Skyline Happenings

Huge sums of money are being spent on developing drugs to prevent, delay or treat Alzheimer’s. The ones so far have very little if any benefit. So could this disease be linked to an infectious source? It took a long time for the scientific community to accept that gastric and duodenal ulcers were caused by H Pylori and can be cured with antibiotics. Likewise, it took quite a while to accept that rheumatic fever was caused by the streptococcus. The infectious theories for Alzheimer’s are nicely reviewed in the following article written by Melinda Wenner Moyer, a science and health journalist.

From Aeon: “On Friday afternoons, Robert Moir, a neurologist at Massachusetts General Hospital in Boston, indulges in what he calls his ‘play hour’. He doesn’t go to the gym or head to the bar; he plops down in front of his computer – OK, yes, usually with a beer in hand – and directs his browser to PubMed, the US National Library of Medicine’s database of study abstracts from life-science journals. Then he hunts around for hidden gems: studies that might provide a fresh perspective or lead him down a new research path. On 11 May 2007, Moir stumbled across a set of studies while sipping a Sam Adams that would change the course of his career.

Moir studies Alzheimer’s disease; more specifically, he investigates beta-amyloid, the protein that clumps into big, gnarly plaques in the brains of Alzheimer’s patients. According to the prevailing dogma known as the amyloid cascade hypothesis, the build-up of beta-amyloid in the brain directly causes Alzheimer’s – it sparks the accumulation of tau tangles (a primary marker for the disease) inside neurons, leading to cell death and, eventually, dementia. Nothing good comes from amyloid plaques, most scientists contend. They are nothing but devastating biological accidents.

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Recently, you may have received an important message about the risk of falls and fractures  when adding new anti-hypertension medications. It importantly stresses the risk of falls and fractures in the first two weeks after adding additional anti-hypertensive therapy: see Antihypertension BP fall prevention. Here are a few additional preventative steps to consider.

When discussing the risks with your doctor, you will want to be thinking about how to prevent falls related to BP medications. Because BP meds can produce postural hypotension, it’s reasonable for patients to check their BP both sitting and standing (the BP often significantly falls with standing). If your systolic drops below 100 mmHg you are certainly at risk for falls. Also, electrolyte imbalance can at times play a role. Low sodium can cause weakness and low potassium as well. So as an advocate, I’d suggest you ask your doc to check your electrolytes; and also home monitor your BP twice daily sitting and standing at least for the first few weeks after BP medication changes. Additionally, after sitting or lying down – hang onto something and gain equilibrium before walking, especially when getting up at night.