A new report from the Alzheimer’s Association says that as many as 5 million Americans have Alzheimer’s disease or some other form of dementia. Every 67 seconds someone in the United States develops Alzheimer’s disease or dementia. That’s 470,000 Americans this year alone. Given that these thieves of memory and personality are so common and so feared, should all older Americans be tested for them? In proposed guidelines released yesterday, the U.S. Preventive Services Task Force said “no.” Why not? Even after conducting a thorough review of the evidence, the panel said that there isn’t enough solid evidence to recommend screening, especially since not enough is known about the benefits and the harms. In part, the recommendation is based on the sad fact that so far there aren’t any truly effective approaches to stop the forward progress of dementia.
What’s bad for the heart is often bad for the brain. High cholesterol, high blood pressure, diabetes, and unhealthy “hardening” of the arteries increase the risk of mental decline or dementia later in life. A study published online today in Neurology shows that older people with the stiffest arteries are more likely to show the kinds of damage to brain tissue often seen in people with dementia. The study adds support to the “two hit” theory of dementia. It suggests that the accumulation of Alzheimer’s-linked amyloid protein in the brain may not pose problems until damage to small blood vessels that nourish the brain nudges them over into dementia. There may be a silver lining to this line of research: Efforts to improve cardiovascular health can also protect the brain.
There are many reasons to keep your blood sugar under control: protecting your arteries and nerves are two of them. Here’s another biggie: preventing dementia, the loss of memory and thinking skills that afflicts millions of older Americans. A study published today in the New England Journal of Medicine shows that even in people without diabetes, above normal blood sugar is associated with an increased risk of developing dementia. The study does not prove that high blood sugar causes dementia, only that there is an association between the two. For that reason, don’t start trying to lower your blood sugar simply to preserve your thinking skills, cautions Dr. Nathan. There’s no evidence that strategy will work, although he says it should be studied. But it is still worth keeping an eye on your blood sugar. Excess blood sugar can lead to diabetes and a variety of other health problems, including heart, eye, kidney, and nerve disease.
How’s this for a mind-bender: Lou Gehrig may not have had Lou Gehrig’s disease. Instead, the disease that ended his life may have been chronic traumatic encephalopathy (CTE). This brain disease is caused by repeated concussions—Gehrig sustained at least four during his baseball career—or other head injuries. It can cause symptoms very similar to those of amyotrophic lateral sclerosis (ALS), now commonly called Lou Gehrig’s disease. More evidence of a connection between CTE and ALS comes from a new study of almost 3,500 retired professional football players, all of whom had played for at least five years in the National Football League. Among the 334 who died during the course of the study, the risk of death from Alzheimer’s disease or ALS was nearly four times higher than expected. Players who manned a “speed” position (such as quarterbacks or receivers) had a risk of dying from Alzheimer’s disease or ALS that was more than three times higher than those playing “non-speed” positions (such as linemen).
Is there a spring in your step—or a wobble in your walk? The speed and stability of your stride could offer important clues about the state of your brain’s health. According to new research, an unsteady gait is one early warning sign that you might be headed for memory problems down the road. A group of studies reported last week at the Alzheimer’s Association International Conference in Vancouver, Canada, revealed a strong link between walking ability and mental function. What’s behind this connection? Walking is a complex task that requires more than just moving the leg muscles. Walking requires scanning the environment for obstacles and safely navigating around them, all while talking and carrying out various other tasks. The studies found that walking rhythm was related to information processing speed; walking variations and speed were associated with executive function (the mental processes we use to plan and organize); and walking speed became significantly slower as mental decline grew more severe.
Some encouraging Alzheimer’s news from Sweden: a vaccine called CAD106 appears to be safe and ramps up the body’s immune system against a protein likely involved in Alzheimer’s. The hope is that this vaccine will slow the progression of Alzheimer’s disease, and possibly even stop it. The vaccine is designed to activate the body’s immune system against beta amyloid, a protein fragment that forms deposits called amyloid plaques between nerve cells in the brain. Three-quarters of those who received CAD106 developed antibodies against beta amyloid protein. Virtually all of them—including those getting the placebo—reported one or more side effects, ranging from inflammation of the nose and throat to headache, muscle pain, and fatigue. None, though, developed meningoencephalitis, an inflammation of brain tissue that derailed work on an earlier version of the vaccine. The next step in the development of CAD106 is a larger clinical trial to confirm the vaccine’s safety and to see if it is effective at slowing the relentless progression of Alzheimer’s disease.
Computer games are being touted as a way to keep the body fit. Can they do the same for your brain? Most experts say “Not so fast.” As described in Improving Memory: Understanding age-related memory loss, a new Special Health Report from Harvard Medical School, people who play these games might get better at the tasks they practice while playing, but the games don’t seem to improve users’ overall brain skills, such as attention, memory, use of language, and ability to navigate. To stretch and exercise your brain, choose an activity you enjoy—reading, playing cards, or doing crossword puzzles are some good examples. If you’re feeling ambitious, try learning to speak a new language or play a musical instrument. Most of these activities come at a much lower cost than brain-training programs, and you’ll probably find them to be a lot more enjoyable, too.
By the year 2050, experts estimate that 16 million Americans will be living with this Alzheimer’s disease. In an effort to head off the explosion, President Obama has signed into law the National Alzheimer’s Project Act. This ambitious project aims to attack Alzheimer’s disease by improving early diagnosis, finding effective prevention and treatment strategies, providing better support for family caregivers, and more. A newly released draft of the project, which a panel of experts is reviewing this week, sets a 2025 deadline for achieving these and other goals. One big drawback—the act doesn’t provide concrete details about how to fund the research and implementation efforts needed to meet the goals.
Everyone has moments of forgetfulness—misplaced keys, a forgotten errand, the name of that movie you want to recommend but can’t get off the tip of your tongue. A certain amount of forgetfulness seems to be a normal byproduct of aging. But how do you know is forgetfulness signals something more serious, like Alzheimer’s disease or another form of dementia? According to “A Guide to Alzheimer’s Disease,” an updated Special Health Report from Harvard Medical School, by exploring several questions you may be able to get a clearer sense of normal versus worrisome forgetfulness: Is my loved one worried about the memory loss? Is he or she getting lost in familiar territory? Are word-finding problems common? Is your loved one losing the ability to socialize, or interest in it?
Many older people develop delirium when they are hospitalized. Delirium is a sudden change in mental status characterized by confusion, disorientation, altered states of consciousness (from hyperalert to unrousable), an inability to focus, and sometimes hallucinations. Hospital delirium is especially common among older people who’ve had surgeries such as hip replacement or heart surgery, or those who are in intensive care. Inflammation, infection, and medications can trigger hospital delirium as can potentially disorienting changes common to hospital stays, including sleep interruptions, unfamiliar surroundings, disruption of usual routines, separation from family and pets, and being without eyeglasses or dentures. Although delirium often recedes, it may have long-lasting aftereffects, including premature death and poorer outcomes, such as dementia and institutionalization.