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:

A Connection Between Sleep and Alzheimer's? “In both humans and mice, levels of a peptide called amyloid-ß rise during waking hours and decline during sleep, researchers have found. They also report that sleep-deprived mice are more prone to developing deposits of amyloid-ß, called plaques, like those found in the brains of Alzheimer's patients. Although far from proven, the finding suggests that sleep disorders could be a risk factor for Alzheimer's. On a brighter note, it also hints at new avenues of treatment. Many lines of evidence suggest that the naturally occurring amyloid-ß builds up in the brain over many years in people who develop Alzheimer's disease, beginning long before people show signs of memory loss. But very little is known about what factors might influence levels of the peptide in the brain, says David Holtzman, a neurologist at Washington University in St. Louis in Missouri. … The findings suggest that people who are chronically sleep deprived may have higher levels of amyloid-ß that make them more susceptible to Alzheimer's disease, Holtzman says.”

Alzheimer's genes link uncovered “The genes were pinpointed in a study of 16,000 DNA samples and are known to be implicated in inflammation and cholesterol breakdown. It is hoped the Nature Genetics study will open the way for new treatments. The last and only gene to be linked to the common form of Alzheimer's disease is APOE4 gene, which has been the focus of much research. “

Alzheimer's Researchers Find High Protein Diet Shrinks Brain

Alzheimer's risk upped in senior smokers “Smoking may contribute to dementia in the same way that it affects cardiovascular health -- by damaging the blood vessels and impairing blood flow. As people age, this may accelerate damage to the brain tissue. On an encouraging note, Peters and her colleagues found that while current smokers had a higher Alzheimer's risk across the studies, former smokers did not. It's not clear what this means, according to Peters, but it is possible that the excess risk of Alzheimer's declines once smokers quit.“

Brain Starvation As We Age Appears To Trigger Alzheimer's - Improving Blood Flow To Brain Is A Preventive Strategy “A new study from Northwestern University's Feinberg School of Medicine has found when the brain doesn't get enough sugar glucose -- as might occur when cardiovascular disease restricts blood flow in arteries to the brain -- a process is launched that ultimately produces the sticky clumps of protein that appear to be a cause of Alzheimer's. … "This finding is significant because it suggests that improving blood flow to the brain might be an effective therapeutic approach to prevent or treat Alzheimer's," said Vassar, a professor of cell and molecular biology at the Feinberg School. A simple preventive strategy people can follow to improve blood flow to the brain is getting exercise, reducing cholesterol and managing hypertension. "If people start early enough, maybe they can dodge the bullet," Vassar said. For people who already have symptoms, vasodilators, which increase blood flow, may help the delivery of oxygen and glucose to the brain, he added.”

Dementia Risk Seen in Players in N.F.L. Study

Diet High in Methionine Could Increase Risk of Alzheimer's “A diet rich in methionine, an amino acid typically found in red meats, fish, beans, eggs, garlic, lentils, onions, yogurt and seeds, can possibly increase the risk of developing Alzheimer's disease, according to a study by Temple researchers.”

High Waist-To-Hip Ratio in Midlife Linked to Later Dementia “"These data emphasize the importance of maintaining a healthy body weight throughout life, and that the prevention of Alzheimer's disease is a life-long process," lead author Dr. Deborah R. Gustafson, of the University of Gothenburg, Sweden, told Reuters Health.”

Higher Diastolic, Not Systolic, Blood Pressure Linked to Impaired Cognition “Higher diastolic blood pressure (DBP) levels, but not systolic blood pressure (SBP) levels, can impair cognitive status in individuals without prior history of stroke or transient ischemic attack, according to the results of a large study reported in the August 25 issue of Neurology. "Although both higher [pulse pressure] and SBP values were related to cognitive impairment in unadjusted analyses, these associations were no longer significant after accounting for demographics, health behaviors, and vascular risk factors," write Georgios Tsivgoulis, MD, from the Comprehensive Stroke Center at the University of Alabama in Birmingham, and colleagues. "The present study indicates that elevated [DBP] levels are linearly and cross-sectionally associated with a higher likelihood of impaired cognitive status. If this association is causally established in future longitudinal studies, than reducing elevated BP levels may result in reducing the incidence of dementia," Dr. Tsivgoulis told Medscape Neurology.”

Long hours link to dementia risk “It found that those working more than 55 hours a week had poorer mental skills than those who worked a standard working week. The American Journal of Epidemiology study found hard workers had problems with short-term memory and word recall. … The effects were cumulative, the longer the working week was the worse the test results were. Employees with long working hours also had shorter sleeping hours, reported more symptoms of depression and used more alcohol than those with normal working hours. “

New Risk Index Predicts Dementia in Elderly “The index items include older age, poor cognitive test performance, body-mass index, 1 or more apolipoprotein E4 alleles, white-matter disease on cerebral magnetic resonance imaging (MRI), ventricular enlargement on cerebral MRI, internal carotid artery thickening on ultrasound, history of bypass surgery, slow physical performance, and lack of alcohol consumption.”

Second-hand Smoke May Cause Dementia “A possible link between active smoking and cognitive impairment has already been established and previous findings also suggest that second-hand smoke exposure could be linked to poor cognitive performance in children and adolescents. However, this is the first large-scale study to conclude that second-hand smoke exposure could lead to dementia and other neurological problems.”

Smoking Appears Linked With Risk for Poor Memory in Middle Age “Compared with study participants who had never smoked, after adjustment for other confounding factors, smokers had a 37% increased risk of having scores in the lowest quintile on a memory test (they were more likely to recall less than 5 of 20 words), Ms. Sabia told Medscape Psychiatry.”

Smoking, High Blood Pressure And Diabetes In Mid-life Can Lead To Dementia

Study Shows Even Moderately Elevated Cholesterol Level Boosts Dementia Risk

Study Ties Mini-Strokes to Memory Loss “People with mini-stroke damage were nearly twice as likely to have mild cognitive impairment that included memory loss, whereas those with stroke damage were more likely to have mild cognitive impairment that did not include memory loss, according to the report in the Aug. 11 issue of Neurology.”

Twin study: Diabetes significantly increases risk for Alzheimer's disease and other dementia “Diabetics have a significantly greater risk of dementia, both Alzheimer's disease — the most common form of dementia — and other dementia, reveals important new data from an ongoing study of twins. The risk of dementia is especially strong if the onset of diabetes occurs in middle age, according to the study. "Our results . . . highlighted the need to maintain a healthy lifestyle during adulthood in order to reduce the risk of dementia late in life," explained Dr. Margaret Gatz, who directs the Study of Dementia in Swedish Twins. “

ARTICLES:

JOURNAL ARTICLES:

A possible role of atrial fibrillation as a risk factor for dementia. ( Arch Gerontol Geriatr. 2009)

Blood pressure and the risk for dementia—A double edged sword (Ageing Research Reviews 2009)

Bone lead levels are associated with measures of memory impairment in older adults. (Neurotoxicology. 2009)

Cardiovascular risk factors and dementia mortality: 40 years of follow-up in the Seven Countries Study. (J Neurol Sci. 2009)

Cumulative Exposure to Lead in Relation to Cognitive Function in Older Women (Environ Health Perspect. 2009) “These findings suggest that cumulative exposure to lead, even at low levels experienced in community settings, may have adverse consequences for women’s cognition in older age.”

Impact of APOE on the Healthy Aging Brain: A Voxel-Based MRI and DTI Study. (J Alzheimers Dis. 2009) “In conclusion, the presence of an ApoE4 allele in nondemented older adults is associated with decreases in cognition and gray and white matter changes in the medial temporal cortex. Overall we provide further evidence of the effects of genetic variance related to imaging and cognitive measures of risk for Alzheimer's disease.”

Overweight in midlife and risk of dementia: a 40-year follow-up study (International Journal of Obesity 2009) “Conclusions: This study gives further support to the notion that overweight in midlife increases later risk of dementia. The risk is increased for both Alzheimer's disease and vascular dementia, and follows the same pattern for men and women.”

Parental history of Alzheimer disease associated with lower plasma apolipoprotein E levels (NEUROLOGY 2009)

The APOE epsilon–4 Allele Is Associated with Incident Mild Cognitive Impairment among Community–Dwelling Older Persons (Neuroepidemiology 2009)

The effect of alcohol and tobacco consumption, and apolipoprotein E genotype, on the age of onset in Alzheimer's disease. (Int J Geriatr Psychiatry. 2009) “CONCLUSION: The results suggest that APOE epsilon4 and heavy drinking and heavy smoking lower the age of onset for AD in an additive fashion.”

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