Alzheimer's Disease - Dementia

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Alzheimer's Disease - Dementia

NIH - Medical Encyclopedia Alzheimer's Disease

"Alzheimer's disease (AD), one form of dementia, is a progressive, degenerative brain disease. It affects memory, thinking, and behavior. Memory impairment is a necessary feature for the diagnosis of this or any type of dementia. Change in one of the following areas must also be present: language, decision-making ability, judgment, attention, and other areas of mental function and personality. The rate of progression is different for each person. If AD develops rapidly, it is likely to continue to progress rapidly. If it has been slow to progress, it will likely continue on a slow course. There are two types of AD -- early onset and late onset. In early onset AD, symptoms first appear before age 60. Early onset AD is much less common, accounting for only 5-10% of cases. However, it tends to progress rapidly. The brain tissue shows "neurofibrillary tangles" (twisted fragments of protein within nerve cells that clog up the cell), "neuritic plaques" (abnormal clusters of dead and dying nerve cells, other brain cells, and protein), and "senile plaques" (areas where products of dying nerve cells have accumulated around protein). Although these changes occur to some extent in all brains with age, there are many more of them in the brains of people with AD."

Highlighted Articles

Education and Alzheimer disease without dementia: support for the cognitive reserve hypothesis. (Neurology. 2007)

"CONCLUSIONS: Regardless of the neuropathologic criteria used, education is predictive of dementia status among individuals with neuropathologic Alzheimer disease. These results support the theory that individuals with greater cognitive reserve, as reflected in years of education, are better able to cope with AD brain pathology without observable deficits in cognition."

Nutritional factors, cognitive decline, and dementia. (Brain Res Bull. 2006)

"Nutritional factors and nutritional deficiencies have been repeatedly associated with cognitive impairment. … Deficiencies of several B vitamins have been associated with cognitive dysfunction in many observational studies. More recently, deficiencies of folate (B(9)) and cobalamine (B(12)) have been studied in relation to hyperhomocysteinemia as potential determinants of cognitive impairment, dementia, and Alzheimer's disease (AD). A small number of studies assessed the association between intake of macronutrients and cognitive function or dementia. Among the others, the intake of fatty acids and cholesterol has received particular attention. Although the results are not always consistent, most studies have reported a protective role of dietary intakes of poly- and mono-unsaturated fatty acids against cognitive decline and AD."

Exercise Is Associated with Reduced Risk for Incident Dementia among Persons 65 Years of Age and Older (Annals of Internal Medicine 2006)

"Conclusion: These results suggest that regular exercise is associated with a delay in onset of dementia and Alzheimer disease, further supporting its value for elderly persons."

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Alzheimer's Disease - Dementia

Risk Factors

NEWS:

Anesthetic Linked to Alzheimer's Risk: Researchers found evidence of neuron death and beta-amyloid plaques after use of isoflurane "The commonly used anesthetic isoflurane can lead to the death of brain cells and the production of amyloid-beta plaque, a hallmark of Alzheimer's disease, Harvard researchers report."

Another Piece of the Puzzle

Drinking Alcohol Shrinks the Brain "Brain shrinkage was slightly greater in female drinkers than in male drinkers and had the biggest impact on women who were in their 70s and were still heavy drinkers, the researchers found."

Alzheimer's cold sore virus link "Evidence is building that the cold sore virus may be linked to Alzheimer's disease, an expert says. In lab tests, Manchester University found brains infected with the herpes simplex virus, HSV-1, saw a rise in a protein linked to Alzheimer's. "

Incidence of Dementia in Mild Cognitive Impairment in the Cardiovascular Health Study Cognition Study (Arch Neurol. 2007) "Conclusions Subjects with MCI are at high risk for dementia. The probable MCI diagnosis identified individuals in the earliest stages of dementia, usually AD, whereas the possible MCI diagnosis identified a more heterogeneous group. However, this latter group had only a slightly lower rate of conversion to dementia than the group with probable MCI, suggesting that even with comorbid conditions, there is a high likelihood of the presence of a progressive dementing disorder."

Second-Hand Smoke Linked to Dementia "When researchers at UC Berkeley studied 3,602 people ages 65 and older for the Cardiovascular Health Study, they found participants with high lifetime exposures to second-hand tobacco smoke were 30 percent more likely to develop dementia than those with low exposure to second-hand tobacco smoke."

Smokers More Likely to Develop Dementia, Alzheimer's Disease "Smoking may increase the risk for dementia through cerebrovascular disease or augmented cholinergic mechanisms by up-regulation of cholinergic nicotinic receptors in the brain through oxidative stress created by smoking, according to the authors."

Study Suggests Vasectomy-Dementia Link " Having a vasectomy may increase a man's risk of developing a rare form of dementia , early research suggests, although more study is needed to confirm the finding. Researchers at Chicago's Northwestern University found that men with a neurological condition known as primary progressive aphasia, or PPA, were more likely to have had the sterilization surgery than men without the disorder. PPA is a rare condition characterized by a steady loss of language skills. "

ARTICLES:

Alzheimer's: Is it in your genes?

JOURNAL ARTICLES:

An introduction to obesity and dementia. (Curr Alzheimer Res. 2007)

Apolipoprotein E genotype and lifetime cognitive decline. (Int Psychogeriatr. 2007)

Association Between Apolipoprotein E4 and Cognitive Decline in Elderly Adults (Journal of the American Geriatrics Society 2007) "CONCLUSION: Findings in PROSPER indicate that E4 is associated with more-rapid cognitive decline and may, therefore, predispose to dementia."

Body mass index in midlife and risk of Alzheimer disease and vascular dementia. (Curr Alzheimer Res. 2007) "These data suggest that midlife BMI is strongly predictive of both AD and VaD, independent of stroke, cardiovascular and diabetes co morbidities."

Carotid atherosclerosis and cognitive decline in patients with Alzheimer's disease. (Neurobiol Aging. 2007) “Results show a link between progression of carotid wall changes and of cognitive decline, and suggest a possible protective role of antihypertensive therapy. Given the potential clinical implications, our preliminary findings could stimulate further investigations into the role of vascular impairment in patients with AD.”

Cognitive Performance in Older Women Relative to ApoE-ϵ4 Genotype and Aerobic Fitness. (Med Sci Sports Exerc. 2007) "CONCLUSION:: The preliminary findings from this study support the possibility that aerobic fitness is positively associated with the memory performance of those individuals at most genetic risk for Alzheimer disease."

Combined Effect of Apolipoprotein E Genotype and Past Fertility on Age at Onset of Alzheimer's Disease in Women. (Dement Geriatr Cogn Disord. 2007) "Results: A comparison of APOE genotype distribution in parous and nulliparous AD women confirmed that the e*3/e*3 genotype is associated with higher fertility and the e*4-carrying genotypes with lower fertility. When the combined effects of fertility and APOE genotypes on AD onset age were analyzed, parity was found to be associated with a significantly lower AD onset age (73.8 +/- 6.2 years) than nulliparity (80.7 +/- 5.0 years; p = 0.0007) among subjects carrying e*3/e*3 and e*3/e*2 genotypes. A similar effect was absent among e*4 carriers. Considering the high frequency of e*3/e*3 plus e*3/e*2 genotypes in Europe (range: 63-87%), past fertility may influence AD onset age in many women. Conclusion: Past fertility may have a relevant effect on AD onset age and this effect is influenced by APOE genotype."

Cortical microinfarcts and demyelination affect cognition in cases at high risk for dementia (NEUROLOGY 2007) "Conclusions: Cortical microinfarcts and, to a lesser degree, periventricular demyelination contribute to the cognitive decline in individuals at high risk for dementia. Both should be taken into account when defining the neuropathologic criteria for mixed dementia."

Depressive Symptoms Associated With Hereditary Alzheimer's Disease: A Case Description. (Am J Alzheimers Dis Other Demen. 2007)

Elevated body mass index is associated with executive dysfunction in otherwise healthy adults (Comprehensive Psychiatry 2007) "These results provide further evidence for the relationship between elevated BMI and reduced cognitive performance and suggest that this relationship does not vary with age."

Heterogeneity in Risk Factors for Cognitive Impairment, No Dementia: Population-Based Longitudinal Study From the Kungsholmen Project (Am J Geriatr Psychiatry 2007) "Conclusions: The results suggest that not only the AD-type neurodegenerative process, but also neuropsychiatric- and frailty-related factors may induce cognitive impairment in nondemented elderly. These findings may have relevant preventive and therapeutic implications."

Hippocampal hypometabolism predicts cognitive decline from normal aging. (Neurobiol Aging. 2007)

Homocysteine, B vitamins, and the incidence of dementia and cognitive impairment: results from the Sacramento Area Latino Study on Aging (American Journal of Clinical Nutrition 2007) "Conclusions:Homocysteine is an independent risk factor for both dementia and CIND. Higher plasma vitamin B-12 may reduce the risk of homocysteine-associated dementia or CIND."

Incidence of Dementia in Mild Cognitive Impairment in the Cardiovascular Health Study Cognition Study (Arch Neurol. 2007) "Conclusions Subjects with MCI are at high risk for dementia. The probable MCI diagnosis identified individuals in the earliest stages of dementia, usually AD, whereas the possible MCI diagnosis identified a more heterogeneous group. However, this latter group had only a slightly lower rate of conversion to dementia than the group with probable MCI, suggesting that even with comorbid conditions, there is a high likelihood of the presence of a progressive dementing disorder."

Increased visceral adipose tissue rather than BMI as a risk factor for dementia. (Age Ageing. 2007)

Inflammatory biomarkers are associated with total brain volume (NEUROLOGY 2007) "Background: Systemic inflammation is associated with ischemia and Alzheimer disease (AD). We hypothesized that inflammatory biomarkers would be associated with neuroimaging markers of ischemia (i.e., white matter hyperintensities [WMH]) and AD (i.e., total brain volume [TCB])."

Inflammatory markers and the risk of Alzheimer disease (NEUROLOGY 2007) "These data strengthen the evidence for a pathophysiologic role of inflammation in the development of clinical AD."

Loneliness and risk of Alzheimer disease. (Arch Gen Psychiatry. 2007) "CONCLUSION: Loneliness is associated with an increased risk of late-life dementia but not with its leading causes."

[Mercury and Alzheimer's Disease.] (Fortschr Neurol Psychiatr. 2007) "In sum, the findings from epidemiological and demographical studies, the frequency of amalgam application in industrialized countries, clinical studies, experimental studies and the dental state of Alzheimer patients in comparison to controls suggest a decisive role for inorganic mercury in the etiology of Alzheimer's disease. Other factors currently discussed as causes (e. g. other metals, inflammations, dietetic factors, vitamin deficiency, oxidative distress, and metabolic impairments) may act as co-factors."

Mild cognitive impairment: a risk indicator of later dementia, or a preclinical phase of the disease? (Int J Geriatr Psychiatry. 2007)

Number of children is associated with neuropathology of Alzheimer's disease in women. (Neurobiol Aging. 2007) “CONCLUSIONS: Since the associations between number of children and neuropathology of AD were found for women only, they might reflect sex-specific mechanisms (such as variations in estrogen or luteinizing hormone levels) rather than social, economic, biological or other mechanisms common to both men and women.”

Relation between smoking and risk of dementia and Alzheimer disease (NEUROLOGY 2007) "Conclusion: Current smoking increases the risk of dementia. This effect is more pronounced in persons without the APOE 4 allele than APOE 4 carriers."

Relation of obesity to cognitive function: importance of central obesity and synergistic influence of concomitant hypertension. The framingham heart study. (Curr Alzheimer Res. 2007) "Conclusions: Executive function and visuomotor skills were differentially affected by the combined presence of midlife hypertension and Q4 WHR while measures of verbal memory function were not related to these risk factors in our sample, a pattern consistent with vascular cognitive impairment. Control of mid-life elevated blood pressure and central obesity may be strategies to reduce cognitive decline with age."

Smokers More Likely to Develop Dementia, Alzheimer's Disease

Smoking as a Risk Factor for Dementia and Cognitive Decline: A Meta-Analysis of Prospective Studies. (Am J Epidemiol. 2007)

The Effect of Borderline Diabetes on the Risk of Dementia and Alzheimer’s Disease (Diabetes 2007) "We conclude that borderline diabetes is associated with increased risks of dementia and Alzheimer’s disease; the risk effect is independent of the future development of diabetes. Borderline diabetes may interact with severe systolic hypertension to multiply the risk of Alzheimer’s disease."

The epidemiology of adiposity and dementia. (Curr Alzheimer Res. 2007)

The metabolic syndrome and Alzheimer disease. (Arch Neurol. 2007) " CONCLUSIONS: This study suggests that Alzheimer disease is associated with the metabolic syndrome. This could have implications for the prevention and treatment of Alzheimer disease."

The risk of dementia with increased body mass index (Age and Ageing 2007) " CONCLUSION: this systematic review supports the hypothesis that increased BMI is independently associated with increased risk of dementia. Long-term studies to examine the mechanisms underlying the relationship between obesity and dementia are needed."

The role of metals in the etiology of Alzheimer's disease. (J Alzheimers Dis. 2007) "While a direct causal role for aluminum or other transition metals (copper, zinc, iron) in AD has not yet been definitively demonstrated, epidemiological evidence suggests that elevated levels of these metals in the brain may be linked to the development or progression of AD."

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