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Alzheimer's - Dementia, Author Interviews, Environmental Risks / 20.12.2019

MedicalResearch.com Interview with: Professor Esme Fuller-Thomson, PhD Director of the Institute for Life Course & Aging, Factor-Inwentash Faculty of Social Work Cross-appointed to the Faculty of Medicine University of Toronto Canada MedicalResearch.com: What is the background for this study? Response: Several studies from the US, Canada, and Europe suggest a promising downward trend in the incidence and prevalence of dementia. Important risk factors for dementia, such as mid-life obesity and mid-life diabetes, have been increasing rapidly, so the decline in dementia incidence is particularly perplexing. (more…)
Alzheimer's - Dementia, Author Interviews, Clots - Coagulation / 09.10.2019

MedicalResearch.com Interview with: Marta Cortes Canteli, PhD Miguel Servet Research Fellow Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) Madrid, Spain MedicalResearch.com: What is the background for this study? Response: Alzheimer´s disease is the most common form of dementia affecting more than 30 million people worldwide. Research in recent years has linked the disease to a reduction in the cerebral circulation; this results in an insufficient supply of nutrients and oxygen to brain cells, leading to their death. Alzheimer disease is also known to be linked to an underlying chronic prothrombotic state. The present study combined physiological and molecular analyses to demonstrate that long-term anticoagulation effectively slows disease progression in a transgenic mouse model of Alzheimer disease. (more…)
Alzheimer's - Dementia, Author Interviews, Mental Health Research / 08.10.2019

MedicalResearch.com Interview with: Marjaana Koponen, PhD Postdoctoral Researcher Kuopio Research Centre of Geriatric Care School of Pharmacy University of Eastern Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is known that antipsychotics are commonly used in the treatment of behavioral and psychological symptoms of dementia, although their use has been linked to serious adverse events. In this study, we found that community dwellers with Alzheimer’s disease who initiated antipsychotic use accumulated more hospital days than non-initiators. This may partially reflect adverse effects and events of antipsychotic use. On the other hand, antipsychotic users accumulated more hospital days due to dementia, mental and behavioral disorders and their caregivers’ days off. Thus, another reason for a higher accumulation of hospital days is care burden and the difficulties in treating the most severe behavioral and psychological symptoms of dementia. (more…)
Alcohol, Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Cognitive Issues / 30.09.2019

MedicalResearch.com Interview with: Manja Koch Dr. oec. troph. (Ph.D. equivalent) Research Associate Department of Nutrition Harvard T.H. Chan School of Public Health Majken K. Jensen, PhD Associate Professor of Nutrition Harvard T.H. Chan School of Public HealthMajken K. Jensen, PhD Associate Professor of Nutrition Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Alzheimer’s disease and other dementias are highly prevalent conditions. According to the Alzheimer’s Association, 50 million people are currently living with Alzheimer’s disease or other dementias worldwide. Given the lack of a cure or even disease-modifying therapies for most dementias, the identification of risk factors or factors that prevent or delay the onset of dementia remains of paramount concern. Alcohol is a globally consumed beverage and light-to-moderate alcohol consumption, defined as up to one drink per day for women and up to two drinks per day for men, tends to be associated with lower risk of cardiovascular disease, a major risk factor for dementia. However, the effects of light-to-moderate alcohol intake on the brain are less clear.  (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Duke, Neurology / 24.09.2019

MedicalResearch.com Interview with: Juan Helen Zhou, PhD, on behalf of the co-authors Associate Professor and Principal Investigator Neuroscience and Behavioural Disorders (NBD) Programme Duke-NUS Medical School, SingaporeJuan Helen Zhou, PhD, on behalf of the co-authors Associate Professor and Principal Investigator Neuroscience and Behavioural Disorders (NBD) Programme Duke-NUS Medical School, Singapore  MedicalResearch.com: What is the background for this study? Response: Alzheimer’s disease and cerebrovascular disease are among the leading disorders affecting the elderly, with up to 50 per cent of dementia patients showing co-occurrence of both disorders. It is therefore of great interest to understand the influence of co-occurring Alzheimer’s disease and cerebrovascular disease pathologies on brain changes, and examine if such changes are able to track early differential disease progression. Past cross-sectional studies have suggested that Alzheimer's disease and cerebrovascular disease pathologies contribute independently to brain functional and structural changes, and cognitive decline. Our study sought to demonstrate the independent contributions of both pathologies to brain functional networks in a longitudinal cohort of mild cognitive impairment patients, often regarded as early stage of the disease. (more…)
Alzheimer's - Dementia, Author Interviews, Memory, Pharmacology / 12.09.2019

MedicalResearch.com Interview with: James O’Donnell, PhD Dean and professor Pharmacy and Pharmaceutical Sciences University at Buffalo School of Pharmacy Ying Xu, MD, PhD Research associate professor University at Buffalo School of Pharmacy and Pharmaceutical SciencesYing Xu, MD, PhD Research associate professor University at Buffalo School of Pharmacy and Pharmaceutical Sciences     MedicalResearch.com: What is the background for this study? Response: We have been studying cyclic nucleotide phosphodiesterase (PDE), an enzyme, for quite a while as a potential target for neuropsychiatric disease.  One aspect involves the effects of PDE inhibitors on memory.  This was prompted by our earlier finding that one form of the enzyme, PDE4, is in the NMDA receptor signaling pathway in neurons; this pathway has been implicated in memory.  (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Mental Health Research, Sleep Disorders / 23.08.2019

MedicalResearch.com Interview with: Chenlu Gao, MA Graduate Student Department of Psychology and Neuroscience Baylor University Michael Scullin, PhD Assistant Professor Department of Psychology and Neuroscience Baylor University  MedicalResearch.com: What is the background for this study? Response: According to the World Alzheimer Report, dementia affects 50 million adults worldwide, and this number is expected to approach 131 million by 2050. Dementia patients often require assistance with daily activities from caregivers. The Alzheimer’s Association reported that, in the United States, 16 million caregivers spend on average 21.9 hours per week providing care for patients with dementia. Being a caregiver is stressful, which not only challenges emotional, cognitive, and physical health, but is also associated with shorter and poorer sleep at night. If a caregiver cannot obtain restorative sleep at night, their quality of life and their abilities to perform the caregiving role can be compromised. For example, sleep loss may jeopardize caregivers’ memory, causing them to forget medications or medical appointments for the patients. Sleep loss can also impair immune functions, causing the caregivers to suffer from illnesses. In the long-term, sleep loss is associated with cortical thinning and accumulation of beta-amyloid and tau, which increase the risks of dementia. Undoubtedly, there is a need to systematically study whether caregivers sleep less or worse during the night and whether we can improve their sleep quality through low-cost behavioral interventions. To answer these questions, we systematically reviewed and meta-analyzed 35 studies with data from 3,268 caregivers of dementia patients.     (more…)
Alzheimer's - Dementia, Author Interviews, Genetic Research, Memory / 23.08.2019

MedicalResearch.com Interview with: Dr. Claude Alain PhD Senior Scientist Baycrest's Rotman Research Institute  MedicalResearch.com: What is the background for this study? Response: Adults carrying a gene associated with a higher risk of Alzheimer’s disease had a harder time accessing recently acquired knowledge, even though they didn’t show any symptoms of memory problems.  MedicalResearch.com: What are the main findings?  Response: Researchers found that older adults carrying a specific strain of the gene, apolipoprotein E4, otherwise known as APOE4, weren’t able to tap into information they had just learned to assist them on a listening test. These findings suggest greater difficulty for these individuals to access knowledge from their memory to guide their attention in ways that would have improved their performance. This work could lead to the development of new ways to detect individuals at risk. (more…)
Alzheimer's - Dementia, Author Interviews, Genetic Research / 31.07.2019

MedicalResearch.com Interview with: Dr. Amy Dunn, PhD Kaczorowski lab The Jackson Laboratory  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Environmental factors, such as a poor diet, are known risk factors for Alzheimer’s disease. But the mechanisms are complex, and it is not known how such environmental perturbations interact with individual genetic variation to confer disease risk. Previous studies have not adequately addressed how the combination of genetic variant and environmental factors combine to alter cognitive response to a poor diet. To investigate gene-by-environment interactions, we fed either a normal diet or a high-fat diet to a genetically diverse Alzheimer’s disease mouse model population starting at six months of age and monitored metabolic and cognitive function. We observed accelerated working memory decline in the mice on the high-fat diet after eight weeks, with substantial gene-by diet effects on both cognitive and metabolic traits. Metabolic dysfunction was more closely related to cognitive function in mice carrying Alzheimer’s mutations than in those without. Interestingly, the high-fat diet affected metabolic function differently in female versus male mice.  (more…)
ALS, Alzheimer's - Dementia, Author Interviews, Biomarkers, JAMA, Multiple Sclerosis / 27.06.2019

MedicalResearch.com Interview with: Charlotte E. Teunissen, PhD Neurochemistry Laboratory, Department of Clinical Chemistry VU University Medical Centre, Neuroscience Campus Amsterdam Amsterdam, the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several reports have shown increased in NfL in various neurological disorders, separately. We wanted to know how the levels are in these disorders relative to each other. Moreover, some reports showed absence of age effects in Multiple Sclerosis (MS) patients, which is normally present in controls. So, we thought that it would be good to study age effects in a large group of controls, and if these effects are absent in other diseases, similarly as in MS. (more…)
Alzheimer's - Dementia, Author Interviews, Sleep Disorders / 21.06.2019

sleep-alzheimers-dementia-insomniaSleep patterns can predict the increase of Alzheimer’s pathology proteins tau and β-amyloid later in life, according to a June 2019 study published in the Journal of Neuroscience. The findings shed hope on earlier diagnosis of Alzheimer’s and the adoption of preventive measures earlier in life. Researchers found a decrease in sleep spindle synchronization, which is linked to higher tau levels. Reduced amplitude of slow wave activity, meanwhile, is closely related to higher β-amyloid levels. In younger people, both slow oscillations and sleep spindles are synchronized. This changes as people grow older, with less coordination between the two being visible. The researchers also noted that subjects who slept less had a higher chance of having Alzheimer’s proteins when they were older. The findings show that both reduced sleep quantity and quality can serve as important warnings of the onset of Alzheimer’s. (more…)
Alzheimer's - Dementia, Author Interviews, Biomarkers, Neurological Disorders, Neurology, University of Pennsylvania / 08.05.2019

MedicalResearch.com Interview with: Lauren McCollum, MDCognitive and Behavioral Neurology FellowPenn Memory Center / Cognitive Neurology DivisionLauren McCollum, MD Cognitive and Behavioral Neurology Fellow Penn Memory Center / Cognitive Neurology Division MedicalResearch.com: What is the background for this study?   Response: Alzheimer’s Disease (AD) is a heterogenous condition, with considerable variability in cognitive symptoms and progression rates. One major reason for this heterogeneity is “mixed pathology,” – i.e., both AD- and non-AD pathology. Examples of non-AD pathology include cerebrovascular disease (CVD), Lewy Bodies, and TDP-43. Pathologically, Alzheimer’s Disease is defined by characteristic amyloid plaques and neurofibrillary tangles, which can be assessed for in living patients with CSF- or PET-based biomarkers for amyloid and tau, respectively. Classically, amyloid deposition begins years or even decades before pathologic tau accumulation, which is in turn associated with brain atrophy and cognitive decline. The recently developed NIA-AA “ATN” research framework allows for the classification of individuals with regard to 3 binary biomarkers: Amyloid (A), Tau (T), and Neurodegeneration (N). An individual’s ATN biomarker status indicates where along the “Alzheimer’s Disease continuum” they lie. Additionally, some ATN statuses are on the “typical AD” continuum, while others are not. Research has shown that 15-30% of cognitively normal older adults have elevated amyloid. It stands to reason that some portion of cognitively impaired individuals with elevated amyloid and neurodegeneration have something other than AD driving their neuronal injury. Within the context of the ATN research framework, this subset of people is the A+T-N+ group (i.e., people who have elevated amyloid and neurodegeneration, but are tau-negative), as amyloid alone (that is, amyloid without tau) is not thought to cause significant cognitive impairment or brain atrophy. Our hypothesis was that, compared to A+T+N+ (a set of typical-AD biomarkers), A+T-N+ have cognitive and neuroimaging profiles that deviate from a typical Alzheimer’s Disease pattern – i.e., with less memory loss and less atrophy in AD-signature regions – and may have biomarkers suggestive of alternate non-AD pathologies [e.g., white matter hyperintensities (WMHs), a marker of CVD]. (more…)
Alzheimer's - Dementia, Author Interviews, End of Life Care, JAMA, University of Pennsylvania / 30.04.2019

MedicalResearch.com Interview with: Emily Largent, PhD, JD, RN Assistant Professor, Medical Ethics and Health Policy Perelman School of Medicine Leonard Davis Institute of Health Economics University of Pennsylvania  MedicalResearch.com: What is the background for this study? What are the main findings?  Response:  Public support for aid in dying in the United States is rapidly growing.  As a result, we’re now seeing debates about whether to expand access to aid-in-dying to new populations – such as people with Alzheimer’s disease – who wouldn’t be eligible under current laws. With those debates in mind, we asked currently healthy people who recently learned about their risk for developing Alzheimer’s disease dementia (i.e., due to the presence of amyloid, an Alzheimer’s disease biomarker) whether they would be interested in aid-in-dying. Our findings suggest that about 20% of individuals with elevated amyloid may be interested in aid-in-dying if they become cognitively impaired.   (more…)
Alzheimer's - Dementia, Author Interviews, Merck, NEJM / 10.04.2019

MedicalResearch.com Interview with: Michael F. Egan, MDVice President,  NeuroscienceGlobal Clinical DevelopmentMerck Research LaboratoriesNorth Wales, PAMichael F. Egan, MD Vice President,  Neuroscience Global Clinical Development Merck Research Laboratories North Wales, PA  MedicalResearch.com: What is the background for this study?   Response: Alzheimer’s disease (AD) appears to be due to the gradual accumulation of amyloid over many years (the “amyloid hypothesis”). At some point, it is thought that amyloid triggers abnormalities in tau, which then forms deposits within neurons and leads to progressive neurodegeneration. Amyloid is made up of  a small, sticky peptide, Abeta, which is produced when the enzyme BACE cleaves a large protein called APP.  In our trial, we tested whether a potent BACE inhibitor, verubecestat, could slow disease progression in subjects with early AD (or prodromal AD) by blocking formation of Abeta.  A previous trial in subjects with dementia due to AD failed to find evidence of efficacy. One possible reason for this failure is that subjects had too much amyloid in their brain already. (more…)
Accidents & Violence, Alzheimer's - Dementia, Author Interviews, JAMA, Mental Health Research / 28.03.2019

MedicalResearch.com Interview with: Madeleine Liljegren, MD Division of Oncology and Pathology Department of Clinical Sciences Lund University Lund, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know from former studies including patients with a clinical diagnosis of dementia, that criminal and socially inappropriate behaviors can be signs of dementia, sometimes even the first signs of a neurodegenerative disorder. We wanted to study this relatively large (n=220) cohort of neuropathologically verified Alzheimer disease (AD) and frontotemporal dementia (FTD) patients, who had been followed clinically by specialists in cognitive medicine or geriatric psychiatry during their disease period, to see if we could confirm results from previous studies. In this paper, we further wanted to study potential differences regarding protein pathology and criminal behavior in frontotemporal dementia patients. This has, to our knowledge, never been done before. (more…)
Alzheimer's - Dementia, Author Interviews, BMJ, Hormone Therapy / 07.03.2019

MedicalResearch.com Interview with: Tomi Mikkola MD Associate Professor Helsinki University Hospital Department of Obstetrics and Gynecology Helsinki, Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: In Finland we have perhaps the most comprehensive and reliable medical registers in the world. Thus, with my research group I have conducted various large studies evaluating association of postmenopausal hormone therapy use and various major diseases (see e.g. the references in the B;MJ paper). There has been various smaller studies indicating that hormone therapy might be protective for all kinds of dementias, also Alzheimer’s disease. However, we have quite recently shown that hormone therapy seems to lower the mortality risk of vascular dementia but not Alzheimer’s disease (Mikkola TS et al. J Clin Endocrinol Metab 2017;102:870-7). Now in this upcoming BMJ-paper we report in a very large case-control study (83 688 women with Alzheimer’s disease and same number of control women without the disease) that systemic hormone therapy was associated with a 9-17% increased risk of Alzheimer’s disease. Furthermore, this risk increase is particularly in women using hormone therapy long, for more than 10 years. This was somewhat surprising finding, but it underlines the fact that mechanisms behind Alzheimer’s disease are likely quite different than in vascular dementia, where the risk factors are similar as in cardiovascular disease. We have also shown how hormone therapy protects against cardiovascular disease, particularly in women who initiate hormone therapy soon after menopause. (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Pharmacology, University of Pittsburgh / 01.03.2019

MedicalResearch.com Interview with: Alvaro San-Juan-Rodriguez, PharmD Pharmacoeconomics, Outcomes and Pharmacoanalytics Research Fellow Pharmacy and Therapeutics School of Pharmacy University of Pittsburgh MedicalResearch.com: What are the main findings? Response: Currently, there are 4 antidementia drugs approved by the FDA for the treatment of Alzheimer’s disease, including 3 acetylcholinesterase inhibitors (AChEIs)—donepezil, rivastigmine, and galantamine—and the N-methyl-D-aspartic receptor antagonist memantine. On the one hand, evidence about the effect of these drugs at delaying nursing home admission is still sparse and conflicting. On the other, all these antidementia medications have been associated with several cardiovascular side effects, such as bradycardia, ventricular tachycardia, syncope, QT interval prolongation, atrioventricular block or even myocardial infarction. In this study, we aimed to compare time to nursing home admission and time to cardiovascular side effects across all drug therapies available for the treatment of Alzheimer’s disease. In doing so, we used 2006-2014 medical and pharmacy claims data from Medicare Part D beneficiaries with a new diagnosis Alzheimer’s disease who initiated antidementia drug therapy. (more…)
Alzheimer's - Dementia, Author Interviews / 27.01.2019

MedicalResearch.com Interview with: Dr. Paul Harch MD Clinical Professor and Director of Hyperbaric Medicine LSU Health New Orleans School of Medicine MedicalResearch.com: What is the background for this study? Response: The background is a 30 year clinical experience and investigation in which I explored the effects of low-pressure hyperbaric oxygen therapy (HBOT) on acute, subacute, and chronic neurological conditions. Beginning with brain-injured Louisiana boxers and commercial divers in the late 1980s I attempted to see if patients with central nervous system disorders could respond to a lower dosing of the drug hyperbaric oxygen therapy than was traditionally used for other wound conditions like diabetic foot wounds, radiation wounds, and decompression sickness (the "bends").  I was successful with the very first cases after which I expanded this treatment to nearly 90 neurological conditions.  The very first patient was a boxer 23 years after his last bout who was formally diagnosed with dementia pugulistica (dementia from boxing). Since that time I have treated over 100 patients with cognitive decline or dementia, including 11 Alzheimer's cases.  Nearly all of the Alzheimer's and other dementia cases were documented with high-resolution brain blood flow imaging (SPECT).  The present case report was the first Alzheimer's case that I was able to document with PET metabolic imaging. (more…)
Alzheimer's - Dementia, Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, JAMA / 25.01.2019

MedicalResearch.com Interview with: Jeff D. Williamson, MD Geriatric Medicine - Sticht Center Wake Forest Baptist Medical Center MedicalResearch.com: What is the background for this study? Response: A growing amount of epidemiologic research has suggested that higher blood pressure is associated with higher risk for dementia, including Alzheimer’s dementia. MedicalResearch.com: What are the main findings? Response: More than 9,300 ambulatory, community dwelling persons over age 50, 30% of whom were over the age of 75, were randomly assigned to a blood pressure goal of 120 vs 140.  Persons in the 120 group had a 19% lower risk for developing MCI an transitional stage between normal and dementia (P<.008).  There was a 17% lower risk for developing dementia but this only achieved a p value = 0.10.  The combined risk for both MCI and dementia was 15% lower in the 120 group (p<0.04).  The dementia outcome was the primary outcome but all the outcomes were pre-specified in the protocol at the beginning of the trial.  Unfortunately the blood pressure intervention was stopped after only 3.3 years due to CVD and mortality benefit and this may well have influenced the ability to reach the expected number of dementia cases.  (more…)
Alzheimer's - Dementia, Author Interviews, Science, Sleep Disorders / 13.01.2019

MedicalResearch.com Interview with: Brendan P. Lucey, MD, MSCI Assistant Professor of Neurology Director, Sleep Medicine Section Washington University School of Medicine Saint Louis, Missouri 63110 MedicalResearch.com: What is the background for this study? Response: Alzheimer’s disease and sleep are currently thought to have a two-way or bidirectional relationship. First, sleep disturbances may increase the risk of developing AD. Second, changes in sleep-wake activity may be due to Alzheimer’s disease pathology and our paper was primarily focused on this aspect of the relationship.    If sleep changes were a marker for AD changes in the brain, then this would be very helpful in future clinical trials and possibly screening in the clinic. (more…)
Alzheimer's - Dementia, Author Interviews, Cost of Health Care, JAMA / 27.12.2018

MedicalResearch.com Interview with: Lee A. Jennings, MD, MSHS Assistant Professor of Medicine Director, Oklahoma Healthy Aging Initiative Reynolds Department of Geriatric Medicine University of Oklahoma Health Sciences Center Oklahoma City, OK 73117 MedicalResearch.com: What is the background for this study? Response: The research study focused on a novel model of care for persons living with Alzheimer’s disease and other types of dementia, the UCLA Alzheimer’s and Dementia Care Program. In the program, people with dementia and their caregivers meet with a nurse practitioner specializing in dementia care for a 90-minute in-person assessment and then receive a personalized dementia care plan that addresses the medical, mental health and social needs of both people. The nurse practitioners work collaboratively with the patient’s primary care provider and specialist physicians to implement the care plan, including adjustments as needs change over time. The research was designed to evaluate the costs of administering the program, as well as the health care services used by program participants, including hospitalizations, emergency room visits, hospital readmissions and long-term nursing home placement. A total of 1,083 Medicare beneficiaries with dementia were enrolled in the program and were followed for three years. The study compared them to a similar group of patients living in the same ZIP codes who did not participate in the program. (more…)
Alzheimer's - Dementia, Author Interviews, MRI / 29.11.2018

MedicalResearch.com Interview with: Cyrus A. Raji, MD PhD Asst Prof of Radiology, Mallinckrodt Institute of Radiology Neuroradiology Faculty and the Neuoimaging Laboratories Washington University School of Medicine St. Louis MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Alzheimer's disease is the most common cause of dementia and every patient suspected of having this disorder receives an MRI scan of the brain. MRI scans of the brain in dementia are currently limited to evaluating for structural lesions that could be leading to memory loss such as stroke or tumor. What this study sought to accomplish was to determine if a newer type of MRI scan called diffusion tensor imaging (DTI) can predict who will experience cognitive decline and dementia. We found that DTI can predict persons who will demented 2.6 years before the earliest onset of symptoms. This study was done in 61 individuals, 30 converters and 31 non-converters, from the Alzheimer's Disease Neuroimaging Initiative and we found that DTI metrics could predict dementia 2.6 years later with 89-95% accuracy. (more…)
Alzheimer's - Dementia, Author Interviews, CMAJ, Pharmacology / 26.11.2018

MedicalResearch.com Interview with: Jennifer Watt, PhD Clinical Epidemiology and Health Care Research Institute of Health Policy, Management, and Evaluation University of Toronto MedicalResearch.com: What is the background for this study?   Response: Behavioral and psychological symptoms of dementia (e.g. aggression, agitation) are common among persons living with dementia. Pharmacological (e.g. antipsychotics) and non-pharmacological (e.g. reminiscence therapy) interventions are often used to alleviate these symptoms. However, antipsychotics are associated with significant harm among older adults with dementia (e.g. death, stroke). Regulatory agencies such as the Food and Drug Administration (FDA) and Health Canada issued black box warnings to advise patients and clinicians of this potential for harm. And initiatives were championed to decrease the use of antipsychotics in persons living with dementia. In response, we have seen a rise in the use of other pharmacological interventions, such as trazodone (an antidepressant). Its potential to cause harm in older adults with dementia is largely unknown. (more…)
Alzheimer's - Dementia, Author Interviews, JAMA / 19.11.2018

MedicalResearch.com Interview with: "A neonate with Down's?" by Sadasiv Swain is licensed under CC BY 2.0Rosalyn Hithersay LonDowns Kings College, London  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In our research group, we have been following a large group of adults with Down syndrome in the UK to track changes with ageing in their health and cognitive function. It has been known for some time now that people with Down syndrome are at high risk for developing dementia due to Alzheimer’s disease. This new study has shown the huge impact that this risk has on mortality for these adults. We found that dementia is now the likely underlying cause of death in more than 70% of adults with Down syndrome aged over 35 years. This is a much bigger proportion of deaths due to Alzheimer’s disease compared to the general population: in England and Wales only 17.5% of deaths past the age of 65 would be related to dementia of any kind.  (more…)
Alzheimer's - Dementia, Author Interviews, Coffee, Parkinson's / 14.11.2018

MedicalResearch.com Interview with: Donald Weaver, PhD, MD, FRCPC, FCAHS Senior Scientist and Director, Research Institute Krembil Research Institute University Health Network Toronto, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: First, we are seeking novel molecules that might have usefulness in the treatment of Alzheimer’s disease (AD). Since Mother Nature is a superb chemist, natural products are an ideal place to start looking for possible therapeutics. There is a long history (penicillin, digitalis …) of drugs identified from natural product sources. Moreover, in earlier work by us, we have shown that other natural products extracted from maple syrup have possible therapeutic efficacy against AD. Therefore, it was logical for us to look at extracts of coffee. We see similarities between maple syrup and coffee. In both of these natural products, the plant derived material (i.e. the coffee bean, or sap from maple syrup) is initially boiled or roasted prior to its use; thus, it is not a direct simple plant product, but one that has been heated (boiled or roasted). We suspect that the heating process “does more chemistry” enabling the generation of new molecules from the plant derived materials. In our study we show that a class of compounds (phenylindanes) from roasted coffee has the ability to inhibit the misfolding of two proteins (beta-amyloid, tau) whose misfolding and aggregation (“clumping”) is implicated in the disease process of AD. Second, as described below, there is already epidemiological evidence that coffee consumption may offer some protective effects against Alzheimer’s disease and Parkinson’s disease (PD), so by looking at the constituents of coffee for chemicals that might block the clumping of beta-amyloid and/or tau, was an attempt to seek a molecular link explaining the epidemiology. (more…)
Alzheimer's - Dementia, Author Interviews, University of Pittsburgh / 18.10.2018

MedicalResearch.com Interview with: Rachel H. Mackey, PhD, MPH, FAHA Assistant Professor of Epidemiology Graduate School of Public Health University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: “Hardening,” or stiffening, of the arteries is a risk factor for heart attacks and other cardiovascular disease. Arterial stiffness can be measured by pulse wave velocity (PWV), because the pulse pressure wave travels faster in stiffer arteries. Stiffer arteries transmit increased pulsatile blood flow to the brain and are linked with markers of silent, or subclinical, brain disease, which are related to increased risk of dementia. However, it was not clear whether arterial stiffening would predict risk of dementia, especially in older adults, who often have existing subclinical brain disease. Therefore, a University of Pittsburgh team, led by Chendi Cui, M.S, doctoral student, and Rachel Mackey, PhD, MPH, FAHA, assistant professor of epidemiology at Pitt Public Health, analyzed the association between arterial stiffness and 15-year risk of dementia among 356 older adults, with an average age of 78. Study participants were part of the Cardiovascular Health Study Cognition Study (CHS‐CS), a long‐term study to identify dementia risk factors, led by coauthors Oscar Lopez MD and Lewis Kuller, MD, DrPH. In 1996-2000, study participants had had arterial stiffness measured by pulse wave velocity (PWV), brain imaging by MRI, and had annual follow-up visits for cognitive status. (more…)
Alzheimer's - Dementia, Author Interviews, Critical Care - Intensive Care - ICUs, Geriatrics, Inflammation, Johns Hopkins / 11.10.2018

MedicalResearch.com Interview with: Keenan Walker, PhD Johns Hopkins University School of Medicine Baltimore MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study was conducted in response to anecdotal accounts and scientific evidence which suggests that major medical conditions, such as critical illness and severe infections, can have a long-term neurological effect on some individuals. There are quite a few studies to date which have found that critical illnesses, such as severe sepsis, are associated with long-term cognitive impairment. Based on this evidence, we wanted to figure out to what degree critical illness and major infection may affect later brain structure and to determine whether the structural changes associated with these events were similar to those observed in Alzheimer’s disease. Our main finding was that individuals who had one or more critical illness or major infection major infection during the decades leading up to older adulthood were more likely to have smaller brain volumes in brain regions most vulnerable to Alzheimer's disease. (more…)
Alzheimer's - Dementia, Author Interviews / 20.09.2018

MedicalResearch.com Interview with: Dr Christina Elliott PhD Postdoctoral Researcher Department of Old Age Psychiatry King’s College London MedicalResearch.com: What is the background for this study? Response: Amyloid-beta (Aβ) and its precursor protein, APP have been long implicated in pathogenesis of Alzheimer’s Disease but how they contribute to disease is not fully understood.  This has been further compounded by numerous failed clinical trials which attempted to target Aβ therapeutically. In Alzheimer’s Disease there is an overproduction of Aβ, which can disrupt how neurons communicate at structures called synapses.  It is thought that progressive synapse loss underpins cognitive impairments commonly seen in Alzheimer Disease patients such as memory loss. Our previous work highlighted a central role of the signalling pathway Wnt signalling in Aβ mediated synapse loss through the induction of dickkopf-1 (Dkk1), a well-known modulator of Wnt signalling. The aim of this study was to further investigate the molecular mechanisms of Aβ mediated synapse loss and explore whether this is connected to the overproduction of Aβ.  By dissecting out the key signalling events involved we hoped this would allow us to identify drugs which could be putative therapeutics for Alzheimer’ Disease.   (more…)
Alzheimer's - Dementia, Author Interviews, CT Scanning, JAMA, Medical Imaging / 20.09.2018

MedicalResearch.com Interview with: PET scanner Wikipedia imageRik Ossenkoppele -PhD Lund University & VU University Medical Center Oskar Hansson - Lund University MedicalResearch.com: What is the background for this study? What are the main findings? Response: [18F]flortaucipir is a relatively novel PET tracer that can be used to detect tau pathology in the living human brain. Previous studies have shown a robust signal in patients with Alzheimer’s disease, but in patients with other types of dementia the signal was more variable. We aimed to assess the ability of [18F]flortaucipir PET to distinguish Alzheimer’s disease from other neurodegenerative disease in more than 700 study participants. T he main finding was that [18F]flortaucipir discriminated Alzheimer’s disease patients from patients with other neurodegenerative diseases with high accuracy. Furthermore, [18F]flortaucipir PET outperformed established MRI markers and showed higher specificity than amyloid-β PET.  (more…)
Alzheimer's - Dementia, Author Interviews / 12.09.2018

MedicalResearch.com Interview with: Elena LeychenkoElena Leychenko is a senior research associate at PIBOC (G.B. Elyakov Pacific Institute of Bioorganic Chemistry which is the Far Eastern Branch of the Russian Academy of Sciences), assistant professor, and lecturer at the chair of bioorganic chemistry and biotechnology of the School of Natural Sciences Far Eastern Federal University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Sea anemones are the main object for study in the laboratory for peptide chemistry of PIBOC. These marine dwellers are very interesting for scientists because of a wide range of biologically active compounds, which are the main components of their venom. The development of modern research methods allows us to receive both major and minor components of that poison, and to study their medical properties. Interestingly, inhibitors of Kunitz-type proteinases, which are also content in sea anemones, can be used as anti-inflammatory compounds. In particular, in complex therapy, it could be applied in the treatment of Alzheimer's disease.  (more…)