Category Archives: Alzheimer’s

Alzheimer’s Disease Researchers Switch Focus to Prevention Methods

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By Melinda Smith

Alzheimer's Disease Researchers Switch Focus to Prevention MethodsWhen scientists look back to the first quarter of the 21st century, they may marvel at what was accomplished in the treatment and prevention of Alzheimer’s Disease. Alzheimer’s is the most common form of dementia and is reaching global proportions. The World Health Organization says more than 35 million people now live with dementia and that number is projected to double by the year 2030.

As people live longer, there is growing pressure to develop a drug or vaccine that stops dementia.

Health and Human Services Secretary Kathleen Sebelius says setting priorities and coordinating research now will save time later.

“We’ve made the first historic investment of funds and a 15 year commitment to prevention and treatment,” she said.

In the past, the disease could be diagnosed only by doing an autopsy after the patient died.

Alzheimer’s researcher Ronald Petersen says new methods now can provide evidence while the patient is still alive.

“We use biomarkers, various imaging tests, blood tests, spinal fluid tests that are going to tell us that these are in fact indicators of what the disease is going to be,” he stated.

In images provided by the Banner Alzheimer’s Institute in Phoenix, Arizona, you can see the progression of the disease.

Inside the brain of an aging patient, the dark areas are formed by plaques – made up of the amyloid protein – and tangles – composed of another protein called tau. The result is a loss of brain cells and neurons responsible for memory and learning.

During a national summit last month on Alzheimer’s research, two promising clinical trials generated a lot of interest. In this trial, patients already showing signs of Alzheimer’s are given nasal syringes of insulin that push the drug into the neurons of the brain.

“Nearly three-quarters of participants showed improvement in memory over the four-month period, a 50 percent improvement,” said Dr. Suzanne Craft, who is in charge of the study..

But another study may promise earlier treatment to actually prevent the disease. Two years ago, New York Times reporter Pam Belluck and a photographer traveled to Colombia to visit an extended family afflicted by early onset Alzheimer’s. Approximately one-third carry a genetic mutation that brings on the disease while they in their ’30s and ’40s. Belluck says the healthier, older generation, often cares for younger victims.

“They may be bedridden. They need to be fed. They may need to be diapered. They’re also agitated,” Belluck spoke with VOA via Skype.

Early next year, a team of American scientists and Colombian doctors will begin a five-year clinical trial of more than 3,000 members of the family. Not all of the patients carry the genetic marker and some will get a placebo.

The head of the American team, Dr. Eric Reiman, says the immunization drug being tested is designed to clear the amyloid quickly from the brain.

“If we intervene sufficiently early before the disease has ravaged the brain, we think these treatments might have their best shot of having a profound effect,” he said.

Pam Belluck says the Colombian family members are anxious for something – or someone – to help them. Facing a grim future, many say they are willing to step forward if it will help them and future generations.

Source: http://www.voanews.com/content/alzheimers-disease-researchers-switch-focus-to-prevention-methods/1147372.html

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Simple Steps to Keep Your Brain Sharp As You Age

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By Consumer Reports

Consumer Reports: Simple steps can help keep your brain sharp even as you ageYou go into the kitchen to get something, only to forget what it was once you get there. You misplace your reading glasses, can’t find your car in a parking lot or draw a blank when trying to remember a friend’s name. It’s normal to have occasional episodes of minor forgetfulness. But “some types of memory loss are more substantial than others as we age,” says Arthur Kramer, a professor of psychology and neuroscience at the University of Illinois at Urbana-Champaign. “One aspect of memory relates different pieces of information and puts them all together, and that’s the type that isn’t quite what it used to be.” But the brain is surprisingly adept at compensating for aging, and other types of memory can improve or remain intact over time. Even more encouraging is that a set of relatively simple and inexpensive lifestyle changes can go a long way toward maintaining a vigorous mind.

Take a Walk

In late adulthood, the hippocampus, which is the brain region responsible for forming some types of memories, shrinks 1 to 2 percent annually, leading to memory problems and an increased risk for dementia. But regular aerobic exercise encourages the growth of new brain cells there, even if the workouts aren’t strenuous. Aim for at least 30 minutes a day, five days a week, of moderate-intensity aerobic exercise, such as brisk walking or biking.

Lead an Active Social Life

Social butterflies are more likely to retain their brain vitality. A 2011 study in the Journal of the International Neuropsychological Society followed 1,138 older people who were initially free of dementia. Researchers assessed their cognitive function and social interaction every year, recording how often they went to restaurants and sporting events, played bingo, did volunteer work, took short trips, visited relatives or friends, participated in social groups and attended religious services. Over an average of five years, the rate of decline on a broad range of cognitive abilities, including several types of memory, was 70 percent lower in the most socially active people compared with the least socially active.

Play Mind Games

Activities that challenge the mind can help keep it sharp by stimulating brain cells and the connections between them. Studies indicate that participation in a variety of activities — such as joining a book club, seeing a play, listening to presidential debates, attending lectures and playing board or card games — helps preserve acumen. Any engaging pastime counts, including needlepoint, gardening, playing the piano, studying a language, bird-watching or memorizing dance steps — and the more, the better.

Eat Food for Thought

Regular consumption of fish, fruit and vegetables might protect mental agility. Researchers from the University of Pittsburgh tracked the diets and, using MRIs, the brain volume of 260 older people with normal cognitive function in a study presented at the Radiological Society of North America last November. After 10 years, those who ate baked or broiled fish at least once a week had larger and healthier cells in brain areas responsible for memory and learning than did those who ate fish less often.

Control Blood Pressure

Chronic diseases that damage the arteries, thereby disrupting blood flow to the brain, might also injure the mind. That’s another reason to treat high cholesterol, hypertension and Type 2 diabetes and to lose weight, if needed.

Get Some Sleep

We need sleep to create memories, think clearly and react quickly; insufficient shut-eye hampers our ability to remember and reason. To combat sleeplessness, keep your bedroom cool and dark, avoid alcohol, caffeine and smoking, don’t exercise in the evening and turn off the television and all technology a few hours before you go to bed.

Reduce Stress

Stress prompts the release of hormones that can weaken memory and even damage brain cells. Just 12 minutes of daily yoga for two months improved cognition among people with memory disorders in a 2010 study in the Journal of Alzheimer’s Disease. Other stress relievers include aerobic exercise, listening to mellow music, meditating or praying, and writing in a journal.

Stop Smoking

Smoking increases the odds of memory loss in later life, but quitting at any age can halt the decline, evidence suggests. In an April 2011 study in the journal NeuroImage, researchers recruited older adults who were smokers and people who had never smoked, and invited the smokers to join a 12-week cessation program. Two years later, the rate of cognitive decline for successful quitters was similar to that of participants who never smoked, but those who were unable to quit declined more than those in either group.

Limit Alcohol

One drink a day for women and two for men is associated with reductions in cognitive decline and the risk of dementia. But heavy drinking can diminish memory by changing chemicals in the brain and causing deficiencies in Vitamin B1 (thiamin). And several studies report greater brain shrinkage among alcoholics.

Source: http://www.washingtonpost.com/national/health-science/consumer-reports-simple-steps-can-help-keep-your-brain-sharp-even-as-you-age/2012/04/23/gIQAxm5mcT_story.html

 

If You Knew Then What You Know Now: Hindsight for Caregivers

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They say hindsight is 20/20. If you could go back in time: what would you now as seasoned caregivers say to your novice self about how to be a caregiver?

 

If You Knew Then What You Know Now: Hindsight for CaregiversAs a seasoned caregiver of multiple elders, I can choose to torture myself with my perceived failures at being a perfect caregiver, or I can choose to forgive myself for being imperfect, and recognize that I did the best I could at the time. You have the same choice.

 

Much like an adult who realizes that he or she has a “wounded child” living inside – a child who suffers from unearned self-blame or low self-esteem because of life events – many adult caregivers carry the guilt from their “infant” caregiving years to their grave. They spend precious time thinking about how they should have understood someone’s needs better, could have been more patient, would have done any number of things better, if only they knew then what they know now.

 

The very people who take on caregiving roles are often the most sensitive to other’s needs. Many also tend to be overly sensitive in other ways. Let’s face it. Whatever we do as caregivers seems to be wrong in the eyes of some lookers-on, generally people without all of the facts, and often people who couldn’t do what we do no matter what. Still, we are sensitive to their judgment.

 

We can decide not to be bothered by criticism from the outside. The problem is, we often aren’t aware that we are judging ourselves even more harshly than outsiders may judge us. This is particularly true in retrospect. We look back and beat ourselves up for slips, real or imagined, because we were novices and didn’t know what we know now.

 

What tips would you give yourself if you were starting fresh? You’d do your research, of that I’m sure. Government websites such as the Administration on Aging, the National Institutes of Health, plus disease specific websites and support sites such as AgingCare.com, all offer a wealth of information. Also, you’d use your local resources for in person support. You’d call your community Alzheimer’s organization, your Area Agency on Aging and watch for educational workshops. You’d take advantage of help that is available.

 

What Comfort Would You Give Your Novice Self?

 

You went into caregiving out of love and didn’t have the education to cope with specific issues, so you made mistakes. Everyone makes mistakes. Move on.

 

Believe that if your care receiver could be the person he or she was before getting ill, you would be told, “job well done.”

 

Remember precious moments rather than perceived mistakes. Remember the intimate times – times that remind you that you were fulfilling an important calling. Remember that you made a difference. Write yourself reminders of those rewarding times and read the notes when you start criticizing your earliest caregiving blunders – or even later ones.

 

Understand that imperfection is human, and your best was – and still is – good enough.

 

Please forgive the suffering caregiver inside of you as you would a friend. Again, I say you did your best given what you knew. Give that novice caregiver a spiritual hug, and a pass for being imperfect. If you do, you’ll leave room for your brain to focus on loving moments with the people you took care of.

 

Move on from self-imposed blame and admire yourself for stepping into the difficult role of being a caregiver and seeing it through to the best of your ability. What’s important in not what you did wrong along the way, but in the end, what you got right.

 

If you could go back in time: what would you now as seasoned caregivers say to your novice self about how to be a caregiver?

 

Source: http://www.agingcare.com/Articles/about-caregiving-in-hindsight-147804.htm

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Brain Food: Fending Off Mental Illness With Diet

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Written by Bret S. Stetka, MD, Editorial Director, Medscape From WebMD

Which Foods Are Best for the Brain?

Brain Food: Fending Off Mental and Neurologic Illness With DietDiet is inextricably linked to conditions such as heart disease, obesity, and diabetes. However, what we consume also seems to have significant implications for the brain: Unhealthy diets may increase risk for psychiatric and neurologic conditions, such as depression and dementia, whereas healthy diets may be protective. Based primarily on recent Medscape News coverage, the following collects some of the more prominent investigations on nutrition and the brain into a single resource to aid in counseling your patients.

Make for Malta in Depression, Stroke, and Dementia

A 2009 study published in Archives of General Psychiatry found that people who follow Mediterranean dietary patterns — that is, a diet high in fruits, vegetables, nuts, whole grains, fish, and unsaturated fat (common in olive and other plant oils) — are up to 30% less likely to develop depression than those who typically consume meatier, dairy-heavy fare. The olive oil-inclined also show a lower risk for ischemic stroke and are less likely to develop mild cognitive impairment and Alzheimer disease, particularly when they engage in higher levels of physical activity.

Fat: The Good and the Bad

A study conducted in Spain reported that consumption of both polyunsaturated fatty acids (found in nuts, seeds, fish, and leafy green vegetables) and monounsaturated fatty acids (found in olive oil, avocados, and nuts) decreases the risk for depression over time. However, there were clear dose-response relationships between dietary intake of trans fats and depression risk, whereas other data support an association between trans fats and ischemic stroke risk. Trans fats are found extensively in processed foods, including many commercial chocolates. A deficiency in polyunsaturated fatty acids has been linked to attention deficit/hyperactivity disorder in children.

Fish Oil to Fend Off Psychosis?

Thanks to their high levels of polyunsaturated fatty acids, namely omega-3 fatty acids, fish can help fend off numerous diseases of the brain. A 2010 study correlated fish consumption with a lower risk for psychotic symptoms, and concurrent work suggested that fish oil may help prevent psychosis in high-risk individuals. Although data are conflicting, new research shows that the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid are beneficial in depression and postpartum depression, respectively, and other research suggests that omega-3 deficiency may be a risk factor for suicide. Oily, cold-water fish, such as salmon, herring, and mackerel, have the highest omega-3 levels.

Berries for Oxidative Stress

Polyphenols, namely anthocyanins, found in berries and other darkly pigmented fruits and vegetables may slow cognitive decline through antioxidant and anti-inflammatory properties. A study in rats from 2010 showed that a diet high in strawberry, blueberry, or blackberry extract leads to a “reversal of age-related deficits in nerve function and behavior involving learning and memory.” In vitro work by the same group found that strawberry, blueberry, and acai berry extracts — albeit in very high concentrations — can induce autophagy, a means by which cells clear debris, such as proteins linked to mental decline and memory loss. Berry anthocyanins may also reduce cardiovascular disease risk by reducing oxidative stress and attenuating inflammatory gene expression.

A “Whole” Diet: Make Room for Red Meat?

A so-called “whole” diet high in fruits, vegetables, whole grains, and high-quality meats and fish results in a 30% risk reduction for depression and anxiety disorders, compared with consumption of a “Western diet” high in processed foods and saturated fats, according to a 2010 study. Even unprocessed red meat seems to be protective against depressive and anxiety disorders, in contrast to many studies in which red meat often falls into the category of “unhealthy” food. In speaking with Medscape News, principal investigator Dr. Felice Jacka specifically addressed the importance of farming practices: Despite the growing locavore movement, much of the livestock in the United States is still raised on industrial feedlots, which “…increases saturated fat and decreases very important good fatty acids…pasture-raised animals have a much healthier fatty acid profile.” A “whole” dietary pattern may also reduce depression risk, as assessed at 5-year follow-up.

Alcohol: Always in Moderation

The Greeks touted “nothing in excess,” a refrain that still rings true: Low to moderate* alcohol consumption has been associated with numerous potential physiologic benefits, including improved cholesterol profiles, beneficial effects on platelet and clotting function, and improved insulin sensitivity. According to a recent meta-analysis, limited alcohol use is associated with a lower risk for overall and Alzheimer dementia, a finding supported by a 2011 study of German primary care patients. Moderate alcohol intake may also protect against cerebrovascular disease, with wine potentially having added benefit because of its polyphenolic antioxidant components (ie, resveratrol). However, the health costs of alcohol consumption beyond low to moderate intake can quickly outweigh benefits to the brain, as heavy and long-term alcohol use can lead to alcohol abuse and dependence, impair memory function, contribute to neurodegenerative disease, and hinder psychosocial functioning.

*The US Food and Drug Administration defines “moderate alcohol consumption” as up to 1 drink per day for women and up to 2 drinks per day for men. One drink is equivalent to 12 fluid ounces of regular beer, 5 fluid ounces of 12% alcohol wine, or 1.5 fluid ounces of distilled spirits.

Brewed Awakening: Coffee for Depression and Stroke

The world’s most widely used stimulant might do more than just wake us up: A 2011 meta-analysis found that consumption of 1-6 cups of coffee a day cut stroke risk by 17%. Although it may increase blood pressure, coffee beans contain antioxidant compounds that may reduce oxidation of low-density lipoprotein cholesterol, and coffee consumption has also been associated with increased insulin sensitivity and reduced concentrations of inflammatory markers. Another 2011 study reported that women who drink 2-3 cups of coffee per day have a 15% decreased risk for depression, compared with those who drink less than 1 cup per week. A 20% decreased risk was seen in those who drank 4 cups or more. The short-term effect of coffee on mood may be due to altered serotonin and dopamine activity, whereas the mechanisms behind its potential long-term effects on mood may relate to its antioxidant and anti-inflammatory properties, both factors that are thought to play a role in depressive illnesses.

Chocolate — and Still More Antioxidants

Chocolate — the darker the better — seems to help scavenge free radicals and improve endothelial and platelet function, likely via flavanols (such as catechin), a group of plant-derived polyphenols. A 2010 cohort study published in European Heart Journal found that consumption of 6 g of chocolate daily — a standard Hershey bar weighs 43 g — was associated with a 39% lower combined risk for myocardial infarction and stroke in adults,[34] whereas data collected from the Swedish Mammography Cohort demonstrated a 20% decreased risk for stroke in women who regularly consume chocolate. Although chocolate has been associated with a positive influence on mood, possibly mediated by the dopamine and opioid systems, an extensive review by Parker and colleagues suggests that the benefits are not sustained, with emotional “comfort” eating actually contributing to depressed mood.

What Not to Eat?

Saturated fats and refined carbohydrates have highly detrimental effects on the immune system, oxidative stress, and neurotrophins, all factors that are known to play a role in depression. The study by Akbaraly and colleagues cited previously showed that a diet rich in high-fat dairy foods and fried, refined, and sugary foods significantly increases risk for depression. Similar findings were seen in another study from Spain, showing that intake of such foods as pizza and hamburgers increased the risk for depression over time, and in another study, women with a diet higher in processed foods were more likely to have clinical major depression or dysthymia. Research published last year also showed for the first time that quality of adolescents’ diets was linked to mental health: Healthier diets were associated with reduced mental health symptoms and unhealthy diets with increased mental health symptoms over time. Excess salt intake has been long known to increase blood pressure and stroke risk; however, recent data also correlate high salt intake, as well as diets high in trans or saturated fats, with impaired cognition.

Source: http://www.medscape.com/features/slideshow/brain-food?src=mp&spon=17

Latest Alzheimer’s Research Progress Report Released

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2010 Alzheimer’s Disease Progress Report: A Deeper Understanding2010 Alzheimer’s Disease Progress Report: A Deeper Understanding, the latest annual Alzheimer’s research report from the National Institutes of Health (NIH), is now available online. Prepared by the National Institute on Aging, which leads the NIH effort conducting and supporting research on age-related cognitive decline and Alzheimer’s disease, the report highlights important developments and directions in NIH-funded research, including:

  • risk for developing Alzheimer’s
  • genes that play a role in the disease
  • neuroimaging and biomarkers that detect and track the disease
  • research into new treatments
  • lifestyle factors that may worsen or protect against the disease
  • help for caregivers

Special features include animation showing the progression of Alzheimer’s in the brain and video interviews highlighting new insights into the disease.

Read online or download @ http://www.nia.nih.gov/alzheimers/publication/2010-alzheimers-disease-progress-report-deeper-understanding.

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Warning Sign? Disrupted Sleep Tied to Alzheimer’s

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By Stephanie Pappas, LiveScience Senior Writer

Warning Sign? Disrupted Sleep Tied to Alzheimer's

People who awaken more during the night are more likely than sound sleepers to have pre-clinical signs of Alzheimer's Disease.

Trouble sleeping in middle age could herald Alzheimer’s disease later in life, according to new research linking dementia and slumber.

The findings can’t yet prove whether disturbed sleep helps contribute to the brain changes that cause Alzheimer’s or whether some other factor links the two; but preliminary results suggest that treating sleep problems might be beneficial for the brain in the long run.

“If sleep is found to affect either the beginning or the progression of Alzheimer’s disease, especially in its early stages, then it’s really an attractive thing to try to manipulate, because getting more sleep or better sleep has really no risk,” said study researcher Yo-el Ju, an assistant professor of neurology at the Washington University School of Medicine in St. Louis.

Plaque in the brain

In 2009, Ju’s Washington University colleague David Holtzman published research in the journal Science reporting that depriving mice of sleep causes a 25 percent increase in the levels of a protein fragment called amyloid beta in the brain. Amyloid beta is the primary ingredient in the amyloid plaques that clog the brains of people with Alzheimer’s.

These mice were genetically engineered to accumulate amyloid beta, and mouse-brain chemistry may not always match that of humans. So Ju and her colleagues, including Holtzman, turned to a group of people enrolled in the Adult Children Study, so named because half of the volunteers in the study are children of parents with Alzheimer’s.

They recruited 100 volunteers ages 45 to 80, all of whom had been clinically tested and showed no signs of memory loss or cognitive decline. The volunteers wore a wristwatch-like device called an actigraph for two weeks. The device measures activity levels, which can then be translated into time asleep and time awake. [Top 10 Spooky Sleep Disorders]

“Other studies that have looked at the relationship between sleep and dementia have generally studied older individuals who are obviously at higher risk of dementia, so I think this study is important because we’re looking at a population that is much younger,” Ju said.

Sleep and dementia

The results revealed that people who spent more of their time in bed tossing and turning rather than sleeping were more likely to show abnormal levels of chemicals that indicate amyloid beta. These chemical markers show up 10 or 15 years before any sign of memory loss or decline, but almost everyone who has them will eventually develop Alzheimer’s if they don’t die of something else first. About 25 percent of the people in the study fell into this “preclinical Alzheimer’s” category.

People who woke up more than average — or more than five times every hour — were also more likely to show signs of amyloid beta accumulation. Participants didn’t necessarily remember these waking periods the next morning, Ju said.

Ju and her colleagues will present their results at the American Academy of Neurology’s 64th annual meeting in New Orleans, which begins April 21. The study has not yet been published in a peer-reviewed journal. In the meantime, they’re continuing the sleep studies on more volunteers. In the long term, Ju said, the researchers hope to find out what causes the troubled sleep in people with preclinical Alzheimer’s.

“These are pretty preliminary results, and although they are intriguing and promising, we really need to do longer-term studies to find out which direction this is going,” Ju said.

Source: http://www.livescience.com/18474-disrupted-sleep-alzheimers.html?utm_source=Newsletter&utm_medium=Email&utm_campaign=LS_02142012

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Overeating May Double Risk of Memory Loss

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By Steven Reinberg – HealthDay Reporter

Too many calories could lead to early signs of Alzheimer’s, preliminary research suggests.

Overeating May Double Risk of Memory LossOlder people who eat too much are at risk for memory impairment, a new study contends.

People 70 and older who eat between 2,100 and 6,000 calories a day may be at double the risk of these deficits in memory, which can be an early sign of Alzheimer’s disease, the study authors said.

“Excessive daily caloric consumption may not be brain-health friendly,” said lead researcher Dr. Yonas Geda, an associate professor of neurology and psychiatry at the Mayo Clinic in Scottsdale, Ariz.

“It may sound like a cliche, but we need to be mindful of our daily caloric consumption,” he said. “The bottom line is that eating in moderation, not in excess amount, may be good for your brain.”

The results of the study are due to be presented in April at the annual meeting of the American Academy of Neurology, in New Orleans. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

For the study, investigators collected data on more than 1,200 people, aged 70 to 89, living in Olmsted County, Minn. Among these people, 163 had been diagnosed with the memory deficits known as “mild cognitive impairment.”

Each person told the researchers how much they ate. One-third ate between 600 and 1,525 calories a day, one-third between 1,526 and 2,142 calories a day, and one-third ate between 2,143 and 6,000 calories a day.

Among those who ate the most, the odds of being diagnosed with the impaired-memory disorder was more than twice that of those who ate the least, the researchers found.

There was no significant increase in risk for memory problems among those in the middle group, the researchers added.

These findings remained the same after taking into account a history of stroke, diabetes, education and other risk factors for memory loss.

“We also looked at BMI and obesity,” Geda said. BMI, or body mass index, is a measurement based on height and weight. “But there was no significant difference between the normal [participants] and mild cognitive impairment when it comes to these two variables,” he said.

Why overeating affects the brain isn’t clear, but “excessive caloric intake may lead to oxidative damage leading to structural changes in the brain,” Geda suggested.

Commenting on the study, Dr. Neelum Aggarwal, an associate professor of neurological sciences at Rush University in Chicago, said that “as the population of the U.S. is aging at a rapid rate, in addition to becoming increasingly obese, physicians are being asked by their elderly patients about their risk for various diseases, specifically cognitive [mental] decline and dementia.”

These findings allow doctors to start the discussion about the links between common healthy living practices — eating a nutritious diet, limiting sugar — to overall brain function, he said.

“This study furthers the discussion of what the possible mechanisms are for the development of cognitive decline and offers strategies for disease prevention through nutrition and caloric restriction,” Aggarwal said.

Another expert, David Loewenstein, a professor of psychiatry and behavioral sciences at the University of Miami Miller School of Medicine, said that “this makes a lot of sense because increased caloric intake is associated with obesity and metabolic syndrome, so it is not at all surprising that increased calories are associated with increased cognitive impairment.” Metabolic syndrome is a group of risk factors linked to heart disease and other health problems.

“This study suggests that anything that’s good for the heart — like decreased calories — is good for the brain,” Loewenstein added.

While the study found an association between overeating and memory impairment, it did not prove a cause-and-effect relationship.

Source: http://consumer.healthday.com/Article.asp?AID=661692

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