Archives for May 2012

How to Tell Apart the Forgetful from Those at Risk of Alzheimer’s Disease

It can be difficult to distinguish between people with normal age-associated memory loss and those with amnestic mild cognitive impairment (aMCI). However people with aMCI are at a greater risk of developing Alzheimer’s disease (AD), and identification of these people would mean that they could begin treatment as early as possible. New research published in BioMed Central’s open access journal BMC Geriatrics shows that specific questions, included as part of a questionnaire designed to help diagnose AD, are also able to discriminate between normal memory loss and aMCI.

Loss of memory can be distressing for the person affected and their families and both the patient and people who know them may complain about their memory as well as difficulties in their daily lives. However memory problems can be a part of normal aging and not necessarily an indicator of incipient dementia. A pilot study had indicated that a simple, short, questionnaire (AQ), designed to identify people with AD by using informant-reported symptoms, was also able to recognize people with aMCI.

The AQ consists of 21 yes/no questions designed to be answered by a relative or carer in a primary care setting. The questions fall into five categories: memory, orientation, functional ability, visuospatial ability, and language. Six of these questions are known to be predictive of AD and are given extra weighting, resulting in a score out of 27. A score above 15 was indicative of AD, and between 5 and 14 of aMCI. Scores of 4 or lower indicate that the person does not have significant memory problems.

While validating the AQ researchers from Banner Sun Health Research Institute discovered that four of the questions were strong indicators of aMCI. Psychometrist Michael Malek-Ahmadi, who led the study, explained, “People with aMCI were more often reported as repeating questions and statements, having trouble knowing the date or time, having difficulties managing their finances and a decreased sense of direction.” He continued, “While the AQ cannot be used as a definitive guide to diagnosing AD or aMCI, it is a quick and simple-to-use indicator that may help physicians determine which individuals should be referred for more extensive testing.”


Story Source: The above story is reprinted from materials provided by BioMed Central Limited, via AlphaGalileo.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:
  1. Michael Malek-Ahmadi, Kathryn Davis, Christine Belden, Sandra Jacobson and Marwan N Sabbagh. Informant-reported cognitive symptoms that predict amnestic mild cognitive impairment. BMC Geriatrics, 2012 (in press)

BioMed Central Limited (2012, February 2). How to tell apart the forgetful from those at risk of Alzheimer’s disease. ScienceDaily. Retrieved February 5, 2012, from­ /releases/2012/02/120202201600.htm
Copyright © 1995-2011 ScienceDaily LLC


The Alzheimer’s Questionnaire

A quick test that tells if your loved one is at risk of Alzheimer’s disease has been devised by doctors. The 21-question test distinguishes between normal absent-mindedness and the more sinister memory lapses that may signal the early stages of dementia. The questions are designed to be answered by a spouse or close friend. The Alzheimer’s Questionnaire, which is almost 90 per cent accurate, measures mild cognitive impairment – the slight memory lapses that can be a precursor of the disease.

A 21 question test will help identify if a person has signs that could point to Alzheimer's disease


Up to 15 per cent of people with MCI develop Alzheimer’s within the next year.

The lack of a cure for dementia means that some may not want to take the test, which was devised by Banner Sun Health Research Institute in Arizona, which specialises in the disease.

Some questions, including one about making the same statements over the course of a day, known as repetitiveness, were found to be particularly valuable.

The 21 questions are answered with a simple ‘yes’ or ‘no’. A ‘yes’ is given a score of one or two and a ‘no’ always scores zero, giving a maximum possible score of 27.

Someone who scores under five is advised that there is no cause  for concern. A score of five to 14 suggests mild cognitive impairment – or memory lapses that could be the early stages of Alzheimer’s.

Any higher than this and the person may already have it. Writing in the journal BMC Geriatrics researcher Michael Malek-Ahmadi said: ‘As the population ages, the need for a quick method of spotting the disease early will grow.’

Mr Malek-Ahmadi stressed that it is up to GPs rather than patients to interpret the results of the test. That said, anyone who scores five or above should seek expert help.



UPDATED: 08:14 EST, 4 February 2012

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The Alzheimer’s Questionnaire is developed by BMC Geriatrics (, an open access, peer-reviewed journal that considers articles on all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.

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Staying Safe: Wandering and The Alzheimer’s Patient

One of the most dangerous behaviors associated with Alzheimer’s disease is wandering. An Alzheimer’s patient who wanders outside alone can easily become lost, confused, injured, and, in harsh weather, even die from exposure. It is imperative, especially in the middle stage of the disease, that caregivers take steps to prevent wandering and know what to do if their loved one is missing. Part of the job of preventing wandering is to try to identify the reasons why a patient may want to wander. Some common reasons for wandering are:

  • Confusion. The patient doesn’t realize that he is at home and sets out to “find” his home.
  • Delusions. The patient may be trying to fulfill a responsibility from the long-ago past, such as going to work or searching for a child.
  • Escape from a real or perceived threat. A patient can be frightened by noise, a strange visitor, or even the belief that her caregiver is trying to hurt her.
  • Agitation, a common symptom of Alzheimer’s disease, can also be exacerbated by some medications.
  • Restlessness brought on by a lack of exercise and other stimulation.
  • Searching for a person, a place, or a personal item that was lost.

Preventing Wandering

An Alzheimer’s patient who is restless or has a tendency to wander should never be left alone. But even with another adult in the house, the caregiver should take certain steps to lessen the danger that the patient will be able to get out of the house alone. Some of these steps include:

  • Giving the patient a safe, uncluttered space to pace in. Eliminate rugs and obstacles that the patient could trip on, and allow him to pace.
  • Ensuring all basic needs are met (toileting, nutrition, thirst).
  • Giving the patient something repetitive to do, such as rocking in a rocking chair or glider, sweeping the floor, or folding clothes.
  • Adding deadbolts to all doors leading to the outside, and keeping the keys in a safe place where the patient can’t get to them.
  • Installing safety devices from your local hardware store on all windows limiting how far they can be opened.
  • Installing bells or alarms that sound whenever an outside door is opened. These are also available at hardware stores.
  • Obtaining a medical identification bracelet for the patient with his name, the words “memory loss,” and an emergency phone number on it. Make sure the patient wears it at all times. These bracelets are often sold in drug stores.
  • If possible, having a fence installed around the house that has a locked gate.
  • Having your loved one wear a GPS or other tracking device, which can help you find him quickly.
  • Notifying your neighbors that your loved one has a tendency to wander, and asking them to alert you immediately if they see her out alone.
  • Searching special catalogs and websites featuring caregiving products created for Alzheimer’s patients, such as motion detectors, electronic beepers, special latches, and other products. (See the Resources section at the back of this brochure for more information.)
  • Covering doors with “camouflage” posters that make them look like book shelves or something other than a door. Doors can also be painted the same color as walls, to make them “disappear.”

If a Person Is Missing

Even if you’ve taken all the above precautions, there is still a possibility that, at some time, your loved one will manage to slip away unnoticed. She may have gone on foot or by other modes of transportation. If this happens, there are several things you should be prepared to do to find her as quickly as possible. These include:

  • Notifying the police. Call 911 or your community’s equivalent. A missing Alzheimer’s patient should always be treated as an emergency.
  • Having several copies of a recent, close-up photograph of the person to give to police, neighbors, and anyone else who might be searching for him.
  • Keeping a list (several copies) with your loved one’s age, sex, height, weight, and other physical features, along with his blood type, health conditions, medications, dental work, dietary needs, and other pertinent information to share with search personnel.
  • Providing an unwashed article of clothing that has been worn by the patient and kept in a plastic bag to assist police dogs in the search for your loved one. Using plastic gloves to avoid adding your own scent, replace the clothing item every month to keep the scent strong.
  • Having a list of dangerous places in your neighborhood that should be searched first, such as busy crossroads, bridges, creeks, overpasses, drainage ditches, or steep terrain.
  • Providing a list of places where the person likes to go, such as a shopping center, place of worship, or park.

Remember that the more people you inform about your loved one’s condition and tendency to wander, the more help you can enlist in preventing him from getting lost.


Alzheimer’s Disease Research

A program of the American Health Assistance Foundation. Provides information and publications to Alzheimer’s caregivers. The website also has a wealth of resources, including how to obtain catalogs of products designed for Alzheimer’s patients. 1-800-437-2423

Please Note: The following organizations are not affiliated with the American Health Assistance Foundation (AHAF), and AHAF does not endorse any programs or products offered by these organizations. Some of the organizations may charge fees for their services and advice.

Alzheimer’s Disease Education and Referral Center

A service of the National Institute on Aging, part of the U.S. federal government’s National Institutes of Health. 1-800-438-4380

The Alzheimer’s Store Catalog

Provides products for people with Alzheimer’s disease and for those caring for them. 1-800-752-3238

Eldercare Locator

National program that can help you locate a range of services in your area, including respite for caregivers. 1-800-677-1116

MedicAlert Foundation International

Nonprofit offering Medical ID with paid 24-hour nationwide emergency response service for individuals with Alzheimer’s, or a related dementia, who wander or have a medical emergency. The people listed as contacts are called during an emergency. 1-888-633-4298

National Adult Day Services Association

Provides state-by-state help in finding local adult day care services. 1-877-745-1440

Alzheimer’s Association CareFinder™

Private foundation that helps find good local care, tackling issues such as planning ahead, care options, and coordinating care. Also provides a 24/7 helpline for Alzheimer’s-related emergencies: 1-800-272-3900 TDD: 1-866-403-3073

Centers for Medicare and Medicaid Services (CMS)

Offers a way to compare hospitals, nursing homes, and home care services on its website. Extensive caregiver resources. 1-800-MEDICARE (1-800-633-4227)

National Institute on Aging (NIA)

NIA, along with the National Library of Medicine, offers NIHSeniorHealth, a website specially designed for seniors. (301) 496-1752

National Resource Center on Supportive Housing and Home Modification

University-based nonprofit offers an extensive library that includes home modification resources (stair lifts, auto flushers, grab bars, etc.). (213) 740-1364

National Respite Locator Service

Helps caregivers and professionals locate respite services in their communities. (703) 256-2084

Care for the Caregiver: Managing Stress
This 8-page booklet discusses warning signs and ways to reduce the stress associated with caregiving for a person with Alzheimer’s.

Free (Order Online | View in PDF format * | Mail Order Form | Order by Phone)

© 2000 – 2012 American Health Assistance Foundation. All rights reserved.


What Does an Alzheimer’s Brain Cell Look Like?

Led by researchers at the University of California, San Diego School of Medicine, scientists have, for the first time, created stem cell-derived, in vitro models of sporadic and hereditary Alzheimer’s disease (AD), using induced pluripotent stem cells from patients with the much-dreaded neurodegenerative disorder.

Stem-cell-derived neurons, made from patients with Alzheimer’s disease, provide a new tool for unraveling the mechanisms underlying the neurodegenerative disease. In this image, DNA is shown in blue, dendrites and cell bodies in red and endosomal markers Rab5 and EEA1 in green and orange, respectively. (Credit: UC San Diego School of Medicine)

“Creating highly purified and functional human Alzheimer’s neurons in a dish — this has never been done before,” said senior study author Lawrence Goldstein, PhD, professor in the Department of Cellular and Molecular Medicine, Howard Hughes Medical Institute Investigator and director of the UC San Diego Stem Cell Program. “It’s a first step. These aren’t perfect models. They’re proof of concept. But now we know how to make them. It requires extraordinary care and diligence, really rigorous quality controls to induce consistent behavior, but we can do it.”

The feat, published in the January 25 online edition of the journal Nature, represents a new and much-needed method for studying the causes of AD, a progressive dementia that afflicts approximately 5.4 million Americans. More importantly, the living cells provide an unprecedented tool for developing and testing drugs to treat the disorder.

“We’re dealing with the human brain. You can’t just do a biopsy on living patients,” said Goldstein. “Instead, researchers have had to work around, mimicking some aspects of the disease in non-neuronal human cells or using limited animal models. Neither approach is really satisfactory.”

Goldstein and colleagues extracted primary fibroblasts from skin tissues taken from two patients with familial AD (a rare, early-onset form of the disease associated with a genetic predisposition), two patients with sporadic AD (the common form whose cause is not known) and two persons with no known neurological problems. They reprogrammed the fibroblasts into induced pluripotent stem cells (iPSCs) that then differentiated into working neurons.

The iPSC-derived neurons from the Alzheimer’s patients exhibited normal electrophysiological activity, formed functional synaptic contacts and, critically, displayed tell-tale indicators of AD. Specifically, they possessed higher-than-normal levels of proteins associated with the disorder.

With the in vitro Alzheimer’s neurons, scientists can more deeply investigate how AD begins and chart the biochemical processes that eventually destroy brain cells associated with elemental cognitive functions like memory. Currently, AD research depends heavily upon studies of post-mortem tissues, long after the damage has been done.

“The differences between a healthy neuron and an Alzheimer’s neuron are subtle,” said Goldstein. “It basically comes down to low-level mischief accumulating over a very long time, with catastrophic results.”

The researchers have already produced some surprising findings. “In this work, we show that one of the early changes in Alzheimer’s neurons thought to be an initiating event in the course of the disease turns out not to be that significant,” Goldstein said, adding that they discovered a different early event plays a bigger role.

The scientists also found that neurons derived from one of the two patients with sporadic AD exhibited biochemical changes possibly linked to the disease. The discovery suggests that there may be sub-categories of the disorder and that, in the future, potential therapies might be targeted to specific groups of AD patients.

Though just a beginning, Goldstein emphasized the iPSC-derived Alzheimer’s neurons present a huge opportunity in a desperate fight. “At the end of the day, we need to use cells like these to better understand Alzheimer’s and find drugs to treat it. We need to do everything we can because the cost of this disease is just too heavy and horrible to contemplate. Without solutions, it will bankrupt us — emotionally and financially.”

Funding for this research came, in part, from the California Institute for Regenerative Medicine, the Weatherstone Foundation, the National Institutes of Health, the Hartwell Foundation, the Lookout Fund and the McDonnell Foundation.

A patent application has been filed on this technology by the University of California, San Diego. For more information, go to:

Co-authors are Mason A. Israel and Sol M. Reyna, Howard Hughes Medical Institute and UCSD Department of Cellular and Molecular Medicine and UCSD Biomedical Sciences Graduate Program; Shauna H. Yuan, Howard Hughes Medical Institute and UCSD Department of Cellular and Molecular Medicine and UCSD Department of Neurosciences; Cedric Bardy and Yangling Mu, The Salk Institute for Biological Studies; Cheryl Herrera, Howard Hughes Medical Institute and UCSD Department of Cellular and Molecular Medicine; Michael P. Hefferan, UCSD Department of Anesthesiology; Sebastiaan Van Gorp, Department of Anesthesiology, Maastricht University Medical Center, Netherlands; Kristopher L. Nazor, Department of Chemical Physiology, The Scripps Research Institute; Francesca S. Boscolo and Louise C. Laurent, UCSD Department of Reproductive Medicine; Christian T. Carson, BD Biosciences; Martin Marsala, UCSD Department of Anesthesiology and Institute of Neurobiology, Slovak Academy of Sciences, Slovakia; Fred H. Gage, The Salk Institute of Biological Studies; Anne M. Remes, Department of Clinical Medicine, Neurology and Clinical Research Center, University of Oulu, Finland; and Edward H. Koo, UCSD Department of Neurosciences.

About Alzheimer’s disease

An estimated 5.4 million Americans have Alzheimer’s disease, according to the Alzheimer’s Association. Two-thirds are women. By 2050, as many as 16 million Americans are projected to have the disease. In 2011, the economic cost of caring for Alzheimer’s patients exceeded $183 billion, projected to rise to $1.1 trillion by 2050. Alzheimer’s is the sixth leading cause of death in the United States, killing more than 75,000 Americans annually. Currently, there are no drugs to prevent, alter or cure the disease.


The above story is reprinted from materials provided by University of California, San Diego Health Sciences, via Newswise.

Mason A. Israel, Shauna H. Yuan, Cedric Bardy, Sol M. Reyna, Yangling Mu, Cheryl Herrera, Michael P. Hefferan, Sebastiaan Van Gorp, Kristopher L. Nazor, Francesca S. Boscolo, Christian T. Carson, Louise C. Laurent, Martin Marsala, Fred H. Gage, Anne M. Remes, Edward H. Koo, Lawrence S. B. Goldstein. Probing sporadic and familial Alzheimer’s disease using induced pluripotent stem cells. Nature, 2012; DOI: 10.1038/nature10821

University of California, San Diego Health Sciences (2012, January 25). Alzheimer’s neurons from pluripotent stem cells: First-ever feat provides new method to understand cause of disease, develop drugs. ScienceDaily. Retrieved January 26, 2012, from­ /releases/2012/01/120125131029.htm

Copyright © 1995-2011 ScienceDaily LLC  —  All rights reserved


Mild Vitamin B12 Deficiency Associated with Accelerated Cognitive Decline

Being mildly vitamin B-12 deficient could be an indication that some older adults are at a greater risk for accelerated cognitive decline, an observational study from researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging (USDA HNRCA) at Tufts University suggests.

Martha Savaria Morris, Ph.D., an epidemiologist in the Nutrition Epidemiology Program at the HNRCA at Tufts University, and colleagues examined data from 549 men and women enrolled in a cohort of the Framingham Heart Study, focusing on scores on the Mini-Mental State Examination (MMSE), a short list of questions and tasks commonly used to screen for dementia. The subjects were divided into five groups, based on their vitamin B-12 blood levels.

Being in the two lowest groups was associated with significantly accelerated cognitive decline, based on an analysis of test scores from 5 MMSE tests given over a period of eight years. The average age at baseline was 75 years-old.

“Men and women in the second lowest group did not fare any better in terms of cognitive decline than those with the worst vitamin B-12 blood levels. Over time, their MMSE scores declined just as rapidly,” Morris said. “Rapid neuropsychiatric decline is a well-known consequence of severe vitamin B-12 deficiency, but our findings suggest that adverse cognitive effects of low vitamin B-12 status may affect a much larger proportion of seniors than previously thought.”

In the August 2012 issue of the Journal of the American Geriatrics Society, Morris and colleagues write that MMSE scores dropped, on average, 0.24 points per year versus an average drop of 0.35 points annually in the two groups with the lowest vitamin B-12 blood levels. The authors observed an even steeper decline of about 1-point per year in some people in the two lowest groups who also exhibited high blood levels of folate or took supplements containing its synthetic form, folic acid, although their models indicate the additional cognitive decline is potentially related to other health problems in this particular study population.

The subjects in this study were mostly Caucasian women who had earned at least a high school diploma. The authors said future research might include more diverse populations and explore whether vitamin B12 status impacts particular cognitive skills, as the MMSE results provide only a general picture of decline.

“While we emphasize our study does not show causation, our associations raise the concern that some cognitive decline may be the result of inadequate vitamin B-12 in older adults, for whom maintaining normal blood levels can be a challenge,” said Paul Jacques, D.Sc., the study’s senior author and director of the Nutrition Epidemiology Program.

Animal proteins, such as lean meats, poultry and eggs, are good sources of vitamin B-12. Because older adults may have a hard time absorbing vitamin B-12 from food, the USDA’s 2010 Dietary Guidelines for Americans recommend that people over 50 years-old incorporate B-12 fortified foods or supplements in their diets.

Jacob Selhub, Ph.D., director of the Vitamin Metabolism Laboratory at the USDA HNRCA, co-authored the study. Selhub and Jacques are also professors at the Friedman School of Nutrition Science and Policy at Tufts University.

This research is supported by the National Institutes of Health (NIH) (grant# 1 R01 NS062877-01A2) and the U.S. Department of Agriculture (USDA).


Morris MS, Selhub J and Jacques PF. “Vitamin B-12 and Folate Status in Relation to Decline in Scores on the Mini-Mental State Examination in the Framingham Heart Study.” Journal of the American Geriatrics Society. 60:1457-1464, August 2012.

The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school’s eight degree programs, which focus on questions relating to famine, hunger, poverty, and communications, are renowned for the application of scientific research to national and international policy. For three decades, the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University has studied the relationship between good nutrition and good health in aging populations. Tufts research scientists work with federal agencies to establish the USDA Dietary Guidelines, the Dietary Reference Intakes, and other significant public policies.

Tufts University

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