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Cognitive Decline - Dementia

:: Jun-Jul 2008


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View all Treatment articles in our Treatment Report . The most recent articles are listed on top (not in alphabetical order). Click on the Topic on our home page and then the subtopic - Alzheimer's Daily Treatment Report, FTD Daily Report, Lewy Body Daily Report, or the Vascular Dementia Daily Report. Stay updated on drugs and their side effects, and various other treatments, including exercise, nutrition, and supplements.

Highlighted Article

Women Over 90 More Likely To Have Dementia Than Men “The researchers reviewed an analysis of 911 people enrolled in the 90+ Study. Of those, 45 percent of the women had dementia, as opposed to 28 percent of the men. The analysis did not determine when the subjects first experienced dementia. The 90-plus age group, or the "oldest old," is the fastest growing segment of the population, according to the U.S. Census. While there are currently nearly 2 million nonagenarians in the U.S. alone, that number is projected to increase to 10 to 12 million by the middle of the century, raising concerns that the current health care system may not be able to accommodate this population. … Research has shown that dementia prevalence for both men and women increases from age 65 to 85. The frequency of dementia increases with age from less than 2 percent for the 65-69-year-olds, to 5 percent for the 75-79-year-olds and to more than 20 percent for the 85-89-year-olds. … It found that the likelihood of having dementia doubled every five years in women after reaching 90, but not in men. The results also showed that women with a higher education appeared to be as much as 45 percent less likely to have dementia compared to women with less education.”

Clinical Guidelines

Internet Sites

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Related Topics - Highlighted Articles

Cardivascular: General

C-Reactive Protein and Cerebral Small-Vessel Disease. The Rotterdam Scan Study (Circulation 2005) "Background--Inflammatory processes are involved in the development and consequences of atherosclerosis. Whether these processes are also involved in cerebral small-vessel disease is unknown. Cerebral white matter lesions and lacunar brain infarcts are caused by small-vessel disease and are commonly observed on MRI scans in elderly people. These lesions are associated with an increased risk of stroke and dementia. Ä Conclusions--Inflammatory processes may be involved in the pathogenesis of cerebral small-vessel disease, in particular, the development of white matter lesions."


Neural Injury: Neurodegeneration

Oxidative DNA damage in peripheral leukocytes of mild cognitive impairment and AD patients. (Neurobiol Aging. 2005) "It is well established that oxidative stress plays a key role in the degenerative neuronal death and progression of Alzheimer's disease (AD), although it is not clear if it is the primary triggering event in the pathogenesis of this disorder. Mild cognitive impairment (MCI) is a clinical condition between normal aging and AD, characterized by a memory deficit without loss of general cognitive and functional abilities. Ä Our results give a further indication that oxidative stress, at least at the DNA level, is an earlier event in the pathogenesis of AD."

 

Diagnosis, Imaging, and Screening

Basal forebrain atrophy is a presymptomatic marker for Alzheimer's disease. (Alzheimers Dement. 2008) “CONCLUSIONS: Atrophy in the basal forebrain precedes the development of AD in subjects with cognition judged to be normal by neuropsychological testing. The time required to develop dementia appears to be shortened if hippocampal atrophy is also present. These data indicate that atrophy restricted to medial basal forebrain is a biomarker that predicts development of probable AD in asymptomatic elderly subjects.”

Higher Cutoff Point on Dementia Screening Test Recommended for Educated Patients

Impact of white matter hyperintensity volume progression on rate of cognitive and motor decline (NEUROLOGY 2008) “Conclusion: Increased total and periventricular (PV) white matter hyperintensity (WMH) burden and progression of PV WMH burden are associated with decreased gait performance over time, while progression of subcortical WMH volume is associated with memory decline in cognitively intact elderly. Greater progression of WMH burden is associated with an increased risk of memory and gait dysfunction, and thus should not be considered a benign process.”

Magnetic Resonance Imaging in Frontotemporal Dementia Shows Subcortical Atrophy. (Dement Geriatr Cogn Disord. 2008) “Conclusion: Subcortical gray matter atrophy may contribute as significantly to symptoms of FTD as cortical atrophy.”

MRI Assessment of Hippocampal Volume Can Identify Alzheimer's Patients “Automated volumetry of the hippocampus based on magnetic resonance imaging can discriminate between Alzheimer's disease (AD), mild cognitive impairment (MCI) and normal aging, French researchers report in the July issue of Radiology. … Hippocampal volume was 32% smaller in AD patients and 19% smaller in MCI patients compared with controls. Hippocampal volume was 15% smaller in AD patients compared with those with amnestic MCI.”

 

General Information

Alzheimer and frontotemporal pathology in subsets of primary progressive aphasia (Annals of Neurology 2008)

Low HDL Cholesterol Is a Risk Factor for Deficit and Decline in Memory in Midlife. The Whitehall II Study. (Arterioscler Thromb Vasc Biol. 2008)

Prevalence of dementia after age 90. Results from The 90+ Study (Neurology 2008) “Conclusions: In a very large sample of participants aged 90 and older, prevalence of all-cause dementia doubled every 5 years for women but not men.”

Study Suggests Early-Stage Alzheimer's Patients Who Were More Fit Had Less Brain Atrophy“Exercise and physical fitness have been shown to slow age-related brain cell death in healthy older adults.”

Total Daily Activity is Associated With Cognition in Older Persons (Am J Geriatr Psychiatry 2008) “Conclusions: Objective measures of total daily physical activity were associated with a broad range of cognitive abilities in older persons. These findings support the link between physical activity and cognition in the elderly.”

 

Risk Factors

Blood pressure 'link to dementia' “Two studies support a link between high blood pressure and dementia risk - with one by an Imperial College London team suggesting treatment could cut this. This study, by published in the Lancet Neurology journal, found blood pressure drugs reduce dementia by 13%. The Alzheimer's Society said better control could save 15,000 lives a year.“

Inflammation and Alzheimer's disease: possible role of periodontal diseases. (Alzheimers Dement. 2008) “Recently, chronic periodontitis has been associated with several systemic diseases including AD. In this article we review the pathogenesis of chronic periodontitis and the role of inflammation in AD. In addition, we propose several potential mechanisms through which chronic periodontitis can possibly contribute to the clinical onset and progression of AD. Because chronic periodontitis is a treatable infection, it might be a readily modifiable risk factor for AD.”

Moms With Alzheimer's May Pass on Risk to Kids “People whose mothers have had Alzheimer's disease may be predisposed to the mind-robbing condition, a new study finds. The link may be a dysfunction in how the brain handles sugar -- something that's probably genetic and starts years before symptoms of Alzheimer's appear, researchers say. "Overall, these findings show that their brains are not working properly to start with, and the metabolic impairment gets worse over time," explained lead researcher Lisa Mosconi, a research assistant professor of psychiatry at the Center for Brain Health at NYU Langone Medical Center in New York City. There is evidence that having a parent affected with Alzheimer's disease increases the risk of developing Alzheimer's disease four- to tenfold, Mosconi said. "However, we don't know why or how this happens. Our study shows for the first time that individuals with an Alzheimer's disease [-affected] mother may be at increased risk for developing Alzheimer's disease themselves because their brains are not utilizing glucose in an effective way," she said.”

Risk Factors for Alzheimer Dementia in a Community-Based Birth Cohort at the Age of 75 Years (Dement Geriatr Cogn Disord 2008) Results: In multivariate analysis an elevated risk for late-onset AD could be found for (1) history of depressive episodes (OR = 2.09; 95% CI = 1.25-3.48); (2) the 4 allele of the APOE gene (OR = 1.86; 95% CI = 1.08-3.23); (3) lower serum level of folate (OR = 0.92; 95% CI = 0.87-0.98); (4) no chronic use of nonsteroidal anti-inflammatory drugs (OR = 0.40; 95% CI = 0.20-0.81), and (5) lower education (OR = 1.43; 95% CI = 1.03-2.00). Conclusions: Five risk factors for late-onset AD could be confirmed, which might be targets for preventive strategies.”

Smoking history and cognitive function in middle age from the Whitehall II study. (Arch Intern Med. 2008) “CONCLUSIONS: Smoking was associated with greater risk of poor memory. Middle-aged smokers are more likely to be lost to follow-up by death or through nonparticipation in cognitive tests. Ex-smokers had a lower risk of poor cognition, possibly owing to improvement in other health behaviors.”

The Association between APOE Genotype and Memory Dysfunction in Subjects with Mild Cognitive Impairment Is Related to Age and Alzheimer Pathology. (Dement Geriatr Cogn Disord. 2008)

Thyroid Function and the Risk of Alzheimer Disease (Arch Intern Med. 2008) “Conclusion Low and high thyrotropin levels were associated with an increased risk of incident AD in women but not in men. “

Tofu 'may raise risk of dementia' “Lead researcher Professor Eef Hogervorst said previous research had linked oestrogen therapy to a doubling of dementia risk in the over-65s. She said oestrogens - and probably phytoestrogens - tended to promote growth among cells, not necessarily a good thing in the ageing brain. Alternatively, high doses of oestrogens might promote the damage caused to cells by particles known as free radicals. A third theory is that damage is caused not by the tofu, but by formaldehyde, which is sometimes used in Indonesia as a preservative. The researchers admit that more research is required to ascertain whether the same effects are found in other ethnic groups. However, previous research has also linked high tofu consumption to an increased risk of dementia in older Japanese American men. “

 

Risk Reduction

Tea consumption and cognitive impairment and decline in older Chinese adults (American Journal of Clinical Nutrition 2008) “Conclusion: Regular tea consumption was associated with lower risks of cognitive impairment and decline. “

 

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