Dementia update 2016

elderly_man_holding_a_custom_text_sign_12871The government has announced a pilot programme to screen 40-year olds for dementia. The government wants to make Britain “the best place in the world to live with dementia“.

There are about 850,000 in the UK who suffer from Alzheimer’s disease and other severe neurodegenerative problems (approx 70% have Alzheimer’s and 20% vascular dementia).

Only those over 65 have a mid-life MoT at present. If the pilot is a success it will be extended to all GPs allowing them to suggest ways that people can cope with it better.

Exercising more, controlling weight and blood pressure, and eating better, are a few ways that could help.

Another part of the project is to enlist people in research to allow doctors to better understand and treat the condition.

Dementia can be frightening and the Alzheimer’s Society says  more than 9 out of 10 people think hospitals are frightening places. The health secretary has pledged that people in high dependency units will be seen regular by consultants, up to twice a day if appropriate.

Dementia support groups welcomed the shift in attitude from the government which has made dementia one of its top four priorities. “Many people with dementia face stigma and a health and care system that simply does not work for them resulting in emergency hospital admissions, extended stays and desperate loneliness

Public Health England is looking at lifestyle as a risk factor and asking doctors to look at patients with high blood pressure, irregular heartbeats or early signs of type 2 diabetes (this is part of the mid-life MoT).

A study published by Cardiff University in 2013 had looked at the lifestyles of over 2,000 men aged 45-59 over 35 years.

It found that men who were non-smokers, who took exercise, kept their weight down, drank little and ate well, had a 60% drop in dementia and cognitive decline as well as 70% fewer instances of heart disease, stroke, and diabetes.

The director of research and development at the Alzheimer’s society says “What’s emerging is that what’s good for the heart, in terms of lifestyle, is also good for the head. We don’t yet understand why this is so and we need to do more research on it”

If we could delay the average age on onset of Alzheimer’s by five years we could cut patient numbers (currently 850,000 and predicted to rise to 2 million by 2050) by a third” Dementia is the leading cause of death for women in England and Wales.

Researchers at Yale University think that helping people to have a more optimistic view of old age could delay the onset. They found that people with pessimistic views of old age, thinking that the elderly are irritable, slow to learn and forgetful, are themselves more likely to acquire the disease.

However it’s hard to untangle the psychological and medical factors given that early changes can take place 15 years before symptoms show. Recent US research suggests that forgetfulness in your 60s can be a sign of a higher dementia risk

However memory loss is not the only symptom.

Walking slowly could be an early sign of dementia, according to researchers in France who measured people’s walking speed and gait. Speed of walking has also been associated with life expectancy along with other simple tasks.

The researchers acknowledge that people could also be influenced by other illnesses such as cardio-vascular disease or depression which could have an impact on the brain.

Some of the symptoms might seem more obvious – like not recognising yourself in the mirror,  forgetting how to work the microwave, or not knowing what day or year it is.

Even a warped sense of humour could be an early sign of dementia. So if you are laughing inappropriately at tragic events or enjoy slapstick humour they could be early warning signs which show up 9 years before other symptoms.

The leader of this research at UCL said “Personality and behaviour changes should be prompts for further investigation and clinicians need to be more aware of these symptoms as a potential early sign of dementia”.

There is a lot of research into this tragic condition and there is also some good news. The number of men developing the condition has dropped considerably since the 1990s when there were 42 cases per thousand population now down to 27. In older men over 85 the incidence has almost halved from 72 to 38 cases per thousand.

This has been attributed to men living healthier lifestyles than they did 20 years ago. However with obesity and diabetes on the increase among the middle-aged these gains might not be maintained. So its back to “what’s good for your heart is good for your brain”

Do vampires know something we don’t?

mouth_vamp_teeth_1600_clr_17745Injecting/transfusing yourself with the blood of virgins (Kim Jong II and Pope Innocent VIII – well maybe not so innocent as blood donors all died), bathing in it (Countess Bathory – or Ingrid Pitt if you’re a Hammer film fan) or just taking a bloody bite (Dracula and a long line of vampires since) may seem other-worldly but scientists now believe that they may have been onto something.

Scientists in California are testing an Alzheimer’s treatment that involves injecting blood plasma from young people in the hope it will reduce brain ageing.

Saul Vileda’s experiments with mice of different ages showed that when you mix their blood. Giving blood from older mice to younger mice accelerated cognitive decline. 

He then found that when he injected older mice with young blood it changed the brain circuitry in the older mice creating new synaptic connections. Plasticity also returned relating to learning and memory-related genes.

He believes it’s because the proportion of different molecules in blood changes with age and older blood has more factors associated with inflammation.

Since the research was published they have received offers of children’s blood and requests from aged billionaires.

However they have taken an ethical stance and in trials at Stanford  University volunteers  with early stage Alzheimer’s  are being injected with young blood plasma. The experiment is reported in a BBC documentary “How to stay young”.

As Vileda says “We have heard about vampires. Is there some truth in that? Children heal so quickly. Is it the fountain of youth?

Well, vampires are immortal after all.

What kind of drunk are you?

stick_figure_drunk_500_wht_11670Some psychologists believe that we turn into one of four character types when we are drunk.

Ernest Hemingway – someone who is barely affected by excess alcohol

Mary Poppins – someone whois friendly and compassionate

The Nutty Professor – a quiet type transformed into a confident extrovert

Mr Hyde – someone who becomes menacing and hostile.

The researchers, at the University of Misoouri-Columbia, found that most people who fell into the last category were women!

The largest numbers of drunks, 40%, equally divided between men and women, fall into the Hemingway category who were very similar whether sober or intoxicated with no apparent impact on their intellect or personal organisation.

Previous studies show that conscientiousness and intellect are affected negatively by alcohol so thesis something of a surprise.

Nutty Professor types found it hardest to keep things together. This group comprises 1/5 of us, mainly men.

Mary Poppins types would be compassionate listeners and look after you but only make up 15% of the population. They suffer the least detriment to their conscientiousness and cognitive ability.

Mr Hyde types are to be avoided. They are hostile and become more disagreeable with each drink showing the dark side of their personality. Most likely to suffer blackouts or be arrested for being drunk and disorderly and suffer more harm to themselves. Unfortunately a quarter of us fall into this category and 2/3 are women.

Scientists have known for a long time that 50% of alcoholism cane be explained by genetics. Researchers have now discovered that the RSU1 gene, which seems to light up in response to rewards such as chocolate, is also associated with alcohol abuse.

Other research suggested that blue-eyed people were more prone to alcoholism.

Dementia update

elderly_man_holding_a_custom_text_sign_12871Just because you’ve retired doesn’t mean you should just slob out.

The National Institute for Health & Care Experience (NICE) is urging GPs to exploit a “window of opportunity” when people retire or have grandchildren to encourage them to eat better and exercise more.

At a time when people might be noticing signs of poor health they may not realise that lack of exercise can increase their risk of dementia.

A new study has shown that getting people to exercise their mind and bodies as they approach old age can stave off dementia. A sample of 1,260 aged 60-77 at risk of dementia were given a programme of moderate exercise, memory and word puzzles plus dietary advice. This group declined more slowly than those who didn’t take the programme.

The study was carried out at the Finnish National Institute for Health & Welfare and the results presented to a conference on Alzheimer’s held in Copenhagen.

Meanwhile scientists at Oxford University have concluded that taking vitamins doesn’t do you any good and taking them to help stave off dementia is a waste of money.

B vitamins fail to slow mental decline and don’t prevent dementia. You’d be better off going for a walk and eating more fruit and vegetables.

People taking supplements score no better on tests of memory, speed or decision-making than those taking placebos in 11 different trials of 22,000 people.

Millions of people spend £10 a pack on vitamins believing that they will help stave off dementia, heart disease or stroke – all to no avail.

However trials with an anti-arthritis drug suggest that it might slow down Alzheimer’s disease. People with mild to moderate Alzhemer’s maintained their mental abilities over 6 months while those on a placebo declined.

The drug, etanercept, may be available for dementia patients in five years if larger clinical trials support the early results discovered  at the University of Southampton.

Finally research in Germany shows that playing games, including video games, can increase the size of your brain.

See earlier post on dementia.

Reading keeps your brain in gear

woman_reading_book_1600_wht_7865 Scientists have found that if you want to stay alert in old age – keep reading!

People who engage in mentally stimulating activities like reading, letter-writing (blogging?) or even visiting libraries, have a slower rate of mental decline when they get older.

294 people were studied over the last years of their lives and were given a memory test each year.

They were also asked how much they took part in mentally stimulating activities when they were younger, when middle-aged, and when old. Then when they dies their brains were examines for plaques and tangles, features associated with dementia.

The researchers discovered that those who had little mental stimulation early in life deteriorated 42% faster than those with average activities.

In turn those with only average activity levels declined 32% faster than those with the most intellectually stimulating childhood.

These results were similar for activities later in life.

The scientists from Rush University in Chicago, who published the results in the journal Neurology, said the results confirmed earlier work but were not clear about the reasons. “Neuro-imaging research suggests that cognitive activity can lead to changes in brain structure”. The results suggest that reading and writing more and doing activities that stimulate the brain, regardless of your age, can slow down late-life cognitive decline.”

See also: Can you keep Alzheimer’s at Bay? and Old doesn’t mean stupid 

Do musicians stay sharp longer?

DSCF1131You have probably heard that singer-songwriter Glen Campbell was diagnosed with Alzheimer’s a couple of years ago.

The 77 year-old has had world-wide hits with “By the time I get to Phoenix” and “Wichita Linesman’ among many others both pop and country.

He announced that he’d made his last album “Ghost on the Canvas”, planned to make a farewell tour, then retire from music. He says he was diagnosed early in 2011 but had suffered memory loss for some time.

You might think that Campbell has done well to be able to follow his dream for so long in what is an inherently un-healthy occupation. So what has helped him to keep going for so long?  Researcher and neuropsychologist Brenda Hanna-Pladdy at Emery University School of Medicine gave tests to people aged over 60 to measure their cognitive ability and memory.

She found that those who had played a musical instrument for ten years or more scored significantly higher on the tests than those with no musical background.

She thinks music lessons, like learning a second language, can help stave off cognitive decline and says; “musical activity throughout life may serve as a challenging cognitive exercise, making your brain fitter and more capable of accommodating the challenges of ageing….. Since studying an instrument requires years of practice and learning, it may create alternate connections in the brain that could compensate for cognitive declines as we get older.”

She doesn’t say whether or not the genre of music is important but when you think how many old rock stars are still performing eg the Stones and Rod Stewart, who are all in their mid-sixties, who didn’t exactly live a healthy lifestyle when they were younger, it makes you wonder.

P1000457A couple of years ago I saw Steve Cropper, former guitarist with Booker T & the MGs and the Stax studio band, co-writer of “Dock of the Bay” (sung by Otis Redding) and a member of the Blues Brothers band, performing live at The Ramsbottom Festival at the age of 70.

And more recently Paul Jones, former Manfred Mann frontman, was performing live at the Burnley Rock & Blues Festival at the age of 71.P1000879

Rock on indeed!

Original version posted September 2011

Put the kettle on

Making a cup of tea is the British response to any stressful situation. And it may have a strong basis in science.

Several years ago researchers at University College London found that drinking tea actually made you less stressed.

The tea lowered cortisol levels. This is the hormone released when we’re stressed and which increases our blood pressure and pulse rate. Tea contains a supernutrient called theanine, which blocks the effect of nerve transmitters leading to raised stress levels, along with other bioactive compounds including one with a mild sedative effect.

So if you want to lower your stress levels drink 4 cups of tea a day.

Other research suggest that drinking 3 cups a day can reduce the risk of coronary heart disease because of the anti-oxidants it contains. These flavinoids, also exist in onions and apples but tea provides 80% of our daily intake.

Flavinoids help to reduce blood pressure by relaxing the blood vessel walls and also make it more difficult for cholesterol to attach and form the plaques that block blood flow and can break off to find their way to the brain to cause strokes. Flavinoids also reduce bad LDL cholesterol by over 10%.

Research in 2010 on almost 5,000 over-65 year olds showed that tea drinkers showed less cognitive decline over a fourteen year period and there is research that shows the positive effects of tea drinking in preventing diabetes by interfering with blood glucose activity.

Now scientists at the University of Western Australia and Unilever have discovered that drinking three cups of black tea a day lowers your blood pressure (both systolic and diastolic). However they don’t know the effect of drinking tea with milk which is strange seeing that most Brits have milk in their tea and probably influenced Australian tea-drinking traditions).


How popular is tea as a drink? Second only water across the world (so coffee still has some catching up to do)

Does tea dehyrdrate you? Research on high altitude climbers showed that tea is not a diuretic and it doesn’t dehydrate you

Is there no caffeine in tea? Tea has about half the caffeine found in coffeee but the more stewed it gets the higher the level.

But isn’t caffeine bad for you? 40-60gm of caffeine helps you to concentrate and combat fatigue so no need to stop drinking coffee.

Is green tea better for you than black tea? Green tea is prepared differently from black tea but from the same plants. Green tea has more catechins (flavonoids) which have antioxidant, antibacterial, and immune system regulating effects. Some experts suggest drinking green tea can raise your metabolism and help you burn more calories.

What about white tea?  Green tea is made from mature fresh tips whereas white tea is made from buds and young leaves. It has a higher level of catechins and a greater antibacterial effect than green tea.

SourcesThe Times 21/11/2006 and Wikipedia

The UCL research was published in Psychopharmacology and described experiments where 75 healthy non-smoking men were allowed their usual tea, coffee and caffeinated drinks for 4 weeks before the experiments. They were then subjected to a series of stressful tests including being accused of shoplifting and threatened with job loss.

Half the group were then asked to drink 4 cups a day of a tea coloured fruit drink which contained all the active constituents of a cup of black tea. The other 38 drank a tea-coloured placebo. After 6 weeks of this the stress tests were repeated. The cortisol levels of those participants drinking the fruit drinks fell more quickly and they reported feeling less stressed than the placebo drinking participants.

The research on the effects on CHD was published in the European Journal of Clinical Nutrition.

The Australian study comprised 95 people aged between 35 and 75 who drank either 3 cups of black tea or a placebo with the same flavour and caffeine content. The study was published in the Archives of Internal Medicine in January 2012

Stress and dementia

People who have been stressed over a long period, through post-traumatic stress disorder (PTSD), or stressful jobs or marriages, suffer cognitive decline which is symptomised by poor memory and diminished problem solving.

Researchers at the Albert Einstein College of Medicine in New York think they know why. A psychiatrist treating CEOs from Wall Street after 9/11 for depression realised that they were actually suffering from PTSD.

When he scanned their brains he found that their hippcampuses had shrunk to a size normally only found in elderly people.

When you are stressed your body releases corticosteroids and the researchers think that these hormones may be toxic to the brain if released in high concentrations over long periods.

This theory is supported by research into war veterans with PTSD who showed signs of accelerated  brain tissue loss (Journal of Neuroimaging) which suggested that “these patients will be at greater risk of cognitive impairment and dementia”.

There was also a study in Canada which found a link between chronic exposure to corticosteroids and cognitive decline.

I posted previously on the effects of religion on the brain which was surprising because people have always believed that religion has a positive effect on your well-being. However in the case of born-again believers it seems the stress element outweighed the positive aspects.

These findings are a real worry as stress appears to be on the increase again with depression becoming more common.

We also know that stress in children has a negative impact on their future lives and that it can even be inherited.

See also my post on Alzheimer’s

Can you keep Alzheimer’s at bay?

Alzheimer’s disease, poetically described by Ronald Reagan in a letter to the American people;  “I now begin the journey which will lead me into the sunset of my life…. affects millions of people in various ways, including mood swings and problems communicating.

It seems particularly cruel when it deprives people of memory and the ability to recognise friends and family.

Research into this progressive disease has led to various drug regimes and the popularity of brain training. Drugs can slow the process down but have limited impact in the long-term and brain training has sadly been proved to be ineffective.

And although Alzheimer’s and dementia are considered an almost inevitable disease of the ageing process (the word senility comes from the latin for old) there is some good research around about how to make the most of your brain.

Scientists now believe that learning a foreign language and speaking it regularly offers more protection against Alzheimer’s than any drugs currently available. Bilingual speakers tend to have the most common form of dementia 4 years later than monolingual speakers according to researchers in Canada.

They think the mental skills required to juggle between the two languages may stimulate the brain and keep it resilient thereby enabling it to perform better under stressful conditions, strengthening the brain’s “cognitive reserve”.

The research was carried out at York University, Toronto, and presented at the American Association for the Advancement of Science conference in Washington this year. They are now examining whether or not bilingualism actually changes the structure of the brain as they believe.

For those of you not brought up bi-lingual or who don’t want to learn a foreign language you could always look at your diet. Jean Carper, in her book “100 simple things to do to prevent Alzheimer’s and age-related memory loss” (featured in Body + Soul in the Times last month) suggests that you should eat the following:

  • Berries of any kind, every day, at least 1/2 a cupful
  • Apple juice or apples every day as they boost acetylcholine in the brain just like Aricept, the Alzheimer drug. (so the old rhyme is true…)
  • Coffee – 5 cups a day will clear up the mess the disease has created  – unless you are pregnant or have high blood pressure
  • Cocoa as it contains flavinol which increases blood flow to the brain or chocolate with 70-80% cocoa content
  • Cinnamon – a teaspoon a day
  • Alpha lipoic acid and Alcar supplements are the strongest anti-oxidant rejuvinators of ageing brains
  • Yellow curry may be the reason elderly people in rural India are 4 times less likely to have Alzheimer’s than elderly people in America. Curry powder contains turmeric which contains cucumin which is believed to slow memory decline.
  • A daily cocktail or glass of wine. Older people who drank 8 – 14 alcoholic drinks a week had over a third lower risk of dementia than non-drinkers. But more than that doubled the risk!
  • Folic acid can slow memory decline by 5 years unless you are deficient in vitamin B12 in which case it could hasten your decline. If you have heart disease or diabetes take medical advice anyway.
  • Almonds or walnuts, a handful a day with the skin on, contain anti-oxidants.
  • Fish –  the more you eat the better especially fatty fish like salmon, tuna, sardines and herring, 2 or 3 times a week.
  • Tea can block neuronal damage. Green tea has  3-4 times more oxidants than black tea. Don’t add milk.
  • Vinegar in everything helps reduce high blood sugar spikes by 30% and the risk factors for diabetes.
  • Olive oil users were 17% less likely to experience a decline in visual memory than non-users.
  • Spinach eaten early in life led to superior long-term memory and less brain damage in old age – at least in rats!
  • Multi-vitamins taken daily in low doses help slow ageing in the brain. (Surprised you need them if you eat all the other stuff).

And what you should avoid:

  • Bad fats- trans fats and saturated fats. Buy low-fat products and cut down on the deep-fried stuff.
  • Iron and copper supplements as excesses can build up in your brain after age 50. Especially dangerous for post-menopausal women or adult males and especially if you have a diet high in saturated fats or trans fats.
  • Sugar apparently spurs the production of a toxin, beta-amyloid, which kills neurones.

Government science advisers have proposed that everyone over 60 should be tested for early signs of Alzheimer’s disease. There is no formal screening system in place at the moment.

The care services minister announced that trials will start in Yorkshire and Humberside (sourceSunday Times 1/5/11).

Barbara Shakian, Professor of clinical neuropsychology at Cambridge University, says: ” The absence of such a system costs the country billions of pounds in care costs and often leaves victims and the families looking after them in growing misery”.                

In the past it was thought there was little point in screening as there were no reliable tests and no treatments. With tests now available and with drugs such as cholinesterase inhibitors boosting brain function and reducing symptoms the situation has changed.

Care Homes
Something as simple as shuffling chairs around in care homes can have a positive impact on the behaviour of patients with dementia according to researchers at the University of Edinburgh (New Scientist 14/5/11).

The researcher Louise Richie found that chairs were often pushed against the walls in lounges giving the rooms “no real purpose”.

Forming small groups with the chairs or positioning them facing a window led to a 16% increase in active behaviours and smaller increase in social interaction.

For further information on Alzheimer’s disease click here