What Does Blood Pressure Have to Do With Alzheimer’s?

This is on study I would really like to get my mother into. She takes three medications now for high blood pressure and it is still out of control. In addition, I discovered after the fact that she was not taking her blood pressure medication as prescribed for years before she was diagnosed with Alzheimer's dementia.

The brain needs lots of blood to work well. That’s made doctors wonder whether high blood pressure, which can reduce blood flow to the brain, is connected to cognitive problems — especially in the elderly, in whom both high blood pressure and mental decline are common. (See, for example, this recent study.)

A small study being presented today at the RSNA conference is the latest finding to suggest there may be a connection. Using a type of MRI that measures blood flow, researchers examined how high blood pressure affected blood flow in the brains of people with and without Alzheimer’s disease (abstract here).

They found that those with high blood pressure had lower levels of blood flow overall, and those with high blood pressure and Alzheimer’s had lower blood flow than those with high blood pressure but not Alzheimer’s.

In an interview with the Health Blog, the lead author, Cyrus Raji, noted that the findings, based on only 88 people, need to be validated by a larger trial. But he said the research presents an interesting possibility that could give doctors and patients yet another reason to try to control high blood pressure.

“We are not saying that hypertension causes Alzheimer’s,” said Raji, a grad student at the University of Pittsburgh. “It’s an extra hit to the brain, and an extra hit in areas that can eventually be affected by Alzheimer’s disease … If that turns out to be the case, which we won’t know until we do a lot more work, that would be a huge impetus for tighter control for hypertension, especially in the elderly.”

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The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

How Much Are CT Scans Increasing Cancer Risk?

My mother received quite a few CT Scans and MRIs over the last few years.

clipped from blogs.wsj.com Americans get about 62 million CT scans every year — which could ultimately cause 1.5% to 2% of all cancers in this country, according to an estimate published in this week’s New England Journal of Medicine (online here). The article suggests that, while many scans are useful and even life-saving, others might be replaced with other procedures. For example, the authors say, ultrasound may often be as effective as CT when diagnosing appendicitis in children. It is tough to estimate the risk of developing cancer from radiation risk. As the authors (two Ph.D.s from Columbia’s Center for Radiological Research) point out, most such estimates are based on studies of survivors of the atomic bombs dropped on Japan in 1945. Arl Van Moore, chairman the American College of Radiology’s board, told the WSJ that “there are scans performed that may well be unnecessary,” he called the authors’ conclusions about the possible 2% rate of future cancer diagnoses “a reach.”

Researchers deem Alzheimer's a Type 3 diabetes

My grandmother was diabetic, my sister is diabetic and my mother suffers from Alzheimer's.

clipped from www.chicagotribune.com Sometimes it's better if great minds don't think alike. Neurobiologists with decidedly different interests recently collaborated at Northwestern University and came up with new evidence about Alzheimer's disease, a form of dementia that affects about 5 million Americans. They now consider it a Type 3 diabetes. This team studied healthy nerve cells from the brain's hippocampus region, growing in culture dishes, and they observed abundant insulin receptors. "If you look closely at a high-resolution [image], you'll see that they are at synapses," Klein said. "Before we added the ADDLs [toxins], they all had insulin receptors." But with the toxin added to the culture dishes, "the insulin receptors disappeared from their surfaces." "[Klein's work] is like finding the missing piece of a jigsaw puzzle," "[Researchers] are looking at drugs that are given to Type 2 diabetics that increase the ability of cells to respond to insulin. It makes the insulin receptors more abundant or more lively."

Could Grapefruit Juice Cut Drug Costs?

The WSJ reports some researchers are now trying to use grapefruit juice to their advantage. A University of Chicago study is pairing grapefruit juice with rapamycin, which is sold by Wyeth as an immunosuppressant and is being studied to treat cancer.

clipped from blogs.wsj.com The WSJ reports, some researchers are now trying to use grapefruit juice to their advantage. An enzyme that lives in the gut, charmingly named CYP3A4, breaks down drugs before they enter the bloodstream. Grapefruit juice has a compound that temporarily gets rid of CYP3A4 — which allows more of a drug to enter the bloodstream. That can be a bad thing in some cases. Patients shouldn’t take statins (such as Pfizer’s Lipitor or Merck’s Zocor) with grapefruit juice, because doing so can cause the drug to build up to unhealthy levels in the body. It’s too early to tell how far this sort of thing might go, and standardizing grapefruit juice as part of a drug regimen could be tricky. But some docs think the grapefruit effect could ultimately allow patients to take lower doses of drugs. Oral oncology therapies are costing $3,000 to $5,000 a month If we can lower the costs of those by 50%, you’re talking about hundreds of millions of dollars saved.”

The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

Dementia often first noticed at holidays

Such gatherings - particularly during the holidays - are a prime time to notice the early stages of dementia, according to doctors who care for Alzheimer's patients. Holiday stress brings out telltale signs of confusion and forgetfulness - like neglecting to buy the turkey or forgetting a grandchild's name.

Dementia often first noticed at holidays
By Heather May

The Salt Lake Tribune

It was at large gatherings that the Holladay family first noticed their mother was suffering from dementia. She couldn't find the bathroom in a family member's home. She sat at the edges of a party, too confused to interact with the family. "Just weird, off-the-wall [behavior], forgetting basic etiquette," is how Peggy Templin, her 50-year-old daughter, describes it.

A diagnosis of Alzheimer's followed for the now 75-year-old woman.

Such gatherings - particularly during the holidays - are a prime time to notice the early stages of dementia, according to doctors who care for Alzheimer's patients. Holiday stress brings out telltale signs of confusion and forgetfulness - like neglecting to buy the turkey or forgetting a grandchild's name. And the holidays may be the first time some family members are around to witness the decline. "Families need to be aware this is a time when dementia symptoms may be more evident," said Norman Foster, director of the University of Utah's Center for Alzheimer's Care, Imaging and Research.

About 30,000 Utahns have Alzheimer's. Another 20,000 are projected to succumb to dementia by 2025. It most commonly affects people in their mid-70s, though it can strike before 65. Early on, patients will show problems with memory, thinking and concentration. All of those come into play during the holidays.
"They have a lot of difficulty early on with short-term memory, so they aren't aware the holiday is coming up," said physician Dennis Genebach, who sees geriatric patients at the Intermountain Senior Clinic and will head a new associated cognitive clinic in January. "They're not doing things like Christmas cards."
But because long-term memory stays intact, sufferers may also show signs of delusion, thinking someone who is long-dead is alive, he said.

"There's a lot of memories attached to holidays," he explained. "When people are gone, you tend to miss them more around those days." The signs of early dementia may be disguised during the year, when sufferers can rely on habit. But mess with the routine - as the holidays do - and the signals become obvious, Foster said.

"If all I have to do is microwave my dinner at night, that's a lot different than making Christmas or Thanksgiving dinner for the 15 family members who are coming in," he said. "If you forget to buy the turkey or thaw the turkey, you have a real problem on your hands."

Other real-life examples of dementia surfacing around the holidays: A patient who forgot to buy presents for all of her grandchildren. Another who bought every grandchild, boys and girls, the same gift. A father who flew to meet his son for Christmas and didn't recognize him at the airport.

General messiness is another sign, since people suffering from dementia have trouble with organizational skills. The house may be dirty, bills may go unpaid.

But don't start overanalyzing grandma and grandpa, the doctors caution - people will lose mental ability as they age. It is a cause for concern, however, if there is a significant change in thinking ability that interferes with daily living.

If a loved one has already been diagnosed with dementia, the holidays can cause them anxiety and depression, Genebach said.

Templin, now involved with the Utah chapter of the Alzheimer's Association, urges families to "continue to treat [relatives with dementia] like human beings. They feel the rejection. They're going through enough. They really need people to embrace them."

The daughter is doing what experts advise: She keeps her mom involved in the holidays by including her in baking, making gifts, setting the Thanksgiving table.

There are other tips for helping patients cope during the season:

* Stick with the familiar. Maintain routines and skip strange and noisy restaurants.
* Keep it small. Large family get togethers "become too disruptive," Genebach said.
* Reminisce. Pull out the scrapbooks and play some old-time music. "Just allowing the person with dementia to do the reminiscing and sharing - it creates a huge amount of surprising conversation," said Nick Zullo, program director of Utah chapter of the Alzheimer's Association.

* Trouble with new memories.
* Struggling to complete familiar actions; misplacing familiar objects; relying on memory helpers; loss of interest in important responsibilities.
* Trouble finding words; confusion about time, place or people.
* Onset of new depression or irritability; making bad decisions; personality changes.
* Seeing or hearing things; expressing false beliefs.
Source: The Alzheimer's Foundation of America

The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

Keeping time with Alzheimer's

The following is an excellent article that I read in the San Francisco Chronicle.

"When guilt catches up with me, I am on the bike path above the creek, ducks swimming along beside me. Guilt rolls off our backs like you know what. Alone at last, I walk at my own pace. Fast. Fast is what Ben can no longer do -- and fast is slow compared with the woman coming toward me as I near the marsh. She is wearing shorts and earphones. She smiles and I smile back. What a good idea this is, walking out in the sun and cold. What could produce better clarity? I don't have to work it out the first day. I don't have to do it right the first time."


Source The SanFrancisco Chronicle

Keeping time with Alzheimer's

Persis Knobbe, Special to The Chronicle
Wednesday, December 27, 2006


Hanging on like the mom of a new kindergartner, I watch my husband from the social worker's glass cubicle. He is facing the piano player, the shrunken woman on one side of him, and on the other, falling asleep, the guy they call the Major. Ben -- of all people -- in that circle, a little dazed, being good, going along with the group, his new group. I can go home now and be alone for six hours. No TV, no one trailing after me. Shadowing, it's called. He doesn't always do it. Not yet.

He nods his head in time to the blues, then Gershwin suddenly returns someone's smile. It's beginning to look like a good bet. Senior Access, it's called, adult day care. This branch is in Novato, the best game in town as far as I know. I checked out every possibility that had a few men on the scene, not just a roomful of elderly ladies. Each time I took one look and said, "Never. Never Ben." So how did never become now?

Here is a moment, and for a change I recognize it. I will have a permanent memory of him joining the circle, lowering himself into the chair, eyes fixed on the piano, head bobbing immediately with the rhythm of the blues, then patting his knee as if he is soothing it. He knows he's in the right place before I do. He's one of them, not as far along on the Alzheimer's road as some, still dapper in his crisp shirt and clean Dockers. But he is one of them.

There is no going back to where he was, doing what passed for functioning at home, where he could still propel himself through the day with TV and frequent naps. He is ready; I'm the one not quite ready. From here in the cubicle, for the first time I see what "down the road" means: squeezing out every ounce of making it work at a level you can live with and then stepping down to the next level. Step, step, stepping along.

This is a good thing, I say to myself on the drive home, and I shouldn't turn it into dross because it's a gift. It's as close to what he needs, what we both need, as anything I could find, stimulation for him, a little freedom for me, twice-a-week freedom. Maybe we can work up to three days, who knows? And what will I do with the time and life this offers me? Catch up with two years of unfinished business? The house, the desk, the roses? Give way to a free-flowing all-out depression?

There is a Costco just off the freeway and the car veers off to the nearest exit on its own. "What am I doing?" I ask myself, as I push a huge cart with three items in it: two plants for the garden and a polo shirt for him. "What am I doing, killing a morning like this, wasting it on shopping?" Guilt approaching panic is making my heart beat faster. I will barely get home and have to go back for him.

Setting the plants near the front door with a thud that loosens the soil, I head for my desk. Checkbook and bank statement to my left, Italian class assignment to my right, I study the space between them until the phone rings. Sandra from the Caregiver's Group. "Would I have time for a few brief questions?" I already had time for a few brief questions. She asks about my family. Are they helping me? Am I being good to myself? Answer on a spectrum of "Always" to "Never." I answer with "Always" or "Never," nothing in between. Sandra says she'll call back another time.

When guilt catches up with me, I am on the bike path above the creek, ducks swimming along beside me. Guilt rolls off our backs like you know what. Alone at last, I walk at my own pace. Fast. Fast is what Ben can no longer do -- and fast is slow compared with the woman coming toward me as I near the marsh. She is wearing shorts and earphones. She smiles and I smile back. What a good idea this is, walking out in the sun and cold. What could produce better clarity? I don't have to work it out the first day. I don't have to do it right the first time.

By the time I go back for Ben, I'm capable of being quite pleasant. I don't ask him how it went. He still looks dazed, but he smiles when he sees me. We drive home, have dinner and rent a movie. A musical. We love musicals, the older, sweeter ones and the biting, jaded shows like tonight's. At least we used to. Neither of us is crazy about this one. I try to pry a critique out of him and he gets as far as "It was ..."

Then he opens his mouth wide, an expression of alarm in his eyes, his arms waving frantically. Abruptly he drops the pose. "It was ..." he says again and waits. "Boffo?" I ask. He doesn't answer. It is hard to engage him. "You mean every number was a showstopper? Over the top? Like Liza Minnelli?" He nods, slowly at first, then with mounting pleasure as I elaborate on the word "boffo" and I know one thing: He's not all gone. Not yet.

Persis Knobbe chronicles her journey with her late husband through his Alzheimer's disease. Read her essay "Farmers' markets can turn into lonely places''
(Home&Garden, July 29) on SFGate or e-mail her at home@sfchronicle.com

The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

Why won't the Queen honour Philip's starlet, Pat Kirkwood?

Why won't the Queen honour Philip's starlet, Pat Kirkwood?

By MICHAEL THORNTON

It is now eight years since the onset of Alzheimer's Disease began to show itself in his wife.

Until 1999, Pat Kirkwood was still performing and making public appearances.

In 1993, she stood alone on stage in a 45-minute solo singing act, and never forgot a single word or note, ending with the audience on its feet in a rapturous ovation.

In 1994, the year in which Michael Aspel presented her with the red book in television's This Is Your Life, she packed Chichester Festival Theatre for ten weeks in the revue, Noel/Cole - Let's Do It.

It was Oscar Wilde who once observed: "It is what you fear that happens." In Pat's autobiography, The Time Of My Life, published in 1999, there is a poignant account of how her mother, Norah Kirkwood, also developed Alzheimer's.

Do You, Or Someone You Know, Work At Deloitte? UK

Spread the word. Likely a serious donation that would make a difference.

clipped from www.medicalnewstoday.com Alzheimer's is on the shortlist to be one of Deloitte's chosen charities for 2008 and 2009, and Deloitte staff across the country are voting for their favourite charities from the list. If we win, Deloitte pledge to raise £500,000 to support Alzheimer's and dementia work in the UK. So if you, or someone you know, works at Deloitte, please join our campaign to secure as many votes as possible. If you're on the Deloitte Facebook network, start an Alzheimer's group. Speak to family, friends, colleagues, penpals, people sitting next to you on the bus, the lad handing out the free paper in the morning - it all helps! Voting opens on Wednesday 21 November and closes on Wednesday 5 December - so join our fight against dementia now!

High Blood Pressure Or Irregular Heartbeat Linked To Alzheimer's Disease Progression

Results showed that 10 with high blood pressure (systolic pressure over 160) at the time of AD diagnosis showed a rate of memory loss roughly 100 percent faster than those with normal blood pressure.

In addition, 10 with atrial fibrillation at the time of the diagnosis showed a rate of memory decline that was 75 percent faster than those with normal heartbeats.

My mother has suffered from high blood pressure for about 30 years. I have an irregular heartbeat.


Source

High Blood Pressure Or Irregular Heartbeat Linked To Alzheimer's Disease Progression

Alzheimer's disease (AD) may progress more rapidly in people with high blood pressure or a form of irregular heartbeat, atrial fibrillation, according to results of a Johns Hopkins study published in Neurology*. The findings suggest that treating these conditions may also slow memory loss in people with AD.

While current medications for Alzheimer's disease are effective for some patients in slowing the rate of AD progression, many patients do not benefit from the treatments or cannot tolerate them, says lead researcher Michelle M. Mielke, Ph.D., of the Department of Psychiatry and Behavioral Sciences at The Johns Hopkins University School of Medicine.

"The possibility that specific vascular conditions may affect how fast a person with AD declines," Mielke says, "provides new opportunities for slowing the rate of AD progression. Treatments for atrial fibrillation and high blood pressure are relatively inexpensive and safe and may reduce memory decline in AD patients with these conditions."

The study examined 135 men and women over 65 who were newly diagnosed with AD. All had undergone annual memory tests for an average of three years.

Results showed that 10 with high blood pressure (systolic pressure over 160) at the time of AD diagnosis showed a rate of memory loss roughly 100 percent faster than those with normal blood pressure.

In addition, 10 with atrial fibrillation at the time of the diagnosis showed a rate of memory decline that was 75 percent faster than those with normal heartbeats.

The study participants were part of the Cache County Study on Memory Health and Aging, which has been following a group of 5,092 people 65 or older living in Cache County, Utah, since 1995.

"What makes this group and study unique is that we have been following these participants in the community for over a decade, even before they were first diagnosed with AD, so we know a good deal about their medical history," says Mielke. "Studies that enroll AD patients only from clinics may miss key factors, such as date of onset and history of cardiovascular disease and treatment."

Mielke says she is currently working on similar studies using larger sample sizes to better understand the potential role that vascular factors play before AD diagnosis and their role over the course of the disease's progression.

Mielke also recently contributed to a study by Johns Hopkins psychiatrist Paul Rosenberg, M.D., that examined drugs that modify high blood pressure and high cholesterol, such as beta-blockers, diuretics, calcium-channel blockers and statins, and their effects on cognitive and functional decline. Results from that study are expected to be released this year.

The research was published in Neurology Nov. 6, 2007. Constantine Lyketsos, M.D., Paul Rosenberg, M.D., and Peter Rabins, M.D., M.P.H. of the Department of Psychiatry and Behavioral Sciences at The Johns Hopkins University School of Medicine also contributed to this study. Additional researchers include JoAnn Tschanz, Ph.D., Maria Norton, Ph.D., Ron Munger, Ph.D., Larry Cook, and Chris Corcoran, Ph.D., of Utah State University in Logan, Utah; Kathleen Hayden, Ph.D., and Kathleen Welsh-Bohmer, Ph.D., of Duke University in Durham, N.C.; Robert Green, M.D., of Boston University; and John Brietner, M.D., of the University of Washington in Seattle.

This study was supported by grants from the National Institute on Aging.

Adapted from materials provided by Johns Hopkins Medical Institutions.

Need to cite this story in your essay, paper, or report?

Johns Hopkins Medical Institutions (2007, November 5). High Blood Pressure Or Irregular Heartbeat Linked To Alzheimer's Disease Progression.

The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

Alzheimer's and Cold Sores Linked

Evidence is building that the cold sore virus may be linked to Alzheimer's disease, an expert says.

BBC NEWS

Alzheimer's cold sore virus link

Evidence is building that the cold sore virus may be linked to Alzheimer's disease, an expert says.

In lab tests, Manchester University found brains infected with the herpes simplexvirus, HSV-1, saw a rise in a protein linked to Alzheimer's.

Scientists believe the discovery could pave the way for a vaccine that may help prevent the brain disorder, New Scientist magazine reported.

But such a breakthrough was a long-time off, experts said.

We need to carry out much more work into this, but the problem is people are quite sceptical of a viral link, Dr Ruth Itzhaki, of Manchester University

The researchers infected cultures of human brain cells with the virus and found a "dramatic" increase in levels of the beta amyloid protein - the building blocks of deposits, or plaques, which form in the brains of people with Alzheimer's.

A similar increase was seen in the brains of mice infected with HSV-1.

In a separate experiment, the team stained brain slices taken from dead Alzheimer's patients and found DNA from HSV-1 attached to the plaques.

Gene interaction

Previous research has established that HSV-1 is found in the brains of up to 70% of people with Alzheimer's.

And a team from the University of Rochester Medical Center in New York found that it was more likely to cause a problem in people who carry a mutant version of a specific gene called ApoE4, which is involved in the breakdown of fats by the body.

They found the vast majority of Alzheimer's patients they examined carried the gene - and suspect that it works to make HSV-1 more active.

Scientists have still to establish a direct link between the virus and the disease, but the Manchester team believe the findings offer hope for the future.

Lead researcher Dr Ruth Itzhaki said: "Alzheimer's is a multi-factorial disease, there are many different causes.

"But our work implies that for some a mixture of the gene variant and the virus could be contributing to it.

"In the future - although it is a long way off - people could even be immunised against the virus which could help protect people against Alzheimer's."

"We need to carry out much more work into this, but the problem is people are quite sceptical of a viral link."

Professor Clive Ballard, director of research at the Alzheimer's Society, said: "A link between the virus and Alzheimer's disease was first suggested ten years ago."

But he added: "More research is needed before we can establish how relevant it may be to the treatment of people with Alzheimer's disease."

Source of Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/7071576.stm

Published: 2007/11/01 00:25:07 GMT

© BBC MMVII

The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life