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

General Information

NEWS:

Abnormal Heart Rhythm Linked To Alzheimer's

Alzheimer's and Its Impact on Women

Alzheimer's Disease and Other Forms of Dementia

Alzheimer's Disease Frequently Asked Questions

Alzheimer's 'Epidemic' Hitting Minorities Hardest “Over 5 million Americans are living with Alzheimer's disease, and blacks and Hispanics are at highest risk of developing the disease, a new report finds. The report, 2010 Alzheimer's Disease Facts and Figures, from the Alzheimer's Association, finds that black Americans are about two times more likely to develop Alzheimer's disease than whites, and Hispanics face about 1.5 times the risk. "Alzheimer's is continuing to be on the rise," said Maria Carrillo, the association's senior director of medical and scientific relations. "So many people are affected by it across the country, but we are rallying to highlight the disparities that exist in populations," she said. Much of the increase in Alzheimer's is because of increasing high blood pressure and diabetes, which increase the odds of developing Alzheimer's in all populations. "African-Americans and Hispanics are particularly vulnerable, because the proportion of these two risk factors is higher even still," Carrillo said. "We can actually do something about this increased risk with better management of the conditions."”

Alzheimer's Memory Problems Originate With Protein Clumps Floating In The Brain, Not Amyloid Plaques

Alzheimer’s Stalks a Colombian Family

Brain Function May Drop Quickly Before Alzheimer's “The scores of people with mild cognitive impairment declined twice as fast each year as did scores of those with no memory problems. The scores for people with Alzheimer's declined four times as fast as those of participants with no cognitive problems, the study found. The results are in the March 23 issue of Neurology. "The changes in rate of decline occur as the brain atrophies due to the disease, first mainly in the hippocampus during the initial symptomatic stage, referred to as mild cognitive impairment, then in the temporal, parietal and frontal cortex during the dementing illness phase of Alzheimer's disease," said Dr. David S. Knopman, of the Mayo Clinic in Rochester, Minn., who wrote an editorial accompanying the study.”

Dementia can steal ability to discern flavors

Dementia May Result from Incomplete Memories

Depression Is a Risk Factor and Not an Early Sign of Alzheimer's Disease, Study Suggests

Depression Linked to Alzheimer's Disease

Diet, Exercise Can Improve Thinking “The group that ate well and exercised regularly had an overall 30 percent improvement in mental function by the end of the four-month period, the researchers noted. Physical activity does seem to have a direct effect on brain cells, Smith said. "There are neurochemical changes that happen with exercise, he said. There is increased production of brain-derived neurotrophic factor, which stimulates connection with other brain cells, he said, but also there is some evidence that it helps grow new brain cells." And the combination of good eating and exercise also produced the expected physical advances. Diet-and-exercise participants lost an average of 19 pounds and lowered systolic blood pressure (the higher of the 120/80 reading) by 16 points and diastolic pressure by 10 points by the end of the four-month program. Some experts believe the study has shortcomings, however. It's a well-done study, but one that has flaws, said Dr. Donald LaVan, a clinical associate professor of medicine at the University of Pennsylvania and a spokesman for the American Heart Association. "Its entirely too small," LaVan said. "I would call it a keyhole study, suggestive but nothing definitive. Also, it did not have a control group to look at the effect of exercise alone. We need a bigger study with a longer duration and a control group for exercise alone." Nothing in the study should deter anyone from exercising for the sake of the mind as well as the body, LaVan said.”

Don't Hesitate to Get Help With a Dementia Patient

Formula Predicts Alzheimer's Longevity

Gum Inflammation Linked to Alzheimer's Disease “The NYU study offers fresh evidence that gum inflammation may contribute to brain inflammation, neurodegeneration, and Alzheimer's disease.”

Implications for brain reserve in Alzheimer disease (NEUROLOGY 2010)

Memory Problems Not The Only Predictor Of Later Mild Cognitive Impairment

Might You Live to 100? Gene Test Tells

New Insight Into the Cause of Common Dementia

People Who Care for Family Members With Dementia Report Frequent Abuse

The 32-year relationship between cholesterol and dementia from midlife to late life (Neurology 2010)

The Little Flaw in the Longevity-Gene Study That Could Be a Big Problem “Remember that Science study from last week linking a whole bunch of genes—including unexpectedly powerful ones—to extreme old age in centenarians? NEWSWEEK reported that a number of outside experts thought it sounded too good to be true, perhaps because of an error in the way the genes were identified that could cause false-positive results. … “UPDATE: Within an hour of this story's publication, the Science study's authors released a statement which a BU spokeswoman described as appearing "because of your inquiry and a similar one from the New York Times concerning methodology used to test 2 of the 150 genetic variants." Here is what the statement says: "Since the publication of our study in Science, which was extensively peer-reviewed, a question has been raised about two elements of the findings. One has to do with two of the 150 genetic variants included in the prediction model, while the other is related to the criteria used to determine the significance of the individual variants. On the first concern, we have been made aware that there is a technical error in the lab test used on approximately 10% of the centenarian sample that involved the two of the 150 variants. Our preliminary analysis of this issue suggests that the apparent error would not effect the overall accuracy of the model. Because the issue has been raised since the publication of the paper, we are now closely re-examining the analysis. Another question that was raised concerns the criteria used to determine if an association between a genetic variant and exceptional longevity was statistically significant. We used standard criteria for the analysis, and we are confident that the appropriate threshold was used."”

Two-Year Study Finds No Brain Benefit for Fish Oil “Numerous studies have shown that people who eat more fish have better mental function, and are less likely to develop dementia. "The problem with a lot of these studies of course is there are lots of reasons why people eat more fish," Dr. Dangour pointed out. To better answer the question of whether fish oil, in and of itself, benefits the brain, Dr. Dangour and his team randomly assigned 748 men and women in their 70s - all free of cognitive impairment at baseline -- to take 200 mg of eicosapentaenoic acid (EPA) plus 300 mg docosahexaenoic acid (DHA) every day for two years or an olive oil placebo capsule. In an April 21st online article in the American Journal of Clinical Nutrition, the researchers report that neither group showed any change in cognitive function over the 24-month trial, as measured by a battery of tests of mental function. “

Untreated Poor Vision: A Contributing Factor to Late-life Dementia

Vision and Dementia (video)

Will you live to 100? Scientists pinpoint 19 markers that tell you if you will have a long life

ARTICLES:

Looking at Young-Onset Dementia

Slideshow: When a Loved One Has Alzheimer's Disease

Unraveling Alzheimer's Disease

Years Later, No Magic Bullet Against Alzheimer’s Disease “In the meantime, doctors are in a bind. Should they tell people to do things like walk briskly or eat vegetables — activities that might someday be shown to protect against Alzheimer’s and that certainly cannot hurt? Or should they wait for absolute proof, confirmation that a diet or a drug or an exercise regimen prevents Alzheimer’s? The Alzheimer’s Association tells people to exercise, challenge themselves mentally, remain socially engaged and keep their hearts healthy. Such measures can only help, says Dr. Maria C. Carrillo, a senior director of the organization. But, she said, “The Alzheimer’s Association certainly agrees that there is not enough evidence to say anything definitive about the prevention of Alzheimer’s disease and any kind of intervention.” Of course, Dr. Hodes said, there are many reasons to follow practices to improve general health. But, he said, researchers have to be careful about implying that any measures will protect against this degenerative brain disease. “

JOURNAL ARTICLES:

A 10-year follow-up of hippocampal volume on magnetic resonance imaging in early dementia and cognitive decline. (Brain. 2010) “We found an increased risk to develop incident dementia per standard deviation faster rate of decline in hippocampal volume [left hippocampus 1.6 (95% confidence interval 1.2-2.3, right hippocampus 1.6 (95% confidence interval 1.2-2.1)]. Furthermore, decline in hippocampal volume predicted onset of clinical dementia when corrected for baseline hippocampal volume. In people who remained free of dementia during the whole follow-up period, we found that decline in hippocampal volume paralleled, and preceded, specific decline in delayed word recall. No associations were found in this sample between rate of hippocampal atrophy, Mini Mental State Examination and tests of executive function. Our results suggest that rate of hippocampal atrophy is an early marker of incipient memory decline and dementia, and could be of additional value when compared with a single hippocampal volume measurement as a surrogate biomarker of dementia.”

Age, Alzheimer's disease and dementia in the Baltimore Longitudinal Study of Ageing. (Brain. 2010)

Alzheimer's pathology in primary progressive aphasia. (Neurobiol Aging. 2010)

Angiotensin Receptor Blockers: Do They Protect Against Dementia and Alzheimer’s Disease in the Elderly? (Aging Health 2010)

APOE predicts amyloid-beta but not tau Alzheimer pathology in cognitively normal aging (Annals of Neurology 2010) “Increasing cerebral A deposition with age is the pathobiological phenotype of APOE4.”

Association of C-Reactive Protein With Cognitive Impairment (Arch Neurol. 2010) “Conclusions High hsCRP may be a marker of memory and visuospatial impairment in the elderly.”

Caffeine as a Protective Factor in Dementia and Alzheimer's Disease. (J Alzheimers Dis. 2010)

Caffeine Intake and Dementia: Systematic Review and Meta-Analysis. (J Alzheimers Dis. 2010)

Cognitive decline in incident Alzheimer disease in a community population. (Neurology. 2010) “In comparison to the no cognitive impairment group, the annual rate of decline was increased more than twofold in mild cognitive impairment (estimate = 0.086, SE = 0.011, p < 0.001) and more than fourfold in AD (estimate = 0.173, SE = 0.020, p < 0.001). Results did not reliably vary by race, sex, or age. CONCLUSIONS: Alzheimer disease has a devastating impact on cognition, even in its prodromal stages, with comparable effects in African American and white persons.”

[Cognitive reserve and its relevance for the prevention and diagnosis of dementia.] (Nervenarzt. 2010)"Confronted with progressive neurodegeneration, these active mechanisms help to compensate for brain damage. Individuals with higher CR show more efficient activation for solving the same task, which helps them to preserve normal levels of cognitive performance for a longer period. "

Could lysine supplementation prevent Alzheimer's dementia? A novel hypothesis. (Neuropsychiatr Dis Treat. 2010)

Depression predicts cognitive disorders in older primary care patients. (J Clin Psychiatry. 2010)

Dementia incidence continues to increase with age in the oldest old: The 90+ study (Annals of Neurology 2010)

Dementia: Continuum or distinct entity? (Psychol Aging. 2010)

[Do dementia patients living at home live longer than in a nursing home?] (Z Gerontol Geriatr. 2010) “Our investigation shows that a clear difference exists in the survival period of dementia patients, according to whether they have lived at home or in a senior citizen's home. Patients in senior citizen's homes had a higher relative dying risk of around 53.1% (hazard ratio), than for those cared for at home (p=0.047).”

Docosahexaenoic Acid Supplementation and Cognitive Decline in Alzheimer Disease (JAMA 2010) “Supplementation with DHA compared with placebo did not slow the rate of cognitive and functional decline in patients with mild to moderate Alzheimer disease.”

Does mild cognitive impairment increase the risk of developing postoperative cognitive dysfunction? (The American Journal of Surgery 2010) “These preliminary findings suggest that surgery negatively impacts attention/concentration in patients with MCI but not in normal individuals. This is the first study that identified a specific subgroup of patients who are predisposed to POCD.”

Early- versus Late-Onset Alzheimer's Disease: More than Age Alone. (J Alzheimers Dis. 2010)

Failure to Engage Spatial Working Memory Contributes to Age-related Declines in Visuomotor Learning. (J Cogn Neurosci. 2010) “These findings suggest that a failure to effectively engage SWM processes during learning contributes to age-related deficits in visuomotor adaptation.”

Food Combination and Alzheimer Disease Risk

Homocysteine, cognition and brain white matter hyperintensities. (Acta Neurol Taiwan. 2010) “Homocysteine is a sulfur-containing amino acid derived from methionine (1). It is converted by folate, vitamin B12 and B6 to cysteine, or can be recycled into methionine. Homocysteine levels in blood increase with age and with diminishing renal function, but are largely determined by dietary intake and levels of vitamins B12, B6, and folate (2). In recent years, studies have shown that hyperhomocysteinemia might be a risk factor for vascular disease, brain atrophy, cognitive impairment, Alzheimer disease (AD), depression, and several neuropsychiatric diseases (3-6). In this issue, Tu and colleagues evaluated 92 AD patients, investigating the relationship between cognition change, plasma homocysteine level, and white matter hyperintensities (WMH) (7). They found that homocysteine levels did not differ between AD patients and controls, and homocysteine levels did not correlate with cognitive scores. However, plasma homocysteine levels were associated with rapid cognitive decline and higher WMH in the trigone area on brain magnetic resonance imaging (MRI). Previous studies relating homocysteine levels to dementia risk have shown inconsistent results (8-13). However, a recent meta-analysis evaluated nine qualitatively good case-control studies, finding a pooled standardized mean difference in homocysteine levels of 1.04 (0.44-1.63), for 631 patients with AD and 703 controls (4). The findings strongly suggest that levels of homocysteine are higher in AD, most likely caused by lower folate, vitamin B12, and possibly vitamin B6 levels during disease.”

Increased iron and free radical generation in preclinical Alzheimer disease and mild cognitive impairment. (Alzheimers Dis. 2010)

Is it ethical to provide enteral tube feedings for patients with dementia (JAAPA 2010)

Is There an Association Between Low-to-Moderate Alcohol Consumption and Risk of Cognitive Decline? (American Journal of Epidemiology 2010) ”This study did not support the hypothesis that low-to-moderate alcohol consumption prevents cognitive decline. The inverse association between low-to-moderate alcohol intake and cognitive decline observed in other studies may have been due to inclusion of former drinkers in the abstainers reference category.”

Late-life dementia predicts mortality beyond established midlife risk factors. (Am J Geriatr Psychiatry. 2011)

Late onset Alzheimer’s disease in older people (Clin Interv Aging. 2010)

Longitudinal Associations between Blood Pressure and Dementia in the Very Old. (Dement Geriatr Cogn Disord. 2010) “Conclusion: In this small longitudinal study on the very old, no association between baseline blood pressure and incident dementia was found, but individuals who developed dementia exhibited a greater blood pressure decline. Low blood pressure could be an effect of dementia in the very old.”

Normal cognitive decline or dementia? (Practitioner. 2010)

Occurrence of depression and its correlates in early onset dementia patients. (Int J Geriatr Psychiatry. 2010)

Outcome over seven years of healthy adults with and without subjective cognitive impairment. (Alzheimers Dement. 2010)

Oxidative Damage and Progression to Alzheimer's Disease in Patients with Mild Cognitive Impairment. (J Alzheimers Dis. 2010) “These results suggest that accumulation of oxidative damage may start in pre-symptomatic phases of AD pathology and that progression to AD might be related to depletion of antioxidant defenses.”

Patterns of Loss of Basic Activities of Daily Living in Alzheimer Patients: A Cross-Sectional Study of the French REAL Cohort (Dement Geriatr Cogn Disord 2010)

Personality changes in Alzheimer's disease: a systematic review (International Journal of Geriatric Psychiatry 2010)

Practice Parameter update: Evaluation and management of driving risk in dementia (Neurology 2010)

Prevalence of dementia disorders in the oldest-old: an autopsy study. (Acta Neuropathol. 2010)

Reduced gray matter volume in normal adults with a maternal family history of Alzheimer disease (NEUROLOGY 2010) “Conclusions: Overall, maternal family history of Alzheimer disease (AD) in cognitively normal individuals is associated with lower gray matter volume in AD-vulnerable brain regions. These data complement and extend reports of cerebral metabolic differences in subjects with a maternal family history.”

Reduced Lean Mass in Early Alzheimer Disease and Its Association With Brain Atrophy (Arch Neurol. 2010) “Conclusion Loss of lean mass is accelerated in AD and is associated with brain atrophy and cognitive performance, perhaps as a direct or indirect consequence of AD pathophysiology or through shared mechanisms common to both AD and sarcopenia.”

[Relearning vocabulary. A comparative analysis between a case of dementia and Alzheimer's dis ease with predominant compromise of language.] (Rev Neurol. 2010)

Staphylococcus aureus carriage in care homes: identification of risk factors, including the role of dementia. (Epidemiol Infect. 2010) “We concluded that cross-infection through staff caring for more dependent residents may spread MRSA within care homes and from the recently hospitalized. Control of MSSA and MRSA in care homes requires focused infection control interventions.”

Subclinical Zinc Deficiency in Alzheimer’s Disease and Parkinson’s Disease (American Journal of Alzheimer's Disease and Other Dementias 2010) “These patients are probably zinc deficient because of nutritional inadequacy.”

Untreated Poor Vision: A Contributing Factor to Late-Life Dementia. (Am J Epidemiol. 2010)

Upper and Lower Extremity Motor Performance and Functional Impairment in Alzheimer's Disease (American Journal of Alzheimer's Disease and Other Dementias 2010)

Verbal memory impairment in subcortical ischemic vascular disease A descriptive analysis in CADASIL. (Neurobiol Aging. 2010)

Very Mild to Severe Dementia and Mortality: A 14-Year Follow-Up – The Odense Study (Dement Geriatr Cogn Disord 2010) “Conclusion: Dementia increased the risk of death. Even in the very early stages of dementia the risk of death was increased.”

Vitamins B12, B6, and folic acid for cognition in older men. (Neurology. 2010) “The daily supplementation of vitamins B12, B6, and folic acid does not benefit cognitive function in older men, nor does it reduce the risk of cognitive impairment or dementia. Classification of evidence: This study provides Class I evidence that vitamin supplementation with daily doses of 400 µg of B12, 2 mg of folic acid, and 25 mg of B6 over 2 years does not improve cognitive function in hypertensive men aged 75 and older.”

Weight loss and incident dementia in elderly Yoruba Nigerians: a 10-year follow-up study. (Int Psychogeriatr. 2010)

What Is Semantic Dementia? (Arch Neurol. 2010)

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