Criminal and Socially Inappropriate Behaviors Could Be Signs of Dementia

MedicalResearch.com Interview with:

Dr. Madeleine Liljegren

Dr. Madeleine Liljegren
Photo: Ingemar Walldén

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.

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Gene Linked To Decreased Plasma Amyloid and Lower Alzheimer’s Disease Risk

MedicalResearch.com Interview with:

Mikko Hiltunen, PhD Professor of Tissue and Cell Biology University of Eastern Finland School of Medicine, Institute of Biomedicine Kuopio,  Finland

Dr. Hiltunen

Mikko Hiltunen, PhD
Professor of Tissue and Cell Biology
University of Eastern Finland
School of Medicine, Institute of Biomedicine
Kuopio,  Finland 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response:  We wanted to assess among the population-based METSIM (METabolic Syndrome In Men) cohort whether protective variant in APP gene (APP A673T) affects the beta-amyloid levels in plasma. The rationale behind this was that previous genetic studies have discovered that the APP A673T variant decreases the risk of having Alzheimer’s disease (AD).

However, the protective functional outcome measures related to this variant were lacking and thus we anticipated that the elucidation of plasma samples in terms of beta-amyloid levels would provide the much needed link between APP A673T variant and potential protective functions.

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Lupron May Preserve Some Cognitive Function in Women With Alzheimer’s Disease

MedicalResearch.com Interview with:
Craig S. Atwood
Associate Professor, University of Wisconsin
Madison, WI

Richard L. Bowen, M.D.
Private Practice, Charleston, SC

Medical Research: What is the background for this study?

Response: Currently, there is no treatment for Alzheimer’s disease that halts or slows its progression. Alzheimer’s disease is a neurodegenerative disorder resulting in memory loss and impairments of behavioral, language and visuo-spatial skills. A growing body of biological, preclinical and epidemiological data suggests that the age-related changes in hormones of the hypothalamic-pituitary-gonadal (HPG) axis are a major etiological factor in Alzheimer disease. The changes in these hormones include not only the decline in the sex steroids, (i.e. 17-estradiol and testosterone), but the elevations in gonadotropin-releasing hormone and luteinizing hormone. In particular there are encouraging epidemiological studies involving the use of Lupron Depot which suppresses these hormones. In one such study which included hundreds of thousands of patients it was found that men who had prostate disease and were treated with Lupron Depot had a 34 to 55 percent decreased risk of developing Alzheimer’s disease compared with prostate-cancer patients who didn’t receive the drug.

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Decreased Cancer Mortality In Patients With Faster Cognitive Decline

Julian Benito-Leon Avda. De la Constituci Coslada, Madrid, Spain.MedicalResearch.com Interview with:
Julian Benito-Leon
University Hospital “12 de Octubre”,
Madrid, Spain

 

MedicalResearch.com: What are the main findings of the study?

Dr. Benito-León: It has been suggested that a major problem with epidemiologic studies that have reported an inverse association between Alzheimer’s disease and cancer is the very likely underdiagnosis of cancer once dementia has been diagnosed. The results of the current study suggest that elderly people without dementia with faster cognitive decline are at reduced risk of mortality from malignant neoplasm. Indeed, the current study GIVES CREDIBILITY TO the inverse association of both conditions, recognized in other studies, since there was no possibility of underdiagnosis of cancer because the subjects with a faster cognitive decline were nondemented,

Cognitively healthy elderly people who are experiencing subtle cognitive decline within the normal range may be undergoing a clinically silent pathologic cascade of brain changes, during this phase, with b-amyloid deposition as the primary event in this cascade. Neural cells may become vulnerable to cytotoxicity by amyloid-forming peptides, such as b-amyloid, which shares the same mechanism of toxicity with host defense peptides, components of innate immune response, whose mission is to eradicate a broad range of microbes and cancer cells.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Benito-León: No, they weren’t. In NEDICES (the population-based study we conducted) study we also demonstrated that Alzheimer’s disease decreased the risk of cancer mortality (please, see attached the paper). Therefore, after demonstrating that association, just next, I analyzed the current association (nondemented with faster cognitive decline and decreased risk of cancer mortality) in our dataset and found these results.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Benito-León: As I said previously, the current study GIVES CREDIBILITY TO the inverse association of Alzheimer’s disease and cancer. If we disentangle the mechanisms related to a decreased risk of cancer in Alzheimer’s disease, we could develop improved drugs to treat each one of the two conditions.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Benito-León: More studies are needed to try to determine the mechanisms behind this relationship between a disease that causes abnormal cell death and one that causes abnormal cell growth. With the increasing number of people with both dementia and cancer, understanding this association could help us better understand and treat both diseases.

Citation:

Faster cognitive decline in elders without dementia and decreased risk of cancer mortality: NEDICES StudyJournal of Alzheimer’s Disease 40 (2014) 465–473
DOI 10.3233/JAD-132048

 

 

Alzheimer Disease: Effect of Vitamin E on Slowing Functional Decline

Maurice Dysken, MD Professor, School of Medicine Department of Psychiatry Minneapolis VA Health Care System, Minneapolis, MinnesotaMedicalResearch.com Interview Invitation
Maurice Dysken, MD
Professor, School of Medicine
Department of Psychiatry
Minneapolis VA Health Care System,
Minneapolis, Minnesota

MedicalResearch.com: What are the main findings of the study?

Dr. Dysken: In patients with mild-to-moderate Alzheimer’s disease who were taking an acetylcholinesterase inhibitor, a dosage of 2000 IU/d of vitamin E significantly slowed functional decline compared to placebo by 6.2 months over the mean follow-up period of 2.27 years.  Over this period of time caregiver time increased least in the vitamin E group compared to the other three groups (memantine alone, vitamin E plus memantine, and placebo) although the only statistically significant difference was between vitamin E alone and memantine alone.  There were no significant safety concerns for vitamin E compared to placebo and mortality was lowest in the vitamin E alone group.  It should be noted that patients who were on warfarin were excluded from the study because of a possible interaction with vitamin E that could have possibly increased bleeding events.
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