Timely along with Bill Gates’ call to arms for a diversified portfolio for Alzheimer’s research, here’s an opportunity for you to respond to the A-list survey and add your ideas about What Matters Most to help you (patients with MCI or Alzheimer’s disease and/or caregivers)!
Let’s make sure we keep this need on our radar for advocacy.
I was a bit startled to learn from this “OpEd” piece in JAMA Neurology today that Parkinson’s disease cases are climbing faster than Alzheimer’s prevalence. Alzheimer’s researchers have dreamt for the acceleration of funding and drug development seen for HIV previously. The co-authors state it outloud here, but for the context of Parkinson’s disease. The timing is interesting, given today’s announcement of Alzheimer’s support by Bill Gates. I encourage you to read the entire pages, including author disclosures at the bottom of the JAMA Neurology piece.
Doctors may compliment a patient by describing him or her as, “appears younger than stated age.” What we get when we do the math on your birthyear is your chronological age. Did you know that the degree of methylation on your DNA depends to a certain extent on your chronological age, but especially given recent evidence from Soriana-Tarraga et al. from the Universitat Autonoma de Barcelona of risks associated with stroke and other diseases of aging (e.g., cancer), that methylation (too much or too little in the wrong places) can betray your biochemical age.
This may have to do with why some people seem “genetically blessed,” going strong with great skin and health into late life, perhaps even despite their poor lifestyle choices.
For a review of methylation (how can we prevent it?) see Johnson et al. 2012.
Back in the 1990s, if a patient asked for a memory evaluation based on his own awareness of memory loss, we used to categorize him as:
- having no results to support a diagnosis of memory loss [the “worried well”], or
- age-associated memory impairment [designed to allay fears of incipient Alzheimer’s but without promises that Alzheimer’s would ever occur, or
- memory impairment secondary to a different diagnosis, such as depression or a recent medical condition, or
- Mild Cognitive Impairment, which indicated that we’d detected more memory problems than expected for age and education, with a higher relative risk than the groups above to develop dementia over the next 5 years
- dementia, most frequently attributable to Alzheimer’s disease
More recently, researchers have identified subjective complaints (whether from the worried well or the age-associated memory loss folks) with being diagnosed (at some point down the line) with dementia. This could mean that people do know themselves well and can “tell” something’s starting. Or it could be that those people are astute at detecting their own age-associated memory impairment. To further pursue this algorithm, Buckley et al. were awarded funding to image participants with what is now referred to as “Subjective Cognitive Decline (SCD)” in the same way that we characterize participants in clinical trials, looking for amyloid and tau in their brains.
My mother has been stating that she’s “losing it” for over a decade but she’s still able to multitask, communicate well, and plan better than most. I’ve kept an eye on this question about SCD in order to respond to her with more objectivity, as opposed to responding as a daughter who will never want to see her “lose it.”
The recent publication in JAMA from this work (editorialized here) did not definitely resolve the issue, but it confirmed that mood, personality trains, sleep, stress levels and age definitely raise the risk of SCD (see 2nd and 3rd bullets above), AND it made the intriguing observation that there is tau deposition in folks with SCD, in an important brain region.
Does my mother have super Spidey-sense about her medial temporal lobes? Perhaps, BUT [Mom, please read this part carefully] that tau deposition in the SCD group may eventually turn out to be something that just comes with age and is not related to Alzheimer’s. Like wisdom and wrinkles. We don’t know yet. Stay tuned for more research in this area.
A recent AAA Westways magazine article by Joseph Younger covered issues related to safe geriatric drivers. I agree with his suggestions! Especially appreciate his story of how he spoke with his own dad about driving privileges. How many of you have been there, done that, would’ve done it differently?
Check out the quiz: Drivers 65-Plus
Have your eyes rechecked annually. Your eyeglass prescription may need changes to deal with night-vision.
Did you know that dimming (not brightening) the dashboard lights for night driving might help you see what’s outside your windshield better?
And yesterday they came out with an article about those things that can distract us while driving. Check out the distraction meter. I’m in the red 😦 An important point is that just listening to the radio counts as a mental distractor! I do favor the newest iOs update that keeps notifications from coming onto the phone while the phone suspects you are driving your vehicle. That should bring me back into the green.
Was just talking with a trainee about Proloquo (yikes, did it always cost so much?) and Speak It, then we googled to see what else was out there, and found this review by The Tavistock Trust for Aphasia in the UK. The list includes relative cost (in pounds sterling symbols), availability on various platforms (e.g., iPhone vs iPad), etc.
Please comment here or on their site, if you would like to further endorse any of the items listed there for North American use.
Garret Davis wrote a play to help enhance awareness of Alzheimer’s disease and available resources among non-mainstream communities. Click here for showtimes and locations. This project has the full support of AfricanAmericans against Alzheimer’s.
About child caregivers, worth the wait! Much Too Young airs on TVO (Canada) at 9pm EST on Thursday Sept 21. If you do not get TVO, but live in Canada, you can see the film online the next day on Friday Sept 22 at TVO.org. If you live in the US and have connections, please contact Chris Wynn through the website for the film.
On a related note, When Dementia Is in the House, our website for teen caregivers, is soon to celebrate it’s 6th anniversary, and Google Analytics shows high continuing activity on the site, likely thanks to the site’s additional availability in Chinese and French.
Not seeing anything new here, so I would not count this as an Update, but the review of our progress in the field is well-stated! Research Gaps and Controversies in Chronic Traumatic Encephalopathy, by Asken et al in JAMA Neurology, published online today.