Healthsifter by mary desmond pinkowish, since 2003

To Prevent Alzheimer's, Chop that Wood, Run That Ultramarathon, Pull that Crab Pot

I'm in a rush on my way out to start pulling tree stumps, but I wanted to post this article from MedPage Today  about a study that was presented this week in Honolulu at the International Conference on Alzheimer's Disease. It was a smallish (1200 people) study showing that physical activity may protect against Alzheimer's disease. Trouble is, that while a walk around the block may help prevent heart disease or stroke (and that's important--no argument there), it apparently takes more strenuous physical activity to prevent (or maybe delay?) Alzheimer's. It's not definitive, but I'm taking it seriously. 

Hey guys...I need some exercise, you need a break...can we trade places for a few hours?

 

Gain Weight, Lose Your Mind?

This article from New Scientist is certainly sobering. But it's more important information about weight gain, especially the pounds we tend to put on at midlife. Here's an excerpt of the New Scientist article about this research, which was conducted at UCLA by Paul Thompson and colleagues and published in the journal Human Brain Mapping.

High insulin levels and type 2 diabetes tend to accompany being overweight and are risk factors for brain tissue loss and dementia. However, the relationship between brain size and body mass index still stood when the researchers accounted for these conditions, indicating that body fat levels may be linked directly to brain shrinkage. Thompson suggests that as increased body fat ups the chances of having clogged arteries, which can reduce blood and oxygen flow to brain cells, the resulting reduction in metabolism could cause brain cell death and the shrinking seen.

I regret the ice cream I had last night, and also the night before (it's hot here). Then again, has anyone quantified the mental health benefits of ice cream? I didn't think so. 

Test Yourself for Alzheimer's Disease

She's helping him cheat?

As reported in the current issue of the British Medical Journal, researchers in Cambridge, England have developed something they call the TYM, or Test Your Memory test that helps self-diagnose Alzheimer's disease. This is what Physicians' First Watch had to say about it:

A 10-task test ("Test Your Memory," or TYM) that takes about 5 minutes to perform can detect over 90% of Alzheimer cases, BMJ reports.

Researchers evaluated the test, which is mostly self-administered, in about 100 patients with Alzheimer disease (diagnosed by a consultant neurologist) and 550 normal controls. The tasks are simple and include orientation, copying a sentence, and verbal fluency.

Controls scored an average of 47 on a 50-point scale, while patients with Alzheimer disease scored an average of 33. The authors say TYM's negative predictive value, if the cutoff point is set at 42 or under, is 99%.

The TYM tests 10 cognitive areas, as described by the researchers in the BMJ article:

"The tasks are orientation (10 points), ability to copy a sentence (2 points), semantic knowledge (3 points), calculation (4 points), verbal fluency (4 points), similarities (4 points), naming (5 points), visuospatial abilities ( 2 tasks, total 7 points), and recall of a copied sentence (6 points). The ability to do the test is also scored (5 points), giving a possible total of 50 points."

It's not clear to me that lots of people with actual dementia will take this test themselves. I suspect that more worried healthy people will do so. But it's interesting.

Diabetes, Blood Sugar, and Dementia

"Chronically elevated blood levels of the simple sugar glucose may contribute to poor cognitive function in elderly people with diabetes, a study in the February Diabetes Care suggests. But whether these levels add to a person’s risk of developing dementia is unclear, the study authors say.

People with diabetes face a risk of old-age dementia that’s roughly 50 percent greater than those without diabetes, past studies have shown. Research has also hinted that surges in blood sugar might account for some of that added risk. Many previous studies have tested for elevated blood glucose by obtaining a snapshot blood sample taken after a person has fasted for a day."

Read more about this story at Science News. Many questions remain, not the least of which is, If blood glucose levels are improved with diet, medication, and exercise, will cognition also improve?

Overtime Fries Your Brain

I really didn't need to read this. WebMD reports on a study in the current issue of the American Journal of Epidemiology showing that compared to people who work 40 hours a week, those working more than 55 hours a week had lower vocabulary and reasoning scores. This held up even after the researchers accounted for differences in education, marital status, healthy, professional attainment, sleep duration, and so forth. The study was conducted in more than 2200 Brits. Here's an excerpt from the WebMD article:

"Long working hours have been found to be associated with cardiovascular and immunologic reactions, reduced sleep duration, unhealthy lifestyle, and adverse health outcomes," the authors write.

There's also increasing evidence that such midlife risks may play a role in later dementia, they write.

Long hours have been found to negatively affect cognitive performance, grammatical acumen, and alertness, the researchers say.

Alzheimer's at 40

Read Shirley Wang's front page story in the Wall Street Journal about Brian Kammerer, a former Wall Streeter who began having symptoms of Alzheimer's while still in his 40s. He has difficulties with memory and language, but retains his mathematical skills.  The article is here.  

Watch this video about Mr. Kammerer and his family at the Wall Street Journal web site

Type 2 Diabetes and Obesity Linked to Alzheimer-Like Brain Damage

Using animal models, researchers at Rhode Island Hospital have demonstrated links among obesity, type 2 diabetes, and brain degeneration that looks a lot like that seen in people with Alzheimer's disease. ScienceDaily reports on this today, and here's a section of that article (T2DM stands for type 2 diabetes mellitus):

"...lead researcher Suzanne de la Monte, MD, MPH, of Rhode Island Hospital, utilized chronic high fat diets to cause a two-fold increase in mean body weight. In these animal models, there was a marginally reduced mean brain weight and a significantly reduced mean brain weight/body weight ratio, providing evidence that obesity with T2DM is sufficient to cause mild global atrophy in the brain."

They go on to say that the extent of brain degeneration in these animal is much less extensive than that seen in people with Alzheimer's disease. But we do know that diabetes increases the risk of Alzheimer's in humans.

This is the reference to the original research: Moroz, N. et al. Limited Alzheimer-Type Neurodegeneration in Experimental Obesity and Type 2 Diabetes Mellitus. Journal of Alzheimer's Disease, 15(1), 29-44

Alzheimer's and Head Size

A new report from the Nun's Study, a decades-long of Alzheimer's risk in women (obviously) again finds that educational attainment--and head size--are predictors of the risk of this disease. Quoting here from today's story at ScienceDaily:

Participants in the Nun Study were studied to identify those who became demented before death or had characteristic brain changes of Alzheimer’s disease at autopsy. Among nuns who became demented or had evidence of Alzheimer’s disease at autopsy, those with small head sizes had significantly lower educational achievement in earlier adult life. In those dying without a dementia diagnosis or autopsy evidence of Alzheimer’s disease, head size had no relationship with education.

Adult head size can be used to estimate the size of the fully-developed brain. Previous studies have found that clinical expression of Alzheimer’s disease is related to head size, with people having smaller heads more likely to show the characteristic symptoms of this illness. Larger brains provide reserve against Alzheimer’s, allowing people to function normally despite having considerable Alzheimer pathology in their brains.

“If brain damage related to Alzheimer’s disease begins earlier in adult life, then having less reserve due to a smaller brain could compromise intellectual ability in those destined to get Alzheimer’s and lead to them getting less education,” said lead author James Mortimer, PhD, professor of epidemiology at USF.

A Surge of New Alzheimer's Drugs Get Tested

As reported here by AMNews, a bunch of medications are entering the later stages of testing in humans to prevent or treat Alzheimer's disease. Some are new compounds, while others are older medications for other disorders that may get a second life as a way to treat dementia. As one of the people they interview here says, people eventually may be treated with several drugs that attack the disease from different angles. Scientists are also working hard to develop a very early diagnostic test for Alzheimer's. The idea is to find people extremely early in the course of disease so that treatments can start immediately, while they still have a chance of working.

ARB Blood Pressure Drugs May Lower Alzheimer's Risk

It's already pretty well established that controlling blood pressure lowers the risk of Alzheimer's disease. New evidence suggests that one class of blood pressure drugs, angiotensin receptor blockers, or ARBs, may be more effective in reducing the risk of Alzheimer's than other drug classes. The study was presented in Chicago at a meeting of the International Conference on Alzheimer's Disease. The BBC reported on this study this morning, and here's an excerpt:

The research looked at records of approximately six million people treated for high blood pressure between 2001 and 2006.

Those who took angiotensin receptor blockers (ARBs) were less likely, over that period, to be diagnosed with dementia compared with those on other blood pressure medication such as ACE inhibitors.

If they already had dementia in 2001, they were 45% less likely to go on to develop delirium, be admitted to a nursing home, or die prematurely.

This evidence suggests that the drugs, which help prevent the constriction of blood vessels, could not only prevent, or at least delay, the arrival of dementia symptoms, but also slow down the progress of the disease.

The Washington Post wrote about the study, which was conducted at Boston University,  in some detail yesterday. As they mention, an intriguing finding is that ARBs may be beneficial in slowing Alzheimer's progression in people who are already showing signs of dementia.