Get a Move on!

Photo from WebMD

If you’re in midlife (defined in many ways, but encompassed by ages 35-65 years), make sure you’re getting physical activity into your schedule! Palta et al. have just added another argument to the benefits of physical activity; this time, they looked at neuroimaging findings that come with aging, and it seems moderate-vigorous intensity physical activity is associated with* fewer cumulative white matter changes and small strokes in late life. Impressively, the data about physical activity were collected 25 years prior to the MRI scans of brain (when I was still in high school!). Talk about a long-term investment.

Moderate-vigorous intensity, per the scale they used, consisted of physical activity amounting to at least 75 minutes/week and meeting 2008/18 US Physical Activity Guidelines for the adult age group. To fill out the modified Baecke Physical Activity Questionnaire used in this study for yourself, click here.

*The association, as I’ve warned before in this blog, doesn’t mean causality, but it is tempting to think we can prevent the ravages of aging on the plumbing to our brains and the integrity between neuronal connections by getting our recommended physical activity. There are various other cerebrovascular lifestyle factors that may associate with moderate to vigorous levels of physical activity that were not included in this study, and those factors may play more causative roles in the improved outcome. For instance, consider the effects of lower fat, lower red meat diets, lower sugar intake as known cardiovascular (and cerebrovascular factors that tend to be associated with people who work moderate to high physical activity into their lives.

A friend once described himself as, “Exercising to eat.” Over time, I’ve had to reconsider that exercising a lot doesn’t give me a free pass to eat all the comfort foods I’d prefer. The struggle is real! We owe it to ourselves and those who might have to take care of us to do what we can to stave off brain injury.

Kudos to the Bennett Family

Photo from AARP website (below)

This came out last month, so thanks go to my mom for calling it to my attention:

In this AARP article, Tony Bennett’s family opens up and describes his course of Alzheimer’s disease. I’ve always held Mr. Bennett in great regard for his support of up and coming talent (esp women!), but to know he has continued to do this while entering the Alzheimer’s path is very meaningful. It takes a lot of integrity to go on with one’s work for society despite a health challenge, and I am speculating, but I think the last 4 years have been productive because those artists working with him have met him halfway or more out of respect for his talent and also out of the kindness of caring for someone who might need a little more help.

And I like how Mr. Bennett’s story highlights that Alzheimer’s leads to changes, but sometimes hardwired activities or talents remain resilient. This retention becomes the focus of our ability to communicate meaningfully with friends and family and patients with Alzheimer’s.

Glen Campbell’s family similarly came forward and helped to destigmatize Alzheimer’s disease by telling their story in 2011, not that long after his diagnosis. Click here for interview with Dr. Ron Petersen, who was Mr. Campbell’s treating specialist.

Hot Off the Presses: the Alzheimer’s Association’s 2021 Facts and Figures Report

Read all about it here. I frequently turn to this report to refresh my stats and check trends. I’m hoping in the near future we’ll have more in the Diversity section about Asian Americans.

Here are some excerpts:

• Estimates for the US indicate that there are about 5 million Americans with Mild Cognitive Impairment, which is a fair parallel to the over 6 million Americans diagnosed with Alzheimer’s disease!

• States with higher (near 30% increase in AD cases) projected over the next 5 years: Alaska (29.4%), Arizona (33.%), Nevada (30.6%), and Wyoming (30%). Are those 4 states ready for this? While California hands down had the largest number of cases of AD in 2020 at 690,000, our projected increase is only 21.7%, similar to that of Hawai’i (20.7%).

• That old argument about whether women are more prone to AD than men! I have maintained for a long time that incidence is the same between men and women although prevalence is higher among women. I’m feeling vindicated with this year’s report: “The prevailing reason that there are more women living with Alzheimer’s or other dementias than men is most likely the fact that women live longer than men on average, and older age is the greatest risk factor for Alzheimer’s….Most studies of incidence in the US have found no significant difference between men and women in the proportion who develop Alzheimer’s or other dementias at any given age.” Do go to that page for their further review that intriguingly raises the possibility that sex differences may be regional or more education- than sex-based.

International Frontotemporal Dementia Conference hosted by UCSF starts WEDNESDAY, Mar 3

Unlike conferences organized by the AFTD, this conference is for health care professionals and researchers, but those with an interest in frontotemporal dementia, primary progressive aphasia, and progressive supranuclear palsy may appreciate the updates and discussion.

I’m especially delighted to see the Latin American contingent fielding a team of speakers!

For details and registration, see here. If you can’t attend in real time Mar 3-5, the conference proceedings will be available for 30 days on playback.

“LIVE STREAM MEETING
This course will be offered as a live interactive virtual conference. Login instructions along with the digital syllabus will be shared with attendees a week before the meeting. Included in your registration fee is access to the course recordings on demand (available within a week after the conference) for any sessions that you miss, available for up to 30 days post-course.

All registrants will receive a webinar log-in link the week of the course. You will enter your full name and email address to “log-in” and authenticate yourself. Once completed, you will have access to the conference, and the system will email you an individualized access link to join the webinar at any time. For the rest of the conference you will use this link to join the webinar each day and you will never need to log-in again. If you click on the link but the webinar hasn’t started yet you will be placed in a waiting room. Attendees will be admitted from the waiting room into the webinar once we begin. All of the live content is recorded and hosted on the course webpage for 30 days post course so you can review anything that you might have missed. “

More Specifics on a Modifiable Risk Factor for Alzheimer’s disease or vascular dementia: for people in Middle-Age

https://www.wikihow.com/Measure-Your-Waist

People who are obese in middle age are at almost four times greater risk of developing dementias such as Alzheimer’s disease in later life than people of normal weight, according to a study on twins.

https://n.neurology.org/content/76/18/1568.abstract

I know Body Mass Index (BMI) management is not as simple as refusing a donut, but DO make sure you have physical activity in your daily routine and eat more vegetables (OMG, I’ve turned into my mother) to help get to the less risky BMI. The BMI calculator doesn’t work for all body types, but the paper mentioned above showed a risk for those with BMI = 25-30 and an even higher risk (the 4x) for those with BMI > 30.

Jan 28th *note change in date*: New Administration, New Opportunities for Progress in Alzheimer’s Disease and other Dementias

New Congress Advocacy Kickoff: Paving the Way in 2021

Join the Alzheimer’s Association & Alzheimer’s Impact Movement (AIM) as we celebrate our recent policy victories and launch our advocacy campaigns in the new 117th U.S. Congress.  Both newly elected and long serving members of Congress will face a broad range of issues, many affecting the Alzheimer’s and dementia community. During this event you will learn more about how the new Congress will work on Alzheimer’s disease, how advocates can continue to lead our movement, and where leaders stand on key issues. This virtual event will take place on January 28st at 7pm ET. Register today!

2020 FTD Awareness Talks Now Available on Demand!

For those of you who may have been tantalized by https://drchowftd.wordpress.com/2020/10/08/were-you-aware-i-almost-entirely-missed-world-ftd-awareness-week-myself/, you can watch those talks now, thanks to the Association for Frontotemporal Degeneration! Bring popcorn, there are 17 hours’ worth of viewing!

“We invite you to check out all of the rich and engaging content that was captured, then subscribe to World FTD United’s YouTube channel and encourage friends and family to do the same: https://bit.ly/3owRaJL“

Today’s Walk4Alz

Hoping you felt my good vibes being broadcast from my neighborhood coastal walk for Alzheimer’s Los Angeles*

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  Selected a plumeria blossom to commemorate my patients and their families, and my grandmother

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  The view of Tourmaline Beach from above

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  Powered up with a latte with Bird Rock’s namesake as backdrop

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*disclosure: I did cheat this, started at 0900 instead of 1000

Were you aware? I almost entirely missed World FTD Awareness Week myself!

Started October 3rd. Click here for page with regional links to a “marathon” of talks that I’m hoping were archived.

Delays, Delays, Delays

Besser et al. reported out findings of an Association for Frontotemporal Degenerations survey conducted in 2017. 698 caregivers participated, and I was glad to see that 56% of patient were able to obtain diagnoses of FTD within a year of first symptoms. Another 17% received their diagnoses within the next year of symptoms.

Back in the early 2000s, it could take ~3 years for a patient to be appropriately referred to a neurologist for diagnosis. Delays had been related to misattributing the symptoms to mid-life crisis (poor judgment, uncharacteristic personality, depression or bipolar disorder). Those differential diagnoses still impact the process per the 2017 survey, and one of my interpretations of 2/3 of the diagnoses being made by neurologists is that we might need to better educate psychiatrists to consider FTD and corticobasal syndrome in their differential diagnosis when patients are older than 40 and manifesting symptoms that run so counter to their prior lives.

To see more of the details, click here