Posts Tagged ‘Dr. John Dougherty’

Exercise for Prevention

A study calculated that an intervention that would delay the onset of AD by 12 months would lead to 9.2 million fewer cases of AD globally. Research has estimated that reducing inactivity by 10-25% could prevent between 380,000 to one million cases of AD worldwide. Based on published reports, if the cost of care for an AD patient is $10,000 more per year than a patient without AD, we would save 3.8 to 10 billion dollars a year.

 

Despite the benefits of exercise, research suggests that the subpopulation of older adults actually exercise less. In general, health-promoting behaviors tend to increase with age, with the exception of exercise. Different factors as to why this age group is more sedentary include: lack of self-efficacy, inadequate education, poor support, limited access to recommended exercise and abnormalities of mobility.

Isolation, cost, lack of socialization as well as poor physician emphasis are also factors. Exercise is a cost effective, non-pharmaceutical treatment to delaying the onset of dementia and improves outcomes. A critical challenge is how to help older adults overcome obstacles that prevent them from developing a healthy exercise habit. One major obstacle is a lack of motivation for exercise.

A growing amount of research reveals that an “enriched” environment may be crucial to improving brain health. “Enriched” simply means that influences such as physical exercise and intellectual stimulation can affect your brain’s functioning. Findings from brain health studies at UC Berkeley have corroborated the importance of exercise on brain health.

It all makes perfect sense, as the brain is a vital part of the body. Since it is comprised of cells nourished by your blood, your heart’s health also plays an important role in your brain’s wellbeing. Regular physical activity improves cerebral blood flow, which promotes better mental functioning. So, it’s easy to see why both physical and intellectual exercises would help improve brain functioning.

Secondary Dementias

Secondary dementias, for the most part, begin with disease outside the nervous system.  They are not associated with a degenerative process like Alzheimer’s disease in which the pathology usually involves the brain itself and no other parts of the body.  The secondary dementias usually involve some general systemic process which affects the brain secondarily.  I have divided these secondary dementias into groups: Infection, Metabolic, Brain Tumors, and Trauma, which I hope will be have some benefit.

 

One important issue to remember about secondary dementias is that in many cases they are treatable dementias.  For example, thyroid dysfunction or toxic states.

 

Infectious Disease:

The most difficult infectious disease is called Creutzfeldt-Jakob disease (CJD).  Creutzfeldt-Jakob is a disease caused not by a virus but by an infectious protein very similar to a virus.  In the past it was quite difficult to diagnosis CJD because we didn’t have adequate neuro-imaging studies.  We used to frequently biopsy the brain in Creutzfeldt-Jokob, but in association with this biopsy there was the potential for the spread of the disease itself.  Now as one recent article suggests an MRI scan with contrast shows abnormalities of the cortical ribbon in the frontal areas.  These findings represent a typical picture associated with CJD and assist greatly in the diagnosis of this condition.

AIDS dementia complex, which is the dementia associated with HIV/AIDS used to be very common.  It’s of particular interest because the brain is one of the few if not the only organ in the body which is actually invaded by the abnormal virus like particle associated with HIV/AIDS.  AIDS dementia complex has undergone a dramatic change as it has become much less common with the new and helpful treatments for HIV/AIDS.  Twenty years ago I saw 5 patients a year with AIDS dementia complex and in 2013 I saw zero.

Cryptococcal meningitis usually occurs in individuals who have immune suppression, for example, a patient with leukemia. In the past it was difficult to diagnosis but we now have antigen antibodies that can identify it relatively easy even from the peripheral blood.  The diagnosis of Cryptococcal meningitis has changed dramatically with advances in our diagnostic tools.

 

Metabolic states:  One of the most common metabolic states is thyroid disease particularly hypothyroidism. I saw an executive person recently who was complaining of a difficulty with memory, unsteadiness, and weight gain. Examination showed that the individual was markedly hypothyroid and improved dramatically with treatment.  The positive treatment outcome associated with treating hypothyroidism emphases the idea that many of these secondary dementias are indeed treatable.

Deficiency states:  The most common deficiency state is a B12 deficiency.  B12 deficiency is an uncommon diagnosis but in my experience it almost always involves the peripheral nerves even prior to involving the brain.  The name for B12 deficiency used to be “combined degeneration” and this is because it involved the brain, the nerves themselves as well as a cognitive impairment.

Toxins:  The specific toxins we will discuss are heavy metals and the abuse of alcohol and drugs. More specifically the heavy metals consist of mercury and possibly arsenic. There are also, reports of people having skin toxicity from mercury causing a multi symptom disease but also involving abnormalities of the brain and cognitive function.  Abuse of alcohol and drugs and I am referring more specifically to continuous long term heavy drinking or use of drugs possibly narcotic abuse has been shown to increase the possibility of cognitive impairment.  It is known however, that a relatively small amount of alcohol and this includes two glasses of wine in men and one glass for women actually may have some preventative effect for AD.

Brain Tumors:  We have seen a few patients that have presented with weakness and confusion associated with a brain tumor.  I saw one patient who was complaining of headaches and weakness and in retrospect had some unilateral symptoms whom I thought from a clinical perspective had AD. After an appropriate examination he very clearly had a lung cancer which had metastasized to the brain.  This can happen particularly in patients who have unilateral frontal lesions.  When the lesion is more posterior one can have weakness in the arm or leg and the diagnosis is much more obvious.  When the lesion is anterior the diagnosis may be much more difficult.

Trauma:

In the case of a subdural hematoma (blood clot on the surface of the brain usually caused by trauma) particular in older adults, the clinical symptom is frequently new onset headaches.  It is very important to take that particular clinical syndrome (new onset headaches) and evaluate it carefully if they have not had a history of headaches.

Normal pressure hydrocephalus (NPH) commonly referred to as “water on the brain” is associated with an increase in spinal fluid within the brain cavities.  In the past the diagnosis of NPH was difficult because we did not have adequate tools to measure long term spinal fluid pressure.  We now have developed new techniques which can actually tell us the prognosis of inserting a shunt (a tubing that reduces brain spinal fluid pressure by draining the fluid into the abdominal cavity).  This allows us to identify patients that would improve with a shunt thus improving the long term outcomes of those with NPH.

Depression:

Depression is a very important issue in regards to older adults.  Depression increases as one ages and the suicide rate can be substantial in older individuals.  The important thing is that we actually have rather good treatments for depression. There are a number of anti-depressant medications which are associated with few side effects and can improve depression significantly.  Depression can produce a cognitive abnormality but the pattern is usually very different from AD and involves more pronounced attention abnormalities.  In addition, symptoms of depression can result in an increase cognitive abnormality in patients with early AD.  Often severe depression and associated depressive thoughts can contribute to the lack of attention seen in AD.

 

It is said that approximately 20% of individuals who present with AD have an associated depression.  This is a very important concept because patients that have a dementia or AD actually can have a substantial superimposed depression and therefore the effects can be synergistic.  The depression may exacerbate the cognitive problem itself and treatment of depression can be very gratifying.

Alzheimer’s Research in Tennessee – Dr. John Dougherty

Medinteract’s co-founder, Dr. John Dougherty and Dr. Alan Solomon from the University of Tennessee Medical Center, discuss the exciting research collaboration with Eli Lilly and Co. and the newly FDA-approved Amyvid which is used in the early diagnosis of mild cognitive impairment (MCI) and early Alzheimer’s disease.

http://www.knoxnews.com/news/2012/apr/15/doctors-collaborate-on-study-of-early-alzheimers/

Sports Illustrated – Finding a Cure

Medinteract Co-founder, Dr. John Dougherty, was quoted in the article “Finding A Cure” by Alexander Wolf in the December 12, 2011 issue.

Excerpt  – “Early diagnosis is so important,” says Dr. John Dougherty, who runs the Memory Clinic at the University of Tennessee’s Cole Neuroscience Center. “The goal is prevention through delay. If we can delay symptoms by five years with medication and exercise, we can reduce the number of sufferers by six- to eight million—[about] the population of metropolitan Atlanta.”

View the full article

The cover featured: Sportsman Of The Year: Mike Krzyzewski / Sportswoman Of The Year: Pat Summitt

The two winningest coaches in Division I college basketball history (907 for him, 1,075 for her) have more in common than just extraordinary success. For reaching far beyond their campuses and refusing to be defined by their genders, SI honors them together.

Medinteract – Selected as the 2011 Technology Company of the Year

Tech 2020′s Tennessee Valley Technology Council presented its annual Navigator Awards Wednesday, November 16, during the first day of the Entrepreneurial Imperative 2011 Conference. Awards of excellence were given for this year’s top entrepreneur, researcher, and technology company, as well as for the Tech Commericalization Champion of the year.

Selected as the 2011 Technology Company of the Year, Medinteract  was cofounded by Andrew Dougherty. Medinteract provides efficient and effective detection of Alzheimer’s disease by their computer based cognitive screening testing technology. Early detection leads to early intervention delaying the impact of the disease. Medinteract is now providing their detection services to a range of medical service providers across the region.

See the full release from Tech2020’s Tennessee Valley Technology Council.

Medinteract Co-Founder – Speaks at Knoxville Event

KNOXVILLE (WATE) – Hundreds of people were at Sevier Heights Baptist Church Thursday to hear what a leading Alzheimer’s specialist had to say about the degenerative brain disease.

Dr. John Dougherty, with Cole Neuroscience Center at UT Medical Center, not only talked, he listened as people of all ages shared their stories about life with a loved one struggling with the mind-robbing disease.

Knoxville News Sentinel – Hundreds turn out to hear Alzheimer’s Expert

WATE TV Knoxville, TN – Alzheimer’s Expert Shares His Knowledge at Knoxville Event

Reports on Alzheimer’s Disease in Knoxville, TN

Below are number of recent news reports on Alzheimer’s disease from Knoxville, TN:

WBIR-TV’s Robin Wilhoit interviews Janice Wade-Whitehead & Board member Dr. Monica Crane

Knox News Sentinel interviews Programming Director Linda Johnson about early onset dementia

WBIR-TV (NBC) interviews local family who wants Pat to know she has a bigger team now

WATE-TV (ABC) interviews local woman about her mother’s fight with Alzheimer’s

 

What Is Mild Cognitive Impairment?

As diagnostic criteria for Mild Cognitive Impairment (MCI) has become more widely embraced by the medical community, more and more patients are receiving a diagnosis and then asking the obvious question: what is it? This is generally followed by: does this mean I have (or will have) Alzheimer’s disease (AD)? Read More

  • News
  • April 13th, 2010

ABC World News: Driving With Alzheimer’s

Dr. Dougherty was featured on ABC World News with Diane Sawyer April 12, discussing his research on driving with Alzheimer’s, in the driving simulator from the University of Tennessee. You can read the full story on the ABC site here, or watch the video below. If you are concerned that you or a loved one may have signs of early Alzheimer’s, you  may take the early warning screen, developed by Dr. Dougherty, here.

  • News
  • April 12th, 2010

Medinteract Founder on ABC World News Tonight

Dr. John Dougherty will be interviewed tonight on ABC World News with Diane Sawyer, to discuss his Alzheimer’s research, using the driving simulator at The University of Tennessee and Cole Neuroscience Center. You can read the original story, aired on Knoxville ABC-affiliate WATE here.