Women Bear Greatest Burden of Alzheimer's

By Mary Elizabeth Dallas, HealthDay News 

Survey finds they're more likely than men to have Alzheimer's or take care of someone with the disease. 

 

MONDAY, July 18, 2011 (HealthDay News) — Women fear Alzheimer's disease more than any other illness except cancer, and they are more often on the front lines of providing care for loved ones battling the disease, new research shows.

"With statistics consistently pointing to the fact that more women are living with Alzheimer's and caring for people with Alzheimer's, it is clear women are disproportionately affected by this disease," said Angela Geiger, chief strategy officer of the Alzheimer's Association.

A survey of women in France, Germany, Spain, Poland and the United States revealed that women are at the center of the global Alzheimer's epidemic. The multinational research team found women in all five countries were more concerned than men about a loved one developing the disease.

Women in all countries, the survey also found, were more likely than men to be involved in the daily care of someone with the disease. In fact, women in France and Poland were significantly more involved in the decision-making and financial support of an Alzheimer's patient.

If roles were reversed and those polled were to develop the disease, most identified their spouse as the person who would be responsible for their primary care. Men, however, identified their wives 6 percent to 18 percent more often than wives identified their husbands. In contrast, women were more likely to say they would rely on their children or paid caregivers outside the family to care for them.

Despite their fear of the disease, which currently affects 36.5 million people worldwide, and their greater burden as caregivers, 71 percent of women in France and 76 percent of women in the United States seem to be more optimistic that a treatment for Alzheimer's will be developed within five years. That may be one reason why the survey also showed that women believe government spending on Alzheimer's research should be increased.

"These insights reinforce the conclusions published in The Shriver Report: A Women's Nation Takes on Alzheimer's, which found the impact of Alzheimer's on women is significant. The perspectives we see in this survey must prompt thoughtful conversations about Alzheimer's with our friends, family members and government officials to change the trajectory of Alzheimer's disease," concluded Geiger.

The research was slated for presentation Monday at the Alzheimer's Association International Conference in Paris. Research presented at medical meetings should be viewed a preliminary until it is published in a peer-reviewed medical journal.

Falls Could Signal Early Alzheimer's Disease

By HealthDay News Staff 

Seniors whose brain scans indicated preclinical disease twice as likely to fall, study finds. 

 

SUNDAY, July 17, 2011 (HealthDay News) — Compared with older people with no signs of Alzheimer's, those whose brains show early signs of the disease are twice as likely to experience a fall, researchers have found. 

In the new study, investigators looked at brain scans of 125 older adults who were participating in a study of memory and aging. The seniors were also asked to keep track of how many times they fell over the course of eight months. 

An increased risk of falls was noted among individuals whose scans showed early signs of Alzheimer's. The study authors suggested that falls could indicate the need for an evaluation for the memory-robbing disease. 

"To our knowledge, this is the first study to identify a risk of increased falls related to a diagnosis of preclinical Alzheimer's disease," study author Susan Stark, an assistant professor of occupational therapy and neurology at Washington University in St. Louis, said in a news release from the Alzheimer's Association International Conference. 

"This finding is consistent with previous studies of mobility problems among persons with very early symptomatic Alzheimer's or mild cognitive impairment. It suggests that higher rates of falls can occur very early in the disease process," Stark added. 

The study, which was slated for presentation Sunday at the Alzheimer's Association International Conference in Paris, found that of the 125 adults studied, 48 people experienced at least one fall. 

The brain scans of the participants showed that higher levels of an imaging agent that binds to the abnormal protein growth that is a signature of Alzheimer's disease, was associated with a 2.7 times higher risk of a fall for each unit of increase on the scan. 

The researchers noted that Alzheimer's has been linked to balance and gait disorders, as well as problems with visual and spatial perception, which could put people with the disease at higher risk for falls. Based on their findings, they added, these symptoms may appear before other more obvious signs of the disease, such as memory loss and impaired thinking. 

"Growing scientific evidence suggests that 'silent' biological changes may be occurring in the brain a decade or more before we can see the outward symptoms of Alzheimer's," Maria Carrillo, Alzheimer's Association senior director of medical and scientific relations, said in the news release. "According to this study, a fall by an older adult who otherwise has a low risk of falling may signal a need for diagnostic evaluation for Alzheimer's." 

The study authors concluded that additional research is needed to improve early detection and intervention in Alzheimer's disease. Lowering the risk of falls, they added, could also have an economic impact since these incidents contribute to higher rates of disability among older adults, premature placements in nursing homes and more than $19 billion in direct medical costs in 2000 alone. 

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Could a Diet Help Prevent Alzheimer's?

By Amanda Gardner, HealthDay News

Low-fat, low-glycemic eating plan improved 'biomarkers' of the disease, researchers say. 

 

MONDAY, June 13, 2011 (HealthDay News) — The low-fat, low-glycemic diet often promoted for general health and well-being may lower the risk of developing Alzheimer's disease if adopted early in life, researchers say. 

But starting such an eating plan after symptoms surface doesn't seem to help prevent deterioration of brain function, according to new research published online June 13 in Archives of Neurology. 

"This is not the first time this concept has emerged, that things you do in midlife or earlier on may have effects later on," said Dr. Marc L. Gordon, chief of neurology at Zucker Hillside Hospital and an Alzheimer's researcher at the Feinstein Institute for Medical Research in Manhasset, N.Y. 

"For example, we know that midlife obesity is associated epidemiologically with a higher risk of late-life dementia," he continued. "Whether that's causal or an effect of the disease is open to speculation, but it suggests that there may be periods of vulnerability that are different in different times in the life span." 

Although numerous studies have probed connections between lifestyle factors and cognitive ability, no solid proof yet exists that diet (or much else) can prevent Alzheimer's, the most common form of dementia among the elderly. 

A low-glycemic diet, which focuses on eating fruits and vegetables, whole grains and lean meats, avoids spikes in blood sugar and is said to promote feelings of fullness. 

A U.S. National Institutes of Health conference convened last spring concluded that, for now, older age is the leading known risk factor for Alzheimer's disease. A gene variation is also tied to increased risk for the brain disorder, the NIH review said. Experts at the conference stressed that the general public should still focus on avoiding behaviors already linked to other chronic diseases. 

This new study looked at the effect of different diets on biomarkers associated with Alzheimer's, such as blood sugar levels, cholesterol and blood lipid levels. The researchers also tested memory after participants followed the assigned diets. 

Twenty healthy adults and 29 with mild memory problems that could be predictive of Alzheimer's followed either a high-fat, high simple-carbohydrate diet ("HIGH" diet) or a diet lower in fat and simple carbohydrates ("LOW" diet). 

After four weeks, healthy participants on the LOW diet had changes in biomarkers, including insulin and lipid levels in the blood, which were moving away from those normally associated with dementia. 

In participants with mild cognitive impairment, this diet had the opposite effect. 

Commenting on the study, Dr. Suzanne de la Monte, professor of neurosurgery and pathology at Brown University and Rhode Island Hospital in Providence, said it remains to be seen if the changes noted in this study actually translate, over the longer term, into differences in risk for developing Alzheimer's disease. 

The bottom line, though, is the same as it's been for eons: A healthy diet lowers your risk of type 2 diabetes, heart disease, cancer and maybe even Alzheimer's. 

That means staying away as much as possible from processed foods, de la Monte advised. 

A second study, in the same issue of the journal, also looked at biomarkers and found that different levels were associated with different measures of cognitive function associated with Alzheimer's disease. 

This finding could help improve diagnosis of Alzheimer's, which now relies mostly on clinical observation.

Forgetfulness About Paperwork, Medicines Might Herald Cognitive Decline

By HealthDay Staff

But one expert added that everyday forgetfulness isn't necessarily a sign that Alzheimer's is near.

 

MONDAY, June 6, 2011 (HealthDay News) — A new study finds that older people with mild cognitive impairment — sometimes a precursor to Alzheimer's disease — have a harder time remembering important dates and medications than those without cognitive problems. 

Mild cognitive impairment can be annoying but it isn't as severe as conditions that significantly disrupt daily life. It can, however, occur before serious conditions such as Alzheimer's disease and other causes of dementia. 

Patrick J. Brown of the New York State Psychiatric Institute and his colleagues looked at neurological test results, brain-imaging studies and other data from 229 people with no cognitive problems, 394 with mild cognitive impairment and memory problems, and 193 diagnosed with mild Alzheimer's disease. 

Those in the latter two groups had much more trouble with at least one kind of cognitive function, especially "assembling tax records, business affairs or other papers" and "remembering appointments, family occasions, holidays and medications," according to the study. 

"These findings show that even mild disruptions in daily functioning may be an important clinical indicator of disease and represent the latter phases of disease progression," the study authors wrote. 

Still, one expert not involved with the study cautioned that people shouldn't read too much into the findings. 

"Just because someone misplaces their keys or glasses, forgets an appointment or a dose of medication does not mean they have early Alzheimer's disease," stressed Dr. James E. Galvin, professor of neurology and psychiatry and director of the Pearl S. Barlow Center for Memory Evaluation and Treatment at NYU Langone Medical Center in New York City. 

He pointed out that the study was seeking to understand which individuals with mild memory problems (called mild cognitive impairment, or MCI) were likely to progress to Alzheimer's disease. 

"Everyone occasionally forgets," Galvin said. "It's when the forgetfulness becomes a consistent feature and in some way interferes with everyday activities that it is time to discuss with your doctor." 

The study was published in the June issue of the Archives of General Psychiatry.

Alzheimer's Risk Gene May Damage Brain Decades Before Symptoms Show

By HealthDay News

Scans indicate even young adults who have the gene have some white-matter deterioration.

 

WEDNESDAY, May 18, 2011 (HealthDay News) — A gene allele that increases the risk of Alzheimer's disease starts to damage the brain 50 years before symptoms of the disease appear, a new study suggests.

An allele is one of two or more forms of a gene.

In 2009, scientists concluded that the clusterin (CLU) gene boosts the chances of Alzheimer's disease by 16 percent, but it wasn't clear how it increased risk.

This new study concluded that the C-allele of the CLU gene impairs development of myelin, the protective covering around the axons of neurons in the brain. This impairs brain wiring and can make a person more vulnerable to the onset of Alzheimer's later in life.

About 88 percent of whites have the CLU C-allele, according to the University of California, Los Angeles (UCLA) researchers.

For this study, they used a newer type of MRI to map the connections in the brains of nearly 400 healthy adults aged 20 to 30. The scans revealed that participants with the CLU C-allele had lower white matter integrity than those with a different variant called the CLU T-allele.

The findings are interesting on several levels, according to senior study author Paul Thompson, a professor of neurology.

"For example, Alzheimer's has traditionally been considered a disease marked by neuronal cell loss and widespread gray matter atrophy," he said in a UCLA news release. "But degeneration of the myelin in white matter fiber pathways is more and more being considered a key disease component and another possible pathway to the disease, and this discovery supports that."

Understanding the effects of the CLU C-allele could lead to ways to intervene and protect the brain in the decades before Alzheimer's develops, Thompson suggested.

The study appears in the current online edition of the Journal of Neuroscience.

Little Evidence That Diet, Lifestyle Cuts Alzheimer's Risk

By Alan Mozes, HealthDay 

Until better data exist, experts still advise practicing good health habits.

Monday, May 9, 2011 (HealthDay News) — Numerous studies have attempted to link specific behaviors and health conditions to the onset of Alzheimer's disease, but scientists still can't say for sure that anything you do or don't do will prevent the brain disorder, according to a new U.S. review of recent research.

The U.S. National Institutes of Health convened a conference last spring to analyze 18 studies of potential risk factors, such as poor eating habits, chronic illness, smoking or little exercise, and development of Alzheimer's disease.

"Although we are not dismissing the potential or important role that these major risk factors might play in the development of Alzheimer's disease, at this time, with what we have currently, we cannot confirm any risk associations," said study lead author Dr. Martha L. Daviglus, a professor of preventive medicine and medicine at the Northwestern University Feinberg School of Medicine in Chicago.

"So we need to conduct more research, if we want to have the evidence in hand," she added.

The study, which summarizes the NIH conference results, is published in the May 9 online edition and September print issue of the Archives of Neurology.

For now, older age is the leading known risk factor for Alzheimer's disease, the study noted. A gene variation is also tied to increased risk, it said. 

An estimated 5.3 million Americans struggle with Alzheimer's, a figure projected to grow as the country's Baby Boomer population ages, the authors said. The disease is responsible for between 60 and 80 percent of dementia cases.

"What we're talking about here is something that is going to affect so many Americans in the years to come," said one expert, Catherine Roe, an instructor in neurology at Washington University School of Medicine in St. Louis. "In fact, there's going to be an explosion in the next 50 years, because everyone is living longer in general," she said.

The studies included in the NIH research review were conducted between 1984 and 2009 in English. Participants were at least 50 years old and living in developed countries.

Some of the studies looked into dietary influences, such as folic acid intake, Mediterranean diet and nutritional supplements. Others looked for a link between health problems, such as diabetes or high cholesterol, and Alzheimer's. Still others explored levels of physical activity or alcohol consumption and risk of Alzheimer's disease.

The NIH team found that, as a whole, the studies were "compromised by methodological limitations" that undercut the ability to draw a firm association between any particular behavioral habit and/or health condition and Alzheimer's.

The authors noted that such limitations resulted from the use of poor diagnostic criteria, poor knowledge of the inner workings of Alzheimer's disease itself, and/or the unreliability of patient-reported physical and mental health status.

Yet despite determining that the current quality of evidence is "inadequate" to draw causal linkages, Daviglus and her colleagues stressed that the general public should still focus on lifestyles that avoid behaviors already linked to other chronic diseases.

"People should follow a healthy lifestyle, which includes exercising, blood pressure control, not smoking, not becoming overweight, and trying to sleep properly," Daviglus said.

"And, of course, our recommendation is that it is very important that we make sure that, in the future, more well-constructed, well thought-out studies be conducted so that we can get better quality results that can confirm associations, when they exist, between risk factors that a large proportion of the population have and the onset of Alzheimer's," she added.

Roe agreed that "more quality research is needed," but added that, "I don't think it's a worse situation than in any other field of research. This is difficult and challenging work. And it costs a lot of money at a time when there's a funding crisis in science."

Still, a sense of urgency should prevail, Roe said. "Today the Baby Boomers are starting to hit the age where Alzheimer's comes into play," she noted. "And it's going to take a huge human toll and economic toll, if we don't find a way to treat it or slow it down. So it's very important that we do more and do it better."

Extra Pounds at Midlife May Boost Dementia Risk Later

By Kathleen Doheny, HealthDay

Being merely overweight in middle age raised risk by 70 percent compared to normal-weight peers, experts find.

 

TUESDAY, May 3 2011  (HealthDay News) — Being overweight during middle age may increase your risk of developing dementia later on, a new Swedish study suggests. 

Several studies have already linked obesity in middle age to dementia in later life, but it was unclear whether merely carrying some extra pounds in midlife was a risk factor. The new research suggests that even being overweight — defined as having a body mass index (BMI) of 25 to 30 — is linked with a higher risk of dementia. 

"Being overweight at midlife increased the risk of dementia in late life by more than 70 percent," said lead study author Dr. Weili Xu, a postdoctoral researcher at Karolinska Institute in Stockholm.

Being obese raised the risk even more, to nearly fourfold.

"Although the effect of midlife overweight on dementia is not as substantial as that of obesity, its impact on public health is significant," Xu said, noting that 1.6 billion adults worldwide are obese or overweight, including 50 percent of adults in the United States and Europe.

The study is published in the May 3 issue of Neurology.

In her study, Xu analyzed information from the Swedish Twin Registry. It included data on 8,534 twins aged 65 and older. Of those, 350 were diagnosed with dementia and 114 with possible dementia.

Thirty years earlier, the participants had provided what then must have seemed like mundane data: their height and weight.

That data would prove invaluable as Xu grouped them according to their BMIs, from underweight to obese (having a BMI higher than 30). Nearly 30 percent, she found, were either overweight or obese during midlife.

Further analysis showed that being overweight or obese in midlife independently increased the risk of later dementia, including Alzheimer's and vascular dementia.

About 26 percent of participants without dementia had been overweight at midlife, compared to 36 percent of those with possible dementia and 39 percent with diagnosed dementia.

And although 2.7 percent of seniors without dementia had been obese at midlife, 6.9 percent of those with dementia had been obese, as well as 5.3 percent of those with possible dementia.

When Xu analyzed twin pairs in which one had dementia in later life and one did not, she found the link to weight no longer significant, suggesting early environment and genetics also play roles in dementia.

Why the weight-dementia link? Several mechanisms could explain it, Xu said. A higher BMI is linked with diabetes and vascular disease, which is in turn related to the risk of dementia. Higher weight at midlife may reflect a long period of exposure to higher inflammation throughout the body, which has been linked with lower cognitive function.

Xu and her colleagues noted several study limitations, including the notion that BMI may not be the perfect measure of body fat composition.

They also noted that in terms of lowering dementia risk, it's never too late to start reducing body fat.

The study has a number of strengths, including the large number of people studied, according to Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center and professor of psychiatry and behavioral science at Albert Einstein College of Medicine in the Bronx.

Although the study finds a link between being overweight in midlife and dementia risk, it does not prove cause-and-effect, he said. Still, there is evidence that fatty tissue secretes inflammatory cytokines and other chemicals. These may have a direct effect on the brain, he said, inflicting damage to the neurons.

Dr. Gisele Wolf-Klein, director of geriatric education at the North Shore-Long Island Jewish Health System in Hyde Park, N.Y., said the study "is of great relevance in view of the growing epidemic of obesity in both the United States and Europe."