Optimal management of Alzheimer’s disease patients

( to involve family caregivers in multimodal treatment )

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Alzheimer’s disease (AD) is the most prevalent cause of dementia encountered in older patients. Late-stage clinical AD can result in substantial clinical burden and a reduction of quality of life (QoL) for the patients and family caregivers. There are a number of effective nonpharmacological and symptomatic pharmacological approaches to treat AD. All of those approaches, however, cannot prevent, cure or stop the progression of the disease. Therefore, the specific goals of current treatments are to preserve cognitive and functional ability, minimize behavioral disturbances, slow disease progression, ease the burdens on the patient and family, and maintain their QoL through clinical management. In optimal management of AD patients, both pharmacological and nonpharmacological treatments must be considered necessary and adapted to meet the individual needs of each AD patient and their family caregivers. In this review, we focus on nonpharmacological approaches that address family advice as part of an optimal clinical management of AD. Family caregivers provide most of the patient care and administer most of the treatments used for patients with AD. They have an important impact on the QoL of dementia patients. Further, they suffer high rates of psychological and physical illness, as well as carrying many of the social and financial consequences. Hence, it is important to involve family caregivers in multimodal treatment settings and provide interventions that are directly addressed to the family caregivers (eg, education programs, support groups, and counseling). In recent years, several clinical guidelines for evidence-based treatment of AD and other forms of dementia have been published worldwide. The authors of the paper review current and internationally relevant guidelines with respect to the given recommendations concerning family advice. Read more: dovepress.com

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Polyphenol-rich juice may boost immune health

A juice containing of green tea, grape seed and grape skin extract and shiitake mushroom may reduce the incidence of common cold, says a new study from Germany.  Read more: nutraingredients.com

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Art imitates life

( tribute to the victims of Alzheimer’s disease )

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The Shelburne Museum bursts at the seams with 11 new exhibits. Arguably the most poignant is “Alzheimer’s: Forgetting Piece by Piece” (May 16-Oct. 24), a look at the effects of Alzheimer’s on patients and their caregivers through written and oral accounts and multimedia artwork. The exhibit shows 52 quilts made by caregivers across the United States, and each comes with an artist’s statement describing the story behind the artwork. The exhibit was organized by the Alzheimer’s Art Quilt Initiative to raise awareness of the 5.3 million Americans with Alzheimer’s.

While the quilts have been shown in museums nationwide, Shelburne partnered with Vermont Public Radio and StoryCorps Memory Loss Initiative to add a new component to their exhibit: recorded conversations between local Vermonters with Alzheimer’s or another memory loss disease and their family or friends. Read more: burlingtonfreepress.com

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Ginger supplements may reduce pain after exercise

Ginger may reduce the pain associated with muscle injury after exercising, offering amateur and professional athletes a natural pain reliever, suggests new data.  Read more: nutraingredients.com

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A way to identify these people at the greatest risk

(Biomarkers and lab testing)

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As patients age, a variety of health problems present themselves. These conditions range from cancer to cardiovascular and autoimmune diseases to diabetes, depression and stroke.
One disease becoming particularly pervasive but which has no approved biomarkers for early detection and only minimally effective therapy is Alzheimer's disease (AD). This principal form of dementia was diagnosed a century ago but only recently has become the focus of large multidisciplinary studies.¹
"If you do a literature search, you'll see from the turn of the century until maybe the '60s or '70s there was not much research on it," said Leslie Shaw, PhD, professor, department of Pathology and Laboratory Medicine at the University of Pennsylvania Medical Center, Philadelphia. "So it is a disease receiving the kind of attention you would have liked to have seen earlier."
As to why it took so long to study AD, for one thing, the disease is complicated to detect. "It's not a skin disease where we can just go and take a snip and study it; it's deep in the brain," pointed oud Richard W. Besdine, MD, professor of Medicine, Greer Professor of Geriatric Medicine; director, Division of Geriatrics and Center for Gerontology and Healthcare Research, The Warren Alpert Medical School of Brown University, Providence, RI. Secondly, a shift in attitude toward age-related mental decline has occurred over the years.
"We used to say, 'Well, Grandma is senile,'" Dr. Besdine said. "Now we know there's no such thing. There is not an age-related decline in cognitive function. It's disease. Depending on which study you look at, anywhere from 50 to 80 percent of the cognitive decline occuring in America is due to Alzheimer's disease."
The prevalence of AD in the world's population was 26.6 million in 2006 and is expected to quadruple by 2050--a "global epidemic," according to H. Hampel, et al., in an accepted manuscript to Experimental Neurology.² The time has never been more ripe for a clinical biomarker. Not only would earlier/better detection help monitor disease progression, but accurate diagnosis is essential for outcomes of therapy trials. "As we try to develop effective treatments, knowing who has [AD] and who doesn't becomes critically important," Dr. Besdine said. Read more: laboratorian.advanceweb.com

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Do food claims improve consumer health

Functional and fortified foods have a key role to play in filling the nutritional gaps in consumer diets, but on-pack signposting is key to helping people make informed choices, says the British Nutrition Foundation (BNF).   Read more: nutraingredients.com

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Gingko Biloba

( is not effective in either preventing dementia )

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In another blow to past optimism about remedies for memory loss and Alzheimer's disease, a large randomized trial recently published found no improvement in slowing cognitive decline in older adults receiving gingko biloba compared with people receiving placebo. Gingko is one of the oldest living tree species, and the extract of its leaves is one of the most popular medicinal herbs in North America.
Of the many reasons people use gingko, several relate to memory and Alzheimer's disease: improving mental function, preventing age-related memory decline, and slowing or preventing Alzheimer's disease. The recent study, known as the Gingko Evaluation of Memory study, was published in the December 23, 2009 Journal of the American Medical Association. Conducted by researchers at six academic medical centers in the U.S., it tracked over 3000 community-dwelling subjects ages 72-96 and followed them for an average of 6 years. Cognition was measured with several standard assessment tools, and included aspects of memory, attention, visuo-spatial construction, language, and executive functions. Read more: alzheimers.about.com

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Natural trumps health claims in adult soft drinks

Health and wellness positioning based on growing consumer awareness of inherent properties such as antioxidants along with provenance is proving a market driver in the adult soft drinks sector as it navigates the challenges posed by EU health claims regulation, claims a Mintel analyst.   Read more: nutraingredients.com

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Vitamins reduce risk of getting Alzheimer’s

( excellent research )

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The great majority of my patient population includes those over 50 years of age. This is in keeping with the fact that we are an aging population.   The baby boomers are restless. They want answers and they want them now. Now more than any other time in history, people are more involved in their health and their well being.
This is why preventative health care providers are so busy today. They want health care, not sick care. People want a full life and are doing many things to allow for proper optimization in health. To simply be pain free is not enough anymore. We are seeing our aging parents and their friends fall prey to degenerative diseases. We all know someone who has Alzheimer’s.
Alzheimer’s disease always seems to be at the forefront of their concerns. In fact, the incidence of Alzheimer’s disease (AD) has increased steadily over the last 50 years with no perceivable decline in the near future. Read more: bclocalnews.com

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Common protein could boost gluten-free rice bread

The volume and texture of rice bread may be enhanced by simply adding glutathione, a protein and safe food additive, and offer better gluten-free products to a growing market, says new research. .   Read more: .foodnavigator.com

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Measurement of hippocampal atrophy using 4D graph-cut segmentation

(Application to ADNI)

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We propose a new method of measuring atrophy of brain structures by simultaneously segmenting longitudinal magnetic resonance (MR) images. In this approach a 4D graph is used to represent the longitudinal data: edges are weighted based on spatial and intensity priors and connect spatially and temporally neighboring voxels represented by vertices in the graph. Solving the min-cut/max-flow problem on this graph yields the segmentation for all timepoints in a single step. By segmenting all timepoints simultaneously, a consistent and atrophy-sensitive segmentation is obtained. The application to hippocampal atrophy measurement in 568 image pairs (Baseline and Month 12 follow-up) as well as 362 image triplets (Baseline, Month 12, and Month 24) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) confirms previous findings for atrophy in Alzheimer's disease (AD) and healthy aging. Highly significant correlations between hippocampal atrophy and clinical variables (Mini Mental State Examination, MMSE and Clinical Dementia Rating, CDR) were found and atrophy rates differ significantly according to subjects' ApoE genotype. Based on one year atrophy rates, a correct classification rate of 82% between AD and control subjects is achieved. Subjects that converted from Mild Cognitive Impairment (MCI) to AD after the period for which atrophy was measured (i.e., after the first 12 months) and subjects for whom conversion is yet to be identified were discriminated with a rate of 64%, a promising result with a view to clinical application. Power analysis shows that 67 and 206 subjects are needed for the AD and MCI groups respectively to detect a 25% change in volume loss with 80% power and 5% significance. Read more: citeulike.org

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Bilberry extract shows colitis benefits

Anthocyanin-rich extracts from bilberry (Vaccinium myrtillus) may reduce inflammation in colitis patients and offer a natural alternative to steroids, suggests new research.    Read more: nutraingredients.com

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Devising an Early Attack

(a very sad story)

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Tucked away on a steep street in this rough-hewn mountain town, an old woman found herself diapering her middle-age children.
At frighteningly young ages, in their 40s, four of Laura Cuartas’s children began forgetting and falling apart, assaulted by what people here have long called La Bobera, the foolishness. It is a condition attributed, in hushed rumors, to everything from touching a mysterious tree to the revenge of a wronged priest.
It is Alzheimer’s disease, and at 82, Mrs. Cuartas, her gray raisin of a face grave, takes care of three of her afflicted children. One son, Darío, 55, babbles incoherently, shreds his socks and diapers, and squirms so vigorously he is sometimes tied to a chair with baggy blue shorts. A daughter, María Elsy, 61, a nurse who at 48 started forgetting patients’ medications, and whose rages made her attack a sister who bathed her, is a human shell, mute, fed by nose tube. Another son, Oderis, 50, denies that his memory is dying, that he remembers to buy only one thing at a time: milk, not milk and plantains. If he gets Alzheimer’s, he says, he will poison himself. Read more: nytimes.com

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Beta-glucan shows potential prebiotic activity

Beta-glucan from barley may boost levels of beneficial bacteria in our gut, particularly in people over 50, says a new study from Greece.  Read more: nutraingredients.com

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