Scientists have long sought to develop a vaccine that may prevent the onset or progression of Alzheimer’s disease. But so far, vaccines have had limited benefit and proved potentially dangerous, sometimes triggering life-threatening inflammation in the brain. Now, researchers say that giving a vaccine at an early stage, before symptoms and brain damage have become prominent, may be critical for getting a vaccine to work.

The researchers, from Georgetown University Medical Center in Washington, worked with lab rats that had been bred to develop a disease that resembles Alzheimer’s in humans. They found that the rodents with a large brain buildup of toxic amyloid protein, similar to the beta-amyloid protein that builds up in the brains of people with Alzheimer’s, were more likely to develop brain inflammation after receiving the vaccine than those with little buildup of the toxic protein. The animals with the least amyloid in the brain were also most likely to benefit from the vaccine, showing a slowing of symptoms suggestive of Alzheimer’s disease.

The results mean that people in the earliest stages of Alzheimer’s, who have little buildup of toxic beta-amyloid in the brain, may be the best candidates for an Alzheimer’s vaccine, since they may be least likely to suffer from toxic side effects of vaccine-induced inflammation. The findings were presented at the 2011 annual meeting of the Society for Neuroscience.

The results also call attention to the need for improved techniques to diagnose Alzheimer’s early, before buildup of beta-amyloid has extensively damaged the brain.

Several Alzheimer’s vaccines are currently being tested. Most target beta-amyloid, and some have shown limited success in preventing the buildup of the toxic protein in the brain. But in early experiments, some have had to be withdrawn from testing because they caused inflammation and brain swelling, both potentially dangerous, in a few patients.

The study is important, said Dr. R. Scott Turner, director of the Georgetown University Memory Disorders Program, because it shows that excessive inflammation occurs in brains that have a high burden of amyloid. The results suggest that benefits from the vaccine will most likely be found in those with less amyloid buildup, or so-called amyloid burden. The study also provides clues as to how and why the inflammation occurs, Dr. Turner says.

The researchers note that the vaccines now being tested in patients with Alzheimer's may work better in patients with mild cognitive impairment, or MCI, a form of memory loss that sometimes precedes Alzheimer’s. They are currently recruiting patients for a trial of a vaccine in people with MCI.

"We may find that in the future, we will have to tailor immunization therapies based on amyloid burden in individual patients," Dr. Turner said. People with more advanced disease, for example, may be given a vaccine tailored to minimize the risk of excessive inflammation in the brain.

By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.

Source: Georgetown University Medical Center. Society for Neuroscience Annual Meeting.

A new type of brain scan may help to detect Alzheimer's early, using no radiation and at less cost than other techniques, researchers report. Doctors at the University of Pennsylvania's Perelman School of Medicine have developed a form of magnetic resonance imaging, or MRI, that detects brain changes that signal Alzheimer's disease. The doctors have developed a modification to the technique called arterial spin labeling, or ASL-MRI. Small studies show, this may be a useful way to diagnose probable early dementia.

MRI scans are routinely used in hospitals to check for tumors and other issues, and seniors with memory problems may undergo the procedure to rule out brain tumors, strokes or other problems that may be causing the deficits. If Alzheimer's is suspected, they may then undergo another scanning procedure, such as a PET scan.

The advantage of the new ASL-MRI technique is that someone could undergo brain scanning in a single session to help determine whether Alzheimer's may be present. The technique looks for changes in blood flow and the uptake of blood sugar, or glucose, in the memory centers of the brain. It requires about an additional 20 minutes compared to standard MRI scans.

"Increases or decreases in brain function are accompanied by changes in both blood flow and glucose metabolism," explained Dr. John Detre, professor of Neurology and Radiology at Penn, who has worked on ASL-MRI for the past 20 years. "We designed ASL-MRI to allow cerebral blood flow to be imaged noninvasively and quantitatively using a routine MRI scanner."

Studies show that the MRI method is similar in effectiveness to current PET scans that inject a radioactive dye to measure these brain changes. However, the ASL-MRI method uses no radiation and costs one-fourth as much.

"If ASL-MRI were included in the initial diagnostic work-up routinely, it would save the time for obtaining an additional PET scan, which we often will order when there is diagnostic uncertainty, and would potentially speed up diagnosis," said Dr. David Wolk, Assistant Director of the Penn Memory Center and a collaborator on the research.

The studies compared the MRI technique and the specialized PET scan results using flurodeoxyglucose, or FDG, a radioactive tracer. In one, published in the journal Alzheimer's and Dementia, doctors compared images from 13 patients diagnosed with Alzheimer's and 18 age-matched controls. Both methods proved equally effective in detecting signs of early Alzheimer's.  In the second study, published in the journal Neurology, data from 15 AD patients were compared to 19 age-matched healthy adults. The patterns of reduction in cerebral blood flow were nearly identical to the patterns of reduced glucose metabolism by the PET scan and showed reductions in brain gray matter typical of Alzheimer's disease.

"Given that ASL-MRI is entirely noninvasive, has no radiation exposure, is widely available and easily incorporated into standard MRI routines, it is potentially more suitable for screening and longitudinal disease tracking than FDG-PET," said the Neurology study authors.

Early diagnosis of Alzheimer's in the doctor's office has long been a goal for those who treat dementia. Increasingly, experts believe that Alzheimer's is a disease that begins many years before symptoms like memory loss and personality changes become apparent. Treatment of the disease may be most effective in these early stages, before damage to the brain has become extensive. In addition, a simple test to measure brain function would be useful for researchers to test and monitor new treatments.

Additional studies of this new MRI technique will focus on larger sample sizes, including patients with mild cognitive impairment and other kinds of brain problems.

By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.

Source: American Academy of Neurology. Musiek ES, Chen Y, Korczykowski M, et al: "Direct Comparison of Flurodeoxyglucose Positron Emission Tomography and Arterial Spin Labeling Magentic Resonance Imaging in Alzheimer's Disease." Alzheimer's and Dementia, Oct. 20, 2011, epub ahead of print. 

Can what you eat help to protect the brain, and possibly help ward off Alzheimer’s disease? A growing body of evidence suggests nutritional factors can influence brain health, including a new report linking certain nutrients to good cognitive health.

Researchers measured blood levels of 30 key vitamins and nutrients in a sample of elderly men and women, all of whom also underwent memory tests. Some also underwent brain scans to measure their brain volumes and look for signs of Alzheimer’s disease.

Five nutrients were linked to good memory and thinking skills: omega-3 fatty acids, the kinds of fats found in fish, and vitamins B, C, D, and E. People who had high blood levels of these nutrients scored better on thinking tests than those who had low blood levels of these nutrients. Their brains also showed less shrinkage, a sign of brain health. People with Alzheimer’s typically have smaller brains than those without the disease.

The study also found that people with high levels of trans fats, an unhealthy type of fat found in packaged baked goods as well as fast, fried and frozen foods, scored lower on thinking and memory tests than those with low trans fat levels. Trans fats are also found in some types of margarine and have been banned in some locales. The findings appeared in Neurology, a journal from the American Academy of Neurology.

The study, part of the Oregon Brain Aging Study, involved 104 people whose average age was 87. Other than advanced age, they had few risk factors for Alzheimer’s disease or other forms of dementia. Over all, the participants were nutritionally sound, though 7 percent were low in vitamin B12, and 25 percent were deficient in vitamin D.

“These results need to be confirmed, but obviously it is very exciting to think that people could potentially stop their brains from shrinking and keep them sharp by adjusting their diet,” said study author Gene Bowman of Oregon Health and Science University in Portland.

Other studies have shown that deficiencies in individual nutrients, like vitamin B12, can lead to memory problems. And anyone with memory problems should be tested for that and other vitamin levels.

This study was the first to use nutrient levels in the blood to analyze the effect of diet on memory and thinking skills and brain volume. Blood measurements are considered more reliable than questionnaires to assess people’s diet, since people often forget exactly what they ate. Food surveys also do not account for how much of the nutrients are absorbed by the body, and poor absorption of certain vitamins and nutrients is often a problem in the elderly.

While dietary factors are complex and foods contain a balance of hundreds of nutrients, the study suggests these five may be especially important for brain health.

Omega-3 fatty acids: Other studies have shown that the oils found in fish are good not just for the heart, but for the brain as well. Oily fish like salmon, tuna, mackerel and trout are particularly high in omega-3s.

Vitamin B: There are many types of B vitamins, and all are important for nerve and brain health. B12 in particular has been shown to be protective against memory problems. After age 50, some people lose the ability to absorb B12 from foods, so supplements may be recommended. B12 is found in meats and other animal foods like fish, eggs and cheese. Some cereals are fortified with B vitamins as well.

Vitamin C: Most people know vitamin C from orange juice, but it’s also found in broccoli, red peppers, dark green vegetables, strawberries and kiwifruits.

Vitamin D: Called the sunshine vitamin because people make it through the skin on exposure to sunlight, vitamin D levels also tend to be low in older people. Milk has added vitamin D, but it’s also found in fatty fish.

Vitamin E: Since vitamin E is stored in fat, you don’t want to overload on it. But it is found in vegetable oils, nuts and seeds, leafy greens and whole grains. Wheat germ is also an excellent source of vitamin E.

By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.

Sources: Christy C. Tangney, Nikolaos Scarmeas: “The Good, Bad, and Ugly? How Blood Nutrient Concentrations May Reflect Cognitive Performance.” Neurology Vol 78 No 1, 2012.

G. L. Bowman, L.C. Silbert, D. Howieson, et al: “Nutrient Biomarker Patterns, Cognitive Funciton, and MRI Measures of Brain Aging.” Neurology Vol 78, No. 1, 2012.

The activity and festivities during Passover and Easter pose special challenges for families coping with Alzheimer’s disease. The hurried pace can be trying at times for just about anyone, but for someone coping with Alzheimer’s disease, the change in routine can be especially disruptive. That’s why it’s important to take steps to minimize disruptions and simplify the gatherings. A few steps can help to assure that anyone with Alzheimer’s, and those who care for and love them, can have fun and be safe.

• Simplify. The change in routine can be disconcerting and upsetting. An Easter egg hunt, or taking up their former role in a large dinner such as the Passover Seder, can be disorienting for someone with memory loss and confusion. Click here for tips on how to reduce the risk of wandering. Rethink your family traditions, and simplify. Pick and choose those traditions that are most important to you. Simplify the decorations, and avoid large crowds and raucous noise. For safety’s sake, avoid candles and artificial fruits and vegetables, which may be mistaken for the real thing.

• Engage the person with Alzheimer’s—but keep things at their usual pace. Someone with Alzheimer’s might enjoy simple tasks, such as decorating eggs. Or, reading a beloved scripture or story at home may be a meaningful alternative to visiting a place of worship. Do not, however, force the person with Alzheimer’s to participate if they resist. Stick to the same daily routine and schedule as much as possible.

• If a loved one with Alzheimer’s lives in a nursing home or assisted-living facility, test the waters by bringing him or her home for a short visit beforehand. For many with Alzheimer’s, being removed from familiar surroundings can be disorienting and upsetting. Even being around family members a person doesn’t see often can make someone with dementia anxious or fearful. If a home visit seems too stressful, arrange for visits by small groups to the nursing home to minimize confusion and upset.

• Apprise family members and relatives who are coming from out of town about the status of a parent, sibling or loved one with Alzheimer’s ahead of time. That way, everyone will be better prepared during family gatherings.

• Delegate. Let family members and friends help with the chores, such as baking. Let others watch a loved one if you need to take time for yourself.

Alzheimer’s is characterized by the buildup of beta-amyloid, a protein that accumulates in the brains of those with the disease. But at least 20 percent of elderly men and women also have evidence of beta-amyloid buildup in the brain on autopsy, despite having normal memory and thinking skills while alive.

Now researchers have demonstrated that plaque buildup occurs in many well-functioning people beginning in middle age or even earlier, and are correlated with subtle disturbances in memory. The findings, published in the journal Neurology, provide further evidence that Alzheimer’s is a long process that begins well before the telltale memory loss and other symptoms of the disease become apparent.

For the study, researchers at the University of Texas at Dallas and UT Southwestern Medical Center recruited 137 healthy men and women ranging in age from 30 to 89. All were free of obvious memory problems.

The study participants underwent brain scans using special dyes to look for signs of beta-amyloid buildup. They also were given tests to look for subtle signs of memory and thinking problems, even though their memory showed no obvious signs of failing.

The researchers found that the older someone was, the more beta-amyloid they tended to have. "In our study, we observed that even in adults with apparently good cognitive health, increasing amounts of beta-amyloid in the brain are related to subtle changes in memory and mental function," said study author Denise C. Park of the Center for Vital Longevity at the University of Texas at Dallas.

Plaque buildup was notably elevated in about one in five of those over 60, more commonly in those who carried a gene called APOE-E4 that raises the risk of developing Alzheimer’s disease. Those with more plaque tended to score worse on memory tests than their peers with less plaque; they did not process thoughts as quickly and were less able to think logically and solve problems requiring reasoning skills.

"We found that this high-amyloid group showed deficits in cognitive performance, even though the individuals were well educated and scored normally on our standard tests of cognition," said Dr. Karen Rodriguez, lead author of the study.

"Our findings suggest that subtle effects on cognition occur early," Dr. Park said. "These are important findings, because imaging patients when they first show signs of very mild cognitive impairment could be essential to determining their risk of future disease."

Determining who will ultimately develop Alzheimer’s is important, since many researchers believe that the best strategy to treat the disease may be to develop new drugs that can be given during middle age, before brain deterioration from the disease becomes irreparable. Currently available drugs do nothing to stop progression of Alzheimer’s.

"Just as many adults take aspirin to lower their risk of heart disease or stroke, one day we may be able to help protect our brains and cognitive health by starting a treatment in our 40s or 50s," Dr. Park said.

The authors also found that some people in their 60s, 70s and 80s seemed to defy the brain deterioration of old age. Levels of beta-amyloid buildup in some of these men and women were as low, or lower, than some others in their 30s, 40s or 50s.

"Another avenue of our future work will be to investigate what factors enable these individuals to maintain cognitive health well into old age, whether they be genetic factors, lifestyle factors or environmental issues," said Dr. Park. "Understanding how the brain and mind stay healthy and vital over the long term will help guide our efforts to delay or even prevent the devastation caused by diseases like Alzheimer's."

By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.

K.M. Rodrigue, PhD K.M. Kennedy, PhD M.D. Devous, Sr., PhD, et al: “Beta-Amyloid Burden in Healthy Aging: Regional Distribution and Cognitive Consequences.” Neurology Vol. 78, 2012, pages 387-395.

A daily walk or jog may help to ward off the memory loss of Alzheimer’s, a new study suggests, particularly in people at increased risk of the disease.

The study, which appeared in the Archives of Neurology, was among the first to look at people’s activity levels and whether they carried a gene called APOE-E4, which increases the risk of developing Alzheimer’s in old age. People who have the gene are at up to 15 times increased risk of getting Alzheimer’s, though carrying the gene only heightens risk and does not mean you will get the disease.

Researchers found that people with APOE-E4, which may be carried by around 20 percent of the population, who were physically active had fewer plaques in their brains compared to less active carriers of APOE-4. The buildup of plaque, composed of a toxic protein called beta-amyloid, is linked to the memory loss of Alzheimer’s. People with Alzheimer’s tend to have lots of beta-amyloid buildup in their brains, and the more beta-amyloid, the worse memory and thinking skills tend to be.

For the study, researchers at Washington University in St. Louis looked at 210 men and women, ages 45 to 88, none of whom had serious memory problems. They were tested to see whether they carried the APOE-E4 gene, and most also underwent spinal taps and specialized brain scans to look for signs of beta-amyloid. They were also asked about their regular exercise habits during the previous 10 years.

The researchers found that those adults who tended to be active and get plenty of exercise had less buildup of beta-amyloid than those who were sedentary, particularly in parts of the brain important for memory and thinking. They also found that people who carried the APOE-E4 gene had more beta-amyloid accumulation than those without the gene.

The combination of carrying the APOE-E4 gene and being sedentary was a particularly destructive combination. People without the gene who did not exercise had some beta-amyloid buildup in their brains, but far less than those who carried the gene. The relationship held even after considering factors like advancing age, obesity, or having diabetes or depression, all of which increase the risk of developing Alzheimer’s.

Exercise, though, appeared to benefit those who carried the APOE-E4 gene. Carriers who walked or jogged regularly had less plaque buildup in the brain. The authors note that, “In summary, our findings suggest that exercise at levels recommended by the American Heart Association may be particularly beneficial in reducing the risk of brain amyloid deposition in cognitively normal APOE-E4-positive individuals.”

The American Heart Association recommends that all adults, including older ones, strive for an “active lifestyle.” That means getting at least 150 minutes per week of moderate exercise, or 75 minutes per week of vigorous exercise, or a combination of both moderate and vigorous activity. That translates to 30 minutes a day, five times a week, though they also note that getting short bursts of activity – say 10 to 15 minutes a few times a day – is also effective. Climbing stairs, playing a sport, walking, jogging, swimming or biking all count. The group also recommends strength and stretching exercises that build overall stamina and flexibility.

Walking, the American Heart Association notes, may be especially apt choice for beginners or older adults. Several studies have shown that people who walk regularly have a lower Alzheimer’s risk, and may have brain changes that promote cognitive health. See, for example, the ALZinfo.org story, “Walk to Keep the Memory Sharp” at http://www.alzinfo.org/12/articles/prevention-and-wellness/walk-memory-sharp.

By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.

Source: Head D, Bugg JM, Goate AM, et al: Exercise Engagement as a Moderator of the Effects of APOE Genotype on Amyloid Deposition. Archives of Neurology.
Published online January 9, 2012. doi:10.1001/archneurol.2011.845.

Would you rate your health as fair or poor? You may be at increased risk of Alzheimer's disease, a new study shows.

Seniors who rated their health as poor or fair were at increased risk of developing Alzheimer's and other forms of dementia later on, a new study shows. The findings appeared in Neurology, the medical journal of the American Academy of Neurology.

The self-assessment was a good predictor of dementia, even among people who did not have memory problems. "Having people rate their own health may be a simple tool for doctors to determine a person’s risk of dementia, especially for people with no symptoms or memory problems," said study author Dr. Christophe Tzourio of the University of Bordeaux in France.

Other research has shown that self-assessment questionnaires about health are reliable predictors of health. Studies have shown, for example, that people who rate their own health as poor are more likely to die from a heart attack or stroke than those who say their health is good.

This study looked at health assessments and the risk of Alzheimer's and other forms of dementia among seniors living in three cities in France. At the start of the study, the researchers asked 8,169 men and women to rate their health, including any problems with thinking or memory or symptoms of depression. The participants were asked to rate their current health on a scale of 1 to 5 in to response to the question, "Do you consider your health at the moment to be very poor, poor, fair (average), good or excellent?"

They were then given health check-ups at two-year intervals over the next seven or so years, including tests to look for signs of dementia.

During that time, 618 of the study participants developed Alzheimer's or another form of dementia. The risk of dementia was 70 percent higher in people who rated their health as poor or very poor, and 34 percent higher in people who rated their health as fair, compared to those who rated their health as good or excellent.

Interestingly, the dementia link was particularly strong among those who did not have problems with memory or thinking at the start of the study, and in those who did not have illnesses that hindered daily function. A poor self-assessment was associated with dementia regardless of whether someone had depression.

Two earlier reports found a link between poor self-assessments of health and Alzheimer's risk. But those studies did not consider other illnesses, including depression, that may mimic signs of dementia. This study took those factors into account.

Doctors aren't sure why a low self-assessment of health would increase dementia risk, but the authors have some theories.

“We know that having a large social network and social activities are associated with a decreased risk of dementia,” said Dr. Tzourio. “Therefore, it’s possible that rating one’s health as poor might be associated with behaviors that limit social interaction and in turn accelerate the dementia process.” Other studies have shown that feeling lonely more than doubles the risk of Alzheimer's disease.

By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.

Source: C. Montlahuc, A. Soumare, C. Fufouil, et al: "Self-Reated Health and Risk of Incident Dementia: A Community-Based Elderly Cohort, the 3C Study." Nuerology, Vol. 77, 2011, pages 14567-1464.

Getting a diagnosis of Alzheimer's or another form of dementia can cause anxiety and depression, at least for a short time. But can mental distress increase the risk for developing dementia?

Scientists assessed that question by reviewing the medical records of more than 70,000 men and women living in the U.K. All were part of the Health Survey of England, a large and ongoing annual survey. All were free of dementia at the start of the study period, in 1994, and their average age was 55.

Study participants were giving annual health questionnaires that asked about problems like anxiety, depression, poor social functioning and loss of confidence. All are general measures of psychological health, and the higher the scores, the greater the likelihood of anxiety and depression.

By the end of the study period, 10 years later, more than 10,000 of the study participants had died from various causes. According to death reports, 455 had died with a diagnosis of Alzheimer's or other forms of dementia.

Those men and women with the highest mental distress scores were more likely to have died from dementia than those who were psychologically healthy. The link between psychological distress and death from dementia was independent of other factors that may raise dementia risk, including smoking, alcohol abuse, years of schooling or physical ailments like heart disease or diabetes.

"Cardiovascular risk factors have been linked with dementia, but the association found in our study remained after controlling for them, thus implicating other explanations for the gradient seen," the authors wrote.

One possibility, the researchers propose, is that chronic levels of psychological distress may raise levels of the stress hormone cortisol. Persistently high levels of cortisol, in turn, may have toxic effects on the hippocampus, a part of the brain that is critical for memory.

They call for further research to investigate whether appropriate treatment of depression reduces dementia risk. They also note that understanding the links between psychological distress and dementia is important, since treatments for depression and anxiety are available and effective.

Tom C. Russ, Mark Hamer, Emmanuel Stramatakis, et al: "Psychological Distress as a Risk Factor for Dementia Death." Archives of Internal Medicine, Vol. 171. No. 20, Nov. 14, 2011.

By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University

Symptoms of depression late in life have been linked to an increased risk of Alzheimer's disease. But is depression a cause or an effect of the disease?

Researchers speculate that in some people, Alzheimer's could be a long process that begins many years before the actual onset of memory loss, showing up as symptoms of depression in the early stages of the disease. Alternatively, it is possible that depression may in some way damage the brain, making it vulnerable to the ravages of Alzheimer's.

In the current study, scientists at the University of Washington set out to clarify the relationship between depression and Alzheimer's by studying 3,410 seniors living in the Seattle area. At the start of the study, less than one in 10 of the participants had symptoms of depression. More than one in five had a history of depression earlier in their lives.

The men and women, aged 65 and older, were followed for an average of seven years. During that time, 658, or about 19 percent, developed Alzheimer's or another form of dementia.

Those who suffered from depression after age 50 were significantly more likely to develop Alzheimer's during the study period. The risk was increased even when the researchers considered age, years of schooling and other known risk factors for Alzheimer's.

Other research suggests that Alzheimer's is preceded by a period in which a person becomes concerned about memory loss and thinking problems. For example, people may respond "Yes" to questions like, "Do you think you move more slowly than you used to?," "Do you feel more exhausted than you used to?" and "Do you have problems concentrating?" Worry about failing memory can, understandably, make someone feel depressed.

This study sought to clarify whether symptoms of depression were an early sign of Alzheimer's. If people who were depressed at younger ages tended to develop Alzheimer's in old age, it would be a sign that depression is linked to the disease.

But in this study, a history of depression before age 50 did not increase the risk of developing Alzheimer's as a senior, suggesting that depression symptoms in later life may, for some people, be early signs of the disease. People who scored high on a test of depression as well as those who subjectively felt like they were slowing down were at increased risk of developing the disease.

Understanding the mechanisms linking depression with Alzheimer’s could suggest novel approaches to delay dementia onset. It is also important to recognize symptoms of depression since, unlike Alzheimer’s, it can be successfully treated. Up to half of patients with Alzheimer’s disease also have depression, which can take a serious toll on both patients and caregivers.

Symptoms of depression are many and varied. They include:

* Feeling sad, apathetic, or hopeless for weeks to months on end.

* Loss of interest in daily activities, especially ones that used to bring pleasure.

* Poor appetite and weight loss; or increased appetite and excessive weight gain.

* Troubled sleep, waking up repeatedly during the night, or an increased need for sleep.

* Feeling anxious or agitated.

* Trouble thinking or an inability to concentrate.

* Focusing on non-serious physical complaints.

If you experience one or more of these symptoms, or other unusual changes in mood or behavior, consult your physician. Medications and therapeutic counseling are available that can provide relief.

By ALZinfo.org, The Alzheimer's Information Site. Reviewed by William J. Netzer, Ph.D., Fisher Center for Alzheimer's Research Foundation at The Rockefeller University.

Source: Ge Li; Lucy Y. Wang; Jane B. Shofer; Mary Lou Thompson; et al: Temporal Relationship Between Depression and Dementia: Findings From a Large Community-Based 15-Year Follow-up Study. Archives of General Psychiatry. Sept. 2011; Vol. 68(9): pages 970-977.