A study published in Science has found that levels of amyloid beta, a protein fragment associated with Alzheimers disease, rose and fell in association with sleep and wakefulness in mice.

It is interesting that there may be a link between sleep and the build up of the protein associated with the development of Alzheimers disease. However, there are many other biological factors that may have an impact on the proteins production, so further research in this area would be needed.

Dementia research is desperately underfunded, with the government investing eight times less in dementia research than cancer research. One million people will develop dementia in the next 10 years. We must act now.

Professor Clive Ballard
Director of Research
Alzheimers Society

JaeEun Kang, Miranda M. Lim, Randall J. Bateman et al, Amyloidbeta dynamics are regulated by Orexin and the SleepWake Cycle, 24 September 2009

Data in a recent study published in Neurology, the medical journal of the American Academy of Neurology links elevated diastolic blood pressure to the cognitive impairment of people over 45

The study of nearly 20,000 people aged 45 (average age 65) found that people with high diastolic blood pressure, the bottom number of a blood pressure reading, were more likely to have cognitive impairment or problems with their memory than people with normal readings.

Previous research has demonstrated that people with high blood pressure have an increased risk of developing dementia later in life.

High blood pressure affects one in three adults in the UK with a quarter of people not aware that they have it.

This large study adds weight to the growing body of evidence that high blood pressure can be linked to cognitive impairment. Now further study is needed to establish why these two factors could be linked.

Alzheimers Society recommends that you can reduce your blood pressure by exercising regularly, eating healthily and not smoking. High blood pressure can often also be controlled by medication so if youre not sure what your blood pressure is or havent had it checked recently you should visit your GP to have it measured.

Dr Susanne Sorensen
Head of Research
Alzheimers Society

Reference Association of higher diastolic blood pressure levels with cognitive impairment G Tsivgoulis, MD, A.V Alexandrov, MD et al (Neurology, 25 August 2009)

Source

Researchers from Boston University School of Medicine (BUSM) have shown that disclosing genetic risk information to adult children of patients with Alzheimers disease (AD) who request this information does not result in significant shortterm psychological distress. The report from the REVEAL Study*, which appears in the July 16 issue of the New England Journal of Medicine, is the first randomized trial to disclose to participants whether or not they carried the ε4 variant of the APOE gene, a variant that has been found to increase the risk of developing AD. The study demonstrated that testrelated distress was reduced among those who learned that they were APOE ε4 negative, and was only transiently increased among those who learned they were APOE ε4 positive. The study also showed that persons with high levels of emotional distress before undergoing genetic testing were more likely to have emotional difficulties after disclosure.

The study comes at a time when gene variants that are associated with risks of common diseases are being rapidly discovered and genetic testing is now being marketed by directtoconsumer genetics testing companies such as 23andMe, Navigenics and DeCodeMe. Considerable controversy has accompanied the launch of these companies and one area of concern has been the potential for psychological harm if individuals learn they are at increased risk for diseases that have no treatment, such as AD.

The BUSM researchers, along with their collaborators at the University of Michigan, Weill Cornell Medical College and Case Western Reserve University School of Medicine randomly assigned 162 asymptomatic adults who had a parent with Alzheimers disease to two groups the disclosure group, who received a risk assessment for their chance to develop AD that included their APOE genotyping results, and the nondisclosure group, who received a risk assessment for AD that excluded their APOE genotyping status. They then measured symptoms of anxiety, depression, and testrelated distress six weeks, six months, and one year after disclosure or nondisclosure and found no significant differences between the two groups in measures of anxiety, depression or testrelated distress.

Comparisons between the subgroup of participants carrying the APOE ε4 variant and those who did not learn their genotype revealed no significant differences, suggesting that learning about increased risk did not cause psychological harm. However, the ε4 negative subgroup had a significantly lower level of testrelated distress than did the ε4 positive subgroup, suggesting a psychological benefit to those who learned they were at lower risk.

“Study participants who learned they were ε4 positive and were therefore at increased risk for Alzheimers disease showed no more anxiety, depression, or testrelated distress than those who did not learn their genotype,” said lead author Robert C. Green, MD, MPH, a professor of neurology, genetics and epidemiology at BUSM as well as a fellow in genetics at Harvard Medical School, “but those who learned they were ε4 negative experienced considerable relief.”

“Its important to recognize that our participants were carefully screened for preexisting emotional problems and that trained genetic counselors disclosed the information,” adds Green, “so it is not the same thing as simply providing risk information to anyone who asks. Nevertheless, our work supports the notion that learning genetic risk information can be a positive and empowering experience for some people, even when the disease is frightening and the genetic information has no clear medical benefit. “

According to the BUSM researchers, larger studies that follow participants for more than one year will be required to detect uncommon and longterm effects, such as delayed emotional repercussions and injudicious life decisions. These studies are currently underway in new REVEAL Study trials.

Funding for this study was provided by the Ethical, Legal and Social Implications (ELSI) Branch of the National Human Genome Research Institute (NHGRI); by a Mentoring Award from the National Institute on Aging; and by a grant from NHGRI at Duke University for Centers of Excellence in ELSI Research.

*REVEAL (Risk Evaluation and Education for Alzheimers Disease) Study

Disclosure Two coauthors (Drs. Relkin and Farrer) received consulting fees from Smart Genetics, which provided directtoconsumer APOE genotyping from March 2008 through October 2008, when it ceased operations. No other potential conflict of interest to this article was reported.

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Gina M. DiGravio