Exercise Makes You Smarter

According to research, exercise makes you smarter. Formerly inactive adults were subjected to 4 months of high-intensity interval training workouts.

After the 4 months, their ability to think, remember and make quick decisions had improved noticeably.

The blood flow to the brain is increased while exercising. The fitter one is, the more the blood flow increases. The research looked at adults with an average age of 49 who were inactive and overweight. The participants went through a series of biological, physiological and cognitive tests prior to the program began so as to establish their body composition, cognitive functions, brain oxygenation while exercising, cardiovascular risk and maximal aerobic ability.

The cognitive tests involved tasks like remembering pairs of symbols and numbers. To determine what was in fact happening inside the brain, the study made use of near-infra red spectroscopy, a method which works with near-infra red range light sent though human tissue which reacts with oxygen inside the blood. It’s so sensitive that it picks up the minute changes in the oxygenation and volume of blood that take place in our brains whenever we think or exercise.

They then started a circuit weight training and exercise bike routine twice a week. After 4 months their fat mass, body mass index, weight and waist circumference were all considerably lower. At the same time, their ability to exercise was up 15%

Cognitive function, brain oxygenation and VO2max for the duration of exercise testing showed that cognitive functions had significantly improved on account of the exercise. VO2max is the optimum capacity of a person’s body to transport and make use of oxygen while exercising. It influences the body’s capability to oxygenate the brain and is associated with cognitive function.  Basically, the more they could exercise, and the more weight people lost, the sharper they became.

Although a decline in cognitive function is a typical part of aging, it’s reassuring to know that one can at least to some extent prevent that decline by losing weight and exercising.

http://www.ahealthblog.com/exercise-makes-you-smarter.html?utm_source=A+Health+Blog+Newsletter&utm_campaign=0c54130a02-MailChimp+Newsletter&utm_medium=email&utm_term=0_52b3a61d8a-0c54130a02-91443825

Health Talk - Parkinson's Disease, 18 June 2016

June 18, 2016 South Africa News

Information about the disease








https://youtu.be/EfbNToAxVdM

Parkinson's sufferer committed to psych ward for planning his death

June 18, 2016

A former high-flying marketing executive living with Parkinson’s disease has told how he was committed to a psychiatric hospital for trying to plan his own death writes Caroline O’Doherty. 

Cartan Finegan, 86, says it is time for a full debate about assisted suicide but he says the medical profession is “scared stiff” of controversy over the issue.

He urges the Government to tackle the subject and says as a first step, they should schedule Dáil debate time on the Dying With Dignity Bill.

Mr Finegan, who is currently living in a nursing home in south Co Dublin, said he had decided last year that he no longer wished to live with Parkinson’s which has robbed him of much of his mobility and speech and is doing increasing damage to his memory.

When he asked a family member abroad to help him, however, his worried relative contacted the health services, which set in train a chain of events culminating in gardaí arriving at his door and his involuntary detention in a psychiatric ward.

“I began to consider euthanasia because I had witnessed persons being kept alive when they would have preferred to die,” he said.

“Although I firmly believe in the right of an individual to have the option of ending their life, I am also aware that this option carries legal consequences.”

He said his situation highlighted the dilemma “between the person who believes there should be a right to terminate their life and the legal profession that is constrained by law to adopt a certain course, and medical professions who are scared stiff of public controversy, irrespective of what they may believe warrants attention and change”.

Mr Cartan, who worked for Bord Bainne, CIÉ and other state bodies, and was integral to the success of the internationally recognised Kerrygold brand, chronicled his experiences in My Last Hurrah! — a collection of writings he compiled last year for family and friends.

He decided to bring them to wider pubic attention following disclosures in this newspaper by Tom Curran, the partner of the late right- to-die campaigner, Marie Fleming, that he had helped her die according to her wishes and had also helped around 200 other terminally ill people prepare plans to end their lives at a time of their choosing.

This article first appeared in the Irish Examiner.

http://health.einnews.com/article/331555105/IQQzFFT-M-TDRf6_

Ask the MD: Head Trauma and Parkinson's Disease

FoxFeed BlogJune 17, 2016

Posted by  Rachel Dolhun, MD,

The possible connection between head trauma and Parkinson's is illustrated ” perhaps nowhere more prominently — by Muhammad Ali's diagnosis of young-onset Parkinson's disease (PD) following a career in boxing. Many have wondered whether repeated hits to the head caused his PD. While it's true that environmental factors — including head injury” have been associated with an increased risk of Parkinson's, few (if any) have been determined to be definitive causes of the disease. Environmental factors and genetics may interact to cause disease, and this complex interplay makes it virtually impossible to point to the exact cause(s) in any individual.

Genetics and Environmental Factors May Contribute to Parkinson's

A number of genetic mutations are associated with Parkinson's disease — some simply increase risk for the disease and others appear to be more direct causes. Many environmental factors (e.g., head trauma, pesticides and solvents) are also linked to an elevated risk of Parkinson's. Generally though, these environmental risks are designated as "associations" rather than "causes" (i.e., for some reason they contribute to an increased risk but they are not sufficient to cause PD in and of themselves).

When faced with these types of associations, researchers look to see if there are other variables or reasons — such as general trauma (to the body rather than specifically to the head or brain) — that are a truer or more important basis for the connection. They also aim to exclude "reverse causation" (i.e., undiagnosed Parkinson's disease leading to falls that cause head trauma — rather than vice versa). Genetics may play a more significant role in some cases, particularly in people who have a younger age of disease onset and/or a family history of PD. However, since family members share genes as well as environmental exposures, the latter cannot be excluded as a strong contributing factor.

Evidence Links Head Trauma and Brain Injury to Parkinson's

Research results have been somewhat inconsistent on Parkinson's and head trauma or traumatic brain injury (one that alters consciousness and leads to temporary or permanent cognitive, physical and/or emotional problems). Still, a number of studies have shown a fairly clear link between PD and head or brain trauma (typically secondary to car accidents, falls or sports-related injuries). These studies have compared the history of head trauma or brain injury between groups of people with and without Parkinson's to demonstrate the association.

In an MJFF-funded study comparing twins (only one of whom had PD), the twin who had previously sustained a head injury was more likely to be diagnosed with Parkinson's. The investigators therefore concluded that mild to moderate head injury may heighten the risk of PD. Another review of several published studies confirmed this connection and added that head trauma resulting in concussion is associated with a higher risk of developing PD. A third study reviewed the medical records of people with traumatic brain injury and individuals with trauma unrelated to the brain (e.g., bone fracture). Their results indicated that traumatic brain injury is linked to an increased risk of a subsequent diagnosis of PD and the risk was higher with more severe or recurrent injuries. 

Multiple Possibilities Exist to Explain the Connection between PD and Head or Brain Injury

Despite data suggesting that head injury might cause Parkinson's, it's still plausible that other factors could explain the association. For example, people with Parkinson's might be more prone to brain injury (as discussed above). Or, the brains of those with PD may be more susceptible to trauma and therefore incur more damage than would otherwise be expected.

Other theories proposed to explain the link between head or brain trauma and PD include:

• Trauma uncovers underlying Parkinson's disease. In other words, a person would have developed PD anyway, but the trauma acts as the proverbial "straw that broke the camel's back." It is just one of many factors (e.g., genetics, other environmental insults, etc.) that leads to PD. The relative importance of head injury toward the development of PD may be greater (or less) than other factors, but together they bring about Parkinson's.
• Injury causes destruction of dopamine-producing cells. The mechanism is either direct or indirect — such as by provoking an inflammatory process and/or causing tiny bleeds deep in the brain that eventually scar.

Research on Head Trauma and Parkinson's Is Challenging

Studying this association is difficult for many reasons:

• Determining the type and amount of an individual's exposure to a certain environmental risk typically relies on examination of medical records and/or a person's recollection to report prior events (both of which might be incorrect). Even in boxing, where hits during matches are recorded, those sustained during practice or at other times are typically unknown. Additionally, hits on helmeted boxers or hits that are partially blocked are likely different than unprotected or direct ones. 
• Characterizing the total lifetime exposure (i.e., the number and magnitude of hits to the head) may be very difficult.
• Varying definitions of what constitutes "head trauma" or a "hit" may be used in studies. 
• Aside from the above considerations, it remains nearly impossible to tell whether most people would have developed Parkinson's even without an exposure that is linked to the disease.

Still, researchers are working to uncover details about the relationship of environmental (and genetic) factors and Parkinson's. As they do so, they learn more about potential mechanisms that damage or destroy dopamine-producing cells. This work, some of which MJFF has funded (e.g., both pre-clinical and clinical studies on inflammation and Parkinson's), points toward new therapies that can be tested for PD. A good example of how environmental associations can inform therapeutic development comes through the NIC-PD trial. In looking at large populations of people, researchers noticed that cigarette smoking was associated with a lower risk of Parkinson's. Delving deeper, they postulated that nicotine (rather than other ingredients in smoke or tobacco) might be a protective factor. This led to the current study which is evaluating that idea — that nicotine (in patch form) might slow or stop PD progression. 

In conjunction with searching for disease-modifying therapies, investigators are looking for a biomarker — an objective measurement to diagnose and monitor Parkinson's. This type of indicator could aid clinical management, accelerate research and (especially if it could diagnose PD before symptoms occur) help parse out the association of environmental factors and disease. In one recently completed study (the results of which are pending), researchers evaluated DaTscans in people without PD one year after a mild traumatic brain injury to determine if these specialized brain images could potentially be used for the evaluation of Parkinson's in this context.

To summarize, head trauma and traumatic brain injury are associated with an increased risk of Parkinson's but the mechanisms for how they are connected are unclear and direct causation (head or brain injury actually causing Parkinson’s) has not been established. More work is necessary to fully understand this relationship. 

https://www.michaeljfox.org/foundation/news-detail.php?ask-the-md-head-trauma-and-parkinsons-disease

Presurgical thoughts about Parkinson's Disease, the decision

June 17, 2016

Writing from Chicago, Illinois this is the Author' Note from the Chicago Judaism Examiner. In the first of two reports, this writer examines the relationship between his Jewish faith and Parkinson's Disease with which he has been afflicted now for nearly eighteen years.

Ben Zoma's famous query, 'Who is rich?' is found in Ethics of The Fathers, the first and best known of the six tractates of the Mishna.

Living thoughtfully with Parkinson's Disease is like holding tightly to a pendulum while it swings 'to and fro' mindful that once you're on you can't get off unless you're thrown off.

Falling down which happens predictably to the typical Parkinson's sufferer; this neurological menace causes more havoc than Dennis ever did. 

A progressively worsening disease over time, this writer admits his delusion led him to denial-that quite inexplicably, his Parkinson's would be different consequently better and milder case and would eventually 'max out' upon reaching a certain plateau. Well, it has not happened and won't.

The simple truth of the matter is it's all uphill from this point forward on as d at an ever increasing angle of incline. In everyday terms, this writer feels good less often more frequently.

Now don't misunderstand the good days when I feel like a "million bucks". I am neither adopting the "chicken little" approach nor any longer deluding myself that Parkinson'. s will not continue to play an important role in my life. Seeking nobody's pity, this writer only wants folks to pay attention to his message: there is no weapon more formidable in our psycho-spiritual arsenal than the alliance between old fashioned stubbornness and the power of prayer and devotion.

On the other hand, the "Parkinsonian" challenges I face every day have strengthened my resolve to live my life as best I can. I learned this approach from my late son Ben Z'L and his grandfather, my dad, Dr. Albert I. Busch, ZT'L both of whom doggedly fought off disease and disability.

As with diabetes management, given proper maintenance and lifestyle, Parkinson’s needn't prevent me from leading a relatively full life, but I ask readers to remember that the key to living well with Parkinson's Disease, as with other afflictions, is to live life purposefully.

The fact my body is not functioning properly as it did for so long is, indeed, lamentable, but that fact is never sufficient reason to 'throw in the towel

Adopting a vacuous approach, the absence of belief and trust in G-d and the power of prayer or a simple negative approach of feeling sorry for myself would only hasten my demise, leaving me without the support of community, alone and lonely.

Did you ever have a lemonade stand when you were a kid? Do you remember what the old expression advises if you're ever handed lemons?

Well, what are you waiting for? Get out there and set an example, become an inspiration to others, be able to say at the end of day: "I've changed a lot of lives for the better."

Physical strength is as fleeting as youth itself, especially if unwedded to "the spirituality of purposefulness". It simply is not enough to lift weights; a better use of your time would be to show folks who need help how to lift the weight of their affliction from their shoulder

Follow these instructions. And yes, you may and should try this at home. Okay, are you ready?

Step 1: Place an empty shoe box on the table in front of you. (If you haven't a shoe box, any box of similar size will do.) Position it on the table within arms’ reach so that you’ll be able to pick it up when I instruct you to do so.

Step 2: Place your hands in your pockets and do not remove them until I tell you, okay? Now, ready for the third step?

Step 3: Pick up the box. Uh uh, no, no, put your hands back in your pockets. Okay, try it again. Pick up the box.

Step 4: I see you're having some difficulty. Once again. On the count of three ...1, 2, 3 pick up the box.

Step 5: Are you alright? That wasn’t too bad, was it? Oh, you can remove your hands from your pockets.

You now have a "hands on" slightly hyperbolized understanding of what PD often feels like to me. Equally important is the awareness that symptomology varies among different PD sufferers. On the other hand, we do have some overlapping of disabilities and medications, but far more interesting is Parkinson's sufferers tend to look alike when our medication levels are low.

We shuffle instead of walk, our speech is slurred and we’re unable to raise the volume of our voices. Our posture is stiff and our faces are frozen as If to say: "Please don't look at me when I'm like this."

Waiting for medications to kick in can be frustrating. The waiting at times seems interminable. I view it differently by remembering how grateful I'll feel when my gait normalizes and my hands work again along with many other benefits.

You see? Good things do come to those who wait.

G-d grants each of us a finite number of days and a gift box of our unique strengths, weaknesses, talents, deficiencies and last but not least ... free will.

What we do with the contents of our gift boxes is another matter but, as you probably are aware, so much depends upon how each of us uses his free will.

Remember that the next time life makes you grumpy. Take a look at the next fellow's situation. Now reevaluate your own and repeat after me: "Ben Zoasks ? Who is rich? He who is 'besemach chelko. He who is happy with his lot.

http://www.examiner.com/article/parkinsons-essays

New Treatment for Neurologic Diseases Begins in Dubai

DUBAI, UNITED ARAB EMIRATES, June 17, 2016 

MRI of the Brain

There are many neurologic diseases that afflict patients in the Middle East- Stroke, Traumatic Brain Injury- TBI, Parkinson’s Disease, Multiple Sclerosis -MS, Peripheral Neuropathy –often from Diabetes, and many others. Difficulties can include trouble with walking, movement, speech, balance, hearing, smell, tremor and pain. Often these diseases have no treatment or very limited treatments to improve the disabilities of the patients. Now a new approach to directly treat the damaged brain and nervous tissue is available in Dubai.

MD Stem Cell is collaborator on the Neurologic Stem Cell Treatment Study (NEXT Study) which is treating Neurologic Diseases in the United States using a patient’s Stem Cells obtained from their own bone marrow. This is also called a Bone Marrow Fraction Treatment (BMFT).  Dr. Jeffrey Weiss, the Stem Cell Surgeon conducting the NEXT Study, is also on staff at the Al-Zahra Hospital and will be providing the same treatment in Dubai on September 4 and 5, 2016.  

“We are very excited to begin treating neurologic diseases in Dubai with the Bone Marrow Fraction Treatment “indicated Dr. Jeffrey Weiss. “ Based on our experience and observations in the United States, and the many reports in the medical literature, we believe that meaningful improvements in a number of different neurologic diseases can be obtained for patients using our minimally invasive approach. ”  

Dr. Jeffrey Weiss

MD Stem Cells and Dr. Jeffrey Weiss have been providing BMFT for ophthalmologic disease in the US since 2013 and in Dubai since 2015 treating hundreds of patients. So they and the staff at Al-Zahra Hospital are very familiar with the procedure to separate the Stem Cells in the BMFT. Dr. Weiss has personally observed improvements in neurologic function in patients receiving these treatments. 

There are over 600 different neurologic diseases and many will be considered eligible for the BMFT treatment. The most common are Stroke, Traumatic Brain Injury, Multiple Sclerosis, Parkinson’s Disease, Peripheral Neuropathy, certain kinds of memory loss such as Multi-Infarct Dementia, certain autoimmune and post viral syndromes such as Myasthenia Gravis, certain hereditary and acquired neurologic degenerations, some Spinal Cord injuries and others. Patients will submit their most recent neurologic exam for the initial assessment.

“We will evaluate each patient record on a case by case basis,” indicates Dr. Weiss. “If there is potential for improvement with the approach we are using, the patient will be offered treatment. With our methods we can introduce stem cells and growth factors to both the brain parenchyma and to the cerebral spinal fluid, allowing movement throughout the nervous system. I have observed neurologic improvements using the Bone Marrow Fraction Treatment and I’m excited to offer this approach in Dubai.”

Patients interested in scheduling Neurologic treatment in Dubai or local physicians may contact MD Stem Cells by email- info@mdstemcells.com , by phone (001) 203-423-9494 or by visiting the website www.mdstemcells.com and using the Contact Us page. Next treatments at Al-Zahra Hospital are being scheduled for September 4 and 5, 2016. Patients must seek an evaluation as early as possible so that the treatment can be arranged ahead of time. They may also contact Jenny Anil, Clinical Affairs Manager at Al-Zahra Hospital, at jenny.anil@zahd.ae for a referral.

MD Stem Cells

Dubai, UAE

(001) 203-423-9494

http://www.einnews.com/pr_news/331342946/new-treatment-for-neurologic-diseases-begins-in-dubai

YMCA taking 'big' steps to combat Parkinson's

Friday, June 17, 2016

By Seth Boyes, Daily Reporter Staff

Though Parkinson's disease may have first entered the limelight after Michael J. Fox made his diagnosis public in 1998, it has once again moved into the public eye following the death of former heavyweight champion Muhammed Ali. 

"Parkinson's disease is a degenerative disease of the brain that is caused by a loss of cells which produce a chemical called dopamine," Jordan Reed, director of rehabilitation services for Spencer Hospital, said, "Among other functions, dopamine plays an important role in controlling and fine tuning movement."

Reed went on to say that the loss of dopamine also contributes to familiar symptoms of Parkinson's, such as stooped posture, a shuffling gait, and difficulties with speech and handwriting.

"For those with Parkinson's disease, these signs and symptoms can make everyday activities time-consuming and difficult and can lead to significant functional limitation," Reed said.

Thankfully, Parkinson's therapy programs are spreading across the country. The programs generally focus on physical activity as a way to counteract the progression of the disease.

"Referrals to community based exercise groups are often part of the recommendations we make to our patients with Parkinson's disease," Reed said, "Exercise is proven to offset many of the physical side effects of Parkinson's disease. The reasons for this include a release of neurotransmitters in the brain during and following exercise, including dopamine, gains in muscular size and strength, improved balance and more efficient motor patterns and movement."

One such exercise group is available at the Spencer Family Y. The class, titled "Delaying the Disease," is led by Josh Kelly, Spencer Y's wellness director. 

Kelly recalled being inspired to start the program shortly after his start at the Y. During a conversation with a member, Kelly learned about a Parkinson's therapy group that the gentleman had attended during his time in Austin, Texas. Kelly then decided to go to Des Moines for training as an instructor and brought the program to Spencer. 

"We'll be going on two years this September," Kelly said.

According to Kelly, the program, which was developed by OhioHealth, is becoming more common at many Y facilities. He indicated that the Y may be an ideal conduit for the program to spread. By his estimation, "Delaying the Disease" is now available in half the states in the country. Comparatively, he estimated that the program was only available in 12 states when the Spencer program began.

Generally, Kelly begins the class with a 5- to 10-minute warm-up. The group walks forward, backward and sideways to improve movement and coordination. The group also works to improve their agility with an exercise common to many sports teams.

"We basically do ladder drills like you would in football," Kelly explained. 

The class also practices what Kelly called "big step walking." This exercise involves the participants taking as long of strides as possible, using their entire body and swinging their arms widely. Other exercises include holding an object on one side of the body, standing on one leg, and standing with feet spread apart. Not only can these exercises help reinforce balance and strength, but participants can practice them at home.

As Reed described, those with Parkinson's often experience "significant functional limitations in speech" and have difficulty being heard and projecting. To address this, the group practices speaking loudly and "shouting" to make projection a habit. Kelly noted that the class sometimes combines two activities, such as shouting numbers and colors while completing the ladder drill. 

In addition to speech, Delaying the Disease also works to address the difficulties with writing.

"Actually, handwriting is one of the big issues people have when they get Parkinson's," Kelly said. He explained that those with Parkinson's often tend to "cramp up" their writing and will write smaller and smaller as they continue across the page. To counter this, the class practices writing and signing their names in "big letters."

"We've had good luck with that," Kelly said.

Yet, according to Kelly, the therapy is not simply physical. The class has formed a social aspect as well.

"That's another thing that's helpful, having that camaraderie," Kelly said, noting that members of the class can often relate to what the others are going through. In fact, he has noticed several of them gathering at the warm water therapy pool before class begins.

Reed echoed Kelly saying, "The relationships and camaraderie that are developed during the classes are oftentimes just as beneficial to participants and their families as the functional gains that are made."

Though some facilities offer therapy programs that last only 8-12 weeks, this is not the case at the Spencer Y.

"We keep it going year-round," Kelly said, adding that, once the participants have completed the entire curriculum, they are welcome to begin again.

Lastly, Kelly noted that if interest in the program continues to grow, another staff member will need to receive training to expand the class. This did not seem to worry him.

"There's always room to grow," Kelly said.

The class meets both Mondays and Wednesdays at 10:15 a.m. for approximately an hour. The program itself is free to members of the Y and senior membership rates are available. Though no doctor's referral is necessary, Kelly encouraged communication between participants and staff regarding fall risks and other similar concerns.

http://www.spencerdailyreporter.com/story/2314681.html

Raise a cup – of coffee; WHO no longer says it can cause cancer

June 16, 2016

Since 1991, coffee has been saddled with the label, “possibly causes cancer.” As of June 15, coffee got a clean bill of health.

The International Agency for Research on Cancer – or IARC – is the WHO agency that evaluates evidence and scientific research on cancer. In 1991 the agency classified coffee as a category 2B carcinogen, which, in effect, labeled it as “possibly causing cancer” in the human bladder.

Twenty-five years later, another IARC group of scientific experts met to assess the body of published scientific literature on whether coffee can cause cancer. This working group, including 23 experts drawn from around the world, and seven observers, met May 24-31, 2016 to evaluate the carcinogenic effects of “coffee, mate, and very hot beverages."

This time, based on the available scientific literature, the expert group decided that the weight of evidence supported a downgrading in the classification. As of June 15, 2016, coffee is now considered in Group 3, or “not classifiable as to its carcinogenicity to humans.” For coffee lovers, this is reassuring news.

How does IARC evaluate whether something causes cancer?

IARC has a carcinogenic classification system ranging from 1 (carcinogenic) to 4 (probably not carcinogenic). Experts evaluate several types of evidence, including studies of cancer in humans, studies of cancer in animals, sources of exposure and mechanisms (what is known about how the substance can cause cancer).

Some substances that IARC has classified as Group 1 (carcinogenic) are not terribly surprising. The list includes, for example, arsenic, formaldehyde, diesel engine exhaust and tobacco.

But when a substance gets a Group 2 classification, the waters become a bit murkier. Both 2A and 2B classifications typically mean there is limited evidence of carcinogenicity in humans. But the classification bumps up from Group 2B (possibly causes cancer) to Group 2A (probably causes cancer) when there is sufficient evidence of carcinogenicity in animals.

For this reevaluation, IARC experts had access to over 1,000 studies, and the combination of evidence did not add up to “possibly causing cancer.” In its report, the 2016 IARC Working Group stated that the previous association between drinking coffee and bladder cancer could have been due to inadequate control for tobacco smoking in the previous studies.

Now that an international team of experts has lessened our concerns about coffee drinking and cancer, are we in the clear?

Bonus: Coffee is good for you

More than half of adults in the United States drink coffee every day – three cups on average.

If you drink coffee, the good news is that you probably don’t need to cut back. If you drink coffee in moderation, there may actually be a range of health benefits. Phew.

Though the definition of “moderate” varies among studies, we are typically talking about 3-5 cups per day. And though a standard cup is 8 ounces, keep in mind that in most coffee shops, a small cup is 12 ounces. A generic 8-ounce cup of coffee has on average 108 mg of caffeine. But the amount can vary depending on the strength of the brew and size of the serving. The Mayo Clinic says that up to 400 mg/day of caffeine (4 cups) is just fine for most healthy adults.

Much of the latest research on coffee is coming out of the Harvard School of Public Health, which reports that moderate coffee consumption is associated with numerous health benefits.

Arguably the most pragmatic health outcome measurement is death, which holds true if the substance is coffee or, indeed, any other substance. On this front, a 2014 and a 2015 meta-analysis (a large statistical analysis that pools data from multiple studies) both showed that moderate coffee consumption was associated with a reduced risk of death from all causes.

Other meta-analyses have shown a reduced risk for serious diseases, including stroke, heart failure, Type 2 diabetes and Parkinson’s disease.

What about cancer, though? Here meta-analyses have also shown that drinking coffee is associated with a reduction in overall cancer incidence, and is especially beneficial in reducing the risk of liver cancer (and managing liver disease). In IARC’s 2016 evaluation, the Working Group stated that the evidence suggested that coffee had no carcinogenetic effect on breast cancer, pancreatic cancer and prostate cancer. They went on to note that coffee had a beneficial effect on uterine endometrium cancer and liver cancer.

And though coffee was once a no-no for pregnant women, obstetricians now say it is safe for pregnant women to have about 200 mg of caffeine per day. This amounts to a 12-ounce cup of coffee. As such, there is no need for a pregnant woman to switch to decaf if she keeps her consumption to only one cup a day. Although it’s worth noting that drinking more could be troublesome. The data are conflicting about whether high caffeine consumption (greater than 200 mg/day) increases the risk of miscarriage.

While it’s becoming clearer that moderate daily coffee consumption can be considered to be healthy, the reasons for its health benefit aren’t so clear. Harvard researchers suspect it’s not the caffeine, but rather coffee’s antioxidant and anti-inflammatory compounds.

What if my coffee is ‘very hot’?

Here’s an interesting nuance: IARC says it’s fine to drink coffee, but only if it’s not too hot. And by this they mean under 149 degrees Fahrenheit. A “very hot beverage” has a Group 2A classification, meaning that it is “probably carcinogenic.”

This is thought to be due to the hot beverage’s damaging effect on cells in the esophagus. In effect, it acts as a tumor promoter. However, this research finding relates to mate, which is traditionally consumed at burning hot temperatures with a metal straw. It’s not really an issue for coffee, which is usually consumed at about 140 degrees Fahrenheit in the United States. So unless the coffee feels burning hot on your lips, no need to cool down your coffee.

Coffee is not great for everyone, of course. Heavy caffeine use (more than 500-600 mg day) can have side effects like insomnia, nervousness, restlessness, irritability, stomach upset, fast heartbeat and muscle tremors. And some people are much more sensitive to caffeine than others, and these side effects may occur with just a little bit of caffeine. Because of this, a risk/benefit analysis may indicate it’s more risky than beneficial for people with health concerns like anxiety disorders, or who are taking certain medications.

If you are like me and you love your coffee, then the best available advice seems that we continue to indulge our thirst – in moderation, of course – but cut back if and when the coffee begins to disagree with you. And, talk to your doctor about any health concerns you may have.

https://theconversation.com/raise-a-cup-of-coffee-who-no-longer-says-it-can-cause-cancer-60096

Research explores screening methods, clinical care for patients with Alzheimer's and all forms of dementia

June 16, 2016

Every 67 seconds someone is the United States develops Alzheimer's disease or some form of dementia. It's the sixth leading cause of death in the U.S. and it's the only cause of death in the top 10 in America that cannot be prevented, cured or slowed. This month, as the nation observes "Alzheimer's & Brain Awareness Month," James E. Galvin, M.D., M.P.H., one of the most prominent neuroscientists in the country, is at the helm of cutting-edge research, screening methods and clinical care for all forms of dementia and cognitive impairments as well as neurodegenerative diseases like Alzheimer's disease and Parkinson's disease.

Galvin is a professor of clinical biomedical science in FAU's Charles E. Schmidt College of Medicine and a professor in the Christine E. Lynn College of Nursing. He also serves as the associate dean for clinical research in the Schmidt College of Medicine and medical director of the Louis and Anne Green Memory and Wellness Center at FAU.

Prior to joining FAU, Galvin held concurrent positions at New York University, including professor of neurology and psychiatry and professor of population health at the NYU Langone School of Medicine; professor of nutrition and public health at the NYU Steinhardt School of Culture, Education and Human Development; and professor of nursing at the NYU College of Nursing.

Galvin is one of the leading international experts on "Lewy Body disease" (LBD) where patients simultaneously experience losses in cognitive function, mobility and behavior. LBD is the second-most-common degenerative disease after Alzheimer's disease. LBD affects more than 1.3 million Americans, but is poorly recognized and diagnosis is often significantly delayed. Former celebrity Robin Williams also had this form of dementia, which can cause visual hallucinations and make depression worse. Galvin has been working to improve clinical detections by combining biomarkers including high density EEG, functional and structural MRI, PET scans and CSF biomarkers to characterize and differentiate LBD from healthy aging and other neurodegenerative diseases.

Galvin has led efforts to develop a number of dementia screening tools, including the AD8, a brief informant interview to translate research findings to community settings. He has done cross-cultural validation of dementia screening methods in comparison with Gold Standard clinical evaluations and biomarker assays. His team also has developed sophisticated statistical models to explore transition points in clinical, cognitive, functional, behavioral and biological markers of disease in healthy aging, mild cognitive impairment, Alzheimer disease, and Parkinson's disease.

"These can be devastating diseases," Galvin said. "We're working on how to detect the diseases as early as possible, make the most accurate diagnoses, and initiate treatment at first sign of detection. That's how we can do the most for people suffering from these diseases."

Galvin also has generated millions of dollars in research funding from the National Institutes of Health, Centers for Disease Control and Prevention, Alzheimer Association, Michael J. Fox Foundation, local and state Departments of Health, and private foundations

Source:

Florida Atlantic University

http://www.news-medical.net/news/20150616/Research-explores-screening-methods-clinical-care-for-patients-with-Alzheimers-and-all-forms-of-dementia.aspx

Five-Factor Score Helps Predict Postural Hypotension, Falls, and Cognitive Impairment in Elderly

June 15, 2016

Dr Christopher Clark

PARIS, FRANCE — A simple algorithm of variables may help clinicians to identify elderly patients with postural hypotension as well as help to predict future falls and even cognitive dysfunction, new research suggests

Examining data from more than 1300 participants in the InChianti study, all of whom lived in Chianti, Italy, investigators found that a newly improved, five-point Detecting Risk of Postural Hypotension (DROP) score helped them to determine those with systolic postural dysfunction, defined as a >20-mm-Hg fall in supine blood pressure on standing, through 9 years of follow-up. The five predictive factors were being older than age 65, a fall in the past 12 months, a previous stroke, having hypertension, and having Parkinson's disease.

Added together, this five-factor DROP score also helped to predict increased mortality, cognitive impairment based on changes in Mini-Mental State Exam (MMSE) scores, and future falls in the next 2 to 3 years.

"We showed that the likelihood of postural hypotension can be predicted from factors in existing medical history," lead author Dr Christopher Clark (University of Exeter Medical School, UK) told attendees here at the European Society of Hypertension (ESH) 2016 Annual Meeting."This project is clinician driven because we have colleagues who aren't detecting this phenomenon of drops in blood pressure, so they're not responding to it," he later added to heartwire from Medscape. "We want to get out the message that 'here's a test that might help in predictions and that will make your lives easier.' "

At last year's ESH meeting, Clark reported "very preliminary" trial results showing that a total DROP score made up of the variables of age >65 years, a recent fall, a previous stroke, and having hypertension or angina could predict postural hypotension.

He noted that the new analysis was more "rigorous" and included cohort comparisons, which could explain why the variable of angina last year was replaced with Parkinson's-disease status in the new report. Interestingly, both last year and this year did not show diabetes as a top-five postural hypotension predictor. "It was one of the univariate associations, but, quite surprisingly, it dropped out of the multivariable model," he said.

Session comoderator Dr Dariusz Gasecki (Medical University of Gdańsk, Poland) said that the study "was well-planned, and the findings are very important for clinical practice."

"What I find exciting was that Parkinson's disease was also involved in this predictive score. I'll keep that in mind and may also use the Mini-Mental score as a predictor," Gasecki said to heartwire . "I think some indices of the brain could really help us."

Clark noted that more than three million older people in the UK fall each year, costing the National Health Service around £2.3 billion. "And postural hypotension is a clear risk factor for these falls." However, this condition isn't routinely looked for in clinical practice.

In a survey they're currently conducting of 90 general practices in Southwest England, "we found that when people have symptoms, they're very likely to have their postural blood pressure checked. But we're not routinely checking those with diabetes and we're only checking about a third of the [nonsymptomatic] elderly."

Clark reported that in addition to completing more analysis on their earlier assessments, the researchers wanted to also investigate whether future falls and cognitive impairment could be predicted in this patient population.

The original population-based InChianti study was created to assess causes of walking difficulties in the elderly, with baseline examinations conducted in 1998—and roughly 9 years of total follow-ups conducted at 3-year time points. BP was measured while the patients were lying down and at 1 and 3 minutes after standing up.

For the current analysis, the investigators randomized 1317 participants into two study cohorts: a "derivation cohort" (n=649; mean age 68.5 years; preexisting diabetes, 12.3%) and a validation cohort (n=668; mean age 68.2 years; preexisting diabetes, 11.4%). "This allowed us to work with one-half of the data set to develop weighted prediction scores and then test those DROP scores in the other half," explained Clark.Candidate predictor variables assessed included age, sex, drugs (including antiarrhythmics and anticholinesterase inhibitors), medical history, frailty, and MMSE scores.

At the end of 9 years of follow-up, 8.6% of the first cohort and 6.7% of the second had systolic drops of >20 mm Hg at 1 minute.

Five Strongest Multivariable Associations With the Presence of Postural Hypotension*

Variable	Prevalence (%)	Odds Ratio	95% CI
Age (>65 years)	100	3.5	1.1–11.6
Hypertension	38	2.2	1.2–4.0
Past-year fall	22	1.8	1.0–3.3
Previous stroke	6	2.3	1.0–5.2
Parkinson's disease	1	9.4	2.4–37.1

*Combined cohorts

The DROP score gave 1 point for each of these variables; thus, a potential score could range from 0 to 5. When researchers examined the performance of the score, the odds ratio (OR) for postural hypotension rose as the score increased (OR per unit increment in DROP score, 1.8; 95% CI 1.3–2.5; P <0.001).

In addition, the score correlated with all-cause mortality. The incremental hazard ratio per unit increase in DROP score was 1.80 (95% CI 1.6–2.0, P<0.001).

The score also predicted falls in the second and third years of follow-up (P<0.01 for trend) and predicted mean reductions in MMSE scores (P<0.001).

"Clearly, further work is needed to validate this DROP score in other relevant populations," said Clark. "And we intend to model the impact of it in reducing postural hypotension," he noted, adding that a new study on implementation is now planned.

In addition, the researchers plan to further examine the data for associations with systolic drops of >20 mm Hg at 3 minutes.

"Very Good Idea"

Gasecki noted that although more data is needed, the findings can be helpful to clinicians now. "I think many people aren't so aware that postural hypotension is important. I'm glad the investigators will be assessing pressure at 3 minutes, but in some patients I think you need 10 minutes to assess properly. Some patients have delayed reactions."

Still, "let's go ahead and do at least this preliminary test for our patients."

His comoderator Dr Cristina Sierra (Hospital Clinic and University of Barcelona, Spain) agreed. She added that postural hypertension is very frequent, especially in older patients, in clinical practices in her country. "So I think this DROP score is a very good idea," she told heartwire .

The study was funded by the National Institute on Aging and by the National Institute for Health Research. The study authors, Gasecki, and Sierra reported no relevant financial relationships.

http://www.medscape.com/viewarticle/864864?src=wnl_edit_tpal