Traumatic Brain Injury and Alzheimer's

Nevada Brain Injury Law 

We know that repeated traumatic brain injury can lead to Alzheimer's disease.  But did you know that even one traumatic brain injury can as well.  So whether multiple blast injuries, sports injuries or even just one car accident with traumatic brain injury, you could raise the chances of developing Alzheimer's in later years.

Over 1.7 million Americans suffer a traumatic brain injury each year, and beyond the immediate effects, growing evidence demonstrates that a single traumatic brain injury, or TBI, may initiate long term processes that further damage the brain. Boxers call this "punch-drunk" syndrome.

Douglas Smith, MD, professor of Neurosurgery and director of the Center for Brain Injury and Repair at Penn's Perelman School of Medicine states:

"A single traumatic brain injury is very serious, both initially, and as we're now learning, even later in life. Plaques and tangles are appearing abnormally early in life, apparently initiated or accelerated by a single TBI."

If you or someone you know has suffered a traumatic brain injury, be on the look out for symptoms of Alzheimer's later in life.  Even at a younger age than you would otherwise think.

The first symptoms of Alzheimer's disease you may notice are increasing forgetfulness and mild confusion.  Here are some others:

Memory

  • Repeat statements and questions over and over
  • Forget conversations, appointments or events, and not remember them later
  • Routinely misplace possessions, often putting them in illogical locations
  • Eventually forget the names of family members and everyday object

Disorientation and misinterpreting spatial relationships

 Speaking and writing
Those with Alzheimer's may have trouble finding the right words to identify objects, express thoughts or take part in conversations. Over time, the ability to read and write also declines.

Difficulty with Thinking and reasoning

Difficulty Making judgments and decisions

Difficulty Planning and performing familiar tasks

Changes in personality and behavior
Brain changes that occur in Alzheimer's disease can affect the way you act and how you feel. People with Alzheimer's may experience:

  • Depression
  • Anxiety
  • Social withdrawal
  • Mood swings
  • Distrust in others
  • Increased stubbornness
  • Irritability and aggressiveness
  • Changes in sleeping habits
  • Wandering

 If you or someone you know has suffered traumatic brain injury, contact the Titolo Law Office today.

A Great Alzheimer's Post

 Cate Newton sent this great post. http://www.medical-assistant.net/alzheimers-resources concerning Alzheimer's.  She asked that I share it with my readers.  Here is part of it.

 

Quick Facts

  • The human brain changes over time, but the abnormal occurrence of plaques and tangles is a sign of dementia-related disorders. While scientists do not know the exact connection between these abnormalities and Alzheimer’s, they do understand that nerve cells are being blocked, causing memory loss and other cognitive disabilities (Alzheimer’s Association).
  • Alzheimer’s usually affects older victims, especially those over 60. The disease slowly progresses, affecting thought, memory, and language in subtle then more apparent ways (Medline Plus).
  • More than 5 million Americans are currently affected by Alzheimer’s and are expected to reach 15 million by 2050. These numbers reach greater proportions internationally, with a current 26 million affected by the disease and a 106 million predicted by 2050 (Alzheimer’s Disease Research).
  • Women are more likely to develop Alzheimer’s than men because women tend to have longer life expectancies and hence are more vulnerable to aging-related diseases (Women’s HealthCare Forum).
  • Genetics is only one of the factors that contributes to Alzheimer’s. While researchers do not know what exactly causes Alzheimer’s, there has been scientific evidence linking four chromosomes to the disease: 1, 14, 18, and 21 (WebMD).

 

Dementia Made Worse by Smoking & Fish Oil Not Helping

Las Vegas Human Brain Injury Blog

We normally attribute smoking to lung cancer. A Recent Study now links smoking to later life dementia. My mother smoked more than a pack a day and finally succumbed to the disease. Her cancer originated in the lungs and metastasized to her brain. The 6 month ordeal was absolutely heartbreaking. And she quit smoking after getting the diagnosis which was obviously too late. She was my personal longitudinal study subject of the consequences of smoking. And she thought she was so clever with her moth balls to hide the odor and pretend she was not smoking. And I remember during the year prior to her diagnosis how her apartment, food she prepared, clothes she washed, and just about everything else smelled like moth balls. A far cry from theEast Coast Long Island Italian aromas of holiday cooking I cherished from my childhood.

Beginning January 1, 2011, the 79 million-member baby boom generation will begin - at a rate of 10,000 per day - reaching the age of 65. Growing older, while not the cause of Alzheimer's, is the single most significant factor in gauging a person's risk of the disease. The Alzheimer's Association estimates that the number of Americans with this devastating disease will balloon from just over 5 million today to 7.7 million by the year 2030 and could reach nearly 16 million by the middle of the century.

And now we have increased risk of dementia due to smoking.

“We found a two-fold increase in risk [of dementia] among those who smoked two packs per day, a 44 percent increase in those who smoked one to two packs, and 37 percent increase in those smoking one-half a pack per day in mid-life,” Dr. Whitmer told Neurology Today. I wonder if my mother began having dementia that ended up being masked by the cancer. She was forgetting things more.

The study, published in the October 2010 issue of Archives of Internal Medicine, sought to discover whether smoking, a know risk factor for several life-threatening diseases, had long-term association with dementia. This link is previously controversial. The study compiled data over many years. The results revealed a 100% increase in dementia. This does not leave a lot of room to think heavy smokers are immune from related dementia.

So what can you do besides not start or quit smoking? Take more Fish Oil? Not so fast.

Fish oil is oil derived from the tissues of oily fish. Fish oils contain the omega-3 fatty acids eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), precursors to eicosanoids that

are known to reduce inflammation throughout the body, Studies published in 2004 and 2009 have suggested that fish oil may reduce the risk of depression and suicide. One such study reported that patients who were given the omega-3 fatty acid docosahexaenoic acid fared no better cognitively or functionally than those who took a placebo over 18 months. and are thought to have many health benefits.

So now you know. To decrease the risk factor for dementiaDO NOT SMOKE. If you think you’re decreasing the risk factor by taking Fish Oil, you may not be. As for me, I continue to not smoke and continue taking Fish Oil.

Research and Hope for Alzheimer's Patients

New research supported in part by grants from the National Institute of Aging, part of the federal government's National Institutes of Health, and the U.S. Department of Defense, brings hope to the understanding and treatment of Alzheimer's Disease.

Reported in the Sept. 2 issue of the journal Nature,  the problem in Alzheimer's disease,  is beta-amyloid, a protein that accumulates in the brain and causes nerve cells to weaken and die.

Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear after age 60.

Alzheimer’s disease is the most common cause of dementia among older people. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—to such an extent that it interferes with a person’s daily life and activities. Estimates vary, but experts suggest that as many as 5.1 million Americans may have Alzheimer’s.

Drugs designed to eliminate plaques made of beta-amyloid have a fatal problem: they need to enter the brain and remove the plaques without attacking healthy brain cells.  Scientists have learned an enormous amount about how beta-amyloid plaques are formed and the toxic effects that these structures as well as the earlier forms of beta-amyloid have on neurons and synapses. These findings have opened up new avenues of investigation and new possibilities for therapeutic targets. New research from the laboratory of Nobel Prize winner Paul Greengard, however, suggests that treatments modeled on the blockbuster cancer drug Gleevec could be the solution. 

Gleevec has the unique ability to bind to a protein that triggers the production of beta-amyloid plaques. The new research from Greengard's lab shows that this protein, called gamma-secretase activating protein (GSAP), dramatically and selectively increases the production of beta-amyloid peptide, which makes up the senile plaques found in the brains of most people with Alzheimer's. 

We are still far from shouting "success" and "cure" but we are inching closer.  Scientists are conducting studies to learn more about plaques, and other features of Alzheimer’s disease. They can now visualize plaques by imaging the brains of living individuals. They are also exploring the very earliest steps in the disease process. Findings from these studies will help them understand the causes of Alzheimer’s.

Alzheimer's? Forget Flavor, Remember Music

Worried about whether your favorite desert will taste the same in years to come?  New research out of Milan, Italy reveals a possible link between flavor and abnormal eating behavior in patients with Alzheimer's Disease.  And words put to music assist those same patients memory of the words sung as opposed to spoken.  But not so for healthy adults.

Forget Flavor?

The Journal Cortex  published "Flavour processing in semantic dementia" by Katherine E. Piwnica-Worms, Rohani Omar, Julia C. Hailstone, and Jason D. Warren, and appears in Cortex, Volume 46, Issue 6 (June 2010).

The researchers tested patients' flavour processing using jelly beans: a convenient and widely available stimulus covering a broad spectrum of flavours. The abilities of patients to discriminate and identify flavours and to assess flavour combinations according to their appropriateness and pleasantness were compared with healthy people of the same age and cultural background. Patients were able to discriminate different flavours normally and to indicate whether they found certain combinations pleasant or not, but they had difficulty identifying individual flavours or assessing the appropriateness of particular flavour combinations (for example, vanilla and pickle).

These findings provide the first evidence that the meaning of flavours, like other things in the world, becomes affected in semantic dementia: this is a truly 'pan-modal' deficiency of knowledge. The research gives clues to the brain basis for the abnormal eating behaviours and the altered valuation of foods shown by many patients with dementia. More broadly, the results offer a perspective on how the brain organises and evaluates those commonplace flavours that enrich our daily lives.

So if you ever hear an elderly person announce, after trying frog legs, "tastes like chicken," consider these findings.

Remember Music

The National Institute on Aging supports Research from Boston University School of Medicine. That research shows that patients with Alzheimer's disease (AD) are better able to remember new verbal information when it is provided in the context of music even when compared to healthy, older adults. The findings, which currently appear on-line in Neuropsychologia, offer possible applications in treating and caring for patients with AD.

Watching Grandma kick it to her genre of music explains these findings, or the other way around. So in the end, the last things I may remember are the lyrics to some old Led Zeppelin or Jethro Tull songs.  "Whole Lotta...Aqualung!"

No Alzheimer's Prevention

New Evidence that prevention will not cure Alzheimer's.  Here is some news that will turn your head around.  Just when you thought you might be doing everything right, you find out you might be wrong.  This reminds me of how much cigarette smoking is condoned Europe.  If you have ever been on an elevator in Italy or France you can not help but notice (and ingest) second hand smoke from the habitual smokers.  Now why is that?  Did Woody Allen's prediction in Sleeper come true?  Are cigarettes really good for you!?  And now the following.

An independent panel of experts meeting in the US concluded there is no evidence that you can prevent or slow down Alzheimer's, a progressive and fatal brain disease, even if you keep yourself active with exercise, social interaction, brain puzzles, or take fish oil, other supplements, or medication.  That is exactly the opposite of what we have been told.

The National Institutes of Health determined that the value of these strategies for delaying the onset and/or reducing the severity of decline or disease hasn't been demonstrated in rigorous studies.  Interestingly, the panel's assessment of the available evidence revealed that progress to understand how the onset of these conditions might be delayed or prevented is limited by inconsistent definitions of what constitutes Alzheimer's disease and cognitive decline. Other factors include incomplete understanding of the natural history of the disease and limited understanding of the aging process in general. The panel recommended that the research community and clinicians collaborate to develop, test, and uniformly adopt objective measures of baseline cognitive function and changes over time.
 

Alzheimer's Disease and Cognitive Decline, Structured Abstract. April 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/tp/alzcogtp.htm actually concludes:

The current research on the list of putative risk or protective factors is largely inadequate to confidently assess their association with AD or cognitive decline. Further research that addresses the limitations of existing studies is needed prior to be able to make recommendations on interventions.

 But the initial ramifications may make us all rethink taking up smoking!  If you have not seen it, watch Woody Allen explain it in this short video.

 

Cigarette and Alcohol Use Contribute to Alzheimer's

Most interesting news pegging the tobacco-industry.

A UCSF analysis of published studies on the relationship between Alzheimer's disease and smoking indicates that smoking cigarettes is a significant risk factor for the disease. After controlling for study design, quality of the journals, time of publication, and tobacco industry affiliation of the authors, the UCSF research team also found an association between tobacco industry affiliation and the conclusions of individual studies. Industry-affiliated studies indicated that smoking protects against the development of Alzheimer's Disease, while independent studies showed that smoking increased the risk of developing the disease.

Study findings were published online in the January issue (19:2) of the Journal of Alzheimer's Disease.  

Alcohol Use Found in Cognitive Decline

Studies of alcohol use and cognition among the elderly are rare and have mixed results. A study of drinking among the elderly in Brazil has found that heavy alcohol use is associated with more memory and cognitive problems than mild-to-moderate alcohol use, especially among women.

Results will be published in the April 2010 issue of Alcoholism: Clinical & Experimental Research .
 

 

Do Cell Phones Prevent or Contribute to Alzheimer's?

Now the million of cell phone users have good reason to keep on talking.  It baffles my mind to learn of something typically regarded as negative being cast into a positive light.  Reminds me of Woody Allen's Sleeper where future scientists discover cigarette smoking and eating fat is healthy.

An international team of researchers studying the long term effects of electromagnetic waves like those emitted by cell phones on mice were surprised to find they protected their brains against Alzheimer's and even reversed the memory damage caused by the disease.

The neuroscientists, electrical engineers, and neurologists published the study and findings in the Journal of Alzheimer's Disease

The research results are exciting.  But since they occur in mice, the ultimate human affects are still not known.  Dr. Susan Sorenson, Alzheimer's Society Head of Research, comments, 'This study could open new doors in Alzheimer's research but it also poses some interesting questions that need answers. However, dementia research is dramatically underfunded. The government currently spends eight times less on dementia research than cancer research. In order to make further scientific advances dementia needs to be given higher priority.' 

"Electromagnetic Field Treatment Protects Against and Reverses Cognitive Impairment in Alzheimer's Disease Mice."
Gary W. Arendash, Juan Sanchez-Ramos, Takashi Mori, Malgorzata Mamcarz, Xiaoyang Lin, Melissa Runfeldt, Li Want, Guixin Zhang, Vasyl Sava, Juan Tan and Chuanhai Cao.
Journal of Alzheimer's Disease, Volume 19:1 (January 2010).
 

Imaging Detects Alzheimer's

The American Medical Association (AMA) reports that PET (postron emission tomography) is able to detect the progression of Alzheimer's in patients with dementia.  Preclinical Alzheimer's disease can be detected by screening an individual's cerebrospinal fluid for biomarkers of the condition. In addition, imaging with positron emission tomography (PET) can detect deposits of the substance linked to dementia in living patients.

159 older adults (average age 71.5) who had undergone PET scans and did not have symptoms of dementia were assessed. These patients were followed for between 0.8 and 5.5 years after having the scan and underwent between two and six assessments for dementia during that timeframe.

A total of 23 participants progressed to clinically detectable dementia during follow-up, and nine were diagnosed with dementia of the Alzheimer type. These diagnoses were made by specialist clinicians who diagnosed the condition at an earlier stage than typically occurs and corroborated the diagnosis by declines in multiple cognitive domains as well as a loss of volume in certain areas of the brain.
 

If this new discovery can assist clinicians in detecting dementia and Alzheimer's symptoms earlier, treatment can be more effective.

This study provides support for the premise that preclinical Alzheimer's disease, detected by the cerebrospinal fluid signature for Alzheimer's disease predicts symptomatic Alzheimer's disease.  The study is published at Arch Neurol. 2009;66[12]:1469-1475.
 

Not Acting Your Age Can Be Healthy

Have you ever seen a 65 year old man with graying head driving with the top down in his brand new red Corvette?  Or how about the 80 year old great grandmother who thinks her jet black hair is fooling anybody?  Well these otherwise refusing-to-act-their age folks might just be on to something.

God bless my grandmother, Mary, 86 years young.  She lives with me and my family and we just got back from a Christmas Holiday cruise.  And that was her second cruise in 6 months!  We call her the energizer bunny for obvious reasons.

Therapies that can keep us younger longer might also push back the clock on Alzheimer's disease, suggests a new study of mice in the December 11th issue of the journal Cell, a Cell Press publication.

Reduction of insulin signaling is known to extend life span, but now Dillin and colleagues report that this strategy can also work to mitigate and forestall the affects of Alzheimer's disease in a mouse model.

Most cases of Alzheimer's disease (AD) exhibit sporadic onset during the seventh decade of life or later, whereas the fewer mutation-linked, familial cases typically manifest during the fifth decade. These temporal features, common to numerous neurodegenerative diseases, define aging as the major risk factor for the development of these maladies (Amaducci and Tesco, 1994).

 

Imaging and Diagnosis of Alzheimer's

A new study published in Proceedings of the National Academy of Sciences (PNAS) promises to improve diagnosis and monitoring of Alzheimer's disease.  Scientists at the University of California, San Diego have developed a fast and accurate method for quantifying subtle, sub-regional brain volume loss using magnetic resonance imaging (MRI). 

The general pattern of brain atrophy resulting from Alzheimer's disease has long been known through autopsy studies, but exploiting this knowledge toward accurate diagnosis and monitoring of the disease has only recently been made possible by improvements in computational algorithms that automate identification of brain structures with MRI. The new methods described in the study provide rapid identification of brain sub-regions combined with measures of change in these regions across time. The methods require at least two brain scans to be performed on the same MRI scanner over a period of several months. The new research shows that changes in the brain's memory regions, in particular a region of the temporal lobe called the entorhinal cortex, offer sensitive measures of the early stages of the disease.
 

New Treatment for Alzheimer's and Parkinson's

Researchers in the USA have discovered a potential new function for anti-epileptic drugs in treating neurodegenerative disorders such as Alzheimer's and Parkinson's disease. The study, published in BioMed Central's open access journal Molecular Neurodegeneration, found that neurons in the brain were protected after treatment with T-type calcium-channel blockers, which are commonly used to treat epilepsy.

Read more here.

Alzheimer's Cognitive Declines Before Memory

A new study from a center for Alzheimer's research in the US suggests that cognitive skills other than memory, for example visuospatial skills that help us work out how objects relate to each other in three dimensions as we look at them, start to decline years before patients receive a clinical diagnosis for Alzheimer's.
 

In an article found at "Longitudinal Study of the Transition From Healthy Aging to Alzheimer Disease."
David K. Johnson; Martha Storandt; John C. Morris; James E. Galvin.
Arch Neurol, Oct 2009; 66: 1254 - 1259, conclusions were that pre-diagnosis events occur that currently do not fit into criteria for Alheimer's diagnosis.  Therefore what was formerly thought to be normal aging may actually be signs of Alzheimer's disease. 
 

The studies were funded by grants from the National Institute of Health.

What is Alzheimer's?

The incidence of Alzheimer's is known to affect adult brains in later years.  But did you know the incidence also increases after and as a result of traumatic brain injury?

Alzheimer's disease is the most common form of dementia. The disease gets worse as it develops - it is a progressive disease. There is no current cure for Alzheimer's, although there are ways of slowing down its advance and helping patients with some of the symptoms. Alzheimer's is also a terminal disease - it is incurable and causes death.

According the National Institute on Aging, there are estimated to be between 2.4 million and 4.5 million Americans who have Alzheimer's. There are approximately 417,000 people in the UK with Alzheimer's, according to the Alzheimer's Society.

Alzheimer's disease is a progressive neurologic disease of the brain leading to the irreversible loss of neurons and the loss of intellectual abilities, including memory and reasoning, which become severe enough to impede social or occupational functioning.

An excellent look at the history, causes and diagnosis of Alzheimer's can be found by clicking here.

Response to Alzheimer's Article

My collegue and friend David Kracke writes from Oregon:

Tim;

Thanks for sharing this informative and important study. I have always suspected this relationship between TBI and symptoms consistant with Alzheimer's Disease. Having a study to confirm it helps significantly.

FYI: Check out an opinion piece I wrote that ran last month in the Oregonian: http://www.oregonlive.com/opinion/index.ssf/2009/06/maxs_law_one_tragedy_that_need.html

Thanks, Tim. Keep up the good work.

David Kracke
Attorney,
Portland, Oregon
503-224-3018

 

Thanks David.  Same to you and hopefully I can visit Portland soon.  I'll call you when I do.

Tim