LIFESTYLE CHANGES ARE KEY TO EASING ALZHEIMER'S RISK

While medications have consistently failed to prevent Alzheimer's or significantly slow its progression, commonsense health activities can make a profound difference, a growing body of research shows.

"Health doesn't always come in the form of a pill," said Alan Lerner, Director of the Brain Health and Memory Center at University Hospitals Case Medical Center in Cleveland, and a Neurologist at Case Western Reserve University.

The combination of eating well, exercising, keeping mentally and socially engaged, and managing obesity, high blood pressure and diabetes can reduce someone's risk of memory decline, according to a new study from Finland. The study, presented Sunday at the Alzheimer's Association International Conference in Denmark, is the first to examine the impact of all four factors together; other studies have looked at pieces of healthy lifestyles, but not the combination.

"The routine things, the things that are simple, have turned out to be protective," said Yonas Geda, a Professor of Neurology and psychiatry at the Mayo Clinic in Scottsdale, Ariz., who was not involved in the Finnish study. "It keeps going back to the old advice from grandma."

In that study, 1,260 Finnish volunteers, ages 60-77, were divided into two groups – one that was encouraged to follow the four healthy lifestyle factors and the other that was given standard care.

At the end of the two-year study period, the group that paid extra attention to healthy eating, exercising, engagement and management of heart-health risk factors performed significantly better on tests of memory and other cognitive abilities than the control group. Researchers will follow both groups an additional seven years to see if the improvement continues.

Geda presented his own research at the conference, showing that exercise in midlife appears to be protective against dementia decades later. People who simply took an after-dinner stroll three times a week in their 50s and 60s were less likely to suffer memory problems in their 80s, according to the study.

He and his colleagues have also shown in past research that mental and social activities, such as reading books, going to Bible study, playing the piano and knitting can reduce the risk of memory loss, as can eating in moderation.

"This is really good news to society," said Geda, who has added an occasional after-dinner stroll to his own schedule. "Physical activity and mental activities are accessible to all people."

Another study, which Lerner led and presented at the conference, was the first to explore whether it is worthwhile to put dementia patients through the discomfort and expense of cataract surgery.

A group of 28 patients who had the surgery declined much more slowly than 14 people with similar vision problems who did not, the study found. The improvement was at least as large as the benefits seen with medication, he said.

"You don't stop being a person just because you have a dementia," Lerner said. "We find that really taking care of the whole person is very important, especially when it comes to sensory deprivation — if you don't perceive it, it's very difficult to remember it."

(Source:  USA Today, 14 July 2014)

ONE IN THREE ALZHEIMER'S CASES PREVENTABLE, SAYS RESEARCH

One in three cases of Alzheimer's disease worldwide is preventable, according to research from the University of Cambridge.

The main risk factors for the disease are a lack of exercise, smoking, depression and poor education, it says.

Previous research from 2011 put the estimate at one in two cases, but this new study takes into account overlapping risk factors.

Alzheimer's Research UK said age was still the biggest risk factor.

Writing in The Lancet Neurology, the Cambridge team analysed population-based data to work out the main seven risk factors for Alzheimer's disease.

These are:

·         Diabetes

·         Mid-life hypertension

·         Mid-life obesity

·         Physical inactivity

·         Depression

·         Smoking

·         Low educational attainment

They worked out that a third of Alzheimer's cases could be linked to lifestyle factors that could be modified, such as lack of exercise and smoking.

The researchers then looked at how reducing these factors could affect  the number of future Alzheimer's cases.  

They found that by reducing each risk factor by 10%, nearly nine million cases of the disease could be prevented by 2050.                                                     

In the UK, a 10% reduction in risk factors would reduce cases by 8.8%, or 200,000, by 2050, they calculated.

Current estimates suggest that more than 106 million people worldwide will be living with Alzheimer's by 2050 - more than three times the number affected in 2010.

Healthier old age

Professor Carol Brayne, from the Institute of Public Health at the University of Cambridge, said: "Although there is no single way to treat dementia, we may be able to take steps to reduce our risk of developing dementia at older ages.”

"We know what many of these factors are, and that they are often linked.”

"Simply tackling physical inactivity, for example, will reduce levels of obesity, hypertension and diabetes, and prevent some people from developing dementia.”

"As well as being healthier in old age in general, it's a win-win situation."

Dr Simon Ridley, Head of Research at charity Alzheimer's Research UK, said there was still much to discover about the disease.

"While age is the biggest risk factor for most cases of Alzheimer's, there are a number of lifestyle and general health factors that could increase or decrease a person's chances of developing the disease.”

"However, we still do not fully understand the mechanisms behind how these factors are related to the onset of Alzheimer's."

Investment

Dr Ridley said there were more than 820,000 people in the UK living with dementia, and an ageing population would lead to spiraling numbers being affected.

"As there is still no certain way to prevent Alzheimer's, research must continue to build the strongest evidence around health and environmental factors to help individuals reduce their risk."

He added: "This new study also highlights that many cases are not due to modifiable risk factors which underlines the need to drive investment into new treatment research."

Of the seven risk factors, the largest proportion of cases of Alzheimer's in the US, UK and the rest of Europe can be attributed to physical inactivity.

The study says about a third of the adult population in these countries are physically inactive.

Physical inactivity is also linked to increased risks of other health problems, such as cancers and cardiovascular diseases.

(Source:  BBC News Health, 14 July 2014)

MEMORY LOSS: IT’S NOT INEVITABLE

The brain contains about 100 billion neurons. A common misconception is that tens of thousands of neurons die each day. In reality, few neurons die over a person's lifetime, but they do shrink. This shrinkage may partially explain why mental functioning slows in middle and older age. (Serious memory problems do occur when major disorders such as a stroke or Alzheimer's destroy whole clusters of neurons.)

In addition to the shrinkage of neurons, starting in middle age the brain begins producing smaller quantities of many neurotransmitters -- chemical messengers that relay information between nerve cells. Brain blood flow is also reduced 15 to 20 percent between ages 30 and 70, although the shrinkage of neurons may account for the reduced flow because less tissue requires less blood.

Cultural attitudes and preconceptions about aging and memory loss can also influence the occurrence of memory lapses as people age. In one study, researchers compared the memory skills of two groups known to harbor few stereotypes concerning old age -- the people of China and deaf Americans -- with those of a third group known to have numerous preconceptions about aging, hearing Americans. Among these preconceptions is the notion that aging causes an inevitable decline in memory skills.

The study results suggest that there is a strong link between culture and memory: The first two groups were less forgetful than the third group, and older Chinese participants performed as well as the younger people in each of these groups. The implication is that if people expect their memory to get worse, they may be less diligent in trying to remember.

Other research indicates that the mental processes required to remember newly acquired information are the same as those needed to retrieve memories from long ago -- something most older people do quite well. This finding implies that older people retain the capacity to recall recent events, but the new information is not being recognized as important or is being discarded instead of stored.

Some researchers interpret this to mean that occasional memory lapses may result from a failure to pay close attention to the information rather than an inability to remember. Thus, it appears that forging new memories depends in large part on staying interested, active and alert.

(Source:  John Hopkins Health Alert, 14 July 2014)

ADI NEWS RELEASE - SMOKING INCREASES RISK OF DEMENTIA

The World Health Organization (WHO) and Alzheimer’s Disease International (ADI) in its latest report highlighted the serious risk that tobacco use creates for dementia. 

The Key Message is:

▪     Smoking is a risk factor for dementia, and quitting could reduce the dementia  burden.

▪     Second-hand smoke exposure may also increase the risk of dementia.

▪     14% of Alzheimer’s disease cases worldwide are potentially attributed to   smoking.

▪     As no treatments are currently available to cure or alter the progressive course of dementia, it is essential to identify modifiable risk factors for reducing the occurrence of the disease, delaying its onset or reducing its burden.

▪     Governments should actively implement and enforce the measures of the WHO Framework Convention on Tobacco Control, especially smoke-free environment laws and systematic access to tobacco cessation services.

Geneva, 09 July 2014:

Smokers have a 45% higher risk of developing dementia than non-smokers, according to information published today by the World Health Organization (WHO) in collaboration with Alzheimer’s Disease International (ADI).

Evidence reviewed by WHO reveals a strong link between smoking and the risk of dementia, and the more a person smokes, the higher the risk. It is estimated that 14% of Alzheimer’s disease cases worldwide are potentially attributable to smoking.

WHO warns that exposure to second-hand smoke (passive smoking) may also increase the risk of dementia.

"Since there is currently no cure for dementia, public health interventions need to focus on prevention by changing modifiable risk factors like smoking,” says Dr Shekhar Saxena, Director of the Department for Mental Health and Substance Abuse at WHO. “This research shows that a decrease in smoking now is likely to result in a substantial decrease in the burden of dementia in the years to come."

Tobacco use is already recognized as the one risk factor common to four main groups of non-communicable diseases (NCDs): cancers, cardiovascular disease, chronic lung disease and diabetes.

“Tobacco is one of the biggest public health threats the world has ever faced, killing nearly six million people a year,” says Dr Douglas Bettcher, Director of the Department for Prevention of Non-communicable Diseases at WHO. “WHO urges governments to actively implement and enforce the measures of the WHO Framework Convention on Tobacco Control, especially smoke-free environment laws and access to tobacco cessation services”.

Laurent Huber, Director of the Framework Convention Alliance (FCA) for Tobacco Control, comments: “It is no surprise to see these findings confirm that tobacco smoking is a major risk factor for dementia. This adds yet another item to the long list of the devastating consequences of tobacco and gives even more reason for personal and public health action to help people to quit smoking.”  

“The research also shows that quitting smoking later in life might be beneficial so encouraging and supporting current tobacco users to quit should be a priority,” says Serge Gauthier, chair of the ADI’s Medical Scientific Advisory Panel.

Dementia affects more than 44 million people worldwide, with almost two thirds of them living in low- and middle-income countries. 

“Every year, there are 7.7 million new cases of dementia. In 2010, the global cost was calculated at US$ 604 billion, which represents 1% of global GDP (gross domestic product),” says Marc Wortmann, ADI Executive Director. “No government can ignore the opportunity to link this new information into its planning and health system activities to reduce smoking and control NCDs.”

ADI believes that this information brief can form the basis for countries to add messages about brain health and dementia risk into public health anti-smoking programs and interventions. 

For further information:
Click on -> Tobacco Use and Dementia   
Visit : http://www.who.int/tobacco/publications/en/ 

ALZHEIMER'S DISEASE COULD BE PREVENTED AFTER NEW BLOOD TEST BREAKTHROUGH

Scientists at Oxford University and Kings College London develop blood test which can predict the onset of Alzheimer's so that drugs could target the disease before symptoms appear

A blood test has been developed to predict if someone will develop Alzheimer’s within a year, raising hopes that the disease could become preventable.

After a decade of research, scientists at Oxford University and King’s College London are confident they have found 10 proteins which show the disease is imminent.

Clinical trials will start on people who have not yet developed Alzheimer’s to find out which drugs halt its onset.

The blood test, which could be available in as little as two years, was described as a “major step forward” by Jeremy Hunt, the Health Secretary, and by charities which said it could revolutionize research into a cure.

“Although we are making drugs they are all failing. But if we could treat people earlier it may be that the drugs are effective,” said Simon Lovestone, Professor of Translational Neuroscience at Oxford. “Alzheimer’s begins to affect the brain many years before patients are diagnosed with the disease. If we could treat the disease in that phase we would in effect have a preventative strategy.”

Clinical trials into so-called “wonder drugs” such as BACE inhibitors and anti-amyloid agents, have shown little improvement for sufferers. Scientists believe that by the time Alzheimer’s is diagnosed, an irreversible “cascade” of symptoms has already occurred.

About 600,000 people in Britain suffer from Alzheimer’s and hundreds of thousands have mild cognitive impairment. Last month, David Cameron pledged to fast-track dementia research.

The new test, which examines 10 proteins in the blood, can predict with 87 per cent accuracy whether someone suffering memory problems will develop Alzheimer’s within a year.

The researchers used data from three international studies. Blood samples were taken from 1,148 people, 476 of whom had Alzheimer’s, 220 with memory problems, and a control group of 452 without any signs of dementia. The scientists found that 16 proteins were associated with brain shrinkage and memory loss and 10 of those could predict whether someone would develop Alzheimer’s.

Mr Hunt said: “This is welcome research on an issue we’re made a national priority. Developing tests and bio markers will be important steps forward in the global fight against dementia as we search for a cure.”

Previous studies have shown that PET brain scans and plasma in lumbar fluid could be used to predict that onset of dementia from mild cognitive impairment. But PET imaging is highly expensive and lumbar punctures are invasive and carry risks.

The first tests are likely to be available in between two and five years. However, the study is likely to throw up ethical dilemmas about whether patients should receive potentially devastating news about their future. Prof Lovestone said it was unlikely that GPs would use the test until a treatment was available.

The breakthrough was welcomed by dementia charities and academics.

Eric Karran, Director of Research at Alzheimer’s Research UK, which helped fund the research, said it brought the prospect of Alzheimer’s becoming a preventable disease “significantly closer”.

Prof Gordon Wilcock, Emeritus Professor of Geratology at Oxford, added that it was “great news”. The study was published in the Journal Alzheimer’s & Dementia.

(Source:  The Telegraph, 8 July 2014)