Exposure to Agent Orange during the Vietnam War doesn’t seem to increase the risk of dementia on its own, but it may exacerbate the effects of other risk factors like PTSD…
In an analysis of Veterans Affairs data, having been exposed to Agent Orange and having PTSD together was associated with a significantly increased risk of dementia according to Deborah Barnes, PhD, MPH, of the University of California San Francisco and the San Francisco VA Medical Center.
They reported their findings at the Alzheimer’s Association International Conference…
Some 8% of veterans were exposed to Agent Orange during the Vietnam War, where it was used as an herbicide to clear dense areas of forest…
Many other studies have looked at the health effects of Agent Orange exposure, and there have been mixed results regarding its neurological effects. Some studies found no adverse neurologic effects, while several recent studies have found worse cognitive function with greater exposure. Other studies have shown that verbal memory is the most affected neurocognitive region among Vietnam veterans.
Yet there haven’t been any studies specifically looking at the relationship between Agent Orange and the risk of dementia among these veterans, Barnes said.
Consequently, she and colleagues accessed VA electronic medical record data on 46,737 Vietnam veterans over age 55 who had at least one baseline visit and one follow-up visit, and who did not have dementia at baseline.
They looked at Agent Orange exposure alone and in combination with PTSD…
Barnes noted that there was a significant difference between the exposed and unexposed populations at baseline. Veterans exposed to Agent Orange were younger and had more comorbidities including diabetes, hypertension, cerebrovascular disease, depression, and PTSD…
When they looked at PTSD and dementia risk, however, they did find a significant association — and having both Agent Orange exposure and PTSD together was associated with a larger increase in risk of dementia…
“Agent Orange alone doesn’t appear to increase the risk of dementia,” Barnes said, “but it may exacerbate the effects of other risk factors such as PTSD.”
She cautioned that the findings were limited because the researchers weren’t able to measure the actual exposure to Agent Orange; they had to rely on patients’ own reports of exposure…
Soldiers on the line ain’t about to forget exposure to Agent Orange. Until they get Alzheimer’s, anyway.
And, no, that wasn’t meant to be a joke.
A recent study suggests that self-reported memory complaints might predict clinical memory impairment later in life. Erin Abner, an assistant professor at the University of Kentucky’s Sanders-Brown Center on Aging, asked 3,701 men aged 60 and higher a simple question: “Have you noticed any change in your memory since you last came in?”
That question led to some interesting results. “It seems that subjective memory complaint can be predictive of clinical memory impairment,” Abner said. “Other epidemiologists have seen similar results, which is encouraging, since it means we might really be on to something.”
The results are meaningful because it might help identify people who are at risk of developing Alzheimer’s Disease sooner. “If the memory and thinking lapses people notice themselves could be early markers of risk for Alzheimer’s disease, we might eventually be able to intervene earlier in the aging process to postpone and/or reduce the effects of cognitive memory impairment.”
Abner, who is also a member of the faculty in the UK Department of Epidemiology, took pains to emphasize that her work shouldn’t necessarily worry everyone who’s ever forgotten where they left their keys.
“I don’t want to alarm people,” she said. “It’s important to distinguish between normal memory lapses and significant memory problems, which usually change over time and affect multiple aspects of daily life.”
If my wife saw this article – and saw me posting it here at my personal blog – she’d give me a smack. She knows I’m a world-class hypochondriac. And here I am encouraging the rest of you.
A new study has found that dementia rates among people 65 and older in England and Wales have plummeted by 25 percent over the past two decades, to 6.2 percent from 8.3 percent, a trend that researchers say is probably occurring across developed countries and that could have major social and economic implications for families and societies.
Another recent study, conducted in Denmark, found that people in their 90s who were given a standard test of mental ability in 2010 scored substantially better than people who had reached their 90s a decade earlier. Nearly one-quarter of those assessed in 2010 scored at the highest level, a rate twice that of those tested in 1998. The percentage of subjects severely impaired fell to 17 percent from 22 percent.
The British study…and the Danish one, which was released last week…soften alarms sounded by advocacy groups and some public health officials who have forecast a rapid rise in the number of people with dementia, as well as in the costs of caring for them. The projections assumed the odds of getting dementia would be unchanged.
Yet experts on aging said the studies also confirmed something they had suspected but had had difficulty proving: that dementia rates would fall and mental acuity improve as the population grew healthier and better educated. The incidence of dementia is lower among those better educated, as well as among those who control their blood pressure and cholesterol, possibly because some dementia is caused by ministrokes and other vascular damage. So as populations controlled cardiovascular risk factors better and had more years of schooling, it made sense that the risk of dementia might decrease…
The new studies offer hope amid a cascade of bad news about Alzheimer’s disease and dementia…Dr. Marcel Olde Rikkert…who wrote an editorial to accompany the Danish study, said estimates of the risk of dementia in older people “urgently need a reset…”
Dr. Anderson, of the National Institute on Aging, said the news was good.
“With these two studies, we are beginning to see that more and more of us will have a chance to reach old age cognitively intact, postponing dementia or avoiding it altogether,” he said. “That is a happy prospect.”
RTFA for advocacy groups primarily American that whine about needing more study. Of course, more study is needed. No one involved with either of the groups in the UK or Denmark says otherwise. Good science always requires the broadest possible investigation.
Still, good news is worth reflecting upon.
Credit: ©James Steidl/Fotolia
In a perspective piece appearing…in the journal Science, researchers at University of Rochester Medical Center (URMC) point to a newly discovered system by which the brain removes waste as a potentially powerful new tool to treat neurological disorders like Alzheimer’s disease. In fact, scientists believe that some of these conditions may arise when the system is not doing its job properly.
“Essentially all neurodegenerative diseases are associated with the accumulation of cellular waste products,” said Maiken Nedergaard…author of the article. “Understanding and ultimately discovering how to modulate the brain’s system for removing toxic waste could point to new ways to treat these diseases.”
The body defends the brain like a fortress and rings it with a complex system of gateways that control which molecules can enter and exit. While this “blood-brain barrier” was first described in the late 1800s, scientists are only now just beginning to understand the dynamics of how these mechanisms function. In fact, the complex network of waste removal, which researchers have dubbed the glymphatic system, was only first disclosed by URMC scientists last August in the journal Science Translational Medicine…
One of the reasons why the glymphatic system had long eluded comprehension is that it cannot be detected in samples of brain tissue. The key to discovering and understanding the system was the advent of a new imaging technology called two-photon microscopy which enables scientists to peer deep within the living brain. Using this technology on mice, whose brains are remarkably similar to humans, Nedergaard and her colleagues were able to observe and document what amounts to an extensive, and heretofore unknown, plumbing system responsible for flushing waste from throughout the brain…
While the discovery of the glymphatic system solved a mystery that had long baffled the scientific community, understanding how the brain removes waste – both effectively and what happens when this system breaks down – has significant implications for the treatment of neurological disorders…
“The idea that ‘dirty brain’ diseases like Alzheimer may result from a slowing down of the glymphatic system as we age is a completely new way to think about neurological disorders,” said Nedergaard. “It also presents us with a new set of targets to potentially increase the efficiency of glymphatic clearance and, ultimately, change the course of these conditions.”
Not very often do I read a scientific article – and reflecting upon it – say to myself, “this is worthy of a Nobel Prize. This is one of those rare instances.
Discovery of the glymphatic system in the human brain opens up possibilities for detecting, repairing and preventing neurodegenerative diseases that plague a population that continues to expand our age range. Delightful work. Important, praiseworthy.
Older individuals with mild cognitive impairment (MCI) who drink up to three cups of coffee a day may help ward off progression to full-blown Alzheimer’s disease by up to two to four years compared to those who consume less caffeine, according to a new study published in the Journal of Alzheimer’s Disease.
Researchers from the University of South Florida and the University of Miami collaborated on the study to investigate how caffeine/coffee intake is associated with a reduced risk of dementia or delayed onset. The study involved 124 people, ages 65 to 88, in Tampa and Miami who had mild cognitive impairment. About 15% of people with MCI develop full-blown Alzheimer’s disease each year.
Blood caffeine levels at the study’s onset were substantially lower (51% lower) in participants diagnosed with MCI who progressed to dementia during the 2- to 4-year follow-up than in those whose mild cognitive impairment remained stable over the same period. No one with MCI who later developed Alzheimer’s had initial blood caffeine levels above a critical level…equivalent to drinking several cups of coffee a few hours before the blood sample was drawn. In contrast, many with stable MCI had blood caffeine levels higher than this critical level.
“We found that 100% of the MCI patients with plasma caffeine levels above the critical level experienced no conversion to Alzheimer’s disease during the 2- to 4-year follow-up period,” said study co-author Dr. Gary Arendash.
Like most of my grayhead peers, another excuse to continue to drink coffee is always welcome. Though no one in my family ever developed Alzheimer’s. Yes, a few were mad as a hatter – but, that’s a different question altogether. :)
His was a love story, Charles D. Snelling wrote — a tale of a shiftless dreamer and the woman who saved him, of the life they built over six decades and the disease that stood no chance of erasing it. By the end, he said, their time together had become a case study in reciprocity.
“She took care of me in every possible way she could for 55 years,” Mr. Snelling wrote of his wife, Adrienne, months before the two were to celebrate their 61st wedding anniversary. “The last six years have been my turn, and certainly I have had the best of the bargain.”
On Thursday, months after contributing a poignant essay to The New York Times about navigating a six-decade marriage upended by his spouse’s Alzheimer’s disease, Mr. Snelling killed his wife and himself, the Snelling family said in a statement released to The Morning Call of Allentown, Pa.. They were found Thursday in their home in Lehigh County in eastern Pennsylvania, the police said. Mr. Snelling shot himself, the coroner said. The ruling on Ms. Snelling’s death was pending. Both were 81.
In the statement, the Snelling family said Mr. Snelling had acted “out of deep devotion and profound love.”
Last December, in response to an Op-Ed column by David Brooks, Mr. Snelling contributed a 5,000-word “Life Report” essay to Nytimes.com, devoting the final section to his wife’s disease and his role in managing it.
“It’s not noble, it’s not sacrificial and it’s not painful,” he wrote of his caretaking duties. “It’s just right in the scheme of things…
Read the article for the story of their love, their lives together.
They grew in love, they died in love. In a nation that truly doesn’t believe in love. We let politicians, pundits and priests order the trappings of our lives with rules that in the end are irrelevant to love. Sufficient to be ignored.
Secel Montgomery Sr. stabbed a woman in the stomach, chest and throat so fiercely that he lost count of the wounds he inflicted. In the nearly 25 years he has been serving a life sentence, he has gotten into fights, threatened a prison official and been caught with marijuana.
Despite that, he has recently been entrusted with an extraordinary responsibility. He and other convicted killers at the California Men’s Colony help care for prisoners with Alzheimer’s disease and other types of dementia, assisting ailing inmates with the most intimate tasks: showering, shaving, applying deodorant, even changing adult diapers.
Their growing roster of patients includes Joaquin Cruz, a convicted killer who is now so addled that he thinks he sees his brother in the water of a toilet, and Walter Gregory, whose short-term memory is ebbing even as he vividly recalls his crime: stabbing and mutilating his girlfriend with a switchblade…
Dementia in prison is an underreported but fast-growing phenomenon, one that many prisons are desperately unprepared to handle. It is an unforeseen consequence of get-tough-on-crime policies — long sentences that have created a large population of aging prisoners. About 10 percent of the 1.6 million inmates in America’s prisons are serving life sentences; another 11 percent are serving over 20 years.
And more older people are being sent to prison. In 2010, 9,560 people 55 and older were sentenced, more than twice as many as in 1995. In that same period, inmates 55 and older almost quadrupled, to nearly 125,000, a Human Rights Watch report found.
While no one has counted cognitively impaired inmates, experts say that prisoners appear more prone to dementia than the general population because they often have more risk factors: limited education, hypertension, diabetes, smoking, depression, substance abuse, even head injuries from fights and other violence…
Scientists say they “serendipitously” discovered that a drug used to treat a type of cancer quickly reversed Alzheimer’s disease in mice.
“It’s really exciting,” said Maria Carrillo, senior director for medical and scientific relations for the Alzheimer’s Association. “They saw very positive and robust behavior effects in the mice.”
In the study, researchers at Case Western Reserve University School of Medicine gave mice mega-doses of bexarotene, a drug used to treat a type of skin cancer called cutaneous T-cell lymphoma. Within 72 hours, the mice showed dramatic improvements in memory and more than 50% of amyloid plaque — a hallmark of Alzheimer’s disease — had been removed from the brain.
Gary Landreth, the lead researcher at Case Western, cautioned that even though his results were impressive in mice, it may turn out not to work in people. “I want to say as loudly and clearly as possible that this was a study in mice, not in humans,” he said. “We’ve fixed Alzheimer’s in mice lots of times, so we need to move forward expeditiously but cautiously.”
Mice — and humans — with Alzheimer’s have high levels of a substance called amyloid beta in their brain. Pathology tests on the mice showed bexarotene lowered the levels of amyloid beta and raised the levels of apolipoprotein E, which helps keep amyloid beta levels low.
Landreth said he hopes to try the drug out in healthy humans within two months, to see if it has the same effect.
Those participating in the trial would be given the standard dose that cancer patients are usually given.
I get to note this sort of occurrence more often than you’d think. One of the benefits of consistent, detailed scientific methodology in research is that tests sometimes appear with beneficial side effects. Part of the overwhelming conservatism of proper science. You note everything. You don’t throw anything away.
It’s only the nutballs and their magic saviors and solutions who pop up into the news stream with a magic cure they cooked up in the garage and tested on a neighborhood cat – if at all.
It’s hard for physicians to determine with much precision how long anyone with a terminal disease can expect to live, but it’s particularly challenging when the disease is advanced dementia.
“People with dementia get sicker inch by inch,” said Lin Simon, director of quality at Gilchrist Hospice in Baltimore, the largest hospice organization in Maryland. “Trying to say, ‘Now, she’s ready for hospice’ is much harder.”
Yet doctors serve as the gateway to hospice, which provides palliative care for the dying and support for their families. Medicare regulations require a physician to certify that a patient entering hospice is likely to die of his or her disease within six months. Doctors are more likely to do so when the disease is cancer or heart failure, which have more predictable trajectories.
That’s the major reason that dementia patients — who can benefit from the better pain control, fewer hospitalizations (so often associated with aggressive treatments that confer no measurable benefit) and greater family satisfaction that hospice has been shown to provide — are under-enrolled in hospice programs…
A 2004 study in The Journal of General Internal Medicine estimated that fewer than one in 10 people dying of dementia receives hospice services. A study of Michigan patients with advanced dementia, conducted about a decade ago, found that just 5.7 percent of nursing home residents and 10.7 percent of those receiving home care died with hospice care.
Nationally, by way of comparison, more than 40 percent of Americans who die each year are in hospice care.
When people with advanced dementia do get a hospice referral, “they’re enrolled quite late, within a few weeks or even days of death,” said Dr. Susan Mitchell, a senior scientist at the Hebrew Senior Life Institute for Aging Research in Boston.
Less bureaucratic fiddling with paperwork instead of solutions – might mean less suffering, as well. Less regulation designed by beancounters instead of physicians might help, too.
It may soon be possible to obtain a highly accurate diagnosis of Alzheimer’s disease by analyzing a sample of spinal fluid. A study released Monday found that a constellation of three substances in the cerebrospinal fluid was present in 90% of people who had been diagnosed with Alzheimer’s.
The test also showed the same markers were found in 72% of people with mild cognitive impairment, considered an early stage of the disease, and in one-third of adults who had no cognitive problems.
Many experts believe that biomarkers in spinal fluid may emerge as the most accurate diagnosis of Alzheimer’s disease. At present, the disease is diagnosed using pencil-and-paper cognitive tests, which are subjective and may be inaccurate. The diagnosis can only be confirmed by examining brain tissue at an autopsy…
In an editorial accompanying the paper, two U.S. experts in the disease said that cerebrospinal fluid analysis should be put into wider practice. “There is now ample evidence that these measurements have value; physicians need to formulate when and how to incorporate cerebrospinal fluid measurements into practice,” they wrote.
Hopefully, the indicators will provide a pathway to a cure – at least symptomatic relief.