Saturday, 31 May 2008

Researchers clear up Alzheimer's plaques in mice

I think we tend to ignore research when we see the word mice. But, this is where medical research often starts. I find this research interesting and promising. If you would like to read more follow the link in the clip.
Blocking a common immune system response cleared up plaques associated with Alzheimer’s Disease and enabled treated mice to recover some lost memory, Yale University researchers report Friday in the journal Nature Medicine.
clipped from www.physorg.com

Researchers hope the new approach may one day overcome one of the biggest obstacles to development of new dementia medications – the difficulty in finding drugs that can safely cross the blood-brain barrier.
The results of the research surprised the scientists working in the lab of Richard Flavell, senior author of the paper, chairman of the Department of Immunobiology at Yale and investigator with the Howard Hughes Medical Institute. Flavell’s team originally thought that blocking the immune system molecule TGF-â(or transforming growth factor), might actually increase the buildup of amyloid plaques associated with Alzheimer’s Disease
the team found that as much as 90 percent of the plaques were eliminated from the brains of mice genetically engineered to block TGF-â in the peripheral immune cells.

It was like a vacuum cleaner had removed the plaques," Flavell said.

blog it

Wednesday, 28 May 2008

Alzheimer's and NSAIDs: Making Sense of the News

Follow the link in the clip for more information and the opposing point of view.
clipped from www.usnews.com

The latest study, published in Neurology, suggests that naproxen, ibuprofen, and aspirin may reduce the risk of Alzheimer's disease. The analysis looked at results from six previous studies. The authors found that those who took NSAIDs had a 23 percent reduced risk of Alzheimer's disease in comparison with those who didn't take the medicines. And another study, published earlier this month in Neurology, found that those who take ibuprofen on a regular basis for five years may be less likely to develop Alzheimer's disease.

Why do researchers think that NSAIDs—though not other analgesics, like Tylenol—might help reduce the risk of dementia? The theory is that the medications might reduce inflammation in the brain that experts think is tied to the development of Alzheimer's disease. Maybe if you get to the root of the inflammation early enough, they say, you can prevent the development of the disease later in life.

 blog it

Amazon #1 Bestseller

A Bigger Brain May Help Protect You from Alzheimer’s

While nobody can control the size of their brains, experts advise that mentally stimulating activities like completing puzzles, traveling, learning a new language, playing a musical instrument, or doing crossword puzzles can help stimulate new connections between brain cells.
A Bigger Brain May Help Protect You from Alzheimer’s


A large hippocampus – a part of the brain devoted to memory – may help ward off Alzheimer’s disease, a new study reports. The findings offer new clues into why some elderly people remain mentally sharp and alert well into their 80s and beyond, even though their brains are riddled with the plaques and tangles of Alzheimer’s disease.

The findings help support the notion of cognitive reserve, the theory that a brain rich in interconnections and working nerve cells may help to ward off the symptoms of Alzheimer’s disease even when a certain amount of brain tissue is already damaged. With a larger hippocampus, the more brain cells. According to the theory, if some cells die off from the ravages of Alzheimer’s or related ailments, enough cells remain so that people can continue to think and function normally..

From autopsies, researchers have long known that some people die with sharp minds and perfect memories, even though their brains are riddled with the plaques and tangles of Alzheimer’s disease. The new research suggests that people who have a larger hippocampus, a seahorse-shaped part of the brain that is critical for memory, may as a result be protected against Alzheimer’s.

“This larger hippocampus may protect these people from the effects of Alzheimer’s disease-related brain changes,” said study author Deniz Erten-Lyons, M.D., with Oregon Health & Science University in Portland. “Hopefully this will lead us eventually to prevention strategies.”

For the study, presented April 15 at the American Academy of Neurology 60th Annual Meeting in Chicago, researchers evaluated the brains of 12 people who had sharp memories and thinking skills at the time of their death. Autopsies revealed that their brains contained large numbers of Alzheimer’s plaques, even though they remained mentally sharp and alert. Their brains were compared to those of 23 people who had the same amount of plaques in their brains, but had been diagnosed with Alzheimer’s disease before death.

Researchers found that the volume of the hippocampus area of the brain was 20 percent larger in the cognitively intact group compared to the Alzheimer's disease group with dementia. There were no other demographic, clinical or pathological differences between the groups. The results remained the same regardless of whether they were men or women, their age and the total brain volume.

The findings help to explain why many people remain mentally sharp well into their 80s and beyond, even though autopsies after death show that their brains contain extensive damage like that seen in Alzheimer’s disease.

While nobody can control the size of their brains, experts advise that mentally stimulating activities like completing puzzles, traveling, learning a new language, playing a musical instrument, or doing crossword puzzles can help stimulate new connections between brain cells. These strengthened connections may help to preserve thinking and memory. Maintaining strong social ties and exercising into old age may also help to protect the brain, studies show.

Subscribe to the Alzheimer's Reading Room
Enter your email address:

Alzheimer's Disease -- Advice and Insight


Bob DeMarco is the Founder of the Alzheimer's Reading Room and an X Wall Street executive turned full time Alzheimer's caregiver. The blog contains more than 2,310 articles with more than 285,100 links on the Internet. Bob resides in Delray Beach, FL.




The Alzheimer's Action Plan
 
300 Tips for Making Life Easier

Original content Bob DeMarco, the Alzheimer's Reading Room

Worried that you or a relative suffers from Alzheimer's? Take the quiz

One of the most important items in my opinion is the ability to make payments and spending money. This is more complex and can be an early indication of the onset of Alzheimer's or dementia. If I had looked closer I would have been tipped off that my mother was suffering from dementia. I also suggest paying close attention to prescription medicines and if they are being taken according to schedule.


If you are worried that you or a relative is developing Alzheimer's, answer the following questions. Answer "yes" if the behavior indicates a change in the last several years.

1. Problems with judgment (such as trouble making decisions, bad financial moves)

2. Less interest in hobbies or activities

3. Repeating the same things over and over (questions, stories or statements)

4. Trouble learning how to use a tool, appliance or gadget

5. Forgets correct month or year

6. Trouble handling complicated financial affairs (such as income taxes, balancing checkbook)

7. Trouble remembering appointments

8. Daily problems with thinking and/or memory

Scoring: A "yes" to none or just one question probably does not indicate any kind of dementia, although the questionnaire can't rule out very early cases. So don't hesitate to get help if you continue to be concerned. If you answer yes to two or more questions, you should seek an assessment by a specialist.

Source: Adapted from J.E. Galvin et. al., "The AD8, a Brief Informant Interview to Detect Dementia," Neurology 65 (2005): 559-64.



The Science Behind Senior Moments

Follow the link at the top of clip to read the entire story.
clipped from online.wsj.com
In Alzheimer's, people often retain obscure old memories, but have trouble recalling recent events and conversations. Or they may forget the names of simple things. "If a person can't find their car in a six-floor garage at JFK because they forgot to look at the number, that's probably just a senior moment," says Dr. Doraiswamy. "But if they can't remember the color or make of the car they've been driving for years," that could be more serious.
 blog it

Wednesday, 21 May 2008

Day Care for older dementia patients: favorable effects on behavioral and psychological symptoms and caregiver stress

This is a clip of a research study.

The conclusions are important and indicate that day care can be effective in reducing behavioral and psychological symptoms of dementia patients. Also alleviates caregiver burden.

My own experience shows that social interaction does have a very positive effect on my mother and her behavior.

Objective
To assess the effects of Day Care (DC) on older subjects with dementia and their caregivers.

Methods
Thirty patients with dementia, consecutively admitted to a DC, were compared with 30 patients, matched for age and cognitive function, who received usual home care (HC).
Results
After adjusting for potential confounders, NPI score significantly decreased in DC group, with a reduction of psychotropic drugs prescription, whereas it increased in HC. No significant between-group difference was observed for cognitive and functional change. CBI significantly decreased in DC, but not HC, caregivers, with no significant between-group difference in depressive symptoms change.
Conclusions
A 2-month period of DC assistance is effective in reducing behavioral and psychological symptoms of dementia patients and in alleviating caregivers' burden. Copyright © 2008 John Wiley & Sons, Ltd.
 blog it

Alzheimer's Caregivers

I recently received my copy of Alzheimer's Caregivers . This free handbook and tip sheet is well worth obtaining. You can get up to three free copies so its also easy to share. Get your free copy.

If you obtain the handbook, please let me know your reaction. Feel free to email this post to your friends and relatives.




The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

Saturday, 17 May 2008

Wii Fit

This is an excellent article about the new fitness module for Wii. I am considering getting this for my mother who suffers from Alzheimer's. Along with this I hope to get friends to come over and bowl with her.

This would satisfy two important needs: exercise and social interaction. Follow the link to read the article.

I'll let you know.
clipped from www.nytimes.com
Exercising with Wii Fit is like having a Bob Harper or a Denise Austin who talks back — gently cajoling you through exercises, praising, nudging, even reminding you to eat a banana once in a while. It also lets you see how you stack up against friends or family members; each user creates a cartoony avatar called a “Mii.”

Friday, 16 May 2008

Families shed light on likely causative gene for Alzheimer's

This is another example of predisposition to Alzheimer's disease....

Families shed light on likely causative gene for Alzheimer's

The genetic profile of two large Georgia families with high rates of late-onset Alzheimer's disease points to a gene that may cause the disease, researchers say.

Genetic variations called single nucleotide polymorphisms, or SNPs, are common in DNA, but this pattern of SNPs shows up in nine out of 10 affected family members.

"We were shocked; we had never seen anything like this before," Dr. Poduslo says of findings published online in the American Journal of Medical Genetics. "If we looked at unaffected spouses, their SNPs were all different. The variants consistently found in affected siblings are suggesting there is something in this gene. Now we have to go back and find what is in this gene that is making it so unique for Alzheimer's patients."


Subscribe to the Alzheimer's Reading Room
Enter your email address:

Read More on the Alzheimer's Reading Room





The Alzheimer’s Action Plan: The Experts’ Guide to the Best Diag­no­sis and Treat­ment for Mem­ory Prob­lems
 
The 36-Hour Day A Family Guide to Caring for People with Alzheimer Disease

Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 2,390 articles with more than 272,100 links on the Internet. Bob resides in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room

Wednesday, 7 May 2008

Ask an Alzheimer's Specialist

Vitamin B-12: Can it improve memory in Alzheimer's?

Mayo Clinic neuropsychologist Glenn Smith, Ph.D., and colleagues answer select questions from readers.
clipped from www.mayoclinic.com
Is it true that vitamin B-12 supplements can improve memory? What about in people with Alzheimer's disease?

Vitamin B-12 may improve memory in people with a proven vitamin B-12 deficiency. Poor memory may be a sign of Vitamin B-12 deficiency. In such cases, supplementing with vitamin B-12 may improve memory. However, there's no evidence that vitamin B-12 enhances memory in people with normal memory.

At this time, there's no evidence that supplementing with vitamin B-12 offers any benefit to people with Alzheimer's disease. However, some studies suggest that people with Alzheimer's disease have reduced blood levels of vitamin B-12 — and that people with reduced blood levels of vitamin B-12 are at increased risk of Alzheimer's. As a result, several large studies are under way to evaluate the potential benefit of vitamin B-12 supplementation in people with Alzheimer's.

blog it

Clinical Trial: EPIX Pharmaceuticals Initiates Phase 2b Program In Alzheimer's Disease

Get information about this clinical trial at Clinical Trials

"We are encouraged by the PRX-03140 data we've seen to date, and based upon this, we are pleased to see EPIX begin the Phase 2b program with PRX-03140 in Alzheimer's disease," said Hugh Cowley, M.D., head of GSK's Center of Excellence for External Drug Discovery (CEEDD). "We believe that patients with Alzheimer's disease may ultimately be treated with combination therapy to manage the progression of the disease and to manage effectively the symptoms of Alzheimer's disease. As a result, we are evaluating PRX-03140 in a combination trial in concert with donepezil as well as in a monotherapy setting."

blog it


Phase 2 Double-Blind Study of PRX-03140 Monotherapy in Subjects With Alzheimer's Disease Receiving a Stable Dose of Donepezil

Detailed description of the Clinical Trial

Contacts
Contact: Julia Kazakin, MD 781-761-7646 jkazakin@epixpharma.com

Sponsors and Collaborators
Epix Pharmaceuticals, Inc.

Eligibility Criteria

* Men or Women with a clinical diagnosis of Probable AD
* MMSE score 12 to 22 inclusive
* Age >50 and <90>6 months may be eligible
* No evidence of the following: current vitamin B12 deficiency, positive syphilis serology, positive HIV test, or abnormalities in thyroid function
* No cognitive rehabilitation within 6 months of the study
* Subject has a regular caregiver willing to attend all study visits
* Signed informed consent by the subject (and legal guardian, if applicable)
* No history of drug or alcohol abuse
* No clinically significant laboratory abnormalities or medical history
* No investigational drug within 30 days of Randomization
* Cannot receive memantine within 2 months of enrollment
* No other prescription acetylcholinesterase inhibitors for AD (other than donepezil) within 4 months of enrollment
* No clinically significant ECG abnormalities or cardiac history
* No history of uncontrolled seizure disorder within 12 months of enrollment
* Cannot be taking MAO inhibitors, bupropion,fluoxetine, paroxetine, quinidine
* No history of malignancy within 3 years of randomization
* Women cannot be pregnant or breastfeeding





Tuesday, 6 May 2008

Alzheimer's Question, Where can I get the best medical evaluation for my wife?

Are Alzheimer's Caregivers
the Forgotten?
Q. My wife’s doctor thinks she may have an early form of Alzheimer’s disease. It’s been a week since he gave us that devastating news, but I now feel able to gather my wits and do whatever I can to help get her the best care. We are retired, 78 years old, and able to travel to any center that is recommended. What medical specialists should we seek out for a more extensive evaluation and/or care?


Also see What’s the Difference Between Alzheimer’s and Dementia and What is Dementia?

Source Johns Hopkins Health Alert

Questions About Alzheimer's Disease

A. Your wife’s primary care physician might be the best person to oversee her care. If you would like to see a specialist in Alzheimer’s disease or would like to participate in research, you should contact the nearest Alzheimer's Disease Research Center or ask your internist if there is a specialist in your community who is particularly knowledgeable about Alzheimer’s disease. Even if you do pursue another opinion or participate in research, you should keep her primary physician informed. In the end, her internist’s care will be crucial to her well being.

Is it Alzheimer's or something else?

Q. Many people assume that if an older person becomes forgetful and can no longer deal with some of the basic activities of daily living, he or she must have Alzheimer’s disease. A sad case in point: My father’s internist diagnosed him with Alzheimer’s disease last year (my father was then 80) and prescribed medication that didn’t seem to help at all. It wasn’t until I took my father to a neurologist that we learned he actually had a benign brain tumor that was affecting his memory and behavior. With that as a backdrop, what are some other brain diseases that may be mistaken for Alzheimer’s? Santa Fe, NM

A. Dementia, the diminution of multiple cognitive abilities occurring in normal alertness, can be caused by numerous factors. These include space-occupying brain lesions (tumors, collections of blood called subdural hematomas, and abscesses); infection (meningitis, encephalitis, syphilis, to name a few); impaired cerebral spinal fluid flow causing normal pressure hydrocephalus; metabolic and endocrine abnormalities (too much or too little thyroid hormone or cortisol are examples); radiation to the brain; brain trauma; stroke; and medication side-effects. Severe depression can also cause dementia. This is why medical, neurologic, and psychiatric assessments are essential parts of the initial evaluation of dementia.

Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 4,301 articles with more than 312,100 links on the Internet. Bob lives in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room

Ibuprofen Reduces Alzheimer's Risk

People who took the painkiller ibuprofen for more than five years had a 40 percent lower risk of developing Alzheimer's disease, U.S. researchers said on Monday...
Alzheimer's Reading Room

The study involved more than 49,000 U.S. veterans aged 55 and older who developed Alzheimer's and nearly 200,000 who had no form of dementia.

DOCTOR Caution: DON'T START TAKING IBUPROFEN

Another important piece of information for those predisposed by genetics to Alzheimer's.


Sources Reuters and journal Neurology

Long-term ibuprofen use cut Alzheimer's risk: study (extract from article)

People who took the painkiller ibuprofen for more than five years had a 40 percent lower risk of developing Alzheimer's disease, U.S. researchers said on Monday.

They also found that certain other medicines in the same class, known as non-steroidal anti-inflammatory drugs, or NSAIDs, reduced the risk of developing the illness by 25 percent.

"Some of these medications taken long-term decrease the risk of Alzheimer's disease, but it's very dependent on the exact drugs used. It doesn't appear that all NSAIDs decrease the risk at the same rate," Dr. Steven Vlad of Boston University School of Medicine, whose study appears in the journal Neurology, said in a statement.

The study involved more than 49,000 U.S. veterans aged 55 and older who developed Alzheimer's and nearly 200,000 who had no form of dementia. The researchers looked at more than five years of prescription data from the U.S. Veterans Affairs health care system, and at several different NSAIDs.

They found those who were prescribed ibuprofen for more than five years were 40 percent less likely to develop Alzheimer's disease than those who did not. The longer they used ibuprofen -- sold under many brand names, including Motrin and Advil -- the lower their risk.

DOCTOR: DON'T START TAKING IBUPROFEN

Alzheimer's disease has been linked with inflammation, and researchers believe that anti-inflammatory drugs might help delay onset of the disease.

Despite the benefits, Vlad does not recommend that people start taking ibuprofen in the hopes of staving off Alzheimer's disease.

"All NSAIDs have significant risks including ulcers, gastrointestinal bleeding, kidney dysfunction, elevated blood pressure and, certainly in the case of COX-II inhibitors like (Merck Inc's withdrawn drug) Vioxx, a cardiovascular risk," he said.

"I think the major implications of this study are more in the direction of prompting further research: a trial of ibuprofen to prevent Alzheimer's disease might be reasonable," he said.



Subscribe to the Alzheimer's Reading Room
Enter Your Email Address

Read More on the Alzheimer's Reading Room


Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 2,560 articles with more than 412,100 links on the Internet. Bob resides in Delray Beach, FL.



The Alzheimer’s Action Plan: The Experts’ Guide to the Best Diag­no­sis and Treat­ment for Mem­ory Prob­lems
 
The 36-Hour Day A Family Guide to Caring for People with Alzheimer Disease


Original content Bob DeMarco, the Alzheimer's Reading Room

Monday, 5 May 2008

Is it Alzheimer's or something else?


Question. Many people assume that if an older person becomes forgetful and can no longer deal with some of the basic activities of daily living, he or she must have Alzheimer’s disease. A sad case in point: My father’s internist diagnosed him with Alzheimer’s disease last year (my father was then 80) and prescribed medication that didn’t seem to help at all. It wasn’t until I took my father to a neurologist that we learned he actually had a benign brain tumor that was affecting his memory and behavior. With that as a backdrop, what are some other brain diseases that may be mistaken for Alzheimer’s?

I cannot tell you how many times I have recommended to someone to go beyond their personal physician and get a neurological consult. They rarely follow through which never stops amazing me.

Also see Most Early-Onset Dementia Not Alzheimer's and Eight Types of Dementia Defined

Source Johns Hopkins Health Alert

Questions About Alzheimer's Disease

Answer. Dementia, the diminution of multiple cognitive abilities occurring in normal alertness, can be caused by numerous factors.

These include space-occupying brain lesions (tumors, collections of blood called subdural hematomas, and abscesses); infection (meningitis, encephalitis, syphilis, to name a few); impaired cerebral spinal fluid flow causing normal pressure hydrocephalus; metabolic and endocrine abnormalities (too much or too little thyroid hormone or cortisol are examples); radiation to the brain; brain trauma; stroke; and medication side-effects.

Severe depression can also cause dementia.

This is why medical, neurologic, and psychiatric assessments are essential parts of the initial evaluation of dementia.

More Insight and Advice for Caregivers





Creating Moments of Joy: A Journal for Caregivers, Fourth Edition
 
The 36-Hour Day A Family Guide to Caring for People with Alzheimer Disease

Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 2,910 articles with more than 652,100 links on the Internet. Bob lives in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room

Rehabiltation Therapy Causes Increase in Gray Matter

Might benefit those predisposed to Alzheimer's via genetics.
clipped from www.newswise.com
Edward Taub, Ph.D., a UAB neuroscientist and developer of
Constraint-Induced (CI) therapy, and Lynne Gauthier, a graduate student
at UAB, discuss findings showing that CI therapy produces an increase in
the gray matter of the brain of stroke patients who undergo the therapy.
This is the first representation that a rehabilitation therapy can
produce structural changes within the human brain after injury. It is
also further proof of neuroplasticity, the brain's ability to remodel
itself following traumatic injury.

A rehabilitation therapy developed by a UAB neuroscientist produces changes in the structure of the brain, the first evidence of actual brain remodeling resulting from a rehabilitation therapy. In findings presented online in Stroke, sophisticated analysis of MRI images of stroke patients showed that Constraint Induced (CI) therapy produced a significant increase in the amount of gray matter present in the brains of patients receiving the therapy.
blog it

Pin1 Is Beneficial in Alzheimer's Disease, Detrimental to Some Forms of Dementia

This is a good example of the need to go beyond your family doctor and get a specialist to diagnose specific types of dementia. I am still amazed at how many people I meet that simply accept the family doctor diagnosis and prescribed treatment. It is not widely known you need to "ask" for the consult as many health care companies don't want to pay for this extra level of "service" and discourage family care doctors from recommending the "consult".

Pin1 Is Beneficial in Alzheimer's Disease, Detrimental to Some Forms of Dementia.
clipped from www.newswise.com
The most common form of dementia, Alzheimer’s disease, and a relatively rare hereditary form of dementia, frontotemporal dementia with parkinsonism-17, share a common pathology: Both are the result of an overaccumulation of tau proteins, which form tangled lesions in the brain’s neurons and eventually lead to the collapse of the brain cells responsible for memory
although mutations in the gene encoding tau have not been found in individuals with Alzheimer’s disease, they have been identified in individual with frontotemporal dementia, and are often used as models for studying Alzheimer’s disease
A new study finds that the Pin1 enzyme, previously shown to be of benefit in “detangling” tau in Alzheimer’s disease, actually has the contradictory effect in cases in which the tau has certain mutations
while increasing Pin1 in neurons effectively suppresses the disease development in cases of Alzheimer’s, it actually accelerates disease progression in the case of frontotemporal dementia
blog it

Florida Congressman Wants Silver Alert Program

We've all heard of Amber Alert, the highly successful program designed to find missing children before it's too late. But have you heard of Silver Alert? Modeled after Amber Alert, Silver Alert notification systems help locate missing individuals who have Alzheimer's disease or related dementias.


Bilirakis recently introduced the Silver Alert Grant Program Act of 2008 (H.R. 5898). If passed, the program would provide state legislatures with seed money to implement their own Silver Alert systems. The congressman recently told the St. Petersburg Times that "states should make this a priority, and we don't want them to have any excuses."


Five states currently operate Silver Alert programs: Colorado, Illinois, Michigan, North Carolina, and Texas. Florida Congressman Gus Bilirakus wants every state to have the resources to start Silver Alert programs.
 blog it

Thursday, 1 May 2008

Health Implications of Family Caregiving

Follow the link for additional information. Sponsored by the National Institute for Health this looks like it could be very informative and of great value to caregivers. This is only a short list of the topics being covered.
clipped from videocast.nih.gov
View event:
You will be able to view the event at http://videocast.nih.gov when the event is live.
Air date:
Wednesday, June 25, 2008, 1:00:00 PM
Caring for a loved one?
Overview of the issue of health and caregivers
Male caregiver’s experience
Powerful Tools for Caregivers
Veterans Affairs efforts to support family caregivers

Sponsors: Centers for Medicare & Medicaid Services and the Department of Health and Human Services New Freedom Initiative Subcommittee on Caregiving


Read More About Alzheimer's

Living Alzheimer's From the Front Row

Five Ways to Keep Alzheimer's Away

A Simple Three Minute Test Can Detect the Earliest Stage of Alzheimer's disease

High cholesterol levels in your 40s raises Alzheimer's risk

Researchers link cocoa flavanols to improved brain blood flow

Can Vitamin B3 Reduce Memory Problems (Nicotinamide)