Journal of Gerontological Nursing

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MRI May Help Identify Type of Dementia

Alzheimer’s disease and frontotemporal lobar degeneration (FTLD) often have similar symptoms, even though the underlying disease process is much different. Now, a new way to use magnetic resonance imaging (MRI) scans may help determine the specific type of dementia, according to new research published in Neurology.

The study involved 185 people who had been diagnosed with a neurodegenerative disease consistent with Alzheimer’s disease or FTLD and had a lumbar puncture and a high-resolution MRI. Of the 185, the diagnosis was confirmed in 32 people either by autopsy or by determining that they had a genetic mutation associated with one of the diseases.

Researchers used the MRIs to predict the ratio of two biomarkers for the diseases in the cerebrospinal fluid, the proteins tau and beta-amyloid. The MRI prediction method was 75% accurate at identifying the correct diagnosis in those with pathology-confirmed diagnoses and those with biomarker levels obtained by lumbar punctures, which shows similar accuracy of the MRI and lumbar puncture methods.

Analysis of cerebrospinal fluid gives physicians reliable diagnostic information, but the procedure is painful and expensive. Using the new MRI method would reduce those burdens. In addition, the researchers stated that this method would be helpful in clinical trials where it may be important to monitor these biomarkers repeatedly over time to determine whether a treatment was working.

Source.“New MRI Method May Help Diagnose Dementia.” (2012, December 26). Retrieved January 28, 2013, from http://www.aan.com/press/index.cfm?fuseaction=release.view&release=1126.

Infant Brains Could Hold Keys to Mental Disruptions Later in Life

Some brain changes that are found in adults with common gene variants linked to disorders such as Alzheimer’s disease, schizophrenia, and autism can also be seen in the brain scans of newborns, according to a study published in Cerebral Cortex.

Impact of the APOE Alzheimer’s disease risk variant on the newborn brain. Blue clusters show decreased brain volumes in newborns with the risk variant. Similar decreases in this brain area, which is involved in memory, are seen in adults with the same variant. Yellow/orange clusters show increased brain volumes in newborns with the risk variant. These changes may be unique to infants and young children and could represent beneficial effects.Image courtesy of Rebecca C. Knickmeyer, PhD

Impact of the APOE Alzheimer’s disease risk variant on the newborn brain. Blue clusters show decreased brain volumes in newborns with the risk variant. Similar decreases in this brain area, which is involved in memory, are seen in adults with the same variant. Yellow/orange clusters show increased brain volumes in newborns with the risk variant. These changes may be unique to infants and young children and could represent beneficial effects.Image courtesy of Rebecca C. Knickmeyer, PhD

The study included 272 infants who received magnetic resonance imaging (MRI) scans shortly after birth. The DNA of each was tested for 10 common variations in 7 genes that have been linked to brain structure in adults. These genes have also been implicated in conditions such as schizophrenia, bipolar disorder, autism, Alzheimer’s disease, anxiety disorders, and depression.

For some polymorphisms—such as a variation in the APOE gene, which is associated with Alzheimer’s disease—the brain changes in infants looked very similar to brain changes found in adults with the same variants.

However, this was not true for every polymorphism included in the study. For example, the study included two variants in the Disrupted In Schizophrenia 1 (DISC1) gene. For one of these variants, known as rs821616, the infant brains looked very similar to the brains of adults with this variant. But there was no such similarity between infant brains and adult brains for the other variant, rs6675281, suggesting that the brain changes associated with this gene variant are not present at birth but develop later in life, perhaps during puberty.

Source.“Risk Genes for Alzheimer’s and Mental Illness Linked to Brain Changes at Birth.” (2012, December 31). Retrieved January 28, 2013, from http://www.newswise.com/articles/risk-genes-for-alzheimer-s-and-mental-illness-linked-to-brain-changes-at-birth.

Media’s Coverage of Nursing Home Industry Influences Consumer Behavior

An analysis of media portrayals of nursing homes has found that negative stories outnumber positive stories by five to one, reports a study in Medical Care. Researchers performed a database search to identify more than 1,500 articles related to nursing homes, published in four major American newspapers between 1999 and 2008. Using a standardized approach, they categorized the tone of each news story as positive, negative, or neutral. The characteristics of articles in the three categories were analyzed as well.

Overall, 49.2% of articles were classified as negative and 10.5% as positive. The remaining 40.3% were categorized as neutral in tone. Some prominent differences were noted in the content of positive versus negative or neutral articles. Positive articles were more likely to discuss the quality of nursing home care, whereas negative articles were often about cases involving negligence or fraud. Negative articles were more likely to focus on the nursing home industry, whereas positive articles tended to focus on the broader community and residents/families. Many of the neutral articles covered financing and business/property issues.

Negative articles involving negligence/fraud were more likely to be found on the front page, compared to positive or neutral articles. Other negative stores were related to natural disasters—particularly to several high-profile incidents involving nursing home residents endangered by Gulf Coast hurricanes. Many of the positive stories were related to local quality-improvement initiatives—particularly ongoing “culture change” efforts seeking to make nursing homes more home-like environments.

The researchers commented that negative media coverage has probably influenced consumer behavior—especially at a time of increasing competition from “alternative care sources with more robust reputations,” such as home- and community-based care and assisted living. They suggest that nursing homes and the nursing home industry may want to develop “more effective media strategies,” highlighting the culture change movement and other innovations to improve care and quality of life for nursing home residents.

Source.“In Media Coverage of Nursing Homes, Negative Stories Predominate.” (2012, December 13). Retrieved January 28, 2013, from http://www.wolterskluwer.com/Press/Latest-News/2012/Pages/pr13Dec2012.aspx#.UQb19me56cY.

Recruitment of Non-Spouse Caregivers Essential for Alzheimer’s Research

A new study published in Neurology has assessed the prevalence of the various types of study partners in Alzheimer’s clinical trials—a patient’s spouse or “other” partners, such as a patient’s adult child—and has discovered that who the study partner is can actually influence the results of the trials and the interpretations of those results.

In their analysis of 2,041 patients with Alzheimer’s disease who had participated in six clinical trials, the researchers found that 67% of these patients had a spouse as their study partner. Yet in the general population, more than two thirds of all unpaid Alzheimer’s disease caregivers are patients’ children, children-in-law, or grandchildren, and half of unpaid caregivers are younger than 50. Importantly, as many as 90% of Alzheimer’s disease patients do not have spouses, confirming that clinical trial researchers are missing a huge population of people they are not enrolling. The study researchers also found that, after controlling for confounding factors, the risk of dropout for the “other” study partner group—the group including adult children—was 70% higher than for the spouse study partner group.

Factors such as patient race and the attitudes of caregivers can also affect recruitment for clinical trials. For example, only 5% of participants in the clinical trials the researchers looked at were Hispanic, and only 6% were African American. Those trial participants who had an adult child as their study partner were twice as likely as those with spouse partners to be Hispanic and nearly three times as likely to be African American.

The study did not explain why clinical trial participants with non-spouse study partners were under-represented. Adult-child study partners were more likely to be working and living apart from the patient, the researchers hypothesized.

Source.“‘Study Partners’ Play Critical Role in Clinical Trials for Alzheimer’s Disease.” (2013, January 8). Retrieved January 28, 2013, from http://www.newswise.com/articles/study-partners-play-critical-role-inclinical-trials-for-alzheimer-s-disease.

Documentary Provides Food (& Drink) For Thought on Aging Well

The secret to longevity may be found within the journey of two 40-something women who traveled the country for 3 years, according to ICareVillage, distributor of videos on health and aging. ICareVillage’s new movie, Whiskey and Apple Pie: Delicious Wit & Wisdom Across America, is a thought-provoking and heartwarming “feel good” documentary that brings into focus the wisdom of our older generation. In this award-winning movie, the two women take a journey across America to capture the wisdom and stories of men and women older than 75. The film includes interviews with both men and women who share their wisdom, humor, joy, and passion and features Tippi Hedren, Mickey Rooney, Dr. Dorothy I. Height, and the musical talent of Sahra Baker, Joe Ruffatto, and the Florence Adams Band.

The trailer and ordering information for Whiskey & Apple Pie can be found at http://www.whiskeyandapplepie.com. The movie is also available at Amazon.com.

Source.“Why Whiskey & Apple Pie is Good for Your Health.” (2012, December 17). Retrieved January 28, 2013, from http://www.pr.com/press-release/461910.

Regained Weight Harmful to Postmenopausal Women’s Cardiovascular Health

New research published in the Journals of Gerontology: Biological Sciences and Medical Sciences has found that gaining weight back after intentional weight loss is associated with negative long-term effects on some cardiometabolic (CM) risk factors in postmenopausal women.

In this article, researchers wanted to look at how weight regain affects health risk in these women. The researchers looked specifically at CM risk factors—a cluster of risk factors that are indicators of a person’s overall risk for type 2 diabetes and cardiovascular disease. They include blood pressure, high- and low-density lipoprotein cholesterol, triglycerides, fasting glucose, and insulin. Specifically, the researchers looked at how CM risk factors change in the year following significant, intentional weight loss and whether these changes are affected by weight regain.

They found that all CM risk factors are improved with weight loss, but most regressed back to their baseline values 12 months later, especially for women who were classified as “regainers.” For women who had regained weight in the year after their weight loss, several risk factors were actually worse than before they lost the weight.

The sample included 112 obese, postmenopausal women (mean age = 58), studied through a 5-month weight loss intervention and a subsequent 12-month non-intervention period. Body weight/composition and CM risk factors were analyzed before and after the weight loss intervention and at 6 and 12 months after the intervention. During the intervention, women lost a significant amount of weight, an average of 25 pounds, and 80 women returned for at least one follow-up measurement. Weight regain status was based on whether a participant regained at least 4 pounds during the follow-up period. Two thirds of the women fell into this category and, on average, regained approximately 70% of lost weight, highlighting the need for future research to better identify barriers to long-term weight loss success and develop effective strategies to promote the maintenance of weight loss in this population.

Source.“Maintaining Weight Loss As Important As Losing It for Older Women.” (2012, December 10). Retrieved January 28, 2013, from http://www.newswise.com/articles/maintaining-weight-loss-as-important-as-losing-it-for-older-women.

10.3928/00989134-20130129-89

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