Can Vitamin E Prevent Alzheimer's?

Can Vitamin E Prevent Alzheimer's?   

      

The evidence:

While there is some evidence that vitamin E slows the progression of Alzheimer's, a recent trial the first large-scale trial to investigate whether antioxidants can prevent dementia found that neither vitamin E nor selenium (another antioxidant) was protective, whether used alone or in combination.

The study, published in JAMA Neurology in 2017, tested the effect of the two antioxidants on about 3,800 men who were at least 60 years old. Participants were divided into four groups, each took supplements or placebo for up to 15 years as follows: vitamin E (400 IU per day), selenium (200 micrograms per day), vitamin E plus selenium, or placebo. All participants were evaluated periodically for dementia, using screening tests and medical records.

Analysis showed that about the same percentage of each of the four groups – 4 percent developed dementia, indicating that neither supplement was protective.

The bottom line:

Don't waste your money on these supplements to prevent Alzheimer's.  A better investment in money and time would be to exercise regularly and follow a healthful diet to reduce your risk for cardiovascular disease. There is convincing evidence that these steps can also help reduce the risk for age-related cognitive decline.

(Source: UC Berkeley Health and Wellness Alerts, 12 December 2017)

WARNING SIGNS OF MILD COGNITIVE IMPAIRMENT

People with mild cognitive impairment are more forgetful than normal for their age, but they don't experience other cognitive problems associated with dementia, such as disorientation or confusion about routine activities.

Routine tasks such as paying bills, shopping, and meal preparation may become challenging. People with mild cognitive impairment may take more time doing these things and they may make more mistakes. They are generally able to live independently but may be less active socially.

About one in five older adults has some type of mild cognitive impairment. In a 2010 study of nearly 2,000 people, about 16 percent of dementia-free people over age 70 were suffering from mild cognitive impairment. Men were more likely to suffer than women, although women may simply experience dementia at a later age. In the study, risk factors included being a carrier of the APOE e4 gene (a known risk factor for late-onset Alzheimer's disease), never having married, and having less than nine years of education.

In a 2011 study of nearly 1,300 women age 85 and older, 23 percent were diagnosed with mild cognitive impairment. The researchers recommend that women this age should be screened for cognitive problems.

The National Institute on Aging-Alzheimer's Association workgroup has come up with new diagnostic guidelines for mild cognitive impairment due to Alzheimer's disease. With mild cognitive impairment, people experience gradual cognitive decline due to Alzheimer's-related brain changes.

What to look for:

A person is thought to suffer from mild cognitive impairment if he or she meets the following criteria:

·         A friend, family member, doctor, or the person in question is concerned about a change in his or her cognition compared to the previous level.

·         The person is experiencing more difficulties in one or more cognitive areas such as memory, attention, and language than would be expected for his or her age or educational background. Difficulty learning and retaining new information is most common in mild cognitive impairment patients who develop Alzheimer's related dementia.

The person is having trouble performing complex tasks such as paying bills, preparing a meal, or shopping. He or she may take more time, be less efficient, and make more mistakes than in the past. Still, he or she maintains his or her independence with minimal assistance.

·         There's no evidence of significant impairment in social or occupational functioning.

·      There should be objective evidence of progressive cognitive decline over time. Cognitive testing can assess the degree of impairment. Scores for people with mild cognitive impairment are usually 1 to 1.5 standard deviations below the mean for their age and education level.

Some formal cognitive tests that assess both immediate and delayed recall can help identify mild cognitive impairment patients who are likely to progress to Alzheimer's dementia within a few years. They include the Free and Cued Selective Reminding Test, the Rev Auditory Verbal Learning Test and the California Verbal Learning Test.

Other tests can determine impairment in problem-solving, reasoning and language. Doctors may also assess a person's cognitive function using informal techniques, like asking a patient to learn a street address and then remember it after a delay.

Vascular, traumatic, and medical illnesses that could explain the decline in cognition must be ruled out. The goal is to increase the likelihood that the underlying cause of mild cognitive impairment is probably Alzheimer's.

·      If a person is known to carry a genetic defect, such as a mutation in APP, PS1 or PS2, he or she is most likely suffering from mild cognitive impairment due to Alzheimer's disease. Most of these carriers develop Alzheimer's before age 65. A person who meets the diagnostic criteria for mild cognitive impairment and carries the apolipoprotein E gene is more likely to progress to Alzheimer's dementia within a few years than someone without this gene.

Biomarkers such as proteins that can be measured in spinal fluid as well as imaging tests like positron-emission tomography (PET) scans are being studied or used to increase accuracy in diagnosing mild cognitive impairment.

Doctors are looking for specific proteins beta-amyloid and tau which are found in the brain of a person affected by Alzheimer's disease. Identifying these proteins could help doctors pinpoint the underlying cause of mild cognitive impairment, which could lead to the best treatment and determine whether a person will progress to a more severe stage of mild cognitive impairment or dementia.

What may help

Researchers have discovered that activities such as exercise and computer use may prevent mild cognitive impairment. In a 2010 Mayo Clinic study, adults between ages 70 and 90 who participated in moderate physical exercise like brisk walking or biking and used a computer were less likely to develop mild cognitive impairment.

Another Mayo Clinic study found that consuming more heart-healthy mono and polyunsaturated fats reduced the risk of mild cognitive impairment among people age 70 and older. These fatty acids which are found in olive oil, nuts, seafood, and vegetable oils appear to prevent inflammation and reduce the risk of blood clots, stroke, and heart disease.

Many experts believe that mild cognitive impairment may be an early warning sign of memory disorders later in life. Studies show that up to 15 percent of people with mild cognitive impairment progress to Alzheimer's disease each year, compared with a rate of 1 to 2 percent a year for the general older population.

Large-scale studies are testing whether therapies can halt or slow the conversion from mild cognitive impairment to Alzheimer's disease. By intervening at the first signs of memory trouble, doctors hope to delay Alzheimer's disease, or prevent it altogether.

In a study published in Neurology, moderate drinking defined as up to one drink per day (mostly wine)—slowed the rate of progression from mild cognitive impairment to dementia by 85 percent compared with those who abstained from alcohol.

Research on medications for staving off dementia has been discouraging, though. For example, in a recent study of people with mild cognitive impairment, researchers found no significant benefit from early intervention with the Alzheimer's drug donepezil (Aricept) or vitamin E.

(Source: UC Berkeley Health and Wellness Alerts, November 2017)

CAN DRINKING TEA PREVENT DEMENTIA?

A study in the December 2016 Journal of Nutrition, Health & Aging showed that drinking tea frequently is associated with a lower risk of dementia, especially for people who are genetically predisposed to the disease.

Researchers followed 957 older adults, average age 65, who were part of the Singapore Longitudinal Aging Study. Of these, 69% drank tea on a frequent basis. After a five-year period, the researchers found that the tea drinkers had a 50% lower risk of dementia. This is consistent with earlier findings that showed tea consumers scored higher on various cognitive tests.

The researchers also conducted genetic tests on the group and found that tea drinkers who carried the APOE4 gene variant, a known risk factor for Alzheimer's, were also at a lower risk compared with people who had APOE4 and did not drink tea.

How tea may help protect against dementia is not known, but other findings suggest that the brain-protecting effects of tea drinking could stem from bioactive compounds in tea leaves, such as flavonoids, which have anti-inflammatory and antioxidant potential, and L-theanine, which regulates neurotransmitter and brain activities.

It did not matter what kind of tea the people drank — black, green, and oolong all had the same association. The key was regular consumption, according to the scientists. The more the people drank tea, the stronger the relationship, and the best results were among those who had tea daily during the entire study period.

(Source:  Harvard Health Publication /Harvard Medical school, July 2017)

DO YOU HAVE MILD COGNITIVE IMPAIRMENT?

Mild cognitive impairment (MCI) falls somewhere between age-associated memory impairment and early dementia. People with mild cognitive impairment are more forgetful than normal for their age, but they don’t experience other cognitive problems associated with dementia, such as disorientation or confusion about routine activities. Routine tasks such as paying bills, shopping and meal preparation may become challenging but can still be performed. People with MCI may take more time doing these activities and they may make more mistakes. They are generally able to live independently but may be less active socially.

About one in five older adults has some type of MCI. In a 2010 study of nearly 2,000 people, about 16 percent of dementia-free people over age 70 were suffering from MCI. Men were more likely to suffer than women, although women may simply experience dementia at a later age. In the study, risk factors included being a carrier of the APOE ε4 gene (a known risk factor for late-onset Alzheimer’s disease), never having married and having less than nine years of education. In a 2011 study of nearly 1,300 women age 85 and older, 23 percent were diagnosed with MCI. The researchers recommend that women this age should be screened for cognitive problems.

The National Institute on Aging/Alzheimer’s Association workgroup has come up with new diagnostic guidelines for MCI due to Alzheimer’s disease. With MCI, people experience gradual cognitive decline due to Alzheimer’s-related brain changes. A person is thought to suffer from MCI if he or she meets the following criteria:

• A friend, family member, doctor or the person in question is concerned about a change in his or her cognition compared to the previous level.

• The person is experiencing more difficulties in one or more cognitive areas such as memory, attention and language than would be expected for his or her age or educational background. Difficulty learning and retaining new information is most common in MCI patients who develop Alzheimer’s-related dementia.

• The person is having trouble performing complex tasks such as paying bills, preparing a meal or shopping. He or she may take more time, be less efficient and make more mistakes than in the past. Still, he or she maintains his or her independence with minimal assistance.

• There’s no evidence of significant impairment in social or occupational functioning.

• There should be objective evidence of progressive cognitive decline over time. Cognitive testing can assess the degree of impairment. Scores for people with MCI are usually 1 to 1.5 standard deviations below the mean for their age and education level. Some formal cognitive tests that assess both immediate and delayed recall can help identify MCI patients who are likely to progress to Alzheimer’s dementia within a few years. Other tests can determine impairment in problem-solving, reasoning and language. Doctors may also assess a person’s cognitive function using informal techniques, like asking a patient to learn a street address and then remember it after a delay.

• Vascular, traumatic and medical illnesses that could explain the decline in cognition must be ruled out. The goal is to increase the likelihood that the underlying cause of MCI is probably Alzheimer’s.

• If a person is known to carry a genetic defect, such as a mutation in APP, PS-1 or PS-2, he or she most likely has MCI due to Alzheimer’s disease. Most of these carriers develop Alzheimer’s before age 65. A person who meets the diagnostic criteria for MCI and carries a variant of the Apolipoprotein E (APOE) gene is more likely to progress to Alzheimer’s dementia within a few years than someone without it.

Researchers have discovered that activities such as exercise and computer use may prevent MCI. In a 2010 Mayo Clinic study, adults between ages 70 and 90 who participated in moderate physical exercise like brisk walking or biking and used a computer were less likely to develop MCI. Another Mayo Clinic study found that consuming more heart-healthy mono- and polyunsaturated fats reduced the risk of MCI among people age 70 and older. These fatty acids—which are found in olive oil, nuts, seafood and vegetable oils—appear to prevent inflammation and reduce the risk of blood clots, stroke and heart disease.

Many experts believe that MCI may be an early warning sign of memory disorders later in life. Studies show that up to 15 percent of people with MCI progress to Alzheimer’s disease each year, compared with a rate of 1 to 2 percent a year for the general older population.

(Source:  Health After 50, 14 April 2016)

Souvenaid – A Nutritional Drink for Alzheimer's Disease?

(Soruce:  Alzheimer's Society, March 2016 Research Update)

       

On 10th March 2016, news outlets reported on a nutritional drink that claimed to "stop the brain from shrinking" and "slow the progression of Alzheimer's disease". We examine the science behind these headlines.

The story is based on clinical trial results that were presented at the Advances in Alzheimer's Therapy congress in Athens. This research team provided evidence that this drink may help to improve some aspects of memory in people who have mild cognitive impairment due to the very early stages of Alzheimer's disease. However, it is recommended that you speak to your GP before starting to take this drink or any other nutritional supplements or medication.

What is the drink?

Souvenaid is a nutritional drink containing an active ingredient called Fortasyn Connect. This is a combination of fatty acids, vitamins and other nutrients. It was developed with the aim of preventing the loss of important connections between brain cells that occurs in Alzheimer's disease. Whilst this effect on brain cells has been shown in animal studies, it has not yet been confirmed that the drink has the same effect in people.

Previous trials of the drink were not able to show any effect on its ability to slow or prevent cognitive decline but there was evidence that it may improve some kinds of memory in people in the early stages of Alzheimer's disease. Therefore, it is approved as a food for medical purposes for people in the earlier stages of the condition and is available over the counter at £3.50 for a daily dose.

What was this trial and what were the results?

The study involved 311 people who had mild cognitive impairment, which is a condition where someone has mild memory problems that are not severe enough for them to be diagnosed with dementia. The study participants had also had tests like brain scans or spinal taps to show that their memory problems were most likely due to the very early stages of Alzheimer's disease.

Half of the people on the trial took the drink containing Fortasyn Connect once a day for two years; the other half took a drink with the same calorie content but without the active ingredient. When the researchers analysed the results at the end of the trial, there was no difference in overall cognitive performance between the two groups.

However, when the researchers used more sensitive tests they found that the people who had taken the drink containing Fortasyn Connect had improvements in their episodic memory (memories of specific events and the time and place that they happened). Brain scans from the trial also showed that the people who took Souvenaid had less shrinkage in certain areas of their brain, including in the hippocampus, which is involved in memory.

There was no evidence presented that those who took Souvenaid were less likely to experience cognitive decline or to progress to full Alzheimer's disease. The research team are still analysing this data from the LipiDiDiet trial.

What do these results mean?

These trial results have not yet been published which means they have not yet been rigorously scrutinised by the scientific community. We need to wait for the trial results to be published to be able to get a detailed understanding of what they mean for people with early Alzheimer's disease.

Based on the results presented at the conference, we cannot say that the drink is able to prevent cognitive decline in those mild cognitive impairment due to the very early stages of Alzheimer's disease. The drink has no overall effect on cognition when it is taken for two years.

There is evidence that it can bring improvements in some aspects of memory after two years. This means it might be able to help people in the very early stages of Alzheimer's disease to manage some of the memory problems they commonly experience.

I'm worried about my memory - should I buy this drink?

If you are worried about your memory, or have a diagnosis of mild cognitive impairment, you should see your GP to discuss the options that are suitable for you.

This trial only looked at people with mild cognitive impairment due to the very early stages of Alzheimer's disease, but there are many other causes of mild cognitive impairment. There is no evidence that this drink would improve memory in everyone who has this condition so it is best to consult with your GP before beginning any nutritional supplement.

There is evidence that regular physical activity, avoiding smoking, eating a healthy, balanced diet and keeping your blood pressure in check are all ways to reduce your risk of developing dementia. This nutritional drink might improve memory in some people with mild memory problems but there is currently no evidence that it will slow cognitive decline or prevent dementia.

DOES POOR SLEEP AFFECT DEMENTIA RISK?

Several people find that having a bad night’s sleep can affect their memory and thinking abilities the next day. But does poor sleep have an effect on your memory in the longer term? This article explores the research into whether there is a link between sleep and dementia risk.

Sleep

People affected by dementia often have several issues with getting a good night's sleep, and sometimes people report that their memory seems worse after a bad night. However, the evidence is unclear on whether poor sleep is a risk factor for dementia.

Sleep and dementia is a complicated topic. Different types of dementia are associated with different sleep problems. Researchers are also not yet sure which way the interaction goes - whether poor sleep causes or exacerbates dementia or if dementia leads to poor sleep. Some researchers believe that both of these theories could be true, and the relationship could be circular. On top of this, it is unclear what the mechanisms are that underlie these interactions.

It is clear that more research is needed to understand this relationship; in particular research that observes large groups of affected people for very long periods of time.

Light Sleep Disorders

Light sleep disorders are often called rapid eye movement sleep behaviour disorder (RBD), and cause people to act out their dreams through moving or talking in their sleep. Dementia with Lewy bodies and Parkinson's disease seem to be particularly associated with light sleep disorders and some studies have suggested that light sleep disorders are a very early indicator of these conditions, particularly in older men.

Some researchers believe that the part of the brain that is damaged with dementia with Lewy bodies or Parkinson's disease also plays a role in light sleep, explaining why people with these conditions are particularly affected by light sleep disorders.

Sleep-Wake Cycle Disorders

The sleep-wake cycle is the 24 hour cycle that the body goes through each day, normally ensuring that we are active during the day and sleepy at night. When this cycle is altered is causes many unusual and disruptive sleep patterns. These include wakefulness at night and problems falling asleep and staying asleep, as well as drowsiness and napping during the day.

These sorts of sleep disturbances are associated with many kinds of dementia, most notably Alzheimer's disease. They also affect people with Parkinson's disease.

It is thought by some researchers that the Alzheimer's hallmark protein amyloid may be behind the link between Alzheimer's disease and sleep-wake cycles. Increased amyloid in the brain is commonly seen in people with Alzheimer's and studies have shown that raised amyloid levels may be associated with poor sleep quality.  The amyloid protein has also been linked to problems with storing memories whilst we sleep and other research indicates that poor sleep may affect the body's ability to clear the toxic amyloid protein from the brain.

This has led to the suggestion that improving sleep quality may have the potential to delay progression of Alzheimer's disease. However, it is also possible that the changes to the sleep-wake cycle are caused by other changes in the brain, and do not have an impact on risk of the condition. More research is needed to understand what the mechanisms linking sleep-wake cycles and Alzheimer's are.

Sleep Disordered Breathing

Sleep disordered breathing is when someone has difficulty breathing when they are asleep. This may be because of obstructions to the airway, making breathing harder work. Sleep disordered breathing is sometimes called sleep apnoea.

People of all ages can be affected by sleep disordered breathing, but it is most common in older people and people with obesity. Some research has suggested that people who are affected by sleep disordered breathing may be at higher risk of cognitive decline or impairment. This is because sleep disordered breathing may cause damage to the brain due to changes of levels of oxygen and carbon dioxide in the blood. It may also change flow of blood to the brain.

Treatments for Poor Sleep

Good quality sleep is linked to good health, including cognitive health. Researchers have also investigated whether there are effective treatments for poor sleep and whether these treatments can affect dementia risk. Some drug treatments for poor sleep, such as benzodiazepines, have been linked to an increased risk of dementia although the evidence behind this link is conflicting. Alzheimer's Society is funding a study into the effects these drugs could have on dementia risk.

Many treatments that have been suggested to improve quality of sleep involve lifestyle changes. Regular sleep regimes, eating schedules and diets, exercise, and ensuring exposure to bright light in the morning are all ways that you can improve your sleep quality. However more research is needed to indicate whether these activities have an effect on risk of dementia or disease progression. There is more information in treatment of sleep disorders on the NHS Choices website or you can speak to your GP.

A machine called continuous positive airway pressure (CPAP) has been shown to reduce the consequences of sleep apnoea by several studies. Before this treatment can be used, research is needed to indicate with more detail how to use it, for example how long the treatment should last and what lifestyle changes can be made to help.

There are also several drugs that have been trialled to improve sleep. Some doctors may prescribe melatonin, a hormone believed to be important in maintaining regular sleep-wake cycles. There is some evidence that this treatment does improve sleep quality in people with Alzheimer's disease and Parkinson's disease but so far evidence suggests melatonin does not affect risk of dementia or cognitive function.

Please consult your GP before making any decisions about taking sleep medication.

(Source:  Alzheimer's Society, March 2016 Research Update)

POOR CIRCULATION IN BRAIN LINKED TO PSYCHOSIS IN ALZHEIMER'S DISEASE PATIENTS

Researchers find conditions such as high blood pressure, smoking may contribute to risk.

Psychosis, including delusions and hallucinations, affects about half of Alzheimer's disease patients and researchers have set out to clarify the link between these two conditions.

Canadian researchers said they found that cerebrovascular disease, a group of conditions that restrict the circulation of blood to the brain, appears to play a significant role in psychosis for those with Alzheimer's disease.

About 19 percent of people with Alzheimer's disease living in the community (rather than in a nursing home) have delusions. Another 14 percent have hallucinations, the researchers said.

Psychotic symptoms among people with Alzheimer's disease can cause added burdens on loved ones and caregivers. These symptoms can also speed up the progression of Alzheimer's disease, the study authors explained.

For the study, the researchers analyzed autopsy data from more than 1,000 people who had been treated at 29 Alzheimer's centers in the United States between 2005 and 2012. An Alzheimer's disease diagnosis can only be confirmed after death by autopsy.

The research team led by Dr. Corinne Fischer from St. Michael's Hospital in Toronto said that 890 of the study patients had been clinically diagnosed with Alzheimer's disease while still alive. Of those, nearly 730 had Alzheimer's disease that was confirmed by an autopsy, according to the report published on 5 January 2016 in the Journal of Alzheimer's Disease.

The autopsies revealed that those with confirmed Alzheimer's disease who had been diagnosed with psychosis didn't have more physical evidence of Alzheimer's disease in their brains (such as protein deposits).

Instead, the researchers were surprised to learn that risk factors linked to blood vessel problems such as, high blood pressure, diabetes and smoking history, appeared to be strongly related to psychosis.

Because researchers haven't known the underlying reason for psychosis in Alzheimer's disease patients, they've been limited in how well they can treat the issue, the study authors explained in a hospital news release.

(Source: Health Day -  St. Michael's Hospital, News Release, 5 January 2016)

A DICE-Y APPROACH TO TAMING DEMENTIA SYMPTOMS

Treatment for managing dementia depends on its type and severity, but drug therapy often plays a role. Drugs can't cure dementia, but psychotropic medications, which include antipsychotics, antidepressants and anticonvulsants, are used with extreme caution in certain cases to help improve behavioural symptoms such as aggression, agitation, lack of inhibition and depression -- symptoms that caregivers tend to feel are more stressful or difficult to handle than the trademark memory loss associated with dementia.

For many people with dementia, the potential risks of psychotropics outweigh their potential benefits. All antipsychotics, including haloperidol (Haldol), olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal), significantly increase the risk of death, perhaps because they also increase the risk of stroke, heart attack and falls.

The DICE approach. In exploring ways to improve symptoms without depending on potent psychotropic drugs, experts from the University of Michigan and Johns Hopkins Medicine developed DICE, a strategy designed to minimize problems by changing a patient's behaviour. The acronym DICE stands for describe, investigate, create and evaluate. The DICE approach is a collaboration among a caregiver, a clinician and, if feasible, the individual with dementia. DICE consists of the following four steps:

Describe: The caregiver describes to the clinician specific behavioural problems the patient is exhibiting and the circumstances and environment under which they occur. The person with dementia describes the situation if he or she has the ability to do so. Both the caregiver and patient convey the degree of distress this behaviour causes them.

Investigate: The clinician examines, excludes and identifies possible underlying medical and mental health causes for the patient's actions as well as drugs the patient may be taking that contribute to the behaviour. The clinician reviews the caregiver's handling of the behaviour and advises the caregiver on issues such as appropriate reaction and expectations. Finally, the clinician will examine the environment for possible improvements, such as reducing clutter or noise and improving lighting.

Create: The clinician and the caregiver create a plan to prevent or respond to either a specific action or general behaviour to enhance the environment and improve caregiver skills and well-being.

Evaluate: The clinician evaluates and assesses the patient's and caregiver's compliance with the suggested plan and makes any needed changes if the desired effects aren't achieved.

The Centers for Medicare and Medicaid Services recommend the DICE approach in an effort to reduce the need for psychotropic drugs. The authors caution that doctors should prescribe psychotropics only after they've made other attempts to change behaviour - unless patients have severe depression, psychosis or aggression that poses a risk to themselves or those around them. The study outlining the DICE approach appeared in the Journal of the American Geriatrics Society.

(Source:  Scientific American Health After 50, 30 March 2015)

DEMENTIA AFFECTS "TASTE" MEMORY: DID YOU KNOW?

Getting enough to eat is a fairly common challenge for people with dementia. A study from Japan suggests that trouble recognizing familiar foods or remembering what a dish tastes like could play a role.

The investigators recruited 65 older adults: 30 had Alzheimer's disease, 20 had vascular dementia and 15 healthy participants served as controls. The participants were presented with replicas (so there would be no odors) of three popular dishes in Japan. They were asked to name the dishes and then to identify replicas of food materials included in them. Participants were also asked to name and describe expected tastes -- such as "sweet," "salty" or "bitter" -- of 12 replica foods.

What they found. Compared with healthy controls, those with Alzheimer's disease and vascular dementia had significantly lower scores on the food and taste cognition tests. Eight of 12 dementia patients, described as poor eaters, had especially low taste cognition scores. Imaging studies showed that taste cognition disorders in those with dementia were highly related to damage of the insular cortex -- a region of the brain associated with taste.

If your loved one is not eating enough, talk to the doctor. Any number of problems could be responsible; for example, difficulty swallowing. If a medical cause is ruled out, support groups or Alzheimer's disease organizations can be good sources for practical ways to deal with mealtime challenges.

This study was published in International Psychogeriatrics (Volume 26, page 1127).

(Source:  Scientific American Health After 50 Alerts, 26 February 2015)

TO KEEP YOUR MIND SHARP: DON’T SKIMP ON SLEEP

The health benefits of a proper night's rest have been shown to help numerous conditions, from hypertension to diabetes and depression. Now, increasing evidence points to the importance of good-quality sleep in keeping your memory and cognitive abilities sharp, too.

Experts recommend that older adults get seven to eight hours of sleep each night for overall good health and optimal functioning. Unfortunately, that may be easier said than done because sleep patterns change with age, and older individuals report more problems in getting to -- and staying -- asleep.

According to the National Institute of Health that nearly half of people aged 60 or older report insomnia. In addition, their sleep is not as deep as it was at a younger age, and they tend to wake more often during the night. Chronic pain, increased sensitivity to noise, and medical problems like obstructive sleep apnea and restless legs syndrome also rob older individuals of restorative sleep.

Sleeping Pill Precautions

Be aware that sleeping pills can affect your memory and cognitive abilities. This is particularly true with benzodiazepine-type sedatives, such as diazepam (Valium), temazepam (Restoril), lorazepam (Ativan), oxazepam (Serax) and alprazolam (Xanax and others). Medications in this class have been shown to increase the risk of cognitive impairment and delirium in older adults. Consequently, the American Geriatrics Society (AGS) recommends that drugs in this class not be used for the treatment of insomnia in seniors.

In addition, short-term memory loss has been linked to the over-the-counter antihistamine diphenhydramine (Benadryl), which is also an ingredient in sleep aids such as Tylenol PM and Unisom.

Newer sleep medications, including zolpidem (Ambien and others), eszopiclone (Lunesta) and ramelteon (Rozerem), have come under scrutiny because of reports that some people have experienced incidents like walking, eating or even driving while sleeping during the first few hours after taking the medication, yet having no memory of it the next day. As a further precaution, the FDA warns people who take zolpidem extended-release (Ambien CR) -- either 6.25 mg or 12.5 mg -- not to drive or engage in other activities that require complete mental alertness the following day because levels of the drug can remain high enough to impair these activities.

(Source:  Scientific American Health After 50 Alerts, 2 March 2015)

Has Stanford University Found A Cure for Alzheimer's Disease?

Scientists at Stanford University believe Alzheimer's disease could be prevented and even cured by boosting the brain's own immune response.

Researchers discovered that nerve cells die because cells which are supposed to clear the brain of bacteria, viruses and dangerous deposits, stop working.

These cells, called 'microglia' functioned well when people are young, but when they age, a single protein called EP2 stops them operating efficiently.

Now scientists have shown that blocking the protein allows the microglia to function normally again so they can hoover up the dangerous sticky amyloid-beta plaques which damage nerve cells in Alzheimer's disease.

The researchers found that, in mice, blocking EP2 with a drug reversed memory loss and myriad other Alzheimer’s-like features in the animals.

“Microglia are the brain’s beat cops,” said Dr Katrin Andreasson, Professor of Neurology and Neurological Sciences at Stanford University School of Medicine.

“Our experiments show that keeping them on the right track counters memory loss and preserves healthy brain physiology.”

By 2015 there will be 850,000 people with dementia in the UK, with Alzheimer's disease being the most common type. The disease kills at least 60,000 people each year.

Microglial cells make up around 10 to 15 per cent of cells in the brain. They act as a frontline defence, looking for suspicious activities and materials. When they spot trouble, they release substances that recruit other microglia to the scene which then destroy and get rid of any foreign invaders.

They also work as garbage collectors, chewing up dead cells and molecular debris strewn among living cells including clusters of amyloid-beta which aggregate as gummy deposits and break the connections between neurons, causing loss of memory and spatial awareness. These clusters are believed to play a substantial role in causing Alzheimer’s.

“The microglia are supposed to be, from the get-go, constantly clearing amyloid-beta, as well as keeping a lid on inflammation,” added Dr Andreasson. “If they lose their ability to function, things get out of control. A-beta builds up in the brain, inducing toxic inflammation.”

The scientists discovered that in young mice, the microglia kept the sticky plaques under control. But when experiments were done on older mice, the protein EP2 swung into action and stopped the microglia producing enzymes which digested the plaques.

Similarly mice which were genetically engineered not to have EP2 did not develop Alzheimer's disease, even when injected with a solution of amyloid-beta, suggesting that their cells were getting rid of the protein naturally.

And for those mice who developed Alzheimer's, blocking EP2 reversed memory decline.

Now Stanford is hoping to produce a compound which only blocks EP2 to prevent unnecessary side effects.

The study was published in the Journal of Clinical Investigation.

 (Source:  The Telegraph, 27 December 2014)

STANDING ON ONE LEG FOR 20 SECONDS CAN PREDICT CHANCE OF DEMENTIA

In the standing on one leg with eyes closed test, men and women able to hold the position for less than two seconds were three times more likely to die than those who could hold it for ten seconds or more

Balancing on one leg may indicate if a person is at risk of dementia or stroke, a study has found.

Scientists found that an inability to stand on one leg for more than 20 seconds was associated with micro-bleeds and "silent" strokes.

Although the brain injuries were too small to cause symptoms, scientists warned they could indicate growing problems.

Silent strokes, or lacunar infarction's, are known to increase the risk of both full-blown strokes and dementia.

Lead researcher Dr Yasuharu Tabara, from Kyoto University in Japan, said: "Our study found that the ability to balance on one leg is an important test for brain health.

"Individuals showing poor balance on one leg should receive increased attention, as this may indicate an increased risk for brain disease and cognitive decline."

The scientists looked at 841 women and 546 men with an average age of 67 who were asked to stand with their eyes open and one leg raised up for a maximum of 60 seconds.

Participants performed the test twice and the better of the two times was used in the study analysis.

They also had magnetic resonance imaging (MRI) scans to assess their levels of cerebral small vessel disease, which can interfere with blood flow in the brain.

The research, published in the journal Stroke, showed that 34.5 of those with more than two lacunar infarction lesions had trouble balancing.

The same was true for 16 per cent of participants with one lacunar infarction lesion and 30 per cent of men and women with more than two sites of micro-bleeding.

"One-leg standing time is a simple measure of postural instability and might be a consequence of the presence of brain abnormalities," said Dr Tabara.

Earlier in the year researchers at the Medical Research Council found that standing on one leg may predict which 53-year-olds at risk of early death.

Men aged 53 years old who could balance on one leg for more than ten seconds and stand up and sit down in a chair more than 37 times in a minute were found to be least at risk of dying early by the researchers.

  

Women of the same age who could stand up and sit down more than 35 times in a minute and stand on one leg for more than ten seconds were also at the lowest risk compared to those who performed less well.

(Source:  The Telegraph, by Sarah Knapton, Science Editor, 18 December  2014)