Tuesday, 5 June 2012


Dear Friends,  



TIME  :  6:00pm – 10.00pm

From 6pm to 10pm on Wednesday, 6 June, the Management and All Staff of the SOUL Society HQ, including Owners Fred Choo, The Commander In Chief and First Lady, Michelle Kwok, will be taking over the floor at SOULed OUT Sri Hartamas SERVING THEIR PATRONS WITH THEIR HEART AND SOUL -  to wait on tables and collect TIPS for CHARITY  !!!

SOULed OUT WILL MATCH THE AMOUNT OF TIPS COLLECTED BY THE HQ TEAM  FOR THE NIGHT,  to raise money for ADFM as part of their Annual CSR Programme.

So for service with a difference, drop by SOULed Out Sri Hartamas between 6pm and 10pm on June 6 for some fun time for a charitable cause !!!!!!

Please help circulate to your family members, business associates, and friends.  


From:  ADFM National Caregivers Network

Monday, 4 June 2012

Amyvid® Now Available To Diagnose Alzheimer’s

Beta-almyloid plaque is a marker for Alzheimer's Disease and for a number of years, the only way to find it was through a brain biopsy or an autopsy. Now a new test has been approved to help doctors diagnose the disease.

It's been an emotional day for 73-year-old Hilda McIntosh. Her son- a psychiatrist- started noticing mental changes in his mom about a year ago and wanted to have her checked for Alzheimer's Disease.

"Her memory isn't quite the same, she is repeating stories and becoming more forgetful," said Hilda's son.

Along with other exams, she also got a PET scan with a recently FDA-approved radioactive dye called Amyvid.

Dr. Rajan Agarwal of Abington PET/CT of Willow Grove says the dye travels through the bloodstream to the brain. If there are amyloid plaques, the dye will bind to them.

"This is the first scan of all the scans out there that actually looks for Beta-almyloid deposits in the brain," said Dr. Agarwal.

Simply because amyloid plaques are detected, doesn't necessarily mean the patient has Alzheimer's. This is just one piece of the puzzle but it does give doctors more confidence in diagnosing the disease.

"This would just help us determine if their cognitive impairment could be related to amyloid deposits in the brain, which might be related to Alzheimer's," said Dr. Agarwal.

Dr. Agarwal says if other tests also point to Alzheimer's, then medication can be started early to slow its progression.

The scans can also help advance research to find better treatments. This is something Hilda would like to see for the millions of people and their families affected with the disease.

"It's so painful. I would like to be a part of helping in any small way to find answers and bring this to some better level than it is today," she said.

There was other good news for Hilda - her scans were negative which means it's highly unlikely she has Alzheimer's Disease.

Regarding the new testing, the dye was just approved in April and it could start being used at more centers soon.

It's important to note that it is not a screening tool. It won't predict Alzheimer's but it can help lead to a more accurate diagnosis.

(Source : Alzheimer's & Dementia Weekly, 3 June 12 -10 June 2012)

Tips from A Professor with Dementia

I am a retired physician and an Emeritus Professor of Medicine. I also have Alzheimer's disease.

Before my diagnosis, I was certainly familiar with the disease, having seen patients with Alzheimer's over the years in my internal medicine practice. But I was slow to suspect my own affliction.

Now that I've been diagnosed, I can trace my problems back some 10 years, to when I was 76. I had been chairing a monthly program in medical ethics, and I knew most of the speakers and found it easy and enjoyable to introduce them. Then, suddenly, I found I had to rely on prepared material to make the introductions. I started to forget names, though never faces. These kinds of lapses are common in aging brains, so it was easy for me to write them off to "senior moments"...

Since my improvement, I have developed a list of insights I'd like to share with others facing memory problems:

  • Carry a small book and write notes whenever there's something you want to recall later.
  • When you cannot remember a name, make a joke and ask the person to repeat it, then write it down.
  • Read books.
  • Take walks.
  • If you cannot walk, exercise in bed.
  • Draw and paint.
  • Garden, if you can.
  • Do puzzles and games.
  • Do Try new things.
  • Organize your day.
  • Learn to prepare food, eat, dress, wash and go to bed in an efficient way.
  • Eat a healthful diet that includes fish twice a week, fruits and vegetables and omega-3 fatty acids.
  • A reliable and good-humored book on a serious subject is "The Memory Bible" by Dr. Gary Small.

Don't withdraw from your friends and your family. This is advice I had to learn the hard way. Afraid of being pitied, I tried to keep my condition a secret, and that meant pulling away from people I cared about. But now that I've decided to be open, I've been gratified to see how accepting people are and how willing to assist.

For the full-length story, go to The Los Angeles Times.

(Source : Alzheimer's & Dementia Weekly, 3 June 2012 - 10 June 2012)

Rays of Hope in the Fight Against the Spread of Alzheimer’s

Nearly five million Americans are living with Alzheimer's disease, according to the Alzheimer's Association. Experts predict the number will reach 16 million by 2050.

Scientists are working to prevent that projection from becoming a reality - or at least trying to find a treatment that will ease the effects of the debilitating, memory-robbing disease. In the past few months, Alzheimer's researchers have made notable progress that could one day lead to improved treatments for the disease or even methods of preventing it. Nonetheless for many of us who have loved ones with Alzheimer’s, breakthroughs in Alzheimer’s research have been slow to show promise.

"Science usually works in a slow, deliberate fashion," says Peter V. Rabins, M.P.H., M.D., director of the Division of Geriatric Psychiatry & Neuropsychiatry at Johns Hopkins. "That is a strength, because it can prevent mistakes such as exposing people to drugs that don't work and that have serious side effects. But it leads to frustration in people when they or their loved ones have the disease being studied."

Here’s a brief overview of a few recent studies you’ll want to follow in the months ahead …
  • Biomarkers in the cerebrospinal fluid in brains and spinal cords of people with mild cognitive impairment, the precursor to Alzheimer's disease, can predict Alzheimer's up to 10 years before symptoms appear. This finding can open the door to the development of new treatments that may stop the disease's progression early on.
  • People who have amnestic mild cognitive impairment (aMCI), a condition in which the only difficulty is with memory, appear to be at increased risk for developing Alzheimer's. Patients with aMCI have more memory loss than normal for their age, but their symptoms aren't as severe as Alzheimer's are. A simple questionnaire can help identify people with aMCI, thereby allowing them to begin Alzheimer's diagnostic testing and treatment sooner rather than later. 
  • Inherited early-onset Alzheimer's disease may be more closely related to late-onset Alzheimer's than previously thought. Scientists have found similar gene mutations in both forms, leading some experts to believe that each may have the same causes. Detection of the gene may give doctors a new tool to help determine the correct treatment approach in current Alzheimer's patients.
  • People who participate in cognitively stimulating activities like reading, writing, playing games and solving puzzles throughout their lives tend to have fewer deposits of beta-amyloid in their brains as they age. Researchers have long suspected that keeping the brain active helps ward off Alzheimer's, but this is the first time they've been able to identify an underlying biological link.

(Source:  John Hopkins Health Alert, Posted in Memory on May 28, 2012)

Sunday, 3 June 2012

Is Coconut Oil Effective For Alzheimer Disease?

(Source : Medscape, 30 May 2012)

Response from Gayle Nicholas Scott, PharmD, Assistant Professor, Eastern Virginia Medical School, Norfolk, Virginia; Clinical Pharmacist, Chesapeake Regional Medical Center, Chesapeake, Virginia.

Coconut oil and a related medical food, Axona® (Accera, Inc; Broomfield, Colorado), are being promoted as treatments for Alzheimer disease (AD). Obtained from the kernel of the coconut palm (Cocos nucifera),[1] coconut oil contains medium-chain fatty acids, predominately lauric acid but also caprylic, myristic, and palmitic acids. Medium-chain triglycerides are the esterified form of medium-chain fatty acids; the terms are often used interchangeably.[2] The active ingredient of Axona is caprylic triglyceride. In the published research available, the product is called AC-1202.[3-5]

Proponents claim that coconut oil and Axona provide ketones as an alternative to glucose for cerebral metabolic processes. Advocates of these treatments describe AD as "diabetes of the brain" and contend that the AD brain is better able to use ketones than glucose.[6] This theory is not widely accepted among AD clinicians and researchers,[7] but some speculate that ketogenesis might improve free radical-mediated pathologies associated with AD.[8]

Normally, metabolic energy comes from glucose. When glucose availability is reduced, the liver produces ketone bodies (primarily acetoacetate and beta-hydroxybutyric acid [beta-OHB]) as energy sources. Unlike the heart and skeletal muscle, the brain cannot use fatty acids as an energy source because it requires glucose or ketone bodies.[8]

Medium-chain triglycerides are more ketogenic than long-chain triglycerides, such as those in animal fat. Ketogenic diets, which are diets high in fat and low in carbohydrates and proteins, have been used since the time of Hippocrates for treatment of epilepsy; the mechanism is still unknown.[8] Ketogenic diets are still used in refractory epilepsy, but poor tolerance of the gastrointestinal side effects and dislike for the diet limit effectiveness.[9] Medium-chain triglyceride diets are better tolerated than classic ketogenic diets, which include more long-chain triglycerides. Because medium-chain triglycerides are highly ketogenic, patients can consume more carbohydrates, making the diet more palatable.[8]

Several theories have been proposed for beneficial effects of ketones in AD, including prevention of amyloid plaques, reduction of proinflammatory mediators associated with neurodegeneration, and a neurotrophic effect of cerebral ketone metabolism.[10] Studies with encouraging results using ketogenic diets in AD have been published.[10-13] In a 6-week clinical study of 23 elderly patients with mild cognitive dysfunction, a diet very low in carbohydrates, which increased ketone levels, improved memory function better than a high-carbohydrate diet.[10] In another preliminary clinical study of 20 persons with AD or mild cognitive impairment, administration of a medium-chain triglyceride beverage was associated with improvement on some cognitive measurements in response to acute elevation of beta-OHB levels 90 minutes after treatment in 2 single-dose study visits, but only in patients without the apolipoprotein E gene (n = 9).[14]

A literature search for coconut oil and AD revealed no clinical studies. A search for the medical food Axona yielded 1 manufacturer-sponsored study and 2 substudies.[3-5] In a 90-day, randomized, double-blind phase 2 study, 152 persons diagnosed with mild to moderate AD received Axona10-20 g/daily or placebo. The primary endpoint was improvement on the AD Assessment Scale-Cognitive subscale (ADAS-Cog). At 45 days, patients receiving the study drug showed improvement on the ADAS-Cog, as noted in company advertising. However, scores were similar in both groups at day 90 and after a 2-week washout period on day 104. In patients without the apolipoprotein E gene, Axona was superior to placebo at both time points.[3]

According to the Alzheimer's Association, the manufacturer of Axona elected to market the product as a medical food rather than conducting phase 3 studies in a larger population to prove effectiveness. Medical foods do not require phase 3 studies.[15]

Both coconut oil and Axona are high in calories and saturated fat, but some research suggests that coconut oil neither increases weight nor adversely affects lipid levels.[2,16,17] Gastrointestinal adverse effects, particularly diarrhea, were frequent causes of discontinuation in the phase 2 study.[3] Coconut oil costs about $12 for 16 oz. Axona costs about $85 per month.

Currently, neither coconut oil nor Axona can be recommended for AD due to lack of credible effectiveness research. For patients or family members who insist on these products, suggest starting with a low dose and gradually increasing the dose to avoid adverse gastrointestinal effects. Healthcare providers should monitor for adverse effects and effectiveness and possibly increased lipid levels. 

Measuring Blood Pressure, Two Arms Are Better Than One

Odds are that when your doctor takes your blood pressure, he or she measures it in only one arm. Yet, guidelines from the American Heart Association have for some time recommended measuring blood pressure in both arms at a patient's initial visit - and findings from a recent study suggest why clinicians should routinely perform the two-arm measurement. The study, published in the Lancet, found that a substantial difference in blood pressure readings between arms indicates an increased risk of developing vascular disease and of dying from heart disease.

A gap between arms in readings of systolic pressure - the top number in the reading, which measures pressure in the arteries when the heart muscle contracts, or beats - can reveal impaired blood flow stemming from vascular diseases, specifically peripheral arterial disease (PAD) and cerebrovascular disease.

When researchers analyzed data from 20 studies involving 16,428 people, they found that a difference of 15 millimeters of mercury (mm Hg) or greater between arms was associated with more than twice the risk of developing PAD when compared with people who had smaller systolic variations. PAD occurs when plaque builds up in the arteries (atherosclerosis), mostly affecting the legs. The blockages, similar to coronary artery disease, increase the risk of a heart attack or stroke.

The study analysis also showed that a difference of 15 mm Hg or more was associated with underlying cerebrovascular disease caused by atherosclerosis in the arteries that deliver blood to the brain, which can lead to stroke or dementia. People in the study with at least a 15 mm Hg difference had a 60 percent increased risk of suffering from the disease.

The difference of 15 mm Hg or more was also associated with a heightened likelihood of premature death from heart disease or another medical condition. And the number of people showing such a gap wasn't insignificant. In one study the researchers analyzed for the Lancet study, up to 7 percent of participants had a difference of 15 mm Hg or higher.

Take away. But another compelling reason to check for a pressure difference between arms is to accurately identify the presence of hypertension, or high blood pressure. If a clinician measures blood pressure in only one arm, and the blood pressure is lower in that arm than in the other, he or she may miss hypertension. For that reason, as well as for potentially identifying a sign of vascular disease, having your blood pressure measured in both arms is certainly worth discussing with your doctor at your next visit

(Source:  John Hopkins Health Alert, 1 June 2012)