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A drug for treating prostate cancer has been linked with increased risk of dementia, study finds

A drug for treating prostate cancer has been linked with increased risk of dementia, study finds

A man sits in his room in a senior living facility.

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A man sits in his room in a senior living facility.
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Getty Images/Andrew Burton
  • Prostate cancer patients who take a hormone-suppressing drug may be at an increased risk for dementia and Alzheimer’s, a study has found.
  • The study of more than 150,000 men found a link between the degenerative diseases and a treatment drug called androgen deprivation therapy.
  • Researchers cautioned doctors to further consider the risks of ADT before giving it to their patients to treat prostate cancer.
  • Visit Business Insider’s homepage for more stories.

A study of more than 150,000 men with prostate cancer found that a certain hormone treatment is linked with increased risks of dementia and Alzheimer’s.

There’s a 20-percent higher chance of having dementia for older men who have taken the prostate cancer treatment, according to the research study from JAMA Network. That drug treatment, called androgen deprivation therapy (ADT), is used to suppress male hormones (like testosterone) that can help to spread prostate cancer in the body.

The research study looked at over 150,000 men, age 66 or older, that had been diagnosed with prostate cancer. Researchers monitored participants over a period of at least 10 years after diagnoses.

Among those that were given ADT to treat their prostate cancer, there was a 20-percent increase in risk of dementia and a 14-percent higher risk of Alzheimer’s disease.

Read more: Nursing homes are giving Alzheimer’s patients baby dolls as a form of therapy

“Our results suggest that clinicians need to carefully weigh the long-term risks and benefits of exposure to ADT in patients with a prolonged life expectancy and stratify patients based on dementia risk prior to ADT initiation,” the researchers wrote in their study.

The study also found that the risk of dementia and Alzheimer’s increased with the number of doses of ADT patients were given.

Nursing homes are giving Alzheimer’s patients baby dolls as a form of therapy

Nursing homes are giving Alzheimer’s patients baby dolls as a form of therapy

Chinese elder who suffers from senile dementia plays with a doll as a treatment to remind her of the old days at the Cihui Rehabilitation Center for the Aged on September 2, 2005 in Guangzhou of Guangdong Province, China.

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Chinese elder who suffers from senile dementia plays with a doll as a treatment to remind her of the old days at the Cihui Rehabilitation Center for the Aged on September 2, 2005 in Guangzhou of Guangdong Province, China.
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Photo by China Photos/Getty Images
  • Pearl’s Memory Babies, a nonprofit group based in Kentucky, is giving hundreds of patients with Alzheimer’s disease baby dolls as a form of therapy.
  • Doll therapy can help ease anxiety among patients with Alzheimer’s or dementia. It is being used at nursing homes across the country.
  • A number of studies suggest the dolls can can improve communication and reduce the need for psychotropic medication.
  • Critics say that the dolls can infantilize elderly patients and demean them.
  • Visit INSIDER’s homepage for more stories.

A group in Kentucky is giving hundreds of patients with Alzheimer’s disease baby dolls as a form of therapy.

Pearl’s Memory Babies, a nonprofit group based in Kentucky, was launched after its founder, Sandy Cambron, saw the lasting effect a doll had on her mother-in-law, Pearl Walker.

“She started talking again and she never went anywhere without that baby,” Cambron told the Washington Post. “She took ‘baby’ to the dining room with her and slept with her in her arms every night. When she passed away a year later, we even buried her with that well-loved baby doll.”

Now Pearl’s Memory Babies has donated more than 300 dolls to patients with Alzheimer’s disease or dementia at nursing homes in Indiana and Kentucky.

“I had no idea that it would take off like this. It’s a simple idea, but it works,” she said. “Some people cry when you hand them their baby. Even though we don’t know exactly what they’re thinking, you can tell that the doll has helped bring back some kind of nice memory.”

Doll therapy is used across the US and even internationally. It can help ease anxiety among patients with Alzheimer’s or dementia.

The research around dolls and Alzheimer’s disease is far from conclusive, but a number of studies suggest the dolls can can improve communication and reduce the need for psychotropic medication, according to NPR.

But critics say that the dolls can infantilize elderly patients and demean them.

Read more: This giant 1950s town replica in California is a new kind of treatment center for people with Alzheimer’s

Stephanie Zeverino who works in community relations for Belmont Village Senior Living Westwood in Texas, told Kaiser Health News in 2016 that the facility prefers to use art and music for therapy, as well as brain games that promote critical thinking.

“They are adults and we want to treat them like adults. Theses are very well-educated residents,” she said. “We want to provide a sense of dignity.”

Ruth Drew, the Alzheimer’s Association’s director of information and support services, told INSIDER that anecdotal evidence suggests that dolls can help calm people who have agitation as a result of the disease, improve overall mood, increase social interaction, and provide a feeling of companionship for people with Alzheimer’s disease or dementia.

“One possible explanation – people living with Alzheimer’s disease tend to forget recent memories first, so holding a doll may bring back old memories of raising their own children – taking them back to a happy time in their live,” she said in an email. “People living with Alzheimer’s – particularly in the later stages – can respond to a variety of different interactions or stimuli. They could include favorite music, photos, puzzles or pets.”

“There are many ways family members can make connections with their loved ones,” she continued. “It’s important to keep trying until you find one that works.”

Weight change in old age increases dementia risk

Weight change in old age increases dementia risk

Older people who experience significant weight gain or weight loss could be raising their risk of developing dementia, suggests a study from South Korea published on May 20, 2019, in the online journal BMJ Open.

Dementia is an important health problem, especially with increasing life expectancy and an ageing population. In 2015, there were an estimated 46.8 million people diagnosed with dementia.

Meanwhile, the global prevalence of obesity, which is closely related to cardiometabolic diseases, has increased by more than 100% over the past four decades.

There is existing evidence of a possible association between cardiometabolic risk factors (such as high blood pressure, cholesterol and blood sugar levels) and dementia.

However, the association bet-ween body mass index (BMI) in late life and dementia risk remains unclear.

Therefore, a team of researchers from South Korea set out to investigate the association between BMI changes over a two-year period and dementia in an elderly Korean population.

They examined 67,219 participants aged 60-79 years who underwent BMI measurement in 2002-2003 and 2004-2005 as part of the National Health Insurance Service – Health Screening Cohort in the country.

At the start of the study period, characteristics were measured, including BMI, socioeconomic status and cardiometabolic risk factors.

The difference between BMI at the start of the study period and at the next health screening (2004-2005) was used to calculate the change in BMI.

After two years, the incidence of dementia was monitored for an average 5.3 years from 2008 to 2013.

During the 5.3 years of follow-up time, the numbers of men and women with dementia totalled 4,887 and 6,685 respectively.

Results showed that there appeared to be a significant association between late-life BMI changes and dementia in both sexes.

Rapid weight change – a 10% or higher increase or decrease in BMI – over a two-year period was associated with a higher risk of dementia, compared with a person with a stable BMI.

However, the BMI at the start of the period was not associated with dementia incidence in either sex, with the exception of low body weight in men.

After breaking down the figures based on BMI at the start of the study period, the researchers found a similar association bet-ween BMI change and dementia in the normal weight subgroup, but the pattern of this association varied in other BMI ranges.

Cardiometabolic risk factors, including pre-existing hypertension, congestive heart failure, diabetes and high fasting blood sugar, were significant risk factors for dementia.

In particular, patients with high fasting blood sugar had a 1.6-fold higher risk of developing dementia, compared to individuals with normal or pre-high fasting blood sugar.

In addition, unhealthy lifestyle habits such as smoking, frequent drinking and less physical activity in late life, were also associated with dementia.

This is an observational study, so it cannot establish cause, and the researchers point to some limitations, including uncertainty around the accuracy of the definition of dementia and reliance on people’s self-reported lifestyle habits, which may not be accurate.

However, the study included a large amount of data and reported various modifiable risk factors of dementia in late life.

As such, the researchers conclude: “Both weight gain and weight loss may be significant risk factors associated with dementia.

“This study revealed that severe weight gain, uncontrolled diabetes, smoking and less physical activity in late life had a detrimental effect on dementia development.

“Our results suggest that continuous weight control, disease management and the maintenance of a healthy lifestyle are beneficial in the prevention of dementia, even in later life.”

An easy way to test for Alzheimer’s disease

An easy way to test for Alzheimer’s disease

The beginning was the worst. It frustrated Janet Parkerson when her father started to forget what he had done that day or the day before.

But soon, names slipped his mind too, and then he failed to recognise people. Then he lost his ability to talk and to walk, and then he died, bedridden.

“I saw my father die of Alzheimer’s,” said Parkerson, 85. “I’ve experienced a lot of what it’s like – it’s terribly sad – and I would be very happy to help people not go through that.”

That’s why she decided to enroll in a five-year-long Alzheimer’s research study in 2014.

In fall 2018, she eagerly sat in the auditorium of East Ridge at Cutler Bay, her Pine Crest senior living community in Florida, United States, alongside about 50 other fellow residents, some of whom had also volunteered for the studies.

They were all there to hear from the man who recruited them for the study, Dr David Loewenstein, a University of Miami expert in neuropsychology who has been studying Alzheimer’s for 32 years.

Dr Loewenstein spoke about one of his team’s most recent findings: For the first time, they successfully used a behavioural test to identify which patients with cognitive impairment are most likely to develop Alzheimer’s.

He and his colleagues found patients with mild cognitive impairment, then divided them into three groups.

The first was patients with underlying Alzheimer’s, as proved by their high levels of amyloid, an aggregation of a protein in the brain of Alzheimer’s patients.

The second was patients who had the symptoms of Alzheimer’s, but didn’t have the high levels of amyloid, which meant they probably had another disease.

And the third included patients with other neurological conditions, such as depression.

Dr Loewenstein’s team used a cognitive stress test developed in 2013 by the University of Miami, and it involves researchers asking patients to learn a list of 15 words from three categories, five from each.

They then ask the patients to learn a new list of 15 words from the same categories.

Using the test, they found the patients with the high amyloid levels had the most trouble remembering the second list of words because the first interfered, even after the patients were given multiple attempts.

This means they accurately identified patients who actually have Alzheimer’s from those who look like they do, but don’t. “It’s a landmark finding,” said Dr Loewenstein.

When he finished his hour-long presentation at East Ridge on Oct 1, 2018, about 15 people rushed to talk to him. Most were fascinated by the fact some of them had had a part in the discovery.

Dr Loewenstein and his team have received more than US$10mil (RM41.4mil) in US state and federal funding for research in the last five years.

In June 2018, he was named the director of the Center for Cognitive Neuroscience and Aging at the University of Miami, which aims to tackle Alzheimer’s as it becomes a greater issue.

As more and more baby boomers get older, the number of Alzheimer’s patients is increasing.

Dr Loewenstein said if the disease isn’t stopped, in the next 10 to 15 years, it will wreak havoc for patients and their families, as well as bankrupt the US federal government, because the cost to care for the ill will be so high.

His team’s most recent milestone with the cognitive stress test helps researchers better understand Alzheimer’s and identify the earliest changes that take place in the brain because of it.

This test could potentially help doctors screen patients for Alzheimer’s at a much cheaper cost than through an amyloid PET scan.

The test will also help scientists better select candidates with Alzheimer’s for clinical and prevention trials.

“I’m satisfied with the effort,” Dr Loewenstein said. “We’re trying very hard, but I don’t think I’ll be completely satisfied until we have a cure or a prevention.

“We’re close, but we’re still not there.” – Miami Herald/Tribune News Service

15 common misconceptions and surprising realities about dementia and Alzheimer’s disease

15 common misconceptions and surprising realities about dementia and Alzheimer’s disease

Dementia currently affects about 50 million people in the world.

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Dementia currently affects about 50 million people in the world.
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De Visu/Shutterstock

There are about 50 million people in the world living with dementia. It’s the umbrella term given to the symptoms caused by various diseases – most commonly Alzheimer’s. This is expected to go up to 152 million in 2050, according to Alzheimer’s Research UK.

Despite the massive impact dementia has on the economy and people’s livelihoods, there are still many misconceptions around it. There are also some facts that still surprise people.

We spoke to Alzheimer’s Research UK to find out what people normally get wrong, and what they often don’t know, about dementia.


1. Alzheimer’s disease and dementia are not the same thing

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Dementia is a term used for symptoms like confusion, memory loss, mood changes, and personality changes. There are a whole range of conditions that can cause dementia, not just Alzheimer’s. The most common are Alzheimer’s Disease, dementia with Lewy bodies, vascular dementia and Frontotemporal dementia.

“Sometimes people will say to me, oh well she has Alzheimer’s disease, but she doesn’t have dementia… But really, if you have Alzheimer’s disease and you’re showing symptoms, then you have dementia,” said Laura Phipps, the head of communications and engagement at Alzheimer’s Research UK. “Dementia is just a word for the symptoms.”


2. People react differently to the words

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Reuters

Although dementia and Alzheimer’s are often confused, people tend to have different reactions to hearing each word.

“When you ask them to think about Alzheimer’s disease, they will put that in with other physical health conditions, like heart disease, stroke, cancer, diabetes,” Phipps said. “And when you ask them to think about dementia, they don’t know what to do with it, and they tend to put it in with things like age and mental health.”

So even though dementia is caused by illnesses like Alzheimer’s, the word itself is conflated with being more of a mental disorder, than something caused by a physical disease.


3. Dementia isn’t an inevitable part of getting older

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Rawpixel.com / Shutterstock

A common misconception is that you get a bit forgetful as you get older, so dementia falls into that as an inevitability that just happens to most people.

“They’ll say, ‘oh yeah my grandma had dementia but she was very old,’ so it’s almost followed by an excuse that it was OK because they were old,” Phipps said. “And so I think that drives this kind of view in society that the diseases that cause dementia are not that important because there’s not much you can do about them.”

But this isn’t true. Dementia is caused by diseases. People understand cancer is a disease, that you shouldn’t have it and it’s unfair, Phipps said, but that’s not yet universally accepted by people when it comes to dementia.


4. More people at 90 don’t have dementia than have it

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Atthapon Raksthaput / Shutterstock

By the time people get to 90 years old, they are more likely not to have any diseases that cause dementia than have one.

Phipps said dementia research is behind a lot of other research because they have an extra mountain to climb. Because people think dementia is inevitable, they are less likely to want to support and fund research.


5. Almost half of adults don’t realise it causes death

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Shutterstock/Burlingham

A survey by Alzheimer’s Research UK found that 51% of adults recognise that dementia leads to death. That means almost half don’t realise, even though it’s the UK’s leading cause of death right now.

“These are physical diseases that ultimately are terminal – they will shorten your life,” Phipps said. “But people don’t recognise that, and again this just shows there is a lack of seriousness about it.”

“You hear people joke about it, like oh have you got Alzheimer’s. And actually, you wouldn’t joke about someone having another fatal illness. It’s not appropriate in society to do that. But people will still do that about dementia because they don’t recognise that diseases that cause dementia like Alzheimer’s are terminal. They will end your life too soon.”


6. A brain that is affected by Alzheimer’s can weigh 140 grams less than an unaffected brain

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Marcelo Hernandez/Getty

There was an Alzheimer’s UK campaign in 2016 called Share the Orange because a brain that is affected by Alzheimer’s can weight up to 140g less than a normal brain – about the weight of an orange.

“That’s actually a huge amount of brain that’s lost, but you can’t see it,” Phipps said. “So if someone was walking around and they had 75% of their leg, you’d probably notice and you might treat them better or cut them some slack or help them out. You can’t see that physical effect with dementia.”


7. There are more symptoms than memory loss

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Jakob Owens / Unsplash

There is a slightly simplified view of dementia that it’s all about getting forgetful when you get older. Memory loss is the most common symptom, Phipps said, but there are many more.

“As dementia progresses, people get more and more symptoms, including physical symptoms,” she said. “So they won’t be able to move around, they’ll have difficulty speaking, they’ll have trouble swallowing – and it’s ultimately those symptoms that make people immobile and much more frail and susceptible to things like falls or infections that they don’t recover from.”


8. A third of risk factors are within our control

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People often understand the risk of dementia, Phipps said. About a third of cases of dementia could actually be down to risk factors that are in our control.

Age is the biggest risk factor because dementia mostly affects older people. Some people have a genetic predisposition to developing diseases like Alzheimer’s, which is out of their control.

“But there are also lifestyle factors that can influence your risk of dementia,” Phipps said. “And at a population level, these come out as things like smoking, like depression, physical inactivity, high blood pressure… so often it’s things that are likely to impact your heart.”

Only about a quarter of UK adults realise there is anything they can do to reduce their risk of dementia, according to Alzheimer’s Research UK surveys.

“If you were to address things like having more aggressive treatment of blood pressure, or stopping people becoming overweight, and if nobody smoked, then we would see a reduction in the number of people getting dementia,” said Phipps. “So there are things people can do that are within their control that can reduce their risk of dementia.”


9. Heart health and brain health are intrinsically linked

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Matt Cardy/Getty Images

Many of the risk factors associated with dementia are the same as those associated with heart health. This is because your brain and heart are intrinsically linked together.

“The majority of the blood that is pumped by your heart is used by your brain,” said Phipps. “So anything that damages how your heart is working will have a knock-on effect on your brain health. And so a lot of the risk factors for dementia at the moment with the best evidence are also heart health risk factors.”

So even though people may be unsure about the risk factors of dementia, if you tell them it’s the same as the ones for cardiovascular disease, stroke, and heart attacks, they might have a better idea.


10. Mid life is the most important window for risk reduction

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Halfpoint/Shutterstock

Many of the most important avoidable risk factors for dementia appear in mid-life, between the ages of about 40 and 64, according to the Alzheimer’s Society, such as type 2 diabetes and high blood pressure.

People who have had periods of depression in mid or later life also have increased rates of dementia.


11. It doesn’t just affect old people

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Lolostock/Shutterstock

Dementia doesn’t just affect older people. About 2-8% of all cases worldwide affect younger people. In the UK, there are about 40,000 people under the age of 65 living with dementia, but people tend to think it’s not something that strikes until later life.

“In 2015 we did some polling, and 46% of people think dementia mostly affects older people, 15% think it affects only older people, and 9% think it can also affect younger people,” Phipps said.


12. Sometimes, it only affects sight and perception

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Irina Bg/Shutterstock

Sometimes memory loss isn’t a symptom of dementia until it is very advanced. The type of dementia Terry Pratchett had, for example, affected how his brain interpreted vision from his eyes.

“So actually he didn’t have memory loss until the late stages, but he couldn’t really see at all,” Phipps said. “So he couldn’t type, and had big gaps in his vision where he couldn’t see things.”

Alzheimer’s Research UK has a virtual reality dementia experience online called A Walk Through Dementia, which shows some of the visual perception tricks dementia can have on someone.

“One thing people often tell us about is that puddles on the ground can look like holes because there are issues with perception and depth perception and colour perception,” said Phipps. “You know when you go into a shop and they used to have those big black mats in front of the door… for some people with dementia that looks like a massive abyss.”

Imagine being faced with large holes in the ground. It would be confusing and alarming. Phipps said this means people with dementia won’t go into shops, or they won’t enter bathrooms because the shiny floors look like water.

“If your brain was working 100% you would probably be able to perceive the difference between shiny and wet,” she said. “But if there’s damage in your brain you just can’t quite make the judgement. Those things seem small but they can have a huge impact.”


13. Aggression and confusion may come from these small perception errors

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Joe Raedle/Getty Images

Small changes can have big impacts on how people with dementia live. It may be something small that is confusing them with a simple fix, but the person with dementia may not be able to articulate the problem.

“There’s a big movement now for people who are showing signs of aggression or agitation, and rather than immediately giving them anti-psychotic drugs, is to try and look at their environment,” said Phipps. “Because it might be something really small like a change in routine or a change in the lamps or the way shadows are being cast around the room that could be having a massive impact on their level of anxiety, causing them to be agitated and aggressive.”

Small tweaks to their environment, like having more lights, or keeping the curtains open, could have a big impact on their quality of life.


14. Disrupted sleep can be a factor

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Omar Havana/Getty Images

Research has shown that disrupted sleep may be associated with a higher risk of early signs of Alzheimer’s disease. This could mean that sleeping badly is an early warning sign of someone developing dementia.

Bad sleep could either be a symptom of dementia, or a cause – or it could be that both are true.

Other research supports the sleep theory, with one study finding that just one night of disrupted sleep could lead to a spike in Alzheimer’s-related proteins.


15. There is no cure or treatment for the progression of diseases that cause dementia

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Jammy Photography / Shutterstock

There is currently no cure for the diseases that cause dementia, and no treatments that will modify the progression.

Some drugs can help people to address certain symptoms, but they don’t stop the disease progressing in the brain.

This is why understanding that dementia may be preventable is so important, Phipps said, because increased awareness means more research.

“There seems to be less stigma, and people seem to be more open about talking about diagnosis with someone, or having a conversation with somebody with dementia,” she said. “I think awareness of dementia is better than it’s ever been, but understanding of dementia hasn’t quite caught up.”

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