Health Watch

Alzheimer's ‘early signs timeline developed’:

Healthy brain and Alzheimer's brain

Scientists have assembled a “timeline” of the unseen progress of Alzheimer's before symptoms appear.

A team at Washington University School of Medicine looked at families with a genetic risk of the disease.

Writing in the New England Journal of Medicine, they say signs appeared up to 25 years before the expected onset of the disease.

UK experts said the ability to detect Alzheimer's early would give the best chance of successful treatment.

‘Key changes’

The 128 people in the study, from the UK, US and Australia, had a 50% chance of inheriting one of three mutations that are certain to cause early Alzheimer's, which often develops in people's 30s and 40s - much earlier than the more common form of Alzheimer's which generally affects people in their 60s.

Those who carry the mutations will go on to develop the disease.

The researchers looked at the age the participants’ parents were when they developed the disease - and therefore how many years it was likely to be before they too showed symptoms.

Continue reading the main story

They underwent blood and spinal fluid tests as well as brain scans and mental ability assessments.

The earliest change - a drop in spinal fluid levels of the key ingredient of Alzheimer's brain plaques - can be detected 25 years before the anticipated age of disease onset, they suggest.

At 15 years, raised levels of tau, a structural protein in brain cells can be seen in spinal fluid - and shrinkage can also be detected within parts of the brain.

Changes in the brain's use of the sugar glucose and slight memory problems become apparent 10 years before symptoms would appear, they suggest.

Researchers also tested other members of the families without the inherited mutations - and found no changes in the markers they tested for.

Prof Clive Ballard, director of research at the Alzheimer's Society, said: “This important research highlights that key changes in the brain, linked to the inherited form of Alzheimer's disease, happen decades before symptoms show, which may have major implications for diagnosis and treatment in the future.

“These findings are a good indicator that there may be key changes in the brain happening early in people who develop non-hereditary Alzheimer's disease, but we can't be sure. Further research into this complex condition is needed to confirm a definite link.”

And Dr Eric Karran, director of Research at Alzheimer's Research UK, said: “These results from people with the inherited form of Alzheimer's seem to be very similar to the changes in the non-genetic, common form of the disease.

“It's likely that any new treatment for Alzheimer's would need to be given early to have the best chance of success.

“The ability to detect the very earliest stages of Alzheimer's would not only allow people to plan and access care and existing treatments far sooner, but would also enable new drugs to be trialled in the right people, at the right time.”

-www.bbc.co.uk
 

Babies in dog-owning families may be healthier

Andrew M. Seaman

Dogs are no longer just man's best friend: The furry family members may also protect infants against breathing problems and infections, a new study suggests.

Researchers found that Finnish babies who lived with a dog or - to a lesser extent - a cat spent fewer weeks with ear infections, coughs or running noses. They were also less likely to need antibiotics than infants in pet-free homes.

Dr. Eija Bergroth from Kuopio University Hospital in Finland and colleagues said one possible explanation for that finding is that dirt and allergens brought in by animals are good for babies’ immune systems.

The researchers studied 397 infants who were born at their hospital between September 2002 and May 2005 for their first year.

Parents filled out weekly diaries starting when the child was nine weeks old, recording information on babies’ health as well as their contact with cats and dogs.

Based on those diaries and a year-end questionnaire, the researchers determined that 35 percent of the children spent the majority of their first year with a pet dog and 24 percent in a home with a cat.

Despite only a third of families owning dogs and fewer owning cats, the majority of babies had at least some contact with a dog at their house during the study period and more than one-third were exposed to a cat.

Before their first birthday, 285 of the babies had at least one fever, 157 had an ear infection, 335 had a cough, 128 wheezed, 384 got stuffy or runny noses and 189 needed to take antibiotics at some point, parents reported.

The researchers found that contact with dogs, more than cats, was tied to fewer weeks of sickness for babies.

For example, infants with no dog contact at home were healthy for 65 percent of parents’ weekly diary reports. That compared to between 72 and 76 percent for those who had a dog at home.

Babies in dog-owning families were also 44 percent less likely to get inner ear infections and 29 percent less likely to need antibiotics.

The researchers said infants who spent more than zero but less than six hours per day at home with a dog were the least likely to get sick.

“A possible explanation for this interesting finding might be that the amount of dirt brought inside the home by dogs could be higher in these families because (the dog) spent more time outdoors,” the researchers wrote Monday in the journal Pediatrics.

Bergroth told Reuters Health in an email that the dirt and germs a dog brings into the house may cause a child's immune system to mature faster, which makes it better at defending against the viruses and bacteria that cause respiratory problems.

That theory is commonly referred to as the “hygiene hypothesis.”

“In many ways, (the study is) saying, if you're exposed to a natural environment... your immune system recognizes that you don't fight the normal allergens,” said Dr. T. Bernard Kinane, the chief of the pediatric pulmonary unit at MassGeneral Hospital for Children in Boston.

Kinane, who was not involved with the new study, told Reuters Health not all research agrees that exposure to dogs and cats helps protect against kids’ breathing problems. But he said there is an overall trend in that direction.

The researchers also can't rule out the possibility that people who own dogs are less likely to get sick for another reason, and not due to protection offered by pets, Bergroth noted.

NEW YORK (Reuters Health)

www.healthnews.com

High-dose vitamin D prevents fractures in elderly

Gene Emery

A new analysis of nearly a dozen studies testing vitamin D in older individuals has concluded that it takes a daily dose of at least 800 international units (IU) to consistently prevent broken bones.

A dose that high was found to reduce the risk of hip fracture by 30 percent and other breaks by 14 percent. Lower doses didn't have any effect.

The report, published in the New England Journal of Medicine, also suggests that too much calcium -- perhaps more than 1,000 milligrams (mg) per day -- can weaken the benefit.

“These hip fractures cost a lot and are a really serious event. They are usually the end of independent life for a senior person; 50 percent do not regain their mobility. Reducing the risk by 30 percent with just a vitamin supplement would be an enormous public health opportunity,” study researcher Dr. Heike Bischoff-Ferrari of University Hospital Zurich in Switzerland told Reuters Health.

The Institute of Medicine recommends that most adults get 1,000 to 1,200 mg of calcium per day and 600 to 800 IU of vitamin D. It sets a recommended upper limit at 2,000 mg of calcium and 4,000 IU of vitamin D.

Bischoff-Ferrari said the lack of benefit seen in other studies “may be explained by adherence to treatment and vitamin D supplements taken outside the study medication.”

Dr. Richard Bockman, a hormone expert at the Hospital for Special Surgery in New York, said the findings are an important counterbalance to last month's widely-reported recommendation by the U.S. Preventive Services Task Force.

The government-backed task force advised against taking doses of less than 400 IU of vitamin D with 1,000 mg of calcium and concluded the evidence was unclear for higher doses. It also said the supplements carry a risk of side effects such as kidney stones.

Bockman said the best trial is a 2003 study, known as the Trivedi trial, in which volunteers received an average of 800 IU per day as a single 100,000 IU dose every four months.

“It clearly showed a reduction in fracture risk in people who were getting vitamin D,” he said.

In an editorial, Dr. Robert Heaney of Creighton University Medical Center in Omaha, Nebraska, said the problem with the conflicting studies may be that most have failed to consider each person's vitamin D levels to start with.

Giving it to people who already have enough, or not giving enough to people with very low levels, may show no benefit, he said.

“In this regard, as in several other respects, nutrients are unlike drugs. Once an adequate concentration has been achieved, additional intake has no effect,” said Heaney.

Bischoff-Ferrari said the new results came without directly including the Trivedi results. “The authors lost the data sets to a computer accident,” she said.

The new analysis is based on 11 trials that tested various regimens of oral vitamin D in people age 65 and older, mostly women, against an inactive placebo. Some of the trials also included calcium.

Overall, there were 4,881 hip and other fractures (not including breaks of the spine) among more than 31,000 people.

Vitamin D did not cut the rate of hip fracture significantly, and the drop in other fractures was small. When the researchers looked at people getting the highest doses of the vitamin, typically 800 IU daily, the benefits were clearer, with a 30-percent drop in hip fractures and 14-percent decline in other broken bones.

“Notably, there was no reduction in the risk of hip fracture at any actual intake level lower than 792 IU per day,” the researchers said.

The benefits at the higher dose were seen regardless of age, additional calcium intake, whether the patients lived at home or in an institution, and baseline levels vitamin D.

Bischoff-Ferrari said the clearest impact was seen in nursing home patients, who were given the highest doses of vitamin D and regularly took their pills because the nurses were giving them.

Just as important is the discovery that too much calcium - more than 1,000 mg per day - may dilute vitamin D's benefits to bones, she said. Because many supplements contain 1,000 mg, the calcium people get in their diets may send people over the limit.

“This is a very, very important public health message,” Bischoff-Ferrari said. “There are still doctors around who are giving calcium without vitamin to hip fracture patients. Imagine giving a calcium supplement and increasing the fracture risk.”

In an earlier study, she added, fewer than 10 percent of the people coming into the hospital for a hip fracture had been taking the vitamin. And 60 percent of them had suffered another fracture in the prior decade, yet “the red flag is not coming up.”

“In the medical world, vitamin D seems like a very low priority. It may be the lack of lobbying for it, the fact that it costs almost nothing” and some people think it's too good to be true, she said. “But the data are impressive.”

NEW YORK Reuters Health

healthnews.com
 

Breast cancer: how South Asian women are learning to treat it

Huma Qureshi

Once considered to be a very low risk group, growing numbers of South Asian women are now having to confront breast cancer – and one support group is helping to raise awareness.

Nine years ago, Bharti Patel discovered a lump in her breast. She was 47 years old. “Breast cancer changes you,” she says slowly, running one hand through her short, streaked hair. “It affects what you wear, what you look like, who you are.”

Now, at 56, she is a breast cancer survivor and finally moving on. This summer, she is going to live in an ashram in northern India for two months. “I've come on in leaps and bounds since the cancer,” she says. “I've forgiven people. I've done so much. I've changed my life.”

Like many women with breast cancer, Patel was physically and emotionally exhausted by her treatment. But the loneliness such strains can bring was exaggerated by what Patel describes as cultural barriers.

“One of the biggest taboos of Asian culture is that if you are ill, you just don't talk about it,” she says. “You don't talk about your breast cancer to the outside world. You don't even say the word ‘breast'. It's just too private.”

While waiting for her radiotherapy treatment one day, she saw a poster for Cancer Black Care, a support group for black and ethnic-minority patients. She called them, explained her Indian heritage and that she was hoping to meet someone of a similar background. A few days later, she was given the number of Pushpa Martin, an Indian woman who, like Bharti, had been searching for other Asians with breast cancer. “We spoke for hours on the phone, before we'd even met,” says Patel.

A medical researcher based at Northwick Park, the hospital in Harrow which treated Patel, invited the women to a group interview for her thesis on post-cancer treatment. Amarjit Panesar also attended and the three hit it off. Together, they founded the Asian Women's Breast Cancer Group, based in Kenton, north London, holding their first meeting in October 2003. News of the group spread quickly via word of mouth and leaflets. Now there are more than 50 members, who meet each month at a local Hindu temple to share their experiences.

Historically, south Asian women were considered to be at a very low risk of breast cancer compared with white women. Doctors put it down to a combination of lifestyle factors common to the Asian subcontinent, including a tendency to have large families at a young age and to breastfeed for long periods.

But last year a study conducted by Dr Anne Stotter, consultant breast surgeon at Glenfield hospital, Leicester, concluded that south Asian women can no longer be considered at a reduced risk, estimating that the number of Asian women being diagnosed with breast cancer has more than doubled since 1998, from 60 to 130 women per 100,000 Asian women every year.

A national study into south Asian women and breast cancer is currently being undertaken by Cancer Research UK. “The trend is for an increased diagnosis of breast cancer nationally in south Asian women,” Stotter says.

- The Guardian

Rainy day diet

Sandhya PANDEY

Keep an eye on what you eat during the rains. With the onset of the monsoon, everybody has a smile on their face. Irrespective of age, everybody enjoys the rainy season.

But this is also a season of illness. So make sure you eat a nutritious and healthy diet and follow basic hygiene to stay safe.

The rainy season often leads to sewage overflowing and mixing with drinking water.

This leads to gastrointestinal disorders. The season also sees the onset of waterborne diseases such as typhoid, diarrhoea and jaundice. There is also a chance of respiratory problems being aggravated. People may experience problems in breathing, as the air is extremely humid.

The high level of humidity also leads fungal growth, which can lead to exacerbation of allergies like allergic rhinitis, bronchial asthma and bronchitis. Due to the change in weather, people are more prone to viral fevers.

- The Hindu