Category Archives: Alzheimers/Dementia

Herpes & Alzheimer’s — More

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Earlier this month, we described a study demonstrating a link between the presence of certain herpes viruses in the brain, and the presence of Alzheimer’s signs. Interestingly, three more studies of this connection have appeared. All three confirm this connection, but the third in addition suggests that aggressive treatment with herpes anti-viral medication can significantly reduce the chance of encountering dementia. However, the study did not attempt to deal with people who had already encountered dementia.

Here are two media articles:
Herpes linked to Alzheimer’s: Antivirals may help
Alzheimer’s risk 10 times lower with herpes medication

Here is an interesting scientific commentary by two researchers active in the area (referenced in both media articles linked above):
Herpes Viruses and Senile Dementia: First Population Evidence for a Causal Link

Here are links to the first two research studies
Increased risk of dementia following herpes zoster ophthalmicus
Epidemiology and long-term disease burden of herpes zoster and postherpetic neuralgia in Taiwan: a population-based, propensity score-matched cohort study

Here is the abstract of the third research article which provides information that “The usage of anti-herpetic medications in the treatment of HSV infections was associated with a decreased risk of dementia”:
Anti-herpetic Medications and Reduced Risk of Dementia in Patients with Herpes Simplex Virus Infections-a Nationwide, Population-Based Cohort Study in Taiwan.

All links have been added to Alzheimer’s > Risk Factors and Alzheimer’s > Neurology & Neuroplasticity

High Blood Pressure In Older People Raises Alzheimer’s Risk

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High blood pressure is known to lead to heart attack/failure, stroke, and kidney disease or failure, among other bad consequences. Now, a recently reported study shows that high blood pressure appears to be linked to higher risk of (silent)infarcts (brain lesions/dead brain tissue) and a higher number of Alzheimer’s tangles (but not plaques — yet), and overall, a higher risk of Alzheimer’s. The study group consisted of nearly 1,300 individuals — 2/3 of whom had high blood pressure — followed for an average of 8 years before their deaths, after which their brains were autopsied to determine the effects of the high blood pressure. Yet another reason to attempt to manage hypertension.

Links to media articles about the work:
Blood pressure linked to lesions, signs of Alzheimer’s in autopsied brains
High blood pressure may increase dementia risk
High blood pressure threatens the aging brain, study finds
Late-Life BP Tied to Brain Infarcts, Tangles
Here is a link to the research article:
Late-life blood pressure association with cerebrovascular and Alzheimer disease pathology

All links have been added to Alzheimer’s > Risk Factors

Herpes & Alzheimer’s

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For many years, theories have been proposed concerning the possible involvement of viruses with Alzheimer’s disease, but they have been seen as controversial. New research, based on examination of brain tissue from 1,000 deceased Alzheimer’s sufferers, has strengthened the case for some sort of link. The examination of those brains showed a much higher incidence of two strains of herpes virus than in the brains of deceased healthy controls. These two strains of herpes are extremely common, and typically begin life-long residence in the body and brain during childhood.

However, all scientists involved stress that it is unknown at present whether the presence of these viruses acts as triggers for Alzheimer’s, or whether the presence is a side-effect of Alzheimer’s.

Media articles on the work:
Researchers Find Herpes Viruses In Brains Marked By Alzheimer’s Disease
A Common Virus May Play Role in Alzheimer’s Disease, Study Finds
Childhood viruses linked to Alzheimer’s
Alzheimer’s link to herpes virus in brain, say scientists
The research article:
Multiscale Analysis of Independent Alzheimer’s Cohorts Finds Disruption of Molecular, Genetic, and Clinical Networks by Human Herpesvirus

All links have been added to Alzheimer’s > Neurology & Neuroplasticity

Advance Directive for Dementia

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Advance Care Directives concerning general medical care are recognized throughout all the states (for example, see the American Bar Associations list Links to State-Specific Advance Directive Forms). More recently, advance care directives specifically aimed at dementia have begun to appear. The point of advance directives is to have a plan in place and to have discussed your wishes with family, potential caregivers, and your doctors — while you are still capable.

A fairly simple straight-forward dementia-oriented directive has been developed by a Washington state internist, and is available as a pdf download at Health Directive for Dementia. The directive was documented by an essay in the JAMA at Advance Directives for Dementia – Meeting a Unique Challenge. Both of these links are available at ADVANCE DIRECTIVE FOR DEMENTIA. A media article about this work appeared at One Day Your Mind May Fade. At Least You’ll Have a Plan.

A more extensive dementia-oriented directive, with detailed directions, can be found at Alzheimers Disease and Dementia Advance Directive , with a general introduction at Alzheimer’s Disease and Dementia Mental Health Advance Directive. This directive apparently has legal weight in Washington state. It is not clear whether Advance Directives for Dementia have yet gained legal weight in other states.

Whatever the legal status of these Advance Directives for Dementia, it is important for anyone at any risk for dementia to engage in discussions of advance care with family, friends, and doctors, and to make their wishes known while they are able.

All the links above have been added to the top of Alzheimer’s > Coping & Caregivers and to the top of Alzheimer’s > General & Resources

Diet Soda And Dementia And Stroke

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Just about a year ago, a study examining the associations of drinking artificially sweetened soda drinks made something of a splash. The study found that people consuming at least a can of so-called diet drinks every day were 2.96 times more likely to suffer an ischaemic stroke and 2.89 times more likely to develop Alzheimer’s disease than those who drank them less than once a week. The study — like many — could not establish a causal relationship either way, only a definite association. But “the best current evidence suggests that when it comes to reducing your risk of dementia, what is good for your heart is also good for your head.”

Here are four media articles about the work:
Stroke and dementia risk linked to artificial sweeteners, study suggests
Diet sodas may be tied to stroke, dementia risk
Is soda bad for your brain? (And is diet soda worse?)
Diet Soda and Dementia: What You Need to Know
Here is a link to the research publication:
Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia
And here is a link to a collection of expert researcher reactions to the publication:
expert reaction to artificially-sweetened fizzy drinks, stroke and dementia

The links have all been added to Alzheimers > Risk Factors and Health > Diet.

Too Many Hours Sitting Shrinks A Brain Memory Area

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The medial temporal lobe (MTL) includes the hippocampus, and is essential to the processing and storage of long-term memories. Recent research demonstrates that in people over 45, the number of hours spent sitting per day is inversely related to the thickness of the MTL. Crudely put, too many hours sitting can reduce your ability to remember. Since it is already known that sedentary behavior is linked to an increased risk of heart disease, diabetes and premature death in middle-age and older adults, this most recent work adds another disturbing element to the argument against sitting too much.

While the research appears to show that physical activity, even at high levels, is insufficient to offset the harmful effects of sitting for extended periods, the work is preliminary in that the study focused on hours spent sitting, and did not take into consideration whether participants took breaks during long stretches of sedentary behavior. The researchers said that this could be a limitation of their results.

Here are links to two media articles on the work:
Sitting Too Much Can Change Your Brain & Impact Your Memory, A New Study Says
Too Much Sitting May Shrink the Part of Your Brain Tied to Memory
Here is a link to the research article:
Sedentary behavior associated with reduced medial temporal lobe thickness in middle-aged and older adults

All the links have been added to Aging, Physical Exercise, and Alzheimers > Risk Factors.

New Biological Definition Of Alzheimer’s Advances

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Historically, Alzheimer’s Dementia (AD) has been defined by visible symptoms, simply because that was all that was available. Around the mid 1990’s, various researchers began pushing for the development of a biologically-based specification of the disease, separate from the manifested symptoms. Among other things, this allows reasoning about the onset of AD before manifestation of symptoms, much like cancer or heart disease. It is believed that the AD process may begin decades before any outward sign of memory loss or other decline.

In 2007, leading AD clinicians formed an international working group (IWG) and proposed using amyloid PET scans, MRI, CSF (cerebrospinal fluid) levels of Aβ and tau, genetic testing, brain structural changes, and subtle cognitive changes to diagnose AD at an earlier stage than before. The NIA/AA (National Institute of Aging, and the Alzheimer’s Association) set up a separate leadership group, and in 2011 it proposed a related set of diagnostic guidelines for AD research that utilized separate criteria for three stages of disease: preclinical AD, mild cognitive impairment, and dementia. The current NIA/AA research framework draws on these two efforts and their personnel.

The workers stress, both in the framework publication and in an associated editorial, that this work is directed at research, and will only slowly begin appearing in the clinical context. But it is expected that the new framework will markedly improve research communication and advances.

Links to media articles on the new framework:
New biological research framework for Alzheimer’s seeks to spur discovery
Alzheimer’s disease redefined: New research framework defines Alzheimer’s by brain changes, not symptoms
New Definition of Alzheimer’s Hinges on Biology, Not Symptoms

Links to two different publications of the framework:
NIA-AA Research Framework: Toward a biological definition of Alzheimer’s disease
NIA-AA Research Framework: Toward a biological definition of Alzheimer’s disease

All the links have been added to Neuro-Psych and to Alzheimers > Neurology & Neuroplasticity

Maybe Flashing Lights For Alzheimer’s Therapy?

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Mice again, but not drugs. Instead, it’s the promising use of strobe-type flashing lights to modify brain waves (neuromodulation) to induce changes beneficial to Alzheimer’s sufferers.

It has been previously noted that both human Alzheimer’s sufferers and the mice models of Alzheimer’s exhibit disrupted gamma waves, which are the highest frequency waves and are associated with higher cognitive events. The study placed mice, genetically engineered to mimic Alzheimer’s symptoms, in a box with strobe lights flashing at 40 cycles per second for an hour a day. This stimulated the visual cortex of the mice to generate more gamma waves, which set in motion an apparent sequence of biological events: A change in gene expression causes microglia (immune cells in the brain) to change shape, going into scavenger mode, where they better perform their usual housekeeping role, clearing away cellular debris, including amyloid-β.

Note how complex the brain and how difficult the science: In Brain Inflammation & Alzheimer’s, we discussed work showing that Alzheimer’s-type inflammatory response on the part of microglia can lead to increase in the deposit of amyloid-β, whereas the present work shows the microglia being stimulated to improve the removal of amyloid-β.

Here is a link to a recent Nature magazine news feature article on the MIT work and related work on the role of brain waves. The article is an excellent explication of the work and how it affects how the brain works:
How flashing lights and pink noise might banish Alzheimer’s, improve memory and more

Below are links to a number of media articles on the work. The first group deals with the MIT group’s earlier report from 2016:
Flashing light therapy’ for Alzheimer’s
Beating Alzheimer’s With Brain Waves
Unique visual stimulation may be new treatment for Alzheimer’s
LED Lights May Be a Promising New Alzheimer’s Treatment, MIT Study Says
Toward Treating Alzheimer’s Disease with Brain Waves
Here is the earlier research article:
Gamma frequency entrainment attenuates amyloid load and modifies microglia

Here are links to media articles on the more recent research:
Alzheimer’s Memory Loss May Be Reversible, MIT Study Says
How does the Sp3-HDAC2 Complex Reduce Synaptic Function in Alzheimer’s?

And here is the more recent research report:
The Transcription Factor Sp3 Cooperates with HDAC2 to Regulate Synaptic Function and Plasticity in Neurons

Light therapy (sitting bathed in light every morning) has been successfully used for treating the form of depression known as Seasonal Affective Disorder (SAD) (see e.g., Take Light, Not Drugs). If this strobe-approach to Alzheimer’s is successful with humans, Alzheimer’s treatment could utilize a similar therapeutic approach, or even possibly the two therapies could be combined when appropriate.

All of the links have been added to Alzheimer’s > Treatment

Diagnosing Dementia & MCI Using Computers

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The first two bodies of work below use computer-based games to research the decline of 3D navigational skills (one of the first symptoms exhibited by the onset of dementia of all kinds), and the diagnosis of mild cognitive impairment (MCI), respectively. The third study reports on the correlation that “Less Daily Computer Use is Related to Smaller Hippocampal Volumes in Cognitively Intact Elderly”.

Sea Hero Quest

Sea Hero Quest is a collaboration between Alzheimer’s Research UK, Deutsche Telekom, the game designers Glitchers and scientists at 7 British universities. Recognizing that one of the first symptoms of dementia is loss of navigational skills, Sea Hero Quest mobile was designed to help researchers to understand the mental processes involved in 3D navigation, while at the same time providing a sea journey quest taken by a son attempting to recover the memories his father has lost to dementia. There are three sections to the game: navigation, shooting flares to test orientation, and chasing creatures. Each section is scientifically valid as well as fun and exciting. The game was launched in 2016 and, according to its website (below), nearly 3 million people have played the game up to now,. This amount of play has generated effectively 80 years worth of data, in turn equivalent to about 12,000 years of typical lab-based dementia research.

Here are three links to media articles about the game:
Sea Hero Quest: the mobile phone game helping fight dementia
Game shows that ability to navigate declines at young age
https://blog.strong-brain.com/wp-admin/post.php?post=2135&action=edit
Here is the Wikipedia entry for the game:
Sea Hero Quest [Wikipedia]
And here is the actual game site on the web, where you can download the Mobile and/or VR versions of the game:
Sea Hero Quest [Site]

Virtual Super Market (VSM)

The study reported here uses as “Virtual Super Market” Virtual Reality (VR) brain-training-style program to assess mild cognitive impairment on the part of the player. It is of definite interest since the testing game and assessment can be carried out without an administrator. Here is a link to a media article about the work:
Mild cognitive impairment (MCI) detected with brain training game

Here are a link to the original study together with an earlier prototype work:
A Preliminary Study on the Feasibility of Using a Virtual Reality Cognitive Training Application for Remote Detection of Mild Cognitive Impairment
Can a Virtual Reality Cognitive Training Application Fulfill a Dual Role? Using the Virtual Supermarket Cognitive Training Application as a Screening Tool for Mild Cognitive Impairment

Computer Use Time Can Correlate With Cognitive Decline

The study followed 27 ‘cognitively-healthy’, dementia-free adults aged 65 or older over 9 years in Portland. On the one hand, the study used MRI scans to measure the volume of the volunteers’ hippocampus, and on the other hand, data on computer use among participants was collected via mouse movement detection software. Embedded sensor technology monitored their mobility, sleep, socialisation, digital activities and medication intake. The research results showed that an additional hour of computer use each day was linked to a 0.025% larger hippocampal volume, leading to the conclusion that lower computer usage could be used to predict cognitive decline.

Here is a link to a media article about the study:
Computer use could help predict early-stage Alzheimer’s

Here is the original research study:
Less Daily Computer Use is Related to Smaller Hippocampal Volumes in Cognitively Intact Elderly

Here is the Wikipedia entry for Hippocampus:
Hippocampus [Wikipedia]

All the links have been added to Diagnosis & Tests.

Diabetes Drug Reverses Alzheimers — In Mice

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It is fairly well established that diabetes and high blood sugar are serious risk factors for Alzheimers (see Alzheimer’s Linked To Sugar & Diabetes and also: Diabetes and Alzheimer’s linked, Alzheimer’s disease
and diabetes
, and research review: Type 2 Diabetes as a Risk Factor for Alzheimer’s Disease: The Confounders, Interactions, and Neuropathology Associated With This Relationship)

So it would seem to be great news that the use of an established drug for treating human diabetes might also directly treat Alzheimer’s or at least the symptoms thereof in mice models. However this snarky, but all-too-true, comment from Hacker News summarizes the situation:

This would be great news if we [had] not cured mice many times before of Alzheimer’s. Unfortunatly all the drugs that have worked in mice failed when tested in humans.

Of course, this might be the magic time. Since the drug is already approved for human use, we’ll find out much sooner whether it works for Alzheimer’s. Here are four media articles about the work (all with similar titles):

A Diabetes Drug Has ‘Significantly Reversed Memory Loss’ in Mice With Alzheimer’s
Diabetes drug ‘significantly reverses memory loss’ in mice with Alzheimer’s
Diabetes drug ‘significantly reverses memory loss’ in mice with Alzheimer’s
Diabetes drug “significantly reverses memory loss” in mice with Alzheimer’s
And here is the original research article:
Neuroprotective effects of a triple GLP-1/GIP/glucagon receptor agonist in the APP/PS1 transgenic mouse model of Alzheimer’s disease

The three links in the first paragraph have been added to Risk Factors. The links regarding the diabetes drug have been added to Treatment > Drugs.