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Dementia

People over age 65 who frequently take over-the-counter sleep aids and certain other commonly used drugs may be increasing their risk of dementia, new findings show. In the study, the researchers looked at drugs that have "anticholinergic effects," meaning they block a neurotransmitter called acetylcholine. Many drugs fall into this class, including tricyclic antidepressants such as doxepin, antihistamines like Chlor-Trimeton (chlorpheniramine) and drugs like Detrol (oxybutinin) used to treat overactive bladder.

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In two cases of progressing dementia, PET imaging with amyloid and tau tracers helped to clarify the diagnosis by ruling out Alzheimer's disease, researchers suggested. This case series highlights two new PET tracers with higher specificity for tau protein and beta-amyloid plaque, allowing researchers to distinguish between traumatic brain injury and Alzheimer's dementia. More rigorous studies are necessary, particularly comparing the PET results to postmortem diagnosis (the gold standard).

Dementia risk scores on standard cognition tests are not as good as scores on cardiovascular and stroke tests, such as the Framingham test, in predicting mental decline. Scores on the Framingham cardiovascular and stroke tests were strongly associated with lower scores on 4 out of 5 cognitive tests, whereas scores on the newer Cardiovascular Risk Factors, Aging and Dementia (CAIDE) were not as strongly correlated with those on tests of cognition, and were associated with only 3 of the 5 tests. The CAIDE dementia and Framingham risk scores predict cognitive decline in late middle age but the Framingham risk scores may have an advantage over the dementia risk score for use in primary prevention for assessing risk of cognitive decline and targeting of modifiable risk factors.

Primary prevention of Alzheimer disease and other types of dementia (all-cause dementia) is an important public health goal. Evidence to date is insufficient to recommend any lifestyle change to prevent or delay the onset of dementia. A prospective, observational cohort study was conducted among 19 458 community-dwelling, nonelderly adults who had a baseline fitness examination. Higher midlife fitness levels seem to be associated with lower hazards of developing all-cause dementia later in life.

Older patients who used benzodiazepine anti-anxiety drugs were at substantially higher risk of developing dementia than nonusers, a French study found. The risk of new-onset dementia during follow-up was 60% greater for those who had used benzodiazepines relative to never-users. Those who had ever used benzodiazepines in this analysis were more likely to develop dementia after the 8-year mark.