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Alzheimer's

Clinical Trials  |  Add a link  |  Regulations  |  Discussion Board  |  Ask the Nurse | Last Update January 1st. 2009  |  About FDA.COM  | Media Kit

 
Also called: AD

Alzheimer's disease (AD) is the most common form of dementia among older people. Dementia is a brain disorder that seriously affects a person's ability to carry out daily activities.

AD begins slowly. It first involves the parts of the brain that control thought, memory and language. People with AD may have trouble remembering things that happened recently or names of people they know. Over time, symptoms get worse. People may not recognize family members or have trouble speaking, reading or writing. They may forget how to brush their teeth or comb their hair. Later on, they may become anxious or aggressive, or wander away from home. Eventually, they need total care. This can cause great stress for family members who must care for them.

AD usually begins after age 60. The risk goes up as you get older. Your risk is also higher if a family member has had the disease.

No treatment can stop the disease. However, some drugs may help keep symptoms from getting worse for a limited time.

Alzheimer's Disease Fact Sheet

PDF PDF (289K)
Spanish Version

Click here to order

Alzheimer’s disease (AD) is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks. In most people with AD, symptoms first appear after age 60.

AD is the most common cause of dementia among older people. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—to such an extent that it interferes with a person’s daily life and activities. According to recent estimates, as many as 2.4 to 4.5 million Americans are living with AD.

AD is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary tangles). Plaques and tangles in the brain are two of the main features of AD. The third is the loss of connections between nerve cells (neurons) in the brain.

Changes in the Brain in AD

Although we still don’t know what starts the AD process, we do know that damage to the brain begins as many as 10 to 20 years before any problems are evident. Tangles begin to develop deep in the brain, in an area called the entorhinal cortex, and plaques form in other areas. As more and more plaques and tangles form in particular brain areas, healthy neurons begin to work less efficiently. Then, they lose their ability to function and communicate with each other, and eventually they die. This damaging process spreads to a nearby structure, called the hippo-campus, which is essential in forming memories. As the death of neurons increases, affected brain regions begin to shrink. By the final stage of AD, damage is widespread and brain tissue has shrunk significantly.

Very Early Signs and Symptoms

Memory problems are one of the first signs of AD. Some people with memory problems have a condition called amnestic mild cognitive impairment (MCI). People with this condition have more memory problems than normal for people their age, but their symptoms are not as severe as those with AD. More people with MCI, compared with those without MCI, go on to develop AD.

Other changes may also signal the very early stages of AD. For example, recent research has found links between some movement difficulties and MCI. Researchers also have seen links between some problems with the sense of smell and cognitive problems. Brain imaging and biomarker studies of people with MCI and those with a family history of AD are beginning to detect early changes in the brain like those seen in AD. These findings will need to be confirmed by other studies but appear promising. Such findings offer hope that some day, we may have tools that could help detect AD early, track the course of the disease, and monitor response to treatments.

Mild AD

As AD progresses, memory loss continues and changes in other cognitive abilities appear. Problems can include getting lost, trouble handling money and paying bills, repeating questions, taking longer to complete normal daily tasks, poor judgment, and mood and personality changes. People often are first diagnosed in this stage.

Moderate AD

In this stage, damage occurs in areas of the brain that control language, reasoning, sensory processing, and conscious thought. Memory loss and confusion increase, and people begin to have problems recognizing family and friends. They may be unable to learn new things, carry out tasks that involve multiple steps (such as getting dressed), or cope with new situations. They may have hallucinations, delusions, and paranoia, and may behave impulsively.

Severe AD

By the final stage, plaques and tangles have spread throughout the brain and brain tissue has shrunk significantly. People with severe AD cannot communicate and are completely dependent on others for their care. Near the end, the person may be in bed most or all of the time as the body shuts down.

 

As Alzheimer's disease progresses, neurofibrillary tangles spread throughout the brain (three images show the spread of neurofibrillary tangles throughout the progression). Plaques also spread throughout the brain, starting in the neocortex. By the final stage, damage is widespread and brain tissue has shrunk significantly.

Click to view a larger image

What Causes AD

Scientists don’t yet fully understand what causes AD, but it is clear that it develops because of a complex series of events that take place in the brain over a long period of time. It is likely that the causes include genetic, environmental, and lifestyle factors. Because people differ in their genetic make-up and lifestyle, the importance of these factors for preventing or delaying AD differs from person to person.

The Basics of AD

Scientists are conducting studies to learn more about plaques, tangles, and other features of AD. They can now visualize plaques by imaging the brains of living individuals. They are also exploring the very earliest steps in the disease process. Findings from these studies will help them understand the causes of AD.

One of the great mysteries of AD is why it largely strikes older adults. Research on how the brain changes normally with age is shedding light on this question. For example, scientists are learning how age-related changes in the brain may harm neurons and contribute to AD damage. These age-related changes include inflammation and the production of unstable molecules called free radicals.

Genetics

In a very few families, people develop AD in their 30s, 40s, and 50s. These people have a mutation, or permanent change, in one of three genes that they inherited from a parent. We know that these gene mutations cause AD in these “early-onset” familial cases.

However, most people with AD have “late-onset” AD, which usually develops after age 60. Many studies have linked a gene called APOE to late-onset AD. This gene has several forms. One of them, APOE e4, increases a person’s risk of getting the disease. About 40 percent of all people who develop late-onset AD carry this gene. However, carrying the APOE e4 form of the gene does not necessarily mean that a person will develop AD, and people carrying no APOE e4 forms can also develop AD.

Scientists think that other risk-factor genes exist as well. A possible new one, SORL1, was discovered in 2007. Large-scale genetic research studies are looking to find other genes. For more about this area of research, see the Alzheimer’s Disease Genetics Fact Sheet, available at www.nia.nih.gov/Alzheimers.

Lifestyle Factors

A nutritious diet, exercise, social engagement, and mentally stimulating pursuits can all help people stay healthy. New research suggests the possibility that these factors also might help to reduce the risk of cognitive decline and AD. Scientists are investigating associations between cognitive decline and heart disease, high blood pressure, diabetes, and obesity. Understanding these relationships and testing them in clinical trials will help us understand whether reducing risk factors for these diseases may help with AD as well.

How AD Is Diagnosed

AD can be definitively diagnosed only after death by linking clinical course with an examination of brain tissue and pathology in an autopsy. But doctors now have several methods and tools to help them determine fairly accurately whether a person who is having memory problems has “possible AD” (the symptoms may be due to another cause) or “probable AD” (no other cause for the symptoms can be found). To diagnose AD, doctors:

  • ask questions about the person’s overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality
  • conduct tests of memory, problem solving, attention, counting, and language
  • carry out medical tests, such as tests of blood, urine, or spinal fluid
  • perform brain scans, such as a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) test

These tests may be repeated to give doctors information about how the person’s memory is changing over time.

Early diagnosis is beneficial for several reasons. Having an early diagnosis and starting treatment in the early stages of the disease can help preserve function for months to years, even though the underlying AD process cannot be changed. Having an early diagnosis also helps families plan for the future, make living arrangements, take care of financial and legal matters, and develop support networks.

In addition, an early diagnosis can provide greater opportunities for people to get involved in clinical trials. In a clinical trial, scientists test drugs or treatments to see which are most effective and for whom they work best. (See the box, below, for more information.)

Participating in Clinical Trials

People with AD, those with MCI, those with a family history of AD, and healthy people with no memory problems and no family history of AD may be able to take part in clinical trials. Study volunteers help scientists learn about the brain in healthy aging as well as what happens in AD. Results of AD clinical trials are used to improve prevention and treatment approaches. Participating in clinical trials is an effective way to help in the fight against AD.

NIA, which is part of the National Institutes of Health (NIH), leads the Federal Government’s research efforts on AD. NIA-supported Alzheimer’s Disease Centers located throughout the United States conduct many clinical trials and carry out a wide range of research, including studies of the causes, diag-nosis, and management of AD. NIA also sponsors the Alzheimer’s Disease Cooperative Study (ADCS), a consortium of leading AD researchers throughout the U.S. and Canada who conduct clinical trials on promising AD treatments.

To find out more about AD clinical trials, talk to your health care provider or contact NIA’s ADEAR Center at 1-800-438-4380. Or, visit the ADEAR Center clinical trials database at www.nia.nih.gov/Alzheimers/ResearchInformation/ClinicalTrials. You also can sign up for email alerts that let you know when new clinical trials are added to the database. More information about clinical trials is available at www.ClinicalTrials.gov.

 

How AD Is Treated

AD is a complex disease, and no single “magic bullet” is likely to prevent or cure it. That’s why current treatments focus on several different aspects, including helping people maintain mental function; managing behavioral symptoms; and slowing, delaying, or preventing AD.

Helping People with AD Maintain Mental Function

Four medications are approved by the U.S. Food and Drug Administration to treat AD. Donepezil (Aricept®), rivastigmine (Exelon®), and galantamine (Razadyne®) are used to treat mild to moderate AD (donepezil can be used for severe AD as well). Memantine (Namenda®) is used to treat moderate to severe AD. These drugs work by regulating neurotransmitters (the chemicals that transmit messages between neurons). They may help maintain thinking, memory, and speaking skills, and help with certain behavioral problems. However, these drugs don’t change the underlying disease process and may help only for a few months to a few years.

Managing Behavioral Symptoms

Common behavioral symptoms of AD include sleeplessness, agitation, wandering, anxiety, anger, and depression. Scientists are learning whyhese symptoms occur and are studying new treatments—drug and non-drug—to manage them. Treating behavioral symptoms often makes people with AD more comfortable and makes their care easier for caregivers.

Slowing, Delaying, or Preventing AD

AD research has developed to a point where scientists can look beyond treating symptoms to think about addressing the underlying disease process. In ongoing AD clinical trials, scientists are looking at many possible interventions, such as cardiovascular treatments, antioxidants, immunization therapy, cognitive training, and physical activity.

Supporting Families and Caregivers

Caring for a person with AD can have high physical, emotional, and financial costs. The demands of day-to-day care, changing family roles, and difficult decisions about placement in a care facility can be hard to handle. Researchers are learning a lot about AD caregiving, and studies are helping experts develop new ways to support caregivers.

Becoming well-informed about AD is one important long-term strategy. Programs that teach families about the various stages of AD and about flexible and practical strategies for dealing with difficult care-giving situations provide vital help to those who care for people with AD.

Developing good coping skills and a strong support network of family and friends also are important ways that caregivers can help themselves handle the stresses of caring for a loved one with AD. For example, staying physically active provides physical and emotional benefits. Some AD caregivers have found that participating in an AD support group is a critical lifeline. These support groups allow caregivers to find respite, express concerns, share experiences, get tips, and receive emotional comfort. The Alzheimer’s Association, Alzheimer’s Disease Centers, and many other organizations sponsor in-person and online AD support groups across the country. There are a growing number of groups for people in the early stage of AD and their families. Support networks can be especially valuable when caregivers face the difficult decision of whether and when to place a loved one in a nursing home.

Advancing Our Understanding

Thirty years ago, we knew very little about AD. Since then, scientists have made many imporant advances. Research supported by NIA and other organizations has expanded knowledge of brain function in healthy older people, identified ways we might lessen normal age-related declines in mental function, and deepened our understanding of AD. Many scientific and clinical fields are now working together to untangle the genetic, biological, and environmental factors that, over many years, ultimately result in AD. This effort is bringing us closer to the day when we will be able to manage successfully or even prevent this devastating disease.

For More Information

To learn about support groups, services, research centers, research studies, and publications about AD, contact the following resources:

Alzheimer’s Disease Education and Referral (ADEAR) Center
P.O. Box 8250
Silver Spring, MD 20907-8250
800-438-4380 (toll-free)
www.nia.nih.gov/Alzheimers

A service of the National Institute on Aging (NIA), the ADEAR Center offers information and publications for families, caregivers, and professionals on diagnosis, treatment, patient care, caregiver needs, long-term care, education and training, and research related to AD. Staff members answer telephone, email, and written requests and make referrals to local and national resources. The ADEAR website provides free, online publications in English and Spanish; email alert and online Connections newsletter subscriptions; an AD clinical trials database; the AD Library database; and more.

Alzheimer’s Association
225 N. Michigan Avenue, Floor 17
Chicago, IL 60601-7633
800-272-3900 (toll-free)
866-403-3073 (TDD/toll-free)
www.alz.org

Alzheimer’s Foundation of America
322 Eighth Avenue, 7th Floor
New York, NY 10001
866-AFA-8484 (866-232-8484; toll-free)
www.alzfdn.org

Eldercare Locator
800-677-1116 (toll-free)
www.eldercare.gov

Family Caregiver Alliance
180 Montgomery Street, Suite 1100
San Francisco, CA 94104
800-445-8106 (toll-free)
www.caregiver.org

NIHSeniorHealth
www.nihseniorhealth.gov

Reference Links - Add a link

Clinical Trials - Add a clinical trial

 top
1
Not yet recruiting
 

 
2
Recruiting
Memantine and Comprehensive,Individualized Management of Alzheimer's Patients and Caregiver Training
Condition:
Alzheimer's Disease 
Interventions:
Behavioral: Caregiver Training Home visits: exercising, doing activities;   Drug: memantine 
 
 

 
3
Recruiting
Alzheimer's Disease Genetics Study
Conditions:
Alzheimer Disease;   Late Onset Alzheimer Disease 
Intervention:
 
 
 

 
4
Not yet recruiting
Safety, Efficacy, Pharmacokinetics, and Pharmacodynamics Study of Bryostatin 1 in Patients With Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Drug: Bryostatin for Injection;   Drug: Placebo 
 
 

 
5
Recruiting
Effects of LY450139, on the Progression of Alzheimer's Disease as Compared With Placebo
Condition:
Alzheimer's Disease 
Interventions:
Drug: LY450139;   Drug: Placebo 
 
 

 
6
Recruiting
Functional Magnetic Resonance Imaging - Synthetic Aperture Magnetometry (fMRI-SAM) and Alzheimer's Disease
Condition:
Alzheimer's Disease 
Intervention:
Procedure: fMRI to detect MCI patients who will convert to Alzheimer's disease 
 
 

 
7
Recruiting
Phase 2, Multiple IV Dose Study Of PF-04360365 In Patients With Mild To Moderate Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Biological: PF-04360365 0.1 mg/kg;   Biological: PF-04360365 0.5 mg/kg;   Biological: PF-04360365 1 mg/kg;   Drug: Placebo 
 
 

 
8
Recruiting
Study of the Effect of Repetitive Transcranial Magnetic Stimulation on Language in Patients With Alzheimer's Disease
Condition:
Alzheimer's Disease 
Intervention:
Device: Repetitive Transcranial Magnetic Coil Stimulation (rTMS) 
 
 

 
9
Recruiting
Randomized Trial of a Nutritional Supplement in Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Dietary Supplement: Resveratrol with Glucose, and Malate;   Dietary Supplement: Placebo 
 
 

 
10
Recruiting
 

 
11
Not yet recruiting
Alzheimer and Sleep
Condition:
Alzheimer's Disease 
Intervention:
Drug: Galantamine and Donepezil 
 
 

 
12
Recruiting
 

 
13
Recruiting
 

 
14
Recruiting
Safety and Cognitive Function Study of EVP-6124 in Patients With Alzheimer's Disease
Conditions:
Alzheimer's Disease;   Central Nervous System Diseases 
Interventions:
Drug: EVP-6124;   Drug: placebo 
 
 

 
15
Recruiting
 

 
16
Recruiting
Efficacy Study of a ZT-1 Implant in Patients Suffering From Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Drug: ZT-1;   Drug: Donepezil 
 
 

 
 
18
Recruiting
A Double-Blind, Placebo-Controlled, 2-Year Study of Galantamine Used to Treat Patients With Mild to Moderate Alzheimer's Disease.
Conditions:
Dementia, Alzheimer Type;   Alzheimer Disease 
Interventions:
Drug: Galantamine;   Drug: Placebo 
 
 

 
19
Recruiting
A Randomized, Clinical Trial of Vitamin E and Memantine in Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Drug: dl-alpha-tocopherol;   Drug: Memantine;   Drug: dl-alpha-tocopherol;   Drug: Memantine;   Drug: Placebo 
 
 

 
20
Recruiting
Progression Delaying Effect of Escitalopram in Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Drug: escitalopram;   Drug: placebo 
 
 

 
21
Recruiting
Brain Uptake and Safety With Probable Alzheimer's Disease, Amnestic Mild Cognitive Impairment and Healthy Volunteers
Conditions:
Alzheimer's Disease;   Amnestic Mild Cognitive Impairment 
Intervention:
Drug: AH110690 (18F) Injection 
 
 

 
22
Recruiting
Raloxifene for Women With Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Drug: raloxifene;   Drug: Placebo 
 
 

 
23
Recruiting
Compliance and Tolerability of Rivastigmine Transdermal Patch 10 cm² in Patients With Probable Alzheimer's Disease.
Condition:
Alzheimer's Disease 
Intervention:
Drug: Rivastigmine transdermal patch 
 
 

 
24
Recruiting
Using Behavioral Programs to Treat Sleep Problems in Individuals With Alzheimer's Disease
Conditions:
Alzheimer Disease;   Sleep Initiation and Maintenance Disorders 
Interventions:
Behavioral: Walking Program;   Behavioral: Light Exposure Program;   Behavioral: Combined Education, Walking and Light Exposure Program;   Behavioral: Routine Medical Care with Education 
 
 

 
25
Recruiting
Anti-Psychotic Discontinuation in Alzheimer's Disease
Conditions:
Alzheimer Disease;   Psychotic Disorders 
Intervention:
Drug: risperidone 
 
 

 
26
Recruiting
Delaying the Progression of Driving Impairment in Individuals With Mild Alzheimer's Disease
Condition:
Alzheimer's Disease 
Intervention:
Drug: Memantine 
 
 

 
27
Recruiting
Methylphenidate for Apathy in Alzheimer's Dementia: A Controlled Study
Conditions:
Alzheimer's Disease;   Apathy;   Dementia;   Methylphenidate 
Interventions:
Drug: Methylphenidate;   Other: Placebo 
 
 

 
28
Not yet recruiting
Efficacy Assessment of Three Non Pharmacological Therapies in Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Behavioral: Standard intervention protocol;   Behavioral: Standard intervention protocol + Cognitive training therapy;   Behavioral: Standard intervention protocol + Reminiscence therapy;   Behavioral: Standard intervention protocol + "Made-to-measure" program 
 
 

 
29
Recruiting
Donepezil and Brain Activity Patterns in Those at Risk For Alzheimer's Disease
Condition:
Alzheimer's Disease 
Intervention:
Drug: donepezil 
 
 

 
30
Recruiting
Memantine for Agitation and Aggression in Severe Alzheimer's Disease
Condition:
Alzheimer's Disease 
Intervention:
Drug: memantine 
 
 

 
31
Not yet recruiting
Study of SB-742457 or Donepezil Versus Placebo in Subjects With Mild-to-Moderate Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Drug: SB-742457;   Drug: Donepezil;   Drug: Placebo 
 
 

 
32
Recruiting
Memantine on Aggression and Agitation of Alzheimer's Disease (AD)
Condition:
Alzheimer's Disease 
Intervention:
Drug: Memantine 
 
 

 
33
Recruiting
Effects of Estrogen on Memory in Post-Menopausal Women and Patients With Alzheimer's Disease
Condition:
Alzheimer Disease 
Interventions:
Drug: Donepezil;   Drug: Estrogen;   Drug: Progesterone 
 
 

 
34
Recruiting
 

 
35
Recruiting
A Study of PRX-03140 in Subjects With Alzheimer's Disease Receiving a Stable Dose of Donepezil
Condition:
Alzheimer's Disease 
Interventions:
Drug: PRX-03140;   Drug: Placebo 
 
 

 
36
Recruiting
Study of PRX-03140 Monotherapy in Subjects With Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Drug: PRX-03140;   Drug: Donepezil;   Drug: Placebo 
 
 

 
37
Recruiting
Safety Study of Nicotinamide to Treat Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Drug: Nicotinamide;   Drug: Enduramide placebo 
 
 

 
38
Not yet recruiting
A Phase II, Multicenter, Double Blind, Placebo-Controlled Safety, Tolerability Study of BMS-708163 in Patients With Mild to Moderate Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Drug: BMS-708163;   Drug: BMS-708163;   Drug: BMS-708163;   Drug: BMS-708163;   Drug: Placebo 
 
 

 
39
Recruiting
A Study of the Safety, Pharmacokinetics, Pharmacodynamics, and Immunogenicity of MABT5102A in Patients With Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Drug: MABT5102A;   Drug: placebo 
 
 

 
40
Recruiting
Efficacy and Safety of T-817MA in Patients With Mild to Moderate Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Drug: T-817MA;   Drug: Placebo 
 
 

 
41
Recruiting
Home-Based Assessment for Alzheimer Disease Prevention
Conditions:
Mild Cognitive Impairment;   Alzheimer's Disease 
Interventions:
Behavioral: Mail and Live Phone;   Behavioral: Interactive Voice Response (IVR);   Behavioral: Home-based Computer Kiosk;   Behavioral: Traditional Evaluation Instruments 
 
 

 
42
Recruiting
Study Evaluating PAZ-417 in Cerebrospinal Fluid in Subjects With Alzheimer's Disease
Condition:
Alzheimer Disease 
Interventions:
Drug: Placebo;   Drug: PAZ-417 
 
 

 
43
Recruiting
Early Diagnosis of Alzheimer's Disease: Clinical, Neuropsychological and Neuroimaging Follow-up of a Cohort of Patients With an Isolated Memory Impairment
Condition:
Alzheimer's Disease 
Interventions:
Other: Neurological and neuropsychological consultation, MRI;   Other: Neurological and neuropsychological consultation, MRI, Studies in imaging of drip, DNA 
 
 

 
44
Recruiting
Biomarkers and Early Alzheimer's Disease
Condition:
Alzheimer's Disease 
Intervention:
 
 
 

 
45
Recruiting
Home Safety Clinical Trial for Alzheimer's Disease
Conditions:
Alzheimer's Disease;   Dementia 
Intervention:
Behavioral: Home Safety Toolkit 
 
 

 
46
Recruiting
Exercise Treatment of Mild-Stage Probable Alzheimer's Disease
Conditions:
Alzheimer Disease;   Memory Disorders;   Dementia 
Intervention:
Behavioral: Participation in a monitored exercise program 
 
 

 
47
Recruiting
Lutein and Alzheimer's Disease Study
Condition:
Alzheimer's Disease 
Interventions:
Dietary Supplement: lutein/zeaxanthin;   Dietary Supplement: placebo 
 
 

 
48
Recruiting
An Innovative Psychosocial Intervention for Adult-Child Caregivers of Parents With Alzheimer's Disease
Condition:
Alzheimer Disease 
Intervention:
Behavioral: Information, counseling and support 
 
 

 
49
Recruiting
AIDMA: A Psycho-Educational Program Designed to Support and Train Carers of Alzheimer's Disease (AD) Patients
Condition:
Alzheimer's Disease 
Interventions:
Behavioral: Controlled diet;   Behavioral: Self-hypnotic relaxation 
 
 

 
50
Recruiting
A Pilot Study of Inflammatory Markers in Alzheimer's Disease
Condition:
Alzheimer's Disease 
Interventions:
Drug: doxycycline;   Drug: rifampin;   Drug: placebo