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 ADHD sufferers are at a higher risk of DLB than AD 
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Joined: Fri Aug 11, 2006 1:46 pm
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Location: SF Bay Area (Northern CA)
Post Re: ADHD sufferers are at a higher risk of DLB than AD
"Does anyone know if there is any research done that shows that ADHD/ADD drugs reduces or increases the risk of DLB later in life?"

As far as I'm aware, no one is looking into this. Perhaps one of the brain banks will look into what drugs those with autopsy-confirmed DLB took in their early years.

Of course there's great risk of developing dementia if one has depression in early life.


Wed Mar 21, 2012 12:44 pm
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Post Re: ADHD sufferers are at a higher risk of DLB than AD
Quote:
Of course there's great risk of developing dementia if one has depression in early life.


Robin, do the researchers know if this is disease-related vs. drug-related? In other words, could anti-depressants be contributing to the increased incidence?

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Wed Mar 21, 2012 3:49 pm
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Post Re: ADHD sufferers are at a higher risk of DLB than AD
It seems unlikely that there is a connection with anti-depressants, because the association has been reported consistently for some time, well before the widespread use of SSRI's and other anti-depressants.

One recent paper makes a pretty strong case that the increased risk of dementia is in fact more specific to vascular dementia, not to Alzheimer's, and that a close temporal link (depression happening not long before onset) suggests that depression may be a very early symptom of vascular dementia. (Lenoir et al, J Alzheimer's Dis, 2011). There are some papers with evidence consistent with this idea. One claims, for example, that depressive symptoms predict decline in executive function but not in memory (Royall et al, Int J Geriatric Psychiatry, 2012). Framingham study says there's increased risk of dementia, maybe 50% greater risk, but they don't seem to be very nit-picky about what kind of dementia (Saczynski et al, Neurology, 2010). Another study says the risk is for AD, and not for vascular factors (Luchsinger et al, Int J Geriatric Psychiatry, 2008). The Honolulu Aging Study folks found that the association of depression with AD may be quite a bit stronger in men with the ApoE4 genotype - their study is men only. Some other studies have suggested there might be a difference between men and women. A few other papers (Becker et al, Am J Geriatric Psychiatry, for example) say that depressed mood - state as opposed to trait? - does not in fact predict dementia.

So while most studies have reported an association, the nature of the relationship, and its consistency across subgroups in the population, are still somewhat murky!

Laurel

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Laurel - mother (97) diagnosed April, 2011, with LBD; died May, 2014.


Wed Mar 21, 2012 6:17 pm
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Post Re: ADHD sufferers are at a higher risk of DLB than AD
I am a sample of one with a dx of LBD....and possible AD, but negative PET-Scan in 2010 (was glucose not PiB) - Brain atrophy on MRI (2006 and 2009, 2010) in frontal and parietal lobes makes my doc think possible early AD with the LBD.......

I was never dx with ADD or ADHD but was a type A personality - I may have had ADD? or have it?....I did also take SSRI and SSNRI meds in small doses for several years prior to my first LBD symptoms.....and during the first couple of years of LBD symptoms at higher doses but not max doses.....I have a history of depression (episodic) and generalized anxiety since teen years.

Interesting discussion....Thank you!

_________________
First symptoms in 2000 at 35 yrs old. LBD early onset dx 2-17-2011 at age 46.

' "I try not to worry about the future, but rather to "wonder"....and "wonder" is one step away from "awe" '......From a wise friend........


Wed Mar 21, 2012 6:37 pm
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Post Re: ADHD sufferers are at a higher risk of DLB than AD
Thanks, Laurel! Wow, so many variables, coupled with the uncertainty of diagnosis makes these studies difficult, I should think.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Wed Mar 21, 2012 6:38 pm
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Joined: Fri Aug 11, 2006 1:46 pm
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Location: SF Bay Area (Northern CA)
Post Re: ADHD sufferers are at a higher risk of DLB than AD
Taking it a step further, I don't think there's evidence that any medication *causes* dementia. Unfortunately in the Whitworths' book on LBD caregiving, they state flat-out that Sinemet causes dementia. (Perhaps they meant to say that Sinemet can trigger psychiatric symptoms.)


Wed Mar 21, 2012 6:46 pm
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Post Re: ADHD sufferers are at a higher risk of DLB than AD
Hi Pat,
Yes, the studies are very challenging - everything from study design (best to follow people over time so you know for sure what came first) to measuring the right things to trying to analyze and sort out the relationships. I did not cite one of the earlier, major studies - Wilson et al, Neurology 2002 - I was a co-author on that one, in the Religious Orders Study, showing that depressive symptoms predicted both onset of AD and decline in cognitive function in general. Bob and the rest of the group wrote some follow-up papers after I left Chicago, confirming findings in a community study, and also suggesting that the association was not accounted for by cerebral infarctions. Complicated stuff - we are all still wrestling with the questions. There is just so much variability, for so many reasons, in older people and how the aging process unfolds. "Personalized medicine" is still more of a goal and a vision than a reality, so far.
Laurel

PS, totally agree with Robin... with the caveat that some medication or combinations of meds can cause short-term confusion/ delirium, and that always has to be considered in diagnosis. My beloved former mother-in-law was very sick one summer, and my daughter was staying with her to help out (they were very close) and got worried that her grandmother might be developing dementia. Quick review of her meds revealed the culprit, and she was back to normal within a week of going off that drug.

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Laurel - mother (97) diagnosed April, 2011, with LBD; died May, 2014.


Wed Mar 21, 2012 6:53 pm
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Post Re: ADHD sufferers are at a higher risk of DLB than AD
Regarding Sinemet - I agree with you Robin - I hope they meant it can "trigger psychiatric symptoms" - My doc actually said because Sinemet acts on processes governed by the basil ganglia, that any cognitive things that go on there could even be improved with Sinemet....I've been on it for 5-6 weeks now and I think my memory is some better.....but the effects on my mobility are significant......I can't believe how much rigidity and gait problems I was having until I started on Sinemet and they got better....my range of motion, swallowing and balance are all amazingly better...I was even able to wear a shoe with a small heel on it (haven't done that in over 2 years) without falling.....But I feel a sort of overall dullness that I am still hoping will pass.....like the nausea which is finally leaving me....

_________________
First symptoms in 2000 at 35 yrs old. LBD early onset dx 2-17-2011 at age 46.

' "I try not to worry about the future, but rather to "wonder"....and "wonder" is one step away from "awe" '......From a wise friend........


Wed Mar 21, 2012 6:59 pm
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Post Re: ADHD sufferers are at a higher risk of DLB than AD
Tonya, Sinemet has been a godsend for Derek, too, even though it has clearly increased certain psychiatric effects. Both his mobility and his cognition showed improvement right away. It also has kept his swallowing functional and his drooling minimal.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Wed Mar 21, 2012 8:02 pm
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Joined: Fri Aug 11, 2006 1:46 pm
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Location: SF Bay Area (Northern CA)
Post Re: ADHD sufferers are at a higher risk of DLB than AD
Tonya,
So glad to see you are receiving some benefits from Sinemet.
Robin


Wed Mar 21, 2012 10:11 pm
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