Relation of higher folate intake to lower risk of Alzheimer disease in the elderly.

Posted on June 4, 2007 by Maurice Preter MD
 
Arch Neurol. 2007 Jan;64(1):86-92.
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Relation of higher folate intake to lower risk of Alzheimer disease in the elderly.

Luchsinger JA, Tang MX, Miller J, Green R, Mayeux R.

Taub Institute for Research of Alzheimer’s Disease and the Aging Brain, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, USA. jal94@columbia.edu

BACKGROUND: Higher intake of folate and vitamins B6 (pyridoxine hydrochloride) and B12 (cyanocobalamin) may decrease the risk of Alzheimer disease (AD) through the lowering of homocysteine levels. OBJECTIVE: To relate intake of folate and vitamins B6 and B12 to AD risk. DESIGN AND PATIENTS: We followed up 965 persons 65 years or older without dementia at baseline for a mean +/- SD period of 6.1 +/- 3.3 person-years after the administration of a semiquantitative food frequency questionnaire. Total, dietary, and supplement intake of folate and vitamins B6 and B12 and kilocalorie intake were estimated from the questionnaire responses. We related energy-adjusted intake of folate and vitamins B6 and B12 to incident AD using the Cox proportional hazards regression model. MAIN OUTCOME MEASURE: Incident AD. RESULTS: We found 192 cases of incident AD. The highest quartile of total folate intake was related to a lower risk of AD (hazard ratio, 0.5; 95% confidence interval, 0.3-0.9; P=.02 for trend) after adjustment for age, sex, education, ethnic group, the epsilon4 allele of apolipoprotein E, diabetes mellitus, hypertension, current smoking, heart disease, stroke, and vitamin B6 and B12 levels. Vitamin B6 and B12 levels were not related to the risk of AD. CONCLUSIONS: Higher folate intake may decrease the risk of AD independent of other risk factors and levels of vitamins B6 and B12. These results require confirmation with clinical trials.

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PMID: 17210813 [PubMed – indexed for MEDLINE]

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Bilingualism as a protection against the onset of symptoms of dementia.

Posted on June 4, 2007 by Maurice Preter MD
 
Neuropsychologia. 2007 Jan 28;45(2):459-64. Epub 2006 Nov 27. Related Articles, Links
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Bilingualism as a protection against the onset of symptoms of dementia.

Bialystok E, Craik FI, Freedman M.

Department of Psychology, York University, Toronto, Ontario, Canada. ellenb@yorku.ca

This study examined the effect of lifelong bilingualism on maintaining cognitive functioning and delaying the onset of symptoms of dementia in old age. The sample was selected from the records of 228 patients referred to a Memory Clinic with cognitive complaints. The final sample consisted of 184 patients diagnosed with dementia, 51% of whom were bilingual. The bilinguals showed symptoms of dementia 4 years later than monolinguals, all other measures being equivalent. Additionally, the rate of decline in Mini-Mental State Examination (MMSE) scores over the 4 years subsequent to the diagnosis was the same for a subset of patients in the two groups, suggesting a shift in onset age with no change in rate of progression.

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PMID: 17125807 [PubMed – indexed for MEDLINE]

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Physical Activity and the Risk of Dementia in Oldest Old

Posted on June 4, 2007 by Maurice Preter MD
 Journal of Aging and Health, Vol. 19, No. 2, 242-259 (2007)
DOI: 10.1177/0898264307299299
© 2007 SAGE Publications

Physical Activity and the Risk of Dementia in Oldest Old

Aleksandra Sumic, MPH

Oregon Health and Science University, Portland, Oregon, sumica@ohsu.edu .

Yvonne L. Michael, ScD

Oregon Health and Science University, Portland, Oregon

Nichole E. Carlson, PhD

Oregon Health and Science University, Portland, Oregon

Diane B. Howieson, PhD

Oregon Health and Science University, Portland, Oregon

Jeffrey A. Kaye, MD, PhD

Oregon Health and Science University, Portland, Oregon

Objective: This study evaluated the protective role of physical activity (PA) against cognitive impairment (CI) in the oldest old (age ≥ 85). Method: Prospective data on 66 optimally healthy, oldest old adults (mean age 88.5) were analyzed using survival analysis. Results: In all, 12 men and 11 women reported exercising > 4 hours per week, and 38 participants developed CI (mean onset age 93; mean follow-up 4.7 years). The effect of exercise was modified by gender. In more active women (> 4 hours/week), the risk of CI was reduced by 88% (95% confidence interval 0.03, 0.41) compared to those less active. Less active women had 2 times the incidence rate of CI compared to less active men and almost 5 times the rate compared to active women. Discussion: This study demonstrates the beneficial effects of exercise on healthy brain aging even in the oldest old and emphasizes the importance of increasing PA in older women.

Key Words: oldest old • physical activity • exercise • dementia • cognitive impairment



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A community study of the presence of anxiety disorder in people with epilepsy.

Posted on May 31, 2007 by Maurice Preter MD
 
Epilepsy Behav. 2007 May 24; [Epub ahead of print] Related Articles, Links
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A community study of the presence of anxiety disorder in people with epilepsy.

Mensah SA, Beavis JM, Thapar AK, Kerr MP.

Academic Department of Neuropsychiatry, Whitchurch Hospital, Cardiff, Wales, UK.

Anxiety represents a major problem for people with epilepsy, and it is important to understand why it arises and how to reduce its potential debilitating and adverse effects. The aim of this study was to determine the prevalence of anxiety in a community-identified sample of people with epilepsy and to identify which demographic and clinical factors are most closely associated with anxiety and which factors predict the presence of anxiety among people with epilepsy. Adults with epilepsy in the community (n=515) were identified through primary care records and sent validated questionnaires, which included the Hospital Anxiety and Depression Scale (HADS). The mailout also included items on demographic and clinical variables. The prevalence of anxiety (HADS score >11) in this sample was 20.5% (95% CI: 16.9-24.1%) and was associated with a current history of depression, perceived side effects of antiepileptic medication, lower educational attainment, chronic ill health, female gender, and unemployment. It was not associated with the duration of epilepsy. The findings from this study suggest that anxiety disorders in a community population with epilepsy are most strongly predicted by factors independent of epilepsy-related variables, with the exception of patient-reported side effects. It is important to be aware of these factors when evaluating an individual with epilepsy.

PMID: 17532266 [PubMed – as supplied by publisher]

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Multiple sclerosis as a painful disease.

Posted on May 31, 2007 by Maurice Preter MD
 
Int Rev Neurobiol. 2007;79:303-21.
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Multiple sclerosis as a painful disease.

Kenner M, Menon U, Elliott DG.

Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71103, USA.

Pain is a common problem of patients with multiple sclerosis (MS) and may be due to central/neuropathic or peripheral/somatic pathology. Rarely MS may present with pain, or pain may herald an MS exacerbation, such as in painful tonic spasms or Lhermitte’s sign. In other patients, pain may become chronic as a long-term sequela of damage to nerve root entry zones (trigeminal neuralgia) or structures in central sensory pathways. Migraine headache may develop as a consequence of MS, and headache can also be a side effect of interferon treatment. The pathophysiology of pain in MS may be linked to certain plaque locations which disrupt the spinothalamic and quintothalamic pathways, abnormal impulses through motor axons, development of an acquired channelopathy in affected nerves, or involve glial cell inflammatory immune mechanisms. At this time, the treatment of pain in MS employs the use of antiepileptic drugs, muscle relaxers/antispasmodic agents, anti-inflammatory drugs, and nonpharmacological measures. Research concerning cannabis-based treatments shows promising results, and substances which block microglial or astrocytic involvement in pain processing are also under investigation.

PMID: 17531847 [PubMed – in process]

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