Life Extension Update
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Mild cognitive impairment not a normal part of aging
Researchers at Rush Presbyterian St Luke’s Medical Center followed 180 participants in the National Institute on Aging-funded Religious Orders Study. The subjects were tested for memory, language and attention skills each year to evaluate their cognitive status. Thirty-seven men and women were diagnosed with mild cognitive impairment and 83 with dementia.
Upon autopsy of the brains of those diagnosed with mild cognitive impairment, over half were found to have Alzheimer’s disease and a third had evidence of cerebral infarcts (strokes). Fewer than one-fourth of those with MCI showed no signs of either disease.
Lead author David A Bennett MD, who is the director of the Rush Alzheimer's Disease Center at Rush University Medical Center, commented, "The study shows that mild cognitive impairment is often the earliest clinical manifestation of one or both of two common age-related neurologic diseases. From a clinical standpoint, even mild loss of cognitive function in older people should not be viewed as normal, but as an indication of a disease process."
Although 60 of the participants in the current study did not exhibit cognitive impairment, half of this group were also found to have Alzheimer’s disease pathology upon death, and one-fourth had cerebral vascular disease. Another NIA-funded study is seeking to determine what keeps these individuals from showing signs of impairment.
Dr Bennett stated, “Preventing the accumulation of disease pathology is a common approach to disease prevention. Another way to prevent loss of cognition is to identify factors that protect us from becoming forgetful despite this pathology.”
"From a public health perspective, the number of people with cognitive loss due to Alzheimer's disease and cerebral vascular disease is probably much larger than current estimates," he concluded.
Cerebral vascular disease
Of particular concern to stroke victims is that silent strokes occur frequently, causing neurological damage days or weeks after the initial crisis. A 2001 study found that one fourth of stroke survivors had at least one silent stroke during the 2 years following their initial stroke (Corea et al. 2001).
Ischemic strokes account for 80% of all strokes and occur as either an embolic or thrombotic stroke. Thrombotic strokes represent 52% of all ischemic strokes. Thrombotic strokes are caused by unhealthy blood vessels becoming clogged with a buildup of fatty deposits, calcium, and blood-clotting factors such as fibrinogen and cholesterol. We generally refer to this as atherosclerotic disease. Simplistically, what happens with a thrombotic stroke is that our bodies regard these buildups as multiple, infinitesimal, repeated injuries to the blood vessel wall. Our own bodies react to these injuries, just as they would if we were bleeding from a small wound, and they respond by forming blood clots. Unfortunately, in the case of thrombotic strokes, these blood clots get caught on the plaque on the vessel walls and reduce or stop blood flow to the brain.
Two types of thrombosis can cause a stroke: large vessel thrombosis and small vessel disease. Thrombotic stroke occurs most often in the large arteries, magnifying the impact and devastation of disease. Most large vessel thrombosis is caused by a combination of long-term atherosclerosis followed by rapid blood clot formation. Many thrombotic stroke patients have coronary artery disease, and heart attacks are a frequent cause of death in patients who have suffered this type of brain attack.
The second type of thrombotic stroke is small vessel disease which occurs when blood flow is blocked to a very small arterial vessel. Little is known about the specific causes of small vessel disease, but it is often closely linked to hypertension and is an indicator of atherosclerotic disease.
Low-dose aspirin is the antiplatelet agent of choice for stroke prevention. Doses of 160-325 mg daily administered within 48 hours of stroke onset have been shown to significantly reduce the risk of recurrent stroke during the first 2 weeks and possibly improve outcome at 6 months (CASTCG 1997; IST 1997). The Second European Stroke Prevention Study reported risk reductions for aspirin treatment, when compared with a placebo, to be as high as 27.6% (Sivenius et al. 1999).
Numerous studies document the multiple health benefits of daily low dose aspirin. Aspirin helps to maintain normal platelet aggregation in blood vessels and the production of prostaglandin E2 and C-reactive protein, which have been linked to many chronic inflammatory conditions.
Eric R. Braverman, MD, one of the foremost integrative medical experts, will be visiting South Florida and conducting individual screening and diagnostic procedures at the Life Extension Medical Center, located at 1100 West Commercial Boulevard in Fort Lauderdale.
Dr. Braverman will be utilizing the Brain Electrical Activity Mapping (BEAM) machines that measure the speed and strength of neurotransmissions via electrical activity. These tests, known as brain mapping, allow early diagnosis of such degenerative conditions that can affect all aspects of our metabolism, immune system, cognitive functions, hormone balance, and cellular integrity. With the results of these tests, early intervention through integrative medicine can mean the difference between optimal longevity and rapid decline.
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