Tag Archives: Dementia

University of Southern California study: Forty percent of dementia cases could be prevented or delayed by targeting 12 risk factors throughout life

10 Aug

Kathleen Fifield wrote in the AARP Journal article, Dementia vs. Alzheimer’s: Which Is It? How to understand the difference — and why it matters:

What it is

Dementia 

In the simplest terms, dementia is a decline in mental function that is usually irreversible. It’s a syndrome, not a disease, notes neurologist Ron Petersen, director of the Mayo Clinic Alzheimer’s Disease Research Center and the Mayo Clinic Study of Aging in Rochester, Minnesota.

The catchall phrase encompasses several disorders that cause chronic memory loss, personality changes or impaired reasoning, Alzheimer’s disease being just one of them, says Dan G. Blazer, a psychiatrist and professor at Duke University Medical Center.

To be called dementia, the disorder must be severe enough to interfere with your daily life, says psychiatrist Constantine George Lyketsos, director of the Johns Hopkins Memory and Alzheimer’s Treatment Center in Baltimore.

What it’s not? Typical forgetfulness caused by aging — say, having trouble remembering the name of an acquaintance who comes up to you on the street. In fact, the earliest stage of dementia, known as mild cognitive impairment, is considered “forgetfulness beyond what is expected from aging,” Petersen says. With mild cognitive impairment, a person is still functioning normally — paying her bills, driving well enough, doing his taxes — though performing some of those tasks may take longer than they used to. When someone starts to need regular assistance to do such daily activities, “that gets into the dementia range,” Petersen says.

Alzheimer’s

Alzheimer’s is a specific brain disease that progressively and irreversibly destroys memory and thinking skills. Age is the biggest risk factor for the disease. Eventually, Alzheimer’s disease takes away the ability to carry out even the simplest tasks.

To help determine whether patients have this particular brain disease, doctors talk to the patients and their close family members about any recent challenges or changes in behavior or memory. They also administer a mental status exam in an office setting, and possibly do a short neuro-psych evaluation….

How it’s diagnosed

Dementia

A doctor must find that you have two cognitive or behavioral areas in decline to diagnose dementia. These areas are disorientation, disorganization, language impairment, mood change, personality change and memory loss. To make an evaluation, a doctor (often a specialist such as a psychiatrist, neurologist or geriatric medicine physician) typically takes a patient history and administers several mental-skill challenges.

Thanks to growing medical consensus that irritability, depression and anxiety often flag dementia before memory issues do (and official changes to the diagnostic criteria to reflect this), doctors also ask more about changes in mood or personality, Lyketsos notes….

Next, a standard and fairly brief round of memory and thinking tests is given in the same office visit. In the Hopkins Verbal Learning Test, for example, you try to memorize and then recall a list of 12 words — and a few similar words may be thrown in to challenge you. Another test — also used to evaluate driving skills — has you draw lines to connect a series of numbers and letters in a complicated sequence.

Alzheimer’s 

For decades, diagnosing Alzheimer’s disease has been a process of elimination based on looking at a person’s symptoms and mental-test scores, then ruling out other types of dementia, such as Parkinson’s dementia or vascular dementia.

With Alzheimer’s in particular, the progression and timing of symptoms is also important. To identify this degenerative brain disease, doctors are looking for “a gradual, insidious onset that is slowly getting worse,” Petersen says.

Until fairly recently, a conclusive diagnosis was not possible until an autopsy was performed and the brain examined for the physical hallmarks of the disease — beta-amyloid and tau, proteins that look like plaques and tangles in the brain.

Now, a patient can immediately request a PET scan or cerebrospinal fluid sampling that can show, with 95 percent accuracy, whether such plaques or tangles are present. But a high percentage of patients never get such a test, doctors say. PET scans aren’t normally covered by insurance, and treatments based on specifics such as whether you have more amyloid plaques or more tau tangles in your brain aren’t yet available.

What’s more, doctors say they are often confident, based on evidence such as memory tests, a patient’s age and the progression of symptoms, that a patient suffers from Alzheimer’s in particular. Having a PET scan done also doesn’t change the available treatment, which so far consists of only a handful of drugs used to briefly control symptoms of the disease. Without conclusive imaging, doctors will still act on what they call the strong assumption someone has “probable” Alzheimer’s….                                                                                                                    https://www.aarp.org/health/dementia/info-2018/difference-between-dementia-alzheimers.html?CMP=KNC-DSO-Adobe-Bing-Health-DementiaSpotlight&utm_source=bing&utm_medium=cpc&utm_campaign=Health%20%3E%20Dementia%20%3E%20Research%20%3E%20Exact&utm_term=dementia%20versus%20alzheimer%27s&utm_content=Dementia%20or%20Alzheimer&gclid=CJri45bkkesCFUrSfgodFWsCBA&gclsrc=ds

Resources:

Alzheimer’s vs. Dementia                                                                                                            webmd.com/alzheimers/guide/alzheimers-and-dementia-whats-the-difference#1

Alzheimer’s and dementia: What’s the difference?                                                                  https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/expert-answers/alzheimers-and-dementia-whats-the-difference/faq-20396861

Dementia and Alzheimer’s: What Are the Differences?                                                            https://www.healthline.com/health/alzheimers-disease/difference-dementia-alzheimers

See,  https://drwilda.com/tag/dementia/

Science Daily reported in Forty percent of dementia cases could be prevented or delayed by targeting 12 risk factors throughout life:

Modifying 12 risk factors over a lifetime could delay or prevent 40% of dementia cases, according to an updated report by the Lancet Commission on dementia prevention, intervention and care presented at the Alzheimer’s Association International Conference (AAIC 2020).

Twenty-eight world-leading dementia experts added three new risk factors in the new report — excessive alcohol intake and head injury in mid-life and air pollution in later life. These are in addition to nine factors previously identified by the commission in 2017: less education early in life; mid-life hearing loss, hypertension and obesity; and smoking, depression, social isolation, physical inactivity and diabetes later in life (65 and up)….

Dementia affects some 50 million people globally, a number that is expected to more than triple by 2050, particularly in low- and middle-income countries where approximately two-thirds of people with dementia live, according to the report. Women are also more likely to develop dementia than men.

However, in certain countries, such as the United States, England and France, the proportion of older people with dementia has fallen, probably in part due to lifestyle changes, demonstrating the possibility of reducing dementia through preventative measures, Schneider says.

Schneider and commission members recommend that policymakers and individuals adopt the following interventions:

  • Aim to maintain systolic blood pressure of 130 mm Hg or less from the age of 40.
  • Encourage use of hearing aids for hearing loss and reduce hearing loss by protecting ears from high noise levels.
  • Reduce exposure to air pollution and second-hand tobacco smoke.
  • Prevent head injury (particularly by targeting high-risk occupations).
  • Limit alcohol intake to no more than 21 units per week (one unit of alcohol equals 10 ml or 8 g pure alcohol).
  • Stop smoking and support others to stop smoking.
  • Provide all children with primary and secondary education.
  • Lead an active life into mid-life and possibly later life.
  • Reduce obesity and the linked condition of diabetes.

The report also advocates for holistic, individualized and evidenced-based care for patients with dementia, who typically have more hospitalizations for conditions that are potentially manageable at home and are at greater risk for COVID-19. In addition, it recommends providing interventions for family caregivers who are at risk for depression and anxiety…..                                                                                                                                        https://www.sciencedaily.com/releases/2020/07/200730123651.htm

 

Citation:

Forty percent of dementia cases could be prevented or delayed by targeting 12 risk factors throughout life

Date:       July 30, 2020

Source:   University of Southern California – Health Sciences

Summary:

Forty percent of dementia cases could be prevented or delayed by targeting 12 risk factors throughout life, experts say.

Journal Reference:

Gill Livingston, Jonathan Huntley, Andrew Sommerlad, David Ames, Clive Ballard, Sube Banerjee, Carol Brayne, Alistair Burns, Jiska Cohen-Mansfield, Claudia Cooper, Sergi G Costafreda, Amit Dias, Nick Fox, Laura N Gitlin, Robert Howard, Helen C Kales, Mika Kivimäki, Eric B Larson, Adesola Ogunniyi, Vasiliki Orgeta, Karen Ritchie, Kenneth Rockwood, Elizabeth L Sampson, Quincy Samus, Lon S Schneider, Geir Selbæk, Linda Teri, Naaheed Mukadam. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 2020; DOI: 10.1016/S0140-6736(20)30367-6

Here is the press release from the University of Southern California:

NEWS RELEASE 30-JUL-2020

Forty percent of dementia cases could be prevented or delayed by targeting 12 risk factors throughout life

An update to the Lancet Commission on dementia prevention, intervention and care adds excessive alcohol intake, head injury and air pollution to nine previously identified modifiable risks

UNIVERSITY OF SOUTHERN CALIFORNIA – HEALTH SCIENCES

LOS ANGELES — Modifying 12 risk factors over a lifetime could delay or prevent 40% of dementia cases, according to an updated report by the Lancet Commission on dementia prevention, intervention and care presented at the Alzheimer’s Association International Conference (AAIC 2020).

Twenty-eight world-leading dementia experts added three new risk factors in the new report — excessive alcohol intake and head injury in mid-life and air pollution in later life. These are in addition to nine factors previously identified by the commission in 2017: less education early in life; mid-life hearing loss, hypertension and obesity; and smoking, depression, social isolation, physical inactivity and diabetes later in life (65 and up).

“We are learning that tactics to avoid dementia begin early and continue throughout life, so it’s never too early or too late to take action,” says commission member and AAIC presenter Lon Schneider, MD, co-director of the USC Alzheimer Disease Research Center’s clinical core and professor of psychiatry and the behavioral sciences and neurology at the Keck School of Medicine of USC.

Dementia affects some 50 million people globally, a number that is expected to more than triple by 2050, particularly in low- and middle-income countries where approximately two-thirds of people with dementia live, according to the report. Women are also more likely to develop dementia than men.

However, in certain countries, such as the United States, England and France, the proportion of older people with dementia has fallen, probably in part due to lifestyle changes, demonstrating the possibility of reducing dementia through preventative measures, Schneider says.

Schneider and commission members recommend that policymakers and individuals adopt the following interventions:

  • Aim to maintain systolic blood pressure of 130 mm Hg or less from the age of 40.
  • Encourage use of hearing aids for hearing loss and reduce hearing loss by protecting ears from high noise levels.
  • Reduce exposure to air pollution and second-hand tobacco smoke.
  • Prevent head injury (particularly by targeting high-risk occupations).
  • Limit alcohol intake to no more than 21 units per week (one unit of alcohol equals 10 ml or 8 g pure alcohol).
  • Stop smoking and support others to stop smoking.
  • Provide all children with primary and secondary education.
  • Lead an active life into mid-life and possibly later life.
  • Reduce obesity and the linked condition of diabetes.

The report also advocates for holistic, individualized and evidenced-based care for patients with dementia, who typically have more hospitalizations for conditions that are potentially manageable at home and are at greater risk for COVID-19. In addition, it recommends providing interventions for family caregivers who are at risk for depression and anxiety.

The commission members conducted a thorough investigation of all the best evidence in the field, including systematic literature reviews, meta-analyses and individual studies, to reach their conclusions.

###

For more information about Keck Medicine of USC, please visit news.KeckMedicine.org.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Alzheimer’s and Dementia Alliance of Wisconsin described why early detection is important:

Early diagnosis is key.
There are at least a dozen advantages to obtaining an early and accurate diagnosis when cognitive symptoms are first noticed.
1. Your symptoms might be reversible.
The symptoms you are concerned about might be caused by a condition that is reversible. And even if there is also an underlying dementia such as Alzheimer’s disease, diagnosis and treatment of reversible conditions can improve brain function and reduce symptoms.

  1. It may be treatable.
    Some causes of cognitive decline are not reversible, but might be treatable. Appropriate treatment can stop or slow the rate of further decline.
    3. With treatments, the sooner the better.
    Treatment of Alzheimer’s and other dementia-causing diseases is typically most effective when started early in the disease process. Once more effective treatments become available, obtaining an early and accurate diagnosis will be even more crucial.
  2. Diagnoses are more accurate early in the disease process.
    A more accurate diagnosis is possible when a complete history can be taken early in the disease process, while the person is still able to answer questions and report concerns and when observers can still recall the order in which symptoms first appeared. Obtaining an accurate diagnosis can be difficult once most of the brain has become affected.
    5. It’s empowering.
    An earlier diagnosis enables the person to participate in their own legal, financial, and long-term care planning and to make their wishes known to family members.
    6. You can focus on what’s important to you.
    It allows the person the opportunity to reprioritize how they spend their time – focusing on what matters most to them – perhaps completing life goals such as travel, recording family history, completing projects, or making memories with grandchildren while they still can.
    7. You can make your best choices.
    Early diagnosis can prevent unwise choices that might otherwise be made in ignorance – such as moving far away from family and friends, or making legal or financial commitments that will be hard to keep as the disease progresses.
    8. You can use the resources available to you.
    Individuals diagnosed early in the disease process can take advantage of early-stage support groups and learn tips and strategies to better manage and cope with the symptoms of the disease.
    9. Participate or advocate for research.
    Those diagnosed early can also take advantage of clinical trials – or advocate for more research and improved care and opportunities.
    10. You can further people’s understanding of the disease.
    Earlier diagnosis helps to reduce the stigma associated with the disease when we learn to associate the disease with people in the early stages, when they are still cogent and active in the community.
    11. It will help your family.
    An earlier diagnosis gives families more opportunity to learn about the disease, develop realistic expectations, and plan for their future together – which can result in reduced stress and feelings of burden and regret later in the disease process.
    12. It will help you, too.
    Early diagnosis allows the person and family to attribute cognitive changes to the disease rather than to personal failings – preserving the person’s ego throughout the disease process….                           https://alzwisc.org/Importance%20of%20an%20early%20diagnosis.htm

AI’s role in treatment of Alzheimer’s is an example of better living through technology.

CONSULT A COMPETENT MEDICAL PROFESSIONAL FOR DIAGNOSIS AND TREATMENT OF ANY SUSPECTED DECLINE IN MENTAL FACULTIES

Resources:

What Is Alzheimer’s?                                                                           https://www.alz.org/alzheimers-dementia/what-is-alzheimers

Understanding Alzheimer’s Disease: the Basics  https://www.webmd.com/alzheimers/guide/understanding-alzheimers-disease-basics

What’s to know about Alzheimer’s disease? https://www.medicalnewstoday.com/articles/159442.php

Alzheimer’s Disease                                       https://www.cdc.gov/aging/aginginfo/alzheimers.htm

What is Artificial Intelligence?  https://www.computerworld.com/article/2906336/emerging-technology/what-is-artificial-intelligence.html

Artificial Intelligence: What it is and why it matters https://www.sas.com/en_us/insights/analytics/what-is-artificial-intelligence.html

Brain                                                                                                           https://drwilda.com/tag/brain/

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McGill University study: AI could predict cognitive decline leading to Alzheimer’s disease in the next five years

7 Oct

The National Institute on Aging described Alzheimer’s disease in What Is Alzheimer’s Disease?:

Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. In most people with the disease—those with the late-onset type—symptoms first appear in their mid-60s. Early-onset Alzheimer’s occurs between a person’s 30s and mid-60s and is very rare. Alzheimer’s disease is the most common cause of dementia among older adults.
The disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles).
These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body. Many other complex brain changes are thought to play a role in Alzheimer’s, too.
This damage initially appears to take place in the hippocampus, the part of the brain essential in forming memories. As neurons die, additional parts of the brain are affected. By the final stage of Alzheimer’s, damage is widespread, and brain tissue has shrunk significantly.
How Many Americans Have Alzheimer’s Disease?
Estimates vary, but experts suggest that as many as 5.5 million Americans age 65 and older may have Alzheimer’s. Many more under age 65 also have the disease. Unless Alzheimer’s can be effectively treated or prevented, the number of people with it will increase significantly if current population trends continue. This is because increasing age is the most important known risk factor for Alzheimer’s disease.
What Does Alzheimer’s Disease Look Like?
Memory problems are typically one of the first signs of Alzheimer’s, though initial symptoms may vary from person to person. A decline in other aspects of thinking, such as finding the right words, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimer’s disease. Mild cognitive impairment (MCI) is a condition that can be an early sign of Alzheimer’s, but not everyone with MCI will develop the disease.
People with Alzheimer’s have trouble doing everyday things like driving a car, cooking a meal, or paying bills. They may ask the same questions over and over, get lost easily, lose things or put them in odd places, and find even simple things confusing. As the disease progresses, some people become worried, angry, or violent…. https://www.nia.nih.gov/health/what-alzheimers-disease

Artificial Intelligence (AI) might provide clues to the early detection of Alzheimer’s.

Live Science described AI in What Is Artificial Intelligence?:

One of the standard textbooks in the field, by University of California computer scientists Stuart Russell and Google’s director of research, Peter Norvig, puts artificial intelligence in to four broad categories:
The differences between them can be subtle, notes Ernest Davis, a professor of computer science at New York University. AlphaGo, the computer program that beat a world champion at Go, acts rationally when it plays the game (it plays to win). But it doesn’t necessarily think the way a human being does, though it engages in some of the same pattern-recognition tasks. Similarly, a machine that acts like a human doesn’t necessarily bear much resemblance to people in the way it processes information.
• machines that think like humans,
• machines that act like humans,
• machines that think rationally,
• machines that act rationally.

Even IBM’s Watson, which acted somewhat like a human when playing Jeopardy, wasn’t using anything like the rational processes humans use.
Tough tasks
Davis says he uses another definition, centered on what one wants a computer to do. “There are a number of cognitive tasks that people do easily — often, indeed, with no conscious thought at all — but that are extremely hard to program on computers. Archetypal examples are vision and natural language understanding. Artificial intelligence, as I define it, is the study of getting computers to carry out these tasks,” he said….
Computer vision has made a lot of strides in the past decade — cameras can now recognize faces Other tasks, though, are proving tougher. For example, Davis and NYU psychology professor Gary Marcus wrote in the Communications of the Association for Computing Machinery of “common sense” tasks that computers find very difficult. A robot serving drinks, for example, can be programmed to recognize a request for one, and even to manipulate a glass and pour one. But if a fly lands in the glass the computer still has a tough time deciding whether to pour the drink in and serve it (or not).

Common sense
The issue is that much of “common sense” is very hard to model. Computer scientists have taken several approaches to get around that problem. IBM’s Watson, for instance, was able to do so well on Jeopardy! because it had a huge database of knowledge to work with and a few rules to string words together to make questions and answers. Watson, though, would have a difficult time with a simple open-ended conversation.
Beyond tasks, though, is the issue of learning. Machines can learn, said Kathleen McKeown, a professor of computer science at Columbia University. “Machine learning is a kind of AI,” she said.
Some machine learning works in a way similar to the way people do it, she noted. Google Translate, for example, uses a large corpus of text in a given language to translate to another language, a statistical process that doesn’t involve looking for the “meaning” of words. Humans, she said, do something similar, in that we learn languages by seeing lots of examples.
That said, Google Translate doesn’t always get it right, precisely because it doesn’t seek meaning and can sometimes be fooled by synonyms or differing connotations….
The upshot is AIs that can handle certain tasks well exist, as do AIs that look almost human because they have a large trove of data to work with. Computer scientists have been less successful coming up with an AI that can think the way we expect a human being to, or to act like a human in more than very limited situations…. https://www.livescience.com/55089-artificial-intelligence.html

AI might prove useful in diagnosing cognitive decline leading to Alzheimer’s.

Science Daily reported in AI could predict cognitive decline leading to Alzheimer’s disease in the next five years:

A team of scientists has successfully trained a new artificial intelligence (AI) algorithm to make accurate predictions regarding cognitive decline leading to Alzheimer’s disease.
Dr. Mallar Chakravarty, a computational neuroscientist at the Douglas Mental Health University Institute, and his colleagues from the University of Toronto and the Centre for Addiction and Mental Health, designed an algorithm that learns signatures from magnetic resonance imaging (MRI), genetics, and clinical data. This specific algorithm can help predict whether an individual’s cognitive faculties are likely to deteriorate towards Alzheimer’s in the next five years.
“At the moment, there are limited ways to treat Alzheimer’s and the best evidence we have is for prevention. Our AI methodology could have significant implications as a ‘doctor’s assistant’ that would help stream people onto the right pathway for treatment. For example, one could even initiate lifestyle changes that may delay the beginning stages of Alzheimer’s or even prevent it altogether,” says Chakravarty, an Assistant Professor in McGill University’s Department of Psychiatry.
The findings, published in PLOS Computational Biology, used data from the Alzheimer’s Disease NeuroImaging Initiative. The researchers trained their algorithms using data from more than 800 people ranging from normal healthy seniors to those experiencing mild cognitive impairment, and Alzheimer’s disease patients. They replicated their results within the study on an independently collected sample from the Australian Imaging and Biomarkers Lifestyle Study of Ageing.
Can the predictions be improved with more data?
“We are currently working on testing the accuracy of predictions using new data. It will help us to refine predictions and determine if we can predict even farther into the future,” says Chakravarty. With more data, the scientists would be able to better identify those in the population at greatest risk for cognitive decline leading to Alzheimer’s.
According to the Alzheimer Society of Canada, 564,000 Canadians had Alzheimer’s or another form of dementia in 2016. The figure will rise to 937,000 within 15 years.
Worldwide, around 50million people have dementia and the total number is projected to reach 82million in 2030 and 152 in 2050, according to the World Health Organization. Alzheimer’s disease, the most common form of dementia, may contribute to 60-70% of cases. Presently, there is no truly effective treatment for this disease…. https://www.sciencedaily.com/releases/2018/10/181004155421.htm

Citation:

AI could predict cognitive decline leading to Alzheimer’s disease in the next five years
Algorithms may help doctors stream people onto prevention path sooner
Date: October 4, 2018
Source: McGill University
Summary:
A team of scientists has successfully trained a new artificial intelligence (AI) algorithm to make accurate predictions regarding cognitive decline leading to Alzheimer’s disease.

Journal Reference:
Nikhil Bhagwat, Joseph D. Viviano, Aristotle N. Voineskos, M. Mallar Chakravarty. Modeling and prediction of clinical symptom trajectories in Alzheimer’s disease using longitudinal data. PLOS Computational Biology, 2018; 14 (9): e1006376 DOI: 10.1371/journal.pcbi.1006376

Here is the press release from McGill University:

AI Could Predict Cognitive Decline Leading to Alzheimer’s Disease in the Next 5 Years
News
Algorithms may help doctors stream people onto prevention path sooner
PUBLISHED: 4OCT2018
A team of scientists has successfully trained a new artificial intelligence (AI) algorithm to make accurate predictions regarding cognitive decline leading to Alzheimer’s disease.
Dr. Mallar Chakravarty, a computational neuroscientist at the Douglas Mental Health University Institute, and his colleagues from the University of Toronto and the Centre for Addiction and Mental Health, designed an algorithm that learns signatures from magnetic resonance imaging (MRI), genetics, and clinical data. This specific algorithm can help predict whether an individual’s cognitive faculties are likely to deteriorate towards Alzheimer’s in the next five years.
“At the moment, there are limited ways to treat Alzheimer’s and the best evidence we have is for prevention. Our AI methodology could have significant implications as a ‘doctor’s assistant’ that would help stream people onto the right pathway for treatment. For example, one could even initiate lifestyle changes that may delay the beginning stages of Alzheimer’s or even prevent it altogether,” says Chakravarty, an Assistant Professor in McGill University’s Department of Psychiatry.
The findings, published in PLOS Computational Biology, used data from the Alzheimer’s Disease NeuroImaging Initiative. The researchers trained their algorithms using data from more than 800 people ranging from normal healthy seniors to those experiencing mild cognitive impairment, and Alzheimer’s disease patients. They replicated their results within the study on an independently collected sample from the Australian Imaging and Biomarkers Lifestyle Study of Ageing.
Can the predictions be improved with more data?
“We are currently working on testing the accuracy of predictions using new data. It will help us to refine predictions and determine if we can predict even farther into the future,” says Chakravarty. With more data, the scientists would be able to better identify those in the population at greatest risk for cognitive decline leading to Alzheimer’s.
According to the Alzheimer Society of Canada, 564,000 Canadians had Alzheimer’s or another form of dementia in 2016. The figure will rise to 937,000 within 15 years.
Worldwide, around 50million people have dementia and the total number is projected to reach 82million in 2030 and 152 in 2050, according to the World Health Organization. Alzheimer’s disease, the most common form of dementia, may contribute to 60–70% of cases. Presently, there is no truly effective treatment for this disease.

This work was funded by the Canadian Institutes of Health Research, the Natural Sciences andEngineering Research Council of Canada, the Fonds de recherche du Québec—Santé, Weston Brain Institute, Michael J. Fox Foundation for Parkinson’s Research, Alzheimer’s Society, Brain Canada, and the McGill University Healthy Brains for Healthy Lives – Canada First Research Excellence Fund.
The article “Modeling and prediction of clinical symptom trajectories in Alzheimer’s disease” was published in PLOS Computational Biology
For information and interviews
Bruno Geoffroy
Press Information Officer – Media Relations Office
CIUSSS de l’Ouest-de-l’Île-de-Montréal (Douglas Mental Health University Institute)
Tel.: 514-630-2225, ext. 5257 //relations.medias.comtl [at] ssss.gouv.qc.ca”>relations.medias.comtl@ssss.gouv.qc.ca

Alzheimer’s and Dementia Alliance of Wisconsin described why early detection is important:

Early diagnosis is key.
There are at least a dozen advantages to obtaining an early and accurate diagnosis when cognitive symptoms are first noticed.
1. Your symptoms might be reversible.
The symptoms you are concerned about might be caused by a condition that is reversible. And even if there is also an underlying dementia such as Alzheimer’s disease, diagnosis and treatment of reversible conditions can improve brain function and reduce symptoms.

2. It may be treatable.
Some causes of cognitive decline are not reversible, but might be treatable. Appropriate treatment can stop or slow the rate of further decline.
3. With treatments, the sooner the better.
Treatment of Alzheimer’s and other dementia-causing diseases is typically most effective when started early in the disease process. Once more effective treatments become available, obtaining an early and accurate diagnosis will be even more crucial.

4. Diagnoses are more accurate early in the disease process.
A more accurate diagnosis is possible when a complete history can be taken early in the disease process, while the person is still able to answer questions and report concerns and when observers can still recall the order in which symptoms first appeared. Obtaining an accurate diagnosis can be difficult once most of the brain has become affected.
5. It’s empowering.
An earlier diagnosis enables the person to participate in their own legal, financial, and long-term care planning and to make their wishes known to family members.
6. You can focus on what’s important to you.
It allows the person the opportunity to reprioritize how they spend their time – focusing on what matters most to them – perhaps completing life goals such as travel, recording family history, completing projects, or making memories with grandchildren while they still can.
7. You can make your best choices.
Early diagnosis can prevent unwise choices that might otherwise be made in ignorance – such as moving far away from family and friends, or making legal or financial commitments that will be hard to keep as the disease progresses.
8. You can use the resources available to you.
Individuals diagnosed early in the disease process can take advantage of early-stage support groups and learn tips and strategies to better manage and cope with the symptoms of the disease.
9. Participate or advocate for research.
Those diagnosed early can also take advantage of clinical trials – or advocate for more research and improved care and opportunities.
10. You can further people’s understanding of the disease.
Earlier diagnosis helps to reduce the stigma associated with the disease when we learn to associate the disease with people in the early stages, when they are still cogent and active in the community.
11. It will help your family.
An earlier diagnosis gives families more opportunity to learn about the disease, develop realistic expectations, and plan for their future together – which can result in reduced stress and feelings of burden and regret later in the disease process.
12. It will help you, too.
Early diagnosis allows the person and family to attribute cognitive changes to the disease rather than to personal failings – preserving the person’s ego throughout the disease process….                             https://alzwisc.org/Importance%20of%20an%20early%20diagnosis.htm

AI’s role in treatment of Alzheimer’s is an example of better living through technology.

Resources:
What Is Alzheimer’s?                                                                            https://www.alz.org/alzheimers-dementia/what-is-alzheimers

Understanding Alzheimer’s Disease: the Basics https://www.webmd.com/alzheimers/guide/understanding-alzheimers-disease-basics

What’s to know about Alzheimer’s disease? https://www.medicalnewstoday.com/articles/159442.php

Alzheimer’s Disease                                         https://www.cdc.gov/aging/aginginfo/alzheimers.htm

What is Artificial Intelligence? https://www.computerworld.com/article/2906336/emerging-technology/what-is-artificial-intelligence.html

Artificial Intelligence: What it is and why it matters https://www.sas.com/en_us/insights/analytics/what-is-artificial-intelligence.html
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University of Virginia study: Alzheimer’s drug may stop disease if used before symptoms develop, study suggests

5 Aug

The Alzheimer’s Association describes Alzheimer’s Disease:

Alzheimer’s and Dementia basics
• Alzheimer’s is the most common cause of dementia, a general term for memory loss and other cognitive abilities serious enough to interfere with daily life. Alzheimer’s disease accounts for 60 percent to 80 percent of dementia cases.
Learn more: What Is Dementia, Research and Progress
• Alzheimer’s is not a normal part of aging. The greatest known risk factor is increasing age, and the majority of people with Alzheimer’s are 65 and older. But Alzheimer’s is not just a disease of old age. Approximately 200,000 Americans under the age of 65 have younger-onset Alzheimer’s disease (also known as early-onset Alzheimer’s).
Learn more: Early-Onset Alzheimer’s, Risk Factors

• Alzheimer’s worsens over time. Alzheimer’s is a progressive disease, where dementia symptoms gradually worsen over a number of years. In its early stages, memory loss is mild, but with late-stage Alzheimer’s, individuals lose the ability to carry on a conversation and respond to their environment. Alzheimer’s is the sixth leading cause of death in the United States. Those with Alzheimer’s live an average of eight years after their symptoms become noticeable to others, but survival can range from four to 20 years, depending on age and other health conditions.
Learn more: 10 Warning Signs, Stages of Alzheimer’s Disease
• Alzheimer’s has no current cure, but treatments for symptoms are available and research continues. Although current Alzheimer’s treatments cannot stop Alzheimer’s from progressing, they can temporarily slow the worsening of dementia symptoms and improve quality of life for those with Alzheimer’s and their caregivers. Today, there is a worldwide effort under way to find better ways to treat the disease, delay its onset, and prevent it from developing.
Learn more: Treatments, Treatment Horizon, Prevention, Clinical Trials
Help is available
If you or a loved one has been diagnosed with Alzheimer’s or another dementia, you are not alone. The Alzheimer’s Association is the trusted resource for reliable information, education, referral and support to millions of people affected by the disease.
• Call our 24/7 Helpline: 800.272.3900
• Locate your local Alzheimer’s Association
• Use our Virtual Library
• Go to Alzheimer’s Navigator to create customized action plans and connect with local support services https://www.alz.org/alzheimers-dementia/what-is-alzheimers

A University of Virginia study points to treating the disease before symptoms manifest as the most desired option.

Science Daily reported in Alzheimer’s drug may stop disease if used before symptoms develop, study suggests:

About 50 percent of people who reach the age of 85 will develop Alzheimer’s disease. Most will die within about five years of exhibiting the hallmark symptoms of the disease — severe memory loss and a precipitous decline in cognitive function.
But the molecular processes that lead to the disease will have begun years earlier.
Currently, there are no known ways to prevent the disease or to stop its progression once it has begun. But research at the University of Virginia offers new understanding of how the disease develops at the molecular level, long before extensive neuronal damage occurs and symptoms show up.
Additionally, the researchers have found that an FDA-approved drug, memantine, currently used only for alleviating the symptoms of moderate-to-severe Alzheimer’s disease, might be used to prevent or slow the progression of the disease if used before symptoms appear. The research also offers, based on extensive experimentation, a hypothesis as to why this might work.
The findings are published currently online in the journal Alzheimer’s & Dementia.
“Based on what we’ve learned so far, it is my opinion that we will never be able to cure Alzheimer’s disease by treating patients once they become symptomatic,” said George Bloom, a UVA professor and chair of the Department of Biology, who oversaw the study in his lab. “The best hope for conquering this disease is to first recognize patients who are at risk, and begin treating them prophylactically with new drugs and perhaps lifestyle adjustments that would reduce the rate at which the silent phase of the disease progresses.
“Ideally, we would prevent it from starting in the first place.”
As Alzheimer’s disease begins, there is a lengthy period of time, perhaps a decade or longer, when brain neurons affected by the disease attempt to divide, possibly as a way to compensate for the death of neurons. This is unusual in that most neurons develop prenatally and then never divide again. But in Alzheimer’s the cells make the attempt, and then die.
“It’s been estimated that as much as 90 percent of neuron death that occurs in the Alzheimer’s brain follows this cell cycle reentry process, which is an abnormal attempt to divide,” Bloom said. “By the end of the course of the disease, the patient will have lost about 30 percent of the neurons in the frontal lobes of the brain…” https://www.sciencedaily.com/releases/2018/08/180801160022.htm

Citation:

Alzheimer’s drug may stop disease if used before symptoms develop, study suggests
Date: August 1, 2018
Source: University of Virginia
Summary:
Biologists have gained new understanding of how Alzheimer’s disease begins, and how it might be halted using a current medication.
Journal Reference:
1. Erin J. Kodis, Sophie Choi, Eric Swanson, Gonzalo Ferreira, George S. Bloom. N-methyl-D-aspartate receptor–mediated calcium influx connects amyloid-β oligomers to ectopic neuronal cell cycle reentry in Alzheimer’s disease. Alzheimer’s & Dementia, 2018; DOI: 10.1016/j.jalz.2018.05.017

Here is the press release from the University of Virginia:

Study: Alzheimer’s Drug May Stop Disease if Used Before Symptoms Develop
July 31, 2018
• Fariss Samarrai, farisss@virginia.edu
About 50 percent of people who reach the age of 85 will develop Alzheimer’s disease. Most will die within about five years of exhibiting the hallmark symptoms of the disease – severe memory loss and a precipitous decline in cognitive function.
But the molecular processes that lead to the disease will have begun years earlier.
Currently, there are no known ways to prevent the disease or to stop its progression once it has begun. But research at the University of Virginia offers new understanding of how the disease develops at the molecular level, long before extensive neuronal damage occurs and symptoms show up.
Additionally, the researchers have found that an FDA-approved drug, memantine, currently used only for alleviating the symptoms of moderate-to-severe Alzheimer’s disease, might be used to prevent or slow the progression of the disease if used before symptoms appear. The research also offers, based on extensive experimentation, a hypothesis as to why this might work.
The findings are published currently online in the journal Alzheimer’s & Dementia.
“Based on what we’ve learned so far, it is my opinion that we will never be able to cure Alzheimer’s disease by treating patients once they become symptomatic,” said George Bloom, a UVA professor and chair of the Department of Biology, who oversaw the study in his lab. “The best hope for conquering this disease is to first recognize patients who are at risk, and begin treating them prophylactically with new drugs and perhaps lifestyle adjustments that would reduce the rate at which the silent phase of the disease progresses.
“Ideally, we would prevent it from starting in the first place.”
As Alzheimer’s disease begins, there is a lengthy period of time, perhaps a decade or longer, when brain neurons affected by the disease attempt to divide, possibly as a way to compensate for the death of neurons. This is unusual in that most neurons develop prenatally and then never divide again. But in Alzheimer’s the cells make the attempt, and then die.
“It’s been estimated that as much as 90 percent of neuron death that occurs in the Alzheimer’s brain follows this cell cycle reentry process, which is an abnormal attempt to divide,” Bloom said. “By the end of the course of the disease, the patient will have lost about 30 percent of the neurons in the frontal lobes of the brain.”
Erin Kodis, a former Ph.D. student in Bloom’s lab and now a scientific editor at AlphaBioCom, hypothesized that excess calcium entering neurons through calcium channels on their surface drive those neurons back into the cell cycle. This occurs before a chain of events that ultimately produce the plaques
The building blocks of the plaques are a protein called amyloid beta oligomers. Kodis found that when neurons are exposed to toxic amyloid oligomers, the channel, called the NMDA receptor, opens, thus allowing the calcium flow that drives neurons back into the cell cycle.
Memantine blocks cell cycle reentry by closing the NMDA receptor, Kodis found.
“The experiments suggest that memantine might have potent disease-modifying properties if it could be administered to patients long before they have become symptomatic and diagnosed with Alzheimer’s disease,” Bloom said. “Perhaps this could prevent the disease or slow its progression long enough that the average age of symptom onset could be significantly later, if it happens at all.”
Side effects of the drug appear to be infrequent and modest.
Bloom said potential patients would need to be screened for Alzheimer’s biomarkers years before symptoms appear. Selected patients then would need to be treated with memantine, possibly for life, in hopes of stopping the disease from ever developing, or further developing.
“I don’t want to raise false hopes,” Bloom said, but “if this idea of using memantine as a prophylactic pans out, it will be because we now understand that calcium is one of the agents that gets the disease started, and we may be able to stop or slow the process if done very early.”
Bloom currently is working with colleagues at the UVA School of Medicine to design a clinical trial to investigate the feasibility of using memantine as an early intervention.
MEDIA CONTACT
Fariss Samarrai
University News AssociateOffice of University Communications
farisss@virginia.edu (434) 924-3778

The U.S. faces a fiscal crisis in dealing with Alzheimer’s.

Here are 2017 Alzheimer’s Statistics
Alzheimer’s Care Costs
• In 2016, 15.9 million family caregivers provided an estimated 18.2 billion hours and $230 billion to people with dementia.
• In 2017, Alzheimer’s cost the United States $259 billion.
• By 2050, costs associated with dementia could be as much as $1.1 trillion.
• The global cost of Alzheimer’s and dementia is estimated to be $605 billion, which is equivalent to 1% of the entire world’s gross domestic product.
• Aggregate Cost of Care by Payer for Americans Age 65 and Older with Alzheimer’s Disease and Other Dementias: Medicare $113 Billion, Medicaid $41 Billion, Out of Pocket $44 Billion, Other $29 Billion.
Alzheimer’s in the United States
• Alzheimer’s is the 6th leading cause of death in the United States.
• Alzheimer’s is the only disease in the 10 leading causes of deaths in the United States that cannot be cured, prevented or slowed.
• 1 in 10 Americans over the age of 65 has Alzheimer’s.
• Between 2017 and 2025 every state is expected to see at least a 14% rise in the prevalence of Alzheimer’s.
• There has been an 89% increase in deaths due to Alzheimer’s between 2000 and 2014.
• More than 5 million Americans are living with Alzheimer’s.
• By 2050, it’s estimated there will be as many as 16 million Americans living with Alzheimer’s.
• Every 66 seconds someone in the United States develops Alzheimer’s.
• 1 in 3 seniors dies with some form of dementia.
• When the first wave of baby boomers reaches age 85 (in 2031), it is projected that more than 3 million people age 85 and older will have Alzheimer’s.
• One-third of Americans over age 85 are afflicted with the illness.
• Typical life expectancy after an Alzheimer’s diagnosis is 4-to-8 years.
• By 2050, there could be as many as 7 million people age 85 and older with Alzheimer’s disease, accounting for half (51%) of all people 65 and older with Alzheimer’s.
• Proportion of People With Alzheimer’s Disease in the United States by Age: 85+ years – 38%, 75-84 years, 44%, 65-74 years, 15%, <65 years, 4% https://www.alzheimers.net/resources/alzheimers-statistics/

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