Iron-rich foods helps cure dementia

Eating a diet low in iron could raise a person’s risk of dementia, according to new research from the University of California, San Francisco and the American Academy of Neurology. The study found that people with low levels of iron in their blood or anemia had a 41 percent higher chance of the cognitive decline. Eating iron-rich foods, such as red meat, chicken, turkey, pork, fish, shellfish, spinach, lentils, tofu and raisins, can help prevent anemia.

The study analyzed 2,552 adults between the ages of 70 and 79 by giving them memory and thinking tests over an 11-year period. All patients were free of dementia at the start of the study, while 393 had been diagnosed with anemia (445 developed it by the end of the study). The results showed that the patients with anemia were considerably more likely to develop dementia compared with those who were not anemic. The results reflected this higher risk of dementia even after researchers controlled for other factors, including age, sex, race and education.

Anemia is not an uncommon condition--more than 3 million Americans have been diagnosed with it. The most common form – iron deficiency anemia – occurs when the body does not get enough iron for healthy hemoglobin production.

source: healthcentral

Dementia more costly than cancer or heart disease treatment

The latest buzz on the medical scene is that dementia treatment is more costly than cancer and heart disease. According to globalpost published today, “Cancer and heart disease are bigger killers, but Alzheimer's is the most expensive malady in the U.S., costing families and society $157 billion to $215 billion a year, according to a new study that looked at this in unprecedented detail. The biggest cost of Alzheimer's and other types of dementia isn't drugs or other medical treatments, but the care that's needed just to get mentally impaired people through daily life, the nonprofit RAND Corp.'s study found.”

Globalpost goes on to say, “Alzheimer's is the most common form of dementia and the sixth leading cause of death in the United States. Dementia also can result from a stroke or other diseases. It is rapidly growing in prevalence as the population ages. Current treatments only temporarily ease symptoms and don't slow the disease. Patients live four to eight years on average after an Alzheimer's diagnosis, but some live 20 years. By age 80, about 75 percent of people with Alzheimer's will be in a nursing home compared with only 4 percent of the general population, the Alzheimer's group says.”

According to Alzheimer’s Society, “Dementia is an umbrella term. It describes the symptoms that occur when the brain is affected by certain diseases or conditions. There are many different types of dementia although some are far more common than others. They are often named according to the condition that has caused the dementia.

Alzheimer’s disease is caused by chemical and structural changes in the brain.

Vascular dementia occurs when not enough oxygen is getting to the brain; brain cells die and a series of strokes may occur.

Dementia with Lewy bodies is caused by, “tiny spherical structures that develop inside nerve cells. Their presence in the brain leads to the degeneration of brain tissue.”

Fronto-temporal dementia is caused by damage to the front part of the brain and rather than affecting memory it affects personality and behavior.

Korsakoff syndrome “is a brain disorder that is usually associated with heavy drinking over a long period. Although it is not strictly speaking a dementia, people with the condition experience loss of short term memory.”

Creutzfeldt Jacob disease occurs when infectious agents evade the nervous system and then travel up to the brain.

The Alzheimer’s Society goes on to say that, “There are many other rarer causes of dementia, including progressive supranuclear palsy and Binswanger's disease. People with multiple sclerosis, motor neurone disease, Parkinson's disease, and Huntington's disease can also be at an increased risk of developing dementia.”

source: examiner

Blush These "Dementia Markers" Out of Your Blood Stream

Daily supplementation using a natural pigment called astaxanthin -- the same coloring that gives flamingos their pink appearance -- can reduce the accumulation of phospholipid hydroperoxides.

These compounds accumulate in the red blood cells of people who suffer from dementia, and scientists now believe that astaxanthin could help prevent dementia, including Alzheimer's.

About 5.4 million Americans suffer from Alzheimer's disease, and that number is only expected to go up in coming years.

According to a study in the British Journal of Nutrition:

"After 12 weeks of treatment, erythrocyte astaxanthin concentrations were higher in both the 6 and 12 mg astaxanthin groups than in the placebo group. In contrast, erythrocyte [phospholipid hydroperoxide] concentrations were lower in the astaxanthin groups than in the placebo group ...

These results suggest that astaxanthin supplementation results in improved erythrocyte antioxidant status and decreased [phospholipid hydroperoxide] levels, which may contribute to the prevention of dementia."

Sources: British Journal of Nutrition January 31, 2011

Conditions That Can Masquerade as "Dementia Getting Worse"

It's easy, but a mistake, to believe that every new physical, cognitive, or behavioral change is caused by worsening dementia. After all, Alzheimer's is a progressive disease. These changes can have many causes. Consider these three:

1. Medication side effects Be especially watchful of new symptoms whenever your loved one is prescribed a new medication or a change in dosage. What looks like a dementia decline may be a reversible effect of the new drug or changed dosage.

Bring all medications (or copies of prescriptions or labels) to appointments with every doctor or specialist you see, including notations of when they were started and why. Include drugs that were started and then stopped (again, with a note about why).

2. Delirium When mental confusion and memory loss suddenly turns worse than usual, the cause may be an underlying infection or dehydration. This unusual state of mental confusion is called delirium. People with dementia are especially vulnerable. Once the problem is identified and resolved, the symptoms usually disappear.

3. Depression People with dementia are at higher risk for depression. What looks like apathy, a dip in memory, or changes to sleep or eating patterns may not necessarily be related to dementia but to a state of depression.

Always report these symptoms to your loved one's doctor and raise the possibility of depression. Treatment (talk therapy and medication) can be effective and lift the worrisome symptoms.

SOURCE: caring

Hearing problems 'may signal dementia'

“Hearing loss could be an ‘early warning’ for dementia,” reported The Daily Telegraph. It said that this finding from a new study “could lead to early interventions against Alzheimer’s disease”.

This news report is of a study that followed 639 adults, aged 39-90 years old, for an average of 12 years to see if those with hearing loss were more likely to develop dementia. About 9% of the participants developed dementia during this time, and those with hearing loss at the start of the study were at greater risk of developing the condition.

The study has strengths in that it tested hearing and ruled out dementia for some participants at its start. It also has some limitations, however, including its relatively small size, and larger studies are needed.

The study has shown an association between hearing loss in older adults and later dementia. However, it is not possible to say, based on this study alone, why an association might exist. It is unclear whether hearing loss contributes to the risk of dementia, is a sign of early dementia, or whether dementia and age-related hearing loss involve similar processes. If the last two scenarios are correct, interventions to improve hearing are unlikely to reduce the risk of dementia.

Where did the story come from?

The study was carried out by researchers from the Johns Hopkins School of Medicine and other research institutions in the US. Funding was provided by the National Institute on Aging and the National Institute on Deafness and Other Communication Disorders. The study was published in the peer-reviewed medical journal Archives of Neurology.

The Daily Telegraph gave a balanced coverage of this study.

What kind of research was this?

This prospective cohort study investigated whether there is a relationship between hearing loss and the risk of developing dementia.

This type of study is ideal for investigating whether an exposure might cause an outcome, or whether a particular phenomenon (in this case, hearing loss) might be an early predictor of increased risk of an outcome (in this case, dementia). One of the study’s strengths is that the participants were given hearing tests and assessments to rule out dementia at the start of the study. This means we can be reasonably sure that the measurements of hearing are accurate and that any hearing loss preceded the onset of detectable dementia.

What did the research involve?

The participants in this study were taking part in an ongoing study called the Baltimore Longitudinal Study of Aging. For the current study, the researchers analysed people who did not have dementia, and measured their hearing ability at the start of the study. They followed these people over time to identify anyone who developed dementia. They then compared the risk of developing dementia in people with and without hearing loss at the beginning of the study to see if there were any differences.

The study included 639 adults, aged 36-90 years old (average about 64 years), who were given a thorough assessment and were found to be free of dementia between 1990 and 1994. A standard hearing test identified those with normal hearing (<25>70 dB, 6 people).

The participants also provided information about their lifestyles and were tested for diabetes and high blood pressure. They were followed up until 2008, an average (median) of about 11.9 years. Depending on their age, participants were given thorough cognitive assessments at intervals from every year to every four years, and standard criteria were used to diagnose dementia.

In their analyses, the researchers took into account factors that could influence the results, such as age, gender, race, education, smoking and having diabetes or high blood pressure.

What were the basic results?

At the start of the study, participants with greater hearing loss were more likely to be older, male and have high blood pressure. During follow-up, 58 people (9.1%) developed dementia of any type. Of these, 37 cases were Alzheimer’s disease.

The greater a person’s hearing loss at the beginning of the study, the more likely they were to develop dementia during follow-up:

* In the normal hearing group, 20 out of 455 people developed dementia (4.4%).
* In the mild hearing loss group, 21 out of 125 people developed dementia (16.8%).
* In the moderate hearing loss group, 15 out of 53 people developed dementia (28.3%).
* In the severe hearing loss group, 2 out of 6 people developed dementia (33.3%).

After differences between the groups, such as age, were taken into account, for every 10 decibels of hearing loss, there was a 27% increase in the risk of developing dementia over the follow-up period (hazard ratio 1.27, 95% confidence interval 1.06 to 1.50).

How did the researchers interpret the results?

The researchers concluded that hearing loss is independently associated with dementia. They say that further study is needed to determine whether hearing loss is a marker for early-stage dementia, or whether hearing loss directly affects the risk of dementia.
Conclusion

This study suggests that there is a link between hearing loss and the risk of developing dementia. Strengths of this study include its prospective assessment of hearing, inclusion of people without evidence of dementia at the start of the study, and regular, thorough assessment of cognitive function. There are some points to note:

* The study was relatively small, and the numbers of people in some subgroups, such as those with severe hearing loss (six people), were very small. Therefore, the results for these subgroups may not be representative of all people with this level of hearing loss and may not be very reliable.

* The development of dementia is a slow process, and people in the very early stages of the disease may not show any detectable signs. Therefore, some people included in the study may have already been in the very early stages of the disease. The authors tried to test whether this was the case by carrying out analyses that excluded people who developed detectable dementia shortly after the start of the study (up to six years). These analyses still showed the link between hearing loss and dementia.

* The study took into account some factors that could affect the risk of dementia, such as age, education, smoking and certain medical conditions. However, there may be other factors, such as genetic factors, that affect the risk of dementia but which were not taken into account. These could have affected the results.

* The authors note that the participants had all volunteered to take part and were generally from high socioeconomic backgrounds. Therefore, they were not representative of the community as a whole.

* Though the cause of hearing loss among the participants was not specified, it seems likely that many cases would be due to the common condition of age-related hearing loss (presbycusis). This occurs when the hair cells in the ear gradually deteriorate, and is more common with increasing age. It is not possible to say from this study whether hearing loss might directly contribute to the risk of dementia, or whether it indicates increased risk of the disease. As both presbycusis and dementia are related to increasing age, it is possible that similar physiological processes of cellular ageing are common to both conditions.

Further investigation of this association is needed. However, if hearing loss is only a marker for dementia, or if common disease-related processes underlie both conditions, interventions to improve hearing are unlikely to reduce the risk of dementia. Ideally, these findings need confirmation in larger studies in more representative groups in the community, as the authors themselves acknowledge.

source: nursingtimes.net

New Brain Health Test to Detect Early Signs of Dementia

Early diagnosis of the risk of dementia could become easy, as the Australian scientists have claimed developing a brain health test that could accurately examine the early symptoms of cognitive impairment.

A computer-based test has been developed by the scientists at the Australian National University (ANU), which would prove beneficial in determining the risk of getting affected with dementia later in life during middle age only.

The test identifies lesions in the brains that are associated with dementia. Also, it evaluates the time taken by a person to react when taking notice of irregular answering patterns.

The research involved around 430 men and women from the Canberra area with ages 44 to 48. The lesions were found in less than 10% of the people.

As stated by Professor David Bunce from the ANU's Centre for Mental Health Research, though it was not certain that the middle aged people detected with lesions would suffer from dementia, but there were some reasons for which the research was important for.

The study was beneficial in finding out the presence of lesions in the brains of some adults who were in their 40s that devastates in dementia.

"Although the presence of the lesions was confirmed through MRI scans, we were able to predict those persons who had them through very simple-to-administer tests", said Mr. Bunce.

source: BW

Chain Smoking Doubles Alzheimer's Disease, Dementia Risk

Heavy smoking in midlife is associated with a 157 percent increased risk of developing Alzheimer's disease and a 172 percent increased risk of developing vascular dementia, according to a Kaiser Permanente study published in the Archives of Internal Medicine.

This is the first study to look at the long-term consequences of heavy smoking on dementia.

Researchers followed an ethnically diverse population of 21,123 men and women from midlife onward for an average of 23 years. Compared with non-smokers, those who had smoked more than two packs of cigarettes a day had more than a 157 percent increased in risk of Alzheimer's disease and 172 percent increased risk of vascular dementia during the mean follow-up period of 23 years.

Vascular dementia, the second most common form of dementia after Alzheimer's disease, is a group of dementia syndromes caused by conditions affecting the blood supply to the brain.

"This study shows that the brain is not immune to the long-term consequences of heavy smoking," said the study's principal investigator, Rachel A. Whitmer, Ph.D., a research scientist with the Kaiser Permanente Division of Research in Oakland, Calif. "We know smoking compromises the vascular system by affecting blood pressure and elevates blood clotting factors, and we know vascular health plays a role in risk of Alzheimer's disease."

Researchers analyzed prospective data from of 21,123 Kaiser Permanente Northern California members who participated in a survey between 1978 and 1985. Diagnoses of dementia, Alzheimer's disease and vascular dementia made in internal medicine, neurology, and neuropsychology were collected from 1994 to 2008. The researchers adjusted for age, sex, education, race, marital status, hypertension, hyperlipidemia, body mass index, diabetes, heart disease, stroke, and alcohol use.

"While we don't know for sure, we think the mechanisms between smoking and Alzheimer's and vascular dementia are complex, including possible deleterious effects to brain blood vessels as well as brain cells," said study co-author Minna Rusanen, MD, of the University of Eastern Finland and Kuopio University Hospital in Finland.

This study is the latest in a series of published Kaiser Permanente research to better understand the modifiable risk factors for dementia. This ongoing body of research adds to evidence base that what is good for the heart is good for the brain, and that midlife is not too soon to begin preventing dementia with good health.

The other studies led by Whitmer found that a large abdomen in midlife increases risk of late-life dementia, elevated cholesterol levels in midlife increase risk of Alzheimer's disease and vascular dementia, and low blood-sugar events in elderly patients with type 2 diabetes increase dementia risk. Another Kaiser Permanente study led by Valerie Crooks of Kaiser Permanente in Southern California found that having a strong social network of friends and family appears to decrease risk for dementia.

source: prnewswire

New technique for Dementia, Huntington's disease diagnosis

A new technique for the development of Huntington's disease and dementia has been established by American scientists.

A team of scientists from America has developed a new method of testing for neurodegenerative brain disorders.

According to an article in the journal Comparative Neurology, this could allow doctors to diagnose conditions such as dementia, Huntington's disease and Parkinson's disease much sooner.

Magnetic Resonance Spectroscopy (MRS) involves applying a magnetic field to a tissue, then disturbing it with a radio frequency. Different atoms react in different ways, which allows doctors to build a picture of tissue structure.

Mice with a Huntington's disease mutation were identified 100 per cent of the time using the system.

"This technology … could potentially provide diagnostic information to distinguish different causes of dementia and other forms of neurological illness, rapidly and non-invasively," said Dr Jason Nikas from the University of Minnesota.

The advantage of early dementia diagnosis was highlighted by a recent study from the British Medical Group, which showed that people who were diagnosed early have a much better survival rate than those who discovered their condition later on.

source: barchester

Don’t Let Alzheimer’s and Dementia Spoil Your Retirement

Dementia and Alzheimer’s disease are giant monkey wrenches that can disrupt the plans you have for enjoying your retirement years, as well as drain your retirement savings. Here’s a little something to get your attention:

Results from an informative report prepared by the Alzheimer’s Association titled 2010 Alzheimer’s Disease Facts and Figures show that:

* An estimated 5.3 million Americans currently have Alzheimer’s disease; this figure is projected to increase to 7.7 million by 2030.

* Alzheimer’s is the fifth-leading cause of death for people aged 65 and older.

* Annual medical expenditures for Alzheimer’s are now at $172 billion; the total exceeds $200 billion when you consider lost wages and lost productivity of unpaid caregivers.

* 10.9 millions Americans are currently providing unpaid care for relatives and friends with dementia or Alzheimer’s, a contribution to the nation valued by the report to be about $144 billion. And this figure doesn’t include the physical and emotional strain on caregivers.

I’m haunted by the prospect of millions of boomers contracting Alzheimer’s disease and dementia in our later years, swamping the health care system, straining our families, and bankrupting our retirement.

While Alzheimer’s and dementia affect both sexes, they are important issues for women on both sides of the spectrum. That’s because women are often caregivers for friends and family members, and are also more likely to end up contracting these diseases. The report from the Alzheimer’s Association reported that 16 percent of women aged 71 and older had Alzheimer’s, while only 11 percent of men had this condition. But that’s because there are more women than men at advanced ages; men and women of the same age have roughly equal chances of contacting Alzheimer’s or dementia.

Before we go any further, let’s make an important distinction about terms. “Dementia” is defined as a dysfunctional loss or decline of memory and other cognitive functions, and it can have a number of causes. While there are various forms of dementia, “Alzheimer’s disease” is the most prevalent. All types of dementia can result in needing some form of long-term care, with the potential of requiring an extensive stay in an expensive nursing home or assisted living facility.

At this time, there’s no cure or effective treatment for Alzheimer’s and other forms of dementia, but many scientists and researchers are currently working on the problem. But while there’s no cure, extensive research has shown that there are lifestyle steps you can take to significantly reduce the odds of contracting dementia.

According to the above report from the Alzheimer’s Association, these steps include:

* Managing the health of your brain — one of the body’s most vascular organs — by mitigating risk factors such as high cholesterol, high blood pressure, Type 2 diabetes, smoking, obesity, and physical inactivity.

* Eating a low-fat diet rich in fresh fruits and vegetables.

* Maintaining a robust social network and a lifetime of curiosity and intellectual stimulation.

What’s great about the above lifestyle factors is that they also reduce the odds of contracting most of the expensive, debilitating chronic conditions of our later years, including heart disease and diabetes — not just dementia.

But here’s my favorite suggested lifestyle step: The New England Journal of Medicine recently published a study that concluded that older people who participate in frequent leisure activities with high cognitive activity, such as reading, playing board games, playing musical instruments, and dancing, have a much lower frequency — up to 63 percent lower — of contracting Alzheimer’s and other forms of dementia.

My father had some form of dementia in his later years, so I witnessed first-hand the personal loss and the costs associated with this condition. As a result, I vowed that I’ll do everything within my power to reduce the odds of this happening to me.

While there are no guarantees in life, it’s a no-brainer for me to eat the right kinds and amounts of food, walk frequently, and get other forms of exercise, and dance as much as possible with my wife (see photo above)!

Warning: Dancing with your spouse has the potential for substantial side effects — it may enhance your marital relationship!

Diabetes and literacy key to beat dementia

Preventing diabetes and depression could have a dramatic impact on cutting cases of dementia, a study suggests.

Boosting levels of education and upping fruit and vegetable consumption would also have a big effect, the British Medical Journal said.

It comes as another study showed dementia patients are missing out on vital early treatments because GPs are being slow to diagnose them.

It is estimated that one million people in the UK will have dementia by 2025.

Several risk factors for the disease have been identified, including obesity, high blood pressure and high cholesterol.

But British and French researchers wanted to assess what public health interventions could have the biggest impact on reducing the burden of dementia in the population.

They took a group of 1,400 elderly people and tested them for signs of dementia after two, four and seven years.

Alongside this they recorded height, weight, education level, monthly income, mobility, dietary habits, alcohol consumption, and tobacco use and asked participants to do a reading test as a measure of intelligence.

Eliminating depression and diabetes and increasing fruit and vegetable consumption were estimated to lead to an overall 21% reduction in new cases of dementia

Increasing education would also lead to an estimated 18% reduction in new cases of dementia across the general population over the next seven years, they reported.

By contrast, removing a gene linked with the disease would only cut new cases by 7%.

Literacy

The team concluded that early screening for diabetes and treatment of depression would be the most useful approach for trying to reduce the future burden of dementia.

And they added that encouraging literacy at all ages and trying to increase population intake of fruit and vegetables would also have an important effect but admitted that these aims were harder to achieve.

Further studies including younger adults are needed to test the impact of such approaches, they added.

In the second study also in the BMJ, analysis of health records of over 135,000 people in the UK found that people with dementia were three times more likely to die in the first year after diagnosis than those without the condition.

That suggests that diagnoses are being made in the later stages of the disease.

Study leader Dr Greta Rait from the Medical Research Council said: "GPs are going to be dealing with more and more dementia cases in future and primary care must get better at detection."

Rebecca Wood, chief executive of the Alzheimer's Research Trust, said the links between depression, diabetes and dementia were well known.

"Any policy that urges clear diagnosis and monitoring of these conditions could help make an impact on dementia.

"What is painfully evident from the study is the gaping hole that remains in our understanding and ability to diagnose or treat dementia effectively, a hole that can only be filled by more research."

Professor Clive Ballard, director of research at the Alzheimer's Society said a healthy lifestyle is key.

"Effective prevention of diabetes, depression and heart disease could potentially improve the lives of millions of people affected by this cruel condition and reduce the billions spent on dementia care each year."

Dr Victoria King, head of research at Diabetes UK, said there is a growing body of evidence suggesting links between diabetes and Alzheimer's disease.

"Finding ways to stop the type 2 diabetes epidemic in its tracks can only be seen as a good thing - especially as this could prevent millions of people developing the serious complications of the condition, which include heart disease, stroke, kidney failure, blindness and amputation."

source: pakwatan

Difference between Alzheimer's and Dementia

Dementia and Alzheimer's disease are two of the greatest fears many people have as they face old age - and the two terms are often used interchangeably, or confusingly. Technically, the difference between Alzheimer's and dementia is that dementia is a term for the deterioration or progressive impairment of mental capacity, and Alzheimer's disease is one of the most common causes of dementia. Dementia is also a symptom of a number of other conditions, many of them associated with aging.

Dementia refers to the abnormal deterioration in mental function, beyond what is normally expected from aging. The most well-known and recognizable consequence of dementia is serious and progressive memory loss, but the term refers to a more general loss of cognitive function, as well. Dementia is most common among the elderly. In addition to being a symptom of Alzheimer's disease, it can also result in aging patients as a result of vascular dementia, dementia with Lewy bodies, Parkinson's disease, and a number of other less common conditions.

Non-elderly adults, and particularly those below 40 or 50, are especially unlikely to develop dementia, especially as a result of the conditions described above, which are normally associated with aging. However, it can develop at a younger age as a result of a brain injury, or as a result of some much more rare conditions. These include Huntington's disease, a hereditary disorder. In addition, very severe and sudden dementia is also the stereotypical symptom of Creutzfeld-Jakob disease, the human variant of mad cow disease.

However, the most common cause of dementia, particularly in elderly populations, is Alzheimer's disease. Alzheimer's is a progressive dementia which usually first becomes noticeable through memory impairment, beginning with the deterioration of new and short-term memory and then extending to long-term memory and control over basic bodily functions. Despite many years of research, medical researchers still know frustratingly little about the causes or potential treatments of Alzheimer's. What they do know is that it is associated with the development of plaque formations and tangled neurons within the brain. Several medications are now used to restrict the disease's symptoms and potentially slow its progression, although there is not yet a way to stop the disease entirely or to truly reverse damage once it has been done.

There is a considerable amount of publicly available information regarding Alzheimer's disease and dementia. However, if you are particularly concerned that you or a loved one is showing early warning signs of dementia, or more specifically of Alzheimer's disease, you should discuss your concerns with your family doctor.

source: helium

Reduced Heart Function Can Lead to Brain Atrophy, Dementia

People with hearts that pumped blood inefficiently throughout the body were found to be a greater risk for loss of brain volume and possible eventual dementia, according to a new study conducted at the Boston University School of Medicine.
Good for the Heart, Good for the Brain

Angela L. Jefferson PhD and colleagues examined brain and heart MRI data on 1504 patients between the ages of 34 and 84 (average 61) without a history of neurologic disease enrolled in the Framingham Offspring Cohort study. Fifty-four percent were women. About 7% of the volunteers had known heart disease, but anyone with significant cardiovascular problems were excluded from the study. The participants were divided into three groups based on their cardiac index, or the pumping ability of the heart.

Cardiac index is a calculation that takes into account body surface area, stroke volume (the volume of blood pumped from one heart ventricle with each beat), heart rate and cardiac output (the volume of blood pumped by a ventricle in one minute). Some of these terms are taught in medical coding classes in universities. Reduced cardiac output can be influenced by heart disease, hypertension, and infection.

Participants whose hearts pumped the least amount of blood showed almost two years more brain aging than those with hearts that pumped more. Even those on the low end of normal had lower brain volumes than those in the upper third. Jefferson theorizes that the lower volume of pumping blood may reduce blood flow to the brain, providing less oxygen and nutrients.

A decrease in brain volume, called atrophy, is considered a sign of brain aging. More severe brain atrophy occurs in people with dementia, such as Alzheimer’s Disease.

The impact on the brain was stronger for study participants under the age of 60. The authors suggest that one reason for this finding may be that as people get older, they have more competing brain health factors.

Heart disease did not account for the all of the people with low cardiac index. As mentioned, 7% of the participants had heart disease, but Jefferson and colleagues found low heart pumping function in 30% of the volunteers.

“These participants are not sick people,” said Dr. Jefferson. “A very small number have heart disease. The observation that nearly a third of the entire sample has low cardiac index and that lower cardiac index is related to smaller brain volume is concerning and requires further study.”

"This is an interesting, strong association. Just as we measure someone's weight, blood pressure and cholesterol to assess their heart disease risk, we now have numbers for cardiac index and brain volume. But, we're still at the association stage, and can't tell if one factor is caused by the other," said Dr. Ralph Sacco, president of the American Heart Association and co-author of an accompanying editorial.

"Our results definitely suggest that cardiac health is related to brain health," Jefferson noted. Controlling heart disease risk factors by exercising regularly, eating right, maintaining a healthy weight, not smoking, and managing conditions such as high blood pressure and diabetes will lead to better cardiovascular and brain health.

Source references:
Jefferson AL, et al "Cardiac index is associated with brain aging: The Framingham Heart Study" Circulation 2010; DOI:10.1161/CIRCULATIONAHA.109.905091.

Wright CB, Sacco RL "Cardiac index as a correlate of brain volume: Separating the wheat of normal aging from the chaff of vascular cognitive disorders" Circulation 2010; DOI:10.1161/CIRCULATIONAHA.110.970301.

Dementia: Rare Brain Disorder Is Highly Hereditary

New research shows that a rare brain disorder that causes early dementia is highly hereditary. The study is published in the November 3, 2009, issue of Neurology®, the medical journal of the American Academy of Neurology.

The brain disorder, called frontotemporal dementia, is formerly known as Pick's disease and destroys parts of the brain, leading to dementia, including problems with language or changes in behavior and personality. The disease often affects people under the age of 65.

"Knowing your family's health history may be one way for people to better predict their risk of developing dementia," said study author Jonathan Rohrer, MRCP Clinical Research Fellow at the Dementia Research Center at the University College London in the United Kingdom.

For the study, blood was drawn from 225 people who were diagnosed with frontotemporal dementia. The people were asked about family history of dementia and given a score of one through four. A score of one represents a person who had at least three relatives with dementia and an autosomal dominant inheritance, meaning that an affected person has one mutant gene and one normal gene and has a 50-percent chance of passing the mutant gene and therefore the disorder on to their offspring. A score of four represents a person with no family history of dementia.

The study found that nearly 42 percent of participants scored between a one and a 3.5, meaning they had some family history of dementia. However, only 10 percent had an autosomal dominant gene history.

The people in the study also had their DNA tested for five gene mutations thought to cause frontotemporal dementia. Mutations were found in two of the five genes.

"Many people were still found to have a strong family history of dementia even without having any of the five known gene mutations, suggesting that there are still unknown genes that cause frontotemporal dementia," said Rohrer.

"Discovering new genes and gene mutations could provide another key to unlocking the doors to new treatments and prevention strategies for dementia."

The study also found that behavioral problems associated with frontotemporal dementia were the most likely to be hereditary, while language problems were the least likely to be hereditary.

The study is supported by the United Kingdom Department of Health's NIHR Biomedical Research Centers, the Medical Research Council UK and the Alzheimer's Research Trust in the United Kingdom.

SOURCE: sciencedaily

New Risk Factor for Second-Most-Common Form of Early-Onset Dementia

Examining brain tissue from over 500 individuals in 11 countries, researchers from the University of Pennsylvania School of Medicine and the Children’s Hospital of Philadelphia, and colleagues found a new risk factor for the second-most-common cause of early-onset dementia after Alzheimer’s disease.

“Using a genome-wide scan for genetic variation in post-mortem brain tissue, we were able to pinpoint variations common to patients with a specific subtype of frontotemporal lobar degeneration, FTLD,” says co-first author Vivianna Van Deerlin, MD, PhD, associate professor of Pathology and Laboratory Medicine at Penn. “This gives us more information on what proteins may underlie the molecular events leading to FTLD, and eventually, new drug targets.” The findings were published online this week in Nature Genetics.

“By identifying gene variants that may play a role in the development and progression of one type of FTLD, this research, if replicated, will take us one step closer to an understanding of the complex biologic pathways involved in this devastating disease,” said Marcelle Morrison-Bogorad, PhD, director of the National Institutes of Health Division of Neuroscience.

The findings build on a 2006 discovery by co-senior authors Virginia Lee, PhD, director of the Center for Neurodegenerative Disease Research, and John Q. Trojanowski, MD, PhD, director of the Institute of Aging at Penn. They led an international team that found that a protein called TDP-43 accumulates abnormally in brain tissue from individuals with one type of heritable FTLD. TDP-43 is a known protein widely expressed throughout the body, with multiple functions, including regulating transcription of the genetic code and as scaffolding for nuclear and motor neuron proteins.

FTLD cases that are characterized by TDP-43 inclusions can be passed from one generation to the next, as a result of mutations in another protein called progranulin (GRN). Using post-mortem brain tissue from 515 patients with TDP-associated FTLD, the team found that these patients had multiple genetic variations called SNPs in common in a region on chromosome 7 containing the protein TMEM106B, compared to over 2,500 disease-free controls.
From this, the team concluded that the TMEM106B gene variants confer a higher genetic risk for all FTLD-TDP patients, as well as in the subset of patients with GRN mutations. What’s more, alterations in levels of TMEM106B protein in the brain may be directly or indirectly involved in causing FTLD.

How TDP-43, GRN, and TMEM106B proteins might normally interact in brain cells and be disrupted in FTLD remains to be deciphered. Nevertheless, the discovery of TMEM106B is an important step toward a better understanding of FTLD. The team plans to sequence the TMEM106B segment of chromosome 7, and in parallel, study the normal functions of TMEM106B.

Patrick M.A. Sleiman, PhD in the Center for Applied Genomics at CHOP; Maria Martinez-Lage, MD, postdoctoral fellow in Pathology and Laboratory Medicine; and Alice Chen-Plotkin, MD, Instructor in the Department of Neurology, both at Penn, along with Van Deerlin, are co-first authors on the Nature Genetics article. Hakon Hakonarson, MD, PhD, director of the Center for Applied Genomics at CHOP is also a senior author on the paper. Other Penn co-authors are Li-San Wang, PhD; Gerard D. Schellenberg, PhD; Murray Grossman, MD, and Steven Arnold, MD.

This study was funded in part by the National Institute on Aging.

Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $3.6 billion enterprise.

Penn’s School of Medicine is currently ranked #3 in U.S. News & World Report’s survey of research-oriented medical schools, and is consistently among the nation’s top recipients of funding from the National Institutes of Health, with $367.2 million awarded in the 2008 fiscal year.

source: newswise

Hypertension Linked to Dementia in Older Women

Older women with hypertension are at increased risk for developing brain lesions that cause dementia later in life, according to data from the Women’s Health Initiative Memory Study (WHIMS). The findings were published in the December 2009 online issue of the Journal of Clinical Hypertension.

The research was conducted as part of the Women’s Health Initiative (WHI), the largest multi-site longitudinal study looking at health risks among postmenopausal women. WHIMS, which involves a subgroup of the women enrolled in WHI, looks at the influence of hormone therapy on thinking and memory. All the women in WHIMS were 65 or older.

Upon enrolling in the trial and annually during their participation in it, the women had their blood pressure measured and underwent tests to measure their cognitive ability. Some of the WHIMS participants – 1,403 of them – also underwent magnetic resonance imaging (MRI) at 14 U.S. academic centers in 2005 and 2006. All of these women were free of dementia when they enrolled. Examination of the data on these 1,403 women was led by Lewis H. Kuller, M.D., Dr.P.H., of the University of Pittsburgh, in conjunction with researchers at other WHI centers, including Dr. Sylvia Wassertheil-Smoller, Ph.D., professor of epidemiology and population health and the Dorothy and William Manealoff Foundation & Molly Rosen Chair in Social Medicine at Albert Einstein College of Medicine. Dr. Wassertheil-Smoller is also the principal investigator of Einstein’s WHI and WHIMS studies.

The MRI studies revealed that women who, on entry to the WHIMS trial, had elevated blood pressure (defined as systolic blood pressure ≥140 mmHg, or diastolic blood pressure ≥ 90 mmHg, or being on antihypertensive drug therapy), had significantly higher amounts of white matter lesions (WMLs) when they underwent MRIs eight years later. Normal blood pressure is defined as a systolic blood pressure of 120 or less and a diastolic pressure of 80 or less.

“Based on our findings, we would encourage women to maintain their blood pressure at normal levels, which may reduce their risk of dementia,” says study co-author Dr. Wassertheil-Smoller.

The small blood vessels in the brain are especially susceptible to damage from even moderately elevated blood pressure – resulting in damage to the white matter served by those vessels. The brain’s white matter is composed of whitish myelin-coated axons (nerve cell appendages) that allow nerve cells to communicate with each other and help the regions of the brain work together. Several studies have found that damage to white matter, as indicated by the presence of WMLs, seems to be an independent risk factor for dementia.

The current study reinforces earlier research showing that hypertension plays a role in causing dementia, suggesting that preventing hypertension from developing – through weight loss, exercise or other lifestyle changes – would be beneficial.

“However, we don’t know whether hypertension treatment will prevent WMLs from developing, or how much blood pressure should be lowered so that these brain lesions won’t occur,” says Dr. Wassertheil-Smoller. “We do have suggestive evidence that the progression of WMLs can be slowed by anti-hypertensive therapy.”

“Nonetheless,” she adds, “it would be prudent for women to keep their blood pressure low, and the earlier in life they start doing so, the better. At present, keeping blood pressure at normal levels is probably the most effective way we know of to prevent dementia from occurring.” According to baseline data on more than 98,705 women ages 50-79 who enrolled in the WHI study, 37.8% had hypertension, which is defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg or being on medication for high blood pressure; 64.3% of the hypertensive women were treated with drugs, and blood pressure was controlled in only 36.1% of the hypertensive women, with lower rates of control in the oldest group.

Dr. Wassertheil-Smoller notes that high blood pressure is also a major risk factor for stroke, “so it is certainly not good for the brain.” She says that further clinical trials are needed to better establish whether anti-hypertensive therapy can prevent or slow WMLs, and, if so, to find the specific drug therapies that work best.

The study, "Relationship of Hypertension, Blood Pressure (BP) and BP Control with White Matter Abnormalities in the Women's Health Initiative Memory Study (WHIMS) MRI Study," was published in the December 16 online edition of the Journal of Clinical Hypertension. Other contributors include: Karen L. Margolis, M.D., Health Partners Research Foundation, Minneapolis, Minn.; Sarah A. Jaramillo, M.S. and Jeff Williamson, M.D., Wake Forest University School of Medicine, Winston-Salem, N.C.; Nick R. Bryan, M.D., University of Pennsylvania, Philadelphia, Penn.; Diana Kerwin, M.D., Froedtert & Medical College of Wisconsin, Milwaukee, Wis.; Marian Limacher, M.D., University of Florida, Gainesville, Fla.; and Jennifer G. Robinson, M.D., M.P.H., University of Iowa, Iowa City, Iowa.

High Diabetes Will Fuel Explosion Of Alzheimer's Dementia

In a new report published in the December issue of the journal Diabetes Care, it is predicted that in the United States the number of people suffering from Diabetes will double over the next 25 years. This is bad news for those of us concerned about the looming epidemic of Alzheimer's Dementia.

Diabetes is a disease of metabolic function in the body that is defined as an inability to control levels of sugar in the blood. However, Diabetes does far more than disturb blood sugar levels. Diabetes adversely affects the functions of virtually every organ in the body. Consequently, it is a major risk factor for heart disease, stroke, and other illness, among which are various forms of dementia.

There are actually two types of diabetes. Diabetes Type I, often referred to as Juvenile Onset Diabetes, is most often seen in children and young people. This form of Diabetes results from a loss of pancreatic function and subsequent decrease in the production of the essential hormone, insulin. The other, far more common form of Diabetes is Diabetes Type II, or what is sometimes referred to as Adult Onset Diabetes. Diabetes Type II is not primarily due to a lack of insulin, but rather to a loss of the body's sensitivity and response to insulin. Whereas Diabetes Type I is usually caused by infections or autoimmune diseases of the pancreas, Diabetes Type II is almost always the result of poor diet, stress and lack of exercise. That is, it is generally the result of poor lifestyle choices. It is Diabetes Type II that is expected to grow in such disturbing fashion over the next 25 years.

Diabetes Type II is a major risk factor for Alzheimer's Dementia. Indeed, having Diabetes Type II is thought to at least double the risk of developing Alzheimer's Dementia. Over the last ten years we have greatly increased our understanding of the relationship between Diabetes Type II and Alzheimer's. The most obvious reason that Diabetes increases the risk of Alzheimer's Dementia is because it increases the incidence of heart disease; high blood pressure; high levels of fat in the form of triglycerides in the blood; decreases in the levels of the good cholesterol, HDL; and increases in levels of the bad cholesterol, LDL. All of these factors are individually known to increase the risk of Alzheimer's Dementia. These conditions also increase the risk of stroke and other forms of damage to blood vessels in the brain, which thus increases the risk of vascular dementia. Unfortunately, vascular dementia accelerates the pathological changes that occur in Alzheimer's Dementia. Thus, vascular dementia is itself a risk factor for Alzheimer's Dementia.

It has more recently become apparent that insulin itself plays an important role in brain chemistry, and that disturbances in the body's response and sensitivity to insulin may play a role in the pathology of Alzheimer's Dementia. Thus, in respect to the growing epidemic of Alzheimer's Dementia, the predicted increase in the incidence of Diabetes is particularly ominous. The hallmarks of the damage done to brain tissue in Alzheimer's Dementia are plaques of abnormal amyloid protein, and tangles of abnormal forms of the brain protein tau. Insulin plays an important role in maintaining normal forms and functions of those proteins. A lack of insulin or insufficient sensitivity to insulin in the brain results in increased build up of amyloid plaques.

Interestingly, the enzyme that breaks down insulin in the brain after it has served its purpose, an enzyme known as Insulin Degrading Enzyme (IDE) is also able to destroy amyloid plaques. Insulin stimulates the production of IDE, and when there is insufficient insulin activity, there is also a decrease in the presence of IDE that could help reduce amyloid plaque build up. Another curious relationship between amyloid and insulin is that amyloid protein resembles insulin closely enough to bind to insulin receptors in the brain and block the effect of insulin. Thus amyloid plaques further decrease the brain's sensitivty to insulin. Insulin also prevents the production of abnormal neurofibrillary tangles of tau protein by inhibiting an enzyme in the brain known as glycogen synthase kinase-3 (GSK3). GSK3 adds phosphate to tau protein and "hyperphosphorylation" of tau protein causes it to tangle.

Beyond its direct effects on amyloid plaques and neurofibrillary tangles of tau, insulin serves as a growth factor in the brain that helps maintain nerve endings where neurons communicate with each other. Maintenance of these nerve endings is essential for what is referred to as "neural plasticity". Neural plasticity allows us to learn and adapt to changing conditions, and without it our brain function deteriorates. Insulin acts to reduce inflammation in the brain. It is known that inflammatory processes play a major role in the progression of Alzheimer's Dementia.

Although increases in the incidence of Diabetes Type II will almost certainly increase the number of individuals who will develop Alzheimer's Dementia, there is also a hidden danger. In most cases, Diabetes Type II arises in individuals who have first developed the condition known as Metabolic Syndrome. Metabolic Syndrome is the presence of high blood pressure, abdominal obesity, high triglycerides, and low HDL cholesterol. The other characteristic of Metabolic Syndrome is high blood sugar. However, the levels of blood sugar in Metabolic Syndrome are not high enough to reach those necessary to diagnose Diabetes. In fact, Metabolic Syndrome is often referred to as "pre-Diabetes".

The underlying cause of Metabolic Syndrome is thought to be insulin resistance, and it is largely due to poor lifestyle choices, that is, too much sugar, too much saturated fat along with it, too much stress, and too little exercise. The frightening fact is that along with the doubling of cases of Diabetes Type II, there will also be an enormous and less apparent growth in the number of individuals with Metabolic Syndrome but not actual Diabetes. Unfortunately, Metabolic Syndrome, even when it does not progress to full-blown Diabetes Type II, is also a major risk factor for developing Alzheimer's Dementia.

The answer to this looming health catastrophe, which will destroy both lives and financial plans, is the dissemination and implementation of common sense protocols of preventative medicine. We must reduce our intake of sugars and simple carbohydrates; reduce our intake of saturated fats, particularly when consumed along with simple carbohydrates; fight obesity and maintain ideal weight; promote exercise and stress reduction; and build a health care system that is dedicated to prevention of disease and monitoring for signs of risk factors for disease that can be improved or reversed. If these steps are not taken, our society faces a heartbreaking and extraordinarily expensive future of ill health, regardless of what type of health care plan congress is able to establish.

Dr. Mendelson is the author of the new book, Beyond Alzheimer's.

source: huffingtonpost

Neuroscientist says we can mostly control aging process

For decades, people have believed they are prisoners of heredity and environment when it comes to brain health and function as one ages.

Although this belief is not entirely false, neuroscientist Glenn Heideman, a former longtime professor at the University of Arizona in Tucson, has reason to believe that the activities we engage in every day directly affect how well we age biologically.

Saturday afternoon at the Prescott Public Library, Heideman told an audience of about 50 people that they have significantly more control over the way their brains evolve than anyone previously believed imaginable even 10 years ago.

"People long thought that the aging process was fixed and that it was a function of the gene pool," Heideman said. "That has been proven false recently."

For example, he said, scientists used to think heredity accounted for 85 percent of the quality of the aging process, and just 15 percent was attributed to lifestyle. Now there is a "new paradigm of aging" telling us the complete opposite is true.

Heideman added that it's empowering to know we can take an active part in the aging process.

One sobering statistic Heideman shared, however, is that 50 percent of the human population aged 85 has developed Alzheimer's or some other form of dementia.

The other 50 percent, he says, are engaging in "brain-healthy behaviors." In other words, they are getting outside, exercising, watching what they eat and stimulating their brains.

A 70-year-old who sits around an apartment all day, doesn't exercise and eats whatever he or she wants is estimated to have a biological age of 85, he said.

However, the 70-year-old who is in control of his or her daily routine under optimal circumstances could have a biological age as young as 55. That's a 30-year difference in the effectiveness of our memory, concentration and judgment.

Heideman said some ways to keep the brain functioning at a high level include learning a new hobby; traversing a different route to a familiar place; learning more about computers; initiating a conversation with someone you don't know; and painting or drawing with one's non-dominant hand.

These activities build multiple new neural pathways in the brain that are necessary to maintain highly functional brains into one's 70s, 80s and 90s.

"We lose neurons as we age," Heideman said. "If we use our brains, we slow down the process of neuron loss. We need to try new things and meet new people. We also need to stay positive and smile, which releases (the healthy chemicals) dopamine and serotonin in our brains. Everything that's good for the brain is good for the heart."

And as long as folks stay active, they can reduce their risk for developing Alzheimer's up to 70 percent.

In addition, Heideman says high levels of stress are like "battery acid" on brain cells. Our thoughts and emotions can either help or harm brain health. It's also important to stop negative thoughts - whether through prayer, meditation or deep breathing, for instance - than let them fester.

"Our brains change every day, depending on what we are doing," Heideman said. "If it was an interesting day with some exercise and an activity, the brain changes for the better. The brain you lay down with tonight will be different than the one you wake up with.

"Science is giving us the power to be at the helm of our own ship."

For more information about Heideman and his discussion, call 520-909-6393.

SOURCE: prescottdailycourier

Alzheimer’s, Dementia Rising Faster Than Expected

Alzheimer’s disease and other dementias will afflict 35.6 million people in 2010, about 10 percent more than previously estimated because of a higher number of cases in developing countries than doctors realized, researchers said.

The number of dementia sufferers may almost double every 20 years to 115.4 million in 2050, researchers at Alzheimer’s Disease International said in a report. The report’s authors had previously projected lower numbers in a 2005 article in the Lancet.

Companies such as Johnson & Johnson, Eli Lilly & Co., Baxter International Inc. and Bristol-Myers Squibb Co. are developing treatments to target the disease. The report recommends that the World Health Organization declare dementia a health priority, and that countries including the U.S. develop a plan for dealing with the greater numbers of dementia patients.

“People, the government, the community need to understand that these numbers are an emergency,” said Daisy Acosta, the chairwoman of the London-based Alzheimer’s patients advocacy group.

Lower and middle-income countries have the fastest increase in prevalence in the next 20 years, the report said. The poorest countries in Latin America will see the biggest increases of 134 to 146 percent. The new numbers are due to better data available since there weren’t many studies of Latin America, Africa, Russia, the Middle East, and Indonesia, the report said.

Care Costs Rising

Alzheimer’s disease and other dementias cost $315 billion a year, according to an estimate from Sweden’s Karolinska Institute cited by the paper. Dementia care costs are rising fastest in low and middle income countries, where per capita income is $11,905 or less, the report found.

Patients and their families currently have few options. The drugs approved in the U.S. to treat Alzheimer’s ease symptoms for 6 to 12 months at most, according to the Alzheimer’s Association. If U.S. health officials and the WHO develop plans for dealing with the increase of dementia, other countries will follow suit, Acosta said.

It has been difficult to get attention from global health organizations, because they often focus on reducing deaths rather than on treating disability, said Alzheimer’s Association Chief Executive Officer Harry Johns.

“The very fact that people are older works against them,” Johns said. Many Alzheimer’s patients have spouses or children who provide their care, quitting their jobs to do so, he said. Between 15 percent and 32 percent of caregivers develop depression, as a result of the strains of providing for the needs of Alzheimer’s patients.

WHO Priority

“We already think dementia is a priority within WHO,” said Tarun Dua, a medical officer at the WHO’s department of mental health and substance abuse. WHO included Alzheimer’s disease as a priority condition when it launched the Mental Health Gap Action Program in October 2008 to bolster care for a range of ailments including mental health, neurology and substance abuse, she said.

“The burden of these disorders is very high and the resources are scarce, especially in low and middle income countries,” Dua said in a telephone interview.

About 5.2 million people in the U.S. have Alzheimer’s disease, according to the Chicago-based Alzheimer’s association. The first symptom of Alzheimer’s may be mild forgetfulness. As the condition progresses, it begins to interfere with patients’ lives as they forget how to brush their teeth, change their clothes, or recognize once-familiar people.

“We’ll be spending the equivalent of the stimulus package every two years if we don’t address this,” Johns said.

source: bloomberg