Brain Health Improving in Seniors, But Alzheimer’s Still a Top Concern

clipped from www.alzinfo.org Memory loss and thinking problems are becoming less common among older Americans, according to a new national survey of seniors aged 70 and older. Though preliminary, the findings correlate with other studies showing that overall, seniors today tend to be more physically fit and suffer from less disability than earlier generations. Still, with the population as a whole growing older, millions of Americans will continue to suffer from Alzheimer’s disease and related disorders in the coming years, making Alzheimer’s a top priority for this and future generations. the researchers, from the University of Michigan Health Center, found than over a 10-year period, from 1993 to 2002, the prevalence of mental impairment in seniors went down by 3.5 percentage points — from 12.2 percent to 8.7 percent, in a sample of some 11,000 people. The difference represents hundreds of thousands of people. seniors with more formal education and personal wealth were less likely to have cognitive problems

Big belly in middle age triples risk of dementia

My mother has visceral fat. At her age it could be life threatening. There is no doubt this is a contributing factor to her Alzheimer's. She is exercising but at the age of 91, and after many years of bad eating habits, it is very difficult to get her to lose weight.

Having a large belly in middle age nearly triples the risk of developing dementia.

Researchers measured the abdominal fat of 6,583 people age 40 to 45 in northern California and some 36 years later 16 percent had developed dementia.

Those who were overweight or obese but did not have a pot belly had an 80 percent increase in the risk of dementia compared to people with a normal body weight and abdominal fat level.

The risk increase jumped to 230 percent among overweight people with a large belly and 360 percent among the obese with large abdomens.

"Where one carries the weight -- especially in midlife -- appears to be an important predictor for dementia risk," Whitmer said.

"These findings imply that the dangerous effects of abdominal obesity on the brain may start long before the signs of dementia appear."

The Alzheimer's Action Plan: The Experts' Guide to the Best Diagnosis and Treatment for Memory Problems
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Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The ARR knowledge base contains more than 3,811 articles with more than 306,100 links on the Internet. Bob lives in Delray Beach, FL.

Original content Bob DeMarco, Alzheimer's Reading Room

Reducing the biological hallmarks of Alzheimer's disease

"We have plenty of epidemiological evidence connecting activity, exercise and education with later onset of Alzheimer's, but it has never been clear which came first...Did the active lifestyle delay disease, or was there something inherent in a disease-resistant brain that led to a mentally and physically active lifestyle?"

Enriched environment delays onset of Alzheimer's in mice

A research group based at the University of Chicago has found that an enriched environment -- in this case more chances to exercise, explore and interact with others -- can dramatically reduce the biological hallmarks of Alzheimer's disease in mice that are genetically predisposed to the disorder.

In the 11 March 2005 issue of Cell, the researchers show that mice raised in a deluxe setting – large cages filled with running wheels, colored tunnels and multiple toys -- had much less of the beta-amyloid peptides that are characteristic of Alzheimer's disease deposited in their brains than genetically similar mice raised in a standard environment. Mice from enriched settings also had more of an enzyme that breaks down amyloid as well as increased activity of several genes involved in learning and memory, brain cell survival and the growth of new blood vessels.

"We have plenty of epidemiological evidence connecting activity, exercise and education with later onset of Alzheimer's, but it has never been clear which came first," said study-author Sangram Sisodia, PhD, professor of neurobiology, pharmacology and physiology at the University of Chicago. "Did the active lifestyle delay disease, or was there something inherent in a disease-resistant brain that led to a mentally and physically active lifestyle?"

"This is the first demonstration," he said, "in a genetically clean, carefully controlled animal model showing that an enhanced environment can have such a tremendously beneficial impact, protecting the brain from the pathological hallmarks of this insidious disease."

These findings support a "potentially causal inverse relationship between a more engaging, enriched life and AD progression," note Stanislav Karsten and Daniel Geschwind of UCLA in an accompanying editorial. They also provide "clear initial directions for exploring the role of the environment and the molecular pathways perturbed in AD and other neurodegenerative disorders."

Sisodia, and colleagues from his lab -- Orly Lazarov, PhD, assistant professor of neurobiology, pharmacology & physiology and lead author of the study, and John Robinson, senior research technician -- studied mice carrying two mutated genes (amyloid precursor protein and presenilin-1) that predispose the animals to develop Alzheimer's disease early in life.

At one month of age, nine of these mice were placed in the enriched environment and seven in standard housing. After five months, the researchers began to search for the pathological signs of AD in the mice's brains.

They found that mice from the enriched environment had a dramatic reduction of amyloid deposits in their brains, including less than half the volume of amyloid deposits in the hippocampus and cortex, regions involved in memory and reasoning.

The researchers also looked for genes that were activated at different levels in brains of mice from enriched versus standard housing. They identified 41 such genes, many of them already known to protect nerve cells. One of them was the gene for an enzyme that degrades beta-amyloid called neprilysin, which was at significantly higher levels in mice from the enhanced setting.

These mice also showed greater activity for several other genes involved in memory and learning, the growth of new nerve cells, cell survival, and the growth of new blood vessels within the brain.

The researchers also noted one "personality" difference among the mice in the enriched environment that influenced amyloid levels. Some of these mice were extremely active, frequently exploring their cages or running on the wheel. Others, the couch-potato mice, had the same opportunities for exercise but chose much less activity.

The most active mice had the least beta-amyloid. Less active mice from the enriched environment had more and those from the standard housing, who got the least exercise, had the most.

A lot of the process involves simple plumbing, Sisodia suspects, delivering blood to the brain and carrying harmful substances away. "It may be all about blood flow," he suggested. Exercise and mental activity can stimulate growth of new vessels while they help keep existing vessels in the brain open and functional, just like in the heart.

"Whenever we find amyloid deposits in the brain we also see them in the vessels," he said. "We suspect a large part of this process is the growing inability of mice, or people, who are developing Alzheimer's to get rid of the substances that comprise amyloid deposits, to slice up the peptides, sweep them into the blood stream and ship them out of the brain."

The take home message for humans, he said, is use it or lose it. "Activity helps, physical activity helps and mental activity helps," he said, "and the earlier you begin the better, a troubling notion in an increasingly inactive society. This is prevention, not therapy."

About 4.5 million people in the United States have Alzheimer's disease, including about five percent of those aged 65 to 74. Risk increases with age.

The National Institutes of Health, the Ellison Medical Research Foundation and the Alzheimer's Association funded this study. Additional authors include first author Orly Lazarov, John Robinson and Ya-Ping Tang of the University of Chicago; Ilana Hairston and Robert Sapolsky of Stanford; Zeljka Korade-Mirnics and Karoly Mirnics of the University of Pittsburgh; Virginia Lee of the University of Pennsylvania; and Lou Hersh of the University of Kentucky.

The University of Chicago Medical Center
Office of Medical Center Communications
850 E. 58th Street, Room 106, MC6063
Chicago, IL 60637
Phone (773) 702-6241 Fax (773) 702-3171

Your Brain and Alzheimer's

I ran across this very interesting tour of the brain on the website of the Alzheimer's Association. You can learn more about the brain and the Brain and Alzheimer's by following the link.

Inside the Brain: an Interactive Tour

Eight Types of Dementia Defined

Dementia is a clinical syndrome of loss or decline in memory and other cognitive abilities. It is caused by various diseases and conditions that result in damaged brain cells.

Alzheimer’s disease is the most common cause of dementia.

This section provides information about the definition of dementia, the characteristics of specific types of dementia and the symptoms, risk factors for and treatment of Alzheimer’s disease.

Dementia: Definition and Specific Types

Dementia is a clinical syndrome of loss or decline in memory and other cognitive abilities. It is caused by various diseases and conditions that result in damaged brain cells. To be classified as dementia, the syndrome must meet the following criteria:

• It must include decline in memory and in at least one of the following cognitive abilities:

1. Ability to generate coherent speech and understand spoken or written language;

2. Ability to recognize or identify objects, assuming intact sensory function;

3. Ability to execute motor activities, assuming intact motor abilities, sensory function and comprehension
of the required task; and

4. Ability to think abstractly, make sound judgments and plan and carry out complex tasks.


• The decline in cognitive abilities must be severe enough to interfere with daily life.
Diff erent types of dementia have been associated with distinct symptom patterns and distinguishing microscopic brain abnormalities. Increasing evidence from long-term epidemiological observation and autopsy studies suggests that many people have microscopic brain abnormalities associated with more than one type of dementia. The symptoms of diff erent types of dementia also overlap and can be further complicated by coexisting medical
conditions.

Table 1 provides information about the most common types of dementia.

Table 1: Common Types of Dementia and Their Typical Characteristics

Type of Dementia Characteristics

Alzheimer’s disease. Most common type of dementia; accounts for 60 to 80 percent of cases.

Difficulty remembering names and recent events is often an early clinical
symptom; later symptoms include impaired judgment, disorientation, confusion,
behavior changes and trouble speaking, swallowing and walking.

Hallmark abnormalities are deposits of the protein fragment beta-amyloid
(plaques) and twisted strands of the protein tau (tangles).

Vascular dementia. Considered the second-most-common type of dementia.

Impairment is caused by decreased blood fl ow to parts of the brain, often due
to a series of small strokes that block arteries.

Symptoms often overlap with those of Alzheimer’s, although memory may not
be as seriously aff ected.

Mixed dementia. Characterized by the presence of the hallmark abnormalities of Alzheimer’s
and another type of dementia, most commonly vascular dementia, but also
other types, such as dementia with Lewy bodies, frontotemporal dementia and
normal pressure hydrocephalus.

Dementia with Lewy bodies. Pattern of decline may be similar to Alzheimer’s, including problems with memory, judgment and behavior changes.

Alertness and severity of cognitive symptoms may fluctuate daily.

Visual hallucinations, muscle rigidity and tremors are common.

Hallmarks include Lewy bodies (abnormal deposits of the protein alphasynuclein)
that form inside nerve cells in the brain.


Parkinson’s disease. Many people who have Parkinson’s disease develop dementia in the later stages of the disease.

The hallmark abnormality is Lewy bodies (abnormal deposits of the protein
alpha-synuclein) that form inside nerve cells in the brain.

Frontotemporal dementia. Involves damage to brain cells, especially in the front and side regions
of the brain.

Typical symptoms include changes in personality and behavior and diffi culty
with language.

No distinguishing microscopic abnormality is linked to all cases.

Pick’s disease, characterized by “Pick’s bodies,” is one type of frontotemporal
dementia.

Creutzfeldt-Jakob disease. Rapidly fatal disorder that impairs memory and coordination and causes behavior changes.

“Variant Creutzfeldt-Jakob disease” is believed to be caused by consumption of
products from cattle affected by “mad cow disease.”

Caused by the misfolding of prion protein throughout the brain.

Normal pressure hydrocephalus. Caused by the buildup of fl uid in the brain.
Symptoms include difficulty walking, memory loss and inability to control urine.

Can sometimes be corrected with surgical installation of a shunt in the brain to
drain excess fluid.

Mild cognitive impairment is a condition in which a person has problems with memory, language or another essential cognitive function that are severe enough to be noticeable to others and show up on tests, but not severe enough to interfere with daily life. Some people with mild cognitive impairment go on to develop dementia. For others, the symptoms of mild cognitive impairment do not progress to dementia, and some people who have mild cognitive impairment at one point in time later revert to normal cognitive status.

_________________________________________________

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_________________________________________________

Bob De Marco
Alzheimer's Reading Room

Original content Bob DeMarco, the Alzheimer's Reading Room

The Validation Breakthrough: Simple Techniques for Communicating with People with Alzheimer's Type Dementia

You might get the impression from the title that this book is only for professionals, this is not the case. The validation theory works and it is simple to apply.

The case studies are invaluable and provide you with specific situations that you are sure to encounter.

I am convinced everyone involved with spouses or parents suffering from dementia or Alzheimers will benefit from by reading and utilizing this book.

The book contains valuable techniques that are designed to help you communicate more effectively with your loved one. Once perfected you will be able to put away those feelings of frustration and helplessness. Importantly, the learned techniques will help you reduce stress for both the person living with dementia, and yourself.

I give The Validation Breakthrough five stars and it is on my must read list.



The Validation Breakthrough:
Simple Techniques for Communicating with People with Alzheimer's Type Dementia


Buyer Reviews
By Martine Davis

If you live with or care for someone with Alzheimer's or other age related dementia, you must read this book ! What an eye-opener! For the first time I finally understood why Alzheimer's patient say what they say and do what they do. It all makes so much sense now. This small book reads quickly and is full of examples of real people who have been helped with the author's techniques. It shows you how to handle the blaming, accusing, name-calling and the repetitive motions ... It also explains why the way most of us react to Alzheimer's patients actions actually worsens the situation and can cause them to progress to a more advanced stage of Alzheimer's disease ! This book could extend the relationship between the patient and caregivers and should be MANDATORY reading for all staff working in nursing homes and long-term care facilities !

By J. Summers, CNA (Alaska)

An excellent book for both the professional caregiver and families trying to deal with this sometimes unfathomable disease. Gives practical ideas and techniques for helping people with dementia deal with issues from paranoia and blaming to sadness and helplessness. I have just begun to explore these techniques and am finding they work so well that they should be mandatory training for nurses, PCAs and CNAs. Instead of treating our seniors like they are children we at last have a way to talk to them on an adult level, tap into where they are at, deal with the problem at hand and we all come out better for the experience.

Reviewer: A reader

More and more relevant as we care for aging parents. With a title like this one might think: "Boring" Absolutely not so! Right from the start, the stories of the people are so real and so touching that one of my friends said she was moved to tears. She was so sad not to have known about this way of relating to her father. "It works," she told me. "Validation Breakthrough" shows a new way of relating to people with dementia of Alzheimer's type. This approach is effective in helping the person to clear up unresolved issues in their lives. You do not have to be a professionally trained therapist to use validation. Validation will make the relationship more rewarding for both people. It is not hard to learn and makes wonderful sense. Some readers may want to ask new questions of care facilities (like nursing homes) as the validation approach will keep loved ones from slipping into a vegetative state. It will also make the care much kinder, and more rewarding for the care givers.

More Insight and Advice for Caregivers

• How Alzheimer's Destroys the Brain -- Video
• Test Your Memory for Alzheimer's (5 Best Self Assessment Tests)
• What is Alzheimer's Disease?
• What is Dementia?
• What’s the Difference Between Alzheimer’s Disease and Dementia
• Communicating in Alzheimer's World
• How the Loss of Memory Works in Alzheimer’s Disease, and How Understanding This Could Help You
• Learning How to Communicate with Someone Suffering From Alzheimer's Disease
• Alzheimer's World -- Trying to Reconnect with Someone Suffering from Alzheimer's Disease
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• 100 Good Reasons to Subscribe to the Alzheimer's Reading Room Now

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

Clinical Trial: Risk Evaluation and Education for Alzheimer's Disease

This study is currently recruiting participants.


Risk Evaluation and Education for Alzheimer's Disease

Official Title

Risk Evaluation and Education for Alzheimer's Disease

Brief Summary

The purpose of this study is to provide healthy adults with genetic testing and information about their chances of developing Alzheimer's disease.

Detailed Description

Alzheimer's disease is a common condition affecting memory and thinking. Genes can sometimes be used to provide risk estimates for the eventual development of certain common diseases. Apolipoprotein E (APOE) is one gene that has been identified which can provide information about a person's chances of developing Alzheimer's diseases. Previous research explored the behavioral and psychological impact of receiving genetic risk information for Alzheimer's disease (AD). The REVEAL I Study, funded in 1999, showed that an Alzheimer's disease genetic risk assessment can be given to relatives of people with AD in a safe way. REVEAL II, which was funded in 2003, demonstrated that this same information can be given in a condensed education and counseling protocol without causing severe psychological harm. REVEAL III will further study different ways of providing genetic risk information for Alzheimer's disease.

Participation in this study will entail an initial screening phone call to determine eligibility, followed by a phone interview which will ask about demographic information and thoughts and feelings about AD. Participants will complete a mailed survey. Following completion of the survey, a genetic counselor will meet with the participant at the clinic to review family and medical history, administer additional questionnaires asking about AD and genetic testing, and draw blood for genetic testing. Results will be disclosed either in person or over the phone about 3 to 4 weeks later. The genetic counselor will make a brief follow-up phone call 1 week after that. The participant will visit the clinic twice to provide additional information, at 6 weeks and 6 months after disclosure. Finally, the participant will complete a mailed 12 month survey, and the genetic counselor will make a brief follow-up phone call.

Recruitment Status:Recruiting
Enrollment: 280
Start Date:March 2007
Completion Date:March 2010
Gender Both
Ages 18 Years to 85 Years
Accepts Healthy Volunteers: Yes

Study Sponsor National Human Genome Research Institute (NHGRI)

Principal Investigator: Robert Green, MD, MPH, Boston University

Information Provided By National Institute on Aging (NIA)

Contact: Susan Hiraki, MS 617-638-5355
shiraki@bu.edu

Links:

Boston University Alzheimer's Disease Center - REVEAL Study

Alzheimer's Disease Genetics Fact Sheet

Alzheimer's Activities: Hundreds of Activities for Men and Women With Alzheimer's Disease and Related Disorders