More insights on Alzheimer’s disease – how some brains are protected

A feature of the brain’s neurons called dendritic spines may protect against dementia, according to new findings.

Neurofibrillary tangles and amyloid plaques appear in the brains of people with Alzheimer’s, but not everyone who has these formations goes on to develop the disease. Between 30 and 50 percent of patients with the plaques and tangles do not develop Alzheimer’s disease. Why not? Scientists have been looking for the reasons.

Researchers at the University of Alabama at Birmingham found the answer may lie in dendritic spines. The dendritic spines of a neuron help it make connections with other neurons and send information. These parts of the neuron may protect against Alzheimer’s disease.

Dendrites, the branched projections of a neuron that transfer electrochemical stimulation from other neural cells to the cell body, have small membranous protrustions called dendritic spines. Each dendritic spine receives input from a single axon at the synapse. The loss of dendritic spines results in the loss of synapses, which can impair cognition. Logically, subects with normal brains would have healthy dendritic spines, and those with dementia would not. The researchers tested the structures and published the results in the journal Annals of Neurology.

The scientists compared dendritic spines in 21 patients with Alzheimer’s, 8 patients who had Alzheimer’s brain changes but no symptoms, and 12 healthy patients. Using bright-field microscopy, Professor Jeremy Herskowitz and the team took images of the dendritic spines, then used the images to create a 3-D digital reconstruction.

The healthy control subjects had more dendritic spines than the subjects with Alzheimer’s. The subjects with Alzheimer’s brain changes but no symptoms also had more spines than the Alzheimer’s subjects — and almost the same dendritic spine density as the healthy subjects. The group with pathology but no symptoms group had very long dendritic spines, longer than both the other groups.

Longer dendritic spines might indicate greater neuroplasticity — the capacity to change and form new neural connections. Increased neuroplasticity could enable the neurons to bypass plaques and tangles, and still communicate with other neurons. If so, this phenomenon could explain why some people who have Alzheimer’s pathology do not show cognitive impairment.

The research suggests that it may be possible for the brain to rebuild neurons. The information gained in the study may help scientists to develop new therapies, especially when brain changes are detected before symptoms appear.

In 2014, a study at NYU Langone Medical Center in New York, published in the journal Science, showed that getting sleep after learning helps neurons form connections, through dendritic branches, that may help brain cells pass information to each other and facilitate long-term memory.

The scientists observed mice that were genetically modified so a particular protein in their brain cells would fluoresce when viewed with a laser scanning microscope. The fluorescence allowed the team to track the growth of new spines along each branch of a dendrite. The mice sprouted new dendritic spines within 6 hours of learning a new task. Different structural changes occurred for different types of learning.

Healthier and more numerous dendritic spines may be a genetic trait, but the brain also may respond to healthy diet and lifestyle. According to Medical News Today, research suggests that as many as a third of dementia cases can be prevented by regular exercise and an active social life.

For more information on Alzheimer’s and dementia, and care choices, see the Guide To Long Term Care.

 

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After Disaster: New Emergency Requirements for Nursing Homes

During Hurricane Irma, 14 people died at The Rehabilitation Center at Hollywood Hills, Florida, due to a power outage that left residents in extreme heat. Lack of air conditioning made the building heat up like an oven. One of the victims died with a body temperature of 109.9 degrees. The nursing home’s owners now face criminal investigation and civil lawsuits.

In response to the tragedy, Florida Governor Rick Scott issued an emergency order requiring nursing homes to have generators that can run air conditioners.

The nursing home industry has brought court cases to challenge the emergency order. But in the meantime, state senators Lauren Book and Rene Garcia have filed bills to make the generator requirement a state law. Also, state senator Gary Farmer is preparing a more comprehensive Florida nursing home reform bill.

On the Federal level, U.S. Representative Debbie Wasserman Schultz is sponsoring a bill that will require nursing homes to have generators that can run air conditioning for at least 96 hours in the event of an emergency power outage. The bill will also put nursing homes on the top priority list, along with hospitals, for restoring power after a hurricane.

The Federal bill provides for loans to help small facilities comply with the new regulation. Homes that have fewer than 50 beds, or a private room monthly rate of $6,000 or less could qualify for a loan to get the generators and other required equipment. This bill also sets up higher fines for facilities that break the rules and adds nursing homes to the critical infrastructure list so power will be restored there first.

Nursing homes are among the most important resources for long term care. For more information about long term care insurance see the Guide To Long Term Care.

 

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Most Americans Incorrectly Believe Health Insurance or Medicare Pays For Long Term Care

More than half of Americans, 55%, incorrectly believe health insurance or Medicare will pay for long term care, the assistance with daily living that some people need because of illness or injury.

People who are sick or injured may need help with activities of daily living such as bathing, dressing, preparing food, and so forth that they would normally do for themselves.

A recent online survey asked adults how they would pay for assistance with activities of daily living if they are unable to take care of themselves for an extended period of time. More than half, 55%, said they would use Medicare or health insurance. But Medicare and health insurance, although they cover some of the medical costs, do not pay for long term assistance with daily living. See “Who Pays for Care”

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Medicare covers these costs for a maximum of 100 days (or until you stop improving). Medicaid will pay for these costs only when the individual’s assets are down to around $2,000 or $3,000 – depending on the state of residence – and Medicaid will recover the costs from the estate after death. This is often done with a lien on the Medicaid recipient’s primary residence.  How long will your savings/investments last if paying $75,000 a year per person for care?

The survey involved 2,065 U.S. adults age 18 and older. People over age 55 were more likely to say they would pay for long term care needs with health insurance and/or Medicare. People ages 18-54 were more likely to say they would borrow money from family and friends or use a credit card or loan. Long term care costs are estimated to be $70,000 a year or more, most of which will not be covered by health insurance or Medicare.

The U.S. Government Accounting Office and The Wall St. Journal report that 72% of Americans will need long term care at some time, either part-time assistance at home or full-time care in a facility. But people need to be educated about the costs of care and how to pay for it. Long term care insurance will relieve some of the burden. Many states now have available a Partnership insurance policy that protects assets by exempting the policyowner from Medicaid spend-down. Read more about The Partnership.

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Urgent Need for Alzheimer’s Disease Study Volunteers

Many researchers are working on a cure for Alzheimer’s disease. But they have run into an obstacle recently: a shortage of volunteers for clinical trials.

There are more than 100 research studies needing around 50,000 volunteers to help. Many studies have been funded, but there are not enough participants.

177851075The trials do not necessarily require people who are elderly or who suffer from dementia, and are not all drug trials. Some studies require participants to do cognitive tests on home computers. Some record data on lifestyle factors such as diet and exercise, or genetic risk factors.

There are studies where the volunteers try out wearable technology. All these tests collect information that can help scientists find ways to help people with Alzheimer’s.

Study subjects can benefit from participating. For example, some people who have Alzheimer’s disease may find a treatment that works. Some people may discover they have a genetic risk of dementia or already are in the early stages, and get prevention or treatment when it is most effective. Many volunteers in these studies will receive medical care for free. Also, some of the drug trials pay participants.

For people with dementia who are isolated, taking part in a study may help them socially. They can make friends with people running the studies and be part of a team. They can also feel good about helping to advance science and benefit others.

Some of the problems scientists have in recruiting study participants: In some studies both the dementia patient and a care partner must be involved. It’s harder to enroll two people. Some drug trials exclude people with certain medical conditions from participating.

Many drug studies require subjects in the early stages of dementia; at this stage there are few, or no, symptoms, so the disease hasn’t yet been identified, making it hard to find subjects.

There are sometimes legal obstacles if a dementia patient is not considered competent enough to give consent. And there are risks with experimental therapies, even though animal studies and FDA reviews are done before human trials.

For information on upcoming trials and on volunteering, visit the Alzheimer’s Association website, they have TrialMatch, a free database where you can find studies that may be right for you.

 

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Dancing Benefits The Aging Brain

Doctors have long recommended physical exercise to reduce or delay the onset of dementia as people age. But a new study indicates that dancing may give even greater benefits than other forms of exercise.

Dr. Kathrin Rehfeld compared the effects of different kinds of exercise on volunteers with an average age of 68. Over 18 months, participants took part in either traditional fitness training with repetitive exercises like cycling or Nordic walking, or dance lessons which featured something new each week.

The study measured changes in the hippocampus, the area of the brain that is connected with learning, memory, and balance, and is affected by Alzheimer’s and similar diseases. In both groups, the hippocampus region of the brain increased. The dancers had a noticeable improvement in balance.

The dance routines varied and included jazz, square dance, line dance, and Latin. The study was published in the journal Frontiers in Human Neuroscience.

Other studies have found similar benefits to dancing:

A study at the Albert Einstein College of Medicine found that brain-stimulating activities such as reading, writing, and doing puzzles lowered the risk of dementia by 47 percent. This study did not find that regular bicycling, swimming, or team sports lowered the risk of dementia significantly. But ballroom dancing reduced the risk of developing dementia by 67 percent!

A study from Korea found that seniors who learned to dance the Cha Cha improved their memory and cognitive function over six months when compared to controls. A study from Canada found that seniors who danced the tango twice a week improved their cognitive scores.

The challenge of constantly learning a variety of new things may be one of the keys to the success of dance in improving mental ability. Dance requires a combination of mental and physical activity – dancers must remember the steps and executive them in rhythm. Also, dance is usually accompanied by music, and music has also been found to benefit people with Alzheimer’s and dementia. Music stimulates memories and positive emotions, and body response to rhythms; music can also have the effect of making people more outgoing and sociable.

For more information on Alzheimer’s and dementia, see the Alzheimer’s Section of Guide To Long Term Care.

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Eye Scan for Alzheimer’s

Scanning the eyes is a new way to detect Alzheimer’s disease.

Researchers at Cedars-Sinai Medical Center in California say Alzheimer’s affects the retina, in the back of the eye, in a similar way to how it affects the brain. A high-definition eye scan can show the buildup of toxic proteins that indicate Alzheimer’s.

The plaque showing in the retina matches the plaque in a corresponding part of the brain. Through repeated scans of the retina over time, doctors will be able monitor the progression of the disease.

At one time, the only way to diagnose Alzheimer’s was by examining the brain after a person died. Now doctors can use brain scans to diagnose the disease in living patients, but these scans are expensive and invasive. The non-invasive eye scans will help doctors to detect the disease earlier, making it possible to intervene with medications and lifestyle changes before more symptoms appear.

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If you do not plan for your long term care who will? See the Guide To Long Term Care for more information on Alzheimer’s and how to prepare for long term care needs.

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Nine lifestyle changes can reduce dementia risk

Nine factors that contribute to the risk of dementia

  • Mid-life hearing loss – responsible for 9% of the risk
  • Failing to complete secondary education – 8%
  • Smoking – 5%
  • Failing to seek early treatment for depression – 4%
  • Physical inactivity – 3%
  • Social isolation – 2%
  • High blood pressure – 2%
  • Obesity – 1%
  • Type 2 diabetes – 1%

These risk factors – which are described as potentially modifiable – add up to 35%. The other 65% of dementia risk is thought to be potentially non-modifiable.
READ  ARTICLE HERE

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Note: Insure before the diagnosis. Once diagnosed insurance is no longer available.

 

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