Voluntary assisted dying is generally called ‘physician assisted death’ in the USA. I acknowledge that this is a sensitive and divisive issue. However, it is important that as many people as possible, especially in Australia, and whatever their attitude to the issue, should be informed about some aspects of the recent New South Wales (NSW) legislation, where the legislation relates to dementia and mental illness. I emphasise in advance that I am merely reporting on some of the provisions of…..

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DBS FOR SEVERE, TREATMENT REFRACTORY OBSESSIVE COMPULSIVE DISORDER. The idea that brain surgery can help someone suffering from a mental illness is still a controversial and, to many people, a confronting one. However, there is now firm evidence that a procedure called Deep Brain Stimulation (DBS) can improve the lives and relieve the crippling and distressing symptoms for some people suffering from very severe obsessive-compulsive disorder (OCD). There have now been four placebo-controlled trials (one of which was Australian) providing…..

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BRAIN EFFECTS OF COVID-19. A recent study from Oxford University confirmed that Covid-19 often does produce changes in the brain during and after infection. These changes may explain some of the symptoms of ‘Long Covid’. The study compared MRI imaging before and after SARS-CoV-2 infection. Most of the infections studied were not associated with severe illness. Participants in the study who had experienced a Covid-19 infection had more grey matter loss and abnormalities in the area of the brain associated…..

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In addition to all the negative effects of infection on individuals, especially older people, Covid has had severe and often fatal indirect effects on the care of older people, including those older people with dementia. During the peak of the recent Omicron wave the exacerbation of existing shortages of skilled workers, and other effects on care had a demonstrable effect on mortality rates in Australian Aged Care. In January 2022 there was a substantial increase in death risk “in aged…..

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Recent research has provided strong evidence of an identified area of the brain associated with the control of hunger. Unexpectedly this area is in the cerebellum – the anterior deep cerebellar nuclei – aDCN. Until recent years the role of the cerebellum, at the base of the brain, was thought only to assist with coordination of movement. It is now known to have a wider role in cognition, emotion and behaviour – incidentally including laughing. People with a rare genetically…..

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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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