Spring Arbor Living Blog

For the first time in almost 30 years there is a new definition for what it means to have Alzheiimer’s Disease. New guidelines were issued to diagnose the disease. It is the only leading disease that has no cure and no treatment. These new Guidelines will hopefully allow doctors to intervene faster and earlier.

for the first time, using the new guidelines, Doctors can diagnose MCI which is forgetfulness beyond natural aging. Without intervention, 80% of these patients will develop Alzheimer's disease within seven years. These people are candidates for clinical trials. Being diagnosed earlier, means intervention earlier as well as preparedness for memory care. Early detection and intervention also helps those family members that would eventually end up as care givers.
 
What is forgetfulness beyond normal aging? If you are concerned, or those around  you are concerned, consult your physician. Watch the below video for more information on the new guidelines for diagnosing Alzheimer's Disease.

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With the passage of time, most of us will notice changes in our memory or thinking. Forgetfulness is a normal part of getting older, but dementia  and Alzheimer's disease is not.

Yet, with good reason, we all worry.

Today, one in ten people 65 and older has Alzheimer's disease - about 5 million people. Yet only half of these people have actually been diagnosed with the disease. The rest don't even know they have it! And it's estimated that by 2050 as many as 16 million people will have Alzheimer's.

We read these statistics and wonder if and when it will it happen to me or someone in my family?"

If you're concerned because you've experienced recurring "senior moments". . . if you have any history of Alzheimer's or related memory disorders in your family. . . if a loved one has been showing signs of memory loss that concern you. . . if you are caring for someone recently diagnosed with Alzheimer's and are wondering about a new drug or therapy. . . it is critically important to learn everything you can about the disease so you can make informed decisions about getting the correct Alzheimer’s care, diagnosis and treatment. Partner with your doctor effectively, ask the right questions, and understand the answers.

For most people, Alzheimer's progresses very slowly. Deterioration of thinking, memory, and judgment are gradual. So you have time to learn about Alzheimer's, to make the best treatment choices, and to plan for the future.

Where Does Normal Forgetfulness End and Mild Cognitive Impairment Begin?

Some experts think that mild cognitive impairment (MCI) is the earliest manifestation of Alzheimer's. There is no definitive test for diagnosing Alzheimer’s - but clinical information from the patient's history and mental status exams are accurate about 90% of the time.

After screening for Alzheimer's, then what? Currently, there are 4 "symptomatic therapies" for Alzheimer's disease - drugs that can improve symptoms better than a placebo, but cannot cure patients or reverse the disease. Researchers estimate that only about 15% of Alzheimer’s patients actually take these medications.

Information from Johns Hopkins

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Memory problems are typically one of the first warning signs of cognitive loss, possibly due to the development of Alzheimer’s disease. Some people with memory problems have a condition called amnestic mild cognitive impairment (MCI). People with this condition have more memory problems than normal for people their age, but their symptoms are not as severe as those seen in people with Alzheimer’s disease. Other recent studies have found links between some movement difficulties and MCI.

Researchers also have seen links between MCI and some problems with the sense of smell. The ability of people with MCI to perform normal daily activities is not significantly impaired. However, more older people with MCI, compared with those without MCI, go on to develop Alzheimer’s.

A decline in other areas of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimer’s disease. Scientists are looking to see whether brain imaging and biomarker studies of people with MCI and those with a family history of Alzheimer’s, can detect early changes in the brain like those seen in Alzheimer’s.

Initial studies indicate that early detection using biomarkers and imaging may be possible, but findings will need to be confirmed by other studies before these techniques can be used to help with diagnosis in everyday medical practice.

These and other studies offer hope that someday we may have tools that could help detect Alzheimer’s early, track the course of the disease, and monitor response to treatments.

Excerpt – National Institute on Aging

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A unique treatment that uses insulin in the form of a nasal spray shows promise for boosting memory in men and women with Alzheimer's disease, according to a study released Sept. 12 in Neurology.

In a four-month study, participants with either mild or moderate Alzheimer's disease or mild cognitive impairment who received a low dose of insulin fared better on memory tests than those who received a placebo. Experts say that these encouraging results should lead to a larger clinical trial to confirm effectiveness of the treatment.

Insulin and Alzheimer's
Researchers selected 104 men and women for the study. All had mild to moderate Alzheimer's or mild cognitive impairment, a condition that increases the risk of developing Alzheimer's, especially when memory is affected.

The study found that men and women who used the insulin nasal spray tended to score better on memory tests than those who used the placebo. The group receiving insulin preserved their level of daily functioning, according to reports from their caregivers.
 
The brain needs insulin
Over the past 10 years scientists have come to learn that insulin plays an important role in the brain. It helps the brain form memories, allows brain cells to communicate with one another and manages levels of brain chemicals.

All cells, including brain cells, use glucose for energy. The hormone insulin makes it possible for glucose, aka blood sugar, to enter cells, enabling them to work properly. With age, however, many people develop a problem called insulin resistance, a condition in which the body and the brain do not use insulin effectively.

If glucose cannot enter brain cells, the cells won't carry out their tasks related to memory and thinking. "This sets the stage for problems in brain function that may develop into conditions like Alzheimer's disease," says Craft, lead author of the study. She and her colleagues set out to determine whether providing insulin directly to the brain could improve the cell's ability to use insulin.

Original article AARP

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The eyes are a window into the brain for many disorders, and Alzheimer's disease may be no exception.

In a pilot study, retinal scans to measure blood vessel thickness at the back of the eye showed strong correlations with the level of beta-amyloid deposits in the brain.

At a press briefing in advance of his formal presentation at the International Conference on Alzheimer's Disease (ICAD), Frost said the retinal scans could be a relatively easy and cheap way to screen people for preclinical Alzheimer's disease.

He reported early findings from a study which is tracking some 500 individuals as they age.

Some earlier studies have linked retinal abnormalities to cognitive dysfunction. For example, in a large 2009 study, patients with mild cognitive impairment were reported to be at almost 40% higher risk for age-related macular degeneration after controlling for other risk factors.

In the current study, participants were classified as having normal cognition, mild cognitive impairment (MCI), or Alzheimer's disease according to clinical assessments. A total of 146 were included in the current study: 110 healthy, 13 with MCI, and 13 with Alzheimer's disease.

The retinal scans measured central retinal arterial and venous diameters, with the arterio-venular ratio (AVR) as the primary indicator of possible Alzheimer's pathology.

Study participants also underwent PET scans.

Frost reported correlations between the retinal and PET scan data for 46 of the healthy controls, nine MCI patients, and three with Alzheimer's disease.

Preliminary findings from the study indicated that AVR values correlated significantly with amount of plaque build-up.

Perhaps the most important finding was that, in the cognitively normal individuals, the AVR values differed according to plaque build-up.

These values were significantly higher in the 15 individuals with large burdens relative to the 31 with low plaque levels.

Frost said the correlations were driven primarily by differences in retinal venous thickness.

William Klunk, of the University of Pittsburgh, who moderated the press briefing, said a test like this would probably be most useful as a preliminary screen.

Right now, the most accurate tests for detecting early or preclinical Alzheimer's disease require cerebrospinal fluid samples and PET scans. But these may be too expensive and invasive for broad screening of individuals with nonspecific symptoms or who only have risk factors for the disease.

"This test [the retinal scan] is on the end of easier to accomplish, completely noninvasive, and relatively inexpensive," he said.

However, "it's not going to have a perfect correlation to pathology in the brain," he added, although it could be very useful for identifying individuals who would possibly need more elaborate testing.

Original article on Medpagetoday.com

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One day your doctor might give you this prescription to prevent Alzheimer’s: Eat less red meat and sugar; eat more fruits, vegetables, fish and olive oil.

At least that seems to be the finding of a new study that found that eating a diet low in saturated fat and sugary treats can improve your memory and may reduce your risk of developing dementia.

Researchers with the University of Washington and Veterans Affairs Puget Sound medical center decided to see if a change in diet could affect the risk for Alzheimer’s or benefit those already suffering some mild but early symptoms of the disease.

What they found was that a diet rich in fruits, vegetables, grains, fish and olive oil can improve some memory skills in both healthy older adults, as well as those already experiencing cognitive difficulty.

More importantly, eating this kind of diet can help healthy adults reduce their risk of developing dementia, says study researcher Suzanne Craft with the Memory Wellness Program at the VA.

Researchers found that after four weeks on the low-fat diet, subjects had fewer toxic proteins and evidence of inflammation in their spinal fluid, both considered to be bio-markers for Alzheimer’s, Craft said.

“I like to think of this kind of diet as promoting healthy brain aging, as well as reducing the risk of Alzheimer’s,” she said.

The Washington state researchers wrote that they decided to take a “whole-diet” approach, rather than focus on a single dietary component, such as omega-3 fish oil. They also chose to test the subjects’ spinal fluid for bio-markers because of the importance of the central nervous system to brain health.

The 49 subjects, all older than 60, included 20 healthy adults with no signs of memory decline, and 29 who were at high-risk for Alzheimer’s, having already been diagnosed with some cognitive impairment.

They were randomly selected to either follow a four-week low-saturated fat, high-fiber plan similar to a Mediterranean diet, or a four-week high-saturated fat diet that included foods like red meat, butter, french fries and soda.

Both groups ate the same amount of protein and the diets were balanced so subjects did not lose or gain or weight.

However, for those who want to protect their brain health, it seems pretty clear from these preliminary results that eating a healthy diet is a powerful first step.

Original article on AARP

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An older person who cares for a spouse with dementia is also at an increased risk of developing problems with attention and memory, according to a new review of studies.

This is because the spousal caregiver likely shared lifestyle risk factors with the person with dementia, and undergoes ongoing stress from caring for the person.

Researchers from the University Of Washington School Of Medicine reviewed more than 100 studies that examined the cognitive health of older adults who cared for a family member with dementia, with the majority of the subjects being spouses. They found that these caregivers have more trouble with attention and memory, also known as cognition, than people who don't have to care for a family member with dementia.

The review of the studies showed that those caregivers had a higher risk of cognitive decline or dementia than people who do not have to care for someone with dementia. This could be due to a number of factors, including depression, loneliness, sleep problems, social isolation, exercise, diet and even obesity.

People who are caring for a spouse with dementia may themselves be at risk for cognitive problems which, in turn, will not only negatively influence their quality of life, but may reduce their ability to provide the necessary care for their spouse.

Most care-recipients prefer to be cared for in their homes, and, by remaining in their homes, health care costs are reduced greatly, therefore, often spouses of end up providing care.

The study was published in the Journal of the American Geriatrics Society.

People with dementia are not the only ones who have health problems – a spouse who cares for them are also at risk for attention and memory problems.

Original article on MSN.com

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Brain scans may help identify which individuals with a mild decline in their mental abilities will go on to develop Alzheimer's disease, according to a new study.
 
The research focused on patients with mild cognitive impairment, a condition in which people experience noticeable declines in their cognitive function, including memory and language problems. These changes are not severe enough to interfere with everyday activities, according to the Alzheimer's Association.
It is known that about 15 to 20 percent of such patients will go on to develop Alzheimer's, but researchers don't know which ones.

In the new study, which involved magnetic resonance imaging (MRI), researchers were able to identify a high-risk group – patients who had a 69 percent chance of developing Alzheimer's disease in the next year.

The study used the MRI scans to identify brain characteristics that put people at risk for Alzheimer's. The researchers determined some patients had just a 3 percent risk of developing Alzheimer's in the next year, which is about the same as for a healthy older person. Others had a 40 percent risk of developing the condition in the next year, or double the risk associated with a diagnosis of mild cognitive impairment, and still others were identified as part of the high-risk group, said study researcher Linda K. McEvoy, an assistant professor in the department of radiology at the University of California, San Diego School of Medicine.

A similar technique could be used one day by doctors to determine the Alzheimer's risk for patients with mild cognitive impairment. However, the patients in the study were not representative of the general population — they had been selected to exclude people who experienced other types of memory problems, such as those due to a stroke. A larger study would be needed before the results could be translated to the doctor's office.

Alzheimer's disease risk
The study looked at MRI scans of the brains of 203 healthy adults, 164 patients with Alzheimer's disease and 317 patients with mild cognitive impairment. Each patient had their brain scanned at the start of the study and again a year later.

The researchers first compared the brains of Alzheimer's disease patients with those of healthy people, looking for differences in the degree of  shrinkage, or atrophy, in particular areas of the brain. Once they developed a way to distinguish these two groups of people, "we could use the same equations on the mild cognitive impairment (MCI) subjects to determine their risk of developing Alzheimer's disease," McEvoy said.
 
When the researchers included information about how the brains had changed in the time between the two scans, they were able to identify the high-risk group.

Future applications
Information in this study will be critical once we have ways to prevent Alzheimer's disease, McEvoy said. "Currently there's no cure or prevention for Alzheimer's disease. But there's a lot of research going on right now into different potential therapies. If any of those therapies turn out to be useful, then this kind of information will be crucial — a doctor needs to know who's at higher risk in order to treat them".

 Original article by Rachael Rettner- MyHealthNewsDaily

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