Be aware of Alzheimer's

I have written about various aspects of Alzheimer’s disease as well as research into new treatment possibility, and, at times, I may have sounded pessimistic because we still have so much to learn.

We have yet to develop a treatment that can stop or significantly slow the progression of dementia in Alzheimer’s patients and we still don’t understand how we can prevent it from occurring in the first place.

Because of this and also due to fear about the prognosis of this degenerative condition, many people wait too long to speak to their doctor if they suspect themselves or loved ones are experiencing the early signs of Alzheimer’s.

It is easy to think that if there is not much to be done to slow or stop the condition, what is the point of getting scared by an official diagnosis.

Although these feelings are certainly understandable, there are many benefits to early diagnosis and management of this disease.

Early diagnosis gives patients and their families some resources and support as they face an unknown future.

Not only can it be reassuring to learn more about the specific type of dementia you’re facing and what its course and difficulties can be, but there are other reasons early diagnosis is helpful.

For some people, the earlier a medication is started, the more effective it can be. Also, an early diagnosis can help the individual be more involved in decisions about future care and management of the condition.

Perhaps one of the most important reasons to speak with your doctor early if you believe you’re experiencing symptoms of dementia, is that these symptoms can be caused by illnesses other than Alzheimer’s.

Some of these conditions are treatable and a proper assessment from a doctor can help determine what the true underlying cause of symptoms may be.

Understanding what is known about your condition and accessing resources and support help to ensure a better quality of life.

Finally, individuals with dementia can advocate on behalf of themselves and others experiencing dementia and even help advance the understanding of Alzheimer’s by participating in clinical trials for potential new treatment.

Although a diagnosis of dementia can seem frightening, it is important to know that there is life even with these symptoms.

If you or a loved one think you might be experiencing early signs of dementia, speak with your doctor immediately.

At Okanagan Clinical Trials we are currently seeking volunteers for a study of an investigational treatment for Alzheimer’s disease.

Contact us for more information or to learn if you are eligible: 250 862-8141 or [email protected].

Mom's presence alters brain

Mother’s presence impacts infants’ brains

If you’ve spent any time with small children, you probably know the mystical quality of a mother’s comfort.

From earliest infancy, it is obvious the mother’s touch is unrivalled in its ability to soothe, and most toddlers seem to believe a kiss or snuggle from mom will make a scraped knee feel better.

Research in rats is finding there is more than folklore and loving feelings behind the effectiveness of a mother’s presence — and the implications could benefit pain management for human infants.

The study out of NYU Langone Medical Center found a mother’s TLC is helpful for soothing pain in infants and may also impact early brain development by altering gene activity in a part of the brain involved with emotions.

In this study, researchers analyzed which genes were active in infant rat brains when the mother was present or not – and they found several hundred genes were more or less active in rat infants experiencing pain than rats not in pain.

When mothers were present, fewer than 100 genes were similarly expressed.

This was the first study to show the short-term effects of maternal care in a distressed infant rat’s brain.

It was also designed to support earlier research by the same group into the long-term consequences of differences in how mammals are nurtured from birth.

Obviously, there is a difference between an infant rat and an infant human. Much research will still need to be done before we can say whether findings in this study can be translated to our own species.

Still, even with rats, we share more similarities than differences, and this is a good starting point.

This study did show that a mother comforting her infant does more than simply elicit a behavioural response — it actually modifies brain circuitry.

When a human infant is in pain due to medical intervention, sickness or injury, we always want to do what we can to reduce suffering. Unfortunately, opiate pain medications are often contraindicated for children because of their addictive properties.

We are left with a significant challenge as to how we can best manage pain.

If maternal presence, cuddling, scent or other cues can help, it is beneficial to learn how and why this works.

I think this research will also shed more light on the ways in which parental nurture truly does affect brain development.

This will not only be important in pain research, but likely also in mental health as we know childhood adversity or lack of nurture can have a negative, long-term impact.

Genes linked to autism

In late 2014, two studies published in the journal Nature identified many genes that appear to be linked to Autism Spectrum Disorder (ASD).

We have long known there is a strong genetic component to autism, but little was understood about exactly which genes are implicated and how they work to cause this condition.

ASD can be severely disabling and has seen a dramatic increase in recent years.

These studies out of the University of California identified 60 genes with more than 90 per cent chance of increasing the risk of ASD.

This was a significant advance in understanding as earlier studies found only 11 such genes.

Scientists from the California studies said their findings enabled a better understanding of the nature of genetic mutations associated with ASD.

Genes uncovered in these studies seemed to cluster around three sets of biological functions:

  • development of synapses important for communication between nerves;
  • the creation of genetic instructions; and DNA packaging within cells.

Each of these areas has the potential to cause traits commonly associated with autism.

Mostly, this research represents an improvement in our understanding of the biology underpinning autism. When we have a better understanding of what is taking place within the body, we are closer to having the ability to create effective treatments for it.

Many people with autism spectrum disorder have limited success with available therapies. A breakthrough could be a huge step forward.

Unlocking the genetics behind autism also provides hope for prevention.

Researchers in these studies noted that some of the genes they identified were genes that are not passed from either parent but developed within the egg or sperm before conception.

More research might help determine what environmental factors may cause those genes to mutate.

ASD affects one in every 165 children. It is a spectrum of conditions that affects brain development and function and tends to cause difficulties with communication and social interaction.

It also results in unusual patterns of behaviour, sensory perception, activities and interests.

Symptoms can range from very mild to debilitating where individuals are virtually unable to communicate.

Treatments with the most success include applied behaviour analysis and educational intervention, which have demonstrated effectiveness at improving global functioning and intellectual ability in young children with ASD.

I look forward to seeing what will come of the continued research into the genetic and biological underpinnings of this complicated set of disorders.

Prednisone side effects

If you have experienced chronic inflammation, back pain, allergies, cancer or many other conditions, it is likely you were put on steroid medication to help suppress the immune system and bring inflammation down.

Glucocorticoids such as Prednisone are some of the most commonly prescribed medicines for many such ailments.

Since they were developed in the 1950s, glucocorticoids have come into use for a wide range of conditions and situations. In the U.S., more than 44 million prescriptions are written each year for these medications.

In the U.K., a study of 400 general practices found that 8.5 per cent of patients aged 18 or older had been prescribed glucocorticoids between 1989 and 2008 and 2.3 per cent had been using the medications for three months or more.

Unfortunately, these widely used medications have been shown to have psychiatric side effects; some cause long-term symptoms.

One study of 80 consecutive patients who had just completed their first round of glucocorticoid therapy found that 52 per cent of patients developed one or more mood-related conditions. 

A quarter of patients in this study reported irritability; 12.5 per cent described euphoric hyperactivity; 11.3 per cent experienced anxiety or depression; and 3.8 per cent had a manic episode.

Six of the patients developed a major psychiatric disorder soon after initiation of glucocorticoid therapy and five of those required hospitalization for their condition.

Another study examining more than 260,000 patients taking glucocorticoids found similar increases in neuropsychiatric symptoms while taking the medications.

Most alarming, glucocorticoid treatment was associated with a sevenfold higher risk of suicide or serious suicide attempt than average.

These medications are also associated with cognitive impairments including difficulties with memory, concentration, analysis and abstraction.

Mental-health symptoms don’t only occur when the drugs are started.

Other studies have also examined neuropsychiatric effects during glucocorticoid withdrawal and have found increased incidence of depression, delirium, confusion, disorientation, mania, panic disorders and suicide attempts.

It seems women are more likely than men to develop depression during glucocorticoid treatment while men are more likely to experience mania, delirium, confusion or disorientation.

Patients between 18 and 50 have the highest risk of suicidal behaviour and those aged 18-30 have the highest risk for panic disorder.

Not surprisingly, people with a history of psychiatric conditions had increased risk of further symptoms while taking glucocorticoid medications.

All of these potential side effects are serious and should definitely be considered by doctors and patients before beginning a course of glucocorticoid treatment.

That said, these medications are sometimes the only effective treatment available for very serious illnesses.

As in any medical intervention, the doctor and patient need to weigh the risks and benefits of any treatment as well as the risks associated with not going ahead with a given treatment.

For many people, glucocorticoids can be used safely and effectively. They should, however, always be carefully monitored by a health-care professional to minimize any ill effects.

More States of Mind articles

About the Author

Paul Latimer has over 25 years experience in clinical practice, research, and administration.

After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar.

Since 1983 he has been practicing psychiatry in Kelowna, BC, where he has held many administrative positions and conducted numerous clinical trials.

He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders.

He is an avid photographer, skier and outdoorsman.

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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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