alzheimer’s

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The Upside Of Alzheimer’s?

(Timothy Kolczak/Unsplash)

(Timothy Kolczak/Unsplash)

Can Alzheimer’s ever heal relationships?

This week Modern Love: The Podcast (a collaboration between WBUR and The New York Times) explores the story of one family whose lives were changed — for the better — by the disease.

According to the National Institutes of Health (NIH), it is estimated that more than 5 million Americans suffer from the disease. Known for its devastating symptoms — memory loss, mood and personality changes — Alzheimer’s ranks third nationwide in the leading cause of death just behind heart disease and cancer.

Narrated by the actor Michael Shannon, Robert Leleux’s Modern Love essay, “A Memory Magically Interrupted,” retells the story of his grandmother’s struggle with the disease. While her memory was erased, her sense of humor remained.

“The wonderful thing about Alzheimer’s,” she would say, unfurling her arm like Bette Davis, “is that you always live in the moment.”

In an interview with WBUR’s Meghna Chakrabarti and New York Times Modern Love editor Daniel Jones, Leleux remembers the “hundreds of letters” he received after the essay was published.

One man wrote of his long estrangement from his father — a difficult man who had survived Auschwitz. Alzheimer’s changed his personality completely, erasing all memories of the trauma he had faced. The man wrote that he was finally able to have a relationship with his father at the end of his father’s life.

To listen to this episode, click here, or the player below:

‘Sundowning’: Why Hospital Staffs Dread Nightfall, And How To Help Seniors Avoid It

By Dr. David Scales

The elderly woman had been normal all day, my colleague told me, tolerating it well when a tube was placed in her bladder to measure her urine. But that evening, she was found wandering the hospital halls yelling in Italian, carrying her urine bag under her arm thinking it was her purse, traumatized that hospital staff were trying to take it away.

Another night in the hospital, a female Sri Lankan colleague saw an elderly man who was convinced she was a Nazi soldier. Reassurances and even a plea from the doctor — “How could I be a Nazi? I have brown skin!” — could not persuade him otherwise. The next day the patient was back to normal, incredulous when told about what transpired the night before.

An 80-year-old man — I’ll call him Bill — came to our emergency room after a fall. He seemed fine and his tests were negative, but his family wanted him admitted over night for observation. That evening, he began shouting out, repeatedly wanting to get up and walk to the bathroom (forgetting he had just gone). Our calming efforts only riled him up more.

This erratic nighttime behavior is called “sundowning.” Staff in hospitals and nursing homes always worry what will happen as twilight approaches. As the sun sets, many elderly patients can change drastically: They can become extremely confused, agitated, not know where they are, and even hallucinate. In other words, they exhibit signs of delirium, a confused state that can lead them to do things they otherwise wouldn’t.

Ulrich Joho/Flickr

Ulrich Joho/Flickr

Thankfully, not every elderly patient sundowns, but when one does, it can be emotionally traumatizing for everyone. To be confused or hallucinate, or to see a relative acting out in irrational ways, is frightening and destabilizing. Yet, sundowning seems to be extremely common. So, what is it? Why do people sundown? And what can you do to minimize the risk of sundowning in yourself or a close friend or relative?

Experts agree that confusion and agitation are more common in the evening and at night. But there is surprisingly little scientific consensus on what sundowning actually is.

The debate is in how much sundowning and delirium are related. Some experts think they’re the same thing, others separate but related entities.

It’s hard to study sundowning without a clear definition and diagnostic criteria. Experts can’t even be sure how often it happens. A recent review found a rate of anywhere from 2.4 percent to 66 percent. Continue reading

State-Funded Lab At Harvard Medical Aims To Reinvent Drug Discovery

Jerry Lin and Sharon Wang at the not yet one-year-old Laboratory of Systems Pharmacology at Harvard Medical School. The two are studying the effects of cancer treatment drugs on the heart. (Robin Lubbock/WBUR)

Jerry Lin and Sharon Wang at the not yet one-year-old Laboratory of Systems Pharmacology at Harvard Medical School. The two are studying the effects of cancer treatment drugs on the heart. (Robin Lubbock/WBUR)

Jerry Lin makes a few adjustments on his microscope and grins.

“Wow, it’s beating,” Lin says as a white cell floating across an inky black background begins to pulse. “That’s cool.” A few colleagues, including Lin’s lab partner, Sharon Wang, murmur approvingly.

“We want to take a real-time video to look at the pattern of how cells beat over time,” Wang says, explaining this stage of the experiment.

Once Lin and Wang understand the morphology of these heart muscle cells, they’ll test how the cells respond to various cancer treatments.

“Later on, we can look at how that frequency of beating responds to different drugs,” Wang says.

The experiment is important, says lab director Peter Sorger, because heart problems can be a side effect of a drug that stops the spread of breast cancer.

“On the one hand, it’s a marvelous magic bullet,” Sorger says. “On the other hand, it does damage on its way in. So the purpose of these studies is to understand precisely why that happens.”

Sorger and his team at the Laboratory of Systems Pharmacology are focused on cancer and on analyzing the ways cancer drugs affect the whole body. They aim to reinvent the drug development process through this systems approach, by going much deeper than would scientists supervising a typical clinical trial and by establishing a new model of collaboration. Continue reading

Dementia As A Global Public Health ‘Tidal Wave’

We often think of dementia as a private, intimate hell. A mother no longer recognizes her daughter’s voice. A father rages incoherently at a family dinner.

But it’s worth remembering the global scope of dementia; it’s a looming, worldwide public health disaster, a ‘tidal wave,” as the head of the World Health Organization recently put it, that’s growing worse each year.

This week, the World Health Organization held the first-ever ministerial conference calling for global action against dementia, saying, essentially, enough already, this is something we really need to deal with now.

The WHO’s Director General, Dr. Margaret Chan, offered some sobering perspective in her opening remarks and noted that there are three specific reasons to act now: “Dementia has a large human cost. Dementia has a large financial cost. Both of these costs are increasing.”

According to remarks distributed by the WHO, Chan spoke of dementia, including Alzheimer’s, in dire terms:

“The world has plans for dealing with a nuclear accident, cleaning up chemical spills, managing natural disasters, responding to an influenza pandemic, and combatting antimicrobial resistance. But we do not have a comprehensive and affordable plan for coping with the tidal wave of dementia that is coming our way.”

And the numbers are staggering:

–Dementia currently affects more than 47 million people worldwide, with more than 75 million people estimated to be living with dementia by 2030. The number is expected to triple by 2050.

–Dementia leads to increased long-term care costs for governments, communities, families and individuals, and to productivity loss for economies. The global cost of dementia care in 2010 was estimated to be U.S. $604 billion – 1.0% of global gross domestic product. By 2030, the cost of caring for people with dementia worldwide could be an estimated US $1.2 trillion or more, which could undermine social and economic development throughout the world.

–Nearly 60% of people with dementia live in low- and middle-income countries, and this proportion is expected to increase rapidly during the next decade, which may contribute to increasing inequalities between countries and populations.

Continue reading

A Boxer’s Brain And The Evolution Of Sports-Related Head Injuries

(don's athletics/Flickr)

(don’s athletics/Flickr)

(This post originally appeared on Boston University’s Research News website as “Head Examiner: Neurologist Ann McKee Talks About Battered Brains, Tangled Tau, And The Future of Sports“)

By Barbara Moran

For Ann McKee, every brain tells a story. And sometimes it’s a tragic one. McKee, a professor of neurology and pathology at the Boston University School of Medicine (MED), is the director of neuropathology for the Veterans Affairs New England Healthcare System, and also directs BU’s Chronic Traumatic Encephalopathy Center. Chronic traumatic encephalopathy (CTE) is a degenerative brain disease found in athletes with a history of repetitive brain trauma. McKee first identified its telltale mark—tiny tangles of a protein called tau, clustered around blood vessels—in the dissected brain of a boxer who had been diagnosed with Alzheimer’s disease.

Although most people associate CTE with professional football players, McKee has found it in the brains of soccer, hockey, rugby, and baseball players as well. Her research has alerted the public to the long-term dangers of repetitive hits in sports and raised tough questions about safety. McKee was invited to speak about this growing public health concern at the annual meeting of the American Association for the Advancement of Science (AAAS), the world’s largest general scientific society, held in February 2015 in San Jose, CA. She told BU Research the story behind her discovery of CTE, and what it might mean for the future of sports.

BU Research: You’re a world expert on tau protein, which has been implicated in Alzheimer’s, CTE, and other brain diseases. Have you studied tau your whole career?

McKee: Yes. I love tau.

Why?

It’s beautiful, the way it collects throughout the nervous system and just sort of fills up the nerve cell. It’s always been quite lovely to look at, visually captivating. I mean, how crazy is that? But it’s true.

When you started studying tau, you were studying Alzheimer’s?

I was interested in Alzheimer’s, but I also worked on PSP (progressive supernuclear palsy), and something called corticobasal degeneration.

Those are not so famous.

No, they’re not so famous. But I got very involved in defining what these individual diseases looked like. It’s like being at the Smithsonian and being really interested in one collection of pottery or something. And once you start understanding it, you start seeing all these differences, and it’s like “Whoa!”

Brains with CTE show a distinct pattern of tau protein, seen here in brown. The two slides on the bottom come from the brain of a 66-year-old ex-NFL player. The slides on top are from a 65-year-old man without CTE. Photo courtesy of Ann McKee

Do you remember the first time you saw a brain with CTE?

Yes. It was phenomenally interesting. The first case was Paul Pender, a professional [middleweight] boxer here in the Boston area. He had twice been world champion. That was my first time seeing it under the microscope. I looked at the slide and it was like “Oh my God! This is so amazing. I’ve never seen anything like this.” It just blew my mind. That was 2003.

How did it look different than, say, a brain with Alzheimer’s?

Alzheimer’s disease has these beta amyloid plaques that look like small puffs of smoke throughout the brain. Continue reading

Summertime Blues: Pesticide-Laden Strawberries And Your Health

Pesticide spraying at a farm on the North Shore of Massachusetts. (Photo: Alexandra Morris)

Pesticide spraying at a farm on the North Shore of Massachusetts. (Photo: Alexandra Morris)

By Alexandra Morris

This weekend marks the start of the summer season, but I can’t help dwelling on the downside. Each year at this time, crowds from urban Boston descend on the farm next to my parents’ house on the North Shore in Mass. to pick their own strawberries – fresh, sweet, ripe…and coated with toxins.

While the farm staff warns visitors to wash the fruit before eating it, many choose to snack along the way (one group was caught sitting in the strawberry field with a can of “Reddi-Whip” in hand). After all, what’s the cost of a few unwashed strawberries?

Unfortunately, when it comes to our health, the cost may be fairly high.

Over the years, researchers have documented the bad effects of pesticide exposure on human health. Recently, though, and at a forum this week at Harvard, there’s been increased attention on the links between pesticides and neurodegenerative diseases, notably Parkinson’s and Alzheimer’s.

In a study published earlier this year in the journal Neurology, researchers from UCLA identified the way in which certain pesticides can increase the risk of Parkinson’s disease. They also found that people with a common genetic variant are even more sensitive to these pesticides – they are two to five times more likely to develop Parkinson’s if exposed.

“Once you identify the toxicity of these things, getting rid of the bad pesticides…would be a goal, not just for the people that live in the area, but for the workers that use it,” said the study’s lead author, Dr. Jeff Bronstein, a professor of neurology at UCLA.

In a separate report out of Rutgers University, published in JAMA Neurology, researchers found that exposure to the pesticide DDT may increase the risk of developing Alzheimer’s disease. In the study, researchers found that levels of DDE, the chemical compound that develops when DDT breaks down, were higher in the blood of Alzheimer’s patients compared to those without the disease.

And the effects go beyond the risk of Parkinson’s and Alzheimer’s. Marc Weisskopf, an associate professor of environmental and occupational epidemiology at the Harvard School of Public Health, who spoke at the Harvard forum, said there is evidence that pesticides contribute to a host of neurodevelopmental disorders as well, from ADHD and developmental disorders to lowered cognitive performance. Continue reading

Facing The Inevitable: From Lost Keys To Dementia

I recently turned 50 and, on cue, my AARP card came in the mail and my doctor told me to schedule my first colonoscopy.

Also on cue, I’ve noticed what seems to be my own increased mental scattered-ness — misplaced keys, sluggish name recall. As a catastrophizer, I immediately link this apparent (but my doctor assures me normal) ever-so-slight decrease in cognitive sharpness to full blown Alzheimer’s and the start of a bleak, diminished future.

I am slightly comforted by two factors. First, I’m hardly alone. As Michael Kinsley eloquently reports in his recent New Yorker piece, “Have You Lost Your Mind?” we baby boomers are the first generation to have witnessed our parents cognitive decline and know in terrifying detail what’s in store for us; but at least we’re all on this sinking ship together. Second, there’s a lot of genetics behind Alzheimer’s and cognitive decline, and in that department, I’m not in bad shape. My parents kvetch, but they’re both nearly 80 and my mother, in particular, lives an incredibly active life on her own in Brooklyn: she recently learned chess, ushers off-Broadway with friends most weekends and walks and does yoga everyday.

joeduty/flickr

joeduty/flickr

Also, researchers are busily trying to tackle this problem on numerous fronts. On Sunday, for example, Harvard scientists reported what felt like a breakthrough: a new protein that in mice seems to have a rejuvenating effect on brains and muscles.

And a fairly technical study just out in Biological Psychiatry also hints at the possibility of future fixes: using something called “imaging genetics” researchers at the Lieber Institute for Brain Development and the National Institute of Mental Health are trying to identify “key molecular switches that control age-related memory impairment” and are specifically looking at a protein known to play a role in human memory, called “KIBRA and the gene responsible for its production.” Continue reading

The Grandma Effect: A Little Caregiving Sharpens Brain, A Lot Dulls It

(Douglas/flickr)

(Douglas/flickr)

There’s an old saying in medicine: “The dose makes the poison.”

Personally, I find the adage holds true in many contexts, from nutrition to exercise to parenting: often too much of a good thing turns toxic.

Here’s the latest twist: A new report finds that grandmothers who care for their grandkids once a week experience a boost in mental sharpness. But if that one day of cozy caregiving expands to five or more days a week, it can put grandma on edge, and her brain can grow duller, with more memory and other cognitive problems.

Here’s what the researchers conclude, from the abstract:

The data suggest that the highest cognitive performance is demonstrated by postmenopausal women who spend 1 day/week minding grandchildren; however, minding grandchildren for 5 days or more per week predicts lower working memory performance and processing speed. These results indicate that highly frequent grandparenting predicts lower cognitive performance.

And here’s more info on the study (via news release) published online in the journal Menopause:

Taking care of grandkids one day a week helps keep grandmothers mentally sharp, finds a study from the Women’s Healthy Aging Project study in Australia…That’s good news for women after menopause, when women need to lower their risks of developing Alzheimer’s disease and other cognitive disorders.

On the other hand, taking care of grandchildren five days a week or more had some negative effects on tests of mental sharpness. “We know that older women who are socially engaged have better cognitive function and a lower risk of developing dementia later, but too much of a good thing just might be bad,” said NAMS Executive Director Margery Gass, MD. Continue reading

Why To Exercise Today: Don’t Get Stupider


Forgive the headline. “Stupid” is a harsh word, though it’s the best descriptor for how I sometimes feel. Rather, shall we say, let us avoid cognitive decline, including dementia.

Two new studies are just out showing that exercise lowers the rate of cognitive impairment in older people. One possible explanation: The brain’s decline can be connected to problems with blood supply, and exercise is good for the cardiovascular system.

From the press release:

CHICAGO – Engaging in regular physical activity is associated with less decline in cognitive function in older adults, according to two studies published Online First by Archives of Internal Medicine, one of the JAMA/Archivesjournals. The articles are being released on July 19 to coincide with the International Conference on Alzheimer’s Disease in Paris and will be included in the July 25 print edition.

According to background information provided in the articles, previous research has suggested that physical activity is associated with reduced rates of cognitive impairment in older adults. However, much of this research has apparently been conducted among individuals who are generally in good health. Further, many of these studies rely on self-reports of physical activity, which are not always accurate; and focus on moderate or vigorous exercise, instead of low-intensity physical activity. The two articles being presented today seek to fill in these gaps in the research. Continue reading

Researchers May Have Key To Predicting Alzheimer's — But Do You Really Want To Know?

Hard questions arise on screening for incurable diseases, like Alzheimer's

By Marielle Segarra, WBUR intern

If you could find out with relative certainty that you’ll get a disease that is currently incurable would you want to know?

Relatives of people with Alzheimer’s Disease may begin asking themselves this question in light of new research that could form the basis of an accurate blood test for the disease.

A Scripps Research Institute study published in the journal Cell this month has identified two antibodies that may be markers for Alzheimer’s.

The levels of these antibodies were three times higher in the blood of those with Alzheimer’s Disease than they were in the blood of healthy participants or participants with Parkinson’s Disease.

Typically, antibodies are difficult to identify because they must be located through antigens that trigger them. But the study pioneered a new method, using synthetic molecules, rather than their antigens, to measure antibodies.

If developed further, the test could prove more accurate than any others already in use.

But how could knowing your status affect you when there is no cure? Continue reading