The Section on Geriatric Psychiatry, recently upgraded from a Unit to Section status within the Laboratory of Clinical Science, concentrates primarily on the comprehensive study of Alzheimer's disease. From basic science investigations of cell biology in the cultured olfactory neuroblasts of Alzheimer patients to developing diagnostic challenge paradigms and testing new combinations of therapeutic agents in patients, the Section focuses on a scientifically integrated approach to the illness. In the past year, significant progress has been made in characterizing and comparing the cultured neuroblasts of Alzheimer patients with normal control neuroblasts; clear differences in the processing of amyloid precursor protein, thought to be central in the pathology of the brain degenerative process, have been documented and are now being explored for possible avenues of therapeutic intervention. Clinically, the Section has continued its longstanding pharmacologic challenge strategy with centrally-active cholinergic antagonists and shown that sensitivity to these agents increases with age; this result has immediate implications for clinicians treating the elderly with anticholinergic agents such as tricyclic antidepressants. From the perspective of therapeutics, the Section completed its first in a series of combination pharmacotherapy studies with Alzheimer's patients which revealed that two research medications with different mechanisms of action could be safely administered in these mostly elderly patients; dosing adjustments are now ongoing to maximize the therapeutic effects of these combinations. Together, these studies represent a coordinated research approach to Alzheimer's disease which is integrated vertically from the laboratory to the bedside such that any basic science advance can quickly lead to a potential therapeutic advance.
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