Study finds correlation between atrial fibrillation and dementia

New research into atrial fibrillation (AF) and dementia has found that the heart condition may increase the risk of dementia when compared to those without AF | Neurology | Story via PHARMAfield

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A study published in the journal Neurology has found that people with atrial fibrillation may experience a faster decline in thinking and memory skills and have a greater risk of dementia than those without the heart condition.

In the study, researchers looked at data on 2,685 participants with an average age of 73 who were followed for an average of six years as part of a larger study. Participants were examined and interviewed at the start of the study and then once after six years for those younger than 78 and once every three years for those 78 and older. All participants were free of dementia at the start of the study, but 243 people, or 9 percent, had atrial fibrillation.

Through face-to-face interviews and medical examinations, researchers gathered lifestyle and medical data on participants at the start of the study and during each follow-up visit. All were screened for atrial fibrillation, for overall thinking and memory skills, as well as dementia.

Over the course of the study, an additional 279 people (11%), developed atrial fibrillation, and 399 (15%), developed dementia.

Researchers found that those who had atrial fibrillation had a faster rate of decline in thinking and memory skills than those without the condition and were 40% more likely to develop dementia. Of the 2,163 people who did not have irregular heartbeat, 278 people developed dementia (10%). Of the 522 people with irregular heartbeat, 121 developed dementia (23%).

Researchers also found that people who took blood thinners for atrial fibrillation had a 60 percent decreased risk of dementia.

Full story at PHARMAfield

Link to research: Mozhu Ding et al. | Atrial fibrillation, antithrombotic treatment, and cognitive aging | Neurology | Published ahead of print on October 10, 2018

 

First patient trial will test new approach to treating Alzheimer’s disease

UCL | October 2018 | First patient trial will test new approach to treating Alzheimer’s disease

A new clinical trial that is using a novel approach to the progression of Alzheimer’s disease is being led by UCL researchers in London. The trial known as DESPIAD will study whether a drug that removes a protein from the brain can help patients with Alzheimer’s disease. 

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 “After a long struggle for funding of our different approach to possible treatment of Alzheimer’s disease, it is exciting to finally have started the DESPIAD trial, which has been made possible by the NIHR and the Wolfson Foundation. We now hope it can proceed as swiftly as possible,” said Professor Sir Mark Pepys (UCL Medicine), who led the development of the new drug.

Almost all medications tested have been focussed on the abnormal fibrous protein accumulations, known as amyloid plaques and neurofibrillary tangles, which are always present in the brain in Alzheimer’s disease. The drugs have aimed at removing or preventing the formation of these abnormal deposits (Source: UCL).

For the full details of the trial, read the press release from  UCL 

See also:

NIHR | Landmark new trial starts for novel Alzheimer’s disease treatment

Setting personal goals for dementia care

Research finds that goal setting may help people with dementia work with healthcare professionals and caregivers to identify and achieve realistic goals that are most important to them. | Journal of the American Geriatrics Society | News Medical

New research published in the Journal of the American Geriatrics Society has concluded that “goal attainment scaling” (GAS) can be used in clinical care to help people with dementia and their caregivers set and achieve personalised health goals.

old-690842_1920The researchers developed a process for using GAS to set goals and to measure whether participants reached those goals. In a first phase of the study, they tested goal setting with 32 people who had dementia and their caregivers.

In the next phase, the dementia care managers helped an additional 101 people with dementia and their caregivers set care goals. The research team used a scale to measure how well the participants achieved their goals 6 and 12 months after setting them.

Most often, the goals focused on improving quality of life for the person with dementia, followed by caregiver support goals. Some commonly chosen goals for the person with dementia included:

  • Maintaining physical safety
  • Continuing to live at home
  • Receiving medical care related to dementia
  • Avoiding hospitalization
  • Maintaining mental stimulation
  • Remaining physically active

Commonly chosen caregiver goals included:

  • Maintaining the caregiver’s own health
  • Managing stress
  • Minimizing family conflict related to dementia caregiving

Full story: Personalized goal setting to improve dementia care | News Medical

Full reference: Lee A. Jennings et al. | Personalized Goal Attainment in Dementia Care: Measuring What Persons with Dementia and Their Caregivers Want | Journal of the American Geriatrics Society | 2018

 

Future Alzheimer’s treatment

Report suggests joint actions and planning in Europe can help provide better coordinated and more timely care for Alzheimer’s patients | RAND Corporation

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  • The burden of Alzheimer’s disease in high-income countries is expected to approximately double between 2015 and 2050. Recent clinical trial results give hope that a disease-modifying therapy might become available in the near future. The therapy is expected to treat early-stage patients to prevent or delay the progression to dementia.
  • This preventive treatment paradigm implies the need to screen, diagnose, and treat a large population of patients with mild cognitive impairment. There would be many undiagnosed prevalent cases that would need to be addressed initially, and then the longer-term capacity to address incident cases would not need to be as high.
  • Researchers used a simulation model to assess the preparedness of the health care system infrastructure in six European countries — France, Germany, Italy, Spain, Sweden, and the United Kingdom — to evaluate, diagnose, and treat the expected number of patients.
  • Projected peak wait times range from five months for treatment in Germany to 19 months for evaluation in France. The first year without wait times would be 2030 in Germany and 2033 in France, and 2042 in the United Kingdom and 2044 in Spain. Specialist capacity is the rate-limiting factor in France, the United Kingdom, and Spain, and treatment delivery capacity is an issue in most of the countries.
  • If a disease-modifying therapy becomes available in 2020, we estimate the projected capacity constraints could result in over 1 million patients with mild cognitive impairment progressing to Alzheimer’s dementia while on wait lists between 2020 and 2050 in these six countries.

Recommendations

  • In addition to increasing specialist and infusion capacity in each individual country, joint actions and planning in Europe can help provide better coordinated and more timely care for Alzheimer’s patients.
  • A combination of reimbursement, regulatory, and workforce planning policies, as well as innovation in diagnosis and treatment delivery, is needed to expand capacity and to ensure that available capacity is leveraged optimally to treat patients with early-stage Alzheimer’s disease.

Full report: Assessing the Preparedness of the Health Care System Infrastructure in Six European Countries for an Alzheimer’s Treatment | RAND Corporation

BBC Music website offers dementia lifeline

Evidence shows that music can help people with dementia to feel and live better. Now, a new BBC website aims to help by connecting dementia patients with the songs they love. | Via BBC

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The new ‘Music Memories’ site  launched as part of BBC Music Day allows people to browse more than 1,800 songs, classical works and TV theme tunes from the last 100 years, creating a playlist of personally meaningful music. Those playlists can then be shared – along with some basic information about the user’s age, gender and place of birth – allowing carers to identify songs that could help others with a similar background.

Eventually, it’s hoped the site will build a database of music that’s effective at triggering memories.

“Music can have such a powerful effect,” said Snow Patrol star Gary Lightbody, whose father suffers from dementia. “It fires all sorts of things in the brain much more immediately than anything else can, whether it be pictures or old home movies or conversations. Music can somehow take you to a place of your youth, or an important part of your life you may not otherwise have access to.”

Beyond that, music therapy has been shown to alleviate depression, anxiety, hallucinations and mobility problems in patients with mild to moderate Alzheimer’s.

Full story at BBC

One in two women and one in three men will develop neurological disease

OnMedica | October 2018 | One in two women and one in three men will develop neurological disease

A research team from the Netherlands studied  lifetime risk of dementia, stroke and parkinsonism, in over 12,102 individuals (just over half of them women) who at baseline were aged at least 45 years (median 62.2 years), and free from these diseases, for 26 years,  between the years 1990 and 2016 in a  prospective population- based study.

Within this period over 1400 individuals were diagnosed with dementia, 1,285 with stroke and more than 250 with parkinsonism; and of these 438 people (14.6%) were diagnosed with multiple diseases. The researchers found that women were almost twice as likely as men to be diagnosed with both stroke and dementia during their lifetime. Females over 45 years of age had a significantly higher lifetime risk of developing dementia and stroke than men (31.4% compared with 18.6% in men; and 21.6% compared with 19.3% in men, respectively); whereas lifetime risk of parkinsonism (4.3% in women and 4.9% in men) was not significantly different. They also saw similar patterns in sex-specific occurrence for Alzheimer’s disease and vascular dementia, ischaemic, haemorrhagic and unspecified stroke and Parkinson’s disease (Source: OnMedica)

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Read the full news story from OnMedica One in two women and one in three men will develop neurological disease

Abstract

Objective To quantify the burden of common neurological disease in older adults in terms of lifetime risks, including their co-occurrence and preventive potential, within a competing risk framework.

Methods Within the prospective population-based Rotterdam Study, we studied lifetime risk of dementia, stroke and parkinsonism between 1990 and 2016. Among 12 102 individuals (57.7% women) aged more than or equal to 45 years free from these diseases at baseline, we studied co-occurrence, and quantified the combined, and disease-specific remaining lifetime risk of these diseases at various ages for men and women separately. We also projected effects on lifetime risk of hypothetical preventive strategies that delay disease onset by 1, 2 and 3 years, respectively.

Results During follow-up of up to 26 years (156 088 person-years of follow-up), 1489 individuals were diagnosed with dementia, 1285 with stroke and 263 with parkinsonism. Of these individuals, 438 (14.6%) were diagnosed with multiple diseases. Women were almost twice as likely as men to be diagnosed with both stroke and dementia during their lifetime. The lifetime risk for any of these diseases at age 45 was 48.2%  in women and 36.2% in men. This difference was driven by a higher risk of dementia as the first manifesting disease in women than in men, while this was similar for stroke  and parkinsonism. Preventive strategies that delay disease onset with 1 to 3 years could theoretically reduce lifetime risk for developing any of these diseases by 20%–50%.

Conclusion One in two women and one in three men will develop dementia, stroke or parkinsonism during their life. These findings strengthen the call for prioritising the focus on preventive interventions at population level which could substantially reduce the burden of common neurological diseases in the ageing population.

The full article is available to read at BMJ Journal of Neurology, Neurosurgery & Psychiatry 

Full reference: Licher SDarweesh SKLWolters FJ, et al. | 2018| 
Lifetime risk of common neurological diseases in the elderly population
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