A useful article by Canadian Pat Croskerry, summarises some recent important, relevant and practical information that can help with diagnostic and other decisions. In our lives and work we repeatedly make quick judgments and decisions – that is not only a good thing but essential to ordinary and professional life. A lot of very good research over recent years has looked at the nature of this intuitive and near intuitive thinking – how it happens and how it can go…..

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A recent large US study* found that the vitamin thiamine was not given to 49 percent of Intensive Care patients who were at risk of thiamine malnutrition associated with Alcohol Use Disorder. This finding suggests disturbing and profound ignorance (despite published guidelines) in the treating teams’ understanding of the need to provide urgent thiamine supplementation when malnutrition is suspected. It could also suggest similar ignorance about the need to give thiamine to patients with malnutrition not associated with alcohol use…..

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In June I posted that the US Food and Drug Administration (FDA) had controversially approved aducanumab under an ‘accelerated approval process’ for the treatment of Alzheimer’s disease. That post goes into some detail – if interested, you may like to read it. Essentially I understand that this drug has been shown to reduce amyloid deposition in the brain and probably to slow or stop cognitive deterioration but not improve cognitive function. Neurologist Jason Karlawisch, speaking about advice he would give…..

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BRAIN HEALTH FOLLOWING SURGERY AND ANAESTHESIA FOR OLDER PEOPLE. Immediately following surgery with an anaesthetic older people may become temporarily confused – suffering from ‘delirium’. Up to 65% of older patients may develop postoperative delirium of varying degrees. Once this confusion has cleared, which may take many months, most recover fully but some may continue to show signs of deteriorated cognitive function (especially learning/memory and executive functions) or even clear-cut dementia. Some older people will show signs of deteriorated cognitive…..

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A very large and well designed study from Glasgow strongly supports an association in professional football players between heading the ball and, later in life, ‘neurodegenerative disease’ (dementia, Alzheimer’s disease, non-Alzheimer dementia, motor neuron disease, and Parkinson’s disease). Five percent of the former soccer players were identified with a neurodegenerative disease diagnosis compared with a neurodegenerative disease diagnosis compared with 1.6 percent of matched population control people. Risk of neurodegenerative disease was highest for defenders and lowest for goalkeepers. Defenders…..

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PROLONGED COVID SYMPTOMS (‘LONG COVID’) AFFECTING BRAIN AND OTHER FUNCTIONS. In a recent German study, at 12 months after onset of Covid symptoms, only 22.9% of people were completely free of symptoms. [because of ‘selection bias’ in the study – see below* – the percentage of people without long covid symptoms at 12 months is likely to be less than 22.9%] Most frequently reported symptoms were: reduced exercise capacity (56.3%), fatigue (53.1%), breathlessness (37.5%), concentration problems (26.0%), problems finding words…..

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A recent opinion paper in the well respected Journal ‘Neurology’ nicely summarises research about the ‘glymphatic system’ in our brain. This system, only recently understood, drains fluid from our brain in a way similar to the way the ‘lymphatic’ system drains fluid from our arms and legs. The glymphatic system particularly works during sleep and probably has a major role in clearing away various break-down products of proteins, peptides and solutes. We know that some of these substances, such as…..

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The US Food and Drug Administration has approved this drug (aducanumab or Aduhelm) under their accelerated approval program ‘which provides patients suffering from a serious disease earlier access to drugs when there is an expectation of the clinical benefit despite some uncertainty about the clinical benefit of the drug’. The drug has been shown by brain imaging to reduce brain Amyloid Beta Plaque, which appears to be an important component of the Alzheimer process. One study also showed that the…..

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I just saw a wonderful film about dementia and more by Florian Zeller: ‘THE FATHER’ with Anthony Hopkins, Olivia Colman and other exceptional actors. Hopkins plays a man experiencing dementia. Colman plays his daughter experiencing the stress and distress associated with her dad’s condition. I won’t spoil it by giving any more detail but I recommend it for everybody who has (or hasn’t!) any involvement with the scourge of dementia. Among many other things, the film raises issues about communicating…..

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A question that comes around again and again. The answer is: ‘yes and no’ or ‘it depends’ but telling fibs should not be ruled out as a way of helping This is discussed in my book on pages 78-79 and 341-345. Rigid, dogmatic, blanket and insensitive application of either ‘Reality Orientation’ or ‘Therapeutic Fibbing’ can be damaging to a person with dementia. This UK Alzheimer’s Society blog (see link) discusses this in practical, wise and compassionate terms. For instance: ‘recognising…..

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