Two months ago, scientists at the University of Pennsylvania announced they developed a remarkably accurate screening test for Alzheimer’s disease.

Unfortunately, the test necessitates a spinal tap which is only slightly less odious than say, colonoscopy.

That’s why many were elated to learn that scientists at UCSF just developed a noninvasive, 15-point assessment tool that does pretty much the same thing, albeit sacrificing some diagnostic accuracy in the process.

Sexagenarians that score eight or higher on the scale are at high risk of developing dementia within the next 6 years, according to lead author Deborah Barnes.

Many items on the test are known risk factors for the condition, including old age, low scores on thinking skill tests, and having a gene linked to the disease.
 
Others are less obvious, including being underweight, completely abstaining from alcohol, a history of coronary bypass surgery, and difficulty with simple physical tasks like buttoning a shirt.
 
“This new risk index could be very important both for research and for people at risk of developing dementia and their families,” Barnes told BurrillReport. “It could be used to identify people at high risk for dementia for studies on new drugs or prevention methods.”

To develop the index, the scientists followed 3,375 elderly people for 6 years. Subjects had no evidence of dementia at study onset, but 480 had developed the condition by the end of the observation period.

The scientists then determined using logistic regression which combination of factors best predicted dementia onset.
 
Nearly 56% of those with high scores on the test developed dementia, compared with 23% of subjects having moderate scores and 4% among subjects with low scores. Overall, 88% of subjects ended up being correctly classified by the test.
 
The study is in Neurology.

A calm, not-so-easily distressed personality is associated with a 49% lower risk of developing dementia, according to Hui-Xin Wang and colleagues from the Karolinska Institute.

And according to the findings, which are published in Neurology,  it’s 49% whether a person is a socially outgoing extrovert or a less socially active, stay-at-home introvert.

The scientists reached these conclusions after reviewing findings from the Kungsholmen Project, a time-oriented population-based study of dementia and aging in Stockholm residents.

“These findings provide further evidence that certain personality traits may play a role in dementia development and that personality-lifestyle interactions may be especially important for determining dementia risk,” wrote the scientists.

Wang’s group believes any impact of chill personality is mediated by stress.

They point to previous studies showing that chronic stress adversely impacts the hippocampus and other regions of the brain, possibly causing dementia.

David Knopman, a Neurology professor at Mayo Clinic who commented on the report for MedPageToday, didn’t buy the link to stress though.

He thinks the chill personality trait reflects a brain that is fundamentally more resistant to dementia.

It’s also possible that folks who can and usually do chill are better at compensating for dementia symptoms, thereby delaying their appearance and skewing the data, according to Knopman.

Alas these findings may be good news for the legions of the laid back, but it’s not clear that the newly identified risk factor is subject to one’s control. And if not it’s about as useful as saying that age and family history are risk factors for dementia.

We have known for ages that exercise reduces the risk of stroke, but this risk is not eliminated altogether especially if other risk factors such as high blood pressure and cigarette smoking are not addressed.

A study published in this week’s Neurology adds a new twist to the story. In the new study, Lars-Henrik Krarup and colleagues at Copenhagen University Hospital found that in a cohort of elderly stroke patients, those who had exercised more vigorously before the event had a better prognosis than those who exercised less vigorously or not at all.

Krarup’s group stratified 295 patients that had recently sustained an ischemic stroke into quartiles based on their prestroke physical activity as determined by a questionnaire. They assessed initial stroke severity using the Scandinavian Stroke Scale and 2-year stroke outcomes using the Rankin Scale.

The scientists found a linear relationship such that for each successive increase in prestroke physical activity, initial stroke severity decreased. The most active group was 2.54 times more likely to incur a mild initial stroke than the least active group. These benefits were maintained after two years, in that the most active group was far less likely to experience marked disability.

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