Sugary beverage intake and preclinical Alzheimer’s

Excess sugar consumption has been linked with Alzheimer’s disease (AD) pathology in animal models | Alzheimers & Dementia

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We examined the cross-sectional association of sugary beverage consumption with neuropsychological (N = 4276) and magnetic resonance imaging (N = 3846) markers of preclinical Alzheimer’s disease and vascular brain injury (VBI) in the community-based Framingham Heart Study. Intake of sugary beverages was estimated using a food frequency questionnaire.

Relative to consuming less than one sugary beverage per day, higher intake of sugary beverages was associated with lower total brain volume (1–2/day, β ± standard error [SE] = −0.55 ± 0.14 mean percent difference, P = .0002; >2/day, β ± SE = −0.68 ± 0.18, P < .0001), and poorer performance on tests of episodic memory (all P < .01). Daily fruit juice intake was associated with lower total brain volume, hippocampal volume, and poorer episodic memory (all P < .05). Sugary beverage intake was not associated with VBI in a consistent manner across outcomes.

Higher intake of sugary beverages was associated cross-sectionally with markers of preclinical AD.

Full reference: Pase, M.P. et a; (2017) Sugary beverage intake and preclinical Alzheimer’s disease in the community. Alzheimers & Dementia. Vol. 13 (Issue 9) pp. 955–964.

Neuropsychiatric signs and symptoms of Alzheimer’s disease: New treatment paradigms

Neuropsychiatric symptoms (NPSs) are hallmarks of Alzheimer’s disease (AD), causing substantial distress for both people with dementia and their caregivers, and contributing to early institutionalization | Alzheimer’s & Dementia: Translational Research & Clinical Interventions

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Image source: Florence Winterflood – Wellcome Images // CC BY 4.0

Image shows an artistic interpretation of Alzheimer’s Disease.

They are among the earliest signs and symptoms of neurocognitive disorders and incipient cognitive decline, yet are under-recognized and often challenging to treat. With this in mind, the Alzheimer’s Association convened a Research Roundtable in May 2016, bringing together experts from academia, industry, and regulatory agencies to discuss the latest understanding of NPSs and review the development of therapeutics and biomarkers of NPSs in AD. This review will explore the neurobiology of NPSs in AD and specific symptoms common in AD such as psychosis, agitation, apathy, depression, and sleep disturbances. In addition, clinical trial designs for NPSs in AD and regulatory considerations will be discussed.

Full reference: Lanctôt, K.L. et al. (2017) Neuropsychiatric signs and symptoms of Alzheimer’s disease: New treatment paradigms. Alzheimer’s & Dementia: Translational Research & Clinical Interventions. Published online: 5th August 2017

Cost-effectiveness of physical activity in Alzheimer’s disease

This study explores the cost-effectiveness of a supervised moderate-to-high intensity aerobic exercise programme in people diagnosed with Alzheimer’s disease (AD) and estimate incremental cost-effectiveness ratios (ICER) using participant-reported and proxy-reported measures of health-related quality of life (HRQoL) | BMJ Open

Interventions: Control group received treatment as usual. The intervention group performed 1 hour of supervised moderate-to-high intensity aerobic exercise three times weekly for 16 weeks.

Primary and secondary outcomes measures: Different physical, functional and health measures were obtained at inclusion (baseline) and 4 and 16 weeks after. HRQoL (EuroQol-5 Dimensions-5 Levels/EQ-Visual Analogue Scale) was reported by the participants and the primary caregivers as proxy respondents. Differences in HRQOL as reported by the participant and caregiver were explored as were different values of caregiver time with respite from care tasks.

Results: The intervention cost was estimated at €608 and €496 per participant, with and without transport cost, respectively. Participants and caregivers in the intervention group reported a small, positive non-significant improvement in EQ-5D-5L and EQ-VAS after 16 weeks. The ICER was estimated at €72 000/quality-adjusted life year using participant-reported outcomes and €87000 using caregiver-reported outcomes.

Conclusions: The findings suggest that the exercise intervention is unlikely to be cost-effective within the commonly applied threshold values. The cost of the intervention might be offset by potential savings from reduction in use of health and social care.

Full reference: Sopina, E. et al. (2017) Cost-effectiveness of a randomised trial of physical activity in Alzheimer’s disease: a secondary analysis exploring patient and proxy-reported health-related quality of life measures in Denmark. BMJ Open. 7:e015217.

Gap in health care for Alzheimer’s disease patients who live alone

46% of patients who are diagnosed with Alzheimer’s disease in Sweden live alone in their homes, in particular older women, researchers report | ScienceDaily

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Swedish researchers report in an article published in the Journal of Alzheimer´s Disease that 46% of patients who are diagnosed with Alzheimer´s disease in Sweden live alone in their homes, in particular older women.

The patients who live alone do not receive the same extent of diagnostic investigations and anti-dementia treatment as those who are co-habiting. On the other hand, they were treated more frequently with antidepressants, antipsychotics and sedative drugs.

According to recent statistics, the number of older people who live alone in their homes, especially women, is increasing in high income countries. When an older person is affected by dementia, such as Alzheimer´s disease, they may not have a close relative living with them, which may complicate the course of the disease. Dementia affects their memory and later can lead to their dependency on caregivers.

What causes Alzheimer’s disease? What we know, don’t know and suspect

This article by by Yen Ying Lim, Research Fellow, Florey Institute of Neuroscience and Mental Health looks at what we currently know, what we don’t know, and what we suspect about Alzheimer’s disease | Via The Conversation

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Alzheimer’s disease is the most common form of dementia, which is an umbrella term used to describe general loss of memory, thinking skills and other day-to-day functions.

A hallmark of Alzheimer’s disease is gradual deterioration of memory. But it is a biological disease, which means that, besides seeing outwards symptoms such as memory loss, we can also measure the breakdown that occurs in the brain as a consequence of disease progression.

In this article, the author examines a range of issues associated with Alzheimer’s disease including:

  • Amyloid and tau
  • The role of genes
  • Diet, diabetes and obesity
  • Physical activity
  • Sleep
  • Mood
  • Cognitive reserve or resilience
  • Preventing Alzheimer’s disease

 

Detecting Alzheimer’s disease before symptoms emerge

Cognitive tests can detect early Alzheimer’s disease in older adults without symptoms according to a new study. | Neuropsychology Review | via ScienceDaily

A new study led by Duke Han, suggests that cognitive tests are able to detect early Alzheimer’s in people without symptoms. Han and his colleagues conducted a meta-analysis of 61 studies to explore whether neuropsychological tests can identify early Alzheimer’s disease in adults over 50 with normal cognition.

The study, which was published in Neuropsychology Review, found that people who had amyloid plaques performed worse on neuropsychological tests of global cognitive function, memory, language, visuospatial ability, processing speed and attention/working memory/executive function than people who did not have amyloid plaques.

The study also found that people with tau pathology or neurodegeneration performed worse on memory tests than people with amyloid plaques. Amyloid plaques and tau pathology were confirmed by PET scan or cerebrospinal fluid analysis.

Han believes that the study results provide a solid argument for incorporating cognitive testing into routine, annual checkups for older people.

Full story at ScienceDaily

Article reference: S. Duke Han et al. Detectable Neuropsychological Differences in Early Preclinical Alzheimer’s Disease: A Meta-Analysis. Neuropsychology Review, 2017

 

Earlier Diagnosis of Alzheimer’s Disease Using Saliva Test?

Pilot research indicates that a chemical in the saliva can be used to differentiate, with relatively high accuracy, between persons who are currently healthy, those with mild cognitive impairment (MCI), and others with Alzheimer’s Disease. Potentially, salivary biomarkers could offer a convenient means of screening people at high risk of developing Alzheimer’s Disease.

Full reference:   Yilmaz, A. Geddes, T. & Han, B. et al. Diagnostic biomarkers of Alzheimer’s Disease as identified in saliva using 1H NMR-based metabolomics.  Journal of Alzheimer’s Disease: May 11th 2017; 58(2): 355-359.

Related: Dementia saliva testing ‘shows early promise’ | NHS Choices

Podcast: can we cure Alzheimer’s?

Alzheimer’s disease affects millions of people worldwide. But despite decades of research costing hundreds of millions of dollars, we have no cure. Why? | The Guardian

Despite drug companies spending decades and hundreds of millions of dollars on development into drugs, so far nothing has been discovered that can stop the disease. But why is Alzheimer’s so hard to cure?

To probe this question Ian Sample is joined by Dr David Reynolds, chief scientific officer at Alzheimer’s Research UK, Professor Roger Morris, a molecular neurobiologist at King’s College London and Professor Giovanna Mallucci from the University of Cambridge.

View the full article and podcast here

Common sedatives linked to increased risk of pneumonia in people with Alzheimer’s disease

Commonly used sedatives called benzodiazepines are associated with an increased risk of pneumonia when used in people with Alzheimer disease, according to a study published in CMAJ (Canadian Medical Association Journal) | ScienceDaily

https://creativecommons.org/licenses/by-nc-nd/2.0/
Image source: FedEx – Flickr // CC BY-NC-ND 2.0

Dementia, of which 60%-70% of cases are Alzheimer disease, is a risk factor for pneumonia, and many people with dementia are prescribed benzodiazepines and non- benzodiazepines (called Z-drugs), both of which have sedative effects.

To determine if there is a link between these drugs and pneumonia, Finnish researchers looked at data from national registries on 49 484 adults living in the community diagnosed with Alzheimer disease between 2005 and 2011 in Finland. The mean age of participants was 80 years and almost two-thirds (62.7%) were women. They matched 5232 patients taking benzodiazepines and 3269 patients taking Z-drugs with the remainder not taking either drug.

They found that benzodiazepines were linked to a 30% increased risk of pneumonia in patients with Alzheimer disease, and the risk was highest at the start of treatment (during the first 30 days).

Read the commentary article here

The original research article is available here

Environmental factors and emergency hospital admissions due to Alzheimer’s disease

Culqui, D.R. et al. (2017) Science of The Total Environment. 592(15) pp. 451–457

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Highlights:

  • Alzheimer’s disease (AD) is the most common cause of dementia among older adults
  • Air pollutants may be risk factors regarding the decompensation of AD
  • PM2.5 concentrations are associated with the development and the exacerbation of AD
  • Heat waves can exacerbate Alzheimer’s hospital admissions
  • More epidemiologic studies will be needed to confirm the relation between AD and environmental factors

Read the full abstract here