Brain Injury Law Blog : Head Injury : Coma : Personal Injury : Las Vegas Nevada Lawyer & Attorney Tim Titolo

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.

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Is it Dementia or Heart Medication?

It may be time to consider guaging your forgetfulnes by the heart medication you take.  2010 generated interesting findings. 

Scientific American  reports Cholesterol-lowering statins such as Lipitor, Crestor and Zocor are the most widely prescribed medications in the world, and they are credited with saving the lives of many heart disease patients. But recently a small number of users have voiced concerns that the drugs cause unexpected cognitive side effects, such as memory loss, fuzzy thinking and learning difficulties.

While these side effects are reported in only a small number of cases, it is important to get proper diagnosis and care: especially if you have high cholesterol.

Is your Brain Fat?

Well...yes it is. Or at least it requires fat to operate well. Cholesterol is a waxy substance that, among other things, provides structure to the body’s cell membranes. It also clogs arteries and blood vessels.

Statins

Some studies report that statins improve memory in certain people by lowering the risk of dementia. But the fact that statins may be bad for others arises because of different biochemical pathways and genetic predispositions.

Statins may prevent the body from making cholesterol-based myelin which insulates axons and speeds neuron connections.

So if you are having difficulty making decisions, remembering things or being yourself, and you are taking statins, talk to your doctor. You can likely switch medicine and see improvement. Of course if you recently hit your head you should also tell your doctor as you may be suffering signs and symptoms of brain injury.

On the other hand, non-statin heart medication has been shown to promote brain health by reducing dementia.

In January 2010, Boston University scientists, reporting in the British Medical Journal, say a class of high blood pressure drugs called angiotensin receptor blockers is associated with a striking decrease in the risk of occurrence and progression of dementia.

The researchers, using information from a U.S. Department of Health System Veterans Affairs database of more than 5 million people, examined records of more than 800,000 predominantly male patients 65 or older.

The researchers compared the patients in groups that included those using an angiotensin receptor blocker (ARB); those using an ACE inhibitor called lisinopril (Prinivil, Zestril); and those using other blood pressure/heart disease medications (excluding statins). 

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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 dementia – DO 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.

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Read this article featured in Discover about Lou Gehrig and the disease that bears his name:

That may seem a strange question, akin to asking who’s buried in Grant’s tomb. But a new study proposes that some athletes diagnosed with Lou Gehrig’s disease may in fact have a different fatal disease that is set off by concussions.

Researchers have previously investigated the link between athletes and this neurodegenerative disease, more technically known as amyotrophic lateral sclerosis (ALS). A recent study examined what seemed to be a higher than usual incidence of Lou Gehrig’s disease among soccer players, and, of course, the disease bears the name of a New York Yankee who was famously undaunted by the hard knocks of his sport. Though it’s impossible to determine now whether Lou Gehrig suffered from ALS or a different condition (Gehrig was cremated), the study’s lead author speculates that Lou Gehrig’s disease might be a misnomer:

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Exercise is a form of anti-dementia.  A May 2010 online issue in the journal Annals of Neurology, the official journal of the American Neurological Association and the Child Neurology Society, reveal results of the study by Boston University School of Medicine.

In the new study, U.S. researchers confirmed the known link between obesity and lower total brain volume and also found that abdominal fat in otherwise healthy middle aged people is associated with lower total brain volume, suggesting a greater risk of dementia and Alzheimer's later on in life.

A clinical diagnosis of dementia is made when two or more brain functions are significantly impaired. The condition shows as short term and long term memory decline, and deterioration of language, problem solving and other cognitive abilities. It can result from irreversible causes such as Alzheimer's disease, vascular dementia, and Huntington's disease, or it can result from treatable causes such as brain tumor, reaction to drugs, or metabolic problems.

According to World Health Organization (WHO) figures released in 2005, there are about 24 million people in the world living with dementia, with 4.6 million new cases coming forward every year.

So the take away here is do not forget to stay slim, eat well, excercise and stay healthy or, later,  you might forget!

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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!"

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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 .
 

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Since I recently posted on the topic linking high blood pressure to dementia, I came across my doctor's newsletter on Blood Pressure.  I reprint it here for those interested.

The leading cause of death and disability in the United States is from cardiovascular diseases, and the most common disease is high blood pressure.  High blood pressure, also known as
hypertension, usually does not have any symptoms – hence, the nickname “silent killer.”

Unfortunately, one-third of those who have high blood pressure do not realize it and are not aware of their risk for heart disease. Therefore, many people live years without treatment, possibly damaging their heart, blood vessels, and kidneys.

Lifestyle choices (e.g., weight control, tobacco use, proper nutrition, regular exercise) can help
prevent and/or control high blood pressure. The following are common questions and answers about blood pressure.

What is blood pressure?

It is the force of blood against the walls of arteries. Systolic pressure (the top number) is the force as the heart beats. Diastolic pressure (the bottom number) is the force as the heart relaxes.

A blood pressure reading of 120/80 mmHg is articulated as “120 over 80.”

What is the meaning of the numbers?

A systolic pressure of 120 or less is considered normal. Diastolic pressure of 80 or less is considered normal. Therefore, 120/80 or less is a normal blood pressure. The chart below shows normal blood pressure levels, as well as the levels of high blood pressure.

What are the dangers of high blood pressure?

High blood pressure places an additional strain on the circulatory system (i.e., heart and blood vessels).  This strain results in arteries becoming thicker, narrower, and weaker, sometimes causing an obstruction.  A completely obstructed artery often leads to heart attacks, strokes, kidney disease, and dementia.

Is low blood pressure a health problem?

The training effect of regular exercise, especially when working out rigorously, is a lower blood pressure. At times, an individual who does not exercise may experience regular low blood pressure. If symptoms do not accompany the low pressure, it usually is not serious. However, if
blood pressure suddenly drops, it may indicate an underlying problem causing inadequate blood flow to the heart, brain, and other vital organs. Symptoms may include dizziness or lightheadedness.

What are some tips to prevent/control high blood pressure?

Healthy living is at the heart of preventing and controlling high blood pressure. Are you:
 Maintaining a healthy weight?
 Engaging in regular physical activity (fi ve 30-minute sessions of aerobic exercise and two
30-minute strength training sessions per week)?
 Eating a low-fat, high-nutrient diet (fruits, vegetables, low-fat dairy foods, low sodium)?
 Limiting alcohol consumption?

References:
1. NIH – National Heart, Lung, Blood
Institute, www.nhlbi.nih.gov
2. American Heart Association,
www.heart.org
3. Blood Pressure Association (United
Kingdom), www.bpassoc.org.uk
Exceptional Doctors. Exceptional Care. Exceptional Results.
LivingWell
The Link Between Heart Health and Blood Pressure
February 2010
 

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 Another study has found that hypertension may contribute to increased risk of dementia, this time with evidence of actual brain abnormalities. I previously wrote about the link between Hypertension and Alzheimer's disease.

This is especially relevant to those who are not controlling their blood pressure. Blood pressure is not something one feels is high or low. Specific medical evaluation, blood pressure test, is necessary. 

Data from an offshoot of the Women's Health Initiative found that participants' baseline blood pressure was strongly correlated with volume of lesions in their brains' white matter, according to Lewis Kuller, MD, DrPH, of the University of Pittsburgh, and colleagues.

Along with earlier studies linking blood pressure to clinical dementia, the evidence "supports tight control of blood pressure levels, especially beginning at younger and middle age as a possible and perhaps only way to prevent dementia," Kuller and colleagues concluded online in the Journal of Clinical Hypertension.

Treating hypertension in the elderly appears to protect against dementia and cognitive decline.  Uncontrolled hypertension in older patients increases the risk of cognitive impairment. Hypertensive patients had a 70% greater risk of non-amnestic mild cognitive impairment compared with nonhypertensive patients according to Christiane Reitz, M.D., Ph.D., of Columbia University in New York. (C Reitz et al. "Hypertension and the risk of mild cognitive impairment." International Society of Vascular Behavioral and Cognitive Disorders meeting, July 11-14, San Antonio. Final program and abstract book. Abstract O-6)

For each year an individual took medication to lower blood pressure, the risk of dementia decreased by about 3%, found Rita Peila, Ph.D., an epidemiologist at the National Institute on Aging and a scientist at the Pacific Health Research Institute in Honolulu.

My question is whether a person who controls their blood pressure and hypertension with medicine can decrease their risk of dementia to that of someone without hypertension.  I predict that other risk factors would need to be accounted for but, other things being equal, can a person with controlled high blood pressure eliminate the risk of dementia?

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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).
 

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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.
 

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A new study published in the Scientific Journal Neurology reveals that women who store fat on their waist in middle age are more than twice as likely to develop dementia when they get older.

The most common symptoms of dementia are forgetfulness, impaired speech and problems with recognition and orientation. It is a condition that can affect all our mental faculties and which is more common as we get older. Around seven per cent of the population over the age of 65 and just over 20 per cent of the over-80s have severe dementia.

Dementia isn't a specific disease. Instead, it describes a group of symptoms affecting intellectual and social abilities severely enough to interfere with daily functioning. It's caused by conditions or changes in the brain. Different types of dementia exist, depending on the cause. Alzheimer's disease is the most common type.

Memory loss generally occurs in dementia, but memory loss alone doesn't mean you have dementia. Dementia indicates problems with at least two brain functions, such as memory loss along with impaired judgment or language. Dementia can make you confused and unable to remember people and names. You may also experience changes in personality and social behavior. However, some causes of dementia are treatable and even reversible.

Dementia symptoms vary depending on the cause, but common signs and symptoms include:

Memory loss
Difficulty communicating
Inability to learn or remember new information
Difficulty with planning and organizing
Difficulty with coordination and motor functions
Personality changes
Inability to reason
Inappropriate behavior
Paranoia
Agitation
Hallucinations
 

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