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Researchers at the Perelman School of Medicine at the University of Pennsylvania have found that available evidence does not support an association between statins and memory loss or dementia. The new study, a collaborative effort between faculty in Penn Medicine’s Preventive Cardiovascular Program, the Penn Memory Center, and the Penn Center for Evidence-Based Practice, will be published in Annals of Internal Medicine.

The research team conducted a systematic review of the published literature and identified 57 statin studies reporting measures of cognitive function. Senior study author Emil deGoma, MD, assistant professor of Medicine and medical director of the Preventive Cardiovascular Program at Penn. and colleagues found no evidence of an increased risk of dementia with statin therapy. In fact, in cohort studies, statin users had a 13 percent lower risk of dementia, a 21 percent lower risk of Alzheimer’s disease, and a 34 percent lower risk of mild cognitive impairment compared to people who did not take statins.  Cognitive test scores were not adversely affected by statin treatment in randomized controlled trials.

“Overall, these findings are quite reassuring. I wouldn’t let concerns about adverse effects on cognition influence the decision to start a statin in patients suffering from atherosclerotic disease or at risk for cardiovascular disease. I also wouldn’t jump to the conclusion that statins are the culprit when an individual who is taking a statin describes forgetfulness. We may be doing more harm than good if we withhold or stop statins – medications proven to reduce the risk of heart attack and stroke – due to fears that statins might possibly cause memory loss,” said Dr. deGoma.

To read more, click here.

Jason Karlawish, M.D., Associate Director of the Penn Memory Center, is quoted in the December 10, 2013 issue of Scientific American. The article, How Brain Scans Might Change the Way Doctors Diagnose Alzheimer’s, discusses the development over the past 10 years of sophisticated brain scans that can estimate the amount of plaque in the brain, and an upcoming clinical trial that will investigate whether giving an experimental drug as soon as the scans detect the formation of plaques can slow or halt the development of Alzheimer’s. That trial, the A4 Study, aims to screen 3,000 healthy senior citizens to identify 1,000 amyloid-positive individuals who will receive either a drug therapy for Alzheimer’s called solanezumab or a placebo for three years. The Penn Memory Center is one of the 60 sites where the study will take place. To read the full Scientific American article, click here.

The online issue of Neurology®, the medical journal of the American Academy of Neurology, reports that speaking a second language may delay the onset of certain types of dementias.

The study found that people who spoke two languages developed dementia four and a half years later than people who only spoke one language.

“Our study is the first to report an advantage of speaking two languages in people who are unable to read, suggesting that a person’s level of education is not a sufficient explanation for this difference,” said study author Suvarna Alladi, DM, with Nizam’s Institute of Medical Sciences in Hyderabad, India.

“Speaking more than one language is thought to lead to better development of the areas of the brain that handle executive functions and attention tasks, which may help protect from the onset of dementia.”

Read more at Neurology®.

More evidence is mounting that engaging in physical exercise leads to a healthier brain. At the Society for Neuroscience meeting currently underway in San Diego, researchers are reporting that “physical exercise can ease depression, slow age-related memory loss and prevent Parkinson-like symptoms.”

If you’re just playing Sudoku or challenging yourself with a crossword puzzle, you may not be doing enough.

“We definitely have more evidence for exercise,” said Teresa Liu-Ambrose of the University of British Columbia. Liu-Ambrose moderated a panel of scientists who presented studies showing that physical activity offers a wide range of brain benefits.

One reason exercise provides mental benefits may be that it actually requires the brain to do a lot of work, Robin Callister of the University of Newcastle said. The brain is coordinating complex movements when you go on a run, she said. Team sports or group exercises also activate parts of the brain devoted to social interactions.

Read more at NPR.

The 7^th Annual Penn Memory Center Thank You Breakfast drew a full house to the Inn at Penn’s Woodlands Ballroom on Saturday, October 26, 2013. The annual invitation-only breakfast is held each year to thank research participants for their contribution to Penn’s Alzheimer’s disease research.

Over 200 research participants, their family members, guests and PMC staff gathered to enjoy a full breakfast buffet before hearing presentations on the latest updates in Alzheimer’s disease and the results of Alzheimer’s disease research done at the Penn Memory Center.

John Trojanowski, MD, PhD, Director of Penn’s Alzheimer’s Disease Core Center; Steven E. Arnold, MD, Director of the Penn Memory Center; Jason Karlawish, MD, Associate Director of the Penn Memory Center; and Felicia Greenfield, Associate Director for Clinical and Research Operations at the Penn Memory Center, presented the latest results from their research studies as well as updates on Penn Memory Center programs and upcoming research opportunities.

The presentations concluded with an open question and answer session. Guests’ questions ranged from the current and future state of Alzheimer’s disease research to the effects of antihistamines on memory.

The Food and Drug Administration approved a radioactive imaging chemical from General Electric to help screen patients for Alzheimer’s disease and dementia. The drug, Vizamyl, is an injection of radioactive material designed to highlight abnormal brain plaque in medical imaging scans.

Vizamyl works by binding to the plaque and creating images that show up on PET scans of the brain. A negative scan means there is little plaque and the cause of dementia is probably not Alzheimer’s, according to an FDA release. A positive scan means the patient has at least some plaque, but does not mean they definitely have Alzheimer’s.

The injection is intended as one tool to help physicians identify the cause of patient’s cognitive decline.

Read the full Associated Press article here.

A new study published in JAMA Neurology suggests that older adults who don’t sleep well have more brain beta-amyloid plaques, which can be indicators of Alzheimer’s disease.

The finding doesn’t prove that not getting enough sleep causes the build-up of beta-amyloid plaques and leads to dementia rather than the other way around. But, the study’s lead author, Adam Spira from the Johns Hopkins Bloomberg School of Public Health said, “It’s exciting that our findings … may point to sleep disturbance as something that can be a modifiable risk factor that can be leveraged to prevent Alzheimer’s disease.”

“We’ve known for a long time that people with Alzheimer’s disease have really disturbed sleep patterns,” Spira told Reuters Health. “People have wondered, well, is it possible that poor sleep is actually leading to cognitive decline?” In the new study, “We were able to look under the hood and see what’s going on in the brain,” he said.

Read the full Reuters Health article here.

The BBC reported on the discovery of a chemical that prevents the death of brain tissue. In tests on mice, the Medical Research Council Toxicology Unit  at the University of Leicester showed brain cell death from prion disease could be prevented.

Researchers used a compound to prevent the natural defense mechanisms that are built into brain cells from kicking in when a virus attacks the brain cell. The study, published in Science Translational Medicine, showed mice with prion disease developed severe memory and movement problems. Mice given the compound showed no sign of brain tissue wasting.

Lead researcher Prof Giovanna Mallucci said of the mice:  “They were absolutely fine, it was extraordinary. What’s really exciting is a compound has completely prevented neurodegeneration and that’s a first. This isn’t the compound you would use in people, but it means we can do it and it’s a start.” The compound did show signs of side effects including an impact on the pancreas; the treated mice developed a mild form of diabetes and lost weight.

Jason Karlawish, M.D., Associate Director of the Penn Memory Center, cautioned that studies done on mice don’t necessarily translate into benefits for humans.

“Many studies of treatments in mice have been spectacular, only to fail in man. So, this finding is a bend in the road, but not a turning point,” Dr. Karlawish said.

To read the full BBC report, click here.

The Robert Wood Johnson Foundation Human Capital Blog features a post written by Dr. Jason Karlawish, Associate Director of the Penn Memory Center, exploring personalized medicine for the seemingly healthy brain that is at risk for neurodegenerative dementias.

“Prescribe the right drug to the right patient at the right time” is not a new medical practice, but when a biomarker—that is, a measure of disease pathophysiology—or a gene makes this decision, that is a radically new medical practice. The promise of personalized medicine is that biomarker and gene driven algorithms will do much of the work of medicine. By predicting patients’ future health and the outcomes of an intervention, they will guide what doctors recommend to their patients. Like the theory of evidence-based medicine, personalized medicine promises a more objective, efficient and precise medical practice.

Read the full blog post here

A leading group of Alzheimer’s researchers contends that, as biomarkers to detect signals of the disease improve at providing clinically meaningful information, researchers will need guidance on how to constructively disclose test results and track how disclosure impacts both patients and the data collected in research studies. A survey conducted by a group including experts from the Perelman School of Medicine at the University of Pennsylvania found that a majority of Alzheimer’s researchers supported disclosure of results to study participants. The study is published online in Neurology.

“While this is not a call to immediately tell subjects their biomarker results, it does show that the field is moving to a point where experts want to share valid and meaningful results with participants,” said co-senior author Jason Karlawish, MD, professor of Medicine and Medical Ethics and Health Policy and Associate Director of the Penn Memory Center. “As we gain more data on the predictive abilities of these measurements, we will need models and methods to effectively reveal results.”

Alan J. Lerner, MD’s editorial, Amyloid imaging – the court of public opinion, in the same issue of Neurology, stated that “human amyloid imaging is one of the great recent
translational medicine stories.” Lerner found that important issues were raised by the study’s findings.

“Revision of research disclosure policies in an age of expanded information access has to be considered, but should be weighed against protecting participants from harm from worrisome but incomplete prognostic information,” Lerner wrote. “Lay people often do not understand the meaning or context of disclosed information, so simple disclosure of data needs to be fashioned into usable information. Disclosing results of amyloid imaging may require skills that current clinicians lack, ” he continued.

Dr. Lerner’s full editorial can be read here Read the full story from Newswise here