Jul 032012
 
American Flag

I have faced many battles in my life.  I served in Vietnam as a Marine Corps corporal. I also completed four tours in Iraq in the U.S. Army, and four of my sons served in Iraq, too.  But all my battles have not been while serving in the military.

My mother passed away from Alzheimer’s disease.  I lost my son, Dennis Jr., in a motorcycle accident.  And now, I am facing my own battle with Alzheimer’s disease.

I was preparing for a sixth deployment to Iraq when my Colonel and my wife brought up concerns about changes they were seeing.  I had just received a Secretary Manager of the Year Award, but I was aware that something was wrong.  I had been waking up in the middle of the night realizing there was something I forgot to do — or something I needed to do.  Recognizing my memory was changing, I decided to retire.   Too many people’s lives would be at risk if I went on a last tour in Iraq.

I was diagnosed in 2008 with early-stage Alzheimer’s.  When I received the diagnosis of Alzheimer’s, it was almost a relief.  It provided an explanation for what was going on.  It also provided a path forward.  There were plans I needed to put in place for the future.

I had made my living will before my first trip to Iraq. But after the diagnosis, my wife Mary and I updated our advance directives, power of attorneys and will.

Dennis Henley Sr. with General Franks and son Dennis Henley Jr.

Everything has been documented, so there is no dispute and no questions for my children when this disease progresses.  We dotted all the “I’s” and crossed all the “T’s” to make sure everything is in place. It’s an important thing for anyone who has been diagnosed to do.

It’s also important to realize that a diagnosis isn’t the end of the world.  Truly – it’s not.  You aren’t alone. There are so many people available to help you and so many people committed to finding a cure.  It’s difficult to accept, but easier to do if you are open and honest with those around you.

In fact, I talked until 2 a.m. about my diagnosis with one of my military buddies last week.  I have friends that I went through grade school, high school and the military with, and we have no secrets. We openly talk about this disease.  It’s a source of strength and comfort to have the people around me know what is going on. Alzheimer’s isn’t my fault.  It’s no one’s fault.  And there is no reason to feel guilt over it.  It’s out of my control.

It really helped having an Alzheimer’s Association representative from my local chapter come and explain why things aren’t like they used to be to my family.  I have 11 grandchildren – and they all understand that things aren’t quite the same and the whole family is making adjustments.  But that doesn’t keep us from spending meaningful time together, which is what I plan to do tomorrow on the Fourth of July.

We will all dress in red, white and blue and gather together for a barbeque at my son’s house.  Our flag will be at half mast, and I will remember the battles I have been in and the one I am facing now.  I believe we are here to help others – to leave a legacy.  As I spend time with my family, I know that I have left my mark by raising my family to be good citizens.  And I still have more to give. I will keep on moving forward and not give up.

Dennis Henley is a member of the national Alzheimer’s Association 2012 Early-Stage Advisory Group. He was diagnosed with early-stage Alzheimer’s in 2008. Prior to his retirement, he served in the U.S. military for 26 years, including working in counter intelligence for the Army and as the Chief of Security for the Army Corp of Engineers in Jacksonville, Fla.  Dennis lives in Littlestown, Pa., with his wife, Mary.  

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Mar 272012
 

But she does a pretty good job of making me feel like she does. I believe she knows there is a connection. She keeps it very simple when she talks to me. Partly I think because she knows that she can’t quite remember but is still witty enough to know that she doesn’t want to make it any more confusing than it already is for her.

I think she is past the most scary part— realizing she is “losing her mind.” She knew something was happening. And at first I thought it was just my mom being dramatic. But looking back a few years, her behavior was strange. And soon it was clear that she was slipping away. That mostly showed up in her feeling scared and not wanting to be alone.

I remember in the fall of 2008, she said something very profound and sadly poetic. She said, “me and the night don’t get along.” I thought that was quite a lyric. My mother was as witty as they come. She wrote tons of poems and parodies of songs. Mostly for co-workers leaving for another job or for cast-mates at the end of a show she was in. Or for my sisters’ bosses or workmates. She would whip something up in an evening. She could do it all. Of course she had and raised nine kids — that says it all.

I don’t want to keep saying WAS because she still IS. She still has her one-liners. She is still sweet and very interested in what you are saying.

When I saw her last December at my sister Carol’s Christmas show at the fabled Footlight Club, she was so into the show. I enjoyed watching her as much as the show. If you didn’t know she had Alzheimer’s, you wouldn’t think it. She was very in the moment — happy to see my father introduce my sister, but also zinging him saying to herself, “he’s awful.” She watched each song— liking some and loving others. But then a few minutes after, I asked if she liked the show, and she answered, “what show, dear?” That kind of sums up where she is right now.

I am no expert and I am 3,000 miles away, but she is doing ok for someone at her stage of this disease. My mother was a force and could do so many things. Now, she is very slow. But through all this there is a bitter sweetness. I hear stories from my siblings about how sweet she is and the simple loving words she says to them. There is still a person in there. And she is alive and still working it out.

I think she still knows that she has some kind of disease, but she has moments of peace. Hopefully, with more funding and the hard work of all involved, we can find a cure so that Alzheimer’s will not affect generations to come. This disease affects the whole family. My mother is so fortunate to have the care she has, but so many are not as lucky.

I will be running the Hollywood Half Marathon on April 7, 2012, in her honor — and in honor of all those affected by Alzheimer’s — and to raise awareness and funds for the Alzheimer’s Association. If you can, please donate to my page at http://www.crowdrise.com/JoeyMcIntyre

Thank you for always supporting me in anyway you can— in your thoughts and prayers and deeds.

Joey McIntyre is a singer/songwriter who rose to fame as a member of New Kids on the Block selling over 80 million albums and countless sold-out shows worldwide. He continues to push boundaries with his music as a solo artist and has vast theatre and screen experience including appearing in Wicked on Broadway and as a season regular on Boston Public. Recently, Joey declared himself an Alzheimer’s Association Champion and is fighting to end Alzheimer’s on behalf of his mother who is living with the disease. 

Mar 182011
 

Last month, researchers Francisco Lopera and colleagues reported in the journal Lancet Neurology that they were able to capture a clear decline in cognition starting in people’s early 30s in the largest-known population with autosomal-dominant (inherited) Alzheimer’s disease. They define an earlier disease stage prior to what is called pre-MCI, in effect pushing the line of detectability back toward younger ages by some four years.

Two other papers go in the same direction. Last year in the journal Brain, Mario Parra and colleagues published a new test that appears to detect a specific visual memory deficit perhaps even earlier, at ages when mutation carriers perform as well as controls on standard neuropsychometric tests. And in last December’s Annals of Neurology, Yakeel Quiroz and colleagues report the first of what is expected to be a wave of preclinical brain imaging findings. Carriers in their thirties, while still performing the memory test at hand as well as non-carriers, push their hippocampus harder to achieve that parity.

Together, these three papers push back the preclinical phase of Alzheimer’s that is detected by neuropsychology and imaging. They characterize the 20 to 15 years prior to symptoms of dementia.

Each of the previous familial Alzheimer’s disease studies was small. In this paper by Lopera and colleagues, the Colombian scientists retrospectively analyzed descendents of the largest-known cohort of autosomal-dominant Alzheimer’s, including 1,784 patients age 17 to 70 who came to Lopera for treatment and research between 1995 and 2010. This study is by far the biggest study of its kind. Four hundred forty-nine people carried the mutation. Four hundred ninety-nine non-carriers served to establish normal parameters on the battery of cognitive tests that the scientists administered to the participants at follow-ups every other year where possible. The studies are helping us get a better sense of the continuum of Alzheimer’s disease, from its asymptomatic stage into the mild cognitive impairment/prodromal stage, followed by the well characterized mild, moderate and severe dementia stage.

Michael S. Rafii, M.D., Ph.D.
Associate Medical Core Director, Alzheimer’s Disease Cooperative Study
This post originally appeared in Alzheimer’s Insights, an ADCS Blog.

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Mar 112011
 

I recently attended an event hosted by the American Heart Association and Go Red Chicago, where a panel of physicians and healthcare providers discussed the effect of diet, hormones and cardiovascular risk factors on the heart and brain. The physicians also touched on emerging data that suggest there may be racial/ethnic differences in the prevalence and effects of cardiovascular risk factors to the development of heart disease and brain functioning in these diverse populations. Thus, I was very interested in reading the following article from Korea that examined the effects of vascular risk factors in mid and late life to dementia risk.

The initial study population included over one million persons aged 30-95 years who participated in at least one biennial National Health Insurance Corporation (NHIC) medical evaluation between 1992 and 1995. The NHIC provides health insurance to government employees, teachers and their dependents and it was estimated that at the time of this study, approximately 11 percent of the Korean population was insured by this organization. Persons were excluded from the study if they reported having cardiovascular disease, cancer, liver disease prior to their initial visit, or if they had missing data on any study variables. Thus the final sample size for this study was 848,505 participants, aged 40 years or older, followed for up to 14 years.

As is typical with many studies focusing on cardiovascular disease, questions regarding history of cigarette use and alcohol consumption were obtained along with height, weight (for body mass index calculations) and blood pressure. Fasting blood samples were obtained for both serum glucose and serum cholesterol. The specific criteria for hypertension were a systolic blood pressure of at least 140 mmHg or a diastolic blood pressure of at least 90 mmHg. Cholesterol was characterized as “desirable” if the serum cholesterol was 200 mg/dl, “borderline high” if it was between 200-239 mm/dl, and “high” if it was greater or equal to 240 mg/dl. Diabetes was defined as a fasting serum glucose level of 126 mg/dl or higher.

As this was a large sample of persons evaluated in clinical hospitals, the main variable of interest was a dementia diagnosis. For these analyses, the dementia categories included Alzheimer’s dementia (AD), Vascular dementia (VaD), and “unspecified” dementia.

Of the 848,505 persons who were evaluated at the baseline examination, there were 358,060 women (age at baseline 53.6 yrs) and 490,445 men (age at baseline 51.9 yrs). The entire population had a low level of body mass index. Both cigarette smoking and alcohol consumption were more common in men compared to women. During the 14 years of follow up, 3,252 persons were hospitalized for issues related to dementia; the majority of those dementias were listed as Alzheimer’s. Increasing dementia incidence of Alzheimer’s was noted as age increased, peaking at the ages of 75-80 years, then decreasing at older ages.

In both women and men, diabetes was associated with all types of dementia, and appeared to be higher for VaD than Alzheimer’s in women. Hypertension (HTN) was also associated with all dementias; strongly associated with VaD in men, but did not appear to be associated with Alzheimer’s in women. In both groups total cholesterol was not associated with dementia.

Further analyses were conducted measuring the impact of vascular risk factors measured in midlife (<65 years old) compared to later (>65 years old). Diabetes appeared to be associated with Alzheimer’s in both the younger and older age groups for men, whereas smoking was associated with Alzheimer’s in midaged men (< 65 years) compared to older men (> 65 years). HTN had a strong association with VaD in both men and women before and after 65 years old. There were no notable interaction effects between HTN and diabetes on the risk of dementia for either gender.

This study in the Korean population supports data from Western population studies, suggesting that diabetes and HTN are important risk factors for the development of both Alzheimer’s and VaD. Further, this large study also suggests that vascular risk factors in midlife appear to have a higher risk for dementia development as compared to later risk factors. One limitation of the study, as noted by the authors, was the relatively high rate of “unspecified dementia cases” (36 percent for men, 39 percent for women) which could affect the strength of these associations. Nevertheless, this study provides support that there is an increased risk of dementia associated with these factors in this Asian population, and highlights the need for aggressive vascular risk reduction treatment as a dementia prevention method.

Thanks for reading.

Neelum T. Aggarwal, M.D.
Steering Committee Member, ADCS
This post originally appeared in Alzheimer’s Insights, an ADCS Blog.

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Mar 012011
 

Dear Readers,

As I discussed in an earlier blog post this month, the association between behavior and/or personality traits to developing dementia is a growing topic of interest that I am asked to discuss frequently. Depression, in particular, arouses a lot of interest, as many studies have shown an association between depression and poor physical, social and cognitive functioning. The latest study from the Women’s Health Initiative Memory Study (WHIMS) examined whether depressive symptoms in post menopausal women would increase the risk of developing mild cognitive impairment and/or dementia.

The Women’s Health Initiative (WHI) is a multisite population-based study that assessed the risk and benefits of hormone therapy in healthy postmenopausal women. The WHIMS, was designed to examine the effect of post menopausal hormone therapy on cognition and memory in healthy women aged 65 and older at the study baseline. A total of 7,497 community dwelling post-menopausal women were enrolled in WHIMS. They were aged 65y to 79y at enrollment and were free of Mild Cognitive Impairment (MCI) and dementia. Analyses for this study were based on the 6,376 ( 85%) WHIMS women who completed: (1) a six item Center for Epidemiologic Studies Depression Scale (CES-D), (2) a two item National Institute of Mental Health’s Diagnostic Interview Schedule (DIS) and (3) attended at least one follow up visit.

Typical questions asked on the CES-D were whether (1) the participant felt depressed (blue or down), (2) had restless sleep (3) enjoyed life (4) had crying spells (5) felt sad and (6) felt that people disliked the participant. The two questions from DIS asked whether in the past two weeks or more if the participant felt sad, blue or depressed and whether if they had for two or more years feelings of depression/sadness. Other baseline data included demographic information, medical history, lifestyle variables including physical activity and body mass index (BMI). Cognitive testing was measured using the Modified Mini Mental State Examination (3MS) at baseline and yearly after that.

The protocol for assessing MCI and dementia was divided into four phases that included administering to all participants a screening exam for cognition, a more in-depth cognitive battery, and then an assessment by a physician experienced in diagnosis dementia. If a participant was suspected of having dementia, they underwent the typical “work up” for dementia and that included a brain scan and laboratory blood tests. The physician then provided the final diagnosis of the type of dementia.

Of the 6,376 women included in these analyses, 508 met criteria for having depression. Women with depressive disorder were more likely to be African American, widowed, separated or divorced; had lower education, income, and global cognitive function. A total of 216 participants (3.4%) developed MCI , 102 (1.6%) developed dementia of any type and 285 (4.5%) women developed MCI or probable dementia during follow up. Those women who had depressive symptoms at baseline, were found at follow up (mean 5.4 years) to have a greater risk of developing subsequent MCI and incident dementia compared to those who were not depressed. These associations did not change after controlling for lifestyle variables, cardiovascular risk factors, cerebrovascular disease or antidepressant use.

Few population based studies have examined the association of depression to development of MCI and dementia in women. This study is the first to examine these associations in a large group of post menopausal women. Other notable strengths of this study include its large and multiethnic sample size, drawn from diverse communities across the US. These findings suggest that depression may indeed be a risk factor for dementia in women, and that adequate screening and possible intervention may prevent the onset of cognitive decline and dementia.

Here are 3 articles you can refer to for learning about this particular study or the latest research on depression, women and cognitive impairment:

Goveas JS, Espeland MA, Woods NF et al: Depressive Symptoms and Incidence of Mild Cognitive Impairment and Probably Dementia in Elderly Women: The Women’s Health Initiative Memory Study. J Am Geriatr So 59: 57-66, 2011

Dal Forno G, Palermo MT, Donohoue JE et al. Depressive Symptoms, Sex and Risk for Alzheimer’s Disease. Ann Neurol 2005; 57: 381-387

Yaffe K, Blackwell T, Gore R et al. Depressive Symptoms and Cognitive Decline in Non Demented Elderly Women: A Prospective Study. Arch Gen Psychiatry 1999; 56: 425-430

Thanks for reading.

Neelum T. Aggarwal, M.D.
Steering Committee Member, ADCS
This post originally appeared in Alzheimer’s Insights, an ADCS Blog.

Jan 252011
 

Using a new technology that relies on thousands of synthetic molecules to fish for disease-specific antibodies, researchers have developed a potential method for detecting Alzheimer’s disease with a simple blood test. The same methodology might lead to blood tests for many important diseases, according to the report published by Thomas Kodadek’s group at the Scripps Research Institute in the January 7th issue of the journal Cell.

The new method relies on the notion that many diseases lead to the production of modified proteins. At some point, the adaptive immune system might begin to recognize those proteins as foreign and mount a response. If tests could be developed to recognize those disease-specific proteins or the antibodies that recognize them, it could be the basis for early diagnosis. But in most cases, researchers have had little luck identifying those abnormal proteins.

Kodadek’s team decided to take a different tack. They used a large library of randomly selected, unnatural molecules known as “peptoids” to screen for antibodies found in the bloodstream of animals or patients with specific diseases and not in healthy controls.

Their method uncovered three peptoids that appear to discriminate between healthy and Alzheimer’s disease blood samples with high accuracy. Three of them reacted strongly to the blood of six patients with the condition, but not that of 16 healthy individuals used as controls. Although this is encouraging the findings must be corroborated by further studies to demonstrate that antibodies can indicate whether the attack opens a picture for diagnosing the disease.

* Reddy MM, Wilson R, Wilson J, Connell S, Gocke A, Hynan L, German D, Kodadek T. Identification of candidate IgG biomarkers for Alzheimer’s disease via combinatorial library screening. Cell 2011 January 7;144:132-142.

Michael S. Rafii, M.D., Ph.D.
Associate Medical Core Director, Alzheimer’s Disease Cooperative Study
This post originally appeared in Alzheimer’s Insights, an ADCS Blog.

Jan 162011
 

Dear Readers,

I was recently on a conference call with women physicians discussing the latest in Women’s Health and was asked about vitamin D and its effect on cognition. Indeed vitamin D has received a lot of media attention lately; attention focused on its potential effect on cardiovascular and bone health, in addition to its anti-inflammatory and anti-oxidative effects. Thus, it was not a surprise to me when the discussion turned to “cognitive health” and whether or not (1) vitamin D levels were associated with cognitive function and (2) whether its supplementation would provide an “added cognitive benefit” to female patients.

At the time the question was posed, I immediately thought about an article I read in Neurology that examined whether weekly dietary intake of vitamin D was associated with cognitive function in older women. Participants in this study came from the EPIDOS, a French community dwelling cohort study that was designed to evaluate the risk factors for hip fracture among women aged 75 years and older. Over a course of two years (1992- 1994) over 7000 women – free of a previous history of hip fracture or hip replacement – were recruited from five French cities to participate in this study. At baseline evaluation all participants received a full medical examination, which consisted of structured questionnaires, information about everyday dietary habits, chronic diseases, disability, sun exposure and a clinical examination. Medications and vitamin supplements were reported by interviewer questions and also by direct inspection of medications brought to the visit. Women were excluded from the study if over the last 18 months they had taken vitamin D drug supplements. A total of 5,596 women met the inclusion criteria and analyses were based on this sample size.

Dietary habits were assessed at baseline examination using a 21 question food frequency questionnaire that included questions on intake of fish (two items), dairy intake (six items) and the consumption of eggs, fruits, vegetables, starchy foods, chocolate and drinking history. The dietary intake of vitamin D per week was calculated by multiplying the content of individual food items (across all areas) by the frequency of consumption and adding this together. The vitamin D content for all food items was based on a dietary content database – continually updated by the French food and safety agency. For the French adult population, the dietary intake of vitamin D was 400 IU /day (or 35 micrograms/week). The assessment of cognitive function used– the Pfeiffer Short Portable Mental State Questionnaire (SPMSQ). This is a 10 item measure that has been in use in large scale studies as a screening tool to assess moderate to severe cognitive deficits. A score of 8 or below indicates cognitive impairment.

Although the mean weekly dietary intake of vitamin D for the entire group was well above the suggestive value of > 35 micrograms/week (mean 62.3 micrograms/week), approximately 14% of the women had inadequate dietary intakes of vitamin D. Based on the cognitive testing results, a total of 11% of the women were deemed to have cognitive impairment. Further, women who had lower levels of weekly vitamin D intakes had lower mean SPMSQ scores. These women were also older and reported more disability on a disability scale. To further examine the association between weekly vitamin D intake and cognitive function, other factors such as body mass index, sun exposure, number of chronic diseases, history of hypertension, depression, disability or use of antidepressants or other medications, were controlled for in their analyses. The association between dietary vitamin D and cognitive function remained significant even after adjusting for all of these factors.

Although the mean weekly dietary intake of vitamin D for the entire group was well above the suggestive value of > 35 micrograms/week (mean 62.3 micrograms/week), approximately 14% of the women had inadequate dietary intakes of vitamin D. Based on the cognitive testing results, a total of 11% of the women were deemed to have cognitive impairment. Further, women who had lower levels of weekly vitamin D intakes had lower mean SPMSQ scores. These women were also older and reported more disability on a disability scale. To further examine the association between weekly vitamin D intake and cognitive function, other factors such as body mass index, sun exposure, number of chronic diseases, history of hypertension, depression, disability or use of antidepressants or other medications, were controlled for in their analyses. The association between dietary vitamin D and cognitive function remained significant even after adjusting for all of these factors.

This study nicely demonstrates that in women free of vitamin D drug supplementation, weekly dietary intake of vitamin D was significantly associated with the cognitive performance. Few studies have examined the association of dietary vitamin D to cognition in a large population sample. Such studies are needed to clarify whether the associations reported in this study exist in other populations (i.e. U.S. based and those that involve substantial numbers of minority participants) and will guide future research as to whether or not to persue large scale clinical trials that examine the benefits of vitamin D supplementation to treat or prevent cognitive impairment.

Here are 3 articles you can refer to, to learn about this particular study or the latest research on vitamin D and cognitive function:

Nov 022010
 
Confused Lady

Dear Readers,

Whenever I give a presentation about the signs and symptoms of Alzheimer’s disease and discuss the known risk factors for the disease, I am asked this question . . . ( 90% of the time by the women audience members) . . . “Dr. A, is stress a risk factor for Alzheimer’s disease?”

Well, based on research findings from a variety of studies, the short answer is “Yes.” Let’s consider the latest finding from a study that revealed that stress in middle-aged women could lead to the development of dementia later on in life.

This research is based on a 35-year-study of 1,415 women from the Prospective Population Study of Women in Gothenburg, Sweden. The women were initially examined in 1968 (ages ranged from 38 years to 60 years), and then re-examined in the following cycles: 1974, 1980, 1992 and 2000. In addition to neuropsychiatric tests and questions on activities of daily living, the following question was asked by a physician to measure the level of stress in the first three cycles of data collection: “Have you experienced any period of stress (one month or longer) in relation to circumstances or everyday life, such as work, health or family situations?”

The measure of “stress” was defined as a sense of irritation, tension, nervousness, anxiety, fear or sleeping problems. Participants were asked to choose “0” if they never experienced stress, “1” if they have experienced stress more than five years ago, “2” if have experienced one period of stress during the last five years, “3” if they have experienced several periods of stress during the last five years, “4” if they have constant stress during the last year, or “5” if they have experienced constant stress during the last five years.

In addition, data was collected on a variety of factors (i.e. confounders) that may affect the association of stress to dementia, such as lifestyle factors (smoking and wine consumption), coronary heart disease, blood pressure and use of antihypertensive medication.

Participants were classified as having dementia at each cycle if they fulfilled the criteria put forth by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The diagnosis of Alzheimer’s disease was based on criteria put forth by National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association. The diagnosis of vascular dementia was based on the criteria proposed by the National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et 1″Enseignement en Neurosciences.

Of the women initially assessed in 1968, 161 developed dementia during the follow-up period of 35 years (105 diagnosed with Alzheimer’s disease, 40 diagnosed with vascular dementia, 16 with another type of dementia). The average age of dementia onset was 76 years. Stress that was rated as “frequent/constant” at the baseline and follow up cycles (1968, 1974 and 1980) was related to increased risk of developing dementia and these associations did not change when adjusted for potential confounding variables.

In addition, among women who participated in all three examinations, the risk of dementia increased with the number of examinations when stress was reported. Compared to a woman who never reported stress, if a woman reported stress at one examination cycle her risk for dementia was 1.10, if she reported stress at two examination cycles her risk was 1.73, and if she reported stress at three examination cycles the risk of dementia rose to 2.51.

These findings suggest that long standing psychological stress in middle-aged females is related to the development of dementia later in life. How the present findings could result in a better understanding of the risk factors for dementia and Alzheimer’s disease will need to be confirmed in studies that aim to study the potential neurobiological mechanisms for these associations.

Here are three articles you can refer to, to learn about this particular study or research in the area of Stress and dementia.

Johansson L, Guo X, Waern M et al. Midlife psychological stress and risk of dementia: a 35 year longitudinal population study. Brain,2010.

Hange D, Bengtsson C, Sundh V et al. The natural history of psychosomatic symptoms and their association with psychological symptoms: observations from the Population Study of Women in Gothenburg. Eur J Gen Pract 2007.

Wilson RS, Evans DA, Bienias JL et al. Proneness to psychological distress is associated with risk of Alzheimer’s disease. Neurology 2003.

Thanks for reading.

Neelum T. Aggarwal, M.D.
Steering Committee Member, ADCS
This post originally appeared in Alzheimer’s Insights, an ADCS Blog.

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