Emily Singer | April 6

Technology Review - By the time a person goes to the doctor with symptoms of Alzheimer's disease, his or her brain is substantially damaged. So scientists are avidly hunting for a way to detect the neurological hallmarks of Alzheimer's early on, in the hopes they can predict -- and eventually prevent -- the disease.

Results of a new study testing a brain-imaging technique based on positron emission tomography (PET) show that it can reliably distinguish Alzheimer's patients from healthy people and those with mild cognitive impairment by detecting plaques and tangles, two types of protein clumps that occur in the brains of Alzheimer's patients. It's the first method that's been able to directly image these neurological changes in living patients, and it could eventually be used to diagnose patients and test new drugs.

Caring for the elderly with Alzheimers is draining emotionally and physically. I used to work in an Alzheimers ward and their physical strength is amazing and scary. The smallest and frailest of women had thrown me to the floor more than once. I know one time it took 4 aides to get me out of a headlock, their moods change so quickly that sometimes you can't see the change in time to protect yourself or them. The ward on a full moon was intense.

It is really neat that they now have adult daycare to help give family members a break. It was hard enough keeping up with the Alzheimers residents in a locked ward let alone in a personal home.

Kara Gavin | Ann Arbor, Michigan | April 18

Science News - Only 43 percent of older people with diabetes receive medicines that could protect their heart and kidneys, despite the fact that virtually all of them could benefit from those drugs, a new study finds. And even among those with the most to gain from the medicines, because of existing heart or kidney problems, the rate of use barely reaches 53 percent.

The classes of prescription medications, called ACE inhibitors and ARBs for short, have been recommended by national diabetes-treatment guidelines for years, because of the strong evidence that they can prevent heart attacks, strokes, kidney failure and other problems that disproportionately threaten older people who have diabetes. The inexpensive drugs are especially recommended for diabetics who already show signs of heart or kidney damage, or who have high blood pressure.

Niles Frantz | Chicago | April 19

AAAS - Though publishing only its fourth issue, Alzheimer's & Dementia: The Journal of the Alzheimer's Association

continues to feature valuable new data, and stimulate thought and discussion with provocative perspectives on key issues, such as alternative theories for the cause of Alzheimer's.

Included in the journal's April 2006 issue are:

Screening - A call for consideration of dementia risk factors in individuals at age 50, with routine yearly screening after age 75.

Cause - A new theory for the cause of Alzheimer's based on research with a well-known diabetes drug.

Risk Factors - A large-scale observational study in twins, some tracked for as long as 45 years, suggests education, physical exercise and inflammatory load (as shown by tooth loss) as risk factors for Alzheimer's disease and vascular dementia.

Screening is common for various types of cancer, diabetes, high blood pressure, high cholesterol and depression to identify disease states early, and to encourage early treatment and lifestyle interventions. The question of whether to screen for Alzheimer's disease (AD), especially in cognitively healthy people, has been controversial. For instance, in 2005, the U.S. Preventive Services Task Force stated that "the evidence is insufficient to recommend for or against routine screening for dementia in older adults."


home page of the Alzheimer's Association

Chicago | April 21

Rush University Having close friends and staying in contact with family members offers a protective effect against the damaging effects of Alzheimer’s disease according to research by physicians at Rush University Medical Center in Chicago. The study, which is currently posted online in The Lancet Neurology, will be published in the May print edition of the journal.

While other studies have shown people with more extensive social networks were at reduced risk of cognitive impairment, the study by Dr. David A. Bennett, and his colleagues from the Rush Alzheimer's Disease Center, is the first to examine the relations between social networks and Alzheimer’s disease pathology.

Bernadene Healy, M.D. | May 8

U.S News & World Report - Women, take your calcium. If that message seems contrary to headlines of just a few months back, you've gotten the wrong idea. This past February, the government-sponsored Women's Health Initiative reported that women ages 50 to 79 who took calcium and vitamin D for seven years didn't lower their risk of fractures compared with those on a placebo. But those who faithfully took their pills had 29 percent fewer broken hips. That "but" was all too often lost in translation.

Last week, an Australian study in the Archives of Internal Medicine came up with almost identical results. At first blush, there was no difference between the elderly women taking calcium and those on dummy pills. In fact, among those who took supplements at least 80 percent of the time, the extra calcium reduced hip fractures by one third.

Roxanne Khamai | July 6

New Scientist - blood test might one day predict a person’s risk of developing dementia, a new study suggests. It links certain levels of two proteins in blood samples with a 10-fold increase of developing Alzheimer’s disease and other forms of dementia.

Alzheimer’s disease has no known cure, and its causes are also mysterious. The disease typically progresses over years, gradually robbing elderly patients of memory, language and other crucial mental skills. In very rare cases, people in their 30s or 40s can develop “early-onset Alzheimer’s”.

Notably, those who carry the genetic mutations known to encourage early-onset Alzheimer’s have elevated levels of certain protein fragments, called amyloid fragments, in their blood.

This finding caught the attention of epidemiologist Monique Breteler of Erasmus Medical Centre in Rotterdam, The Netherlands, because the same amyloid fragments form plaques in the brains of patients with Alzheimer’s, regardless of the age at which they develop the disease.<!--break-->

Bruce Bower | June 24

Science News - Given all the bad news that science has delivered about brain cells withering and memory waning as the years mount, older people have a right to be cranky. But, instead, the over-50 crowd handles life's rotten realities and finds life's bright side more effectively than whippersnappers do. In no small part, that's because the aging brain makes critical emotional adjustments, a new study indicates.

As people age, from 12 to 79 years old, they respond to fear with greater and greater boosts in medial prefrontal activity and to happiness with smaller and smaller boosts.

Advancing age heralds a growth in emotional stability accompanied by a neural transition to increased control over negative emotions and greater accessibility of positive emotions, according to a team led by neuroscientist Leanne M. Williams of Westmead (Australia) Hospital. A brain area needed for conscious thought, the medial prefrontal cortex, primarily influences these emotional reactions in older adults, Williams and her colleagues say.

In contrast, people under age 50 experience negative emotions more easily than they do positive ones. These younger adults' emotion-related activity centers on the amygdala, a brain structure previously implicated in automatic fear responses.

This gradual reorganization of the brain's emotion system may result from older folk responding to accumulating personal experiences by increasingly looking for meaning in life, the researchers propose in the June 14 Journal of Neuroscience.

Alzheimer's disease monolithic image starts to crack
Posted: 19 September 2006 1638 hrs

PARIS : World Alzheimer's Day this Thursday marks the 100th anniversary of when a brain-destroying disorder that many might call the cruellest disease of all entered the medical books.

In a study in 1906 that broke new ground in knowledge about dementia, German doctor Alois Alzheimer presented the case history of a 51-year-old woman, Auguste D.

Five years earlier, Auguste D. had started to suffer memory loss. She developed problems with speaking, became confused, paranoid and agitated. By the time she died, she had become incontinent, bedridden and oblivious to her surroundings.

Carrying out an autopsy on his former patient, Alzheimer found Auguste D.'s brain had shrunk through loss of neurons and was clogged with fibrous tangles and plaques.

Alzheimer presented his findings at a conference in the university of Tuebingen in November 1906. But for the next eight decades, knowledge of the disease that bore his name stayed to a large degree unchanged.

Alzheimer's became a byword for dread of ageing - but also bafflement as to its cause, and despondency about how to treat it.

Today, though, the news about this darkest of diseases burns with a flame of hope.

Alzheimer's is being attacked on so many fronts that some researchers, while balking at talk of a cure, believe a treatment to slow or possibly stop its clinical advance is tantalisingly within reach.

"If you look at beta amyloid formation alone, there are three or four approaches and all can bear fruit within 10 years," said Bengt Winblad, a professor of geriatrics at Sweden's Karolinska Institute in Stockholm.

Beta amlyoid formation refers to the plaques of proteins that clump outside the brain cells. They are a hallmark of Alzheimer's, as are the tangles of so-called tau protein inside the neurons. It is still unclear, though, whether tau is a cause or an effect of Alzheimer's.

Two research areas that could yield a marketable drug "within three to five years" focus on interfering with the molecular cascade that allows the plaques to form and stick together, said Winblad.

"Even if there is no cure, if you delay progression or halt disease, that is something that the relatives of the patients 1/8with Alzheimer's 3/8 would be very happy with indeed," he said.

Another approach is to clear the brain of the plaque deposits. This could be achieved by an "active vaccine" in which part of the beta amyloid would be injected into the body in order to prime the immune system against it, or by injecting antibodies directly.

Much of this encouraging research has already left the lab and is undergoing early human trials, a long, costly three-phase approach to test a new molecule for safety and effectiveness.

In addition, more and more is known about telltale pre-stages of Alzheimer's and about conditions such as smoking, obesity, diabetes and high blood pressure that appear to contribute to it, while mental exercise and a diet rich in fruit and vegetables appear to have a protective effect. There is also an indication that some people may be genetically more susceptible to it than others.

A breakthrough is urgently needed when it comes to Alzheimer's.

Alzheimer's primarily shows up in people beyond their mid-60s. Thus, as more and more people around the world live longer, the disease is bound to progress.

According to a study published last December in the journal The Lancet, 24 million people today have dementia, and the figure will rise to 42 million by 2020 and 81 million by 2040.

China and South Asia will see a tripling of Alzheimer's patients by 2040, the study said. It did not break down the figures for the different forms of dementia; Alzheimer's is estimated elsewhere to be the cause in around half of dementia cases.

Compared with cancer and cardiovascular patients, Alzheimer's lags far behind in raw numbers and receives only a fraction of these diseases' research funds.

But it catches up when it comes to cost, both in terms of the financial burden to health system and the brutal toll exacted on families.

"We have to solve dementia crisis, otherwise the health care system in many countries will collapse," said Winblad. "We have to resolve how we shall handle dementia patients, with drugs or care, otherwise with the demographic changes, in 20 or 30 years they will be occupying every (hospital) bed that we have today."

Alzheimer's: A factfile

WHAT IS IT?
Alzheimer's disease is the commonest form of dementia, a degenerative disease of the brain that causes forgetfulness and disturbs thinking, emotions and behaviour.

HOW MANY PEOPLE HAVE IT?
Twenty-four million people today have dementia, a figure likely to rise to 42 million by 2020 and 81 million by 2040. Alzheimer's accounts for between 50 and 60 percent of all dementia cases. The direct and indirect annual costs of caring for people in the United States alone are put at at least 100 billion dollars annually.

WHAT HAPPENS?
Clumps of protein called amyloid plaques and tau tangles proliferate in the brain, especially the cortex and hippocampus, destroying brain cells and their connections. The onset of symptoms is gradual. Psychiatric, physical and neuro-imaging tests are needed to confirm diagnosis.

WHO IS AT RISK?
Alzheimer's most commonly appears after the age of 65 and the risk increases with ageing. The precise cause is unclear but genes, environment and lifestyle may all play a role. On average, people live eight years after diagnosis, but this can range from as little as three to as many as 20 years.

IS THERE A CURE?
No. If all goes well, the first drugs to slow or block the spread of Alzheimer's could be only a few years away. Present drugs have a temporary effect by inhibiting an enzyme that reduces acetylcholine, a vital chemical used in communication between brain cells.

OTHER TREATMENT:
Antidepressants, anti-anxiety drugs and tranquillisers can ease sleeplessness, agitation, wandering, anxiety and depression, thus making the patient more comfortable and easing the burden of caregivers. Psychological, art and music therapy are also commonly used to try to stimulate the brain of Alzheimer's patients.

Sources:
Alzheimer's Disease International (http://www.alz.co.uk/)
US National Institutes of Health (NIH) 2001-2 Alzheimer's Disease Progress Report; US National Institute of Ageing (http://www.nia.nih.gov/Alzheimers/Publications/adfact.htm)
The Lancet (issue of December 17 2005)

http://www.channelnewsasia.com/stories/health/view/231279/1/.html

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In these times you have to be an optimist to open your eyes when you awake in the morning. ~ Carl Sandburg

h/t candy

Denise Grady | October 24

NYT - When he learned in 1995 that he had Alzheimer’s disease, William Utermohlen, an American artist in London, responded in characteristic fashion.

“From that moment on, he began to try to understand it by painting himself,” said his wife, Patricia Utermohlen, a professor of art history.

[ snip ]

Dr. Bruce Miller, a neurologist at the University of California, San Francisco, who studies artistic creativity in people with brain diseases, said some patients could still produce powerful work.

“Alzheimer’s affects the right parietal lobe in particular, which is important for visualizing something internally and then putting it onto a canvas,” Dr. Miller said. “The art becomes more abstract, the images are blurrier and vague, more surrealistic. Sometimes there’s use of beautiful, subtle color.”

Alison Motluk | November 20

New Scientist - Alzheimer's disease has a range of disparate risk factors, but researchers may now have found one underlying cause that links them all: a lack of oxygen.

Previous studies have shown that diabetes, stroke, clogged arteries and ageing all increase the risk of developing Alzheimer’s. Only 5% of cases appear to have been strongly influenced by genetic factors. Now evidence has emerged that lack of oxygen may be the ultimate cause.

Weihong Song at the University of British Columbia in Vancouver, Canada, and colleagues took mice engineered to develop Alzheimer’s-like plaques and put them in a hypoxia chamber, which limits the amount of available oxygen. For 16 hours per day, for one month, the mice received less than 40% of the oxygen they normally use.

Six months later, the oxygen-deprived mice had developed twice as many beta-amyloid plaques – the hallmark of Alzheimer’s disease – compared with similar mice kept in normal conditions. The hypoxic mice also performed worse on memory tests.

Beta-amyloid is formed when a gene called BACE1 produces an enzyme that cuts long strands of harmless amyloid protein into small, potentially plaque-forming pieces. The plaques eventually cause brain cells to die.

http://www.alznyc.org/

(not just confined to information about NY caregiving groups and research studies)

_{"at some point I'm hopeful I'll figure out something to put here"}

Emily Singer | October 19

Technology Review - New approaches to immunizing patients against the harmful protein buildup characteristic of Alzheimer's disease offer hope for safer treatments.

Vaccination against Alzheimer's disease is one of the most promising treatment strategies. But safety concerns arising after initial human trials have slowed clinical development of such vaccines. Now new research that aims to bring the benefits of vaccines without the harmful side effects are raising hopes once again for this largely untreatable disease.

"There is tremendous interest in this approach," says Neil Buckholtz, chief of the dementias of aging branch at the National Institute on Aging (NIA), in Bethesda, MD. "People believe this could be a promising therapeutic, but they are proceeding slowly because of safety concerns."

Alzheimer's vaccines work by preventing or clearing the buildup of a protein, known as beta-amyloid, which clogs the brains of Alzheimer's patients. A patient can be injected with either an active or passive vaccine. Active vaccines contain the protein itself, triggering the body's immune response to produce protein-specific antibodies that tag the protein for clearance. Passive vaccines, on the other hand, contain antibodies to the protein and therefore may not require an active immune response.

Animal tests of both approaches have been promising: animals given the vaccines showed less buildup of the toxic protein and better performance on cognitive tests. But an early clinical trial of an active vaccine, sponsored by the Ireland-based Elan Corporation, was stopped in 2002 after four patients developed encephalitis, an inflammation of the brain. Later, autopsies of these patients' brains showed that despite the inflammation, the vaccine did clear the toxic protein from the brain.

"The challenge now is, are there other ways to use the immunotherapy approach to get the benefits without the adverse effects?" says Richard J. Hodes, director of the NIA.

The NIA is sponsoring a new trial, announced earlier this week at the Society for Neurosciences conference, in Atlanta, of a different type of antibody therapy: intravenous immunoglobulin (IVIg), a blood product used to treat immune disorders. IVIg contains a mix of different antibodies, including one against amyloid. Because the product has already been used to treat thousands of people with immune disease, scientists say it is unlikely to cause the inflammatory problems seen in the first Elan trial. "We have a good understanding of the side effects and how to avoid them," says Hodes.

Elan is also testing a passive vaccine, currently in clinical trials.

Scientists still aren't sure exactly what part of the complex immune response is necessary to successfully clear amyloid protein or what part triggers excessive inflammation, as seen in the first Elan trial. But second-generation vaccines that create more-targeted responses might soon answer that question.

William Bowers and Howard Federoff of the University of Rochester Medical Center, in New York, are working on a gene-therapy vaccine delivered via a stripped-down herpes-simplex virus. Their vaccine carries both the code for the toxic protein and the code for genes involved in different aspects of the immune response. "We can shape the response and evoke different kinds of antibodies and different immune responses," says Bowers, who presented his findings at the neuroscience meeting. In addition, the researchers can use different genetic "promoters"--genetic sequences that control where and when a gene is expressed--to target the vaccine to specific cell types. By testing different varieties of the vaccines, they hope to tease apart each component's effects.

"This is an example of how to deal with a promising pre-clinical therapy that didn't work in the clinic," says Marcelle Morrison-Bogorad, associate director of NIA's neuroscience and neuropsychology of aging program. "Don't give up--just go back to the bench."

_{"at some point I'm hopeful I'll figure out something to put here"}

Maureen Morley | Chicago | November 27

AAAS - A new study offers older adults a simple way to combat memory loss: memorization. Researchers found that seniors who engaged in an intensive period of rote learning followed by an equally long rest period exhibited improved memory and verbal recall. The study was presented today at the annual meeting of the Radiological Society of North America (RSNA).

“We didn’t see an immediate improvement following the intensive memorization period,” said Jonathan McNulty, B.Sc., H.Dip., of Diagnostic Imaging at the School of Medicine and Medical Science, University College Dublin in Ireland. “However, after a six-week rest, the volunteers manifested both metabolic changes in the brain and improved memory performance.”

As people age, they often begin to experience forgetfulness and may have difficulty learning new material. Approximately 40 percent of people over age 60 have some kind of memory difficulty. Mild, age-related memory loss is caused by the loss of brain cells over time, along with changes in brain chemistry. The researchers studied how repeated cognitive exercise impacts memory and recall, as well as the health of brain cells involved in memory.

HIV and STDs are on the rise among senior citizens. So when it comes to safe sex, it may be time to teach America's old dogs some new tricks.

By Liz Langley
Pages 1 2 3
SALON

Dec. 4, 2006 | A few years ago there was a popular Pepsi commercial featuring presidential candidate and Viagra spokesman Bob Dole watching Britney Spears dance on TV. At the end of the ad, a dog sitting at Dole's side barks at the set. "Easy, boy," says Dole to the pooch -- though I always thought it was slyly implied that he was actually talking to his own reanimated wiener.

This three-alarm image of the senator erect is uncomfortable on a lot of levels, but the most obvious is that people aren't used to thinking of seniors in a sexual way and aren't in a rush to start. We love to see Grandma and Grandpa running marathons, volunteering and taking tap class. But imagining them doing the mattress mambo is another story.

Senior sexuality is certainly important in Florida, the oldest state in the country, and where, according to the U.S. Census Bureau, 17 percent of the population was 65 or over as of July 1, 2005. And those seniors aren't just sitting home playing bridge: In "Sexuality at Midlife and Beyond," a 2004 update to a 1999 AARP survey, more than half of respondents, aged 45 and up, cited sexual activity as a critical part of good relationships and as an important factor in quality of life. Eighty-four percent disagreed or strongly disagreed that "Sex is only for young people" and reported having intimate experiences once a week, ranging from kissing to intercourse. In September of 2006, the CNBC Special Report "Boomer Nation" reported that over-50 singles make up Match.com's fastest-growing demographic. "People are orgasmic well into their 90s," says Sallie Foley, director for the Center for Sexual Health at the University of Michigan Health System, author, and "Modern Love" columnist for the AARP magazine. A sex therapist, Foley recently had a client who experienced her first orgasm at 67.

Of course, lives -- and libidos -- don't end at 50. But a growing concern is that the same parents and grandparents who once scolded their kids for playing outside without coats may not always be covering up where it counts beneath the sheets. According to Tom Liberti, chief of the Bureau of HIV/AIDS for the Florida Department of Health, 16 percent of newly reported HIV cases in 2005 were in people over 50. Numbers on other sexually transmitted diseases don't suggest that they're spreading like wildfire among seniors (though not all STDs are necessarily reported to the DOH). Still, with more older singles than ever, well, you know the sex talk your parents dreaded having with you when you were a kid? Now you might want to have a similar one with them. (Well, want might be taking it a bit far.)

much more at SALON, worth watching the short advert

Possible Fingerprint of Alzheimer's Found
By Lauran Neergaard
December 12, 2006 7:44AM

About 4.5 million Americans have Alzheimer's, a toll expected to more than triple by 2050 as the population grays. The creeping brain disease gradually robs sufferers of their memories and ability to care for themselves, eventually killing them. There is no known cure; today's drugs only temporarily alleviate symptoms.

Scientists appear to have found a fingerprint of Alzheimer's disease lurking in patients' spinal fluid, a step toward a long-awaited test for the memory-robbing disease that today can be diagnosed definitively only at autopsy.

Researchers at New York's Weill Cornell Medical College discovered a pattern of 23 proteins floating in spinal fluid that, in very preliminary testing, seems to identify Alzheimer's -- not perfectly, but with pretty good accuracy.

Far more research is needed before doctors could try spinal-tap tests in people worried they have Alzheimer's, specialists caution.

But the scientists already are preparing for larger studies to see if this potential "biomarker" of Alzheimer's, reported Tuesday in the journal Annals of Neurology, holds up.

"We're looking to an era in which the kinds of uncertainties that many patients and their families face about the diagnosis of Alzheimer's disease will no longer be a problem," predicts Dr. Norman Relkin, a neurologist and the study's senior researcher.

About 4.5 million Americans have Alzheimer's, a toll expected to more than triple by 2050 as the population grays. The creeping brain disease gradually robs sufferers of their memories and ability to care for themselves, eventually killing them. There is no known cure; today's drugs only temporarily alleviate symptoms.

Currently, doctors diagnose Alzheimer's mainly by symptoms. That makes early diagnosis particularly difficult, and even more advanced disease can be confused with other forms of dementia. Nor is there a good way to track the disease's progression, important both for decisions about patient care as well as in testing the effectiveness of new drugs.

Major research is under way to try to change that, including a $60 million study now under way to give brain scans to 800 older Americans and try to pin down the earliest brain changes associated with Alzheimer's.

At the same time, scientists also are hunting what they call biomarkers -- signs of the disease in areas other than hard-to-test brain tissue.

more

Audra Cox | Valhalla, New York | December 28

American Journal of Pathology - Recent studies show promise for significantly reducing vascular aging by inactivating TNFa, which has been linked to blood vessel dysfunction and cell death. The related report by Csiszar et al., "Vasculoprotective effects of anti-TNFa treatment in aging," appears in the January issue of The American Journal of Pathology.

Age-related vascular diseases, including high blood pressure, heart attack and stroke, occur naturally, even in otherwise healthy individuals. Advanced age is also associated with increased levels of TNFa, a protein that can attack and destroy tumor cells but can also exacerbate chronic inflammatory diseases. To date, no studies have investigated the potential beneficial effects of TNFa inhibition in vascular aging, making this the first study of its kind.

Csiszar and collegues treated aged rats with etanercept to test the hypothesis that anti-TNFa treatment exerts vasculoprotective effects in aging. Etanercept (Enbrel) is an FDA-approved drug that binds and inactivates circulating TNFa. Recent studies have demonstrated that anti-TNFa therapies, including etanercept, may improve inflammation-related vascular disease, including heart failure.

http://agonist.org/node/39048

September 23, 2007
More Profit and Less Nursing at Many Homes
By CHARLES DUHIGG

The Times examined more than 1,200 nursing homes purchased by large private investment groups since 2000, and more than 14,000 other homes. The analysis compared investor-owned homes against national averages in multiple categories, including complaints received by regulators, health and safety violations cited by regulators, fines levied by state and federal authorities, the performance of homes as reported in a national database known as the Minimum Data Set Repository and the performance of homes as reported in the Online Survey, Certification and Reporting database.

Habana Health Care Center, a 150-bed nursing home in Tampa, Fla., was struggling when a group of large private investment firms purchased it and 48 other nursing homes in 2002.

The facility’s managers quickly cut costs. Within months, the number of clinical registered nurses at the home was half what it had been a year earlier, records collected by the Centers for Medicare and Medicaid Services indicate. Budgets for nursing supplies, resident activities and other services also fell, according to Florida’s Agency for Health Care Administration.

The investors and operators were soon earning millions of dollars a year from their 49 homes.

Residents fared less well. Over three years, 15 at Habana died from what their families contend was negligent care in lawsuits filed in state court. Regulators repeatedly warned the home that staff levels were below mandatory minimums. When regulators visited, they found malfunctioning fire doors, unhygienic kitchens and a resident using a leg brace that was broken.

“They’ve created a hellhole,” said Vivian Hewitt, who sued Habana in 2004 when her mother died after a large bedsore became infected by feces.

Habana is one of thousands of nursing homes across the nation that large Wall Street investment companies have bought or agreed to acquire in recent years.

Those investors include prominent private equity firms like Warburg Pincus and the Carlyle Group, better known for buying companies like Dunkin’ Donuts.

As such investors have acquired nursing homes, they have often reduced costs, increased profits and quickly resold facilities for significant gains.

But by many regulatory benchmarks, residents at those nursing homes are worse off, on average, than they were under previous owners, according to an analysis by The New York Times of data collected by government agencies from 2000 to 2006.

The Times analysis shows that, as at Habana, managers at many other nursing homes acquired by large private investors have cut expenses and staff, sometimes below minimum legal requirements.

Regulators say residents at these homes have suffered. At facilities owned by private investment firms, residents on average have fared more poorly than occupants of other homes in common problems like depression, loss of mobility and loss of ability to dress and bathe themselves, according to data collected by the Centers for Medicare and Medicaid Services.

The typical nursing home acquired by a large investment company before 2006 scored worse than national rates in 12 of 14 indicators that regulators use to track ailments of long-term residents. Those ailments include bedsores and easily preventable infections, as well as the need to be restrained. Before they were acquired by private investors, many of those homes scored at or above national averages in similar measurements.

In the past, residents’ families often responded to such declines in care by suing, and regulators levied heavy fines against nursing home chains where understaffing led to lapses in care.

But private investment companies have made it very difficult for plaintiffs to succeed in court and for regulators to levy chainwide fines by creating complex corporate structures that obscure who controls their nursing homes.

By contrast, publicly owned nursing home chains are essentially required to disclose who controls their facilities in securities filings and other regulatory documents.

The Byzantine structures established at homes owned by private investment firms also make it harder for regulators to know if one company is responsible for multiple centers. And the structures help managers bypass rules that require them to report when they, in effect, pay themselves from programs like Medicare and Medicaid.

Investors in these homes say such structures are common in other businesses and have helped them revive an industry that was on the brink of widespread bankruptcy.

“Lawyers were convincing nursing home residents to sue over almost anything,” said Arnold M. Whitman, a principal with the fund that bought Habana in 2002, Formation Properties I.

Homes were closing because of ballooning litigation costs, he said. So investors like Mr. Whitman created corporate structures that insulated them from costly lawsuits, according to his company.

“We should be recognized for supporting this industry when almost everyone else was running away,” Mr. Whitman said in an interview.

Some families of residents say those structures unjustly protect investors who profit while care declines.

When Mrs. Hewitt sued Habana over her mother’s death, for example, she found that its owners and managers had spread control of Habana among 15 companies and five layers of firms.

As a result, Mrs. Hewitt’s lawyer, like many others confronting privately owned homes, has been unable to establish definitively who was responsible for her mother’s care.

Current staff members at Habana declined to comment. Formation Properties I said it owned only Habana’s real estate and leased it to an independent company, and thus bore no responsibility for resident care.

That independent company — Florida Health Care Properties, which eventually became Epsilon Health Care Properties and subleased the home’s operation to Tampa Health Care Associates — is affiliated with Warburg Pincus, one of the world’s largest private equity firms. Warburg Pincus, Florida Health Care, Epsilon and Tampa Health Care all declined to comment.

Demand for Nursing Homes

The graying of America has presented financial opportunities for all kinds of businesses. Nursing homes, which received more than $75 billion last year from taxpayer programs like Medicare and Medicaid, offer some of the biggest rewards.

“There’s essentially unlimited consumer demand as the baby boomers age,” said Ronald E. Silva, president and chief executive of Fillmore Capital Partners, which paid $1.8 billion last year to buy one of the nation’s largest nursing home chains. “I’ve never seen a surer bet.”

much more

October 9, 2007
Aging and Gay, and Facing Prejudice in Twilight
By JANE GROSS

Even now, at 81 and with her memory beginning to fade, Gloria Donadello recalls her painful brush with bigotry at an assisted-living center in Santa Fe, N.M. Sitting with those she considered friends, “people were laughing and making certain kinds of comments, and I told them, ‘Please don’t do that, because I’m gay.’”

The result of her outspokenness, Ms. Donadello said, was swift and merciless. “Everyone looked horrified,” she said. No longer included in conversation or welcome at meals, she plunged into depression. Medication did not help. With her emotional health deteriorating, Ms. Donadello moved into an adult community nearby that caters to gay men and lesbians.

“I felt like I was a pariah,” she said, settled in her new home. “For me, it was a choice between life and death.”

Elderly gay people like Ms. Donadello, living in nursing homes or assisted-living centers or receiving home care, increasingly report that they have been disrespected, shunned or mistreated in ways that range from hurtful to deadly, even leading some to commit suicide.

Some have seen their partners and friends insulted or isolated. Others live in fear of the day when they are dependent on strangers for the most personal care. That dread alone can be damaging, physically and emotionally, say geriatric doctors, psychiatrists and social workers.

The plight of the gay elderly has been taken up by a generation of gay men and lesbians, concerned about their own futures, who have begun a national drive to educate care providers about the social isolation, even outright discrimination, that lesbian, gay, bisexual and transgender clients face.

Several solutions are emerging. In Boston, New York, Chicago, Atlanta and other urban centers, so-called L.G.B.T. Aging Projects are springing up, to train long-term care providers. At the same time, there is a move to separate care, with the comfort of the familiar.

In the Boston suburbs, the Chelsea Jewish Nursing Home will break ground in December for a complex that includes a unit for the gay and lesbian elderly. And Stonewall Communities in Boston has begun selling homes designed for older gay people with support services similar to assisted-living centers. There are also openly gay geriatric case managers who can guide clients to compassionate services.

“Many times gay people avoid seeking help at all because of their fears about how they’ll be treated,” said David Aronstein, president of Stonewall Communities. “Unless they see affirming actions, they’ll assume the worst.”

Homophobia directed at the elderly has many faces.

Home health aides must be reminded not to wear gloves at inappropriate times, for example while opening the front door or making the bed, when there is no evidence of H.I.V. infection, said Joe Collura, a nurse at the largest home care agency in Greenwich Village.

A lesbian checking into a double room at a Chicago rehabilitation center was greeted by a roommate yelling, “Get the man out of here!” The lesbian patient, Renae Ogletree, summoned a friend to take her elsewhere.

Sometimes tragedy results. In one nursing home, an openly gay man, without family or friends, was recently moved off his floor to quiet the protests of other residents and their families. He was given a room among patients with severe disabilities or dementia. The home called upon Amber Hollibaugh, now a senior strategist at the National Gay and Lesbian Task Force and the author of the first training curriculum for nursing homes. Ms. Hollibaugh assured the 79-year-old man that a more humane solution would be found, but he hanged himself, Ms. Hollibaugh said. She was unwilling to identify the nursing home or even its East Coast city, because she still consults there, among other places.

While this outcome is exceedingly rare, moving gay residents to placate others is common, said Dr. Melinda Lantz, chief of geriatric psychiatry at Beth Israel Medical Center in New York, who spent 13 years in a similar post at the Jewish Home and Hospital Lifecare System. “When you’re stuck and have to move someone because they’re being ganged up on, you put them with people who are very confused,” Dr. Lantz said. “That’s a terrible nuts-and-bolts reality.”

The most common reaction, in a generation accustomed to being in the closet, is a retreat back to the invisibility that was necessary for most of their lives, when homosexuality was considered both a crime and a mental illness. A partner is identified as a brother. No pictures or gay-themed books are left around.

Elderly heterosexuals also suffer the indignities of old age, but not to the same extent, Dr. Lantz said. “There is something special about having to hide this part of your identity at a time when your entire identity is threatened,” she said. “That’s a faster pathway to depression, failure to thrive and even premature death.”

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I'm using A public computer that won't allow me to respond to the above article, presumably because it says gay? Renae is one of Chicago's leading gay rights advocates, IIRC she had breast cancer some years back. may she be in full recovery.

what I wanted to say tho, is I'd like to highly recommend and applaud the services and care of the Arbor Hospice group in MI and elsewhere. These folks do an outstanding job of caring for the patient and their families as well as working to educate more folks in the practice of hospice and palliative care. anyone facing this tough situation can be glad that there are still non-profit organizations that take seriously their commitment to providing for the community

Test 'can spot Alzheimer's risk'

A newly developed blood test can identify those at risk of Alzheimer's disease up to six years before symptoms would become apparent, researchers say.

The test identifies changes in a handful of proteins that cells use to convey messages to one another.

The US researchers found it could indicate who had Alzheimer's, as well as who was likely to develop the condition, with 90% accuracy.

The work, led by Stanford University, features in Nature Medicine.

One of the most distressing aspects of Alzheimer's disease is the difficulty in determining whether mild memory problems are the beginning of an inevitable mental decline.

Currently, Alzheimer's is effectively diagnosed by ruling out other causes of mental decline.

Even then it can only be categorically confirmed by carrying out a post-mortem.

The latest study pinpointed a connection between changes in the brain accompanying Alzheimer's, and changes in the way cells communicate with each other.

Lead researcher Dr Tony Wyss-Coray said: "Just as a psychiatrist can conclude a lot of things by listening to the words of a patient, so by 'listening' to different proteins we are measuring whether something is going wrong in the cells."

Protein pattern

The researchers measured levels of 120 proteins used by cells to communicate to see if any could give a clue about Alzheimer's.

Samples from five people with Alzheimer's were compared with samples from five people clear of the disease.

Levels of a number of proteins were strikingly different between the two groups.

Next, the researchers further refined their search by examining blood samples from 129 people with symptoms ranging from mild mental impairment to severe Alzheimer's.

They found that Alzheimer's was associated with specific levels of 18 key proteins.

They used this tell-tale pattern to assess a further 92 patients who had already been clinically assessed for Alzheimer's - and the diagnoses matched in nine out of 10 cases.

The test produced a similar level of success when it was used to analyse blood samples which had been taken two to six years earlier from patients, who were then followed up to find out whether their mild mental decline had progressed to something more severe.

Blood cell production

The 18 proteins that indicate Alzheimer's are also involved in the production of new blood cells, immune processes and the death of cells at the end of their natural life cycle.

Dr Wyss-Coray said: "Our hypothesis is that there is something wrong with the production of certain blood cells, which may be needed to clear that stuff that accumulates in the brain in Alzheimer's disease."

The Stanford team stressed more work was needed to confirm their results, but Satoris, a company for which Dr Wyss-Coray works as a consultant, plans to develop a prototype test for use in research labs.

Rebecca Wood, of the Alzheimer's Research Trust, said: "This is exciting research and the results and accuracy levels are very promising.

"However, further research is needed with a larger sample group to confirm these findings and determine if a simple, accurate blood test for Alzheimer's can become a reality."

Dr Susanne Sorensen, of the Alzheimer's Society, said a blood test would be a huge breakthrough.

She said: "Early diagnosis is essential if we are ever to develop treatments that can change the course or halt the progression of dementia rather than just treat the symptoms."

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/7041192.stm

O'Connor's Son Discusses Ailing Father

Wednesday November 14, 2007 1:46 AM

PHOENIX (AP) - Sandra Day O'Connor's husband struck up a romance with a fellow Alzheimer's patient after moving into an assisted living center, and under the circumstances, the retired Supreme Court justice is just glad that he is comfortable, her son told a TV station.

The retired justice isn't jealous about his relationship with the woman, Scott O'Connor told KPNX in Phoenix in a broadcast that aired Thursday. He said it has dramatically changed the outlook of his father, John, toward being in the Huger Mercy Living Center.

Sandra Day O'Connor, the first woman on the Supreme Court, cited her husband's illness and her need to take care of him when she retired in 2005. He was diagnosed with the neurological disease 17 years ago.

``Mom was thrilled that Dad was relaxed and happy and comfortable living here and wasn't complaining,'' their son said.

It was different when he first came to the center recently, the son said: ``He knew this was sort of the beginning of the end. ... It was basically suicide talk.''

John O'Connor was shifted to another cottage at the center, Scott O'Connor said, and ``48 hours after moving into that new cottage he was a teenager in love. He was happy.''

Sandra Day O'Connor declined a request for comment by The Associated Press sent via e-mail to Supreme Court spokeswoman Kathy Arberg. A message left with the only Scott O'Connor found in a Phoenix phone listing was not returned.

Lisa O'Toole, manager at the assisted-living facility, said there are three romances among the center's 48 residents. She described the relationships as almost childlike, with the couples holding hands, hugging or simply having dinner together.

As for their families' reactions, she said, ``I've seen total extremes where families just fall apart, the wife doesn't understand, and they'll cry. And then you have the other end, the opposite spectrum ... that it's OK that they have somebody to make them happy.''

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REBECCA DUBE, November 15, Globe and Mail

Sandra Day O'Connor retired from the U.S. Supreme Court last year to care for her husband, John, who has Alzheimer's disease.

Now he's fallen in love with another woman - and his wife approves.

John O'Connor was diagnosed with Alzheimer's disease 17 years ago, and Ms. O'Connor was his sole caregiver for a long time. In the early years, she sometimes took him to court with her.

When he moved into a nursing home recently, his son says, he became severely depressed. But all that changed when he moved into a new cottage at the nursing facility and met a woman, identified only as Kay, who also has Alzheimer's.

"He was a teenager in love," Scott O'Connor told KPNX-Channel 12 in Phoenix, Ariz., where his parents live.

The O'Connors' situation closely mirrors the plot of the 2006 film Away from Her, directed by Sarah Polley and based on an Alice Munro short story, in which a woman with Alzheimer's forgets about her husband and falls in love with another patient at her nursing home.

It's not uncommon for patients with Alzheimer's or other forms of dementia to forget that they are married and strike up a new romance.

The disease may rob them of their memories, but it does not strip away their basic human need to love and be loved.

The normalcy of an Alzheimer's romance doesn't make it any easier for spouses, though. Some react like Ms. O'Connor, who was relieved that her husband of 54 years finally felt content in his nursing home.

"Mom was thrilled that Dad was relaxed and happy and comfortable being here," her son said.

Others feel betrayed and angry.

"I've seen people be very accepting and I've seen people have a huge struggle," said Marija Padjen, program manager for the Alzheimer Society of Toronto. "It often comes down to dealing with the grief of losing that person," she said - and anger over a new romance may mask fear and grief about losing a spouse to illness and ultimately death.

"The key is, people [with dementia] still feel emotion. That need for love and intimacy stays with us," Ms. Padjen said.

Romances among people with dementia can sometimes be hard for nursing home staff to accept as well. Staff members need to observe budding relationships to ensure that they're mutually consensual, says Ruth Goodman, senior social worker with Baycrest Geriatric Health Care System in Toronto.

"It is a complex and very nuanced area," Ms. Goodman said. Elderly people, including those with dementia, "have a right to relationships that are freely chosen," she said.

Caregivers have to make sure that public displays of affection don't get out of hand. Rather than scolding two patients who are making out in the hallway, Ms. Goodman said, staff members might redirect them to a private room. And increasingly, nursing homes are setting aside private places where two consenting patients can be intimate.
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By RON FEEMSTER, December 9, NYT

This year, researchers completed work on a 50-question telephone quiz to help them identify Alzheimer’s patients long before they exhibit typical symptoms. Such a quiz may soon become part of regular medical care.

This new tool measures what the researchers call “cognitive vital signs” like short-term memory loss, which is the most important early sign of Alzheimer’s, and detects declines in everyday abilities like using a telephone, preparing meals or managing finances. The quiz also picks up behavioral warning signs including apathy, irritability and depression.

“If somebody is failing these cognitive tests, they already have the characteristics of the disease,” says Jeffrey Cummings, director of the Alzheimer Disease Center at U.C.L.A., “just in a very early and mild form.” Cummings says the quiz reliably shows when a person crosses the line between normal mental life and the mild cognitive impairment found in early Alzheimer’s, but adds that anyone who fails should get a detailed follow-up exam.

Cummings and his fellow researchers created the quiz to drastically reduce expensive, face-to-face exams in coming clinical trials of new drugs that may prevent Alzheimer’s. Only about 1 in 100 healthy 70-year-olds will develop Alzheimer’s during a year of testing, so to get statistically meaningful results, researchers must enroll about 5,000 people with no Alzheimer’s symptoms. In Cummings’s proposed trials, one group of healthy volunteers would take an experimental drug and the other would get a placebo — and every six months, they would all take the quiz by phone. “If people in the placebo group are proceeding to abnormality more quickly than the treatment group,” Cummings says, “that suggests first, that they might have Alzheimer’s, and second, that we have slowed the disease in the treatment group.”

A welcome second use of the trial: screening. Cummings suggests check-ups beginning at age 55, since the odds of getting Alzheimer’s double every five years at that point: 2 percent of 65-year-olds have Alzheimer’s, 4 percent of 70-year-olds and so on. By age 85, one in three people have the disease. “Without a preventive therapy, Alzheimer’s will overwhelm the Medicare system,” Cummings says. “A test like this should be as common as checking blood pressure.

Posted by adrena

Finding Alzheimer’s Before a Mind Fails

December 26, 2007
Finding Alzheimer’s Before a Mind Fails
By DENISE GRADY

For a perfectly healthy woman, Dianne Kerley has had quite a few medical tests in recent years: M.R.I. and PET scans of her brain, two spinal taps and hours of memory and thinking tests.

Ms. Kerley, 52, has spent much of her life in the shadow of an illness that gradually destroys memory, personality and the ability to think, speak and live independently. Her mother, grandmother and a maternal great-aunt all developed Alzheimer’s disease. Her mother, 78, is in a nursing home in the advanced stages of dementia, helpless and barely responsive.

“She’s in her own private purgatory,” Ms. Kerley said.

Ms. Kerley is part of an ambitious new scientific effort to find ways to detect Alzheimer’s disease at the earliest possible moment. Although the disease may seem like a calamity that strikes suddenly in old age, scientists now think it begins long before the mind fails.

“Alzheimer’s disease may be a chronic condition in which changes begin in midlife or even earlier,” said Dr. John C. Morris, director of the Alzheimer’s Disease Research Center at Washington University in St. Louis, where Ms. Kerley volunteers for studies.

But currently, the diagnosis is not made until symptoms develop, and by then it may already be too late to rescue the brain. Drugs now in use temporarily ease symptoms for some, but cannot halt the underlying disease.

Many scientists believe the best hope of progress, maybe the only hope, lies in detecting the disease early and devising treatments to stop it before brain damage becomes extensive. Better still, they would like to intervene even sooner, by identifying risk factors and treating people preventively — the same strategy that has markedly lowered death rates from heart disease, stroke and some cancers.

So far, Alzheimer’s has been unyielding. But research now under way may start answering major questions about when the disease begins and how best to fight it.

A radioactive dye called PIB (for Pittsburgh Compound B) has made it possible to use PET scans to find deposits of amyloid, an Alzheimer’s-related protein, in the brains of live human beings. It may lead to earlier diagnosis, help doctors distinguish Alzheimer’s from other forms of dementia and let them monitor the effects of treatment.

Studies with the dye have already found significant deposits in 20 percent to 25 percent of seemingly normal people over 65, suggesting that they may be on the way to Alzheimer’s, though only time will tell.

“PIB is about the future of where Alzheimer’s disease needs to be,” said Dr. William E. Klunk, a co-discoverer of the dye at the Alzheimer’s research center at the University of Pittsburgh. “PIB is being used today to help determine whether drugs that are meant to prevent or remove amyloid from the brain are working, so we can find drugs that prevent the underlying pathology of the disease.”

Though PIB is experimental now, studies began in November that are intended to lead to government approval for wider use.

Currently, for the most common form of Alzheimer’s disease, which occurs after age 65, there is no proven means of early detection, no definitive genetic test. But PIB tests might be ready before new treatments emerge, making it possible to predict who will develop Alzheimer’s — without being able to help.

Researchers are also using M.R.I. scans to look for early brain changes, and testing blood and spinal fluid for amyloid and other “biomarkers” to see if they can be used to predict Alzheimer’s or find it early.

Studies of families in which multiple members have dementia are helping to sort out the genetic underpinnings of the disease.

Finally, experiments are under way to find out whether drugs and vaccines can remove amyloid from the brain or prevent its buildup, and whether doing so would help patients. The new drugs, unlike the ones now available, have the potential to stop or slow the progress of the disease. At the very least, the drug studies will be the first real test of the leading theory of Alzheimer’s, which blames amyloid for setting off a chain of events that ultimately ruin the brain.

Some scientists doubt the amyloid theory, but even a staunch skeptic said the studies were important.

Among the skeptics is Dr. Peter Davies, a professor at Albert Einstein Medical College, who said: “You’ve got to try. Somebody’s going to get this right.”

But if the amyloid hypothesis does not hold up, much of Alzheimer’s research could wind up back at Square 1.

much more, permanent link

US scientists claim a drug can reverse some of the early symptoms of Alzheimer's disease - with the first effects seen within 10 minutes.

The Journal of Neuroinflammation reports how the memory of an 81-year-old man improved sharply after etanercept was injected into his spine.

His wife described it as her husband being "put back to where he was".

But UK experts warned that a single success did not prove that the drug would work for every dementia patient.

An ageing population means a substantial increase in the numbers of people suffering Alzheimer's disease.
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Alzheimer's helmet therapy hope

An experimental helmet is being tested by scientists as a treatment for Alzheimer's disease.

It delivers low levels of infra-red light, which researchers at the University of Sunderland, believe may stimulate the growth of brain cells.

Tests in mice showed it improved learning ability and a study in humans is due to begin in the summer.

Current treatments for Alzheimer's delay progression of the disease but cannot reverse memory loss.

The infra-red therapy was first developed to treat cold sores.

But when researchers studied how it worked, they found it stimulated growth of cells and may have applications in other conditions.

Daily therapy

In tests in people with dementia using infra-red lasers, eight out of nine people showed some improvement, said Dr Gordon Dougal, a GP and director of Virulite, a medical research company based in County Durham.

However, in order to safely deliver the treatment through the scalp, he developed a helmet which bathes the brain in low levels of infra-red light and would only need to be worn for 10 minutes a day.

Trials of around a 100 people with age-related memory problems will now look to see if the beneficial results seen in mice can be replicated in humans.

Dr Dougal said as cells age they lose the ability to repair and regenerate themselves, which in the brain leads to loss of memory.

"Currently all you can do with dementia is to slow down the rate of decay - this new process will not only stop that rate of decay but partially reverse it," he added.

The Alzheimer's Society said it was a potentially interesting technique.

"A treatment that reverses the effects of dementia rather than just temporarily halting its symptoms could change the lives of the hundreds of thousands of people who live with this devastating condition.

"We look forward to further research to determine whether it could help improve cognition in humans.

"Only then can we begin to investigate whether near infra-red could benefit people with dementia."

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/7208768.stm

Big Bellies Linked to Alzheimer's Disease

By Rob Stein
Washington Post Staff Writer
Wednesday, March 26, 2008; 4:00 PM

People who have big bellies in their 40s are much more likely to get Alzheimer's disease and other forms of dementia in their 70s, according to new research that links the middle-age spread to fading minds for the first time.

The study of more than 6,000 people found the more fat they had in their guts in their early to mid-40s the greater their chances of becoming forgetful or confused or showing other signs of senility as they aged. Those who had the most impressive midsections faced more than twice the risk of the leanest.

Surprisingly, a sizable stomach seems to increase the risk even among those who are not obese, or even overweight, the researchers reported in a paper published online today by the journal Neurology.

"A large belly independent of total weight is a potent predictor of dementia," said Rachel A. Whitmer, a research scientist at the Kaiser Permanente Division of Research in Oakland, Calif., who led the new study.

The findings are alarming in light of America's growing girth, Whitmer and other experts said.

"If these findings are replicated and better understood, it looks like an unhealthy brain could be another consequence of this epidemic of obesity," Lenore Launer of the National Institute on Aging said.

The research is the latest evidence that fat in the abdomen is the most dangerous kind. Previous studies have linked the apple-shaped physique to a greater risk of diabetes, heart disease and even cancer. Researchers suspect that those fat cells are the worst because of their proximity to major organs. They ooze noxious chemicals, stoking inflammation, constricting blood vessels and triggering other processes that might also damage brain cells.

"There is a lot of work out there that suggests that the fat wrapped around your inner organs is much more metabolically active than other types of fat right under the skin," Whitmer said. "It's pumping out toxic substances. It's very potent toxic fat."

Whitmer and her colleagues analyzed data from 6,583 members of Kaiser Permanente of Northern California who had their belly fat carefully calculated as part of a broad health study between 1964 and 1973. The researchers examined whether there was a link between abdominal obesity between the ages of 40 and 45 and the chances of developing Alzheimer's and other forms of dementia by the time they hit their 70s between 1994 and 2006.

The risk for dementia, the researchers found, increased steadily with the amount of fat in the abdomen, even after accounting for alternative explanations, such as other diseases, bad habits and lower education. They found no such association for fat in the thigh.

The researchers used a complicated method for measuring fat known as sagittal abdominal diameter (SAD). Those with a SAD score above 25 had the biggest bellies and the greatest risk. That is roughly equivalent to a waist of at least 39 inches.

Previous studies have shown people who are overweight are at increased risk for dementia. But when the researchers examined the relationship between body mass index (BMI), which is most common way to determine whether someone is overweight or obese, they found that those with big bellies were still nearly twice as likely to develop dementia even if they had BMIs that were considered healthy. In fact, their risk was about the same as for those who were overweight or obese.

"What that tells you is the effect of the belly is over and above that of being overweight," Whitmer said. "One of the take-home messages is it's not just your weight but where you carry your weight in middle age that is a strong predictor of dementia."

Stomach fat might increase the risk for dementia in the same ways it promotes heart disease -- by boosting blood pressure and constricting blood flow, Jose A. Luchsinger of Columbia University said. But Luchsinger and others said it might also promote the accumulation of a substance found in brain of Alzheimer's patients known as amyloid.

"We think the buildup and clumping of this material is an important risk factor," said Sam Gandy of the Mount Sinai School of Medicine, who chairs the Alzheimer's Association's medical and scientific advisory council. Previous research has found that people who are obese have higher levels of amyloid in their blood, he said.

Some experts remained skeptical, saying this kind of study cannot rule out the possibility that whatever is making people gain weight in their bellies in their 40s also puts them at risk for dementia in their 70s.

"There could be a connection. I'm not saying there couldn't be," said Barbara Corkery, director of Boston University's obesity research center. "But it could be those two things are caused by the same root cause."

While acknowledging that more research was needed, Whitmer said the findings provide one more reason to try to maintain a healthy weight, noting that this type of fat is the most easily shed by dieting and exercise.

"It's not as stubborn as the fat under the skin," she said. "It's a modifiable risk factor."

BBC

Coffee may cut the risk of dementia by blocking the damage cholesterol can inflict on the body, research suggests.

The drink has already been linked to a lower risk of Alzheimer's Disease, and a study by a US team for the Journal of Neuroinflammation may explain why.

A vital barrier between the brain and the main blood supply of rabbits fed a fat-rich diet was protected in those given a caffeine supplement.

UK experts said it was the "best evidence yet" of coffee's benefits.

The "blood brain barrier" is a filter which protects the central nervous system from potentially harmful chemicals carried around in the rest of the bloodstream.

Other studies have shown that high levels of cholesterol in the blood can make this barrier "leaky".

Alzheimer's researchers suggest this makes the brain vulnerable to damage which can trigger or contribute to the condition.

The University of North Dakota study used the equivalent to just one daily cup of coffee in their experiments on rabbits.

After 12 weeks of a high-cholesterol diet, the blood brain barrier in those given caffeine was far more intact than in those given no caffeine.

'Safe drug'

"Caffeine appears to block several of the disruptive effects of cholesterol that make the blood-brain barrier leaky," said Dr Jonathan Geiger, who led the study.

"High levels of cholesterol are a risk factor for Alzheimer's disease, perhaps by compromising the protective nature of the blood brain barrier.

"Caffeine is a safe and readily available drug and its ability to stabilise the blood brain barrier means it could have an important part to play in therapies against neurological disorders."

A spokesman for the Alzheimer's Disease Society said that the study shed "important light" on why previous research had showed benefits for drinking coffee.

"This is the best evidence yet that caffeine equivalent to one cup of coffee a day can help protect the brain against cholesterol.

"In addition to its effect on the vascular system, elevated cholesterol levels also cause problems with the blood brain barrier.

"This barrier, which protects the brain from toxins and infections, is less efficient prior to brain damage caused by Alzheimer's disease or strokes."

She called for more research into whether the same effect could be seen in humans.

Rotterdam, Holland | April 7

BBC - People who have had depression may be more prone to Alzheimer's disease, two studies suggest.

Dutch researchers found Alzheimer's was 2.5 times more likely in people with a history of depression.

h/t raja

By Yoko Kubota

TOKYO, April 11 (Reuters) - Equipped with devices such as a misplaced goods detector and a beeping pill case, a model house near Tokyo shows that a little bit of technology can help dementia patients live more independently.

"The greatest merit of these welfare devices is that the patients can do things on their own...rather than relying on other people," said Takenobu Inoue, a director at the National Rehabilitation Center for Persons with Disabilities, which runs the model house.

Dementia is a significant loss of mental skills that affect daily life, and is caused by factors such as strokes, tumours, head injuries and Alzheimer's disease.

The disease may weigh on heavy in Japan, where the population is ageing rapidly. The government estimates that dementia patients in Japan will reach 3.2 million in 2025 from around 1.7 million in 2005.

A majority of the 58 devices exhibited at the model house, which opened in December, came from European countries where research started over a decade ago, Inoue said.

In the kitchen, a gas stove made in Britain would speak and tell the user to turn off the gas if it senses anything burning.

In the living room is the misplaced goods detector, which looks like a silver remote control. By attaching small, colourful tags to things that people often misplace -- such as mobile phones or keys -- the detector can locate them by beeping.

There is also a pill case that notifies the user when it's time for medicine by beeping and flashing a light.

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The Independent, By Jeremy Laurance, April 12

An injection that dramatically relieved the symptoms of Alzheimer's disease within minutes would qualify as the discovery of the decade. That is exactly what was claimed yesterday for an experimental treatment being tested in America.

Scientists at the Institute for Neurological Research at the University of California have treated around 50 patients at a private clinic by injecting an anti-arthritic drug, etanercept, into the spinal column in the neck and then tilting the patients to encourage the drug to flow to the brain.

They claim 90 percent respond to the treatment, usually within minutes, and have released videos of patients to prove it.

In one, a nurse sits down with an 82-year-old patient, Marvin Millar, who frowns and mumbles incoherently as she asks him identify everyday objects such as a bracelet and a pencil, which he is unable to do.

But five minutes after being injected with etanercept – according to the film which was supplied and edited by the clinic – he greets his wife. Visibly shocked, she says he has not recognised her for years. Mr Miller then hugs her.

---

_{"Frankly, we've lost a lot in recent years." - General Colin Powell}

Biggest benefit for those who pass on beer, liquor

Women who drink wine appear to be protected against dementia in middle age and the effect is strongest in women who drink wine exclusively, new research shows.

What's more, wine drinkers -- at least women -- are less likely to develop dementia than regular beer or liquor drinkers, even though they're more likely to live long enough to develop the brain disorder.

The study is based on a random sample of nearly 1,500 women living in Gothenburg, Sweden who, beginning in 1968, were followed for 34 years. Researchers looked at the association between different types of alcohol and the risk of dementia.

Women who reported drinking wine were 40 per cent less likely to develop dementia. For women who consumed wine only, their risk dropped almost 70 per cent.

By contrast, women who drank liquor had an increased risk of dementia.

Overall, after taking into account eight different combinations of drinking beer, wine and liquor, the study "showed a robust protective association for exclusive consumption of wine only," the team reports in the American Journal of Epidemiology.

It's not clear why, but the difference in the effect of different types of alcohol suggests something other than ethanol may be at play. One explanation may be antioxidants in wine that act on blood vessels that aren't typically found in beer or hard liquors such as gin or vodka.

As well, "it could be that there's something special about this wine-only group that we really can't interpret very well," says Lauren Lissner, a professor of epidemiology in the department of public health and community medicine at University of Gothenburg. "The people who drink wine might have other characteristics that we simply can't measure. But the fact that it gets even stronger in the wine group could also be viewed as evidence that there is something in the wine."

She says the findings are important, given the way women drink today: In 1968, fewer than 20 per cent of women in the study said they drank wine every week. But from 1980 onward, more than 60 per cent were reporting that they were weekly wine drinkers.

The study isn't proof that wine protects the brain from memory-robbing dementia, Ms. Lissner says. "And we're not saying that our results are anything to base recommendations on or that women should change their wine consumption patterns."

As well, when it comes to women and alcohol, there are other associations that "don't look quite so rosy," she says. Alcohol has long been suspected of increasing a woman's risk of breast cancer. Now a new study, released this past weekend at the American Association for Cancer Research meeting, found that post-menopausal women who drink even moderately -- one or two drinks per day -- raise their risk of developing hormone sensitive breast cancers, the most common form of breast cancer.

Women who had three or more glasses of alcohol daily had as much as a 51-per-cent increased breast cancer risk, according to researchers who analysed data from more than 184,000 women enrolled in a large American diet and health study.
More

Wed May 14, 2008 3:56pm EDT
By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) - Retired U.S. Supreme Court justice Sandra Day O'Connor made a rare public appearance on Wednesday with emotional testimony in Congress in which she told how Alzheimer's disease had forced her to bring her husband to work with her.

Eventually, she retired early and reluctantly from the bench to care for him, O'Connor told a hearing at which she urged Congress and the federal government to back a comprehensive plan to eradicate the debilitating disease.

"You may remember that in the early days of my husband's illness, I often took him to court with me because he could not be left alone," O'Connor told a hearing of the U.S. Senate Special Committee on Aging.

"And, as you know, I retired from the U.S. Supreme Court in 2006 to find a care center for John in Phoenix, where two of our children live. Many caregivers make similarly difficult decisions each and every day.

"Sadly, these life-changing decisions are simply part of caring for someone with Alzheimer's," she said. Alzheimer's affects more than 5 million Americans and doctors predict it will become an epidemic as the population ages.

O'Connor, the first woman to serve on the U.S. Supreme Court, is part of the Alzheimer's Study Group, made up of experts, former politicians and others that aims to write a national strategic plan for Alzheimer's.

"Under current trends federal spending on Alzheimer's will increase to more than $1 trillion per year by 2050 in today's dollars," former House of Representatives Speaker Newt Gingrich, another member of the group, told the hearing.

GROWING ALZHEIMER'S CRISIS

"That's more than one tenth of America's current economy. With this amount of money at stake, the government simply will not be able to solve its looming fiscal problems if it fails to address the growing Alzheimer's crisis."

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I hope we don't see the same thing happen here, surely a failure of society

* Justin McCurry in Tokyo
* guardian.co.uk,
* Thursday June 19 2008

An average of almost 100 Japanese people killed themselves each day last year, according to figures out today, dealing a serious blow to a government campaign to drastically reduce the suicide rate by 2016.

A total of 33,093 people committed suicide in 2007, up 3% from 2006 and the 10th year in a row the number has exceeded 30,000, the national police agency said. The figure is the second highest after the 34,427 recorded suicides in 2003.

Depression was identified as the main factor in around a fifth of cases, followed by physical illness and debt.

The number of elderly people who killed themselves rose 9% from a year earlier as Japan grapples with a rapidly aging society and rising poverty among pensioners.

People aged over 60 made up the biggest individual group of victims, rising to a record high of 36.6% of the total, the agency said.

More than half the elderly suicides were connected with ill-health, but a sizeable number were due to financial pressures, the report said.

"I think the number will continue to rise as more elderly people find themselves isolated and struggling financially," a counsellor at Inochi no Denwa, Japan's biggest telephone counselling service, told the Guardian.

"Their traditional support mechanisms - the welfare state and extended families - are under threat, so I'm very pessimistic."

Japan's senior citizens - who now make up more than 20% of the population - have been hit hard by the pensions squeeze and healthcare reforms designed to rein in public spending.

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Exercise may ward off Alzheimer's and slow down its progression

Being physically fit could hold back the advance of Alzheimer's disease, US researchers have suggested.

Their study, published in the journal Neurology, looked at 121 people aged over 60, around half of them in the early stages of the disease.

Those with Alzheimer's who were less fit had four times more signs of brain shrinkage than those who were fit.

The Alzheimer's Research Trust said other research showed exercise reduced the risk of dementia.

more at BBC

In other words , get off your ass to stay healthy!

By Emma Wilkinson
Health reporter, BBC News

UK scientists have developed a drug which may halt the progression of Alzheimer's disease.

Trials of the drug, known as rember, in 321 patients showed an 81% difference in rate of mental decline compared with those not taking the treatment.

The Aberdeen University researchers said the drug targeted the build-up of a specific protein in the brain.

Alzheimer's experts were optimistic about the results, but said larger trials were now needed.

Presenting the results at the International Conference on Alzheimer's Disease, Professor Claude Wischik said the drug may be on the market by 2012.

Patients with mild to moderate Alzheimer's disease were given either 30, 60 or 100mg of the drug or a placebo.

The 60mg dose produced the most pronounced effect - over 50 weeks there was a seven-point difference on a scale used to measure severity of dementia.

At 19 months there was no significant decline in mental function in patients taking the drug, the researchers said.

Imaging data also suggests the drug may be having its biggest effect in the parts of the brain responsible for memory.

The link between clumps or "tangles" of protein inside nerve cells in the brain and Alzheimer's disease was first made over 100 years ago.

Later shown to be made up of a protein called Tau, the tangles build up inside cells involved in memory, destroying them in the process.

Rember, or methylthioninium chloride, is the first treatment specifically designed to target the Tau tangles.

Other treatments for Alzheimer's tend to focus on combating a waste protein in the brain, beta-amyloid, which is known to form hard plaques. The latest work suggests targeting Tau may produce better results.

Methylthioninium chloride is more commonly used as a blue dye in laboratory experiments.

more with video at BBC

September 30, 2008

By ROBERT PEAR
WASHINGTON — More than 90 percent of nursing homes were cited for violations of federal health and safety standards last year, and for-profit homes were more likely to have problems than other types of nursing homes, federal investigators say in a report issued on Monday.

About 17 percent of nursing homes had deficiencies that caused “actual harm or immediate jeopardy” to patients, said the report, by Daniel R. Levinson, the inspector general of the Department of Health and Human Services.

Problems included infected bedsores, medication mix-ups, poor nutrition, and abuse and neglect of patients.

Inspectors received 37,150 complaints about conditions in nursing homes last year, and they substantiated 39 percent of them, the report said. About one-fifth of the complaints verified by federal and state authorities involved the abuse or neglect of patients.

About two-thirds of nursing homes are owned by for-profit companies, while 27 percent are owned by nonprofit organizations and 6 percent by government entities, the report said.

The inspector general said 94 percent of for-profit nursing homes were cited for deficiencies last year, compared with 88 percent of nonprofit homes and 91 percent of government homes.

“For-profit nursing homes had a higher average number of deficiencies than the other types of nursing homes,” Mr. Levinson said. “In 2007, for-profit nursing homes averaged 7.6 deficiencies per home, while not-for-profit and government homes averaged 5.7 and 6.3, respectively.”

On Monday, Mr. Levinson issued a compliance guide for nursing homes that says some homes “have systematically failed to provide staff in sufficient numbers and with appropriate clinical expertise to serve their residents.”

Researchers have found that people receive better care at homes with a higher ratio of nursing staff members to patients.

The inspector general said he had found some cases in which nursing homes billed Medicare and Medicaid for services that “were not provided, or were so wholly deficient that they amounted to no care at all.”

Bruce A. Yarwood, president of the American Health Care Association, a trade group, said: “We know we have to do a better job. We have been doing a better job, in treating pressure sores, managing pain and reducing the use of physical restraints.”

Mr. Yarwood said that the inspection system was broken. “It does not reliably measure quality,” he said. “It does not create any positive incentives.”

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Incentives? Sure there are incentives, you get to keep the doors open and pay less insurance when employees and residents are not put into unneccesary danger.

a view you don't hear every day..

01 Oct 2008 13:01:00 GMT
Written by: HelpAge International

Reuters and AlertNet are not responsible for the content of this article or for any external internet sites. The views expressed are the author's alone.

Richard Blewitt, chief executive of aid agency HelpAge International, marks U.N. International Day of Older People.

According to the U.N., this is a day when age should be celebrated, when older people's contribution to society should be recognised and applauded.

It's certainly a nice idea. Trouble is, I'm not sure the 100 million older people living on less than $1 a day feel particularly recognised right now. As they struggle to survive in the face of discrimination, marginalisation and a lack of economic and physical security, they probably feel pretty invisible.

Unfortunately, this is reflected in current international development policy. Initiatives such as the Millennium Development Goals focus largely on women and children, while global responses to HIV and AIDS target younger generations.

Older people are nowhere to be seen. Until this changes, the situation of older people living in poverty will continue to deteriorate.

The irony is that older people are the missing link in development. They are the backbone of society in many developing countries and play a vital role in supporting families and communities.

It's older people who facilitate the economic growth fueled by migration of younger generations to urban areas - staying behind to look after homes and children. It's older people, caring for the sick and the orphaned, who are at the frontline of the battle against HIV and AIDS. And it's older people who, without access to pensions, work long into old age to feed extended families.

Imagine what could be achieved then, if older people were not only recognised in international development policy but actively supported, if they were seen as a resource, rather than a burden on society.

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_{"Go confidently in the direction of your dreams! Live the life you've imagined." -Henry David Thoreau}

Cheap cold sore drugs could offer best treatment yet

The virus that causes cold sores may be one of the main causes of Alzheimer’s disease, according to research that suggests that existing drugs could be used to treat the most common form of dementia.

Compelling new evidence found by British scientists has implicated the cold sore virus, known as herpes simplex virus 1 (HSV1), in up to 60 per cent of Alzheimer’s cases.

Though the findings from the University of Manchester remain preliminary, they could transform scientific understanding of a brain disorder that affects more than 400,000 people in Britain, and open an entirely new approach to treating it.

The insight is particularly encouraging because cheap antiviral drugs that can control HSV1 infections, such as acyclovir or Zovirax, have been available for many years, and are sufficiently safe to be sold over the counter.
More

_{Tolerating prostitution is tolerating abuse and torture of women and children.}

IHT
By Jane E. Brody
Published: December 16, 2008

Is alcohol a tonic or a toxin? The question is especially critical to older people, whose overall medical picture gives alcohol the potential to be a health benefit or a life-shortening hazard.

Yet experts say that doctors rarely ask older patients how much and how often they drink. Not knowing the answers to these questions can result in misdiagnosis, medical complications and life-threatening accidents. Doctors may also fail to recognize the symptoms of alcohol abuse, a problem that is expected to become increasingly common as baby boomers, who have been found to drink more than previous generations, reach age 65 and beyond.

At the same time, older people who are in good health should know that moderate drinking under the right conditions may improve their health in several important ways. In a comprehensive review in the October issue of The Journal of the American Dietetic Association, Maria Pontes Ferreira and M.K. Suzy Weems described the myriad health benefits and risks of alcohol consumption by aging adults.

In summarizing the findings in an interview, Ferreira, a registered dietitian, said that "although there are a lot of benefits from moderate alcohol consumption, you can't make a blanket statement; you have to look at the big picture."

"Moderate alcohol consumption can improve appetite and nutrition and reduce the risk of several important diseases, including cardiovascular diseases and diabetes," said Ferreira, a post-doctoral fellow at Haskell Indian Nations University in Lawrence, Kansas. "But a lot of folks over 50 are already dealing with diseases associated with aging and medication use that can result in possible complications and drug interactions. And older people who abuse alcohol are consuming an inordinate amount of calories that can displace important nutrients."
Today in Health & Science
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Cleveland surgeons perform first major face transplant in U.S.

Furthermore, Dr. Frederick Blow, professor of psychiatry at the University of Michigan Medical School and an expert on alcohol and aging, pointed out in an interview that "even at lower levels of consumption, alcohol can be problematic for older people."

"Because of an increased sensitivity to alcohol and decreased tolerance as one ages, lower amounts of alcohol can have a bigger effect," he said. "Older people get into trouble with doses of alcohol that wouldn't be a problem with a younger person."

Madeline Naegle, professor at the New York College of Nursing, fears that publicity about the benefits of alcohol has dangerously tipped the scales, prompting some people to think that "if one drink is good, two or three must be better."

"Recommendations about drinking must be qualified by the level of a person's health," she emphasized in an interview.

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_{"Go confidently in the direction of your dreams! Live the life you've imagined." -Henry David Thoreau}

February 23, 2009
nyt
By PAM BELLUCK

LANTANA, Fla. — Partly paralyzed, with diabetes and colitis, Linda Lent needs extensive care at home.

But with her husband working long hours at a bowling alley, Ms. Lent, 47, relies on a caregiver who travels by school bus toting a homework-filled backpack: her 13-year-old daughter, Annmarie.

Annmarie injects migraine medicine, dispenses pills, takes blood from her mother’s finger for tests and responds to seizures — responsibilities she has at times found overwhelming.

At 11, she said, she felt “fed up,” thinking: “There’s no law says I have to take care of her. Why should I have to do it? Other kids, they could go out and play with friends.”

Across the country, children are providing care for sick parents or grandparents — lifting frail bodies off beds or toilets, managing medication, washing, feeding, dressing, talking with doctors. Schools, social service agencies and health providers are often unaware of those responsibilities because families members may be too embarrassed, or stoic.

Some children develop maturity and self-esteem. But others grow anxious, depressed or angry, sacrifice social and extracurricular activities and miss — or quit — school.

“Our society thinks of children as being taken care of; it doesn’t think of children as taking care of anybody,” said Carol Levine, director of families and health care at United Hospital Fund, a health services organization that studied child caregivers.

“Kids who do it well gain confidence,” Ms. Levine said, but “they may be resentful, not do as well in school and feel limited because their role is to be the caregiver.”

Health organizations are increasingly “realizing the extent of what children are doing,” said Nancy Law, an executive vice president of the National Multiple Sclerosis Society. “Everything from children who become overly responsible” to “the kid who totally rebels and gets into trouble.”

“This is an issue that’s growing,” she said.

A 2005 nationwide study suggested that about 3 percent of households with children ages 8 to 18 included child caregivers. Experts say they expect the numbers to grow as chronically ill patients leave hospitals sooner and live longer, the recession compels patients to forgo paid help and veterans need home care.

Recently, programs have been formed to help children find support. Several Florida schools now have classes and meetings regarding caregiving.

Other countries do more. In Britain and Australia, the census counts child caregivers, and many of them have rights to participate in patient-care discussions and to ask agencies for help or compensation.

Hundreds of programs help them, said Saul Becker, a sociology professor at the University of Nottingham. “It’s such a big issue.”

Experts say that in the United States, the issue is often hidden.

“It is embarrassing for grownups to admit they’re so helpless that a child is caring for them,” said Kim Shifren, a psychology professor at Towson University, who studies child caregivers and was one herself.

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_{"Go confidently in the direction of your dreams! Live the life you've imagined." -Henry David Thoreau}

June 14, 2009
All-Night Care for Dementia’s Restless Minds
By CARA BUCKLEY and JAMES ESTRIN
Also see -Slideshow: Nightwatch
Behind the Scenes: Capturing Mental Twilight

THE patients were on the loose again, moving their shrunken frames through the nursing home’s shadowy halls, chattering and giggling like children sneaking out of camp.

It was after midnight. Nearly everyone inside the Hebrew Home at Riverdale, which hugs the banks of the Hudson River in the northern Bronx, was fast asleep. The group crept past a large fish tank and rounded a corner, startling a security guard who jumped at the sight of them: seven tiny women with lights glinting off their silvery hair. Then the guard noticed a young employee pushing one of the women in a wheelchair, and relaxed. It was just the night-care group, out for a supervised stroll.

One of the ladies began singing a salsa song, creakily sashaying her hips. Another took note and grinned. “Shake it, don’t break it,” she called out.

The seven women all have Alzheimer’s disease or dementia, and are part of the Hebrew Home’s ElderServe at Night, a dusk-to-dawn drop-off program intended to strengthen their decaying minds while sating their thirst to be active after dark.

Alzheimer’s is an irreversible brain disease that destroys memory, and it is one form of dementia, a disorder marked by the loss of mental functions. Nighttime can be treacherous for people with dementia, who are often struck by sleeplessness or night terrors and prone to wandering about. This agitation and disorientation, called “sundowning,” is especially vexing for relatives trying to care for them at home, and often hastens their placement in nursing homes.

While there are countless day care programs for the nation’s estimated 5.3 million Alzheimer’s patients, some experts believe that ElderServe at Night, which began a decade ago, is the only one of its kind in the country.

Participants are fetched from their homes by vans and spend 7 p.m. to 7 a.m. painting, potting plants, dancing and talking — or, for those immobilized by their disease, relaxing amid music, massage and twinkling lights. The patients rest as they need, for a few minutes or a few hours, and return home the next morning fed, showered and, usually, tuckered out.

“At home we’re alone, with no one to talk to,” said Maria Viera, 73, who lives by herself in the Mott Haven neighborhood of the Bronx and has been in the program since 2007. “And it’s a good place to pass the night, because we can’t be alone in our houses.”

Friendships are forged, and at least one romance has bloomed: Luis Maldonado used to hold the hand of tiny Isabel Quevedo and kiss her cheek. Mr. Maldonado died in April at 83. When asked about boyfriends, she scoffed. Men want just one thing, said Ms. Quevedo, 79, “and I don’t want my reputation to go down.”

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Drinking five cups of coffee a day could reverse memory problems seen in Alzheimer's disease, US scientists say.

The Florida research, carried out on mice, also suggested caffeine hampered the production of the protein plaques which are the hallmark of the disease.

Previous research has also suggested a protective effect from caffeine.

..... "It is too early to say whether drinking coffee or taking caffeine supplements will help people with Alzheimer's.

Neil Hunt, chief executive of the Alzheimer's Society, said previous research into caffeine had suggested it could delay Alzheimer's disease and even protect against vascular dementia.

"This research in mice suggests that coffee may actually reverse some element of memory impairment.

"However much more research is needed to determine whether drinking coffee has the same impact in people.

"It is too soon to say whether a cup of coffee is anything more than a pleasant pick me up." More

_{Tolerating prostitution is tolerating abuse and torture of women and children.}

Scientists Discover 3 More Genes With Links to Alzheimer's Disease

By David Brown
Washington Post Staff Writer
Monday, September 7, 2009

Two European research teams have identified three genes that affect a person's risk of developing Alzheimer's disease, the most common cause of dementia in the elderly.

The new genes appear to have at least as big a role as four others discovered in the last 15 years that are known to play a role in Alzheimer's.

"The message here is that genes are important in Alzheimer's disease . . . and there may be multiple ways of reducing the risk that the genes produce," said Julie Williams, a neuroscientist at Cardiff University in Wales who helped lead one of the teams.

All so-called Alzheimer genes have normal roles in brain physiology; they don't exist solely to cause dementia. Instead, small variations in their DNA alter their function and, through processes only now being uncovered, increase or reduce a person's risk of developing the disease.

Two of the genes described in the new research may be involved in determining the brain's capacity to clear itself of toxic "amyloid" proteins that collect outside neurons, eventually poisoning them.

The most important previously known Alzheimer gene promoted overproduction of amyloid. The new findings suggest that at least two processes -- production of amyloid and its removal -- are involved in the disease.

At least 5 million Americans have Alzheimer's disease. By one estimate, one in seven people age 72 and older has dementia, with Alzheimer's the most common form.

The new findings, reported Sunday in the journal Nature Genetics, will have no immediate consequence in either diagnosis or treatment of the disease. However, they will help illuminate a process that goes on for years or even decades before memory loss, the cardinal symptom of the disease, becomes apparent.

more

bbc
The dying cells of this mouse with Alzheimer's show up as green dots

A simple eye test might be able to detect Alzheimer's and other diseases before symptoms develop, according to UK scientists.

The technique uses fluorescent markers which attach to dying cells which can be seen in the retina and give an early indication of brain cell death.

The research has been carried out on mice, but human trials are planned.

Scientists from University College London hope this could lead to a high street opticians test for the disease.

The research, which is published in the journal, Cell Death and Disease, could enable scientists to overcome the difficulty of investigating what is happening inside the brains of those with Alzheimer's.

They currently have to rely on expensive MRI scans or post-mortems.

Fluorescent dye

This new technique enables scientists to track the progress of brain disease by looking at dying cells in the retina.

The cells show up as green dots because they absorb the fluorescent dye.

These findings have the potential to transform the way we diagnose Alzheimer's

Rebecca Wood, Alzheimer's Research Trust

The research has so far been carried out on mice, but the team is optimistic that the technique can be translated to humans.

Professor Francesca Coredeiro, lead author from University College London Institute of Ophthalmology said: "Few people realise that the retina is a direct, albeit thin, extension of the brain.

"It is entirely possible that in the future a visit to a high-street optician to check on your eyesight will also be a check on the state of your brain."

"I hope that screening for Alzheimer's will be available on the high street within five years."

She said the research could help scientists to see how the disease is progressing by comparing retinal cell death a few weeks apart.

"Currently, the biggest obstacle to research into new treatments for neurodegenerative diseases is the lack of a technique where the brain's response to new treatments can be directly assessed - this technique could potentially help overcome that."

Patient trials

The first patient trials to assess the technique for the eye disease will begin later this year.

Rebecca Wood, Chief Executive of the Alzheimer's Research Trust, said: "These findings have the potential to transform the way we diagnose Alzheimer's, greatly enhancing efforts to develop new treatments and cures.

"If we spot Alzheimer's in its earliest stages, we may be able to treat and reverse the progression of the disease as new treatments are developed.

"Dementia scientists currently lack a way of assessing the brain's responses to new treatments in real time; this technique may help overcome that obstacle.

"700,000 people in the UK live with Alzheimer's and other dementias, and that number is set to double within a generation unless scientists make rapid progress in their race for a cure."

Dr Susanne Sorensen from the Alzheimer's Society also welcomed the research, but stressed much more research was needed to see if the technique could indeed be used to diagnose the disease, or monitor the effects of drugs under development.

Loss of Smell Function May Predict Early Onset of Alzheimer's Disease

Science Daily, January 13

A study published in the January 13, 2010 issue of the Journal of Neuroscience links a loss of smell function in Alzheimer's disease (AD) model animals with amyloid (protein) accumulation in the brain, a distinguishing hallmark of Alzheimer's disease. Research conducted by NYU Langone Medical Center suggests that olfactory dysfunction, a common symptom of AD, may serve as an early diagnostic tool for the disease.

The formation of amyloid plaques and neurofibrillary tangles are believed to contribute to the degradation of the neurons in the brain and the subsequent symptoms of AD. In this newly published study, NYU Langone scientists used genetically engineered mice, which developed amyloids in their brains, reflecting a progressive Alzheimer's disease pathology similar to humans. They found that Alzheimer's disease amyloid pathology occurs first in a region of the mouse brain responsible for smelling -- which is directly above their noses. This pathology also coincided with the animals having abnormal abilities to smell. The mice with a high concentration of amyloid in their brains had to sniff odors longer to "learn" them than mice with less amyloid. They also had problems differentiating between odors.

As the article in the Journal of Neuroscience suggests, since the behavioral symptoms of AD often occur early in life, it is possible that this new olfactory method, looking at olfactory perception across multiple presentations of the same odor, may be advantageous in early detection of Alzheimer's -- prior to substantial degeneration of the brain.

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_{They sicken of the calm, who knew the storm.}

The Guardian, Denis Campbell, January 13

Study in British Medical Journal says angiotensin receptor blockers play key role in delaying symptoms

Millions of older people who take drugs for high blood pressure or heart problems can more than halve their risk of developing Alzheimer's disease and dementia, according to research.

Use of angiotensin receptor blockers (ARBs) is linked to a "striking decrease" in the chance of getting the condition or of it progressing, especially in men, says a study published in the British Medical Journal. The drugs play a key role in delaying the symptoms of dementia and so may reduce the number of people dying early or needing to enter a nursing home, the study finds.

Patients taking ARBs had up to a 50% lesser risk of getting dementia, the journal reports. While ARBs are only one of the types of drugs used to treat high blood pressure and cardiovascular disease, the research pinpoints their usefulness in tackling dementia. In 2008, a total of 14.5m doses of ARBs were prescribed to patients in England at a cost of £272m.

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_{They sicken of the calm, who knew the storm.}

January 12, 2010
Personal Health
Healthy Aging, With Nary a Supplement
By JANE E. BRODY

The Great Recession, so I’m told, has been great for one segment of the economy — the makers of pills and potions that offer the promise of keeping people healthy. A middle-aged woman remarked as she perused the supplement shelves in my local health food store (I was buying bulgur): “I can’t afford to get sick. I lost my job and I have no health insurance.”

Each year millions of people fall prey to false promises that this, that or the other formula or fortified food can protect their hearts, prevent cancer, improve memory, strengthen their bones, uncreak their joints, build their muscles, even enable them to burn extra calories without moving.

The desire to achieve a healthy old age is laudable indeed, and will be even more so in the future. According to a projection of the century-long rise in life expectancy published in The Lancet in October, more than half the children born since 2000 in wealthy countries can expect to celebrate their 100th birthday.

If so many of us are destined to become centenarians, it is all the more important to be able to enjoy those years unencumbered by chronic disease and disability. There is no virtue in simply living long; the goal should be to live long and well.

But while much is known about how to raise the odds of a healthy old age, only a minority of Americans incorporate into their lives what is likely to give them the biggest bang for their buck. Like the woman in the health food store, they’d rather rely on supplements of vitamins and minerals, fish oils and herbs, perhaps washed down with pricey antioxidant juices.

Unfortunately, sound evidence for the benefits of most such products is sorely lacking; in some cases the best scientific evidence has shown no benefit, and in a few cases has even shown harm. Human chemistry is far more complex than visionaries thought just two decades ago, when reputable scientists pushed for fortifying foods with substances they believed would prevent cancer and heart disease.

The Longevity Diet

After decades of government guidelines and advice from friends, family and physicians, Americans have made some improvements in their eating habits. On average, we consume less red meat and saturated fat and somewhat more whole grains, fruits and vegetables. Our processed foods were recently stripped of artery-clogging trans fats, thanks to a campaign that challenged the food industry to better protect American hearts. And our pigs (though, alas, not our people) have gotten much leaner in recent years.

But, and this is a big but, we are a long way from consuming the kind of diet most closely linked to a low risk of heart disease, cancer, diabetes, stroke and dementia. That diet need not be strictly vegetarian, but it should emphasize plant-based foods over the meat and other products that come from animals that eat plants. The closer to the earth we eat, the healthier — and leaner — we are likely to be.

Most of the evidence for the assumed health benefits of specific nutrients comes not from stuffing people with supplements but rather from observing the effects of eating foods rich in these nutrients. Supplements of antioxidants failed to protect against disease the way a diet rich in fruits and vegetables seems to. Rather than isolated nutrients, combinations of them, along with other perhaps unidentified substances in foods, are now thought to confer the observed health benefits.

You have no doubt heard much about the so-called Mediterranean diet, and with good reason. This eating style, in its classic form, is most closely linked to a healthy body and mind as people age: a lower risk of heart disease, high blood pressure, stroke, diabetes, breast cancer and Alzheimer’s disease. It is loaded with nutrient-rich vegetables and fruits, beans and grains, fish and shellfish, but relatively little meat and poultry. Olive oil is the primary fat for cooking and eating, even replacing butter as a smear on bread.

But the Mediterranean diet does not come in a pill or potion. You have to eat the foods to reap the rewards. Consider also taking supplements of two nutrients in otherwise short supply — calcium and vitamin D. In addition to protecting bones from age-related decline, vitamin D in amounts of 800 to 1,000 international units daily for middle-aged and older adults may improve muscle strength (and thus reduce the risk of falls and fractures), help prevent several common cancers, counter depression and enhance cognitive function, various studies have suggested.

The second crucial ingredient is regular physical exercise. I know, you’ve heard this song before and you know you should do it, but ... fill in the blank: you hate exercise, you have no time, the weather is lousy, the children are sick, you’re injured, you don’t get enough sleep as it is. It’s easy to find reasons not to exercise.

It’s time to stop making excuses and make regular physical activity an integral part of your life, like eating, sleeping and brushing your teeth. You don’t decide every day to do these things, you just do them. Likewise with exercise.

Move for Good Health

The single most effective activity, studies have found, is an aerobic activity like brisk walking — about 30 minutes a day. If you can’t get out of the house, walk inside. Go up and down stairs, walk the hall, walk from room to room, walk in place. If walking doesn’t suit you, try dancing to music.

In a 2006 study of people aged 60 to 79, those who were assigned to walk briskly three days a week for 45 minutes a day experienced an increase in the brain’s volume, especially in regions involved in memory, planning and multitasking.

Even people already afflicted with chronic ailments — heart or lung disease, arthritis, diabetes, depression, early dementia — can reap significant health benefits from exercise, studies have found.

Americans have yet to learn what Hippocrates, the father of medicine, recognized in 400 B.C. “All parts of the body which have a function if used in moderation and exercised in labors in which each is accustomed, become thereby healthy, well developed and age more slowly; but if unused and left idle they become liable to disease, defective in growth and age quickly.”

So get off the couch and make this year the year you discover the joys and benefits of movement.

Memory lapses are common and increase with age; when do they signal Alzheimer's?

By Rachel Saslow
Washington Post Staff Writer
Tuesday, February 9, 2010; HE01

Where did I park my car?

What is that lady's name?

Where are my glasses?

Some call these "senior moments" or "tip-of-the-tongue" experiences. They're mundane for many elderly (and not-so-elderly) adults, but when do they become something more serious? How does one know when it's time to get screened for a memory disorder?

"The reason it's becoming such an acute concern for everybody is that baby boomers are starting to get into the higher-risk age group, but the bigger driver for this is the baby boomers' parents," says James Lah, an Emory University neurologist, who is 48 and has parents ages 73 and 81. "That age bracket is very high risk, and seeing it in our parents makes you acutely aware and afraid of that prospect."

The risk of mild cognitive disorder and dementia increase with age; Alzheimer's disease is the leading cause of dementia. About 5 million Americans live with Alzheimer's and, in 2008, it passed diabetes to become the sixth-leading cause of death in this country, according to the Centers for Disease Control and Prevention, partially because of the lack of treatments to stop or reverse it. Some studies estimate that a person's risk of developing the disease doubles every five years after age 65.

Memory lapses start in our 20s, though people don't typically notice or fret about them until their 50s. In a study published last year in the journal Neurobiology of Aging, psychologists asked about 2,000 participants to solve puzzles, identify patterns and remember words and details from stories, among other memory tests. The top performers were 22 years old; researchers saw a notable decline in the ability to make rapid comparisons, remember unrelated information and detect relationships by age 27. A weakening memory can usually be detected by around age 37, according to the study. The good news was that people's vocabulary and general knowledge increase until at least age 60.

"Once you hit your 40s and especially your 50s, your memory is not as good as it used to be," says Gary Small, a professor of psychiatry and aging at the University of California at Los Angeles. "The brain science of aging certainly backs that up."

While it's not healthy to over-interpret everyday memory lapses, it's important to bring up with a doctor anything that strikes you or your family as unusual. It's also wise to do this sooner rather than later, because treatments for Alzheimer's, though not completely effective, may provide some help when the disease is diagnosed early. Also, a doctor can screen a patient for other conditions that can cause memory loss, such as stroke, a bad interaction among medications or a thyroid disorder.

More common conditions such as depression, hormonal changes, stress, fatigue and a poor diet can contribute to forgetfulness, so sometimes lifestyle changes can restore memory function. The strongest memory-protective lifestyle strategy is physical exercise, Small says. Just 10 minutes of brisk walking each day can help lower one's Alzheimer's risk, he says. Lah says his male patients uniformly hate his suggestion to take up ballroom dancing, which is more likely to protect against dementia than, say, golf, because it is more physically demanding and requires a more active thought process.

"It's always good for a giggle during an otherwise difficult discussion," he says.

Some people turn to "brain calisthenics" such as crossword puzzles, playing music or learning a new language to stay sharp. A study published last year in the journal Neurology backed up this approach: Scientists found that people who did 11 such activities a week delayed rapid memory loss by about 1.3 years compared with those who did just four a week. Still, both Small and Lah say it's a stretch to claim that any of the brain exercise programs are proven to prevent memory disorders.

Others swear by ginkgo biloba, but a study last year in the Journal of the American Medical Association suggested that the extract does not reduce the chances of dementia. Then there are omega-3 fatty acids -- which Small says some studies suggest may be helpful although "the evidence is not overwhelming" -- and the much-ballyhooed pomegranate juice. The bright-red seeds of the pomegranate have lots of Vitamin C and other antioxidants, which fight the free radicals that can damage brain cells. Studies show an association between ingesting antioxidants and having a lower risk for Alzheimer's, but any claim that drinking pomegranate juice would be beneficial would have to be based on a double-blind, placebo-controlled trial, "which I have not seen," Small says.

"With memory lapses, it's the degree of the problem," he says. "If you forget where you place your keys, that's common. But if you put them in the refrigerator repeatedly, that's a problem."

Starting with Small's example, here are some common "senior moments," juxtaposed with situations that might be more troublesome:

NORMAL: Forgetting your keys.

PROBLEMATIC: Putting your keys in the refrigerator.

Acting as if the keys belong between the milk and the eggs shows a level of confusion that interferes with daily life, a good benchmark for determining if a slip is something more serious. So if you find your car keys in the dairy drawer, is it time to see a neurologist? Not exactly, says Molly V. Wagster, chief of the behavioral and systems neuroscience branch at the National Institute on Aging.

"I can see a cognitively healthy person of any driving age getting distracted, carrying several packages at once and then they get a yogurt out on the way to work and put the keys in the refrigerator," Wagster says.

Multitasking gets more difficult as people age. What's important is that the person realizes something is missing and they keep searching for it until they find it, she says. People with dementia might forget that they need to find the car keys and then forget that they need to go to work.

NORMAL: Forgetting where you parked.

PROBLEMATIC: Forgetting where you parked once a week.

Working memory is a kind of short-term memory that is particularly vulnerable as we age. Our working memory contains information that you hang on to for a short while for a specific purpose, such as where we parked the car. The brain also has to be able to change and update information in the working memory.

"If you park in a parking lot next to a large shopping mall and go in, walk through several stores and exit from a different door, you need to be able to update your working memory because you're exiting at a different orientation," Wagster says. "But once you get to your car, you don't need that information anymore" and can therefore shed it.

While forgetting where you parked once in a while is normal, doing so once a week suggests a faulty working memory, interferes with daily life and could signal a larger problem.

NORMAL: Forgetting a person's name.

PROBLEMATIC: Forgetting a person's name and then repeatedly asking him or her, "What's your name again?"

It's normal for our brains to change over time, just like our muscles, bones and skin show their ages, Lah says.

"Just as you don't run as fast at 70 as 20, likewise those brain cells you've been carrying around for 70 years don't fire and transmit information as quickly as they did when you were 20," he says.

To retrieve information such as a person's name, it has to be stored correctly. That means that when you meet a new person, you have to learn his or her face, name and some identifying details and then consolidate those bits of information. If that system isn't working, retrieval won't be possible.

"Where it becomes much more worrisome for those concerned with Alzheimer's, it's not just the retrieval process that becomes inefficient: The brain cells and networks responsible for learning information become damaged."

Repeating questions is a common symptom of Alzheimer's and could signal a damaged short-term memory.

NORMAL: Inability to program the cable box.

PROBLEMATIC: Forgetting how to turn on the television.

Programming a cable box is something you rarely have to do, and with three remotes and increasingly complicated entertainment systems, it's normal to need some help. But if someone watches television every night and is suddenly befuddled by the buttons on the remote, that could be a problem. People with memory disorders often find it difficult to complete daily tasks that they used to do automatically, such as driving to work, remembering the rules of a favorite game or even bathing.

Four in 10 men over 75 say they are still having sex (but only two in 10 women)

Survey reveals a startling increase in libido among the 'Viagra generation'

By Jeremy Laurance, Health Editor
Wednesday, 10 March 2010

The feminist academic Camille Paglia once described sex at age 90 as "like trying to shoot pool with a rope". But despite her coruscating verdict sexual life expectancy is increasing, researchers say.

A study published today shows that among 75 to 85 year olds, four out of 10 men and two out of 10 women are still having sex – or they claim to, at least.

All sex surveys based on self reports are bedevilled by the accuracy of measurement. It is hard to be sure whether the gender imbalance shows the resilience of male interest in sex or the resilience of their propensity to boast about it.

more

June 23, 2010
Promise Seen for Detection of Alzheimer’s
By GINA KOLATA

Dr. Daniel Skovronsky sat at a small round table in his corner office, laptop open, waiting for an e-mail message. His right leg jiggled nervously.

A few minutes later, the message arrived — results that showed his tiny start-up company might have overcome one of the biggest obstacles in diagnosing Alzheimer’s disease. It had found a dye and a brain scan that, he said, can show the hallmark plaque building up in the brains of people with the disease.

The findings, which will be presented at an international meeting of the Alzheimer’s Association in Honolulu on July 11, must still be confirmed and approved by the Food and Drug Administration. But if they hold up, it will mean that for the first time doctors would have a reliable way to diagnose the presence of Alzheimer’s in patients with memory problems.

And researchers would have a way to figure out whether drugs are slowing or halting the disease, a step that “will change everyone’s thinking about Alzheimer’s in a dramatic way,” said Dr. Michael Weiner of the University of California, San Francisco, who is not part of the company’s study and directs a federal project to study ways of diagnosing Alzheimer’s.

Still, the long tale behind this finding shows just how difficult this disease is and why progress toward preventing or curing it has been so slow.

Ever since Alzheimer’s disease was described by a German doctor, Alois Alzheimer, in 1906, there was only one way to know for sure that a person had it. A pathologist, examining the brain after death, would see microscopic black freckles, plaque, sticking to brain slices like barnacles. Without plaque, a person with memory loss did not have the disease.

There is no treatment yet to stop or slow the progress of Alzheimer’s. But every major drug company has new experimental drugs it hopes will work, particularly if they are started early. The questions though, are who should be getting the drugs and who really has Alzheimer’s or is developing it?

Even at the best medical centers, doctors often are wrong. Twenty percent of people with dementia — a loss of memory and intellectual functions — who received a diagnosis of Alzheimer’s, did not have it. There was no plaque when their brains were biopsied. Half with milder memory loss, thought to be on their way to Alzheimer’s, do not get the disease. And with such a high rate of misdiagnosis, some who are mistakenly told that they have Alzheimer’s are not treated for conditions, like depression or low levels of thyroid hormone or drug side effects and interactions, that are causing their memory problems.

Brain scans that showed plaque could help with some fundamental questions — who has or is getting Alzheimer’s, whether the disease ever stops or slows down on its own and even whether plaque is the main culprit causing brain cell death.

Dr. Skovronsky thought he had a way to make scans work. He and his team had developed a dye that could get into the brain and stick to plaque. They labeled the dye with a commonly used radioactive tracer and used a PET scanner to directly see plaque in a living person’s brain. But the technology and the dye itself were so new they had to be rigorously tested.

more

New York Times, By Gina Kolata, July 13

For the first time in 25 years, medical experts are proposing a major change in the criteria for Alzheimer’s disease, part of a new movement to diagnose and, eventually, treat the disease earlier.

The new diagnostic guidelines, presented Tuesday at an international Alzheimer’s meeting in Hawaii, would mean that new technology like brain scans would be used to detect the disease even before there are evident memory problems or other symptoms.

If the guidelines are adopted in the fall, as expected, some experts predict a two- to threefold increase in the number of people with Alzheimer’s disease. Many more people would be told they probably are on their way to getting it. The Alzheimer’s Association says 5.3 million Americans now have the disease.

The changes could also help drug companies that are, for the first time, developing new drugs to try to attack the disease earlier. So far, there are no drugs that alter the course of the disease.

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_{One owes respect to the living. To the dead, one owes only the truth.}

New York Times, By Gina Kolata, July 12

A small company with a new brain scan for detecting plaque, the hallmark physical sign of Alzheimer’s disease, presented its results on Sunday at an international conference in Hawaii, and experts who attended said the data persuaded them that the method works.

Until now, the only definitive way to diagnose Alzheimer’s has been to search for plaque with a brain autopsy after the patient dies. Scientists hope the new scanning technique, described June 24 in The New York Times’s series “The Vanishing Mind,” will allow doctors to see plaque while the patient is still alive, improving diagnosis and aiding research on drugs to slow or stop plaque accumulation.

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_{One owes respect to the living. To the dead, one owes only the truth.}

BBC, By Caroline Parkinson, August 22

A protein produced in cases of rheumatoid arthritis appears to protect against the development of Alzheimer's disease, US scientists have said.

In the Journal of Alzheimer's Research study, mice with memory loss given the protein fared better in tests.

A synthetic version of GM-CSF protein is already used as a cancer treatment.

UK experts said the study was "an important first step" and tests were needed to see if the drug worked for people with Alzheimer's.

[...]

The researchers have suggested the protein may attract an influx of cells called microglia from the peripheral blood supply around the brain, which then attack the characteristic plaques that form in people with Alzheimer's.

[...]

An artificial version of GM-CSF, a drug called Leukine, is already approved by the US Food and Drug Administration and has been used to treat cancer patients who need to generate more immune cells.

Dr Potter added. "Our study, along with the drug's track record for safety, suggests Leukine should be tested in humans as a potential treatment for Alzheimer's disease."

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_{One owes respect to the living. To the dead, one owes only the truth.}

NPR, By Alison Aubrey, September 4

When it comes to staving off dementia, new evidence suggests that the "use it or lose it" dictum holds true -- at least for a while. But it also appears that mentally stimulating lifestyles may speed up dementia once it hits in old age.

"We do think that a cognitively active lifestyle is protective up to some point," says Robert Wilson, a professor of neurological sciences at Rush University Medical Center in Chicago.

But the protection doesn't hold up indefinitely.

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_{One owes respect to the living. To the dead, one owes only the truth.}

NYT

a much better approach

December 31, 2010
Giving Alzheimer’s Patients Their Way, Even Chocolate
By PAM BELLUCK

PHOENIX — Margaret Nance was, to put it mildly, a difficult case. Agitated, combative, often reluctant to eat, she would hit staff members and fellow residents at nursing homes, several of which kicked her out. But when Beatitudes nursing home agreed to an urgent plea to accept her, all that changed.

Disregarding typical nursing-home rules, Beatitudes allowed Ms. Nance, 96 and afflicted with Alzheimer’s, to sleep, be bathed and dine whenever she wanted, even at 2 a.m. She could eat anything, too, no matter how unhealthy, including unlimited chocolate.

And she was given a baby doll, a move that seemed so jarring that a supervisor initially objected until she saw how calm Ms. Nance became when she rocked, caressed and fed her “baby,” often agreeing to eat herself after the doll “ate” several spoonfuls.

Dementia patients at Beatitudes are allowed practically anything that brings comfort, even an alcoholic “nip at night,” said Tena Alonzo, director of research. “Whatever your vice is, we’re your folks,” she said.

Once, Ms. Alonzo said: “The state tried to cite us for having chocolate on the nursing chart. They were like, ‘It’s not a medication.’ Yes, it is. It’s better than Xanax.”

It is an unusual posture for a nursing home, but Beatitudes is actually following some of the latest science. Research suggests that creating positive emotional experiences for Alzheimer’s patients diminishes distress and behavior problems.

In fact, science is weighing in on many aspects of taking care of dementia patients, applying evidence-based research to what used to be considered subjective and ad hoc.

With virtually no effective medical treatment for Alzheimer’s yet, most dementia therapy is the caregiving performed by families and nursing homes. Some 11 million people care for Alzheimer’s-afflicted relatives at home. In nursing homes, two-thirds of residents have some dementia.

Caregiving is considered so crucial that several federal and state agencies, including the Department of Veterans Affairs, are adopting research-tested programs to support and train caregivers. This month, the Senate Special Committee on Aging held a forum about Alzheimer’s caregiving.

“There’s actually better evidence and more significant results in caregiver interventions than there is in anything to treat this disease so far,” said Lisa P. Gwyther, education director for the Bryan Alzheimer’s Disease Research Center at Duke University.

The National Institute on Aging and the Administration on Aging are now financing caregiving studies on “things that just kind of make the life of an Alzheimer’s patient and his or her caregiver less burdensome,” said Sidney M. Stahl, chief of the Individual Behavioral Processes branch of the Institute on Aging. “At least initially, these seem to be good nonpharmacological techniques.”

Techniques include using food, scheduling, art, music and exercise to generate positive emotions; engaging patients in activities that salvage fragments of their skills; and helping caregivers be more accepting and competent.

Changing the Mood

Some efforts involve stopping anti-anxiety or antipsychotic drugs, used to quell hallucinations or aggression, but potentially harmful to dementia patients, who can be especially sensitive to side effects. Instead, some experts recommend primarily giving drugs for pain or depression, addressing what might be making patients unhappy.

Others recommend making cosmetic changes to rooms and buildings to affect behavior or mood.

A study in The Journal of the American Medical Association found that brightening lights in dementia facilities decreased depression, cognitive deterioration and loss of functional abilities. Increased light bolsters circadian rhythms and helps patients see better so they can be more active, said Elizabeth C. Brawley, a dementia care design expert not involved in the study, adding, “If I could change one thing in these places it would be the lighting.”

Several German nursing homes have fake bus stops outside to keep patients from wandering; they wait for nonexistent buses until they forget where they wanted to go, or agree to come inside.

And Beatitudes installed a rectangle of black carpet in front of the dementia unit’s fourth-floor elevators because residents appear to interpret it as a cliff or hole, no longer darting into elevators and wandering away.

“They’ll walk right along the edge but don’t want to step in the black,” said Ms. Alonzo, who finds it less unsettling than methods some facilities use, bracelets that trigger alarms when residents exit. “People with dementia have visual-spatial problems. We’ve actually had some people so wary of it that when we have to get them on the elevator to take them somewhere, we put down a white towel or something to cover it up.”

When elevator doors open, Beatitudes staff members stand casually in front, distracting residents with “over-the-top” hellos, she said: “We look like Cheshire cats,” but “who’s going to want to get on the elevator when here’s this lovely smiling person greeting you? It gets through to the emotional brain.”

more

New York Times, By Gina Kolata, January 21

An advisory committee to the Food and Drug Administration recommended unanimously Thursday that the agency approve the first test — a brain scan — that can show the characteristic plaques of Alzheimer’s disease in the brain of a living person. The approval was contingent on radiologists agreeing on what the scans say and doctors being trained in how to read the scans.

An advisory committee to the Food and Drug Administration recommended unanimously Thursday that the agency approve the first test — a brain scan — that can show the characteristic plaques of Alzheimer’s disease in the brain of a living person. The approval was contingent on radiologists agreeing on what the scans say and doctors being trained in how to read the scans.

[...]

The approval would be for a dye that homes in on plaque in the brain, making it visible on PET scans. Such scans would be especially valuable in a common and troubling situation — trying to make a diagnosis when it is not clear whether a patient’s memory problems are a result of Alzheimer’s disease or something else. If a scan shows no plaque, the problems are not caused by Alzheimer’s and could be from tiny strokes or other diseases.

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_{One owes respect to the living. To the dead, one owes only the truth.}

At the age of 83, Dr. Patrick McGeer is fighting Alzheimer’s.

But not in the way you may think. He doesn’t have the disease. McGeer is fit and healthy, in mind and body.

The former British Columbia cabinet minister works as a medical researcher every day from 7:30 to 5:30, plays tennis and skis, travels widely for work and for pleasure, and maintains the same weight he had as an Olympic basketball player 63 years ago.

McGeer is fighting Alzheimer’s on behalf of the rest of us, as outspoken president and research team leader of the Canadian Dementia Action Network (CDAN).

With his talk of “eradicating the disease” and “bringing effective treatment to the bedside within five years,” he and his colleagues are clearly fighting to win. “This is a malevolent disease that can and will be eliminated,” he insists.

“We know what the target is,” McGeer explains, referring to the amyloid plaques in the brain that characterize Alzheimer’s. “We don’t know which biochemicals are going to hit the target well enough to get rid of the disease, but we know it’s going to happen. It’s not difficult from a biochemical point of view, and we should pursue it vigorously.” More

_{Real men don't buy sex. ~ Dallas Cowboy Jay Ratliff}

It’s a café where the most important offering isn’t on the menu.

Several dozen people gathered recently in this town a few hours northeast of Halifax at the country’s first Alzheimer Café, a model of support increasingly widespread in Europe.

The idea is to bring together people with Alzheimer’s disease, their caregivers and members of the public in a non-institutional setting that feels like a regular café, with food, drink and entertainment. There is a short information session, but the goal is explicitly social.

The last factor is crucial to the model and ultimately what separates it from more traditional support groups. Organizer Elizabeth McGibbon notes that people with Alzheimer’s and other forms of dementia can easily become housebound because of embarrassment or fear.

“It’s about getting out of the house in an emancipatory way,” says Dr. McGibbon, a nursing professor in the faculty of science at St. Francis Xavier University, who is assisting this project on a voluntary basis. “We often have a situation where people stay home. It can be very difficult to get people with dementia to go out in public. Social interactions are very, very difficult.”

The result is increased isolation that can accelerate mental decline.

Sian Turner came to the event with her 82-year-old mother, who was diagnosed five years ago with Alzheimer’s.

“She had a lot of fun and obviously enjoyed herself,” Ms. Turner says. “She doesn’t get out at all. [This is] a place we can all go together. I don’t want to go places where they might be unsympathetic.”

Experts in the field say that a substantial social stigma remains against those with dementia. Even well-meaning people might not be sure how to react to them. And issues as basic as going to a public toilet can raise problems if assistance is needed from a caregiver who is of a different gender.

Alzheimer cafés started in Netherlands 14 years ago, and are now so ubiquitous no resident of the country is said to be more than nine kilometres from one. Such cafés have also gained ground in the United States and across Europe. It was in Britain, where they are often held in pubs, that St. Francis Xavier nursing student Danielle Martensson was exposed to the idea.

She was 12 and brought to the café by her mother and stepfather, who thought it would be an interesting experience. At that point, Ms. Martensson had a negative view of people with dementia, having been told by a teacher that they could be erratic, even violent. But concerns about the condition she’d always thought was “fearful” were quickly dispelled.

“Everyone was enjoying each other and they were civil with each other and it was a fantastic environment,” she says. “They weren’t scary. They were people too.”

Ms. Martensson was exploring the concept of Alzheimer cafés for an honours project and ended up as a volunteer on the steering committee. The group in Antigonish did a soft-launch of the concept in January and held its second event on Feb. 4 in a local school. The official opening is early next month.

Elements of these cafés are used across Canada, but the one being established in Antigonish is the first formal example of the model.

“I like the idea of the informal [Alzheimer Café] myself,” says David Harvey, who works in public policy with the Alzheimer’s Society of Canada. “But maybe doing it formally will almost be a demonstration of how this can be done. And perhaps people will pick up ideas and create informal ones.” Source

_{Real men don't buy sex. ~ Dallas Cowboy Jay Ratliff}

Studies in older veterans, football players tie head injuries to risk of Alzheimer’s, dementia

AP, July 18

PARIS — A large study in older veterans raises fresh concern about mild brain injuries that hundreds of thousands of troops have suffered from explosions in recent wars. Even concussions seem to raise the risk of developing Alzheimer’s disease or other dementia later in life, researchers found.

Closed-head, traumatic brain injuries are a legacy of the Afghanistan and Iraq wars. Body armor is helping troops survive bomb blasts, but the long-term effects of their head injuries are unknown.

Other research found a possibly high rate of mild cognitive impairment, or “pre-Alzheimer’s,” in some retired pro-football players, who take many hits to the head in their careers.

The studies, reported Monday at the Alzheimer’s Association International Conference in France, challenge the current view that only moderate or severe brain injuries predispose people to dementia.

“Even a concussion or a mild brain injury can put you at risk,” said Laurie Ryan, a neuropsychiatrist who used to work at Walter Reed Army Medical Center and now oversees Alzheimer’s grants at the U.S. National Institute on Aging.

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_{One owes respect to the living. To the dead, one owes only the truth.}

See here.

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_{One owes respect to the living. To the dead, one owes only the truth.}

San Jose Mercury News, By Lisa Krieger, July 19

A provocative new analysis identifies the biggest risk factors for Alzheimer's disease -- and concludes that more than half of all cases are potentially preventable through simple lifestyle changes, such as exercising, quitting smoking and improving diet.

[...]

But he cautioned that because the disease likely is caused by many factors, including things still unidentified, "A lot of people are going to do everything right, and they'll still get Alzheimer's disease. We have to be careful not to blame the victim."

The study found that the biggest changeable factor in the United States is physical inactivity -- accounting for 21 percent of the risk, followed by depression and smoking. When added together, these risk factors account for about 50 percent of the cases.

If these risk factors were decreased by just 10 percent, about 184,000 Alzheimer's cases in the U.S., and 1.1 million cases worldwide, could be prevented, according to the study.

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Worried you’ll get Alzheimer’s? Then follow these seven steps

The Independent, By Jeremy Laurence, July 20

Playing chess in old age and going jogging or swimming could be the best preventative measures against the development of the degenerative Alzheimer's disease that affects one in 14 people aged 65 or over.

Along with five other factors – controlling weight, blood pressure and diabetes, avoiding depression and quitting smoking – keeping mentally and physically fit could dramatically cut the incidence of dementia, which is becoming a major human and financial burden around the globe. Mental and physical exercise are most important because they influence the others, by keeping weight and blood pressure down, reducing the risk of diabetes and depression.

People who can do all this and avoid smoking substantially reduce their risk of developing Alzheimer's. Worldwide, an estimated 33.9 million people have the condition and that number is expected to triple in the next 40 years.

[...]

Deborah Barnes and Kristine Yaffe, of the University of California at San Francisco, who wrote the review, say that education and mental stimulation throughout life are believed to reduce the risk of Alzheimer's and dementia "by helping to build a cognitive reserve that enables individuals to continue functioning at a normal level despite experiencing neurodegenerative changes".

Post-mortem examinations have shown that people who were mentally active throughout their lives, with no sign of the symptoms of Alzheimer's disease, nevertheless had the same degeneration of the brain seen in those who suffered serious dementia while alive. The implication is that the despite this neuro-degeneration, mentally active people manage to stave off the symptoms of Alzheimer's.

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_{One owes respect to the living. To the dead, one owes only the truth.}

dpa

New Haven, Connecticut/London - A team of US scientists say a chemical substance in the brain that slows down the rate of neuron activity is the source of forgetfulness in elderly people. Their findings, which have been published in the journal Nature, show that treatments may be developed one day to reverse the process.

Tests with elderly people are already in the planning.

Older brains have weaker connections between their neurons.

Additionally, the neurons themselves are slower to fire signals.

Amy Arnsten and her team of colleagues from Yale University School of Medicine say this leads to forgetfulness in seniors. The scientists are the first to have carried out research into age-induced change in nerve cells in the frontal area of the cerebral cortex, which is responsible for the cognitive function of the brain.

These neurons are constantly firing off impulses in order to keep information 'fresh' in the memory. This helps to remember things such as where you last left your car keys.

It's also the basis for abstract thinking, multitasking and the suppression of 'inappropriate' thoughts. But for this form of 'random access memory' to work properly it must be constantly updated.

Arnsten and her team studied the rate at which neurons fired in laboratory animals. They found that neurons signalled slower in elderly animals but that the frequency could be increased when the neurons' chemical environment was matched to that of a younger animal.

The scientists discovered that the frontal lobes of elderly brains had too high a concentration of what are known as cMAP molecules. These molecules slow the rate of neuron activity by opening the walls of the nerve cells and allowing electrically charged particles in.

Arnsten and her team believe cMAP blockers could reverse memory loss. The substance Guanfacine appears to be an effective cMAP inhibitor and clinical trials with the chemical are in the planning stage.

sacbee.com

PUBLISHED THURSDAY, AUG. 18, 2011

Starting in his early 50s, Lou Bordisso Jr. knew something was wrong.

One time, he got lost in a Macy's store in San Francisco and couldn't find his way out. Another time, expected in a meeting, he rode confused from floor to floor in one Financial District skyscraper, then the one next door.

"I could not for the life of me find the conference room," said Bordisso. "Then one day, I couldn't remember how to log in to my computer. That was the beginning."

At 57, the American Catholic Diocese of California priest should be in the prime of his life – but last year, he was diagnosed with dementia related to Alzheimer's disease.

There's good reason we think of Alzheimer's as a problem of old age: Age is the degenerative brain disease's only known risk factor. Fully 90 percent of people with Alzheimer's are 75 and older, experts say, and nearly half of people over 85 have it.

Even so, according to the Alzheimer's Association, a small sliver of the diagnosed – up to 5 percent – haven't yet seen their 65th birthdays. That means 200,000 Americans younger than 65, including 19,200 Californians, have the disease.

The early-onset form of Alzheimer's is little understood. Experts know that for a small number of people whose memory loss begins in their 30s and 40s, genetic factors play a role. But why do other people in their 50s and early 60s get the disease?

Researchers don't know.

"It's a less common age to have this disease," said Judy Filippoff of the Alzheimer's Association of Northern California. "At 65 and younger, most people don't expect this diagnosis. They have many responsibilities, and they haven't slowed down, either physically or mentally.

"And now they have to change their life in ways they didn't imagine. It can be quite a shock."

Much too early, people diagnosed with early-onset Alzheimer's lose their past as well as their future. The disease is both progressive and fatal and has no known cure.

Mike Fisher spent his career with law enforcement in Contra Costa County. At 50, he was Lafayette police chief as well a Sheriff's Department lieutenant.

Then he was diagnosed with Alzheimer's.

"I was having a hard time remembering codes," said Fisher, now 53, who lives in Benicia. "I was having memory problems in my 40s, it seems like. I hit 50, and it's gotten worse more quickly."

Many people with early-onset Alzheimer's still have kids to raise and families to support. Many are helping care for their own aging parents or planning for their own retirements.

Suddenly, the future they mapped out disappears, not only for them but also for their loved ones.

In that sense, Fisher is lucky: He retired from the Contra Costa County Sheriff's Department with generous pension and medical benefits, and his 18-year-old daughter recently entered community college. Yet he knows his wife of more than two decades will be his caregiver one day.

"You plan as much as you can," he said. "We go to support groups, and you can see the progression of the disease. It's kind of scary, to be honest. It can be very sad at times."

In her blog inspired by her mother's dementia, 34-year-old Phoenix writer Kathy Ritchie has discussed Alzheimer's as an ongoing process of grief and loss for family members. Many people coping with their parents' early-onset disease are still in their 20s, she says, and they feel cheated out of the friendships that develop between parents and their adult children.

"We don't have survivors," said Ritchie. "The only people who bear witness to this disease are family members. It wreaks havoc on families. The toll it takes, I can't even describe it."

Lou Bordisso Jr.'s diagnosis presents a different kind of role reversal. His father is 97, and though Lou Sr.'s hearing is bad, his mind is still sharp. As Lou Sr. recovers in a rehab facility from a recent illness, his son came home to Sacramento from Vallejo earlier this year to care for him.

Instead, father and son share a caregiver.

Lou Jr. can't drive any more, because he misjudges distances. His balance is off: Unless he uses a cane, he's unsteady on his feet. Without help, he forgets how much medication he's taken.

Since his diagnosis in May 2010, his life has changed enormously, downsized to a quieter, more manageable shape. He was bishop of his diocese for several years, but he took bishop emeritus status instead. The longtime marriage and family therapist also resigned from his secular job in forensic mental health with Contra Costa County.

"I was making mistakes," he said.

He lives now in the Land Park house where he was raised. Being on familiar territory helps. Never married, he counts on his close-knit extended family for assistance.

Bordisso receives state disability insurance and has applied for early benefits from Social Security, which has added early-onset Alzheimer's to its expedited access list of "compassionate allowance" conditions.

"I'm used to being a responsible person and doing my part," said Bordisso. "Being on the receiving end of services is a difficult place to be. I'd like to be a productive member of society. I want to be able to contribute."

Not long ago, he was named to the Alzheimer's Association's early stage advocacy committee, a national advisory board.

And he finds new, unexpected meaning in this unwanted stage of life.

"I can't recapture the past," he said. "I don't remember it. The future, I have no idea what it holds.

"The gift of this disease is to live in the moment. Now is all I have. Literally."

He has a new album coming out and plans for an international concert tour. What else would a singer who has Alzheimer's disease do?

Glen Campbell looks forward with gratitude
By Randy Lewis, Los Angeles Times
August 28, 2011

At Glen Campbell's house in Malibu, a large framed painting of the great Gypsy jazz guitarist Django Reinhardt hangs over a baby grand piano in the living room.

Campbell is proud of the portrait of the musician who quite possibly is Campbell's biggest hero on the instrument with which both men came to fame, happily showing it off to a visitor on an overcast morning recently.

"I was walking down the street — not this one…," he says, prompting his wife, Kim, to remind him: "Rodeo Drive."

"Rodeo Drive," he confirms, "and here's Django! I bought it for $225."

Kim, sitting next to him around the island amid their kitchen, calmly interjects, "Not on Rodeo you didn't!"

Campbell pauses, looks at her, reconsidering his remark. "How much was it?"

"I think it was more like $2,000."

He pauses again for a split second, then jokes, "Well, shoot, sell it back. I've seen it enough now."

Some of the facts of his 75 years may be getting a bit hazy as the five-time Grammy-winning singer of hits including "By the Time I Get to Phoenix," "Galveston," and "Rhinestone Cowboy" contends with the Alzheimer's disease he recently made public.

But the quick country-boy wit, long a staple of his concerts and a big part of what made him a TV star four decades ago on "The Glen Campbell Goodtime Hour," is intact, ever-ready to pounce on a good setup line.

To upend the adage, at Campbell's house lights may be starting to flicker, but he's still home and happy to be there.

much more

By Agence France-Presse
Sunday, October 23, 2011

WASHINGTON — The first shoes with built-in GPS devices — to help track down dementia-suffering seniors who wander off and get lost — are set to hit the US market this month, the manufacturer says.

GTX Corp said the first batch of 3,000 pairs of shoes has been shipped to the footwear firm Aetrex Worldwide, two years after plans were announced to develop the product.

The shoes will sell at around $300 a pair and buyers will be able to set up a monitoring service to locate “wandering” seniors suffering from Alzheimer’s Disease.

Andrew Carle, a professor at George Mason University’s College of Health and Human Services who was an adviser on the project, said the shoes are likely to save lives and avoid embarrassing and costly incidents with the elderly.

“It’s especially important for people in the earliest stages of Alzheimer’s who are at the highest risk,” Carle told AFP.

“They might be living in their home but they’re confused. They go for a walk and they can get lost for days.”

Carle said studies indicate more than five million Americans suffer from Alzheimer’s, a number expected to quadruple in the coming years. He said 60 percent of sufferers will wander and become lost and up to half of those lost who are not found within 24 hours may die, from dehydration, exposure or injury.

Other devices such as bracelets or pendants can provide similar protection but seniors often reject these.

“The primary reason is that paranoia is a manifestation of the disease,” Carle said. “If you put something on someone with Alzeheimer’s that they don’t recognize, they remove it. If it’s a wristwatch and it’s not their wristwatch, they will take it off. So you have to hide it.”

The GPS system, which is implanted in the heel of what appears to be a normal walking shoe, allows family members or carers to monitor the wearer and to set up a “geofence” that would trigger an alert if the person strays beyond a certain area.

The shoes are being developed by GTX Corp., which makes miniaturized Global Positioning Satellite tracking and location-transmitting technology, and Aetrex. They received certification from the Federal Communications Commission this year for the system.

The makers say the market for such shoes is growing, given the soaring costs of Alzheimer’s.

“This is a significant milestone for both companies and while the $604 billion worldwide cost of dementia has become and will continue to be a significant fiscal challenge, the under $300 GPS enabled shoes will ease the enormous physical and emotional burden borne by Alzheimer’s victims, caregivers and their geographically distant family members,” said Patrick Bertagna, chief executive of GTX Corp.

Professor Carle said the original idea was to develop the shoes for children and long-distance runners but the makers changed the plan when he offered his advice, noting that the devices can also help ease a lot of anxiety about seniors who want to remain active.

“They feel a need to walk and it is good for them,” he said. “They should take a walk. It’s good for them.”

by Chip Ainsworth

Shortly after finishing his three-month, 3,312-mile run from the coast of Oregon to the Rhode Island shore, Glenn Caffery visited his physician and complained that his feet were numb.

“What’d you expect?” the doctor replied.

Caffery, a 49-year-old data management teacher at the University of Massachusetts in Amherst, lives in Leyden, a small town in the Connecticut River Valley that borders Vermont. His cross-country pilgrimage was to raise awareness about the Alzheimer’s disease that killed his father at age 68.

“He was diagnosed at 55,” said Caffery, “but it was symptomatic at least two years prior to that.”

On May 19, Caffery stuck his foot into the Pacific Ocean and began his long, arduous journey across Oregon, Idaho, Wyoming, South Dakota, and Minnesota on toward the Northeast and into New England. On Aug. 17, surrounded by friends and family, he splashed into the Atlantic Ocean at Misquamicut Beach in Rhode Island.

Along the way he had jogged through towns named Mud Butte and Faith and avoided roads with rumble strips that rattled the three-wheeled stroller he kept packed with supplies and camping gear. “It was kind of comfortable to have it with me. I never gave it a name. I’m glad it never came to that.”

more Scholars and Rogues

The patients know who they are, and can remember the details of their distant past. But they can’t recall most things that have happened in the years since their brains were damaged. The doctor they met a week ago is a stranger, lunch is forgotten as soon as it has been eaten.

Yet, in Asaf Gilboa’s lab, they quickly learn and retain information about exotic fruits or animals they had never heard of before, like an Australian anteater called the numbat.

It’s the way they acquired this new knowledge that seemed to make it stick, said Dr. Gilboa, who is helping patients with amnesia tap into a dormant memory process in the brain. The learning was incidental – the new information was picked in the process of doing something else – and is similar to the way many researchers believe young children add 10 or more new words to their vocabulary every day.

This mechanism is called fast-mapping, and Dr. Gilboa and his colleagues at Baycrest’s Rotman Research Institute in Toronto are using brain imaging to learn more about how it works. Their goal is to develop a new rehabilitative therapy for patients with neurological disorders that affect memory, including Alzheimer’s disease. They hope shedding light on how the brain learns will help their patients move beyond animals and fruit to remembering faces and names. More

_{Sexual inequality is "The Mother of all Inequalities".
Liberate female sexuality and you will eliminate racism, homophobia, financial greed, and violence.}

Bridie Smith
December 9, 2011

AUSTRALIAN researchers have proved that an Alzheimer's vaccine could halt the disease – and even see the return of some losses – well after the symptoms first appear.

Lars Ittner from the Alzheimer's and Parkinson's disease laboratory at Sydney University said it was the first time researchers had proved a vaccine targeting the tau protein in mice could be effective after the disease had set in.

Tau proteins stabilise microtubules, which help maintain cell structure. When defective, they can result in dementias such as Alzheimer's disease.

Professor Ittner said targeting the tau protein in younger animals before the onset of the disease was a different approach, as most researchers worked with animals after the onset of Alzheimer's.

"What we tried to do was to work with older mice with a lot of damage," he said. "Because in people, by the time they realise their symptoms are Alzheimer's, a lot of the damage has already been done."

In a paper in the scientific journal PLoS ONE today, the research team says the novel approach worked, producing some of the most improved results recorded in mice with advanced dementia.

"The older group with the very advanced Alzheimer's actually benefited the most," Professor Ittner said.

While human trials are at least five years away, he said such positive results from the animal trials were a surprise.

Three groups of mice were used in the study. Each group was formed according to age – six months, 12 months and 18 months. The older the group, the more advanced the the stage of Alzheimer's disease.

The mice were treated for 10 months and assessed at the end of that period. Professor Ittner said there were also signs the animals had regained some losses such as weight loss and activity levels.

"But this was limited as, when there's damage to a neuron, it's gone. It doesn't regenerate," he said.

The team, which is already collaborating with the US pharmaceutical industry in the quest to develop a vaccine, aims to create a monthly injection which would become part of a broader treatment of the disease.

According to Alzheimer's Australia about 269,000 Australians live with dementia. Without a significant medical breakthrough, it is forecast about 981,000 Australians will be living with dementia by 2050.

Dementia is used to describe a large group of illnesses which cause a progressive decline, including a loss of memory, intellect, rationality, social skills and physical functioning. Alzheimer's disease is the most common form of dementia, accounting for up to 70 per cent of cases.

Read more: http://www.smh.com.au/national/breakthrough-closer-for-alzheimers-treatment-after-vaccine-success-20111209-1om3c.html#ixzz1gFdc2pHs

Welcome To “Dementia Village,” A European Experiment In Long-Term Alzheimer's Care

Following a similar project outside of Amsterdam, Swiss developers plan to build an entire village for people with Alzheimer's and other forms of dementia. The $27 million Swiss facility will recreate the environment of the 1950s. Not all think it's such a good idea.

WorldCrunch/Tages-Anzeiger, By Beat Bühlmann, January 21

It’s a village like many others. Street signs, front gardens with little gnome figurines, a restaurant, beauty parlor and supermarket. What is different about it is that the 150 men and women who live here suffer from serious dementia. They can move around freely in the village. But they can’t leave it. This is Hogewey, a nursing facility near Amsterdam that is considered a pioneer in dementia care. Care givers stay behind the scenes, and are dressed like gardeners, hairdressers, and sales people.

Now Switzerland is to get its own “dementia village” in Wiedlisbach, canton Bern. Still in the planning stages, the village will occupy the site of an existing nursing home and will be called the “Village For People With Dementia.” Representatives of the community have already approved the plan. “Right now we’re planning a village for 100 men and women, but later we could expand to 200 or even 300,” says general manager Markus Vögtlin. Construction is expected to last between five and seven years and cost roughly 25 million Swiss francs (nearly $27 million).

Vögtlin, who has visited Hogewey, was impressed by its anxiety-free atmosphere. “People with dementia are often restless and aggressive, but there they were relaxed and content.” A village allows them to pursue the accentuated need for moving around that is typical of dementia.

February 1, 2012
Faulty Protein Is Like a Virus in Alzheimer’s

NYT

By GINA KOLATA
Alzheimer’s disease seems to spread like an infection from brain cell to brain cell, two new studies in mice have found. But instead of viruses or bacteria, what is being spread is a distorted protein known as tau.

The surprising finding answers a longstanding question and has immediate implications for developing treatments, researchers said. And they suspect that other degenerative brain diseases like Parkinson’s may spread in a similar way.

Alzheimer’s researchers have long known that dying, tau-filled cells first emerge in a small area of the brain where memories are made and stored. The disease then slowly moves outward to larger areas that involve remembering and reasoning.

But for more than a quarter-century, researchers have been unable to decide between two explanations. One is that the spread may mean that the disease is transmitted from neuron to neuron, perhaps along the paths that nerve cells use to communicate with one another. Or it could simply mean that some brain areas are more resilient than others and resist the disease longer.

The new studies provide an answer. And they indicate it may be possible to bring Alzheimer’s disease to an abrupt halt early on by preventing cell-to-cell transmission, perhaps with an antibody that blocks tau.

The studies, done independently by researchers at Columbia and Harvard, involved genetically engineered mice that could make abnormal human tau proteins, predominantly in the entorhinal (pronounced en-toh-RYE-nal) cortex, a sliver of tissue behind the ears, toward the middle of the brain, where cells first start dying in Alzheimer’s disease. As expected, tau showed up there. And, as also expected, entorhinal cortex cells in the mice started dying, filled with tangled, spaghettilike strands of tau.

Over the next two years, the cell death and destruction spread outward to other cells along the same network. Since those other cells could not make human tau, the only way they could get the protein was by transmission from nerve cell to nerve cell.

And that, said Dr. Samuel E. Gandy, associate director of the Alzheimer’s Disease Research Center at Mount Sinai School of Medicine in New York, was “very unexpected, very intriguing.”

Although the studies were in mice, researchers say they expect that the same phenomenon occurs in humans because the mice had a human tau gene and the progressive wave of cell death matched what they see in people with Alzheimer’s disease.

One study, by Karen Duff and Dr. Scott A. Small and their colleagues at the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain at Columbia University Medical Center, was published on Wednesday in the journal PLoS One. The other, by Dr. Bradley T. Hyman, director of the Alzheimer’s Disease Research Center at Massachusetts General Hospital, and his colleagues, is to be published in the journal Neuron.

Both groups of researchers were inspired by the many observations over the years that Alzheimer’s starts in the entorhinal cortex and spreads.

But, said Dr. Small, “what do we mean by ‘spreads?’ ”

Researchers knew that something set off Alzheimer’s disease. The most likely candidate is a protein known as beta amyloid, which accumulates in the brain of Alzheimer’s patients, forming hard, barnaclelike plaques. But beta amyloid is very different from tau. It is secreted and clumps outside cells. Although researchers have looked, they have never seen evidence that amyloid spreads from cell to cell in a network.

Still, amyloid creates what amounts to a bad neighborhood in memory regions of the brain. Then tau comes in — some researchers call it “the executioner” — piling up inside cells and killing them. If some cells take longer than others to succumb to the bad neighborhood, that would explain the spread of the disease in the brain, and there would be no need to blame something odd, like the spread of tau from cell to cell.

Studies in humans, though, could not determine whether that hypothesis was correct. They involved autopsy and brain imaging studies and were “indirect and inconclusive,” Dr. Small said.

Looking at the brains of people who have died of the disease, Dr. Duff said, is like looking at a wrecked car and trying to figure out the accident’s cause. Faulty brakes? Broken struts?

The question of which hypothesis was correct — tau spreading cell to cell, or a bad neighborhood in the brain and cells with different vulnerabilities to it — remained unanswerable. Dr. Hyman said he tried for 25 years to find a good way to address it. One of his ideas was to find a patient or two who had had a stroke or other injury that severed the entorhinal cortex from the rest of the brain. If the patient developed Alzheimer’s in the entorhinal cortex — and it remained contained there — he would have evidence that the disease spread like an infection. But he never found such patients.

The solution came when researchers were able to develop genetically engineered mice that expressed abnormal human tau, but only in their entorhinal cortexes. Those mice offered the cleanest way to get an answer, said John Hardy, an Alzheimer’s researcher at University College London who was not involved in either of the new studies.

There is another advantage, too, Dr. Hyman said. The mice give him a tool to test ways to block tau’s spread — and that, he added, “is one of the things we’re excited about.”

But if tau spreads from neuron to neuron, Dr. Hardy said, it may be necessary to block both beta amyloid production, which seems to get the disease going, and the spread of tau, which continues it, to bring Alzheimer’s to a halt.

He and others are also asking if other degenerative diseases spread through the brain because proteins pass from nerve cell to nerve cell.

Dr. Hardy thought he saw provocative human evidence that it might be happening in Parkinson’s disease. Two Parkinson’s patients being treated by a colleague had fetal brain cells implanted to replace dead and dying neurons. When the patients died, years later, autopsies showed they still had the fetal cells, but they had balls of a Parkinson’s disease protein, synuclein, inside. The most obvious way that could happen, the researchers reasoned, was if the toxic protein had spread from the patient’s diseased cells to the healthy fetal cells. But they could not rule out the bad-neighborhood hypothesis.

Now, Dr. Hardy said, with the mouse studies, the issue of a bad neighborhood is settled. The answer in Alzheimer’s disease, he said, “is that isn’t possible.”

“That is what is different between these papers and all the others,” Dr. Hardy said. “It isn’t a bad neighborhood. It is contagion from one neuron to another.”

9 February 2012 Last updated at 14:01 ET

By James Gallagher
Health and science reporter, BBC News

Destructive plaques found in the brains of Alzheimer's patients have been rapidly cleared by researchers testing a cancer drug on mice.

The US study, published in the journal Science, reported the plaques were broken down at "unprecedented" speed.

Tests also showed an improvement in some brain function.

Specialists said the results were promising, but warned that successful drugs in mice often failed to work in people.

The exact cause of Alzheimer's remains unknown, but one of the leading theories involves the formation of clumps of a protein called beta-amyloid. These damage and kill brain cells, eventually resulting in memory problems and the inability to think clearly.

Clearing protein plaques is a major focus of Alzheimer's research and drugs are already being tested in human clinical trials.

In the body, the role of removing beta-amyloid falls to apolipoprotein E - or ApoE. However, people have different versions of the protein. Having the ApoE4 genetic variant is one of the biggest risk factors for developing the disease.

Helping hand

Scientists at the Case Western Reserve University in Ohio were investigating ways of boosting levels of ApoE, which in theory should reduce levels of beta-amyloid.

They tested bexarotene, which has been approved for use to treat cancers in the skin, on mice with an illness similar to Alzheimer's.

After one dose in young mice, the levels of beta-amyloid in the brain were "rapidly lowered" within six hours and a 25% reduction was sustained for 70 hours.

In older mice with established amyloid plaques, seven days of treatment halved the number of plaques in the brain.

The study said there were improvements in brain function after treatment, in nest building, maze performance and remembering electrical shocks.

Researchers Paige Cramer said: "This is an unprecedented finding. Previously, the best existing treatment for Alzheimer's disease in mice required several months to reduce plaque in the brain."

In people?

The research is at a very early stage, and drugs often do not make the leap from animal experiment to human treatment.

more
http://www.bbc.co.uk/news/health-16945466

Claim that giving up almost all food for one or two days a week can counteract impact of Alzheimer's and Parkinson's

Robin McKie, science editor
guardian.co.uk, Saturday 18 February 2012 15.36 EST

http://www.guardian.co.uk/society/2012/feb/18/fasting-protect-brain-diseases-scientists

Love, Loss and Laughter: Seeing Alzheimer's Differently, Photo Exhibit Redefines Alzheimer's

http://www.alzheimersreadingroom.com/2012/03/love-loss-and-laughter-seeing.html

Always keep an open mind and a compassionate heart. ~ Phil Jackson

The Wall Street Journal, By Shirley S. Wang, April 8

A much-anticipated test developed by Eli Lilly & Co. that detects the presence of proteins in the brain that are related to Alzheimer's disease was approved Friday by the Food and Drug Administration.

The tool could enable clinicians to detect Alzheimer's earlier and more accurately in patients at the earliest sign of memory problems—a potential boon to treatment and developing drugs against the disease.

The test uses a chemical called florbetapir, known by the brand name Amyvid, which is a radioactive agent that tags clumps of a sticky substance called an amyloid. Amyloid proteins are hallmarks of Alzheimer's disease. The chemical, which costs $1,600 per dose, then is detected using a brain imaging technique called positron emission tomography, known as PET scans.

[...]

The imaging agent can't be used to diagnose someone with Alzheimer's disease if the individual doesn't experience memory impairment because the presence of amyloid in the brain doesn't alone suggest that someone has Alzheimer's.

Before the development of imaging agents, amyloid plaques could be determined only after death, by examining the brain during an autopsy.