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As belly size gets larger, the memory center in the brain gets smaller
Researchers at University College London link waist circumference with dementia.
30 June, 2020
Photos: Robyn Beck, Ronaldo Schemidt, Paul Ellis/AFP via Getty Images
- Researchers at University College London have discovered a link between waist circumference and dementia.
- Seventy-four percent of volunteers that developed dementia were overweight or obese.
- Women with central obesity had a 39 percent greater risk of dementia.
<p>One of every eight deaths in England was attributed to dementia in 2017. Considering the substantial public health burden this adds to a society, researchers at University College London wanted to understand the role of obesity on cognitive decline. A <a href="https://academic.oup.com/ije/article/doi/10.1093/ije/dyaa099/5861491" target="_blank">new study</a>, published in the International Journal of Epidemiology, sheds light on this connection.</p><p>Obesity impacts a range of health problems, including cardiovascular disease, diabetes, stroke, and dementia. Around the planet, obesity rates in adults have tripled since 1975. In 2016, an estimated 39 percent of adults in England were obese.</p><p>The researchers specifically wanted to know if waist circumference (WC) plays a role in increasing dementia rates. The team pulled data from 6,582 participants from the <a href="https://www.elsa-project.ac.uk/" target="_blank">English Longitudinal Study of Ageing</a>, an 18-year study (so far) featuring over 18,000 volunteers. </p><p>For this study, adults over age 50 were considered. They were broken into normal weight, overweight, and obese groups. Body Mass Index (BMI) was one of two markers used. The relevance of this particular measurement—(Weight in Pounds x 703) / (Height in inches x Height in inches)—has <a href="https://www.health.harvard.edu/blog/how-useful-is-the-body-mass-index-bmi-201603309339" target="_blank">long been contested</a>. It does not account for muscle mass or how fat is distributed throughout the body. </p><p>The WC measurement, which the researchers refer to as <em>central obesity</em>, adds a bit of clarity to the study. They define excess central obesity as 35+ inches for women and 40+ inches for men.</p><p>In total, 6.9 percent of volunteers developed dementia over a (maximum) 15-year follow-up period. Seventy-four percent of participants that developed dementia were overweight or obese. These findings are independent of demographics, lifestyle behaviors, hypertension, diabetes, and APOE E-ε4, a genetic risk factor for dementia.</p><p>Notably, women with excessive central obesity had a 39 percent greater risk of developing dementia compared with non-central obese women.</p>
Mediterranean Diet Has Huge Health Benefits, New Study Finds | The New York Times
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="f003c82b77eb38381dedb83ebf2e802a"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/_JiKXdZwiIg?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>Co-author Andrew Steptoe, a professor of psychology and epidemiology at the university, <a href="https://www.cnn.com/2020/06/23/health/belly-fat-dementia-link-wellness/index.html" target="_blank">sums up</a> the team's work:</p><p style="margin-left: 20px;">"Dementia is one of the major health challenges of the 21st century that could threaten successful aging of the population. Our findings suggest that rising obesity rates will compound the issue."</p><p>Dr. Dorina Cadar, a senior fellow at UCL and corresponding author of the study, suggests monitoring both BMI and WC status. Her suggestions include following a Mediterranean diet, reducing alcohol consumption, and regular exercise. </p><p>Dr. Richard Isaacson, the director of the Alzheimer's Prevention Clinic at Weill Cornell Medical College, <a href="https://www.cnn.com/2020/06/23/health/belly-fat-dementia-link-wellness/index.html" target="_blank">says</a> that brain health and waist size are linked, especially for women.</p><p style="margin-left: 20px;">"Based on emerging data from studies like this, we are now able to clarify sex differences in dementia risk. Combining these findings with my clinical experience, I have seen greater impact on visceral fat on memory function in women, likely mediated by metabolic pathways."</p><p>This is another in a long list of studies linking obesity to cognitive problems, and serves as a reminder as to why <a href="https://bigthink.com/21st-century-spirituality/does-lack-of-exercise-lead-to-dementia" target="_self">exercise</a> and <a href="https://bigthink.com/mind-brain/intermittent-fasting" target="_self">nutrition</a> remain your best defense against dementia. Regardless of the conveniences of modern society, human beings evolved during times of scarcity. We're not built for excess. Our brains pay the price when we indulge. </p><p><span></span>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
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By 2050, the U.S. Alzheimer's population will double. We're not prepared.
The Alzheimer's Association says its new analysis and surveys "should sound an alarm regarding the future of dementia care in America."
17 March, 2020
Pixabay
- By 2050, the number of Americans over age 65 with Alzheimer's is expected to rise from 5.8 to 13.8 million.
- A new report from the Alzheimer's Association highlights how the already-stressed U.S. healthcare system is not prepared to meet this surge.
- There's currently no cure for Alzheimer's, which is a degenerative and potentially deadly form of dementia.
<p>A <a href="https://urldefense.proofpoint.com/v2/url?u=https-3A__alz.org_media_Documents_alzheimers-2Dfacts-2Dand-2Dfigures.pdf&d=DwMFaQ&c=RAhzPLrCAq19eJdrcQiUVEwFYoMRqGDAXQ_puw5tYjg&r=GgivkKNHTVnLjjXi-z78EdTOTAei-Qk2cgtA-vxxZao&m=7Kavl7xY7G4-ShhGSI030JDQPta1lV0pc0snRWgRUhM&s=oWTt98a52Dwlgt4w2FCLc4sZ8u8x7cEA-E-RTEEuyGc&e=" target="_blank">new report from the Alzheimer's Association</a> forecasts a looming health-care problem: The number of Americans with Alzheimer's disease is expected to double by 2050, and unless things change, there will be a severe shortage of health-care professionals able to care for these dementia patients.</p>
<p>There are two key factors driving the problem: an aging U.S. population and a lack of health-care professionals trained to care for Alzheimer's patients. There are currently about 5.8 million Americans ages 65 and older living with Alzheimer's disease, which is about 10 percent of that age cohort. By 2050, that number is expected to hit 13.8 million. This surge poses a problem, given that the U.S. health-care system already struggles to treat people with Alzheimer's and other forms of dementia. </p>
<p style="margin-left: 20px;">"According to the National Center for Health Workforce Analysis, there was already a shortage of geriatricians in 2013, and although a modest increase in supply was projected by 2025, it was not expected to meet demand," the report states. "As a nation, we need to triple the number of geriatricians who were practicing in 2019 to have enough geriatricians to care for those 65 and older who are projected to have Alzheimer's dementia in 2050."</p>
The front lines of diagnosing & treating Alzheimer's
<p>A broad array of practitioners help to treat Alzheimer's, including physicians, nurses, neuropsychologists, and allied health care professionals such as occupational and physical therapists and home health aides, the report notes. Primary care physicians are generally considered to be on the "front lines" of treating and diagnosing the disease. But over-relying on primary care physicians comes with costs.</p><p>The report notes:</p><ul><li>The vast majority of older Americans diagnosed with dementia never see a dementia care specialist and are overwhelmingly diagnosed and cared for by non-specialists.</li><li>85% of people first diagnosed with dementia were diagnosed by a non-dementia specialist physician, usually a primary care physician.</li><li>More than half of PCPs say there are not enough specialists to receive patient referrals.</li></ul><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMjg4MTU2My9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYzNzk4ODkwMH0.vrK3Iy1OQM5JnR9SpsDSVlP7GNU89avU2xJVDzjkuY0/img.png?width=980" id="cd67c" class="rm-shortcode" data-rm-shortcode-id="73fd54bef0834f33eab0d3022b9ed6e5" data-rm-shortcode-name="rebelmouse-image" />
The Alzheimer's Association
<p>What's especially alarming is that some primary care physicians aren't comfortable being on the front lines. The survey found that 39 percent of PCPs reported "never or only sometimes being comfortable personally making a diagnosis of Alzheimer's or other dementias." That's a problem, considering Alzheimer's treatments are more beneficial if the disease is diagnosed early.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMjg4MTU4My9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYxOTU1MzQyOH0.Tnqf5AOGP4tDGUI7HE-OLa1gaoZkNh4017VwrbVcNQI/img.png?width=980" id="00c42" class="rm-shortcode" data-rm-shortcode-id="f9a186f943470af8c91a37e18182ca89" data-rm-shortcode-name="rebelmouse-image" />
The Alzheimer's Association
<p>The Alzheimer's Association <a href="https://www.alz.org/alzheimers-dementia/diagnosis/why-get-checked#:~:text=An%20early%20Alzheimer's%20diagnosis%20provides,and%20may%20provide%20medical%20benefits." target="_blank">notes</a> that an early diagnosis allows patients the option to start taking medication for symptoms, make lifestyle changes, and participate in clinical trials. What's more, diagnosing Alzheimer's as early as possible would likely save the U.S. trillions in medical and long-term care costs for the degenerative disease, which can cause memory loss, cognitive impairment, hallucinations, and eventually death.</p><p>So, how can the U.S. prepare for the influx of Alzheimer's patients, besides continuing to search for a cure? The Alzheimer's Association report recommended several policy strategies that could help meet future demand:</p><ul><li>Offer scholarship and loan forgiveness programs, which incentivize people to attend medical and nursing schools, and to practice in rural areas.</li><li>Boost educational funding: "For example, federal funding of departments of family medicine at U.S. medical schools is associated with an expansion of the primary care workforce."</li><li>Support programs that build capacity in primary care: "One example is Project ECHO® (Extension for Community Healthcare Outcomes), a highly successful tele-mentoring program for health care providers developed by the University of New Mexico. Project ECHO has been shown to improve primary care for multiple diseases, including hepatitis C606 and complex diabetes."</li></ul>
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'Self is not entirely lost in dementia,' argues new review
The assumption "that without memory, there can be no self" is wrong, say researchers.
16 February, 2019
Photo credit: Darren Hauck / Getty Images
In the past when scholars have reflected on the psychological impact of dementia they have frequently referred to the loss of the "self" in dramatic and devastating terms, using language such as the "unbecoming of the self" or the "disintegration" of the self. In a new review released as a preprint at PsyArXiv, an international team of psychologists led by Muireann Irish at the University of Sydney challenge this bleak picture which they attribute to the common, but mistaken, assumption "that without memory, there can be no self" (as encapsulated by the line from Hume: "Memory alone… 'tis to be considered… as the source of personal identity").
<p>In their review, Irish and her colleagues, including doctoral candidate and lead author Cherie Strikwerda-Brown, present a more optimistic perspective based on their analysis of the research literature on autobiographical memory loss in people with Alzheimer's Disease, people with Semantic Dementia, and others with Frontotemporal Dementia. "Overall," they write, "… the self is not entirely lost in dementia, with distinct elements of preservation emerging contingent on life epoch and dementia syndrome".</p><p>Central to the authors' argument is that our autobiographical memories, upon which our sense of self is based, are made up of two interdependent elements: the episodic (the subjective sense of having experienced past events) and the semantic (a factual knowledge of what happened), certain aspects of which are to some extent spared across different types of dementia and different epochs of one's life.</p><p>In people with dementia of the Alzheimer's type, they explain that there is often (especially in the early to moderate stages of the illness) a sparing of autobiographical <em>knowledge</em>, particularly from earlier in life. Specifically, so-called "general event memories" are spared, such as remembering "I used to go dancing on Fridays" or "I used to work as a teacher in my twenties and thirties" – even though a subjective sense of having lived those past experiences is lost. Irish and her colleagues say that this preserved semantic knowledge, including of one's own traits and preferences, can provide a sense of "narrative self-continuity" and helps explain why social abilities can remain relatively intact for many years after a diagnosis of Alzheimer's.</p><p>That's not to say there are no problems with the sense of self: "They [people with Alzheimer's] may display an out of date self-schema, in that 'who I was' becomes 'who I am', and this non-updated framework governs their everyday behaviour," the authors write, pointing to anecdotal cases of people with Alzheimer's acting out roles from earlier in their lives, such as believing they are still a nurse (rather than retired) or a mother (rather than grandmother).</p><p>Conversely, Irish and her colleagues explain how people with Semantic Dementia lose much of their factual knowledge about themselves, especially from their more distant past, while they retain their <em>recent, subjectively experienced</em> episodic memories, especially for the last year or so. These first-hand experiential memories for recent lived experiences – together with a general, temporally unspecified knowledge of the kind of events they experience frequently – can provide another basis for a consistent sense of self, albeit one that is largely rooted in the present and recent past. In turn, this time-limited sense of self may help explain the rigid behaviours and routines often observed in people with Semantic Dementia – a preference for wearing the same clothes, for instance, and always going to the same places at the same time of week.</p>
<p>To provide another perspective, Irish and her team highlight the more severe impairments of self shown by people with Frontotemporal Dementia, which is characterised by marked personality change, together with various degrees of lost semantic and episodic autobiographical memory. While the characteristic traits, humour, morals and behaviour of people with this form of dementia are radically altered by their illness, and perceived as such by close friends and family, the patients themselves lack any self-insight into these changes, which is hugely distressing for their loved ones, but at the same time affords the person with this form of dementia some emotional protection from their condition. Frontotemporal Dementia "equates to a much more profound disruption of the self" according to Irish and her co-authors.</p><p>There is much that we don't yet know about how different forms of dementia impact upon the sense of self, the review authors also point out – particularly there has been little research on future thinking (the ability to imagine the self in the future) and mind-wandering in these conditions. What limited research that has been conducted has thrown up some intriguing results – for instance, while people with Alzheimer's have an impaired ability to imagine future events, they describe such imaginings as seeming as vivid as do healthy people.</p><p>Irish and her co-authors believe research on mind-wandering may be particularly revealing about the way the self is affected by dementia because in healthy people it often involves thoughts about the self in the past and future – what the authors refer to as "spontaneous expressions of the self". "More crucially," they add, "such investigations may provide important insights to guide appropriate interventions to improve overall quality of life in dementia."<br></p><p>A message the authors stress repeatedly in their review is that "despite … severe memory disturbances, [for many people with dementia] self-continuity remains present to varying degrees across past and future contexts." Irish and her team believe this is an important point, not just philosophically but clinically. "Notably, our approach highlights the multifaceted and dynamic nature in which the self is likely to change in healthy and pathological ageing, with important ramifications for the development of person-centred care," they write.</p><p>The optimistic notion that a sense of self can survive dementia – at least in the earlier to moderate stages of the illness – can be considered alongside other research, not mentioned in the review, such as that the <a href="https://digest.bps.org.uk/2008/02/18/alzheimers-patients-retain-their-taste-in-art/" target="_blank">aesthetic tastes</a> and abilities of people with Alzheimer's-type dementia is often preserved for many years. Recognising the value in the lives of people with dementia also helps to challenge the offensive "zombie metaphor" that has emerged in some clinical circles (with published book titles like <em>Alzheimer's Disease: Coping With A Living Death</em> being all too common).</p><p>As John Zeisel – author of <em>I'm Still Here</em> – has argued, "it is possible to have a decent life with Alzheimer's disease, even though most people don't believe it … In fact, a great many people in the first ten years of this condition live their lives to the fullest – renewing and deepening relationships with those they love and who love them."</p><p><a href="https://psyarxiv.com/8r3dw/" target="_blank">"All is not lost" – Rethinking the nature of the self in dementia</a></p><p><a href="http://www.psychologywriter.org.uk/" target="_blank">Christian Jarrett</a> (<a href="https://twitter.com/psych_Writer" target="_blank">@Psych_Writer</a>) is Editor of <a href="https://digest.bps.org.uk/" target="_blank">BPS Research Digest</a></p><p>--</p><p>This article was originally published on <a href="http://theconversation.com/" target="_blank"></a><a href="https://digest.bps.org.uk/" target="_blank">BPS Research Digest</a>. Read the <a href="https://digest.bps.org.uk/2018/04/03/another-nail-in-the-coffin-for-learning-styles-students-did-not-benefit-from-studying-according-to-their-supposed-learning-style/" target="_blank">original article</a>.</p>
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The cause of Alzheimer’s may be gum disease
This means the disease may be curable and a vaccine possible.
27 January, 2019
Photo credit: SEBASTIEN BOZON / AFP / Getty Images
- Bacteria in periodontitis seems to be the culprit.
- Reported amyloid and tau buildups may be a response, not a cause.
- Compelling research offers a genuine reason for optimism.
<p><em><strong></strong><strong></strong></em><strong>Update, 1/31/2019</strong>: <em><a href="https://www.sciencenews.org/article/gum-disease-bacteria-alzheimers-brain-study-link-tenuous?tgt=nr" target="_blank">Science News</a> has reported on the funding of this study, unpublished contradictory evidence, and the broad conclusions made in media headlines. Whenever new research claims a breakthrough, it's wise to reserve judgment just a bit, as we do. According to Rudolph Tanzi, Alzheimer's researcher at Massachusetts General Hospital in Boston, while it's true that gum disease may lead to Alzheimer's, it's far from proven. You can read his concerns <a href="https://www.sciencenews.org/article/gum-disease-bacteria-alzheimers-brain-study-link-tenuous?tgt=nr" target="_blank">here</a>.</em></p>
<p>Dementia is now the fifth leading cause of death around the world, and 70 percent of that is due to Alzheimer's disease. Until now, experts have been baffled by what causes it, and powerless at slowing or reversing the cruel progress of this condition. Alzheimer's pulls its victims away from reality as their families watch, hearts breaking, until death delivers the final blow. That may be about to change, though, thanks to <a href="http://advances.sciencemag.org/content/5/1/eaau3333" target="_blank">new research</a> that suggests the cause of Alzheimer's is actually bacteria. </p><p><em>Porphyromonas </em><em>gingivalis</em>, to be specific — the inflamer of gum disease.</p>
Has the role of protein deposits in patients’ brains been misunderstood?
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTEyMTYyOS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyMTY2Njg4N30.hCgY7D0UeFqKN-KZR10cs79fOel074DmOHdTivqw5PA/img.jpg?width=980" id="bcce3" class="rm-shortcode" data-rm-shortcode-id="0e9fb798b6a34ce4c1435c84613e4d8f" data-rm-shortcode-name="rebelmouse-image" />Brain exhibiting plaque build-up, in blue. Image source: NIH Image Gallery
<p>It's been known for a while that the brains of Alzheimer's victims have unusually high amounts of amyloid and tau proteins.This has led, naturally, to a suspicion that these proteins cause the disease. However, it turns out that some older people with exceptionally good memories have <a href="https://www.newscientist.com/article/2112820-superagers-with-amazing-memories-have-alzheimers-brain-plaques/" target="_blank" data-vivaldi-spatnav-clickable="1">significant amounts</a> of amyloid and tau proteins in their brains. This has called into question their causal role in the disease, and has led scientists to investigations of the possibility that the proteins may be appearing as a <em>response</em> to the actual culprit.</p>Gum disease in mice
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTEyMTYzMS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyNDIyNDMxNn0.c8Y12VYxaG_fi-eFZPGRO1dHMZycneh73exsr4WYDkA/img.jpg?width=980" id="61579" class="rm-shortcode" data-rm-shortcode-id="ed4a53f109c3fcbf5653c9fc64f3c79e" data-rm-shortcode-name="rebelmouse-image" />P. gingivalis. Image source: NIH Image Gallery
<p>Research from 2009 had identified a gum-disease bacteria, <em>P. gingivalis IgG</em>, as a frequent malady of Alzheimers suffers and frequently present in their brains. It was unclear, however, whether the patients' periodontitis had something to do with the disease or was simply a condition sufferers acquired after its onset.</p><p>A number of research teams conducted <em>P. gingivalis</em> experiments and found that its presence worsens Alzheimer's symptoms — including amyloid buildup — in mice bred to have the disease, and actually causes Alzheimer's in healthy mice.</p>An early clue
<p> A few years back, Massachusetts General Hospital's <a href="https://www.massgeneral.org/neurology/research/researchlab.aspx?id=1419" target="_blank">Robert Moir</a> started looking into the behaviors of a particular sequence of amino acids in <a href="https://en.wikipedia.org/wiki/Amyloid_beta" target="_blank" data-vivaldi-spatnav-clickable="1">beta amyloids</a>. It exists in 70 percent of vertebrates, as well as some other animals, intriguing Moir, who told <a href="https://www.newscientist.com/article/2090221-alzheimers-may-be-caused-by-brains-sticky-defence-against-bugs/" target="_blank" data-vivaldi-spatnav-clickable="1"><em>New Scientist</em></a>, "This is a very old peptide doing something that's important." He found that the protein was a bacterial microbe killer. This suggested that the familiar buildups could be defending the brain against invading bacteria.</p>The smoking gun
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTEyMTYzMy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYwNDg0MzY4M30.daBFzFFjmvjDXBBNy6rDdqTbHJN0h00_si2STqi4X8o/img.jpg?width=980" id="3ea3f" class="rm-shortcode" data-rm-shortcode-id="f99e3e2515b915de9924ba903d4f3b09" data-rm-shortcode-name="rebelmouse-image" />(Dominy, et al)
<p>The new study, which was published in <em>Science Advances</em> on January 23, reveals that toxic enzymes, gingipains, which allow <em>P. gingivalis</em> to feed on human flesh, were found in 96 percent of the tissue they examined from 54 Alzheimers' victims. Also, when they examined the DNA of three Alzheimer brains they found the <em>P gingivalis</em> in them all. Researcher <a href="https://www.uclan.ac.uk/staff_profiles/dr_sim_k_singhrao.php" target="_blank" data-vivaldi-spatnav-clickable="1">Sim Singhrao</a> of University of Central Lancashire, not involved in the study, tells <a href="https://www.newscientist.com/article/2191814-we-may-finally-know-what-causes-alzheimers-and-how-to-stop-it/" target="_blank" data-vivaldi-spatnav-clickable="1"><em>New Scientist</em></a>, "This is the first report showing<em> P. gingivalis</em> DNA in human brains, and the associated gingipains, co-lococalising with plaques."</p><p>As further confirmation, there was more of both the bacteria and its gingipains — and amyloid and tau buildup — in patients experiencing more advanced dementia.</p><p>The study also found that the gingipains mangle tau proteins so that they begin killing neurons. The result? Dementia.</p>What this means
<p>Altogether, this may finally be the Alzheimer's breakthrough scientists have been waiting for.</p><ul><li>First off, the researchers discovered <em>P. gingivalis</em> in the spinal fluid of living patients, suggesting a means of early diagnosis since Alzheimer's may take from 10 to 20 years to develop before becoming symptomatic.<span></span></li></ul><ul><li>Second, the bacteria may be vulnerable to treatment. Pharmaceutical firm <a href="https://www.cortexyme.com/single-post/2019/01/23/Cortexyme-announces-publication-of-foundational-data-for-groundbreaking-approach-to-treating-Alzheimers-disease-in-Science-Advances" target="_blank" data-vivaldi-spatnav-clickable="1">Cortexyme</a> is testing gingipain blockers that has resulted in improvement for Alzheimer's patients. Larger trials are imminent.<span></span></li></ul><ul><li>Third, <a href="https://www.mtpconnect.org.au/Article?Action=View&Article_id=55" target="_blank" data-vivaldi-spatnav-clickable="1">another team</a> in Melbourne, Australia is working on a vaccine against gum disease and thus Alzheimer's.</li></ul>The beginning of the end of Alzheimer’s?
<p>We've gotten our hopes up before, but the new research provides genuine reason for optimism. The cause of this tragic condition may finally have been identified. As Cortexyme's Casey Lynch says, "We believe this is a universal hypothesis of pathogenesis."</p>
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A new brain implant could slow Alzheimer’s progression
One patient retained the ability to dress herself, make a simple meal, and even change her plans depending on the weather.
11 February, 2018
Illustration showing where Alzheimer's is in the brain. Credit: Getty Images.
Electrical brain stimulation has been shown to boost memory and enhance learning. Now, scientists have turned their sights on neurodegenerative diseases. Researchers at Ohio State University’s Wexner Medical Center, found they could delay cognitive decline in Alzheimer’s by using deep brain stimulation. This could allow such patients to be independent for a longer period of time. Their results were published in The Journal of Alzheimer’s Disease.
<p></p><p>Instead of trying to improve memory like most Alzheimer’s treatments do, this one focused on <a href="https://www.livescience.com/61573-alzheimers-brain-pacemaker.html" target="_blank" title="Live Science">preserving cognitive and behavioral functions</a>. Scientists selected three patients and surgically implanted a deep-brain-stimulation (DBS) device inside their brains, near the frontal lobe.</p> <p></p><p>This is where executive function occurs, which includes such things as decision-making, attention, focus, learning, problem-solving, and judgement. Dr. Douglas Scharre was a co-author on this study. He’s the director of the Division of Cognitive Neurology at the university’s Neurological Institute.</p> <p></p><p>Dr. Scharre told <em>Science Daily</em>,</p> <p></p><blockquote><p>We have many memory aides, tools, and pharmaceutical treatments to help Alzheimer's patients with memory, but we don't have anything to help with improving their judgments, making good decisions, or increasing their ability to selectively focus attention on the task at hand and avoid distractions. These skills are necessary in performing daily tasks such as making the bed, choosing what to eat and having meaningful socializing with friends and family.</p></blockquote><p> </p><p> </p><p></p><p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xODI0MTM1Ni9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTU5NDY1MzU3MH0.58vRAkmezuMjCKJ85z9JZeBbUO4PdecGtV-qYWNFf-M/img.jpg?width=980" id="c66b0" class="rm-shortcode" data-rm-shortcode-id="9abc6ba336215c8437d0c6834ca4f947" data-rm-shortcode-name="rebelmouse-image"> </p> <p></p><p><em>Those with mild Alzheimer’s find normal daily tasks like making the bed difficult. Credit: Getty Images. </em></p> <p></p><p>The DBS device operates exactly like a pacemaker, but for the brain. It sends out electrical impulses at specifically calculated intervals. The electrodes implanted in the frontal lobe are attached through very fine wires to a pulse generator <a href="http://www.bbc.com/news/health-42857576" target="_blank" title="The BBC">underneath the skin of the chest wall.</a> This type of device is usually used to treat Parkinson’s disease. It’s been tried as a therapy for depression and obsessive compulsive disorder (OCD), too.</p> <p></p><p>Researchers aren’t exactly sure how it works. They know it increases coherence between brain regions. But how does it do this? Does it help block out unnecessary signals that cause interference? Or does it instead increase the speed at which neurons communicate?</p> <p></p><p>In this study, what Dr. Scharre and colleagues wanted to know is, if DBS could slow the degeneration of executive function in early stage Alzheimer’s and allow the patient to remain independent for longer. First, three participants were selected. They each had electrodes surgically implanted into a part on their frontal lobe known as the ventral striatum. Then these patients and 100 others who also had Alzheimer’s, were made to take part in a number of different tests which mimicked daily tasks, to see how well they could navigate them.</p> <p></p><p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xODI0MTM1Ny9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYyMzc1NDY0NH0.XK_CaR5aQZg2iiNG4ZF7uekcTfI0uPJWPDlqrrD4yfU/img.png?width=980" id="60a7f" class="rm-shortcode" data-rm-shortcode-id="25ede0512588fbaa8d492a637fb42f57" data-rm-shortcode-name="rebelmouse-image"> </p> <p></p><p><em>Illustration of a pacemaker. Credit: Wikimedia Commons.</em></p> <p></p><p>“The Alzheimer's subjects cognitive and daily functional abilities as a whole declined more slowly than Alzheimer's patients in a matched comparison group not being treated with DBS,” Dr. Scharre said. “The pilot study found that DBS targeting frontal brain regions can reduce the overall performance decline typically seen in people with mild or early stage Alzheimer's.” This was a two year study. All subjects implanted with a DBS showed a slowed decline. But for one patient in particular, 85 year-old LaVonne Moore of Delaware, Ohio, the results were more significant.</p> <p></p><p>Today, she can dress herself, make a simple meal, and even decide what she’ll do that day—alternating her plans depending on the weather, tasks impossible for most people with her level of Alzheimer’s. Researchers don’t know how long it’ll last. Her husband, 89 year-old Tom Moore said, "LaVonne has had Alzheimer's disease longer than anybody I know, and that sounds negative, but it's really a positive thing because it shows that we're doing something right."</p> <p></p><p>Since it was such a small study, the results will have to be repeated. In future research, Dr. Scharre and colleagues plan to try the same technique using non-invasive brain stimulation. We’re in dire need of new treatment options. According to the Alzheimer’s Association, over 5 million Americans are living with the disease today.</p> <p></p><p>That number is expected to balloon to 16 million by 2050. What’s more, it’s a very complicated disease. Truly managing Alzheimer’s may require hitting multiple targets at once, meaning a number of different treatments must be applied in concert. This technique could become an important part of such a strategy.</p> <p></p><p>To learn more about Alzheimer’s, click <a href="https://www.youtube.com/watch?v=aLsVS0lrRD0" target="_blank" title="YouTube">here</a>.</p>
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