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Over-The-Counter Sleep Aids Linked To Dementia

Sleep Aid 2A new study has found a significant link between high use of anticholinergic drugs – including popular non-prescription sleep aids and the antihistamine Benadryl (diphenhydramine) – and increased risk of developing dementia and Alzheimer’s disease in older people.

Many medications – including some popular over the counter drugs – have strong anticholinergic effects.

Anticholinergics are a class of drug that blocks the action of the neurotransmitter acetylcholine in the brain and body.

This can lead to many side effects, including drowsiness, constipation, retaining urine and dry mouth and eyes.sleep aid 3

The researchers, led by Shelly Gray, a professor in the University of Washington School of Pharmacy in Seattle, report their findings in JAMA Internal Medicine.

Prof. Gray says:

“Older adults should be aware that many medications – including some available without a prescription, such as over-the-counter sleep aids – have strong anticholinergic effects.”

Prof. Gray urges people not to stop their therapy based on the findings of this study – they should talk to their health care Sleep Aid 1provider, and also tell them about all their over-the-counter drug use.

“Health care providers should regularly review their older patients’ drug regimens – including over-the-counter medications – to look for chances to use fewer anticholinergic medications at lower doses,” she says.

If providers need to prescribe anticholinergics to their patients because they offer the best treatment, then “they should use the lowest effective dose, monitor the therapy regularly to ensure it’s working, and stop the therapy if it’s ineffective,” she adds.

Although the link between raised risk of dementia and anticholinergics has been found before, the new study uses more rigorous methods – including over 7 years of follow-up – to establish the strength of the link. By accessing pharmacy records, the researchers were also able to include non-prescription use of anticholinergics in their data.

It is also the first study to show a dose-response effect, note the authors. That is, the higher the cumulative amount of drug taken, the higher the risk of developing dementia.

And another first for the study, is that it also shows that dementia risk linked to anticholinergics may persist long after people stop taking the drugs.

Source: Medical News Today


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Researchers say Vitamin D deficiency raises Alzheimer’s risk

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People with moderate-to-severe vitamin D deficiencies are significantly more likely to develop Alzheimer’s disease or other forms of dementia than those who have an adequate supply of the vitamin in their body, a new study has found.

Researchers, led by David J. Llewellyn at the University of Exeter Medical School, found that adults who suffered from a moderate deficiency of vitamin D had a 53 percent higher risk of some form of dementia, while the risk increased 125 percent in those with severe deficiencies. People moderately deficient in vitamin D were 69 percent more likely to develop Alzheimer’s-caused dementia, while those severely deficient raised the risk to 122 percent.

The team discovered what appear to be clear threshold levels for brain health using standard medical measurements of concentration in the blood. The risk of dementia appears to rise for people with vitamin D blood levels below 25 nanomoles per liter, while vitamin D levels above 50 nanomoles appear to be good levels for brain health.

The researchers acknowledged the possibility of reverse causation — that is, that having dementia might alter a person’s behavior or diet in such a way as to contribute to vitamin D deficiency — but suggested that the makeup of the study made that unlikely.

Llewellyn said that although the international team of researchers expected to find a link between vitamin D deficiency and dementia, the strong correlation between the two was surprising. He said further study was necessary to determine whether consuming oily fish or vitamin D supplements might prevent Alzheimer’s disease.

 “We thought it was important for bone health. But there’s this recent revelation that it might be playing an important role throughout the body,” Llewellyn said. He said more recent research suggests that vitamin D may act as a buffer regulating calcium levels in brain cells.
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Alzheimer’s disease is the leading form of dementia, affecting more than 5 million people in the United States. That number is expected to reach 16 million by 2050 as the population ages.

Vitamin D, which helps the body use calcium, is created when skin is exposed to sunshine. Milk is often fortified with the vitamin, and it is also found in fatty fish and other foods.

Researchers in the Exeter study noted that laboratory experiments have shown that vitamin D may play a role in ridding cells of beta-amyloid plaques, an abnormality that distinguishes Alzheimer’s.

“It seems to be that vitamin D was actually helping to break down and take away those protein abnormalities,” Llewellyn said Wednesday in an interview.

Knowing that previous studies have also linked vitamin D deficiency to heightened risk of cognitive decline in older people, the multinational team of researchers studied vitamin D blood levels in 1,658 people age 65 and older who were able to walk, free of dementia, and without a history of cardiovascular disease or stroke. Medical personnel tracked the subjects over six years, using brain scans, cognitive tests, medical records and other diagnostic tools, to see how many developed Alzheimer’s disease or other forms of dementia.

The study, funded in part by the Alzheimer’s Association, appeared Wednesday in Neurology, the medical journal of the American Academy of Neurology.

Source: Washington Post


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Active Mind and Body Fend Off Alzheimer’s, Study Says

Sleep disturbances such as apnea may increase the risk of Alzheimer’s disease, while moderate exercise in middle age and mentally stimulating games, such as crossword puzzles, may prevent the onset of the dementia-causing disease, according to research to be presented Monday.

oldpeopleThe findings — which are to be introduced during the six-day Alzheimer’s Association International Conference in Copenhagen — bolster previous studies that suggest sleep plays a critical role in the aging brain’s health, perhaps by allowing the body to cleanse itself of Alzheimer’s-related compounds during downtime. The studies also add to a growing body of literature that suggests keeping the brain busy keeps it healthy.

The battle against Alzheimer’s disease has become more urgent for the United States and other developing nations as their populations turn increasingly gray. The disease is the leading cause of dementia in older people and afflicts more than 5 million Americans. At its current pace, the number is expected to soar to 16 million people by 2050.

In 2012, the United States adopted a national plan to combat the disease and the Group of Eight nations last year adopted a goal of providing better treatment and prevention by 2025.

Erin Heintz, a spokeswoman for the Alzheimer’s Association, said U.S. government funding to combat the disease now stands at about $500 million a year. To reach its 2025 goal, th e United States should be spending $2 billion a year, she said.

The sleep study, conducted by University of California at San Francisco researchers on a large sample of veterans, found that those with diagnosed sleep disorders such as apnea or insomnia were 30 percent more likely to suffer dementia than veterans without such problems. Veterans who suffered from sleep problems and post-traumatic stress disorder (PTSD) had an 80 percent greater risk.

“I would say that this is another important study showing this link between sleep and subsequent diagnosis of dementia,” Kristine Yaffe, a psychiatry professor at UCSF who heads its Dementia Epidemiology Research Group, said in a telephone interview. She said her study’s findings benefited from having such a large sample of participants: Researchers used eight years of records on 200,000 veterans, most of whom were male and 55 or older.

It is well known that people afflicted with Alzheimer’s suffer from sleep disorders, Yaffe said, but further research is necessary to determine whether sleep disturbance heightens the risk of getting dementia or is a symptom.

In a separate study, researchers at the Wisconsin Alzheimer’s Institute and the Wisconsin Alzheimer’s Disease Research Center wanted to find out whether middle-aged people who engage in mentally stimulating activities might reduce their risk of cognitive impairment and dementia. Forty percent of the subject group carried the gene linked to Alzheimer’s and 74 percent had a parent with the illness, two factors known to increase the risk of getting the disease.

The researchers studied 329 participants — 69 percent of whom were women, whose mean age was about 60 — to find out how often the participants read books, visited museums, played games such as checkers or worked on puzzles.

The subjects also underwent a battery of tests, including MRI brain scans to measure the volume of those regions commonly afflicted by Alzheimer’s.

For purposes of the study, researchers focused on the group’s game-playing habits to see if the frequency of playing games was related to better brain and cognitive health.

Stephanie Schultz, lead author of the study, said that although more research is necessary to know for sure, the findings suggest that stimulating the brain with ordinary diversions such as crossword puzzles may help some people preserve brain tissue and cognitive functions that are vulnerable to dementia. Those who reported a higher frequency of playing games also had greater brain volume in regions affected by Alzheimer’s, such as the hippocampus.

“The more they play these types of games, the better it is for … brain health,” she said.

One reason could be that game-playing involves more complicated processes across multiple regions of the brain, compared with more passive forms of mental engagement, the researchers said.

“It’s very clear it’s a different quality of mental engagement when you’re playing games of skill than when you’re reading a book,” said Ozioma Okonkwo, an assistant professor of medicine at the University of Wisconsin School of Medicine and senior author of the study. “To win a card game, you have to judge, you have to plan, you have to do something, you have to remember what the last player played.”

Okonkwo said the results were exciting particularly because they held true for people with a family history of Alzheimer’s and a genetic disposition to the disease.

“These individuals already have two strikes against them,” he said.

Similarly, a three-year study of people with mild cognitive impairment by researchers at the Mayo Clinic Study of Aging suggests that moderate physical exercise in middle age could decrease the risk that their cognitive deficits progress to dementia. The study looked at the timing of regular exercise — undertaken either in midlife between the ages of 50 and 65, or later in life, from age 70 and up — and its relationship to the onset of dementia in a group of 280 elderly people. Their median age was 81.

Oddly, however, the association did not hold for people who engaged in light or vigorous exercise in middle age or for any level of physical activity later in life.

On a similarly counterintuitive note, another study suggested that high blood pressure among people at least 90 years old — “the oldest old” — may protect against cognitive impairment. Researchers at the University of California at Irvine said that although hypertension is believed to increase the risk of Alzheimer’s and dementia for middle-aged people, the risk may shift with time.

Their study, which examined 625 people who are 90 or older, found that people who were diagnosed with high blood pressure between the ages of 80 and 89 had a significantly lower risk of dementia. People with hypertension after the age of 90 had an even lower risk, the researchers said.

(Source: Washington Post)


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Women are at the ‘epicenter of Alzheimer’s disease,’ says new report

Report: Alzheimer's far more likely than breast cancer in women over 60

Women are at a much higher risk for developing Alzheimer’s disease than men, and the condition poses an even greater risk for elderly women than breast cancer, a new report finds.

According to the latest Alzheimer’s Association 2014 Alzheimer’s Disease Facts and Figures report, women have a 1 in 6 estimated lifetime risk of developing the disease at age 65, while the risk for men is nearly 1 in 11. Additionally, women in their 60s are about twice as likely to develop Alzheimer’s as they are to develop breast cancer.
These differences in gender are further reflected by the fact that there are 2.5 times as many women than men providing 24-hour care for someone living with Alzheimer’s.
Acting as an “on-duty” caregiver for someone living with Alzheimer’s creates a strain that leads to feelings of isolation and depression, as well as the need to take a leave of absence or give up working entirely. While performing caregiving duties, 20 percent of women went from working full-time to working part-time, compared to 3 percent of men.

“[W]e know that women are the epicenter of Alzheimer’s disease, representing majority of both people with the disease and Alzheimer’s caregivers. Alzheimer’s Association Facts and Figures examines the impact of this unbalanced burden,” said Angela Geiger, chief strategy officer of the Alzheimer’s Association.
Alzheimer’s disease is currently the sixth leading cause of death in the United States and affects more than 5 million Americans – including 3.2 million women. Adding to that, 15.5 million caregivers provide 17.7 billion hours of unpaid care. Dementia caregiving resulted in an estimated $9.3 billion in increased health care costs for caregivers in 2013.

Given these statistics, the Alzheimer’s Association is calling for a greater investment in research of the disease.
“Well-deserved investments in breast cancer and other leading causes of death such as heart disease, stroke and HIV/AIDS have resulted in substantial decreases in death. Comparable investments are now needed to realize the same success with Alzheimer’s in preventing and treating the disease,” Geiger said.

The Alzheimer’s Association points out that there is still a lack of understanding about the disease – a form of dementia that causes problems with memory, thinking and behavior.

“Despite being the nation’s biggest health threat, Alzheimer’s disease is still largely misunderstood. Everyone with a brain — male or female, family history or not — is at risk for Alzheimer’s,” Geiger said. “Age is the greatest risk factor for Alzheimer’s, and America is aging. As a nation, we must band together to protect our greatest asset, our brains.”

Source: Fox News


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Cooking Meat ‘May Be Dementia Risk’

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Browning meat in the oven, grill or frying pan produces chemicals which may increase the risk of developing dementia, US researchers suggest. Advanced glycation end (AGE) products have been linked to diseases such as type-2 diabetes. Mice fed a high-AGEs diet had a build-up of dangerous proteins in the brain and impaired cognitive function.

Experts said the results were “compelling” but did not provide “definitive answers”. AGEs are formed when proteins or fats react with sugar. This can happen naturally and during the cooking process.

Researchers at the Icahn school of medicine at Mount Sinai, in New York, tested the effect of AGEs on mice and people. The animal experiments, published in Proceedings of the National Academy of Sciences, showed that a diet rich in AGEs affects the chemistry of the brain. It leads to a build-up of defective beta amyloid protein – a hallmark of Alzheimer’s disease. The mice eating a low-AGEs diet were able to prevent the production of damaged amyloid.

The mice performed less well in physical and thinking tasks after their AGEs-rich diet. A short-term analysis of people over 60 suggested a link between high levels of AGEs in the blood and cognitive decline.

The study concluded: “We report that age-related dementia may be causally linked to high levels of food advanced glycation end products. Importantly, reduction of food-derived AGEs is feasible and may provide an effective treatment strategy.”

Derek Hill, a professor of medical imaging sciences at University College London, commented: “The results are compelling. Because cures for Alzheimer’s disease remain a distant hope, efforts to prevent it are extremely important, but this study should be seen as encouraging further work, rather than as providing definitive answers.

“But it is grounds for optimism – this paper adds to the body of evidence suggesting that using preventative strategies might reduce the prevalence of Alzheimer’s disease and other dementias in society and that could have very positive impact on us all.”

Dr Simon Ridley, from the charity Alzheimer’s Research UK, said: “Diabetes has previously been linked to an increased risk of dementia, and this small study provides some new insight into some of the possible molecular processes that may link the two conditions.It’s important to note that the people in this study did not have dementia. This subject has so far not been well studied in people, and we don’t yet know whether the amount of AGEs in our diet might affect our risk of dementia.”

Source: BBC


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Mediterranean Diet Improves Cognition

 

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Worldwide prevalence of dementia is expected to reach 65.7 million and 115.4 million in 2030 and 2050, respectively. Currently, there is no effective therapy to delay the onset or halt the progression of dementia, a growing public health problem with priority for research. The potential protection on cognition has been examined for some nutrients such as fatty acids, vitamins, fish, fruit and vegetables but observational and experimental studies have provided inconsistent results. Defining the effect of diet on health by the overall dietary pattern instead of a single or a few nutrients allows to study the synergy among nutrients and avoids problems due to confounding, multiple testing and collinearity among them. The Mediterranean diet (MedDiet) is characterized by the use of olive oil as the main culinary fat and high consumption of plant-based foods (fruits and nuts, vegetables, legumes and minimally processed cereals). It also includes moderate-to-high consumption of fish and seafood and low consumption of butter or other dairy products and meat or meat products. Regular but moderate intake of alcohol, preferentially red wine during meals, is customary. An intervention with MedDiets enhanced with either EVOO or nuts appears to improve cognition compared with a low-fat diet. (Journal of Neurology, Neurosurgery, and Psychiatry)

Read more here.


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New Insights into the Dementia Epidemic

Described in the early 1980s as “The Silent Epidemic,” dementia in the elderly will soon become a clarion call for public health experts worldwide. The epidemic is largely explained by the prevalence of dementia in persons 8- years of age or older. In most countries around the world, especially wealthy ones, this “old old” population will continue to grow, and since it accounts for the largest proportion of dementia cases, the dementia epidemic will grow worldwide. Eventually, we will have results of studies conducted over longer periods with presumably more definitive findings. But for now, the evidence supports the theory that better education and greater economic well-being enhance life expectancy and reduce the risk of late-life dementias in people who survive to old age. The results also suggest that controlling vascular and other risk factors during midlife and early old age has unexpected benefits. That is, individual risk-factor control may provide substantial public health benefits if it leads to lower rates of late-life dementias.

Read more at the New England Journal of Medicine.