ACA’s Weekly Email, December 6, 2024

Physical activity of any intensity after a diagnosis of dementia is associated with a significantly lower risk for all-cause mortality, a new study showed. Researchers noted that the findings suggest encouraging regular exercise may significantly improve survival rates in people with dementia.  As dementia cannot be reversed with any medications, a nonpharmacologic approach, such as lifestyle modification, is considered important to modify the progression of dementia. Reducing sedentary behavior and promoting engaging in physical activity of any intensity should be recommended for patients with dementia.  Exercise Linked to Lower Mortality Risk in Dementia Patients

Older adults at risk for dementia can be identified using mobile data obtained during a wayfinding task, a novel real-world study suggested.  During a smartphone-assisted scavenger hunt on a university campus, researchers observed that older adults with subjective cognitive decline (SCD) paused more frequently, likely to reorient themselves, than those without SCD. This behavior served as an identifier of individuals with SCD.  Deficits in spatial navigation are one of the first signs of Alzheimer’s disease. Smartphone Data Flag Early Dementia Risk in Older Adults

With the approval of anti-amyloid monoclonal antibodies to treat early-stage Alzheimer’s disease (AD), the need for accurate and early diagnosis is crucial.  Blood-based biomarkers offer a promising alternative to amyloid PET scans and cerebrospinal fluid (CSF) analysis and are being increasingly used in clinical practice to support an AD diagnosis.  Recently, an expert workgroup convened by the Global CEO Initiative on Alzheimer’s Disease published recommendations for the clinical implementation of AD blood-based biomarkers.  The group recommends two implementation pathways for AD blood biomarkers — one for current use for triaging and another for future use to confirm amyloid pathology once blood biomarker tests have reached sufficient performance for this purpose.  In the triage pathway, a negative blood biomarker test would flag individuals unlikely to have detectable brain amyloid pathology. This outcome would prompt clinicians to focus on evaluating non–AD-related causes of cognitive impairment, which may streamline the diagnosis of other causes of cognitive impairment, the authors said.  A positive triage blood test would suggest a higher likelihood of amyloid pathology and prompt referral to secondary care for further assessment and consideration for a second, more accurate test, such as amyloid PET or CSF for amyloid confirmation.  In the confirmatory pathway, a positive blood biomarker test result would identify amyloid pathology without the need for a second test, providing a faster route to diagnosis. Blood Tests for Alzheimer’s Are Here…Are Clinicians Ready?

Less than a decade ago, the use of wearable devices in Parkinson’s disease (PD) was considered futuristic. Today, there’s an array of innovative tools from commercial activity trackers to tremor suppression gloves and laser-guided walking sticks to help manage the highly variable and fluctuating symptoms of PD.  Over the past 5 years, the landscape of wearable technology for Parkinson’s monitoring has transformed remarkably.  Advances in sensor technology, data analytics, and machine learning have significantly enhanced the precision and usability of wearable devices, he noted. They now offer continuous, real-time monitoring of both motor and nonmotor symptoms, which supports personalized treatment plans and more accurate tracking of disease progression.  Wearable Devices for Parkinson’s Disease: The Future Is Here

This year’s World Alzheimer Report revealed that 65% of health and care professionals incorrectly believe that dementia is a normal part of ageing—a figure that has risen from 62% in 2019. This alarming insight highlights the urgent need to address dementia stigma in health and care systems. At the beginning of November, ADI hosted an insightful webinar on dementia stigma in health and care systems.  You can watch the 1;hour 15 minute video here:  https://www.youtube.com/watch?v=NesqCLNfAvI

Microplastics have been found in the lungs, liver, blood, and heart. Now, researchers report they have found the first evidence of the substances in human brains.  A recent study examined olfactory bulb tissue from deceased individuals, 8 of the 15 decedent brains showed the presence of microplastics, most commonly polypropylene, a plastic typically used in food packaging and water bottles.  Measuring less than 5 mm in size, microplastics are formed over time as plastic materials break down but don’t biodegrade. While scientists are learning more about how these substances are absorbed by the body, questions remain about how much exposure is safe, what effect — if any — microplastics could have on brain function, and what clinicians should tell their patients.  The Plastic Health Council estimates that more than 500 million metric tons of plastic are produced worldwide each year. In addition, it reports that plastic products can contain more than 16,000 chemicals, about a quarter of which have been found to be hazardous to human health and the environment. Microplastics and nanoplastics can enter the body through the air, in food, or absorption through the skin.  Microplastics Have Been Found in the Human Brain. Now What?