seniors

Factors predicting conversion of mild cognitive impairment to Alzheimer’s identified

March, 2010

New analysis reveals the most important factors for predicting whether amnestic-MCI would develop into Alzheimer’s within 2 years were hyperglycemia, female gender and having the Alzheimer's gene.

An analysis technique using artificial neural networks has revealed that the most important factors for predicting whether amnestic mild cognitive impairment (MCI-A) would develop into Alzheimer’s within 2 years were hyperglycemia, female gender and having the APOE4 gene (in that order). These were followed by the scores on attentional and short memory tests.

Reference: 

Tabaton, M. et al. 2010. Artificial Neural Networks Identify the Predictive Values of Risk Factors on the Conversion of Amnestic Mild Cognitive Impairment. Journal of Alzheimer's Disease, 19 (3), 1035-1040.

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Untreated vision problems linked to dementia in the elderly

March, 2010

Data from over 600 older adults has revealed that those with very good or excellent vision had a 63% reduced risk of dementia over the 8.5-year study period, while those with poorer vision who did not visit an ophthalmologist had a 9.5-fold increased risk of Alzheimer disease. The findings point to the need for older adults to seek treatment for their eye problems.

Data from 625 elderly Americans, followed for an average of 8.5 years, has revealed that those with very good or excellent vision at the beginning of the study had a 63% reduced risk of dementia over the study period. Those with poorer vision who did not visit an ophthalmologist had a 9.5-fold increased risk of Alzheimer disease and a 5-fold increased risk of cognitively impaired but no dementia. For the very-old (90+), 78% who maintained normal cognition had received at least one previous eye procedure compared with 51.7% of those with Alzheimer disease. The findings point to the need for older adults to seek treatment for their eye problems. The study raises the possibility that poor vision is not simply a symptom of developing dementia, but a contributing factor — possibly through its effect on curtailing activities which would help prevent it.

Reference: 

[325] Rogers, M. A. M., & Langa K. M.
(2010).  Untreated Poor Vision: A Contributing Factor to Late-Life Dementia.
Am. J. Epidemiol.. 171(6), 728 - 735.

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Alzheimer's memory problems originate with oligomers not plaques

April, 2010

While everyone agrees that amyloid-beta protein is part of the problem, not everyone agrees that amyloid plaques are the cause (or one of them) of Alzheimer’s. A new study provides convincing evidence that floating clumps called oligomers or ADDLs are the real problem.

While everyone agrees that amyloid-beta protein is part of the problem, not everyone agrees that amyloid plaques are the cause (or one of them) of Alzheimer’s. Other forms of amyloid-beta have been pointed to, including floating clumps called oligomers or ADDLs. A new study, using mice engineered to form only these oligomers, and never any plaques, throughout their lives, provides more support for this theory. Mice that never developed plaques were just as impaired by the disease as mice with both plaques and oligomers, and when a gene that converted oligomers into plaques was added to the mice, the mice were no more impaired than they had been before. This may explain why treatments aimed at removing plaques have not been successful, and offers a new approach to the treatment of Alzheimer’s.

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More evidence for benefits of Rapamycin

April, 2010

Another study using a different strain of genetically engineered mice has confirmed the finding that the transplant drug rapamycin prevented cognitive impairment.

A few months ago, I reported on an exciting finding that rapamycin, a drug currently used in transplant patients, improved memory in Alzheimer's mice. Now a different strain of mice (ones engineered to have defects in the genes that make amyloid precursor protein) has also shown improvements in learning and memory, correlated with less damage in brain tissue, after rapamycin treatment lowered levels of amyloid-beta-42. The mice given the drug performed at levels comparable with normal mice.

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New guideline on when people with Alzheimer's disease should stop driving

April, 2010

The American Academy of Neurology has updated its guidelines on when people with dementia should stop driving. The guidelines support caregivers’ instincts, but not use of the patient’s own self-rating.

The American Academy of Neurology has updated its guidelines on when people with dementia should stop driving. While the guidelines point out that this decision is a complex one that should be made by a doctor using the Clinical Dementia Rating scale, they also supported caregivers’ instincts, which have been found to often be correct. For caregivers and family members, the following warning signs are identified:

  • Decreased miles being driven
  • Collisions
  • Moving violations
  • Avoiding certain driving situations, such as driving at night or in the rain
  • Aggressive or impulsive personality traits

However, the patient’s own self-rating, and a lack of situational avoidance, are not regarded as useful evidence.

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New gene associated with increased risk of Alzheimer's

April, 2010

Another gene has been identified that appears to increase risk of Alzheimer’s. The gene is involved in influencing the body's levels of homocysteine (high levels are known to be a strong risk factor), and have also been implicated in coronary artery disease.

Another gene has been identified that appears to increase risk of Alzheimer’s. The gene, MTHFD1L, is located on chromosome six. Comparison of the genomes of 2,269 people with late-onset Alzheimer's disease and 3,107 people without the disease found those with a particular variation in this gene were almost twice as likely to develop Alzheimer's disease as those people without the variation. The gene is involved in influencing the body's levels of homocysteine (high levels are known to be a strong risk factor), and have also been implicated in coronary artery disease.

Reference: 

The results were presented at the American Academy of Neurology's 62nd Annual Meeting in Toronto, April 10–17, 2010.

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Losing muscle mass early sign of Alzheimer’s

April, 2010
  • Previous research has found that unexplained weight loss is an early sign of Alzheimer's. Now a new study has revealed that it is not the overall weight or fat levels that are important, but the loss of lean mass (weight of an individual's bones, muscles and organs without body fat).

Previous research has found that unexplained weight loss is an early sign of Alzheimer's. Now a study involving 140 older adults (60+), of whom half had early-stage Alzheimer's disease, has revealed that it is not the overall weight or fat levels that are important, but the loss of lean mass (weight of an individual's bones, muscles and organs without body fat). This directly correlated with reductions in the volume of the whole brain and of white matter only, along with declines in cognitive performance. The finding is consistent with research suggesting that brain pathology contributes to a decline in body composition, perhaps by disrupting the regulation of energy metabolism and food intake, perhaps through behavioral changes (there is a strong association between loss of muscle mass and reductions in physical activity), or perhaps through a common underlying mechanism, such as inflammation.

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Memory problems not the only predictor of later mild cognitive impairment

August, 2010

A study finds poor learning plus depression or slow processing speed predicts the development of amnestic mild cognitive impairment for seniors.

Amnestic mild cognitive impairment often leads to Alzheimer's disease, but what predicts aMCI? A study involving 94 older adults has revealed that lower performance on tests measuring learning, in conjunction with either slower visuomotor processing speed or depressive symptoms, predicted the development of aMCI a year later with an accuracy of 80-100%. It is worth emphasizing that poor learning alone was not predictive in that time-frame, although one learning measure was predictive of aMCI two years later. Interestingly, neither gender nor possession of the ‘Alzheimer’s gene’ —long believed to be risk factors for mild cognitive impairment — had any substantial influence on later impairment.

Reference: 

[1690] Han, D. S., Suzuki H., Jak A. J., Chang Y-L., Salmon D. P., & Bondi M. W.
(2010).  Hierarchical Cognitive and Psychosocial Predictors of Amnestic Mild Cognitive Impairment.
Journal of the International Neuropsychological Society. 16(04), 721 - 729.

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Apple juice improves behavior in Alzheimer's patients

August, 2010

A pilot study found daily apple juice improved behavioral and psychotic symptoms in those with moderate-to-severe Alzheimer’s.

A pilot study involving 21 institutionalized individuals with moderate-to-severe Alzheimer’s found that, although drinking two 4-oz glasses of apple juice daily for a month produced no change in the Dementia Rating Scale or in the Activities of Daily Living measure, there was a significant (27%) improvement in behavioral and psychotic symptoms. The largest changes occurred in anxiety, agitation, and delusion.

Reference: 

[1630] Remington, R., Chan A., Lepore A., Kotlya E., & Shea T. B.
(2010).  Apple Juice Improved Behavioral But Not Cognitive Symptoms in Moderate-to-Late Stage Alzheimer’s Disease in an Open-Label Pilot Study.
American Journal of Alzheimer's Disease and Other Dementias. 367 - 371.

Full text is available free for a limited time at http://aja.sagepub.com/cgi/reprint/25/4/367.

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TMS improves language comprehension in Alzheimer's sufferers

August, 2010

A pilot study found two weeks of daily repetitive transcranial magnetic stimulation to the prefrontal lobes improved speech comprehension in those with moderate Alzheimer's.

A pilot study involving 10 patients with moderate Alzheimer's disease, of whom half were randomly assigned to the treatment, has found that two weeks of receiving daily (25 minute) periods of repetitive transcranial magnetic stimulation to the prefrontal lobes produced a significant improvement in the patients’ ability to understand spoken language. Correct answers on a comprehension test rose from 66% to over 77%. Two further weeks of the treatment produced no further improvement, but the improvements were still evident eight weeks after the end of the treatment. The effect was limited to this specific cognitive function.

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