August 5, 2008
College grads with MMSE below 27 need dementia testing, says Mayo team
The bar should be set higher in suspecting a diagnosis of early Alzheimer’s among highly educated patients, according to a new report in Archives of Neurology.
A study from the Mayo Clinic Alzheimer Research Center shows that, for college-educated individuals, an MMSE score below 27 is a much better predictor of dementia risk than the customary cutoff score of 24.
The difference is important because highly educated folks with Alzheimer’s decline faster and die sooner, according to the medical literature.
But there’s good news: Higher education also delays the steepest part of the cognitive decline, reports another recent study.
Well-educated people may want to know that physical exercise seems to diminish brain atrophy in Alzheimer’s, according to another new study. (Whether that translates to an effect on cognitive function is not yet determined.)
Other Alzheimer News
dimebon Alzheimer
etanercept Alzheimer speech
Clinical Trials
Scholarly people with memory loss may want to help researchers determine whether mental exercise can delay dementia, by enrolling in a clinical trial that’s testing the question.
Practical Articles/News
Read a review about medical treatment for early Alzheimer’s recently published in Consultant.
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Dementia, Family Medicine, Geriatrics, Psychiatry | Tagged: Alzheimer's disease, Dementia, education, memory | 
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June 10, 2008
Any antipsychotic triples risk of serious events for elderly with dementia
Giving antipsychotics of any kind to an elderly person with dementia, even briefly, increases the risk of death or hospitalization by three or four times, according to a new longitudinal study in the Archives of Internal Medicine.
The study of over 40,000 elderly Canadians, equally divided between those living in nursing homes and those in the community, compared people who took antipsychotics with those who did not. The authors felt they have identified only the “tip of the iceberg” in terms of adverse events.
Research/Reviews
The risk of serious consequences in this study is considerably larger than in earlier studies that compared typical and atypical antipsychotics among the elderly.
Another recent study has found non-steroidal anti-inflammatory drugs (NSAIDs) of no value in preventing cognitive decline in Alzheimer dementia.
Clinical Trials
What’s happening in research using statins to treat Alzheimer disease?
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Dementia, Geriatrics, Uncategorized | Tagged: antipsychotics, Dementia, elderly | 
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April 1, 2008
Five million over age 70 have memory loss. One-fourth are chronically ill.
A groundbreaking nationwide longitudinal study has documented the dimensions of dementia. It estimates that 22% of Americans over age 70—more than five million people–have cognitive impairment without dementia.
On average, this progresses to dementia within about 18 months in about 12% of cases, according to the report in the Annals of Internal Medicine. (The rate of progression varies by subtype of cognitive impairment.)
In 24% of elderly patients, cognitive impairment without dementia is associated with a chronic comorbidity such as diabetes or heart disease. The report notes that doctors busy with the medical condition probably often overlook the cognitive issues (perhaps hindering the success of treatment).
The new national results echo earlier studies that associated early dementia with medical comorbidities.
A series of articles and letters in recent issues of the Journal of the American Medical Association pondered whether primary care doctors should begin screening for cognitive impairment in elderly patients.
Practice Guidelines
Look in this category for national guidelines on diagnosing mild cognitive impairment.
Cardiovascular
A recent study suggests best followup tests for cognitive impairment in stroke patients.
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Dementia, Family Medicine, Geriatrics, Psychiatry | Tagged: cognitive impairment, Dementia, stroke | 
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