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Tag: Alzheimer

  • Women’s Heart Rhythm Disorder Linked to Faster Cognitive Decline

    Women’s Heart Rhythm Disorder Linked to Faster Cognitive Decline

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    Newswise — Edinburgh, UK – 23 June 2023:  Women with atrial fibrillation progress more rapidly to cognitive impairment and dementia than men with the heart rhythm condition, according to research presented today at ACNAP 2023, a scientific congress of the European Society of Cardiology (ESC)1 and published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

    “Symptoms of atrial fibrillation in women are often ignored by healthcare providers or attributed to stress or anxiety so it can go undiagnosed for long period of time, while men are more likely to be diagnosed and treated quickly,” said study author Dr. Kathryn Wood of Emory University, Atlanta, US. “Being undiagnosed means not receiving oral anticoagulant medication to prevent blood clots and strokes caused by atrial fibrillation. These women may be having clots that go to small blood vessels in their brain, causing them to lose brain function gradually and develop cognitive impairment.”

    “ESC Guidelines for the care of patients with atrial fibrillation recommend oral anticoagulants for both women and men,” continued Dr. Wood.2 “However, we know that women are less likely to receive these medications than men.3,4 This is another reason why women may have small silent strokes that go unrecognised and damage brain tissue leading to cognitive impairment.”

    Atrial fibrillation is the most common heart rhythm disorder, affecting more than 40 million people worldwide.2 People with this condition have a five-fold increased risk of stroke compared with their healthy peers. Women have more atrial fibrillation symptoms than men and worse outcomes from the disorder, with a higher risk of death and more disabling strokes.2,5,6

    Dementia is more common in women than men.7 Atrial fibrillation is associated with a higher risk for cognitive impairment and dementia, possibly because the condition is linked with a more than two-fold risk of silent strokes.8 The accumulation of silent strokes and the associated brain injuries over time may contribute to cognitive impairment. Stroke prevention with oral anticoagulant drugs is the main priority in the management of atrial fibrillation and may reduce the risk of dementia.

    This was the first longitudinal study to use multicentre data to examine sex differences in the prevalence of cognitive disease in patients with atrial fibrillation and the trajectory to dementia. The study included 43,630 participants of the National Alzheimer’s Coordinating Center (NACC) cohort which has enrolled adults from the US general population since 1984. Of those, 4,593 (11%) had atrial fibrillation at baseline and 39,037 (89%) did not. The average age was 78.5 years and 46% were women. To be included in this study, participants were required to have at least three annual clinic visits during which they took neuropsychological tests and were categorised as normal cognition, mild cognitive impairment (MCI) or dementia.

    The researchers analysed the associations between 1) atrial fibrillation and baseline cognitive diagnosis; and 2) atrial fibrillation and time to progression in cognitive diagnosis. The analyses were adjusted for factors that could influence the relationships including age, sex, race, education, body mass index, smoking, depression, hypertension, diabetes, high cholesterol, heart failure, stroke, and sleep apnoea. Men and women with atrial fibrillation were compared to those without the condition and differences by gender were examined.

    Women with atrial fibrillation were three times more likely to have MCI and dementia at baseline compared to women without atrial fibrillation, with odds ratios of 3.43 (MCI) and 3.00 (dementia). The odds ratios for men were 1.73 and 1.60, respectively, but neither association was statistically significant in men.

    During a median follow-up of four years, 30% of participants progressed to a worse stage of cognitive impairment and 21% developed dementia. Women with atrial fibrillation had a higher risk of progressing to a worse stage of cognitive impairment compared to women without atrial fibrillation, with a hazard ratio (HR) of 1.21. Regarding progression to each stage, compared to women without atrial fibrillation, women with the condition were more likely to transition from normal cognition to MCI (HR 1.17) and from MCI to vascular dementia (HR 2.57). The associations between atrial fibrillation and more rapid cognition decline were not statistically significant in men.

    Dr. Wood said: “The analyses indicate stronger associations between atrial fibrillation and declining cognitive function in women compared with men. Establishing ways to identify atrial fibrillation patients at the highest risk of cognitive decline and stroke will inform future interventions to prevent or slow the progression to cognitive impairment and dementia.”

     

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    European Society of Cardiology

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  • Link between vitreous biomarkers, Alzheimer’s found

    Link between vitreous biomarkers, Alzheimer’s found

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    Newswise — BOSTON – New research from Boston Medical Center found a significant correlation between biomarkers in the vitreous humor of the eye and pathologically confirmed cases of Alzheimer’s disease (AD) and Chronic Traumatic Encephalopathy (CTE) in post-mortem brain and eye tissue. Published in IOS Press, this exploratory study indicates that biomarkers in the vitreous humor may serve as a proxy for neuropathological disease.

    The incidence of dementias like AD continues to rise. As of 2021, 6.2 million North Americans above 65 years of age are suffering from AD, and this number is projected to reach 13.2 million by 2060. Diagnosis of both AD and CTE is based on symptoms, clinical exam findings, and cognitive testing, but the diagnoses are not confirmed until post-mortem examination of the brain. In Alzheimer’s disease, neuropathological changes occur decades before symptom onset, so by the time a patient is diagnosed, the therapeutic effect is often limited. Studying biomarkers that may predict disease and can be measured before symptoms develop is a significant priority in AD research.

    Patients with eye disease have an increased risk for developing neurodegenerative disease, and several studies have established a link between neurodegenerative diseases and ophthalmic conditions like glaucoma, diabetic retinopathy, age-related macular degeneration, and cataracts. Patients with these eye conditions are known to have an increased risk of developing AD, so investigating biomarkers in this at-risk population is important in order to study their role in early diagnosis.

    “To our knowledge, this is the first study to investigate the role of vitreous fluid biomarkers and link it to confirmed post-mortem brain tissue pathological examination of AD. In addition, this is the first study to find a link between vitreous fluid biomarkers and confirmed CTE. Our findings provide further evidence to support the potential role of vitreous biomarkers in early diagnosis and prognostication of diseases like AD and CTE,” said Manju Subramanian, MD, an ophthalmologist at Boston Medical Center and an associate professor in ophthalmology at Boston University Chobanian & Avedisian School of Medicine.

    Researchers in this study found a link of biomarkers, including total Tau and neurofilament light-chain (NfL) with pathologically confirmed AD and CTE. Alterations of these neurodegenerative proteins in the vitreous fluid confirm that the eye reflects neuropathological changes in the brain and further supports investigations into the eye’s potential role in the diagnosis of these diseases.

    The findings of this study build on the authors’ previous work that biomarkers in vitreous fluid are linked to cognitive function in live patients with both normal cognition and mild cognitive impairment. These findings are also foundational for future studies to continue to investigate the role of biomarkers and other eye fluid in the diagnosis, prognostication, and management of diseases such as AD and CTE.

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    Boston Medical Center

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  • Universal stem cell therapy treats brain diseases in study

    Universal stem cell therapy treats brain diseases in study

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    FINDINGS
    Scientists at City of Hope, one of the largest cancer research and treatment organizations in the United States and a leading research center for diabetes and other life-threatening illnesses, have developed universal donor stem cells that could one day provide lifesaving therapy to children with lethal brain conditions, such as Canavan disease, as well as to people with other degenerative diseases, such as Alzheimer’s and multiple sclerosis. The study was recently published in Advanced Science.

    “The off-the-shelf approach City of Hope is taking can easily be extended to improve the quality of life of cancer patients who are experiencing cognitive impairment or impaired motor function as a side effect of chemotherapy or radiation,” said Yanhong Shi, Ph.D., chair of the Department of Neurodegenerative Diseases and the Herbert Horvitz Professor in Neuroscience at Beckman Research Institute of City of Hope. Shi has been working on this research for 12 years.

    SIGNIFICANCE
    This is the first time stem cells have been engineered to become universal donors for cell therapy targeting diseases of the central nervous system, Shi said. This “off-the-shelf” approach can provide patients who need cell therapy with lifesaving treatments three to six months earlier.

    BACKGROUND
    Shi and her colleagues engineered healthy human skin cells containing the functional aspartoacylase (ASPA) gene into induced pluripotent stem cells (iPSCs) and then differentiated the iPSCs into oligodendroglial progenitor cells, the precursor cells that produce myelin, an insulating sheath that wraps around nerve fibers. Like a bullet train, myelin sheaths facilitate the light-speed transport of information along neuronal axons.

    The treated Canavan disease animal models exhibited increased ASPA activity compared to the control mice and had a reduction in the toxic accumulation of the metabolite N-acetyl-L-aspartate (NAA) in the brain. Too much NAA has been linked to impaired motor function, mental deficiencies and premature death. As a result, the treated mice exhibited increased myelination and vastly improved motor function. Importantly, the universal donor cells were able to evade immune attack from the recipient mice.

    While the previous technique her team established created a cell therapy from a patient’s own cells to avoid immune rejection, this new approach used techniques that allowed engineered hypoimmunogenic cells from a healthy donor to be transplanted into a humanized disease model without activating the immune system to kill the foreign therapeutic.

    FUNDING
    The study was supported by the California Institute for Regenerative Medicine (TRAN1-08525), the National Institute of Neurological Disorders and Stroke of the National Institutes of Health (NIH) (U01 NS122101), and the National Cancer Institute of the NIH (P30CA33572).

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    City of Hope

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  • Leqembi Coverage– Alzheimer’s Expert Dr. James Galvin Available for Interviews

    Leqembi Coverage– Alzheimer’s Expert Dr. James Galvin Available for Interviews

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    Dr. James Galvin, who is director of the Comprehensive Center for Brain Health and the Lewy Body Dementia Research Center of Excellence at the University of Miami Miller School of Medicine, is available for interviews following the FDA advisory panel’s June 9th endorsment for the approval of the drug Leqembi (lecanemab) as an effective therapy for people with early signs of the disease.

    The decision paves the way for full approval of the drug, which the FDA is expected to decided on by July 6. 

    Dr. James Galvin, a top neurologist and Alzheimer’s expert, can provide expert commentary on the new drug, how Leqembi works in the scheme of the new class of drugs that have recently been approved, the research data that led to the FDA’s approval and how it could benefit patients, among other related topics.

    Learn more on Dr. James Galvin. https://umiamibrainhealth.org/about/ 

     

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    University of Miami Health System, Miller School of Medicine

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  • University of Michigan Sleep Expert Research Highlights at #SLEEP2023

    University of Michigan Sleep Expert Research Highlights at #SLEEP2023

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    BYLINE: Noah Fromson

    June 3 marks the start of the Annual Meeting for the American Academy of Sleep Medicine and the Sleep Research Society. The Michigan Medicine Sleep Disorders Centers will be well-represented with leadership and participation in over 20 events, from oral and poster presentations to discussions and posters. We have scores of experts available to discuss innovations and developments in the field of sleep medicine. We also have a few presentations of note:

    • Late-breaking Abstracts:
      • Obstructive Sleep Apnea and Cumulative Dementia Risk Among Women and Men: A Population-based Study – Tiffany Braley, M.D., Ronald Chervin, M.D., Galit Dunietz, Ph.D. (6/6 at 5 p.m. CT)
        • Key finding: The presence of known or suspected obstructive sleep apnea is associated with a greater cumulative risk of dementia onset in older women and men.
      • Within-person Ambulatory Measures of Sleep Duration Predict Chronic Symptom Severity in Multiple Sclerosis – Tiffany Braley, M.D., Ronald Chervin, M.D., Daniel Whibley, Ph.D. (6/6 at 12 p.m. CT)
        • Key finding: Greater within-person variability in sleep duration, and previous night’s sleep duration, were strongly associated with symptoms of daytime impairment in MS, including fatigue, cognitive difficulties, and pain.  In contrast to more commonly used aggregate sleep metrics, measures of night-to-night variability in sleep and previous night’s sleep within an individual more sensitively predict chronic symptom severity in people with MS in real time, and could be used to guide personalized approaches to chronic MS symptom management.
    •  Oral Presentation:
      • Sleep disturbances and subsequent mobility disability in chronic disease: Findings from the Nurses’ Health Study – Daniel Whibley, Ph.D., Tiffany Braley, M.D. (6/7 at 11:15 a.m. CT)
        • Key finding: Indicators of poor sleep health predicted a more marked increase in mobility disability over time. Notably, known or suspected obstructive sleep apnea was a consistent predictor of a greater likelihood of escalation in mobility disability.
    •  Posters:
      • Behavioral sleep characteristics may differ in toddlers with epilepsy compared to children without – Gita Gupta, M.D. (6/6 at 12 p.m. CT)
        • Key finding: The nature of behavioral sleep challenges in toddlers with epilepsy is complex and differs compared to children without epilepsy. The interplay between the child and their caregiver, in addition to the child’s own sleep behaviors is important to understand disordered sleep in toddlers with epilepsy.  
      • Obstetrician-Gynecologists’ knowledge and practice patterns regarding sleep disorders in pregnant patients – Greta Raglan, Ph.D., Leslie Swanson, Ph.D. (6/6 at 5 p.m. CT)
        • Key finding: Most OB-GYNs don’t regularly screen for sleep concerns during pregnancy and lack training on management of sleep disorders during pregnancy.

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    Michigan Medicine – University of Michigan

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  • New Study Links Air Pollution To Dementia

    New Study Links Air Pollution To Dementia

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    When you think about the causes of dementia, age probably springs first to mind as it is primarily associated with Alzheimer’s, a disease which hits the older adult age groups the hardest. Diabetes and high cholesterol are also in the high risk category, as are family history, smoking and alcohol use, according to Stanford Medicine. One cause you may not have associated with this devastating condition is air pollution, but according to a recent study conducted by the University of California San Diego, there is a link.

    Health Concerns

    If you’re thinking that this doesn’t affect you as someone living far from a busy highway or industrial facility, you could be in for a scary surprise. The pollutants cited in the study are fine particulate matter (PM 2.5) and nitrogen dioxide (NO2) “associated with accelerated age-related cognitive impairment, and Alzheimer’s disease and related dementias (ADRD),” according to the study’s authors from UCSD’s psychiatry and aging departments.

    They looked at 1100 men between the ages of 56 and 68 and saw a decline in cognitive performance related to higher exposure to the studied pollutants, notably concluding that “risk for later life cognitive decline or progression to dementia may begin in midlife.” In other words, environmental factors in your home and neighborhood now can contribute to devastating health impacts later.

    Particulate Matter

    Higher PM levels can be a health and safety factor inside your homes. According to the Environmental Protection Agency, our indoor air can be up to five times as polluted as the air we breathe outdoors. “Indoor PM can be generated through cooking, combustion activities (including burning of candles, use of fireplaces, use of unvented space heaters or kerosene heaters, cigarette smoking) and some hobbies.”

    Outdoor sources coming into our homes can include automotive and industrial air pollution, as well as smoke and ash from wildfires, which can spread thousands of miles beyond the flames.

    In addition to posing a dementia risk, PM can aggravate heart and lung diseases and irritate eyes, noses and throats.

    Nitrogen Dioxide

    NO2 can also originate inside your home. The National Institutes of Health shared on its website: “The most important indoor sources include tobacco smoke and gas-, wood-, oil-, kerosene- and coal-burning appliances such as stoves, ovens, space and water heaters and fireplaces, particularly unflued or poorly maintained appliances.”

    Outdoor sources that could easily enter your home include NO2 from gas-burning vehicles, lawn and garden equipment, and construction sites, all of which can be as close as the yard or property line beyond your window.

    In addition to posing a dementia risk, NO2 can also aggravate respiratory issues, especially among asthma patients, can contribute to developing asthma and has been linked to learning disabilities in children and Parkinson Disease in other studies.

    Wellness Planning Strategies

    Architects, interior designers and remodeling professionals are looking at these issues when they take on residential projects. San Francisco-based Daniel Ian Smith has to address wildfire considerations for his Bay Area clients, along with the other factors that contribute to a healthier, safer urban area home. “For extensive renovations of San Francisco Victorians, new HVAC systems with HEPA filtration are a no-brainer. However, for the simplest design projects, we still plan for standalone air purifiers in each bedroom and living room. They are invaluable during fire season, but there’s increasing evidence that they’re just as valuable for removing common indoor pollutants all year long,” he commented in a Facebook design industry group discussion. These solutions he cites can all address PM risks.

    Smith also observed the impacts of California’s phase out of gas appliances for new construction homes as advancing clients’ awareness of indoor pollutants. “Combined with a discussion on the federal level, concern has spread all the way to our East Coast clients.” He noted that while gas has long been a gold standard for cooking, induction is proving an attractive alternative to his clients. This can help eliminate a cause of NO2 exposure.

    Architecture firm Mithun, with offices in San Francisco, Seattle and Los Angeles, frequently works on large scale multifamily and mixed use projects. Principal Hilary Noll pointed out that recent California and Bay Area codes now require enhanced ventilation and filtration systems, and other proactive measures for buildings within targeted areas of poor air quality. “Many of our multifamily housing projects have installed MERV 13 prior to this being a code requirement,” she shared in an email.

    “Another strategy we use is the incorporation of heat or energy recovery ventilation systems (HRVs or ERVs) which supply continuous, filtered fresh air while tempering air intake with the exhaust to improve indoor thermal comfort as well indoor air quality. Those are being installed in every residential unit, exceeding energy code compliance,” she noted.

    Noll also commented on the elimination of natural gas within building systems and appliances in favor of electrification, which she cited as “another proven strategy to improve indoor air quality and specifically pollutants associated with fossil fuel combustion including nitrogen dioxide.”

    Wellness Maintenance Strategies

    Kim Levell designs for homeowners in Tampa and Chapel Hill, North Carolina and suggested clean building practices and nontoxic materials in another designer group discussion on Facebook. “I have air cleaners I recommend. Cleaning chemicals, forever chemicals, poor water, things like PFAs and use of toxins are everywhere,” she declared. “Off-gassing of furniture and building products concern me more than a gas range that is properly ventilated,” she added.

    Studies have shown that many homeowners don’t use their kitchen vent fans because they’re noisy and inefficient, so there are gas stoves that should be properly ventilated, but aren’t. Plus, some fans that can fairly be described as ‘working’ merely recirculate air into the room.

    When replacing appliances with a design professional like Levell or Smith as part of a new build or remodel, you’ll get advice on quiet models suitable for your cooking surface. When simply replacing appliances with a retailer, be sure to ask about pairing your new (or existing) cooktop or range with a properly sized and rated model that will keep your kitchen cleaner and safer. In addition to enjoying the benefits of a healthier, more comfortable home today, it could contribute to your health in future years too.

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    Jamie Gold, Contributor

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  • Former Football Player’s Cognitive Symptoms Improved with New Diagnosis and Treatment

    Former Football Player’s Cognitive Symptoms Improved with New Diagnosis and Treatment

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    Newswise — Football players who have had repetitive head trauma and concussion are at heightened risk for chronic traumatic encephalopathy (CTE), an irreversible condition that leads to dementia. But not every case of cognitive decline means CTE, as illustrated by a new case study published by researchers from Mass General Brigham in Current Sports Medicine Reports.

    In the publication, Adam Tenforde, MD, a physician in Mass General Brigham’s Sports medicine program and medical director of the Spaulding National Running Center, co-authored a study that described the case of a 54-year-old former professional football player who was suffering from life-altering cognitive, behavioral and personality changes when he enrolled in the Harvard Football Players Health Study. As part of the study, which comprehensively assesses each participants’ health over the course of a three-day study visit, the participant received a brain MRI. The MRI revealed signs of hydrocephalus—swelling in the brain that can be treated and reversed. After receiving treatment, the participant experienced improvements in mood and cognition.

    “We see with this case report that it’s important to always be curious as to why an individual experiences a change in function,” said Tenforde. “There can be unconscious bias in how we approach former and current athletes, and those biases can affect care. Providers might assume a decline in cognition is indicative of a diagnosis or condition that is untreatable. But one of the key findings from our work on this ongoing study is that when we take a more comprehensive approach, we may find alternative explanations and a treatable diagnosis.”

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    Mass General Brigham

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  • Microplastics can enter the human brain

    Microplastics can enter the human brain

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    Newswise — The study was carried out in an animal model with oral administration of MNPs, in this case polystyrene, a widely-used plastic which is also found in food packaging. Led by Lukas Kenner (Department of Pathology at MedUni Vienna and Department of Laboratory Animal Pathology at Vetmeduni) and Oldamur Hollóczki (Department of Physical Chemistry, University of Debrecen, Hungary) the research team was able to determine that tiny polystyrene particles could be detected in the brain just two hours after ingestion. The mechanism that enabled them to breach the blood-brain barrier was previously unknown to medical science. “With the help of computer models, we discovered that a certain surface structure (biomolecular corona) was crucial in enabling plastic particles to pass into the brain,” Oldamur Hollóczki explained.

    Researching impact on health
    The blood-brain barrier is an important cellular barrier that prevents pathogens or toxins from reaching the brain. The intestine has a similar protective wall (intestinal barrier), which can also be breached by MNPs, as various scientific studies have demonstrated. Intensive research is being conducted on the health effects of plastic particles in the body. MNPs in the gastrointestinal tract have already been linked with local inflammatory and immune reactions, and the development of cancer. “In the brain, plastic particles could increase the risk of inflammation, neurological disorders or even neurodegenerative diseases such as Alzheimer’s or Parkinson’s,” said Lukas Kenner, pointing out that more research is needed in this area.

    Restrict the use of MNPs
    Nanoplastics are defined as having a size of less than 0.001 millimetres, while at 0.001 to 5 millimetres, some microplastics are still visible to the naked eye. MNPs enter the food chain through various sources including packaging waste. But it is not just solid food that plays a role, but liquids too: according to one study, anyone who drinks the recommended 1.5-2 litres of water per day from plastic bottles will end up ingesting around 90,000 plastic particles a year in the process. However, drinking tap water instead can – depending on the geographical location – help reduce this figure to 40,000. “To minimise the potential harm of micro- and nanoplastic particles to humans and the environment, it is crucial to limit exposure and restrict their use while further research is carried out into the effects of MNPs,” Lukas Kenner explained. The newly discovered mechanism by which MNPs breach protective barriers in the body has the potential to advance research in this area decisively.

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    Medical University of Vienna (MedUni Wien)

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  • TRANSCRIPT AND VIDEO AVAILABLE Live Event for April 21: Sleeping pill reduces levels of Alzheimer’s proteins

    TRANSCRIPT AND VIDEO AVAILABLE Live Event for April 21: Sleeping pill reduces levels of Alzheimer’s proteins

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    What: Researcher at Washington University School of Medicine in St. Louis will discuss the study which involved a sleeping aid known as suvorexant that is already approved by the Food and Drug Administration (FDA) for insomnia, hints at the potential of sleep medications to slow or stop the progression of Alzheimer’s disease.

    When: April 21st, 2PM EST

    Where: Live Events Zoom Room (link will be given once you register)

    Who: Dr. Brendan P. Lucey, MD -Associate Professor of Neurology, Section Head, Sleep Medicine

    Researcher’s info:

    Brendan Lucey is associate professor of neurology and Sleep Medicine Section head. Born and raised in Burlington, Vermont, he received his undergraduate degree at the University of Vermont and his medical degree from the Johns Hopkins University School of Medicine. Following medical school, Lucey completed his neurology residency at Washington University and a clinical neurophysiology fellowship at Brigham and Women’s Hospital. From 2008-2012, Lucey was on active duty in the U.S. Air Force and then joined the Department of Neurology at Washington University.

    Lucey’s current research interests are in sleep, aging and Alzheimer’s disease. His lab focuses on studying the potential of sleep interventions to prevent or delay the onset of Alzheimer’s disease. Using lumbar catheters, he investigates how sleep affects different markers of Alzheimer’s disease changes in the brain such as amyloid-beta and tau. Lucey is also interested in whether or not sleep changes may be non-invasive markers for Alzheimer’s disease progression.

     

     

    Media Register to Attend Here

     

    Transcript:

    Thom: Welcome to today’s newswise live event. We have with us today Dr. Brendan Lucey, MD from Washington University in St. Louis. He is Associate Professor of Neurology and section head of Sleep Medicine.

    There was a recent study just off embargo that examined patients taking sleep meds and testing for the presence of key Alzheimer’s proteins. So I want to ask Dr. Lucey, the lead author, your study builds on previous research in mice to demonstrate for the first time that there’s a similar response in humans. So can you describe the participants in this trial and the results that were observed?

    Dr. Brendan Lucey: Yeah, thank you, Tom. The participants in this trial were aged 45 to 65 years old. They didn’t have any evidence of problems with their memory or thinking, we did measure their quality of their sleep using an activity monitor that’s worn on the wrist. And they had evidence that their efficiency of how much they slept at night was lower. And then they were randomized to receive either placebo, or one of two doses of a drug called suvorexant 10 or 20 milligrams. And those are both FDA approved doses to treat insomnia. And our goal is to see how this drug affected the levels of amyloid beta and tau and phosphorylated tau in the fluid that’s around the brain. And these proteins, amyloid and tau and phosphorylated tau, are markers for Alzheimer’s disease pathology that are used to identify individuals who may have changes in the brain consistent with Alzheimer’s disease, and our targets for potential interventions, we wanted to see if this drug lowered the amounts of amyloid beta, which has been shown in mice a similar type of drug has been shown to lower amyloid beta in mice. And then to extend that into looking at the tau protein as well.

    Thom: We have a question from Alicia Medscape. Given that these dual orexin receptor antagonists are controlled substances, would the author’s envision a time when they’d be recommended for daily use? Can you talk about the safety and efficacy and their status as controlled substance?

    Dr. Brendan Lucey: Well, I think that what’s exciting about this study and these results is that suvorexant is approved by the FDA for treatment of insomnia. And it’s been on the market since 2015. And so it has a lot of safety data already available. The FDA also has an additional indication for suvorexant to treat insomnia in individuals with mild to moderate Alzheimer’s disease. So although it’s a controlled substance, in contrast to some other drugs that have been investigated as potential ad modifying drugs and interventions, you know, the safety profile is already well known. I’m thinking specifically of base inhibitors whose trials were shut down a few years ago due to adverse events.

    Thom: Another question from Alicia Medscape. This being a small proof of concept study, what are your plans for larger trials? And are they already underway? And when might you expect to have further results?

    Dr. Brendan Lucey: Let’s think that’s an excellent question. I mean, this is a very small trial looking at changes over hours. But an important proof of concept, as the questioner said, and we do have funding for additional trials that are getting underway now, where we’ll be answering a couple of important questions. One, do we see similar changes in these biomarkers or these proteins, when these drugs are given for months? That’s one question that we have. So giving longer periods of time, we’re going to be testing some different doses of this class of medication to see, you know, if we give 10 milligrams of one drug do we see a much greater effect at a higher dose. And we’re also looking at individuals who are cognitively unimpaired. They don’t have any problems with memory and thinking, but they do have biomarker evidence of amyloid pathology. So these participants, these participants in our study, were biomarker negative. We didn’t screen for them actually to get into the trial, but we did have their amyloid beta and tau phosphorylated tau protein means at the end, and we know that they don’t have evidence of amyloid deposition based on those markers. But we actually want to recruit people who do. And to see if we see we see similar changes, which would suggest potential larger studies could then be done as a secondary prevention for Alzheimer’s disease.

    Thom: Question from Lynn at Belvoir media. Do the researchers have a theory about the mechanism for the effect of this dual orexin receptor and antagonist?

    Dr. Brendan Lucey: Yeah, I mean, the our hypothesized effect was that we would be affecting sleep. And I think that that is definitely I believe that is a mechanism that plays a role. The this drug suvorexant is a dual orexin receptor antagonist. So it blocks the effect of orexin at its receptor. Orexin is weight promoting and so by blocking that you induce sleep. But orexin has a number of other roles. There’s a role in metabolism, energy management, the reward system, and others that conceivably could be affecting these biomarkers as well. And so I think that those mechanisms really need to be explored to better understand what this drug is doing. A big hole in the literature is that there have not been trials of different sleep drugs that have different mechanisms head to head. So in the same trial under the same conditions, looking at drug A and drug B, that are hitting different systems in the brain. They may be affecting sleep as the outcome, but they are different neurotransmitter systems. And are you seeing similar effects? Are they different? And I think that those sorts of studies really need to be done to address that question. We also did monitor sleep during the two days that the participants were in our research unit. And just in looking at measures like total sleep time and their sleep efficiency and time in different sleep stages. There were no significant differences statistically between the groups, which I think suggests that while sleep probably played a role, there may be some other mechanisms that we need to explore. That could be important targets for future interventions.

    Thom: If anybody in the audience has questions, please chat them. And I can ask them on your behalf. Or if you’re interested, we can enable your audio and let you ask them yourself. Doctor, how early should people start thinking about their risk for Alzheimer’s and potentially taking preventive measures?

    Dr. Brendan Lucey: I think that from a prevention point of view as early as problems can certain problems can be identified that we know affect Alzheimer’s disease risk and also sort of good general health should be intervened on, such as high blood pressure and sleep problems like obstructive sleep apnea. A lot of this the studies for interventions over you know, decades are, are obviously very challenging, if not impossible to get funded. But there is data showing that, you know, for instance, with sleep disturbances, very early sleep disturbances, say in midlife and your 40s have been associated with increased risk of, of having cognitive impairment or dementia as much as 25 years later. And so if you have insomnia or obstructive sleep apnea, getting that treated, you know, as early as it gets identified, has the potential to really change your risk profile and going forward.

    Thom: And tell us more about the potential for those entire class of drugs for further study in relation to these effects.

    Dr. Brendan Lucey: As I mentioned, the suvorexant was approved to treat insomnia in 2015. And so has a lot of safety data already available. But in the meantime, additional medications in this class have been approved. So these are dual the RX and receptor antagonists and there’s now three that have been approved. And I think even within this class, there’s the potential to look at different drugs like you know, maybe suvorexant isn’t the best drug for potential intervention and Alzheimer’s disease and maybe it’s one of these other compounds. But like suvorexant, they’ve also been approved for treatment of insomnia, which you know, from a safety profile going forward, is very, very encouraging for future studies that these will be safe and well tolerated.

    Thom: Will you be following up the participants in this study for future longitudinal results?

    Dr. Brendan Lucey: We don’t have any plans right now to do that. A number of participants have reached out who were in the study did you know indicate they are interested in future studies and we do plan that if they seem to be eligible based on what we know from this study, reaching out to them if they expressed interest about enrolling in some of our future studies, we are looking to move in addition to amyloid positive individuals also into older adults who are at a higher risk of Alzheimer’s disease. So there are many participants in the study who wouldn’t qualify for some of those studies because it was a 45 to 65 year old age range.

    Thom: And looking at patients who have potential sleep disturbances at that earlier midlife age, when it’s maybe decades before Alzheimer’s would present, your advice to anybody with those kinds of sleep disturbance in light of this research, what would you say?

    Dr. Brendan Lucey: Yeah, I get asked that question a lot. And, and I think the state of the research is such that, the recommendations are fairly general, you know, this is really a proof of concept study, and certainly does not support going out and taking suvorexant to prevent or delay Alzheimer’s disease. But, you know, I think that individuals need to allow themselves enough time to sleep. Most people on average need seven, seven and a half hours of time to sleep that’s not interrupted, has a good sleep environment with the lower temperature and it’s dark and quiet, sleeping at night, rather than during the day. And when I tell folks is that, you know, if they’re sleep is a problem, where it’s, you know, impacting their, you know, certainly their daily lives, you know, because they’re, they’re too tired to perform at work or to do things that they want to do in their lives, that they should certainly get that checked out. If they’re having insomnia and difficulty maintaining sleep at night, if they have symptoms of sleep disorders, like sleep apnea was snoring and pauses in their breathing while sleeping that they’ve been told about that those should be investigated. And, and treated. And I get that at this point. That’s really the best advice that we can, we can give.

    Thom: If there are any other questions from our audience, please do chat them to us. And we’ll also make sure to share the contact information for the communicators at Washington University who can help get in touch with Dr. Lucey for any further follow up questions. Dr. Lucey, it seems to me that if someone’s experiencing sleep disturbances, they already have lots of reasons to maybe get that checked out. But now this is just one more reason to say the importance of sleep can really not be overstated. Would you agree with that?

    Dr. Brendan Lucey: Absolutely. I think that one of the great aspects of sleep, but also a real challenge in doing these sorts of studies is that sleep affects everything. So you know, sleep disturbances have negative effect on Heart, heart disease outcomes, pulmonary function, the endocrine system metabolism, it’s more, it’s probably more fruitful to find a system that doesn’t, that isn’t affected by sleep. And so I think it’s part of good, good general health. And it’s definitely one that I think that our society in general has somewhat neglected. And, and hopefully, that’s beginning to change, because I think there’s increasing recognition of the importance of sleep to health.

    Thom: Absolutely. Well, thank you for contributing your study to that knowledge about the importance of sleep, and expanding our understanding of what can be early signs and early prevention of Alzheimer’s. I think these are two really important areas that people need to be more and more aware of for their health. So thank you so much for taking the time to answer our questions. I will chat here, the contact information for Judy at Washington University so she can help any other reporters who’d like to get in touch with Dr. Lucey, for further questions, you can do that. And we’ll also provide a transcript and a recording of this discussion. So any members of the media can utilize that for any articles that they’re writing about this. Dr. Lucey, anything you’d like to say in conclusion before we wrap things up here about your study?

    Dr. Brendan Lucey: No, I think we’ve covered it and I really appreciate the opportunity to present this study to everyone who’s on the call.

    Thom: Thank you, Dr. Lucey and we look forward to the bigger and more in depth studies on this topic as we learn more about the results here. Thank you so much and good luck with the next steps of everything.

    Dr. Brendan Lucey: Thank you, appreciate it.

    Thom: Thank you, everyone!

    Lucey’s current research interests are in sleep, aging and Alzheimer’s disease. His lab focuses on studying the potential of sleep interventions to prevent or delay the onset of Alzheimer’s disease. Using lumbar catheters, he investigates how sleep affects different markers of Alzheimer’s disease changes in the brain such as amyloid-beta and tau. Lucey is also interested in whether or not sleep changes may be non-invasive markers for Alzheimer’s disease progression. 

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  • Could Fixing a Problem with the Heart Be Good for Your Brain?

    Could Fixing a Problem with the Heart Be Good for Your Brain?

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    EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, TUESDAY, APRIL 18, 2023

    Newswise — MINNEAPOLIS – People who have an irregular heartbeat called atrial fibrillation that is treated with a procedure called catheter ablation may have a reduced risk of dementia compared to those who are treated with medication alone. The preliminary study released April 18, 2023, will be presented at the American Academy of Neurology’s 75th Annual Meeting being held in person in Boston and live online from April 22-27, 2023.

    Catheter ablation uses radiofrequency through a tube into the heart to destroy small areas of heart tissue that may be causing the abnormal heartbeat.

    “Previous studies have found that people with arrythmias may have long-term thinking and memory problems due to how this condition may affect the blood flow to the brain,” said Bahadar Srichawla, DO, of University of Massachusetts Chan Medical School in Worcester and a member of the American Academy of Neurology. “Our findings show that treatment with catheter ablation is linked to a reduced risk of cognitive impairment.”

    The study involved 887 people with an average age of 75 at the start of the study. Of this group, 193 people received catheter ablation.

    Participants completed a memory and thinking test at the start of the study, at one year and at two years. This test included questions regarding short-term memory, attention, concentration and language. Scores ranged from zero to 30. Cognitive impairment was defined as a score of 23 or less. People who received catheter ablation had an average score of 25 compared to people who did not receive the procedure with an average score of 23.

    After adjusting for factors like heart disease, renal disease, sleep apnea and atrial fibrillation risk score, those who underwent catheter ablation were 36% less likely to develop cognitive impairment than those who did not receive the procedure and were treated only with medication.

    “Our results are encouraging, however there are many factors taken into consideration when catheter ablation is prescribed,” Srichawla added. “More research is needed to confirm our results.”

    A limitation of the study was that no tests of blood flow to the brain were recorded.

    Learn more about dementia at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.

    When posting to social media channels about this research, we encourage you to use the American Academy of Neurology’s Annual Meeting hashtag #AANAM.

    The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with over 40,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.

    For more information about the American Academy of Neurology, visit AAN.com or find us on Facebook, Twitter, Instagram, LinkedIn and YouTube.

    Dr. Srichawla will present the study findings at 11:15 a.m. ET, Monday, April 24, in room 210C at the Boston Convention and Exhibition Center.

    Please send an email to  to schedule an advance interview. 

    Emerging Science abstracts are embargoed until 12:01 a.m., ET, Friday, April 21, 2023, unless otherwise noted by the Academy’s Media and Public Relations Department.

    To access Non-emerging Science abstracts to be presented at the 2023 AAN Annual Meeting, visit https://www.aan.com/events/annual-meeting-abstracts-awards.  

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  • Can phototherapy improve cognitive function in patients with dementia?

    Can phototherapy improve cognitive function in patients with dementia?

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    Newswise — In an analysis of published clinical trials, investigators found that phototherapy—or exposure to sessions of bright light—may be a promising non-pharmacological intervention for lessening symptoms of dementia.

    The analysis in Brain and Behavior included 12 randomized clinical trials. Results indicated that phototherapy improved cognitive function in patients with dementia, but it did not affect symptoms of depression or sleep quality.

    “Further well-designed studies are needed to explore the most effective clinical implementation conditions, including device type, duration, frequency, and time,” the authors wrote.

    URL upon publication: https://onlinelibrary.wiley.com/doi/10.1002/brb3.2952

     

    Additional Information
    NOTE:     The information contained in this release is protected by copyright. Please include journal attribution in all coverage.

    About the Journal
    Brain and Behavior is a peer-reviewed, open access, interdisciplinary journal, providing rapid publication of scientifically sound research across neurology, neuroscience, psychology and psychiatry.

    About Wiley
    Wiley is one of the world’s largest publishers and a global leader in scientific research and career-connected education. Founded in 1807, Wiley enables discovery, powers education, and shapes workforces. Through its industry-leading content, digital platforms, and knowledge networks, the company delivers on its timeless mission to unlock human potential. Visit us at Wiley.com. Follow us on Facebook, Twitter, LinkedIn and Instagram.

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  • U.S. Sets Up $300 Million Database for Alzheimer’s Research

    U.S. Sets Up $300 Million Database for Alzheimer’s Research

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    By Cara Murez 

    HealthDay Reporter

    WEDNESDAY, April 5, 2023 (HealthDay News) — A new national Alzheimer’s disease and dementia database could be a game changer for research on the memory-robbing condition that now affects more than 6 million Americans.

    Planning has begun at the National Institute on Aging (NIA) to fund the data platform. A $300 million grant for the six-year project has been posted online.

    The database “aims to transform” the Alzheimer’s disease research enterprise “by serving as a central hub of research access,” the NIA said recently.

    The project’s earliest start date is April 2024. The NIA will commit $50 million per year to fund one award, CNN reported.

    In creating the database, the goal is to provide something that can “improve applicability and generalizability of findings.” It could be used as a tool for researchers, making it possible to more rapidly answer scientific questions, the NIA said in a posting.

    “The newly announced NIA funding for a large-scale Alzheimer’s disease research database is truly exciting and a very important step forward for our field, and the Alzheimer’s Association will apply for that grant,” Maria Carrillo, Alzheimer’s Association chief science officer, told CNN Tuesday.

    “The [Alzheimer’s] Association is already leading ALZ-NET, which is a national network of physicians that is collecting data — including measures of cognition, function and safety — for patients treated with new FDA-approved Alzheimer’s treatments,” Carrillo added. “The NIA funding could expand ALZ-NET’s scope to the benefit of all stakeholders.”

    A growing number of people are expected to be diagnosed with Alzheimer’s disease and related dementias in the coming years, with an estimated 13.8 million cases predicted by 2060, according to the Alzheimer’s Association.

    Alzheimer’s disease and related dementias affect memory and thinking skills.

    More information

    The U.S. Centers for Disease Control and Prevention has more on Alzheimer’s disease and related dementias.

     

     

    SOURCE: CNN

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  • Mediterranean Diet Cuts Dementia Risk, Regardless of Genetic Risk

    Mediterranean Diet Cuts Dementia Risk, Regardless of Genetic Risk

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    March 14, 2023 – Sticking closely to the Mediterranean diet – rich in healthy fruits, vegetables, nuts, whole grains, and seafood – may help protect the aging brain.

    In a large study of older adults, close following of a Mediterranean diet was tied to a 23% lower risk of getting dementia over an average of 9 years. 

    This was true even in people with genes that make them more likely to have dementia, study investigator Oliver Shannon, PhD, with Newcastle University, Newcastle Upon Tyne, U.K., tells WebMD. 

    The study was published online March 14 in the journal BMC Medicine. 

    Diet may be an important risk factor for dementia. Focusing on diet, and eating healthier, could be targeted to prevent or cut the risk of the memory-robbing disease. Yet, prior studies exploring the impact of the Mediterranean diet have typically been limited in size, and few have explored the impact of one’s genetic makeup. 

    In the new study, researchers looked at genetic and dietary data for more than 60,000 adults in the United Kingdom who were 60 and older. Over the course of about 9 years, 882 got dementia.

    People who ate mostly the Mediterranean diet had a 23% lower risk of dementia, compared to peers who were least careful about following the diet plan. Sticking closely to the largely plant-based diet was equal to a 0.55% reduction in risk of getting dementia. 

    This was the case regardless of a person’s individual genetic risk profile. 

    “This is one of the largest studies in this area to date and, importantly, we found that even for those with higher genetic risk, having a more Mediterranean-like diet reduced the likelihood of developing dementia,” Shannon says. 

    In a statement, Susan Mitchell, PhD, with Alzheimer’s Research UK, who was not involved in the study, said there is a “wealth of evidence that eating a healthy, balanced diet can help reduce the risk of cognitive decline. But evidence for specific diets is much less clear cut.”

    “This new, large study adds to this overall picture, but it only drew on data from people with white, British or Irish ancestry,” she said.

    “More research is needed to build on its intriguing findings, and uncover whether these reported benefits also translate to minority communities, where historically dementia has often been misunderstood and highly stigmatized, and where awareness of how people can reduce their risk is low,” Mitchell said. 

    The new study adds to research published earlier this month, which found that people who most closely followed the Mediterranean diet or the brain-focused MIND diet had fewer signs of the hallmarks of Alzheimer’s disease in their brain after they died.

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  • Fresh understanding of ageing in the brain offers hope for treating neurological diseases

    Fresh understanding of ageing in the brain offers hope for treating neurological diseases

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    Newswise — Scientists from the Trinity Biomedical Sciences Institute (TBSI) have shed new light on ageing processes in the brain. By linking the increased presence of specialised immune cells to conditions such as Alzheimer’s disease and traumatic brain injury for the first time, they have unearthed a possible new target for therapies aimed at treating age-related neurological diseases.

    The research, which benefited from a collaboration with experts at the University of Maryland School of Medicine and focused on microglia in the brain and spinal cord, is published today in leading international journal, Science Advances.

    Microglia are a unique type of immune cell whose job it is to support nerve cells, defend against invading microbes, clear debris and remove dying nerve cells by engulfing and eating them. Emerging research indicates that microglia can have different functional responses depending on molecular and biochemical changes occurring within these specialised cells. 

    In fact, various subtypes of microglia can be distinguished based on a property called autofluorescence. This is the tendency of cells to emit light of one colour after they have absorbed light of another, and it occurs because specific substances inside the cells absorb light. The substances stored in specialised cellular compartments include fat molecules, cholesterol crystals, metals and other misfolded proteins. 

    David Loane, Assistant Professor of Neuroscience in Trinity’s School of Biochemistry and Immunology in TBSI is the lead author of the research. He said:

    “As the brain ages, these materials build up inside autofluorescent microglia, which increase their autofluorescence as a result. Unfortunately, this accumulation of cellular debris also makes it harder for the microglia to perform their essential garbage collection tasks in the brain and to prevent neurological injury and neurodegenerative disease.

    “In this study we found – in aged animals – that these microglia adopt a unique, dysfunctional state, which has a number of problematic impacts. For example, there is an increase in cellular stress and damage, an accumulation of fats and iron, alterations to metabolic processes and an increase in production of molecules that over-egg the immune response.” 

    In addition, the scientists demonstrated that autofluorescent microglia and associated inflammation were more pronounced under pathological conditions, such as in genetic risk factor models of Alzheimer’s disease, and – promisingly – were reversed by drug-assisted microglial replacement in aged animals. 

    Prof Loane added: 

    “Furthermore, environmental exposure to acute traumatic brain injury in animals accelerated the age of onset and tissue-wide distribution autofluorescent microglia by increasing oxidative stress damage in the brain of injured animals. 

    “As a result, increasing evidence now suggests that the accumulation of autofluorescent microglia contributes to diseases of ageing and neurodegeneration. If these sub-populations of microglia are highly inflammatory and damaging to the brain, then targeting them could be a new strategy for treating aging-related diseases.”

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    Trinity College Dublin

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  • Trouble falling asleep at bedtime or in the middle of the night? It could impact your risk for developing dementia

    Trouble falling asleep at bedtime or in the middle of the night? It could impact your risk for developing dementia

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    Newswise — Ann Arbor, March 6, 2023 – Adding to the growing body of evidence on sleep disturbances and cognitive impairment, new research finds significant links between three measures of sleep disturbance and the risk for developing dementia over a 10-year period. The results, reported in the American Journal of Preventive Medicine, published by Elsevier, associate sleep-initiation insomnia (trouble falling asleep within 30 minutes) and sleep medication use with higher risk for developing dementia. The investigators also found that people who reported having sleep-maintenance insomnia (trouble falling back to sleep after waking) were less likely to develop dementia over the course of the study.

    “We expected sleep-initiation insomnia and sleep medication usage to increase dementia risk, but we were surprised to find sleep-maintenance insomnia decreased dementia risk,” explained lead investigator Roger Wong, PhD, MPH, MSW, an Assistant Professor in the Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA. “The motivation behind this research was prompted on a personal level. My father has been experiencing chronic sleep disturbances since the COVID-19 pandemic began, and I was concerned how this would affect his cognition in the future. After reading the existing literature, I was surprised to see mixed findings on the sleep-dementia relationship, so I decided to investigate this topic.”

    This research is novel because it is the first to examine how long-term sleep disturbance measures are associated with dementia risk using a nationally representative US older adult sample. Previous research has associated REM sleep behavior, sleep deprivation (less than five hours of sleep), and the use of short-acting benzodiazepines with cognitive decline. Their results for sleep-maintenance insomnia support other recent studies using smaller, separate data samples.

    This study used 10 annual waves (2011−2020) of prospective data from the National Health and Aging Trends Study (NHATS), a longitudinal panel study that surveys a nationally representative sample of Medicare beneficiaries aged 65 years and older within the USA. This study included only people who were dementia-free at baseline in 2011.

    There is no cure for dementia and recent pharmaceutical approaches to treat dementia have had limited success, pointing to the importance of preventive approaches to dementia. “By focusing on the variations in sleep disturbances, our findings can help to inform lifestyle changes that can reduce dementia risk,” explained co-investigator Margaret Anne Lovier, MPH, Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.

    While the mechanism for decreased dementia risk among those with sleep-maintenance insomnia is still unknown, the investigators theorize that greater engagement in activities that preserve or increase cognitive reserve may thereby decrease dementia risk.

    Recent evidence indicates there is a higher prevalence of sleep disturbances among older adults than among other age groups. This could be attributed to a variety of factors including anxiety about the COVID-19 pandemic or warmer nights as a consequence of climate change.

    “Older adults are losing sleep over a wide variety of concerns. More research is needed to better understand its causes and manifestations and limit the long-term consequences,” added Dr. Wong. “Our findings highlight the importance of considering sleep disturbance history when assessing the dementia risk profile for older adults. Future research is needed to examine other sleep disturbance measures using a national longitudinal sample, whether these sleep-dementia findings hold true for specific dementia subtypes, and how certain sociodemographic characteristics may interact with sleep disturbances to influence dementia risk.”

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  • Black People Less Likely to Receive Dementia-Related Medications

    Black People Less Likely to Receive Dementia-Related Medications

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    EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, SUNDAY, FEBRUARY 26, 2023

    Newswise — MINNEAPOLIS – Black people are receiving medications for dementia less often than white people, according to a preliminary study released today, February 26, 2023, that will be presented at the American Academy of Neurology’s 75th Annual Meeting being held in person in Boston and live online from April 22-27, 2023.

    “Previous research has shown that due to racial disparities, people with dementia do not always receive the same access to medications that may be beneficial in nursing homes and hospitals,” said Alice Hawkins, MD, of Mount Sinai in New York, New York, and a member of the American Academy of Neurology. “However, there is limited data for the use of dementia medications that people take at home. Our study found disparities in this area as well. We hope our findings lead to a better understanding of these disparities so that steps can be taken to eliminate this health inequity.”

    The study involved 25,930 people. Of this group, 3,655 were Black and 12,885 were white. Researchers collected information on the participants including asking them about race and outpatient medications.

    Researchers looked at how often participants received one or more of five medication classes typically prescribed for dementia. Cholinesterase inhibitors prevent the breakdown of a chemical messenger in the brain called acetylcholine, which is important for memory and thought. People with dementia may also use N-methyl-D-aspartate (NMDA) antagonists, which can help cognitive function. Both drug classes help facilitate communication between nerve cells. Selective serotonin reuptake inhibitors (SSRIs) are common antidepressants, antipsychotics treat psychosis and benzodiazepines can be used to treat anxiety and agitation.

    Researchers found that Black people with dementia received all five medication types less often than white people.

    For cholinesterase inhibitors, 20% of Black people received a prescription compared to 30% of white people. For NMDA antagonists, the numbers were 10% for Black people and 17% for white people. For SSRIs, the numbers were 24% and 40%. For antipsychotics, the numbers were 18% and 22%. For benzodiazepines, the numbers were 18% and 37%.

    The differences remained after researchers controlled for factors such as age, sex, and insurance type.

    “Black people who saw a neurologist were receiving cholinesterase inhibitors and NMDA antagonists at rates more comparable to white people,” said Hawkins. “Therefore, referrals to specialists such as neurologists may decrease the disparities for these prescriptions.”

    A limitation of the study was that the data relied on what was present in participants’ medical records. Another limitation is that data on the actual prescription behavior of physicians could not be reliably collected. Therefore, Hawkins said it remains unclear how much of the observed disparity is due to physicians prescribing fewer medications to Black people versus other patient-related factors, such as inability to afford medications.

    Hawkins noted, “More research is needed to understand the root cause of such disparities and design programs to eliminate them.”

    The study was supported by the American Academy of Neurology Resident Research Scholarship, which was awarded to Hawkins.

    Learn more about dementia at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, Twitter and Instagram.

    When posting to social media channels about this research, we encourage you to use the American Academy of Neurology’s Annual Meeting hashtag #AANAM.

    The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with over 38,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.

    For more information about the American Academy of Neurology, visit AAN.com or find us on Facebook, Twitter, Instagram, LinkedIn and YouTube.

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  • Researchers find a link between traffic noise and tinnitus

    Researchers find a link between traffic noise and tinnitus

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    Newswise — If you live near a busy road, it may increase your stress levels and affect your sleep. When we are under stress and sleep poorly, we may be at a higher risk of developing tinnitus.

    In a new study with data from 3.5 million Danes, researchers from the Department of Clinical Research and the Mærsk Mc-Kinney Møller Institute at the University of Southern Denmark (SDU) have found that the more traffic noise Danish residents are exposed to in their homes, the more they are at risk of developing tinnitus.

    Tinnitus is most clearly manifested by annoying whistling tones in the ears, which are disturbing for many.

    Risk increases with noise levels

    It is the first time that researchers have found a link between residential traffic noise exposure and hearing-related outcomes.

    -In our data, we have found more than 40,000 cases of tinnitus and can see that for every ten decibels more noise in people’s home, the risk of developing tinnitus increases by six percent, says Manuella Lech Cantuaria, PhD., Assistant Professor at the Mærsk Mc-Kinney-Møller Institute and affiliated to the the Department of Clinical Research at SDU.

    She and her colleague Jesper Hvass Schmidt, Associate Professor at the Department of Clinical Research   and Chief Physician at Odense University Hospital (OUH) are concerned about the many health problems that traffic noise seems to cause. In 2021, they found a correlation between traffic noise and dementia (read here: https://www.sdu.dk/en/nyheder/forskningsnyheder/trafikstoej-demens ).

    -There is a need for more focus on the importance of traffic noise for health. It is alarming that noise seems to increase the risk of tinnitus, cardiovascular diseases and dementia, among other diseases, says Jesper Hvass Schmidt.

    Tip of the iceberg

    It is at hearing clinics, such as the one at OUH, where Jesper Hvass Schmidt works, that patients can get the diagnosis of tinnitus. But only the worst cases are referred from their own doctor or an otorhinolaryngologist . The high number of reported cases of tinnitus are probably only the tip of the iceberg, he believes.

    -In general, about ten percent of the population experience tinnitus from time to time. It is associated with stress and poor sleep, which can be worsened by traffic noise, and here we have a potential cycle.

    More studies are needed so that researchers can be sure that traffic noise causes tinnitus, and how this happens.

    -But we know that traffic noise can make us stressed and affect our sleep. And that tinnitus can get worse when we live under stressful situations and we do not sleep well, Jesper Hvass Schmidt says.

    Noise at night is worse

    The researchers believe that noise at nighttime can be even worse for health

    -It affects our sleep, which is so important for restoring both our physical and mental health. Therefore, it is worth considering whether you can do something to improve your sleep if you live next to a busy road, Manuella Lech Cantuaria says.

    What to do

    In the study, higher associations were found when noise was measured at the quiet side of their houses, that is, the side facing away from the road. This is where most people would place their bedroom whenever possible, therefore researchers believe this is a better indicator of noise during sleep.

    -There are different things one can do to reduce noise in their homes, for example by sleeping in a room that does not face the road or by installing soundproof windows.

    But not everyone has those options.

    -It is therefore necessary that traffic noise is considered a health risk that must be taken into account in urban planning and political decisions, says Manuella Lech Cantuaria.

     

    Facts about traffic noise:

    The Danish guidance level for harmful traffic noise is 58 decibels. It is estimated that 1.4 million Danes are exposed to noise over 58 decibels in their homes. You can see the noise level for your place of residence here: dingeo.dk

    It is a myth that replacing fuel cars by electric cars can significantly reduce traffic noise exposure at people’s houses. The noise comes mainly from the contact between the tires and the road.

    In Germany, speed limits have been lowered in some places at night, in order to minimize the disturbance of sleep for residents near roads.

    Another way to reduce traffic noise is by placing noise barriers along the road or changing the road surface to one that dampens the tire noise.

    Facts on tinnitus:
    Tinnitus is a subjective experience of sound that does not come from an external source. It can be described as a ringing, buzzing, humming or other form of sound in the ears or in the head. Tinnitus can be a symptom of an underlying disease or injury, but can also be idiopathic, which means the cause is not known. Very often tinnitus occurs in connection with hearing loss. Tinnitus can have a negative impact on quality of life as it can cause sleep problems, difficulty concentrating, and depression. There are several possibilities to reduce tinnitus symptoms, including psychological treatment and hearing aids.

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    University of Southern Denmark

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  • ChatGPT’s AI Could Help Catch Alzheimer’s Early

    ChatGPT’s AI Could Help Catch Alzheimer’s Early

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    Feb. 3, 2023 — The artificial intelligence that can write essays and pass tests can also help identify dementia.

    Researchers at Drexel University in Philadelphia used the AI behind ChatGPT (which has grabbed headlines for writing believable term papers and passing bar exams) to analyze speech, and the system correctly identified Alzheimer’s patients 80% of the time, according to the study published in the journal PLOS Digital Health.

    The researchers used GPT-3, the language model that drives ChatGPT, to analyze audio clips of people describing a picture in a standard test for dementia. 

    Alzheimer’s patients often repeated themselves, strayed from describing the picture’s contents, didn’t finish thoughts, and referred to objects vaguely as a “thing” or “something.”

    “GPT-3 is able to capture such a subtle difference reflected in the text,” says study author Hualou Liang, PhD, professor of biomedical engineering at Drexel. 

    The software analyzed text transcribed (also by software) from 10-second recordings of healthy adults and Alzheimer’s patients. The text trained the GPT-3 model to identify the subtle differences between regular language and speech from someone experiencing cognitive decline.

    The GPT-3 machine learning models understand passages of text by converting words into mathematical representations called “embeddings.” The embeddings are multi-dimensional signals, which allow the AI to identify subtle differences and similarities that even experienced doctors can’t hear. GPT-3 compares the text passages by measuring the distance between those signals in the embeddings. 

    Because GPT-3 only analyzes written text, the process bypasses the pauses and other sounds in spoken language that aren’t words. In this case, that turned out to be an advantage: The GPT-3 analysis outperformed some machine learning models developed by other laboratories that included those sounds.

    Other studies, however, have found that the “ahs” and “ums” in speech can be important in revealing Alzheimer’s. A 2021 study that encoded those pauses allowed a machine learning model to detect Alzheimer’s disease with 90% accuracy, and a separate study conducted in Slovenia that combined text and acoustic features achieved an accuracy of 94%.

    “The best combination tends to be combining both types of features together,” says Frank Rudzicz, PhD, associate professor of computer science at the University of Toronto. “There’s a lot of information in the words and structure of the transcripts, but also in our tone of voice.”

    Using Voice to Spot Alzheimer’s

    More and more researchers are looking at voice as a biomarker, a way to detect various diseases including Alzheimer’s. 

    Worldwide, Alzheimer’s cases are successfully detected just 48% of the time, according to estimates by the World Health Organization. Higher-income countries achieve a 54% diagnostic rate, while low- and middle-income countries are only identifying 24% of Alzheimer’s cases.

    Researchers in this field hope to close that gap by developing a tool that can detect Alzheimer’s early — when the effects may be too subtle for a physician to notice. “There is no cure for Alzheimer’s disease yet, but there are life changes that can delay some of its effects, so early diagnosis is still important,” says Rudzicz, who co-founded a speech analytics mobile app called Winterlight. “These kinds of technologies could also be applied to other disorders, including Parkinson’s, depression, and so on.”

    Doctors could eventually use a device or computer program to test a patient’s cognitive abilities in their office. Brain scans or other clinical tests could then confirm the Alzheimer’s diagnosis.

    Another application might use smart devices like Alexa and Siri to monitor your regular conversations (with your consent) and alert you if it notices any worrying word fumbles. It may even detect other psychological problems like depression and stress. 

    “The analysis could be done in a privacy-preserving manner once the system is fully functional,” says Liang. “As such, it could make an immediate and significant impact on mitigating the dementia problem in the older adult community.”

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  • Investigadores descubren otras enfermedades que podrían imitar a un trastorno cerebral raro relacionado con la demencia

    Investigadores descubren otras enfermedades que podrían imitar a un trastorno cerebral raro relacionado con la demencia

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    Newswise — JACKSONVILLE, Florida. — Investigadores y colaboradores de Mayo Clinic han descubierto hallazgos clínicos clave que pueden ayudar a los médicos clínicos a reconocer causas que podrían tratar la demencia rápidamente progresiva en pacientes que, de lo contrario, podrían recibir un diagnóstico de enfermedad de Creutzfeldt-Jakob. Su estudio se publicó en la versión en línea de Neurology Clinical Practice, la revista médica oficial de la Academia Americana de Neurología.

    De acuerdo con los investigadores de Mayo Clinic, son muchas las afecciones que pueden imitar a la enfermedad de Creutzfeldt-Jakob, con síntomas que incluyen cambios en la personalidad, pérdida de la memoria, convulsiones, dificultad en el habla o para tragar, y movimientos espasmódicos y repentinos. La enfermedad es rara, no tiene cura y tiene una supervivencia media de menos de un año. Diversas enfermedades neurodegenerativas, vasculares e inmunitarias presentan síntomas parecidos, y un pequeño grupo de pacientes puede recibir un diagnóstico equivocado de enfermedad de Creutzfeldt-Jakob. Después de presentar síntomas, muchos de estos pacientes se someten a pruebas para detectar la enfermedad de Creutzfeldt-Jakob en centros especializados y esperan días, o incluso semanas, hasta obtener los resultados.  

    “Eso es tiempo perdido”, afirma el Dr. Gregory Day, neurólogo de Mayo Clinic en Florida y el autor del artículo. “Hay una necesidad insatisfecha del paciente que debemos aprovechar con características clínicas y pruebas rápidas para distinguir la demencia rápidamente progresiva debido a la enfermedad de Creutzfeldt-Jakob de los síntomas imitados. Esta necesidad es incluso más urgente, teniendo en cuenta que algunas de las enfermedades que imitan a la enfermedad de Creutzfeldt-Jakob se pueden ser tratar y, en algunos casos, son reversibles“.

    Los investigadores utilizaron análisis estadísticos para revisar los resultados de pruebas de diagnóstico y características clínicas de pacientes que reunían los criterios de diagnóstico de la enfermedad de Creutzfeldt-Jakob, pero que, en última instancia, presentaban diferentes causas de demencia rápidamente progresiva. A continuación, compararon los historiales médicos de pacientes con aquellos de pacientes con enfermedad de Creutzfeldt-Jakob posible o probada. Los pacientes se habían evaluado en Mayo Clinic o en la Universidad de Washington en St. Louis entre 2014 y 2021.

    Los pacientes que no tenían la enfermedad de Creutzfeldt-Jakob presentaban encefalitis autoinmunitaria, demencia frontotemporal, fístulas arteriovenosas durales, angiopatía amiloide cerebral, que puede derivar en un accidente cerebrovascular, o lupus sistémico. La mayoría tenía niveles elevados de glóbulos blancos que combaten la enfermedad o proteínas en el líquido cefalorraquídeo. Se detectaron anticuerpos en la sangre o en el líquido cefalorraquídeo de alguna de las afecciones a través de pruebas diagnósticas en los Laboratorios de Mayo Clinic.  En contraposición, se descubrió que la mayoría de los pacientes que de hecho tenían la enfermedad de Creutzfeldt-Jakob presentaban niveles normales de glóbulos blancos y proteínas en el líquido cefalorraquídeo.

    “Se deben considerar otras enfermedades que imitan a la enfermedad de Creutzfeldt-Jakob en pacientes que hayan tenido un trastorno motriz temprano y cantidades elevadas de glóbulos blancos y proteínas en el líquido cefalorraquídeo”, afirma el Dr. Day. “Se debe evaluar rápidamente a estos pacientes para detectar enfermedades que imiten a la enfermedad de Creutzfeldt-Jakob y brindarles tratamiento, de ser posible, mientras se esperan los resultados de pruebas adicionales”.

    El Dr. Day planea continuar con esta investigación para descubrir otras medidas biológicas que podrían mejorar el reconocimiento y diagnóstico tempranos en pacientes con demencia rápidamente progresiva. Él afirma que en ese momento los tratamientos posiblemente serán más eficaces y que los pacientes quizás obtengan mejores resultados.

    Esta investigación contó con una subvención de los Institutos Nacionales de la Salud (NIH, por sus siglas en inglés). Para conocer la lista completa de autores, divulgaciones y financiamiento, puede consultarse en la investigación publicada.

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    Información sobre Mayo Clinic

    Mayo Clinic es una organización sin fines de lucro, dedicada a innovar la práctica clínica, la educación y la investigación, así como a ofrecer pericia, compasión y respuestas a todos los que necesitan recobrar la salud. Visite la Red Informativa de Mayo Clinic para leer más noticias sobre Mayo Clinic.

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  • Marriage Could Be a ‘Buffer’ Against Dementia

    Marriage Could Be a ‘Buffer’ Against Dementia

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    By Amy Norton 

    HealthDay Reporter

    TUESDAY, Jan. 31, 2023 (HealthDay News) — Tying the knot is now tied to healthier aging brains: People who stay married for the long haul may gain some protection from dementia, a new study suggests.

    Researchers found that compared with both divorced people and lifelong singles, older adults in a long-term marriage were less likely to develop dementia. Roughly 11% were diagnosed with dementia after age 70, versus 12% to 14% of their divorced or single counterparts.

    When the researchers weighed other factors that could affect dementia risk — like education levels and lifestyle habits — long-term marriage was still linked to a protective effect: Divorced and unmarried adults were 50% to 73% more likely to be diagnosed with dementia.

    The study is not the first to tie marital status to dementia risk, according to researcher Bjorn Heine Strand, a senior scientist with the Norwegian Institute of Public Health, in Oslo.

    “Marriage has been reported to be associated with reduced dementia risk in numerous studies, and our results add to this evidence,” Strand said.

    The big question is why the link exists. Figuring out the reasons, Strand said, is important — especially considering changing demographics and social norms. The elderly population is growing, meaning more people are at risk of dementia; meanwhile, more people are getting divorced or saying no to marriage altogether.

    The findings, published in the Journal of Aging and Health, are based on over 8,700 Norwegian adults whose marital status was tracked from age 44 to 68. Strand’s team then looked for correlations with participants’ likelihood of being diagnosed with dementia after age 70.

    Overall, just under 12% were diagnosed with dementia during the study period, while another 35% developed mild cognitive impairment — problems with memory and thinking skills that may, or may not, progress to dementia.

    In general, Strand’s team found, marital status was not strongly tied to the risk of milder impairments. But there was a clear relationship with dementia risk: Staying married conferred more protection, versus being divorced (consistently or “intermittently”) or unmarried (which counted singles and people who lived with a partner).

    The researchers tried to find explanations. Physical health conditions, like heart disease, may contribute to dementia. Similarly, depression, lower education levels, smoking and being sedentary have all been tied to higher dementia risk.

    None of those factors, however, seemed to fully account for why divorced and unmarried people had a higher dementia risk.

    When the researchers focused on the unmarried group, it did appear that being childless accounted for a good deal of the relationship with higher dementia risk. But that still leaves the question of why.

    “Some of the explanation could be that if you have children, you stay more cognitively engaged,” Strand said. “For example, you have to deal with people and participate in activities that you wouldn’t otherwise have to.”

    It’s theorized, he noted, that such mental and social stimulation — as well as formal education — may help thwart dementia to a degree. People who are more cognitively engaged throughout life may have more “cognitive reserve” — an ability to withstand more of the brain changes that mark the dementia process before symptoms appear.

    The findings are consistent with past research on marital status and dementia, agreed Claire Sexton, senior director of scientific programs and outreach for the Alzheimer’s Association.

    But there are “important caveats,” said Sexton, who was not involved in the study.

    One is that studies like this cannot prove cause and effect. Beyond that, Sexton said, it’s not clear whether findings from older generations would apply to young people today. It’s now much more common, for example, for unmarried couples to live together, versus decades ago.

    And then there’s the bigger picture. Dementia is complicated, Sexton said, and influenced by many factors — including age, genetics, lifestyle habits, physical health and environment. If marital status matters, it would be only one of the variables.

    For now, Sexton pointed to the importance of staying socially connected, which may be part of the story when it comes to marital status and dementia.

    “Staying socially engaged may support cognitive health,” she said. “The Alzheimer’s Association recommends engaging in social activities that are meaningful to you, and that you share those activities with friends and family.”

    In this study, Strand’s team did look at whether people reported having “no close friends,” and that did not explain their findings.

    But in future work, he said, they plan to dig deeper — looking at whether social inactivity, loneliness or general life satisfaction could help explain why marital status is tied to dementia risk.

    More information

    The Alzheimer’s Association has advice on supporting brain health.

     

    SOURCES: Bjorn Heine Strand, PhD, senior scientist, department of physical health and aging, Norwegian Institute of Public Health, Oslo, Norway; Claire Sexton, DPhil, senior director, scientific programs & outreach, Alzheimer’s Association, Chicago; Journal of Aging and Health, Nov. 2, 2022, online

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