DEMENTIA NEWS

EDITION 14, 2013 - 26 SEPTEMBER

UNDERSTAND PARTICIPATE

DISCUSS

EDITORIAL

Hello Dementia News readers,

The big news in this edition is the election commitment from the Coalition to provide an additional $200 million over five years for dementia research. As most readers will know, additional funding for dementia research has been a central part of the Fight Dementia campaign since it was launched in 2011. If elected, the Coalition has indicated that the funding would be used to build dementia research capacity by supporting the best and brightest new researchers; to support high priority dementia research projects; to translate existing research into better dementia care; and to invest in vital dementia research infrastructure. $9 million of this funding would be provided to the Clem Jones Centre for Ageing Dementia Research at the University of Queensland. The Coalition policy is available here.

Outside of politics, there have been lots of new updates coming in from the research sector and I’ve picked a few to focus on, including:• Breastfeeding may reduce risk of Alzheimer’s

disease.

• Difficulty recognising famous faces could be a sign of dementia.

• A new biomarker which could detect Alzheimer’s disease before symptoms occur.

• New ways to access dementia research.

This edition’s Discuss the Science section looks at risk and protective factors for dementia, and in particular, how people can work out which of the many factors we hear about in the media – several just this fortnight – are more important than others? I found it quite interesting to compare the media headlines to what is actually published in the scientific articles, and I would be happy to hear your thoughts on this as well. Who do you rely on for your sources of information, particularly in relation to dementia research?

I’d like to also thank those who gave feedback on the last edition. Several comments focused on the story about the impact of caring for someone with dementia, and one reader asked if there is any research on positive impacts of caring for people with dementia that we could report on. I am happy to say yes, there has been. In late 2010, researchers from Griffith University in Queensland surveyed residential aged care staff who care for people with dementia. They found that carer attitudes towards the person with dementia were positive and job satisfaction was high, particularly in relation to interactions that allowed person-centred care. You can read the full article here.

There is also good news to report about our local dementia researchers. Congratulations to Professor Ralph Martins, AO, Director of Research at the McCusker Alzheimer’s Research Foundation, Foundation Chair of Ageing and Alzheimer’s Disease at Edith Cowan University, and a member of the Alzheimer’s Australia Dementia Research Foundation Scientific and Medical Panel. Ralph was awarded a Lotterywest grant of $2.4 million for his research into Alzheimer’s disease.

We’d also like to congratulate one of the AADRF PhD scholars, Mr Phillip Ward, who is competing in the finals of the Monash University 3 Minute Thesis competition in September, having won his heat earlier this year. If you haven’t previously heard, the 3 Minute Thesis competition is run around the world and gives PhD scholars the chance to entertain, inform and educate an audience about their research, all in 3 minutes or less. There are major prizes on offer, and national finalists have a chance to represent their country. So good luck Phil!

I hope you enjoy this issue,

Dementia News editor,Ian McDonald

1 Dementia News

Women who breastfed after giving birth had a reduced risk of Alzheimer’s disease compared to those who did not, according to a new study by researchers from the Department of Biological Anthropology at the University of Cambridge, UK. Their findings were recently published in the Journal of Alzheimer’s Disease. All women who volunteered in the study were over the age of 70 and were asked questions relating to reproductive history, dementia status (determined by CDR) and information about factors that would potentially confound the relationship between Alzheimer’s disease and hormone exposure (such as a stroke, previous medications, etc). In total, 81 Caucasian British women (aged between 70-100) were included in the analysis of the data.

The results showed that if two women of the same age and similar lifestyles had and had not breastfed their child or children, the mother who had breastfed would on average have a 64 % lower risk of Alzheimer’s disease. They also found that a longer breastfeeding history and a higher breastfeeding to pregnancy ratio were both associated with a reduced Alzheimer’s disease risk.

The authors propose a few reasons as to why breastfeeding may reduce the risk of Alzheimer’s disease:

• Progesterone levels may play a key role in Alzheimer’s disease risk. One theory states that the human reproductive cycle may have evolved to let the higher levels of progesterone during pregnancy be counterbalanced by lower levels during breastfeeding. If so, it is possible that mothers who don’t breastfeed may experience higher levels of progesterone, which may result in desensitised oestrogen receptors and in turn result in a greater risk of Alzheimer’s disease.

• Pregnancy induces a natural state of insulin resistance – meaning cells are unable to use insulin as efficiently as usual. Breastfeeding after pregnancy increases glucose tolerance, thus minimising insulin resistance post pregnancy. We have previously reported that there is a strong and emerging link between Alzheimer’s disease and type 2 diabetes – see September 21, 2012 and June 05, 2013 editions of Dementia News - and this study gives further evidence to suggest that there may be a link between the two. Interestingly, longer term breastfeeding has also been shown to lower the risk of type 2 diabetes.

For more information click on the links below:Media link: Fox NewsUnviersity media link: Cambridge University PressJournal link: Journal of Alzheimer’s Disease

BREASTFEEDING ASSOCIATED WITH REDUCED RISK OF ALZHEIMER’S DISEASE

UNDERSTAND NEW RESEARCH

CDR = Clinical Dementia Rating scale.

This scale was developed by researchers at the Washington University, School of Medicine, Alzheimer’s disease Research Centre Memory and Ageing Project. The test evaluates six categories of functioning including:

• memory, • orientation, • judgement and problem solving, • home and hobbies, • community affairs and • personal care

The CDR produces score that rates the severity of dementia symptoms from 0-18. A score of zero meaning no signs of dementia.

Dementia News 2

IS THAT ELVIS? DIFFICULTY RECOGNISING FAMOUS FACES LINKED WITH DEMENTIA

Difficulty recognising photos of famous faces has been shown to be associated with Primary Progressive Aphasia (PPA) - a rare form of dementia that sometimes affects people aged from 40-65. A current issue with many of the tests for dementia is that they are not designed for younger generations and contain stimuli which are unfamiliar, irrespective of memory loss. As such, researchers from the Feinberg School of Medicine at the Northwestern University in Chicago created the NUFFACE test, which uses stimuli such as black and white photos of famous faces relevant for individuals younger then 65 years of age.

A total of 57 participants took part in this initial study – 27 were considered cognitively healthy when they undertook the study (i.e. normal brain function) and 30 were diagnosed with PPA. The NUFFACE test was then separated into two distinct areas - the ability to name and the ability to recognise the famous person in the photo.

Those with normal brain function who undertook the test scored on average 93.4% and 96.9% accuracy for the naming and recognition aspects of the test, respectively. Those diagnosed with PPA, on average could only name around half of people in the photos (scoring on average 46.4%) but could recognise 78.5% of those who were pictured (e.g. if Elvis was pictured they might say “singer”). Moreover, it was found that brain scans of the individuals with PPA indicated loss of brain tissue in those areas responsible for recognising faces, which may suggest why those test scores were seen in this group.

From these results, researchers concluded that the NUFFACE test was a convenient clinical tool for the assessment of face naming and recognition in individuals between 40-65 years old. Lead researcher Ms. Tamar Gefen said “We would like to now test in other patient groups with different forms of dementia, and in larger groups to validate the test further. It is our hope that this test be incorporated into a clinician’s series of tests, especially if presented with a younger patient complaining of difficulties identifying a famous face, or a loved-one’s face. Identifying a disease at the earliest stages is always beneficial – for appropriate medication, emotional and social support, and practically, for planning. There is no cure for Primary Progressive Aphasia but our centre is working hard to understand the disease further, with the ultimate goal of finding a treatment.”

For more information click on the links below:Media link: ABC NewsJournal link: Neurology

NUFFACE: The Northwestern University Face Test includes twenty black and white printed images of famous faces based on the following criteria.

• Popularity and celebrity status of each person in the visual media

• Race and sex

• Time era in which the person was famous

PPA: Primary Progressive Aphasia is a syndrome characterised by progressive language difficulties and associated with brain function loss in areas important for work and object representations.

Source: Metro Goldwyn Mayer Inc

3 Dementia News

DNA IN SPINAL FLUID - A NEW KEY TO DETECTING ALZHEIMER’S DISEASEA decrease in cell free mitochondrial DNA (mtDNA) concentration in cerebral spinal fluid may indicate pre-clinical signs of Alzheimer’s disease, almost 10 years before symptoms actually show. Cerebral spinal fluid is in direct contact with the brain and therefore may act as a substitute for changes in the brain. Researchers have been trying to find more accurate and early biomarkers that precede the appearance of clinical symptoms. Since neurons in the brain are highly dependent on energy provided by the mitochondria, it was hypothesised that low levels of mtDNA in the cerebral spinal fluid might indicate pre-clinical symptoms of Alzheimer’s disease. This study, undertaken by researchers from the CSIC institute of Biomedical Research in Barcelona, analysed cerebral spinal fluid from 282 people.

The researchers discovered that they could measure free mtDNA in the spinal fluid, so they wanted to test its potential use as a biomarker. They sampled cerebral spinal fluid samples from the study participants and found that people with Alzheimer’s disease or at risk of Alzheimer’s disease had mtDNA levels that were 75 to 85 % lower than those without any brain impairment. The results suggest that low mtDNA levels in cerebral spinal fluid could be an early sign of pre-clinical Alzheimer’s disease. Long-term studies are necessary to make confident conclusions about these results. It is hoped that by identifying early biomarkers for Alzheimer’s disease scientists could find a treatment for the disease by preventing brain degeneration before the appearance of symptoms.

For more information click on the links below:Media link: Medical NewsJournal link: Annals of Neurology

A biomarker is a biological substance that indicates the risk or presence of a specific disease. Current pre-clinical biomarkers for Alzheimer’s disease include:

• Brain accumulation of Amyloid beta (Ab) or low Ab1-42 content in cerebral spinal fluid.

• Elevated cerebral spinal fluid total tau (t-tau) and phosphorylated-tau (p-tau).

Current biomarker measurements may not always be a correct indication of Alzheimer’s disease. Post-mortem tests have indicated that up to 30% of people without dementia exhibit these biomarkers.

Mitochondria are mini organs inside a cell that convert chemical energy from food into energy that cells can use. They can be described as the power plants of the cell. They have their own DNA (mtDNA), which is separate to the chromosomes or the main DNA of a cell.

Dementia News 4

ACCESSING SCIENCE – DEMENTIA SEARCH FILTER PROVIDING THE LATEST RESEARCH. This month, a new set of search filters for dementia research was released. A development that was made possible through a related project on palliative dementia care, funded by the Alzheimer’s Australia National Quality Dementia Care Initiative.

The new search filter provides instant clicks to lists of recent and relevant academic papers on topics ranging from stigma, to behavioural and psychological symptoms, to specific types of dementia such as Creutzfeldt-Jakob Syndrome. Users can choose to search for the strongest evidence, the latest evidence, and can choose to only receive results from Open Access (i.e. freely downloadable) journals.

Each year, over 1.5 million scientific papers are published in over 30,000 scientific journals. With this including the thousands of dementia research papers published, even the leading research experts struggle to keep up with advances in knowledge, which means the task can be almost impossible for consumers or health and aged care professionals.

Tools are being developed to help people process the vast amount of new information and to access the best and latest science, without having to wade through all of the papers themselves.

The research team from Flinders University in South Australia called Flinders Filters is leading the way in the development of ‘search filters’ which use rigorous methods to develop a set of ‘filters’ which can provide people with a list of the latest, relevant research papers on a range of specific issues at the click of a button.This is a great resource for everyone interested in dementia, whether from a research, professional or personal point of view.

You can do your own search using the filter by clicking here.

5 Dementia News

We see regular reports in the media about different aspects of our lives that have been found to increase or decrease our risk of dementia; in the past fortnight alone there have been multiple studies and subsequent media articles released relating particularly to what we eat and drink. Here’s a small taste - see next page for more details:• Drinking two cups of hot chocolate per day can

reduce your risk of dementia.

• Overconsumption of sugar can increase your risk of dementia (so, stick to unsweetened hot chocolate, presumably).

• Excessive alcohol during early adulthood increases your risk of dementia.

• Iron rich food may decrease your risk of dementia.

• Copper rich foods might increase your risk of dementia.

With all this information coming in from across the globe it can be difficult to comprehend and decipher.

Firstly, you need to think critically about what is reported. Some of the things to keep in mind are: • How large the study was? The results from studies

with more people generally carry more weight than those with smaller samples. Likewise, the findings of pilot studies generally need to be re-examined in larger studies before people will have confidence in them.

• Did the study involve animals or humans? Findings from animal studies don’t generalise well to humans. Even studies that do involve humans may not generalise to you, if the participants lived in a different country, or were of a different age, education, background etc.

Factors that can be harder to determine include the design of the study (for example, whether or not there were control groups, the statistical methods used, and the levels of statistical confidence in the outcomes. Scientific reports (and particularly those published in academic journals) are generally critically reviewed by other experts in the field before being published, so scientists have confidence in the findings. However, the media (and even journal publishers or research institutes who write media releases) don’t always report the full detail of published studies, and occasionally headlines can trump the facts (or at least bend them). That’s where trusted information sources like Dementia News come in.

Coming back to dementia risk factors, almost all of the headlines from the past fortnight have been from relatively small studies or pilot studies. For example, the study relating to copper levels in food potentially enhancing the risk of dementia was undertaken using mice. There is currently no evidence to suggest that similar results would be seen in humans until human clinical trials are undertaken. Others, such as the hot chocolate study had a small sample size (60 people), so again needs to repeated on a larger scale.

The underlying message in all these results is about keeping a healthy brain by maintaining a healthy body. This is the key message of Alzheimer’s Australia’s Your Brain Matters Dementia Risk Reduction Program – click here. This website has lots of tips to help everybody keep fit and healthy through eating and drinking correctly and exercising regularly. It is important to remember that while we should be vigilant about what the scientific literature is telling us, we should always look closely into the results before we start making lifestyle changes, and if you ever have any concerns it is always important to consult your GP.

DEMENTIA RISKS FACTORS WHAT TO BELIEVE?

DISCUSS THE SCIENCE

Dementia News 6

HOT CHOCOLATEA 30 day trial in 60 older people was undertaken to determine the effects of cocoa consumption on brain health. 18 people in the group had impaired blood flow in the brain to begin, and after 30 days drinking cocoa they had an 8.3% improvement in blood flow and improved their cognitive test scores. Increasing blood flow to the brain can help to reduce dementia risk and improve cognitive performance, but for most people a better way to achieve this is through regular physical exercise. More work needs to be done before we have a concrete link between regular cocoa consumption and dementia prevention.

For more information click on the link below:Media link: The AustralianJournal link: Neurology

ALCOHOLData was collected from 488,484 men conscripted for mandatory military service from September 1969 through to December 1979. Looking at this sample almost 40 years later, 487 of these men were diagnosed with dementia at an average age of 54. It was found that hospital-treated alcohol intoxication was the single most important risk factor in those identified with dementia. The study also identified that strokes; the use of antipsychotics; depression; drug use; low cognitive function at conscription; low height and high blood pressure were also risk factors.

For more information click on the link below:Media link: The GuardianJournal link: JAMA internal medicine

IRON RICH FOODS2,552 people aged 70 and 79 participated in memory and thinking tests over an 11-year period. At the beginning of the study, no one had dementia, however 393 were diagnosed with anaemia. At the end of the study, 445 had developed dementia. The results showed that people with anaemia were 41% more likely to develop dementia compared with those who were not anaemic. The association persisted even after the researchers took other factors into account, such as age, sex, race and education.

For more information click on the link below:Media link: Medical NewsJournal link: Neurology

COPPER RICH FOODSMice were dosed with a specific amount of copper (0.13mg/L in water) for 90 consecutive days. Copper is essential for the proper functioning of our bodies and our brains, and is found in many foods. However, it can build up in the brain and disrupt the body’s ability to clear away amyloid beta proteins before they form the plaques, the hallmark of Alzheimer’s disease. This study found that in mice, copper regulates amyloid beta clearance in the brain, and that increased copper levels in the ageing mouse brain may led to accumulation of amyloid beta , potentially leading to Alzheimer’s disease. It is far too early to draw any conclusions about the effects of dietary or environmental copper in humans.For more information click on the link below:Media link: Medical News Journal link: PNAS

7 Dementia News

PARTICIPATE TO LEARN MORE

ALZHEIMER’S ACT MEMORY WALK

Alzheimer’s Australia ACT is holding its very first Memory Walk & Jog.

Memory Walk & Jog is a fundraising event to support Alzheimer’s Australia ACT. It’s all about coming together with your friends and family to raise vital funds to support people living with dementia and their carers. You don’t need to be a fitness fanatic to be a part of Memory Walk & Jog - it has something for everyone! You can run, walk, skip, dance or even dress up for the Memory Walk & Jog. So whether you’re 8 or 80, a pro-athlete or just looking for a fun morning out, join us to support the work of Alzheimer’s ACT.

After your walk/jog join us for a BBQ with the Rotary Club of Canberra North or you can bring your own picnic lunch.

Date: Saturday, 21 September 2013Start Point: Opposite Aspen Island, Kings ParkTime: 10.00am - 1.30pmEntry Fee: $15 pp, children under 16 free (all proceeds to Alzheimer’s Australia ACT)To Register: Go to www.fightdementia.org.au and select ACT/Events/Memory Walk & Jog or call 6255 0722.

MAKE YOUR VOTE COUNT FOR DEMENTIA THIS FEDERAL ELECTION

To show your support for dementia in the upcoming election, Alzheimer’s Australia has produced its own Ballot Paper.

You can make your vote count by filling out the electronic ballot paper via the following link - click here.

Tell us why this issue is important to you and what your priorities are in this area.

These responses will then be collated and sent to Mr Rudd and Mr Abbott on September 2nd. The more people who fill out this ballot, the larger our voice will be.

Dementia is the public health challenge of the 21st century and is the third leading cause of death of Australians. There are more than 321,000 Australians living with dementia today and an estimated 1.2 million Australians who support them.

Dementia News 8

CONTACT

This newsletter was funded by the Australian Government as well as the Dementia Collaborative Research Centre: Carers and Consumers © Alzheimer’s Australia as represented by the Dementia Collaborative Research Centre: Carers and Consumers, 2011DISCLAIMER:The views expressed in this work are the views of its author/s and not necessarily those of the Australian Government.

Any questions or comments are welcome.To subscribe/unsubscribe or if you have any information you would like to see included in future editions please contact:E: dementia.news@alzheimers.org.au P: (02) 6278 8916

NATIONAL DEMENTIAHELPLINE1800 100 500

DEMENTIA AWARENESS WEEK SEPTEMBER 16-22

Dementia Awareness Week is the national flagship week for Alzheimer’s Australia’s community awareness activities each year.

This year Dementia Awareness Week (DAW) will take place from 16 to 22 September, with World Alzheimer’s Day occurring on 21 September.

The theme this year is Brain Health: Making the Connections.

This theme gives organisations and individuals an opportunity to get involved in promoting brain-healthy lifestyles, promoting early detection and raising awareness of dementia. This year, Alzheimer’s Australia welcomes international guest speaker, Dr Kristine Yaffe, MD, who will give a series of public lectures on prevention strategies in selected capital cities across Australia.

There will also be many other events and activities around the country to broaden understanding of dementia during DAW. Local activities and events will be announced closer to September. Contact your local Alzheimer’s Australia office for more information on how you can get involved.Click here for more information.