Yearly Archives: 2013

No firm evidence of benefit for any treatment or approach

A systematic review has examined the best 32 randomised controlled trials (RCTs) investigating treatments for cognitive decline, including drug treatments, hormone therapies, nutritional supplements, physical activity and cognitive exercises. The authors looked comprehensively at pharmacological treatments and non-pharmacological treatments in healthy adults. The study was recently published in the Journal of the Canadian Medical Association.

There was no firm evidence that pharmacological treatments – such as cholinesterase inhibitors, NMDA (N-methyl-D-aspartate) receptor antagonists or vitamin pills – are of any benefit for preventing cognitive decline. Oestrogen therapies may actually cause a decline in memory.

Contrary to other research, there was only inconsistent evidence concerning the benefits of physical activity for preventing cognitive decline. The authors discovered some evidence (from only three studies) that brain training exercises might help prevent cognitive decline; as measured in terms of auditory memory (for spoken information) and attention.

The authors conclude that most treatments and approaches for preventing cognitive decline do not appear to work (or may occasionally be harmful), and that even the benefits of cognitive training remain uncertain. The studies examined so far have been variable in quality, so further high-quality research is needed.

TED Talk by Neurosurgeon Andres Lozano

In a recent TED talk, neurosurgeon Andres Lozano discusses recent developments in the potential uses of deep brain stimulation (DBS) for the alleviation of symptoms across many different neurological / neuropsychological conditions, including Parkinson’s Disease, dystonia, depression and other mental illnesses, and possibly even for the improvement of cognitive functioning in people with mild cognitive impairment (MCI) and the earlier stages of Alzheimer’s Disease.

"Deep brain stimulation is becoming very precise. This technique allows surgeons to place electrodes in almost any area of the brain, and turn them up or down – like a radio dial or thermostat – to correct dysfunction".

Note: Some of this promising work on the treatment of dementia is at an early stage and clinical trials are still underway.

A study of 20-year changes in dementia occurrence suggest decreasing incidence in central Stockholm, Sweden.

A study – based on two cross-sectional surveys of people aged 75 years or over in Stockholm – explored whether the prevalence, survival, and incidence of dementia changed from 1987-1994 to 2001-2008 (in Stockholm, Sweden).

It was found that the prevalence of dementia was stable from the late 1980s to the early 2000s in central Stockholm, Sweden, but the survival of patients with dementia had increased (probably due to improvements in health care); which implies that incidence of dementia may have decreased during the same period.

This research is contrary to the widespread presumptions concerning an increasing incidence of dementia.

Pubmed link to the study is available at the link below:

The Michael J. Fox Foundation has launched a new arm of their Parkinson’s Progression Markers Initiative (PPMI), studying at-risk populations in Parkinson’s Disease

The PPMI has completed enrollment of its initial 600-member cohort of Parkinson’s patients and controls, and is now launching additional study cohorts to leverage the existing PPMI infrastructure and evaluate multiple potential biomarkers for Parkinson’s disease (PD).

The first of these new cohorts recent launched and will investigate risk factors for PD that may enable diagnosis before the onset of motor symptoms.

More information at the link below:

An integrated systems approach has identified genetic nodes and networks in late-onset Alzheimers Disease

In the April 25 Cell, Valur Emilsson at the Icelandic Heart Association and Eric Schadt at Icahn School of Medicine at Mount Sinai, New York, report that they have identified molecular networks that are perturbed in Alzheimer’s disease patients compared to normal, age-matched controls.

Several of these networks comprise genes previously linked to AD, including TREM2 and CD33. The scientists also identified a new player, TYROBP, as a master regulator of these molecular modules. This finding tightens the link between AD pathology and microglial dysfunction.

Full article is available at the link below:

New compound that slows down the onset and progression of Parkinson’s disease in mice

Research groups led by Armin Giese of LMU Munich and Christian Griesinger at the Max Planck Institute for Biophysical Chemistry in Göttingen have developed a chemical compound that slows down the onset and progression of Parkinson’s disease in mice. As a consequence, mice treated with this agent remain disease-free for longer than non-medicated controls.

More information at the link below:

The two-year Joint Action on Alzheimer Cooperative Valuation in Europe recently published its recommendations

The aim of the ALCOVE, (ALzheimer COoperative Valuation in Europe) project was to improve knowledge on dementia and its consequences, as well as promote the exchange of information to preserve health, quality of life, autonomy and dignity of people living with dementia and their carers in Europe.

19 countries participated in the project, with findings being published in March 2013.  The project’s recommendations focus on the collection of clinical and epidemiological data, diagnostic assessments, approaches to the treatment of behavioural disorders, limiting antipsychotic use, and competence assessments. 

ALCOVE was funded by the European Commission’s Public Health Programme. A number of online videos summarise project aims and progress to date. 

View the recommendations and all the videos at the links below:

Science and Technology Options Assessment (STOA) Workshop on April 23rd, 2013

The STOA workshop entitled “What does it mean to live with a brain disorder?” is a prelude to the many events taking place in May as part of the European Month of the Brain initiative.

The workshop will be chaired by STOA Chairman António Correia de Campos, MEP, and Elena Becker-Barroso, Editor, The Lancet Neurology.

Mre information is available at the link below:

The UK’s Alzheimer’s Society’s second annual report examines the quality of life for people with dementia

This report concentrates on findings from a survey showing that

• over half of the general public believe people with dementia lead a poor quality of life
• feedback from people with dementia, 70% of whom have stopped doing things they used to (through lack of confidence)
• most people with dementia feel anxious or depressed, with a third of these people reporting they have lost friends since diagnosis

The “Dementia 2013: the hidden voice of loneliness” report recommends that commissioners should ensure appropriate support services are available, and calls on the population at large to help ensure communities are dementia friendly.

Moe information is available at the link below:

Variation in the gene ABCA7 causes increased risk of late-onset Alzheimer’s disease

African-Americans have a higher incidence of late-onset Alzheimer’s.  A large-scale GWAS study has identified that a variation in the gene ABCA7 causes the risk of late-onset Alzheimer’s disease to double in African-Americans.  The study was recently published in JAMA.

The research, the largest analysis yet to establish genetic risk linked to late-onset Azheimer’s disease in African-Americans, was undertaken by the Alzheimer’s Disease Genetics Consortium and led by scientists from Columbia University Medical Center.

The ABCA7 gene plays a part in the production of lipids and cholesterol, which indicates that lipid metabolism might be a more crucial pathway for the disease in African-American individuals than in whites.

It is more common for African-Americans to experience lipid and cholesterol imbalances – which ultimately result in heart attacks, strokes, and vascular disease. Therefore, the authors explained that treatments that lower cholesterol and vascular disease could possibly be a successful way to decrease or delay Alzheimer’s among this group of people.