Alzheimer’s Disease – what is it and how can it be treated?

Posted on January 27, 2017 by Maurice Preter MD

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Dr. Preter Bio now on video

Posted on January 25, 2017 by Maurice Preter MD

Dr. Preter Bio now on video

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Dementia and Alzheimers’ Disease – How Can It Be Treated?

Posted on January 21, 2017 by Maurice Preter MD

Dementia and Alzheimers’ Disease – How Can It Be Treated?

The Latin word “De-mentia”, literally means, the removal of a person from their own mind. It stands for a significant decrease in brain function, including memory, goal-directed thinking, orientation in space and time, and language ability.

Most dementias are progressive. They cannot be cured and will gradually cause more severe problems for the patient, and for the patient’s caretakers. As the population ages, Alzheimer’s disease is on its way to becoming the third most common fatal disease.

The frustration caused by this situation prompted me to make the development of an anti-dementia treatment protocol a major focus of my clinical work.

As always, we start with a thorough neuropsychiatric assessment, looking for potentially reversible causes of cognitive decline such as a thyroid condition, vitamin deficiency, a sleep disorder, elevated blood sugar and diabetes. Importantly, untreated depression and chronic high stress and anxiety levels are associated with a higher risk for dementia. Most of the time, psychotherapy is a far better alternative to the all-too-common multiple prescription drugs.

The protocol uses a number of carefully evaluated novel interventions and components based on sound neuroscientific principles, sourced from both functional medicine and traditional medical systems, such as Ayurvedic and traditional Chinese medicine.

The protocol stabilizes many of my patients, and improves their functioning and quality of life. It has shown promising results not only for dementia, but also for traumatic brain injury.

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Living near major traffic linked to higher risk of dementia

Posted on January 5, 2017 by Maurice Preter MD

Living near major traffic linked to higher risk of dementia

This type of air pollution is now emerging as a major risk factor. Possibly related to brain deposits of magnetite microspheres?

People who live close to high-traffic roadways face a higher risk of developing dementia than those who live further away, new research from Public Health Ontario (PHO) and the Institute for Clinical Evaluative Sciences (ICES) has found.

Led by PHO and ICES scientists, the study found that people who lived within 50 metres of high-traffic roads (like Ontario’s Hwy. 401) had a seven per cent higher likelihood of developing dementia compared to those who lived more than 300 meters away from busy roads.

Published in The Lancet, the researchers examined records of more than 6.5 million Ontario residents aged 20-85 to investigate the correlation between living close to major roads and dementia, Parkinson’s disease and multiple sclerosis.

Scientists identified 243,611 cases of dementia, 31,577 cases of Parkinson’s disease, and 9,247 cases of multiple sclerosis in Ontario between 2001 and 2012. In addition, they mapped individuals’ proximity to major roadways using the postal code of their residence. The findings indicate that living close to major roads increased the risk of developing dementia, but not Parkinson’s disease or multiple sclerosis, two other major neurological disorders.

“Little is known in current research about how to reduce the risk of dementia. Our findings show the closer you live to roads with heavy day-to-day traffic, the greater the risk of developing dementia. With our widespread exposure to traffic and the greater tendency for people to live in cities these days, this has serious public health implications,” says Dr. Hong Chen, environmental and occupational health scientist at PHO and an adjunct scientist at ICES. Dr. Chen is lead author on the paper titled “Living near major roads and the incidence of dementia, Parkinson’s disease, and multiple sclerosis: a population-based cohort study.”

“Our study is the first in Canada to suggest that pollutants from heavy, day-to-day traffic are linked to dementia. We know from previous research that air pollutants can get into the blood stream and lead to inflammation, which is linked with cardiovascular disease and possibly other conditions such as diabetes. This study suggests air pollutants that can get into the brain via the blood stream can lead to neurological problems,” says Dr. Ray Copes, chief of environmental and occupational health at PHO and an author on the paper.

As urban centres become more densely populated and more congested with vehicles on major roads, Dr. Copes suggests the findings of this paper could be used to help inform municipal land use decisions as well as building design to take into account air pollution factors and the impact on residents.

This research was conducted in collaboration with scientists from the University of Toronto, Carleton University, Dalhousie University, Oregon State University, and Health Canada. The study was funded by Health Canada.

Key findings:

  • Using data held at ICES, the researchers examined records of more than 6.5 million Ontario residents, aged 20-85, and mapped them according to residential postal codes five years before the study started.
  • Between 2001 and 2012, 243,611 cases of dementia, 31,577 cases of Parkinson’s disease, and 9,247 cases of multiple sclerosis were identified in Ontario.
  • People who lived within 50 metres of high-traffic roads had a seven per cent higher likelihood of dementia than those who lived more 300 meters away from busy roads.
  • The increase in the risk of developing dementia went down to four per cent if people lived 50-100 metres from major traffic, and to two per cent if they lived within 101-200 metres. At over 200 metres, there was no elevated risk of dementia.
  • There was no correlation between major traffic proximity and Parkinson’s disease or multiple sclerosis.

Public Health Ontario is a Crown corporation dedicated to protecting and promoting the health of all Ontarians and reducing inequities in health. Public Health Ontario links public health practitioners, front-line health workers and researchers to the best scientific intelligence and knowledge from around the world. For the latest PHO news, follow us on Twitter: @publichealthON.

The Institute for Clinical Evaluative Sciences (ICES) is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario

FOR MORE INFORMATION, PLEASE CONTACT:

Janet Wong
Media Relations Advisor, PHO
media@oahpp.ca
647-260-7247

Deborah Creatura
Media Advisor, ICES
deborah.creatura@ices.on.ca
(o) 416-480-4780 or (c) 647-406-5996

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Relationships Between Caffeine Intake and Risk for Probable Dementia or Global Cognitive Impairment: The Women’s Health Initiative Memory Study

Posted on January 5, 2017 by Maurice Preter MD

Relationships Between Caffeine Intake and Risk for Probable Dementia or Global Cognitive Impairment: The Women’s Health Initiative Memory Study

 

  1. Ira Driscoll1,
  2. Sally A. Shumaker2,
  3. Beverly M. Snively3,
  4. Karen L. Margolis4,
  5. JoAnn E. Manson5,
  6. Mara Z. Vitolins6,
  7. Rebecca C. Rossom4 and
  8. Mark A. Espeland3

+Author Affiliations


  1. 1 Department of Psychology, University of Wisconsin–Milwaukee.

  2. 2 Department of Social Sciences and Health Policy and

  3. 3 Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.

  4. 4 Health Partners Institute for Education and Research, Minneapolis, Minnesota.

  5. 5 Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.

  6. 6 Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
  1. Address correspondence to Ira Driscoll, PhD, Department of Psychology, University of Wisconsin–Milwaukee, 224 Garland Hall, 2441 East Hartford Avenue, Milwaukee, WI 53211. Email: driscoli@uwm.edu
  • Received December 1, 2015.
  • Accepted April 7, 2016.

Abstract

Background: Nonhuman studies suggest a protective effect of caffeine on cognition. Although human literature remains less consistent, reviews suggest a possible favorable relationship between caffeine consumption and cognitive impairment or dementia. We investigated the relationship between caffeine intake and incidence of cognitive impairment or probable dementia in women aged 65 and older from the Women’s Health Initiative Memory Study.

Methods: All women with self-reported caffeine consumption at enrollment were included (N = 6,467). In 10 years or less of follow-up with annual assessments of cognitive function, 388 of these women received a diagnosis of probable dementia based on a 4-phase protocol that included central adjudication. We used proportional hazards regression to assess differences in the distributions of times until incidence of probable dementia or composite cognitive impairment among women grouped by baseline level of caffeine intake, adjusting for risk factors (hormone therapy, age, race, education, body mass index, sleep quality, depression, hypertension, prior cardiovascular disease, diabetes, smoking, and alcohol consumption).

Results: Women consuming above median levels (mean intake = 261mg) of caffeine intake for this group were less likely to develop incident dementia (hazard ratio = 0.74, 95% confidence interval [0.56, 0.99], p = .04) or any cognitive impairment (hazard ratio = 0.74, confidence interval [0.60, 0.91], p = .005) compared to those consuming below median amounts (mean intake = 64mg) of caffeine for this group.

Conclusion: Our findings suggest lower odds of probable dementia or cognitive impairment in older women whose caffeine consumption was above median for this group and are consistent with the existing literature showing an inverse association between caffeine intake and age-related cognitive impairment.

Key words

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