Tag Archives: dementia

Time until dementia symptoms appear can be estimated via brain scan

Researchers at Washington University School of Medicine in St. Louis have developed an approach to estimating when a person who is likely to develop Alzheimer’s disease, but has no cognitive symptoms, will start showing signs of Alzheimer’s dementia.

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The algorithm, available online in the journal Neurology, uses data from a kind of brain scan known as amyloid positron emission tomography (PET) to gauge brain levels of the key Alzheimer’s protein amyloid beta.

In those who eventually develop Alzheimer’s dementia, amyloid silently builds up in the brain for up to two decades before the first signs of confusion and forgetfulness appear. Amyloid PET scans already are used widely in Alzheimer’s research, and this algorithm represents a new way of analyzing such scans to approximate when symptoms will arise. Using a person’s age and data from a single amyloid PET scan, the algorithm yields an estimate of how far a person has progressed toward dementia — and how much time is left before cognitive impairment sets in.

“I perform amyloid PET scans for research studies, and when I tell cognitively normal individuals about positive results, the first question is always, ‘How long do I have until I get dementia?’,” said senior author Suzanne Schindler, MD, PhD, an assistant professor of neurology. “Until now, the answer I’d have to give was something like, ‘You have an increased risk of developing dementia in the next five years.’ But what does that mean? Individuals want to know when they are likely to develop symptoms, not just whether they are at higher risk.”

Schindler and colleagues analyzed amyloid PET scans from 236 people participating in Alzheimer’s research studies through Washington University’s Charles F. and Joanne Knight Alzheimer Disease Research Center. The participants were an average of 67 years old at the beginning of the study. All participants underwent at least two brain scans an average of 4½ years apart. The researchers applied a widely used metric known as the standard uptake value ratio (SUVR) to the scans to estimate the amount of amyloid in each participant’s brain at each time point.

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Could This Test Determine Dementia Risk?

People whose scores on a dementia risk test indicated a less brain-healthy lifestyle,  including smoking, high blood pressure and a poor diet, may also have the following: lower scores on thinking skills tests, more changes on brain scans and a higher risk of cognitive impairment. That’s according to a new study published in the August 25, 2021, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study also found that in men, the test scores were associated with poor memory function and markers of brain shrinkage.

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“Dementia risk scores might be useful to help identify people at higher risk of dementia earlier, so that potential lifestyle factors can be addressed earlier and monitored more closely,” said study author Sebastian Köhler, PhD, of Maastricht University, the Netherlands. “Our study found that a substantial proportion of brain changes might be attributable to risk factors that can be modified.”

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Improving Air Quality Reduces Dementia Risk – Studies

Improving air quality may improve cognitive function and reduce dementia risk, according to several studies reported at the Alzheimer’s Association International Conference® (AAIC®) 2021 in Denver and virtually.

Previous reports have linked long-term air pollution exposure with accumulation of Alzheimer’s disease-related brain plaques, but this is the first accumulated evidence that reducing pollution, especially fine particulates in the air and pollutants from the burning of fuel, is associated with lower risk of all-cause dementia and Alzheimer’s disease.

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Both increasing levels of air pollution and increasing cases of dementia are worldwide public health crises. While research has linked air quality and cognition previously, these new data at AAIC 2021 explore how air pollutants might impact dementia and what reducing them might mean for long-term brain health.

Among the key findings are:

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Diabetes and dementia risk: More good reasons to keep blood sugar in check

There are many reasons to avoid getting diabetes, or to keep it controlled if you already have it: Higher risks for heart disease, stroke and for having a foot or leg amputation. But here’s another one: It’s a major risk factor for dementia.

While researchers are still investigating what causes that increased risk, one thing they do know is it’s linked to highs – and lows – in the body’s blood sugar levels.

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“Whether it’s Type 1 or Type 2 diabetes, glycemic control is very important” for maintaining good brain health, said Rachel Whitmer, chief of the division of epidemiology at University of California, Davis and associate director of the school’s Alzheimer’s Disease Research Center. “This is another motivation to have good control.”

Good management of blood glucose levels is one of seven lifestyle changes people can make to support better heart and brain health, called Life’s Simple 7 by the American Heart Association. It’s a step that could potentially help more than 34.2 million people in the U.S. living with diabetes.

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Is it normal aging or early signs of dementia?

Because I have people on both sides of my family who have suffered from Alzheimer’s or dementia, I know I am particularly sensitive to my cognitive state. But, I believe that is typical of everyone over 50 years old.

Misplacing keys. Forgetting names. Struggling to find the right word. Walking into a room and forgetting why.

Are these early signs of dementia? Or normal signs of aging?

It all depends on the circumstances, health experts say. To distinguish between changes associated with typical aging and concerning signs of cognitive loss requires a deeper look.

“Instead of thinking about things in terms of what is a sign of dementia, I would ask, ‘What is the situation in which those signs appear?'” said Dr. Jeffrey Keller, founder and director of the Institute for Dementia Research and Prevention in Baton Rouge, Louisiana. “It’s how the brain functions in response to a challenge that demonstrates early changes that can lead to dementia.”

In other words, a person experiencing normal aging may experience some memory lapses, he said. But more important than whether they’ve misplaced their keys is whether they’re able to retrace their steps to find them. Or whether they can retain information long enough to carry out a multi-part task, such as filling out medical or tax forms, even if interrupted while doing so.

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How brain cells repair their DNA reveals ‘hot spots’ of aging and disease

Neurons lack the ability to replicate their DNA, so they’re constantly working to repair damage to their genome. Now, a new study by Salk scientists finds that these repairs are not random, but instead focus on protecting certain genetic “hot spots” that appear to play a critical role in neural identity and function, according to Science Daily.

The findings, published in the April 2, 2021, issue of Science, give novel insights into the genetic structures involved in aging and neuro-degeneration, and could point to the development of potential new therapies for diseases such Alzheimer’s, Parkinson’s and other age-related dementia disorders.

“This research shows for the first time that there are sections of genome that neurons prioritize when it comes to repair,” says Professor and Salk President Rusty Gage, the paper’s co-corresponding author. “We’re excited about the potential of these findings to change the way we view many age-related diseases of the nervous system and potentially explore DNA repair as a therapeutic approach.”

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Why is good health so hard to achieve? – AHA

It ought to be a no-brainer, so to speak: Research has pinpointed seven ways people can achieve ideal heart and brain health. And – bonus – if Americans did those things, they also could help prevent many other chronic illnesses, According to the American Heart Association News.

But most people don’t, at least not consistently. What’s stopping them?

“Most of these steps require a great deal of self-regulation and self-control,” said Dolores Albarracin, a professor of psychology at the University of Illinois at Urbana-Champaign. “It’s not just getting one thing done, like going to get a vaccine, where you can do it and forget about it for a year.”

Volumes of research point to at least seven behaviors, called Life’s Simple 7, that can dramatically lower the burden of heart disease, stroke and dementia. Not smoking, eating a healthy diet, exercising regularly, maintaining a healthy weight, and keeping blood glucose, blood pressure and cholesterol levels in a healthy range have the potential to collectively wipe out a vast majority of heart disease and stroke and prevent or delay a significant number of dementias.

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Poor fitness linked to weaker brain fiber, higher dementia risk

Scientists have more evidence that exercise improves brain health and could be a lifesaving ingredient that prevents Alzheimer’s disease.

In particular, a new study from the University of Texas (UT) Southwestern’s O’Donnell Brain Institute suggests that the lower the fitness level, the faster the deterioration of vital nerve fibers in the brain. This deterioration results in cognitive decline, including memory issues characteristic of dementia patients.

Brain imaging shows yellow and reddish pixels representing areas where the functionality of white matter is associated with higher fitness levels. The images are based on cumulative data from patients in a study showing potential links between physical fitness and deterioration of white matter.

“This research supports the hypothesis that improving people’s fitness may improve their brain health and slow down the aging process,” said Dr. Kan Ding, a neurologist from the Peter O’Donnell Jr. Brain Institute who authored the study. 

White matter

The study published in the Journal of Alzheimer’s Disease focused on a type of brain tissue called white matter, which is comprised of millions of bundles of nerve fibers used by neurons to communicate across the brain.

Dr. Ding’s team enrolled older patients at high risk to develop Alzheimer’s disease who have early signs of memory loss, or mild cognitive impairment (MCI). The researchers determined that lower fitness levels were associated with weaker white matter, which in turn correlated with lower brain function.

Distinctive tactics

Unlike previous studies that relied on study participants to assess their own fitness, the new research objectively measured cardiorespiratory fitness with a scientific formula called maximal oxygen uptake. Scientists also used brain imaging to measure the functionality of each patient’s white matter.

Patients were then given memory and other cognitive tests to measure brain function, allowing scientists to establish strong correlations between exercise, brain health, and cognition.

Lingering Mysteries

The study adds to a growing body of evidence pointing to a simple yet crucial mandate for human health: Exercise regularly.

However, the study leaves plenty of unanswered questions about how fitness and Alzheimer’s disease are intertwined. For instance, what fitness level is needed to notably reduce the risk of dementia? Is it too late to intervene when patients begin showing symptoms?

Some of these topics are already being researched through a five-year national clinical trial led by the O’Donnell Brain Institute.

The trial, which includes six medical centers across the country, aims to determine whether regular aerobic exercise and taking specific medications to reduce high blood pressure and cholesterol levels can help preserve brain function. It involves more than 600 older adults at high risk to develop Alzheimer’s disease.

“Evidence suggests that what is bad for your heart is bad for your brain. We need studies like this to find out how the two are intertwined and hopefully find the right formula to help prevent Alzheimer’s disease,” said Dr. Rong Zhang of UT Southwestern, who oversees the clinical trial and is Director of the Cerebrovascular Laboratory in the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, where the Dallas arm of the study is being carried out.

Prior Findings

The research builds upon prior investigations linking healthy lifestyles to better brain function, including a 2013 study from Dr. Zhang’s team that found neuronal messages are more efficiently relayed in the brains of older adults who exercise.

In addition, other teams at the O’Donnell Brain Institute are designing tests for the early detection of patients who will develop dementia, and seeking methods to slow or stop the spread of toxic proteins associated with the disease such as beta-amyloid and tau, which are blamed for destroying certain groups of neurons in the brain.

“A lot of work remains to better understand and treat dementia,” said Dr. Ding, Assistant Professor of Neurology & Neurotherapeutics. “But, eventually, the hope is that our studies will convince people to exercise more.

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Dementia linked to increased pain years before diagnosis – HHS

People with dementia may experience increased levels of pain 16 years before their diagnosis, according to new research. The study, funded in part by NIA and published in Pain, is the first to examine the link between pain and dementia over an extended period.

Dementia and chronic pain both cause changes to the brain and can affect a person’s brain health. Although many people who have dementia also have chronic pain, it is unclear whether chronic pain causes or accelerates the onset of dementia, is a symptom of dementia, or is simply associated with dementia because both are caused by some other factor. The new study, led by researchers at Université de Paris, examined the timeline of the association between dementia and self-reported pain by analyzing data from a study that has been gathering data on participants for as many as 27 years.

The researchers used data from the Whitehall II study, a long-term study of health in British government employees. Participants were between the ages of 35 and 55 when they enrolled in the study. Using surveys conducted multiple times over the course of the study, the researchers measured two aspects of participant-reported pain: pain intensity, which is how much bodily pain a participant experiences, and pain interference, which is how much a participant’s pain affects his or her daily activities. They used electronic health records to determine whether (and when) participants were diagnosed with dementia.

Out of 9,046 participants, 567 developed dementia during the period of observation. People who were diagnosed with dementia reported slightly more pain as early as 16 years before their diagnosis, driven mostly by differences in pain interference. These participants reported steadily increasing pain levels relative to those who were never diagnosed with dementia. At the time of diagnosis, people with dementia reported significantly more pain than people without dementia.

The researchers note that, because the brain changes associated with dementia start decades before diagnosis, it is unlikely that pain causes or increases the risk of dementia. Instead, they suggest that chronic pain might be an early symptom of dementia or simply correlated with dementia. Future studies that include data on the cause, type, location, and characteristics of pain and the type and seriousness of a patient’s dementia could help define in more detail the link between dementia and pain.

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Exercise may help slow memory loss for people living with Alzheimer’s dementia – Study

Since my family has Alzheimer’s or dementia on both sides, this was one of those studies that resonated with me. Eat less; move more; live longer and think better.

Promising new research shows aerobic exercise may help slow memory loss for older adults living with Alzheimer’s dementia.

ASU Edson College of Nursing and Health Innovation Professor Fang Yu led a pilot randomized control trial that included 96 older adults living with mild to moderate Alzheimer’s dementia.

Participants were randomized to either a cycling (stationary bike) or stretching intervention for six months. Using the Alzheimer’s Disease Assessment Scale-Cognition (ADAS-Cog) to assess cognition, the results of the trial were substantial.

The six-month change in ADAS-Cog was 1.0±4.6 (cycling) and 0.1±4.1 (stretching), which were both significantly less than the expected 3.2±6.3-point increase observed naturally with disease progression.

“Our primary finding indicates that a six-month aerobic exercise intervention significantly reduced cognitive decline in comparison to the natural course of changes for Alzheimer’s dementia. However, we didn’t find a superior effect of aerobic exercise to stretching, which is likely due to the pilot nature of our trial. We don’t have the statistical power to detect between-group differences, there was substantial social interaction effect in the stretching group, and many stretching participants did aerobic exercise on their own.” Yu said.

The findings are described in a recently published article, Cognitive Effects of Aerobic Exercise in Alzheimer’s Disease: A Pilot Randomized Controlled Trial, in the Journal of Alzheimer’s Disease.

Yu says their results are encouraging and support the clinical relevance of promoting aerobic exercise in individuals with Alzheimer’s dementia to maintain cognition.

“Aerobic exercise has a low profile of adverse events in older adults with Alzheimer’s dementia as demonstrated by our trial,” said Yu. “Regardless of its effect on cognition, the current collective evidence on its benefits supports the use of aerobic exercise as an additional therapy for Alzheimer’s disease.”

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People with dementia at higher risk for COVID-19 – Study

Patients with dementia were at a significantly increased risk for COVID-19 — and the risk was higher still for African Americans with dementia, according to a study led by Case Western Reserve University researchers.

Reviewing electronic health records of 61.9 million adults in the United States, researchers found the risk of contracting COVID-19 was twice as high for patients with dementia than for those without it — while among those with dementia, African Americans had close to three times the risk of being infected with COVID-19 as Caucasians did.

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In addition, patients with dementia who contracted COVID-19 had significantly worse outcomes in terms of hospitalizations and deaths than those who had COVID-19 but not dementia.

The study was published Feb. 9 by the peer-reviewed Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association and highlights the need to protect people with dementia — particularly African Americans — as part of the strategy to control the pandemic.

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Apathy could predict onset of dementia years before other symptoms

Apathy – a lack of interest or motivation – could predict the onset of some forms of dementia many years before symptoms start, offering a ‘window of opportunity’ to treat the disease at an early stage, according to new research from a team of scientists led by Professor James Rowe at the University of Cambridge.

Frontotemporal dementia is a significant cause of dementia among younger people. It is often diagnosed between the ages of 45 and 65. It changes behavior, language and personality, leading to impulsivity, socially inappropriate behavior, and repetitive or compulsive behaviors.

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A common feature of frontotemporal dementia is apathy, with a loss of motivation, initiative and interest in things. It is not depression, or laziness, but it can be mistaken for them. Brain-scanning studies have shown that in people with frontotemporal dementia it is caused by shrinkage in special parts at the front of the brain – and the more severe the shrinkage, the worse the apathy. But, apathy can begin decades before other symptoms, and be a sign of problems to come.

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Neighborhood Noise May Increase Dementia Risk

Alzheimer’s disease and other forms of dementia affect millions of older adults in the US—but not equally. Past research has identified risk factors including genes, education, racism, and air pollution, and a growing number of studies now point to noise as another influence on risk of dementia.

Now, a new study co-led by a School of Public Health researcher finds that 10 decibels more daytime neighborhood noise is associated with 36 percent higher odds of mild cognitive impairment and 30 percent higher odds of Alzheimer’s disease.

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Published in Alzheimer’s & Dementia, the journal of the Alzheimer’s Association, the study is the first of its kind in the US.

“We remain in early stages in researching noise and dementia, but the signals so far, including those from our study, suggest we should pay more attention to the possibility that noise affects cognitive risk as we age,” says study first author Jennifer Weuve, associate professor of epidemiology.

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Healthy Lifestyle Habits May Lower the Risk for Developing Dementia

Can your eating habits and physical and mental activity lower your risk for developing dementia as you age? Obviously, it is important to learn all we can about how health habits affect the risks for developing dementia, a debilitating decline in memory and other mental abilities. Experts expect the number of people with dementia worldwide to rise to 82 million by 2030 and to over 152 million by 2050.

A team of researchers designed a study to learn more about whether adopting healthier lifestyle habits can help prevent or slow the onset of dementia. It was published in the Journal of the American Geriatrics Society.

The researchers suggest that prevention strategies should focus on lowering dementia risk for people who are starting to experience cognitive decline, specifically subjective cognitive decline (SCD) and mild cognitive impairment (MCI).

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Is definition of Alzheimer’s disease changing? – Mayo Clinic

The National Institute on Aging and the Alzheimer’s Association are suggesting changes to the research definition of Alzheimer’s disease. There are new criteria to define what Alzheimer’s disease is and who has it — but only as it relates to clinical trials and research, and not the diagnosis in your doctor’s office, according to Jonathan Graff-Radford, M.D. of the Mayo Clinic.

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Previously, Alzheimer’s disease dementia was characterized by symptoms such as memory loss and changes in thinking and cognition. And that’s still the case when your doctor diagnoses Alzheimer’s disease dementia.

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Older people with early, asymptomatic Alzheimer’s at risk of falls

Falls are the leading cause of fatal injuries in older adults, causing more than 800,000 hospitalizations and about 30,000 deaths in the U.S. every year. Some risk factors are well-known — advanced age, problems with vision or balance, muscle weakness — but an under-recognized factor is early Alzheimer’s disease. Older people in the earliest stages of Alzheimer’s, before cognitive problems arise, are more likely to suffer a fall than people who are not on track to develop dementia.

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Researchers at Washington University School of Medicine in St. Louis have found that, in older people without cognitive problems who experience a fall, the process of neuro-degeneration that leads to Alzheimer’s dementia already may have begun. The findings, available online in the Journal of Alzheimer’s Disease, suggest that older people who have experienced falls should be screened for Alzheimer’s and that new strategies may be needed to reduce the risk of falling for people in the disease’s early stages.

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