People whose brains have less myelin — the fatty tissue that insulates nerve cells — experience steeper declines in cognition over time, according to an NIA study published in Alzheimer’s & Dementia. The findings show the impact of myelin content as healthy people age and underscore myelin as a potential therapeutic target for neurodegenerative diseases, such as Alzheimer’s and mild cognitive impairment.

Myelin is an insulating layer that forms around nerves, including those in the brain. It helps neurons communicate more efficiently, maintain a healthy water balance, and respond to signals involved in memory formation and other cognitive functions. Previous studies have shown that myelin production slows as people age, but whether changes in myelin are linked to age-related changes in cognition remained unknown. However, some animal study evidence suggests changes in myelin may be responsible for cognitive deficits in neurodegenerative diseases.

For this study, the team of NIA scientists gathered data from 123 cognitively unimpaired adults enrolled in the Baltimore Longitudinal Study of Aging and from the Genetic and Epigenetic Signatures of Translational Aging Laboratory Testing study. The researchers tested several different types of cognition and used magnetic resonance imaging (MRI) brain scans to measure myelin content in the brain. They looked at two different MRI-based measurements to estimate the amount of myelin: myelin water fraction (MWF) and longitudinal relaxation rate (R1).

For both measurements, lower myelin was linked to greater cognitive decline over time. Lower myelin, as measured with MWF, was associated with a steeper decline in executive function, which includes skills such as planning, problem-solving, organization, and multitasking. Lower myelin as measured with R1 was associated with a faster decline in verbal fluency, which measures the ability to retrieve information from memory. These findings contribute to a foundation for further studies that explore how age-related changes in myelin are different in people who develop neurodegenerative diseases.

While, overall, this study establishes a meaningful relationship between myelin content and cognition, the authors noted some limitations, mainly that the cohort size was relatively small and included a higher proportion of men and White participants. Future research should reexamine the link in a larger, more diverse study cohort; explore the link between myelin and cognition in people with neurodegenerative diseases; and test whether promoting myelin production could be an effective strategy to prevent disease.

Some viral illnesses may increase a person’s chances of later developing Alzheimer’s disease or another neurodegenerative disorder. Though a causal link cannot be confirmed, an NIH study in which researchers mined the medical records of hundreds of thousands of people in Finland and the United Kingdom found significant associations.

NIH scientists used biobank data to estimate the chances that some viral infections, including influenzas (see picture), may lead to a neurodegenerative disorder diagnosis. Credit NIAID/NIH.

As published in Neuron, the researchers found there may be at least 22 pairings between a neurodegenerative disorder diagnosis and a previous viral infection that led to a hospital visit. The strongest risk association was between viral encephalitis — an inflammation of the brain caused by a virus — and Alzheimer’s disease. Meanwhile, hospitalizations due to pneumonia-causing flu viruses were linked to the diagnoses of several disorders, including dementia, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS). The study results also raised the possibility that existing vaccinations may help some people reduce the chances of experiencing these disorders.

Neurodegenerative disorders damage different parts of the nervous system. Typically, this happens later in life and produces a variety of problems, including with thinking, remembering, and moving. Several previous studies have suggested that certain viruses may play a role in each of these disorders. For example, a 1991 study of autopsied brain tissue suggested there may be link between herpes simplex virus and Alzheimer’s disease. More recently, scientists found evidence for a link between the Epstein Barr virus and multiple sclerosis by analyzing patient blood samples and medical records. The latter study sparked the CARD team to conduct this new study.

“After reading the Epstein Barr virus study we realized that for years scientists had been searching, one-by-one, for links between an individual neurodegenerative disorder and a specific virus,” said Michael Nalls, Ph.D., leader of the NIH CARD Advanced Analytics Expert Group and study senior author.

Led by Kristin S. Levine, M.S. and Hampton L. Leonard, M.S., two NIH CARD data scientists, the researchers mined the medical records of 300,000 individuals stored in FinnGen, a nationwide Finnish biobank. Specifically, they searched for individuals who had one of six neurodegenerative disorder diagnoses: Alzheimer’s disease, ALS, generalized dementia, multiple sclerosis, Parkinson’s disease, or vascular dementia; and then checked to see if a viral infection caused those individuals to make a prior visit to the hospital. Hospitalizations due to COVID-19 were not included in the study.

Initially, they found 45 significant associations between a neurodegenerative disease diagnosis and a previous viral infection. That number narrowed to 22 associations after the scientists performed a second search of UKBiobank, which contains the records of 500,000 individuals from the United Kingdom.

Of all the neurodegenerative disorders, generalized dementia had the most associations, with links to six different virus exposures. These exposures were categorized as viral encephalitis, viral warts, other viral diseases, all influenza, influenza and pneumonia, and viral pneumonia. Individuals who had viral encephalitis were at least 20 times more likely to be diagnosed with Alzheimer’s than those who did not experience that virus.

Severe cases of influenza were linked to the widest range of risks. Influenza and pneumonia exposures were associated with all the neurodegenerative disorder diagnoses except multiple sclerosis.

This study was funded by the Intramural Research Program at NIA (ZIAAG000535).

by Patricia Schallert

I met Robert Warnagieris, Ed.D at the Ventura Retired Men’s Group. This is what he has to say about his life as a retired senior.

“I was born in Chicago but came to California at the age of 6 months.  Therefore, I am a California product who grew up on the West Coast and received early schooling in San Luis Obispo County.  I ended up in Ventura in 1970 because I like what the VC county seat of Ventura had to offer in terms of cultural, educational, youth/senior programs, medical facilities, shopping and climate opportunities for me and my family. I had put in 38 ½ years in with the US Navy as a civilian and was able to retire with 40 years of credit.  It was time for me to move on. I am happy being retired from full time employment, but I really didn’t retire from an active life, I just don’t get paid.  I have been retired for 28 years.”

“I have more time to pursue time with my wife, hobbies, home maintenance/landscaping and community activities. I don’t have to meet any special schedule nor travel for business purposes.  I am free to stay home and scratch the dog’s ears if I please. I can do most anything I desire, and I do.  I am a versatile person and often say I have expertise in many fields but master of none.  I have been able to use all my experience, knowledge, and skills in many different venues.”

“When I retired, I expected to be able to switch from government service to an educational teaching or leadership position easily.  It was not so easy; however, I was able to continue my graduate level teaching on a part-time basis.”

“There were unexpected changes in my marital status and the eventual stability I achieved in that regard. As an 88-year-old retired person I spend time taking care of my wife and myself, pursuing physical fitness, hunting, fishing, golfing, community activities, various forms of entertainment, gardening/landscaping, watercolor painting, writing, time with my family, visiting friends, reading, walking the dog daily, cooking, maintaining my home, financial activities, and, of course, visits with multiple doctors.  Since the pandemic and aging, my long-distance traveling has been limited.  I tend to be an extreme do-it-yourselfer.”

“My parents encouraged me to graduate from high school in 3 years and then enroll for college.  I graduated at the age of 17 and enrolled in an engineering major at Cal Poly (SLO).  The continued pursuance of education to advance in many fields has been a major factor in my life.”

“In my 20’s I didn’t realize what I could achieve with perseverance.  I’m no genius but I set goals and achieved them. I wrote an Ethical Will for my family and listed 48 values that guide my life, ranging from education to having a dog.  They are in no particular order, however, high on the list are family matters, education, physical fitness, citizenship, career, professionalism, integrity, long term friends, and spiritual matters.”

Editor: If you are a senior (over 70-years please), or know of one, who would like to share their retirement, or job, with us please let us know at [email protected].

by NIH

Doctors may ask questions about health, conduct cognitive tests, and carry out standard medical tests to determine whether to diagnose a person with Alzheimer’s disease. If a doctor thinks a person may have Alzheimer’s, they may refer the person to a specialist, such as a neurologist, for further assessment. Specialists may conduct additional tests, such as brain scans or lab tests of spinal fluid, to help make a diagnosis. These tests measure signs of the disease, such as changes in brain size or levels of certain proteins.

There is currently no cure for Alzheimer’s, though there are several medicines approved by the U.S. Food and Drug Administration (FDA) that can help manage some symptoms of the disease along with coping strategies to manage behavioral symptoms. In 2021, FDA provided accelerated approval for a new medication, aducanumab, that targets the protein beta-amyloid, which accumulates abnormally in the brains of people with Alzheimer’s. The new medication helps to reduce amyloid deposits but has not yet been shown to affect clinical symptoms or outcomes, such as progression of cognitive decline or dementia.

Most medicines work best for people in the early or middle stages of Alzheimer’s. Researchers are exploring other drug therapies and nondrug interventions to delay or prevent the disease as well as treat its symptoms.

Alzheimer’s disease slowly gets worse over time. People with this disease progress at different rates and in several stages. Symptoms may get worse and then improve, but until an effective treatment for the disease itself is found, the person’s ability will continue to decline over the course of the disease.

Early-stage Alzheimer’s is when a person begins to experience memory loss and other cognitive difficulties, though the symptoms appear gradual to the person and their family. Alzheimer’s disease is often diagnosed at this stage.

During middle-stage Alzheimer’s, damage occurs in areas of the brain that control language, reasoning, sensory processing, and conscious thought. People at this stage may have more confusion and trouble recognizing family and friends.

In late-stage Alzheimer’s, a person cannot communicate, is completely dependent on others for care, and may be in bed most or all the time as the body shuts down.

How long a person can live with Alzheimer’s disease varies. A person may live as few as three or four years if he or she is older than 80 when diagnosed, to as long as 10 or more years if the person is younger. Older adults with Alzheimer’s disease need to know their end-of-life care options and express their wishes to caregivers as early as possible after a diagnosis, before their thinking and speaking abilities fail.

Mild cognitive impairment, or MCI, is a condition in which people have more memory problems than normal for their age but are still able to carry out their normal daily activities. A doctor can do thinking, memory, and language tests to see if a person has MCI. People with MCI are at a greater risk for developing Alzheimer’s disease, so it’s important to see a doctor or specialist regularly if you have this condition.

If you are concerned about memory problems or other symptoms, call your doctor. If you or someone you know has recently been diagnosed, explore the resources on this website and linked below to find out more about the disease, care, support, and research.

For over 700,000 people in California living with Alzheimer’s disease, wandering is a very common symptom that can be dangerous — even life-threatening — and the stress of this risk weighs heavily on caregivers and family.

It is estimated that 60% of people with dementia will wander and become lost at some point, and many do so repeatedly. If not found within 24 hours, up to half of wandering individuals will suffer serious injury or death.

There are several warning signs that lead to wandering, including forgetting how to get to familiar places or talking about fulfilling former obligations, such as going to work and wanting to ‘go home’ even when at home.

“Individuals who wander often have a specific intention,” said Kathryn Westland, Director of Programs for the Alzheimer’s Association California Central Coast Chapter. “They may have a personal need such as going to the bathroom. But if they become disoriented, even in a familiar place, this simple task can become a challenge and may prompt them to leave the house.”

While preventative measures cannot guarantee that a person living with dementia won’t wander, there are certain tips to help reduce the risk of wandering.

Identify the time of day the person is most likely to wander. Plan things to do during this time, including exercise, to help reduce anxiety and restlessness.

Ensure all basic needs are met, including toileting, nutrition and hydration.

Create a daily plan and involve the person in daily activities and chores.

Consider using a GPS device, a tracking app or other technology if the person is still safely driving,or remove access to any car keys if the person is no longer driving.

Avoid busy places like shopping malls and other busy areas, which can be confusing and cause disorientation.

Assess the person’s response to new surroundings and do not leave them, providing reassurance if they feel lost or abandoned.

If a family member does wander and get lost, begin your search immediately. Start by searching the immediate vicinity, including “less-traveled” areas in your home. Outside the home, search the yard and nearby surroundings. Most wanderers are found within a half mile of their homes or starting location.

If, after 15 minutes, the person is not located, call 911 to file a missing person’s report. California has implemented a Silver Alert, which is activated when an elderly, developmentally, or cognitively-impaired person has gone missing and is determined to be at-risk.

For more information and free support services, visit the Alzheimer’s Association online at alz.org/cacentral. Their Ventura office is located at 2580 E Main Street #201, and their 24/7 Helpline is 800.272.3900 for around-the-clock support and information in English and Spanish.

From NIH Research Matters

Neurodegenerative diseases can damage different parts of the nervous system, including the brain. This may lead to problems with thinking, memory, and/or movement. Examples include Alzheimer’s disease (AD), multiple sclerosis (MS), and Parkinson’s disease (PD). These diseases tend to happen late in life. There are few effective treatments.

Previous findings have suggested that viruses may play a role in certain neurodegenerative diseases. For example, a recent study found a link between Epstein-Barr virus infection and the risk of MS. There are also concerns about cognitive impacts from SARS-CoV-2, the virus that causes COVID-19.

A research team led by Drs. Mike Nalls, Kristin Levine, and Hampton Leonard of NIH’s Center for Alzheimer’s and Related Dementias examined links between viruses and neurodegenerative diseases more generally. To do so, they analyzed data from the FinnGen project. This is a repository of biomedical data, or biobank, from more than 300,000 people in Finland.

The team searched the biobank for people who had been diagnosed with one of six different conditions: AD, amyotrophic lateral sclerosis, generalized dementia, vascular dementia, PD, and MS. They then checked how many had been hospitalized for a viral illness before. To confirm their findings, they looked for the same associations in the UK Biobank, which contains data from almost 500,000 people in the United Kingdom. Results appeared in Neuron on Jan. 19, 2023.

The researchers found 45 associations between viruses and neurodegenerative diseases in FinnGen. Of these, 22 also appeared in the UK Biobank. The strongest association was between viral encephalitis — brain inflammation caused by a virus — and AD. A person with viral encephalitis in the FinnGen database was 30 times as likely to be diagnosed with AD as someone without encephalitis. Results were similar in the UK Biobank; people with viral encephalitis were 22 times as likely to develop AD as those without.

The team also found, in FinnGen, the association between Epstein-Barr virus and MS that was described before. The association wasn’t seen in the UK Biobank, but this may reflect how the different biobanks use hospital diagnostic codes; Epstein-Barr viruses are common and so often not noted.

Influenza with pneumonia was associated with all the neurodegenerative diseases except MS. The researchers only included cases of influenza severe enough to need hospitalization in the study. Thus, these associations only apply to the most severe cases of influenza.

FinnGen contains data on the same people over time. The team used this to examine how the associations depended on the time since infection. They found that some viral infections were associated with increased risk of neurodegenerative disease as much as 15 years later.

The researchers note that vaccines exist for some of the viruses they identified. These include influenza, varicella zoster (which causes chickenpox and shingles), and certain pneumonia-causing viruses. Vaccination might thus reduce some of the risk of the conditions they examined.

Reference: Levine KS, et al. Virus exposure and neurodegenerative disease risk across national biobanks. Neuron. 2023. Epub Jan 11. doi: 10.1016/j.neuron.2022.12.029.

by Carol Leish, MA

Consider nominating an exceptional business, organization, or individual that exemplifies commitment to service for: 1) Older Adults; 2) People with Disabilities; and/or, 3) Caregivers. Nominations are now being accepted by the Ventura County Area Agency on Aging between June 1^st-September 1^st, 2023. Award recipients will be announced in November, 2023.

The 2023 VC Area Agency on Aging Legacy Award Categories include: 1) Business/Organization; 2) Dementia-Friendly Business/Organization; and/or, 3) Community Member (Volunteer Based). The Legacy Awards are designed to recognize businesses, organizations, and community volunteers who have excelled in their roles to help improve the lives of older adults, individuals with disabilities and caregivers.

To nominate an individual, business, or organization, or faith-based organization for this award, the business must meet these requirements: 1) Must be doing business and serving clients within Ventura County: 2) Must be providing services for individuals 60 and older; and 3) Mus bet providing business to individuals with disabilities, and/or caregivers.

Nominating a Dementia Friendly Business/Organization must meet the criteria of: 1) Doing business and serving clients in Ventura County; 2) Exemplifying the Dementia Friendly Ventura County movement; and, 3) Making strides to better the customer service experience for individuals with dementia and their caregivers. The business or organization must also be providing services for individuals 60 and older, individuals with disabilities and/or caregivers.

In order to nominate a Community Member (Volunteer Based), the person nominated or selected to receive the Legacy Award must be living within Ventura County and must be working solely as a volunteer. This individual cannot be receiving pay for work performed on behalf of their fellow Ventura County residents. This person being nominated for this award mut be 60 years old or older and must be providing services for individuals 60 and older, individuals with disabilities, and/or caregivers.

For more information, such as the nominating form, or to learn about past winners of the Legacy Awards, visit https//vcaaa.org/legacy. Or, call: (805) 477-7306. And, submit your nomination form to [email protected].