Better understanding of dementia leading to more effective therapies
Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it’s Dr. Otis Brawley, chief medical officer at the American Cancer Society.
Last week, I answered a question about the symptoms of Alzheimer’s disease. Today I want to talk a little about how dementia is treated.
Just a decade ago when a diagnosis of dementia was given, very little could be done for most patients except for treating behavioral disturbances and changing the environment to support safety and functioning.
Better understanding of the biology of these illnesses has led to some treatments that can improve cognition. For most, the current treatments are far from satisfying, but they do give us hope that better drugs can be developed.
The dementia should evaluated and diagnosed by a physician with special training in cognitive disorders. This may be a neurologist, a psychiatrist or, in certain instances, an internist or geriatric physician with specialized training. A precise diagnosis is important for effective management.
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Can Gum Disease Lead to Alzheimer’s? Study Says It Just Might
(CBS) If you needed another reason to brush and floss, maybe this will help.
Researchers at New York University have found that gum disease may increase the risk of cognitive dysfunction associated with Alzheimer’s disease.
This NYU study provides fresh evidence that gum inflammation is associated with inflammation in the brain.
The research team, led by Dr. Angela Kamer, assistant professor of periodontology & implant dentistry, studied 20 years of data from Denmark that support the hypothesis of a link between periodontal disease and Alzheimer’s.
Those with gum disease at age 70 were nine times more likely to test in the lower range of brain function tests compared to those with little or no periodontal inflammation.
Other health factors that tend to lower test scores, such as obesity, cigarette smoking, and tooth loss unrelated to gum inflammation, were factored in, but the strong association held true.
Kamer is working on a follow-up study, which will include a more ethnically diverse pool of people.
But why wait follow-up–go brush your teeth!
Sniffing Insulin May Help Memory in Alzheimer’s Patients
(CBS) Sniffing insulin seems to help people suffering from Alzheimer’s disease and a related condition known as mild cognitive impairment, or MCI.
That’s the word from University of Washington researchers, who reported results of a study showing that patients given twice-daily doses of an insulin nasal spray for four months experienced improvements in memory and were better able to manage the tasks of daily living.
The study, presented in Honolulu at a meeting of the Alzheimer’s Association, builds upon previous research showing that insulin is needed for proper brain function and that there are abnormally low levels of insulin in the brains of people with Alzheimer’s or MCI.
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Exercise may be best way to fight Alzheimer’s
MILWAUKEE, Wisconsin — Scientists are reporting advances in detecting and predicting Alzheimer’s disease at a conference in Honolulu this week, plus offering more proof that getting enough exercise and vitamin D may lower your risk.
There are better brain scans to spot Alzheimer’s disease. More genes that affect risk. Blood and spinal fluid tests that may help tell who will develop the mind-robbing illness and when.
But what is needed most — a treatment that does more than just ease symptoms — is not at hand.
“We don’t have anything that slows or stops the course,” said William Thies, the Alzheimer’s Association scientific director. “We’re really in a silent window right now” with new drugs, he said.
Several promising ones flopped in late-stage tests — most recently, Pfizer Inc.’s Dimebon. Results on several others won’t be ready until next year.
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Study identifies best tests to predict Alzheimer’s
(Reuters) – Combining a specific imaging test of the brain with a memory recall test appears to be the best predictor so far of Alzheimer’s disease, U.S. researchers said on Wednesday.
The findings were culled from a large, ongoing study testing various brain imaging tests and biomarkers that aims to identify which patients with cognitive problems will progress to Alzheimer’s disease.
“When you look at them all independently, they are all useful for predicting conversion (to Alzheimer’s disease) and decline,” said Susan Landau of the University of California, Berkeley, whose study appears in the journal Neurology.
“The novel thing we did was put them all together in the same statistical model and compared them to see which were the most useful,” she said in a telephone interview.
For the study, researchers did memory and brain scan tests on 85 people with mild cognitive impairment who were part of the larger Alzheimer’s Disease Neuroimaging Initiative study.
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Brain Stimulation Seems to Boost Language Skills in Alzheimer’s Patients
THURSDAY, June 24 (HealthDay News) — People with Alzheimer’s who are losing their language skills may see some improvement by using a technique called repetitive transcranial magnetic stimulation (rTMS), early research by an Italian team suggests.
The noninvasive procedure delivers a series of rapid magnetic pulses at frequencies up to 100 Hz to the brain. Earlier studies have found that these pulses can change brain activity, depending on the frequency, the researchers explained.
Though “preliminary,” the new findings “hold considerable promise, not only for advancing our understanding of brain plasticity mechanisms, but also for designing new rehabilitation strategies in patients with neurodegenerative disease,” according to lead researcher Maria Cotelli, from IRCCS Centro San Giovanni di Dio Fatebenefratelli in Brescia.
The report is published in the June 24 online edition of the Journal of Neurology, Neurosurgery and Psychiatry.
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Brain scan study confirms role of Alzheimer’s genes
(Reuters) – A study of brain scans has confirmed the role of several genes linked with Alzheimer’s disease, and turned up two others that are worth exploring, U.S. researchers said on Monday.
A team at Massachusetts General Hospital in Boston used magnetic resonance imaging or MRI scans to study changes in brain structures — such as the size of the hippocampus and amygdala — in 700 healthy volunteers and Alzheimer’s patients.
They used computer programs to sort through the genetic sequences of the 700 volunteers to see which gene mutations are most linked with these changes.
The study turned up a known offender – the APOE4 gene – as the most strongly linked with the disease, but it also confirmed three other genes – CLU, CRI, PICALM – that have been more recently linked with Alzheimer’s.
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Alzheimer’s Disease: Bad News and Good News
Seniors hoping to stay sharp in old age are bombarded with recommendations, from doing brainteasers to drinking red wine. But a recent review of research brings sobering news: Currently, there is no good evidence that any supplement, medication, diet or behavior change actually prevents Alzheimer’s or other age-related cognitive decline.
Such a grim verdict on a much-dreaded disease might seem like cause for despair. It’s not, say researchers.
“The bad news is we have nothing that’s been proven to prevent Alzheimer’s disease,” said Cynthia Carlsson, a professor and Alzheimer’s researcher at the University of Wisconsin School of Medicine and Public Health, who was not on the panel that reviewed the research. “But the good news is we’re really at a tremendous point in understanding more about the disease causes.”
For instance, evidence is mounting to suggest Alzheimer’s damages the brain well before outward mental impairment
shows up. So if doctors had tools to identify these pre-symptomatic individuals, they could start early treatments to help at least slow the mental slide.
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Baxter drug progresses as Alzheimer’s treatment
By Bruce Japsen
Baxter International Inc.’s immune system drug helped preserve “thinking” abilities and reduced brain “shrinkage” in a small group of patients with Alzheimer’s disease that have been studied for 18 months, new research released this afternoon shows.
As the pharmaceutical industry embarks on a critical stage of testing before possible submission to U.S. regulators for possible approval, Baxter’s Gammagard is among those working well enough that today’s study in 24 patients is further evidence the company’s move is justified to expand research to more than 350 patients in a final-stage U.S. clinical trial. That means, if the final-stage trial just beginning is successful, Baxter could submit the product to the U.S. Food and Drug Administration within two to three years if all goes well, observers have said.
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Alzheimer’s ‘Epidemic’ Hitting Minorities Hardest
TUESDAY, March 9 (HealthDay News) — 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.
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