Stop-Motion Animated Film About the Progression of Alzheimer’s

Art, with its capacity for expressing in abstract form experiences and emotions too complex or confusing to name explicitly, has proven itself a powerful medium for exploring mental health issues — from artist Bobby Baker’s diary drawings of borderline personality disorder to children’s illustrations of what it’s like to have autism.

Now comes Undone, a beautiful and bittersweet stop-motion film by animator Hayley Morris, inspired by her grandfather, which captures with tender abstraction the progression of Alzheimer’s disease.

Alzheimer's Disease: Damage Starts earlier than first thought

The first changes in the brain of a person with Alzheimer’s disease can be observed as much as ten years in advance – ten years before the person in question has become so ill that he or she can be diagnosed with the disease.

This is what a new study from Lund University in Sweden has found.

Physician Oskar Hansson and his research group are studying biomarkers – substances present in spinal fluid and linked to Alzheimer’s disease.

The group has studied close to 140 people with mild memory impairment, showing that a certain combination of markers (low levels of the substance beta-amyloid and high levels of the substance tau) indicate a high risk of developing Alzheimer’s disease in the future.

As many as 91 per cent of the patients with mild memory impairment who had these risk markers went on to develop Alzheimer’s within a ten-year period.

In contrast, those who had memory impairment but normal values for the markers did not run a higher risk of getting Alzheimer’s than healthy individuals. Oskar Hansson previously carried out a study showing that pathological changes can be seen in the brain of an Alzheimer’s patient five years before the diagnosis.

The new study has thus doubled this time span to ten years.

“This is a very important finding with regard to the development of new therapies against the disease.

All prospective therapies have so far shown to be ineffective in stopping the disease, and many people are concerned that the pharmaceutical companies will give up their efforts in this field.

But these failures may depend on the fact that the new therapies were initiated too late. When a patient receives a diagnosis today, the damage has already gone too far,” says Oskar Hansson.

With the help of the biomarkers studied by the group, pharmaceutical companies will now be able to identify the people with mild symptoms who run the highest risk of developing Alzheimer’s within a ten-year period.

These individuals can then be offered the opportunity of taking part in trials for new medicines, while those who run a low risk of developing the disease do not need to be involved. A new trial of this kind is already underway, on the basis of the earlier study by the Hansson group.

The 90 per cent accuracy of the risk markers means that they are not sufficient as the only method for early diagnosis of Alzheimer’s. But if they can be combined with a clinical assessment and, for example, imaging of the blood flow in the brain, it should be possible to increase the level of accuracy, according to Oskar Hansson.

However, this will only be relevant once drugs that are effective in slowing down the disease have been developed. Only then will it really be meaningful to identify patients earlier than is currently possible.

By observing how the levels of the biomarkers develop over the ten years before the patient’s diagnosis, the research group has also been able to map the progression of the disease in the brain.

The results indicate that it starts with a modified turnover of beta-amyloid. Only later is this followed by changes in the tau protein and damage to nerve cells. This can be important information for those developing new therapies for Alzheimer’s.

Adiponectin: Hormone affects Dementia in Woman

Women with an abnormal number of a certain hormone are more likely to develop dementia, as suggested by latest study conducted in cooperation with the Framingham Heart Study (FHS).

Participants from the Boston University cardiovascular research initiatives provided frozen blood samples that allowed scientists to isolate a hormone known as adiponectin, which the new research findings said appear to be connected with dementia.

According to a report by U.S. network ABC, the study drew its conclusion on the analysis of 840 participants, which were monitored for 13 years, with 159 of them suffering brain degeneration with one common denominator - high presence of adiponectin.

The results, according to Dr Ernst Schaefer of Tufts University, were somewhat perplexing as the pursued links between dementia and diabetes were further complicated by what the researchers have so far appreciated from the decade-old study.

While science generally regards adiponectin as an important agent in preventing the onset of diabetes, its purportedly dementia-inducing function, at least in the context of the FHS experiment, had caught the researchers by surprise.

Trackers: GPS shoes for Alzheimer's patients

The first shoes with built-in GPS devices, to help track down dementia-suffering seniors who wander off and get lost, are set to hit the US market this month, the manufacturer says.

GTX Corp said the first batch of 3,000 pairs of shoes has been shipped to the footwear firm Aetrex Worldwide, two years after plans were announced to develop the product.

The shoes will sell at around $300 a pair and buyers will be able to set up a monitoring service to locate "wandering" seniors suffering from Alzheimer's Disease.

Andrew Carle, a professor at George Mason University's College of Health and Human Services who was an adviser on the project, said the shoes are likely to save lives and avoid embarrassing and costly incidents with the elderly.

"It's especially important for people in the earliest stages of Alzheimer's who are at the highest risk," Carle told AFP.

"They might be living in their home but they're confused. They go for a walk and they can get lost for days."

Carle said studies indicate more than five million Americans suffer from Alzheimer's, a number expected to quadruple in the coming years. He said 60 percent of sufferers will wander and become lost and up to half of those lost who are not found within 24 hours may die, from dehydration, exposure or injury.

Other devices such as bracelets or pendants can provide similar protection but seniors often reject these.

"The primary reason is that paranoia is a manifestation of the disease," Carle said. "If you put something on someone with Alzeheimer's that they don't recognize, they remove it. If it's a wristwatch and it's not their wristwatch, they will take it off. So you have to hide it."

The GPS system, which is implanted in the heel of what appears to be a normal walking shoe, allows family members or carers to monitor the wearer and to set up a "geofence" that would trigger an alert if the person strays beyond a certain area.

The shoes are being developed by GTX Corp., which makes miniaturized Global Positioning Satellite tracking and location-transmitting technology, and Aetrex. They received certification from the Federal Communications Commission this year for the system.

The makers say the market for such shoes is growing, given the soaring costs of Alzheimer's.

"This is a significant milestone for both companies and while the $604 billion worldwide cost of dementia has become and will continue to be a significant fiscal challenge, the under $300 GPS enabled shoes will ease the enormous physical and emotional burden borne by Alzheimer's victims, caregivers and their geographically distant family members," said Patrick Bertagna, chief executive of GTX Corp.

Professor Carle said the original idea was to develop the shoes for children and long-distance runners but the makers changed the plan when he offered his advice, noting that the devices can also help ease a lot of anxiety about seniors who want to remain active.

"They feel a need to walk and it is good for them," he said. "They should take a walk. It's good for them."

Repeated Head Blows may cause Premature Dementia disease in athlete brain

Professional athletes who suffer repeated blows to the head are at risk for developing a brain disease that years later manifests as memory loss, mood disorders, and even early dementia.

The pattern of protein tangles and plaques associated with the disease, known as chronic traumatic encephalopathy (CTE), is distinct from those in Alzheimer’s patients, according to new research reported in the journal Neurosurgery.

“The first thing is to identify the disease, give it a name, and identify its pathology. We’ve done that,” says Bennet Omalu, associate clinical professor of pathology at University of California, Davis. Omalu was the first to describe CTE in 2002, after examining the brain of former Pittsburgh Steelers football player Mike Webster
“We’re seeing CTE in any activity that subjects your brain to repeated acceleration and deceleration.”

In the current study, Omalu and colleagues detailed histological examinations of the brains of 17 athletes who played contact sports, including eight professional football players, four professional wrestlers, and three high school football players. All had died suddenly from suicide, drug abuse, or in accidents.

The researchers diagnosed CTE in 10 of the 14 professional athletes, and one high school football player.

Important differences exist between CTE and Alzheimer’s disease, Omalu says.

Subjects with CTE have tangles of tau proteins in their brains that were similar to those seen in later-stage Alzheimer’s patients, but they occurred in a very different pattern. While the tangles in Alzheimer’s patients are scattered throughout the brain, those in the athletes exhibited a “skip phenomenon.”

The tangles occurred in some areas of the cerebral cortex but were absent in others within the same lobe. In addition, the brains of the athletes did not show the classic neuritic amyloid plaques or the widespread cerebral atrophy characteristic of Alzheimer’s disease.

Finally, the subjects diagnosed with CTE ranged from 18 to 52 years old, whereas Alzheimer’s disease typically does not occur until after age 60.

The study also questions the connection between CTE and a variant of the apolipoprotein E gene. Previous researchers have linked the ApoE4 allele to a predisposition for Alzheimer’s disease and the behaviour changes of CTE, but the CTE-positive subjects in this study were more likely to have the ApoE3 genotype, which is associated with tangle-only dementia. The CTE also produces tangle-only brain abnormalities.

Identifying the genotypes associated with CTE could help patients evaluate the risks they face when playing high contact sports.

“Although we do not have the capability now, it may one day be possible to develop a battery of genetic tests to identify individuals at high, medium or low risk for CTE. Knowing whether you had these certain types of genes, you may be advised not to play football,” Omalu says.

Currently, CTE can only be diagnosed during autopsy. Omalu and his colleagues are now focusing their research on ways to identify the disease in the living and to develop potential drug treatments.

In the meantime, “parents need to be aware of the dangers of repeated blows to the head sustained by children in football, wrestling, and hockey. The younger you are when you start playing, the greater risk you have of permanent brain damage,” says Omalu.

“We need to embark on an aggressive education of physicians and parents, so people are able to make informed judgments before they decide to play or not to play.”

The research received funding from the West Virginia University Foundation, the Hazel Ruby McQuain Charitable Trust, and Robert Fitzsimmons.

More news from UC Davis: http://www.news.ucdavis.edu/

Spouses of dementia sufferers have a 6-fold increased risk of dementia onset | ScienceBlog.com

Spouses of dementia sufferers have a 6-fold increased risk of dementia onset ScienceBlog.com

Older married adults whose spouse has dementia are at significantly higher risk for developing dementia themselves, compared to similar older married adults whose spouse never develops dementia. This is the key finding of a study published today in the Journal of the American Geriatrics Society.

Informal dementia caregiving for a spouse is a natural marital obligation, and spousal caregivers often report positive feelings toward caregiving, yet it is difficult, requiring time, energy and usually physical exertion.

Dementia caregivers have been shown to provide more assistance, and to report more personal sacrifices and stress, than those who care for physically-impaired elderly without dementia.

While there are many published studies showing that dementia caregivers are at higher risk for health problems and depression, none have examined risk for dementia in the caregiver.

2,442 subjects (1,221 married couples) aged 65 and older from Northern Utah, USA, without dementia at onset were studied for up to 12 years to monitor for onset of dementia in husbands, wives or both. During this time, 125 cases of dementia only in the husband were diagnosed, 70 only in the wife, and 30 where both spouses were diagnosed (60 people).

The researchers, led by Dr. Maria Norton of Utah State University, USA, adjusted for socioeconomic status, a significant predictor of many health-related outcomes including dementia to control for shared environmental exposures that might influence risk for dementia in both spouses.

The results showed that incident dementia was significantly associated with older age, and having a spouse with dementia. Participants with a spouse who developed dementia were at a six times increased risk of developing dementia, net of the effect of age, gender, APOE genotype, and socioeconomic status, with higher risk in men (11.9) than women (3.7).

"Future studies are needed to determine how much of this association is due to caregiver stress compared to a shared environment," said Norton. "On the positive side, the majority of these individuals, with spouses who develop dementia, did not themselves develop dementia, therefore more research is needed to explore which factors distinguish those who are more vulnerable."

"Given the significant public health concern of Alzheimer's disease and other dementias, and the upcoming shift in population age composition, continued research into the causes of dementia is urgent," concluded Norton.

Link: http://www.wiley.com/wiley-blackwell

Dementia: The Networking Brain Breaks Down

(Image: George Mattei / SPL)

The network structure of healthy brains allows very efficient communication between different brain regions.

YOU might expect the brain of someone with a mental disorder to be disorganised. But it's the nature of the disorganisation that's important - a finding that one day could help early diagnosis of different types of dementia.

We already know that the different regions of healthy brains are linked in a so-called small-world network, which makes communication very efficient. For people with Alzheimer's or other types of dementia, however, it's a different story.

In small-world networks - which also emerge, for example, in social networks - each node is connected to a lot of nearby nodes, but also has a few links to distant ones. Because of this, any node can communicate with almost any other in just a few hops.

This may explain the brain's formidable ability to process masses of information rapidly. "A small world, in theoretical terms, is the optimal network," says Willem de Haan of the VU University Medical Center in Amsterdam, the Netherlands.

De Haan's team used scalp electrodes to measure the brain activity of resting volunteers, of whom 20 had mild to moderate Alzheimer's, 15 had a rare form of dementia called frontal temporal lobe dementia (FTLD), and 23 were healthy. The researchers figured out the underlying network structure of the volunteers' brains from the electrical activity in different regions over time.

In healthy brains, this structure resembled a small-world network, as expected. In people with Alzheimer's, the nodes were connected more randomly; in FTLD, the network was more ordered, with fewer long-distance links. The researchers think that in both abnormal cases the brain networks would be less efficient at exchanging information, and that this might explain some of the cognitive problems experienced by people with these disorders (BMC Neuroscience, DOI: 10.1186/1471-2202-10-101).