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Saturday, 2 May 2020

You can Defeat Frontotemporal Dementia by Adopting Constructive Lifestyle Modifications

A recent scientific research conducted by a team at the UC San Francisco Memory and Ageing Centre reveals that lifestyle modifications made by patients have the ability to influence outcomes - a hereditary diagnosis notwithstanding.

Source: Google images

The new study suggests that patients who physically and mentally get involved in active lifestyle will effortlessly prevent the onset and development of frontotemporal dementia (FTD), even if they are genetically expected to eventually develop the illness later in their life.
The study seriously supports the time-honoured research that suggests that exercise and cognitive fitness are one of the best approaches to preventing or slowing down Alzheimer's disease. This however, is the leading research effort to reveal that the same types of behaviours can be of immense advantage to people with frontotemporal dementia (FTD), which leads to a different kind of brain deterioration.
FTD is known to be a neurodegenerative ailment that is capable of disordering personality, decision-making, language, or movement abilities, and characteristically it starts about the ages of 45 to 65.
Source: Google images

This disease is known to be the most common form of dementia in people below 65 years of age. Experts say this holds explanation for 5 to 15 per cent of dementia cases generally, and that it would usually lead to fast decline in cognitive and physical capabilities as well as death in less than 10 years. And as far as modern medicine is concerned at the moment, there are no drugs to treat the disease; all the same, a great number of clinical trials for FTD are on-going at UCSF Memory and Ageing Centre and some other places.
"This is devastating disease without good medical treatments, but our results suggest that even people with a genetic predisposition for FTD can still take actions to increase their chances of living a long and productive life. Their fate may not be set in stone," said Kaitlin Casaletto, PhD, assistant professor of neurology at the UCSF Memory and Ageing Centre and corresponding author of the new study, published January 8, 2020 in Alzheimer's and Dementia.
'If This Were a Drug, We Would Be Giving it to All Our Patients'
Around 40 per cent of people with FTD have a family history of it, and researchers have recognised the exact overriding genetic mutations that drive the growth of the disease in approximately half of these cases. However, even in these people, the disease can have very different courses and levels of seriousness.
"There's incredible variability in FTD, even among people with the same genetic mutations driving their disease. Some people are just more resilient than others for reasons we still don't understand," said, Casaletto, a member of the UCSF Weill Institute for Neurosciences. "Our hypothesis was that the activities people engage in each day of their lives may contribute to the very different trajectories we see in clinic, including when the disease develops and how it progresses."
Reading - a form of mental exercise           Source: Google images

Putting this hypothesis to test, Casaletto and her team examined how differences in lifestyle choices affected FTD progression in 105 individuals with dominant, disease-causing genetic mutations who were mostly asymptomatic or had experiences only with mild, early-stage symptoms. Participants in the research were pulled from two large multisite research works, called ARTFL and LEFFTDS (lately put together to form a study referred to as ALLFTD), led by co-authors Adam Boxer, MD, PhD, and Howie Rosen, MD, also of the UCSF Memory and Ageing Centre.
Being part of these larger research efforts, every participant had to undergo initial MRI scans to ascertain the extent of brain collapse as a result of the disease, completed tests of thinking and memory, and gave reports on their present levels of cognitive and physical activity in their day-to-day living, such as in reading, spending time with friends, jogging, etc. Simultaneously, their family members were made to complete regular gold-standard evaluations of how well the research participants were operating in their lives e.g., managing money, taking their drugs, bathing themselves, etc. All of these measures were repeated at follow-up visits each year to monitor and follow the long-term progression of participants' disease.
Even after only two to three visits (one to two years into the on-going research), Casaletto and her team have already started to observe substantial changes in the speed and severity of FTD between the most and least mentally and physically active persons in the study, with mentally and physically active ways of life revealing related effects across partakers.
Precisely, the study team discovered that functional decline, as measured by participants' family members, was 55 per cent slower in the most active 25 per cent of participants in comparison to the least active five per cent. "This was a remarkable effect to see so early on," Casaletto said. "If this were a drug, we would be giving it to all of our patients."
They also discovered that participants' ways of life did not considerably alter the inevitable worsening of brain tissue that is linked to FTD, as assessed by follow-up MRI scans after a year into embarking on the research. But even among participants whose brain scans showed signs of atrophy, the most mentally and physically active participants continued to perform twice as well as the least active participants on cognitive assessments. These results put forward that active daily life will possibly slow down FTD symptoms by providing some form of cognitive resilience to the consequences of brain degeneration.
Findings Could Illuminate Biology of Brain Resilience Across Dementias
The scientists expect that seeing even larger differences in cognitive decline between more and less active groups as the merged ALLFTD research work continues to follow these participants over time. "We've seen such significant effects in just the first year or two in people with very mild disease - if these results hold, we may see that an active lifestyle sets individuals on a different trajectory for the coming years," Casaletto said.
Following this step of the study is to take account of more detailed and objective evaluations of participants' physical and mental activity, together with fitting them with wearable FitBit activity sensors - to start to assess precisely how much activity is required to stimulate cognitive resilience.
Source: Google images

However, Casaletto warns that the results, however exciting, so far only report a connection: "It is possible that some participants have less active lifestyles because they have a more severe or aggressive form of FTD, which is already impacting their ability to be active. Clinical trials that manipulate cognitive and physical activity levels in people with FTD mutations are needed to prove that lifestyle changes can alter the course of the disease."
Having this warning in mind, Casaletto is full of expectations that the results will not only encourage care teams and individuals with family histories of FTD to embrace lifestyle changes that could provide more productive years of life, but also that the study on hand will result into a better biological appreciation of the drivers of resilience in people with FTD.
"We can see that lifestyle differences impact people's resilience to FTD despite very penetrant genetics, so now we can start to ask more fundamental questions, like how these behaviours actually affect the brain's biology to confer that resilience," Casaletto said. Furthermore she asks, "Is that biological effect something we could replicate pharmacologically to help slow the progression of this terrible disease for everyone?"

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