Alzheimer's Disease Archive

How a healthy lifestyle can make a difference in Alzheimer’s prevention.

Alzheimer's disease, the most common form of dementia, is characterized by the accumulation of two types of protein in the brain: tangles (tau) and plaques (amyloid-beta). Eventually, Alzheimer's kills brain cells and takes people's lives.

Alzheimer’s causes

What causes Alzheimer's? We still aren't sure. "For 1% of all cases, there are three genes that determine definitively whether or not you will have Alzheimer's, and all three relate to amyloid-beta production, which in these cases is likely the cause of Alzheimer's," says Dr. Gad Marshall, associate medical director of clinical trials at the Center for Alzheimer Research and Treatment at Harvard-affiliated Brigham and Women's Hospital. "For the other 99%, amyloid and tau are closely associated with Alzheimer's, but many things may contribute to the development of symptoms, such as inflammation in the brain, vascular risk factors, and lifestyle."

Ask the doctor

Q. I hear that there are outbreaks of measles in the United States. I think I had measles when I was young, but I'm not sure. Do I need to worry?

A. The measles virus has been infecting humans for at least 1,000 years. When I was very young, in the 1940s, I got the measles. So did nearly every kid I knew; it is very contagious. I had a high fever, sneezing, coughing, very red eyes, and then a rash on my face and all over my body. Fortunately, I didn't develop the severe complications of measles: pneumonia (which affects one in 20 people with measles) or encephalitis (which affects one in 1,000 and can be fatal). Still, I was miserable for more than a week.

New research aims to capture and eventually cure incessant ringing in the ears.

More than 50 million Americans struggle with tinnitus, a constant or recurring ringing in the ears that ranges from irritating to debilitating. Some treatments work for some people, but none seems to work for everyone.

Tinnitus is a tough condition for doctors to study. "There's no way to measure it directly. The only way we know you have tinnitus is if you tell us. Even if there were a cure, we wouldn't know how it worked because we have to rely on verbal descriptions of what your tinnitus sounds like and how loud it is," says Daniel Polley, director of the Lauer Tinnitus Research Center at Harvard-affiliated Massachusetts Eye and Ear.

News briefs

Here's some relief for people with urinary incontinence who don't want to take pills to treat the problem: behavioral therapy (bladder training) works better for urinary incontinence than medication, according to a study published online March 18, 2019, by Annals of Internal Medicine. Researchers reviewed 84 randomized trials of women (average age 55). The studies evaluated 14 categories of incontinence treatments, including pill-free therapy and medications such as anticholinergic drugs — for example, oxybutynin (Ditropan). Most of the strategies (except taking hormones or getting injections of a bulking agent near the urethra) were more effective than doing nothing to treat incontinence. But for both stress incontinence (the kind that makes you leak when you laugh) and urge incontinence (the kind that makes you rush to the bathroom), behavioral therapy was the most effective treatment, beating medications and neuromodulation (electrical stimulation of the nerves that control the bladder). The catch: it takes practice to make behavioral therapy effective. But it may be worth the effort, since medications for incontinence often have side effects.

The three Ms — mindfulness, meditation, and mantras — sharpen work-related soft skills and improve your memory.

Think back to how your mind operated during your work career. Your mental skills were divided into two types: hard and soft. Hard skills related to the technical knowledge you needed to perform a specific job. Soft skills consisted of everyday thinking, like making decisions, being a good listener, and having a positive attitude.

You might not need hard skills as much now, but maintaining soft skills will always be valuable.

In the journals

Spending just 20 minutes connecting with nature can help lower stress hormone levels, according to a study in the April 4, 2019, Frontiers in Psychology. Previous research has shown that interacting with nature reduces stress, but it is not clear how long and how often the engagement needs to be, or even what kind of nature experience is best.

Here, researchers asked 36 people to spend 10 minutes or longer, three days a week for eight weeks, in an outdoor place where they could interact with nature. The settings varied from yards to public parks to green areas near their place of work. They also either walked or sat during their nature time.

In the journals

It's well known that regular exercise helps maintain brain function. New research finds that brain activity increases and memory improves immediately after even a short, single bout of exercise.

And the more exertion you put into that exercise, the greater the improvements. In addition, whatever level of exertion you're able to achieve on that single exercise predicts how much brain boost you'll get if you continue to exercise at the same intensity over a longer term. These findings were presented at the Cognitive Neuroscience Society's annual meeting on March 24, 2019. Researchers recruited 34 people, average age 67, and gave each a baseline functional MRI (fMRI) scan, which reflects brain activity, and a memory test in which they had to remember faces. The researchers then asked the participants to exercise for 20 minutes on a stationary bike that could measure their physical effort.

Many Americans have fatty liver disease, a condition that can lead to serious liver problems.

If you're not a big drinker, you may not give much thought to the health of your liver. But there might be reason to be concerned. An estimated 64 million Americans have an often-symptomless liver condition called nonalcoholic fatty liver disease (NAFLD), which may put them at risk not only for serious liver disease, but for heart disease as well.

Many people — including doctors — didn't pay much attention to NAFLD until the 1980s, but life insurance companies have had this issue on their radar for years, says Dr. Michelle Lai, an assistant professor of medicine at Harvard Medical School. They knew that an abnormal liver blood test could reflect a lower life expectancy, and they set the premium higher or decline to insure people with the condition, she says.

A new study supports the use of noninvasive brain stimulation in people with severe depression who haven't responded to medication.

If medication isn't helping to ease severe depression, nonsurgical brain stimulation may be an effective alternative to consider, according to a study published online March 27 by The BMJ. Specifically, the study found that evidence seems to back the use of repetitive transcranial magnetic stimulation (rTMS) and electroconvulsive therapy (ECT) over other, newer brain stimulation therapies.

"Many psychiatrists are unaware of these techniques, or at least don't think to recommend them for their patients," says Dr. Daniel Press, associate professor of neurology at Harvard Medical School and the clinical director for the Berenson-Allen Center for Noninvasive Brain Stimulation at Beth Israel Deaconess Medical Center. "So, studies like this are helpful in raising the banner and reminding people that these are very effective options for a large percentage of people."

The is the second part of "Treating opiate addiction". Click here to read Part I: Detoxification and maintenance.

Naltrexone

A different kind of drug treatment for opioid use disorder is the long-acting opiate antagonist naltrexone, usually taken once per day after detoxification. It neutralizes or reverses the effects of opiates, and triggers a withdrawal reaction in anyone who is physically dependent on opiates. A person who takes naltrexone faithfully will never relapse, but most people simply stop using it, or refuse to take it in the first place. A newer slow-release naltrexone injection is now available. However, it is too soon to know if it will have a better success rate than the oral form.