Category Archives: Alzheimers/Dementia

Closer To A Blood Test For Alzheimer’s

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Clumps of amyloid beta can begin building up in the brains of Alzheimer’s sufferers nearly 20 years before the individuals exhibit the memory loss and confusion characteristic of Alzheimer’s disease. Currently, the most reliable method of detecting amyloid beta buildup before exhibition of behavioral symptoms is using a PET scan (Positron emission tomography) (Brain Scans Prevent Alzheimer’s Misdiagnosis and Lead to Better Treatment—But They’re Not Covered By Medicare), but these are expensive, not covered by insurance, and take time and a visit to a site with the right scanning machinery. Because of this, few people have the scans done on a routine annual basis, and it is very difficult for drug researchers to recruit participants who might develop Alzheimer’s in the future, but don’t current exhibit memory loss and confusion.

These are all reasons why a blood test which could detect buildup of amyloid beta as early as PET scans would be highly desirable. A recent research publication reports on work coming very close to such a test. A certain amount of amyloid beta is naturally present in both brain and blood. The test first chops up the amyloid obtained from a blood sample with enzymes. The amounts of two fragments, called a-beta 42 and a-beta 40, are obtained by mass spectrometry, and their ratio is computed. As amyloid beta starts building up in the brain, less of the fragment a-beta 42 is available for circulation in the blood, and so the computed ratio goes down. Utilizing this ratio, together with an individual’s age and genetic risk, the test was able to match PET scan performance on 94% of the study participants.

Although at present there are no reliable methods of treating Alzheimer’s, a positive result on a blood test such as this would enable one to take steps to defer the onset of the disease, using:

And, sensibly, one could ensure that one’s will and healthcare advance directive were up to date, and one could consider creating an Advance Directive for Dementia.

Here are three media articles on the blood test work:
Blood test can identify Alzheimer’s 2 decades before symptoms
Blood test is 94% accurate at identifying early Alzheimer’s disease
New Alzheimer’s Blood Test Proved 94% Accurate in Finding Brain Changes Related to the Disease

Here is the published research article:
High-precision plasma β-amyloid 42/40 predicts current and future brain amyloidosis

All links have been added to Alzheimers > Diagnosis & Tests

Anticholinergic Drugs Might Lead To Dementia

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Acetylcholine (ACh) is a neurotransmitter (chemical messenger) occurring widely in the brains and bodies of humans and many animals. Anticholinergics are chemical substances (drugs) which block the action of acetylcholine at synapses in the central and the peripheral nervous system. For some years, many scientists have suspected that long-term use of various anticholinergics might tend to increase the risk of dementia. A succession of studies have shown a strong association between long-term use of various anticholinergics and the later development of dementia. We set out three of them here. In total, the three studies involved 637,843 participants.

The most recent study was published June 24, 2019. It showed that the strongest associations between anticholinergics and dementia was for these classes of drugs: antidepressants, bladder antimuscarinics (treating overactive bladder), antipsychotics and antiepileptic drugs.

Here are four media articles about the most recent work:
Anticholinergic Drugs Associated With Dementia Risk
Commonly prescribed drugs are tied to nearly 50% higher dementia risk in older adults, study says
Widely used class of drugs linked to dementia
Anticholinergic Drugs Could Account for 10% of Dementia Cases

Here is the original research article, together with a page of commentary by related experts:
Anticholinergic Drug Exposure and the Risk of Dementia, A Nested Case-Control Study
expert reaction to anticholinergic drug exposure and risk of dementia

Here are summaries concerning anticholinergic drugs:
Anticholinergic Drugs to Avoid in the Elderly
List of Anticholinergic Drugs and Why Some of Them are Dangerous for Seniors
Here is a table merging the information from the two pages above:
Table of Anticholinergic Drugs


The next study was published April 25, 2018 and showed that anticholinergics for depression, Parkinson’s and urinary incontinence carry a higher risk of dementia than others.

Here are three media articles about this research:
Some antidepressants linked to dementia risk
Certain common medications tied to 30% higher dementia risk, study finds
Some antidepressants and incontinence drugs linked to dementia
CAN ALLERGY MEDICATIONS HARM YOUR BRAIN?

Here is a summary concerning anticholinergic drugs:
Anticholinergics

Here is an NIH abstract of the research, together with the original research article:
Anticholinergic drugs and risk of dementia: case-control study. (NIH Abstract)
Anticholinergic drugs and risk of dementia: case-control study (Full Publication)


The research reports above both build on earlier work, in particular research reported on March 1, 2015. Here are two articles about that work:
Common anticholinergic drugs like Benadryl linked to increased dementia risk
Benadryl and Other Common Medications are Linked to Dementia in Men and Women

And here is the original research article:
Cumulative use of strong anticholinergics and incident dementia: A prospective cohort study

All links have been added to Alzheimers > Risk Factors.

Once Again, Lifestyle Counts

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Another new study, involving 196,383 UK adults age 60 and older, has re-confirmed the importance of following healthy lifestyles for lowering your dementia risk — even if you have a high genetic risk for dementia. The study results showed a statistically significant difference: 1.13% of those with a healthy lifestyle developed dementia later in life compared with 1.78% of those with a less healthy lifestyle. The definition of healthy lifestyle included the following:

  • avoid smoking tobacco
  • be physically active
  • drink alcohol in moderation, or not at all
  • healthy diet: following recommendations on dietary priorities for cardiometabolic health

Here are three media articles on the study:
Your lifestyle can lower your dementia risk, even if you have high genetic risk, study says
Healthy lifestyle may offset genetic risk of dementia
Is healthy lifestyle associated with lower risk of dementia regardless of genetic risk?
The study was simultaneously presented at the 2019 Alzheimer’s Association International Conference together with JAMA publication here:
Association of Lifestyle and Genetic Risk With Incidence of Dementia

Another study presented at the Alzheimer’s Association Conference looked at similar issues. It tracked 2,765 individuals over about 10 years, rating them 1 point for maintaining each of the following healthy behaviors:

  • a low-fat diet
  • did not smoke
  • exercised at least 150 minutes each week at moderate-to-vigorous levels
  • drank moderately
  • engaged in some late-life cognitive activities

Those who rated 4 or 5 (i.e., participated in 4 or 5 of the healthy behaviors) were were 60% less likely to develop Alzheimer’s compared with participants who rated only 0 or 1 (i.e. participated in none or one of the healthy behaviors). The results did not vary by race or gender.
Here are two media articles on the work (formal publication is not yet available):
It May Be Possible to Counter Some of the Genetic Risk of Alzheimer’s With These Lifestyle Changes
Doing these five things could decrease your risk of Alzheimer’s by 60 percent, new study says

All links have been added to Alzheimers > Amelioration/Prevention, Alzheimers > RiskFactors, Alzheimers > Mental Exercise, Health > Diet, and to Health > Physical Exercise.

Outdoors for Physical & Mental Health (Green!)

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Some time back, we posted Green for Health on studies, small and large, showing that the greener one’s environment, the greater the boost to one’s health. Now a new study shows that getting out of the city and into nature (forest, park, beach, whatever) will improve both your physical and mental health.
Here are two media articles on the study:
Spending time in nature boosts health, study finds
Two-hour ‘dose’ of nature significantly boosts health – study
Here is the original research report:
Spending at least 120 minutes a week in nature is associated with good health and wellbeing

Combining this work with that we pointed to in
More On Air Pollution & Dementia
and
Air Pollution: Shorter Life, More Dementia Risk, Worse Thinking
strengthens the case for trying to maximize time spent outside of dense urban environments.

This is particularly strengthened by another air pollution study showing that very large numbers of pollution particles are found in the hearts of urban dwellers.
Media article:
Billions of air pollution particles found in hearts of city dwellers
Original research article:
Combustion- and friction-derived magnetic air pollution nanoparticles in human hearts

All links have been added to Alzheimers > Amelioration/Prevention and to Alzheimers > RiskFactors

Distilled: Signs of the Onset of Dementia

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We’ve collected a number of web pages offering lists of symptoms of the onset of demetia, and have distilled out 18 of the signs. Keep in mind that the occasional and not long lasting appearance of one of these is most likely a sign of aging. However, regular occurrence of one or more of these signs is an indication that a visit to a physician or clinincal psychologist specializing in cognition is warrented.
The web links contributing to this list are collected at the bottom of this post.
Here are the 18 distilled signs:

1. Memory loss that disrupts daily life fairly often — not the occasional forgetting of a name or date that comes back later.
2. Challenges in planning or solving problems, or following recipes or keeping track of monthly bills.
3. Difficulty with numbers and/or handling money in shops.
4. Difficulty making familiar trips (walking or driving).
5. A failing sense of direction and spatial orientation, including wandering and getting lost.
6. Confusion about time or place.
7. Repeating questions after a short interval.
8. Vision problems, including difficulty reading, judging distance and determining color or contrast — not due to cataracts or other eye problems.
9. Problems with words in conversations or writing, including repeating themselves or stopping mid-conversation unable to continue; also failure to find the right word.
10. Difficulty following storylines.
11. Misplacing things (often in very unusal places) and losing the ability to retrace steps to find them.
12. Decreased or poor judgment, including mishandling money, and decreased attention to grooming and keeping clean.
13. Notable weight changes.
14. Withdrawal from work or social activities.
15. Apathy, or loss of spontaneity and sense of initiative.
16. Changes in mood and personality, including becoming confused, suspicious, depressed, fearful or anxious, or aggressive.
17. Lessening of ability to focus and concentrate.
18. Failure to recognize people they know.

Here are links to the web pages contributing:

10 Early Signs and Symptoms of Alzheimer’s
What are the early signs of dementia?
10 Early Symptoms of Dementia
Dementia – early signs
What Are the Signs of Alzheimer’s Disease?
Symptoms of dementia
Symptoms
Well, that was a weird moment’ and other signs of dementia family members should watch for [Possible paywall]
Dementia’s Signs May Come Early [Possible paywall]

All links have been added to Alzheimer’s > Diagnosis & Tests

More On Air Pollution & Dementia

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We previously put out a longish post about the effects of air pollution: Air Pollution: Shorter Life, More Dementia Risk, Worse Thinking. A London-based study from 2018 now extends those previous studies, showing that “We have found evidence of a positive association between residential levels of air pollution across London and being diagnosed with dementia, which is unexplained by known confounding factors.”

Here are two media articles on this study:
Is air pollution tied to higher dementia risk?
Air pollution linked to much greater risk of dementia
Here is a link to the study itself:
Are noise and air pollution related to the incidence of dementia? A cohort study in London, England

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

US Dementia & Death Rates Increasing

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Dementia continues to grow as a significant problem in the United States. The CDC forecasts that between 2014 and 2060, the percent of the U.S. population living with dementia will rise from 1.6% of the population (5 million people) in 2014 to approximately 3.3% (13.9 million people) in 2060. And the rate at which Americans are dying directly from dementia has more than doubled from 30.5 deaths per 100,000 people in 2000 to 66.7 per 100,000 in 2017. And the cost to the U.S. is staggering, approaching $300 billion per year.

Here are two media articles about the expected doubling of the percent of U.S. persons living with dementia:
Rate of Americans living with Alzheimer’s expected to double by 2060
World Alzheimer’s Day: Why US Dementia Rates Will Likely Double By 2060
Here is the published CDC report:
Racial and ethnic estimates of Alzheimer’s disease and related dementias in the United States (2015–2060) in adults aged ≥65 years

Here are two media articles about the more than double increase in U.S. deaths directly due to dementia:
Deaths from dementia have more than doubled in US, report says
U.S. Dementia-Linked Death Rate More Than Doubles
Here is the CDC report:
Dementia Mortality in the United States, 2000–2017

Here are two media articles on the costs of Alzheimer’s disease to the U.S. health care system:

Alzheimer’s costs Americans $277 billion a year — and rising

Alzheimer’s: The Most Expensive Disease in America

All links have been added to Alzheimer’s > Epidemiology.

Sleep & Alzheimer’s

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Recent research demonstrates a good reason to sleep deeply: the slow and steady brain (and cardiopulmonary) activity associated with deep non-REM sleep are best for the function of the glymphatic system, the brain’s unique process of removing waste. That waste includes toxic proteins like beta amyloid and tau which are associated with Alzheimer’s.

Here are two media articles on the work:
Not all sleep is equal when it comes to cleaning the brain
Study: Deep Sleep Best for Brain ‘Cleaning,’ Emphasizes Link Between Sleep and Alzheimer’s

The research article is published at [paywall]: Science 22 Feb 2019: Vol. 363, Issue 6429, pp. 831-832.

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

Sniffing For Alzheimer’s

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The idea of being able to utilize an inexpensive “scratch & sniff” test such as described in Smelling Alzheimer’s & Brain Injury? to obtain early warnings of possible Alzheimer’s onset is certainly intriguing, and work is ongoing. Most recently, a study reported a correlation between development of poor sense of smell and a notably higher incidence of death within 10 years. The mechanism(s) and meaning(s) remain unclear.

Here are two media articles on the work:
Routine sense of smell tests could be used to spot signs of dementia
Poor sense of smell associated with nearly 50 percent higher risk for death in 10 years

Here is the research publication Summary for Patients:
Poor Sense of Smell and Risk for Death in Older Adults

Here are interesting overviews from 2017 and 2018:
Smell Test May Sniff Out Oncoming Parkinson’s and Alzheimer’s
Can a Smell Test Sniff Out Alzheimer’s Disease?

Here are media articles on several smell-related research reports from 2017:
Sniffing out dementia with a simple smell test
Alzheimer’s could be diagnosed early with sniff tests
Sniffing out dementia with a simple smell test

All links have been added to Alzheimer’s > Diagnosis & Tests.

World Health Organization (WHO) Dementia Recommendations

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The WHO recently released it’s first recommendations regarding prevention or delay of dementia. They include: getting regular physical exercise, not using tobacco, drinking less alcohol, maintaining healthy blood pressure, cholesterol, and blood sugar levels, and eating a healthy diet — particularly a Mediterranean diet. WHO also warned against taking dietary supplements such as vitamins B and E in an effort to combat cognitive decline and dementia.
Additionally, “An essential element of every national dementia plan is support for carers of people with dementia,” said Dr Dévora Kestel, Director of the Department of Mental Health and Substance Abuse at WHO. “Dementia carers are very often family members who need to make considerable adjustments to their family and professional lives to care for their loved ones.

Here are five media articles about the WHO report, including two covering expert reactions to the report:
Eat well, exercise more: New global guidelines to reduce risk of dementia
6 Ways To Reduce Your Risk Of Dementia, According To A New Report
WHO issues first advice on dementia: exercise and don’t smoke
expert reaction to WHO Guidelines on risk reduction of cognitive decline and dementia
How to cut your dementia risk, according to experts

Here are two WHO press releases, together with a set of WHO links on management of dementia:
Adopting a healthy lifestyle helps reduce the risk of dementia
WHO guidelines on risk reduction of cognitive decline and dementia
Evidence-based recommendations for management of dementia in non-specialized health settings

All links have been added to Alzheimer’s > Amelioration/Prevention.