treatment

Nutritional drink may help fight Alzheimer's

January, 2010
  • A clinical trial has found improvement in verbal (but not general) memory in patients with mild Alzheimer's who drank a nutritional cocktail for 12 weeks.

A European trial involving 225 patients with mild Alzheimer's has found that those who drank Souvenaid (a cocktail of uridine, choline and the omega-3 fatty acid DHA, plus B vitamins, phosopholipids and antioxidants) for 12 weeks were more likely to improve their performance in a delayed verbal recall task. 40% of the Souvenaid group showed improved performance compared to 24% of the placebo group. Those with the mildest cases of Alzheimer’s showed the most improvement. There was no improvement on the more general ADAS-cog test. Three further clinical trials, one in the U.S. and two in Europe, are now underway.

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Scheltens, P. et al. 2010. Efficacy of a medical food in mild Alzheimer's disease: A randomized, controlled trial. Alzheimer's & Dementia, 6 (1), 1-10.

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Rapamycin rescues memory in Alzheimer's mice

February, 2010

A mouse study found Rapamycin improved learning and memory and reduced Alzheimer's-like damage in the brain.

Rapamycin, a drug that keeps the immune system from attacking transplanted organs, was recently found to extend the life span of aged research mice. Now a study involving genetically engineered mice has found that 10 weeks of taking the drug improved learning and memory and reduced Alzheimer's-like damage in the brain.

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More evidence for benefits of Rapamycin

April, 2010

Another study using a different strain of genetically engineered mice has confirmed the finding that the transplant drug rapamycin prevented cognitive impairment.

A few months ago, I reported on an exciting finding that rapamycin, a drug currently used in transplant patients, improved memory in Alzheimer's mice. Now a different strain of mice (ones engineered to have defects in the genes that make amyloid precursor protein) has also shown improvements in learning and memory, correlated with less damage in brain tissue, after rapamycin treatment lowered levels of amyloid-beta-42. The mice given the drug performed at levels comparable with normal mice.

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New guideline on when people with Alzheimer's disease should stop driving

April, 2010

The American Academy of Neurology has updated its guidelines on when people with dementia should stop driving. The guidelines support caregivers’ instincts, but not use of the patient’s own self-rating.

The American Academy of Neurology has updated its guidelines on when people with dementia should stop driving. While the guidelines point out that this decision is a complex one that should be made by a doctor using the Clinical Dementia Rating scale, they also supported caregivers’ instincts, which have been found to often be correct. For caregivers and family members, the following warning signs are identified:

  • Decreased miles being driven
  • Collisions
  • Moving violations
  • Avoiding certain driving situations, such as driving at night or in the rain
  • Aggressive or impulsive personality traits

However, the patient’s own self-rating, and a lack of situational avoidance, are not regarded as useful evidence.

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Clinical trial shows intervention reduces brain atrophy in Alzheimer’s patients

April, 2010

The Phase II clinical trial of a treatment using naturally occurring antibodies has been successful in slowing (and in some cases preventing) the progression of the disease in patients with mild-to-moderate Alzheimer's. A much larger trial is now being carried out.

The Phase II clinical trial of a treatment using naturally occurring antibodies (IGIV) has achieved significantly lower rates of ventricular enlargement (6.7% vs 12.7% per year) and less whole-brain atrophy (1.6% vs 2.2% per year) than control subjects who initially received placebo. The trial ran for 18 months and involved 24 patients with mild to moderate Alzheimer's disease, of whom 16 received IGIV once or twice a month for the whole period, and 8 received a placebo for the first 6 months. Those who responded best to IGIV did not measurably decline over 18 months, and had an average rate of brain shrinkage and average rate of ventricular enlargement comparable to the rate previously reported in normal elderly individuals. Most tellingly, differences in rates were associated with dosage rates (there were four different regimens). A much larger trial is now being carried out.

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The results were presented April 13 at the American Academy of 62nd Annual Meeting in Toronto.

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Apple juice improves behavior in Alzheimer's patients

August, 2010

A pilot study found daily apple juice improved behavioral and psychotic symptoms in those with moderate-to-severe Alzheimer’s.

A pilot study involving 21 institutionalized individuals with moderate-to-severe Alzheimer’s found that, although drinking two 4-oz glasses of apple juice daily for a month produced no change in the Dementia Rating Scale or in the Activities of Daily Living measure, there was a significant (27%) improvement in behavioral and psychotic symptoms. The largest changes occurred in anxiety, agitation, and delusion.

Reference: 

[1630] Remington, R., Chan A., Lepore A., Kotlya E., & Shea T. B.
(2010).  Apple Juice Improved Behavioral But Not Cognitive Symptoms in Moderate-to-Late Stage Alzheimer’s Disease in an Open-Label Pilot Study.
American Journal of Alzheimer's Disease and Other Dementias. 367 - 371.

Full text is available free for a limited time at http://aja.sagepub.com/cgi/reprint/25/4/367.

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Common Alzheimer's medication helps skills necessary for safe driving

August, 2010

The most common type of Alzheimer's drugs (cholinesterase inhibitors) was associated with improved attention and driving skills in those with early stage Alzheimer's.

A study involving outpatients with early stage Alzheimer’s found that their performance on some computerized tests of executive function and visual attention, including a simulated driving task, improved significantly after three months of taking cholinesterase inhibitors. Specifically, the drug treatment was associated with an improved ability to accurately maintain lane position during the simulated driving task; to accurately and quickly detect a target in a visual search task; to more quickly complete computerized mazes.

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Animal studies indicate caffeine may slow dementia and cognitive decline but human studies less conclusive

July, 2010
  • Several recent studies and reviews suggest that the benefits of caffeine for age-related cognitive impairment and dementia are limited. It may be that the association only exists for women.

A special supplement in the Journal of Alzheimer's Disease focuses on the effects of caffeine on dementia and age-related cognitive decline. Here are the highlights:

A mouse study has found memory restoration and lower levels of amyloid-beta in Alzheimer’s mice following only 1-2 months of caffeine treatment. The researchers talk of “ a surprising ability of moderate caffeine intake to protect against or treat AD”, and define moderate intake as around 5 cups of coffee a day(!).

A review of studies into the relation between caffeine intake, diabetes, cognition and dementia, concludes that indications that coffee/caffeine consumption is associated with a decreased risk of Type 2 diabetes and possibly also with a decreased dementia risk, cannot yet be confirmed with any certainty.

A study involving 351 older adults without dementia found the association between caffeine intake and cognitive performance disappeared once socioeconomic status was taken into account.

A study involving 641 older adults found caffeine consumption was significantly associated with less cognitive decline for women only. Supporting this, white matter lesions were significantly fewer in women consuming more than 3 units of caffeine per day (after adjustment for age) than in women consuming less.

A Portuguese study involving 648 older adults found that caffeine intake was associated with a lower risk of cognitive decline in women, but not significantly in men.

A review of published studies examining the relation between caffeine intake and cognitive decline or dementia shows a trend towards a protective effect of caffeine, but because of the limited number of epidemiological studies, and the methodological differences between them, is unable to come up with a definitive conclusion.

A review of published epidemiological studies looking at the association between caffeine intake and Parkinson’s Disease confirms that higher caffeine intake is associated with a lower risk of developing Parkinson’s Disease (though this association may be stronger for men than women). Other studies provide evidence of caffeine’s potential in treatment, improving both the motor deficits and non-motor symptoms of Parkinson’s.

Reference: 

Arendash, G.W. & Cao, C. Caffeine and Coffee as Therapeutics Against Alzheimer’s Disease. Journal of Alzheimer's Disease, 20 (Supp 1), 117-126.
Biessels, G.J. Caffeine, Diabetes, Cognition, and Dementia. Journal of Alzheimer's Disease, 20 (Supp 1), 143-150.
Kyle, J., Fox, H.C. & Whalley, L.J. Caffeine, Cognition, and Socioeconomic Status. Journal of Alzheimer's Disease, 20 (Supp 1), 151-159.
Ritchie, K. et al. Caffeine, Cognitive Functioning, and White Matter Lesions in the Elderly: Establishing Causality from Epidemiological Evidence. Journal of Alzheimer's Disease, 20 (Supp 1), 161-161
Santos, C. et al. Caffeine Intake is Associated with a Lower Risk of Cognitive Decline: A Cohort Study from Portugal. Journal of Alzheimer's Disease, 20 (Supp 1), 175-185.
Santos, C. et al. Caffeine Intake and Dementia: Systematic Review and Meta-Analysis. Journal of Alzheimer's Disease, 20 (Supp 1), 187-204.
Costa, J. et al. Caffeine Exposure and the Risk of Parkinson’s Disease: A Systematic Review and Meta-Analysis of Observational Studies. Journal of Alzheimer's Disease, 20 (Supp 1), 221-238.
Prediger, R.D.S. Effects of Caffeine in Parkinson’s Disease: From Neuroprotection to the Management of Motor and Non-Motor Symptoms. Journal of Alzheimer's Disease, 20 (Supp 1), 205-220.

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Promise of drug therapy for age-related memory loss

July, 2010

Mouse studies suggest a way to reverse both normal age-related memory loss, and dementia.

Although research has so far been confined to mouse studies, researchers are optimistic about the promise of histone deacetylase inhibitors in reversing age-related memory loss — both normal decline, and the far more dramatic loss produced by Alzheimer’s. The latest study reveals that memory impairment in the aging mouse is associated with altered hippocampal chromatin plasticity, specifically with the failure of histone H4 lysine 12 acetylation, leading to a failure to initiate the gene expression program associated with memory consolidation. Restoring this acetylation leads to the recovery of cognitive abilities.

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