Memory Loss May Not Be Present in Early-Onset Alzheimer’s

More than a third of people with early-onset Alzheimer’s, a form of Alzheimer’s that typically occurs before age 60, do not have memory loss as their chief complaint, a new study reports. Instead, many have behavioral problems or problems with vision or language that raise red flags, and Alzheimer’s often goes undiagnosed in such patients.

Early-onset Alzheimer’s is rare compared to the late-onset Alzheimer’s that typically strikes after age 65. But the findings highlight the fact that although memory loss is the most prominent feature of Alzheimer’s, thinking and perception problems also typically afflict people with all forms of the disease. The study was published in Neurology, the medical journal from the American Academy of Neurology.

For the study, investigators in Barcelona, Spain, reviewed cases of 40 middle-aged people, ages 46 to 60, whose Alzheimer’s was confirmed on autopsy. Fifteen of them did not have memory loss, but had personality changes and acted erratically or had problems with vision or language or with carrying out day-to-day tasks.

More than half of those without memory problems were diagnosed by doctors as having a disease other than Alzheimer’s, often another form of dementia. By comparison, when memory problems were present, Alzheimer’s was almost always diagnosed.

"People who develop early-onset Alzheimer's disease often experience these atypical symptoms rather than memory problems, which can make getting an accurate diagnosis difficult," said study author Dr. Albert Lladó of the Alzheimer's Disease and Other Cognitive Disorders Unit at the Hospital Clínic of Barcelona. The authors call for more accurate tests to detect Alzheimer’s early, so that proper treatments can be given.

Men and women with the far more common late-onset of Alzheimer’s disease that typically afflicts those in their 60s, 70s or older are more likely to have memory loss as one of their chief complaints than younger people with the disease. But it is important for doctors and family members to recognize that memory loss is not the only problem that affects those with Alzheimer’s. In some cases, behavioral problems can be treated with medications and other therapies.

(Source: ALZinfo.org, 4 November 2011, The Alzheimer's Information Site, Center for Alzheimer's Research Foundation at The Rockefeller University)

Fish Oil Supplements May Boost Brain Health

Many people take fish oil supplements for heart health, and there is some research to suggest that fish oils may be good for the brain as well. Now researchers have shown that fish oil supplements may affect parts of the brain critical for memory and thinking skills.

For the study, scientists at Rhode Island Hospital's Alzheimer's Disease and Memory Disorders Center studied 819 men and women, 117 of whom were taking fish oil supplements. All were part of the Alzheimer's Disease Neuroimaging Initiative, a large and ongoing study at multiple medical centers across the country. The participants were given memory tests at the start of the study, and periodically over the next three years. Their brains were also scanned as part of the study.

The researchers found that among those who were healthy at the study's start, those who were taking fish oil supplements scored higher, over all, on tests of memory and thinking than those who were not taking fish oils. Fish oils seemed to provide benefits for those who did not carry a gene called APOE-E4, which increases the risk for Alzheimer's disease.

In addition, the brains of those taking fish oils were larger than those who were not taking the supplements, particularly in two brain structures critical for memory and thinking: the hippocampus and the cerebral cortex. A larger brain is generally a sign of better cognitive health; conversely, brain shrinkage has been associated with Alzheimer's disease. Again, the brain benefits applied only to those who did not carry the APOE-E4 gene.

The findings, reported at the International Conference on Alzheimer's Disease in Paris, "should motivate further study of the possible effects of long-term fish oil supplementation on important markers of cognitive decline and the potential influence of genetics on these outcomes," said Dr. Lori Daiello, who led the study.

Other studies have shown that a diet rich in fish, particularly oily fish like tuna, salmon, mackerel, sardines and anchovies, may lower the risk of Alzheimer's disease and other forms of dementia. Studies of people who eat a traditional Mediterranean diet rich in fish as well as fruits and vegetables, for example, have shown that the diet may have brain-protective effects. Another survey of seniors in Asia, Latin American and the Caribbean found that those who ate fish almost every day were almost 20 percent less likely to develop dementia than those who ate fish a few days a week. Eating fish may also help to ease the agitation and depression of Alzheimer’s, other research shows.

Fish oils contain omega-3 fatty acids like DHA, or docosahexaenoic acid, which is known to be good for cardiovascular health. People with high levels of DHA in their bodies had a lower risk of developing Alzheimer's disease in one large study. Researchers speculate that the omega-3s in fish oil may quell inflammation, which is emerging as a possible underlying cause of heart disease and other ills, including Alzheimer’s disease.

Fish oil supplements containing DHA and other omega-3s are widely available in pharmacies and health-food stores. But more study is needed to better define the effects of diet on brain health. Advancing age, family history and genes like APOE-E4, as this study indicates, can all influence the risk for Alzheimer's disease.

(Source: ALZinfo.org, 4 November 2011. The Alzheimer's Information Site, Fisher Center for Alzheimer's Research Foundation at The Rockefeller University)