According to new study in the New England Journal of Medicine, people with a gene variant that sharply increases the risk of Alzheimer’s disease in old age may show memory impairment earlier than thought.

A variant of the APOE gene indicates whether a person has a greater risk of developing Alzheimer’s disease.
 Between 20 and 35 percent of Americans have one or two copies of this gene variant, inherited from one or both parents. People with one copy of the variant, called apolipoprotein E-e4 (APOE e4), have a 29 percent lifetime risk of developing Alzheimer’s disease, while people who don’t have it have a 9 percent risk.

People with two copies of APOE e4 have an even higher Alzheimer’s risk, but it’s hard to define the exact percentage as only 2 percent of the population falls into this category.

Despite the gene-related health problems, another study in the same issue of the journal suggests that people who learn they do have APOE e4 seem to handle the information pretty well. But the researchers excluded people with anxiety or depression, and they followed people for just a year.

In a recent report released by the Alzheimer’s Association estimates that Alzheimer’s disease and dementia triple the health-care costs for those seniors.The people who live in nursing homes or assisted living facilities pay an average of $17,000 in out-of-pocket costs each year, researchers found. The association also estimates that nearly 10 million unpaid caregivers of people with Alzheimer’s disease spent 8.5 billion hours in 2008 watching over their loved ones, care valued at an estimated $94 billion.

About 5.3 million Americans have Alzheimer’s disease, according to the association’s Facts and Figures report for 2009. The number includes about 14 percent of people aged 71 and older.

The report finds that:

The average annual health-care cost for someone older than 65 with Alzheimer’s or another form of dementia was $33,007 in 2004 — three times more than the $10,603 for people that age without the conditions.
Deaths from Alzheimer’s disease rose by 47 percent from 2000 to 2006 while the number of deaths from several other major diseases — including heart attack, stroke, breast cancer and prostate cancer — fell during that period.
States in the Rocky Mountains and Northwest will see the number of people with Alzheimer’s disease increase by at least 81 percent between 2000 and 2025.
By 2025, California and Florida will each be home to more than a half-million people with Alzheimer’s disease.

Startling Stats! You can visit www.alz.org to read the entire article.

According to U.S. News and World Report’s America’s Best Nursing Homes rankings alaska has the largest percentage of five-star rated facilities in the United States, while Louisiana has the lowest. The list expands on information from the Centers for Medicare & Medicaid Services’ Nursing Home Compare Web site, which houses the new “five-star” rating system.

The CMS five-star system rates nursing homes on three criteria: health inspection performance, nurse staffing levels, and quality performance and improvement measures. The U.S. News system creates a multi-tiered approach to deciphering the CMS model. Nursing home search results are grouped based on the number of CMS stars received in each of the three categories, and allow for combined searches. For example, users can search for a CMS five-star rated facility in a certain state or zip code, then refine the search to show only religious facilities or facilities with only Medicare residents, according to the magazine.

Facilities that receive five stars in all three CMS categories are placed on an honor roll. There are currently 27 facilities on the list and information is updated quarterly. You can view the full list at:http://health.usnews.com/sections/health/best-nursing-homes/index.html.

A recent research study suggests there may one day be a blood test to accurately diagnose Alzheimer’s disease and its level of severity.

A team of scientists from the Medical College of Georgia and the University of Georgia discovered a “strong and consistent relationship” between certain antibodies and levels of cognitive impairment associated with Alzheimer’s. The antibodies are created when the body detects the presence of two specific proteins that are strongly associated with Alzheimer’s disease: amyloid-beta protein and RAGE protein.

For the study, researchers took blood samples from 118 older adults and compared antibody levels with levels of cognitive impairment. Researchers hope the discovery of the link between the two factors will eventually lead to a blood test for the disease.

The research can be found in the current issue of the Journal of Gerontology: Medical Sciences.

Diabetics, including those who become diagnosed in middle age, have more than double the risk of acquiring Alzheimer’s or other forms of dementia later in life, new research shows. Those who got diabetes before the age of 65 were 125% more likely to acquire Alzheimer’s, Gatz said. Study results were published in last month’s issue of the American Diabetes Association journal Diabetes.

“Our results highlighted the need to maintain a healthy lifestyle during adulthood in order to reduce the risk of dementia late in life,” said Dr. Margaret Gatz, director of the Study of Dementia in Swedish Twins.

Those who got diabetes before the age of 65 were 125% more likely to acquire Alzheimer’s, Gatz said. Study results were published in last month’s issue of the American Diabetes Association journal Diabetes.

In the January issue of the Journal of Alzheimer’s Disease a recent study found that individuals who drink three to five cups of coffee in middle age have lower risks for dementia and Alzheimer’s later in life than those who drink more, or steer clear of the brew altogether.

“Given the large amount of coffee consumption globally, the results might have important implications for the prevention of or delaying the onset of dementia/AD,” said lead researcher Miia Kivipelto an associate professor at the University of Kuopio in Finland and Karolinska Institute in Sweden. “The finding needs to be confirmed by other studies, but it opens the possibility that dietary interventions could modify the risk of dementia/AD. Also, identification of mechanisms of how coffee exerts its protection against dementia/AD might help in the development of new therapies for these diseases.”

Source: Journal of Alzheimer’s Disease

In more than half of the studies, published since the 1990s, moderate drinkers of wine, beer and liquor had lower dementia risks than nondrinkers. In only a few studies were there increased risks.

“Alcohol is a two-edged sword,” said Michael Collins, Ph.D., a professor and neuroscientist at Loyola University Chicago Stritch School of Medicine and lead author of the refereed report in the journal Alcoholism: Clinical and Experimental Research. “Too much is bad. But a little might actually be helpful.”

Moderate alcohol consumption generally is defined as 1 drink or less per day for women and 1-2 drinks or less per day for men.

The article will be published in the February 2009 issue of the journal, and is available on line now. The article summarizes a roundtable, organized by Collins, held at the Research Society on Alcoholism meetings in Chicago in 2007.

“The pathological damage and vast social havoc from addiction to and abuse of alcohol are well known, and of necessity should continue to receive primary attention by doctors, scientific researchers and health professionals,” Collins and colleagues write. “However, light-to-moderate responsible alcohol consumption “appears to carry certain health benefits.”

Long-term alcohol abuse can cause memory loss and impair cognitive function. It’s unknown why moderate alcohol use appears to have the opposite effect. One theory is that the well-known cardiovascular benefits of moderate alcohol consumption also can reduce the risk of mini strokes that cause dementia.

Collins and another Loyola professor, neuroscientist Edward Neafsey, Ph.D., suggest a second possible explanation. Small amounts of alcohol might, in effect, make brain cells more fit. Alcohol in moderate levels stresses cells and thus toughens them up to cope with major stresses down the road that could cause dementia.

For most people who drink responsibly and in moderation, there’s probably no reason to quit. But because of the potential for alcohol to be abused, Collins and Neafsey do not recommend that abstainers begin drinking. The researchers note there are other things besides moderate drinking that can reduce the risk of dementia, including exercise, green tea, education and a Mediterranean diet high in fruits, vegetables, cereals, beans, nuts and seeds.

Moreover, there are times when people should never drink, including adolescence, pregnancy and before driving, Collins said.

Source: Loyola University

A recent study done by North Carolina State University found that spikes in blood pressure are directly linked to diminished cognitive function among the elderly. This correlation holds especially true for those seniors with already high blood pressure, their report suggests. Study subjects with an average systolic blood pressure of 130 or higher experienced a significant decrease in cognitive function when faced with a sudden spike in blood pressure.

Typically, such spikes occur during stressful moments, report authors say. This suggests that some seniors may find it hard to think rationally or logically during stressful situations. Report authors note that seniors with normal or lower blood pressure do not experience the same diminished cognitive functions under stress. 

Source: Journal of Gerontology: Psychological Sciences.

Long before any doctor diagnoses the disease, most people who have Alzheimer’s have done something that is very out of character, embarrassing or even dangerous to themselves or others. The Alzheimer’s label rarely surprises family members or friends—rather, it just gives a name to the changes they have already been witnessing.

When will Alzheimer’s patients have the luxury of getting their diagnosis in the privacy of their doctor’s office, early enough so they can still comprehend the news in time to do something to stop the disease’s progress (assuming treatments become available)? Researchers who are developing the technology for early diagnosis predict that this may happen as soon as five years from now. Here are a few examples of what the scientists are working on:

With a type of magnetic resonance imaging (MRI) used primarily in research studies, researchers compared the brains of two groups of women. A high-risk group in their late 50s had both a family history of dementia as well as the apolipoprotein E4 allele (APOE4), a genetic variant that increases a person’s chances of getting Alzheimer’s. A comparison group in their late 60s had no extra risk factors. All of the women did fine on an extensive set of memory and intelligence tests.

The MRI assessed the brain’s white matter, which is made up of the fibers that connect one brain region to another. Myelin insulates these fibers, but that insulation thins as people age. Despite their normal cognitive abilities, the women carrying the genetic risk for Alzheimer’s had changes in these fibers that were not caused by aging and were similar to those seen in people with the disease.

New research suggests that medical officials often fail to record severe dementia as a cause of death in patients with the condition.

This finding not only points to a lack of knowledge about how dementia — a hallmark of Alzheimer’s disease — can be a deadly illness, it suggests that deaths due to Alzheimer’s and dementia may be severely underestimated, said report co-author Dr. Susan Mitchell, an associate professor of medicine at Harvard Medical School.
“With dementia so underrepresented on death certificates, it further exacerbates the issue of dementia not being a terminal illness,” Mitchell said. In addition, she said, bad assumptions about dementia can lead doctors and relatives to make ill-informed decisions about patients at the end of life.
Alzheimer’s disease is the fifth leading cause of death among people 65 and older in the United States, according to 2004 federal statistics. Those figures were based on information from death certificates, Mitchell said, and some studies have suggested the numbers are too low.
In the new study, Mitchell and her colleagues examined the medical records and death certificates of 165 patients with advanced dementia who died between 2003 and 2007. They all lived in Boston-area nursing homes.
Thirty-seven percent of the death certificates didn’t list dementia as the main cause of death or a contributing factor. Just 16 percent listed dementia as the main cause of death.
In patients with diagnosed Alzheimer’s disease, one-third didn’t mention the condition as a cause of death or contributing factor, the study found.