Archive for April, 2011

There are currently two classes of medications that are FDA approved for treating Alzheimer’s disease. The cholinesterase inhibitors have been in use the longest. There are three drugs in this class Aricept (generic name is donepezil and it is now available in generic equivalent form), Exelon (generic name is rivastigmine and is available as either an oral tablet or as a patch), and Razadyne (generic name is galantamine). In general, despite conflicting opinions of efficacy and mechanism of action, drugs from this class tend to increase the level of acetylcholine in neurons and slow the rate of progression in many who can tolerate them. These medications are FDA approved for all stages of Alzheimer’s disease. There is no clear clinical benefit for one over another. The other medication is named Namenda (other brand names are Axura, Akatinol, Ebixa, or Memox […]

Alzheimer’s disease is being redefined to include three phases. An early phase where there are no obvious symptoms but changes are occurring in the brain. A middle phase where the problems are mild and the diagnosis would be called Mild Cognitive Impairment. A third phase where the changes are severe enough to be called dementia (i.e., independence is lost). The most sticking, and hopefully controversial, change is the addition of the early phase where there are changes in the brain but no symptoms of cognitive decline. This phase is defined by the use of biomarkers such as brain scans and tests of cerebral spinal fluid. The problems with this early phase include the fact that there are no standardized biological tests or results defining this phase. Second, 30% of people with amyloid plaques never develop clinical signs of Alzheimer’s disease. […]

We often focus on the cognitive changes such as memory that predict risk of decline and future dementia. But those who work or live with persons that ultimately obtain a diagnosis of Alzheimer’s disease know there is more to it than just memory. Equally as damaging are changes in what researchers at Rush University Medical Center are call “life space.” Life space is getting out and about. Those with restricted life space don’t venture far from home. One of the studies recently coming out of Rush’s longitudinal study of aging demonstrated a link between restricted life space and latter development of Mild Cognitive Impairment and Alzheimer’s disease. There were 1294 participants who had no mental decline at the beginning of the study. Participants were assessed after 4 to 8 years with detailed tests of cognitive functioning. Life space was defined […]

It’s never too early to start monitoring and measuring cardiovascular and brain/memory functioning. It’s never too early to start a life plan to protect your heart and your brain. Recent results from the Whitehall II study indicate that cardiovascular risk profile in midlife predicts later cognitive decline. Cardiovascular risk was calculated from the Framingham General Cardiovascular Risk Profile (which you can look up online). The Framingham profile includes age, sex, total cholesterol, HDL cholesterol, smoking status, systolic blood pressure, and medications for blood pressure. The Whitehall II study was begun in 1985-1988 and recruited 10,308 civil servants in London. The participants were aged 35-55 at the time. The most recent findings were based on 3486 men and 1314 women who were free of cardiovascular disease at entry into the study and had an average age of 55. Cognitive function (i.e., […]

Lewy Body Disease is the second most common cause of progressive dementia after Alzheimer’s disease affecting over 1 million in the U.S. Dr. Frederich discovered aggregates of proteins in the brain stem that deplete a neurotransmitter known as dopamine. This causes Parkinson’s symptoms and the abnormal proteins are known as Lewy Bodies. In some persons, Lewy bodies diffuse out of the core brain structures to other areas of the brain causing diffuse Lewy body disease. Lewy Body disease is a progressive brain disorder characterized by decline in short-term memory (not as prominent as in Alzheimer’s disease), visual hallucinations (but other types of hallucinations may occur), movement disorders (e.g., slowness of movement or speaking, shuffling feet, walking stiffly, falls, blank stare), delusions (false ideas about another person such as partner having an affair), sleep disorders (e.g., movement, gesturing, speaking during sleep […]

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