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Patients with gout were found to have a lower risk of Alzheimer’s disease
Uric acid, an excess of which causes gout, is thought to play a role in the protection against Alzheimer’s.
A large scale study, published in the Annals of the Rheumatic Diseases, found an interesting benefit of gout —a form of arthritis that is caused by a build-up of uric acid often found in certain meats, seafood, alcohol, and sweetened beverages — in the form of a reduced risk for Alzheimer’s disease.
The five-year study compared 59,204 British men and women who suffered from gout with 238,805 subjects who did not, the sum of whom had an average age of 65. In subjects with gout, 309 people also had Alzheimers; in subjects without, 1,942 subjects were affected by Alzheimer’s.
In patients with gout, researchers found a 24 percent lower risk of Alzheimer’s. Although the data is only a preliminary indicator of the relationship between these two conditions, the paper’s senior author, Dr. Hyon K. Choi, a professor of medicine at Harvard, suggests that uric acid is the key.
“This is a dilemma, because uric acid is thought to be bad, associated with heart disease and stroke,” Dr. Choi told the New York Times. “This is the first piece of data suggesting that uric acid isn’t all bad. Maybe there is some benefit. It has to be confirmed in randomized trials, but that’s the interesting twist in this story.”
Each human cell contains the instructions a cell needs to do its job. These instructions are made up of DNA (deoxyribonucleic acid), which is packed tightly into structures called chromosomes. Each chromosome has thousands of segments called genes.
Genes are passed down from a person's biological parents. They carry information that defines traits such as eye color and height. Genes also play a role in keeping the body's cells healthy.
Problems with genes—even small changes to a gene—can cause diseases like Alzheimer's.
Researchers Find Reduced Risk for Alzheimer’s Disease in Patients with Gout - Recipes
Gout is a common form of inflammatory arthritis that is very painful. It usually affects one joint at a time (often the big toe joint). There are times when symptoms get worse, known as flares, and times when there are no symptoms, known as remission. Repeated bouts of gout can lead to gouty arthritis, a worsening form of arthritis.
There is no cure for gout, but you can effectively treat and manage the condition with medication and self-management strategies.
What are the signs and symptoms of gout?
Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remission&mdashweeks, months, or years&mdashwithout symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.
Symptoms in the affected joint(s) may include:
What causes gout?
Gout is caused by a condition known as hyperuricemia, where there is too much uric acid in the body. The body makes uric acid when it breaks down purines, which are found in your body and the foods you eat. When there is too much uric acid in the body, uric acid crystals (monosodium urate) can build up in joints, fluids, and tissues within the body. Hyperuricemia does not always cause gout, and hyperuricemia without gout symptoms does not need to be treated.
What increases your chances for gout?
The following make it more likely that you will develop hyperuricemia, which causes gout:
- Being male
- Being obese
- Having certain health conditions, including:
- Congestive heart failure
- Hypertension (high blood pressure)
- Insulin resistance
- Metabolic syndrome
- Poor kidney function
How is gout diagnosed?
A medical doctor diagnoses gout by assessing your symptoms and the results of your physical examination, X-rays, and lab tests. Gout can only be diagnosed during a flare when a joint is hot, swollen, and painful and when a lab test finds uric acid crystals in the affected joint.
Who should diagnose and treat gout?
The disease should be diagnosed and treated by a doctor or a team of doctors who specialize in care of gout patients. This is important because the signs and symptoms of gout are not specific and can look like signs and symptoms of other inflammatory diseases. Doctors who specialize in gout and other forms of arthritis are called rheumatologists. To find a provider near you, visit the database of rheumatologists external icon on the American College of Rheumatology website. Once a rheumatologist has diagnosed and effectively treated your gout, a primary care provider can usually track your condition and help you manage your gout.
How is gout treated?
Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to
- Manage the pain of a flare. Treatment for flares consists of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, steroids, and the anti-inflammatory drug colchicine.
- Prevent future flares. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, eating less purine-rich food (like red meat or organ meat), may help prevent future attacks. Changing or stopping medications associated with hyperuricemia (like diuretics) may also help.
- Prevent tophi and kidney stones from forming as a result of chronic high levels of uric acid. Tophi are hard, uric acid deposits under the skin. For people with frequent acute flares or chronic gout, doctors may recommend preventive therapy to lower uric acid levels in the blood using drugs like allopurinol, febuxostat, and pegloticase.
In addition to medical treatment, you can manage your gout with self-management strategies. Self-management is what you do day to day to manage your condition and stay healthy, like making healthy lifestyle choices. The self-management strategies described below are proven to reduce pain and disability, so you can pursue the activities important to you.
How can I manage my gout and improve my quality of life?
Gout affects many aspects of daily living, including work and leisure activities. Fortunately, there are many low-cost self-management strategies that are proven to improve the quality of life of people with gout.
- Eat a healthy diet. Avoid foods that may trigger a gout flare, including foods high in purines (like a diet rich in red meat, organ meat, and seafood), and limit alcohol intake (particularly beer and hard liquor).
CDC&rsquos Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms. These can help with gout as well.
Recommended Lifestyle Changes For Dementia Risk Reduction
The steps listed above for preventing mild memory loss will also help you establish a reserve against dementia. Some additional preventive measures include the following:
- Maintain a positive attitude. Studies show that a positive emotional state may help ward off cognitive decline. Social ties, involvement in church and community, and meaningful relationships all seem to be protective.
- Keep your blood pressure under control. High blood pressure is the strongest risk factor for multi-infarct dementia.
- Exercise regularly. You can slow memory loss with regular aerobic exercise.
- Keep your mind active. Combine physical and mental exercise: sing familiar songs while walking, or read the newspaper while riding a stationary exercise bike.
Nutrition & Supplements For Dementia Risk Reduction
Consider a daily low-dose aspirin. Some studies link the use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDS) with reduced risk of Alzheimer’s disease.
Try turmeric, a unique spice. Recent animal research suggests that the yellow spice turmeric, a major ingredient in American mustard and Indian curry, can reduce the risk of Alzheimer’s disease. This may help explain the unusually low incidence of Alzheimer’s in India, where people consume significant amounts of turmeric as part of the daily diet.
Concussions shown to have similarities with Alzheimer’s, study shows
It turns out that mild traumatic brain injuries and Alzheimer’s disease have similar effects on the brain.
A study from the University of Southern California was published Monday in the journal GeroScience. It indicated there are new ways to pinpoint patients who have an increased Alzheimer’s risk.
“These findings are the first to suggest that cognitive impairment following a traumatic brain injury is useful for predicting the magnitude of Alzheimer’s-like brain degradation,” study author Andrei Irimia, an assistant professor of gerontology, neuroscience and biomedical engineering at the USC Leonard Davis School of Gerontology and the USC Viterbi School of Engineering said in a press release. “The results may help health professionals to identify TBI victims who are at greater risk for Alzheimer’s disease.”
For the study, researchers analyzed MRIs of the brains of 180 participants. They included 33 patients who had a mild TBI, or concussion from a fall, 66 who had been diagnosed with Alzheimer’s disease and 81 healthy control participants who did not have TBI or Alzheimer’s. Researchers also developed more computer-generated models to compare dozens of different brain structures. They charted the differences and similarities between the different groups, too.
Looking at multiple areas of the brain, researchers found reduced cortical thickness — an area that is roughly associated with the age of a brain, and thinning is usually linked to memory loss and other deficits — when compared to the healthy controls. MRIs also showed similarities in brains with TBI and Alzheimer’s disease. Gray matter showed the most similarities in areas involved in decision-making and memory. The white matter showed comparable deterioration patterns in structures responsible for limb movement, memory function and exchanging information between brain hemispheres.
“Using machine learning, we find that the severity of (Alzheimer’s disease)-like brain changes observed during the chronic stage of (minor traumatic brain injuries) can be accurately prognosticated based on acute assessments of post-traumatic mild cognitive impairment,” researchers wrote. “These findings suggest that acute post-traumatic cognitive impairment predicts the magnitude of (Alzheimer’s disease)-like brain atrophy, which is itself associated with (Alzheimer’s disease) risk.”
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No, there is no evidence for a link between video games and Alzheimer’s disease
Here we go again. In a study published in the Proceedings of the Royal Society B, a team of Canadian researchers compared the way a group of regular gamers learn and pay attention to a group of non-gamers. Not surprisingly they found that the gamers behave differently. They also used a technique called electroencephalography to show that a brain wave called the N2PC is different in gamers, which fits with their behavioural results.
So far this is all pretty sensible, so where is the link to Alzheimer’s disease? In fact, the researchers didn’t look at dementia or perform any clinical tests. But they nevertheless embark on a series of logical leaps, which go like this:
1. The type of learning shown by the gamers has been associated in previous studies with increased use of a brain region called the caudate nucleus
2. Increased use of the caudate nucleus can be associated with reduced volume of the hippocampus
3. Reduced volume of the hippocampus can be associated with increased risk of Alzheimer’s disease
4. Therefore (take a deep breath) video gaming could increase risk of Alzheimer’s disease
As usual, the news headlines conflate this conjecture with fact. “Call of Duty increases risk of Alzheimer’s disease”, said the Telegraph. “Video game link to psychiatric disorders suggested by study”, reported the Guardian. The Daily Mail posed the problem as a question, “Could video games increase your risk of Alzheimer’s?”, reminding us that whenever a news headline asks a question, the answer is no.
We know that when science news is hyped, most of the hype is already present in the press releases issued by universities. This case is no exception - the press release was issued by the Douglas Mental Health University Institute, and unsurprisingly it focuses almost entirely on the tenuous link to Alzheimer’s disease.
The press release also includes a statement from the lead researcher that is a clear exaggeration. Dr Gregory West is quoted as saying “we also found that gamers rely on the caudate nucleus to a greater degree than non-gamers”. Actually they didn’t find this at all, because their study didn’t measure activity in the caudate nucleus. Instead it measured a type of behaviour that previous studies have associated with activity in the caudate nucleus. There is a world of difference between these two, and readers would do well to take these latest claims with a generous helping of salt.
So once again, we’re faced with a situation in which a study that tenuously claims a negative effect of playing video games is vastly overhyped, both in the press release and the subsequent media coverage. We can do better than this.
West GL, Drisdelle BL, Konishi K, Jackson J, Jolicoeur P, Bohbot VD. 2015 Habitual action video game playing is associated with caudate nucleus-dependent navigational strategies. Proc. R. Soc. B, 2014, 2952. DOI: 10.1098/rspb.2014.2952
What Are the Seven Stages of Dementia?
Dementia is a general term used for progressive mental or cognitive decline that has affected 47 million people globally by 2050, this number is expected to increase to an estimated 131 million people.
Out of the various diseases that have dementia as one of their characteristics, Alzheimer&rsquos disease is the most common. The progression of dementia (in Alzheimer&rsquos disease) has been divided into seven stages as per the &lsquoGlobal Deterioration Scale (GDS)&rsquo of primary degenerative dementia prepared by Dr. Riesberg and his team.
Stage 1 (No cognitive decline)
The imaging techniques such as computed tomography (CT) scan of the brain might show some changes but the patient does not exhibit any of the cognitive signs and symptoms.
Stage 2 (Very mild cognitive decline)
- The patient starts forgetting words or misplacing objects this may go unnoticed by people around them.
- It should be remembered that this stage might also occur due to the normal aging process.
Stage 3 (Mild cognitive decline)
- The patient suffers from short-term memory loss&mdashforgetting what they just read and the names of new acquaintances.
- They can&rsquot make plans or organize things as earlier.
- They might frequently start misplacing and losing things.
Stage 4 (Moderate cognitive decline)
- The patient starts to lose interest in the things that they used to enjoy and avoids meeting people and, attending social events.
- Calculating simple expenses and adding up the financial bills becomes difficult.
- They become disoriented to time and place&mdashthey forget or figure out the present time, date and place
- The signs and symptoms of cognitive decline become clear to everyone around the patient.
- Clinical diagnosis of dementia is most likely to be made at this stage.
Stage 5 (Moderately severe cognitive decline)
- The patient experiences major memory disturbances such as forgetting their phone number and address.
- They may forget how to bath and face trouble while choosing and wearing clothes.
Stage 6 (Severe cognitive decline):
- The patient loses his memory as much as that they fail to remember the names of closed ones and might mistake one person for another.
- They suffer from severe confusion and anxiety.
- As dementia worsens, they might need help to go to the bathroom.
Stage 7 (Very severe cognitive decline):
- This is the final stage or end-stage of dementia.
- The patient becomes completely dependent on other patients to carry even basic activities like eating, drinking, walking, and sitting.
- There is loss of bladder and bowel control.
- Their ability to communicate is hampered drastically as they speak too little struggling with words.
It should be noted that the speed of progression through the stages of Alzheimer&rsquos disease differs amongst patients. Not all patients will experience the same changes at each stage and the cognitive decline that occurs may overlap stages.
How is dementia treated?
Treatment of dementia depends on its cause. For example, dementia that has developed due to vitamin deficiency can be treated with vitamin supplements and hence is reversible. Other causes of dementia such as depression, thyroid problems can also be treated.
For progressive dementias, including Alzheimer's disease, no treatment can halt its progression, and research is still going on to find out the same. But, some medications may temporarily help relieve its symptoms such as memory loss and confusion. These are:
Patients should ask their doctor about which medicine can be used at the stage of dementia they are currently in.
Some of the non-drug approaches can be adopted by the patient&rsquos family, friends, or caregivers. This helps improve the quality of life of patients with dementia. Some of the non-drug therapies include:
- Monitoring the patient&rsquos comfort
- Being gentle in arguing or explaining certain facts
- Learning how to cope with the patient&rsquos agitation
- Diverting the patient&rsquos attention
- Creating a calm atmosphere
- Creating a safe and secure environment (such as Install safety switches throughout the home)
- Helping the patient join a dementia support group
Can dementia be prevented?
Some risk factors such as genes and age cannot be avoided. Research suggests that patients with dementia can follow a healthy lifestyle to reduce their risk of dementia. Suggestive healthy practices include:
- Following a healthy diet
- Avoiding smoking
- Being physically active
- Doing mental activities (such as playing chess, solving crosswords) that stimulate cognitive abilities
Drink Wine To Beat Dementia Risk, But Find The Balance Study Reports
For over thirty years research has been done and much debate has carried on about the benefits or risks associated with drinking alcohol and wine in particular. After an analysis of research since 1977, it has been determined that drinking moderate amounts of alcohol, especially wine, may lower the risk of dementia which often leads to severe Alzheimer&rsquos Disease. Too much increases the risk so balance is necessary.
As a matter of fact, the association between moderate drinking and reduced risk of dementia and cognitive impairment was statistically significant in 14 of 19 countries, including the United States.
Resveratrol, found in wine at fairly high levels, is a naturally occurring antioxidant too that decreases the stickiness of blood platelets and helps blood vessels remain open and flexible. It is also known that it inhibits the enzymes that can stimulate cancer cell growth and suppress immune response.
Wine is the primary dietary source of resveratrol, and red wine contains much greater amounts of resveratrol than does white wine, since resveratrol is concentrated in the grape skin and the manufacturing process of red wine includes prolonged contact with grape skins.
Edward J. Neafsey, a professor in the department of molecular pharmacology and therapeutics at Loyola University Medical Center said:
&ldquoWe don&rsquot recommend that nondrinkers start drinking. But moderate drinking, if it is truly moderate, can be beneficial.&rdquo
Moderate drinkers were 23% less likely to develop dementia, Alzheimer&rsquos disease and other forms of cognitive impairment, but don&rsquot get it twisted or see this fact as a reprieve to drink heavily. More than three to five drinks per day was associated with a higher risk of dementia and cognitive impairment.
Dr. Sam Gandy, chair in Alzheimer&rsquos disease Research and professor of neurology at the Mount Sinai Alzheimer&rsquos Disease Research Center, Mount Sinai School of Medicine in New York City continues:
&ldquoThis study was well-designed and well-executed but falls in the category of epidemiology [population wide, observational studies]. There are at least a dozen reports such as this, touting the beneficial neurological effects of alcohol. Each report brings calls and visits from patients, interested in what advice they can take away and apply to their own lives. Until there are some randomized clinical trial data, no patient guidance is warranted.&rdquo
It is true however that it isn&rsquot clear why moderate drinking may reduce the risk of dementia and cognitive impairment, but one school of thought suggests that alcohol might improve blood flow in the brain and thus brain metabolism which keeps the brain sharp. Learning multiple languages has the same effect.
Dr. James Galvin, director of the Pearl Barlow Center for Memory Evaluation and Treatment at NYU Langone Medical Center in New York City points out many things one can do to stave off the onset of dementia:
&ldquoThe Mediterranean diet with whole grains, fresh fruit and vegetables, olive oil and moderate red wine also reduces the risk of dementia, as does exercise, social engagement, mental activities and an optimistic outlook on life. It is clear that heart healthy behaviors are also brain healthy behaviors.&rdquo
Researchers Find Reduced Risk for Alzheimer’s Disease in Patients with Gout - Recipes
Gout is a health problem that causes inflamed, painful joints. The symptoms are caused by deposits of urate crystals at the joints. Gout used to be associated with kings who overindulged in rich food and wine. In truth, anyone can get gout. Gout affects more men than women. It is often linked with obesity, high blood pressure, high levels of lipids in the blood (hyperlipidemia), and diabetes.
This condition is a form of inflammatory arthritis that results in painful attacks in the joints. It can cause swelling and redness, and in some cases, it can lead to lumpy deposits that can be seen under the skin. It can also lead to the development of kidney stones.
Researchers Find Reduced Risk for Alzheimer’s Disease in Patients with Gout - Recipes
Learn about the possible links between rheumatoid arthritis and cognitive effects and how to manage them.
By Linda Rath
A lot of people with rheumatoid arthritis (RA) report having trouble with memory, attention, and mental focus. They forget names and appointments, struggle to find the right words and have trouble making and carrying out plans. Some say that the loss of mental clarity, commonly called brain fog, is almost as distressing as arthritis itself.
It&rsquos hard to say exactly how common fuzzy think­ing is in RA because researchers have largely ignored it.
&ldquoWe have relatively good literature on cognitive problems in lupus and fibromyalgia, where brain fog is well established, but nobody has really studied RA,&rdquo explains Patti Katz, PhD, a professor of medi­cine at the University of California, San Francisco.
Katz and her colleagues looked at 15 studies on RA and cognition published between 1994 and 2016. Many were small &ndash less than 100 patients &ndash and not all were high quality. Yet most showed that people with rheumatoid arthritis performed more poorly on cognitive tests than their peers or controls. Memory, verbal communica­tion, attention, concentration and problem-solving seemed to cause the most trouble.
Who Gets It and Why?
There are several theories why cognitive prob­lems may be more common in RA and other inflammatory types of arthritis.
Some scientists, including Mark Swain, MD, a professor at the University of Calgary in Canada, think inflammation tops the list. More than a decade ago, he and his colleagues demonstrated that chronic inflammation in the body &ndash the result of cytokines like tumor necrosis factor (TNF) &ndash can change the way the brain functions. The brain doesn&rsquot change structurally, but networks of nerves start talking to each other differently. This can contribute to many disease-associated symptoms, including brain fog.
Swedish researchers reached the same conclusion after fol­lowing nearly 1,500 patients with various joint disorders for two decades. They found a significantly higher rate of cognitive decline in those with RA and suggested that chronic inflammation &ldquoplayed an important role in increasing the risk.&rdquo
But Katz thinks it might not be that simple.
&ldquoRA is a disease that has a lot of elements, and we need to think about all of them because people are really complicated,&rdquo she says.
Some factors that may contribute to brain fog include:
&bull Pain. It&rsquos well known that chronic pain can affect thinking. Some of the brain&rsquos pain processing centers overlap with areas involved with memory and attention. When they compete for limited processing resources, pain often wins out. Pain may also rewire how the brain works.
&bull Depression. Depression is common in RA. Symptoms can include trouble with planning, decision-making, memory and mental clarity &ndash the same symptoms reported by people with brain fog. Katz says one of the challenges of studying cognitive problems is the difficulty in distinguishing them from depression. Some researchers &ndash though not Katz &ndash see brain fog as a symptom of depression, not a separate condition.
&bull Cardiovascular Disease. People with RA are more likely to have narrowed or blocked arteries in the brain &ndash the result of systemic inflammation. This can cause problems with memory, thinking and reasoning.
&bull Arthritis Meds. Methotrexate is a mainstay of RA treatment and corticosteroids are sometimes used for short-term pain relief. Both may cause cognitive problems, mood changes and confusion. A small study published in Toxicology and Applied Pharmacology in 2017 found that RA patients treated with methotrexate and other conventional disease-modifying antirheumatic drugs (DMARDs) had higher risk of developing dementia than those who took other medications. Moderate to high doses of corticosteroids can lead to cognitive problems in some people, more commonly women.
&bull Lack of Exercise. Few things have a stronger demonstrated link to brain health than exercise. Thousands of studies show the long-term benefits, but new research suggests exercise can have an immediate effect, too. Carson Smith, MD, and colleagues in the University of Maryland School of Public Health found that older adults&rsquo memory improved significantly after a single 30-minute exercise session. A French study found that just a 15-minute jog boosted energy and mental clarity.
What the CDC Says
In 2017, Centers for Disease Control and Prevention (CDC) researchers published a study comparing cognition in more than 6,000 people with and without arthritis. Unlike earlier, smaller studies, it found no difference in brain function between the two groups. The researchers say they had different results because they considered pain, depression, lack of exercise, age and other factors linked to both brain fog and RA. Once these were accounted for, people with RA showed no more cognitive problems than other older adults. What was associated with elements of impaired brain function were a sedentary lifestyle, depression and having a lower socioeconomic level. The implication is that RA itself doesn&rsquot cause brain fog, but factors associated with it may.
Targeting Several Risk Factors
If cognitive problems are complex, then the solution needs to be complex, too. That&rsquos the thinking behind a groundbreaking clinical trial in Finland called the FINGER study. In this two-year ran­domized controlled trial involving more than 1,200 older adults with an elevated risk of dementia, lifestyle changes including an anti-inflammatory diet, exercise and brain training cut cognitive decline by 30%. Targeting several risk factors will deliver the optimal benefits.
Here are some tips that can help you keep your brain sharp:
&bull Sleep well. Deep, restorative sleep helps to clear away the cobwebs. Develop a healthy sleep routine and stick to it. Make sure your bedroom is cool and dark, avoid late-day caffeine and turn off screens at least an hour before bed.
&bull Talk to your doctor about medications. If you take conventional DMARDs or long-term corticosteroids, discuss the pros and cons of switching to another drug. Talk about your other meds, too. Some, including anti­cholinergics (used to treat overactive bladder, COPD and other conditions) can also cause brain fog.
&bull Don&rsquot skip workouts. There&rsquos almost nothing exercise doesn&rsquot help. Pain, mobility, mood, fatigue and mental clarity all may improve in a single session, but the greatest benefits happen over time.
&bull Notice brain fog patterns. Your symptoms may be worse in the morning or when you&rsquore tired or stressed. Try to schedule tasks that require focus and attention when you&rsquore at your best.
&bull Be present. It&rsquos easy to worry about the future, espe­cially when you have a chronic illness. But concern about things that haven&rsquot happened yet take up valuable mental space. Instead, focus on the present moment, says Ashira Blazer, MD, a rheumatologist and assistant professor at NYU Langone Health in New York
Bottomline, whether having RA directly contributes to cognitive impairment or not, following a healthy lifestyle and keeping your disease under control can help keep brain fog at bay.