A US team compared the brains of 35 people who had Alzheimer’s “plaques”, some of whom died with sharp minds and others who showed no dementia symptoms.

The hippocampus, an area at the base of the brain, was on average 20% larger in those with cognitive functions intact.

The Alzheimer’s Society cautioned that it was a “relatively small study”.

The research was presented at a meeting of the American Academy of Neurology.

It has long been recognised that people can die with all the biological evidence of Alzheimer’s – such as a build-up of plaques and tangles within the brain – but having remained perfectly lucid until the last.

Researchers at Oregon Health and Science University in Portland compared the brains of 12 such people with 23 others who had similar levels of plaques, but had been diagnosed with Alzheimer’s before death.

Prevention strategies

“This work is consistent with increasing research that has shown that people with higher levels of education or cognitive reserve may be protected from some of the effects of dementia” Professor Clive Ballard Alzheimer’s Society

The hippocampus is located close to the junction with the spinal cord and is believed to “encode” experiences so they can be stored as long-term memories in another part of the brain.

“This larger hippocampus may protect these people from the effects of Alzheimer’s disease-related brain changes,” said lead researcher Deniz Erten-Lyons.

“Hopefully this will lead us eventually to prevention strategies.”

The Alzheimer’s Society said it remained unclear from this “relatively small study” whether the larger hippocampus really was the reason why people with dementia did not display the signs.

“However this work is consistent with increasing research that has shown that people with higher levels of education or cognitive reserve may be protected from some of the effects of dementia,” said Professor Clive Ballard.

“This is an exciting area of research which needs more exploration.”

News reported by The BBC

Alzheimers Research Trust
Alzheimers Society

A study of 900 people aged over 60 found early onset was most likely in those who also had a high-risk gene.

A second US study found people with high cholesterol in their early 40s are one and a half times more likely to develop Alzheimer’s.

The research was presented at an American Academy of Neurology meeting.

It has been estimated that a delay in the onset of Alzheimer’s disease by five years would lead to a 50% drop in the number of cases.

“It’s possible that if we can reduce or eliminate heavy smoking and drinking, we could substantially delay the onset of Alzheimer’s disease for people and reduce the number of people who have Alzheimer’s at any point in time” Dr Ranjan Duara

The researchers said their findings showed heavy drinking and smoking were two of the most important preventable risk factors for the condition.

Those taking part in the study had been diagnosed with possible or probable Alzheimer’s disease and smoking and drinking history was obtained from family members.

Risk factors

Heavy drinking, defined as more than two drinks a day was found to lead to an almost five-year earlier onset of Alzheimer’s.

And those who smoked more than 20 cigarettes a day developed the disease two years sooner.

People with a specific gene – APOE variant 4 – developed Alzheimer’s disease three years earlier than those without the gene variant.

All three risk factors together were associated with onset of the disease 8.5 years earlier than those with none of the risk factors.

Study leader, Dr Ranjan Duara, from Mount Sinai Medical Center in Florida said: “It’s possible that if we can reduce or eliminate heavy smoking and drinking, we could substantially delay the onset of Alzheimer’s disease for people and reduce the number of people who have Alzheimer’s at any point in time.”

In the second study, 9,700 men and women were followed from the age of 40.

Those with cholesterol levels higher than around six millimols per litre (mmol/L) had a one and a half times higher risk of developing Alzheimer’s than those with low cholesterol.

“High mid-life cholesterol increased the risk of Alzheimer’s disease regardless of diabetes, high blood pressure, obesity, smoking and late-life stroke,” said researcher Alina Solomon.

Dr Susanne Sorensen, head of research at the Alzheimer’s Society said the research added to the weight of evidence on drinking and smoking habits and the risk of developing dementia.

“The best way to reduce your risk is to eat a balanced diet rich in antioxidants and vitamins and to exercise regularly.

“Not smoking, drinking only in moderation and getting your blood pressure and cholesterol checked regularly throughout life are also important ways people can reduce their risk of dementia.”

News reported by The BBC

Alzheimers Research Trust
Alzheimers Society

Two studies support a link between high blood pressure and dementia risk – with one by an Imperial College London team suggesting treatment could cut this.

This study, by published in the Lancet Neurology journal, found blood pressure drugs reduce dementia by 13%.

The Alzheimer’s Society said better control could save 15,000 lives a year.

“Only half of people over 65 receive effective treatment, yet we know treatment works” Professor Clive Ballard Alzheimer’s Society

As many as one in four people has high blood pressure, in many cases undiagnosed or untreated.

The precise reasons why high blood pressure might increase the risk of dementia are not fully understood although many scientists believe that it can starve the brain of bloodflow and the oxygen it carries.

Patients suffering this restricted bloodflow are often described as having “vascular dementia”, and account for approximately a quarter of dementia patients.

Other types of dementia, such as Alzheimer’s disease, have no obvious link to bloodflow, but some experts think that blood pressure may still be somehow contributory in some cases.

The Lancet Neurology study looked at a trial of elderly patients with high blood pressure to see if those who were receiving treatment were less likely to develop any form of dementia compared with those left untreated.

Clear benefit

The trial was stopped early after the benefits of treatment in terms of reducing strokes and heart disease were so obvious it became unethical to deny them to everyone.

Although this meant that no benefits in terms of dementia could be found, when these results were combined with other similar studies in different age groups, the incidence of dementia was 13% lower in the treated groups.

Dr Ingmar Skoog, from the Institute of Neurosciences at Sweden’s Goteburg University, said that the need to treat high blood pressure, reducing heart attacks and strokes, was clear, even without the additional results on dementia.

Rebecca Wood, from the Alzheimer’s Research Trust, said the finding was an “exciting development”, which, if repeated, could offer hope to the 700,000 people in the UK with dementia.

Healthy living

The Alzheimer’s Society, however, stressed the need to try to prevent the disease.

Its own unpublished research suggested that vascular dementia was six times more likely to develop in people who had high blood pressure in their 40s and 50s.

If “best practice” in blood pressure treatment was applied to the UK population, it said, with every case detected and treated appropriately, this would save 15,000 lives a year.

Professor Clive Ballard, its director of research, said: “Only half of people over 65 receive effective treatment, yet we know treatment works.”

The charity’s chief executive, Neil Hunt, urged everyone, even those in middle age, to have regular blood pressure and cholesterol checks.

News reported by The BBC

Alzheimers Research Trust
Alzheimers Society

Who’s affected?
The older a person is, the greater the chance they will develop a disease that harms the brain. Diseases that damage the areas that control thinking, memory, reasoning and language can lead to dementia.

It’s rare in people under the age of 60, but affects one person in 20 over the age of 65 and one in five over 80.

What causes it?

In a small number of cases the disease is reversible

When someone is diagnosed with dementia it’s vital the cause is established as far as possible because in a small number of cases the disease is reversible.

Even when the cause is not reversible, a clear diagnosis is important as different drugs are recommended in different types of dementia.

Causes include:

– Diseases resulting in progressive degeneration or death of nerve cells. These include Alzheimer’s (which accounts for more than half of all cases), Parkinson’s disease, Huntington’s disease, Creutzfeldt-Jakob disease and a group of conditions referred to as frontotemporal dementia (FTD). Another condition, called Lewy Body dementia, affects 20 per cent of people with dementia.
– Conditions, such as atherosclerosis, that harm the blood vessels supplying the brain. This type of dementia is known as vascular dementia and accounts for about 20 per cent of dementia cases.
– Conditions producing a dementia that can be reversed with treatment. These include hypothyroidism (underactive thyroid), vitamin B12 deficiency, folate deficiency, syphilis of the nervous system, subdural haematoma (a blood clot round the brain, usually following a blow to the head), hypercalcaemia (abnormally high calcium levels), undiagnosed diabetes, brain tumours or infections, and a condition called normal pressure hydrocephalus.
– Some medicines can interfere with concentration and memory, producing dementia-like symptoms. These include tranquilisers and sleeping pills, antidepressants and certain drugs with an anticholinergic effect (for example, some hayfever and cold remedies, some stomach ulcer drugs and treatments for diarrhoea).

What are the symptoms?
People with dementia often don’t look ill, especially in the early stages, and may have no particular symptoms. But family and friends may notice a change in the person’s personality, or that they seem to have problems remembering things.

The condition usually progresses slowly, and three types of symptoms may appear:

– Cognitive problems – a disturbance of understanding, memory, thinking, calculation, learning capacity, language and judgement.
– Functional problems – difficulty carrying out complex tasks and, as the condition progresses, difficulty with daily living activities, such as personal hygiene and dressing.
– Emotional problems – changes in mood, loss of emotional control and a withdrawal from previous interests, activities and social interactions.

Different types of dementia show slightly different patterns of disease. For example, in Lewy Body dementia, severity varies markedly from day to day, while in Alzheimer’s there is only slight variation from day to day.

In frontotemporal dementia (including Pick’s disease), shrinking of the frontal and temporal lobes of the brain typically causes problems with either behaviour and/or language but not with memory.

People with FTD often become disinhibited and irritable, rude, aggressive or apathetic. They may change their normal habits, become more interested in sex and neglect basic personal hygiene.

At the same time, they lose insight and don’t understand why their behaviour’s causing distress. Alternatively, or at the same time, they may progressively struggle to speak or understand speech. FTD tends to affect younger people (average age of onset is 60), has a strong inherited pattern and is usually relentlessly progressive with behaviour that’s difficult to control.

How is it diagnosed?
There’s no single test that can identify dementia, although a range of blood tests and sophisticated brain scans can help and are important in ruling out reversible causes.

Diagnosis is made by an assessment of symptoms and the use of brief questionnaires that test ability to remember facts, or draw simple diagrams.

What’s the treatment?
Most types of dementia progress slowly. People may live with the condition for ten years or more, requiring increasing levels of support as they become less independent. By carefully planning the person’s environment, and giving structure to their day with supportive activities, it may be possible to reduce the impact of the symptoms.

While there is no treatment that can cure progressive dementia, drugs (especially a type known as cholinesterase inhibitors) play an important part in controlling symptoms and can enable a person with dementia to live independently in the community for longer.

These treatments may also help behavioural symptoms such as restlessness or agitation, and improve the quality of life for the person with dementia and their carers. Some people don’t respond to any existing treatments.

Possible future treatments
Scientists are investigating the use of stem cell therapy, antioxidants and vaccination to stop plaque build-up in the brain.

It’s unclear how beneficial the herb Gingko biloba is in delaying the progression of Alzheimer’s and vascular dementia, and relieving their symptoms. There’s some evidence suggesting it may help.

Mental activity is believed to slow the progress of certain types of dementia, so keeping the brain active by doing puzzles and crosswords, for example, is recommended.

Depression is common among people with dementia and antidepressants can also help to improve symptoms.

This article was last medically reviewed by Dr Rob Hicks in January 2008

News reported by The BBC

Alzheimers Research Trust
Alzheimers Society

An Alzheimer’s Society poll of 2,300 people in England found two thirds of patients paid towards care such as help with washing, eating and dressing.

The charity said this should be free as it was linked to a medical condition, but was often classed as a social care need and therefore means-tested.

The government said dementia was a significant challenge facing society.

An estimated 570,000 people have the condition in England, and the figure is expected to double within 30 years.

“Dementia is now one of the most significant health challenges facing our society” Department of Health spokeswoman

The survey, of patients and carers, found a third of people being cared for at home were paying more than £50 a week, while more than half of those in care homes were paying £300.

The Alzheimer’s Society estimates that, overall, patients pay £2bn a year in fees that should be picked up by the NHS, and described it as a dementia tax.

The charity said dementia patients were discriminated against in a way other patients, such as those with cancer, would never be.

Alzheimer’s Society chief executive Neil Hunt said: “The system is not functioning and the way dementia patients are being treated is unfair.

“As the care is because of a medical condition it should be treated free under the NHS. That is not happening and probably won’t if we are being realistic.”

The charity has produced its report as the government carries out a consultation ahead of its social care green paper early next year, which is expected to propose a reform of funding.

Currently, anyone with assets of more than £22,250, including property, has to pay for their care.

Similar systems operate in Wales and Northern Ireland, but in Scotland personal care is free.

However, all four nations have been dogged by problems of rationing, with ever more limited packages being offered as councils struggle to keep pace with the ageing population.

‘Fair and transparent’

Mr Hunt said he believed people would be willing to contribute towards the cost of their care, but that it should be a fair and transparent system.

He said the charity did not have a recommended model in mind, although many experts favour some sort of basic care guarantee that could be topped up by contributions from the individual.

The Department of Health said its consultation ahead of the green paper on social care funding was aimed at finding a fair solution for “patients and taxpayers”.

But a spokeswoman added good quality care was “not just about money, but how services are provided and coordinated” – something which was being addressed by the dementia strategy launched earlier this month.

And she said: “Dementia is now one of the most significant health challenges facing our society.”

News reported by The BBC

Alzheimers Research Trust
Alzheimers Society

This is the question we at Care at Home recently asked ourselves and, as a result decided to launch a new 5-day week live in care service. So effectively providing part-time live in care for only 5 days a week.

We receive many calls from people looking for visiting care, where really and truely in a number of cases they may need full-time live in care. However, the cost of full-time live in care is sometimes cost prohibitive when the weekly start cost is £650 per week. However, our new 5-day week part-time service starts at £500 per week, which represents a 23% saving.

Visiting care could cost around £420 per week for three 1-hour visits per day, where this is for 7-days a week at a charge of around £20 an hour. The total charge would obviously be less if the visits were less than 1-hour each time, but could equally be more if say 4 daily visits were required.

The types of care where visiting care is perhaps more questionable is where the person has either Alzheimers or Dementia. A person might receive a visit at say 8:30am and not be re-visited until around mid-day. This means that the person is left on their own for long periods of time and being that they are forgetful and have a tendency to wonder there is a problem. In some cases the person is locked in their own home, which effectively becomes a prison. Being locked in their own home could become a real hazard, if a fire were to break out, for example. In these circumstances we believe that live-in care would be the preferred and safer choice.

Visiting care is fine, so long as the person being cared for is “Safe” to be left alone for long periods of time. However, it is important to note that the elderly are prone to falling and it only takes one fall at a time when they are alone to be a problem. This is not to say that visiting care is not good, it has it’s place, but when any relative is looking for care for an elderly loved one, it needs to be thought through very carefully.

The part-time live in care service would mean that the family will have to look after their elderly relative over the weekends, but it does mean that during the week they can still go to work in the knowledge that their loved one is being looked after and at a price which is more affordable.

We are hoping that with a reduced price for a 5-day week instead of the full 7-day week package, combined with the possibility of obtaining government help towards the payments by way of direct payment, our new service will be well received.

For more details visit our main site and contacts us for a free no obligation care plan and quote

An Alzheimer’s Society poll of 2,300 people in England found two thirds of patients paid towards care such as help with washing, eating and dressing.

The charity said this should be free as it was linked to a medical condition, but was often classed as a social care need and therefore means-tested.

The government said dementia was a significant challenge facing society.

An estimated 570,000 people have the condition in England, and the figure is expected to double within 30 years.

“Dementia is now one of the most significant health challenges facing our society” Department of Health spokeswoman

‘My wages went on husband’s care’

The survey, of patients and carers, found a third of people being cared for at home were paying more than £50 a week, while more than half of those in care homes were paying £300.

The Alzheimer’s Society estimates that, overall, patients pay £2bn a year in fees that should be picked up by the NHS, and described it as a dementia tax.

The charity said dementia patients were discriminated against in a way other patients, such as those with cancer, would never be.

Alzheimer’s Society chief executive Neil Hunt said: “The system is not functioning and the way dementia patients are being treated is unfair.

“As the care is because of a medical condition it should be treated free under the NHS. That is not happening and probably won’t if we are being realistic.”

The charity has produced its report as the government carries out a consultation ahead of its social care green paper early next year, which is expected to propose a reform of funding.

Currently, anyone with assets of more than £22,250, including property, has to pay for their care.

Similar systems operate in Wales and Northern Ireland, but in Scotland personal care is free.

However, all four nations have been dogged by problems of rationing, with ever more limited packages being offered as councils struggle to keep pace with the ageing population.

‘Fair and transparent’

Mr Hunt said he believed people would be willing to contribute towards the cost of their care, but that it should be a fair and transparent system.

He said the charity did not have a recommended model in mind, although many experts favour some sort of basic care guarantee that could be topped up by contributions from the individual.

The Department of Health said its consultation ahead of the green paper on social care funding was aimed at finding a fair solution for “patients and taxpayers”.

But a spokeswoman added good quality care was “not just about money, but how services are provided and coordinated” – something which was being addressed by the dementia strategy launched earlier this month.

And she said: “Dementia is now one of the most significant health challenges facing our society.”

News reported by BBC