ED drug Cialis to be used in Dementia trials

British pensioners will be given erectile dysfunction drug Cialis for the world’s first clinical trial of its kind to see if the drug can be used in the fight against dementia.

Tadalafil – Cialis’ active ingredient – belongs to the same class of medications (PDE5 inhibitors) as Pfizer’s Viagra, and works by dilating blood vessels in the penis so blood can flow there more easily.
Because of its benefits to blood flow, scientists were curious if tadalafil could help to avert the development of a common form of dementia (vascular dementia) by again increasing blood flow, but this time to the brain.

The Alzheimer’s Society and the Alzheimer’s Drug Discovery Foundation (ADDF) in New York are jointly funding the £328,000 cross-Atlantic research partnership.

Scientists led by Dr Atticus Hainsworth at St George’s, University of London, will assess 50 people aged over 65 in the UK that have experienced mild symptoms of dementia – such as memory loss – or have shown signs of blood vessel damage, following a stroke.

Dr Hainsworth commented: “My colleagues and I are very enthusiastic about this trans-Atlantic initiative as there are too few drugs in the medicine cupboard for dementia. We want to know whether a well-known, well-tolerated drug can be used to combat dementia, which has been called the twenty first century plague. The drug Tadalafil is widely used to increase blood flow in penile tissue. Now we’re asking whether it can do the same for another vital organ – the brain.”

Vascular dementia is the second most common type of dementia and an estimated 110,000 cases of dementia in the UK are this form of the disease. It is usually caused due to damage of the small blood vessels of the brain, leading to less blood being transported to the brain tissue as the artery walls are too thick and stiff.

This type of damage is also referred to as ‘small vessel disease’ and is evident in around 50-70% of older people because the damage usually develops and worsens over many years.

However, the researchers involved in the new clinical trials are optimistic that tadalafil’s blood-flow boosting properties will hopefully be able to stop the damage that causes vascular dementia.

The researchers will monitor the participants’ blood flow to the brain prior to and following a dose of tadalafil, using a special type of MRI called arterial spin labelling.

This involves the use of radiowaves to magnetise water within the blood and then monitor it as it travels to the brain, which will help the researchers to see the amount of blood that is getting to different areas of brain tissue.

The low dose of tadalafil will occasionally be switched for a placebo so the scientists can contrast the blood flow with and without tadalafil.

Patients already with dementia will be unable to be involved in the trials as those pioneering the research say they want to see if tadalafil may be able to actually prevent the onset of the disease.

Dr Doug Brown, Director of Research and Development at Alzheimer’s Society, said: “Drug development can take decades and sadly, the path towards developing dementia treatments over the past decade is littered with drugs that have failed in clinical trials. As we learn more about the causes of dementia and its links to other conditions, there is hope that treatments we routinely use for other diseases may also work for people with dementia.

“These incredibly exciting studies could see existing treatments turned into drugs for the most common forms of dementia in a fraction of the time and at a fraction of the cost of developing new drugs from scratch. By next year 850,000 people in the UK will have dementia and we owe it to them to do everything we can to develop better treatments and ultimately find a cure. Research like this is a huge part of that goal.”

Smokers warned they are 45% more at risk of dementia

It isn’t the first time the two have been linked together, but more research has shown a clear association between smoking and the onset of dementia.

Despite the fact anybody can develop the debilitating disease, research released by the World Health Organization (WHO) working together with Alzheimer’s disease International (ADI) has highlighted a link between smoking and dementia risk.

The report warns that smokers are putting themselves at a staggering 45% increased risk of developing dementia compared to non-smokers, and the more someone smokes, the higher the risk goes.

The experts involved in the report believe 14% of all cases of Alzheimer’s cases around the globe are because of smoking and WHO state that even those exposed to second-hand smoke (known as passive smoking) can still have an increased risk of developing dementia.

Shekhar Saxena, director of the Department for Mental Health and Substance Abuse at the WHO, said: “Since there is currently no cure for dementia, public health interventions need to focus on prevention by changing modifiable risk factors like smoking.

“This research shows that a decrease in smoking now is likely to result in a substantial decrease in the burden of dementia in the years to come.”

Serge Gauthier, chair of Alzheimer’s Disease International’s medical scientific advisory panel, added: “The research also shows that quitting smoking later in life might be beneficial so encouraging and supporting current tobacco users to quit should be a priority.”

Doug Brown, director of research and development at the Alzheimer’s Society, said: “This shocking estimate that so many cases of Alzheimer’s may be linked to smoking surely means we must count the global burden of the condition alongside the millions of deaths we already know are caused by tobacco.

“With 44 million people worldwide living with dementia, it is now time to rank the condition alongside others like cancer and heart disease when we talk about tackling smoking.

“With no cure yet for dementia, we need more research to gain a better understanding about how lifestyle factors can increase risk and a significant public health effort to attempt to reduce the number of future cases of the condition.”

Dementia is a term used for a group of symptoms that are the result of one of a number of brain diseases, with Alzheimer’s being the most common by far. When somebody develops dementia, it is not only tragic for the affected person, but for all friends and family of that person.

The condition impairs a person’s ability to think, rationalise things and remember. Memory loss is often viewed as the obvious sign of dementia, but there are other signs to look for such as: changes in personality and mood, speech and language difficulty, delusions or hallucinations, wandering or restlessness, depression or anxiety, agitation and balance problems.

The Alzheimer’s Society say there are about 800,000 people in the UK that have dementia. A third of the over-65s will develop dementia, with two thirds of sufferers being women.

As people are now generally living a lot longer, the numbers will only increase. By 2021, there could be as many as 1 million people living in the UK with dementia.

However, people can act now to help lower the risk of developing the disease, such as: engaging in regular exercise, maintaining a healthy body weight, stopping smoking, sticking to a healthy diet and limiting alcohol intake.

The five healthy lifestyle rules that could prevent dementia

By adhering to five healthy, positive lifestyle choices, a person stands to slash their risk of developing dementia by around two thirds, according to the findings of a new Welsh study.

Lead author Professor Peter Elwood, from Cardiff University’s School of Medicine, said healthy aspects of life are “far more beneficial effect than any medical treatment or preventive procedure”.

“The size of reduction in the instance of disease owing to these simple healthy steps has really amazed us and is of enormous importance in an ageing population,” he said.

“What the research shows is that following a healthy lifestyle confers surprisingly large benefits to health – healthy behaviours have a far more beneficial effect than any medical treatment or preventive procedure.”

Professor Elwood said that it was apparent that “very few people” had a healthy enough lifestyle that would be sufficient in avoiding the onset of dementia.

“Taking up and following a healthy lifestyle is however the responsibility of the individual him or herself,” he said.

“Sadly, the evidence from this study shows that very few people follow a fully healthy lifestyle. Furthermore, our findings reveal that while the number of people who smoke has gone down since the study started, the number of people leading a fully healthy lifestyle has not changed.”

The five key aspects of staving off a disease that has afflicted 800,000 people in the UK are as follows: engaging in regular exercise, maintaining a healthy body weight, not smoking, sticking to a healthy diet and minimising alcohol intake.

Making sure to stick to at least four of the five healthy lifestyle habits may reduce the risk of dementia and cognitive decline by a staggering 60%, the researchers from Cardiff University found.
The benefits of following four of the habits doesn’t stop there though, this could also help to reduce new cases of diabetes, heart disease and stroke by 70%. This would be compared to those who followed none of the lifestyle habits.

The researchers, beginning in 1979, tracked 2,235 men from Caerphilly who were aged between 25 and 49, for a 35-year period. Behavioural patterns were recorded, with regards to the participants’ health, firstly looking at the possible causes of heart disease as this disease was rife in the area.
However, as time passed through the cohort study, focus was shifted to analysing the devastating effects of dementia and strokes.

It was determined that if half of the men involved in the study had be pressed into even adopting just one of the healthy lifestyle habits in 1979, this could have resulted in a 13% drop in dementia cases, in addition to 12% less diabetes diagnoses, 6% fewer cases of vascular disease and the number of fatalities may have even been 5% less.

The findings were published in advance of today’s crucial meeting of health ministers from the G8 nations, which will aim to find new, more efficient ways of tackling the disease worldwide.

David Cameron has already state that by 2025 the UK will double its annual funding for dementia research to £132 million, a significant increase from the 2015 target of £66 milliom. The prime minister’s announcement will be welcomed by many with estimates showing that the global number of dementia sufferers could treble to 135 million by 2050.

Moreover, the Care Quality Commission (CQC) recently unveiled their plan to conduct random, unannounced inspection visits that will assess the care of dementia patients at 150 institutions across England.

Can two cups of hot chocolate per day boost your memory?

The elderly may benefit from two cups of cocoa per day, following the results of a new study published in the journal Neurology which shows that drinking two cups of hot chocolate each day gave older people a boost to their memory and thinking skills.

In the study, conducted by researchers at Harvard Medical School in Boston, 60 people with an average age of 73 were assessed; none of whom had any problems with dementia. However, 18 were experiencing impaired blood flow at the beginning of the study. This was shown through ultrasound tests.

The participants were told to drink two cups of hot cocoa on a daily basis for 30 days and to not consume any chocolate during this period. Half were given cocoa rich in flavanol and the rest were given low-flavanol cocoa.

Flavanols are a distinct group of compounds in the flavonoid family and are naturally occurring antioxidants. They can be found in red wine and tea in addition to cocoa. For many years, health experts have raved about the positive effect that cocoa flavanols can have on the body’s vascular system. Flavanols are great for healthy blood flow as they stimulate the production of nitric oxide; a naturally produced chemical in the body that dilates blood vessels.

“We're learning more about blood flow in the brain and its effect on thinking skills. As different areas of the brain need more energy to complete their tasks, they also need greater blood flow. This relationship, called neurovascular coupling, may play an important role in diseases such as Alzheimer's,” said Dr Farzaneh Sorond, the study's lead author from Brigham and Women’s Hospital in Boston.

It was found that 88% of those who had impaired blood flow at the start of the study had experienced an improvement to their blood flow by an average of 8.3%. This is in comparison to 37% of people improving in a similar manner that had a normal blood flow at the beginning of the study.

In addition, those with a normal blood flow did not improve on tests that measured their thinking skills, however the 18 people with impaired blood flow did. The latter actually managed to reduce the time they required to complete tasks; dropping from an average of 167 seconds to 116 seconds for tasks such as connecting sequential dots on pieces of paper or recognising particular characters on computer screens.

There were no major statistical differences in blood flow or in test scores between the two hot chocolate groups that would favour flavonol-rich cocoa or vice versa and the researchers believe it may only require a small amount of flavanol to prove beneficial for those with impaired blood flow. Alternatively, they acknowledge that it could be another ingredient, such as caffeine, that is causing the changes.

Before people start bulk-buying large amounts of hot chocolate, the study authors urge caution. “We're several steps removed from that recommendation. Before we recommend cocoa, it's important to go back and figure out what's in it that's doing this and make sure it's sustainable,” says Dr Sorond.
Moreover, consuming large amounts of a sugary drink will invariably lead to a risk of tooth decay and weight gain/obesity – with the latter also linked to cognitive problems in itself.

The Alzheimer's Association issued a statement yesterday criticising the study and its implications.

“This is a very small and very preliminary study, and it is not well-designed as a test of an intervention or therapy,” said Maria Carrillo, vice president of medical and scientific relations at the association. She added: “No one should start drinking cocoa with the expectation that it will provide cognitive benefits based on this study. There was no control group in this study to compare to the group that drank the cocoa.”

Contraceptive pills could avert the onset of dementia in later life

Young women who are taking the contraceptive pill could be prevented from developing memory problems and dementia in their later years claims a new U.S. study.

In particularly it is believed that the group of female hormones, oestrogen, are the key. Oestrogen is present in contraceptive pills such as Dianette, Marvelon and Yasmin and scientists say it is linked to a better memory as it stops arteries from hardening and therefore increases the supply of blood into the brain.

It has long been common knowledge that Hormone replacement therapy (HRT), (also containing oestrogen) can help stave off dementia. However, it is only now that a study has emerged that has analysed the possible benefits of contraceptive pills.

Researchers from the University of Wisconsin decided to focus their investigations on 261 women who had conducted health surveys and were aged between 40 to 65.

The women had to perform memory tests such as naming as many words as possible about a particular subject as well as naming certain objects. What intrigued researchers was the fact that a lot of the woman who had been taking a contraceptive pill came out with better results than those women who had not. In addition, a correlation was established between length of time on the pill and a higher rate of scores the women managed to attain.

Researchers say that the oestrogen could also be promoting the growth of certain cells within both the brain and spinal cord in addition to maintaining blood flow to the brain.

The study, published in the Journal of Women’s Health, was led by researcher Kelly Egan, who said: “Our analysis indicated that hormonal contraceptive use may have a protective cognitive (memory) effect, even years after use is discontinued. This is especially true in subjects with a longer duration of use.”

Their study did not go into looking at the causes and risk factors for dementia however, or how it can be treated.

Dementia is a term given to a collection of related conditions that are connected to the on-going, gradual decline of the brain and changes to its structure, Memory, thinking, speech, understanding and judgement can all be severely impacted when someone is suffering from dementia, and the sufferer will almost always require some form of help from family and friends, in particularly in relation to decision making.

There are currently 570,000 people living with dementia just in England. Over the next 30 years it is predicted that this number is going to double. The most common type of dementia is Alzheimer’s disease, where there is a progressive loss of brain cells. There is no definitive cause of Alzheimer’s but it is believed to be due to a number of things such as lifestyle factors that are contributing to vascular disease, a family history of the condition and also has been linked to severe head injuries.
Unfortunately there are no medical cures for dementia and the condition will gradually worsen over time. However, if you or a family member has been diagnosed with dementia, The NHS, social services and voluntary organisations are able to give advice and offer any necessary support to help you and your family.