Tag: Alzheimer’s disease

Does Hormone Replacement Therapy Prevent Alzheimer’s Disease

Just as many women are throwing out their hormone replacement prescriptions, an ongoing study has shown a link between prior use of hormone replacement therapy (HRT) and a reduced risk of Alzheimer’s disease. However, the data suggest that the benefits can take 10 years to appear, say researchers for the Cache County Study.

In this long-term trial, 1,889 women and 1,357 men were first assessed between 1995 and 1997. Between the initial interview and follow-up, 88 women (4.7%) and 35 men (2.6%) were found to have Alzheimer’s disease. Among those over 80 years of age, the risk for women was double that for men; however, in women who reported earlier use of HRT, the risk was 41% lower. Alzheimer’s disease developed in 26 of 1,066 women who had received HRT compared with 58 of 800 women who had never used HRT. The risk varied with the duration of therapy, and this sex-specific increased risk disappeared with more than 10 years of treatment.
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If the theory about the10-year lag time is correct, one of the study coauthors stated that “it explains a very large and seemingly conflicted literature” on the relationship between HRT and Alzheimer’s disease. The study findings corroborate other recent research suggesting that HRT may help prevent Alzheimer’s disease.

Alzheimer’s Disease, Anticholinergics Don’t Mix

Alzheimer's Disease

The treatment of Alzheimer’s disease (AD) relies heavily on cholinesterase inhibitors, which help salvage acetyl-choline and maintain function in the cho-linergic system. However, these agents are expensive and affect cognition only slightly. Patients with AD are sensitive to cognitive impairments induced by anti-cholinergic drugs.

Avoidance of anticholinergic agents should be the rule for patients with AD, the researchers say, because of the “exquisite sensitivity” of these patients to the cognitive and other psychiatric adverse effects associated with these agents, whether or not they are receiving a cholinesterase inhibitor.
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If a patient is already receiving the drugs in combination, the researchers advise stopping the anticholinergic medication or choosing a “less” anticholin-ergic drug. They also advise substituting cautiously, because an anticholinergic withdrawal syndrome can cause seizures if the drug is stopped too abruptly.

Memory, Mice, and Genes: A Clue to Alzheimer’s Disease?

Alzheimer's Disease

Mice with brain damage recovered lost memories after scientists “turned off” a gene known to cause symptoms similar to those found in patients with Alzheimer’s disease (AD). AD destroys the brain’s nerve cells and leads to loss of memory and the ability to learn.

Scientists used this gene, derived from human DNA, to induce brain damage and premature aging in mice. When scientists turned this gene off, 70% of the mice regained memories on how to exit an underwater maze. The study was conducted at the University of Minnesota.

Although the study did not involve AD directly, the gene used caused a type of brain damage similar to damage believed to be a marker for AD. The markers or proteins, called tangles, were present in the rodents’ brains but did not decrease when memory was recovered.
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The investigators were surprised at this finding; they were also surprised to learn that the mice recovered memories from parts of the brain that had been damaged before the gene was turned off.

Bill Thies, vice president of medical and science affairs for the Alzheimer’s Disease Association, said that even though human brains might not react the same way, the study should inspire pharmaceutical companies to develop treatments.

Atypical Antipsychotic Agents For Alzheimer’s Disease: Risks May Outweigh Benefits

Alzheimer's Disease

Atypical antipsychotic drugs are now common choices for treating delusions, hallucinations, aggression, and agitation in patients with Alzheimer’s disease (AD). These drugs are considered to be at least as effective as haloperidol decan-oate (Haldol, Ortho-McNeil) and other conventional antipsychotic agents, with a lower risk of most adverse effects. However, studies have been relatively sparse and data have been inconsistent, say members of the Clinical Antipsychotic Trials of Intervention Effectiveness Alzheimer’s Disease Study Group. Their own findings suggest that the adverse effects of atypical antipsychotics offset the advantages in patients with AD.

In a multicenter, double-blind, placebo-controlled trial, 421 outpatients with AD and psychosis, aggression, or agitation were randomly assigned to receive olanzapine (Zyprexa generic, Eli Lilly) (mean, 5.5 mg/ day), quetiapine fumarate (Seroquel medication, AstraZeneca) (mean, 56.5 mg/day), risperidone (Generic Risperdal, Janssen) (mean, 1 mg/day), or placebo. Doses were adjusted as needed, and patients were followed for up to 36 weeks. Risperidone and olanzapine doses were within the recommended ranges, and the quetia-pine dose was one-half to one-quarter of that used in two nursing-home trials.

By 12 weeks, improvement was seen in 32% of patients receiving olanzapine, in 29% of those receiving risperidone, 26% of those taking generic quetiapine, and 21% of those receiving placebo. However, 77% to 85% of patients discontinued treatment. Over time, 24% of the olanzapine patients, 18% of the risperidone patients, 16% of the quetiapine patients, and 5% of the placebo patients withdrew from treatment because of adverse events or intolerability.

Sedation was very probable with olan-zapine, which was also associated with increased confusion. Extrapyramidal signs and symptoms with both risperi-done and drug olanzapine were common reasons for stopping treatment.

Patients gained weight with olanza-pine and risperidone tablet and lost weight with placebo. The possibility that anti-psychotic drugs might cause metabolic syndrome in the elderly requires further investigation, the researchers advise.

Future Blood Test For Alzheimer’s Disease?

Researchers at Stanford University School of Medicine have identified some distinctive proteins in the blood of patients with Alzheimer’s disease (AD) that could be used to diagnose the condition more effectively. Doctors generally diagnose AD only by eliminating other possible causes of mental decline. Only after a patient dies can surgeons examine brain tissue to look for the protein plaques and tangles that are the hallmark of the disease.