Level of Job Difficulty Linked to Alzheimer's

The Milwaukee Journal Sentinel - August 10, 2004

People who developed Alzheimer’s disease tended to hold jobs with lower mental demands during their 30s, 40s, and 50s than people who did not get the disease, according to new research.

The study is the latest in a growing body of research suggesting that higher levels of education as well as mentally stimulating activities may offer some protection against a disorder that now affects 4.5 million Americans, a number that is expected to grow dramatically in the coming decades.

The study is the first look at mental job demands over the course of several decades and link those demands to Alzheimer’s. An extensive U.S. Department of Labor ranking of occupational demands was used to determine mental and physical job demands.

Examples of jobs with high mental demands included engineers, doctors, science and math teachers, architects, computer programmers and journalists. Jobs with lower levels included janitors, construction laborers, machine operators, assemblers and food preparation workers.

The study, which compared 122 people with Alzheimer’s to 235 who did not have the disease, was published today in the journal Neurology.

When both groups were in their 20s, they had jobs with similar mental demands, a level that was about 15 percent above the national average. However, as they grew older those who would later develop Alzheimer’s tended to stay in jobs with about the same level of mental demands while those who did not get the disease tended to go into jobs with increasing mental demands.

As scientists now try to find ways to prevent the disease, a burning question is whether people can reduce their risk by staying mentally active throughout life.

"Not everybody can be an astrophysicist," said lead author Kathleen Smyth, a researcher at Case Western Reserve University. "(But) you want to keep your mind active. Some people call it novelty seeking . . . things that get you thinking in a different way."

Smyth said even lower-end jobs can be made more mentally stimulating. And people can find ways to keep their minds active outside of work by playing games such as chess or crossword puzzles, playing a musical instrument, reading novels or taking an educational course.

However, there still is some uncertainty about exactly how a job or education affects a person’s chances of getting Alzheimer’s disease.

One explanation is that the disease process actually begins decades before symptoms appear and that a person simply starts to adapt by finding progressively less demanding activities over the years.

However, another possibility is that staying mentally active strengthens connections between neurons and builds a brain reserve, which may delay the onset of the disease.

"You really can’t change your IQ, but this study underscores the protection of lifelong learning," said Diana Kerwin, an assistant professor of medicine and a geriatrics and dementia specialist with the Medical College of Wisconsin. "You can still have a manual labor job and overcome it by outside activities."

The concept of building a brain reserve also was bolstered by a 2003 study of 130 Catholic priests and nuns.

The study found that years of formal education, or something related to education, appeared to provide a type of cognitive reserve that reduced the harmful effect of plaques that build up in the brains of people with Alzheimer’s.

The study’s authors said it appeared that higher levels of education helped people tolerate the pathology of the disease.

A 2001 study found that leisure activity may reduce the risk of dementia regardless of a person’s education or occupational background.

Those with high levels of leisure activity had a 38 percent lower risk of developing dementia, even when controlling for other risk factors, including ethnic background. Leisure activities included reading, going to movies, taking walks and talking with friends.

To see more of the Milwaukee Journal Sentinel, or to subscribe to the newspaper, go to http://www.jsonline.com.

(c) 2004, Milwaukee Journal Sentinel. Distributed by Knight Ridder/Tribune Business News. For information on republishing this content, contact us at (800) 661-2511 (U.S.), (213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail reprints@krtinfo.com.

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Brain Fitness, Weight and Exercise

October 11, 2006 at 4:49 pm · Filed under Brain Fitness, Brain Training, Brain exercises, Cognitive Neuroscience, Lifelong learning, Mind Fitness, Mind/Body, Physical Fitness

http://sharpbrains.wordpress.com/2006/10/11/brain-weightlifting-more-weight-less-memory-%E2%80%93-links-between-physical-and-brain-fitness/

A recently published study in the journal Neurology shows that people who were tested cognitively at age 11 in 1932 and were tested again almost 70 years later showed better cognitive function if they were in good physical shape. “The important result of the study is that fitness contributes to better cognitive ability in old age,” according to psychologist Ian J. Deary, Ph.D., of the University of Edinburgh. “Thus, two people starting out with the same IQ at age 11, the fitter person at age 79 will, on average, have better cognitive function.”

In a separate study published by The American Academy of Neurology, researchers found the corollary that “a higher BMI was associated with lower cognitive test scores. Results from a test involving word memory recall show people with a BMI of 20 remembered an average of nine out of 16 words, while people with a BMI of 30 remembered an average of seven out of 16 words.” They did not, however, find a correlation between a change in BMI and a change in cognitive performance, according to epidemiologist Maxime Cournot, M.D. of Toulouse University Hospital.

Take-Home Points
Managing obesity in middle-aged adults might help reduce dementia later. John Gunstad, PhD, an assistant professor of psychology at Kent State University in Kent, Ohio says “We’ve known [for many years] that obesity is linked to high blood pressure and other problems. The fact that its impact on brain function may be independent [of other problems] is newer.”

It’s never too late to get your brain or your body in shape.

Physical Fitness – Brain Fitness – Social Fitness … they are all interconnected and essential to your general wellbeing.

Permalink

herbal and vitamin supplements that protects memory

Question:
Are there herbal and vitamin supplements that will protect my memory?

http://www.sharpbrains.com/blog/2007/02/22/are-there-herbal-and-vitamin-supplements-that-will-protect-my-memory/

Key Points:

• Omega-3 and omega-6 fatty acids found in cold-water fish may be helpful to long term brain health.
• Folic acid may also be helpful to both cognitive function and hearing.
• Ginkgo biloba and DHEA do not appear to help your brain.
• There is still more research to be done and never dismiss the placebo effect!

Answer:

Perhaps. The New England Journal of Medicine published an article debunking DHEA, a steroid precursor to testosterone and estrogen used to fight aging. The conclusion of a two-year study at the Mayo Clinic in Minnesota and University of Padua in Italy showed it did not improve strength, physical performance, or other measures of health. The study’s lead author, Dr. Nair said, “No beneficial effects on quality of life were observed. There’s no evidence based on this study that DHEA has an antiaging effect.”

Ginkgo biloba is another over-the-counter memory-enhancing supplement frequently mentioned. Yet, Paul Solomon from Williams College found “when taken following the manufacturer’s instructions, ginkgo provides no measurable benefit in memory or related cognitive function to adults with healthy cognitive function.” Nicholas Burns from the University of Adelaide, Australia found longer-term memory improved in healthy 55-79 year olds, but no other cognitive measure improved for either younger or older participants. Sarah Elsabagh from King’s College London found ginkgo initially improved attention and memory. However, there were no benefits after 6 weeks, suggesting that a tolerance develops quickly. Not an overwhelming endorsement.

Omega-3 fatty acids found in cold-water fish such as mackerel, herring, salmon, and tuna look more promising. Giuliano Fontani’s work at the University of Siena in Italy associated omega-3 supplementation with improved attentional and physiological functions, particularly those involving complex cortical processing.

Folic acid supplementation also shows promise of protecting and improving cognitive function in older adults, according to a 2007 study published in Lancet by Jane Durga and colleagues. It may also reduce age-related decline in hearing.

What can you do right now?

1. Eat a balanced diet with plenty of green leafy vegetables such as spinach, kale and collards.
2. Get plenty of physical exercise.
3. Stay cognitively active.
4. Reduce your stress.
5. And as always, talk with your doctor about any health concerns.

Further Reading

• Durga J, Verhoef P, Anteunis LJ, Schouten EG, Kok FJ. Effects of folic acid supplementation on hearing in older adults: a randomized, controlled trial. Ann Intern Med. 2007;146:1-9.
• Durga J, van Boxtel MP, Schouten EG, Kok FJ, Jolles J, Katan MB, Verhoef P. Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial. Lancet. 2007;369:208-16.
• Fontani G, Corradeschi F, Felici A, Alfatti F, Migliorini S, Lodi L. Cognitive and physiological effects of Omega-3 polyunsaturated fatty acid supplementation in healthy subjects. Eur J Clin Invest. 2005;35:691-9.
• Morris MC, Evans DA, Tangney CC, Bienias JL, Wilson RS. Associations of vegetable and fruit consumption with age-related cognitive change. Neurology. 2006;67:1370-1376.
• Nair KS, Rizza RA, O'Brien P, et al. DHEA in elderly women and DHEA or testosterone in elderly men. N Engl J Med. 2006;355:1647-59.
• Solomon PR, Adams F, Silver A, Zimmer J, DeVeaux R. Ginkgo for memory enhancement: a randomized controlled trial. JAMA. 2002;288:835-40.

Pet Related Infections

Pet-Related Infections

Human contact with cats, dogs, and other pets results in several million infections each year in the United States, ranging from self-limited skin conditions to life-threatening systemic illnesses. Toxoplasmosis is one of the most common pet-related parasitic infections. Although toxoplasmosis is usually asymptomatic or mild, it may cause serious congenital infection if a woman is exposed during pregnancy, particularly in the first trimester. Common pet-borne fungal infections include tinea corporis/capitis (ringworm); campylobacteriosis and salmonellosis are among the most common bacterial infections associated with pet ownership. Less commonly, pets can transmit arthropod-borne and viral illnesses (e.g., scabies, rabies). Infection in a pet can provide sentinel warning of local vectors and endemic conditions, such as Lyme disease risk.

Treatment is infection-specific, although many infections are self-limited.

Prevention involves common sense measures such as adequate hand washing, proper disposal of animal waste, and ensuring that infected animals are diagnosed and treated. Special precautions are indicated for immunocompromised persons. Increased communication between primary care physicians and veterinarians could improve treatment and prevention of these conditions. (Am Fam Physician 2007;76:1314-22. Copyright © 2007 American Academy of Family Physicians.)

PETER M. RABINOWITZ, MD, MPH, Yale University School of Medicine, New Haven, Connecticut

ZIMRA GORDON, DVM, MPH, Rippowam Animal Hospital, Stamford, Connecticut

LYNDA ODOFIN, DVM, MSPH, Yale University School of Medicine, New Haven, Connecticut

American Family Physician article (Free)

Obese child higher heart attack risk

Childhood Obesity Epidemic Holds Implications for Future Cardiovascular Health

Excess weight during childhood increases the risk for coronary heart disease during adult years, portending serious public health consequences, according to two studies in the New England Journal of Medicine.

The first study, based on annual height-and-weight measurements in some 275,000 Danish schoolchildren, followed their health after age 25. Researchers found that higher BMI scores predicted higher risks for coronary diseases — both fatal and nonfatal — in adulthood. For example, a 13-year-old boy overweight by 11 kg (25 pounds) had a 33% higher risk for coronary disease in adulthood.

The second study, using a model based on U.S. health statistics, finds that with current rates of childhood obesity, the prevalence of coronary disease will increase between 5% and 16% by 2035.

A commentator recommends laws to regulate advertising of junk food, changes in farm subsidies, and funding for "decent lunches and regular physical activities at school."

Physician's First Watch for December 6, 2007
David G. Fairchild, MD, MPH, Editor-in-Chief

Rubber bullets Kill

Rubber bullets can kill @ close range - not safe for crowd control

Rubber bullets were used for the first time by British forces in Northern Ireland in 1970. These "missiles" are intended to inflict superficial painful injuries, thereby deterring demonstrators from continuing further hostile activities, while at the same time avoiding serious injuries and deaths that arise with conventional firearms.

Police forces are instructed to fire the rubber bullets from a “safe range” of more than 40 m and to aim exclusively at the lower limbs of rioters. The inaccuracy of the bullets makes it difficult or impossible to avoid hitting the face, head, and chest.

Between 1970 and 1975, over 55 000 rubber bullets were fired in Northern Ireland, with an estimated death rate of one in 18 000 rounds, and serious injury rate of one in 1100 rounds. Children and teenagers have been reported to have the most severe injuries from these bullets, particularly skull fractures and brain injuries, along with injuries to the lungs, liver, and spleen.

The Israeli Police Force also uses rubber bullets to control demonstrations. Dr. Ahmad Mahajna and his researchers looked at the 201 proven rubber bullet injuries sustained by 152 persons admitted to a front-line clinic, two hospitals and a trauma center in Haifa and Nazareth, Israel following the riots in October 2000. Their paper, published in the Lancet, 26 May 2002, reviewed 61% patients who had blunt injuries and 59 (39%) with penetrating ones.

Three died from their injuries, two from brain damage after the bullets entered the skull through the eyes. The third died post-operatively following knee surgery. Long-term morbidity was noted in one patient with head and neck injury (post-traumatic psychosis), in three with facial injuries (blindness), and in two with abdominal injuries (repeated intestinal obstruction because of adhesions).

Inaccuracy of rubber bullets and improper aiming and range of use have resulted in severe injury and death.

This ammunition should therefore not be considered a safe method of crowd control.

Afghanistan From the Lens of a Doctor

(Medical volunteer Northern Afghanistan 30 May – 11 June 2002)

Afghanistan is twice the size of Malaysia. It shares land borders with China 76 km, Iran 936 km, Pakistan 2,430 km, Tajikistan 1,206 km, Turkmenistan 744 km, and Uzbekistan 137 km. Border crossings are literally a donkey ride or long walk away - hence the easy “disappearance” of wanted persons!”

The population is estimated at 21 million with four major ethnic groups: Pashtuns 38%, Tajiks 25%, Hazaras 19%, and Uzbeks 6%. 99% are Muslims (Sunni 84%). Life expectancy is 46 years (Malaysian male 70.3 yrs, female 75.2 yrs). Birth-rate is 41.4 /1,000 (Malaysian 23.5). Each woman has an average of 5.79 children with a high infant mortality of 16 % (Malaysia 0.8% in 2001). One in four Afghani children die before they reach five years. An estimated 50% of children have chronic malnutrition and 10% acute malnutrition. The maternal mortality is 17 per 1000 live births. Literacy rate (aged 15 years and over who can read and write) is estimated to be 31.5% , male: 47.2% female: 15% (1999 est.)

Afghanistan is now reputed to be a major source of hashish and the world's largest illicit opium producer, surpassing Burma.

Volunteering?

First screening question: “Are you prepared to be raped, robbed, killed or left behind? There will be no sacrificial ‘Black Hawke’ rescue for stragglers”. If your answer is “yes”, (that includes paying for all travel, lodging, meals and insurance), a seven page questionnaire follows (presumably to exclude the mentally unstable, religiously deranged and those with any delusion of grandeur or death wish).

Warnings abound on the internet e.g. current at 07 May 2002 “ We strongly advise against travel to Afghanistan. There is a threat from global terrorism, including to humanitarian relief workers. The situation in Afghanistan remains unstable, extremely volatile and dangerous for foreigners”.

One travel information web page had this friendly advice: “Those who still insist on travel to Afghanistan (read “suicidal”) …’’

Landmines

There is an estimated 11 million unexploded ordnances (UXOs) after the 23 years of war (?more after the US versus Taliban contribution?). An estimated 500 or more mine accidents were recorded monthly, about 150 fatal. CIA has an Afghani map for UXOs - colored white (“cleared of mines”) to dark brown (where no angel would dare to tread).

Travel insurance that included repatriation of body was surprisingly cheap, less than a hundred ringgit. Why so cheap? Comment: “They don’t expect you to need a big box. DHL enough-lah” .

A quick check with my life insurance agent(s) : Sorry, your policies do not cover war zones.

A lawyer argues: “How long have you had the policy? More than one year? Most life insurance cover policy holders who commit suicide as long as it is more than one year after they sign up. Volunteers to Afghanistan – it is not reasonable that they should be not be classed in the same category.” (Needless to say he is now my lawyer, if ever such need to claim should arise).

No joke – when we were in Mazar i Shariff, we passed the International Orthopedic Hospital. On one of the walls was written in English in bold letters “Do not deal with explosive items. They may kill you.” This came not far after a sign over a shop that reads “the Spare Parts of Abdul”.

The Taliban atrocities

According to the people we spoke to, public executions were carried out in the football field even in the small town of Shebarghan where we were based. Guilty women were buried to their chest and stoned to death. The goal posts were used as hanging gallows for convicted men. Shopkeepers were forced to close their shops to go and watch.

Grown men were not allowed to cut their beards. Those who were thought not to comply would be whipped by the inspectors. The beating could be quite severe. Music was totally banned. The radio only had news and statements. Inspectors would “creep around the flat roof tops” listening for the sound of music. Where this was thought to be heard, they would burst into the house. One engineer had a gun put to his head, and commanded to bring out his player or tape. Fortunately for him, they could not find any.

School was closed to girls and women teachers were forced to stay at home. Boys continued to go to school, but opportunities for leaving the country for university education was curtailed. (Turkey, prior to the late Taliban era, offered scholarship and university places for Afghanis).

The Taliban was notorious for the way they would slaughter men, women, children, dogs and farm animals without exception in the villages they conquered. When asked why they did this, the reply was “They were trained in Pakistan. This is their way of war. They think we Afghanis are not Muslim enough, so killing us is jihad”. This could explain why in some places we saw more graves than houses.

Peace

Everyone we met, including the local Governor who was the Mullah and Commander of the Mujahideen, talked about the desire for peace, “How are we to stop war, when a whole generation has grown up and their only skill is fighting. We need help to provide them alternative training and occupation”

Russian tanks stand silhouetted in the desert horizon. Abandoned armory were as many as the graves of the slain marked only by tattered cloth squares tied to bent poles. Expansive fields of ripening wheat were interspersed with desert and destroyed ruins, with people harvesting and grazing their sheep and goats. Here and there in the corner of the fields are graves, with large stones neatly arranged on them, with sometimes white and sometimes green flags.

Toilets

Most toilets are P.Ls (pit latrine) where nose holding is highly recommended. Taxi drivers and locals know where cleaner ones are. Whenever team members come back from the toilets and exclaim ecstatically “so clean” it is relative to the degree of smell and the amounts of visible deposits. MBKS (local council) standards should not be implied.

Our P.L in Gosh Tepa clinic had a little curtain, that flaps happily in the wind, fixed up only for us. There was no roof or door. We did think of putting up a white flag every time someone went in, but did not get round to it. This was a good thing, in restrospect. We learned that the Talibans used to use a white flag for their flag unlike the present tricolor green, red and black Afghani flag.

The lack of a door, the type you can lock, or at least attempt to keep closed, is universal. The ability to whistle or sing badly may help to keep people at bay. It is interesting to watch the sunset over the hills as one goes about one’s business of (trying to) emptying yesterday’s meals. You really need cooperative sphincters.

Sleeping arrangements a.k.a place to lay your head

For the twelve days, one had to get used to sleeping in a room with nine erstwhile strangers, to all the noises each make before they fall asleep, as they sleep (dog-tired) and when they awake. Dawn is very early at 4:30 am, so all get (woken) up by then.

With only one pit toilet and one bathroom (water carried in little pails from the well up the hill) between us, major adjustments to our daily ablutions had to be made. I fell back to my three-minute houseman bath. Plus an extra minute for getting in and out of the salwa kameez – the XXL trousers, which is held up by string, must be properly secured if you do not wish to lose it in public.

All had to bathe with less than 2- 3 liters of well water each, brushing teeth with precious bottled water (rationed to 3 litres/day as each 1.5 l bottle cost US$ 0.53). We were thankful for the cloudy water fetched from the pond, with its happy tadpoles, strained, (hopefully, before boiling) for chyar (tea).

It was a blessing to be forced to live simply, apart from the clutter that defines us, binds us but also blinds us.

Once one is prepared to lose it all, everything else is gain.

- July 2002