START therapy reduces anxiety and depression in dementia carers

A new study presented at the Alzheimer's Association International Conference 2014 shows that eight sessions of psychological therapy can help reduce anxiety and depression in people caring for a family member with dementia. The two-year trial, from researchers at UCL in London, recruited 260 family carers, with some participants enrolled in a programme called START (STrAtegies for RelaTives). The programme consisted of eight sessions of psychological therapy over two to four months, which included education about dementia, ways to find emotional support and techniques for managing difficult behaviour. After two years, the researchers found those who had been on the START programme had better scores on measures of depression and anxiety than those who were not on the programme.

Rebecca Wood, Chief Executive of Alzheimer's Research UK, the UK's leading dementia research charity, said:
"This study serves as a reminder that dementia doesn't only affect those who are diagnosed with the condition: its effects are felt far and wide, not least for individuals and families who are caring for their loved ones. Around 23 million people the UK - roughly a third of the population - have a close friend or family member with dementia, and it's these unsung heroes who take on much of the strain of the condition. It's important to find ways to support carers and protect their health, and these results suggest that the START programme can help reduce anxiety and depression for carers. Ultimately, if we are to reduce the burden dementia places on carers and society as a whole, we must deliver effective treatments capable of stopping the condition it in its tracks."

Abstract: The long term clinical effectiveness of START (STrAtegies for RelaTives), for family carers of people with dementia and the effects on cost of care by G Livingston et al is presented on Wednesday 16 July at the Alzheimer's Association International Conference 2014.

Making several lifestyle changes improves memory and thinking in older adults

Researchers in Finland have determined that making many simultaneous lifestyle changes can help to improve memory and thinking skills in older adults who are deemed 'at risk' of developing dementia.

The study, which was presented at the Alzheimer's Association International Conference 2014, was a two year randomised controlled trial involving participants aged between 60 and 77. All participants had been classed as 'at risk' of developing dementia score based on cardiovascular health and other lifestyle factors. The participants were split into two groups. The 'control' group was given health advice only, whereas the 'intervention' group had several lifestyle factors changed, including nutritional guidance, physical exercise and management of heart health. The study found that after two years, the memory and thinking skills of the intervention group were better than that of the control group. The researchers are planning on a seven year follow-up study to validate these preliminary results and measure the incidence of dementia.

Dr Laura Phipps of Alzheimer's Research UK, the UK's leading dementia research charity, said:
"While this study showed benefits of exercise on memory and thinking performance rather than focusing on whether it could prevent dementia, the results add to previous suggestions that adopting an overall healthy lifestyle is important for brain health as we get older. The findings build on previous evidence that several different lifestyle factors may be involved in our cognitive health, including exercise and heart health.

"It will be interesting to see the results of an extended version of this study and to look at the effects of these interventions on overall dementia risk within the group. It is also important for research to take into account other potential factors such as genetics in addition to age and cardiovascular health as indicators of dementia risk."

Abstract: A Multi-domain Two-Year Randomized Controlled Trial to Prevent Cognitive Impairment - the FINGER study by M Kivipelto et al is presented at AAIC2014 on Sunday 13 July.

A third 'partner in crime' in Alzheimer's disease

Amyloid and tau are the two major proteins shown to play a role in Alzheimer's disease. New research presented at the Alzheimer's Association International Conference 2014 shows that the build-up of a third protein, TDP-43, may also cause memory and thinking problems. In a study of nearly 350 post-mortem brain samples, those people with high levels of TDP-43 were 10 times more likely to have worse problems with cognition at the time of death.

Dr Simon Ridley, Head of Research at Alzheimer's Research UK, the UK's leading dementia research charity, said:
"This study adds to the growing evidence that there are other critical proteins, besides amyloid and tau that drive the damage seen in Alzheimer's. Understanding more about the biological processes underlying memory loss is critical for developing ways to find an effective treatment to stop damage to nerve cells. With no treatments available that can slow or stop Alzheimer's, there is a desperate need for more research into the disease and for this research to be translated into benefits for those affected."

Abstract: TDP-43 amplifies memory loss and hippocampal atrophy in Alzheimer's disease by K Josephs et al is presented on Wednesday 16 July at the Alzheimer's Association International Conference 2014.

New brain scan to pick up early memory loss

Work presented at the Alzheimer's Association International Conference 2014 suggests that build-up of a protein called tau in the brain, known to be a hallmark of Alzheimer's, is associated with worsening memory score tests over time in healthy individuals.

The authors of the study used PET scanning to detect the build-up of tau in areas of the brain important for memory. They scanned over 50 healthy older people who had had memory tests carried out once a year for three years. They found a greater build-up of tau in those people whose memory scores had deteriorated over time.

Dr Eric Karran, Director of Research at Alzheimer's Research UK, said:
"We have known for some time that a build-up of tau in the brain is strongly linked to worsening memory and thinking skills. This small study suggests that detecting tau using PET scanning may be useful for predicting early memory decline. Although no treatments exist yet to halt diseases like Alzheimer's, detecting early changes in the brain will allow people to enter clinical trials, testing new therapies before the disease has progressed too far. We desperately need effective treatments for the diseases that cause dementia and understanding early memory decline and being able to track damage in the brain are important steps towards that goal. "

Abstract: Tau Protein Found through PET Scans in Living Normal Older Adults Linked to Memory Decline by K Johnson et al is presented on Wednesday 16 July at the Alzheimer's Association International Conference 2014.