The University of Arizona (UA) is offering a new "From Chemistry to Cure" course in which pharmacy students will develop drugs to combat Alzheimer's, reports the Daily Wildcat . "The students have an Alzheimer's-causing protein target that they will pick during the course and will find compounds that virtually bind to this target," said UA Professor May Khanna, who will teach the class. "They will optimize these compounds with the help of chemists and pharmaceutical scientists and progress through the whole drug discovery path. At the end of the course, some students will progress to the second phase to create a startup company to further develop the compound." Following the drug discovery stage, the students will meet with Tech Launch Arizona, the university office that commercializes new inventions by UA researchers. Khanna said the selected students will pitch their ideas for a potential startup, with one group's compound chosen at the end of the course. That compound will be sent for testing to a contract research organization the following summer. Khanna emphasized the course's primary goal is to cultivate students' critical thinking and entrepreneurial skills.

A study in PLOS Medicine found people who experienced persistent and substantial changes in blood pressure were at a higher risk of developing dementia, reports Being Patient . The researchers monitored more than 5,000 dementia-free people in Rotterdam for about 15 years, and learned that those who had the largest increases — or declines — in blood pressure over the years were at greater risk of developing dementia than those whose numbers remained steady. "The association between blood pressure variation and dementia appears most pronounced when this variation occurred long before the diagnosis," the authors noted. The implication is that people might enjoy more benefits in seeking stable blood pressure earlier in life, long before any symptoms of neurodegenerative decline manifest. A separate study in Alzheimer's & Dementia: The Journal of the Alzheimer's Association suggested a regimen of lifestyle changes and medical interventions can slow cognitive decline from Alzheimer's or other neurodegenerative disorders.

A study published in Nature explored the role of the protein complex called the NLRP3 inflammasome in Alzheimer's and frontotemporal dementia (FTD), reports Medical News Today . The research characterized how tau protein changes under the influence of inflammation processes from the brain's immune system. Normally, tau proteins help stabilize the skeleton of the nerve cell or neuron, but in Alzheimer's and FTD, the proteins experience chemical changes that make them detach from the skeleton and clump to each other, eventually causing the cell to die. This effect is induced by a process called hyperphosphorylation, which changes the chemical composition and behavior of the protein molecules. Hyperphosphorylation involves the protein molecule's saturation with added phosphate groups, and the researchers discovered the NLRP3 inflammasome activates the enzymes that saturate the tau proteins with phosphate, so that they detach from the cell skeleton and clump. Earlier research had already identified NLRP3 inflammasome as a promoter of beta-amyloid protein accumulation. "Our results support the amyloid cascade hypothesis for the development of Alzheimer's," says University of Bonn Professor Michael T. Heneka. The implication is that the inflammasome is the missing link that bridges the disease processes of beta-amyloid and tau, and Heneka suggests these findings could lead to development of drugs that target tau pathology by altering the immune response.

The Washington Department of Social and Health Services has awarded Nurses Improving Care for Healthsystem Elders (NICHE) at New York University (NYU) Rory Meyers College of Nursing a grant of more than $644,000 to enhance the quality of care for older adults living in Washington State nursing home communities, reports News-Medical . The three-year project is underwritten by the Centers for Medicare & Medicaid Services' Civil Money Penalty Reinvestment Program, a national initiative to lower adverse events, improve staffing quality, and better dementia care in such places. The project will supply nurses and certified nursing assistants in 30 Washington State nursing communities with specialized education and leadership development training to deploy evidence-based care for seniors. Over 3,000 Washingtonians could potentially benefit. Nurse leaders at participating communities will take an eight-week online leadership training course and work with expert mentors to develop a quality improvement project concentrating on two clinical areas. NICHE mentors and faculty will then assist teams on site in implementing those action plans. Staff will also complete specialized continuing education classes on older adult care. "Research shows that NICHE organizations have improved outcomes, decreased costs, and reduced hospital readmissions, all of which have led to higher older adult and staff satisfaction," concludes NYU Meyers' Mattia Gilmartin.

Geriatric assessment can play a crucial role in cancer care, reports National Public Radio . The assessment includes questionnaires and tests to rate individuals' physical, mental, and functional capacity, accounting for social lives, daily activities, and goals. This approach can help doctors better estimate who will likely develop toxicities to chemotherapy and other serious potential complications of treatment. Such assessment does not yield complete accuracy, but "it's better than the clinician eyeball test," says University of Rochester Professor Supriya Gupta Mohile. "If I didn't do a geriatric assessment and just looked at someone I wouldn't have the same information." Mohile notes geriatric oncologists take a different approach than many other oncologists, with emphasis on avoiding toxicities in the treatment regimen. A study in the Journal of Geriatric Oncology found that in 197 persons with cancer 70 years and older, 27 percent of the treatment recommendations they received from the tumor board differed from those received after completing a geriatric assessment, which called for less intensive treatment or palliative care. Moreover, a 2017 Cochrane review of 29 studies of geriatric assessments on persons who had been hospitalized found that such subjects were more likely to be alive and at home 12 months later, versus those who received standard care.

A study of 11,084 postmenopausal women in the Journal of Bone and Mineral Research suggests short sleep may damage bone health, reports Medical News Today . "I hope that it can . . . serve as a reminder to strive for the recommended seven or more hours of sleep per night for our physical and mental health," said University at Buffalo, New York Professor Heather M. Ochs-Balcom. The researchers learned that women who reported getting only up to five hours of sleep per night had significantly lower values in four bone mineral density (BMD) measures — the whole body, the hip, the neck, and the spine — compared with women who slept longer. The lower BMD measures among the short sleep cohort were equivalent to being one year older. The results excluded other potential influential factors like age, race, effects of menopause, smoking status, alcohol use, body mass index, use of sleeping pills, exercise, and type of bone density scanner. The researchers said an important message to consider is that sleep, like diet and exercise, is often modifiable.

A study in Obesity found obese and overweight older adults who lose weight have lower bone mineral density (BMD) in their hips, reports Medical Xpress . Seventy-seven adults about 67 years old on average were assessed at baseline, 18 months, and 30 months throughout an 18-month weight-loss program. The researchers compiled data on their body mass and body composition, BMD, trabecular bone score, and regional bone scores at the hip, femoral neck, and lumbar spine. Participants were classified as either weight regainers (WRs) or weight maintainers (WMs). The only significant reduction was seen in BMD across the intervention, in both WRs and WMs. WRs had slightly lower losses in hip BMD versus those who maintained their weight at 30 months, but the difference was statistically insignificant. The change in hip BMD also had a direct association with change in total fat mass and total lean body mass, but the inverse relationship between total body lean mass and trabecular bone score was nonsignificant. "These data add to a growing body of literature suggesting that bone loss persists after weight loss ends," the authors concluded. "Thus, to preserve the integrity of the skeletal system, geriatricians and their care recipients should strive to minimize bone loss during active weight loss attempts and approach weight loss as a permanent lifestyle change."

When a parent's decision-making capacity is impaired by dementia, family members often face a contentious debate over what forms of self-determination are safe and reasonable for that parent, reports Forbes . Such a diagnosis does not necessarily mean the parent is incapable of making any decisions at all. Finances will likely need to be managed by someone else, but the right to make decisions about where to live must be considered independently. Options for the parent's living situation also should be discussed jointly within families, with the parent's right to some self-determination in mind. Safety needs to be the preeminent concern, but deciding what is safe works best when all family members weigh the expressed wishes of the parent, along with the latest medical information. Grief, stress, relocation, depression, and other factors can significantly impact what a doctor observes in examining a person for dementia. Recurrent and updated evaluations are critical in deciding what is best for any aging parent diagnosed with dementia.

Engineers and social workers at the University of Texas at Arlington (UTA) are using a $248,628 National Institute of Transportation and Communities grant to enhance transportation for seniors in assisted-living communities throughout the Dallas area, reports EurekAlert . Under UTA Professor Kate Hyun's guidance, the researchers will explore ways to increase seniors' willingness to try ride-sharing companies, which require basic computer skills. Fellow UTA Professor Kathy Lee said social work is an essential ingredient of this effort, as "so much of what we're talking about in this project deals with getting people to understand, accept, and learn that there are ways to offer better transportation that can empower them." UTA Professor Caroline Krejci is tasked with combining data collected by Lee and the results of Hyun's transportation analysis into a computational model that will enable the researchers to simulate the effects of various policies on older residents' transportation-related decisions and behaviors over time, in order to predict mobility outcomes. "Human behavior is complex, and a well-intentioned strategy to improve mobility for older adults might yield unexpected consequences," Krejci noted. "This model will help us to understand these complexities and provide data-driven recommendations for transportation policy."