Waterford Research on Alzheimer’s Disease Suggests That Measuring Macular Pigment Offers Potential as a Biomarker of Cognitive Health

(Journal of Alzheimer’s Disease)  Ongoing European Research Council-funded research at Waterford Institute of Technology’s (WIT) Macular Pigment Research Group (MPRG) is investigating the potential link between cognitive function and levels of a vital eye pigment linked to diet. The study suggests that measuring macular pigment offers potential as a biomarker of cognitive health. The results of this study are highlighted to a global audience through the prestigious international medical journal, the Journal of Alzheimer’s Disease.

The Waterford clinical trial research, conducted by a team of 10 researchers and healthcare professionals, investigated two patient groups – those free of retinal disease but with low macular pigment and those with early age-related macular degeneration.

A series of tests were carried out on the volunteer trial patients at the analytical and vision laboratories in Carriganore House on WIT’s West Campus where the MPRG is based. These examined the relationship between serum concentrations of the macular carotenoids lutein and zeaxanthin, macular pigment levels in the eye and cognitive function.

The results showed a significant link between macular pigment levels in the eye and various measures of cognitive performance in both groups of patients, while serum lutein and zeaxanthin levels correlated with cognitive performance on only two tests. When the researchers controlled for variables such as age, gender, diet, and education levels, the correlations between macular pigment and cognitive function remained statistically significant, while the correlations between serum lutein and zeaxanthin and cognitive function were no longer significant.

Prof John Nolan, Principal Investigator at the MPRG and a Fulbright Scholar, Howard Foundation Chair and European Research Council (ERC)-funded Fellow, said:

“Given the growing prevalence of Alzheimer’s, it is obviously very exciting to be involved in leading-edge research that is opening up new possibilities in terms of detecting patients at most risk of the disease at an earlier stage than has previously been possible.”

“The opportunity to disseminate our research to a relevant worldwide audience through this publication in the Journal of Alzheimer’s Disease is particularly welcome as we continue exploring the potential connections between macular pigment in the eye and cognitive function.”

The study is published online ahead of the September issue.

Dr George Perry, Editor-in-Chief of the Journal of Alzheimer’s Disease, commented that the surprising and novel result of this study opens new therapeutic and conceptual insights to benefit patients in the near term. A respected neuroscientist, Dr Perry is Dean of the College of Sciences and Professor of Biology at the University of Texas at San Antonio.

Citation

http://www.j-alz.com/content/waterford-research-alzheimer%E2%80%99s-disease-suggests-measuring-macular-pigment-offers-potential

Cognitive Function and Its Relationship with Macular Pigment Optical Density and Serum Concentrations of its Constituent Carotenoids, by David Kelly, Robert F. Coen, Kwadwo Owusu Akuffo, Stephen Beatty, Jessica Dennison, Rachel Moran, Jim Stack, Alan N. Howard, Riona Mulcahy, John M. Nolan, Journal of Alzheimer’s Disease 48(1), September 2015.

Journal of Alzheimer’s Disease is published by IOS Press

Copyright © 2015

 

Has Someone You Know been Diagnosed with Alzheimer’s Disease?

(Alzheimer’s Prevention Registry) Does someone you know have trouble remembering words or names? Have familiar places or faces slipped his or her mind? Perhaps he or she has trouble performing routine tasks or keeping appointments. If you have noticed a change in their memory in the last year, you both may be interested in a new research study.

The EPOCH Research Study is a clinical research study sponsored by Merck that is evaluating the safety and effectiveness of an investigational medication to see if it may help slow the progression of mild to moderate Alzheimer’s disease.

To participate, one must:

  • Be between 55 and 85 years old
  • Have had memory problems for at least 1 year
  • Have someone that can attend study visits and help him or her follow study requirements

There are additional eligibility requirements that must be met in order to participate. The study doctor will explain these to them. Qualified participants will receive all study-related care at no charge and be monitored by a team of Alzheimer’s researchers.

About Alzheimer’s Disease

Alzheimer’s disease (AD) causes problems with memory, thinking, and behavior. The most common symptom of early AD is trouble remembering something just learned, such as where the car is parked. A person may also have trouble remembering phone numbers or the details of an important conversation. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily activities. Not everyone with these symptoms has AD. Only a qualified professional can determine if you have AD.

Mild Alzheimer’s Disease

People in this stage begin having trouble with complex tasks, such as paying bills, going to the grocery store, or planning a party. They may also have trouble recalling recent major events, such as a holiday gathering.

Moderate Alzheimer’s Disease

At this stage, people have more trouble with language and thinking clearly. They may have trouble picking appropriate clothing for the weather or may wear the same clothes every day unless they are reminded to change. They may forget significant aspects of their lives, such as their address or where they graduated from school. They may even become suspicious of others.

Memory Problems May Not Be a Normal Part of Aging

It is normal on occasion for everyone to forget or lose something or to make a bad decision. It is a problem when these incidents impact the ability to perform daily activities. The earlier an accurate diagnosis is made, the greater potential there is to effectively manage symptoms and impact the course of the disease.

Why is Clinical Research so Important for Alzheimer’s Disease?

There is currently no cure for Alzheimer’s disease and no treatments to slow or stop its progression. Results of clinical research studies may lead to new prevention and treatment options that could help improve the lives of people with Alzheimer’s disease, their families, and future generations.

To learn more about the possible risks and benefits of participation and to see if someone you know may qualify, visit http://www.EpochMemoryStudy.com or call 844-675-7575.


About the Alzheimer’s Prevention Registry

Banner Alzheimer’s Institute (BAI) created and leads the Alzheimer’s Prevention Registry in collaboration with partnering organizations as part of its mission to end Alzheimer’s disease without losing another generation. The Phoenix-based nonprofit organization is part of Banner Health, one of the largest nonprofit health care systems in the country.

BAI is helping to lead the fight against Alzheimer’s through its cutting-edge studies in detection, treatment and prevention and through a comprehensive model of care that addresses both medical and non-medical needs of patients and their families.

The Registry is part of the Alzheimer’s Prevention Initiative, also championed by BAI, an international collaborative formed to launch a new era of Alzheimer’s prevention research. API is focused on evaluating the most promising therapies in cognitively normal people who, based on their age and genetic background, are at the highest imminent risk of developing Alzheimer’s disease symptoms.

The Alzheimer’s Prevention Registry is funded through generous donations to the Banner Alzheimer’s Foundation, with seed funding from the Geoffrey Beene Foundation Alzheimer’s Initiative.

Citation

http://www.endalznow.org/

©2015 Banner Health

Diabetes Complications Linked to Rising Risk of Dementia

(Endocrine Society) Better blood sugar control can help prevent decline in mental ability.

People who have diabetes and experience high rates of complications are more likely to develop dementia as they age than people who have fewer diabetic complications, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

An individual develops diabetes when the pancreas doesn’t produce enough of the hormone insulin or the body can’t use insulin properly to process sugar. When blood sugar levels remain high due to uncontrolled diabetes, serious complications can develop, including blindness, kidney failure and decreased blood flow in limbs that can lead to amputation.

More than 29 million Americans have diabetes, according to the Society’s Endocrine Facts and Figures Report. Among every 100 Americans diagnosed with the condition, 21 have nerve damage, 27 have diabetic kidney disease, and between 29 and 33 have diabetic eye disease that can cloud vision.

“Our research is the first nationwide study to examine how the severity and progression of diabetes is related to dementia diagnosis rates in an older population,” said one of the study’s authors, Wei-Che Chiu, MD, PhD, of the National Taiwan University College of Public Health, Cathay General Hospital and Fu Jen Catholic University, all in Taipei, Taiwan.

“We found that as diabetes progresses and an individual experiences more complications from the disease, the risk of dementia rises as well.”

The 12-year-long population-based cohort study used the Taiwan National Health Insurance Research Database’s records dating back to 1999 to identify 431,178 people who were older than 50 and newly diagnosed with diabetes.

The researchers reviewed records to determine how many people in the cohort were admitted to a hospital or had at least three outpatient medical visits for dementia after they were diagnosed with diabetes.

To evaluate the progression of each individual’s diabetes, the researchers used an adapted version of the Diabetes Complications Severity Index, a tool used to predict deaths and hospitalizations among people with diabetes.

Among the people in the cohort, 26,856 people, or 6.2 percent, were diagnosed with dementia. The risk of developing dementia was higher among people who had a high score on the Diabetes Complications Severity Index than for those who had a low score.

“The study demonstrates why it is so crucial for people with diabetes to work closely with health care providers on controlling their blood sugar,” Chiu said. “Managing the disease can help prevent the onset of dementia later in life.”

Citation

The study, “Progess of Diabetic Severity and Risk of Dementia,” was published online at http://press.endocrine.org/doi/10.1210/jc.2015-1677, ahead of print.

http://www.endocrine.org/news-room/current-press-releases/diabetes-complications-linked-to-rising-risk-of-dementiaJournal Reference:

Wei-Che Chiu, MD, PhD et al. Progess of Diabetic Severity and Risk of Dementia. Journal of Clinical Endocrinology & Metabolism, July 2015 DOI: 10.1210/jc.2015-1677

 

The Role of a Good Night’s Sleep in Dementia Risk Reduction

(Alzheimer’s Australia Dementia Research Foundation) New research has reiterated that a good night’s sleep may be one of the keys in reducing your risk of dementia, particularly Alzheimer’s disease.

Researchers from UC Berkeley, USA published results in the Journal Nature Neuroscience which suggest that sleep deficit may be a channel through which amyloid beta proteins (a major hallmark of Alzheimer’s disease) are triggered and cause the onset of Alzheimer’s disease symptoms.

In their study, the researchers suggest that sleep disruption might be a pathway through which amyloid beta pathology occurs and contributes to memory decline particularly that associated with hippocampal dysfunction (a part of the brain important for memory).

UC Berkeley neuroscience professor Matthew Walker said that these findings reveal a new pathway through which Alzheimer’s disease may cause memory decline later in life and suggests that this research does offer some hope for the future.

“Poor sleep is potentially treatable and can be enhanced through exercise, behavioural therapy and even electrical stimulation that amplifies brain waves during sleep, a technology that has been used successfully in young adults to increase their overnight memory.”

He finished by saying:

“Sleep could be a novel therapeutic target for fighting back against memory impairment in older adults and even those with dementia.” Walker said.

In late 2013, Dementia News also covered this topic when researchers from the John Hopkins Bloomberg School of Public Health also suggested that a good night’s sleep may help clean the brain of amyloid beta deposition. You can read this article here.

Watch the short clip below which further explains how poor sleep may be associated with memory loss.

For more information on sleeping and dementia you can also visit the Alzheimer’s Australia website. Dr Zoe Terpening from the University of Sydney is also currently being funded by the Alzheimer’s Australia Dementia Research Foundation to look into whether treating people for sleep apnoea can in fact improve cognition.

 

New MIND Diet May Significantly Protect Against Alzheimer’s Disease

(Rush University Medical Center)  A new diet, appropriately known by the acronym MIND, could significantly lower a person’s risk of developing Alzheimer’s disease, even if the diet is not meticulously followed, according to a paper published online for subscribers in the journal Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

Rush nutritional epidemiologist Martha Clare Morris, PhD, and colleagues developed the “Mediterranean-DASH Intervention for Neurodegenerative Delay” (MIND) diet. The study shows that the MIND diet lowered the risk of AD by as much as 53 percent in participants who adhered to the diet rigorously, and by about 35 percent in those who followed it moderately well.

“One of the more exciting things about this is that people who adhered even moderately to the MIND diet had a reduction in their risk for AD,” said Morris, a Rush professor, assistant provost for Community Research, and director of Nutrition and Nutritional Epidemiology. “I think that will motivate people.”

Morris and her colleagues developed the MIND diet based on information that has accrued from years’ worth of past research about what foods and nutrients have good, and bad, effects on the functioning of the brain over time. This is the first study to relate the MIND diet to Alzheimer’s disease.

“I was so very pleased to see the outcome we got from the new diet,” she said.

The MIND diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets, both of which have been found to reduce the risk of cardiovascular conditions, like hypertension, heart attack and stroke. Some researchers have found that the two older diets provide protection against dementia as well.

In the latest study, the MIND diet was compared with the two other diets. People with high adherence to the DASH and Mediterranean diets also had reductions in AD — 39 percent with the DASH diet and 54 percent with the Mediterranean diet — but got negligible benefits from moderate adherence to either of the two other diets.

The MIND diet is also easier to follow than, say, the Mediterranean diet, which calls for daily consumption of fish and three to four daily servings of each of fruits and vegetables, Morris said.

The MIND diet has 15 dietary components, including 10 “brain-healthy food groups” — green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and wine — and five unhealthy groups that comprise red meats, butter and stick margarine, cheese, pastries and sweets, and fried or fast food.

The MIND diet includes at least three servings of whole grains, a salad and one other vegetable every day — along with a glass of wine. It also involves snacking most days on nuts and eating beans every other day or so, poultry and berries at least twice a week and fish at least once a week. Dieters must limit eating the designated unhealthy foods, especially butter (less than 1 tablespoon a day), cheese, and fried or fast food (less than a serving a week for any of the three), to have a real shot at avoiding the devastating effects of Alzheimer’s, according to the study.

Berries are the only fruit specifically to make the MIND diet.

“Blueberries are one of the more potent foods in terms of protecting the brain,”

Morris said, and strawberries have also performed well in past studies of the effect of food on cognitive function.

The MIND diet was not an intervention in this study, however; researchers looked at what people were already eating. Participants earned points if they ate brain-healthy foods frequently and avoided unhealthy foods. The one exception was that participants got one point if they said olive oil was the primary oil used in their homes.

The study enlisted volunteers already participating in the ongoing Rush Memory and Aging Project (MAP), which began in 1997 among residents of Chicago-area retirement communities and senior public housing complexes. An optional “food frequency questionnaire” was added from 2004 to February 2013, and the MIND diet study looked at results for 923 volunteers. A total of 144 cases of AD developed in this cohort.

AD, which takes a devastating toll on cognitive function, is not unlike heart disease in that there appear to be

“many factors that play into who gets the disease,” including behavioral, environmental and genetic components, Dr. Morris said.

“With late-onset AD, with that older group of people, genetic risk factors are a small piece of the picture,” she said. Past studies have yielded evidence that suggests that what we eat may play a significant role in determining who gets AD and who doesn’t, Morris said.

When the researchers in the new study left out of the analyses those participants who changed their diets somewhere along the line — say, on a doctor’s orders after a stroke — they found that “the association became stronger between the MIND diet and [favorable] outcomes” in terms of AD, Morris said. “That probably means that people who eat this diet consistently over the years get the best protection.”

In other words, it looks like the longer a person eats the MIND diet, the less risk that person will have of developing AD, Morris said. As is the case with many health-related habits, including physical exercise, she said,

“You’ll be healthier if you’ve been doing the right thing for a long time.”

Morris said,

“We devised a diet and it worked in this Chicago study.  The results need to be confirmed by other investigators in different populations and also through randomized trials.”

That is the best way to establish a cause-and-effect relationship between the MIND diet and reductions in the incidence of Alzheimer’s disease, she said.

The study was funded by the National Institute on Aging. All the researchers on this study were from Rush except for Frank M. Sacks MD, professor of Cardiovascular Disease Prevention, Department of Nutrition, at the Harvard School of Public Health. Dr. Sacks chaired the committee that developed the DASH diet.

Citation

By Nancy DiFiore

https://www.rush.edu/news/press-releases/new-mind-diet-may-significantly-protect-against-alzheimers-disease

© Rush University Medical Center

 

Dementia Patients, Caregivers Prefer Better Care, Support over Research for Alzheimer’s Cure

(University at Buffalo)  More than $100 million in federal funding was spent last year toward searching for a cure for Alzheimer’s disease. However, if given the choice, most people with dementia and those caring for them would like to see the money go elsewhere, according to a recent study led by University at Buffalo researcher Davina Porock.

The study surveyed people with dementia and their care providers on how funding from the National Alzheimer’s Project Act (NAPA), a federal plan to overcome the disease, should be spent.

It revealed that the majority of respondents ranked caregiving support and resources for long-term care ahead of research for a cure.

The findings are in contrast to current NAPA spending to support those with Alzheimer’s disease, which dedicated only $10 million to care services and education, according to the Department of Health and Human Services.

With more than 5 million people in the U.S. living with dementia, each person receives less than $2 for care support, says Porock.

“Sure, most people in our surveys would love for there to be a cure, but in the meantime they all have this disease and they need help,” says Porock, PhD, professor in the UB School of Nursing.

“We have 10 times more money going toward research instead of supporting the people who are living with dementia. Research is still high on the agenda, but they think that support is more important.”

The study, “National Priorities for Dementia Care: Perspectives of Persons Living with Dementia and their Care Partners,” was published in the Journal of Gerontological Nursing.

The nationwide survey recorded nearly 700 responses, drawing participants from more than 25 Alzheimer’s disease advocacy and patient-support groups. Participants were asked to rank funding priorities based on 11 themes that included care setting, quality of life, and advocacy and awareness.

Of the responses, the top five priorities were:

  1. Financial resources for respite care and short-term caregiving support – care that typically lasts less than a week and is used to relieve family and daily care providers;
  2. Financial resources for long-term care support and aging in place, which includes assistance with nursing home and assisted living expenses;
  3. Research for a cure and medication;
  4. Education and training for families, health professionals and volunteers;
  5. Advocacy and awareness to reduce the stigma of dementia.

Respondents also preferred that not all research funding be allocated to finding a cure. Other areas of focus included workforce issues, education and training, impact on quality of life and the family, and alternative therapies and treatments.

Person-centered approaches to care were a clear theme in many of the responses. Most participants desired the person and family living with dementia, and not the disease, to be the center of care, policy and research.

Dementia is an irreversible condition that slowly impairs memory and cognitive skills, and eventually a person’s ability to carry out daily activities. People with dementia often need assistance eating, bathing and dressing, and sometimes have difficulties communicating.

Alzheimer’s disease makes up nearly half of all dementia cases, and symptoms typically first appear after age 65.

“It’s a taxing job to take care of someone with dementia,” says Porock. “Families, as much as they love each other, can find these tasks physically and emotionally difficult to do. And when the caregiver is a spouse who is close in age, it’s not unheard of for them to die first.”

Another common issue involves caregivers putting their careers on hold to support an ailing family member and having difficulty returning to the workforce, says Porock.

Increased funding for families living with dementia could improve their ability to afford nursing support in their home or at an assisted living home.

“Dementia is a major, and increasing, issue in the world because we have more and more people living longer. And one of the consequences of us not dying from heart disease, cancer or other organ failures is that we live long enough for our brains to wear out,” says Porock.

Porock hopes the results lead policymakers and the NAPA advisory council to reconsider the priorities for funding to better address the needs of those living with dementia and those who care for them.

Citation

http://www.sciencedaily.com/releases/2015/08/150803102852.htmJournal Reference:

Davina Porock. National Priorities for Dementia Care: Perspectives of Persons Living with Dementia and their Care Partners. Journal of Gerontological Nursing, August 2015

Copyright 2015 ScienceDaily or by third parties, where indicated.

 

For Alzheimer’s Patients, Music Can Be Good Medicine

(AARP.org) “I’ve been a bad girl. Am I in trouble?” asks an obviously distraught Naomi. Tears begin to form in the corners of her eyes. She wrings her hands as she sits in her wheelchair in the lobby of an Alzheimer’s disease care facility.

“No, you’re not in trouble,” says recreational therapist Mindy Smith. But nothing seems to help Naomi’s mood. “I’ve been a bad girl,” she repeats over and over.

Then Mindy says, “Do you want your music?” Naomi’s face brightens as headphones are gently placed over her ears. And as a big band arrangement of George Gershwin’s ” ‘S Wonderful” flows from her iPod, Naomi begins to smile.

Scenes like this are being repeated in nursing facilities and homes across America. New research is confirming and expanding an idea long held by those who work with dementia patients: Music can not only improve the mood of people with neurological diseases, it can boost cognitive skills and reduce the need for antipsychotic drugs.

Music therapists who work with Alzheimer’s patients describe seeing people “wake up” when the sounds of loved and familiar music fills their heads. Often, after months or even years of not speaking at all, they begin to talk again, become more social and seem more engaged by their surroundings. Some begin to remember names long forgotten. Some even do what Alzheimer’s patients often cannot do as their disease worsens: They remember who they are.

Neurologist Oliver Sacks wrote in his book Musicophilia that for Alzheimer’s patients, music can be very much like medicine.

“Music is no luxury to them, but a necessity, and it can have a power beyond anything else to restore them to themselves, and to others, at least for a while.”

More than 5 million people in the U.S. have Alzheimer’s, a disease for which there is no cure. One in 8 boomers will get the disease, according to estimates. About 15 million family members in the U.S. are locked in what can become a heartbreaking nightmare of taking care of a loved one with whom they can’t communicate. For many, music can be an important part of easing that suffering. Researchers are finding new ways to use music as part of the treatment of dementia.

Jane Flinn, a behavioral neuroscientist at George Mason University, and graduate student Linda Maguire tested the effects of singing on people with Alzheimer’s disease with songs like “Somewhere Over the Rainbow” and “Isn’t It Romantic?” Flinn and Maguire followed a group of 45 people impaired with Alzheimer’s or other dementia who regularly sang. They tested the group constantly with the Mini Mental State Examination, a cognitive diagnostic test. Flinn and Maguire showed that the mental acuity of those people who regularly sang went up sharply over a four-month period.

“Twenty-one drugs to treat Alzheimer’s have failed in the last nine years,” Flinn says. “I do believe they will eventually find the right drug. But it’s going so slowly. In the meantime, these non-pharmaceutical approaches are helpful.”

Connie Tomaino is one of music therapy’s pioneers. More than 37 years ago, she walked into a dementia unit carrying her guitar and looked at the patients.

“Many were overmedicated. Half of them were catatonic and had feeding tubes. The ones that were agitated had mitts on their hands and were tied to wheelchairs,” she says.

“I just started singing ‘Let Me Call You Sweetheart.’ Many of the people who were considered to be catatonic lifted up their heads and looked at me. And the people who were agitated stopped being upset. Most of them started singing the words to the song.”

She founded the Institute for Music and Neurologic Function to encourage study of the effects of music on the brain.

“Music is very complex,” she says. “The auditory nerve has an immediate contact to part of the brain called the amygdala — what’s often called the ‘fight or flight’ area of the brain. So the immediate thing with sound is arousal. The person becomes startled or suddenly pays attention.”

Tomaino found that even some late-stage Alzheimer’s sufferers could respond to songs meaningful to them.

“One woman who was nonverbal — after one month, she started speaking again. She said things like, ‘The kids are coming, I have to get home to make dinner.’

They were memories and words elicited by the songs.” Her advice: If someone you know is in the early stages of Alzheimer’s, start associating key songs with family members or important ideas. Later, those songs may trigger that association.

A father’s pain eased

I have seen the healing power of music up close. When I quit my job as a radio news anchor in New York to come home to help my mother care for my father, who had Alzheimer’s, we used music in every aspect of caregiving. I sang or played Frank Sinatra’s “In the Wee Small Hours of the Morning” to wake him up. Instead of being lost and confused in the mornings, as often happens for people with Alzheimer’s, the song made him realize where he was and who my mother and I were.

My father loved jazz and had been an accomplished singer. Jazz classics like George Gershwin’s “Summertime” and Cole Porter’s “Night and Day” were great for showering, brushing teeth and getting dressed. I used the songs to distract him during these tasks.

In the afternoons, when what’s called “sundowning” sometimes occurs and Alzheimer’s patients get anxious or angry, Diana Krall’s version of “I Get Along Without You Very Well” would calm him down. As his disease progressed, when he would become almost catatonic, all I had to do was start singing the words to the fight song of his alma mater, the University of Michigan — and his eyes would engage and he would sing along.

When my father died in 2010 at age 83, our sadness was relieved a bit by the sense that his last years of life were less isolated and dark than they might have been otherwise.

Programs spread nationwide

Music therapy programs are a critical part of care in several states and cities.

In Wisconsin, two-thirds of the state’s nursing homes use personalized playlists of music as part of daily caregiving routines. Tom Hlavacek, director of the Southeastern Wisconsin Chapter of the Alzheimer’s Association, says something unexpected happened when the program began: a drastic reduction in the use of psychotropic drugs. “Three years ago, when they started ranking states’ use of psychotropic drugs in nursing homes, Wisconsin came in 14th,” he said. “Now we’re fourth in the country. We’re way ahead of the curve.”

A choir has been formed in Minneapolis from people living with Alzheimer’s and other brain diseases and their caregivers. The cofounder of the Giving Voice Chorus, Mary Lenard, says so much of the disease involves

“things they can no longer do or navigate. So the choir is something they can do. They can be joyful and laugh and sing and be part of this new community.”

One choir member told Lenard, “When I’m here, it’s like I don’t have Alzheimer’s.”

Jewish Family Services in Utah hopes personalized music can help keep Alzheimer’s patients at home with their loved ones longer.

“We’re one of just a few agencies in the U.S. that’s doing this more home-based than institution-based,” executive director Ellen Silver says. Alzheimer’s hits married couples particularly hard. “Some other kinds of intimacy are lost,” she said. “What I’ve seen this music do is create an intimacy that is so meaningful to the caregiver.”

‘An absolute lifesaver’

Dan Cohen, who was trained as a social worker in New York, runs a program called Music and Memory. He uses webinars to teach elder-care professionals how to set up personalized playlists delivered to patients on digital devices. Cohen says,

“Unfortunately, as a society, we view persons with advanced dementia as no longer being able to experience pleasure. Music obliterates that misconception.”

Cohen’s program now operates in more than 1,000 locations across the U.S. and Canada and in a dozen caregiving facilities in eight other countries. While waiting for a cure, he says, “we must focus on maximizing the quality of life for persons with the disease.

“We must use tools at our disposal, such as music, to help us keep in touch with those we care about and for.”

For many, those tools can mean the difference between tender interactions with loved ones and losing them completely.

Kathleen Keller uses iPods and headsets to help take care of her 93-year-old father and mother, who both have dementia. They listen to Bing Crosby, Tony Bennett, Rosemary Clooney, Patti Page and Louis Armstrong. She plays personalized music for them during caregiving, and calms her father during long doctor visits with his iPod.

“For us, this gift of music has been an absolute delight,” she says. “And for me as a caregiver, it has been an absolute lifesaver.”

Citation

http://www.aarp.org/health/brain-health/info-2015/music-therapy-for-alzheimers.html?intcmp=AE-HP-spot9

Copyright 2015 AARP (American Association of Retired Persons)

 

Alzheimer’s Association International Conference 2015: the Highlights

(Medical News Today) This week, the world’s largest dementia forum has taken place – the annual 2015 Alzheimer’s Association International Conference in Washington, DC. The conference provides the opportunity for dementia researchers around the globe to come together and share their study results, with the aim of stepping closer to prevention and treatment strategies for Alzheimer’s and other dementias. And this year’s conference has reported some of the most promising results to date.

alzheimers-definitionIt is estimated that by 2050, around 13.8 million older adults in the US will be living with Alzheimer’s.

Worldwide, around 36 million people are living with Alzheimer’s disease – a condition that accounts for around 60-80% of dementia cases. In the US alone, around 5.3 million people are living with the disease – of whom 5.1 million are aged 65 and older.

Over the next 10 years, the number of seniors with the condition is expected to rise to 7.1 million. By 2050, around 13.8 million older adults will be living with Alzheimer’s.

This year, it is estimated that around 700,000 people in the US aged 65 and older will die from Alzheimer’s, making it the 6th leading cause of death in the country – the only cause of death in the top 10 for which their is no way to prevent, slow or cure it.

In August last year, a Spotlight feature from Medical News Today investigated how close researchers are to finding a cure for Alzheimer’s.

The feature highlighted many barriers to prevention and treatment strategies for Alzheimer’s. Prominent among these was lack of techniques to diagnose Alzheimer’s in its early stages, and many researchers believe early intervention is key to combatting the disease.

Helen Snyder, PhD, director of medical and scientific operations at the Alzheimer’s Association told MNT:

“Evidence suggests that the process of Alzheimer’s disease begins more than a decade before clinical symptoms appear, suggesting we may need to intervene earlier to have a major impact on the course of the disease, particularly when using therapies designed to prevent the development of abnormal protein structures – plaques and tangles – that are abundant in the brains of people with Alzheimer’s.”

Gaining a better understanding of the risk factors for Alzheimer’s is also important for prevention of the disease; if we are aware of what triggers the condition, more can be done to reduce the risk of developing it.

These points were the focus of a number of studies presented at this year’s Alzheimer’s Association International Conference (AAIC). And yesterday, the results of one study were labeled by many as a “potential breakthrough” in Alzheimer’s research – the discovery of a drug that could delay Alzheimer’s decline if administered in the early stages of the disease.

In this Spotlight, we take a look at some of the studies presented at the AAIC that are advancing our knowledge of dementia and Alzheimer’s, bringing researchers closer to finding ways to stop the condition in its tracks.

The Risk for Alzheimer’s

Age is the most well-established risk factor for Alzheimer’s; the vast majority of individuals with the disease are aged 65 and older.

According to the Alzheimer’s Association, the risk for Alzheimer’s doubles every 5 years after the age of 65, while after the age of 85, the risk rises to almost 50%.

A family history of Alzheimer’s and the presence of certain genes – such as apolipoprotein E-e4 (APOE-e4) – are also considered to be risk factors for the disease, but increasingly, researchers are uncovering other elements that may contribute to increased likelihood for Alzheimer’s.

Sedentary Behavior and Lack of Exercise

At the AAIC, Tina Hoang, of the Northern California Institute of Research and Education (NCIRE) in San Francisco, and colleagues presented a study suggesting lack of physical activity and high TV viewing between the ages of 18 and 30 may lead to poorer cognitive function later in life, potentially increasing the risk for Alzheimer’s and other dementias.

The study, involving more than 3,200 adults aged 18-30 who were followed-up for 25 years, revealed that subjects who watched at least 4 hours of TV daily or who had low physical activity levels – defined as activity below 300 Kcal per 50-minute session, three times weekly – had poorer memory, executive function and processing speed in cognitive tests taken in mid-life.

Based on these findings, Hoang and colleagues believe physical activity in early and mid-adulthood may be an important factor for healthy cognitive aging.

“Sedentary behaviors, like TV viewing, could be especially relevant for future generations of adults due to the growing use of screen-based technologies,” says Hoang.

“Because research indicates that Alzheimer’s and other dementias develop over several decades, increasing physical activity and reducing sedentary behavior beginning in early adulthood may have a significant public health impact.”

Type 1 Diabetes

Previous research has indicated that individuals with type 2 diabetes may be at greater risk for Alzheimer’s and other dementias. But according to Rachel Whitmer, PhD, of Kaiser Permanente Division of Research in Oakland, CA, and colleagues, it has been unclear how type 1 diabetes impacts Alzheimer’s risk.

At the AAIC, Whitmer and colleagues presented the first study of dementia among elderly adults with type 1 diabetes.

high-blood-glucoseCompared with participants without type 1 diabetes, adults with this condition were found to be at 83% higher risk for dementia.

To reach their findings, the team analyzed the health history of 490,344 individuals aged 60 and older who had no history of dementia. Of these participants, 334 had type 1 diabetes.

The incidence of dementia among the elderly adults with type 1 diabetes was assessed over 12 years of follow-up and was compared with dementia incidence among participants with type 2 diabetes and those without diabetes.

Compared with participants without type 1 diabetes, adults with this condition were found to be at 83% higher risk for dementia. After adjusting for stroke, hypertension and peripheral arterial disease, the increased risk stood at 61%.

When participants with type 2 diabetes were excluded – leaving only participants without any form of diabetes – the team found the dementia risk for those with type 1 diabetes increased to 93% – 73% after adjusting for stroke, hypertension and peripheral arterial disease.

Whitmer notes that managing type 1 diabetes is tricky, requiring “vigilance and constant self-care.” As such, she says cognitive impairment poses a significant threat to this vulnerable population.

“More research is needed to identify risk and protective factors for Alzheimer’s and other dementias in this group that is newly entering the aging population,” she adds.

Cognitive Ability in Childhood and Job Complexity in Adulthood

In April, Medical News Today reported on a study published in Neurology that associated more challenging jobs with longer survival from frontotemporal dementia – a form of dementia that, unlike Alzheimer’s, does not affect memory.

Such studies have raised questions about whether an individual’s cognitive ability – in both childhood and adulthood – may affect the risk of dementia development. This was the focus of a new study presented at the AAIC.

In one study, Serhiy Dekhtyar, PhD, of the Karolinska Institutet in Sweden, and colleagues gathered data on the childhood cognitive ability – as determined by school grades at the age of 10 – of 7,574 adults aged 65 and older who were part of Sweden’s Uppsala Birth Cohort Study.

The incidence of dementia among the participants was assessed via 20 years of follow-up, and data on their educational attainment and occupational complexity was also gathered. During follow-up, 950 cases of dementia occurred.

The results of the analysis revealed that participants who fell into the lowest 20% of childhood school grades were at 21% greater dementia risk, compared with those who had higher school grades, regardless of their occupational complexity in adulthood.

However, higher childhood school grades alongside greater job complexity – as determined by high complexity with data and numbers – were found to be at 39% reduced risk for dementia, while a 23% lower risk was found among individuals with higher job complexity alone.

These findings, the team says, suggest that cognitive performance in childhood and early adulthood is important for “cognitive reserve” – the ability for the brain to recover quickly from any damage sustained, preserving memory and thinking later in life.

“Our findings highlight the importance of early-life cognitive performance for the late-life risk of dementia,” says Dekhtyar.

“It appears that baseline cognitive ability – even at age 10 – may provide the foundation for successful cognitive aging much later in life. Formation of cognitive reserve is a process that apparently begins early in life.”

Loneliness and Depression

Loneliness in older age is a well-known risk factor for depression, but could it also be a risk factor for Alzheimer’s? Dr. Nancy J. Donovan, of Brigham and Women’s Hospital and Harvard Medical School in Boston, MA, and colleagues suggest so.

The team presented a study at the AAIC in which they assessed data from more than 8,300 adults aged 65 and older who were part of the US Health and Retirement Study from 1998-2010.

Every 2 years, the researchers collected data on participants’ loneliness, depression, health status, cognitive function and memory and social network. At study baseline, 17% of participants reported loneliness, with around half reporting depression.

Over a 12-year follow-up period, the team found that the loneliest subjects experienced cognitive decline around 20% faster than participants who did not report loneliness. In addition, participants who reported depression at study baseline also experienced faster cognitive decline.

Commenting on the findings, Dr. Donovan says:

“We found that lonely people decline cognitively at a faster rate than people who report more satisfying social networks and connections.

Although loneliness and depression appear closely linked, loneliness may, by itself, have effects on cognitive decline. This is important to know as we develop treatments to enhance cognitive health and quality of life for older adults.”

Predicting Dementia Risk and Early Diagnosis

Dementia researchers believe early detection of Alzheimer’s and other dementias is key for successful treatment of symptoms. But at present, there is no single test to diagnose the condition.

Doctors currently rely on medical evaluation, including mental status testing and physical and neurological examinations, in order to make a dementia diagnosis.

However, new research presented at the AAIC has offered new insight into potential ways to predict the risk for dementia, bringing us closer to early diagnostic techniques.

Saliva Testing

A small study led by Shraddha Sapkota, PhD, a neuroscience graduate of the University of Alberta in Canada, suggests an individual’s risk of Alzheimer’s could be detected through a simple saliva test.

older-man-having-a-saliva-swabResearchers say it is possible the risk of cognitive decline could be detected through a saliva test.

Sapkota and colleagues used liquid chromatography-mass spectrometry (LCMS) to assess the saliva samples of 35 participants with normal cognitive functioning, 22 participants with Alzheimer’s and 25 participants with mild cognitive impairment (MCI) – a risk factor for Alzheimer’s.

Compared with participants with normal cognitive functioning, those with MCI and Alzheimer’s had compounds present in their saliva that the researchers linked to poorer cognitive functioning.

Sapkota says their results hold promise for a cheap, noninvasive saliva test for identifying a person’s risk for Alzheimer’s.

“Saliva is easily obtained, safe and affordable, and has promising potential for predicting and tracking cognitive decline, but we’re in the very early stages of this work and much more research is needed,” says Sapkota.

Cerebrospinal Fluid

Dr. Maartje Kester, of the VU University Medical Center in Amsterdam, and colleagues presented a study suggesting a protein found in cerebrospinal fluid (CSF) may be effective for predicting the decline to Alzheimer’s among people with MCI.

Over a 2-year period, 162 participants with either normal cognitive functioning, MCI or Alzheimer’s had two CSF samples taken.

At study baseline, the researchers found that CSF samples from participants with Alzheimer’s had higher levels of a protein called neurogranin, which is expressed in the brain, than participants with MCI or normal cognitive function.

In addition, baseline neurogranin levels were found to be higher among subjects with MCI that had progressed to Alzheimer’s. The team says this indicates neurogranin could be a predictor of cognitive decline among people with MCI.

“We found that neurogranin is a potentially useful marker for the diagnosis, prognosis and monitoring of Alzheimer’s,” says Dr. Kester.

Preventing and Treating Dementia

The long-term goal for all dementia researchers is to find ways to prevent, slow and treat the condition, but this has proved to be very challenging.

One of the difficulties faced in uncovering such strategies has been the inability to determine exactly what causes dementia.

When it comes to Alzheimer’s, two abnormal brain structures are believed to be key players in development of the condition – plaques and tangles. Plaques are pieces of a protein called beta-amyloid that accumulate in the spaces between nerve cells, and tangles are twisted fibers of a protein called tau, which build up inside brain cells.

While the specific role of plaques and tangles in Alzheimer’s development is unclear, researchers believe they block communication between nerve cells, killing them and leading to the loss of brain tissue.

Early Results Suggest Solanezumab May Slow Alzheimer’s Progression

In perhaps the most highly anticipated study presented at the AAIC, researchers suggest a drug called solanezumab, if administered early enough, could slow Alzheimer’s disease by stopping the formation of plaques in the brain.

In a clinical trial of solanezumab – a genetically engineered antibody developed by Eli Lilly and Company – Hong Liu-Seifert, PhD, research advisor for the Alzheimer’s Disease Global Development Team at Eli Lilly, and colleagues adopted a “delayed-start” approach.

This involved individuals with mild Alzheimer’s disease being randomized to one of two groups. One group was treated with solanezumab for 18 months, while the other group was given a placebo. The placebo group then began taking solanezumab after 18 months. Both groups were then monitored for a further 2 years.

“This new analytical method enabled us to assess if solanezumab had an effect that is consistent with slowing progression of disease by modifying the underlying disease progression, which, up until now, has not been studied,” says Liu-Seifert.

The results of the trial showed that both groups of patients benefitted from the drug, with both showing reductions in the rate of cognitive decline. However, the group who began taking the drug later – allowing more time for disease progression – were unable to “catch up” with the reduction in cognitive decline seen in the group who began taking solanezumab earlier.

The team says their results indicate solanezumab slows disease progression, otherwise the group who started taking the drug later would have been able to catch up with the early-start group. The findings also suggest solanezumab may be most beneficial when taken in the early stages of Alzheimer’s.

Maria Carillo, PhD, chief science officer of the Alzheimer’s Association, says the study results emphasize the importance of detecting Alzheimer’s early.

“If it proves to be true, it is the strongest argument to date for early Alzheimer’s diagnosis, because getting the drug earlier makes a significant difference in the outcome,” she adds.

Dr. Eric Karran, director of Alzheimer’s research at Alzheimer’s Research UK told BBC News that if these results are replicated, we may be on the verge of a “real breakthrough in Alzheimer’s research.”

As the results stand, many researchers believe they should be approached with “cautious optimism.”

Claire Walton, research manager at the Alzheimer’s Society, told BBC News:

“The data hints that the antibodies are having an effect, it is promising and it’s better than no effect, but it’s inconclusive.

After a decade of no treatments and many drug failures, it’s exciting to get promising news, but it doesn’t really tell us either way, and we need to wait for the phase-three study, and that is in 18 months.”

Funding Remains a Barrier to Researching Prevention and Treatment

There is no doubt that the studies presented at this year’s AAIC demonstrate how far the dementia research community has come in advancing knowledge of the condition, bringing us a step closer to discovering prevention and treatment strategies.

But there are still a number of factors hindering ongoing research in this field.

Funding is a major factor. Last year, Alzheimer’s disease received $562 million in funding from the National Institutes of Health (NIH). While this was an increase from the $504 million allocated to the field in 2013, it is still far less than the funding other conditions receive.

For example, cancer received almost $5.4 billion in funding from the NIH last year, while breast cancer alone received more funding than Alzheimer’s – at $682 million.

“Dementia is the biggest health and social care challenge of our generation, but research into the condition has been hugely underfunded,” James Pickett, head of research at the Alzheimer’s Society told MNT.

“This lack of funding has hampered progress and also restricted the number of scientists and clinicians working in the dementia field.”

“Other diseases have demonstrated that sustained investment in research can improve lives, reduce death rates and ultimately produce effective treatments and preventions,” added Heather Snyder of the Alzheimer’s Association.

“We have the tools and the talent to achieve breakthroughs in Alzheimer’s disease, but we need the resources to make this a reality.”

Despite lack of funding, scientists around the globe continue to make great strides in dementia research, as demonstrated by the studies presented at the AAIC this week. Given the optimism emitted by this year’s conference, there are high hopes for even better results next year.