Antidepressants May Pose a Risk for Alzheimer's Patients
Research shows that patients newly diagnosed with Alzheimer's disease who recently began using antidepressents are at a higher risk for head injuries and traumatic brain injuries. Heidi Taipale and colleagues from the University of Eastern Finland wrote that for older people who use antidepressants, the risk for falling and having bone fractures, head injury, and brain injury increases with aging.
The researchers sought to determine if head and brain injuries in Alzheimer's patients were linked to the use of antidepressants, so they conducted a cohort research study of 10,910 patients who have recently begun using antidepressants and 21,280 Alzheimer's patients who were not using antidepressants between 2005 and 2011.
They also found that Alzheimer's patients who used antidepressants were at an increased risk of experiencing a head injury or a traumatic brain injury due to a fall. The risk of a head or brain injury was highest in patients who had just begun using antidepressants for the first 30 days, but the risk for head injuries continued well past 2 years of use of antidepressants. The researchers conducted a case-crossover analysis and determined that the risk for head injuries remained consistently linked to use of antidepressants.
The researchers commented that further studies should be conducted to confirm the association between head and brain injuries and the use of antidepressants. Because antidepressants have previously been shown to be associated with an increase in falling, the authors of the research state that clinicians should use caution when considering the use of antidepressants where it applies to the safety of patients who are vulnerable.
New approach may determine dementia risk in patients with MCI
A new study suggests that there may be a new approach for determining dementia in Alzheimer's patients as well as any other type of dementia in patients who have mild cognitive impairment.
Ingrid S. van Maurik and colleagues from the VU University Medical Center in Amsterdam stated that the identification of abnormal biomarkers found in patients who have mild cognitive impairment may help clinicians identify those who are at the greatest risk for developing a progression of Alzheimer's disease dementia. Current biomarkers for Alzheimer's disease include an atrophy on a brain MRI and cerebrospinal fluid concentrations of amyloid-1-42, as well as tau protein which have both been found to be associated with an increased risk of developing Alzheimer's disease dementia. Unfortunately, these criteria do not provide clinicians with enough information to appropriately deal with borderline or conflicting biomarker results or patient characteristics.
In order to design biomarker-based prognostic models that can determine the future development of Alzheimer's disease dementia in patients with mild cognitive impairment, researchers have evaluated and analyzed 525 patients who have mild cognitive impairment from the Amsterdam Dementia Cohort. The baseline visits of participants to a memory clinic were taken from September of 1997 to August of 2014 with an average age of 67 years old. The clinical endpoints included Alzheimer's disease, dementia, as well as any other type of dementia beyond 1 and 3 years.
The authors of the study suggest that the prognostic models used in the research may have the potential to become easily implemented in daily clinical practice. The authors further state that the models could contribute to personalized diagnostic care and more harmonious clinical practice. This research is thought to present a framework for a more precise medicine approach to determining patient risk for developing progressing Alzheimer's disease dementia. The authors also stated the future models may improve if longer-term follow-up becomes available. However, the researchers believe that the models do show how research of biomarkers could be used in clinical practice in a practical manner.
New Alzheimer's disease study makes connection to cause
Alzheimer's disease is a very frustrating, heartbreaking, and scary ordeal for any family to have to go through in life. Alzheimer's disease is just as frustrating for the researchers who try to find new ways to prevent and treat the disease. There are currently no viable therapies and an estimated 55 percent of patients don't even know they have it. The disease is extremely complex to understand and researchers still are trying to figure out what causes its onset nd the mechanism of how it operates. The most that a lot of researchers can hope for is to understand what factors play a role in Alzheimer's, and a group of researchers at the Duke Institute for Brain Sciences believe that they have found a link in the immune system.
Professor Carol Colton, a neurologist at the Duke University School of Medicine who led the study, suggests that certain immune cells that might normally protect the brain begin to abnormally consume arginine, which is an important ingredient. Colton said that they used a small-molecule drug to help block this process and prevent memory loss and brain plaques in mice.
Colton had assumed that the researchers might have been able to block and reverse the disease if the consumption of arginine was indeed important to the disease process. Research on Alzheimer's disease has often been filled with a lot of pressure due to the high number of people who are affected by it. Researchers have been trying for some time to find new direction and different approaches to deal with Alzheimer's disease and this is what prompted Colton's team to take a novel look at the disease and consider whether or not they should approach it like other diseases and inspect the role of the immune response.
Immunity plays a big role in all diseases, so it made sense to consider its role in Alzheimer's. The brains of people who have Alzheimer's disease shows the two primary hallmarks of plaques and tangles, which have puzzled researchers for some time. The plaque is a buildup of beta amyloid, a sticky protein, and the tangle is a twisted strand tau protein.
The researchers used a mouse model that had been developed several years ago with an immune system that was more similar to a human. The mouse model had developed behavioral changes and a loss of neurons that allowed the researchers the opportunity to study the brain over time and analyze the onset of Alzheimer's disease. The researchers were able to see the beginning of the disease process and investigate the response of the immune system, starting at a younger age and then progressing to an older age with clear characteristics of the disease.
The researchers refer to the immune system as either a warrior or a nurturer and say that the nurturer phase was turned on during the early stage of the mouse model's disease. The nurturer phase contains a large amount of toxicity which causes nutrient deprivation. Researchers believe that the immune system pulls away nutrients from diseased cells, causing damage to the cells.
The researchers also believe that certain medications and procedures using safety toxicity may be able to be used as a potential therapy for Alzheimer's and are currently conducting research to determine its potential. The ultimate goal of these researchers is to slow the progression of the disease to prolong the quality of life for those affected. However, a lot more research is needed before a cure might be developed.
References:
Taipale, H. (2017). Antidepressant use in Alzheimer’s disease increases risk for head injury, TBI. [Web]. In Healio. Retrieved from: https://www.healio.com/psychiatry/alzheimers-disease-dementia/news/online/%7Bb68ffc55-1953-4d47-85b7-317da572f5eb%7D/antidepressant-use-in-alzheimers-disease-increases-risk-for-head-injury-tbi
van Maurik, I. (2017). New approach may determine dementia risk in patients with MCI. [Web]. In Healio. Retrieved from: https://www.healio.com/psychiatry/alzheimers-disease-dementia/news/online/%7Ba4efd15c-38cc-4192-a468-91a54db59e06%7D/new-approach-may-determine-dementia-risk-in-patients-with-mci?page=2
Wargo, B. (2015). New Alzheimer Disease Study Makes Connection To Cause. [Web]. In Huffington Post. Retrieved from: https://www.huffingtonpost.com/buck-wargo/new-alzheimer-disease-study-makes-connection-to-cause_b_7535446.html
