Without an effective treatment, the cumulative costs of caring for patients with Alzheimer's disease in the United States could top $20 trillion over the next 40 years, according to a new report from the Alzheimer's Association.
By the year 2050, the number of people with Alzheimer's disease will climb from roughly 5.1 million today to an estimated 13.5 million, the report released this week said. If that happens, annual costs would also rise—from $172 billion to more than $1 trillion. Costs to Medicare will jump by more than 600% to $627 billion per year. That compares to $88 billion today. Meanwhile, Medicaid costs will soar to $178 billion, up from the current $34 billion, according to the report.
Read full article...
Monday, May 24, 2010
Wednesday, May 19, 2010
New study characterizes cognitive and anatomic differences in Alzheimer's disease gene carriers
ScienceDaily (2010-05-19) -- In the most comprehensive study to date, neurologists have clearly identified significant differences in the ways that Alzheimer's disease affects patients with and without the apolipoprotein E e4 gene, a known genetic risk factor for the neurodegenerative disease, using a combination of cognitive and neuroanatomic measures. The study found that this gene influences the way the disease manifests, even at its mildest clinical stages. ... > read full article
Study uncovers link between elderly falls, and high blood pressure, altered blood flow in brain
There may be a connection between high blood pressure and hardened arteries, and an increased risk of falls among seniors, according to a new study.
Researchers with Harvard University's Institute for Aging Research measured the brain blood flow of 419 seniors aged 65 and older. The seniors' mobility was also measured over a 12-foot walking course. Seniors with higher blood pressure or stiffened arteries were less able to transport oxygen and glucose to the brain during periods of heavy breathing. Seniors in the bottom 20% for good blood flow were 70% more likely to experience a fall during the course of the study than seniors with better brain blood flow, according to the results of the trial.
High blood pressure treatments, including treatments with statins to reduce high cholesterol levels, could help improve blood flow to the brain, researchers say. This, in turn, could help reduce the likelihood of falls in some seniors, though more research is needed to determine the potential benefits of blood pressure treatment on falls, they conclude. The report appears in the May 18 issue of Neurology.
Tuesday, May 18, 2010
Studies highlight positive effects of caffeine on brain health - McKnight's Long Term Care News
Caffeine helps us stay alert. Research suggests it also could slow the progression of Alzheimer's and Parkinson's diseases.
In a new collection of studies from around the world on the effects of caffeine on cognitive decline, a number of researchers present evidence of the drug's ability to slow the progression of these two diseases, as well as a number of other benefits. Here are some of the findings from the 22 new studies: Moderate caffeine intake could provide therapeutic potential for humans, caffeine was associated with lower cognitive decline in women than in men, and caffeine helps reduce the production of amyloid-beta, which is associated with Alzheimer's. Many of the studies used animal models in the tests.
The studies appear in a special supplement to the recent edition of the Journal of Alzheimer's Disease, "Therapeutic Opportunities for Caffeine in Alzheimer's Disease and Other Neurodegenerative Diseases."
In a new collection of studies from around the world on the effects of caffeine on cognitive decline, a number of researchers present evidence of the drug's ability to slow the progression of these two diseases, as well as a number of other benefits. Here are some of the findings from the 22 new studies: Moderate caffeine intake could provide therapeutic potential for humans, caffeine was associated with lower cognitive decline in women than in men, and caffeine helps reduce the production of amyloid-beta, which is associated with Alzheimer's. Many of the studies used animal models in the tests.
The studies appear in a special supplement to the recent edition of the Journal of Alzheimer's Disease, "Therapeutic Opportunities for Caffeine in Alzheimer's Disease and Other Neurodegenerative Diseases."
Thursday, May 13, 2010
Dementia Takes Away the Meaning of Flavours: Clues to Brain Basis for Abnormal Food Preferences
ScienceDaily (May 13, 2010) — Flavor is literally the spice of life and for many people life without the pleasures of the table would be unthinkable. Yet just this aspect of everyday life is vulnerable in certain degenerative dementias, with patients developing abnormal eating behaviors including changes in food preferences, faddism and pathological sweet tooth. Read full article...
Wednesday, May 12, 2010
Music Helps Alzheimer's Patients Remember New Information
Researchers from Boston University School of Medicine (BUSM) have shown that patients with Alzheimer's disease (AD) are better able to remember new verbal information when it is provided in the context of music even when compared to healthy, older adults. The findings, which currently appear on-line in Neuropsychologia, offer possible applications in treating and caring for patients with AD.
AD, the most common form of dementia, is characterized by a general, progressive decline in cognitive function that typically presents first as impaired episodic memory. The onset and rate of this decline tends to vary across cognitive domains, and some functions may be preferentially spared in patients with AD.
To determine whether music can enhance new learning of information, AD patients and healthy controls were presented with either the words spoken, or the lyrics sung with full musical accompaniment along with the printed lyrics on a computer screen. The participants were presented visually with the lyrics to 40 songs. Twenty of the song lyrics were accompanied by their corresponding sung recording and 20 were accompanied by their spoken recording.
After each presentation, participants were asked to indicate whether or not they were previously familiar with the song they had just heard. The BUSM researchers found accuracy was greater in the sung condition than in the spoken condition for AD patients but not for healthy older controls.
"Our results confirmed our hypothesis that patients with AD performed better on a task of recognition memory for the lyrics of songs when those lyrics were accompanied by a sung recording than when they were accompanied by a spoken recording," said senior author Brandon Ally, PhD, an assistant professor of neurology and director of Neuropsychology Research at the BUSM Center for Translational Cognitive Neuroscience. "However, contrary to our hypothesis, healthy older adults showed no such benefit of music, he added.
These results suggest a fundamental difference in the encoding and retrieval processes for musical versus nonmusical stimuli between patients with AD and healthy older adults. "Music processing encompasses a complex neural network that recruits from all areas of the brain, that are affected at a slower rate in AD compared to the areas of the brain typically associated with memory. Thus, stimuli accompanied by music and a sung recording may create a more robust association at encoding than do stimuli accompanied by only a spoken recording in patients with AD," explained Ally.
According to the researchers understanding the nature of musical processing and memory in patients with AD may allow the development of effective and comprehensive therapies for this increasingly prevalent disease.
This research was supported by National Institute on Aging.
Informed caregivers can improve quality of life of Alzheimer's residents
Why are people who are diagnosed with Alzheimer's, the seventh leading cause of death in the United States, not being cared for the way they should be? We wanted to find a way to improve the quality of life ("QoL") of the resident with Alzheimer's living with a debilitating disease.
This idea formed the basis of a research study at Signature HealthCARE LLC that revealed a direct correlation between the quality of life for individuals diagnosed with Alzheimer's disease and their caregivers.
Alzheimer's disease (AD) is a silent killer that gradually destroys a person's memory, ability to learn and communicate, and the ability to carry out daily activities. As AD progresses, individuals can experience other weakening side effects, including anxiety, irritation, and possible hallucinations. AD patients experience side effects that ultimately impact their quality of life, which is defined as being in a state of complete physical, mental and social well-being. Read full article...
This idea formed the basis of a research study at Signature HealthCARE LLC that revealed a direct correlation between the quality of life for individuals diagnosed with Alzheimer's disease and their caregivers.
Alzheimer's disease (AD) is a silent killer that gradually destroys a person's memory, ability to learn and communicate, and the ability to carry out daily activities. As AD progresses, individuals can experience other weakening side effects, including anxiety, irritation, and possible hallucinations. AD patients experience side effects that ultimately impact their quality of life, which is defined as being in a state of complete physical, mental and social well-being. Read full article...
Wednesday, May 05, 2010
Dementia Risk Higher in Spouses of Dementia Patients
By Joyce Frieden, News Editor, MedPage Today
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.
Spouses of dementia patients are six times more likely to develop dementia than spouses of persons without dementia, a study has found.
The fully adjusted hazard ratio for developing dementia after being exposed to a spouse's dementia was 6.0 (95% CI 2.2 to 16.2, P<0.001), according to Maria C. Norton, PhD, of Utah State University in Logan, and colleagues.
In analyses by sex, the effect of exposure to a spouse's dementia was higher for men (HR 11.9, 95% CI 1.7 to 85.5) than women (HR 3.7, 95% CI 5 1.2 to 11.6), the authors reported in the May issue of the Journal of the American Geriatrics Society.
However, "given the overlap in confidence intervals, the difference could be due to chance and needs further study," they added.
The distress of watching a spouse suffer from dementia and the physical and mental burden of providing dementia care are potential causal factors, given the influence of care-giving on risk for depression and mortality, the authors suggested.
"Having a loved one with dementia is stressful regardless of age, but the burden for spouses may be even greater because of close emotional ties to their partner, their own medical comorbidity, greater risk for functional limitations, and greater likelihood of fatigue with physical exertion."
One specific mechanism might be the detrimental effects of chronic stress on the hippocampus, a brain region responsible for memory, they theorized, noting that "there may be a relationship between having a spouse with dementia and adverse cognitive function with stress as the potential mediator."
To see whether older married adults would be at greater risk of dementia after onset of dementia in their spouses, the authors examined existing data from the Cache County (Utah) Study on Memory Health and Aging. This is a population-based epidemiological study of county residents ages 65 and older.
Norton and colleagues identified 1,221 married couples in the database as suitable for the study. Average age of respondents was 75.7 for husbands and 73.1 for wives. The couples were followed for up to 12.6 years, with a median follow-up of 3.3 years. Apolipoprotein E (APOE) genotypes were obtained at baseline.
The study used a multistage protocol for diagnosing dementia. Screening began with an in-person interview, including the modified Mini-Mental State Examination or, for those unable to participate, the Informant Questionnaire on Cognitive Decline in the Elderly.
Participants whose screening scores suggested possible dementia then completed an in-depth clinical assessment.
Specially trained nurses and psychometric technicians administered the clinical assessment, which included a brief physical evaluation, a history of medical and cognitive symptoms, a structured neurological examination, and a one-hour battery of neuropsychological tests.
A geriatric psychiatrist and neuropsychologist, along with the assessment team, reviewed these data and assigned working diagnoses of dementia or other cognitive syndromes based on DSM-III-R criteria.
Of the 2,442 people selected for the dementia study, 253 screened positive for dementia but failed to complete the clinical assessment because they died, refused to continue, or moved out-of-state after the initial screening.
However, some of those respondents had completed a dementia questionnaire after the initial screening, and scores from the questionnaire were used to impute dementia status. For the remaining respondents in this group, the screening data itself was used.
Incident dementia among the 1,221 couples was diagnosed as follows:
•Only in the husband (n=125)
•Only in the wife (n=70)
•In both spouses (n=30)
•In neither spouse (n=996)
Incident dementia was significantly associated with older age, presence of one or more APOE e4 alleles, and having a spouse with dementia.
In 10 couples (0.4%), one spouse resided in a nursing home at baseline. Institutionalization after dementia onset occurred in only 12% of incident cases. All other couples where dementia was present lived together over the entire period of observation.
The authors offered several possible explanations for their finding that spouses of dementia patients were at higher risk of the disease.
One possibility was shared environmental exposures.
Another possibility was socioeconomic status. Although the models used did account for socioeconomic status (SES), "adjustment for SES does not provide a complete control for potential confounders, such as access to medical care, smoking, alcohol consumption, and diet, although the random effects models controlled for shared, unmeasured exposures without any appreciable change in the findings," they noted.
A third mechanism may be homogamy, or positive assortative mating, "to the extent that similarity in proneness to distress or mental illness may influence shared risk for dementia in couples," they wrote.
They concluded that "the relative contribution of each of these potential mechanisms to this overall effect is unknown and needs further study."
Regardless of which mechanisms are creating this effect, "it is imperative that more research be conducted to help protect older adults with spouses who are suffering from dementia from suffering the same fate themselves," the authors wrote.
Study strengths included a large, community-based sample that avoided the selection bias of clinical samples, along with high baseline participation rate, and longitudinal follow-up.
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.
Spouses of dementia patients are six times more likely to develop dementia than spouses of persons without dementia, a study has found.
The fully adjusted hazard ratio for developing dementia after being exposed to a spouse's dementia was 6.0 (95% CI 2.2 to 16.2, P<0.001), according to Maria C. Norton, PhD, of Utah State University in Logan, and colleagues.
In analyses by sex, the effect of exposure to a spouse's dementia was higher for men (HR 11.9, 95% CI 1.7 to 85.5) than women (HR 3.7, 95% CI 5 1.2 to 11.6), the authors reported in the May issue of the Journal of the American Geriatrics Society.
However, "given the overlap in confidence intervals, the difference could be due to chance and needs further study," they added.
The distress of watching a spouse suffer from dementia and the physical and mental burden of providing dementia care are potential causal factors, given the influence of care-giving on risk for depression and mortality, the authors suggested.
"Having a loved one with dementia is stressful regardless of age, but the burden for spouses may be even greater because of close emotional ties to their partner, their own medical comorbidity, greater risk for functional limitations, and greater likelihood of fatigue with physical exertion."
One specific mechanism might be the detrimental effects of chronic stress on the hippocampus, a brain region responsible for memory, they theorized, noting that "there may be a relationship between having a spouse with dementia and adverse cognitive function with stress as the potential mediator."
To see whether older married adults would be at greater risk of dementia after onset of dementia in their spouses, the authors examined existing data from the Cache County (Utah) Study on Memory Health and Aging. This is a population-based epidemiological study of county residents ages 65 and older.
Norton and colleagues identified 1,221 married couples in the database as suitable for the study. Average age of respondents was 75.7 for husbands and 73.1 for wives. The couples were followed for up to 12.6 years, with a median follow-up of 3.3 years. Apolipoprotein E (APOE) genotypes were obtained at baseline.
The study used a multistage protocol for diagnosing dementia. Screening began with an in-person interview, including the modified Mini-Mental State Examination or, for those unable to participate, the Informant Questionnaire on Cognitive Decline in the Elderly.
Participants whose screening scores suggested possible dementia then completed an in-depth clinical assessment.
Specially trained nurses and psychometric technicians administered the clinical assessment, which included a brief physical evaluation, a history of medical and cognitive symptoms, a structured neurological examination, and a one-hour battery of neuropsychological tests.
A geriatric psychiatrist and neuropsychologist, along with the assessment team, reviewed these data and assigned working diagnoses of dementia or other cognitive syndromes based on DSM-III-R criteria.
Of the 2,442 people selected for the dementia study, 253 screened positive for dementia but failed to complete the clinical assessment because they died, refused to continue, or moved out-of-state after the initial screening.
However, some of those respondents had completed a dementia questionnaire after the initial screening, and scores from the questionnaire were used to impute dementia status. For the remaining respondents in this group, the screening data itself was used.
Incident dementia among the 1,221 couples was diagnosed as follows:
•Only in the husband (n=125)
•Only in the wife (n=70)
•In both spouses (n=30)
•In neither spouse (n=996)
Incident dementia was significantly associated with older age, presence of one or more APOE e4 alleles, and having a spouse with dementia.
In 10 couples (0.4%), one spouse resided in a nursing home at baseline. Institutionalization after dementia onset occurred in only 12% of incident cases. All other couples where dementia was present lived together over the entire period of observation.
The authors offered several possible explanations for their finding that spouses of dementia patients were at higher risk of the disease.
One possibility was shared environmental exposures.
Another possibility was socioeconomic status. Although the models used did account for socioeconomic status (SES), "adjustment for SES does not provide a complete control for potential confounders, such as access to medical care, smoking, alcohol consumption, and diet, although the random effects models controlled for shared, unmeasured exposures without any appreciable change in the findings," they noted.
A third mechanism may be homogamy, or positive assortative mating, "to the extent that similarity in proneness to distress or mental illness may influence shared risk for dementia in couples," they wrote.
They concluded that "the relative contribution of each of these potential mechanisms to this overall effect is unknown and needs further study."
Regardless of which mechanisms are creating this effect, "it is imperative that more research be conducted to help protect older adults with spouses who are suffering from dementia from suffering the same fate themselves," the authors wrote.
Study strengths included a large, community-based sample that avoided the selection bias of clinical samples, along with high baseline participation rate, and longitudinal follow-up.
Tuesday, May 04, 2010
New flu shot for seniors may be available, but the jury's still out on its effectiveness - McKnight's Long Term Care News
A new, stronger flu vaccine for seniors aged 65 and older has been licensed for use, according to recent reports.
The new vaccine contains four times the amount of antigen as a normal flu vaccine, according to an April 30 report in the journal Morbidity and Mortality Weekly. The Advisory Committee on Immunization Practices at the Centers for Disease Control and Prevention is still evaluating whether the new vaccine will be more effective, and is holding off its approval until more data can be gathered. Health experts say the vaccine could be very useful for seniors, especially those with chronic health conditions, such as diabetes or chronic obstructive pulmonary disease.
Seniors are particularly vulnerable to the seasonal flu. Each year, roughly 36,000 seniors die from influenza and influenza-related complication. During the last flu season, roughly 68% of adults over the age of 65 received a vaccine—the highest percentage for any age group, according to CDC data.
The new vaccine contains four times the amount of antigen as a normal flu vaccine, according to an April 30 report in the journal Morbidity and Mortality Weekly. The Advisory Committee on Immunization Practices at the Centers for Disease Control and Prevention is still evaluating whether the new vaccine will be more effective, and is holding off its approval until more data can be gathered. Health experts say the vaccine could be very useful for seniors, especially those with chronic health conditions, such as diabetes or chronic obstructive pulmonary disease.
Seniors are particularly vulnerable to the seasonal flu. Each year, roughly 36,000 seniors die from influenza and influenza-related complication. During the last flu season, roughly 68% of adults over the age of 65 received a vaccine—the highest percentage for any age group, according to CDC data.
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