Alzheimer's - Dementia, Author Interviews, Race/Ethnic Diversity, UCSF / 20.04.2022

MedicalResearch.com Interview with: Erica Kornblith, PhD Assistant Professor, Psychiatry UCSF Weill Institute for Neurosciences MedicalResearch.com:  What is the background for this study?  What are the main findings?  Response: As the population of the United States grows more diverse and dementia is a serious public health concern, we hoped to understand whether differences in dementia risk exist based on race or ethnicity.  Older studies have shown that Black and Hispanic folks have higher risk of dementia, perhaps due to medical risk factors, diagnostic bias, lack of equal access to health care and education, or the health effects of racism, among other factors.  However, these older studies have been small or limited geographically or by only studying a few race and ethnicity groups. Our study used a nationwide sample of almost two million older Veterans who all had access to care through the Veterans Health Administration (VHA), and we examined 5 race or ethnicity groups: American Indians or Alaska Natives, Asians, Blacks, Hispanics, and Whites. Our results show that dementia risk is higher for Black and Hispanic Veterans compared to white Veterans, even when education and medical factors are considered. (more…)
Aging, Author Interviews, Geriatrics, PLoS, Social Issues / 17.03.2022

MedicalResearch.com Interview with: Dr. Holly Bennett PhD Research Associate Population Health Sciences Institute Campus for Ageing and Vitality Newcastle upon Tyne MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Life expectancy has been increasing over time and we want to ensure these are years in good health rather than increasing years in poor health. There has mainly been good news for those living with long term health conditions. With better treatment, prevention and care, the proportion of remaining years lived disability-free has increased for more recent generations. (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Ophthalmology / 06.12.2021

MedicalResearch.com Interview with: Cecilia S. Lee, MD, MS Associate Professor,Director, Clinical Research Department of Ophthalmology Harborview Medical Center University of Washington Seattle, WA MedicalResearch.com: What is the background for this study? Response: Cataract is a natural aging process of the eye and affects the majority of older adults who are at risk for dementia. Sensory loss, including vision and hearing, is of interest to the research community as a possible risk factor for dementia, and also as a potential point of intervention. Because cataract surgery improves visual function, we hypothesized that older people who undergo cataract surgery may have a decreased risk of developing Alzheimer disease and dementia. We used the longitudinal data from an ongoing, prospective, community based cohort, Adult Changes in Thought (ACT) study. The ACT study includes over 5000 participants to date who are dementia free at recruitment and followed until they develop Alzheimer disease or dementia. We had access to their extensive medical history including comprehensive ophthalmology visit data. We investigated whether cataract surgery was associated with a decreased risk of developing Alzheimer disease and dementia.  (more…)
Abuse and Neglect, BMJ, Cognitive Issues, Occupational Health / 24.08.2021

MedicalResearch.com Interview with: Prof Mika Kivimaki PhD Director, Whitehall II Study Dept. of Epidemiology University College London MedicalResearch.com: What is the background for this study? Response: The Lancet 2020 Commission on Dementia Prevention, which is the most comprehensive and up-to-date review on the evidence in this field, did not list cognitive stimulation in adulthood as a protective factor against dementia. This was because trials results are inconsistent and observational studies suggest that leisure time cognitive activity does not reduce risk of dementia. However, it was unclear whether the reason for modest findings is that the decrease in brain plasticity with age prevents cognitive activities across adult life from conferring protection against dementia, or, in the case of interventions, that the cognitive stimulation studied has not been intensive or engaging enough to preserve cognitive function. To address this question, we decided to focus on cognitive stimulation at work rather than leisure time cognitive activity or cognitive interventions. We thought that this approach would allow us to detect an effect, if there is one, because exposure to cognitive stimulation at work typically lasts considerably longer than cognitively stimulating hobbies or cognitive interventions. We contacted 13 cohort studies in Europe which had data on cognitive stimulation at work. Seven had also a dementia follow-up and were selected to our analyses, a total of 107 896 dementia-free participants from the UK, France, Sweden and Finland. Follow-up of incident dementia varied between 13.7 to 30.1 years depending on the cohort. 1143 people developed dementia during this follow-up. (more…)
Alzheimer's - Dementia, Author Interviews, Dermatology / 15.08.2021

MedicalResearch.com Interview with: Annakaisa Haapasalo, PhD Adjunct Professor Research Director (Associate Professor A.I. Virtanen Institute for Molecular Sciences Molecular Neurodegeneration University of Eastern Finland | UEF |   MedicalResearch.com: What is the background for this study? At what age might these changes be present? Response: Our research team is interested in understanding the underlying disease mechanisms and developing biomarkers for frontotemporal dementia (FTD). FTD is the second most common cause of dementia in the working age population. Presently, no efficient therapies exist for FTD, it is challenging to diagnose, and the disease mechanisms of different types of FTD remain largely unclear. We are especially interested in FTD associated with the C9orf72 repeat expansion because it is the most common genetic cause of frontotemporal dementia and exceptionally prevalent in Finnish FTD patients. Many current studies of FTD and C9orf72 repeat expansion have largely concentrated on examining neurons, as these are the principle CNS cells that are affected in neurodegeneration. Neurons are also one of our key research interests, but obtaining neurons directly from living patients is difficult in many ways. Therefore, we became interested in exploring the FTD patient skin fibroblasts with the idea in mind that they might represent more easily accessible patient-derived cells than neurons for trying to decipher disease mechanisms of FTD. Moreover, we were interested in finding out if these cells show any specific alterations or deficiencies that could be utilized later on in biomarker studies or testing drug effects.  (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Obstructive Sleep Apnea, Pulmonary Disease, University of Michigan / 16.04.2021

MedicalResearch.com Interview with: Galit Levi Dunietz  MPH, PhD Assistant Professor

Tiffany Braley, MD, MS Associate Professor

University of Michigan, Medical School Department of Neurology Department of Nutritional Sciences Ann Arbor, MI 48109-5845 MedicalResearch.com: What is the background for this study? Response: Dementia is a public health crisis that affects more than 6 million Americans.  As no treatments to effectively reverse dementia are currently available, interest has shifted toward modifiable risk factors for dementia, which may offer a critical window for prevention or intervention. Recent research suggests that obstructive sleep apnea (OSA) is a common, yet undiagnosed, risk factor for cognition impairment in older adults. However, few studies have examined whether treatment of OSA with positive airway pressure (PAP) therapy could protect those with OSA against developing dementia, says principal investigator, Dr. Tiffany Braley, MD, MS, Associate Professor of Neurology from the University of Michigan. To address this gap, Dr. Braley and Dr. Galit Levi Dunietz, PhD, MPH, Assistant Professor and sleep epidemiologist, examined associations between PAP therapy use and 3-year incidence of Alzheimer’s disease, mild cognitive impairment (MCI), or other forms of dementia (DNOS, “dementia not otherwise specified”). (more…)
Alzheimer's - Dementia, Author Interviews, Lipids, Mental Health Research, Microbiome / 18.11.2020

MedicalResearch.com Interview with: Moira Marizzoni, PhD Researcher, Fatebenefratelli Center in Brescia  MedicalResearch.com: What is the background for this study? Response: Alzheimer’s disease is the most common cause of dementia. Still incurable, it directly affects nearly one million people in Europe, and indirectly millions of family members as well as society as a whole. The gut microbiota could play a role in brain diseases including Alzheimer’s disease. Some gut bacteria components or products can reach the brain via the blood and might promote brain amyloidosis (one of the main pathological features in Alzheimer’s disease).   MedicalResearch.com: What are the main findings?  Response: This study evaluated a cohort of 89 people between 65 and 85 years of age composed of subjects suffering from Alzheimer’s disease or other neurodegenerative diseases causing similar memory problems, and of subjects with no memory problems. The study revealed that elevated levels of microbiota-products with known pro-inflammatory properties (i.e. lipopolysaccharides and the short chain fatty acids acetate and valerate) were associated with greater cerebral amyloid pathology while elevated levels of those with anti-inflammatory properties (i.e. the short chain fatty acid butyrate) were associated with lower amyloid pathology. (more…)
Alzheimer's - Dementia, Author Interviews, Blood Pressure - Hypertension, Neurology, UCSF / 10.08.2020

MedicalResearch.com Interview with: Laure Rouch, PharmD PhD Department of Psychiatry Dr. Kristine Yaffe, MD (Senior Author) Departments of Psychiatry, Neurology, and Epidemiology University of California San Francisco, San Francisco VA Medical Center, San Francisco, CA, USA MedicalResearch.com: What is the background for this study? Response: Worldwide, around 50 million people have dementia and this number is set to triple by 2050. Prevention of dementia and identification of potentially modifiable risk factors are, therefore, critically important. Postural changes in blood pressure increase with advancing age and affect 20% to 30% of older adults. Yet it has not been explored deeply how orthostatic hypotension and blood pressure postural changes variability over time are associated with dementia risk. As multiple pharmacologic and nonpharmacologic interventions may improve orthostatic symptoms, this question has major public health implications. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, JAMA, Lipids / 14.07.2020

MedicalResearch.com Interview with: Manja Koch, Ph.D., Research Associate Department of Nutrition Harvard T.H. Chan School of Public Health Majken K. Jensen, Ph.D. Adjunct Professor of Nutrition Harvard T.H. Chan School of Public Health & Professor in the Department of Public Health University of Copenhagen, Copenhagen, Denmark     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. Lower apolipoprotein E in plasma is a risk factor for dementia, but the underlying biological mechanisms are not fully understood. Thus, we investigated the role of apolipoprotein E overall and in lipoproteins with distinct metabolic functions in relation to cognitive function and dementia risk.. (more…)
Author Interviews / 01.07.2020

MedicalResearch.com Interview with: Ruiyuan Zhang, MD, MS Department of Epidemiology and Biostatistics University of Georgia College of Public Health Athens, Georgia MedicalResearch.com: What is the background for this study? Response: Although there are several studies that focused on the effect of alcohol drinking on cognitive function, their findings were still mixed. So we want to use some new analysis techniques on this topic to see if we can have new findings. MedicalResearch.com: What are the main findings? Response: The main finding of our study is that low-to-moderate alcohol drinking is associated with better cognitive function outcomes. (more…)
Alzheimer's - Dementia, Author Interviews, Hearing Loss / 28.02.2020

MedicalResearch.com Interview with: Julia Sarant, PhD Associate Professor Department of Audiology and Speech Pathology Faculty of Medicine, Dentistry and Health Sciences Melbourne School of Health Sciences MedicalResearch.com: What is the background for this study? Response: Dementia is a rapidly growing global problem. Hearing loss has been identified by the Lancet Commissions as a modifiable risk factor for dementia. There is no treatment for dementia. This study investigated the effect of hearing aid use on cognition over time in older adults, objectively assessing hearing loss treatment, compliance and benefits while controlling for the effects of other known risk factors for dementia.  (more…)
Author Interviews, Cognitive Issues / 24.02.2020

MedicalResearch.com Interview with: Terese Sara Høj Jørgensen PhD Assistant Professor Faculty of Health and Medical Sciences University of Copenhagen MedicalResearch.com: What is the background for this study? Response: Dementia may develop as a result of both genetics and environmental exposures operating throughout the life course, and the risk of dementia may already be established early in life. Body height has a strong genetic component and is at the same time influenced by environmental factors early in life. Body height is an expression of growth early in life and a taller body height could express that the body has had an optimal development. At the same time, a shorter body height could be an indicator of harmful exposures early in life. A few smaller studies have identified a link between body height and dementia. However, rather than being a risk factor of dementia in itself, body height is likely an indicator of harmful exposures early in life and hereby linked to dementia. Body growth could furthermore be linked to dementia as an indicator of brain and cognitive reserve. Thus, to understand the relationship between body height and dementia, large scale high-quality longitudinal studies exploring the impact of early environmental factors and genetics to explain the link between body height and dementia were needed prior to this study. (more…)
Alzheimer's - Dementia, Author Interviews, Technology / 08.01.2020

MedicalResearch.com Interview with: Dr.med.univ. Roland Beisteiner Department of Neurology Laboratory for Functional Brain Diagnostics and Therapy High Field MR Center, Medical University of Vienna Vienna, Austria MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is the development of a new brain therapy which allows to support brain regeneration by activation of neurons with pulsed ultrasound. Main findings are that Alzheimer's patients improve their memory up to 3 months. (more…)
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, 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…)
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, 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…)
Author Interviews, Cognitive Issues, End of Life Care, Gender Differences, JAMA / 16.08.2019

MedicalResearch.com Interview with: Dr. Nathan Stall, MD Geriatrician and Research fellow Women’s College Research Institute       Dr. Paula Rochon, MD, MPH, FRCPC Periatrician and Vice-President of Research Women’s College Hospital     MedicalResearch.com: What is the background for this study? Response: The advanced stages of the dementia are characterized by profound memory impairment, an inability to recognize family, minimal verbal communication, loss of ambulatory abilities, and an inability to perform basic activities of daily living. Nursing homes become a common site of care for people living with advanced dementia, who have a median survival of 1.3 years. In the advanced stages of the disease, the focus of care should generally be on maximizing quality of life. Our study examined the frequency and sex-based differences in burdensome interventions received by nursing home residents with advanced dementia at the very end of life. Burdensome interventions include a variety of treatment and procedures that are often avoidable, may not improve comfort, and are frequently distressing to residents and their families. We found that in the last 30 days of life, nearly one in 10 nursing home residents visited an emergency department, more than one in five were hospitalized, and one in seven died in an acute care setting. In addition, almost one in 10 residents received life-threatening critical care; more than one in four were physically restrained; and more than one in three received antibiotics. (more…)
Author Interviews, Cognitive Issues, Nutrition, Red Meat / 08.08.2019

MedicalResearch.com Interview with: Jyrki Virtanen, PhD Assistant professor of nutritional epidemiology University of Eastern Finland Institute of Public Health and Clinical Nutrition Kuopio, Finland MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We have previously found in this same eastern Finnish male study population that higher egg intake was associated with lower risk of developing dementia and with better performance in tests assessing cognitive capacity. Eggs are a major source of choline, especially phosphatidylcholine, and choline (which is an essential nutrient) is necessary for the formation of acetylcholine, which is a neurotransmitter. Earlier studies have linked choline intake with better cognitive processing but there was no information whether choline intake would also be associated with lower risk of developing dementia. So the purpose of our current study was to investigate whether higher choline intake would associate with better cognitive performance and with lower risk of dementia, which would support our previous findings with egg intake. And in the current study we did find that especially higher phosphatidylcholine intake was associated with a lower risk of developing dementia and also with better performance in tests measuring memory and linguistic abilities of the men in the study. (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…)
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, 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…)
ALS, Author Interviews, Brigham & Women's - Harvard, Cognitive Issues, JAMA, Multiple Sclerosis / 08.01.2019

MedicalResearch.com Interview with: Michael Fralick, MD, FRCPC, SM, PhD (Cand) Clinical Associate, General Internal Medicine St Michael’s Hospital Phillipson Scholar, Clinician Scientist Program, University of Toronto PhD Candidate, IHPME, University of Toronto Affiliated Faculty, Program On Regulation, Therapeutics, And Law, Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital, Harvard University MedicalResearch.com: What is the background for this study? What are the main findings? Response: This medication is a pill that combines two ingredients: dextromethorphan (the active ingredient in cough syrup) and quinidine (used to increase the concentration of dextromethorphan). The medication was primarily studied and evaluated in patients with amyotrophic lateral sclerosis (ALS)   or (multiple sclerosis) MS, but anecdotal evidence suggested it was being prescribed to patients with dementia. We used data from two nationwide healthcare databases to understand how the medication was being used in routine care. (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…)