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Researchers at Mayo Clinic in Rochester, Minnesota conducted brain scans of 448 people without any thinking or memory problems and 141 individuals with mild cognitive difficulties. All the participants were 70 or older. Each group was asked whether they had experienced a brain injury that involved a temporary loss of consciousness or memory.
Seventeen percent of the cognitively normal participants said they had had a brain injury and 18 percent of those with memory and thinking difficulties reported suffering a concussion or head trauma.
The study found no differences in brain imaging measurements among the cognitively healthy individuals, whether or not they had experienced a brain injury. However, in those with mild cognitive impairment and a history of concussion, the scans revealed an 18 percent higher level of amyloid plaques. Those protein deposits in the brain are the hallmark of Alzheimers disease.
Lead researcher Michelle Mielke calls the findings interesting, suggesting there may be a relationship between concussion and Alzheimers disease. An article on the findings is published in the journal Neurology.
Head Trauma Linked to Alzheimer?s Disease Plaques
In a study of more than 600 older veterans, high doses of the vitamin delayed the decline in daily living skills, such as making meals, getting dressed and holding a conversation, by about six months over a two-year period. The benefit was equivalent to keeping one major skill that otherwise would have been lost, such as being able to bathe without help. For some people, that could mean living independently rather than needing a nursing home. Vitamin E did not preserve thinking abilities, though, and it did no good for patients who took it with another Alzheimer's medication. But those taking vitamin E alone required less help from caregivers about two fewer hours each day than some others in the study. "It's not a miracle or, obviously, a cure," said study leader Dr. Maurice Dysken of the Minneapolis VA Health Care System. "The best we can do at this point is slow down the rate of progression."
The U.S. Department of Veterans Affairs sponsored the study, published Tuesday by the Journal of the American Medical Association. No one should rush out and buy vitamin E, several doctors warned. It failed to prevent healthy people from developing dementia or to help those with mild impairment ("pre-Alzheimer's") in other studies, and one suggested it might even be harmful. Still, many experts cheered the new results after so many recent flops of once-promising drugs. "This is truly a breakthrough paper and constitutes what we have been working toward for nearly three decades: the first truly disease-modifying intervention for Alzheimer's," said Dr. Sam Gandy of Mount Sinai School of Medicine in New York. "I am very enthusiastic about the results."
About 35 million people worldwide have dementia, and Alzheimer's is the most common type. In the U.S., about 5 million have Alzheimer's. There is no cure and current medicines just temporarily ease symptoms. Researchers don't know how vitamin E might help, but it is an antioxidant, like those found in red wine, grapes and some teas. Antioxidants help protect cells from damage that can contribute to other diseases, says the federal Office on Dietary Supplements. Many foods contain vitamin E, such as nuts, seeds, grains, leafy greens and vegetable oils. There are many forms, and the study tested a synthetic version of one alpha-tocopherol at a pharmaceutical grade and strength, 2,000 international units a day.
Years ago, another study found that the same form and dose helped people with more advanced Alzheimer's, and many were prescribed it. But vitamin E fell out of favor after a 2005 analysis of many studies found that those taking more than 400 units a day were more likely to die of any cause. The new study involved 613 veterans, nearly all male, 79 years old on average, with mild to moderate Alzheimer's, at 14 VA centers. All were already taking Aricept, Razadyne or Exelon widely used, similar dementia medicines. Participants were placed in four groups and given either vitamin E, another dementia medicine called memantine (its brand name is Namenda), both pills or dummy pills.
After a little more than two years of follow-up, those on vitamin E alone had a 19 percent lower annual rate of decline in daily living skills compared to the placebo group. Memantine made no difference, and vitamin E did not affect several tests of thinking skills. "It's a subtle effect but it's probably real," Dr. Ron Petersen, the Mayo Clinic's Alzheimer's research chief, said of the benefit on daily living from vitamin E. "That has to be weighed against the potential risks" seen in earlier studies, he said. Heather Snyder, director of medical and scientific operations for the Alzheimer's Association, said the group's position is that "no one should take vitamin E for Alzheimer's disease or other memory issues except under the supervision of a physician," because it can interfere with blood thinners, cholesterol drugs and other medicines. The new results also need to be verified in a fresh study that includes more women and minorities, she said.
Vitamin E may slow Alzheimer's disease progression
Dementia is a collective name for a progressive, degenerative disease that affects memory, thinking, behavior and emotion. It can involve personality and mood changes. And frequently, those with dementia or Alzheimer's, its most common form, get agitated or even aggressive.
Dr. Jeffrey Cummings, director of the Cleveland Clinic Lou Ruvo Center for Brain Health, said agitation is hard to bear both for caregivers and patients. "Agitation in Alzheimer's disease is one of the most disabling aspects of the disease," Cummings said. "It interferes with the patient's life. It interferes with the ability of the caregiver to take care of the patient. It degrades the quality of life of both the patient and the caregiver." Cummings led a study involving 220 Alzheimer's patients who also had agitation. Some of the patients got a placebo. Others got a drug cocktail that combined dextromethorphan and quinidine.
Dextromethorphan is commonly used in cough medicine. Quinidine is normally used to regulate an abnormal heart beat. Cummings said the combination pill had a substantial effect, greatly reducing agitation compared to the patients who got the placebo. Furthermore, he said, the caregivers also benefited. "There was a reduction in the stress experienced for caregivers of the patients who were treated with the dextromethorphan-quinidine combination.
While both drugs have been approved by the U.S. Food and Drug Administration, the combination pill is not. More studies need to be done before results can be presented to the agency for approval. The study appears in JAMA, the Journal of the American Medical Association.
Drug Combination Reduces Agitation in Alzheimer's Patients
Everyone experiences stress from time to time. It could be prompted by the death of a spouse or loss of a job; but, psychiatrist Richard Lipton says it could also be something much less traumatic, like getting a traffic ticket. “One person gets a speeding ticket and they think, 'This is horrible. My insurance premiums are going to go up and I’m going to get a $100 dollar fine," said Lipton. "This is a disaster for me.' And another person thinks, 'Hmmm. I shouldn’t have been speeding. I ’m going to be more careful in the future.'" While a great loss can be devastating and the effects long-lasting, it’s the person who perceives common situations as stressful - like the first driver Lipton described - who could be putting his or her psychological health at risk.
Lipton, who is with the Albert Einstein College of Medicine in New York, explains that 'stressing out' over the small hassles of everyday life can lead to mild cognitive impairment, which is a risk factor for a far more serious disorder. “People who have mild amnestic cognitive impairment go on to develop diagnosable Alzheimer’s dementia at the rate of about 10 to 15 percent per year. So, amnestic cognitive impairment is essentially most often an early form of Alzheimer’s disease before dementia develops," he said. In a study reported in the journal Alzheimer’s Disease and Associated Disorders, Lipton and colleagues administered a stress assessment test to just over 500 individuals ages 70 and older.
Patients with Alzheimer's and dementia are seen during a therapy session.
The test rated their level of perceived stress. None of the participants had signs of mild cognitive impairment or dementia at the start of the study, called the Einstein Aging Study. They were followed for an average of 3.5 years with a battery of neuropsychological tests and given physical exams. During the study, 71 participants were diagnosed with mild cognitive impairment. Those with the highest stress levels were two-and-a-half times more likely to develop the pre-Alzheimer’s condition.
Most were women with less education and higher levels of depression. Lipton says chronic stress has a number of negative effects on the body. “When stressful events happen and people perceive them to be stressful, there’s a whole series of physiologic changes that take place. Blood pressure goes up, pulse goes up, the stress hormone cortisol is secreted and, over time, chronic stress can produce wear and tear on the body and wear and tear on the brain and lead to long-term health consequences," he said. Lipton says that lowering levels of perceived stress – by engaging in activities such as yoga and meditation, for example - could help reduce the risk of Alzheimer’s.
Study: Chronic Stress Can Lead to Early Alzheimer’s
Danish researchers believe they have traced the Christmas spirit – either feelings of warmth and joy or what they playfully call the “bah humbug” syndrome – to a number of areas of the brain. They assembled two groups of volunteers. One group, which they called the Christmas group, comprised ten ethnic Danes who celebrate Christmas. The second, non-Christmas group was made up of ten people, including individuals of Pakistani, Iraqi, Indian and Turkish descent, with no tradition of celebrating the holiday. Using high-tech fMRI imaging, researchers scanned the brains of all the subjects while showing them both holiday-inspired images and ordinary ones.
President Barack Obama, first lady Michelle Obama, and their daughters Sasha, and Malia, and Michelle's mother Marian Robinson, react as they light the National Christmas Tree during the National Christmas Tree Lighting ceremony at the Ellipse in Washington
In the first group, a “Christmas spirit network” appeared - five areas of the brain that lit up. That neural activity is associated with spirituality, experiencing emotions shared by other people and mouth actions suggesting pleasure in eating meals with loved ones. Similar responses were not seen in the non-Christmas group. Bryan Haddock is a medical physicist at a hospital affiliated with Copenhagen University. “When you have a reaction to Christmas and decorations are around you and the scenery you are looking at, there is definitely something that happens. We’re able to catch it on scanner. There is something that goes on in the brain when you see something that puts you in the Christmas mood," said Haddock.
The findings were published in the British Medical Journal. At this point, Haddock says it’s hard to generalize the study’s conclusions to other festive occasions. “Now that we’ve seen where it is in the brain, what can we say? Can we say that some people are missing something, can we say that some people have an extra something, can we say that this is the festive center, can we say that this is something unique to Christmas? These are questions that we actually can’t answer," he said. So for the time being… “Merry Christmas, however you take that.” “Yes. Merry Christmas to you.”
Christmas Spirit, Bah Humbug Syndrome, Traced to Brain Activity
Writing in the journal Brain, researchers from the University of California, Irvine, say the drug “disarms” the brain’s reaction to beta-amyloid plaques, a “hallmark” of the degenerative brain disease. Researchers say that in response to the plaques, the brain produces inflammatory cells called microglia, which “contribute to the neuronal and memory deficits seen in this neurodegenerative disease.” "Our findings demonstrate the critical role that inflammation plays in Alzheimer's-related memory and cognitive losses," said Kim Green, an assistant professor of neurobiology and behavior. "While we were successful in removing the elevated microglia resulting from beta-amyloid, further research is required to better understand the link among beta-amyloid, inflammation and neurodegeneration in Alzheimer's."
One hemisphere of a healthy brain (L) is pictured next to one hemisphere of a brain of a person suffering from Alzheimer disease.
Green said the drug, pexidartinib, or PLX3397, is being used to treat cancer, but that it also selectively blocks microglia signaling from their surface receptors, which “are necessary for microglial survival and proliferation in response to various stimuli, including beta-amyloid.” This led to a “dramatic reduction” of inflammatory cells. The researchers said the drug “restored memory function in test mice.” Even though the drug appeared to remove the microglia, the plaques remained.
In a healthy person, microglia “act as the first and main form of immune defense in the central nervous system,” researchers noted. However for those with Alzheimer’s, the microglia “turn against the healthy tissue they were originally assigned to protect, causing inflammation in the brain.” "Our work is telling us that these cells may contribute to the disease process, and targeting them with such specific drugs is a promising new approach," he said.
Cancer Drug May Offer Hope Against Alzheimer’s
