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South 18 Woodham Focus
South Woodham Focus
FOCUS ON HEALTH
EARLY DIAGNOSIS. This week there is news that eye changes
might accurately predict dementia, but there's nothing new
under the sun. Two years ago to the day (almost)The Guardian
published a PA story under the caption: "Eye and smell tests may
reveal early dementia signs." At first glance, the headline
suggests that people who can't see clearly and have what used
to be called 'BO' may be well on the way to senility - but there's
more to it than that. I quote: "Researchers at Moorfields eye
hospital and the UCL Institute of Ophthalmology found a link
between poor cognitive ability – a “clear warning sign” of the
early stages of Alzheimer’s – and the thickness of people’s retinal
nerves. In a trial of more than 33,000 participants who were
tested on memory, reaction time and reasoning, eye scans
showed the nerve fibre layer was significantly thinner among
those who performed poorly on cognitive tests.
The findings, presented at the Alzheimer’s Association
International Conference in Toronto, Canada, could be key as
doctors believe diagnosing the condition early is essential for
most effective treatment.
Dr Clare Walton, research manager at the Alzheimer’s Society,
said: “Changes in the brain associated with dementia can begin
several years before any memory symptoms appear. This research
suggests that some of these changes happen in the retina of the
eye, too, which could give us a relatively easy, non-invasive way
to spot them early. Eye tests are fairly common for older people,
so there is great potential to incorporate additional tests into
their regular check-up.” But "while the tests could help with
early intervention, it is not expected to be a primary way to
diagnose the condition" she added.
In 2017 Traci Pedersen published an article in PsychCentral in
which she said that "A new study suggests that a simple eye
exam and retinal imaging test may help improve the diagnostic
accuracy of frontotemporal degeneration (FTD), a disease which
causes progressive damage to the temporal and/or frontal lobes
of the brain.
FTD is often misdiagnosed as Alzheimer’s or vice versa but there
are some key differences between the two. For example, FTD
typically manifests as a gradual decline in behaviour and/or
language, but unlike Alzheimer’s, memory is often wellpreserved.
In addition, onset of FTD usually occurs in a person’s
50s and 60s, although it has been seen as early as 21 and as late
as 80 years. Alzheimer’s typically begins after age 65.
Dogs, like horses, are quadrupeds. That is to say they have four
rupeds - one at each corner. Frank Muir.
This week Martin Bagot wrote in The Mirror that: "The thickness
of the retina can predict a decline in brain power, an eye test
study has proved. Scientists found that people with thin retinas
were twice as likely to perform poorly in subtle tests on everyday
memory, reaction time and reasoning. When tested again three
years later, these people were also twice as likely to have
suffered mental decline. Separate research building on the
breakthrough findings shows the changes can be tracked to
predict full-blown dementia nearly a decade later."
So what? If there isn't a 'cure' what's the point of being given
bad news of this sort? Well ... there might not be a cure but there
are things you can do to prevent or delay the onset of dementia.
The article tells us that "Experts hope drugs or lifestyle changes,
such as quitting booze and smoking, could slow or even halt
onset of the disease in those identified as at risk. Prof Paul
Foster, lead study author, said: “We now know we need to find
people at the earliest stages before the brain is irreparably
damaged. The hope is that either a drug or lifestyle advice can
stop this."
If you send your dog to get the paper make sure it knows which
one to get, and don't give it too much money or it might not
come back. Mike Harding
There were 2 studies published in the same edition of Jama
Neurology journal which both pointed in the same direction. The
first, which featured the ongoing work of the aforementioned
researchers at University College London and Moorfields Eye
Hospital, shows how it might be possible to roll out diagnosis of
the condition in the very early stages. Prof Foster said: “This is
even before pre-dementia. It is very mild cognitive impairment
like forgetting the number of your local takeaway. Things that in
the past they would’ve been able to dredge up from their
memory. It’s about one in 20 who struggles a bit more with that
kind of recall.” (I've never been able to remember the number of
my local take-away, Prof, so where does that leave me?)
The second study, which confirmed the findings, was conducted
by the Erasmus Medical Centre in Rotterdam. Prevention is
always better than cure - and in this case it's much, much better
than treatment. The sad fact is that 99% of trials globally from
2002 to 2012 for potential Alzheimer’s treatments failed
miserably.
And now here are the results of the Sheepdog Trials. All the
sheepdogs were found 'Not Guilty'. Keith Waterhouse.
NEW MALARIA 'CURE'. The newspapers are always looking for a
new 'wonder cure' and all too often they are rubbish - but at last
there's one that looks as if it deserves the title. Michaela Fleming,
writing in the Pharmacy Times, reports that: "The US Food and
Drug Administration (FDA) has approved, under Priority Review,
GlaxoSmithKline (GSK)’s tafenoquine (Krintafel), which is the
first single-dose medicine for the prevention of Plasmodium
vivax (P vivax) malaria relapse in patients over the age of 16 years
who are receiving antimalarial therapy. This is the first drug to be
approved for the treatment of P vivax in over 60 years.
The problem with this form of the disease is well explained in
the article: "After an infected mosquito bite, the P vivax parasite
infects the blood and causes an acute malaria episode and can
also lie dormant in the liver (in a form known as hypnozoite)
from where it periodically reactivates to cause relapses, which
can occur weeks, months, or years after the onset of the initial
infection. The dormant liver forms cannot be readily treated with
most anti-malarial treatments. Primaquine has been the only
FDA-approved medicine that targeted the dormant liver stage
to prevent relapse; however, effectiveness only occurs after 14
days and the treatment has shown to have poor compliance."
(Poor compliance, by the way, means that far too many people
don't heed the instructions and stop the medication before they
have completed the course ... so they fall ill again.)
The new drug has activity against all stages of the P vivax
lifecycle and the fact that a single dose is enough to kill it stone
dead is a great boon. Indeed it brings hope that P vivax may
eventually be eradicated. Given that the first evidence of malaria
parasites was found in 30 million year old mosquitoes which are
preserved in amber from the Palaeogene period, it's about time!
Dr John
SOUTH WOODHAM
FOCUS