Many Factors in Middle-Age May Shrink Your Brain

(American Health Newswire) -- A new study suggests smoking, high blood pressure, diabetes and being overweight in middle age may cause brain shrinkage and lead to cognitive problems up to a decade later.

"These factors appeared to cause the brain to lose volume, to develop lesions secondary to presumed vascular injury, and also appeared to affect its ability to plan and make decisions as quickly as 10 years later. A different pattern of association was observed for each of the factors," study author Charles DeCarli, MD, with the University of California at Davis in Sacramento and a Fellow of the American Academy of Neurology, was quoted as saying. "Our findings provide evidence that identifying these risk factors early in people of middle age could be useful in screening people for at-risk dementia and encouraging people to make changes to their lifestyle before it's too late."

The study involved 1,352 people without dementia from the Framingham Offspring Study with an average age of 54. Participants had body mass and waist circumference measures taken and were given blood pressure, cholesterol and diabetes tests. They also underwent brain MRI scans over the span of a decade, the first starting about seven years after the initial risk factor exam. Participants with stroke and dementia at baseline were excluded, and between the first and last MRI exams, 19 people had a stroke and two developed dementia.

The study found that people with high blood pressure developed white matter hyper intensities, or small areas of vascular brain damage, at a faster rate than those with normal blood pressure readings and had a more rapid worsening of scores on tests of executive function, or planning and decision making, corresponding to five and eight years of chronological aging respectively.

People with diabetes in middle age lost brain volume in the hippocampus (measured indirectly using a surrogate marker) at a faster rate than those without diabetes. Smokers lost brain volume overall and in the hippocampus at a faster rate than nonsmokers and were also more likely to have a rapid increase in white matter hyper intensities.

People who were obese at middle age were more likely to be in the top 25 percent of those with the faster rate of decline in scores on tests of executive function, DeCarli said. People with a high waist-to-hip ratio were more likely to be in the top 25 percent of those with faster decrease in their brain volume.

SOURCE: Neurology, published online August 3, 2011

New Sleep Apnea Treatment: Right Under Your Nose

NEW YORK, NY (American Health Newswire) -- 18 million Americans have sleep apnea. It's a condition that not only disrupts sleep but may lead to high blood pressure, heart attacks, stroke or diabetes if left untreated. Now, a simple device that fits over the nose is helping patients get the treatment they need without any discomfort.

Joyce Nemoga is up and at 'em, starting her day with a brisk walk and a little gardening. But Joyce didn't always have this much energy.

"I would wake up groggy," Joyce Nemoga told American Health. "It would take me an hour or something to wake up and kind of get going."

And she wasn't the only one suffering.

"My husband started complaining that I was snoring, and I was waking him up," Joyce said.

Doctors diagnosed Joyce with sleep apnea. Like most patients, Joyce was told to wear a C-pap mask to bed every night. The problem was it was bulky, uncomfortable, and just plain inconvenient.

"I tried, I honestly tried," Joyce said. "I couldn't really handle it. It's too much."

She isn't alone; more than half of all patients stop C-pap treatment because they find it cumbersome. This can put them at risk for several dangerous diseases.

Dr. Amit Patel had a different option for Joyce, called Provent Sleep Apnea therapy. It attaches right over the patient's nostrils.

"This device takes advantage of the fact that 92 percent or more of people automatically breathe through their nose when they fall asleep," Amit V. Patel, M.D., an assistant professor of medicine at the Center for Sleep Medicine at NewYork-Presbyterian Hospital/Weill Cornell, explained.

In sleep apnea, muscles in the throat relax and cause the airway to collapse. As a result, patients can stop breathing periodically. With the Provent device, valves inside open during inhalation and close when the patient exhales. This increases the pressure and may help keep the airway open.

"When they breathe in, there's no resistance. When they breathe out, there forms a resistance," Dr. Patel said.

Study results show 72 percent of patients had more than a 50 percent reduction in AHI, which is the number of times per hour they stopped breathing at night. Snoring was reduced by 65 percent, and more than 88 percent of patients reported wearing the device all night.

There is no mask, tubes or machines, just two small adhesives that Joyce puts on each night. She says it's made a huge difference.

"I wake up better. I'm more awake. I get up earlier now," Joyce said.

And she can enjoy more time with her husband during the day and at night.

"We don't have to worry about sleeping in separate rooms! We could sleep together for the rest of our lives!" Joyce said.

The Provent device is covered by some insurance. It costs about 60 dollars a month. The C-pap machine is covered by most insurance companies. The most common side effects reported by 

Provent users are a sense of nasal congestion or nasal discomfort.