Now the challenge was to determine the level of her dementia, how it was affecting her lifestyle, and whether or not there might be some hope in a new medication that had just been released for clinical trials. Part of the protocol required that she read something, and other parts that she perform an action, or recall items shown to her, and she would need her glasses for these tests.

When asked to replace her glasses, she looked at them as strange objects and had no idea what to do with them. Turning the glasses over and examining them, she still didn’t understand what they were meant to do.

Her daughter, who accompanied her for the evaluation, was almost in tears as she told me, “It has become even worse when we sit down for dinner because she doesn’t know what is food and what utensils are. She often tries to eat her fork, and we have to stop her.”

The woman was in her early 70s and previously had a successful clothing design business. But there had been noticeable slips in her behavior and even her ability to keep her company’s accounts correct. A math whiz, she kept blaming it on the sunlight coming in through the windows in her office.

She no longer went to the office after daily arguments, and her suspicion regarding her staff disrupted her business. Previously, she enjoyed good interactions with everyone in the office. Most had worked with her for decades and were shocked at her behavior.

The Thief We Fail to Acknowledge

Dementia prevalence increases in direct correlation with age; it reaches 1% in the 60–64 age group and 24–33 % in the 85+ age group. The term “dementia with late onset” refers to the disorder’s emergence after the age of 65, whereas “early-onset dementia” describes its incidence before that age. The signs may be subtle and even experienced clinicians may miss the probable diagnosis of dementia.

Roughly half of the 600 older persons whose brain scans and health indicators were investigated went on to acquire cognitive impairment. In addition to signs of brain aging, they found that the genotype, specific cognitive test scores, hearing loss, memory problems reported by the individual themselves, and symptoms of depression were associated with future cognitive impairment in older persons who were otherwise neurologically healthy.

According to a recent study, people with dementia start losing weight at least ten years before their symptoms appear, and this process speeds up in the two to four years leading up to the diagnosis. Dementia progression may be accelerated by hormonal and metabolic changes associated with weight reduction.

I can remember a neighbor who lived alone, was in her 80s, and went out several times a week to volunteer with, as she said,” the elderly at the local hospital.” No, she never saw herself as elderly or incapable of caring for all of her needs.

But one day, she mentioned to me that she had an evil twin coming into her home and hiding things on her. “I know she’s hiding things,” she said, “because I find them in places I would never have put them.” It was at this point that she stopped preparing food for herself, and I had to arrange for a local senior-support organization to deliver meals to her. But things got worse and she was becoming more mentally unstable until she was evaluated by a healthcare professional from that local hospital.

Once the evaluation was completed and she went to meet a team that worked on a dementia-related unit at the hospital where she had volunteered, she related the story of the evil twin. The decision was made that she could be admitted, and they would care for her.

Within months of arriving on the unit, she was discovered to have advanced cancer, had three surgeries, and died. We will never know if her dementia was related, somehow, to her cancer or the use of pain medication for it.

What Do We Look for?

Some of the subtle and not so subtle changes that should be noted in potential neurocognitive changes:

1. Losing track of newly acquired knowledge. Another symptom is an increase in the frequency with which you need to use memory aides, as well as a tendency to forget crucial dates or events.
2. Difficulty maintaining track of regular expenses or following a tried-and-true recipe.
3. Navigating to a known place, problems with a shopping list, or recalling the rules of a beloved game.
4. Sometimes they need assistance with the microwave’s settings or record a TV program.
5. Perplexed by events that do not unfold in real-time. They could become disoriented and lose track of their way at times.
6. They might also have trouble maintaining balance or reading, seeing colors, or gauging contrast, which could make them dangerous drivers.
7. Difficulty keeping up with or contributing to a discussion. They might repeat themselves or freeze up in the midst of a sentence, leaving you to figure out what to say next. They might not know how to spell certain words, have problems identifying commonplace objects, or even call something the wrong name (such a “watch” being called a “hand-clock”). One thing to remember is that sometimes there are regional names for certain things such as a door knocker may be called something else.
8. Possibly misplace items and not be able to trace their path back to them. As the illness advances, he or she may begin to falsely accuse others of stealing.
9. Perhaps they are careless with their money or do not keep themselves clean. Lack of care for personal cleanliness can also be caused by depression.
10. Do not participate in extracurricular activities, hobbies, or social gatherings. If they have a favorite team or pastime, they could struggle to keep up. And feelings of bewilderment, suspicion, depression, anxiety, or terror may set in. Whether they are at home, with friends, or somewhere else, they could quickly become agitated.

Although there are numerous changes that we may notice, there are a number of other reasons that some of these changes may be due to something else. We know that medication as well as a loss of active involvement in work or some other activity may be the reason for changes in behavior.

Remember, don’t jump to a conclusion that the person is suffering from a cognitive impairment. Go slow, consider everything, and have an evaluation by a healthcare professional.

The post Spotlighting Emerging Dementia in Its Many Iterations and Stages appeared first on Medika Life.

Alzheimer’s disease is mostly marked by dementia that includes memory problems, cognitive problems, executive dysfunction, and changes in attitude and behavior. Most people with this disease also have signs of a mental disorder. Careful attention and medicine can help with these signs for a short time, but there are no specific ways to stop or cure Alzheimer’s disease.

Dementia mostly affects older people, and the rates of occurrence and prevalence rise with age. This is more common in low- and middle-income countries and places. It is putting a lot of stress on families and societies in terms of money and illness. What does this mean for you if you have someone in your family with AD?

Based on studies of twins, AD is thought to be passed down 70% of the time. Clinically diagnosed AD has found more than 70 genomic loci in people with mostly European heritage. The discovery of these new genomic loci must be taken with a grain of salt.

Let’s look at what genetic inheritance can and cannot do and what may affect it. Even if you had a gene for a specific illness, even a serious mental illness, it might never be what we call “expressed” because there are a variety of things that must coalesce to make that happen.

A cell’s gene expression code is similar to a cookbook. Essential for all bodily functions, each gene is a blueprint for the production of a particular protein. The frequency with which your genes are activated or deactivated, or expressed, depends on a number of conditions.

At birth, you have a blueprint for your genes in the form of your DNA. But environmental factors, including your diet, level of physical activity, and smoking status, can affect gene expression. You name it; it can be impacted by factors including the medications you take.

Also, your gene expression might alter with age or specific medical issues. Although your DNA cannot be changed, there are certain things that can be altered, such as your lifestyle and the environment in which you are born. You can use this to keep yourself healthy and control certain medical issues.

Stress is one of the factors that has been indicated to potentially push these genes to become evident in behaviors, but what else could do it? There are too many variables regarding what might cause it to flare up, and the problem becomes knowing you have a gene for something specific and wondering if you will ever experience it in a behavior of some type.

It is possible that more than a third of cases of dementia could be avoided. Getting kids to go to school and exercise more, keeping up with friends and family, smoking less or quitting altogether, and taking care of hearing loss, depression, diabetes, high blood pressure, and obesity could all help avoid or delay dementia. There is also some early information about other risk factors that might be able to be changed.

What Does This Mean?

It is possible that further research based on these results may help diagnose and cure diseases in the future. Those who are concerned about the possibility of AD, or who have been found to have the genes, should consider the following:

1 Stay Informed: Learn about current research and developments in Alzheimer’s disease, the genetic basis of the disease, and how this can be managed through changes in lifestyle.

2. Talk about genetic risks. If your family has a history of Alzheimer’s disease, you should see your doctor about genetic testing to assess your risk.

3. Stick to the basics when it comes to keeping fit and avoiding illness — a healthy diet, regular exercise, keeping the mind active, and the control of chronic diseases such as diabetes and hypertension.

4. Consider participating in research. It is important that more people from different backgrounds become a part of the study to help advance research and develop more personalized treatments.

5. Keep talking to your doctor. Genetic study is interesting, but the best way to handle health issues is to prevent them from happening in the first place through the help of current treatments. If there is anything that you have concerns about or what to do next, you should report it to your healthcare provider.

How Do Interventions Work?

Lifestyle: Engaging in mental exercises on a regular basis, such as solving puzzles, reading, or picking up new skills, can help build cognitive reserve and potentially postpone the start of symptoms.

Sleep: The brain is able to eliminate toxic proteins and consolidate memories when you maintain a quality sleep routine of seven to eight hours per night.

Stress management: Reduced cortisol levels, which can eventually harm brain cells, are one benefit of stress management practices like mindfulness and meditation.

Smoking and alcohol: Promoting brain health through avoiding smoking and limiting alcohol use helps to maintain adequate blood flow and reduce inflammation. Smoking acts as a stress-reduction technique because nicotine is a natural substance reducing anxiety, but the downside is cancer.

Aerobic exercise promotes neuronal and synaptic growth by increasing blood flow to the brain, which carries oxygen and nutrients. By keeping insulin sensitivity high, resistance exercise protects against cognitive loss caused by diabetes and promotes overall brain health. Physical exercise improves clearance processes, which may lower beta-amyloid plaques, a characteristic of Alzheimer’s disease. Regular moderate exercise, even for just 150 minutes a week, improves cardiovascular health, decreases inflammation, and drastically reduces the risk of Alzheimer’s disease.

Socialization: The brain’s neural connections and plasticity are both supported by the cognitive stimulation that occurs during regular social contact, which is a key component of socialization. Potentially as a result of less stress and a stronger feeling of purpose, those with strong social networks have slower rates of cognitive deterioration. One of the most effective ways to stave off cognitive loss is to participate in group activities that mix socializing with mental or physical demands. Dementia risk factors include social isolation; in fact, research suggests that those who are lonely may have twice the chance of getting Alzheimer’s as those who have strong social connections.

Diet: The anti-inflammatory features of the Mediterranean and MIND diets have been associated with a substantially reduced risk of Alzheimer’s disease. These diets are rich in leafy greens, berries, nuts, fish, and olive oil. Free radicals damage brain cells and contribute to cognitive loss; foods rich in antioxidants can neutralize these radicals.

Overall, despite any genetic inheritance, we may have more power over our cognition than we have been led to believe in the past. Regularly attending to the above points can improve our mental and physical health, as shown by research, and lead to positive outcomes.

The post Alzheimer’s New Gene Discovery May Prove Decisive in Early Diagnosis or Not. What CAN You Do? appeared first on Medika Life.

Now, I have one more reason to dodge high blood pressure.

A new study recently published online in Neurology discovered this:

People ages 60 and above with untreated high blood pressure may be at greater risk of Alzheimer’s disease.

I’ll review this article before giving you some tips to reduce dementia risk.

Alzheimer’s Disease

It’s common.

Alzheimer’s disease (AD) affects nearly 7 million people in the U.S. alone, according to the Alzheimer’s Association.

AD is the most common dementia type, comprising up to 80 percent of cases.

While the greatest risk factor is increasing age, it’s important to remember that Alzheimer’s disease is not a normal part of aging.

This means that there are steps we can take to reduce our risk.

AD is known as younger-onset Alzheimer’s if it affects an individual under 65.

I hope never to experience dementia symptoms, including memory and cognition, that are sufficiently bad enough to interfere with my daily life.

Hypertension and Dementia

A new study examined how untreated high blood pressure (hypertension) affects an individual’s risk of suffering from Alzheimer’s disease.

The study examined how untreated high blood pressure affects people’s risk of this very common disease.

For this meta-analysis (that had individual patient data), researchers analyzed data from 14 nations.

Researchers analyzed data from over 31,000 individuals. The study participants had an average age of 72.

During an average follow-up of four years, just over 1,400 developed Alzheimer’s disease.

Study Results

After adjusting for factors such as blood pressure readings, a diagnosis of hypertension, and high blood pressure medication use, researchers discovered the following:

• Nine percent were not treating their high blood pressure
• 51 percent were using blood pressure medicines
• 36 percent did not have high blood pressure
• 4 percent were unsure of their blood pressure status

After adjusting for factors that might influence findings, the study authors report this:

Untreated high blood pressure was associated with a 1.36 times increased risk of Alzheimer’s disease (compared to those without high blood pressure).

And this:

Those with untreated high blood pressure had a 1.42 times increased risk for Alzheimer’s disease (compared with those treating their high blood pressure with medications).

How Might Hypertension Increase Dementia Risk?

Simply put, a healthy heart means a healthy brain.

When our blood pressure is high, it can cause damage to the blood vessels, including those in the brain.

This damage can result in an inadequate brain blood supply, leading to diminished functioning.

On another note, high blood pressure can increase the risk for another form of dementia, vascular dementia.

In summary, treating high blood pressure (that typically develops as we age) may be vital to reducing your dementia risk.

Tactics to Reduce Your Dementia Risk

Alzheimer’s disease has many potential contributing risks.

Here are the factors that I try to optimize to lower my risk of ever suffering from dementia.

• Heart health. As I stated earlier, heart health is brain health. I focus on my blood pressure, blood sugar (avoiding type 2 diabetes), and cholesterol.
• Healthy diet. I try to adhere to a Mediterranean-style diet. I consume many anti-oxidants, omega-3 fatty acids, and lower saturated fats.
• Physical activity. I get plenty of physical activity, which helps keep my blood pressure low while optimizing my brain health.
• Social engagement. I work to keep strong social ties with others.
• Cognitive stimulation. I look forward to working through my 60s and staying engaged in other stimulating activities (including reading, writing, learning the Japanese language, and playing classical piano music).

Summary

The new study reports that untreated high blood pressure was linked to a higher risk for Alzheimer’s disease.

This finding could significantly impact our daily lives and health decisions.

High blood pressure can damage our blood vessels, leading to diminished blood flow to the brain.

Medicines and lifestyle changes — including eating a balanced diet, getting physical activity, and managing stress — can help those with high blood pressure, not smoking, and avoiding excess alcohol consumption.

The post This Common Condition Could Increase Your Alzheimer’s Risk By 42% appeared first on Medika Life.

Even as researchers are making some progress in their various hypotheses regarding Alzheimer’s, we are still contending with a very troubling one: it might be an infectious viral disease. But there might only be sporadic instances of this form of SDAT (Senile Dementia of the Alzheimer’s Type). If that’s the case, there may need to be multiple treatment modalities for Alzheimer’s and not one drug. Two broad categories of SDAT have been designated: familial and sporadic, with the latter being poorly understood.

Now, more focus is being placed on factors that were previously thought to be unrelated to AD, such as diet, lifestyle choices, and gut microbiome. Studies have shown that these factors all affect the progression of AD, which raises the possibility that these factors could be key to combating the disease.

Recently, there has been speculation that the gut microbiota-brain axis, a bidirectional communication link between the GI tract and the central nervous system (CNS), may have a role in the etiology and pathogenesis of AD. There may be a link between this axis and the disruption of certain metabolisms or clearances by microbes, the increased permeability of the blood-brain barrier, changes in the neuroinflammatory response, and the blocking of vital hippocampal neurogenesis needed for memory maintenance. These changes in this axis may help explain how AD develops.

Think about how certain foods can alter the gut microbiota, which may lead to changes more in line with the onset of Alzheimer’s. The analysis of the fermented food research has shown promising effects on amyloid-β metabolism, inflammation, and cognitive impairment in animals and humans. The pathogenesis of Alzheimer’s disease emphasizes the role of the gut-brain axis, and studies examining the use of fermented foods are showing promising new research routes. But there’s even more research outside the plumbing of foods and lifestyles.

Globally, the prevalence of mild cognitive impairment, which ranges from 7 % to 25 % in adults aged 60 to 84, continues to increase with advancing age.

Depression, an emotional change seen in Alzheimer’s patients, deserves more attention than it has received in the past. I can remember asking researchers why they weren’t going further in studying depression in these patients. The answer? The patients had depression because of the changes it brought to their lives. Little thought was given to depression as a signaling area of potential research. How might depression, in the biological sense, be involved in this disease? Now that area is opening up to study.

Multiple pathophysiological mechanisms have been proposed to explain the bidirectional relationship between depression and AD. Evidence suggests that midlife depression may be an AD risk factor, while a chronic course of depression in late life may be a sign or symptom of dementia.

There are possible explanations for the possible reciprocal relationship between MCI and depressive symptoms. One is the scarring theory, which holds that depressive episodes make people more vulnerable to cognitive deficits that frequently persist long after affective symptoms have decreased. But, even here, there is a more nuanced approach to both depression and AD and it lies in one hormone, known as the “happiness hormone,” serotonin.

In one study, it was discovered that MCI patients had up to 25% lower serotonin transporter levels in brain regions specifically linked to executive function, emotion, and memory than healthy controls. In addition, the MCI patients had higher levels of plaque material.

Foods that contain preservatives may also play a role in the regulation of serotonin, appetite suppression, and cognition. Sodium benzoate and sodium metabisulfite have the potential to increase serotonin production, which would activate calorie restriction, prolong life expectancy, and improve cognitive performance. Unfortunately, highly processed foods that may contain these two preservatives can bring on other health issues.

Are “happiness” and Alzheimer’s related in some way, as are the foods that aid the gut-microbiota-brain axis in regulating mood and, potentially, Alzheimer’s? The jury is out on this one, but important evidence is being accumulated that may bring new hypotheses and treatments early on in the disease or, potentially, halt it in its tracks. Maybe the lowly pickle will pave the way to a new understanding of fermented foods’ involvement.

The post Is Happiness Related to Alzheimer’s and a Specific Hormone? appeared first on Medika Life.

As soon as the video came on, I knew I was witnessing my mother’s final moments. It was too loud for me to tell her anything — that I loved her; that I was grateful for everything she had done for me; that I was proud of all she had accomplished — and I convinced myself that it would be easier to speak if I could take a few minutes to get off the ship and call back from a quieter spot. By the time I was able to ring again, she was gone.

The awful truth is that I said goodbye to my mom a long time ago. She first showed the lasting signs of Alzheimer’s Disease more than a decade ago and her decline was steep but lengthy. Despite continuing to travel to remote areas of Africa and Asia as a volunteer health worker — a path she picked up after joining the Peace Corps in retirement with my dad — she knew something was wrong. Her memory and judgment started to fade rapidly just before the pandemic, and I took whatever opportunities I had to share my feelings with her. COVID-19 isolation took its toll and by the time we could spend time together, she no longer knew who I was.

My experience with Alzheimer’s is one shared by millions of people around the world. Right now, in the U.S. alone, six million people are afflicted with the disease or a related form of dementia. And that number is expected to explode over the next 25 years to 13 million cases with the long tail of aging Baby Boomers. The failure rate for new therapeutics has been remarkably high. The two approved drugs have significant downsides, but that could change as artificial intelligence and modified mRNA treatments demonstrate greater viability.

What else could help?

We must prioritize Alzheimer’s as a public health threat and focus greater resources on reducing many of the root causes that scientists now suspect are linked to increased likelihood of developing the disease.

For years, I was among the many people who believed that Alzheimer’s Disease was largely linked to genetics. If my mother had it, and my grandmother had it, then there was a good chance Alzheimer’s was in my future as well. But this is wrong. Only 1 percent of cases are inherited, and most are related to rare, early-onset forms of the disease.

Increasingly, scientists are finding stronger links with other health threats — hypertension, inactivity, diabetes — that could signal predisposition. Reducing these chronic health issues has been a white whale in public health — it’s notoriously difficult to encourage people to adopt healthier behavior.

The expected boom in Alzheimer’s Disease cases comes with a unique opportunity.

One of the most effective ways to change behavior is by providing people with a single person or patient with whom they can identify. It’s called the identifiable victim effect, and it works like this: humans frequently get overwhelmed by large numbers — the thousands of people who die in a war, or get infected with a virus, or suffer from malnutrition. Stories that include statistics and big numbers lose their punch because the scale overwhelms us. We are numb to the impact as it relates to our own lives.

But when we hear a story about one person who is similar to someone we know, or we experience a health episode ourselves, we are significantly more likely to change our behavior and to advocate to those around us to consider alternatives. This may be a possible opportunity for course correction against Alzheimer’s: As more people experience their loved ones battling the disease or are thrust into the role of caretaker, the awareness of a connection between chronic disease and Alzheimer’s prevention could usher in a dramatic shift in healthier behavior among younger generations.

Such a shift can’t come too soon.

The projected economic burden from Alzheimer’s Disease is already $321 billion and is expected to top a staggering $1 trillion by 2050. Family and volunteer caretakers already spend 18 billion hours of unpaid time helping relatives with Alzheimer’s Disease. As more people like me enter the sandwich generation of caring for young families and aging parents at the same time, it is fair to assume that we will see a decline in productivity and corresponding increases in mental health crises and the kind of stressful behavior that fuels the cycle of health issues later in life. Outside of the companies that stand to profit from the health challenges of an aging population directly, the looming economic burden of Alzheimer’s should be a clear signal that chronic disease prevention is everyone’s business.

Framing Alzheimer’s Disease as a public health imperative linked to chronic disease prevention could be the catalyst we need to encourage younger people to adopt healthier behavior while there’s still enough time.

The post We Have More Control Over Preventing Alzheimer’s Disease Than We Think appeared first on Medika Life.

We will visit Mars in person in the coming decades, a months-long trip one-way. As I look forward to playing Bethesda Game Studio’s Starfield after recently finishing all nine books of Iain M. Banks’s Culture series, I think about the plans that incorporate even further destinations. Being a physician-scientist, it is hard not to think of the challenges that come from long-distance travel! While some health concerns of space travel are already reasonably well known, such as muscle deconditioning or the bombardment from cosmic radiation, several conditions have not yet been considered hazards in space travel. This is mainly because the technologies that would make them a reasonable point of alarm for an astronaut have not been invented yet!

Eventually, there will be a way for everything that a human needs to be synthesized onboard a spaceship. Means of accomplishing this are already being investigated, such as through harnessing microorganisms, like bacteria, towards producing everything a human could need, like oxygen, food, and raw materials. As for putting a human in “stasis” for a long journey, artificial hibernation has been academically engaged as a concept, making applications more feasible for the future (although it will take time to evaluate such a procedure due to ethical and safety concerns).

So, let us say that we can keep some humans alive indefinitely in a space shuttle. What else do we need to think of? As a physician and Alzheimer’s disease researcher, I think you can guess one such thing.

Alzheimer’s disease is the most common form of dementia, typically affecting around 10% of individuals older than 65. One’s risk of Alzheimer’s increases as one gets older, with one in three over age 85 having the disease. Alzheimer’s is believed to be caused by the progressive death of neurons, the cells in your brain that contribute to memory and your ability to function.

If I were to jump on a NASA mission right now, travel time to the nearest star system, Alpha Centauri, is a greater concern (130,000 years!). In 2017, NASA proposed a new technology for space travel called solar sails, which could speed this up (44 years). Despite this design remaining a concept and its construction proposed for over 40 years from now (and likely not going to host an astronaut), what would happen if I boarded this vehicle in my seventies and placed in stasis until I arrived?

With every year of traveling, you could count on the risk of developing Alzheimer’s persisting. Unless hibernation technologies find a way to prevent neuronal cell death or the natural deposition of debris in the brain as we age, it is possible that I could wake up having Alzheimer’s! Imagine that, after traveling further than anyone ever had before? While there are “modifiable” risks for Alzheimer’s that could arguably be addressed to reduce the risk of disease, like reducing the risk of blood vessel disease through a healthy diet and exercise, one can only do so much.

One day, we will have to face the music of how we will keep our astronauts healthy on long trips. As with other health conditions, which I will touch on in future articles (be sure to give this article a clap and subscribe), medical research will have to address possible problems arising across body systems rather than a singular goal of having our own intergalactic visitor survive a long trip because there is a lot more to life than simply living, as many of us could agree.

There is reason to be optimistic! In the Alzheimer’s and Aging research fields that I am part of, energy (including mine) and money are going towards finding out how we can help people live longer and better. While science takes longer to yield results than we would like (even AI took decades to develop before it was ready for consumers as ChatGPT), progress is always happening, and getting human life out among the stars is something that people care about.

Let me know your thoughts on prioritizing traveling among the stars! Do you think we should try going as far as possible or focus more on taking it slow?

The post Alzheimer’s Will Limit Human Space Travel appeared first on Medika Life.

We live in a very exciting time! Alzheimer’s medications that are more promising than past drugs are starting to hit the shelves, with others on the way. Eli Lilly’s new daratumumab medication has been suggested to slow the progression of early Alzheimer’s by up to 35%. So if it took someone five years to progress to more serious Alzheimer’s without medication, this could slow it, so it could instead take seven years, meaning more years being more present with one’s family. Lecanemab (Leqembi), from Eisei and Biogen, was also found to reduce cognitive decline, keeping our parents or ourselves fully present as we traverse life’s journey together!

In this article, I will talk about why these drugs offer society hope yet will also cause a big problem, at least in the short term (i.e., until generics become available when the drugs’ patents expire). As for my background, I earned my M.D. in the United States to soon earn my Ph.D. in Canada, focusing on Genetics. Today, I work as a postdoctoral scientist at Massachusetts General Hospital, studying the genetics of Alzheimer’s disease. In my medical training, I have seen the tragedy that can happen to people’s parents or themselves as they face newly diagnosed dementia and late-stage disease.

To be clear, these medications are a good thing. They could help many of those around us, whether a parent, sibling, or ourselves. Dementia is a horrible disease; until now, not much could be done about it. A family member is diagnosed with the disease in the office and told that they are showing signs of this illness and that very little can be done to help them. Over time, their personality changes, and they slowly become less like themselves daily, aware of what is happening.

This can cause significant distress for those with this illness and their family and friends. We spend years with these people. We are forced to watch, unable to make a difference, as they lose their ability to function and lose who they are. These medications could slow these changes, finally offering some semblance of hope for those with these diseases.

As with any medication, these drugs do not come without risks. One in four people who received Leqembi had a “transfusion reaction,” which in most people means that they may have had redness and swelling in the arm they received the medication. While such reactions can be severe, causing one’s airway to close up in an anaphylactic reaction, these responses are generally uncommon. Some individuals who received Leqembi or Donanemab experienced swelling in their brain, known as cerebral edema. While not necessarily a problem, in that it does not necessarily produce symptoms, one in four people who took Donanemab developed this swelling, one of four of which had symptoms. So if we considered a group of 1000 people who took this drug, using the study’s results, about 60 in 1000 could experience headaches or confusion. Some of these 60 individuals may develop bleeding in their brains. Around two could die from the swelling or bleeding. While concerning, 940 of these hypothetical 1000 people had no side effects. Even if you took this med and experienced side effects, you could be sure that your doctor would do everything they could to keep you safe, including discontinuing the medication that often resolves adverse effects.

So it sounds like my opinion is that these drugs sound promising. Why the doom and gloom article title? This is because these are or will be very expensive drugs. The price for a single person to receive enough Leqembi for a single year is forecasted to be $26,500. While Donanemab does not yet have an official cost, it is predicted to be over $26,000 annually. Think about that amount of money for a moment. The federal poverty line for a family of four, which could include a couple, a child, and a grandparent, is $30,000. More than one in 10 people in the United States are impoverished and struggling to make ends meet. This number is likely even higher, considering you do not have to be impoverished to have financial difficulty. What would happen if a couple’s loving grandmother or grandfather started showing signs of dementia?

While the elderly are entitled to Medicare, would Medicare cover such an expensive drug when it has to care for the entire country’s elderly population? Even if it pays for it, how much of it? After consulting physician colleagues of mine, we think it is unlikely that Medicare as is would pay this much. It would be great if they did, but there are likely not enough Medicare dollars to permit this.

Families could face impossible decisions or immense stress once these medications are more broadly available, and they have hope in front of them, yet this hope is financially inaccessible. While some private insurance may help pay for these cutting-edge treatments, perhaps with Medicare offering a small contribution, insurance is expensive, and we sadly do not all have health plans that enable us to not think about how we are going to make managing our health work, alongside taking care of supporting children, family, and parents.

There is also the concern that these medications may offer more benefit to those of certain ancestral groups, as reported by Reuters. This was not because the study’s designers or the company sought to exclude non-whites. For medical research to be approved, generally, one must communicate how the research will benefit a more diverse group. Describing how people are recruited into appropriately designed clinical trials and why medications may help people of European descent more than those of African descent is its own article, so I will not touch on this here. This is important because non-whites have higher rates of Alzheimer’s and have historically had less access to healthcare resources.

Such a financial predicament is not unique to these upcoming new medications (or healthcare in general in the United States). Research and development of new medications often cost over $2 billion when a new treatment is available for the general public. Companies need to give treatments a price that enables them to make up for what they spent and enable their other projects, which can also provide hope for better health management. While this approach is understandable (companies need to avoid going bankrupt. Even non-profits need to do that), it can still limit our access to treatments that could save or improve our lives.

The only fix that could address these issues is legislation, which the American Medical Association is consistently striving to improve people’s health in the United States, including driving healthcare reform and expanding (versus cutting) Medicare coverage. Your doctors are not just treating you in the office. They are going to Washington, D.C., and suffering the stresses of politics to improve your lives!

In conclusion, we have reasons to be optimistic about these new drugs. We are also facing the same problems that we have in the past, with promising treatments often being beyond the reach of those with less financial resources and those who have historically had limited access to treatments that could mitigate suffering.

The post New Alzheimer’s Drugs Will Worsen Inequality appeared first on Medika Life.

Dementia is a group of cognitive disorders that affect a person’s ability to think, remember, and reason. Exploring potential preventative measures for this condition is important, given that no known cure exists.

One potential risk-reducing measure is diet. Studies have shown that certain dietary patterns, such as the Mediterranean diet, may reduce the risk of developing dementia. Additionally, specific nutrients and foods, like omega-3 fatty acids and leafy greens, have been linked to improved brain health and function.

While more research is needed to understand the relationship between diet and dementia fully, there is promising evidence to suggest that making dietary changes may be a practical step in preventing this condition.

“Tears, idle tears, I know not what they mean,
Tears from the depths of some devine despair
Rise in the heart, and gather to the eyes,
In looking on the happy autumn fields,
And thinking of the days that are no more.”
― Alfred Lord Tennyson

Dementia is common

Dementia is a catch-all term for several diseases that impact thinking, memory, and the ability to perform the activities of daily living. Unfortunately, the illness worsens over time. While dementia often strikes older individuals, it is not inevitable with aging.

Here are some of the things that increase dementia risk, according to the World Health Organization:

• age (more common in those 65 or older)
• high blood pressure
• high blood sugar (diabetes)
• being overweight
• smoking
• consuming too much alcohol
• being sedentary
• being socially isolated
• depression.

Alzheimer’s dementia causes

While for the most part, we do not know the causes of Alzheimer’s disease. Dementia is related to several diseases that, over time, destroy nerve cells in the brain. These changes typically lead to deterioration in cognitive functioning (the ability to process thought) beyond what we typically observe with normal aging.

Dementia does not affect consciousness, but cognitive impairment is commonly associated with mood changes, behavioral issues, or problems with motivation.

Dementia symptoms

As once-healthy nerve cells (neurons) in the brain cease to work or lose connections with other brain cells, dementia symptoms emerge. We all lose neurons with age, but those with dementia have a much greater loss.

Dementia symptoms vary among individuals but often include the following:

• Memory loss, confusion, or poor judgment
• Difficulty understanding, speaking, and expressing thoughts, or reading and writing
• Getting lost in a familiar neighborhood
• Challenges handling money responsibly (for example, paying bills)
• Repeating questions over and over again
• Using unusual words to refer to familiar things
• Taking longer to finish normal daily tasks
• Losing interest in normal daily activities or events
• Hallucinating or experiencing delusions or paranoia
• Acting impulsively [or mood changes]
• Not caring about other people’s feelings
• Losing balance and problems with movement

I would add the following symptoms: Feeling anxious, angry, or sad about memory loss. Some have personality changes or inappropriate behavior. Others withdraw from social activities or work.

It can be helpful to consider an individual’s current abilities and watch for changes that might signal dementia. Often, symptoms worsen over time (although some may disappear).

Ultimately, many folks with dementia cannot recognize family members or friends, may have challenges moving around, struggle with eating or drinking, and can lose bowel or bladder control.

Common dementia forms

Dementia is an umbrella term for many diseases or injuries that damage the brain. Alzheimer’s disease is the most common form of the condition, representing 60 to 70 percent of cases.

Other dementia forms include:

• Vascular dementia.
• Dementia with Lewy bodies (abnormal deposits of protein inside nerve cells).
• A group of diseases contributes to frontotemporal dementia (degeneration of the brain’s frontal lobe).

Some develop dementia after a stroke or are associated with infectious diseases like HIV. Others get dementia in the context of harmful use of alcohol, repeated traumatic brain injuries (chronic traumatic encephalopathy), or nutritional deficiencies. There are also mixed forms of dementia.

Diet and dementia — A new review

I am concerned about dementia, not because I have a higher risk but because the idea of losing my mind terrifies me. I try to get adequate sleep and physical activity and embrace intellectual challenges. I often wonder about what role diet might play in mitigating dementia risk.

Alas, diet studies are notoriously difficult to do. The available evidence hints at the ability of some foods and diets to reduce dementia risk. The New York Times recently queried two dozen experts and reviewed the clinical literature to understand the association between nutrition and dementia better.

The article notes that individuals with heart disease, obesity, diabetes, and high blood pressure have a higher risk of experiencing age-related cognitive decline.

A poor diet and sedentary behavior influence the risk of developing these problems. Let’s turn to some evidence-based ways that you may reduce your chances of suffering from cognitive decline.

Two diets that protect against cognitive decline

Keep your arteries healthy, and you will drop your risk of dementia. The Mediterranean diet and the MIND diet — both of which incorporate fresh produce, legumes and nuts, fish, whole grains, and olive oil — strongly protect against cognitive decline.

A 2017 study analyzed the diets and cognitive performance of over 5,900 older U.S. adults. Those most closely adhering to either the Mediterranean diet or the MIND diet had a one-third reduction in their risk of cognitive impairment (than those adhering to these diets less strictly).

Want more evidence? In a 2022 Israeli randomized controlled trial, researchers took brain scans of over 200 individuals split into three diet groups. Here are the results after 18 months:

Those who followed a “green” Mediterranean diet — one rich in a nutrient-packed green plant called Mankai — had the slowest rate of age-related brain loss (atrophy). Those following a traditional Mediterranean diet were close behind. Researchers saw the greatest declines among those who followed regular (less plant-based) healthy diet guidelines that allowed for more processed and red meat.

What is good for the arteries is good for the brain. Commenting in the New York Times, Dr. Walter Willett, a professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health, explains that “pretty much anything that will help keep arteries healthy will reduce risk of dementia.”

Here are beginner’s guides to the MIND and Mediterranean diets:

The MIND Diet

The MIND diet is designed to prevent dementia and loss of brain function as you age. The MIND diet combines the…

www.healthline.com

Mediterranean Diet 101: Meal Plan, Foods List, and Tips

Rich in flavorful ingredients like fruits, vegetables, whole grains, and heart-healthy fats, the Mediterranean diet is…

www.healthline.com

Diet and dementia — My take

Are there miracle foods when it comes to dodging cognitive decline? No, but consuming lots of fruits and vegetables is good. And no, supplements are not a good substitute. I love this pithy observation of Dr. Ronald Petersen, a neurologist and the director of the Mayo Clinic Alzheimer’s Disease Research Center:

“If it comes from a plant, eat it. If it’s made in a plant, don’t eat it.”

The post Can Food Ward Off Dementia? Two Diets Come Out on Top. appeared first on Medika Life.

They drew blood at the many clinical trial sites, psychological testing was administered and the families, dutifully and in hope, brought their affected loved ones week after week. The trial would go on with hundreds of supposedly healthy, but impaired, older adults agreeing to all of it. And yet there was one piece missing in the trials and no one noticed it. What was it?

We stood at a major medical center in the New England states and talked about the patients, the test results, and the findings. Among those peering at the data were several interns writing dissertations on the disease, each one looking for a scrap on which to pin their epic piece of professional accomplishment.

I had recently returned from a trip to the Mid-West as part of my travels to various centers and I had one question that bothered me. As a psychologist, they trained me to look at people, but not confine my questions to one person, but to look at the group. After visiting at least ten centers, something became apparent to me and I had to voice my concern.

“Where’s the data on the caregivers,” I asked the group. They looked at me as though I must be falling into Alzheimer’s grip, too. Data on caregivers? No one was collecting that.

We know people don’t live in vacuums, and yet here was a multi-million dollar grant, written over weeks, that concentrated solely on testing the patient in every regard but one, the social side. Sure, they had a scale for that. How did they prepare themselves for the day? Were they able to dress, close their buttons, and comb their hair? Could they recognize themselves in the mirror? How did they interact with others?

I remembered my interaction with a couple where the wife began crying. Her husband, a former editor of a well-known journal, was frequently in the basement, fashioning bayonets from kitchen knives. The reason? He said he’d have to defend them once “they” came. Who “they” were was never mentioned, but they were out there and they’d be coming.

She had to put a bracelet with his name and phone number on it around his wrist when he went out on his bicycle now because he often got lost. Driving was out of the question after several car accidents. But the bike didn’t prove a suitable solution, either. Now, he had to wait and prepare at home and couldn’t leave her alone because they were coming.

As I sat and listened to her and many other spouses over the months of my travels, I became convinced that the protocol had a flaw; nothing about the caregivers. We didn’t ask them if they were depressed or anxious, or how they got through this incredible journey into darkness. Most of the time, they sat quietly next to the patient. This was less to help our research than to encourage the patient to take part.

I recall the husband who tried to eat paperclips because he couldn’t decide what was food and what wasn’t. Often, he’d leave the couple’s seventeenth-floor apartment, and, once out the door, he didn’t know which apartment was theirs. He’d opened the only door he found and was then locked into the stairwell.

Another patient, a woman in her 70s, once she took her eyeglasses off, couldn’t figure out how to put them back on. She also had difficulty at dinnertime, trying to eat the flatware instead of the food.

Imagine the frustration, alarm, and depression any of this can cause someone when it happens daily. How can anyone tolerate it without some help for their mental health?

We have diagnosed slightly fewer than seven million people in the United States with Alzheimer’s. If each of them has one caregiver, the number of people who require help with this disorder will be doubled. And, if things progress, thanks to medical advances, the number may quadruple in the next decade or two. But who is looking at the disease’s effects on caregivers, who, like the primary patient, are suffering from, if not with, Alzheimer’s?

I saw the mental torment of the man who had to drive his wife for almost two hours from their home to the testing center. “She kept changing the radio dials all the way,” he said, almost sobbing. “I couldn’t get her to stop.”

Then there was the extremely patient aide who had to keep coaxing an elderly woman with a promise of ice cream and lunch at a local deli. “All she wants to do is go for ice cream,” she said. The patient was delightful and used humor to answer every question. It turned out to be a common defense against memory loss and the pain it caused so many people.

One man, who had been married for almost fifty years, was on the verge of tears as he told me how his wife screamed when he tried to get into bed with her. “She keeps saying she has a husband, and he’ll come and find him there.”

Another man said that his wife was sure that someone was trying to break into their million-dollar home, so they had security systems put in at least three times. She never felt safe, whatever system was installed. And she kept firing the staff because she was sure they were stealing. In fact, she couldn’t remember where she’d put her jewelry and accused them of stealing it.

I turned to the group that day and asked what was the reason no measures were being taken for caregivers. As I recall, I said, “It’s a great resource for a dissertation any of you want to write.” I think that caught more attention than the computer screen.

Of course, that was two decades ago and we’re still trying to figure out how to help the other Alzheimer’s patients, the caregivers. How has the spread of this scary disease through social contact hurt their physical and mental health?

We have two groups that need to be assessed and treated, but we often fail to notice the second one.

The post The Forgotten Ones in the Tragedy of Alzheimer’s Disease appeared first on Medika Life.

Alzheimer’s dementia is not a normal part of the aging process. Still, the most significant risk factor is increasing age, with most of those with Alzheimer’s disease 65 years and older.

For those who get it at a younger age, we refer to it as early-onset Alzheimer’s disease. These younger folks can be in the condition’s early, middle, or late stages.

We may conveniently divide Alzheimer’s disease into two forms:

• Common Alzheimer’s disease. Those with early-onset Alzheimer’s disease have the common form. It progresses similar to AD seen in older adults.
• Genetic (familial) Alzheimer’s disease. This type of AD is uncommon. Symptoms typically emerge while individuals are in their 30s, 40s, or 50s. Family history is the only known risk factor for genetic (familial) Alzheimer’s disease.

Dementia is the product of brain cell damage, with this injury interfering with brain cells’ communicating with one another. Without good inter-nerve cell chatting, behavior and feelings can change.

Dementia: A global public health epidemic

Dementia is a global health issue of increasing importance. There are tremendous negative consequences for numerous socioeconomic measures (and the burden on sufferers).

By 2030, over 82 million people — and over 150 million by 2050 — will have Alzheimer’s dementia. Unfortunately, there are no curative treatments, and we don’t understand why the disease occurs.

For those without the less common genetic form, why does dementia happen? Researchers are examining shared genetics with other diseases to understand better the biological mechanisms underlying Alzheimer’s disease.

A new study adds support for a brain-gut connection.

The gut-dementia connection

Family history is the only known risk factor for Alzheimer’s dementia. We have to do better in identifying causes. Now comes an innovative study connecting the gut microbiome to the brain and dementia risk.

Several studies demonstrate the co-occurrence of dementia (especially Alzheimer’s) with gut disorders such as gastritis, the gut microbiome, and certain medicines (such as proton pump inhibitors) used to treat peptic ulcer disease.

Gut-brain axis

While such studies suggest an association between Alzheimer’s and gastrointestinal tract disorders, it is unclear whether the gut issues are risk factors for dementia or vice-versa. The gut-brain axis exists for other central nervous system problems such as Parkinson’s disease and depression.

Today we examine an Australian study that comprehensively analyzes the link between Alzheimer’s disease and gut disorders. While we will learn that they could not find a causal relationship between dementia and the gastrointestinal tract, they did find shared genes and enrichment of autoimmunity and more.

The gut, the brain, genetics, and dementia

The research investigation incorporated data from historical genome-wide association studies. They looked for patients with Alzheimer’s dementia, gastroesophageal reflux disease (heartburn), peptic ulcer disease, irritable bowel syndrome, inflammation of the stomach and small intestine (gastritis-duodenitis).

The final group analysis represented more than 450,000 individuals. Here are the results:

All the gastrointestinal tract disorders (except irritable bowel syndrome) appeared to correlate with Alzheimer’s dementia.

Among the biological factors examined, abnormal cholesterol appeared to underscore the gut-brain connection. Abnormal cholesterol appeared to be a risk factor for gut disorders and Alzheimer’s dementia.

The study authors suggest that cholesterol-lowering statin drugs (such as atorvastatin or lovastatin) be studied to see if they help protect the gut and, in turn, the brain.

My take — The gut, brain, and dementia

Of course, correlation is not causality: We don’t have evidence that gut disorders cause Alzheimer’s or vice-versa. Still, the researchers point to a Mediterranean-type diet — one rich in natural fats and vegetables — as not a bad idea.

The researchers report no relevant financial relationships. Thank you for joining me in this look at the relationship between the gut and Alzheimer’s dementia.

The post Is Our Gut a Key to Whether We Get Dementia? appeared first on Medika Life.