Antipsychotics and Alzheimer's

A new study from the UK suggests that neuroleptics commonly given to Alzheimer's patients with behavioral problems provide no benefit and may actually decrease verbal skills.

The term "neuroleptic" refers to medications that are used to affect behavior such as confusion, delusions, hallucinations, aggression, and agitation in patients with psychotic symptoms.  They are also used as sedatives in patients with dementia.

Some of the more common neuroleptics include Haldol, Risperdal, Clozapine, Zyprexa, Seroquel, Geodon, and Abilify.

Many Alzheimer's patients in nursing homes are given neuroleptics to control their behavior.  

In the British study, published in the Public Library of Medical Science, six months of treatment with a neuroleptic resulted in pronounced deficits in verbal skills.  Another study is underway to investigate the hypothesis that neuroleptics may also increase death rates.

Researchers suggest that using neuroleptics to treat behavior problems should be considered a last resort in patients with severe problems who have not responded to other forms of treatment.

Prevent Head Injuries in Older Adults

Falling is the single largest cause of injuries for adults over the age of 65 in the United States.  One way to lower your risk of developing dementia is to lower your risk of falling and injuring your head.

To make your living environment safer, the Centers for Disease Control and Prevention advises the following:

-- Remove anything that might cause you to trip, including throw rugs or excessive clutter in walkways

-- Use non-slip mats in the bathtub or on shower floors

-- Install grab bars next to the toilet and tub or shower

-- Install handrails on both sides of a stairway

-- Improve lighting throughout the home

-- Maintain a regular exercise program to improve lower body strength and balance

Research suggests that a person who has experienced a head injury has a significantly greater likelihood of developing dementia.  

Is it Depression or Dementia

Do you know the difference between depression and dementia?  

Depression is often referred to as "pseudo-dementia" because the symptoms can look like dementia in older adults.  Differentiating between depression and dementia is important because each condition requires different treatment and has a different expected outcome.

Here is a quick guide to distinguishing between depression and dementia:

Memory:

In depression, memory deficits are usually due to reduced attention and concentration. One key indicator is that the person usually complains and worries about their memory difficulties.

In dementia, a person has difficulty remembering things that occurred a short time ago, such as what they ate for breakfast.  Many adults with dementia try to mask their deficits for as long as possible so they do not usually complain about their poor memory.

Memory and Mood:

In a depressed person, mood and memory are often related.  If the person is experiencing impairments in memory, than their mood is often depressed.

In a demented adult, mood and memory are not related.  As a person memory declines, they often become irritable and dull as they withdraw from activities they used to enjoy.

Language:

People who are depressed may complain about having a difficult time expressing themselves, but they are able to speak, write and use language in an appropriate manner.

People with dementia often have trouble finding the right name for an object.  They may point to their watch when they are trying to discuss the time or refer to a toothbrush as "that thing I clean my teeth with."

Adults with dementia also have difficulty remembering the proper use for common everyday objects.  

When a doctor attempts to test a person's cognition, people with depression will make disparaging comments about their poor memory, often describing it as being worse than it actually is.  Adults with dementia try to hide their impairments and will often become irritable or try to change the subject to avoid the test.

If you are concerned about whether or not a loved one's memory loss is due to depression or dementia, a neuropsychological assessment can help to differentiate between the two so that appropriate interventions can be put into place.

Study Shows a Large Belly Increases the Risk of Dementia

A Kaiser Permanente study, published in the March 26, 2008 issue of Neurology, suggests that people in their 40's with larger bellies have a higher risk of developing dementia when they reach their 70's.

Previous studies have also shown that a large abdomen increases the risk of diabetes, stroke, and coronary heart disease.  These illnesses also increase the risk of dementia.

Researchers in Northern California studied 6583 adults aged 40-45.  Approximately 36 years later, 16% of these people had developed dementia.  

Those who were overweight and carried excess fat in their abdomen were 2.3 times more likely to develop dementia than similarly matched adults at a healthier weight.  

Subjects who were obese and had a large belly had a 3.6 times greater likelihood of developing dementia than their healthy counterparts.

Obesity is defined as having a Body Mass Index (BMI) of 30 or above while overweight is considered a BMI of 25.  A BMI of 30 means a person is approximately 30 pounds overweight.  The BMI is calculated using a person's height and weight and correlates strongly with overall fat content.

To calculate your own BMI go to www.halls.md/body-mass-index/av.htm

Additionally, researchers found that those most likely to have abdominal obesity were non-whites, smokers, people with high blood pressure, high cholesterol or diabetes, and those with less than a high school education.

Alzheimer's Patients Being Enrolled in Eli Lilly Study

Eli Lilly has started Phase 3 of a clinical trial investigating the use of a potential new medication for Alzheimer's patients with mild to moderate dementia.  

The medication is a gamma secretase inhibitor, which means it is supposed to inhibit the action of gamma secretase, which is an enzyme that can create amyloid beta, the sticky protein that forms plaque in the brain.  The plaque is believed to be at least partially responsible for killing brain cells, resulting in the cognitive decline that are the hallmark of Alzheimer's dementia.

The clinical trial is called The IDENTITY Trial:  Interrupting Alzheimer's Dementia by EvaluatiNg Treatment of AmyloId PaThologY.

For more information about the IDENTITY Trial, go to Eli Lilly's website:

www.lillytrials.com  or www.clinicaltrials.gov

You can also call 1-877-CTLilly  (1-877-285-4559).