Skip to content
Aisen PS, et al. "Clinical Core of the Alzheimer's Disease
Neuroimaging Initiative: Progress and Plans," Alzheimer's
& Dementia (May 2010): Vol. 6, No. 3, pp. 239–46.
Alzheimer's Association. Proposed Revisions to Diagnostic
Criteria for Alzheimer's Disease: Backgrounder/FAQ,
available online at www.alz.org/research/diagnostic_criteria.
"Consensus Report of the Working Group on 'Molecular and
Biochemical Markers of Alzheimer's Disease,' The Ronald and Nancy
Reagan Research Institute of the Alzheimer's Association and the
National Institute on Aging Working Group," Neurobiology of
Aging (March-Apr. 1998): Vol. 19, No. 2, pp. 109–16.
Baucom DH, et al. "Cognitive-Behavioral Couple Therapy," in
Gurman AS, ed. Clinical Handbook of Couple Therapy (The
Guilford Press, 2008).
Fals-Stewart W, et al. "Behavioral Couples Therapy for Substance
Abuse: Rationale, Methods, and Findings," Science and
Practice Perspectives (Aug. 2004): Vol. 2, No. 2, pp. 30–41.
McLean LM, et al. "A Couples Intervention for Patients Facing
Advanced Cancer and Their Spouse Caregivers: Outcomes of a Pilot
Study," Psychooncology (Nov. 2008): Vol. 17, No. 11, pp.
Berman RM, et al. "Antidepressant Effects of Ketamine in
Depressed Patients," Biological Psychiatry (Feb. 15,
2000): Vol. 47, No. 4, pp. 351–54.
Diazgranados N, et al. "A Randomized Add-On Trial of an
N-Methyl-D-Aspartate Antagonist in Treatment-Resistant Bipolar
Depression," Archives of General Psychiatry (Aug. 2010):
Vol. 67, No. 8, pp. 793–802.
Krystal JH. "Ketamine and the Potential Role for Rapid-Acting
Antidepressant Medications," Swiss Medical Weekly (April
21, 2007): Vol. 137, No. 15–16, pp. 215–16.
The brain changes that lead to Alzheimer's disease probably begin
years, and possibly even more than a decade, before symptoms such
as memory impairment appear. For this reason, Alzheimer's
researchers have long hoped to find biomarkers — early biological
signs of disease pathology — that could help identify people at
risk before symptoms develop.
Heart disease provides one example of how biomarkers can be useful.
Elevated levels of unhealthy LDL cholesterol or total cholesterol,
detected with a simple blood test, are biomarkers that indicate
someone may be at increased risk of having a heart attack. Statins
(anti-cholesterol drugs) reduce both LDL levels and risk of heart
As yet, however, there is nothing close to an Alzheimer's
equivalent of a cholesterol blood test. The tests for two of the
most promising categories of Alzheimer's biomarkers — brain imaging
scans and spinal fluid sampling — are more cumbersome to perform
than blood tests. Although the research on these biomarkers is
interesting and may be promising, none are yet reliable enough to
use in the clinical setting.
Perhaps most significant for patients concerned about their own
risk, no treatments are available to stop Alzheimer's disease
progression. Although a number of "disease-modifying" compounds are
under investigation, so far all have failed in the late-stage
clinical trials that are necessary to prove efficacy. The most
recent flop occurred in August 2010, when a drug company halted
development of a compound known as semagacestat after patients with
Alzheimer's participating in a clinical trial fared worse after
taking the drug than those taking placebo.
Still, the research on biomarkers continues because some
investigators believe that the disease-modifying drugs must be
given earlier in the Alzheimer's disease process to be effective.
Whether or not that is true remains to be seen.
Traditional wedding vows include a promise to stay together in
sickness and in health. But cancer, heart disease, major
depression, substance abuse, and other types of serious medical
illnesses can create stress in a marriage or in any type of
committed relationship. Illness affects not only the person who
receives the diagnosis, but his or her partner as well.
For example, a woman receiving treatment for breast cancer may be
physically uncomfortable, constantly tired, and worried about her
sexuality and body image. Likewise, a man undergoing treatment for
prostate cancer may experience unpleasant side effects such as
impotence and incontinence. Both are likely to worry about the
future and their mortality. Although these concerns may surface at
various times during cancer treatment, they can become especially
troublesome once treatment ends, as couples make the transition to
a "new normal."
When the diagnosis is diabetes or heart disease, one or both
partners may need to make significant lifestyle changes such as
quitting smoking, losing weight, and adopting new dietary habits.
Although some couples function as a team in response to these
challenges, others may find themselves at odds over food choices,
leisure activities, and the like.
Many couples are able to manage the challenges of illness
reasonably well and can find ways to cope on their own, but some
will need help. For those who do, couples therapy can enable
partners to cope with the stress of medical illness or addiction.
The methods are similar to those employed in individual therapy:
interpreting emotional conflicts and the influence of the past;
understanding fixed patterns of relating; encouraging insight and
empathy into how those patterns may derive from early life
experiences of each partner; assigning exercises for behavior
change; challenging beliefs; offering advice, reassurance, and
support; and teaching social skills and problem solving. All of
these skills may be useful in helping couples to deal more
productively with a serious illness.
A small study found that people with major depression who
received one dose of ketamine experienced a significant
improvement in mood, but the results will be of interest mainly
to researchers, because of how ketamine acts on the brain.
People from 19 different countries who suffer from serious mental
illnesses earn significantly less than other workers.
The phenomenon experienced by people with depression of seeing
things as flat, dull, or gray may have a biological explanation.
What is the blood-brain barrier? I've heard that it may have
something to do with psychiatric disorders. Is that true?