Social media decreases loneliness for older adults, research finds

01 april 2013—Social media can be an effective tool for decreasing loneliness for older Australians according to new research conducted at the University of Sydney.

Social isolation can pose a significant problem for older adults especially for those who are house-bound, says Professor Robert Steele who led the Connecting Older Adults research project.

Professor Steele says while technologies are increasingly assisting older Australians to reside longer in their homes, there is also a flip side: an increased risk of loneliness or isolation. He says the year and a half long research project aimed to determine if social media use could provide benefits for older adults in relation to loneliness and social engagement.

Professor Steele, Head of Discipline and Chair of the Discipline of Health Informatics at the University's Faculty of Health Sciences, said that in commencing the project, he was additionally interested in such questions as do cost, privacy concerns or lack of interest or self-efficacy in using the technologies pose significant obstacles to older adults utilising them.

The Connecting Older Adults project was funded by the Department of Family and Community Services and was carried out with collaboration from peak seniors community bodies, the Australian Seniors Computing Clubs Association and Council on the Ageing NSW.

The study involved 150 participants aged 55 and over with the majority aged 65 and over. They were provided with only brief training in three social media technologies, Twitter, Facebook and Skype, prior to a six month trial period.

"The results we have are very interesting and supportive of these technologies" reported Professor Steele. Standardised scales were used to measure loneliness, such as the 20 item UCLA loneliness scale, pre and post the trial period. Results showed a highly statistically significant decrease in loneliness when comparing pre-trial data to post-trial data, for participants who started using the social media technologies. The majority of participants also reported that the use of technologies help them to be more connected and engaged with the community.

"In post-trial data we also wished to further determine the views of the older adult participants to determine their possible continued future use of the technologies or otherwise and other indicators of their perceptions of the technologies" says Professor Steele. A number of results strongly supported the effectiveness of the technologies: approximately 80 percent of respondents indicated they would continue to use the social media technologies after the end of the trial, and approximately 65 percent agreed or strongly agreed that the technologies were easy to use. This suggested that even providing short training sessions may be effective in overcoming technology barriers.

While the researchers expected costs to be a possible barrier in using the technologies, surprisingly over 90 percent agreed or strongly agreed that the technologies were affordable to use, and even a majority indicated that they considered the use of the social media technologies would be a factor in enabling them to live independently at home for longer.

Other interesting results showed variation between pre-trial views and observed participant behaviours. In the pre-trial data collection, Facebook was initially viewed negatively by a number of participants with quite a few of the participants declining to participate in Facebook training for this reason. However based on the post-trial data, of the three technologies Facebook emerged to be the most frequently used by the largest number of participants, followed by Skype, and with Twitter being the least used technology, and by the smallest number of participants.

Provided by University of Sydney

A third of US seniors die with dementia, study finds

Report tallies enormous medical, financial and caregiver toll of conditions like Alzheimer's.

30 mar 2013—There's more troubling news for America's aging population: A new report finds that one in every three seniors now dies while suffering from Alzheimer's or another form of dementia.

In many cases, dementia is the cause of death or contributes to it, the Alzheimer's Association study finds.

The rate of deaths related to Alzheimer's disease rose 68 percent from 2000 to 2010, according to the report. At the same time, deaths from other major diseases, such as heart disease and HIV/AIDS, have declined.

"Alzheimer's disease is a public health crisis that is here," said Beth Kallmyer, vice president of constituent services for the Alzheimer's Association. "One in three seniors is dying with Alzheimer's or another dementia. For other major diseases, the death rate is going down because the federal government funds and invests in research. We have not seen that same commitment for Alzheimer's disease."

Released Tuesday, the report also focuses on the toll that Alzheimer's takes on families, particularly those caregiving from a distance. In 2012, more than 15 million people were Alzheimer's caregivers. They provided more than 17 billion hours of unpaid care that the Alzheimer's group estimated was valued at $216 billion.

Direct out-of-pocket costs for families of people with Alzheimer's are $34 billion, according to Kallmyer. "The cost of care is a challenge, and not everyone has access to the services they need," she said.

About 15 percent of Alzheimer's caregivers live more than an hour away from their loved ones. Out-of-pocket costs for these long-distance caregivers are nearly twice as high as those who live close by. Each year, a long-distance caregiver has nearly $10,000 in expenses compared with about $5,000 for a local caregiver, according to the report.

"Long-distance caregiving can be financially, emotionally and physically more draining. Managing the day-to-day care can certainly be a challenge, but long-distance caregivers can feel guilt, and they may feel resentment from other family members. And, they may have to manage the daily care from a long distance," Kallmyer said.

Overall, the cost of caring for the 5 million people with Alzheimer's disease is about $203 billion, according to the report. That figure includes Medicare, Medicaid, family costs and private insurance costs. The lion's share of the cost—about $142 billion—is paid by Medicare and Medicaid.

Even more concerning is that the Alzheimer's Association estimates that by 2050, nearly 14 million people will have Alzheimer's disease. That could drive costs for Alzheimer's care as high as $1.2 trillion in 2050.

The U.S. government currently funds about $500 million in Alzheimer's research, according to Kallmyer. In comparison, heart disease receives about $4 billion in research funding and cancer gets about $6 billion, she said.

Dr. Brian Appleby, a physician with the Center for Brain Health at the Cleveland Clinic, said he wasn't surprised by these latest figures.

"Alzheimer's is going to affect all of us individually. Soon, we'll all have someone we know or someone in the family or even ourselves with Alzheimer's disease. It's something we all need to be prepared for," Appleby said.

He said that while current treatments won't cure or reverse the disease, they can increase the amount of time until someone needs nursing home care. Right now, he said, the focus is on trying to prevent Alzheimer's disease from occurring.

"Alzheimer's disease is really a chronic illness. It starts decades before we see the symptoms," Appleby said. The best advice to potentially prevent Alzheimer's disease is to keep your heart healthy, he said. That means quitting smoking, eating healthy, maintaining a healthy weight and getting regular exercise. It also means staying active mentally, he added. Do crosswords and other puzzles, and read, he advised.

And, stay socially active, he recommended. "People who are socially isolated are at a greater risk of Alzheimer's disease," Appleby said.

For her part, Kallmyer added: "Alzheimer's is impacting so many people already, and the impact is significant. And, as the baby boomers age, the rate of Alzheimer's and the death rate from Alzheimer's is only going to increase."

More information: Create a free care plan for your loved one and find local resources with the Alzheimer's navigator from the Alzheimer's Association.

97 percent of UK doctors have given placebos to patients at least once

A survey of UK doctors found that 97% have prescribed placebo treatments to patients at least once in their career.

29 mar 2013--Researchers at the Universities of Oxford and Southampton in the UK discovered that 97% of doctors have used 'impure' placebo treatments, while 12% have used 'pure' placebos.

'Impure' placebos are treatments that are unproven, such as antibiotics for suspected viral infections, or more commonly non-essential physical examinations and blood tests performed to reassure patients. 'Pure' placebos are treatments such as sugar pills or saline injections which contain no active ingredients.

A random sample of doctors was surveyed online, and returned 783 responses. This sample was found to be representative of all UK doctors registered with the General Medical Council (GMC). The research was funded by the National Institute for Health Research, the University of Oxford Department of Primary Health Care Sciences and The Southampton Complementary Medical Research Trust. The results are published in the open-access journal PLOS ONE.

'This is not about doctors deceiving patients,' says Dr Jeremy Howick, co-lead author of the study from the University of Oxford, 'The study shows that placebo use is widespread in the UK, and doctors clearly believe that placebos can help patients.'

The survey showed that doctors prescribing both pure and impure placebos reported doing so for broadly similar reasons. Placebos were mainly given to either induce psychological treatment effects, because patients requested treatment or to reassure patients.

Ethical attitudes towards placebo usage varied among doctors, with 66% saying that pure placebos are ethically acceptable under certain circumstances and 33% saying they are never acceptable. Impure placebos were more widely accepted, with 84% of doctors deeming them acceptable.

This widespread use and acceptance of placebos is consistent with similar studies worldwide, yet they are still against General Medical Council ethical codes. 'Current ethical rulings on placebos ought to be revisited in light of the strong evidence suggesting that doctors broadly support their use,' says Dr Howick.

For both pure and impure placebos, over 90% of doctors objected to their use where it endangered patient/doctor trust and over 80% were against using them if it involved deception.

'This latest study with the University of Oxford demonstrates that doctors are generally using placebos in good faith to help patients,' says Professor George Lewith, co-lead author of the study from the University of Southampton, 'Other previous published studies by Southampton have clearly shown placebos can help many people and can be effective for a long time after administration. The placebo effect works by releasing our body's own natural painkillers into our nervous system. In my opinion the stigma attached to placebo use is irrational, and further investigation is needed to develop ethical, cost-effective placebos.'

More information: dx.plos.org/10.137… pone.0058247

Provided by Oxford University

Researchers accurately predict cognitive decline

28 mar 2013—Researchers have shown they can predict impending cognitive decline using a sensitive behavioral task up to three years in advance of clinical evidence. Until now, it has not been possible to reliably differentiate individuals at risk of mild cognitive impairment (MCI) and Alzheimer's disease (AD) from those who are not at risk. The results of this study are in the current (March 2013) issue of the American Journal of Alzheimer's Disease & Other Dementias.

Stuart Zola, PhD, director of the Yerkes National Primate Research Center, and his Emory-based research team administered the Visual Paired Comparison (VPC) task using noninvasive, infrared eyetracking to assess memory function, an important function of the medial temporal lobe region of the brain. The team's findings demonstrate the VPC task performance scores are an early predictor of which individuals diagnosed with amnestic MCI (aMCI) will progress to AD during the subsequent three years and which individuals are not at risk. In addition, the findings also predict which control subjects will develop aMCI and which will not.

"Previous studies have focused on detecting the presence of disease," said Zola. "Our study focused on predicting whether and when the disease will occur. The earlier we can intervene, the more likely we can provide more effective treatment. In addition, a three-year advance notice could give families more time to prepare for the future," Zola continued.

The researchers assessed 92 participants who were either diagnosed with aMCI or were elderly control subjects (CON). Participants viewed images on a computer screen while the researchers recorded the participants' eye movements. Researchers compared the scores of the participants on the VPC task with information from their clinical visits and diagnoses. The scores accurately reflected those participants who were most at risk for cognitive decline and those who were not at risk at all. The researchers believe the VPC task also may be useful in predicting onset and progression of memory dysfunction in other medical conditions in which disruption of the medial temporal lobe memory system could occur, for example, depression, autism spectrum disorder and HIV/AIDS.

"The task used for this study was developed in nonhuman primates in our laboratory and then modified for our studies with patients," Zola said. Our findings not only have the ability to impact countless lives, but this study makes clear the translational connection between research in nonhuman primates and applications to the clinical setting and patient care," he continued.

Provided by Emory University

Depression in Alzheimer's patients associated with declining ability to handle daily activities

More symptoms of depression and lower cognitive status are independently associated with a more rapid decline in the ability to handle tasks of everyday living, according to a study by Columbia University Medical Center researchers in this month's Journal of Alzheimer's Disease.

27 mar 2013--Although these findings are observational, they could suggest that providing mental health treatment for people with Alzheimer's disease might slow the loss of independence, said senior author Yaakov Stern, PhD, professor of neuropsychology (in neurology, psychiatry, psychology, the Taub Institute for Research on Alzheimer's Disease and the Aging Brain and the Gertrude H. Sergievsky Center) at CUMC.

"This is the first paper to show that declines in function and cognition are inter-related over time, and that the presence of depression is associated with more rapid functional decline," said Dr. Stern, who also directs the Cognitive Neuroscience Division of the Department of Neurology at CUMC.

Because almost half of Alzheimer's patients have depression, the researchers, who were studying the long-term association between cognitive and functional abilities in the disease, also looked at the role of depressive symptoms in disease progression. They reviewed data that tracked changes in cognition, depression, and daily functioning in 517 patients with probable Alzheimer's at NewYork-Presbyterian Hospital/Columbia, Johns Hopkins School of Medicine, Massachusetts General Hospital, and the Hôpital de la Salpêtrière in Paris, France. Patients were assessed prospectively every six months for more than 5.5 years.

"Making a prognosis for Alzheimer's disease is notoriously difficult because patients progress at such different rates," said first author Laura B. Zahodne, PhD, a postdoctoral fellow in the cognitive neuroscience division in the Department of Neurology and the Taub Institute at CUMC. "These results show that not only should we measure patients' memory and thinking abilities, we should also assess their depression, anxiety, and other psychological symptoms that may affect their prognosis."

More information: The title of the paper is "Coupled Cognitive and Functional Change in Alzheimer's Disease and the Influence of Depressive Symptoms" (JAD Volume 34/Issue 4 (March 2013)).

Provided by Columbia University Medical Center

Isolation, loneliness may raise death risk for elderly

Study found lack of social contact a bigger predictor of early death than just feeling alone.

26 mar 2013—Elderly people who are socially isolated and lonely may be at greater risk of early death, British researchers report.

Lack of social contact might be an even bigger risk factor than loneliness, they added. Why, however, isolation is such a powerful predictor of death isn't clear.

"Social contact is a fundamental aspect of human existence. The scientific evidence is that being socially isolated is probably bad for your health, and may lead to the development of serious illness and a reduced life span," said lead researcher Andrew Steptoe, director of the Institute of Epidemiology and Health Care at University College London.

There is also research suggesting that loneliness has similar associations with poor health, he said.

"In many ways, social isolation and loneliness are two sides of the same coin. Social isolation indicates a lack of contact with friends, relatives and organizations, while loneliness is a subjective experience of lack of companionship and social contact," Steptoe said.

The investigators found that social isolation was a more consistent predictor of not surviving than was loneliness, and was related to greater risk of dying even after age and background health were taken into account, he said.

One expert said the findings were a little unexpected.

"You would think that loneliness would compound the risk for mortality, as opposed to just isolation—it's a bit of a surprise," said Dr. Bryan Bruno, acting chair of psychiatry at Lenox Hill Hospital in New York City, who was not involved with the study.

However, Steptoe explained, "Knowing about how lonely participants felt did not add to our ability to predict future mortality. This is not to say that loneliness is unimportant, or that we should not strive to reduce loneliness in older men and women," he said.

"But, we need to keep an eye on the social connections of older people, since maintaining social contacts among seniors and reducing isolation may be particularly important for their future survival," Steptoe added.

Bruno agreed that isolation is a significant factor in both reduced quality of life and mortality. "It is a difficult, challenging problem," he said.

"For my elderly patients, I often do a lot of education about the risk associated with being isolated and encourage them to spend as much time with other people as possible, whether it be family, friends or joining groups, community organizations or doing volunteer work," Bruno noted.

The report was published March 25 in the online edition of the Proceedings of the National Academy of Sciences.

To look at the risks of loneliness and social isolation on dying, Steptoe's team collected data on 6,500 men and women aged 52 and older who took part in the English Longitudinal Study of Aging in 2004.

People who had limited contact with family or friends or community were classified as socially isolated. The researchers used a questionnaire to assess loneliness, which was described in background information in the study as a person's "dissatisfaction with the frequency and closeness of their social contacts, or the discrepancy between the relationships they have and the relationships they would like to have."

During nearly eight years of follow-up, 918 people died and social isolation and loneliness both predicted an early death.

Social isolation, however, increased the risk of dying regardless of one's health and other factors, while loneliness increased the risk of dying only among those with underlying mental or physical problems, the researchers found.

More information: "Social isolation, loneliness, and all-cause mortality in older men and women," by Andrew Steptoe, Aparna Shankar, Panayotes Demakakos, and Jane Wardle, PNAS, 2013.

Acting out dreams linked to development of dementia, study finds

The strongest predictor of whether a man is developing dementia with Lewy bodies—the second most common form of dementia in the elderly—is whether he acts out his dreams while sleeping, Mayo Clinic researchers have discovered. Patients are five times more likely to have dementia with Lewy bodies if they experience a condition known as rapid eye movement (REM) sleep behavior disorder than if they have one of the risk factors now used to make a diagnosis, such as fluctuating cognition or hallucinations, the study found.

25 mar 2013--The findings were being presented at the annual meeting of the American Academy of Neurology in San Diego. REM sleep behavior disorder is caused by loss of the normal muscle paralysis that occurs during REM sleep. It can appear three decades or more before a diagnosis of dementia with Lewy bodies is made in males, the researchers say. The link between dementia with Lewy bodies and the sleep disorder is not as strong in women, they add.

"While it is, of course, true that not everyone who has this sleep disorder develops dementia with Lewy bodies, as many as 75 to 80 percent of men with dementia with Lewy bodies in our Mayo database did experience REM sleep behavior disorder. So it is a very powerful marker for the disease," says lead investigator Melissa Murray, Ph.D., a neuroscientist at Mayo Clinic in Florida.

The study's findings could improve diagnosis of this dementia, which can lead to beneficial treatment, Dr. Murray says.

"Screening for the sleep disorder in a patient with dementia could help clinicians diagnose either dementia with Lewy bodies or Alzheimer's disease," she says. "It can sometimes be very difficult to tell the difference between these two dementias, especially in the early stages, but we have found that only 2 to 3 percent of patients with Alzheimer's disease have a history of this sleep disorder."

Once the diagnosis of dementia with Lewy bodies is made, patients can use drugs that can treat cognitive issues, Dr. Murray says. No cure is currently available.

Researchers at Mayo Clinic in Minnesota and Florida, led by Dr. Murray, examined magnetic resonance imaging, or MRI, scans of the brains of 75 patients diagnosed with probable dementia with Lewy bodies. A low-to-high likelihood of dementia was made upon an autopsy examination of the brain.

The researchers checked the patients' histories to see if the sleep disorder had been diagnosed while under Mayo care. Using this data and the brain scans, they matched a definitive diagnosis of the sleep disorder with a definite diagnosis of dementia with Lewy bodies five times more often than they could match risk factors, such as loss of brain volume, now used to aid in the diagnosis. The researchers also showed that low-probability dementia with Lewy bodies patients who did not have the sleep disorder had findings characteristic of Alzheimer's disease.

"When there is greater certainty in the diagnosis, we can treat patients accordingly. Dementia with Lewy bodies patients who lack Alzheimer's-like atrophy on an MRI scan are more likely to respond to therapy—certain classes of drugs—than those who have some Alzheimer's pathology," Dr. Murray says.

Provided by Mayo Clinic

European Guidance for the diagnosis and management of osteoporosis in postmenopausal women

A new Guidance recently published by the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the International Osteoporosis Foundation (IOF) reflects the most current advances in the diagnosis and management of osteoporosis, the 'silent disease' which affects up to one in two postmenopausal women.

23 mar 2013--"The serious impact of fragility fractures due to osteoporosis is vastly underestimated by many health care professionals," stated ESCEO President Professor Jean-Yves Reginster.

"Statistics clearly show that fragility fractures in older adults can result in early death or lead to long-term disability, diminished quality of life and loss of physical independence. Nevertheless, diagnosis and treatment rates are appallingly low, even among those patients who have already suffered a fracture. Barely 20% of these clearly 'high risk' patients receive treatment to prevent future fractures," he said.

The 2013 European Guidance for the Diagnosis & Management of Osteoporosis in Postmenopausal Women, published in Osteoporosis International, is an update of the ESCEO Guidance published in 2008. The new report reflects the significant advances in the field over the past five years, including the development of new techniques for measuring bone mineral density, improved methods of assessing fracture risk and new treatments that significantly reduce the risk of fractures.

The Guidance highlights the following: 

• Statistics related to cost and prevalence, morbidity and mortality in Europe
• Diagnostic guidelines and risk factors
• Management algorithm for the assessment of fracture risk with FRAX
• Intervention thresholds
• Assessment of fracture risk with limited or unlimited access to BMD using DXA
• General management regarding mobility and falls
• Nutrition recommendations
• Diagnostic work-up of patients with osteoporosis
• Anti-fracture efficacy of major interventions for postmenopausal osteoporosis

IOF President John Kanis commented, "Although this new Guidance is written from a European regional perspective, we hope that it will help inform the development or revision of guidelines at the national level, both in Europe and around the world. Given the serious impact of fractures on women's health worldwide, it is essential that clinicians are sensitized to the need for early diagnosis and treatment and are able to implement the latest strategies for the benefit of their patients."

More information: JA Kanis, EV McCloskey, H Johansson, C Cooper, R Rizzoli, J-Y Reginster (2013). European Guidance for the Diagnosis & Management of Osteoporosis in Postmenopausal Women. Osteoporosis Int 24: 23-57. Open Access at link.springer.com/… 8-012-2074-y

A special session on April 19, 2013 at the European Congress on Osteoporosis and Osteoarthritis (ESCEO13-IOF) in Rome, Italy will highlight specific topics presented in the European Guidance, allowing for discussion with key experts. Further information is available atwww.ecceo13-iof.org

The European Guidance is freely available online on the Springer Publisher website at link.springer.com/… 8-012-2074-y

A teaching slide-kit can be downloaded from the IOF website at www.iofbonehealth.… pausal-women or the ESCEO website at www.esceo.org/publ… Kit-2013.ppt

Provided by International Osteoporosis Foundation

180,000 deaths worldwide may be associated with sugary soft drinks

Sugar-sweetened sodas, sports drinks and fruit drinks may be associated with about 180,000 deaths around the world each year, according to research presented at the American Heart Association's Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013 Scientific Sessions.

21 mar 2013--Sugar-sweetened beverages are consumed throughout the world, and contribute to excess body weight, which increases the risk of developing diabetes, cardiovascular diseases and some cancers. Using data collected as part of the 2010 Global Burden of Diseases Study, the researchers linked intake of sugar- sweetened beverages to 133,000 diabetes deaths, 44,000 deaths from cardiovascular diseases and 6,000 cancer deaths. Seventy-eight percent of these deaths due to over-consuming sugary drinks were in low and middle-income countries, rather than high-income countries.

"In the U.S., our research shows that about 25,000 deaths in 2010 were linked to drinking sugar-sweetened beverages," said Gitanjali M. Singh, Ph.D., co-author of the study and a postdoctoral research fellow at the Harvard School of Public Health in Boston, Mass.

Researchers calculated the quantities of sugar-sweetened beverage intake around the world by age and sex; the effects of this consumption on obesity and diabetes; and the impact of obesity and diabetes-related deaths. Of nine world regions, Latin America/Caribbean had the most diabetes deaths (38,000) related to the consumption of sugar-sweetened beverages in 2010. East/Central Eurasia had the largest numbers of cardiovascular deaths (11,000) related to sugary beverage consumption in 2010. Among the world's 15 most populous countries, Mexico—one of the countries with the highest per-capita consumption of sugary beverages in the world—had the highest death rate due to these beverages, with 318 deaths per million adults linked to sugar-sweetened beverage intake.

Japan, one of the countries with lowest per-capita consumption of sugary beverages in the world, had the lowest death rate associated with the consumption of sugary beverages, at about 10 deaths due to per million adults.

"Because we were focused on deaths due to chronic diseases, our study focused on adults. Future research should assess the amount of sugary beverage consumption in children across the world and how this affects their current and future health," Singh said.

The Global Burden of Disease Study 2010 is an international, collaborative, systematic effort to quantify the global distribution and causes of major diseases, injuries and health risk factors.

The American Heart Association recommends adults consume no more than 450 calories per week, from sugar-sweetened beverages, based on a 2,000 calorie diet and offers tips on how Life's Simple 7™ can help you make better lifestyle choices and eat healthier.

Provided by American Heart Association

New study points to major discovery for Alzheimer's disease

The Journal of Neuroscience has published a study led by researchers at the Max Planck Florida Institute for Neuroscience, the first and only U.S. extension of the prestigious Max Planck Society, that may hold a stunning breakthrough in the fight to treat Alzheimer's disease. The study potentially identifies a cause of Alzheimer's disease—based on a newly-discovered signaling pathway in cellular models of Alzheimer's disease—and opens the door for new treatments by successfully blocking this pathway. The Institute, which recently opened in December 2012, focuses solely on basic neuroscience research that aims to analyze, map, and decode the human brain—the most important and least understood organ in the body.

20 mar 2013--"This study transforms our understanding of the direct cause of Alzheimer's disease," said Principal Investigator Dr. Ryohei Yasuda. "With further research, we may open up an entirely new avenue for treatments to combat this disease."

The scientific community so far has widely accepted that Alzheimer's disease is caused by the accumulation of a peptide called Amyloid beta. When Amyloid beta is applied to neurons, neuronal morphology becomes abnormal and synaptic function is impaired. However, how Amyloid beta causes dysfunction is unknown. The MPFI research indicates that the presence of Amyloid beta triggers increased levels of a signaling protein, called centaurin-1 (CentA1), that appears to cause neuronal dysfunction – a potentially groundbreaking discovery that uncovers an important intermediary step in the progression of the disease.

As part of the research, the scientists were able to identify CentA1 and measure its negative effects on neurons. Utilizing an RNA silencing technique, they turned down the cellular production of CentA1, and showed that affected neurons, exposed to Amyloid beta and exhibiting Alzheimer's related symptoms, returned to normal morphology and synaptic function, even with the continued presence of Amyloid beta. They further found that increased CentA1 activates a series of proteins, and these proteins form a signaling pathway from CentA1 to neuronal dysfunction. Thus, inhibiting other proteins in the pathway also "cured" affected neurons.

The initial tests reported were conducted on rat brain slices. MPFI has already started to expand their studies to mouse models of Alzheimer's disease and preliminary experiments show promising results. Ultimately, targeting the components of this newly identified signaling pathway has the potential to open the door for new pharmacological and gene therapies in treatment of Alzheimer's disease. Dr. Yasuda also anecdotally reports that the effects of CentA1 knock down were observed to be sustained over several weeks and an avenue for future study will be to examine how long the positive effects on neurons are sustained which may indicate the potential impact of treatments derived from this research.

More information: The full study will be available at http://www.jneurosci.org/ on March 20, 2013.

Provided by Max Planck Society

Green tea, coffee may help lower stroke risk

Green tea. Credit: Wikimedia Commons

Green tea and coffee may help lower your risk of having a stroke, especially when both are a regular part of your diet, according to research published in Stroke: Journal of the American Heart Association.

18 mar 2013--"This is the first large-scale study to examine the combined effects of both green tea and coffee on stroke risks," said Yoshihiro Kokubo, M.D., Ph.D., F.A.H.A., F.A.C.C., F.E.S.C., lead author of the study at Japan's National Cerebral and Cardiovascular Center. "You may make a small but positive lifestyle change to help lower the risk of stroke by adding daily green tea to your diet."

Researchers asked 83,269 Japanese adults about their green tea and coffee drinking habits, following them for an average 13 years. They found that the more green tea or coffee people drink, the lower their stroke risks. 

• People who drank at least one cup of coffee daily had about a 20 percent lower risk of stroke compared to those who rarely drank it.
• People who drank two to three cups of green tea daily had a 14 percent lower risk of stroke and those who had at least four cups had a 20 percent lower risk, compared to those who rarely drank it.
• People who drank at least one cup of coffee or two cups of green tea daily had a 32 percent lower risk of intracerebral hemorrhage, compared to those who rarely drank either beverage. (Intracerebral hemorrhage happens when a blood vessel bursts and bleeds inside the brain. About 13 percent of strokes are hemorrhagic.)

Participants in the study were 45 to 74 years old, almost evenly divided in gender, and were free from cancer and cardiovascular disease.

During the 13-years of follow-up, researchers reviewed participants' hospital medical records and death certificates, collecting data about heart disease, strokes and causes of death. They adjusted their findings to account for age, sex and lifestyle factors like smoking, alcohol, weight, diet and exercise.

Green tea drinkers in the study were more likely to exercise compared to non-drinkers.

Previous limited research has shown green tea's link to lower death risks from heart disease, but has only touched on its association with lower stroke risks. Other studies have shown inconsistent connections between coffee and stroke risks.

Initial study results showed that drinking more than two cups of coffee daily was linked to increasing coronary heart disease rates in age- and sex-adjusted analysis. But researchers didn't find the association after factoring in the effects of cigarette smoking—underscoring smoking's negative health impact on heart and stroke health.

A typical cup of coffee or tea in Japan was approximately six ounces. "However, our self-reported data may be reasonably accurate, because nationwide annual health screenings produced similar results, and our validation study showed relatively high validity." Kokubo said. "The regular action of drinking tea, coffee, largely benefits cardiovascular health because it partly keeps blood clots from forming."

Tea and coffee are the most popular drinks in the world after water, suggesting that these results may apply in America and other countries.

It's unclear how green tea affects stroke risks. A compound group known as catechins may provide some protection. Catechins have an antioxidant anti-inflammatory effect, increasing plasma antioxidant capacity and anti-thrombogenic effects.

Some chemicals in coffee include chlorogenic acid, thus cutting stroke risks by lowering the chances of developing type 2 diabetes. Further research could clarify how the interaction between coffee and green tea might help further lower stroke risks, Kokubo said.

More information: For additional information on stroke:

newsroom.heart.org/news/672 
www.heart.org/HEAR… _Article.jsp

Provided by American Heart Association

Resveratrol in a red wine sauce: Fountain of youth or snake-oil?

Resveratrol is being be touted as the latest wonder drug that will add years to our lives. Credit: Greg Bishop

Resveratrol, a molecule found in red wine (and red grape skin and elsewhere) is back in the headlines after an international team of researchers published a paper in the journal Sciencelate last week. The news made headlines around the world.

17 mar 2013--Researchers believe resveratrol could extend the human life span, and protect people against a wide range of diseases such as cancer, type II diabetes, Alzheimer's, and heart disease.

But is it too good to be true?

Is resveratrol the latest wonder drug that will add years to our lives? Or is this simply the newest science and marketing spiel that will take the rest of our lives to unravel?

And what if resveratrol does not live up to its promise? Who is to blame? The scientists? The media? The marketers? Or the gullible fools who make up the general public?

The health-giving properties of red wine have been advanced as a possible explanation for the French Paradox, the observation that the French have relatively low heart disease despite a high-fat diet. Researchers suggest that the resveratrol in the red wine could be a contributing factor.

The promise of resveratrol has been escalated with research suggesting that it has the capacity to activate a protein called SIRT1 found in mammals. SIRT1 is one of a larger class of proteins called sirtuins that have been shown to extend the life span of yeast, worms, flies and, maybe, mice.

Yes, "maybe mice" because whether it extends a mouse's life is disputed. In fact, the truth seems less clear and more highly valued than a couple of cases of 1950s Grange Hermitage.

Despite doubts about the real value of resveratrol, in 2008 GSK paid $720m for SIRTRIS, a company established by some of the scientists advancing the positive claims for resveratrol.

This may just be the latest attempt at finding the fountain of youth. 

The paper published recently in Science simply reaffirms an earlier claim against contrary evidence. This is science as usual; a scientific shoot-out at the frontier of knowledge in an effort to establish truth.

But some of the claims for resveratrol certainly seem overstated. We are, after all, talking about research that, to this point, has been focused on relatively short-term effects observed on just a few leaves on the phylogenetic tree, in carefully controlled laboratory conditions.

Despite the hype about the connection with red wine, even the researchers admit that the amount of resveratrol in a glass or three of red wine is insignificant relative to the dosing that showed effects in mice. Even so, one of the researchers admits taking resveratrol supplements perhaps to amplify his claims in a style akin to Australian Nobel-laureate Barry Marshall.

So, it may be premature to assume that these findings generalise to humans in the wild.

Add to this the problem of falsification. No, not philosopher of science Karl Popper's notion of falsification as a basis for advancing scientific knowledge, but falsification in terms of made-up data. A number of published studies showing the benefits of resveratrol have been retracted for being fabricated.

All this before the media and marketers get to create a label and write advertising copy to make an appetising and digestible sound-bite (or tipple) for the masses.

The great problem here for seekers of truth is to separate fact from fiction, to separate the infinitely more nuanced reality from vastly simplified human representation.

"Science," said Karl Popper, "may be described as the art of systematic over-simplification." And if scientists are bad, then the media and marketers are probably even worse.

Still, they are all simply selling a story; it appeals because people want to believe it.

The search for the fountain of youth has gone on for millennia. And this search has uncovered just one thing – the spring of human hope flows endlessly. We are hopelessly hopeful.

Our eternal optimism offers value to medicine through the placebo effect, which suggests that people's beliefs can help their own healing. Sadly, this also means that it can take a long time for people to realise that they have been duped.

And anyway, who is to blame when the whole thing is a product of human nature? Do we blame the public for their unbridled optimism and desire for a quick fix? Or the scientific, media and marketing professions for desiring social and financial success?

The flipside to all this is that some of the claimed benefits of resveratrol are available to the public right now. Sirtuins can be activated by exercising a bit more, and eating a bit less.

But that's not a very interesting story; fiction feeds dreams while the facts foster drudgery.

The amount of resveratrol in a glass of red wine is unlikely to have any effect on your health, but if it makes you feel better, raise a glass to the placebo effect. And the proof that science, media, marketers and consumers can together create much value from very little.

Source: The Conversation

This story is published courtesy of The Conversation (under Creative Commons-Attribution/No derivatives).

Women live longer, but have a lower quality of life

the Institute of Gender Medicine at the MedUni Vienna has presented an alarming result obtained from gender-specific research. According to recent studies, women's quality of life is significantly worse than that of men in terms of health.

16 mar 2013--In Austria and Europe, women live on average around six years longer than men. This is a very positive result for women, one might think, especially in terms of their health. This popular assumption, however, is incorrect. According to Alexandra Kautzy-Willer, Head of the Gender Medicine Unit at the MedUni Vienna, a closer look at the data indicates that women suffer more frequently than men from chronic diseases and functional restrictions and have a poorer quality of life in terms of their health.

Karin Gutierrez-Lobos, MedUni Vienna's Vice Rector for Teaching, Gender and Diversity and Austria's first Professor of Gender Medicine at the MedUni Vienna, adds: "These recent results confirm just how important gender medicine is. They clearly illustrate that women's equality of treatment status is a vital influencing factor on health. If their social status, quality of treatment index or career opportunities improve, for example, so too does their health-related quality of life."

Sex hormones, role models and social behaviour make the difference

According to Kautzky-Willer, the more marked among women phases of life that are greatly influenced by changes in sex hormones, but also by their role models, are also of tremendous importance.

From puberty, women are more affected than men by painful syndromes such as irritable bowel, fibromyalgia and migraine, but also by autoimmune diseases such as lupus, multiple sclerosis, thyroid glandabnormalities or asthma. Menstrual cycle anomalies, infertility or complications of pregnancy can provide vital indicators of an increased risk of illness later in life. After gestational diabetes, for example, women have a seven times greater risk of developing diabetes and are at significantly increased risk of vascular problems. Lifestyle changes such as smoking, taking the contraceptive pill, stress and lack of exercise lead to an increase in mortality from heart attacks, especially in young women. From the menopause onwards, women are more troubled by fat metabolism problems, high blood pressure, cardiovascular disease and osteoporosis. Elderly women are ultimately significantly more severely affected by Alzheimer's dementia, incontinence and immobility. And if all this wasn't enough, women are also two times more likely to suffer depression than men.

"There are a variety of reasons behind these clear differences. They include, for example, the many differences in biology and sex hormones, but most importantly the different effects of environmental influences, differences in lifestyle, gender roles and differences in social behaviour," says Kautzky-Willer. Even the causes and effects of stress differ between men and women.

Recent study researches gender-specific differences in coping with autoimmune diseases

An interdisciplinary study currently underway at the University Department of Internal Medicine III at the MedUni Vienna and the Gender Medicine Unit is investigating a series of autoimmune diseases from gender-specific perspectives. Preliminary results are already available for Crohn's disease, a common disease of the bowel. Says Kautzky-Willer: "If social support, job satisfaction and self-efficacy improve, the positive effect on the course of the illness is the same for both men and women. For women, however, the activity of the disease but most importantly esteem and good resilience are important." These results may in future lead to new, gender-sensitive approaches to the treatment of autoimmune diseases.

Provided by Medical University of Vienna

Lowering salt intake in diets important and very feasible, study finds

15 mar 2013--—A newly published study has found that it would be relatively easy for New Zealanders to reach recommended levels of lower salt intake to reduce the risk of heart disease, stroke and stomach cancer. This is even if some meals have occasional high salt ingredients such as sausages or other processed foods.

The University of Otago, Wellington study found that a healthy daily diet that reached all nutrient recommendations for men, including salt at under 5.8 grams per day, was readily achievable at a cost of under $9 per day. Similar results were obtained when modelling diets for women. New Zealanders are currently estimated to consume at least twice the recommended intake of salt.

In fact all of the eight sample daily diets studied, many with familiar meal components, but with little of the processed food that is high in salt, achieved the ideal "target" salt intake. This is under 4 grams of salt (two thirds of a teaspoon) per day which is equivalent to 1.6 grams of sodium per day.

"We were interested in studying low-salt diets as a high salt diet is ranked 11th in the world as a risk factor for disease and is also ranked 11th for the New Zealand and Australia region. This ranking is ahead of such risk factors as diet low in vegetables (ranked 12th) and a diet high in processed meat (ranked 14th)," says lead author Associate Professor Nick Wilson.

He says that while the lower salt in diets would help prevent heart disease, there were other features of these optimised low-salt diets which would improve heart health. "These include a better ratio of good fats such as polyunsaturated fats to the more hazardous saturated fat. The higher levels of fruit and vegetables in these diets would also help prevent heart disease and some cancers."

The study used a mathematical technique of "linear programming" to find different diets which were low in salt and affordable, using New Zealand price and nutrition data. Included on purpose in some of the studied diets were familiar meals and ingredients such as porridge for breakfast and a lunch that include a cheese sandwich and peanut butter sandwich.

One of the evening meals included mince on toast. Another main meal included sausages, potatoes and a dessert of ice-cream with canned fruit. Another involved a tuna pasta dish and a Pacific-style main meal – including tuna, taro and coconut cream.

While all sample diets achieved the desired levels of low salt, the healthiest sample diets were the Mediterranean style and an Asian-style diets that excluded high-salt sauces such as soy sauce. This was mainly because these diets usually have much higher levels of vegetables and fruit.

"While individuals could choose to have healthier low-salt foods it would be much easier for them to make healthy choices if the Government did something to help," says Associate Professor Wilson. "It could do this by regulating down the maximum level of salt permitted in commercially produced foods, particularly in bread, processed meats and sauces."

"A tax on junk food would also help as such food is usually high in salt as well as sugar and saturated fat. The money from such a tax could then fund healthy school lunches and help pay for better health services for diseases caused by high salt – especially stroke and heart attacks."

There has been progress on lowering salt in bread through the Heart Foundation working with the food industry. "But this is not enough and that's why regulating down salt levels as well as considering taxes on junk food are needed to achieve the big gains in health," he says.

Associate Professor Wilson says controls on maximum salt levels are relatively easy as people can't detect minor reductions of salt in food at around 10% per year. Co-researcher Rachel Foster says it makes sense to reduce the burden of strokes and heart attacks on the health system, so this should be a priority for Government action to both protect health and save taxpayer funds.

This study has been published in the international journal PLOS ONE and was funded as part of the BODE3 Programme by the Health Research Council. The BODE3 Programme will be using the results of this study in future modelling work on the most cost-effective ways of reducing the high salt levels in the New Zealand diet.

More information: www.plosone.org/ar… pone.0058539

Provided by University of Otago

Sleep loss precedes Alzheimer's symptoms

Sleep is disrupted in people who likely have early Alzheimer's disease but do not yet have the memory loss or other cognitive problems characteristic of full-blown disease, researchers at Washington University School of Medicine in St. Louis report March 11 in JAMA Neurology.

13 mar 2013--The finding confirms earlier observations by some of the same researchers. Those studies showed a link in mice between sleep loss and brain plaques, a hallmark of Alzheimer's disease. Early evidence tentatively suggests the connection may work in both directions: Alzheimer's plaques disrupt sleep, and lack of sleep promotes Alzheimer's plaques.

"This link may provide us with an easily detectable sign of Alzheimer's pathology," says senior author David M. Holtzman, MD, the Andrew B. and Gretchen P. Jones Professor and head of Washington University's Department of Neurology. "As we start to treat people who have markers of early Alzheimer's, changes in sleep in response to treatments may serve as an indicator of whether the new treatments are succeeding."

Sleep problems are common in people who have symptomatic Alzheimer's disease, but scientists recently have begun to suspect that they also may be an indicator of early disease. The new paper is among the first to connect early Alzheimer's disease and sleep disruption in humans.

For the new study, researchers recruited 145 volunteers from the University's Charles F. and Joanne Knight Alzheimer's Disease Research Center. All of the volunteers were 45 to 75 years old and cognitively normal when they enrolled.

As a part of other research at the center, scientists already had analyzed samples of the volunteers' spinal fluids for markers of Alzheimer's disease. The samples showed that 32 participants had preclinical Alzheimer's disease, meaning they were likely to have amyloid plaquespresent in their brains but were not yet cognitively impaired.

Participants kept daily sleep diaries for two weeks, noting the time they went to bed and got up, the number of naps taken on the previous day, and other sleep-related information.

The researchers tracked the participants' activity levels using sensors worn on the wrist that detected the wearer's movements.

"Most people don't move when they're asleep, and we developed a way to use the data we collected as a marker for whether a person was asleep or awake," says first author Yo-El Ju, MD, assistant professor of neurology. "This let us assess sleep efficiency, which is a measure of how much time in bed is spent asleep."

Participants who had preclinical Alzheimer's disease had poorer sleep efficiency (80.4 percent) than people without markers of Alzheimer's (83.7 percent). On average, those with preclinical disease were in bed as long as other participants, but they spent less time asleep. They also napped more often.

"When we looked specifically at the worst sleepers, those with a sleep efficiency lower than 75 percent, they were more than five times more likely to have preclinical Alzheimer's disease than good sleepers," Ju says.

Ju and her colleagues are following up with studies in younger participants who have sleep disorders.

"We think this may help us get a better feel for the way this connection flows—does sleep loss drive Alzheimer's, does Alzheimer's lead to sleep loss, or is it a combination?" Ju says. "That will help us determine whether we can change the course of disease with pharmaceuticals or other treatments."

More information: Ju Y-E S, McLeland JS, Toedebusch CD, Xiong C, Fagan AM, Duntley SP, Morris JC, Holtzman DM. Sleep quality and preclinical Alzheimer disease. JAMA Neurology, online March 11.

Provided by Washington University School of Medicine

Worming our way to new treatments for Alzheimer's disease 

According to a 2012 World Health Organization report, over 35 million people worldwide currently have dementia, a number that is expected to double by 2030 (66 million) and triple by 2050 (115 million). Alzheimer's disease, the most common form of dementia, has no cure and there are currently only a handful of approved treatments that slow, but do not prevent, the progression of symptoms.

11 mar 2013--New drug development, no matter the disease, is a slow, expensive, and risky process. Thus, innovative techniques to study and assess the possibilities of already-existing drugs for different diseases can be used to alleviate the traditional burdens of cost and time. Detailed in their new article in Biological Psychiatry, researchers from the University of Washington, led by Dr. Brian Kraemer, have developed an exciting new approach to screening potential new treatments for Alzheimer's disease using C. elegans, a small transparent worm.

Their focus was on tau, a protein involved in maintaining brain cell structure. In Alzheimer's disease and related disorders, tau protein becomes abnormally modified and forms clumps of protein called aggregates. These aggregates are a hallmark of the dying nerve cells in Alzheimer's disease and other related disorders. Diseases with abnormal tau are called tauopathies.

Dr. Kraemer's lab previously developed a worm model for tauopathy by expressing human tau in C. elegans nerve cells. This model has behavioral abnormalities, accumulates abnormal tau protein, and exhibits loss of nerve cells—all of which are general features of Alzheimer's disease.

Using their worm model for this study, they screened a library of 1,120 drugs approved for human use and tested each at three different concentrations to identify compounds that suppress the effects of abnormal tau aggregation.

"We have identified six compounds capable of reliably alleviating tau induced behavioral abnormalities in our C. elegans model for tauopathy. In a human cultured cell model for abnormal tau protein, we have also seen that azaperone treatment can decrease the amount of abnormal tau," said Kraemer.

Azaperone, an antipsychotic drug, normally binds to certain dopamine receptors found in nerve cells. They demonstrated that removing those receptors in either C. elegans or human cells has the same effect as azaperone treatment, indicating that azaperone and related drugs should alter abnormal tau accumulation. Other antipsychotic drugs also have a similar effect to azaperone.

Tests of these compounds for anti-tau properties are now underway in existing mouse models of Alzheimer's disease.

"This study is an exemplary instance of how a simple C. elegans model system may be used to rapidly screen drugs for diseases and evaluate mechanism of action," said Drs. Sangeetha Iyer and Jonathan Pierce-Shimomura, authors of a commentary that accompanies this article.

Dr. John Krystal, Editor of Biological Psychiatry, agrees and added: "Studying the worm, C. elegans, has already provided us with fundamental insights into how the brain develops. The new approach described by McCormick and colleagues suggests that this animal model may be a powerful new approach to studying novel treatments that prevent its decline."

More information: The article is "Dopamine D2 Receptor Antagonism Suppresses Tau Aggregation and Neurotoxicity" by Allyson V. McCormick, Jeanna M. Wheeler, Chris R. Guthrie, Nicole F. Liachko, and Brian C. Kraemer (doi: 10.1016/j.biopsych.2012.08.027). The commentary is "Worming Our Way to Alzheimer's Disease Drug Discovery" by Sangeetha Iyer and Jonathan T. Pierce-Shimomura (doi: 10.1016/j.biopsych.2012.12.026). Both appear in Biological Psychiatry, Volume 73, Issue 5 (March 1, 2013)

Provided by Elsevier

End-of-life plans benefit patients and families

Without an EOL plan, it can be difficult for health care providers to provide care which meets the needs of patients.

10 mar 2013—Health care at the end of life is a difficult issue but a new study highlights the importance of making a plan for end-of-life decisions.

The study, published in the Australian Health Review, aimed to identify end-of-life (EOL) decision-making processes for patients with non-cancer illnesses in a major metropolitan hospital.

Lead researcher Dr Susan Lee, from the Palliative Care Research Team at Monash University, said most patients involved in the study did not discuss plans for end-of-life care until the last 24 hours, affecting their quality of care at the end of their lives.

"In 64 per cent of people, the first discussions about EOL care did not occur until the last 24 hours of life. There were some patients who had a clear plan developed with patient/family involvement, which was fully implemented. However, many others had no plan and minimal patient/family involvement in decision-making," Dr Lee said.

"Without an EOL plan, it can be difficult for health care providers to provide care which meets the needs of patients and reflects their priorities and beliefs. For example, decisions about pain relief, resuscitation, the location of treatment as well as psychological and spiritual care can be outlined in an EOL plan which can give health services guidance when providing care."

The study involved a review of 47 randomly selected patient records over a six-month period. This represented 53 per cent of total deaths in the study period.

The study also found the development and effective implementation of EOL plans was associated with the active involvement of both family members and health professionals. It also identified that there were risks in delaying EOL discussions until illness has progressed to a late stage.

Health care services and providers also played an important role. The study found that trust in, and positive communication with, health professionals and timely referral to palliative care help in the development and successful implementation of EOL plans.

"Factors which were associated with having an EOL plan were multiple previous admissions, shorter hospitalisations and being older at the time of death," Dr Lee said.

"Based on this study, more effort needs to be put into promoting the benefits of EOL plans and supporting health services and providers to implement plans as closely as possible. This will assist in improving the quality of care for people at the end of their lives."

Provided by Monash University