Tag Archives: Dementia

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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Medical, Research, Science

The availability of cheap drugs offers hope for dementia sufferers

DEMENTIA

SCIENTISTS in Scotland have found a potential cure for the most common cause of dementia and strokes in old people – using cheap, everyday drugs.

Human trials are already being carried out after rats were treated with a combination of cilostazol and isosorbide mononitrate.

Researchers say once trials are complete they could be available to patients within two years.

The breakthrough comes days after new figures showed Scotland is facing a dementia “timebomb” as experts warn conditions such as Alzheimer’s will soon overtake heart disease as the biggest killer.

The drugs involved in the latest study repaired the deterioration of blood vessels in rats’ brains associated with a condition called cerebral small vessel disease, or SVD, and reversed the symptoms.

SVD is responsible for almost half of all dementia cases in the UK and accounts for one in five strokes. It can also aggravate the symptoms of Alzheimer’s disease.

Professor Anna Williams, group leader at Edinburgh University’s Medical Research Council (MRC) Centre for Regenerative Medicine, said: “We are very excited because it is the first time we have really got to the bottom of why this disease called cerebral small vessel disease happens.

“We gave rats some drugs that made the cells happier and managed to reverse the changes in the brain. We have found a way to reverse it. That is exciting for people with dementia.”

Professor Williams added: “The nice things about these drugs is that they are already tested on people, they are cheap and readily available so can quickly be given to people.”

Cilostazol and isosorbide mononitrate are commonly used by patients with heart and blood pressure ailments. Pills are available for around 60p and 20p respectively.

The research team discovered that SVD occurs when cells that line the small blood vessels in the brain become dysfunctional. This causes them to secrete a molecule into the brain, which stops production of myelin, a protective layer that surrounds brain cells, leading to brain damage. The drugs prevent this.

Experts hailed the breakthrough. A spokesperson for the charity Age Scotland, said: “Any development of this nature and any measures to combat dementia is good news indeed.”

The research, first published in Science Translational Medicine, was carried out at the MRC centre and the UK Dementia Research Institute at Edinburgh University. It was funded by the MRC, Alzheimer’s Research UK and the private Leducq Foundation, based in Paris.

Dr Sara Imarisio, head of research at Alzheimer’s Research UK, said: “The findings highlight a promising direction for research into treatments that could limit the damaging effects of blood vessel changes and help keep nerve cells functioning for longer.”

Researchers say further studies will be needed to test whether the treatment also works once the disease is firmly established, but trials will be over within a year.

Estimates indicate there are almost 47 million people living with dementia worldwide and the numbers affected are expected to double every 20 years, rising to more than 115 million by 2050.

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Health, Medical, Society

New medical guidelines for dementia patients

DEMENTIA

DOCTORS have been instructed to recognise the “human value” of patients with dementia as part of a major overhaul of care.

Dementia patients should be treated as individuals, have a say in their care and not face discrimination for their age or the severity of the illness, new guidelines say.

While there is currently no cure for dementia, the guidelines stress the importance of diagnosis so that patients and their families can prepare for the future and start treatments to slow its advance. This includes giving patients a controversial spinal tap when doctors are unsure whether they have dementia.

. See also Research reveals a healthy diet helps to stave off dementia

Charities have welcomed the care blueprint but warned that substantial investment would be needed to implement the measures, which include appointing dementia “champions” to advise patients and their families on the care available.

A spokesperson from the Alzheimer’s Society, said: “It’s encouraging to see the steps it’s taking to ensure the needs and rights of people with dementia are met. However, the guideline is just a starting point. What we need now is support to implement these recommendations.”

Recent figures suggest a million Britons are living with dementia. This is expected to double by 2051 due to the ageing population and obesity, which raises the risk of the condition.

Health watchdog NICE drew up the new advice – the first changes to healthcare guidance in a decade – to improve the postcode lottery of care on the NHS following concerns that dementia patients were being failed across the UK.

Ofsted-style ratings carried out in 2016 found that 57 per cent of health boards were giving patients with dementia and Alzheimer’s inadequate care.

Officials found some patients were never diagnosed with dementia, while many of those who were did not receive a check-up for 12 months. Last year, a major study found hundreds of thousands of Britons had dementia but did not know because they were never given a formal diagnosis in case it made them anxious.

For the first time, the guidelines urge doctors to carry out a spinal tap – using a needle to extract spinal fluid from patients whose diagnosis is unclear. However, the procedure is uncomfortable, sometimes painful, and can cause side-effects such as severe headaches and infections.

Other changes include a recommendation for more training for staff such as carers at home, in care homes and GPs to better support people living with dementia. The guidance says people with dementia and their carers should be assigned a health or social care professional to co-ordinate treatment, rather than being left to navigate the options themselves.

Initial assessments should include recording a history – including cognitive, behavioural and psychological symptoms – and how it affects daily life.

This should either come from the patient or a spouse, loved one or carer who knows them well, it recommends.

Alzheimer’s Research UK said: “We’re very happy to see the NICE guidelines give additional attention to how health professionals can help people with dementia get involved in research.”

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