Calcium pills 'increase' risk of heart attack

Calcium supplements taken by many older people could be increasing their risk of a heart attack, research shows.

The study, in the British Medical Journal, said people who took supplements were 30% more likely to have a heart attack.

Data from 11 trials also suggested the medicines were not very effective at preventing bone fractures.

Almost 3m people in the UK are thought to have osteoporosis and many take calcium pills to prevent fractures.

The study recommends doctors review their use of calcium supplements for managing osteoporosis.

The National Osteoporosis Society said most people should be able to get enough calcium through their diets, rather than reaching for the medicine cabinet.

The researchers said those who had a diet naturally high in calcium were at no increased danger.

'Limited benefit'

In all 12,000 people aged over 40 took part in the trials of calcium supplements of 500mg or more a day.

The risk of heart attack was seen across men and women, was independent of age and the type of supplement given.

A small increased risk of death was seen in the study but was not statistically significant, the researchers said.

The reason for the increased risk of heart attack is not clear but it is thought the extra calcium circulating in the blood could lead to a hardening of the arteries.

Calcium in the diet is safe and the Food Standards Agency recommends adults have 700mg of calcium a day from milk, cheese and green, leafy vegetables.

Dr Alison Avenell, from the University of Aberdeen which did the research with colleagues in New Zealand and the US, said the evidence suggests calcium supplements only have a limited benefit in preventing fractures, especially when compared to other treatments available.

"It is a balance of risks - people should consider the risks involved and how they apply to their own circumstances and discuss the matter with their GP," she said.

She added the results did not necessarily apply to younger people with conditions for which they take calcium.

Judy O'Sullivan, senior cardiac nurse at the British Heart Foundation, said the results should be interpreted with caution because the trials did not set out to look at the risk of heart attack.

"However, the research should not be completely ignored," she said.

"Any new guidelines on the prevention of fractures in those most vulnerable to them should take this type of analysis into account."

Dr Claire Bowring, of the National Osteoporosis Society, said: "We've always recommended that people should aim to get the calcium they need from their diet to help build stronger bones.

"If you get all of the calcium that you need from your diet and adequate vitamin D from exposure to sunshine, then a supplement will not be necessary."

She said there were still questions to be answered about the treatment of osteoporosis but advised people taking calcium supplements to talk to their GP, especially if they have a heart condition.

Celiac Disease Diagnosis Up 4-Fold Worldwide

July 30, 2010 — Studies from the United States, Europe, and elsewhere indicate that the prevalence of celiac disease (CD) has increased significantly in the last 3 decades — possibly by as much as a factor of 4.

"More and more studies indicate a prevalence of CD of more than 1% in both adults and children. This should be compared with lower prevalence figures [from] 20 to 30 years ago," Jonas Ludvigsson, MD, from the Department of Medicine, Epidemiology Unit, at the Karolinska Institute and Orebro University Hospital, Sweden, and an expert in CD, noted in an email to Medscape Medical News.

"The reason for this increase is mutlifactorial, but there is probably a true underlying increase. This has been shown when old sera have been analyzed with modern techniques, (eg, in Finland)," Dr. Ludvigsson pointed out.

Mayo Clinic Research Confirms Rise in CD

Researchers at the Mayo Clinic also report an increase in CD, according to an article in the summer issue of the Mayo Clinic's research magazine Discovery's Edge. Joseph Murray, MD, and colleagues analyzed stored blood samples, taken from Air Force recruits in the early 1950s, for gluten antibodies. They assumed that 1% would be positive, mirroring today's rate. That assumption was wrong — the number of positive results was far smaller, indicating that CD was "rare," Dr. Murray noted in the article.

This led him and his colleagues to compare those results with 2 more recently collected sets from Olmsted County, Minnesota. Their findings suggest that CD is roughly 4 times more common now than in the 1950s.

"This tells us that whatever has happened with CD has happened since 1950," Dr. Murray said. "This increase has affected young and old people. It suggests something has happened in a pervasive fashion from the environmental perspective," he added.

Excess Mortality Seen With CD and Latent CD

Recent research by Dr. Ludvigsson's team (JAMA. 2009;302:1171-1178) and others supports the concept of "latent CD" or "gluten sensitivity." Latent CD, defined in the Journal of the American Medical Association study by Dr. Ludvigsson's team as having normal small intestinal mucosa but positive CD serology, is something that is estimated to occur in at least 1 in 1000 individuals.

Dr. Ludvigsson's team has also reported evidence that in 1 year, 10 of 1000 individuals with CD will die compared with an expected 7 in 1000 without the disease.

"Not only is the mortality raised in patients with [CD] but also in those individuals with latent [CD]," Dr. Ludvigsson noted in a statement from the United European Gastroenterology Federation.

However, in comments to Medscape Medical News, he emphasized that "although patients with CD are at increased risk of a number of disorders, and at increased risk of death, the absolute risk increase is very small."

A Tricky Disease

CD remains a "tricky disease," Dr. Ludvigsson said. "It can be asymptomatic; have so-called traditional symptoms such as diarrhea, weight loss, failure to grow (in children), fatigue, and malnutrition; and have nontraditional symptoms such as osteoporosis, depression, adverse pregnancy outcome; and increased risks of both malignancy and death."

The onset of certain autoimmune disorders including autoimmune liver disease, thyroid disease, type 1 diabetes, and Addison's disease can actually signal CD, he noted. "This means that clinicians should consider CD in a number of symptoms and disorders."

CD Often Undetected; Cause Unknown

CD often goes undetected, although the percentage of undetected cases varies between countries, Dr. Ludvigsson noted. "In most countries, at least two thirds of individuals with CD have not received a diagnosis by a doctor." The reason for the high percentage of undetected disease is that the disease can be difficult to diagnose, and "it is sometimes almost asymptomatic," he added.

Detection Methods Are Improving

Over the years, Dr. Ludvigsson told Medscape Medical News, "we have improved existing means to diagnose CD. Antibody tests are becoming better and better, although a positive antibody test should be confirmed with a small intestinal biopsy before the diagnosis is certain. Transient increases in CD antibody levels occur. In the future, I expect microscopy in the very small intestine to become a tool for diagnosis."

Alternatives to the Gluten-Free Diet?

At this time, Dr. Ludvigsson said, the gluten-free diet remains the cornerstone of treatment for CD. However, "in the future, alternative treatment strategies may be available. The recent discovery of the structure of transglutaminase 2 may help in designing inhibitors of transglutaminase 2 to treat CD," he said. "Another potential treatment strategy is to ingest enzymes that digest gluten, thereby increasing the safe threshold for gluten intake.

"There is also ongoing research on the topic of decreasing the bowel's permeability to gluten, Dr. Ludvigsson told Medscape Medical News. He added, however, that the safety of this approach is unclear, as "a decreased permeability here might mean that the body cannot absorb other needed substances.

"Finally, agricultural research may mean that we can modify the gluten structure in wheat produce a kind of wheat that will not illicit an immune response in patients with CD," the researcher noted.

Counseling CD Patients Is Important

Although evidence is scarce, said Dr. Ludvigsson, "most researchers believe that a gluten-free diet will reduce the risk of complications/comorbidity in CD, and it is important for the doctor to underline this for the patients. In patients with CD who do not become better on a gluten-free diet, the most common reason is probably that the patients do not eat a strictly gluten-free diet," he said.

Dr. Murray advocates greater vigilance in CD patients. "It's not enough to say, 'You've got CD, be gluten-free, goodbye,' " he said. "CD requires medical follow-up."

This October, at the United European Gastroenterology Week in Barcelona, Spain, Dr. Ludvigsson will be 1 of 8 researchers to receive the Association of National European and Mediterranean Societies of Gastroenterology and United European Gastroenterology Federation Rising Stars award.

Treatment of Primary Sjögren's Syndrome Reviewed

July 28, 2010 — There is a very low level of evidence for the majority of drugs currently used in primary Sjögren's syndrome, according to the results of a systematic review reported in the July 28 issue of the Journal of the American Medical Association.

"A variety of topical and systemic drugs are available to treat primary Sjögren syndrome, although no evidence-based therapeutic guidelines are currently available," write Manuel Ramos-Casals, MD, PhD, from Sjögren Syndrome Research Group (AGAUR), Hospital Clínic in Barcelona, Spain, and colleagues. "The purpose of this systematic review was to analyze and summarize the evidence on drug therapies (topical and systemic) for the main clinical manifestations of primary Sjögren syndrome (sicca symptoms and extraglandular involvement) in adults."

The reviewers searched MEDLINE and EMBASE for articles on drug treatment of primary Sjögren's syndrome published between January 1, 1986, and April 30, 2010. There were 37 studies identified meeting inclusion criteria of randomized controlled trials of topical and systemic drugs tested in adult patients with primary Sjögren's syndrome.

In a placebo-controlled trial, patients treated with topical ocular 0.05% cyclosporine had significant improvement in the Schirmer and corneal staining scores, blurred vision, and artificial tear use. In 3 placebo-controlled trials, pilocarpine was associated with improvements in dry mouth (61% - 70% vs 24% - 31% for placebo) and in dry eye (42% - 53% vs 26%).

Cevimeline was associated with improved dry mouth in 2 placebo-controlled trials (66% - 76% vs 35% - 37% in the placebo group), as well as with improved dry eye (39% - 72% vs 24% - 30%). Oral prednisone or hydroxychloroquine did not significantly improve sicca outcomes in small trials enrolling fewer than 20 patients. Benefits were limited for the immunosuppressive drugs azathioprine and cyclosporine evaluated in small trials.

Oral interferon alfa-2a was associated with limited benefits in a large trial. The primary outcome (a composite visual analog scale measuring joint pain, fatigue, and dryness) was not reached in 2 placebo-controlled trials of infliximab and etanercept or in 2 small trials of rituximab in fewer than 30 patients. However, some secondary endpoints showed significant improvements from baseline.

"In primary Sjögren syndrome, evidence from controlled trials suggests benefits for pilocarpine and cevimeline for sicca features and topical cyclosporine for moderate or severe dry eye," the review authors write. "Anti–tumor necrosis factor agents have not shown clinical efficacy, and larger controlled trials are needed to establish the efficacy of rituximab."

Limitations of this study include those inherent in the included studies.

"In the last 3 decades, therapeutic approaches in primary Sjögren syndrome have been based on the use of substitute agents for sicca features and glucocorticoids and immunosuppressive agents for extraglandular involvement," the review authors conclude. "The emergence of new immunosuppressive agents and biologic therapies has increased the therapeutic armamentarium available in the most severe situations, but their use is limited by the lack of specific licensing. This systematic review highlights the limited evidence available for the drugs most frequently used in primary Sjögren syndrome and the difficulties of offering solid therapeutic recommendations."

La Marató de TV3 and Fondo de Investigaciones Sanitarias supported this study. The review authors have disclosed no relevant financial relationships.

Drinking alcohol can 'reduce severity' of arthritis

Drinking alcohol can not only ease the symptoms of rheumatoid arthritis it appears to reduce disease severity too, research suggests.

Scientists at the University of Sheffield asked two groups of patients with and without the disease to provide details of their drinking habits.

They found that patients who had drunk alcohol most frequently experienced less joint pain and swelling.

Experts say this should not be taken as a green light for drinking more.

In the study, 873 patients with rheumatoid arthritis (RA) were compared to 1,004 people who did not have it.

Both groups were asked how often they had drunk alcohol in the month running up to the start of the study.

Patients completed a detailed questionnaire, had X-rays and blood tests, and a nurse examined their joints.

'Less damage'

Dr James Maxwell, consultant rheumatologist and lead author of the study, explained the findings.

"We found that patients who had drunk alcohol most frequently had symptoms that were less severe than those who had never drunk alcohol or only drunk it infrequently."

X-rays showed there was less damage to their joints, blood tests showed lower levels of inflammation, and there was less joint pain, swelling and disability in those patients, the researchers found.

They say they do not yet understand why drinking alcohol should reduce the severity of RA, and people's susceptibility to developing it.

Dr Maxwell said: "There is some evidence to show that alcohol suppresses the activity of the immune system, and that this may influence the pathways by which RA develops.

"Once someone has developed RA, it's possible that the anti-inflammatory and analgesic effects of alcohol may play a role in reducing the severity of symptoms," he added.

The authors say that further research is needed to confirm the results of the study and to investigate how and why alcohol has an effect on rheumatoid arthritis.

Risk and rewards
Previous studies have shown that alcohol may reduce the risk of developing the disease in the first place.

Similarly, in the current study non-drinkers were four times more likely to develop RA than people who drank alcohol on more than 10 days a month.

A spokeswoman for Arthritis Research UK, which co-funded the research, said: "We would not want people with RA to take this research to mean that they should go out and start drinking alcohol frequently and in large amounts as this could be detrimental to their health."

She said some RA treatments, like the immunosuppressant drug methotrexate, can damage the liver when taken with large amounts of alcohol.

The patients in the study did not drink more than the recommended limit of 10 units of alcohol a week.
www.bbc.co.uk/health

Doctors remove metal hook lodged two inches inside boy's brain.

Doctors remove metal hook lodged two inches inside boy's brain.

La Crosse Virus Neuroinvasive Disease Reported in Missouri

July 26, 2010 — The Centers for Disease Control and Prevention (CDC) is reporting the first case of La Crosse virus (LACV) neuroinvasive disease, a rare mosquito-borne disease, to occur in Missouri since 2002.

Most LACV cases since the mid-1980s have been reported in Mid-Atlantic states, including North Carolina, Tennessee, Virginia, and West Virginia. "The reason for the increase in cases reported outside the upper Midwest is unclear but might be related to changes in diagnosis, reporting, or the ecology of the vectors," the authors suggest.

According to the case description in the CDC's Morbidity and Mortality Weekly Report, on August 7, 2009, the Missouri Department of Health and Senior Services was notified of suspected LACV neuroinvasive disease in a boy aged 8 years from northwest Missouri.

The previously healthy boy, who lived in Kansas City, Missouri, presented with headache, fatigue, nausea, vomiting, and abdominal pain and received amoxicillin for presumed streptococcal pharyngitis.

"During the next 48 hours, he continued to have vomiting and developed fever and worsening headache, prompting a second emergency department visit on July 31," Sarah Patrick, PhD, from the Missouri Department of Health and Senior Services, and colleagues write. No neurological signs were apparent, but the boy was admitted to hospital on August 1 because of suspicion of acute meningitis.

Once hospitalized, the patient received vancomycin and ceftriaxone for possible bacterial meningitis. On August 7, immunofluorescence assay results of serum and cerebrospinal fluid were positive for immunoglobulin M and immunoglobulin G against California serogroup viruses, of which LACV is the most prevalent; thus, a presumptive diagnosis of LACV was made. The CDC later confirmed the presence of LACV-neutralizing antibodies in the cerebrospinal fluid.

The patient's headache and neck and abdominal pain improved, and he was discharged on August 7. He remained healthy, and no neurologic abnormalities were detected through medical follow-up.

According to the report, the boy had been bitten multiple times by mosquitoes about a week before symptom onset, but he had not recently traveled outside of northwest Missouri.

High Clinical Suspicion

Healthcare providers serving central Kansas, Missouri, and eastern Nebraska should "maintain a high clinical suspicion for LACV among patients with unexplained meningoencephalitis during summer and fall, when mosquitoes are active," Dr. Patrick and colleagues write.

California serogroup virus neuroinvasive disease has been nationally notifiable since 1995. From 2003 to 2007, 412 neuroinvasive disease cases were reported, of which 407 (99%) were confirmed as LACV. Of the 398 LACV cases for which the outcome was known, 7 (2%) were fatal, the authors note. "The disease is likely underdiagnosed because it mimics other viral encephalitides (e.g., enteroviral and herpes virus encephalitides)."

"La Crosse virus encephalitis only occurs in children under the age of 15, and fortunately, the case fatality rate is relatively low (<3%)," noted independent commentator Samantha Soldan, PhD, from the Department of Neurology at the University of Pennsylvania, Philadelphia. "However, approximately 2% of children with LACV encephalitis will have persistent neurological sequelae including persistent paresis, attention deficit disorder, learning disabilities, and cognitive defects," she told Medscape Medical News.

Dr. Soldan added that LACV is a leading cause of pediatric encephalitis and aseptic meningitis in the Midwestern United States, where its primary vector, the eastern treehole mosquito, resides. "In recent years, LACV has spread by the invasive Asian tiger mosquito (Aedes albopictus) into Tennessee, North Carolina, West Virginia, Missouri, and Texas. Therefore, the potential emergence of LACV throughout the rest of North America is of great concern," she said.

According to Dr. Soldan, future research will be needed to determine the optimal antiviral and neuroprotective therapeutics necessary, as well as to identify factors that make developing brains more susceptible to LACV encephalitis than adult brains. "It will also be important to determine which mechanisms the virus uses to counter the host immune response," she said.

According to the CDC, LACV neuroinvasive disease was first described from La Crosse County, Wisconsin, after isolation of the virus in 1964 from brain tissue of a girl aged 4 years who had died of encephalitis in 1960.

The authors and commentator have disclosed no relevant financial relationships.

Motherly love 'does breed confidence'

Being lavished with affection by your mum as a young child makes you better able to cope with the stresses and strains of adult life, say researchers.

Hugs, kisses and expressive declarations of love appear to rub off and foster emotional resilience.

The results are from nearly 500 people, from the US state of Rhode Island, who were studied as children and adults.

A secure mother-child bond may be key, the Journal of Epidemiology and Community Health reports.

But experts say it is important to know when to stop. Over-mothering can be intrusive and embarrassing, especially as children grow older.

Maternal warmth

High levels of motherly affection are likely to facilitate secure attachments and bonding, say the study authors, led by Dr Joanna Maselko.

This not only lowers distress but may also help a child to develop effective life, social, and coping skills, which will stand them in good stead as adults.

In the study, a psychologist rated the quality of interactions between the mothers and their eight-month-old children during a routine developmental check-up.

The psychologist judged how well the mother responded to her child's emotions and needs, and gave her an "affection score" based on the warmth of the interaction.

Thirty years later, the researchers approached the children, who were now adults, and asked them to take part in a survey about their well-being and emotions.

The group was also asked whether they thought their mothers had been affectionate towards them, with responses ranging from "strongly agree" to "strongly disagree".

The results revealed that children whose mothers gave them lots of affection handled all types of distress better.

In particular, the children of warm mothers were far better at dealing with anxiety than those of emotionally cold mothers.

The researchers said: "It is striking that a brief observation of level of maternal warmth in infancy is associated with distress in adult offspring 30 years later."

They said the findings added to the growing evidence that early childhood helped set the stage for later life experiences, but said the influence of other factors, such as personality, upbringing and schooling, could not be ruled out.

Dr Terri Apter, a psychologist, writer and senior tutor at Newnham College, Cambridge, has studied the effects of mother-child relationships.

"What you really want is responsiveness as well as affection - a mother who is in sync with her baby," she said.

"Babies are not born knowing how to regulate their emotions. They learn by being distressed and being soothed.

"And a responsive mum will pick up on cues that a child has had enough."

A responsive mum will know not only when to give cuddles but also when to stop.

"If she is being responsive she will say: 'You are a big 12-year-old and I guess it is embarrassing if I kiss and squeeze you like I did when you were a baby'. And she won't make you feel bad about it," added Dr Apter.

Hamstring Graft Favored Over Patellar Tendon for ACL Reconstruction

NEW YORK (Reuters Health) Jul 23 - Seven to 10 years after anterior cruciate ligament (ACL) reconstruction, hamstring grafts have some advantages over patellar tendon grafts, Swedish researchers have found.

For decades, patellar tendon grafts were standard for ACL reconstruction, but that technique leaves patients with pain at the front of the knee afterward, which can be severe enough to prevent them from kneeling.

Increasingly, surgeons are shifting to semitendinosus tendon grafts, with or without the gracilis tendon.

In 1995 to 1997, Dr. Bjorn Barenius from Karolinska Institutet, Stockholm, Swede, and colleagues enrolled 164 patients with ACL tears in a randomized trial comparing the two approaches to reconstruction.

Now they have long-term follow-up data on 153 of those patients, which they report in a June 21st online article in The American Journal of Sports Medicine. The patellar tendon group currently has a mean age of 33 - two years younger than the mean age in the hamstring tendon group.

The authors first note that two-year results, reported earlier, showed equal stability and knee function with the two approaches, but patients in the semitendinosus group had better kneeling ability.

After surgery, 23 patients in each group had an additional procedure in the reconstructed ACL knee, including 33 (15 semitendinosus, 18 patellar) after the two-year follow-up report.

At a mean of 8.4 years after reconstruction, range of motion, stability, and knee function did not differ in the two groups. Health-related quality of life scores were also similar.

But patients with patellar tendon grafts reported significantly more problems with kneeling, had worse results in the knee-walking test, and reported more pronounced loss of skin sensation, compared with patients who received semitendinosus grafts.

Regardless of graft type, however, "there was a slight deterioration of knee function with time, and the consequences of the ACL injury were still present for many of the subjects after 8 years," the authors say.

Most patients (94%) said they did not regret their ACL surgery.

Patients who had early reconstruction (before 5 months) had better activity levels and better health-related quality of life than patients with late reconstruction.

Health-related quality of life was also better in patients who didn't have meniscal injury at baseline, and patients who didn't need medial meniscal surgery had better knee osteoarthritis outcome scores, especially for sports and recreation subscales.

"The conclusion drawn from this study was that an ACL reconstruction with a semitendinosus graft stood the test of time and is a better choice than is the patellar graft," the investigators say.

SOURCE: http://link.reuters.com/byq39m

Boy, 6, Suddenly Gets 107-Degree Temperature, Dies; Was It Rare Condition?

Six-year-old Vincent Groetzner was enjoying one of his first days of summer vacation splashing in a wading pool in his Florida neighborhood when his legs began to hurt. Then he broke out in a heavy sweat and his heart began to race.Within hours, the young boy's vital organs had failed and he was pronounced dead despite his mother's fervent efforts to keep him alive.

Now, doctors are trying to determine whether the boy suffered from a rare hereditary disorder known as malignant hyperthermia that affects only about 1,000 people each year -- and his mother hopes finding out could help save Vincent's three siblings and other kids.

While most cases of the heredity disorder occur when a patient is undergoing surgery -- the condition is sparked by a reaction to general anesthesia -- Vincent was outside playing when he fell ill.

"Vincent's case is certainly unusual," said Dr. Henry Rosenberg, an anesthesiologist and president of the Malignant Hyperthermia Association of the United States.

Quadrivalent HPV Vaccine Safe and Effective in Men

NEW YORK (Reuters Health) Jul 22 - The quadrivalent human papillomavirus (HPV) vaccine (Gardasil) prevents infection and disease in men, according to data presented today at AIDS 2010 in Vienna.

In fact, the efficacy data were so good that the U.S. Food and Drug Administration stopped the trial early so that men in the placebo group could get the vaccine, presenter Dr. Heiko Jessen from Berlin, Germany, told Reuters Health.

Infection with oncogenic HPV can cause cancers of the penis, anus, and head and neck in men, and AIDS substantially increases the risk of HPV-related invasive cancers. Earlier this year the US Centers for Disease Control and Prevention issued a "permissive recommendation" for HPV vaccination in males ages 9 through 26. (See Reuters Health reports of Jan 4, 2010 and Jul 31, 2009.)

The randomized, double-blind, placebo-controlled trial started out with more than 4000 healthy men aged 16 to 26 years from 18 countries. The per-protocol analysis, reported here, involved 1400 men (including 200 men who have sex with men) in each arm followed for 3 years, Dr. Jessen said.

As noted in their meeting abstract, the researchers detected 3 external genital lesions related to HPV types 6, 11, 16 or 18 in the vaccine arm and 31 in the placebo arm - primarily condylomata acuminate - for an efficacy of 90.4%.

Efficacy against HPV vaccine types was 85.6%, and against HPV DNA detection at any time was 44.7%.

"People who are immune may still have HPV DNA," Dr. Jessen said, but the significance is unknown.

There were no cases of penile, perianal or perineal intraepithelial neoplasia, but one wouldn't expect these in young healthy men during a short follow-up trial, he added. The research team will continue to follow the participants.

"For now it makes sense to give the HPV vaccine to boys and men ages 9 to 26," Dr. Jessen said, but his group intends to examine its efficacy in older men as well, particularly in men who have sex with men, who are at higher risk for HPV-related malignancy.

There were no serious vaccine-related adverse experiences, he added.

Education 'helps brain compensate for dementia changes'

People who stay in education for longer appear to be better able to compensate for the effects of dementia on the brain, a study suggests.

A UK and Finnish team found those with more education were as likely to show the signs of dementia in their brains at death as those with less.

But they were less likely to have displayed symptoms during their lifetime, the study in Brain said.

Experts said scientists now had to find out why the effect occurred.

Over the past decade, studies on dementia have consistently shown that the more time you spend in education, the lower the risk of dementia.

But studies have been unable to show whether or not education - which is linked to higher socio-economic status and healthier lifestyles - protects the brain against dementia.

Compensation

The researchers in this study examined the brains of 872 people who had been part of three large ageing studies.

Before their deaths they had also completed questionnaires about their education.

The researchers found that more education makes people better able to cope with changes in the brain associated with dementia
Post-mortems showed the pathology - signs of disease - in the brains of people with and without long educations were at similar levels.

But the researchers found those with more education are better able to compensate for the effects of the condition.

It also showed that, for each year spent in education, there was an 11% decreased risk of developing dementia.

Dr Hannah Keage of the University of Cambridge, who co-authored the study, said: "Previous research has shown that there is not a one-to-one relationship between being diagnosed with dementia during life and changes seen in the brain at death.

"One person may show lots of pathology in their brain while another shows very little, yet both may have had dementia.

"Our study shows education in early life appears to enable some people to cope with a lot of changes in their brain before showing dementia symptoms."

'Dementia resistant'

The researchers used data from the Eclipse collaboration, which combines the three European population-based longitudinal studies of ageing from the UK and Finland which have assessed people for up to 20 years.

Professor Carol Brayne, who led the study, said: "Education is known to be good for population health and equity.

"This study provides strong support for investment in early life factors which should have an impact on society and the whole lifespan.

"This is hugely relevant to policy decisions about the importance of resource allocation between health and education."

Ruth Sutherland, chief executive of the Alzheimer's Society, said: "This is the largest study ever to confirm that hitting the books could help you fight the symptoms of dementia in later life. What we don't know is why a longer education is so good for you.

"It could be that the types of people who study longer have large brains which adapt better to changes associated with dementia.

"Another reason could be that educated people find ways of managing or hiding their symptoms."

She added: "We now need more research to find out why an education can make the brain more 'dementia resistant'. Until then the message appears to be stay in school."

Rebecca Wood, chief executive of the Alzheimer's Research Trust, added: "During dementia, proteins build up in the brain and nerve cells become damaged. This research suggests that education is not able to stop the damage but enables the brain to cope better and alleviate its impact. "