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Alzheimer's, Dementia & Mental Health - Opinion

Alzheimer's Conference Offers Signs of Hope in Battle Against Mind-Crushing Disease

Below are some of the highlights from the Alzheimer's Association International Conference that are important to every senior citizen

By Tucker Sutherland, editor, SeniorJournal.com

July 16, 2014 – For the first time in the almost-20-years that I have closely followed the battle against Alzheimer’s disease, I am encouraged about our odds. As the Alzheimer’s Association International Conference for this year wraps up in Copenhagen, the researchers and other experts who made presentations convinced me we are finally getting our arms around this cruel killer, and have a chance to - someday - bring it under control. Below are the highlights and every senior citizen, the primary victims of the disease, needs to read them.

There were several reports from the United States and Europe suggesting the possibility of reducing risk and maybe even preventing the disease most feared by most seniors. We have a full report on this that you can reach by clicking here.

Other data includes advances in early detection and diagnosis, identifying risk factors and possible risk reduction strategies, and the first-ever long-term clinical trial of a multifaceted lifestyle change in older adults.

Also released at AAIC 2014 was new information on the basic brain science of Alzheimer’s, trends in new cases of dementia and overall numbers of people with the disease, the multiple benefits of cataract surgery for people with Alzheimer’s and additional data about drugs involved in Alzheimer’s prevention trials.

AAIC is the premier annual forum for presentation and discussion of the latest Alzheimer’s and dementia research. Bringing the world closer to breakthroughs in dementia science, AAIC 2014 brought together approximately 4,000 leading experts and researchers from 75 countries around the world, and featured more than 1,700 scientific presentations.

Below are the summaries of discoveries you should read about.

Potential for smell and eye tests in early detection of Alzheimer’s

Two studies from AAIC 2014 provide increasing evidence that the inability to correctly identify odors may indicate the development of cognitive impairment and Alzheimer’s disease. Based on smell identification tests, cognitive tests and brain size, researchers in one study of 215 elderly individuals found that loss of brain cell function and worsened memory were associated with smell identification ability.

A second study of 757 individuals representing multiple ethnicities found that odor identification deficits were linked with an increased risk of transition from mild cognitive impairment (MCI) - a slight but noticeable and measurable decline in memory and thinking skills - to Alzheimer’s disease. For each point lower a study participant subject scored on a smell identification test, their risk for Alzheimer’s increased by about 10 percent.

 

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Two studies of beta-amyloid in the eye

Two additional studies looked at possible eye tests to detect Alzheimer’s. Preliminary results from one study, based on findings from 40 of the study’s 200 participants, suggest that there is a significant association between the level of beta-amyloid protein, the main component of Alzheimer’s brain “plaques,” in the brain and levels detected in the retina.

Study participants took a proprietary supplement containing curcumin, which binds to beta-amyloid and has fluorescent properties that allow amyloid plaques to be detected on the retina of the eye with an advanced imaging technology.

In another study, researchers used a new laser scanning system to measure beta-amyloid levels in the lenses of the eyes of 20 study participants with Alzheimer’s disease and 20 without the disease.

When the scientists, who were unaware of the Alzheimer’s status of their subjects, compared amyloid levels based on the eye lens test to amyloid plaque buildup estimates from brain positron emission tomography (PET) scans, they were able to accurately differentiate those with Alzheimer’s disease from those without it.

Largest study of brain tau PET imaging suggests scans’ ability for early detection of dementia

The presence of “tangles” of abnormal tau protein in the brain is one of the defining characteristics of Alzheimer’s. When this protein becomes abnormal, it forms tangles of twisted fibers inside brain cells, which kills them.

In a study of 52 cognitively normal seniors – the largest study of its kind to date – researchers found that tau buildup in several brain regions was closely linked with memory decline. Using a newly developed PET scan technology to “see” tau in the brains of living people, scientists found that study participants with higher levels of tau buildup in areas of the brain important to memory performed worse on memory tests over three years.

The Alzheimer’s Association says the findings demonstrate the potential value of tau PET scans in early detection of dementia and in identifying participants for Alzheimer’s and dementia research studies.

Lifestyle interventions may improve memory and thinking in middle-age and older adults

A two-year randomized controlled clinical trial in Finland is the first to demonstrate that a structured program of multiple changes in lifestyle factors can improve memory and thinking in older adults at risk for cognitive impairment and Alzheimer's.

The 1,260 older adults in the trial, whose ages ranged from 60 to 77, were divided into two groups. One group received an intervention that included nutritional guidance, physical exercise, cognitive training, social activities and management of heart health risk factors, while the control group received only regular health advice.

After two years, the intervention group performed significantly better on a comprehensive scale of memory and thinking, and on specific tests of memory and executive function (including planning, judgment and problem-solving).

A separate study of 329 cognitively normal middle-aged adults in the U.S. with a genetic predisposition or parental family history of Alzheimer’s found that participation in mentally stimulating activities in middle-age may help protect against the development of Alzheimer’s disease and dementia later in life.

The researchers found that participants who self-reported a higher level of activities such as reading books and going to the museum, especially those who reported playing games like puzzles and cards more often, had higher test scores for memory and thinking challenges, such as planning, judgment and problem-solving. They also had greater volume in several brain regions involved in Alzheimer’s disease.

Exercise in mid- and late-life associated with decreased risk of dementia

Two studies reported at AAIC 2014 presented evidence that regular physical activity may reduce the risk of Alzheimer’s and other dementias.

In one study, 280 adults in the U.S. with a median age of 81 completed a questionnaire on the frequency and intensity of exercise during their lifetime. After observing the participants for about three years, the researchers found that a history of moderate physical exercise in middle age was associated with a significantly decreased risk of mild cognitive impairment (MCI).

In a second study, researchers examined the frequency and intensity of exercise of 1,830 adults with normal cognition. The researchers found that light physical exercise in mid-life and late-life was associated with a decreased risk of MCI, as was vigorous physical exercise in mid-life and moderate physical exercise in late-life. The Alzheimer’s Association urges everyone to keep their brain healthy throughout their life. Tips and the latest research are at alz.org.

Late-onset high blood pressure could protect against dementia

While hypertension during midlife may increase risk for Alzheimer’s and other dementias, there is emerging evidence that its association with dementia risk may change over time, and may instead help protect against dementia in people age 90 and over.

Researchers followed 625 older adults in the U.S. without dementia for up to 10 years and found that those with the onset of high blood pressure at age 80 to 89 had a significantly lower risk of developing dementia compared with participants with no history of high blood pressure. Those with the onset of hypertension at age 90 or older had even lower dementia risk.

Cataract surgery improves not only vision but cognition and quality of life

A small clinical trial in the U.S. found that cataract surgery for people with Alzheimer’s and other dementias not only improves vision but can slow decline in cognition and improve quality of life for both people with the disease and their caregivers.

Preliminary analysis of results found that 20 participants who had surgery to remove cataract had significantly improved vision and quality of life compared to the eight participants who did not receive surgery.

In addition, those who received the surgery experienced a reduced decline in memory and mental tasks such as planning, judgment, and problem-solving, as well as improvements in behavioral measures.

Levels of perceived burden for caregivers of people in the surgical group showed improvement. The Alzheimer’s Association recommends that preferences about medical treatment and decisions should be addressed early in the disease process through the execution of advance directives.

Psychological intervention for caregivers may reduce anxiety and depression

A randomized controlled trial in the U.K. found that a psychological support program for family caregivers of people with dementia significantly reduced caregivers’ anxiety and depression, and the impact lasted for two years.

In the trial, 260 family caregivers were divided into two groups. One group received standard care and the other received an intervention consisting of eight sessions that included education about dementia, caregiver stress and where to get emotional support, and techniques for dealing with caregiving challenges. Caregivers who received the eight-session intervention showed significantly better results on measures of depression, anxiety and cost of care.

Researchers noted this may help caregivers stay in their role longer and provide more consistent care, which may delay placement of the person with dementia into a nursing home. The Alzheimer’s Association believes it is very important for caregivers to take care of themselves, and to reach out for help. Learn more at www.alz.org.

Diabetes drug associated with reduced risk of dementia

A study of a large German database of people age 60 or older who were free of Alzheimer’s and others dementias found that long-term use of the diabetes drug pioglitazone may reduce incidence of dementia. Researchers at AAIC 2014 presented the study, which examined more 145,712 subjects over six years. Results suggest that reduced risk of dementia was significantly associated with use of pioglitazone. Researchers noted one possible theory is the drug’s ability to suppress neuroinflammation.

Additional abnormal protein, TDP-43, found in brains of people with Alzheimer’s

Researchers identified that an abnormal protein, known as TDP-43, may play an important role in Alzheimer's disease along with two previously identified proteins. Researchers examined the brains of 342 people identified after death as having Alzheimer’s-related changes for the presence, amount and distribution of TDP-43. More than half the brains had TDP-43.

In addition, people with TDP-43 were ten times more likely to have been cognitively impaired at death than subjects without it. The scientists speculate that TDP-43 may help explain why some people have Alzheimer’s changes in their brain, but do not experience dementia. It is vitally important to fund basic research to learn more about Alzheimer’s disease, and to feed the front end of the therapy pipeline. The Alzheimer’s Association is the world’s leading nonprofit funder of Alzheimer’s disease research.

About AAIC

The Alzheimer’s Association International Conference (AAIC) is the world’s largest gathering of leading researchers from around the world focused on Alzheimer’s and other dementias. As a part of the Alzheimer’s Association’s research program, AAIC serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community. Scientists leading the advancement of research gather to report and discuss the most current data on the cause, diagnosis, treatment and prevention of Alzheimer’s disease and related disorders.

About the Alzheimer’s Association

The Alzheimer’s Association is the world’s leading voluntary health organization in Alzheimer care, support and research. Our mission is to eliminate Alzheimer’s disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer’s. Visit www.alz.org or call 800.272.3900.

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