Alzheimer's Disease Archive

News briefs

Encouraging news for people who suffer with migraines: in May, the FDA approved erenumab (Aimovig), the first medication aimed at preventing these debilitating headaches. Current medications to treat migraines were actually designed to control other conditions, such as seizures or an irregular heartbeat; their side effects (like sexual dysfunction and fuzzy thinking) often cause people to skip treatment. Erenumab offers a new approach. Injected once a month, it works by blocking a molecule (calcitonin gene-related peptide) involved in migraine attacks, and compared with other drugs, it appears to have fewer side effects (primarily constipation and injection site reactions). "This drug is for people who have more than four migraines per month, but it won't take migraines away entirely," says Dr. Gad Marshall, a neurologist at Harvard-affiliated Brigham and Women's Hospital. Clinical trials suggest it can reduce frequency by one or two migraines per month, or even more in some people. "For people with frequent debilitating migraines it could be a game changer," says Dr. Lee Schwamm, a neurologist at Harvard-affiliated Massachusetts General Hospital. "But erenumab is expensive, and it will take time to find out if it's effective and safe over the long term."

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An observational study published online May 30, 2018, by JAMA Psychiatry found that engaging in intellectually stimulating activities, even later in life, may lower the odds of dementia. Researchers followed over 15,000 Chinese men and women in their 70s for seven years with annual assessments of health and lifestyle habits, including a variety of leisure activities. The odds of being diagnosed with dementia during the study period were 29% lower in people who challenged their brains daily with such activities as playing board games, reading, and even betting on horse racing. In contrast, less mentally demanding recreational activities (like watching TV or shopping) or social activities (like going to tea with friends) did not appear to be associated with a lower risk of dementia. Other studies have found similar evidence, but this one made a special effort to adjust for factors like better overall health that might otherwise account for the association between brain exercise and dementia.

Two recent drugs have opened new treatment opportunities for this common eye disease.

Glaucoma is a leading cause of blindness in people over age 60, and it's estimated that the number of new cases will more than double over the next few decades. "There is no cure for glaucoma once it appears, so treating it at its earliest stages can help save your vision," says Dr. David Solá-Del Valle, an ophthalmologist with Harvard-affiliated Massachusetts Eye and Ear.

Once diagnosed, glaucoma is treated with eye drops to reduce pressure inside the eye by lowering the amount of fluid or improving fluid drainage. They can keep glaucoma from getting worse and hopefully avoid the need for surgery to correct this drainage problem.

In the journals

Anticholinergic medications used to treat bladder conditions, Parkinson's disease, and depression are associated with an increased risk of dementia, according to a large study published online April 25, 2018, by The BMJ. Anticholinergic drugs help to contract and relax muscles. They work by blocking acetylcholine, a substance that also transmits messages in the nervous system. In the study, researchers compared the medical records of 40,770 people older than 65 who were diagnosed with dementia and 283,933 seniors without.

They found that people diagnosed with dementia were up to 30% more likely to have been prescribed anticholinergic medications for Parkinson's, bladder problems, or depression. Frequently prescribed anticholinergic drugs include procyclidine (Kemadrin) for Parkinson's; tolterodine, oxybutynin, and solifenacin (Vesicare) for urological conditions like overactive bladder or incontinence; and amitriptyline, dosulepin, and paroxetine for depression. However, there was no association between dementia and anticholinergic drugs used to treat other common conditions like hay fever, travel sickness, and stomach cramps.

In the journals

Aerobic exercise has been linked with reducing symptoms of depression, but resistance training, such as weight lifting and bodyweight exercises like push-ups, can have the same effect.

A meta-analysis published in the June 2018 JAMA Psychiatry examined the effects of resistance training on depression symptoms in 33 clinical trials involving 1,877 people. The researchers found that people who did this type of exercise reported a significant reduction in such symptoms as low mood, loss of interest in activities, and feelings of worthlessness, compared with those who did not exercise.

Understanding superbugs can help you avoid them.

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It used to be that if you got an infection, you could pop an antibiotic pill and rest assured that it could help you fend off your bacterial attacker. But those old tried-and-true pills may not be as effective as they once were, thanks to a rising number of new types of bacteria often referred to as superbugs.

"'Superbug' is essentially a slang term developed by the press that refers to highly antibiotic-resistant bacteria that can cause human infections," says Dr. David Hooper, an infectious disease specialist and professor of medicine at Harvard Medical School.

Research we're watching

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You may want to take precautions if you're planning on swimming or using a hot tub at your hotel on your next vacation. Data released May 18 in the CDC's Morbidity and Mortality Weekly Report shows that these attractions are hot spots for waterborne diseases. In fact, one-third of waterborne disease outbreaks between 2000 and 2014 were traced to hotel pools or hot tubs.

The three main culprits causing infections in swimmers and hot tub users are Cryptosporidium, Pseudomonas, and Legionella. More than half of the outbreaks were caused by Cryptosporidium parasites, which are typically spread when someone ingests water contaminated by a sick swimmer with diarrhea. Legionella and Pseudomonas bacteria, which caused 16% and 13% of outbreaks respectively, cause pneumonia, flu-like illness, swimmer's ear, or a rash. Any one of these conditions can quickly drain the fun from any trip.

Research we're watching

If you're able to quickly shrug off stressful events, that may be good for your health. A study in the March 19 issue of Psychological Science found that people who held on to stress—those who reported still having negative feelings about a stressful event the day after it happened — had more chronic health problems a decade later.

Researchers analyzed data from a nationwide survey that asked more than 1,100 adults about the number and type of stressful experiences they had each day for eight days. These included everything from arguments with others to problems at work, home, or school. Participants rated their emotional reactions to these stressors at the time and afterward.

Ask the doctor

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Q. My daughter has just been diagnosed with lupus. What is it, and what can be done to help?

A. A healthy, young patient of mine once asked me what the chances were that she might one day develop a "terrible disease." When I asked her what she meant by "terrible disease," she surprised me: she didn't say a disease that could be fatal, but rather a disease that could attack every part of her body. By that definition, systemic lupus erythematosus (lupus for short) is, indeed, a terrible disease.

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Vitamin D is an essential vitamin; low levels are associated with poor bone and muscle health and other chronic conditions, such as heart disease and cancer. Now, a study published online April 19, 2018, by PLOS One has tied higher vitamin D levels to a lower diabetes risk. Researchers followed 900 older adults (average age 74) for 12 years, checking their vitamin D and blood sugar levels during clinic visits. Compared with people whose blood levels of vitamin D were below 30 nanograms per milliliter (ng/ml), people with vitamin D levels of 30 ng/ml or more had one-third the risk for developing diabetes, and people whose D levels were 50 ng/ml or more had one-fifth the risk. This study does not prove that taking vitamin D supplements to raise blood levels of vitamin D would reduce the risk of diabetes, although that is possible. The Institute of Medicine maintains that a blood level of 20 ng/ml or higher is sufficient for 97% of the population. Other authorities think that levels higher than 20 ng/ml are better for health. Large studies are under way to help resolve these differences of opinion.

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