New Tool Predicts Dementia Years Before Onset

 

 With your excellent chance of getting dementia post stroke what are the EXACT DEMENTIA PREVENTION PROTOCOLS from your doctor?

Your chances of getting dementia.

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018 

Maybe because s/he has nothing in the way of a dementia prevention protocol?  There is no excuse for such incompetency, see the following; You are on your own for prevention.

• dementia prevention (261 posts to November 2015)
• Alzheimers prevention (141 posts to November 2021)

New Tool Predicts Dementia Years Before Onset

A new predictive tool combining amyloid PET data with key clinical factors estimates an individual’s lifetime risk for mild cognitive impairment (MCI) and dementia years before symptoms, potentially transforming the way risk is assessed.

The model combines age, sex, APOE-ε4 status and findings on amyloid PET scans, with amyloid PET results having the largest effect on risk. The lifetime and 10-year absolute risk for MCI and dementia in older adults with normal cognition increased continuously with increasing centiloid value for all combinations of sex and APOE-ε4 status.

“This tool will allow patients to determine their likelihood of developing cognitive impairment in the near future when trying to decide if they should consider therapy. This will be necessary if and when therapies become approved for treating cognitively normal persons who are amyloid-positive,” study investigator Ronald Petersen, MD, PhD, neurologist and director of the Mayo Clinic Study of Aging, told Medscape Medical News.

The study was published online on November 12 in Lancet Neurology.

Flagging Early-Intervention Candidates

The lifetime risk of developing cognitive impairment among individuals who are cognitively normal but have abnormal Alzheimer’s disease (AD) biomarkers remains a key knowledge gap.Using data from the long-running Mayo Clinic Study of Aging, Petersen and colleagues developed a prediction model to gauge lifetime and 10-year absolute risk for cognitive impairment in adults aged 50 or older at enrollment.

The primary predictor of interest was biological AD severity, based on amyloid PET centiloid value. Other predictors were starting age, sex, and APOE-ε4 status. Analyses were based on 5158 adults (51% women) who were cognitively unimpaired and 700 individuals (44% women) with MCI.

The researchers observed that an individual’s lifetime risk for MCI and dementia increased uniformly with increasing amyloid PET centiloid value (P < .0001), which was the predictor with the largest effect.

Lifetime risk for MCI for male APOE-ε4 carriers who were cognitively unimpaired at age 75 years was 56.2% for centiloid 5, 60.2% for centiloid 25, 71.0% for centiloid 50, 75.2% for centiloid 75, and 76.5% for centiloid 100.

For female APOE-ε4 carriers who were cognitively normal at age 75 years, lifetime risk for MCI was 68.9% for centiloid 5, 71.3% for centiloid 25, 77.6% for centiloid 50, 81.2% for centiloid 75, and 83.8% for centiloid 100.

“The high lifetime risk in participants with higher centiloid values addresses academic controversies concerning risk of future impairment associated with biomarkers of Alzheimer’s disease among individuals who are cognitively unimpaired,” the authors noted.

Within each centiloid group, lifetime and 10-year absolute risk for MCI and dementia was greater for APOE-ε4 carriers than for noncarriers (P < .0001), “consistent with previous evidence that APOE-ε4 confers deleterious effects beyond those measured by amyloid PET severity,” they noted.

“We anticipate that lifetime and 10-year absolute risk estimates from amyloid PET (or plasma surrogates) will be important for clinicians in the future when weighing the risks vs benefits of therapeutic interventions in patients who are cognitively unimpaired,” they concluded.

A Step Toward Dementia Prevention

Reached for comment, Christopher Weber, PhD, Alzheimer’s Association senior director of global science initiatives, said a “unique aspect” of the study is that it looked at lifetime risk rather than relative risk.

“Relative risk is helpful in research where you’re comparing two groups, for example, high vs low amyloid burden, and determining their chances of developing Alzheimer’s disease. But absolute or lifetime risk answers a question people really care about: What’s my risk, or what are my chances?” Weber told Medscape Medical News.

The observation that lifetime and absolute risk for MCI and dementia were most closely related to increasing biological severity of AD “supports recent and ongoing efforts, led by the Alzheimer’s Association, to define the diagnosis and staging of the disease by its biology,” Weber said.

He cautioned that this is “not a diagnostic tool,” but from an intervention or treatment standpoint, these data are “exciting, if replicated and confirmed, in how they could help patients, families, and their doctors discuss and decide what interventions may be appropriate at the very early stages of this disease.”

Weber said it’s also important to note that the study population was 98% White, relatively healthy, and well-educated. “This limits our ability to generalize the study findings and applicability of this tool to other individuals and populations. It strengthens the call for replication in more representative study populations,” he said.

The authors of a linked commentary noted that the field of dementia is “decisively” moving towards prevention programs for MCI and dementia, following the successful model of the vascular prevention of stroke, myocardial infarction, and peripheral artery disease.

“In such programs, the assessment of amyloid-related risk for neurodegeneration will take place in the context of a comprehensive assessment of all other known risk factors for MCI and dementia,” wrote Giovanni Frisoni, MD, and Augusto Mendes, PhD, with University of Geneva, Geneva, Switzerland.

“The shared vision is that risk profiling will be followed by personalized, domain-specific risk-reduction interventions with nonpharmacological and pharmacological strategies such as monoclonal antibodies, which are actively being developed,” Frisoni and Mendes added.

Funding for the study was provided by the US National Institutes of Health, GHR Foundation, and Alexander Family. Petersen declared having consulted for Roche, Genentech, Eli Lilly, Nestle, and Eisai; participating on a data safety monitoring board for Genentech; and receiving royalties from UpToDate and Oxford University Press for Mild Cognitive Impairment. Frisoni declared receiving fees for consulting from Biogen, Diadem, Eisai, Lilly, Roche, and Synaptica and fees for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Biogen, Roche, Novo Nordisk, and GE HealthCare. Mendes had no disclosures.

Muscle Loss In This Area Could Be A Key Indicator Of Dementia. An Expert Explains The Warning Signs.

 How is your competent? doctor ensuring that you don't get sarcopenia? DOING NOTHING? So, you DON'T have a functioning, do you?

Sarcopenia has been known as a problem for a long time. And your incompetent doctor has done nothing in the past 8+ years I bet!

sarcopenia (17 posts to March 2016)

Muscle Loss In This Area Could Be A Key Indicator Of Dementia. An Expert Explains The Warning Signs.

Dementia is a devastating condition that impacts up to 10 percent of older adults. And while there's no cure, getting diagnosed early can help patients get on a treatment plan and families prepare.

Now, new research suggests that the reduced size of a specific muscle could indicate that someone has an increased risk of dementia. Of course, it’s a little complicated. Here’s what the study found, plus what you can do to lower your dementia risk.

Meet the expert: Ryan Glatt, CPT, senior brain health coach and director of the FitBrain Program at Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California.

What did the study find?

The study, which was presented at the Radiological Society of North America meeting this month, analyzed data from 621 cognitively healthy people who participated in the Alzheimer’s Disease Neuroimaging Initiative.

The researchers looked at the temporalis muscles, which are related to the jaw, on MRI images. Participants were then grouped into categories based on their muscle size. For about 5.8 years, researchers tracked whether anyone was diagnosed with dementia, plus any changes to brain structure, cognition, and functioning.

The scientists discovered that people who had smaller temporalis muscles had a 60 percent higher chance of developing Alzheimer’s disease or dementia. A smaller temporalis muscle size was also linked to a drop in memory, functional abilities, and brain volumes.

“These results demonstrate that older adults with smaller skeletal muscles are at greater risk of cognitive decline,” the researchers said in a statement.

Is muscle loss a dementia warning sign?

This isn’t the first study to link muscle loss with a decline in cognitive function. In 2022, a JAMA Network Open cohort study of 8,279 older adults found that low muscle mass was linked with a faster drop in executive function, which are a set of skills that allow you to plan and organize. Other research has found that low skeletal muscle mass is linked with cognitive impairment and dementia in older adults.

“The relationship between muscle loss and dementia is increasingly recognized as significant, though not yet fully understood,” says Ryan Glatt, CPT, senior brain health coach and director of the FitBrain Program at Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California.

A smaller temporalis muscle can actually indicate sarcopenia, which is the age-related loss of muscle mass and strength. “Systemic sarcopenia “is often linked to frailty, reduced mobility, and metabolic dysfunction, all factors that are associated with cognitive decline,” Glatt says.

It's not entirely clear why this happens, but Glatt says that muscle loss likely plays a role in the larger processes that impact brain health.

While the relationship between muscle loss and dementia is still being explored, Glatt says that it should be seen as a “meaningful warning sign,” especially when it gets worse with age.

“It often reflects underlying health concerns, including poor nutrition, reduced physical activity, and systemic inflammation, all of which can contribute to dementia risk,” he says. “Addressing muscle loss through resistance training, proper nutrition, and regular physical activity is essential for maintaining overall health and may offer protective benefits for cognitive function.”

What are other warning signs of dementia?

Previous research has found that these are some of the biggest warning signs of dementia:

• Having poor physical health

• History of having a stroke

• Not having a private health insurance plan at age 60

• No work experience, or only a few years of work experience

• Having diabetes or a body mass index of 35 or more at 60

• Never exercising

• Scoring low on physical tests, including breathing, grip strength, walking speed, and balance

• Never drinking alcohol

• Drinking alcohol excessively

• Not having a responsible personality

• Having certain genes

• Not really having hobbies or doing activities that promote learning

Is it possible to prevent dementia?

Dementia is a complicated condition, and researchers are still unpacking a lot about its underlying causes. However, there are some things doctors generally agree on when it comes to prevention. Those include:

• Taking care of your heart health

• Try to get 150 minutes of exercise a week

• Being social

• Trying to learn something new every day

• Looking for vitamin deficiencies

• Stimulating your senses

• Protecting your head from injuries

• Turning off screens a few hours before bed

A New and Early Predictor of Dementia? Frailty

 EXACTLY HOW is your competent? doctor ensuring that you leave the hospital without frailty? This is your doctor's responsibility. Don't let them weasel out of it! Screaming may be required.

A New and Early Predictor of Dementia?

Signs of frailty may signal future dementia more than a decade before cognitive symptoms occur, in new findings that may provide a potential opportunity to identify high-risk populations for targeted enrollment in clinical trials of dementia prevention and treatment.

Results of an international study assessing frailty trajectories showed frailty levels notably increased in the 4-9 years before dementia diagnosis. Even among study participants whose baseline frailty measurement was taken prior to that acceleration period, frailty was still positively associated with dementia risk, the investigators noted.

"We found that with every four to five additional health problems, there is on average a 40% higher risk of developing dementia, while the risk is lower for people who are more physically fit," study investigator David Ward, PhD, of the Centre for Health Services Research, The University of Queensland, Brisbane, Australia, told Medscape Medical News.

David Ward, PhD

The findings were published online on November 11 in JAMA Neurology.

A Promising Biomarker

An accessible biomarker for both biologic age and dementia risk is essential for advancing dementia prevention and treatment strategies, the investigators noted, adding that growing evidence suggests frailty may be a promising candidate for this role.

To learn more about the association between frailty and dementia, Ward and his team analyzed data on 29,849 participants aged 60 years or above (mean age, 71.6 years; 62% women) who participated in four cohort studies: the English Longitudinal Study of Ageing (ELSA; n = 6771), the Health and Retirement Study (HRS; n = 9045), the Rush Memory and Aging Project (MAP; n = 1451), and the National Alzheimer’s Coordinating Center (NACC; n = 12,582).

The primary outcome was all-cause dementia. Depending on the cohort, dementia diagnoses were determined through cognitive testing, self- or family report of physician diagnosis, or a diagnosis by the study physician. Participants were excluded if they had cognitive impairment at baseline.

Investigators retrospectively determined frailty index scores by gathering information on health and functional outcomes for participants from each cohort. Only participants with frailty data on at least 30 deficits were included.

Commonly included deficits included high blood pressure, cancer, and chronic pain, as well as functional problems such as hearing impairment, difficulty with mobility, and challenges managing finances.

Investigators conducted follow-up visits with participants until they developed dementia or until the study ended, with follow-up periods varying across cohorts.

After adjusting for potential confounders, frailty scores were modeled using backward time scales.

Among participants who developed incident dementia (n = 3154), covariate-adjusted expected frailty index scores were, on average, higher in women than in men by 18.5% in ELSA, 20.9% in HRS, and 16.2% in MAP. There were no differences in frailty scores between sexes in the NACC cohort.

When measured on a timeline, as compared with those who didn't develop dementia, frailty scores were significantly and consistently higher in the dementia groups 8-20 before dementia onset (20 years in HRS; 13 in MAP; 12 in ELSA; 8 in NACC).

Increases in the rates of frailty index scores began accelerating 4-9 years before dementia onset for the various cohorts, investigators noted.

In all four cohorts, each 0.1 increase in frailty scores was positively associated with increased dementia risk.

Adjusted hazard ratios [aHRs] ranged from 1.18 in the HRS cohort to 1.73 in the NACC cohort, which showed the strongest association.

In participants whose baseline frailty measurement was conducted before the predementia acceleration period began, the association of frailty scores and dementia risk was positive. These aHRs ranged from 1.18 in the HRS cohort to 1.43 in the NACC cohort.

The 'Four Pillars' of Prevention

The good news, investigators said, is that the long trajectory of frailty symptoms preceding dementia onset provides plenty of opportunity for intervention.

To slow the development of frailty, Ward suggested adhering to the "four pillars of frailty prevention and management," which include good nutrition with plenty of protein, exercise, optimizing medications for chronic conditions, and maintaining a strong social network.(I'm good at all of these.)

Ward suggested neurologists track frailty in their patients and pointed to a recent article focused on helping neurologists use frailty measures to influence care planning.

Study limitations include the possibility of reverse causality and the fact that investigators could not adjust for genetic risk for dementia.

Unclear Pathway

Commenting on the findings for Medscape Medical News, Lycia Neumann, PhD, senior director of Health Services Research at the Alzheimer's Association, noted that many studies over the years have shown a link between frailty and dementia. However, she cautioned that a link does not imply causation.

Lycia Neumann, PhD

The pathway from frailty to dementia is not 100% clear, and both are complex conditions, said Neumann, who was not part of the study.

"Adopting healthy lifestyle behaviors early and consistently can help decrease the risk of — or postpone the onset of — both frailty and cognitive decline," she said. Neumann added that physical activity, a healthy diet, social engagement, and controlling diabetes and blood pressure can also reduce the risk for dementia as well as cardiovascular disease.

The study was funded in part by the Deep Dementia Phenotyping Network through the Frailty and Dementia Special Interest Group. Ward and Neumann reported no relevant financial relationships.

07

New Study Finds That Cholesterol & Triglyceride Levels Might Help Predict Your Risk for Dementia—Here's What to Know

You'll have to ask your doctor how your levels compare to this. 

Your chances of getting dementia.

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.`    

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018

New Study Finds That Cholesterol & Triglyceride Levels Might Help Predict Your Risk for Dementia—Here's What to Know

This study is another reminder that brain health and cardiovascular health are linked!

Getty Images© Provided by EatingWell

Reviewed by Dietitian Jessica Ball, M.S., RD

We know that yo-yo dieting and frequent blood sugar roller coasters do a number on our bodies. This week, we're learning more about the potential health harms related to fluctuations of another health factor: cholesterol.

According to a study published July 5, 2023 in the journal Neurology, individuals who have high variability in their total cholesterol and triglyceride levels—meaning large changes throughout the lifespan—appear to be at higher risk for developing dementia later in life compared to their more steady-cholesterol peers.

What Types of Exercise Reduce Dementia Risk?

Didn't your doctor or hospital or therapist already give you this information? It's been out there for years. Or is incompetence the problem and you haven't fired them yet to find someone better?

What Types of Exercise Reduce Dementia Risk?

Several large studies have confirmed that vigorous exercise, walking and even doing household chores can greatly benefit the brain.

Credit...Getty Images

By Rachel Fairbank

Aug. 15, 2022

Sign up for the Well newsletter, for Times subscribers only.  Essential news and guidance to live your healthiest life.

Experts had long believed that exercise could help protect against developing dementia. However, though they had observed a general pattern of reduced risk, studies on the subject had been small — and often conflicting — with little consensus on the type, frequency or intensity of exercise that might be best.

“There’s no real clear prescription that we can provide for physical activity,” said Dr. Joel Salinas, an assistant professor of neurology at New York University’s Grossman School of Medicine, who specializes in treating people with dementia.

But three major long-term studies released in recent months have attempted to characterize the types, intensities and durations of physical activity that confer the most overall protection against dementia. These studies, which followed thousands, and even hundreds of thousands, of people for years at a time, confirm that regular physical activity, in many forms, plays a substantial role in decreasing the risk of developing dementia.

Vigorous exercise seems to be best, but even non-traditional exercise, such as doing household chores, can offer a significant benefit. And, surprisingly, it’s just as effective at reducing the risk in those with a family history of dementia.

Many forms of exercise can stave off dementia.

In the first study, published July 27 in the journal Neurology, researchers analyzed the health information of 501,376 participants who did not have dementia in a British database called UK Biobank to establish links between physical activity and the risk of developing the disease.

One of the main advantages of this database was that it had “very enriched data about the genetics” of the participants, said Dr. Huan Song, a researcher at West China Hospital, Sichuan University, who was one of the study’s authors. This included a risk profile of participants based on whether they had genetic variants known to be associated with dementia, or whether they had immediate family members with the condition.

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At the beginning of the study, participants filled out detailed questionnaires about their participation in physical activities, such as playing sports, climbing stairs or walking, and whether they regularly walked or biked to work. They were also asked about various lifestyle factors, including how often they completed household chores.

One of the major constraints of previous studies was that “the definition of physical activity is quite weak,” Dr. Song said. “Some use the total amount, and some just focus on one mode of activity.” The British questionnaires offered specificity on exactly which activities participants were engaging in on a regular basis.

Participants were followed for 11 years, during which time 5,185 developed dementia. The study found that, in participants who engaged in regular, vigorous activity, such as playing sports or working out, the risk of developing dementia was reduced by 35 percent. Surprisingly, people who reported regularly completing household chores also experienced a significant benefit; they had a 21 percent lower risk.

“Some people work up quite a sweat when they are doing household chores,” said Dr. Sandra Weintraub, a neurologist at Northwestern University’s Feinberg School of Medicine, who was not associated with this study. “It might be that if you do three hours of household chores, you are as good as if you did 30 minutes of aerobic exercise.”

For Dr. Salinas, who recommends that people aim for 150 minutes of moderate- to high-intensity exercise a week, the results strengthen the idea that regular moderate to vigorous exercise can promote brain health. Cultivating this habit of exercise “is likely to have a very profound synergistic effect,” he said. “You get a lot more bang for your buck in terms of helping to promote your own health through physical activity.”

Perhaps most encouragingly, the association between physical activity and a reduced risk of dementia extended to participants who had a family history of dementia.

“It’s very important to know that if you have a family history of dementia, you can use physical activity to reduce your risk,” Dr. Song said.

Start by doing what you like best.

The second paper, published last week in Neurology, compiled 38 studies to see which leisure activities were associated with a reduced risk of dementia. Altogether, the studies followed more than two million participants without dementia over at least three years, during which time 74,700 developed dementia.

After controlling for age, education and gender, the researchers found that participants who exercised regularly — defined as engaging in activities such as walking, running, swimming, dancing, participating in sports or working out at the gym — had a 17 percent lower risk of developing dementia compared with those who did not.

This meta-analysis shows that dementia prevention is not limited to one activity, or even one type of activity. Given the diversity of physical activities that participants engaged in, “we recommend to people to do the exercise that you like,” said Le Shi, a researcher at Peking University and one of the study’s authors.

When it comes to reaping the benefits of physical activity, it’s never too soon to start. In a third study published this month, researchers followed more than 1,200 children between 7 and 15 for more than 30 years. Those with higher levels of fitness as children had higher levels of cognitive functioning in midlife, suggesting that establishing a lifelong habit of physical activity could be beneficial for brain health.

Together, these studies suggest the ways we move our bodies on a daily basis could add up over time. They also solidify the notion that regular, lifelong physical activity, in all of its forms, goes a long way toward reducing the risk of dementia, even for people who are classified as high-risk.

“Your brain is part of your body and is going to benefit from anything you do that is good for your general health,” Dr.

Walking Speed Helps Predict Future Dementia

 

Your doctor is responsible to get you recovered enough to do a high enough walking speed. YOUR DOCTOR'S RESPONSIBILITY.  Don't let them weasel out of responsibility by quoting this shitworthy statement: 'All strokes are different, all stroke recoveries are different'. Laugh maniacally in their face if they use such crapola.

 

Walking Speed Helps Predict Future Dementia

A combined drop in both walking speed and cognitive function was tied to an increased risk of dementia, a study of nearly 17,000 older adults showed.

Dual decline in gait speed and cognition carried a higher risk of dementia than either gait-only decline or cognitive-only decline, reported Taya Collyer, PhD, of Monash University in Victoria, Australia, and co-authors, in JAMA Network Open.

Dementia risk was highest in people who had slower gait speeds coupled with lower memory scores over time.

"Slowing gait and failing memory may be the best combination of clinical measures to identify people at risk of future dementia," co-author Michele Callisaya, PhD, of the National Center for Healthy Aging at Monash University and Peninsula Health, told MedPage Today.

"By the time a diagnosis of dementia is made, there's already been a substantial buildup of pathology in the brain," Callisaya said. "It's important to identify at-risk individuals early to address modifiable risk factors for dementia prevention and start new treatments as they become available."

"Gait speed is quick to measure and only requires a measured distance and a stopwatch," she pointed out. "Slowing of more than 0.05 meters per second per year should trigger a more comprehensive assessment."

Gait evaluations often are not performed in clinics, noted Joe Verghese, MD, of Albert Einstein College of Medicine in New York City, in an invited commentary.

"Despite the established predictive validity of gait assessments for geriatric syndromes, an implementation barrier for routine gait assessment in clinics exists that needs to be addressed to improve care of older patients," Verghese observed.

Traditionally, gait dysfunction has not been considered an early clinical feature of Alzheimer's disease and was seen more as a marker of non-Alzheimer's pathology, Verghese noted.

"However, systematic longitudinal studies and finer-grain analysis of gait performance in the context of cognitive decline is calling this view into question," he wrote. A recent exploratory study suggested Alzheimer's and Lewy body disease have unique signatures of gait impairment that may reflect underlying pathology, for example.

Collyer and colleagues analyzed data from 16,885 participants in the ASPREE trial of low-dose aspirin, which ran from 2010 to 2017 in the U.S. and Australia. Mean age of participants was 75 and 56% were women.

At baseline and at years 2, 4, 6, and study close-out, participants had gait speed measured by completing two walks of 3 meters each. Gait decline was defined as a drop in speed of at least 0.05 meters/second/year across the study.

At baseline and years 1, 3, 5, and close-out, participants underwent four different cognitive assessments: the Modified Mini-Mental State Examination to measure global cognitive function, the Hopkins Verbal Learning Test Revised to assess memory, the Controlled Oral Word Association Test for verbal fluency, and the Symbol Digit Modalities Test for processing speed. Cognitive decline was defined as the the lowest tertile of annual change.

Compared with non-decliners, dementia incidence was highest in people who had declines in both gait and memory (HR 24.7), followed by gait and global cognition (HR 22.2), gait and verbal fluency (HR 4.7), and gait and processing speed (HR 4.3).

"Importantly, we answer the question as to whether dual decline in gait speed and a test of processing speed or verbal fluency exhibits a similar association with progression to dementia as decline in memory (delayed recall) or global cognition," Collyer and co-authors wrote.

The analysis had a few limitations, the researchers noted. Gait and cognition were measured at separate time points throughout the study. ASPREE participants also were healthier than many older adults, and results might not apply to other populations.

• Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Follow

Disclosures

The ASPREE trial was funded by the National Institute on Aging in the U.S. and National Health and Medical Research Council in Australia.

Researchers reported relationships with NIH, Victorian Cancer Agency, Biogen, Roche, National Health and Medical Research Council, Neurology, International Journal of Stroke, Amylyx Pharmaceuticals, Athira Pharma, Eli Lilly, Genentech, Novartis, and the Alzheimer's Association.

The editorialist reported relationships with NIH, Catch-U, and MedRhythms.

Primary Source

JAMA Network Open

Source Reference: Collyer TA, et al "Association of dual decline in cognition and gait speed with risk of dementia in older adults" JAMA Netw Open 2022; DOI: 10.1001/jamanetworkopen.2022.14647.

Secondary Source

JAMA Network Open

Source Reference: Verghese J "Gait and cognitive declines in dementia -- double or nothing" JAMA Netw Open 2022; DOI: 10.1001/jamanetworkopen.2022.14654.

 

New Research Identifies Blood Biomarker for Predicting Dementia Before Symptoms Develop

 

You better hope like hell your doctor has a protocol on testing for this post stroke and then has the protocols to prevent dementia.

New Research Identifies Blood Biomarker for Predicting Dementia Before Symptoms Develop

Researchers have identified a blood biomarker that could help identify people with the earliest signs of dementia, even before the onset of symptoms.

The findings were published in the Journal of Alzheimer’s Disease.

Emer McGrath, MD, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland, and colleagues measured blood levels of P-tau181, a marker of neurodegeneration, in 52 cognitively healthy adults who were part of the US-based Framingham Heart Study, who later went on to have specialised brain positron emission tomography (PET) scans. The blood samples were taken from people who had no cognitive symptoms and who had normal cognitive testing at the time of blood testing.

The analysis found that elevated levels of P-tau181 in the blood were associated with greater accumulation of ß-amyloid on specialised brain scans. These scans were completed on average 7 years after the blood test.

Further analysis showed the biomarker P-tau181 outperformed t2other biomarkers in predicting signs of ß-amyloid on brain scans.

“The results of this study are very promising,” said Dr. McGrath. “P-tau181 has the potential to help us identify individuals at high risk of dementia at a very early stage of the disease, before they develop memory difficulties or changes in behaviour.”

The research team said the identification of a biomarker also points to the potential for a population screening programme.

“This study was carried out among people living in the community, reflecting those attending GP practices,” said Dr. McGrath. “A blood test measuring P-tau181 levels could potentially be used as a population-level screening tool for predicting risk of dementia in individuals at mid to late-life, or even earlier. This research also has important potential implications in the context of clinical trials. Blood levels of P-tau181 could be used to identify suitable participants for further research, including in clinical trials of new therapies for dementia. We could use this biomarker to identify those at a high risk of developing dementia but still at a very early stage in the disease, when there is still an opportunity to prevent the disease from progressing.”

Reference: https://content.iospress.com/articles/journal-of-alzheimers-disease/jad215639

SOURCE: National University of Ireland Galway

Sleep disorder serves as 'significant predictor' of incident dementia in patients with TBI

WHOM will be doing the research to determine if the same applies for stroke? Specific names only. That way we can apply those dementia prevention protocols our doctor should have.

Sleep disorder serves as 'significant predictor' of incident dementia in patients with TBI

Sleep disorders in both men and women with traumatic brain injury independently correlated with the onset of dementia, according to results of a retrospective cohort study that included than 712,000 adult patients.

Researchers first published the findings in Sleep, the journal of the Sleep Research Society, and presented the study results at the society’s annual meeting, which is being held virtually.

Sleep disorders in both men and women with traumatic brain injury independently correlated with the onset of dementia, according to results of a retrospective cohort study presented during SLEEP 2021. Source: Adobe Stock

“Our study’s novelty is its confirmation of sleep disorders’ association with incident dementia in both male and female patients, independently of other known dementia risks,” Tatyana Mollayeva, MD, PhD, associate director of the acquired brain injury research lab at the University of Toronto and affiliate scientist at the KITE Research Institute in the University Hospital Network, University of Toronto, said in a press release. “We are also the first to report on the risks that sleep disorders and other factors pose separately for male and female patients with TBI.”

Mollayeva and colleagues sought to analyze the relationship between sleep disorders and risk for dementia in a population-based cohort of adult men and women with TBI. The retrospective cohort study included patients admitted to the ED or acute care hospital with TBI diagnoses between May 2003 and April 2013. The researchers followed all patients through May 2016. The primary exposure was a sleep disorder, while dementia served as the primary outcome; the researchers defined both variables according to the ICD 10th revision diagnosis. Mollayeva and colleagues examined the relationship between sleep disorders and dementia using multivariate Cox proportional hazard modeling, according to the study report.

The analysis included 712,708 patients with TBI of all severities (median age, 44 years; 59% men).

During a median follow-up period of 52 months (interquartile range, 19-86 months), 4.6% of patients (n = 32,834) developed dementia. After controlling for age, sex, income level, injury severity and known comorbidity risks, a diagnosed sleep disorder served as a “significant predictor” of incident dementia (HR = 1.25; 95% CI, 1.146-1.363), according to the study results.

When the researchers stratified the results by sex, they found that the relationship between a sleep disorder and dementia remained significant among both men (HR = 1.255; 95% CI, 1.112-1.415) and women (HR = 1.234; 95% CI, 1.088-1.4).

“Sensitivity analyses on Alzheimer’s disease case definition and using fine and gray competing risk models confirmed the association between sleep disorder and dementia in both sexes,” Mollayeva and colleagues wrote.

The results indicated that screening for sleep disorders should be “part of regular care” for patients with TBI, according to the researchers. They also noted that, because of the “steady” increase in TBI survivors and in life expectancy, undiagnosed sleep disorders could result in “a new cascade” of cognitive deficits independent of TBI.

“The strong links to incidence of dementia in both sexes suggest a need for more targeted sleep disorders risk awareness in patients with TBI,” Mollayeva said in the press release.

Reference:

SLEEP 2021. Sleep disorders are associated with increased dementia risk in patients with traumatic brain injury. Available at: https://www.sleepmeeting.org/sleep-disorders-are-associated-with-increased-dementia-risk-in-patients-with-traumatic-brain-injury/. Accessed June 10, 2021.

 

Blood Biomarker Predicts Dementia in Cerebral Small Vessel Disease

 Describes a problem, OFFERS NO SOLUTION. USELESS.

But then your doctor should have already been doing something about this for 2.5 years already.

Serum neurofilament light - A biomarker of neuroaxonal injury after ischemic stroke October 2018 

I'd suggest firing the board of directors since they are obviously not setting the correct goals for your stroke hospital. 100% recovery for all is the only goal in stroke, the status quo is a complete failure and only YOU can change that trajectory.

 

The latest here:

Blood Biomarker Predicts Dementia in Cerebral Small Vessel Disease

Baseline neurofilament light predicted cognitive decline in SVD over 5 years

by Judy George, Senior Staff Writer, MedPage Today February 12, 2021

Serum neurofilament light chain (NfL), a marker of axonal damage, predicted future dementia risk in cerebral small vessel disease (SVD), a small longitudinal study suggested.

Baseline NfL predicted cognitive decline (global cognition β = -0.335 ± 0.094, P=0.001) and risk of converting to dementia (HR 1.676, 95% CI 1.183-2.373, P=0.004) over up to 5 years, reported Marco Egle, MSc, and Hugh Markus, MD, of the University of Cambridge in England, and co-authors in the Journal of Neurology, Neurosurgery, and Psychiatry.

"Our results demonstrate that NfL may be a useful marker to predict dementia risk in patients with lacunar stroke and SVD, and our analyses showed that it added extra prediction to simple clinical and demographic markers," Egle told MedPage Today.

While some patients with cerebral small vessel disease will develop dementia, others remain dementia-free, Egle noted. "Magnetic imaging resonance techniques provide radiological markers of SVD, which do allow some prediction. However, this is an expensive technique and is not available to all patients with this small vessel disease," he said.

Increased levels of NfL occur in neurodegenerative disorders, including Alzheimer's disease. NfL has been linked to cognition and disability in a cross-sectional study of SVD, but few studies have looked at whether it can predict cognitive changes over time. "The novelty of our study was its prospective design," Egle said.

The researchers used baseline and follow-up data from 121 patients with moderate-to-severe SVD in the St. George's Cognition and Neuroimaging in Stroke (SCANS) study. Participants were followed annually for 5 years.

Average baseline age was 70, and 74% of participants were men. MRI was performed at baseline and after 1, 2, and 3 years; blood samples also were collected then. Cognition was evaluated annually. Disability was assessed using the modified Rankin score (mRS). The study began in January 2008 and ended in October 2013; all assays were performed in 2019-2020. Six incidences of strokes were recorded over the 5-year follow-up period, four lacunar strokes and two intracerebral haemorrhages.

Baseline serum NfL levels averaged 36.51 pg/mL. Cross-sectional analyses showed NfL levels were inversely associated with global cognitive function, executive function, and processing speed. They also were negatively correlated with disability. Higher NfL levels were positively associated with lacune count, cerebral microbleed count, white matter hyperintensities, and diffusion tensor imaging (DTI) measures, and were negatively associated with normalized brain volume.

Over 5 years, both global cognition and processing speed declined significantly. Higher NfL at baseline predicted lower function in global cognition independently of clinical markers and baseline cognition.

A total of 107 participants had complete baseline DTI and NfL data; 19 of them converted to dementia over time. Higher baseline NfL predicted not only dementia, but changes in lacune count, microbleed count, and brain volume, independently of initial MRI baseline values and patient age.

In contrast to imaging, there was no change in NfL values during follow-up. A potential application of NfL might be in clinical trials of SVD where it could be used to assess treatment effect, Egle noted. "We assessed this use by measuring NfL levels on repeated blood testing over a 3-year period to see if changes in levels predicted dementia," he said. "However, we were unable to detect any significant changes in NfL levels over this time, demonstrating that they are unlikely to be a useful marker in a clinical trial in SVD."

The study had several limitations, the researchers noted. Sample sizes were small and NfL levels at more than one time point were not available for all participants. Other research showed that participants who dropped out of the SCANS study had worse cognitive function than those who remained, which may have led to cognitive, MRI, and NfL changes over time being underestimated. Larger studies are needed to confirm the findings.

Last Updated February 12, 2021

• Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Follow

Disclosures

This study was supported by the European Union's Horizon 2020 research and innovation program. The SCANS study was supported by a Wellcome Trust grant.

Egle is supported by a grant from the Stroke Association. Markus is supported by an NIHR Senior Investigator award and his work receives support from the Cambridge University Hospitals NIHR Biomedical Research Centre.

Primary Source

Journal of Neurology, Neurosurgery, and Psychiatry

Source Reference: Egle M, et al "Neurofilament light chain predicts future dementia risk in cerebral small vessel disease " J Neurol Neurosurg Psychiatry 2021; DOI: 10.1136/jnnp-2020-325681.

 

Cognitive Test Given in Childhood May Predict Future Dementia

Useless piece of crap.  We need to know NOW what needs to be done to prevent dementia after our strokes. ARE YOU THAT FUCKING STUPID AND LAZY?

Your chances of getting dementia.

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018 

5. Parkinson’s Disease May Have Link to Stroke March 2017

 

 

Cognitive Test Given in Childhood May Predict Future Dementia

Childhood thinking skills may influence cognitive performance later in life, according to a study published in Neurology.

The study also found that education level and socioeconomic status were also predictors of thinking and memory performance.

“Finding these predictors is important because if we can understand what influences an individual’s cognitive performance in later life, we can determine which aspects might be modifiable by education or lifestyle changes like exercise, diet, or sleep, which may in turn slow the development of cognitive decline,” said Jonathan M. Schott, MD, University College London, London, United Kingdom.

For the study, Kirsty Lu, PhD, University College London, and colleagues analysed 502 individuals born in the same week in 1946 who took cognitive tests when they were aged 8 years. Between ages 69 and 71 years, participants took thinking and memory tests again. One test, similar to a test they completed as children, involved looking at various arrangements of geometric shapes and identifying the missing piece from 5 options. Other tests evaluated skills like memory, attention, orientation, and language. Performance was characterised with respect to sex, childhood cognitive ability, education, and socioeconomic position.

In a subsample of 406 cognitively normal participants, associations were investigated between cognition and amyloid beta positivity, whole brain volumes, white matter hyperintensity volumes, and APOE E4.

Participants had positron emission tomography scans to see if they had amyloid beta plaques in the brain associated with Alzheimer’s disease. They also had detailed brain magnetic resonance imaging scans.

The researchers found that childhood thinking skills were associated with scores on the cognitive tests taken more than 60 years later, and there were independent effects of education and socioeconomic status. Women performed better than men in test of memory and thinking speed.

In addition, the researchers found that participants with amyloid beta plaques had lower scores on cognitive testing. However the presence of these plaques was not associated with sex, childhood cognitive skills, education, or socioeconomic status.

“Our study found that small differences in thinking and memory associated with amyloid plaques in the brain are detectable in older adults even at an age when those who are destined to develop dementia are still likely to be many years away from having symptoms,” concluded Dr. Schott. “It also found that childhood cognitive skills, education, and socioeconomic status all independently influence cognitive performance at age 70. Continued follow-up of these individuals, and future studies are needed to determine how to best use these findings to more accurately predict how a person’s thinking and memory will change as they age.”

Reference: https://doi.org/10.1212/WNL.0000000000008534

SOURCE: American Academy of Neurology

Advanced MRI Brain Scan May Help Predict Stroke-Related Dementia

With your excellent chance of getting dementia post stroke why hasn't your doctor offered you this option? 

Your chances of getting dementia.

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018 

5. Parkinson’s Disease May Have Link to Stroke March 2017

Maybe because s/he has nothing in the way of a dementia prevention protocol?  There is no excuse for such incompetency, see the following; You are on your own for prevention.

• dementia prevention (111)
• Alzheimers prevention (58)

 

Advanced MRI Brain Scan May Help Predict Stroke-Related Dementia

An advanced magnetic resonance imaging (MRI) brain scan analysis in patients with stroke-related, small vessel disease helps predict problems with thinking, memory, and even dementia, according to a study published in Stroke.

“We have developed a useful tool for monitoring patients at risk of developing dementia and could target those who need early treatment,” said Rebecca A. Charlton, PhD, University of London, London, United Kingdom.

For the study, Owen A. Williams, PhD, St. George’s University of London, London, United Kingdom, and colleagues analysed 99 patients aged 43 to 89 years with small vessel disease who underwent annual diffusion tensor imaging (DTI) for 3 years and cognitive assessment for 5 years.

The researchers used DTI as a whole-cerebrum measure of small vessel disease severity. Dementia diagnosis was based on Diagnostic and Statistical Manual of Mental Disorders V criteria.

During the study period, 18.2% of patients converted to dementia.

The study found that patients with the most brain damage seen via DTI were much more likely to experience a decline in executive function and global cognition. The analysis also helped predict three-fourths of the dementia cases that occurred during the study.

This advanced MRI analysis offers a highly accurate and sensitive marker of small vessel disease severity in a single measure that can be used to detect who will and will not go on the develop dementia in a 5-year period, concluded Dr. Charlton.

Useless because you have NO PREVENTION PROTOCOL.

Reference: http://dx.doi.org/10.1161/STROKEAHA.119.025843

SOURCE: American Heart Association