Early Balding May Be Linked With Lou Gehrig's Disease

Men who show signs of early balding may be at an increased risk of the rare but incurable disease amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, a new study finds.

The link between the two conditions may provide a new direction in investigating the poorly understood neurodegenerative condition, the researchers said.

The researchers looked at more than 50,000 men ages 46 to 81, and asked them to recall the shape of their hairline at age 45, and choose from a series of pictures depicting no balding, moderate or extensive balding.

Nearly 44 percent of men reported no balding, about 42 percent of men reported moderate balding and 14 percent reported extensive balding at 45 years old.

Sixteen years later, 11 of 5,500 men who had reported extensive balding were diagnosed with ALS, while 13 of 17,500 men with no balding were affected by the disease. The researchers calculated that men with extensive early balding were about three times as likely to develop ALS, compared with men who hadn't lost hair early in life.

The researchers said their results should be interpreted cautiously until the link between early balding and ALS is confirmed in future studies.

"This doesn't mean that bald people should worry," said study author Elinor Fondell, researcher at Harvard School of Public Health. Moreover, the link may not be true for everyone there were 11 people diagnosed with ALS who didn't have early balding, Fondell noted.

A mysterious disease

ALS is a disease of the nerve cells in the brain and spinal cord that control muscle movement. The early symptoms of the condition usually include weakness and shrinking of muscles, and as the condition progresses, patients develop disabling movement problems, and ultimately cannot breathe on their own.

About 5,600 people in the United States are diagnosed with ALS each year, according to the ALS Association. Men are at higher risk for ALS than women. Half of people affected by the disease live more than three years after diagnosis, but less than 10 percent of patients live more than 10 years after diagnosis.

"We know very little about what causes ALS, and there's only one approved drug that prolongs life, for about three months," Fondell said.

"If the link between early balding and ALS can be confirmed in other populations, and if other researchers look at this on a molecular level and see if there's some basis to this, then that in the future may lead to new drugs for ALS," she said.

Men in the study with moderate early balding had a 50 percent higher risk of ALS compared with men with no balding. The results showed a clear trend: with increasing levels of balding at age 45, the risk of ALS increased, the researchers said.

The results were controlled for potential risk factors of both early balding or ALS, such as smoking, weight, as well as vitamin E intake, which may protect against ALS.

What may underlie the link

One possible mechanism for a link between ALS and early balding may involve a protein called the androgen receptor, a protein that regulates the hormone testosterone and has been shown to be associated with an increased risk of early balding.

In 1980, researchers proposed the possibility that androgen receptor is involved in ALS. The idea originated when researchers observed that the disease affected all motor neurons except those that lacked the androgen receptor.

"Everybody got so excited about this theory," Fondell said. "So they tested it, but found that the androgen receptor does work," so the idea wasn't pursued further.

"I think they dropped it too early," Fondell said.

Another possible explanation could involve a genetic variation in early balding recently identified in an analysis of genetic studies of the condition. The variation is in a gene located close to another gene that has been implicated in ALS. Given the physical proximity of the two genes, it is possible that one affects the other, the researchers said.


The study was published Aug. 13 in the American Journal of Epidemiology.

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Study Seeks Super Agers' Secrets To Brain Health

CHICAGO (AP) — They're called "super agers" — men and women who are in their 80s and 90s, but with brains and memories that seem far younger.

Researchers are looking at this rare group in the hope that they may find ways to help protect others from memory loss. And they've had some tantalizing findings: Imaging tests have found unusually low amounts of age-related plaques along with more brain mass related to attention and memory in these elite seniors.

"We're living long but we're not necessarily living well in our older years and so we hope that the SuperAging study can find factors that are modifiable and that we'll be able to use those to help people live long and live well," said study leader Emily Rogalski, a neuroscientist at Northwestern University's cognitive neurology and Alzheimer's disease center in Chicago.

The study is still seeking volunteers, but chances are you don't qualify: Fewer than 10 percent of would-be participants have met study criteria.

"We've screened over 400 people at this point and only about 35 of them have been eligible for this study, so it really represents a rare portion of the population," Rogalski said.

They include an octogenarian attorney, a 96-year-old retired neuroscientist, a 92-year-old Holocaust survivor and an 81-year-old pack-a-day smoker who drinks a nightly martini.

To qualify, would-be participants have to undergo a battery of mental tests. Once enrolled, they undergo periodic imaging scans and other medical tests. They also must be willing to donate their brains after death.

The memory tests include lists of about 15 words. "Super agers can remember at least nine of them 30 minutes later, which is really impressive because often older adults in their 80s can only remember just a couple," Rogalski said.

Special MRI scans have yielded other remarkable clues, Rogalski said. They show that in super agers, the brain's cortex, or outer layer, responsible for many mental functions including memory, is thicker than in typical 80- and 90-year-olds. And deep within the brain, a small region called the anterior cingulate, important for attention, is bigger than even in many 50- and 60-year-olds.

The super agers aren't just different on the inside; they have more energy than most people their age and share a positive, inquisitive outlook. Rogalski said the researchers are looking into whether those traits contribute to brain health.

Other research has linked a positive attitude with overall health. And some studies have suggested that people who are "cognitively active and socially engaged" have a reduced chance of developing Alzheimer's disease, but which comes first — a healthy brain or a great attitude — isn't known, said Heather Snyder, director of medical and scientific operations for the Alzheimer's Association.

Snyder said the SuperAging study is an important effort that may help provide some answers.

Edith Stern is among the super agers. The petite woman looks far younger than her 92 years, and is a vibrant presence at her Chicago retirement home, where she acts as a sort of room mother, volunteering in the gift shop, helping residents settle in and making sure their needs are met.

Stern lost most of her family in the Holocaust and takes her work seriously.

"What I couldn't do for my parents, I try to do for the residents in the home," she said, her voice still thick with the accent of her native Czechoslovakia.

Stern acknowledges she's different from most people at the home, even many younger residents.

"I am young — inside. And I think that's the difference," she said.

"I grasp fast," she adds. "If people say something, they don't have to tell me twice. I don't forget it."

She's different in other ways, too.

"When you get old, people are mainly interested in themselves. They talk about the doctor, what hurts," she said. "You are not so important that you just concentrate on yourself. You have to think about other people."

Study participant Don Tenbrunsel has a similar mindset. The 85-year-old retired businessman doesn't think of himself as a super ager. "Neither do my children," he says, chuckling.

But Tenbrunsel says his memory has been sharp "from the time I was born. My mother used to say, 'Donald, come sing with me — not because I had a good voice, but because I always knew the words," he said. "I think I'm just lucky, not only with respect to my memory, but I'm able to get around very well; I walk a lot and I have a pretty good attitude toward life itself."

Tenbrunsel volunteers several hours a week at a food pantry run by the Chicago church where he is a parishioner. One recent morning in the sun-filled rectory kitchen, he nimbly packaged ham and cheese sandwiches, set out bags of chips and cans of soda, and cheerfully greeted a steady stream of customers.

"Good morning, good to see you," he said, standing at the pantry's bright red door. He gave everyone their choice of chips — a small gesture but important, he said, because it gives them some sense of control over their hard-luck lives.

"I enjoy doing it. I probably get more out of it than I give," Tenbrunsel said.

Ken Zwiener, of Deerfield, Ill., is another super ager. He had "more than an inkling" he might qualify for the study, and his kids encouraged him to enroll.

"They said, 'Dad, your brain is the best thing about you,'" the 81-year-old retired businessman recalled.

He's a golfer and Broadway musical "nut" who created a 300-plus-page computer database of shows. Zwiener uses an iPad, recently went hot-air ballooning and is trying to learn Spanish.

He also pours himself a vodka martini every night and is a pack-a-day cigarette smoker, but says he doesn't think his habits have made much difference. His healthy brain, he says, may be due to heredity and genes, but Zwiener said he hopes the study comes up with more "scientific insights".

"My dad lived into his middle 90s and was pretty sharp right up until the day he died," Zwiener said.

Zwiener's motivation for joining the study was simple: The best man at his wedding died of Alzheimer's disease before age 50.

"To lose a mind ... is just a terrible way to go," he said.

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Online:

SuperAging study: http://tinyurl.com/lo75t7b

Alzheimer's Association: http://www.alz.org

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner