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Diabetes may significantly increase your risk of dementia

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Diabetes may significantly increase your risk of dementia

September 19th, 2011 in Neuroscience

People with diabetes appear to be at a significantly increased risk of developing dementia, according to a study published in the September 20, 2011, print issue of Neurology, the medical journal of the American Academy of Neurology.

"Our findings emphasize the need to consider diabetes as a potential risk factor for dementia," said study author Yutaka Kiyohara, MD, PhD, of Kyushu University in Fukuoka, Japan. "Diabetes is a common disorder, and the number of people with it has been growing in recent years all over the world. Controlling diabetes is now more important than ever."

People with diabetes were more likely to develop Alzheimer's disease and other types of dementia, such as vascular dementia, which occurs when there is damage to blood vessels that eventually deprive the brain of oxygen.

For the study, a total of 1,017 people who were age 60 and older were given a glucose (sugar) tolerance test after an overnight fast to determine if they had diabetes. Study participants were monitored for an average of 11 years and then tested for dementia. During the study, 232 people developed dementia.

The study found that people with diabetes were twice as likely to develop dementia as people with normal blood sugar levels. Of the 150 people with diabetes, 41 developed dementia, compared to 115 of the 559 people without diabetes who developed dementia.

The results remained the same after the researchers accounted for factors such as high blood pressure, high cholesterol and smoking. The risk of dementia was also higher in people who did not have diabetes, but had impaired glucose tolerance, or were "pre-diabetes."

In addition, the study found the risk of developing dementia significantly increased when blood sugar was still high two hours after a meal.

Provided by American Academy of Neurology

"Diabetes may significantly increase your risk of dementia." September 19th, 2011. http://medicalxpress.com/news/2011-09-diabetes-significantly-dementia.html

bidirectional relationship between schizophrenia and epilepsy

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Study finds bidirectional relationship between schizophrenia and epilepsy

September 19th, 2011 in Research

Researchers from Taiwan have confirmed a bidirectional relation between schizophrenia and epilepsy. The study published today in Epilepsia, a journal of the International League Against Epilepsy (ILAE), reports that patients with epilepsy were nearly 8 times more likely to develop schizophrenia and those with schizophrenia were close to 6 times more likely to develop epilepsy.

Prior clinical studies have shown a prevalence of psychosis among epilepsy patients and studies of psychiatric illness have found a strong relationship between schizophrenia and epilepsy, suggesting a shared susceptibility between the diseases that may be a result of genetic, environmental or neurobiological causes. While a number of studies have established a bidirectional relationship between depression, mood disorder and epilepsy, the current study is the first to investigate this type of relation between schizophrenia and epilepsy.

Using data from the Taiwan National Health Insurance database, the team identified 5195 patients with schizophrenia and 11527 patients with epilepsy who were diagnosed between 1999 and 2008. The patient groups were compared to age and sex-matched controls. Analysis included the incidence and risk of developing epilepsy in the schizophrenia patient group and schizophrenia in the epilepsy cohort.

The findings show that the incidence of epilepsy was higher in the schizophrenia patient group at 6.99 per 1,000 person-years compared to 1.19 in the non-schizophrenia control. Incidence of schizophrenia was 3.53 per 1,000 person-years for patient with epilepsy compared to 0.46 in the non-epilepsy group. Researchers also reported that schizophrenia incidence was slightly higher in men with epilepsy than in women with the disease.

"Our research results show a strong bidirectional relation between schizophrenia and epilepsy," said lead author I-Ching Chou, M.D., with China Medical University Hospital and Associate Professor with China Medical University in Taichung, Taiwan. "This relationship may be due to common pathogenesis in these diseases such as genetic susceptibility and environmental factors, but further investigation of the pathological mechanisms are needed."

More information: "Bidirectional Relation Between Schizophrenia and Epilepsy: A Population-Based Retrospective Cohort Study." Yu-Tzu Chang, Pei-Chun Chen, I-Ju Tsai, Fung-Chang Sung, Zheng-Nan Chin, Huang-Tsung Kuo, Chang-Hai Tsai and I-Ching Chou. Epilepsia; Published Online: September 19, 2011 (DOI: 10.1111/j.1528-1167.2011.03268.x).

Provided by Wiley

"Study finds bidirectional relationship between schizophrenia and epilepsy." September 19th, 2011. http://medicalxpress.com/news/2011-09-bidirectional-relationship-schizophrenia-epilepsy.html

Study finds over 70 percent of suicidal teens don't get the mental health services they need

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Study finds over 70 percent of suicidal teens don't get the mental health services they need

September 14th, 2011 in Psychology & Psychiatry

Suicidal teens are not likely to get the mental healthcare they need. This is according to a team of researchers at Seattle Children's Research Institute, the University of Washington (UW), and Group Health Research Institute. The study, "Adolescents With Suicidal Ideation: Health Care Use and Functioning," was recently published in Academic Pediatrics.

The researchers found that only 13 percent of teens with suicidal thoughts received mental health visits through their healthcare network and only 16 percent received services in the year after, despite being eligible for and having access to mental healthcare without a referral and with relatively small co-pays. Additionally, when all types of mental health services were combined (including antidepressants and care received through outside sources), still only 26 percent of teens with suicide ideation in the study received services the year prior.

"Teen suicide is a very real issue today in the United States. Until now, we've known very little about how much or how little suicidal teens use healthcare services. We found it particularly striking to observe such low rates of healthcare service use among most teens in our study," said lead author Carolyn A. McCarty, PhD of Seattle Children's Research Institute, and research associate professor of pediatrics at the University of Washington School of Medicine.

According to the Centers for Disease Control and Prevention, suicide is the third leading cause of death for people aged 15 to 24 and the fourth leading cause of death for children between the ages of 10 and 14. Identifying suicidal ideation is critical to preventing suicide. While many experts consider suicidal thoughts normative during adolescence, this study confirms teens with suicidal ideation experience more functional impairment such as interpersonal difficulties, school problems, and mental health problems. Researchers in this study found these impairments persisted into a six-month follow-up period. These difficulties can, in turn, intensify the need for mental healthcare.

In the study, Dr. McCarty and co-investigators examined the use of healthcare services among teens aged 13-18 who were patients at Group Health Cooperative. A total of 198 teens were studied, including 99 teens who endorsed suicidal thoughts, and 99 control teens, matched on age and gender. Administrative data spanning two years were collected from medical records, in addition to interviews conducted with teens and their parents.

Utilization of mental health services was low among both the control group and those with suicidal thoughts. Although 86 percent of the youth with suicidal ideation had seen a healthcare provider, only 13 percent had a mental health specialty visit, and only 7 percent received antidepressant medications. Only 10 percent of those without suicidal ideation had received any mental health visits within the Group Health Cooperative system in the prior year. However, respondents with suicidal ideation had significantly more severe depression, a greater prevalence of lifetime diagnosis of depression or anxiety, and higher scores of pediatric chronic disease. When all mental health service questions were combined, 26 percent of the teens with suicide ideation received services the prior year, and 16 percent received services in the following year. These findings confirmed previous studies examining self-reported mental health services among adolescents.

"We know that asking teens about suicidal ideation does not worsen their problems," said Dr. McCarty. "It's absolutely crucial for a teen who is having thoughts of self-harm or significant depression to be able to tell a helpful, trustworthy adult."

"These findings underscore the need for clinicians to be aware of the potential for suicide in adolescence," added Dr. McCarty. "Primary care physicians and healthcare providers should be specifically assessing suicidal ideation in the context of depression screening for teenagers. Effective screening tools are available, as are effective treatments for depression."

Provided by Seattle Children's

"Study finds over 70 percent of suicidal teens don't get the mental health services they need." September 14th, 2011. http://medicalxpress.com/news/2011-09-percent-suicidal-teens-dont-mental.html

Mortality gap for people with serious mental illness is increasing

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Mortality gap for people with serious mental illness is increasing

September 14th, 2011 in Psychology & Psychiatry

(Medical Xpress) -- People with serious mental illnesses in England are not seeing the improvement in death rates the rest of the population is experiencing, a study led by Oxford University has found.

This is leading to a ‘persistent and increasing’ mortality gap, where people with schizophrenia and bipolar disorder are at a greater risk of premature death compared with the general population – despite many improvements in mental health care.

The findings, published in the BMJ medical journal, highlight the challenge faced by the UK government’s recent mental health strategy, which states that “fewer people with mental health problems will die prematurely.”

Dr. Uy Hoang, an academic clinical fellow in the Department of Public Health at Oxford University, who led the work, says: "More needs to be done to understand the reasons for the increasing mortality gap. And a lot more can be done to identify and treat patients to reduce the number of preventable deaths."

The research team from the University of Oxford and the Institute of Psychiatry analyzed records for all people with schizophrenia or bipolar disorder discharged from inpatient care in England.

They compared the risk of death in the 12 months following discharge with mortality rates in the general population for each year from 1999 to 2006.

They found a significant increase over this period in the mortality gap between patients with schizophrenia or bipolar disorder, and the general population.

By 2006, the risk of death in the year following discharge had reached double the average risk for the population as a whole.

This widening disparity occurred as mortality rates in the general population declined, while those in people with serious mental disorders did not.

About three quarters of the deaths among those with schizophrenia and bipolar disorder were from natural causes. And it was increasing disparities in deaths from heart and respiratory diseases that in large part drove the widening mortality gap.

The researchers say they are encouraged that the UK government has recognized and prioritized the importance of preventing premature mortality in its recently published mental health strategy.

"We do welcome the focus on this mortality gap. It will present a real challenge to the government’s reforms of mental health services," says Dr. Hoang.

Professor Peter Kinderman of the University of Liverpool, who was not involved in the study, says: "We know some of the risks – people with serious mental health problems are at risk from lifestyle factors (smoking, drinking, lack of exercise, poor diet) but also potentially from the medication that is prescribed, often for very long periods ... And, when physical problems are identified, people with mental health problems often receive inadequate care. So it’s vital that mental health services improve – to give people the care they need and to avoid inappropriate forms of care – and work better with physical health services and primary care."

Provided by Oxford University

"Mortality gap for people with serious mental illness is increasing." September 14th, 2011. http://medicalxpress.com/news/2011-09-mortality-gap-people-mental-illness.html

Autism breakthrough could lead to new treatments

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Autism breakthrough could lead to new treatments

September 8th, 2011 in Diseases

Researchers say they have identified two different types of autism, paving the way for more targeted treatment. Credit: Flickr/Pondspider

US researchers say they have identified at least two distinct types of autism, paving the way for new and more targeted treatments.

Autism, a neurobiological disorder that impairs social interaction skills and causes an unusual interest in repetitive behaviour, affects around 1 in 160 Australian children. Four out of five children with autism are boys.

Treatment options range from behavioral and therapy-based interventions to alternative medicines but so far researchers have been unable to differentiate between shades of autism.

Now the world’s largest study of children with autism has led to the discovery that there are at least two biologically distinct subtypes of the disorder.

Researchers from the MIND Institute at the University of California used data on 350 children with autism from the five year Autism Phenome Project, to identify the two types.

One group have unusually large brains by four to five months of age, even where the symptoms of autism are not seen until 18 to 24 months.

Another subgroup was identified in which the children had some kind of immune system dysfunction.

Dr. David Amaral, Research Director of the UC Davis MIND Institute in the USA, said further research may reveal several more subgroups of autism, paving the way for more specialised treatments.

“I’d use the analogy of cancer. We know there’s something in the order of 200 to 300 types of cancer and what causes them is different things. It hasn’t made sense in cancer to try to solve all cancer at the same time, you go after them one at a time,” he said.

“Autism is equally complex and we are fairly confident with the idea that what causes the autism in different individuals could be quite different.”

“Trying to understand autism all at once is not productive,” he said.

A better understanding of the different causes could lead to the development of new medicines targeting those abnormal processes, he said.

Dr. Amaral presented his findings at the Asia Pacific Autism Conference in Perth today.

--------------------------------------------------------------------------------

This story is published courtesy of the The Conversation (under Creative Commons-Attribution/No derivatives).

Provided by The Conversation

"Autism breakthrough could lead to new treatments." September 8th, 2011. http://medicalxpress.com/news/2011-09-autism-breakthrough-newtreatments.html

people who practice self-injury

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During the past 10 years two Colorado professors have collected the widest available base of knowledge about people who practice self-injury and now are offering new insights into people who deliberately injure themselves by cutting, burning, branding and bone-breaking.

Patti Adler, a professor of sociology at the University of Colorado Boulder, and Peter Adler, a professor of sociology and criminology at the University of Denver, conducted in-depth interviews with 150 self-injurers from all over the world in addition to examining 30,000 to 40,000 Internet posts in chat rooms. Other self-injury practices include re-opening wounds, biting, scratching, hair-pulling and swallowing or embedding objects.

Before their research, studies of self-injury had primarily been conducted by psychologists or physicians, and their research subjects came from therapeutic or hospital settings, Patti Adler said. Originally thought to be a suicidal gesture, the picture that emerged from these previous studies was one of an addictive behavior practiced mostly by privileged, white teenage girls.

A completely different picture emerges when a close look is taken at all self-injurers, Adler said.

Self-injury emerged from obscurity in the 1990s and spread dramatically as a typical behavior among adolescents, she said. The practice occurs mostly among those in their teens and 20s, and can still occur in the 30s but grows more rare after age 40.

The Adlers trace the evolution of societal attitudes toward a behavior that once was highly stigmatized but now is considered more of a "thing that people do." And rather than a suicidal gesture or an addictive behavior, they found that it is a coping mechanism.

The majority of people involved in self-injury do it to deal with anxiety or emotional pain, Adler said. It "self-soothes" and gives people a sense of control. And it helps many people get over a rough patch in their lives.

"Although society was initially shocked to discover that people might harm their bodies intentionally, when compared to other ways that people seek relief from pain it offers several benefits: it's not illegal, it's not addictive, it doesn't hurt others and the body eventually heals," Adler said. "For those trapped in bad situations, it can be a way to make it through until their lives improve."

Similarly, Internet chat rooms provide a safe place where self-injurers can find others like themselves. These sites help by making people realize their behavior does not mean they are "crazy, weak-willed, sick or bad," she said.

A host of free support groups for self-injurers are available on the Internet, Adler said. Other types of help also are available for those who want to stop including outpatient therapy, therapeutic drugs and specialized clinics that offer inpatient treatment.

"Our longitudinal data show that many people who struggle with self-injury during their formative years, like those who try drugs, eating disorders or delinquency, grow out of it to live fully functioning productive lives as professionals, parents and spouses without further problems," she said.

The Adlers research was published last month in a book titled "The Tender Cut" by New York University Press.

More information: For more information on "The Tender Cut" visit nyupress.org/books/book-details.aspx?bookId=3299

Provided by University of Colorado at Boulder (news : web)

Older adults with too much salt in diet and too little exercise at greater risk of cognitive decline

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Older adults with too much salt in diet and too little exercise at greater risk of cognitive decline

August 22nd, 2011 in Health

Older adults who lead sedentary lifestyles and consume a lot of sodium in their diet may be putting themselves at risk for more than just heart disease.

A study led by researchers at Baycrest in Toronto – in collaboration with colleagues at the Institut Universitaire de Gériatrie de Montréal, McGill University and the Université de Sherbrooke – has found evidence that high-salt diets coupled with low physical activity can be detrimental to cognitive health in older adults.

The finding, which appears online today in the journal Neurobiology of Aging, ahead of print publication, may have significant public health implications, emphasizing the importance of addressing multiple lifestyle factors that can impact brain health.

The study followed the sodium consumption and physical activity levels of 1,262 healthy older men and women (ages 67 – 84) residing in Quebec, Canada, over three years. The adults were recruited from a large pool of participants in the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge).

While low sodium intake is associated with reduced blood pressure and risk of heart disease, this is believed to be the first study to extend the benefits of a low sodium diet to brain health in healthy older adults.

"We have generated important evidence that sodium intake not only impacts heart health, but brain health as well," said Dr. Alexandra Fiocco, a scientist with Baycrest's Kunin-Lunenfeld Applied and Evaluative Research Unit (KLAERU) and the study's lead investigator.

Health Canada's sodium reduction strategy recommends that people 14 years of age and older consume no more than 2,300 mg of sodium per day in their diet. In the Baycrest study, senior participants were assessed as low, mid or high level sodium consumers based on a food frequency questionnaire they each completed. Low sodium intake was defined as not exceeding 2,263 mg/day; mid sodium intake 3,090 mg/day; and high sodium intake 3,091 and greater (this went as high as 8,098) mg/day.

Researchers used a modified Mini-Mental State Examination to measure cognitive function in participants at year one (baseline) and annually for three additional years. Physical activity levels were measured using the Physical Activity Scale for the Elderly.

"The results of our study showed that a diet high in sodium, combined with little exercise, was especially detrimental to the cognitive performance of older adults," said Dr. Fiocco.

"But the good news is that sedentary older adults showed no cognitive decline over the three years that we followed them if they had low sodium intake."

"These data are especially relevant as we know that munching on high-salt processed snacks when engaged in sedentary activities, such as watching TV or playing in front of the computer, is a frequent pastime for many adults," said Dr. Carol Greenwood, a senior author on the study and internationally-renowned scientist in the field of nutrition and cognitive function in late life.

"This study addresses an additional risk associated with lifestyles that are highly apparent in North American populations."

With brain failure rates expected to rise significantly as Canada's large boomer demographic ages, educating the public about lifestyle changes that can help delay or prevent normal, age-related cognitive decline – including adopting a healthier diet – is a way to give people some control over how their brain health will hold up in later years, said Dr. Greenwood, senior scientist with Baycrest's KLAERU and professor in the Department of Nutritional Sciences at the University of Toronto.

Provided by Baycrest Centre for Geriatric Care

vitamin C dissolves toxic protein aggregates in Alzheimer's disease

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Treatment with vitamin C dissolves toxic protein aggregates in Alzheimer's disease

August 18th, 2011 in Research

Researchers at Lund University have discovered a new function for vitamin C. Treatment with vitamin C can dissolve the toxic protein aggregates that build up in the brain in Alzheimer's disease. The research findings are now being presented in the Journal of Biological Chemistry.

The brains of people with Alzheimer's disease contain lumps of so-called amyloid plaques which consist of misfolded protein aggregates. They cause nerve cell death in the brain and the first nerves to be attacked are the ones in the brain's memory centre.

"When we treated brain tissue from mice suffering from Alzheimer's disease with vitamin C, we could see that the toxic protein aggregates were dissolved. Our results show a previously unknown model for how vitamin C affects the amyloid plaques", says Katrin Mani, reader in Molecular Medicine at Lund University.

"Another interesting finding is that the useful vitamin C does not need to come from fresh fruit. In our experiments, we show that the vitamin C can also be absorbed in larger quantities in the form of dehydroascorbic acid from juice that has been kept overnight in a refrigerator, for example".

There is at present no treatment that cures Alzheimer's disease, but the research is aimed at treatments and methods to delay and alleviate the progression of the disease by addressing the symptoms.

That antioxidants such as vitamin C have a protective effect against a number of diseases, from the common cold to heart attacks and dementia, has long been a current focus of research.

"The notion that vitamin C can have a positive effect on Alzheimer's disease is controversial, but our results open up new opportunities for research into Alzheimer's and the possibilities offered by vitamin C", says Katrin Mani.

More information: Suppression of amyloid beta A11-immunoreactivity by vitamin C: possible role of heparan sulfate oligosaccharides derived from glypican-1 by ascorbate-induced, NO-catalyzed degradation. Fang Cheng, Roberto Cappai, G.D. Ciccotosto, Gabriel Svensson, Gerd Multhaup, Lars-Åke Fransson and Katrin Mani. Journal of Biological Chemistry, 286, 27559-27572, 2011.

Provided by Lund University

vitamin C dissolves toxic protein aggregates in Alzheimer's disease

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Treatment with vitamin C dissolves toxic protein aggregates in Alzheimer's disease

August 18th, 2011 in Research

Researchers at Lund University have discovered a new function for vitamin C. Treatment with vitamin C can dissolve the toxic protein aggregates that build up in the brain in Alzheimer's disease. The research findings are now being presented in the Journal of Biological Chemistry.

The brains of people with Alzheimer's disease contain lumps of so-called amyloid plaques which consist of misfolded protein aggregates. They cause nerve cell death in the brain and the first nerves to be attacked are the ones in the brain's memory centre.

"When we treated brain tissue from mice suffering from Alzheimer's disease with vitamin C, we could see that the toxic protein aggregates were dissolved. Our results show a previously unknown model for how vitamin C affects the amyloid plaques", says Katrin Mani, reader in Molecular Medicine at Lund University.

"Another interesting finding is that the useful vitamin C does not need to come from fresh fruit. In our experiments, we show that the vitamin C can also be absorbed in larger quantities in the form of dehydroascorbic acid from juice that has been kept overnight in a refrigerator, for example".

There is at present no treatment that cures Alzheimer's disease, but the research is aimed at treatments and methods to delay and alleviate the progression of the disease by addressing the symptoms.

That antioxidants such as vitamin C have a protective effect against a number of diseases, from the common cold to heart attacks and dementia, has long been a current focus of research.

"The notion that vitamin C can have a positive effect on Alzheimer's disease is controversial, but our results open up new opportunities for research into Alzheimer's and the possibilities offered by vitamin C", says Katrin Mani.

More information: Suppression of amyloid beta A11-immunoreactivity by vitamin C: possible role of heparan sulfate oligosaccharides derived from glypican-1 by ascorbate-induced, NO-catalyzed degradation. Fang Cheng, Roberto Cappai, G.D. Ciccotosto, Gabriel Svensson, Gerd Multhaup, Lars-Åke Fransson and Katrin Mani. Journal of Biological Chemistry, 286, 27559-27572, 2011.

Provided by Lund University

Help available for borderline personality disorder

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Help available for borderline personality disorder

August 12th, 2011 in Psychology & Psychiatry

(Medical Xpress) -- Normally, pro football stars call news conferences to discuss touchdowns, tackles or Twitter accounts. But Miami Dolphins wide receiver Brandon Marshall had a completely different objective when he stepped to the lectern earlier this summer at the team’s training camp.

Marshall used the occasion to announce that he has borderline personality disorder, a mental illness characterized by instability in personal relationships, high sensitivity to stress and difficulty in

controlling urges.

"I have a dream home, my house is beautiful. … We have two nice cars, and three beautiful dogs,” Marshall said. "But with all of that said, I haven’t enjoyed one part of it.”

James Curell, MD, a UC Health psychiatrist and associate professor in the University of Cincinnati (UC) Department of Psychiatry and Behavioral Neuroscience, says borderline personality disorder got its name because patients tend to occupy an area between psychosis—full-blown mental illness, such as schizophrenia or bipolar disorder—and milder conditions of neurosis, such as inhibitions or phobias.

"These people tend to be unstable, always in distress,” says Curell. "They tend to act out in terms of substance use or violence, either toward others or themselves, and usually in reaction to stress of some kind.

"These patients are exquisitely sensitive to rejection, criticism or abandonment, and have tremendous conflicts about whether people care about them or not. But they don’t like to be controlled, so they have a conflict over dependence vs. independence and can’t find a happy medium where they feel comfortable.”

Causes of borderline personality disorder can stem from childhood, Curell says, and include feelings of abandonment, sexual or physical abuse and neglect. "Never really having a caregiver can be devastating,” Curell says.

Genetic factors are also believed to play a role. "There are some people who are just genetically more vulnerable than others,” Curell says. "We don’t know all the genetics of it, but I think eventually we will confirm that there’s a genetic component to it as well.”

Borderline personality disorder can be diagnosed through a psychological evaluation, which includes the history and severity of the symptoms. Once diagnosed, Curell says, it can be treated with drugs or therapy.

"Pharmacologic (drugs) management tends to be symptomatic,” Curell says. "If the patient has a lot of depression, you would treat the depression. If they have impulse control problems, you treat that. But to keep it economical and not just keep throwing drugs at symptoms, you try to get to the core symptom or group of symptoms.”

The mainstay of a treatment regimen for borderline personality disorder, Curell says, is psychotherapy.

"These people need to feel that somebody really cares for them and is in their corner,” he says. "There’s no substitute for that—a good, caring relationship with a good therapist who does care.”

Patients also need to develop insight into their behavior so they can understand what triggers their emotions and how they can control their reaction to those triggers.

"If they can start to contain their emotions and not act out, then they can start to change,” Curell says. "They start to build what we call ego strength or personality strength that enables them to adjust to the world in a healthier way.”

Provided by University of Cincinnati

Model of enigmatic Alzheimer's protein described for first time

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Model of enigmatic Alzheimer's protein described for first time

July 18th, 2011 in Research

Side views of the structure of a Flak protein, a member of the same family of proteins that include presenilin, which is implicated in the onset of Alzheimer's. Understanding the structure of these proteins is an early step in the development of drugs that can combat dementia.

Yale School of Medicine researchers have described for the first time the structure of a member in an enigmatic family of proteins linked to Alzheimer's disease, a crucial early step in understanding key mechanisms of the disease and designing drugs to combat dementia.

The technical tour de force was published online July 17 in the journal Nature.

The Yale team described the crystal structure of a protease — a protein that acts like molecular scissors, cutting up proteins into component parts — found in membranes of an a single-celled organism. This membrane protein belongs to the GxGD membrane protease family. The most "famous" member of the family is a human protein called presenilin, which has been implicated in the production of amyloid beta, peptides that cause Alzheimer's disease. Presenilin carries more than 100 mutations that can lead to familial and early-onset Alzheimer's disease.

"Some of the key structural elements that allow the (archaea) protein to do its job are very similar to the existing structure models of human presenilin," noted Jian Hu, associate research scientist. Hu and colleague Yi Xue are lead authors of the Yale study.

The crystal structure of the protease called Flak from the archeon Methanococcus maripaludis is characterized by six transmembrane helices, the researchers found. Three of these segments form the catalytic site where the cutting of proteins is initiated. The arrangements of these three transmembrane helices are similar to those predicted in models of presenilin and therefore Flak is an ideal model system for presenilin research.

Provided by Yale University

"Model of enigmatic Alzheimer's protein described for first time." July 18th, 2011. http://medicalxpress.com/news/2011-07-enigmatic-alzheimer-protein.html

grapes may protect against Alzheimer's disease

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Natural chemical found in grapes may protect against Alzheimer's disease

July 15th, 2011 in Diseases

Researchers at Mount Sinai School of Medicine have found that grape seed polyphenols—a natural antioxidant—may help prevent the development or delay the progression of Alzheimer's disease. The research, led by Giulio Maria Pasinetti, MD, PhD, The Saunder Family Professor in Neurology, and Professor of Psychiatry and Geriatrics and Adult Development at Mount Sinai School of Medicine, was published online in the current issue of the Journal of Alzheimer's Disease.

This is the first study to evaluate the ability of grape-derived polyphenols to prevent the generation of a specific form of β-amyloid (Aβ) peptide, a substance in the brain long known to cause the neurotoxicity associated with Alzheimer disease. In partnership with a team at the University of Minnesota led by Karen Hsiao Ashe, MD, PhD, Dr. Pasinetti and his collaborators administered grape seed polyphenolic extracts to mice genetically determined to develop memory deficits and Aβ neurotoxins similar to those found in Alzheimer's disease. They found that the brain content of the Aβ*56, a specific form of Aβ previously implicated in the promotion of Alzheimer's disease memory loss, was substantially reduced after treatment.

Previous studies suggest that increased consumption of grape-derived polyphenols, whose content, for example, is very high in red wine, may protect against cognitive decline in Alzheimer's. This new finding, showing a selective decrease in the neurotoxin Aβ*56 following grape-derived polyphenols treatment, corroborates those theories.

"Since naturally occurring polyphenols are also generally commercially available as nutritional supplements and have negligible adverse events even after prolonged periods of treatment, this new finding holds significant promise as a preventive method or treatment, and is being tested in translational studies in Alzheimer's disease patients," said Dr. Pasinetti.

The study authors emphasize that in order for grape-derived polyphenols to be effective, scientists need to identify a biomarker of disease that would pinpoint who is at high risk to develop Alzheimer's disease.

"It will be critical to identify subjects who are at high risk of developing Alzheimer's disease, so that we can initiate treatments very early and possibly even in asymptomatic patients," said Dr. Pasinetti. "However, for Alzheimer's disease patients who have already progressed into the initial stages of the disease, early intervention with this treatment might be beneficial as well. Our study implicating that these neurotoxins such as Aβ*56 in the brain are targeted by grape-derived polyphenols holds significant promise."

This research was funded by a grant from the National Institutes of Health. Dr. Giulio Pasinetti is a named inventor of a pending patent application filed by Mount Sinai School of Medicine (MSSM) related to the study of Alzheimer's disease. In the event the pending or issued patent is licensed, Dr. Pasinetti would be entitled to a share of any proceeds MSSM receives from the licensee.

Provided by The Mount Sinai Hospital / Mount Sinai School of Medicine

Fewer mental illness beds linked with increase in involuntary hospital detentions

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Fewer mental illness beds linked with increase in involuntary hospital detentions

July 7th, 2011 in Psychology & Psychiatry

The number of patients compulsorily detained in hospitals for mental illness in England has risen sharply as the numbers of beds have been cut back.

Researchers at Newcastle University have found a direct correlation between the reduction in mental illness bed provision, which has been part of the policy to increase community alternatives to hospitalization, and growing rates of patients being admitted to psychiatric facilities involuntarily. The study looking at the past 21 years, is published in the British Medical Journal.

The closure of mental illness beds in high-income countries including England (along with changes to legislations such as the introduction of the Mental Health Act 1983) has been part of ongoing efforts to deinstitutionalise the care of the mentally ill in recent years.

However, in many of these countries, rates of involuntary admission into psychiatric facilities have been rising despite the introduction of various community-based services such as community mental health teams, assertive outreach, and crisis resolution home treatment.

The increase in the use of compulsory detention is unpopular with both patients and health care professionals and is generally seen as a source of concern to service commissioners and service providers due to the high costs associated with in-patient care.

Researchers from Newcastle University, Warwick University and Queen Mary, University of London set out to explore why the rates of involuntary admissions have been rising over the past 21 years, and to test the hypothesis that there is a direct association with the reduction in mental illness bed provision in the NHS in England.

They analyzed publically available data from the NHS Information Centre and Department of Health hospital activity statistics on NHS mental illness bed provision and involuntary admission rates for each year between 1988 and 2008.

They found that between 1988 and 2008, the rate of involuntary admissions per year rose by 64% from 40.2 to 65.6 per 100,000 adults, while the provision of mental illness beds fell by 62% from 166.1 to 63.2 per 100,000 adults over the same period.

The strongest association between these variables was observed when a time delay of one year was applied, with bed reductions preceding increases in involuntary admissions. Their results indicate that, on average, for every two beds that closed there was one additional involuntary admission in the following year.

The dataset did not include information on the clinical reasons for admissions, but the authors say it is unlikely that the increase reflects "an otherwise unreported dramatic increase in the prevalence of severe mental disorders in England."

Dr. Patrick Keown, Honorary Clinical Senior Lecturer at Newcastle University said: “We emphasise that this paper does not suggest that bed closures are intrinsically inappropriate. This strategy may well be a reasonable course of action; but the bed mix needs to be examined more closely and the rate and consequences of bed closures may need to be considered more carefully.

“Ultimately this study provides important evidence for the need to anticipate the effects of bed closures.”

More information: Association between provision of mental illness beds and rate of involuntary admissions in the NHS in England 1988-2008: ecological study, P Keown, et al. BMJ 2011; 343:d3736 doi:10.1136/bmj.d3736

Provided by Newcastle University

Alzheimer's prevention in your pantry

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Alzheimer's prevention in your pantry

June 27th, 2011 in Research

(Medical Xpress) -- Alzheimer's, the degenerative brain disorder that disrupts memory, thought and behavior, is devastating to both patients and loved ones. According to the Alzheimer's Association, one in eight Americans over the age of 65 suffers from the disease. Now Tel Aviv University has discovered that an everyday spice in your kitchen cupboard could hold the key to Alzheimer's prevention.

An extract found in cinnamon bark, called CEppt, contains properties that can inhibit the development of the disease, according to Prof. Michael Ovadia of the Department of Zoology at Tel Aviv University. His research, conducted in collaboration with Prof. Ehud Gazit, Prof. Daniel Segal and Dr. Dan Frenkel, was recently published in the journal PLoS ONE.

Taking a cue from the ancient world

Prof. Ovadia was inspired to investigate the healing properties of cinnamon by a passage in the Bible. It describes high priests using the spice in a holy ointment, he explains, presumably meant to protect them from infectious diseases during sacrifices. After discovering that the cinnamon extract had antiviral properties, Prof. Ovadia empirically tested these properties in both laboratory and animal Alzheimer's models.

The researchers isolated CEppt by grinding cinnamon and extracting the substance into an aqueous buffer solution. They then introduced this solution into the drinking water of mice that had been genetically altered to develop an aggressive form of Alzheimer's disease, and fruit flies that had been mutated with a human gene that also stimulated Alzheimer's disease and shortened their lifespan.

After four months, the researchers discovered that development of the disease had slowed remarkably and the animals' activity levels and longevity were comparable to that of their healthy counterparts. The extract, explains Prof. Ovadia, inhibited the formation of toxic amyloid polypeptide oligomers and fibrils, which compose deposits of plaque found in the brains of Alzheimer's patients.

In the test-tube model, the substance was also found to break up amyloid fibers, similar to those collected in the brain to kill neurons. According to Prof. Ovadia, this finding indicates that CEppt may not just fight against the development of the disease, but may help to cure it after Alzheimer's molecules have already formed. In the future, he says, the team of researchers should work towards achieving the same result in animal models.

Adding a dash of cinnamon

Don't rush to your spice cabinet just yet, however. It would take far more than a toxic level of the spice — more than 10 grams of raw cinnamon a day — to reap the therapeutic benefits. The solution to this medical catch-22, Prof. Ovadia says, would be to extract the active substance from cinnamon, separating it from the toxic elements.

"The discovery is extremely exciting. While there are companies developing synthetic AD inhibiting substances, our extract would not be a drug with side effects, but a safe, natural substance that human beings have been consuming for millennia," says Prof. Ovadia.

Though it can't yet be used to fight Alzheimer's, cinnamon still has its therapeutic benefits — it can also prevent viral infections when sprinkled into your morning tea.

Provided by Tel Aviv

Common drugs linked to cognitive impairment and possibly to increased risk of death

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Common drugs linked to cognitive impairment and possibly to increased risk of death

June 24th, 2011 in Medications

A large, long-term study confirms that medications with anticholinergic activity, which include many drugs frequently taken by older adults, cause cognitive impairment. The research is also the first to identify a possible link between these drugs – which include over-the-counter and prescription sleep aids and incontinence treatments – and risk of death.

The two-year study of the impact of these medications on 13,000 men and women aged 65 and older is part of the Medical Research Council (UK) Cognitive Function and Ageing Studies (CFAS), a large UK-based longitudinal multi-center study initiative looking at health and cognitive function in older adults. Results of the study of anticholinergics appear June 24, 2011 in an advanced online publication of the Journal of the American Geriatrics Society.

Anticholinergics affect the brain by blocking acetylcholine, a nervous system neurotransmitter. Over-the-counter products containing diphenhydramine, sold under various brand names such as Benadryl, Dramamine, Excedrin PM, Nytol, Sominex, Tylenol PM, and Unisom, have anticolinergic activity. Other anticholinergic drugs, such as Paxil, Detrol, Demerol and Elavil are available by prescription.

"Our findings make it clear that clinicians need to review the cumulative anticholinergic burden in people presenting with cognitive impairment to determine if the drugs are causing decline in mental status," said co-author Malaz Boustani, M.D., Regenstrief Institute investigator, Indiana University School of Medicine associate professor of medicine, and research scientist with the IU Center for Aging Research.

"Physicians should review with older patients all the over-the-counter and prescription drugs they are taking to determine exposure," said Dr. Boustani a geriatrician who sees patients at Wishard Health Services' Healthy Aging Brain Center in Indianapolis.

The researchers, led by Chris Fox, M.D., of the University of East Anglia and Carol Brayne, M.D. of the University of Cambridge, used the Anticholinergic Cognitive Burden Scale developed by Dr. Boustani and colleagues at the Regenstrief Institute, Indiana University and in the United Kingdom to evaluate the link between anticholinergic activity and cognitive decline.

Medications with anticholinergic effects are used for many diseases including hypertension and congestive heart failure. The study found that older age, lower income, and greater number of health conditions increased use of medications with anticholinergic activity. Women were more likely to report taking anticholinergic medications, due to the greater number of health conditions reported by women than by men. Participants living in institutions were more likely to report taking anticholinergic medications.

"We looked at drugs with either moderate and severe anticholinergic activity. After adjusting for age, sex, baseline mental status, education, income level, number of non-anticholinergic medications and health conditions, we found that taking anticholinergic medications was linked to cognitive impairment and for the first time to death," said study corresponding author Dr. Fox, a psychiatrist. "We need follow-up to determine the degree to which anticholinergics are being prescribed for diseases with significant risk of death and the impact of that on our findings."

Authors of the study are Chris Fox, M.D., University of East Anglia; Carol Brayne, M.D., Kathryn Richardson, M.Sc. and George M. Savva, Ph.D, University of Cambridge; Ian D. Maidment, M.A., Kent and Medway NHS and Social Care Partnership Trust; Fiona E. Matthews, Ph.D., Medical Research Council Biostatistics Unit; David Smithard, M.D., Kent Community Health NHS Trust; Simon Coulton M.Sc., University of Kent; Cornelius Katona, M.D., University College London and Malaz Boustani, M.D., M.P.H., Regenstrief Institute, Indiana University School of Medicine and IU Center for Aging Research.

"The Anticholinergic Medication Use and Cognitive Impairment in the Older Population: The Medical Research Council Cognitive Function and Ageing Study (CFAS)" was funded by the Medical Research Council.

"The Medical Research Council invests in cohort studies like CFAS because they provide vital clinical information through observation. Such projects require long-term commitment to fulfill their potential but having supported cohort studies for well over half a century, MRC funding and collaborations have made us an international leader in this field," said Chris Kennard, MBBS, Ph.D., chairman of the MRC's Neuroscience and Mental Health Board.

Provided by Indiana University School of Medicine

Alzheimer's may cause global cash crunch: experts

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Alzheimer's may cause global cash crunch: experts

June 23rd, 2011 in Medicine & Health / Health

Alzheimer's disease could cause a global cash crunch in coming generations -- as people begin to regularly live to 100 -- and must be considered a serious fiscal danger, experts said Thursday.

Already 24-37 million people worldwide live with the incurable form of dementia, and that number is projected to reach 115 million by 2050, a panel of Alzheimer's disease experts told the US House Committee on Foreign Affairs.

As women bear fewer children and the population ages, the world will become increasingly ill-prepared to cope with large numbers of dependent elderly people and must begin investing more in research to prevent the disease, they said.

Places like Russia, Europe, the United States and parts of Asia are experiencing "declining populations, fewer workers and more people dependent upon public health systems for their support," said George Vradenburg, founder of an advocacy group called USAgainstAlzheimer's.

"That is producing fiscal stress on our health systems around the world and it is producing the risk that the developed world -- particularly the Asian rim and particularly western Europe -- are going to be declining in their economic growth and prosperity in the coming years."

According to the London-based Alzheimer's Disease International, the total estimated worldwide cost of the disease in 2010 was 604 billion dollars, or nearly one percent of global GDP.

"If Alzheimer's were a country, it would be the 18th largest economy based on GDP," said Daisy Acosta, the chair of ADI, describing Alzheimer's as "the single most important health and social crisis of the 21st century."

"The impact of this disease today is massive and will accelerate with the years to come," she said.

And yet, compared to other major health woes such as cancer and HIV/AIDS, the amount of research money being spent on preventing it is minimal.

"We invest six billion a year for cancer, four billion dollars a year for heart disease, two billion dollars a year for AIDS," said Bill Thies, chief scientific officer at the Alzheimer's Association.

"We are at about 450 million a year for Alzheimer's disease," he said.

"Without increasing that significantly we are going to see the peak of this epidemic and we are going to see the worst possibilities of it."

The experts acknowledged that the strain of caring for an Alzheimer's patient usually falls on the family, but in the years to come nations as a whole could prepare themselves better by considering how to run an aging economy.

"My grandchildren, aging experts tell me, will live to 110 or 120," said Vradenburg, noting that after age 85 one in two people is diagnosed with dementia.

"We are going to see increasingly a physically able population but a cognitively disabled population."

In order to prevent the older set from consuming a nation's economic resources for health care, countries must think about how to put dementia patients to work in order to keep their economies from collapsing, he said.

"We need to change our aging populations from people who are taking a public benefit... and turn them into productive taxpayers who are participants in the workforce," Vradenburg said.

"Those countries that get it right and figure out how to support their aging populations -- keeping them healthy and keeping them productive -- are going to be winners in the 21st century."

Those who do not will be "losers," he added.

"It is critical for the world to begin to recognize this not just as a health issue but as a fiscal issue."

Eric Hall, president of the Alzheimer's Foundation of America, called for a global meeting early next year to compare notes among nations on how to best approach the problem and formulate a global action plan.

House Representative Ed Markey, a Democrat from Massachusetts, said the world must come together to find a solution.

"We are in a race against time here... and that is across the whole planet," said Markey.

"It is imperative for us to have an action plan that does work, because failure is not an option here."

(c) 2011 AFP

GPs missing early dementia -- new study

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GPs missing early dementia -- new study

June 20th, 2011 in Diseases

New research from the University of Leicester demonstrates that general practitioners (GPs) are struggling to correctly identify people in the early stages of dementia resulting in both missed cases (false negatives) and misidentifications (false positives).

Researchers from the University of Leicester in the UK and National Collaborating Centre for Mental Health, London, UK and the Department of General Practice, Dusseldorf, Germany examined 30 previous studies involving 15,277 people seen in primary care for cognitive disorders, including 7109 assessed for dementia.

Although GPs managed to identify eight out of ten people with moderate to severe dementia, most patients with early dementia were not recognized. Only 45% of people with early dementia and mild cognitive impairment were identified. Mild cognitive impairment is a condition that may precede dementia in some people.

Across the whole spectrum, GPs identified 3 out of 5 of people attending for broadly defined memory problems.

Dr Alex Mitchell, a consultant psychiatrist with the Leicestershire Partnership NHS Trust and a researcher at the University, said: "This study highlights for the first time that GPs trying to identify dementia actually make more false positive errors, with misidentifications outnumbering missed cases at least two to one."

"GPs working in busy settings struggle to identify early dementia and prodromal conditions based on their initial clinical judgement. This was particularly the case for patients living alone where no informant was available and when patients had relatively preserved daily function. Furthermore, GPs' attitudes towards dementia may play an important role in dementia recognition. A project within the German Competence Network Degenerative Dementias (CNDD) at the University of Dusseldorf is currently investigating this.

"Conversely patients with depression or hearing problems were more at risk of being misidentified with dementia. However, the main influence is severity. Patients with mild dementia may not volunteer troubling memory problems and GPs are often unsure about the value of screening tests. Given the problem of false positives and false negatives we found that the application of a simple cognitive screening test after a clinical diagnosis would help GPs to achieve about 90% accuracy. We report separately which screening test may be best in Am J Geriatr Psychiatry 2010;18:759."

Provided by University of Leicester

coffee boosts protection against Alzheimer's disease

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Mystery ingredient in coffee boosts protection against Alzheimer's disease

June 21st, 2011 in Health

A yet unidentified component of coffee interacts with the beverage's caffeine, which could be a surprising reason why daily coffee intake protects against Alzheimer's disease. A new Alzheimer's mouse study by researchers at the University of South Florida found that this interaction boosts blood levels of a critical growth factor that seems to fight off the Alzheimer's disease process.

The findings appear in the early online version of an article to be published June 28 in the Journal of Alzheimer's Disease. Using mice bred to develop symptoms mimicking Alzheimer's disease, the USF team presents the first evidence that caffeinated coffee offers protection against the memory-robbing disease that is not possible with other caffeine-containing drinks or decaffeinated coffee.

Previous observational studies in humans reported that daily coffee/caffeine intake during mid-life and in older age decreases the risk of Alzheimer's disease. The USF researchers' earlier studies in Alzheimer's mice indicated that caffeine was likely the ingredient in coffee that provides this protection because it decreases brain production of the abnormal protein beta-amyloid, which is thought to cause the disease.

The new study does not diminish the importance of caffeine to protect against Alzheimer's. Rather it shows that caffeinated coffee induces an increase in blood levels of a growth factor called GCSF (granulocyte colony stimulating factor). GCSF is a substance greatly decreased in patients with Alzheimer's disease and demonstrated to improve memory in Alzheimer's mice. A just-completed clinical trial at the USF Health Byrd Alzheimer's Institute is investigating GCSF treatment to prevent full-blown Alzheimer's in patients with mild cognitive impairment, a condition preceding the disease. The results of that trial are currently being evaluated and should be known soon.

"Caffeinated coffee provides a natural increase in blood GCSF levels," said USF neuroscientist Dr. Chuanhai Cao, lead author of the study. "The exact way that this occurs is not understood. There is a synergistic interaction between caffeine and some mystery component of coffee that provides this beneficial increase in blood GCSF levels."

The researchers would like to identify this yet unknown component so that coffee and other beverages could be enriched with it to provide long-term protection against Alzheimer's.

In their study, the researchers compared the effects of caffeinated and decaffeinated coffee to those of caffeine alone. In both Alzheimer's mice and normal mice, treatment with caffeinated coffee greatly increased blood levels of GCSF; neither caffeine alone or decaffeinated coffee provided this effect. The researchers caution that, since they used only "drip" coffee in their studies, they do not know whether "instant" caffeinated coffee would provide the same GCSF response.

The boost in GCSF levels is important, because the researchers also reported that long-term treatment with coffee (but not decaffeinated coffee) enhances memory in Alzheimer's mice. Higher blood GCSF levels due to coffee intake were associated with better memory. The researchers identified three ways that GCSF seems to improve memory performance in the Alzheimer's mice. First, GCSF recruits stem cells from bone marrow to enter the brain and remove the harmful beta-amyloid protein that initiates the disease. GCSF also creates new connections between brain cells and increases the birth of new neurons in the brain.

"All three mechanisms could complement caffeine's ability to suppress beta amyloid production in the brain" Dr. Cao said, "Together these actions appear to give coffee an amazing potential to protect against Alzheimer's -- but only if you drink moderate amounts of caffeinated coffee."

Although the present study was performed in Alzheimer's mice, the researchers indicated that they've gathered clinical evidence of caffeine/coffee's ability to protect humans against Alzheimer's and will soon publish those findings.

Coffee is safe for most Americans to consume in the moderate amounts (4 to 5 cups a day) that appear necessary to protect against Alzheimer's disease. The USF researchers previously reported this level of coffee/caffeine intake was needed to counteract the brain pathology and memory impairment in Alzheimer's mice. The average American drinks 1½ to 2 cups of coffee a day, considerably less than the amount the researchers believe protects against Alzheimer's.

"No synthetic drugs have yet been developed to treat the underlying Alzheimer's disease process" said Dr. Gary Arendash, the study's other lead author. "We see no reason why an inherently natural product such as coffee cannot be more beneficial and safer than medications, especially to protect against a disease that takes decades to become apparent after it starts in the brain."

The researchers believe that moderate daily coffee intake starting at least by middle age (30s – 50s) is optimal for providing protection against Alzheimer's disease, although starting even in older age appears protective from their studies. "We are not saying that daily moderate coffee consumption will completely protect people from getting Alzheimer's disease," Dr. Cao said. "However, we do believe that moderate coffee consumption can appreciably reduce your risk of this dreaded disease or delay its onset."

The researchers conclude that coffee is the best source of caffeine to counteract the cognitive decline of Alzheimer's because its yet unidentified component synergizes with caffeine to increase blood GCSF levels. Other sources of caffeine, such as carbonated drinks, energy drinks, and tea, would not provide the same level of protection against Alzheimer's as coffee, they said.

Coffee also contains many ingredients other than caffeine that potentially offer cognitive benefits against Alzheimer's disease. "The average American gets most of their daily antioxidants intake through coffee," Dr. Cao said. "Coffee is high in anti-inflammatory compounds that also may provide protective benefits against Alzheimer's disease."

An increasing body of scientific literature indicates that moderate consumption of coffee decreases the risk of several diseases of aging, including Parkinson's disease, Type II diabetes and stroke. Just within the last few months, new studies have reported that drinking coffee in moderation may also significantly reduce the risk of breast and prostate cancers.

"Now is the time to aggressively pursue the protective benefits of coffee against Alzheimer's disease," Dr. Arendash said. "Hopefully, the coffee industry will soon become an active partner with Alzheimer's researchers to find the protective ingredient in coffee and concentrate it in dietary sources."

New Alzheimer's diagnostic guidelines, now encompassing the full continuum of the disease from no overt symptoms to mild impairment to clear cognitive decline, could double the number of Americans with some form of the disease to more than 10 million. With the baby-boomer generation entering older age, these numbers will climb even more unless an effective preventive measure is identified.

"Because Alzheimer's starts in the brain several decades before it is diagnosed, any protective therapy would obviously need to be taken for decades," Dr. Cao said. "We believe moderate daily consumption of caffeinated coffee is the best current option for long-term protection against Alzheimer's memory loss. Coffee is inexpensive, readily available, easily gets into the brain, appears to directly attack the disease process, and has few side-effects for most of us."

According to the researchers, no other Alzheimer's therapy being developed comes close to meeting all these criteria.

"Aside from coffee, two other lifestyle choices -- physical and cognitive activity -- appear to reduce the risk of dementia. Combining regular physical and mental exercise with moderate coffee consumption would seem to be an excellent multi-faceted approach to reducing risk or delaying Alzheimer's," Dr. Arendash said. "With pharmaceutical companies spending millions of dollars trying to develop drugs against Alzheimer's disease, there may very well be an effective preventive right under our noses every morning – caffeinated coffee."

More information: Caffeine Synergizes with Another Coffee Component to Increase Plasma GCSF: Linkage to Cognitive Benefits in Alzheimer's Mice; Chuanhai Cao, Li Wang, Xiaoyang Lin, Malgorzata Mamcarz, Chi Zhang, Ge Bai, Jasson Nong, Sam Sussman and Gary Arendash; Journal of Alzheimer's Disease, 25(2), June 28, 2011.

Provided by University of South Florida

Is coming out always a good thing?

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Is coming out always a good thing?

June 20th, 2011 in Psychology & Psychiatry

Coming out as lesbian, gay, or bisexual increases emotional well-being even more than earlier research has indicated. But the psychological benefits of revealing one's sexual identity -- less anger, less depression, and higher self-esteem – are limited to supportive settings, shows a study published June 20 in Social Psychology and Personality Science.

The findings underscore the importance of creating workplaces and other social settings that are accepting of all people, but especially gay, lesbian or bisexual individuals, says coauthor Richard Ryan, professor of psychology at the University of Rochester.

"In general, research shows that coming out is a good thing," says Ryan. "Decades of studies have found that openness allows gay people to develop an authentic sense of themselves and to cultivate a positive minority sexual identity." By contrast, research has confirmed that being closeted poses serious psychological risks, including more troubled romantic relationships, more distress, and even increased suicidal tendencies, adds Ryan.

Despite the costs of staying in the closet and the benefits of coming out, earlier studies uncovered only slightly improved mental health from revealing a minority sexual identity. The problem, says Ryan, was that these studies lumped everyone together – people who came out in supportive settings as well as those who faced stigma and discrimination.

By teasing out the effects of different contexts, this study shows that "environment plays a huge role in determining when coming out actually makes you happier," says Nicole Legate, a doctoral student at the University of Rochester, who led the study with Ryan and Netta Weinstein from the University of Essex in England. Among accepting groups, individuals experience significant psychological payback from being open about their sexual identity. But among hostile groups, the costs and stigma of identifying as lesbian, gay, or bisexual cancel out these benefits.

In judgmental contexts, "those who come out may actually feel no better than those who conceal," says Legate.

To measure these different effects, the researchers asked 161 lesbian, gay, and bisexual individuals detailed questions about their experiences with five groups: friends, family, coworkers, school peers, and religious community. The participants were recruited from discussion boards, community and social networking web sites, and university LGB alliance listservs. They reported their answers anonymously online.

For each of the five contexts, participants indicated their level of outness, their sense of well-being, and their perceptions of acceptance or "autonomy support". For well-being, they rated the veracity of such statements as: "When I am with my family, I am lonely" or "When I am with my school peers I feel positive about myself." For autonomy support, they agreed or disagreed on a seven-point scale with assertions like: "My coworkers listen to my thoughts and ideas" or "My religious community provides me with choice and options."

Across all contexts, participants were more closeted in environments they rated as controlling and judgmental. They kept their sexual orientation hidden the most in their religious communities (69 percent), schools (50 percent), and at work (45 percent) and were somewhat more open with their families (36 percent). Friends by far represented the most accepting group for most lesbian, gay, and bisexual individuals. All but 13 percent of participants had come out to their friends, and they reported feeling significantly less anger and greater self-esteem with friends than with any other group.

The study, which included participants from 18 to 65 years old, found that age made no difference in who comes out. Nor did gender or sexual orientation. Instead, the key determinant for revealing a minority sexual orientation was the supportiveness of the environment.

"The vast majority of gay people are not out in every setting," says Ryan. "People are reading their environment and determining whether it is safe or not."

Disclosing in some situations, but not in others, had no effect on mental health, suggesting that such selectivity may be neither helpful nor harmful, the authors concluded.

Other results from the study suggested that gay men experienced lower well-being across measures, while lesbians enjoyed the most autonomy support. Lesbians were the most out of the three groups, bisexuals the least.

Provided by University of Rochester

World's first trial of new anorexia treatment

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World's first trial of new anorexia treatment

June 20th, 2011 in Health

(Medical Xpress) -- Researchers from the University of Western Sydney are trialling a new method of treatment for anorexia nervosa, which addresses the role of extreme exercise in perpetuating the dangerous and debilitating cycle of the disorder.

Professor Phillipa Hay, from the UWS School of Medicine, says compulsive and excessive exercise is a key feature of anorexia which presents in a majority of patients.

"In addition to having distorted views of their body shape and weight and disturbances in their eating behavior, many patients also experience a compulsion to push their body past its physical limits through exercise," says Professor Hay.

"Extreme exercise can be dangerous for anyone, but when coupled with the poor health and nutrition of anorexia patients it can lead to a tide of other medical problems and is often associated with higher levels of psychological distress, longer hospital stays, and relapses from treatment."

In a world-first, the University of Western Sydney will trial a new method of anorexia treatment that looks specifically at the role of extreme exercise in the maintenance of anorexia.

The new treatment, which is based on the 'Loughborough Eating disorders Activity theraPy', (also known as 'LEAP') aims to promote healthy attitudes, beliefs and behaviors and equip patients with the knowledge and skills to regain control over their exercise.

Professor Hay says the relationship between extreme exercise and anorexia has not been thoroughly examined by researchers and its serious impacts are not sufficiently addressed in current treatment programs.

"Anorexia treatments traditionally aim to prevent further physical harm by restricting patients to low impact exercises, such as yoga or walking, or banning patients from exercising entirely," says Professor Hay.

"However, this approach does not address the patients' underlying compulsions or addiction to exercise and does not consider that forcing them to stop exercising may have adverse psychological effects."

According to Professor Hay, LEAP is an innovative treatment which recognises anorexia patients' overwhelming urges to exercise and it allows them to develop the capacity to do so in a healthier way.

"Used in conjunction with a form of cognitive behavioural therapy, LEAP also aims to restore weight and normal eating habits by challenging underlying beliefs and thoughts through cognitive restructuring and behavior change."

The UWS study requires 100 adult volunteers with anorexia nervosa to participate in 34 free treatment sessions. The treatment sessions will be held in convenient locations in Campbelltown, Westmead or Camperdown.

Provided by University of Western Sydney


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