Sophisticated scan may spot seeds of Alzheimer's risk

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Steve Reinberg HealthDay news

Using an advanced MRI scan, researchers believe they have found changes in the chemistry of the brains of people with no cognitive problems that signal who is at future risk for Alzheimer's disease and other dementias.

And although there is no good treatment or cure for the disease, experts say finding ways to identify those at risk is essential when treatments and possibly a cure become available.

"We found biochemical changes that correlated with cognitive performance," said lead researcher Dr. Kejal Kantarci, a radiologist at Mayo Clinic in Rochester, Minn. "The better people did on tests that measure cognitive abilities, the fewer changes there were."

These biochemical changes were also associated with other changes in the brain that are markers for Alzheimer's disease, Kantarci said.

Kantarci said that people should not be looking at getting scans to detect these changes. "We are just at the early stages of identifying markers," she stressed.

However, finding these biomarkers is important, Kantarci added. "When possibilities for preventive intervention come about, then we will have a marker which will help us identify those individuals who would benefit from these preventive interventions," she said.

The report was published in the Aug. 24 online edition of Neurology.

For the study, Kantarci's group used a technique called proton magnetic resonance spectroscopy to see if they could identify changes in brain chemistry in 311 men and women in their 70s and 80s who had no apparent cognitive problems.

The participants also underwent PET scans to see if there were any amyloid-beta deposits, or plaques, in the brain. These plaques are the first signs of Alzheimer's disease, the researchers noted.

In addition, participants took tests that evaluated memory, language and other skills.

Kantarci's team found that 33 percent of the people had significantly high levels of amyloid-beta deposits in their brains. These people also had high levels of two chemicals: myoinositol/creatine and choline/creatine.

Those with high levels of these so-called brain metabolites also were more likely to have lower scores on several of the cognitive tests, regardless of the amount of amyloid-beta deposits in their brains, the researchers added.

Kantarci said these biochemical changes start years before people show signs of cognitive problems. Whether these markers are a cause of dementia or only a signal for other changes isn't known, she said. "What we are seeing is a marker of a pathological process rather than a cause," she explained.

Heather M. Snyder, senior associate director of medical & scientific relations at the Alzheimer's Association, said "there is a growing body of evidence that biological changes associated with Alzheimer's disease are occurring maybe even 20 years prior to any individual having any cognitive issues."

"The goal is that we would like people to live a healthy life as long as possible, so if we can diagnose people with these changes as early as possible, when a treatment is available we can intervene -- that's really our ultimate goal," she said.

That's why finding ways to identify people at risk early is important while the search for treatments and cures continues, Snyder said.

Identifying people at risk for dementia is also important for research, said Dr. Marc L. Gordon, a neurologist and Alzheimer's researcher at The Feinstein Institute for Medical Research in Manhasset, N.Y.

"It is important to identify people at risk of dementia, particularly if we want to test therapies that have the potential to alter the process to try to prevent people from converting to dementia," he said.

Greg M. Cole, a neuroscientist at the Greater Los Angeles VA Healthcare System and associate director of the Alzheimer's Disease Research Center at the University of California Los Angeles David Geffen School of Medicine, said that "these results show that more and more specific biochemical changes that presage Alzheimer's disease can be detected in our normal aging population using sophisticated imaging technology."

But, Cole added, "The question now is whether we can find a way to intervene in people where these very early steps in the disease process are measurable by suppressing the pathological process until we normalize the disease indices and show that they don't go on to develop dementia."

Secondhand Smoke Linked to Adult Cognitive Impairment ( part 2 )

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By John Gever, Senior Editor, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco . Earn CME/CE credit
for reading medical news

CAMBRIDGE, England,

Dr. Llewellyn and colleagues said earlier research had found an association between passive smoking and the risk of developing dementia, but those findings failed to reach statistical significance after adjusting for age, sex, and education. (See: AAN: Secondhand Smoke Can Add to Dementia Risk)


The researchers said the cognitive impairments seemingly associated with passive smoking may originate with the well-known vascular effects of tobacco. Over a long period, these effects could "compromise the blood supply to the brain," they wrote.


Arguing against that hypothesis was a finding in the current study that the presence or absence of cardiovascular disease, did not affect the results. Nevertheless, said Dr. Llewellyn and colleagues, "exposure to secondhand smoke may interact with subclinical cardiovascular disease."


In an accompanying editorial, Mark D. Eisner, M.D., M.P.H., of the University of California San Francisco, agreed that the study was additional evidence that secondhand smoke can impair brain function.


He also echoed the researchers' call for prospective studies, noting that cotinine was a marker only of tobacco exposure within the last day or so of sampling.


"Although recent exposure probably correlates with longer term exposure, studies that examine the longitudinal effect of self-reported lifetime exposure on cognitive impairment would strengthen the evidence of a causal association," Dr. Eisner said.


He added that, because dementia is such a frightening disorder, more publicity about it as an effect of public smoking may be an effective deterrent.


"Greater public awareness would eventually translate into political action aimed at passing smoke-free legislation in regions of the world where public smoking is still permitted," he contended.



The study was funded by the National Institute on Aging and several agencies of the British government.

No potential conflicts of interest were reported by study authors or the editorialist.

Secondhand Smoke Linked to Adult Cognitive Impairment

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By John Gever, Senior Editor, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco . Earn CME/CE credit
for reading medical news

CAMBRIDGE, England, Passive smoking can damage the brain of those 50 and older, researchers here said

Nonsmokers with the heaviest secondhand smoke exposure were at a 44% higher risk of scoring in the bottom 10% on cognitive testing, compared with those with the lowest level of passive smoking (P=0.02), reported David J. Llewellyn, Ph.D., of the University of Cambridge, and colleagues online in BMJ.


This result occurred after controlling for such potential confounding factors as age, sex, ethnicity, alcohol consumption, socioeconomic status, education, physical activity, body weight, medical history, depressive symptoms, and ex-smoker status.


"This analysis is to our knowledge the first to examine the relation between exposure to secondhand smoke and cognitive impairment in a large heterogeneous population-based sample," according to the researchers. Other studies have connected secondhand smoke exposure to impaired cognition in children and adolescents.


They said the findings were of "major public health significance" and called for additional, prospective studies to confirm and extend them.


The study involved 4,809 self-described nonsmokers at least 50 years old who participated in both of two large national health surveys and gave saliva samples.


One of the surveys, the English Longitudinal Study of Aging, included detailed cognitive testing that evaluated immediate and delayed verbal memory, attention and processing speed, prospective memory, numerical abilities, and semantic fluency.


Those in the bottom 10% of the combined cognitive score were considered impaired.


Cotinine, a nicotine metabolite that signals recent exposure to tobacco smoke, was measured in the saliva samples. Participants with cotinine levels higher than 14 ng/mL were excluded to ensure the study population did not contain clandestine tobacco users.


After adjusting for the potential confounding factors, the researchers found that people in the highest quartile of cotinine level -- 0.8 to 13.5 ng/mL -- had an odds ratio of 1.44 of being impaired (95% CI 1.07 to 1.94), relative to those in the lowest quartile.


Participants in the second and third quartiles showed small and statistically insignificant risks of cognitive impairment.


The relation between passive smoking exposure and cognitive impairment was strongest in participants who never smoked.


Never-smokers in the highest cotinine quartile had an odds ratio for impairment of 1.70 (95% CI 1.03 to 2.80). For ex-smokers with the heaviest smoke exposure, the odds ratio was 1.32 (95% CI 0.92 to 1.91).


Dr. Llewellyn and colleagues said.......more later

Moderate drinkers '25% less likely to develop dementia'

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Craegimoor.co.uk

According to the latest research, light to moderate drinkers are 25 per cent less likely to develop dementia than those who do not drink any alcohol.

Research studies, based on a survey of 10,000 people worldwide, explored links between drinking and dementia through meta-analysis of 15 research studies.

Results of studies were followed up with participants at intervals over two to eight years, according to study leader Kaarin Anstey, of the Australian National University.

"We found that light to moderate drinkers were 28 per cent less likely to develop Alzheimer's than non-drinkers, 25 per cent less likely to develop vascular dementia, and 26 per cent less likely to develop any dementia'," Ms Anstey said.

The report was published in the American Journal of Geriatric Psychiatry.

Some of the research projects considered in the ANU synthesis study only reported whether participants were drinkers or non-drinkers and did not explore the extent of their drinking.

The news comes as research carried out by the Norwegian University of Science and Technology found that people who do not drink alcohol have an increased risk of anxiety and depression.

Can Memory Loss Be Prevented?

New York Times

By Anne Underwood

At the age of 78, Bob Branham, a retired computer software developer in Dallas, Tex., took up quilting. It wasn’t his idea, actually. He’d never dreamed of piecing together his own Amish diamond coverlet or rummaging around Jo-Ann Fabrics in search of calico prints. But then he enrolled in a trial sponsored by the National Institute on Aging to assess whether learning a new skill can help preserve cognitive function in old age. By random assignment, he landed in the quilting group.

When it comes to mental agility, we’re more likely to think of crosswords than cross-stitch. But neuroscientists suspect that learning a challenging new skill — a new language, a new musical instrument — may be even more effective than mental games at keeping the brain sharp. And quilting is more complicated than it may seem.

“It’s a very abstract task,” said Dr. Denise Park, a cognitive neuroscientist at the University of Texas at Dallas, who is leading the trial. “You have to picture what the pattern will look like, match fabrics, manipulate geometric forms, mentally rotate objects.”

In Mr. Branham’s case, he also had to learn to use a sewing machine. And while it’s too early to tell if quilting is sharpening his mind, he quickly found that he loved his new pastime. He spends as much as 40 hours a week piecing and stitching, both at home and at the social center that Dr. Park set up for the trial.

“I get ideas and pointers from the instructor and the other participants,” he said. “We have a real good time.”

Memory is among the least understood areas of neuroscience, and the sad truth is that there is no magic pill or potion at present that will prevent our parents’ minds from failing. But a panel of 30 experts from the United States and Europe recently issued a consensus statement on what we do know about maintaining brain fitness (which includes not only memory, but also reasoning, attention and speed of processing). The verdict was that three things are crucial: physical exercise, mental challenges and good health habits in general.

But wait! What about the supplements and software programs we’ve been stocking up on? “There’s a lot of snake oil out there,” warned Dr. Laura Carstensen, director of the Center on Longevity at Stanford University, who co-chaired the panel. In short, don’t count on supplements. (The rationale behind ginkgo biloba is plausible, but there is no scientific evidence it works.) Steer clear of anything that promises to prevent Alzheimer’s disease. (Such a claim would require approval from the Food and Drug Administration, and no product has it.) And look skeptically on software programs. (Most improve performance only on the games themselves, not mental function in general.)

Brandon Thibodeaux for The New York TimesInstead, Dr. Carstensen said,.......read more Can Memory Loss Be Prevented?

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Alzheimer's Disease Could Be Triggered by Brain Toxins

Kitsap Sun

By Elizabeth Smoots

Many people fear losing their mental abilities as they age. If you were to develop a degenerative brain disease, your quality of life would inevitably fall.

No one really knows what causes degenerative conditions like Alzheimer’s or Parkinson’s disease. The common view is that they’re largely genetic, leading many of us to believe the disorders are beyond our control.

But emerging evidence indicates that toxic environmental exposures, in combination with nutritional, social, and exercise factors, may play a major role in the development of Alzheimer’s disease, Parkinson’s disease, and other chronic degenerative diseases, according to Philip Landrigan, MD.

Landrigan is chairman of community and preventive medicine at Mount Sinai School of Medicine in New York.

Here I’ve summarized a report from Landrigan and his colleagues about environmental factors that threaten the health of your brain.

Environmental Risks

Lead: In a study of older men, participants with the highest lead exposure showed.....read the whole thing

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Sunbathing 'could boost your intellect and prevent dementia'

Telegraph.co.uk

Being a sun worshipper could make you cleverer in later life and ward off dementia, claim scientists.

By Richard Alleyne, Science Correspondent

Researchers found that increased levels of vitamin D, obtained from exposure to sun or eating oily fish, could help keep our brains in top condition as we age.

The findings suggest that retirement to warmer climes or taking dietary supplements could boost your brain's ability to stay active later in life.

Scientists at the University of Manchester discovered that higher levels of vitamin D are linked with improved mental ability in middle-aged and older men.

The study, published in the Journal of Neurology, Neurosurgery and Psychiatry, compared the brain agility of 3,133 men aged 40 to 79 at eight test centres across Europe.

They were tested for memory and speed of recollection as well as for mood and physical activity levels, all of which add up to overall mental agility.

Blood samples were then taken to measure blood levels of vitamin D.

The researchers found that men with ..........read about sunbathers Vitamin D and dementia

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Simple dietary steps may help prevent dementia

By Dr. Terry Gaff

Although there are lots of things about my memory and ability to think that I would like to change, they all involve a desire to improve brain function. The reality is, at my age, my thinking is more likely to get worse rather than better. Therefore, I want to make every effort to keep what I have and add a few things here and there to help make up for inevitable losses.

I am especially concerned about the possibility of developing frontotemporal dementia (FTD). This problem causes an inability to spot sarcasm or to read negative emotions in others and being more gullible than other people according to a study published in the journal Brain. I am concerned that if I cannot identify sarcasm, my ability to understand what my wife is saying to me will be greatly decreased.

The number of people suffering from dementia is expected to double over the next 30 years. Therefore, I keep an eye out for things I can do to avoid being part of that statistic.

Some people have suggested that more education might help to prevent dementia because you start with more knowledge. Therefore, it will take more time for that knowledge and thinking ability to melt away. Unfortunately, in a study of 6,533 people with an average age of 72 at the beginning of testing, researchers found that education does not protect against decline in thinking. However, it does delay the presentation of dementia. Then, when dementia occurs, it takes the typical progressive course. In fact, greater education was associated with slightly less rapid decline early in follow-up, but with faster decline later.

Since we are what we eat, it would make some sense that diet and medicines might affect our thinking abilities. The problem is that even “the experts” do not know what the best choices are......read the whole article

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Eat Your Way to Clearer Thinking

Healthnotes:Newswire
By Suzanne Dixon, MPH, MS, RD
Healthnotes Newswire (March 12, 2009)—Anyone who’s cared for a loved one with dementia understands the agony of watching a clear mind slip away. But new research on this topic brings new hope: A healthy Mediterranean diet may not only prevent the beginning stages of dementia, known as mild cognitive impairment, but in people already experiencing mild cognitive impairment, it may also reduce the risk of developing full-blown dementia.

Fresh food, fish, & fat—three keys to staying sharp

Researchers assessed the eating habits of 1,875 men and women, 482 of whom were classified as having mild cognitive impairment at the start of the study. To determine how closely each person followed a typical Mediterranean eating pattern, researchers looked at eight food categories: dairy, meat, fruits, vegetables, legumes (beans), cereals, fish, and fat.

Eating more dairy and meat was classified as not following a Mediterranean diet and bad for health. Eating more fruits, vegetables, legumes, cereals, fish, and monounsaturated fat, particularly in olive oil, was classified as more closely following a Mediterranean diet and protective of good health.

Study participants were 77 years old, on average, and were classified into groups with low, medium, or high levels of adherence to a Mediterranean diet, depending on how much or how little of each of the eight food categories they typically ate.

After following the group for approximately four and a half years, the researchers found that people in the high Mediterranean diet group had 28% lower risk of developing mild cognitive impairment than people in the low Mediterranean diet group. Among those with mild cognitive impairment at the beginning of the study, those in the medium and high Mediterranean diet groups had 45% and 48% lower risk, respectively, of developing full-blown dementia or Alzheimer’s disease compared with those in the low Mediterranean diet group.

In summary, the less meat and dairy, and the more fruits, vegetables, legumes, cereals, fish, and olive oil a person ate, the less likely he or she was to develop mild cognitive impairment or dementia and Alzheimer’s disease.

Healthy choices for a healthy brain

Use the following diet tips to........read the whole story

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20 tips to help ward off dementia

earlier.

By Linda Shrieves

The Orlando Sentin
Timing is everything, comedians say.

It's also important when it comes to taking care of your brain. Yet most of us start worrying about dementia after retirement — and that may be too little, too late.

Experts say that if you really want to ward off dementia, you need to start taking care of your bean in your 30s and 40s — or even earlier.

"More and more research is suggesting that lifestyle is very important to your brain's health," says Dr. Paul Nussbaum, a neuropsychologist and an adjunct associate professor at the University of Pittsburgh School of Medicine. "If you want to live a long, healthy life, then many of us need to start as early as we can."

So what can you do to beef up your brain — and possibly ward off dementia? Nussbaum, who recently gave a speech on the topic for the Winter Park (Fla.) Health Foundation, offers 20 tips that may help.

1. Join clubs or organizations that need volunteers. If you start volunteering now, you won't feel lost and unneeded after you retire.

2. Develop a hobby or two. Hobbies help you develop a robust brain because you're trying something new and complex.

3. Practice writing with your nondominant hand several minutes every day. This will exercise the opposite side of your brain and fire up those neurons.

4. Take dance lessons. In a study of nearly 500 people, dancing was the only regular physical activity associated with a significant decrease in the incidence of dementia, including Alzheimer's disease. The people who danced three or four times a week showed 76 percent less incidence of dementia than those who danced only once a week or not at all.

5. Need a hobby? Start gardening. Researchers in New Zealand found that, of 1,000 people, those who gardened regularly were less likely to suffer from.... read the whle story and a comment

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Workaholics Risk Dementia, Study Finds

BBC News

Long working hours may raise the risk of mental decline and possibly dementia, research suggests.

The Finnish-led study was based on analysis of 2,214 middle-aged British civil servants.

It found that those working more than 55 hours a week had poorer mental skills than those who worked a standard working week.

The American Journal of Epidemiology study found hard workers had problems with short-term memory and word recall.

This should say to employers that insisting people work long hours is actually not good for your business

Professor Cary Cooper
University of Lancaster
Lead researcher Dr Marianna Virtanen, from the Finnish Institute of Occupational Health, said: "The disadvantages of overtime work should be taken seriously."

It is not known why working long hours might have an adverse effect on the brain.

However, the researchers say key factors could include..............read more

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Diet could cut risk of dementia

By Mary Brophy Marcus, USA TODAY
A new study suggests a diet laden with fish, olive oil, veggies and other foods common in Mediterranean-style cuisine may help ward off mild cognitive impairment, sometimes called borderline dementia. The study also suggests this diet reduces the chance of transitioning from mild cognitive decline to Alzheimer's disease.
"We know from previous research that a healthy diet like this is....read the whole article

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