Health, Medical, Research, Science

Lifestyle factors in keeping dementia at bay

MEDICAL RESEARCH

DOCTORS have identified seven lifestyle factors in middle age which have a significant influence on the risk of developing dementia in later life.

A major study suggests each of the seven elements – weight, diet, exercise, cholesterol, blood sugar, blood pressure and smoking – contributes to the chance of getting dementia.

Scientists at the University of Bordeaux tracked more than 6,600 French people from Bordeaux, Dijon and Montpellier.

The participants, who were at least 65 at the start of the study, were tested for the seven elements and then monitored for an average of eight and a half years.

For each of the seven tests that they “passed” as healthy, the risk of developing dementia over the following years went down by 10 per cent.

The scientists, whose findings were first reported and published in the JAMA medical journal, said their study demonstrates the link between cardiovascular health and the resilience of the brain.

“These findings may support the promotion of cardiovascular health to prevent risk factors associated with cognitive decline and dementia,” they wrote.

Experts in Britain say the findings from the research highlight the fact that the risk of dementia can be reduced with a healthy lifestyle.

A spokesperson for Alzheimer’s Research UK, said: “Although age is the largest risk factor for dementia, the condition is not an inevitable part of getting older and there are things we can all do to help reduce our risk.

“This large study of over 6,000 older people in France adds to a wealth of existing evidence indicating that what is good for the heart is also good for the brain.

“We know that the diseases that cause dementia can begin to develop in the brain up to 20 years before symptoms show so it’s never too early to take steps to reduce your risk.

“As well as these seven aspects of healthy living, drinking within recommended guidelines and staying mentally active and socially engaged have also been linked to better brain health in later life.”

Dr Doug Brown, chief policy officer at the Alzheimer’s Society, said: “Of all the diseases in the UK dementia is now the biggest killer, so exploring potential factors which could reduce the risk of developing this devastating condition is fundamental to beating it.

“Taking care of your cardiovascular health… may help slow cognitive decline and reduce your risk of getting dementia.

“Although this study stopped short of examining whether participants had healthy hearts in earlier life – which might have contributed to fewer of them getting dementia in later life – everyone should take steps from an early age such as eating a balanced diet, avoiding smoking and heavy drinking, and exercising regularly.”

The Seven Lifestyle Factors

. Weight – Have a body mass index (BMI) of less than 25

. Diet – Eat fish twice a week and fruits and vegetables at least three times a day

. Exercise – Walk more than two hours a day or take part in intensive sport more than twice a week

. Cholesterol – Levels need to be less than 200 mg/dL (milligrams per decilitre)

. Blood Sugar – Should be less than 100 mg/dL

. Blood Pressure – Should be less than 120/80 mmHg

. Smoking – Not smoking


MANY adults put off going to see their GP because they do not like being told what to do, research suggests.

Data from 4.300 Britons saw nearly one in five admit they had delayed making an appointment to avoid being lectured about lifestyle changes.

Experts say patients stay away for fear of giving away control – even when they are already showing worrying health symptoms – and warns this poses a considerable threat to public health.

The report, by experts at University College London, the University of Bedfordshire and thinktank 2020 Health, says many people also have a “fear of finding out” they are unhealthy and so avoid their doctor.

This can lead to major issues in the long term because minor problems missed at an early stage can escalate into far more severe issues. Many people – especially the rising number who know they do too little exercise or are overweight – do not report health complaints for fear of being lectured about their lifestyle.

GPs are encouraged by the NHS to ask patients about their weight and how much exercise they do, and are often given financial incentives to give weight-loss advice.

A spokesperson for 2020 Health, said: “It’s easy to think that consumers are wilfully refusing to change unhealthy habits, but the truth is, we are bombarded by conflicting health advice and mixed messages everywhere we turn.

“This is both confusing and dangerous as it can lead to important, evidence-based health information and guidance being lost or overlooked.

“Not only are lifestyle changes undermined, but the importance of getting specific symptoms checked out early are obscured.” Some 18 per cent of participants in the study – nearly one in five – said they had delayed an appointment because they were worried they might be pressured to change their lifestyle.

With 68 per cent of men and 58 per cent of women in Britain now overweight or obese, many may have reason to fear being lectured.

A quarter of participants said they had avoided a doctor because they did not want to be physically examined. A fifth said they were anxious about treatment that might be required, and another fifth were worried about the impact a diagnosis may have on family members.

The report, funded by pharmaceutical firm AbbVie, said patients who go to their doctor when they have a problem actually have a smaller impact on the NHS.

It said: “The model of the ‘good patient’ [is] one who adopts a healthier lifestyle, sees the doctor promptly if they notice what could be the early signs of illness and turns up to routine health checks and screening appointments.”

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Health, Medical, Research, Science

Could a new ‘universal vaccine’ stop all strains of flu virus?

MEDICAL RESEARCH

A NEW universal long-lasting vaccine could prevent the need for yearly flu jabs.

Currently, scientists have to predict every year what the new strain of flu will look like, but by the time the vaccine has been made, the strain of virus may already have mutated and changed.

Recently released figures reveal the vaccine given to ten million over-65s, children and at-risk adults last year offered little protection against the killer H3N2 strain, known as Aussie flu, which put unprecedented pressure on the NHS during the winter months.

Public Health officials have admitted the jab had “no significant effectiveness” in preventing people from being struck down – and was deemed only 15 per cent effective overall.

UK researchers are now working on a “universal” vaccine to protect against a number of strains.

The cells of the flu virus are like spherical cushions with lots of pins sticking out. Flu vaccines currently work by triggering an immune response to antigens – the heads of the pins – on the cell’s surface.

The immune system creates antibodies, which are then primed to attack and block the real flu virus when it comes along: the antibodies recognise the virus by its antigens.

The new vaccine, developed at the University of Oxford, protects the body against flu in a way that makes it more universal.

 

SCIENTISTS have found that while flu strains vary, all flu viruses contain epitopes (parts of the antigen to which antibodies attach), which vary much less than previously thought. Targeting these epitopes through vaccination would protect against all strains of the virus.

The new vaccine is designed to home in on these common epitopes and help the immune system create antibodies to fight them.

So far they’ve identified specific epitopes for two main types of flu – influenza A virus (subtypes H1 and H3) and influenza B. Researchers say a vaccine using this new approach could provide immunity without the need for yearly vaccinations, and could work against many types of flu even if the virus mutates.

Two or three injections would give long-term protection against different strains, they say.

Sunetra Gupta, a professor of theoretical epidemiology who led the research, says: “We believe our methods can be applied to produce vaccines against all subtypes of influenza, thereby providing the opportunity to develop not only a more effective vaccine against endemic influenza, with lower healthcare costs, but also better protection against potential influenza pandemics.

“The same strategy can also be used to produce vaccines for swine and avian influenza, which will have significant economic consequences, and the control of which will reduce the probability of new lineages emerging with pandemic potential.”

Vaccination is the most effective way to protect against the virus and is given annually in the UK to people at risk, including the over-65s, children aged two to nine, pregnant women, and people in long-stay residential care homes.

But the problem with existing vaccines is that the flu virus frequently mutates in two ways.

The first, known as antigenic drift, involves small changes in the genes of influenza viruses as the virus replicates.

These small genetic changes usually produce viruses that are closely related to one another, and share the same antigenic properties, so an immune system exposed to a similar virus will usually recognise it and respond.

But these small changes can accumulate over time and eventually the immune system may not recognise them and respond.

The less common route is antigenic shift – an abrupt, major change in the influenza A virus, and most people have little or no protection against the new virus.

 

TO ENSURE vaccines are available when needed, six months before the flu season, scientists try to predict the new strain. However, as the latest figures show, they don’t always get it right.

Commenting on the research, Professor Wendy Barclay, the Action Medical Research Chair in Virology at Imperial College London, says: “There are lots of different ideas about to make a universal flu vaccine and how universal it would actually be.

“This work from the Oxford group would mean we don’t have to update the flu vaccine yearly, but if a new pandemic came along, chances are this type of vaccine wouldn’t work against that.

“But it would mean we don’t have to chase after the virus as it constantly drifts and we try to keep up.”

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Health, Medical, Research, Science

Blood pressure study linked to dementia

MEDICAL RESEARCH

A major study suggests that hundreds of thousands of people could be saved from dementia if blood pressure tablets were used more widely.

Researchers have shown for the first time that aggressively treating high blood pressure – particularly in middle age – could also significantly reduce the risk of dementia later on.

NHS officials are under growing pressure to lower the threshold at which people can be given the drugs, a policy that could make 14million eligible for treatment.

Patients are currently considered to have hypertension – or high blood pressure – only if they have a reading of more than 140/90 mm Hg.

But a study of 9,400 people in the US found cutting the systolic threshold – the higher reading – to 120 instead of 140 slowed cognitive decline.

An ideal blood pressure reading is between 90/60 millimetres of mercury (mm Hg) and 120/80. The first figure is the systolic pressure, the “surge” that occurs with each heartbeat. The second is the diastolic reading, which measures the pressure in the “rest” between heartbeats.

Using the new threshold over eight years reduced rates of dementia and mild cognitive impairment by 15 per cent, according to results presented at the Alzheimer’s Association International Conference in Chicago.

Similar trials have shown cutting the threshold for treatment would reduce the risk of heart disease by a fifth, and strokes by about a quarter.

Health watchdogs are already reviewing blood pressure guidelines with a view to cutting rates of heart disease and a decision is expected next year.

But they will now face greater pressure to change the rules after the new research, the first to look in detail at the impact of such a policy on dementia.

Study leader Professor Jeff Williamson, of the Wake Forest School of Medicine in North Carolina, said: “These results support the need to maintain well-controlled blood pressure, especially for persons over 50.”

A second study of 670 patients by the University of Pennsylvania found that the lower threshold also showed shrinkage of white brain matter, strengthening the link between blood pressure and dementia.

The US has led the way on blood pressure policy, lowering the treatment threshold in November from a systolic score of 140 to 130.

If the UK followed suit, it would mean an estimated 14million people – a third of all adults – would be eligible. Currently seven million are eligible.

A policy to increase this, however, would be controversial as it would affect many people who until now have been considered healthy. A similar change that lowered the threshold for cholesterol-busting statin drugs in 2014 led to a huge backlash, fueling accusations that health professionals were “over-medicalising” the middle aged.

A spokesperson for Alzheimer’s Research UK, said: “This study suggests treating high blood pressure intensively . . . may help to reduce the risk of memory and thinking problems.

“There is robust evidence that what’s good for the heart is also good for the brain and maintaining good vascular health is one of the key things people can do to reduce their risk of dementia.”

But Professor Clive Ballard, of Exeter University, warned: “All anti-hypertensives come with some risk of adverse effects, most seriously for kidney function.”

 

THOSE who feel light-headed when standing up after a long time sitting may be at a greater risk of dementia and stroke, according to a US study of more than 11,000 people.

Scientists at John Hopkins University found those whose blood pressure dropped when they stood up – a problem known as orthostatic hypotension – had twice the risk of suffering a stroke in later life. Their risk of dementia was 54 per cent higher.

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