Letters to the Editor

23 April 2018

Response to McGeer et al.: Alzheimer’s Disease Can Be Spared by Nonsteroidal Anti-Inflammatory Drugs

In their recent publication, McGeer and colleagues [1] recommend a simple diagnostic test at age 55 to identify people who, as they elsewhere describe, are “fated to develop Alzheimer’s” [2], further suggesting that they could benefit from a daily dose of a generic anti-inflammatory drug for prevention. However, their paper presents no real data (positive and negative predictive values) on how the test would perform if used clinically.

19 March 2018

Is LMTM the Norwegian Blue of Alzheimer's Therapy?

Treatment and interpretation of LMTM trial data by Wilcock and colleagues [1] is reminiscent of the Monty Python sketch in which the demise of an obviously dead parrot is disputed by a desperate shop owner who describes it as merely resting, stunned or pining for the fjords. This phase 3 trial of 18 months' treatment in patients with mild Alzheimer's disease (AD) followed a 15-month study in mild to moderate patients that showed no treatment benefits for LMTM [2]. The latest trial was also apparently negative.

21 February 2018

The Semmelweis Reflex, Medical Bilingualism, and treatment of MCI and Early Alzheimer’s Dementia

I recently attended the Annual Mild Cognitive Impairment Symposium in Miami, where a presentation on the future treatment of dementia focused solely on pharmaceuticals. As a psychopharmacologist, I was familiar with the data. I questioned why the presenter did not include Functional Medicine (FM, a translational medicine approach which converts preclinical research into clinical treatments for chronic diseases) in the future of MCI and AD treatment, since efficacy has been documented in early studies [1,2].

2 January 2018

Atrial Fibrillation and Dementia: What is the Link?

Regarding atrial fibrillation (AF), post-stroke cognitive impairment (PSCI), and post-stroke dementia (PSD), a recently published article in October 2017 by Chander and colleagues [1] reported that AF is a significant and independent risk factor for PSCI even after correction of other risk factors and that we should do follow up for patients with AF regardless of infarction type. This agrees with a meta-analysis done in 2012 [2]. Also in a systemic review done in 2017 [3], stroke patients with AF have a risk of dementia which is 1.68 times compared with patients without AF.

22 September 2017

Dietary factors for prevention of late-onset Alzheimer’s disease and related dementia: what is optimal?

Solfrizzi et al. [1] recently published a systematic review of observational studies published between 2014 to 2016 on dietary factors and late-life cognitive disorders. While the authors relayed the growing promise and potential of diet to change the course of late-onset Alzheimer’s disease and related dementia, their conclusion—that certain foods that have been thought to increase health risk are not as damaging as previously described—is not consistent with the emerging unifying concepts on protective dietary factors for Alzheimer’s disease [2-4].

28 September 2016

The Cognitive Basis for Florence Foster Jenkins' “Tone Deafness"

The brilliant film portrayal by Meryl Streep of the tone-deaf diva Florence Foster Jenkins is amplified in the historian Darryl W. Bullock's fine new book, Florence ! Foster !! Jenkins !!! the Life of the World's Worst Opera Singer (Overlook Press, New York, 2016). I offer here a scientific postulation for this striking example of "dysmusia " (or tune-deafness), of which she was quite likely cognitively unaware.

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