggest that two common antibiotics taken together might delay the symptoms of Alzheimer's disease (AD), said researchers here October 12th at the 41st Annual Infectious Diseases Society of America (IDSA) Meeting. The antibiotics doxycycline and rifampin may have a therapeutic role in temporarily slowing the progression of Alzheimer's disease symptoms, but the mechanisms of that action remain to be elucidated, according to lead author Mark B. Loeb, MD, MSc, associate professor, departments of pathology and molecular medicine, and clinical epidemiology and biostatistics, McMaster University, Hamilton, Ontario, Canada. In the study, people with AD who took the antibiotics had significantly reduced decline in mental function for at least 6 months compared to those given the placebo, said Dr. Loeb. Most people in the study had been treated with other drugs, and "were not doing very well." "Does this mean you should ask that mom or dad be put on an antibiotic regimen if they have Alzheimer's?" he continued. "If everything else has failed, it's a possibility and something to talk to the physician about, although antibiotic resistance issues should be considered" Other experts consulted at the meeting think that recommendation is premature and point out that the beneficial effects might be as a result of the anti-inflammatory effects of the antibiotics, not their antibacterial actions. "This was a well-designed, preliminary study with clearly interesting findings, but we need to replicate the findings and determine the underlying mechanism involved," said Christopher L. Karp, MD, professor of paediatrics and director of molecular biology, University of Cincinnati Children's Hospital, Cincinnati, Ohio, United States. Dr. Karp was vice chair of the IDSA program committee. "The hypothesis going in to this research was that there are potentially bacteria that are involved in exacerbating Alzheimer's," continued Dr. Karp. "I think it is even more likely that it is the anti-inflammatory effects of doxycycline that they are seeing." Dr. Karp pointed out that there is "very good data in the literature that doxycycline has anti-inflammatory activity. "We know that Alzheimer's disease is associated with a chronic low-grade, local inflammatory response," he explained. "If I were to bet, I would think that the most likely mechanism of action here is inhibition of inflammation." Therapy with doxycycline and rifampin may have a therapeutic role in patients with mild to moderate Alzheimer's Disease, but the beneficial mechanism "is unlikely" to be due to the antibacterial effects of those agents, said Dr. Loeb and his colleagues in their presentation. He suggested that the antibiotics might work by interfering with the accumulation of protein plaques around the neurons in the brain, a process that is known to be associated with AD. In a news release prepared by the IDSA, Dr. Loeb and his colleagues stated that prolonged exposure to rifampin and doxycycline could contribute to development of antimicrobial-resistant bacteria, which is "an important potential limitation of the therapy." The study by Dr. Loeb and colleagues was carried out at three Canadian tertiary care facilities and two community geriatric clinics. The study included 101 people with suspected mild to moderate AD. In the study, 50 patients received placebo pills, and 51 were assigned to take two 100-mg tablets of doxycycline and one 300-mg tablet of rifampin daily for 3 months. The study was triple-blinded, so the patient, the treating physicians and the study investigators were not aware who was receiving the antibiotics or the placebos. The size of the study is comparable to that of other interventions tested for the treatment of AD, said Dr. Loeb. A standard Alzheimer's disease test was given to the patients to determine mental function before the study began. Six months later, the test was re-administered to 43 people in the antibiotic group and 39 people in the placebo group (the remainder had dropped out, died or otherwise did not complete the study). Over the 6-month period, The mental scores in the placebo group declined significantly by an average of 2.75 points more, on a 70-point scale, than those who received the antibiotic. At 12 months, there was still a difference between the two groups, although that difference was not considered to be statistically significant. Standard Alzheimer's tests typically show a steady downward slope in mental function during a period of months, and patients on antibiotics showed a reduction in that slope, said Dr. Loeb. Based on the results of the study, 3 months might be an appropriate period to try the antibiotic regimen, he said. Further study might reveal the most appropriate duration of treatment, he said. "The study certainly does need follow-up studies, because I consider most of the data presented here to be science fiction and of little promise," disagreed Margaret R. Hammerschlag, MD, professor of paediatrics and medicine, State University of New York Downstate Medical Center, New York. "The so-called reduction in cognitive decline was no greater than what has been found in studies of placebos. Whatever improvement that was found could be attributed to the anti-inflammation benefits of the antibiotics," said Dr. Hammerschlag. In the news release put out by IDSA, Dr. Loeb said the Canadian study was undertaken because of an existing theory that suggested that the bacterium Chlamydia pneumoniae might play a role in the development of AD and because doxycycline and rifampin are very effective against this bacterium, according to Dr. Loeb. Dr. Hammerschlag pointed out that the study authors themselves found no evidence that levels of C. pneumoniae were reduced significantly, as would be expected if the slowing of cognitive decline in the patients was due to that factor. That's why Dr. Loeb and his colleagues stated in their conclusion that the antibiotic mechanism "is unlikely" to have caused the patients' improvement. The only medications approved for the treatment of AD by the U.S. Food and Drug Administration and Canadian Health Protection Branch are cholinesterase inhibitors, which are designed to preserve brain chemicals important for memory. About half of people who take these medications experience modest improvement, according to the Alzheimer's Association. Most of the patients in the Canadian study were taking cholinesterase inhibitors when the trial began. Co-authors of the paper are William Molloy, Marek Smieja, Tim Standish, Charles Goldsmith, Jim Mahony, Stephanie Smith, Martin O'Donnell, Max Chernesky, Michael Borrie, Earl Decoteau, Warren Davidson, Allan McDougall and Judy Gnarpe. [Study title: A Randomized Controlled Trial of Doxycycline and Rifampin for Patients with Alzheimer Disease. Abstract 516]

Diabetics progress to Alzheimer's

Can you explain to this diabetic what you mean?

My dad was also diabetic and dependent on daily insulin injections. His daily breakfast was an awful pile of carbohydrates...a bowl of fruit, cranberry juice, donuts, chocolate candies, coffee. I warned him that the daily carbohydrate bomb was going to steal his eyesight. It did.

It seems C. difficile is a problem in hospitals. Clostridia are strict anaerobes. Under stress, then produce a spore to protect the genetic material. Certain hospital cleaning agents that don't contain bleach can stress C. difficle into active sporulation. That actually increases the probability that it will survive to contaminate food and make it back into the digestive tract of a patient. The usual victims are elderly people who develop severe diarrhea.

"Other experts consulted at the meeting think that recommendation is premature and point out that the beneficial effects might be as a result of the anti-inflammatory effects of the antibiotics, not their antibacterial actions."

Has NSAID testing ever been done on alzheimer patients?

Thanks.

BTW, paragraph are our friends.