Archive for December, 2008

Treatment for sleep apnea may improve mental function in Alzheimers

NightAlzheimer’s patients who also have obstructive sleep apnea may experience improved mental function from treatment with continuous positive airway pressure (CPAP), according to a recent study from University of California San Diego.

Previous studies have suggested that more severe dementia is associated with more severe obstructive sleep apnea. And in fact, Alzheimer’s patients have a high incidence of obstructive sleep apnea. Previous studies have found that approximately 70% to 80% of Alzheimer’s patients experience at least five episodes of apnea or hypopnea per hour and 40% to 50% have 20 or more episodes per hour.

Sleep apnea occurs when a person’s breathing repeatedly stops and starts for short periods of time during sleep. This abnormal breathing pattern only occurs during sleep, therefore, the person with the disorder may be the last to know he or she has a problem.

Obstructive sleep apnea (OSA), is usually associated with loud snoring (though not everyone who snores has this disorder). Risk factors for obstructive sleep apnea include being male, overweight, and over the age of forty. This condition occurs two to three times more often in older adults and is twice as common in men as in women.  However, sleep apnea can affect anyone at any age, even children.

If you think you might have sleep apnea, ask your health care provider for help.

Read more about Obstructive Sleep Apnea from Bay Area Medical Information

via Ancoli-Israel S, et al “Cognitive effects of treating obstructive sleep apnea in Alzheimer’s disease: a randomized controlled study” J Am Geriatr Soc. 2008; 56: 2076-2081.

via MedPage Today, December 4, 2008

Depression linked with increased mortality in heart failure patients

A man who appears depressedDepression increases the risk of death in patients with heart failure, but the risk apparently disappears with antidepressant use, according to a recent study from Duke University Medical Center.

Depression is not a sign of weakness or a character flaw. It is a true medical condition like diabetes or hypertension, and it is often an overwhelming disease.

More people suffer from depression than you might think. Twenty-five percent of all women and up to 12% of all men in the U.S. will experience an episode of major depression some time in their lives. A person who is depressed to the point that it interferes with daily activities should seek medical care.

Read about the symptoms of depression from Bay Area Medical Information

Source: Archives of Internal Medicine, November 10, 2008.

Regular exercise is good for the brain

Walking is an aerobic exerciseRegular aerobic exercise appears to improve blood flow in the brain, thus improving the brain’s ability to function, according to a recent study out of the Jefferson Medical College in Philadelphia.  These findings add to the growing body of literature that points to exercise being both preventive of mental decline and helpful in improving cognitive function in older adults. 

Regular exercise is also one of the best ways to improve your mental outlook, lose weight, appear youthful, and ward off viruses as well as many chronic illnesses.  Read more  about the 18 life-changing benefits of exercise and how to get started.

via Rahman FN, et al “Relationship of exercise to cerebral vasculature and blood flow in older adults” RSNA 2008; Abstract LL-NR2256-D03.
via “RSNA: Exercise May Prevent Loss of Small Blood Vessels in the Brain” MedPage Today, Dec. 1, 2008

Psychiatric disorders are prevalent, yet undertreated, in college kids

College drinkersThe college years are a particularly vulnerable time of development. What’s more, the academic and social pressures can be overwhelming for a college student, living in a new, transitional, and highly influential environment. 

The major task of this age is to become their own person. They need to learn to make choices and commitments, follow through with them, and stand up independently in the world. But college-aged kids swing back and forth between dependence and independence as they work on these tasks.   What’s more, college-aged individuals may have less well-developed coping mechanisms or less experience than older adults with romantic disappointments and interpersonal difficulties, making them particularly vulnerable to the effects of these and related stressors. 

A recent large Columbia study of 5,000 individuals, aged 19 to 25, found that mental health problems are highly prevalent among both college students and nonstudents alike.   In this study, an alarming 46%  of students and 48% of non-students in this age group technically had a psychiatric disorder according to objective DSM-IV criteria.

That is not to say that almost half of our youth will go on to suffer mental illness for the rest of their lives.  Many of the 19 to 25 year olds who use healthy coping mechanisms will overcome this challenging and emotional phase of their lives.  Regular exercise, adequate sleep, a well-balanced diet, choosing friends wisely, and seeking professional counseling when needed will build a solid foundation for happiness and success in their later years.  Others who turn to alcohol, heavy partying, excessive sleeping, smoking, or drugs to deal with their stressors, will more likely go on to develop more serious mental illness. Continue reading ‘Psychiatric disorders are prevalent, yet undertreated, in college kids’

Two dietary supplements have been recalled by the FDA

Over-the-counter pillsUndeclared drugs have been detected in two dietary supplements which has prompted a recall by the the FDA.  Two potentially dangerous ingredients have been found in the products that are not listed on the label. 

Distributed in the U.S. and sold via the Internet, Zhen De Shou capsules were found by the FDA to contain sibutramine, a potentially dangerous appetite suppressant.  Sibutramine has been shown to increase blood pressure and pulse rate in some people, and may be a significant risk for those with a history of coronary artery disease, congestive heart failure, arrhythmias, or stroke. The Zhen De Shou capsule is sold in a box with an inner foil pouch that contains a blister pack of light and dark green capsules. The recall affects all lots. 

Starcaps Diet System supplements is the second drug to be recalled.  The FDA has detected an undeclared ingredient, bumetanide, which is a prescription-only diuretic. The drug has been distributed nationwide through U.S. retail outlets and online sales. Currently, the recall applies only to lot 12/2011 — 84810, but the company is in the process of testing other lots. Potential adverse effects of bumetanide include fluid and electrolyte loss, hypotension, fainting  and an elevation in uric acid concentrations. Serious drug-drug interactions can occur, particularly with digoxin and lithium, which could lead to an increased risk of toxicity.

In general, diet drugs should be avoided altogether.  Aside from their potential side effects, they entice people into a weight-loss program that can’t be sustained.  The weight loss achieved with appetite suppressants can’t be maintained without a true change in life style.  Weight loss quickly turns into weight gain once the appetite suppressants are stopped.

via FDA, Recall of Zhen De Shou Fat Loss Capsules, November 2008
via FDA, Recall of Starcaps Diet System supplements, November 2008

Simple screening for mental decline in five minutes

The Mini-Cog is a simple written screening toolScreening for mild cognitive impairment can be accomplished in less than five minutes with a three-word memory test and a clock-drawing task, according to Emory researchers. This new test, called the Mini-Cog, is reasonably accurate and allows quick screening by health care professionals. It appears to be a valuable aid for early identification of patients who might be at risk for later development of a serious dementia, such as Alzheimer’s Disease. 

The Mini-Cog, combined with a simple functional activities questionnaire, accurately diagnosed 83% of patients with mild cognitive impairment, in this recent Emory study.  Current screening for mild cognitive impairment is often logistically difficult because it typically requires 40 to 60 minutes of formal neuropsychological testing and it only achieves 80% accuracy or higher. 

Dementia is defined by the American Psychiatric Association as an acquired syndrome of decline in memory and at least one other cognitive domain such as language, visuo-spatial, or executive function sufficient to interfere with social or occupational functioning in an alert person.  It’s very important to keep in mind that the word dementia describes a general syndrome and many different diseases can cause dementia. Alzheimer’s disease and cerebrovascular ischemia (vascular dementia) are the 2 most common causes. Some potentially reversible conditions, such as hypothyroidism or vitamin B-12 deficiency, are also some of the many different causes of dementia.

The Mini-Cog test results should only be used in conjunction with other testing  in forming a diagnosis by a health care professionals, and should not be used in isolation of diagnostic tests for Alzheimer’s disease.

If a family member starts showing signs of memory loss or other symptoms of mental decline, never assume that nothing can be done.  See your health care provider for evaluation and help.

“Memory Loss Screening Tool for Caregivers/Family” from Bay Area Medical Information

The Mini-Cog” from Bay Area Medical Information