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Lifestyle changes may combat a dementia that strikes people in their 40s and 50s – CNN



The first symptom is likely a loss of interest in life and the well-being of others. A person might ignore their spouse or children’s feelings, get uncharacteristically frustrated and say or do inappropriate things — such as laugh at a funeral.
Your lifestyle can lower your dementia risk, even if you have high genetic risk, study says
Even worse, they’ll likely have no idea they have changed.
“It’s a pretty devastating disease that impacts people in the prime of their lives,” said neurologist Kaitlin Casaletto, an assistant professor in the Memory and Aging Center at the University of California, San Francisco. “It’s especially hard on family members who can see the changes in their loved one they themselves often can’t see.”
Science has struggled to provide interventions to help these patients. Now, a new study published Wednesday suggests that lifestyle changes may help slow the disease progression.
Casaletto and her colleagues followed the activity levels of 105 people with the inherited form of the disease, the first study to do so in this population. They found people who ranked highest in levels of mental and physical activity slowed their functional decline from the disease by half.
“This is an extremely important study providing the strongest evidence yet that lifestyle factors can positively impact brain health, not only for Alzheimer’s disease, but frontotemporal lobar dementia as well,” said neurologist Dr. Richard Isaacson, director of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine.
Mediterranean style diet may prevent dementiaMediterranean style diet may prevent dementia
“The study is even more impactful in that patients had a gene that would definitely cause dementia, but they were still able to impact cognitive decline by over 55%,” Isaacson said.
“It was a remarkable effect to see so early on,” Casaletto said. “If this were a drug, we would be giving it to all of our patients.”

A devastating disease

An estimated 50,000 to 60,000 Americans live with FTD or frontotemporal dementia, Casaletto said. About 30% of all cases are inherited. In comparison, only about 1% of Alzheimer’s cases are passed on via a familial gene, she said.
In the most common form of FTD, called “behavioral variant,” the executive (frontal) and emotive (temporal) parts of the brain are affected, thus impacting a person’s ability to control their thinking and emotions.
Alzheimer's risk may be 75% higher for people who eat trans fatsAlzheimer's risk may be 75% higher for people who eat trans fats
“The connection between the two is critically important,” Casaletto said. “So if you think of the frontal lobe as the start-stop inhibition control center, with the temporal lobe in charge of empathy and anger, you can imagine that when those start to degenerate how wildly unregulated one can become.”
In two other variants, the disease attacks areas of the frontal lobe responsible for names of objects and pronouncing words, leading to difficulty with reading, writing and speaking.
As the diseases progress, people have trouble concentrating, planning, making decisions and understanding conversations. They begin overeating, or forget to bathe. They may become compulsive buyers, steal from neighbors or rummage in their garbage, even shoplift at stores. Sometimes, they might begin to walk more slowly, show less muscle strength and have trouble swallowing.
There is no cure, and little science can do. Antidepressants called selective serotonin reuptake inhibitors may help with irritability, agitation and apathy. Life span after diagnosis is only six to 10 years.

The role of mental and physical activity

Lifestyle changes improved cognition in people at risk for Alzheimers, study showsLifestyle changes improved cognition in people at risk for Alzheimers, study shows
Ongoing research in Alzheimer’s suggests lifestyle factors such as adequate sleep, a healthy diet, and physical and mental exercises can improve brain health. In fact, a recent study on Alzheimer’s found personalized lifestyle interventions not only stopped cognitive decline in people at risk for Alzheimer’s, but actually increased their memory and thinking skills within 18 months.
But no one had ever studied those interventions in frontotemporal dementia.
“There’s incredible variability in FTD, even among people with the same genetic mutations driving their disease. Some people are just more resilient than others for reasons we still don’t understand,” Casaletto said. The study was designed to explore the role of lifestyle in those differences.
People with FTD in the study were mostly asymptomatic or had only mild, early-stage symptoms. Caregivers were asked to rate their loved one’s cognitive and physical activity over several years. The type of physical activity wasn’t critical — it could be walking, jogging, even doing heavy housework or yard chores.
“Studies show even walking is associated with better cognitive outcomes,” Casaletto said. “It seems that every movement counts.”
The 10 warning signs of Alzheimer's The 10 warning signs of Alzheimer's
A cognitively active lifestyle was defined as reading, writing, going to a concert, socializing, doing games, puzzles and hobbies, she said, anything that challenges the brain.
MRIs recorded disease levels in the brain at the start of the study; participants were given tests of thinking and memory and then rechecked annually. The results at the end of two years were surprising: Despite continued degeneration of brain tissue on scans, the people who scored in the top 25% of either mental or physical activity performed twice as well on cognitive tests as those in the lowest 5% of activity.
“Our results suggest that even people with a genetic predisposition for FTD can still take actions to increase their chances of living a long and productive life,” Casaletto said. “Their fate may not be set in stone.”
The study will continue and researchers plan to outfit participants with activity trackers to better understand which type of physical activity may be most beneficial. They also plan to tease out other factors that might be involved; at this time, the results are only a correlation.
Despite this study’s limitations, this small but growing pool of research should be a wake-up call to anyone facing a diagnosis of dementia, Isaacson said.
“It is essential for people at risk for dementia and their physicians to change their thinking from, ‘There is nothing we can do,'” Isaacson said. “People at risk should feel empowered and hopeful that they can take some degree of control of their brain health.”

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Get COVID-19 and flu shot at the same time – Windsor Star



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You can get a COVID-19 vaccination and annual flu shot at the same time, Windsor Essex County Health Unit director of health protection Kristy McBeth said Thursday.

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The National Advisory Committee on Immunization, which makes recommendations on the use of vaccines in Canada, recommended recently that the COVID-19 vaccine can be administered at the same time or any time before or after other vaccines, including the flu shot.

Previously, the committee had recommended that COVID-19 vaccines be administered at least 28 days before or 14 days after other shots as a precautionary measure.

After reviewing the evolving evidence on COVID-19 vaccines and considering the extensive data on administering other routine vaccines at the same time or within days of each other, the committee has determined that the earlier, precautionary approach is no longer necessary.

The new recommendation is expected to help the rollout of the flu shot this fall as well as make it easier for people to get  other vaccines they may have missed during the pandemic.

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The flu shot is free in Ontario and available at doctors’ offices and pharmacies. Hospitals, long-term care homes, doctors’ offices, walk-in clinics and pharmacies here have already received their supplies.

People over age 65 and those at risk of complications from flu have been given priority and are receiving the vaccine now. The shot will be available to the general public in November.

The health unit will begin promoting the shot more widely next month.

“We will be doing some extra promotion, urging people to get it,” McBeth told the health unit’s board of directors.

Between 150,000 and 200,000 doses are expected to be administered here this season, up from 97,000 last year.

Ontario has ordered 7.6 million doses this year, 1.4 million more than last year, Health Minister Christine Elliott said Tuesday.

There were few cases of flu last season because many people worked from home, their children learned remotely and the economy and society were locked down.

But more cases are expected this season because many people have returned to offices, schools have reopened and many restrictions have been lifted, allowing people to be out in the community more and to socialize and travel.

People are being urged to get the flu shot to avoid overwhelming hospitals that are still caring for COVID-19 patients.

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Canada scraps COVID-19 travel advisory; Ontario to end mask, vaccine rules by March



Canada has scrapped an official advisory urging its citizens to shun  non-essential foreign travel, given its successful campaign to inoculate people against COVID-19, the country’s top medical officer said on Friday.

Hours later, Canada’s most populous province, Ontario, issued a timeline to lift all remaining COVID-19 restrictions, with the aim of removing all proof of vaccination and mask requirements by March 2022.

Canada’s travel warning was issued in March 2020, when the COVID-19 pandemic erupted.

Ottawa removed the advice to avoid unnecessary travel late on Thursday, however it is still telling people to avoid cruise ship travel outside of the country.

“The beginnings of the transition away from the more blanket approach really recognizes vaccines are very effective at preventing severe outcome,” Chief Medical Officer Theresa Tam told a briefing.

According to official data, just under 82% of eligible Canadians had been fully vaccinated against COVID-19 by Oct 8.

Tam said the latest surveillance data showed “a continued decline in disease activity nationally and in most jurisdictions.”

“Now is not the time to just freely go wherever,” she added, citing high cases of coronavirus in some nations.

Ontario laid out a six-month timeline to lift all COVID-19 restrictions, starting with removing capacity limits in the “vast majority” of public venues on Oct. 25, and culminating in an end to all mask and proof of vaccination requirements by March.

The timeline will be dependent on “the absence of concerning (pandemic) trends,” it said in a statement.

“This plan is built for the long term,” Premier Doug Ford said. “It will guide us safely through the winter and out of this pandemic, while avoiding lockdowns and ensuring we don’t lose the hard-fought gains we have made.”

Ontario spent much of the past 18 months in some form of  lockdown due to high infection rates and hospital bed occupancy of COVID-19 patients.

(Reporting by David Ljunggren in Ottawa and Moira Warburton in Vancouver; Editing by Paul Simao and Bill Berkrot)

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COVID-19 vaccines not linked to pregnancy loss; mixing vaccines may confer greater protection



The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that have yet to be certified by peer review.

COVID-19 vaccines not linked with pregnancy loss

Two studies in major medical journals add to evidence that COVID-19 vaccines are safe before and during pregnancy. One study, published in The New England Journal of Medicine on Wednesday, tracked nearly 18,500 pregnant women in Norway, including about 4,500 who had miscarriages. Researchers found no link between COVID-19 vaccines and risk of first-trimester miscarriage, regardless of whether the vaccines were from Moderna, Pfizer and BioNTech, or AstraZeneca. Overall, the women with miscarriages were 9% less likely to have been vaccinated, according to the researchers’ calculations. In a separate study published on Thursday in The Lancet, researchers tracked 107 women who became pregnant while participating in trials of AstraZeneca’s vaccine in the UK, Brazil and South Africa. Seventy-two of the women had received the vaccine while the others got a placebo. AstraZeneca’s vaccine had no effect on the odds of safely carrying the pregnancy to term, the researchers reported. “It is important that pregnant women are vaccinated since they have a higher risk of hospitalizations and COVID-19-complications, and their infants are at higher risk of being born too early,” the authors of the Norwegian study wrote. “Also, vaccination during pregnancy is likely to provide protection to the newborn infant against COVID-19 infection in the first months after birth.”

Vaccine combinations with different technologies may be best

Healthcare workers in France who got a first shot of AstraZeneca’s COVID-19 vaccine and then the Pfizer/BioNTech vaccine for their second shot showed stronger immune responses than those who had received two shots of the Pfizer vaccine, in a recent study. Combining different technologies is known to boost immune responses to other viruses, and the current study suggests it may be true for the coronavirus as well. Both vaccines in the study deliver instructions that teach cells in the body to make a piece of protein that resembles the spike on the coronavirus and that triggers an immune response. But they do it in very different ways. Both protocols provided “safe and efficient” protection, said Vincent Legros of Universite de Lyon in France, coauthor of a report published on Thursday in Nature. But combining the AstraZeneca shot with the Pfizer/BioNTech vaccine “conferred even better protection” than two doses of Pfizer’s shot, including against the Delta variant, Legros said. The two technologies combined induced an antibody response of better quality, with more neutralizing antibodies that could block the virus, and more cells that have been “trained” by the vaccine to have increased defense potential, he said. Combination vaccination “is safe and may provide interesting options… for clinicians to prevent SARS-CoV-2 infection,” Legros concluded.

Cognitive problems seen in middle-aged COVID-19 survivors

A “substantial proportion” of middle-aged COVID-19 survivors with no previous dementia had cognitive problems more than half a year after diagnosis, researchers have found. They looked at 740 people who ranged in age from 38 to 59. About half were white, and 63% were female. On tests of thinking skills, 20% had trouble converting short-term memories to long-term memories, 18% had trouble processing information rapidly, and 16% had trouble with skills needed for planning, focusing attention, remembering instructions, and juggling multiple tasks. The average time from diagnosis was 7.6 months. About one-in-four patients had been hospitalized, but most of them were not critically ill. “We can’t exactly say that the cognitive issues were lasting because we can’t determine when they began,” said Dr. Jacqueline Becker of the Icahn School of Medicine at Mount Sinai in New York City, who co-led the study published on Friday in JAMA Network Open. “But we can say that our cohort had higher than anticipated frequency of cognitive impairment” given that they were relatively young and healthy, Becker said.

Data support use of Pfizer vaccine in children and teens

The Pfizer/BioNTech COVID-19 vaccine showed 90.7% efficacy against the coronavirus in a trial of children ages 5 to 11, the U.S. drugmaker said on Friday in briefing documents submitted to the U.S. Food and Drug Administration but not formally published. The children were given two shots of a 10-microgram dose of the vaccine – a third of the strength given to people 12 and older. The study was not primarily designed to measure efficacy against the virus. Instead, it compared the amount of neutralizing antibodies induced by the vaccine in the children to the response of recipients in their adult trial. Pfizer and BioNTech said the vaccine induced a robust immune response in the children. Outside advisers to the FDA are scheduled to meet on Tuesday to vote on whether to recommend authorization of the vaccine for that age group. A separate study from Israel conducted while the Delta variant was prevalent and published on Wednesday in The New England Journal of Medicine, compared nearly 95,000 12- to -18-year-olds who had received Pfizer’s vaccine with an equal number of adolescents who had not been vaccinated. The results show the vaccine “was highly effective in the first few weeks after vaccination against both documented infection and symptomatic COVID-19 with the Delta variant” in this age group, the research team reported.

Click for a Reuters graphic on vaccines in development.


(Reporting by Nancy Lapid; Additional reporting by Michael Erman; Editing by Bill Berkrot)

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