The Morning Drill: July 19, 2011

A collection of dentistry and health related links/comments for your day.

Study: Healthy living can help prevent Alzheimer's

Taking care of your body just might save your mind. Millions of cases of Alzheimer's disease worldwide could be prevented by curbing risk factors such as high blood pressure, smoking, obesity and lack of exercise, new research suggests.

The study offers more than the usual pep talk about healthy living. Seven conditions or behaviors account for up to half of the 35 million cases of Alzheimer's around the world, it found. With no cure or treatment to reverse the mind-robbing disease, preventing new cases is crucial.

The study was presented Tuesday at the Alzheimer's Association International Conference in France, where sessions on prevention have been drawing standing-room-only crowds for several days.

"Prevention is a particularly attractive option given the state of therapy. That's why there's so much interest in it," said William Thies, the association's chief scientific officer.

The study was led by Deborah Barnes, associate professor of psychiatry at the University of California, San Francisco. Results also were published online by the British journal Lancet Neurology. The researchers have grants from the Alzheimer's Association and the U.S. National Institutes on Aging.

The study used a mathematical model to estimate the impact of top modifiable risk factors for Alzheimer's disease: smoking, depression, low education, diabetes, too little exercise, and obesity and high blood pressure in mid-life.

How much of an impact each one has on total Alzheimer's cases depends on how common it is and how strongly it affects dementia risk. Researchers calculated the impact globally and just for the United States.

Worldwide, the biggest impact on Alzheimer's cases is low education, because illiteracy is so common, they found. Low education can be a sign of many factors that harm minds, such as poor nutrition. But it also is harmful by itself, because there is less opportunity to develop "brain power" that can carry you into old age.

"Education, even at a young age, starts to build your neural networks," so being deprived of it means less brain development, Barnes explained.

Smoking had the second biggest impact on cases worldwide, followed by too little exercise.

In the United States, however, inactivity is the leading problem because a third of the population is sedentary, Barnes said.

Depression made the next biggest impact on Alzheimer's cases in the U.S., followed by smoking and high blood pressure in mid-life. Untreated or inadequately treated depression has long been known to raise the risk of developing Alzheimer's disease.

Reducing these seven risk factors by 25 percent could mean 3 million fewer cases of Alzheimer's worldwide, including half a million in the U.S., researchers estimated. Reducing risk factors by 10 percent would translate to 1.1 million fewer cases.

Flu Vaccines for 2011-2012 Season Receive FDA Approval

The US Food and Drug Administration (FDA) has approved a trivalent formulation for the influenza vaccine for the 2011 to 2012 influenza season, the agency announced today.

On the basis of advice from experts from the FDA's Vaccines and Related Biological Products Advisory Committee, the World Health Organization, the Centers for Disease Control and Prevention, and others in the public health community who have studied virus samples and patterns of infection, the FDA has identified the virus strains most likely to cause the most illness during the upcoming influenza season.

The strains selected for the 2011 to 2012 influenza seasonal vaccine include:

•     A/California/7/09 (H1N1)-like virus (pandemic (H1N1) 2009 influenza virus),
•     A/Perth/16/2009 (H3N2)-like virus, and
•     B/Brisbane/60/2008-like virus.

The brand names and manufacturers of the vaccines for the upcoming season are:

•     Afluria, CSL Limited;
•     Fluarix, GlaxoSmithKline Biologicals;
•     FluLaval, ID Biomedical Corporation;
•     FluMist, MedImmune Vaccines Inc;
•     Fluvirin, Novartis Vaccines and Diagnostics Limited; and
•     Fluzone, Fluzone High-Dose and Fluzone Intradermal, Sanofi Pasteur Inc.

Fluzone Intradermal, approved on May 9, 2011, will be available for those aged 18 through 64 years.

Persons aged 65 years and older, infants, pregnant women, and people of any age with certain chronic medical conditions are at high risk for complications, the CDC notes. These people, their household and close contacts, and all healthcare personnel should "be a primary focus for vaccination efforts as providers and programs transition to routinely vaccinating all people 6 months of age and older."

Dentists Can Identify People With Undiagnosed Diabetes

In a study, Identification of unrecognized diabetes and pre-diabetes in a dental setting, published in the July 2011 issue of the Journal of Dental Research, researchers at Columbia University College of Dental Medicine found that dental visits represented a chance to intervene in the diabetes epidemic by identifying individuals with diabetes or pre-diabetes who are unaware of their condition. The study sought to develop and evaluate an identification protocol for high blood sugar levels in dental patients and was supported by a research grant from Colgate-Palmolive.

Researchers found that, in this at-risk dental population, a simple algorithm composed of only two dental parameters (number of missing teeth and percentage of deep periodontal pockets) was effective in identifying patients with unrecognized pre-diabetes or diabetes. The addition of the point-of-care A1c test was of significant value, further improving the performance of this algorithm.

"Early recognition of diabetes has been the focus of efforts from medical and public health colleagues for years, as early treatment of affected individuals can limit the development of many serious complications," says Dr. Evanthia Lalla, an associate professor at the College of Dental Medicine, and the lead author on the paper. "Relatively simple lifestyle changes in pre-diabetic individuals can prevent progression to frank diabetes, so identifying this group of individuals is also important," she adds. "Our findings provide a simple approach that can be easily used in all dental-care settings."

Amazon Now Offering Money-Saving Digital Textbook Rentals

Amazon, the online purveyor of everything to everyone, is now making cash-strapped medical students happy with a new option to rent textbooks via the Kindle reader. You can select a rental period of anywhere between 30 and 360 days and the cost will be calculated accordingly. Any annotations you make within the Kindle will remain with you once the rental period expires and they’ll appear within the textbook if you rent it again.  There’s still a lot of books than need to be made available through rental, but we’re glad to see a new paradigm emerging that allows for substantial savings for students without them having to deal with reselling their books.

Enjoy your day!