The first ever National Audit of Dementia found a “shocking” lack of care delivery.It found that care was often delivered in an impersonal manner, staff ignored patients’ requests for help and staff were not trained sufficiently in the care of dementia patients despite figures showing one in four hospital beds is occupied by people with the condition.

Data from 210 hospitals in England and Wales was used in the report along with ward level data from a sample of 145 wards, over 2,000 staff questionnaires and observations of care on the wards.

Professor Peter Crome, the co-author of the report and Chairman of the National Audit of Dementia Steering Group, said that the report had “found problems across practically every aspect of care for patients admitted to hospitals with dementia.”

He added: “There were deficiencies in the assessment of people and there were deficiencies in the interaction betweem staff and patients.”

Hannah Clack from the Alzheimer’s Society called the report “shocking” and stressed the need for “a huge and radical shake-up of the way the NHS deals with people with dementia.”

She added: “People are going into hospital and they’re coming out worse in terms of their dementia and in terms of their physical health.”

The report recommended that all staff should have basic training in dementia, and that all hospitals should have Dementia Champions on every ward.

Eating fish could protect against Alzheimer’s disease and memory loss – but only if it is baked or grilled, researchers have claimed.A study by US scientists found that elderly people who eat fish at least once a week are three to five times less likely to develop the conditions than people who did not.

But it is essential that the fish is cooked in a manner that preserves the vital Omega-3 fatty acids which help protect the brain, researchers said.

Grilling or baking the meat provides the maximum levels of Omega-3, which increase blood flow to the brain, reduce inflammation and limit the build-up of harmful plaques which precedes Alzheimer’s.

In contrast fried fish has very low amounts of Omega-3 and consequently offers no protection whatsoever against dementia and age-related memory loss, known as Mild Cognitive Impairment (MCI).

Researchers from the University of Pittsburgh studied a group of 260 healthy volunteers with an average age of 76.

In a study Eating Fish Reduces Risk of Alzheimer’s Disease to be presented at the Radiological Society of North America annual meeting they questioned the participants about how regularly they ate fish.

Brain scans carried out ten years later showed that those who did not eat fish regularly had suffered much more shrinkage in key areas of the brain linked to working memory.

A further five years on, they found that 31 per cent of non-regular fish eaters had gone on to develop Alzheimer’s or MCI, compared with between three and eight per cent of those who ate fish at least once a week.

Dr Cyrus A. Raji, who led the study, said further studies could help identify whether Omega-3 supplements yielded similar effects, and whether some types of fish offered better protection than others.

He said: “We know from other studies that salmon gives the maximum amount of Omega-3 fatty acids so it is very possible, but we did not look at which fish people were eating in the study.

“Studies like this definitely justify trials that will look at Omega-3 fatty acid supplements. Having said that, I would speculate that taking supplements is no substitute for a lifetime of eating fish.”

Dr Simon Ridley, head of research at Alzheimer’s Research UK, said: “This study suggests that eating fish on a weekly basis may reduce the risk of cognitive decline, but it is not clear whether other underlying factors may have contributed to the lower risk in people who eat fish.

“As a number of controlled studies using fatty acids from oily fish have failed to show benefits for dementia, there is a clear need for more conclusive research into the effects of dietary fish on our cognitive health.”

Dr Anne Corbett, research manager of the Alzheimer’s Society, added: “This moderately sized study adds weight to existing evidence suggesting that eating fish reduces your risk of developing cognitive decline.

“However, this research did not account for lifestyle factors such as other foods or exercise which could also have had an effect. The best way to lessen your chance of developing dementia is to eat a healthy diet including fruit and vegetables along with taking regular exercise and giving up smoking.”

Middle aged people who are overweight but not obese, are 71% more likely to develop dementia than those with a normal weight, according to research.
Previous studies have also indicated a link between obesity and dementia.

But a study 8,534 of Swedish twins, in the journal Neurology, suggests just being overweight is also a risk factor.

About one out of every 20 people above the age of the 65 has dementia. The Alzheimer’s Society said a healthy lifestyle could reduce the risk.

Those with a body mass index (BMI) – which measures weight relative to height – greater than 30, who are classified as obese, were 288% more likely to develop dementia than those with a BMI between 20 and 25, according to the study.

The clinically overweight, who have a BMI between 25 and 30, were 71% more likely.

Alzheimer’s Society head of research, Dr Susanne Sorensen, said: “This robust study adds to the large body of evidence which suggests that if you pile on the pounds in middle age, your chances of developing dementia later in life are also increased.

“By eating healthily and exercising regularly, you can lessen your risk of developing dementia.”

Alzheimer’s Research UK head of research, Dr Simon Ridley, said: “This study adds to existing evidence that excess weight in middle age could increase our risk of developing dementia.

“It’s likely that dementia is caused by a complex mix of genetic, environmental and lifestyle factors. However, we still need to know much more about the causes of dementia if we are to find an effective treatment that is so desperately needed.”

From: http://www.bbc.co.uk/news/health-13213755

Hundreds of thousands of patients in the early stages of Alzheimer’s disease could get drug treatments following a U turn by the killer quango NICE.
Having banned the use of Alzheimers drugs for several years the National Institute for Curbing Expenditure (NICE), now says the evidence backs the use of drugs for “mild” symptoms.

Current rules prevent NHS doctors prescribing donepezil, galantamine and rivastigmine in such early cases.

Campaigners said the release of the new draft guidance was a “momentous day”.

As many as 465,000 people in the UK have Alzheimer’s disease, and this is expected to rise as the population ages.

The availability of drugs for the condition on the NHS has been source of controversy for almost a decade.

While there has always been evidence they diminished the symptoms and boosted quality of life for some, it has not always been clear exactly how much improvement they could deliver, to which groups of patients, and for how long.

In 2005, killer quango drugs watchdog NICE ruled that no-one should get the drugs on the NHS, then conceded a year later that patients with “moderate” disease should receive them, while still ruling out “mild” patients.

The secret formula used by NICE to calculate how much “value for money” the drugs offer to the NHS was then the subject of a court action by the Alzheimer’s Society and pharmaceutical companies.

* 2005 Draft NICE guidance recommends no patients should receive Aricept (donepezil), Reminyl (galantamine) or Exelon (rivastigmine)
* May 2006 Final guidance says those with moderate Alzheimer’s are eligible, but not those with mild disease
* October 2006 Internal NICE panel rejects appeals over decision to exclude “mild” patients
* June 2007 High Court backs NICE decision following Judicial Review
* May 2008 Court of Appeal rules NICE should make public their “economic model” which calculates the financial benefits of a drug
* June 2009 NICE admits “technical inaccuracies” in the model, amends it, but does not alter guidance
* October 2010 Five years on, a fresh review of the guidance backs prescribing three drugs for mild Alzheimer’s, and includes a fourth for more advanced disease

After the case went all the way to the House of Lords, NICE was forced to first disclose the formula, then amend it after admitting “technical inaccuracies”, although it said this did not change the outcome.

That new review now proposes giving the drugs to patients with mild symptoms – which covers people in the early stages of the disease, perhaps suffering memory loss and confusion, but not yet dependent on carers for day-to-day activities.

It has also suggested a fourth drug, Ebixa, be made available for the first time to patients with more advanced disease.

The guidance is still subject to appeal by the quango.

Ruth Sutherland, the interim chief executive of the Alzheimer’s Society, said that it was “a momentous day”, with approximately half of the 62,000 people who develop the disease every year likely to benefit from the drugs.

She said that the drugs, which cost approximately £2.80 per person per day, were not a “miracle cure”, but made important differences to people’s lives.

She said: “For the price of a cup of coffee they can mean the difference between recognising your loved ones and playing with your grandchildren.

“It is critical that this draft decision becomes a reality and that all people with Alzheimer’s are given the opportunity to benefit.”

The society’s Director of Research, Professor Clive Ballard, said: “If this guidance is issued, doctors will no longer have to watch people deteriorate without being able to treat them.”

Professor Roy Jones, from the Research Institute for the Care of Older People in Bath, described the decision as “an important milestone”.

He said: “Early diagnosis and access to medication is critical to help reduce both the short and long-term impact of this devastating condition on patients, families and carers.”

From: http://www.bbc.co.uk/news/health-11486367

Tests suggest daily vitamin B supplements can dramatically slow the onset of Alzheimer’s and similar diseases.
Researchers from the University of Oxford have found that taking tablets of three B vitamins every day slows the brain shrinkage that happens with age, causing early signs of dementia such as memory loss.

In a two-year trial, the vitamin supplement delayed the rate of brain atrophy by up to half in a group of elderly people, with a more than 30 per cent reduction overall. Cognitive tests show those with the least shrinkage perform best.

A vitamin pill that curbed the mental decline associated with ageing would have colossal implications. About 1.5 million people in the UK, 14 million in Europe and five million in the US have problems with memory, language or other mental functions known as Mild Cognitive Impairment (MCI), half of whom go on to develop Alzheimer’s or another form of dementia within five years.

Even a slight slowing of this process would have immense human and economic benefits. However, the researchers said it was too soon to recommend elderly people suffering memory lapses should take B vitamin supplements, until further studies had confirmed the benefits and risks.

Large doses of around 300 times the daily recommended intake of B12 and four times the recommended levels of folic acid were used in the trial. The researchers said this meant they acted like a pharmaceutical drug rather than a nutritional supplement and would require further safety tests. They are now seeking funding for another trial.

The best sources of vitamin B are fresh dairy products and meats. The word fresh is key, as the nutritional value of foods can decline when they are frozen, overcooked, or combined with different additives.

Dark-green leafy vegetables such as spinach, arugula, kale, collard greens, chicory, dandelion greens and Swiss chard, are a great source of folic acid. By steaming these vegetables as opposed to frying or simmering, you reap the greatest benefits because their vitamin content remains intact.

The Oxford research, carried out in association with colleagues in Norway, involved 168 people with MCI, half of whom were given daily doses of vitamin B12, B6 and folic acid (B9).

After two years, MRI scans showed the brains of those who had taken the vitamins had shrunk less – by 0.76 per cent a year – than those given placebo (1.08 per cent) – a 31 per cent difference. In the quarter of elderly people who responded best, the reduction in the rate of shrinkage was 53 per cent.

Brain shrinkage is known to occur more rapidly in people with MCI or Alzheimer’s and high levels of the amino acid homocysteine are linked to an increased risk of the conditions. The researchers believe that the B vitamins slowed the brain atrophy seen in MCI and Alzheimer’s by reducing the levels of homocysteine. People with the highest levels of homocysteine in their blood benefited most.

Although the trial was not designed to measure thinking ability, the researchers found that individuals with the lowest rates of shrinkage had the highest mental test scores.

The findings are published in the journal PLoS [Public Library of Science] One.

Professor David Smith of the Department of Pharmacology, Oxford University, and co-leader of the trial, said: “This is a very striking, dramatic result. It is our hope that this simple and safe treatment will delay the development of Alzheimer’s disease in many people who suffer from mild memory problems.

“These are immensely promising results but we do need to do more trials to conclude whether these particular B vitamins can slow or prevent development of Alzheimer’s. So I wouldn’t yet recommend that anyone getting a bit older and beginning to be worried about memory lapses should rush out and buy vitamin B supplements without seeing a doctor.”

Professor Smith said the key question was whether MCI was a mild manifestation of the more extreme Alzheimer’s disease. “Is this a continuum? Are we seeing a disease that begins a long time ago and gets worse and worse? I personally think so.”

The long-term effects of taking big doses of the vitamins were not known, and there was some evidence that high folate intake could be linked to cancer, he said. However, asked if he would try the vitamin treatment if he was diagnosed with MCI he said: “Yes, no hesitation. I would take it.”

Chris Kennard, chair of the Medical Research Council’s Neurosciences and Mental Health Board which co-funded the study, said: “This trial brings us a step closer to unravelling the complex neurobiology of ageing and cognitive decline.”

From: http://www.independent.co.uk/daily-vitamin-pill-could-reduce-dementias-effects-by-up-to-50-per-cent