What’s the future of treatment for Alzheimer’s disease?

CASSANDRA EI SZOEKE, STEPHEN R CAMPBELL, NICOLA T LAUTENSCHLAGER, OLGA YASTRUBETSKAYA, DAVID AMES

Abstract

Accurate diagnosis of the dementia syndrome is essential to provide the best possible therapy. Current treatment options for Alzheimer’s disease are limited to symptomatic therapies (including cholinesterase inhibitors and N-methyl-D-aspartate receptor antagonists). Potential new treatments are focusing on decreasing amyloid production, increasing amyloid clearance and using immunotherapies.

Key Points

  • Due to our ageing population the prospect of dementia is of increasing concern to people and their families.
  • Dementia is a syndrome characterised by a decline in memory and at least one other cognitive ability that is severe enough to cause a significant impairment of social or occupational functioning.
  • Modifiable risk factors include the potentially protective effects of a high antioxidant diet, statin therapy, exercise and higher education.
  • Current treatment options for Alzheimer’s disease are limited to symptomatic therapies. These include cholinesterase inhibitors and N-methyl-D-aspartate receptor antagonists.
  • Nonpharmacological approaches are worth considering because of their low costs and low risks of side effects, as well as their ability to complement pharmacological approaches and their benefits to other health outcomes.
  • Potential new treatments for Alzheimer’s disease are focusing on removing amyloid by decreasing amyloid production, increasing amyloid clearance and using immunotherapies. Other major treatment targets include correcting neuronal damage, neuroprotection and use of anti-inflammatories.

 

Managing panic disorder and generalised anxiety disorder

EDWARD WIMS, ALISON MAHONEY, GAVIN ANDREWS

Abstract

Patients with panic disorder or generalised anxiety disorder require an accurate diagnosis and thorough education regarding the nature of the condition. A stepwise approach to the management and treatment of these disorders is recommended.

Key Points

  • Panic disorder and generalised anxiety disorder are common and debilitating conditions.
  • Patients with anxiety disorders require an accurate diagnosis and thorough education regarding the nature of their disorder.
  • A stepwise approach to the management and treatment of panic disorder and generalised anxiety disorder is ideal.
  • Cognitive behavioural therapy (CBT), including group CBT, individual CBT or clinician-assisted computerised CBT, is the treatment of choice for patients with these anxiety disorders.
  • Pharmacotherapy in the form of selective serotonin reuptake inhibitors or tricyclic antidepressants can also have a useful role in these patients.
  • Both panic disorder and generalised anxiety disorder are treatable, and with appropriate care affected patients can return to baseline functioning.

 

Obesity – a growing family issue for male fertility

IE-WEN SIM, ROBERT MCLACHLAN

Abstract

Obesity in men has been associated with reduced fertility. The impact of paternal body mass index on fertility is multifactorial, with increased weight associated with endocrine dysregulation and impaired sexual desire and function. Weight loss may improve fertility outcomes as well as conferring longer-term health benefits.

Article Extract

Obesity is a growing health issue that causes substantial morbidity and mortality. Epidemiological data suggest an association between increasing body mass index (BMI) and reduced fertility in men, with one study suggesting that a gain of 10kg decreases male fertility by approximately 10%. The effect of BMI on male fertility is multifactorial, with increased weight associated with changes in sex hormone profile and impaired sexual desire and function. Some studies also suggest poorer semen parameters in overweight men.

Despite the prevalence and costs of male subfertility, there are few data regarding the fertility benefits of weight loss in men. Although weight reduction may normalise the hormone profile, the extent that this improves fertility and the time course of any improvement are unclear.