Getting older, in and of itself, is not the cause of so-called “senior moments”. A new study found that even these mild memory lapses are caused by the same brain lesions associated with Alzheimer’s disease and other dementias.
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Researchers found that in the last four to five years of life, people’s memory showed a very rapid decline. Pathologic lesions were found to be related to this rapid decline. The preceding years showed a much more gradual decline that was the actual result of normal aging.
According to Newswise: “… [R]ecognizing that the earliest changes in memory are related to Alzheimer’s pathology can lead to early diagnosis and will be critical information if a treatment is developed that can alter the pathologic course of the disease.”
For the very first time, a medicine has been shown to protect against the development of Alzheimer’s disease. French scientists were able to demonstrate that taking 240 mg of Ginkgo extract EGb 761® per day regularly over a period of at least 4 years can cut the risk of developing Alzheimer’s disease by nearly 50%.
“Meta-analyses of the data by independent scientists consistently substantiate the efficacy of EGb 761® at the onset of cognitive decline.”
“The results of the GuidAge study are remarkable”, according to Prof. Michael Habs. “It is the first time ever that a protective effect against Alzheimer’s disease has been demonstrated for a medicine. The multifaceted effects of the plant extract appear to positively influence the complex developmental processes of dementia.”
The GuidAge study was a large-scale study, in which 2854 elderly people with memory complaints were randomly assigned to receive either 240 mg/day of the patented Ginkgo special extract or a placebo for five years. Of those subjects taking the study medication for at least 4 years 29 out of 966 (3.0 %) taking placebo developed Alzheimer’s disease; in contrast only 15 out of 947 (1.6 %) treated with EGb 761® developed the disease (p=0.03). The result of this prospectively planned analysis shows that the Ginkgo special extract can lower the risk of dementia by 47%.
The brain pathology that leads to overt Alzheimer’s disease develops over the course of many years. It is therefore not surprising that those study participants who developed dementia early in the study gained less protective benefit from EGb 761® treatment, because they already had the disease. When these subjects as well as those who left the study prematurely, i.e. all study participants were included in the analysis, the overall treatment effect was still detectable, although not statistically significant.
The results were commented on as follows by Prof. Ralf Ihl: „There have been hints that Ginkgo biloba may exert a preventive effect. With the findings of this study we have first scientifically verifiable results suggesting that the extract may be useful for preventing the development of Alzheimer’s disease.“
The result of the GuidAge study agrees with the findings of two earlier cohort studies carried out in France, which also suggested a protective effect of EGb 761®. A study funded by the US National Institute on Aging as well found a dementia-protective effect in those subjects, who had taken their medication regularly. In another US study, a protective effect was not found, however. But towards the end of this study, the medicine was actually only taken by little more than half of the subjects. The results of the GuidAge study now again confirm the importance of a regular and long enough intake of 240 mg EGb 761® per day: A very high proportion of 93% of the participants took their medication regularly during the whole treatment period. Once again the excellent long-term safety profile of EGb 761® was confirmed.
Animal models also showed that EGb 761® intervenes in several of the processes decisive to the development of Alzheimer’s disease: the formation of harmful protein-compounds (so-called ?-amyloid) is inhibited and the nerve cell damage caused by these as well as by ageing processes reduced so that energy generation in the nerve cells can be maintained. The patented special extract EGb 761® contains a particularly high proportion of plant substances that are unique to Ginkgo, ginkgolides and bilobalide, and that are especially important for the protection of nerve cells.
The efficacy of EGb 761® in the treatment of dementia diseases has been confirmed recently in several meta-analyses of available studies. EGb 761® can also improve cognitive performance in people who do not yet show significant impairment. In summarizing the study results, Dr. Reiner Kaschel concluded: “Meta-analyses of the data by independent scientists consistently substantiate the efficacy of EGb 761® at the onset of cognitive decline.”
Tebonin® is a phytopharmaceutical for the treatment of decreasing mental capacity. It contains the patented Ginkgo special extract EGb 761®, developed and manufactured by Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe. EGb 761® is widely recognized as the best researched phytopharmaceutical world-wide and is available in more than 80 countries.
The Washington Post advises:– “…while the volume of that research grows, the safest course of action for both body and mind appears to be to keep our weight down, follow a regular course of moderate to intense exercise, and stick with it.”
How your morning lie-in could double risk of Alzheimer’s. ……….
Those who sleep for more than eight hours a day are twice as likely to develop Alzheimer’s, research suggests.
The danger affects both those who enjoy regular lie-ins in the morning and those who take naps in the afternoon, a study found.
The reason for the trend remains unclear. It could be that excessive sleep is an early sign of Alzheimer’s or other forms of dementia.
Staying in bed could also be a sign of depression, which is known to increase the risk of dementia in the elderly.
But it is also possible that excessive sleep actually increases the risk of developing the disease.
Researchers urged doctors to be on the look-out for long sleep as a warning that a patient is at risk.
Alzheimer’s affects an estimated 750,000 Britons and this is expected to rise as the population lives longer.
The latest research into the disease was carried out by experts at the University Hospital of Madrid in Spain.
They studied 3,286 men and women aged 65 or over.
Each one was asked about their health and lifestyle, such as how many hours of sleep they averaged over a 24-hour period, including afternoon naps.
The volunteers were then followed for more than three years, during which 140 went on to develop Alzheimer’s or another form of dementia.
The results showed those who averaged more than eight or nine hours of sleep a day were twice as likely to have developed dementia.
In a report on their findings, published in the European Journal of Neurology, the researchers said: ‘We found a significant association between long sleep duration and dementia.
‘Long sleep may be an early symptom of dementia, or could lead to an increased risk of it. But the mechanisms underlying this association are not readily explainable.’
Dr Susanne Sorensen, head of research at the Alzheimer’s Society, said: ‘This report demonstrates that sleeping longer than normal and feeling sleepy during the day is linked to getting dementia within three years.
‘There is no apparent physiological link and it is unlikely that sleeping more than normal is a direct risk factor for dementia; it may simply be an early sign of a yet undiagnosed condition. As currently only a third of people with dementia ever receive a formal diagnosis, more research is now needed to investigate these results.’
Alzheimer’s destroys chemical messengers in the brain.
It starts with the build-up of deposits called plaques and tangles which can disrupt normal messaging systems by causing inflammation.
The cause remains unknown but research suggests keeping the mind active, such as by doing quizzes, puzzles or crosswords, may help protect against this.
Earlier this week a report found that exercising regularly and sticking to a Mediterranean diet rich in fruit, vegetables, oily fish and nuts could cut the risk of Alzheimer’s by 80 per cent.
A study earlier this year found too much sleep is also linked to type two diabetes.
Regular lunchtime siestas increased the risk by 26 per cent, possibly by disrupting the body’s hormonal balance.
A radical approach to dementia care has been invented by a grandmother who has no medical training. Now the professionals are taking notice.
By all accounts, Dorothy Johnson was quite a woman. An international bridge player and an imaginative social organiser, she was entrepreneurial in the way she thought and fun to be with. She also succeeded in being best friend to her daughter, Penny. And, as Penny Garner puts it, if your best friend says something, you pay attention.
So when, at 59, Dorothy started to show symptoms of dementia and simultaneously to provide illuminating shafts of information about what was happening to her, Penny watched and listened hard. Like her mother, she was intrigued. She remembers the day Dorothy, feeling agitated, stood in her kitchen holding a list of reminders written for her by her concerned — and highly organised — husband.
“She looked at us and said, ‘Can you explain what is the point of writing these lists if I’m not going to remember to read them?’” On another occasion at Penny’s home Dorothy brandished a milk bottle and asked where the fridge was. “I wouldn’t be asking if I didn’t need the information,” she explained.
Over five years or so Penny made a series of observations that has enabled her to develop a radical new treatment for all forms of dementia. Called Specal — Specialised Early Care for Alzheimer’s — which is also the name of her charity, based in Burford in Oxfordshire, it revolves around her insight that while people who have dementia cannot store new facts, they can store new feelings.
As we all run on what’s just happened, and they can’t store new facts, their fuel is feelings,” she points out. “It’s abundantly clear that feelings are more important than facts to the person with dementia.”
This means that when a well-meaning carer points out to the person that they have forgotten something — say, to post a letter — they feel embarrassed and agitated. They have been unable to store the new information about needing to post the letter, but because they have been confronted with this fact, of which they have no knowledge, their overwhelming feeling is that they are not in control. Penny’s therapy is designed to cut out the confrontation that causes the person with dementia to dwell on negative emotions, so that even though they can’t remember what has just happened, they feel content.
Last year Oliver James, the clinical psychologist and Penny’s son-in-law, explained Specal in a book called Contented Dementia, which this week becomes available in paperback. The hardback sales, 20,000 so far and achieved largely through word of mouth, show that it is acquiring a following in families affected by dementia, and Penny is aware that it is filtering into GPs’ surgeries and care homes.
She and James recently presented her ideas to the Shadow Health Minister, Lord McColl of Dulwich, at the Centre for Policy Studies (CPS), and it is likely that Specal will become part of a future Conservative government’s policy, not least because people are living longer. At present 700,000 people in the UK have dementia and their care costs £17 billion a year. If, as expected, the number of people with dementia doubles over the next 30 years, the cost of care will spiral much higher.
“Increasing longevity and the sheer number of people with dementia means that there’s a huge need to find a better way to help than heavily drugging them and providing a poor quality life, as often happens,” says Jill Kirby, director of the CPS.
“Getting the Specal programme into nursing homes and local authorities is not potentially costly and, more importantly, it is humane. It’s a thoughtful and practical way of dealing with the needs of people with dementia and the Conservatives are quite likely to take it up.”
In many ways Specal is an unlikely therapy. It’s creator may be extremely bright, charismatic and intuitive, but she is also a Cotswolds granny in her mid-sixties who has no medical or nursing qualifications, just the confidence to make up her own rules based on 30 years of working with people who have dementia.
And Specal can seem counterintuitive. Conventional logic may tell us to try to orientate a person who has dementia by reminding them that today is Monday and they have forgotten to do something. Much better not to challenge them, Penny suggests. Instead bypass what they can’t remember and tune in to their long-term memory, which is still functioning as brain scans have proved, and use that to make emotional connections that enable them to make sense of the present.
“They haven’t lost their ability to reason, they’ve lost the information that other people around them are using to reason with,” she says. “But they do have some substitute stuff in their memory. My mother could recall stacks of stuff and when she did that she was confident. She would make an intelligent match between what she saw and old facts. Sitting in the doctor’s waiting room, she would think she was at an airport and ask if our flight had been called. If I said, ‘Not yet’, she was happy.
“But by challenging her my father could reduce her very easily to a dithering wreck. I began to see that there were facts that she could access in her memory, but that she couldn’t reach them when she was stressed. She was showing me that she could be two different people: one the person who had always been there, the other deranged. My mother was in there and she was unchanged if she was in touch with language and information that she understood.” Penny uses the metaphor of a photograph album. The photographs represent memories that we all have and that we use to make sense of what is happening to us. For someone with dementia the recent pages are blank, the old pages much more complete.
Specal focuses on this stored information, which relates to the past when the person was capable and felt in control, and uses that to engender feelings of well-being. Doing this relies on understanding an individual’s past, especially their enthusiasms, and plugging into what’s there, protecting them from needing new information. If someone enjoyed growing vegetables, ferreting out the expressions they use that relate to that and using them regularly not only enables them to make sense of what is happening to them, but makes them feel safe, in control and induces calm. Something like showing them a packet of seeds or saying, “The carrots will be coming along nicely,” can be used to get them to a table for a meal, or to the bathroom.”
Above all, Penny insists, don’t ask questions, don’t contradict. “That throws them on to today’s page of pictures, which is blank, so they don’t have the answers. It’s as though their memory is an artificial leg. If you argue with them about their inability to recall the present you’re kicking that away, pointing out their disability and rendering them incompetent. The carer has to understand that it’s he or she who has got to change.”
Isn’t it unethical to collude with people who think they are waiting for a flight when they are in the doctor’s surgery? “Which is the more unethical?” Penny counters. “To insist that they find something that isn’t in their memory? Or to use what they have got and make as good a match as they can?”
Oliver James believes that it is unethical not to facilitate the happier state, and points out that there is a cultural inconsistency here as most adults are happy to encourage children to believe in tooth fairies and Father Christmas.
“In psychiatric terms, there is a world of difference between somebody claiming to be Queen Victoria, and somebody describing a memory,” he says. “If somebody is experiencing a past in their present and that is giving them wellbeing, where is the ethical case for potentially starting off a cycle of loss of self-confidence and fear of madness? That’s what happens when you impose your version of reality on theirs.”
Specal has been endorsed by the Royal College of Nursing and the Alzheimer’s Society, and carers who have used it have reported a plateau of decline in their clients. Penny believes that this is because Specal clients no longer feel frightened by a world that they can’t understand. Carers also benefit from the lack of stress, she says, and Specal obviates the need for antipsychotic drugs, which subdue 100,000 of the 244,000 people with dementia living in care homes. There are also considerable cost savings associated with Specal’s reduction of the use of acute medical care.
Its weakness is that as yet there is only anecdotal evidence to show that it works. Dorothy Johnson died in 1984; 25 years later Penny and her son-in-law know that a scientific validation of the procedures that she initiated is a high priority.
Source: Timesonline, August 3, 2009