GA with halogenated anaesthetic gases increases dementia risk in elderly


https://speciality.medicaldialogues.in/ga-with-halogenated-anaesthetic-gases-increases-dementia-risk-in-elderly/

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How to Stay Sharp in Old Age


Of all the common consequences of aging, none is more frightening than memory loss. Even if you’ve never helplessly watched a loved one succumb to Alzheimer’s—which I promise is worse than it sounds—it’s natural to wonder if something similar could happen to you.

Our collective fear of aging has long been exploited for profit; cognitive decline is no exception. Most people are terrified of losing their mental faculties as they age, and corporations know it—brain power-boosting games and apps are a big business these days. Their claims are bold: Lumosity promises to help users “improve memory, increase focus, and find calm.” 2013 Apple App of the Year winner Elevate touts itself as “a brain training program designed to improve focus, speaking abilities, processing speed, memory, math skills, and more.” Using fear to sell products may be an effective marketing strategy, but those products rarely solve any actual problems.

There’s so much about dementia that we still don’t know, but one thing is certain: it’s caused by a complex confluence of many, many factors. In other words, any single prevention-minded strategy—like playing a game on your phone for a few minutes a day—probably won’t make a difference, but a multi-pronged approach just might. While the majority of risk factors are beyond our control, some of them are within our power to change, and knowing the difference is your best protection.

What is dementia, and what causes it?

There are three main types of memory loss: age-related cognitive decline, mild cognitive impairment (MCI), and dementia. Although the symptoms overlap somewhat, these are distinct conditions and it’s important to know the differences between them.

Age-related cognitive decline

Age-related cognitive decline is what we call the somewhat normal level of memory loss. Just like our hair, skin, and muscles, brain cells age along with us, which can cause impaired cell function and communication. Everyone loses some neurons as a normal part of the aging process, so mild memory problems can be chalked up to getting older.

Mild cognitive impairment

MCI lies between normal aging and dementia on the severity scale. People with MCI have more memory problems than is considered normal for their age group, but can still function on their own. (As always, determining what’s “normal” is at the discretion of a qualified medical professional.) It makes accomplishing day-to-day tasks more difficult, like remembering appointments and medications, but unlike dementia, MCI typically doesn’t cause behavioral changes.

Dementia

Dementia, according to the National Institute on Aging, is “the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.” People with dementia forget appointments and medications, but they can also experience impaired vision, language skills, spatial reasoning, and decision-making. They may wander or get lost. Dementia can eventually cause personality changes: irritability, paranoia, hallucinations, aggression, unusual sexual behavior, and even physical violence.

The most common cause of dementia is Alzheimer’s disease, which can be either early- or late-onset. In late-onset Alzheimer’s, the more common type, dementia symptoms set in during or after the mid to late 60s. Early-onset Alzheimer’s is rarer, accounting for roughly 10 percent of all cases, and sets in anytime between age 30 and 60.

Video courtesy of the National Institute on Aging.

Scientists don’t fully understand why dementia develops, but in general, cognitive issues arise when neurons stop communicating with other brain cells and eventually die. In Alzheimer’s disease specifically, amyloid proteins and neurofibrillary (or tau) fibers clump together in abnormal formations, interrupting neuron connections and killing formerly healthy tissue. These formations, called amyloid plaques and tau tangles, are believed to at least partially explain the cognitive and behavioral changes observed in Alzheimer’s patients. The areas of the brain involved with memory are the usually first to be damaged, causing forgetfulness and broader memory loss; as the disease progresses to other parts of the brain, the patient gradually loses their ability to reason, speak, and behave normally. Eventually, the damage becomes so widespread that it affects basic physical functions like breathing and swallowing.

Who’s at risk?

The exact physiological causes of dementia are largely unknown, which makes early detection all but impossible; if there’s a precursor that shows up in routine blood work or imaging, we haven’t found it yet. For most people, dementia symptoms are their only warning, so it’s important to know your risk.

The single biggest risk factor for dementia is age. Whether it’s caused by Alzheimer’s or something else, dementia is much more common in the elderly; the NIH estimates that half of people over age 85 have some form of dementia. Family history also plays a role. Some people with no family history at all develop dementia, but as with many other medical conditions, the more people in your family that have had it, the higher your risk. Additionally, mental illness, particularly depression, is associated with an increased risk of developing dementia.

Both early- and late-onset Alzheimer’s have a genetic component, but that doesn’t mean you evaluate your risk with a DNA test—it just means that researchers have identified some of the chromosomes and genetic mutations involved in Alzheimer’s development. Your genes are just a few of many factors at play in a complex, decades-long process; plenty of Alzheimer’s patients don’t have any of the relevant mutations at all. It is worth noting, though, that most people with Down syndrome will develop Alzheimer’s. This could be because the gene that produces amyloid proteins is located on chromosome 21, of which people with Down syndrome have an extra copy.

What can we do about It?

There’s no sugarcoating this: Dementia cannot currently be prevented, and there’s no way to stop, reverse, or slow its progression. Finding a cure is a top priority, but the ultimate goal of dementia research is to prevent it altogether—ideally through easily-adopted lifestyle changes. Scientists have explored several interventions that could delay the onset of cognitive decline, but only some of them are truly promising.

Exercise may help, but we’re not sure

Of all the potential interventions, none have been studied more than exercise. The results are mostly inconclusive. While some studies suggest that increased physical activity may delay normal age-related cognitive decline, there’s no evidence that the same is true for MCI or dementia. Still, staying physically active has enough general health benefits that it’s worth your time—it’s just not the one thing that’ll keep you from developing dementia.

Brain training games may not improve your brain in real life

Another increasingly popular intervention is “cognitive training,” or playing increasingly difficult games to challenge different parts of your brain. It’s an attractive idea: play enough games and solve enough puzzles and you, too, can improve your overall cognition. Unfortunately, the research doesn’t quite back it up. Some games show more promise than others, but for the most part, brain training seems to mostly improve your ability to play that specific game.

For cognitive training to work, any benefits gained from playing games should carry over into related tasks in what’s known as a “transfer effect.” Proving this is way harder than it sounds: scientists disagree about which aspects of cognition correspond to brain training games, as well as how to meaningfully test for improvement. As a result, very few researchers have observed transfer effects. That hasn’t stopped corporations like Lumosity from claiming otherwise, even though there’s no proof these games can stave off cognitive decline. (Lumosity was fined $2 million by the FTC in 2016 for “deceptive advertising charges.”)

Treating high blood pressure may help

Something that could be more helpful is aggressive hypertension treatment, which just means bringing your blood pressure into the normal range—120/80 mmHg or less. A recent randomized clinical trial of more than 9000 hypertensive adults found a connection between intensive blood pressure management and the risk of MCI and probable dementia: people who reduced their systolic blood pressure to 120 mmHg or lower had a significantly lower rate of MCI than those whose systolic pressure was under 140 mmHG (14.6 vs 18.3 cases per 1000 person-years, respectively). Intensive blood pressure reduction also significantly reduced the combined risk of MCI and dementia. As for probable dementia on its own, researchers observed a measurable reduction—7.2 vs 8.6 cases per 1000 person-years for the 120 mmHg and 140 mmHG groups, respectively—but it was not statistically significant.

That doesn’t mean this study is bunk; quite the opposite, actually. It’s the first large-scale randomized clinical trial to find a statistically meaningful link between a common, treatable physical condition and the risk of MCI. On top of that, the study was so successful at reducing cardiovascular events and overall mortality that the blood pressure management program ended after 3.3 years—more than a year and a half early. MCI and dementia assessment continued for the full five years. Given the participants’ relative youth (about 68 years on average), the short observation window, and the fact that MCI usually presents earlier than dementia, it makes sense that significant results were only observed in relation to MCI—and therefore pretty exciting that any dementia result was observed at all. It’s always possible that future research will contradict these findings, but until then, it seems like as good a reason as any to keep your blood pressure under control.

Social interaction is our most promising strategy so far

Finally, and perhaps most promisingly, there is mounting evidence that social isolation is a major risk factor for cognitive decline and dementia. A 2017 Lancet Commission report estimates that social isolation accounts for up to 2 percent of lifetime dementia risk—just as much as hypertension. Though it’s a relatively new area of research, more and more studies are exploring the intervention potential of increased socialization. To learn more, I spoke with the author of one of these studies: Dr. Hiroko Dodge, principal investigator of Oregon Health & Science University’s I-CONECT project.

In a June 2015 Alzheimer’s & Dementia paper, Dr. Dodge et. al. designed a clinical trial to test the effect of “naturalistic human contact” on cognitive function in elderly (80 years, on average) adults. About half of the participants video-chatted with trained interviewers 30 minutes a day for six weeks; the others did not. Compared with baseline scores and the control group, the video chatters showed improvement in semantic fluency (being able to find and produce words in a certain category) and psychomotor speed (reaction time). The only statistically significant results were observed in subjects with normal cognition—i.e., no impairment or dementia—but subjects with MCI still showed improvement relative to controls. The study was considered a success, and a larger-scale follow-up trial is currently ongoing.

Dr. Dodge believes that the human element of video chat is key to their observed results. In the conversation sessions, interviewers were trained to prioritize eye contact and back-and-forth conversation, two important aspects of face-to-face contact that socially isolated people don’t get enough of. Plus, video chat is accessible to the people who stand to benefit from it the most: physically and socially isolated adults. I asked Dr. Dodge if FaceTiming or video chatting with isolated elderly relatives was a good thing to do regularly. “Definitely,” she said, explaining that regular face-to-face conversations could improve cognitive compensation mechanisms—the brain’s ability to work around cognitive impairments.

Of course, a cure or prevention for dementia is a ways off. The NIH calls clinical trials the “gold standard” of medical proof, but getting statistically significant results out of them is exceptionally difficult. As Dr. Dodge explained to me, this is because variability is very high in dementia research, particularly where human subjects are concerned:

“If you ask [subjects] in the morning to do tests, and then in the afternoon to do tests, even within an individual the fluctuation is so high. … When they’re feeling good, or if they slept well last night, they do much better. If they didn’t sleep well, or if they have a little cold, that really shifts around the scores.”

She also mentioned that cognitive compensation complicates things further: people with the same degree of cognitive impairment can perform differently on tests depending on how (or if) they’ve learned to cope with it.

Social isolation research is promising, but it’s just beginning—and until it studies more people of different ages, ethnicities, nationalities, genders, and socioeconomic classes, we won’t know for sure just how much it can help.

Taken together, the body of research on dementia intervention suggests that staying socially and physically active is our best bet for long, healthy lives. However, as Dr. Dodge reminded me, you can do everything “right” and still get dementia—so we have got to stop blaming people for failing to prevent an unpreventable disease. “If somebody gets dementia, others may say, ‘Oh, she didn’t do social interaction, or she didn’t do cognitive stimulation’ … unfortunately, some people will get the disease, and it’s not their fault.”

Frailty a Risk Factor for Dementia


Frailty is associated with a higher risk of both Alzheimer’s disease and its crippling symptoms, a new study shows.

“By reducing an individual’s physiological reserve, frailty could trigger the clinical expression of dementia when it might remain asymptomatic in someone who is not frail,” said study leader Dr. Kenneth Rockwood, a professor at Dalhousie University in Halifax, Canada.

“This indicates that a ‘frail brain‘ might be more susceptible to neurological problems like dementia as it is less able to cope with the pathological burden,” he added.

The study included 456 adults in Illinois, aged 59 and older, who did not have Alzheimer’s when first enrolled in the Rush Memory and Aging Project. They underwent annual assessments of their mental and physical health, and their brains were examined after they died.

By their last assessment, 53 percent of the participants had been diagnosed with possible or probable Alzheimer’s disease.

For the physical assessments, the researchers created a frailty index using 41 components, including fatigue, joint and heart problems, osteoporosis, mobility and meal preparation abilities.

Overall, 8 percent of the participants had significant Alzheimer’s disease-related brain changes without having been diagnosed with dementia, and 11 percent had Alzheimer’s but little evidence of disease-related brain changes.

Those with higher levels of frailty were more likely to have both Alzheimer’s disease-related brain changes and symptoms of dementia, while others with substantial brain changes, but who were not frail, had fewer symptoms of the disease.

After adjusting for age, sex and education, the researchers concluded that frailty and Alzheimer’s disease-related brain changes independently contribute to dementia, though they could not prove that frailty caused Alzheimer’s and its symptoms.

The investigators also said there was a significant association between frailty and Alzheimer’s-related brain changes after they excluded activities of daily living from the frailty index and adjusted for other risk factors such as stroke, heart failure, high blood pressure and diabetes.

The study was published Jan. 17 in The Lancet Neurology journal.

“This is an enormous step in the right direction for Alzheimer’s research,” Rockwood said in a journal news release. “Our findings suggest that the expression of dementia symptoms results from several causes, and Alzheimer’s disease-related brain changes are likely to be only one factor in a whole cascade of events that lead to clinical symptoms.”

Understanding frailty could help predict and prevent dementia, Dr. Francesco Panza, from the University of Bari Aldo Moro in Italy, wrote in an accompanying editorial.

Three Common Dementia Screens Faulty, Inaccurate


Three brief cognitive assessments often used in primary care settings to identify patients with cognitive impairment who could benefit from a full diagnostic workup for dementia are often inaccurate, new research shows.

The three tests are the Mini–Mental State Examination (MMSE), which assesses orientation to time and place and the ability to remember words; the Memory Impairment Screen (MIS), which focuses on the ability to remember words; and Animal Naming (AN), which involves naming as many animals as possible in 60 seconds.

“Our study found that all three tests often give incorrect results that may wrongly conclude that a person does or does not have dementia,” study author David Llewellyn, PhD, of the University of Exeter Medical School, United Kingdom, said in a news release.

The study also found that each test has a different pattern of biases, so people are more likely to be misclassified by one test than another, depending on factors such as their age, education, and ethnicity.

“While these results are at first concerning, knowing the specific limitations for each test will help clinicians decide which is the most appropriate for their patient,” lead author Janice Ranson, doctoral researcher in clinical epidemiology at the University of Exeter Medical School, told Medscape Medical News.

“There are many available brief tests, which all have some limitations and biases, and there is currently not strong enough evidence to suggest one particular test is best for everyone. From our findings, it appears that the best test depends on the clinical context and patient characteristics,” said Ranson.

The study was published online November 28 in Neurology Clinical Practice, a journal of the American Academy of Neurology.

Huge Need for Better Tests

The study included 824 adults (mean age, 82 years) from the population-based Aging, Demographics and Memory Study (ADAMS) who underwent a comprehensive workup for dementia. The workup included physical examination, genetic testing for the APOE gene, psychological testing, and comprehensive memory and thinking tests. On the basis of these results, 35% of the patients were found to have dementia, and 65% were found not to.

Armed with this information, the researchers then had participants take the three brief cognitive assessment tests. They found that 35.7% of participants were wrongly classified by at least one test, 13.4% were misclassified by two or more tests, and 1.7% were misclassified by all three tests. Overall dementia misclassification rates for the MMSE, the MIS, and the AN were 21%, 16%, and 14%, respectively. These rates included both false positive and false negative results.

Years of education predicted higher rates of false negative results (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.07 – 1.40) and lower rates of false positive results (OR 0.77; 95% CI, 0.70 – 0.83) on the MMSE.

Nursing home residency predicted lower rates of false negative results (OR, 0.15; 95% CI, 0.03 – 0.63) and higher rates of false positive results (OR, 4.85; 95% CI, 1.27 – 18.45) on the AN.

Across all tests, not having an informant (such as a family member or friend) weigh in on the patient’s memory was associated with increased risk for misclassification.

“Each test is biased in different ways, so the accuracy of each test varies with the characteristics of the patient,” said Ranson.

“There is clearly great potential for improvement of this initial stage in the diagnostic pathway for dementia. We desperately need more accurate and less biased ways of detecting dementia swiftly in clinic,” he added.

This reinforces that we don’t have one simple test. Dr Steven DeKosky

“Not Surprising”

Reached for comment, Steven DeKosky, MD, McKnight Brain Institute, Florida Alzheimer’s Disease Research Center, Gainesville, said he’s not surprised by the data.

“We have known about this for a long time, and kudos to this group for doing this careful analysis of all three tests. The fact that only 1.7% of the cases were misdiagnosed when all three tests were used is testimony to the fact that the diagnosis is proportional to the amount of time that you spend testing a patient,” said DeKosky, a fellow of the American Academy of Neurology.

“Everybody is looking for the one test that will tell you whether the patient has Alzheimer’s disease or whether they are impaired, and the human brain is a little too complicated for that.

“Dementia and cognitive impairment of normal aging are multidimensional, continuous processes, and we are trying to nail a state out of what is a bunch of declining lines or stable lines of cognition. This reinforces that we don’t have one simple test. There will always be some people that are missed if you use just one test,” said DeKosky.

He said the study also highlights the importance of having the patient’s partner provide information on whether there is memory loss or not.

“Patients will often tell you that they don’t have memory loss, which is either their denial or possibly loss of insight because they are developing one, or because they just don’t want to believe it. So often, the partner is a more accurate source,” said DeKosky.

The truth about amyloid plaque and its connection to Alzheimer’s disease


Image: The truth about amyloid plaque and its connection to Alzheimer’s disease

Scientists have been studying the link between amyloid plaques and Alzheimer’s disease for over 20 years, but a growing number of experts are questioning this prevailing hypothesis. Thomas J. Lewis, Ph.D. has been leading the call to change the way the medical community looks at, and treats, Alzheimer’s disease. And according to this Alzheimer’s expert, the notion that amyloid plaque is the sole cause of Alzheimer’s disease is nothing more than a myth, peddled by the profit-seeking pharma industry for their own financial gain.

Dr. Lewis is the CEO and founder of RealHealth Clinics, and has spent years researching and developing alternative treatments for the condition. Despite the fact that amyloid plaques and the “amyloid cascade” hypothesis have been the cornerstone of Alzheimer’s disease research for decades, Lewis believes that other forces are at play. Other experts have also begun to question the amyloid dogma — and for good reason.

Amyloid plaques and Alzheimer’s disease

As sources explain, the current accepted theory about Alzheimer’s goes like so: Beta amyloid, a protein fragment, accumulates in the brain and forms clumps of amyloid plaque. This plaque is believed to destroy synapses, cause nerve cell death and ultimately, impair brain function.

The theory sounds good on paper, but as Dr. Lewis explains, there are some glaring problems with this hypothesis.

And as sources report, more than 100 amyloid-targeting drugs have been tested in the treatment of Alzheimer’s disease; all have failed. Researchers have even tried using these drugs in milder cases of dementia, still to no avail. Now, rather than admit their prevailing theory is wrong, Big Pharma is looking to employ totally healthy people as their guinea pigs. If amyloid plaques were the problem, the drugs should have offered at least some benefit. Further, giving healthy people drugs to prevent a disease they don’t have, ultimately, won’t even provide substantiating proof of concept, anyways — not that a lack of convincing evidence has ever stopped Big Pharma before.

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More, Dr. Lewis explained at a recent summit, there are many cases of Alzheimer’s disease in which no amyloid plaques are present. This alone is a bit of a red flag; after all, if the plaques are the only thing that causes Alzheimer’s, they should be present in all patients.

This finding, at the very least, suggests that there is more than one cause of Alzheimer’s.

Even more interesting is the finding that amyloid plaque is often present in the brains of individuals not affected by Alzheimer’s disease.

As Dr. Lewis notes further, research by Harvard University has shown that beta amyloid is actually part of the immune system response. This, he posits, could mean that amyloid plaques may actually play a protective role in the brain. Instead of causing Alzheimer’s, the accumulation of beta amyloid may be a sign that something else is going awry.

So, the drugs designed to target the “cause” of Alzheimer’s do nothing to actually help treat the disease, and studies have indicated that amyloid plaque, at the very least, is not the only factor that contributes to it, either. It is no wonder that experts like Dr. Lewis propose that perhaps another factor is at play.

Indeed, it would seem that like other conditions, Alzheimer’s disease can be triggered by an array of causes. Dr. Lewis notes, however, that inflammation is virtually always present. He posits that  environmental toxins, stress, poor nutrition, lack of sleep and bacterial and viral infections can all play a role in the onset of the disease.

Research has shown that prescription drugs and vaccines can also contribute to the development of Alzheimer’s. All things considered, it’s clear that the way mainstream medicine currently looks at Alzheimer’s disease is misguided. You can learn more at Dementia.news.

Sources for this article include:

NaturalHealth365.com

Alzheimers.net

High levels of CoQ10 can lower your chances of dementia by 77%


Image: High levels of CoQ10 can lower your chances of dementia by 77%

Dementia, despite its prevalence, remains largely a mystery to doctors and scientists, who have yet to find a foolproof way to prevent or treat the illness. We’ve all heard that foods like blueberries and those containing omega 3s can reduce your risk to a degree, but one of the more exciting developments in the fight against dementia in recent years is the ability of coenzyme Q10, or coQ10, to significantly lower your risk.

A study that was published in the Atherosclerosis journal highlighted this ability after looking at adults aged between 40 and 69. They compared those who developed dementia with control subjects who were the same age but did not develop the disease, measuring the serum CoQ10 levels of everyone involved.

They discovered that those individuals whose levels of CoQ10 were within the top 25 percent of all those measured enjoyed a remarkable 77 percent lower chance of developing dementia than those who fell into the lowest quarter of CoQ10 levels. In addition, those with the highest levels of CoQ10 also had healthier levels of cholesterol.

Why is CoQ10 so useful in this regard? According to experts, it lowers oxidative stress in the brain, along with amyloid plaque. It also helps to heal the mitochondrial impairment that stands in the way of energy production.

Could you use more CoQ10?

Your body naturally produces the antioxidant CoQ10, which is also known as ubiquinone. Its main job is helping your body convert the food you eat into the energy needed to power your brain and your body in general, but it also serves other purposes, such as preventing blood clots.

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As you age, your CoQ10 levels will decrease naturally, and they also drop very low if you have heart disease, dementia, Parkinson’s, HIV/AIDS, or cancer. Deficiencies can also be seen in those who take statins. Unfortunately, having low levels of CoQ10 has been linked to a host of illnesses like cancer progression and melanoma metastasis.

Because nearly every cell in your body depends on CoQ10, it’s important to ensure you are getting enough of it – especially if you are hoping to reduce your chances of developing dementia later in life, along with other brain diseases like Parkinson’s.

You can find CoQ10 in oily fish like salmon, sardines, mackerel and tuna, which also have the benefit of containing lots of healthy fats. It can also be found in soybeans, peanuts, spinach, cauliflower, and broccoli.

It’s difficult to get enough CoQ10 from your diet, so many people enlist the help of supplements to ensure their levels are adequate. In fact, CoQ10 supplements have proven useful in lowering cancer risk and helping to heal heart disease. The supplements can also help those suffering from high blood sugar and even diabetes.

Because it’s made naturally by your body, it is considered generally quite safe to take as a supplement, as long as you are getting a pure product from a trustworthy source. Studies haven’t found any serious side effects, although some people may experience mild effects like nausea, heartburn, headaches or insomnia. Some people might want to steer clear, however, such as those who are pregnant or taking blood thinners, chemotherapy medications, or beta blockers.

Although we are still only scratching the surface when it comes to understanding this puzzling disease, it’s encouraging to know that there are safe and natural ways you can reduce the chances you’ll develop dementia.

Worldwide Dementia Rates More Than Doubled Over 26-Year Span


Rates of dementia worldwide more than doubled from 1990 to 2016, mainly due to population aging, a new report from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 Dementia Collaborators indicates.

“With limited scope for prevention and the absence of an effective disease-modifying treatment, the burden on caregivers and the parts of health-care systems devoted to care of the elderly will continue to increase rapidly,” researchers warn.

The report includes data on dementia between 1990 and 2016 are from 195 countries and regions. It was published online November 26 in Lancet Neurology.

Over the 26-year study period, there was only a minor increase of 1.7% in the global age-adjusted prevalence of dementia, from 701 cases per 100,000 population in 1990 to 712 per 100,000 population in 2016, the authors note.

However, due to population aging and growth, the number of people affected by dementia worldwide has more than doubled, from 20.2 million in 1990 to 43.8 million in 2016 — an increase of 117%.

Among those with dementia in 2016, 27 million were women and 16.8 million were men.

The number of deaths due to dementia jumped by 148% between 1990 and 2016. Dementia was the fifth leading cause of death globally in 2016, accounting for 2.4 million deaths.

Overall, 28.8 million disability-adjusted life-years (DALYs) were attributed to dementia; 6.4 million of these could be attributed to four modifiable risk factors: high body mass index (BMI), high fasting plasma glucose, smoking, and a high intake of sugar-sweetened beverages, the report notes.

A Growing Challenge

It’s been estimated that by 2050, the number of people living with dementia could be around 100 million. “Tackling this will require training of health professionals, as well as planning and building facilities to cater to increasing numbers [of] individuals with dementia,” the authors write.

“Despite the low return on research investment in dementia in the past, the size of the burden and its increasing trend warrant a continued effort to find effective means of intervening. Until such breakthroughs are made, dementia will constitute an increasing challenge to health-care systems across the globe,” they note.

Monitoring trends in dementia is difficult, say the researchers, because there is “substantial heterogeneity” in the global literature on how dementia cases and deaths are recorded, “highlighting the need for more consistency in future research.”

In an accompanying editorial, Lenore Launer, PhD, of the neuroepidemiology section at the National Institute on Aging, notes that the definition of dementia is “still evolving in research and clinical communities, and this affects how data are entered into administrative databases. From a public health and disease-prevention perspective, too few quality data are available for dementia that fit the complex reality of this devastating public health problem.”

Going forward, Launer notes several areas of data collection and interpretation that need strengthening: improving research methods used in data collection and interpretation; developing a consensus about valid coding of dementia for administrative databases; and developing flexible approaches that take into account the variation in place and over time of health and social conditions that may lead to severe cognitive impairment.

Depression, PTSD in Women Tied to Subsequent Dementia


Women with depression or posttraumatic stress disorder (PTSD) or who have experienced a traumatic brain injury (TBI) are at increased risk for subsequent dementia, new research suggests.

A cohort study of more than 100,000 female veterans showed that those who had one of these “military-related risk factors” at baseline were 50% to 80% more likely to develop dementia 4 years later than women without PTSD, TBI, or depression.

The findings were even more dire for those who had two or more of these risk factors, such as TBI with depression. For those women, the risk for developing dementia was doubled.

“These ‘military-related risk factors’ aren’t unique to the military, but military veterans have a probably 3 to 5 [times] greater chance of these exposures,” lead author Kristine Yaffe, MD, San Francisco Veterans Affairs (VA) Medical Center and Departments of Psychiatry, Neurology, and Epidemiology & Biostatistics at the University of California, San Francisco, told Medscape Medical News.

“This is the first study that I’m aware of looking at older women veterans and trying to understand what the risks are for getting dementia. And we think the findings are quite robust and important,” she added.

Dr Kristine Yaffe

Yaffe noted that the results may also be generalizable to nonveteran women.

“I think the biology is not different whether you’re a veteran or not. The difference here is just in the exposure. If you’re a military veteran, your chances are much higher you’ll be exposed” to these risk factors, she said.

The findings were published online November 12 in Neurology.

Disparity in the Field

Although past research has shown a significant link between dementia and TBI, PTSD, or depression, these studies “have been conducted almost exclusively among men,” the investigators write.

“This is a considerable disparity in the field, especially because more women are joining the military and female veterans may be at greater risk for certain psychiatric conditions compared to male veterans,” they add.

“It turns out that there is very little known about women veterans, particularly the older women. They just haven’t been asked to be part of research in any topic really,” said Yaffe.

For the current study, “we actually identified every female veteran who was 55 or older and who was getting their care at the VA,” she reported.

The investigators then assessed records from the National Patient Care Databases and the Vital Status File database for 109,140 female veterans who sought care from a US VA medical center between October 2004 and September 2015.

All of the included study participants (mean age, 68.5 years) completed at least one follow-up visit and were assessed at baseline for TBI, PTSD, depression, and comorbid conditions on the basis of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes.

At baseline, 488 of the women had TBI only, 1363 had PTSD only, 20,410 had depression only, 5044 had more than one military-related risk factor, and 81,835 had none of these risk factors.

ICD-9-CM codes from the 2016 version of the VA Dementia Steering Committee were used to determine dementia prevalence at baseline and dementia incidence at follow-up.

Increased Dementia Risk

During a mean follow-up of 4.0 years, 4% of the study participants developed dementia.

After adjusting for demographics and comorbid conditions such as diabetes mellitus, hypertension, and alcohol and tobacco use, there was a significantly greater risk for developing dementia in the women with vs without the following conditions:

  • PTSD: adjusted hazard ratio (HR), 1.78; 95% confidence interval [CI], 1.34 – 2.36;
  • Depression: HR, 1.67; 95% CI, 1.55 – 1.80; or
  • TBI: HR, 1.49; 95% CI, 1.01 – 2.20.

The investigators note that the finding that having a TBI increased dementia risk by 50% parallels “estimates from our prior study of male veterans in which TBI was similarly associated with a 60% increase in the risk of dementia.”

As for the almost 80% increased risk for dementia in the women with PTSD, “this is consistent with other investigations in male veterans that report an increase in risk of 80% to 100%,” the researchers write.

“There is [also] a robust body of evidence to support depression as a risk factor for developing dementia with studies in both community-based populations of women and (mostly male) veterans,” they add.

Yaffe noted that although their findings showed the highest risk for PTSD, followed by depression, and then TBI, “a ratio of 1.5 vs 1.8 may not be statistically different from one another. All three of the risk factors are important — and they often go together.”

The rates of incident dementia in those with TBI, depression, or PTSD only were 5.7%, 5.2%, and 3.9%, respectively, compared with 3.4% of the women who had no military-related risk factors (all comparisons, P < .001).

The incident dementia rate was 3.9% in the women who had more than one military-related risk factor; and their adjusted HR for dementia was 2.15 compared with those with none of the risk factors (95% CI, 1.84 – 2.51).

“These findings highlight the need for increased screening of TBI, PTSD, and depression in older women, especially female veterans,” the investigators write.

“If women have a history of PTSD or depression, they probably should be followed more closely and given periodic screening for their memory and other cognitive aspects as they get older,” Yaffe added.

In addition, these risk factors “are something we can maybe do something about. Certainly you can try to prevent traumatic brain injury with helmets and seat belts, and hopefully you can try to better treat PTSD and depression. And maybe all of this could actually decrease risk of dementia,” she said.

She noted that the study isn’t saying that an individual with one of these risk factors will definitively develop dementia. “It means that it increases your risk but it’s not a 1-to-1 correlation,” said Yaffe.

“Clear Need for More Studies”

In an accompanying editorial, Andrea L.C. Schneider, MD, PhD, and Geoffrey Ling, MD, PhD, from the Department of Neurology at Johns Hopkins University School of Medicine, Baltimore, Maryland and the Uniformed Services University of the Health Sciences, Bethesda, Maryland, note that although the study provides new evidence, it “also highlights that there is a clear need for more studies.”

They also point out that the “important findings” need to be confirmed and that causality needs to be determined.

“Future studies will need to include both men and women to assess directly for possible interaction by sex in associations between TBI, PTSD, and depression and dementia risk. Indeed, animal studies suggest sex differences in response to TBI and sex differences in the neurobiology of PTSD and depression,” they write.

“Given this, it is possible that neuropsychiatric conditions may be differentially associated with dementia risk in men vs in women,” they add.

The editorialists note that the study also relied only on ICD-9-CM codes to define the military-related risk factors and dementia — and that these codes are less sensitive than diagnostic interviews.

“It follows that a higher number of encounters with the health care system would make an individual have more opportunities to receive a diagnosis,” they write.

Overall, “a great deal more remains to be learned about the associations, underlying mechanisms, and possible sex differences in associations relating neuropsychiatric conditions…with dementia, both in military veteran populations and in general populations,” write Schneider and Ling.

“But importantly, the study by Yaffe et al. suggests that associations of TBI, PTSD, and depression with increased risk of dementia also occur in female military veterans and are not unique to male military veterans,” they conclude.

Dementia or something else? See which health conditions that are often mistaken for the degenerative disease


Image: Dementia or something else? See which health conditions that are often mistaken for the degenerative disease

(Natural News) The Alzheimer’s Association defines dementia as “a general term for loss of memory and other mental abilities severe enough to interfere with daily life.” However, over 40 percent of dementia diagnoses are actually wrong.

Here are seven health conditions that are often confused for dementia or Alzheimer’s.

  1. Side effects of artificial flavors, food colors, and sweeteners – These artificial additives are linked to dementia symptoms. Studies have determined that aspartame, an artificial sweetener, can impair cognitive function and cause memory loss.
  2. Inflammation from food allergies, low-level infections, Lyme Disease, and mold – Inflammation occurs when the body tries to get rid of toxic elements or organisms. Studies imply that neuroinflammation may cause mental disorders.
  3. Mercury or other heavy metal poisoning – Silver amalgam fillings contain 50 percent mercury that isn’t stable or inert. The mercury in filling “off-gasses, crosses the blood-brain barrier, and destroys neurons even without contact.” It’s hazardous to remove these fillings unless mercury-safe protocols are observed. Annual flu shots also contain heavy metals like aluminum and mercury.
  4. Nutritional imbalances and deficiencies – Deficiencies of folate (vitamin B9), magnesium, omega 3s, probiotics, selenium, vitamin B12, vitamin C, vitamin D, and other nutrients may cause the symptoms of Alzheimer’s and dementia. To address deficiencies, follow a balanced Mediterranean-style diet to slow down cognitive decline and reduce the risk of Alzheimer’s. Coconut oil can boost brain health while turmeric can improve your memory.
  5. Prescription medication side effects – Drugs, like pain medications, psychotropic drugs, statins (for lowering blood cholesterol), and sleep medication may severely disrupt cognition and increase the risk of dementia.
  6. Stress and stagnation or inactivity – Stress will elevate cortisol levels, and this causes inflammation. Inflammation then results in cognitive impairment, delayed healing time, hormone imbalances, hypertension, increased blood sugar levels, and susceptibility to disease. The body’s self-healing mechanisms requires the unimpeded flow of blood, lymph, and other fluids, which are improved with exercise. However, if you lead a sedentary lifestyle, cells in your body may shut down or become blocked, which can impede the natural healing process. Misdiagnosis linked to stress and inactivity often occurs in individuals with depression or alcohol addiction. (Related: The many ways stress makes you sick.)
  7. Thyroid and other hormonal imbalances – Individuals diagnosed with Alzheimer’s or dementia often have low T3 thyroid hormone levels, which aren’t measured in standard thyroid tests. At least 10 to 15 percent of residents in all nursing home residents are misdiagnosed due to low T3 levels.

https://www.brighteon.com/embed/5805404356001

Determining a cure for dementia

Experts from the University of California, Los Angeles (UCLA) and the Buck Institute for Research on Aging are collaborating on a new program that can help individuals with dementia, which may prevent misdiagnosis in patients with other conditions.

The research team reported that this is the first study of its kind and that it can prove that natural therapies may help slow the progress of dementia and even reverse it. Data from the paper, titled “Reversal of Cognitive Decline: A novel therapeutic program” and published in the journal AGING, revealed that out of the 10 participants diagnosed with dementia, nine “got their minds back.”

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As people grow older, their fear of developing cognitive decline increases. Alzheimer’s disease is one of the several types of dementia. An individual with the disease may have problems with their behavior, memory, and thinking. The symptoms of Alzheimer’s tend to develop and worsen gradually until they interfere with simple daily tasks.

At least 5.4 million Americans have Alzheimer’s while 30 million people worldwide are diagnosed with the condition. Experts posit that by 2050, 160 million individuals around the world, including 13 million Americans, will have the disease. To date, Alzheimer’s, the third leading cause of death in the U.S., can’t be treated.

Dr. Dale Bredesen, the study’s lead author and a professor of neurology at The Mary S. Easton Center for Alzheimer’s Disease Research at UCLA, supposes that different factors affect the development of dementia and Alzheimer’s. For the study, Dr. Bredesen and his colleagues developed personalized and comprehensive protocols to address memory loss in 10 patients.

The study results were positive, and nine of the 10 participants showed improvement in their memories after being on the program for only three to six months. Out of the 10 patients, six patients have discontinued working or were struggling with their jobs when they joined the study. Once they joined the program, the six participants were able to work again or continue working with improved performance.

Five of the participants had memory loss linked to Alzheimer’s while the rest had amnestic mild cognitive impairment and subjective cognitive impairment. Only one patient with late-stage Alzheimer’s didn’t improve.

Doctors used a “systems approach” to treat the patients who joined the program. This “complex, 36-point therapeutic program” included:

  • Brain stimulation
  • Comprehensive changes in diet
  • Exercise
  • Sleep optimization
  • Specific pharmaceuticals and vitamins

The program also involved other steps concerning brain chemistry. Dr. Bredesen concluded that even if the program is complex and involves many lifestyle changes, the protocol is worth implementing since its only side effect was “improved health and an optimal body mass index, a stark contrast to the side effects of many drugs.”

You can read more articles about natural cures for the different conditions mistaken as dementia at Health.news.

Sources include:

GreenMedInfo.com

ALZ.org

Diabetes, Dementia Can Be Deadly Combination


The risk of death from dangerously low blood sugar is much higher among seniors who have both diabetes and dementia than those with diabetes alone, a new study finds.

Researchers analyzed data from nearly 20,000 people aged 65 and older with type 1 or type 2 diabetes who were followed for up to five years after their first recorded low blood sugar episode.

Those with both diabetes and dementia had a 67 percent higher risk of death following dangerously low blood sugar (hypoglycemia) than those with diabetes alone, according to study findings.

“Hypoglycemia is an under-recognized risk factor for death in older adults with diabetes and dementia,” said study author Dr. Katharina Mattishent, an Alzheimer’s Society clinical research fellow at Norwich Medical School in England.

“In this vulnerable group, clinicians and patients should move away from relentless pursuit of strict glucose-lowering targets, she said. “The focus must be directed at rigorous detection of hypoglycemia using continuous glucose monitoring devices.”

The findings were presented Monday at the annual meeting of the European Association for the Study of Diabetes, in Berlin. Such research is considered preliminary until published in a peer-reviewed journal.

“With no new dementia drugs in 15 years, minimizing risk and improving care is key. We know that diabetes can raise the risk of developing dementia, and with both of these illnesses on the rise we urgently need to understand this relationship better,” said James Pickett, head of research at the Alzheimer’s Society.

“Very low blood sugar levels are clearly dangerous to anyone with diabetes, and this suggests the effects might be even more extreme in people with dementia,” Pickett said in a meeting news release.

“The study didn’t show cause and effect but, given the dangers of low blood sugar levels, clearly it should be managed carefully,” he added.

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