March 1st Clippings

Most elderly Indians die from stroke

Chronic diseases are becoming the main source of death in people over 65 in low- and middle-income nations, with stroke being the leading cause, a new study has revealed.

Researchers surveyed 12,373 people aged 65 and over between 2003 and 2005 in a total of 10 urban and rural sites in Cuba, the Dominican Republic, Venezuela, Peru, Mexico, China and India, documenting over 2,000 deaths over a three to five year follow-up period.

"Chronic diseases are rapidly replacing communicable diseases as the leading cause of mortality and disability in developing countries," said Professor Martin Prince, who led the study from the 10/66 Dementia Research Group at the Institute of Psychiatry at King's College London

Since stroke is the leading cause of death in older people, and education is a strong protective factor, prevention may be possible, adding years to life and life to years.

"The current global health chronic disease agenda is largely focused on reducing mortality among working age adults. The concept of 'premature mortality' applied in such cases, is essentially ageist," said Professor Prince, who is also co-director of London's Centre for Global Mental Health (CGMH).

"I hope our findings will help highlight the lack of information about end of life among older people in developing countries, both regarding potential for prevention, and support and care of the dying, who, in the poorest settings, may not receive timely or effective medical intervention."

In 2005, deaths of people aged 60 and over accounted 61 per cent of all deaths in middle-income countries, and 33 per cent in low-income countries, compared to 84 per cent in high-income countries, yet there has been little research into the causes and determinants of these deaths.

Chronic diseases - particularly stroke, heart disease and diabetes - were the leading causes of death in all sites other than rural Peru.

Overall, stroke was the most common cause of death (21.4 percent), ranking first in all sites other than rural Peru and rural Mexico.

The authors found that education, more than occupational status and wealth in late-life, had a strong effect in reducing mortality risk in later life.

Most deaths occurred at home, with a particularly high proportion in rural China (91 per cent), India (86 per cent), and rural Mexico (65 per cent).

Other than in India, most received medical care for their final illness, but this was usually at home rather than in the hospital or clinic.

The study has been published in PLoS Medicine.

Source: www.timesofindia.com

01.03.2012

Alzheimer’s cure lies in brain's sugar level

Slowing or preventing the development of Alzheimer's disease could be as simple as ensuring that the supply of brain protein's sugar levels are maintained, a new study has suggested.

Seven researchers, including David Vocadlo, a Simon Fraser University chemistry professor and Canada Research Chair in Chemical Glycobiology, described how they've used an inhibitor they have chemically created - Thiamet-G - to stop O-GlcNAcase, a naturally occurring enzyme, from depleting the protein Tau of sugar molecules.

"The general thinking in science," said Vocadlo, "is that Tau stabilizes structures in the brain called microtubules. They are kind of like highways inside cells that allow cells to move things around."

Previous research has shown that the linkage of these sugar molecules to proteins, like Tau, in cells is essential. In fact, said Vocadlo, researchers have tried but failed to rear mice that don't have these sugar molecules attached to proteins.

Vocadlo, an accomplished chess player in his spare time, is having great success checkmating troublesome enzymes with inhibitors he and his students are creating in the SFU chemistry department's Laboratory of Chemical Glycobiology.

Research prior to Vocadlo's has shown that clumps of Tau from an Alzheimer brain have almost none of this sugar attached to them, and O-GlcNAcase is the enzyme that is robbing them.

Such clumping is an early event in the development of Alzheimer's and the number of clumps correlate with the disease's severity. Scott Yuzwa and Xiaoyang Shan, grad students in Vocadlo's lab, found that Thiamet-G blocks O-GlcNAcase from removing sugars off Tau in mice that drank water with a daily dose of the inhibitor. Yuzwa and Shan are co-first authors on this paper.

The research team found that mice given the inhibitor had fewer clumps of Tau and maintained healthier brains.

"This work shows targeting the enzyme O-GlcNAcase with inhibitors is a new potential approach to treating Alzheimer's," said Vocadlo.

"This is vital since to date there are no treatments to slow its progression. A lot of effort is needed to tackle this disease and different approaches should be pursued to maximize the chance of successfully fighting it. "In the short term, we need to develop better inhibitors of the enzyme and test them in mice. Once we have better inhibitors, they can be clinically tested," Vocadlo added.

The study has been published in Nature Chemical Biology.

Source: www.timesofindia.com

01.03.2012

Life begins with a thought, is processed with belief, and carried out with an action

Delton Jackson