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Recent research

As stated in the article, with references;

"Recent research supports the previously obscure theory that Herpes simplex virus type 1 plays a role as a possible cause of AD in people carrying the susceptible versions of the apoE gene"

Shouldn't more people be made aware of this? Have there been any further developments? Thanks Stevej000 (talk) 20:16, 18 February 2009 (UTC)

Causes section

The causes section says the cholinergic hypothesis was the earliest one and the amyloid hypothesis did not come about until the 1990s, but I wondered how this could be the case as Alois Alzheimer wrote about amyloid plaques right from the beginning. Does this mean nobody thought to associate amyloid formation with the disease for the first hundred odd years even though it was the first thing noticed? That is the basis of the amyloid hypothesis right?

Also, I've done a fair bit of reading around the subject to say the least and I don't think the article really reflects the weight put on the different hypotheses, at least not without bias or with consistency. I always thought that the amyloid hypothesis was by far the most common hypothesis with the most research around it, with the Tau hypothesis coming in second and rather far behind.

PS. Whats with some of these references? Nazi zombies and baptists?!?!--KX36 (talk) 20:27, 1 March 2009 (UTC)

Regarding the refs: The first title is due to vandalism and I have corrected it; however the second one is the true title of the article referenced (some people do writte strange things as titles). Regarding the weight, when the article became a FA it was probably this section that was most difficult to develop. If you find good quality refs that weight differently the proposed hipothesis feel free to rewritte the section. However since it is a FA article; and therefore quite stable it would be great if you could propose any big changes here. You could for example create a proposal in a sandbox and show it here so other editors can give their feedback. Bests regards. --Garrondo (talk) 08:40, 2 March 2009 (UTC)
Well, I just learned something new about editing. I couldn't figure out why everyone put colons in front of their writing. Anyways, I read over the history of this article, which must have been 1000 edits. You did a great job. If I could comment, the causes section is a bit confusing between the various causes. I got a different read than KX36 did however--it reads like the b-amyloid theory is the strongest one. SciMedKnowledge (talk) 20:41, 17 March 2009 (UTC)

New publication in Neurology

  • Henneman WJP, Sluimer JD, Barnes J, van der Flier WM, Sluimer IC, Fox NC, Scheltens P, Vrenken H, Barkhof F (2009). "Hippocampal atrophy rates in Alzheimer disease : Added value over whole brain volume measures". Neurology. 72: 999–1007. PMID (pending) 19289740 (pending). {{cite journal}}: Check |pmid= value (help); Unknown parameter |laysummary= ignored (help)CS1 maint: multiple names: authors list (link)
  • I'm a bit confused by the article. It's not a predictor of AD is it? The measurement almost feels like it confirms the diagnosis. Not sure. I'm sorry if I'm doing anything out of school since this is the first article I've edited. I was doing a blog on good medicine on the internet, and I was using sample diseases to examine differences between internet based resources. For AD, google shows the AD org and this article as #1 and 2. When I read it, I had some critiques in my blog, but not too many. I've been observing some of the issues on Wikipedia for 3 or 4 months. It seems kind of stressful, so I'm not sure I want to participate all that much. Anyways, this is a good article, and I want to do what I can to help out.SciMedKnowledge (talk) 20:36, 17 March 2009 (UTC)
If you're confused why did you undid my edit?--Nutriveg (talk) 22:15, 17 March 2009 (UTC)
I'm sorry if you think I was attacking your edit by undoing it. My point about being confused was that the article isn't saying anything useful for the article. One other point, I find this one of the better medical articles on Wikipedia (and I've done a lot of research on a wide range of articles here), and you're using a tertiary source. According to WP:MEDRS, secondary sources are preferred, as the one used above. Finally, and I don't want it to appear that I'm attacking you, but every citation on this article uses the cite journal format, and you used a citation format that really doesn't give enough information to full support the statement.SciMedKnowledge (talk) 04:39, 18 March 2009 (UTC)
This is getting a bit confusing. First, I don't understand the reason for mentioning the Neurology article. Second, Science Daily is not a good source -- it often bases its stories on press releases, which are not validated by peer review. If the story was referring to a journal article, that might be a good source. However, there are plenty of good sources to back up the prevalence of early damage to the hippocampus in AD, and that may well be important enough to be worth mentioning in the Neuropathology section. (Ref 60 already supports it.) Looie496 (talk) 05:07, 18 March 2009 (UTC)
To clarify, Henneman et al were comparing different measures to find the best predictor of progress to AD. They did this with three cadres, respectively AD, MCI, and controls.The measures considered were whole-brain atrophy rate, whole-hippocampus volume, whole-hippocampus atrophy rate, and regional hippocampus atrophy rate. They found that the subjects most likely to progress from MCI to AD were those who were measured with a small, fast-shrinking hippocampus. Providing an explicit link to a lay summary can be helpful when source articles are written in a speciallized jargon that lay readers would find difficult to understand. It does not replace the citation of the summarized source, which is understood to be more authoritative.LeadSongDog come howl 19:30, 31 March 2009 (UTC)

Revert of good faith editions

I recently reverted the following: Two research papers published in 2009 have shown that specific toxic species of Aβ, oligomeric (o)Aβ42, when in soluble intracellular form, acutely inhibit synaptic transmission associated with casein kinase 2 (CK2) activation. Which is a pathophysiology that characterizes AD, but it was soon back

I was asked to say why I had eliminated the sections in talk page; and I have plenty of reasons. I would welcome feedback:

  • Although PNAS is a very important journal both articles are primary sources; per WP:MEDRS secondary sources (usually reviews) are preferred. The reason is to prevent too new discoveries which have not been yet validated by the scintific communitiy. These two articles are too new and advance a theory not yet accepted (As far as I understand)
  • They are too specific for the causes section: We all know that there are many mechanisms implicated in the disease; but until one is not proven to be the most important I do not believe that we shall fall into saying a line on every article that explains one. The fact that both of the do not talk about alzheimer; but about alzheimer animal models (which is not the same) is additional evidence that they are not general enough for the main article
  • The writting (and also sources) are too technical: wikipedia is intended for a lay audience: I doubt a lay audience is interested or understands "oligomeric (o)Aβ42","soluble intracellular form", "casein kinase 2 (CK2)"...
  • Finally stilistically speaking the addition breaks the flow of the paragraph with a subsection of only a line.

My proposal is to move it the biochemistry of AD subarticle since I am sure the info is worth; but too much specific for the main article. I will not touch it until other editors (including the author of the addition) give their opinions.

Comments? Bests.--Garrondo (talk) 15:22, 31 March 2009 (UTC)

I agree with your actions here. Looie496 (talk) 17:01, 31 March 2009 (UTC)
Agree with your comments, just explain better next time and be bold to improve (rewrite or move) instead of simple deleting, waiting someone to realize by itself what should modified.--Nutriveg (talk) 18:45, 31 March 2009 (UTC)
Agree with the removal. The material might be better suited for inclusion at Alzheimer's disease clinical research where it makes sense to include primary sources (in the WP:MEDRS sense of primary - they are still secondary in the WP:RS sense. There's no implication of WP:SPS.LeadSongDog come howl 19:38, 31 March 2009 (UTC)
Rewrite, improve move is much more constructive than deleting. Moves the article forward, and doesn't lose the goodwill of someone who is volunteering time to provide content.—Preceding unsigned comment added by User:67.101.142.13 (talk • contribs) 18:13, 23 April 2009

Cause of Alzheimers confirmed

Could someone add this information to the page, please? http://www.upi.com/Science_News/2009/04/16/Alzheimers-memory-loss-cause-is-confirmed/UPI-59141239891069/

The problem with taking info from news articles is that they usually simplify too much; and this is a good example: the only thing they really say is that there is some proof on the very specific mechanism of how "amyloid-beta peptides damage brain cell membranes", which is far from being the cause of AD.--Garrondo (talk) 07:27, 17 April 2009 (UTC)
That release also provided enough to find this version of the press release, which in turn was enough to identify the as-yet unpublished paper:
Ricardo Capone; et al. (2009). "Amyloid-beta-induced ion flux in artificial lipid bilayers and neuronal cells: Resolving a controversy". Journal of Neurotoxicity Research. doi:10.1007/s12640-009-9033-1. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)
Also, on the U Mich Biomembrane Lab site we find listed:
Capone R., Prangkio P., Sauer A.M., Bautista M.R., Turner R.S., Yang J., Mayer M. (2008). "Alzheimer's Disease-Related Amyloid-Beta Ion Channels: Resolving a Controversy". Neurotoxicity Research.{{cite journal}}: CS1 maint: multiple names: authors list (link), accepted.
Looking for that title finds Yang's site at UCSDhere
All this suggests that the paper may be interesting when it comes out, but it's not yet meeting WP:MEDRS.LeadSongDog come howl 13:30, 17 April 2009 (UTC)
The article is here http://biomembrane.engin.umich.edu/publications/papers/CaponeMayer-Amyloid-2008.pdf and has been published
"amyloid-beta peptides damage brain cell membranes, which is far from being the cause of AD" - Garrondo
Damage to the cell membrane by amyloid beta seems to be the majority opinion of the ultimate biochemical cause, although their are many people with differing views
--Biophysik (talk) 04:16, 21 May 2009 (UTC)
In an article like this, where there are hundreds of studies pointing in many different directions, it is particularly important to follow WP:MEDRS by relying on secondary sources (review papers) and avoiding primary research publications. Looie496 (talk) 16:22, 22 May 2009 (UTC)

Recent pub on immunological approach

It's still a mouse study, but looks very promising. One to watch:

  • Henrieta Scholtzova, Richard J. Kascsak, Kristyn A. Bates, Allal Boutajangout, Daniel J. Kerr, Harry C. Meeker, Pankaj D. Mehta, Daryl S. Spinner, Thomas Wisniewski (February 11, 2009). "Induction of Toll-Like Receptor 9 Signaling as a Method for Ameliorating Alzheimer's Disease-Related Pathology". The Journal of Neuroscience. 29 (6): 1846–1854. doi:10.1523/JNEUROSCI.5715-08.2009. In the present study, we have stimulated the innate immune system via the Toll-like receptor 9 (TLR9) with cytosine-guanosine-containing DNA oligodeoxynucleotides in Tg2576 AD model transgenic mice. This treatment produced a 66% and 80% reduction in the cortical (p = 0.0001) and vascular (p = 0.0039) amyloid burden, respectively, compared with nontreated AD mice. This was in association with significant reductions in Aβ42, Aβ40, and Aβ oligomer levels. We also show that treated Tg mice performed similarly to wild-type mice on a radial arm maze. Our data suggest that stimulation of innate immunity via TLR9 is highly effective at reducing the parenchymal and vascular amyloid burden, along with Aβ oligomers, without apparent toxicity. {{cite journal}}: Unknown parameter |laysummary= ignored (help)CS1 maint: multiple names: authors list (link) (pmid pending)

There are plenty of human trials also going on.--Bastilleday uky (talk) 07:35, 26 May 2009 (UTC)

It's PMID 19211891, the study is only a primary source. We have long agreed to wait for reviews in accordance with WP:MEDRS, and especially for this article. LeadSongDog come howl 02:42, 27 May 2009 (UTC)

Diagnostic

Neurophycological investigation is so mutch more then MMSE. MMSE is only used as a first guideline if you would go further on the investigation. So, please, delete "...sutch as MMSE..". C Hauer, neurophycoligist, geritriskt centrum, Sweden —Preceding unsigned comment added by 193.10.32.221 (talk) 14:16, 27 March 2009 (UTC)

I am also a neuropsychologist and one of the main authors of the article: I do not really like the MMSE, but it is true that it is probably the most used measuring instrument. Since the next sentence states "More comprehensive test arrays are necessary for high reliability of results, particularly in the earliest stages of the disease" I do not feel it is necessary to eliminate the reference to the MMSE: We name the most common test and we also say that longer tests are required for higher reliability. Bests. --Garrondo (talk) 14:27, 27 March 2009 (UTC)

I would like to address the issue of clinical diagnosis and definitive diagnosis. If I am correct when a clinician diagnoses AD, they are making a probable diagnosis that may or may not be confirmed at death by pathological features. Thus the sentence "Alzheimer's disease is usually diagnosed clinically from the patient history, ..." should be changed to: "A probable diagnosis of Alzheimer's disease is usually made clinically from the patient history, ...". Please leave me feedback on this. --Bastilleday uky (talk) 19:47, 23 April 2009 (UTC)

I'd say that statement could apply to any diagnosis with varying quantitative values of "probable". It might be possible to quantify the probability of clinical mis-diagnosis of vascular dementia (the most common similar dementia) as AD but I haven't seen any papers on it that I recall.LeadSongDog come howl 21:24, 23 April 2009 (UTC)
That is not true: e.g. if you have a cancer, we do a biopsy, send it to pathology and get a diagnosis. But no one gets a biopsy of the brain, when they are suspected of having Alzheimer's disease: thus we make a probable diagnosis. Other examples of definite diagnoses are infections (definite diagnosis done by culture). I think that your point applies to some disease where diagnosis is not really possible (many psychiatric diseases), however this is not the case in Alzheimer's disease. Am I not correct?--Bastilleday uky (talk) 20:52, 26 April 2009 (UTC)
A new paper asserts that an in-vitro skin sample test using the PKC enzyme can verify and quantify the presence of A-beta with 98% accuracy. See: Khan TK, Nelson TJ, Verma VA, Wender PA, Alkon DL (2009). Neurobiology of Disease. 34 (2): 332–9. doi:10.1016/j.nbd.2009.02.003. {{cite journal}}: Missing or empty |title= (help); Unknown parameter |laysummary= ignored (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) If borne out, this is a very promising development.LeadSongDog come howl 18:52, 27 May 2009 (UTC)
  • There's a promising result in x-ray imaging of early plaques at Connor, M.; Benveniste, H.; Dilmanian, A.; Kritzer, F.; Miller, M.; Zhong, Z. (Jul 2009). "Computed tomography of amyloid plaques in a mouse model of Alzheimer's disease using diffraction enhanced imaging". NeuroImage. 46 (4): 908–914. doi:10.1016/j.neuroimage.2009.03.019. ISSN 1053-8119. PMID 19303447.
  • It would, however, require further improvements in x-ray detector sensitivity to lower the x-ray dose to an acceptable level for human studies. LeadSongDog come howl 17:48, 6 July 2009 (UTC)

Ibuprofen powerfully preventive, other NSAIDs don't help (or may actually harm)

In the largest study of NSAIDs, released in 2009, use of ibuprofen for over five years was found to be particularly protective, reducing risks by 44% PMID 18458226. Vlad, Miller, Kowall, Felson NEUROLOGY 2008;70:1672-1677 © 2008 American Academy of Neurology Protective effects of NSAIDs on the development of Alzheimer disease http://www.neurology.org/cgi/content/abstract/70/19/1672</ref>

This issue (whether NSAIDs, especially ibuprofen can reduce incidence of AD still widely being debated). see: http://archneur.ama-assn.org/cgi/content/extract/66/4/539-a?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=N.+Bregman,+A.+Karni,+and+A.+D.+Korczyn&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
furthermore, the study you are siting is not from 2009 but from 2008 --Bastilleday uky (talk) 21:06, 26 April 2009 (UTC)
The aforementioned study uses a lot of subjects but a weak methodology, and clearly it hasn't changed many people's minds. Looie496 (talk) 22:49, 26 April 2009 (UTC)

Lyme hypothesis

A recent hypothesis [1] suggests that certain types of Alzheimer's have been caused by the lyme spirochete. Differential diagnosis is important, especially in early cases, where treatment of the infectious disease may alter the course of the development of Alzheimer's. -- The above was added to the Diagnostic section of the article. I've moved it here for discussion.LeadSongDog come howl 07:17, 12 July 2009 (UTC)

Last editions in Prevention section

Recent editions have lowered from my point of view the quality of the section: they have converted it to almost a list format, included excessive detail about the studies, given too much weight to primary sources... My proposal would be to revert the last editions. I now its a bit drastic but I do not believe last editions add valuable info. Thoughts?--Garrondo (talk) 07:41, 16 July 2009 (UTC)

Swiss study on causes

I've just reverted this recent edit based on a weak finding in a primary source. Until we have a secondary wp:MEDRS it's just not reliable enough for the article.LeadSongDog come howl 20:20, 10 August 2009 (UTC)

There's no need for a secondary source as wp:MEDRS says "edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge", but anyway, a secondary source: [1].--Nutriveg (talk) 22:01, 10 August 2009 (UTC)
I agree with LeadSongDog: secondary sources are preferred. This is too much specific on the first hand, and also has not been reevaluated. I would wait until there is some consensus on it.--Garrondo (talk) 07:14, 11 August 2009 (UTC)
Sorry. I had not seen the link to the secondary source. Nevertheless we already had the proposal in the prevention section when it talks on magnetic fields; since one of the refs talks about electromagnetic fields. I am going to add the review you provide since it is of higher quality.--Garrondo (talk) 11:41, 11 August 2009 (UTC)
Please do not eliminate references or text without consensus; specially from a debated section (among experts). I believe we should try to look for the best quality review articles on the theme and then try to reach a consensus to include it in the article.--Garrondo (talk) 13:46, 11 August 2009 (UTC)
I kept the same secondary source you added and separated the text (EMF from Aluminiun). Solvents was primary. Please re add the references you think are important.--Nutriveg (talk) 13:57, 11 August 2009 (UTC)
Please do not eliminate references or text without consensus; specially from a debated section (among experts). I believe we should try to look for the best quality review articles on the theme and then try to reach a consensus to include it in the article.--Garrondo (talk) 13:46, 11 August 2009 (UTC)
I am sorry I repeated myself (I copied text in an edit conflict and pasted it): I did not want to sound rude. My apologies. I am in a rush right now so I'll have to take a closer look at your editions and refs tomorrow or later. Bests.--Garrondo (talk) 15:21, 11 August 2009 (UTC)

Previous text

I add here the previous text so as not to loose it inside the different versions: I believe although it is true it had a mixture of primary and secondary sources which should be solved it did not misinterpret data as I feel the one now does. We might be able to work from it to a consensus version.

Some studies have shown an increased risk of developing AD with environmental factors such as occupational exposure to electromagnetic fields,[2] intake of metals, particularly aluminium,[3][4] or exposure to solvents.[5] The quality of some of these studies has been criticised,[6] and other studies have concluded that there is no relationship between these environmental factors and the development of AD.[7][8][9][10]

Possible references

I am going to add here reviews here that could be used as a reference for the last paragraph of epidemiology (enviromental risk factors). It would be great for anybody else to do the same. We may already have some of them in the article. I will add refs in English in the last 5 years that name neurodegenerative diseases in abstract. We can take a closer look later to see what they say specifically and which one is of higher quality (if there is one). Bests.--Garrondo (talk) 14:06, 11 August 2009 (UTC)

Regarding exposure to magnetic fields

Again, I'm open to the addition of referenced text you think is important.--Nutriveg (talk) 14:59, 11 August 2009 (UTC)

Reworked the above a bit, adding more recent reviews.LeadSongDog come howl 20:47, 11 August 2009 (UTC) :

Some studies have shown a correlation between AD rates and environmental factors such as occupational exposure to electromagnetic fields,[11] intake of metals, particularly aluminium,[3][12] or exposure to solvents.[5] The quality of some of these studies has been criticised,[13][14] and other studies have concluded that there is no direct relationship between these environmental factors and the development of AD,[15][8][9][10], or that these exposures are just surrogate markers for lower initial intelligence which is itself a predictor of late-onset AD.[14][16] —Preceding unsigned comment added by LeadSongDog (talk • contribs)

It is mixed, outdated and imprecise. I've posted several secondary sources but I'm still waiting for recent critical reviews that support the "nothing to see here" POV.--Nutriveg (talk) 22:19, 11 August 2009 (UTC)

It's so weak that one author of the referenced critic (Ana M García) is the same that suggests association on a later review.--Nutriveg (talk) 02:43, 12 August 2009 (UTC)
I have to say that for the moment I have only had time to review EMF. A big problem is that I only have access to the full text of the last review article. However, conclusions I draw from this article and the other abstracts is in all cases similar:
  • 1-Studies point at a possible relationship (Hug K)
  • 2-However results have been highly inconsistent (Kheifets). I quote from the article: Early studies of Alzheimer disease provided weak evidence of an association with EMF. The strongest evidence came from two clinic-based studies, whereas evidence from four population-based studies was considerably weaker and more inconsistent, for example, in terms of exposure timing. Eight studies published in 2000 or later were population based, and again the results were mostly inconsistent, whereas one clinic-based study was consistent with previous studies by the same investigators that used their original design
  • 3-Some of the studies are of low quality (Santibáñez).
  • 4-There are still inadequate data to draw conclusions.
Do we have an agreement in my conclusions from the articles?--Garrondo (talk) 13:32, 12 August 2009 (UTC)
I would agree, though looking back a few days, I believe Nutriveg also wanted to use Huss et al.:

Huss, A.; Spoerri, A.; Egger, M.; Röösli, M.; Swiss National Cohort, Y. (Jan 2009). "Residence near power lines and mortality from neurodegenerative diseases: longitudinal study of the Swiss population". American Journal of Epidemiology. 169 (2): 167–175. doi:10.1093/aje/kwn297. ISSN 0002-9262. PMID 18990717. (Journal Article) For my part, I find the lack of direct dose metrics devalue the studies. Using duration of 50m proximity as a proxy for dosage makes little to no sense. At those ranges the primary ELF exposure of residents is to the normal household wiring, not the far-field effect of a balanced tri-phase transmission line. Any proximity effect study should also be controlling for chemical exposures, e.g. to any defoliants that might be used under the transmission lines in some places. I don't see that kind of rigour in the reviewed studies.LeadSongDog come howl 14:14, 12 August 2009 (UTC)

First of all it's not EMF, but Extremely low frequency EMF. If you put all EMF studies or reviews together for sure results will differ.
My version of the text said this:
Several cohort scientific studies have consistently showed an increased risk of developing AD associated with exposure to high power extremely low frequency electromagnetic fields..[17][18][19][20]
2-All cohort studies were consistent as review of (García, Am - 2008) and later cohort studies of (Röösli, M, 2007) and (Huss, A, 2009) as well. Only case control studies or broadly EMF (not specific ELF) have shown inconsistent results. You can add that information if you will.
3-The author of (García, Am - 2008) was an author in (Santibáñez, 2007). (Huss, A, 2009) also address some critics.
4-The conclusions of the cited references included in my text are pretty clear for me.[17][18][19][20]
LeadSongDog, by WP:OR please find a source that support your POV.--Nutriveg (talk) 14:55, 12 August 2009 (UTC)
We should consider WHO Fact Sheet 322 and the WHO ELF Environmental Health Criteria Monograph No.238 as key references (if not the key reference in any discussion of ELF EMF health effects. The latter work's chapters 1, 2, 7, and 12 pertain to this article. LeadSongDog come howl 16:52, 12 August 2009 (UTC)
I don't see why. It's 2007 and the most recent Alzheimer's article it cites is 2003. Completely outdated.--Nutriveg (talk) 17:10, 12 August 2009 (UTC)
Because it is a) worldwide, b) long-running, c) ongoing, d) credible, e) thorough, f) understandable, g) well-resourced and h) conveniently available in multiple languages. The physics hasn't changed. The designs change very slowly (utilities plan on multi-decade life cycles). AD is a slow-moving disease anyhow, so a four year lag only represents a single cycle of the disease. It's not like we are talking about ignoring some obvious research breakthrough showing a massive effect, this is deep into read-the-tea-leaves-and-calculate-the-implied-lunar-mass territory.LeadSongDog come howl 18:05, 12 August 2009 (UTC)
The disease is slow but science is not. The WHO document doesn't provide raw data for future analysis, and that would still be WP:OR anyway, but a review of scientific studies at least seven years old so it is impossible to use it as a critic of the studies, and their conclusions, produced since then. And there was enough secondary sources supporting the text you reverted so I don't see what's your point here beyond your own original research.--Nutriveg (talk) 18:40, 12 August 2009 (UTC)
I'm not trying to insert this stuff into a featured article, I'm just giving your suggestions due consideration. So far, I can't say I'm seeing much that's convincing. Interpreting correlation as causality certainly won't lend much credence to the article. Still, if we need an expert in epidemiology perhaps a request at the doctor's mess would be in order when we have a solid candidate paragraph. Mostly I just want to ensure that the nearly 4000 people per day reading this article get content they can trust. Often that necessitates throwing a little cold water on an enthusiastic editor. LeadSongDog come howl 20:23, 12 August 2009 (UTC)
It is not "this stuff", it's a very well referenced and updated text. Sure you are not trying anything but to avoid by anyway the inclusion of that text because you just don't like it, at the same time you conversely pose no objection to keeping the text unbalanced towards outdated, low quality (case control) and unspecific (broad EMF) studies that support the "nothing to see here" POV. My text says exactly what is in the conclusion of those cited studies, it's not Wikipedia role to keep content palatable. I've said several times that I'm open to inclusion of critical reviews of the cited studies, but you failed to provide so since "keeping content I think trustworthy (like)" and "knowing what's better for 4000 people" seems to be more important than referencing, even if the other option involves refraining another user that tries to do so.--Nutriveg (talk) 21:41, 12 August 2009 (UTC)
The change you pushed in (against Garrondo's request for discussion) was this. I reverted them to permit discussion. That's it. If you wish to take the points for discussion one at a time, I'm happy to do so. The text you were adding was:


Several cohort scientific studies have consistently showed an increased risk of developing AD associated with exposure to high power extremely low frequency electromagnetic fields.[17]</ref>[18]</ref>[19]Cite error: The <ref> tag name cannot be a simple integer (see the help page). Intake of metals, particularly aluminium has also been associated with a increase risk of developing the disease.[3]
/and you also had replaced several older refs with Rondeau, V.; Jacqmin-Gadda, H.; Commenges, D.; Helmer, C.; Dartigues, F. (Feb 2009). "Aluminum and silica in drinking water and the risk of Alzheimer's disease or cognitive decline: findings from 15-year follow-up of the PAQUID cohort". American Journal of Epidemiology. 169 (4): 489–496. doi:10.1093/aje/kwn348. ISSN 0002-9262. PMC 2809081. PMID 19064650. (Journal Article)
Is that much correct?LeadSongDog come howl 22:11, 12 August 2009 (UTC)

I do not see differences between conclusions in reviews between EMF and ELF-EMF: We only have two reviews that specifically tackle this subkind of EMF: The meta-analysis and the Kheifets review, reaching opposite conclussions: although the meta-analysis concludes that the risk is increased they also acknowledeged that publication bias could be affecting results and that effects are very small. On the other hand Kheifets, which is a newer review, concludes that evidences are greatly inconsistent. Although I can not access Santibañez article I suspect that some of the articles they critizise will be the same to those used by Kheifets and the metananalysis so I still feel that the quality critic holds (Nevertheless, does anybody have access to this article?). What I would do would be the same I proposed: combine EMF and VLF-EMF and say: 1-studies point at a possible relationship between EMF and dementia, including VLF-EMF(Hugh, Garcia, Davanipour), 2-Results have been inconsistent (Keiffets, Feytching), 3-Positive results can be partly due to low quality of some of the studies (Santibáñez, Keiffets) or publication bias(Garcia). There is no consensus between experts in their conclussions (Davanipour, Keiffets, García).--Garrondo (talk) 09:00, 13 August 2009 (UTC)

The point here is ELF-EMF, there are differences of broad EMF, so let's keep the discussion on topic. Kheifets analyzes both case control and cohort studies on the same basket, his conclusions can surely be added to my proposed paragraph, but it's necessary to say different studies were analyzed for each conclusion. The meta-analysis (García, 2008) clearly states that all cohort studies showed consistent results, as were two later cohort studies not analyzed by that meta-analysis, and bias was found "mostly for case-control studies". Although Kheifets was published later it doesn't cite the meta-analysis (García, 2008), so one can't say it's newer. Kheifets is about general diseases, not Alzheimer's specific, so lower quality is presumed than (García, 2008) that analysed it in a much more detailed level. Kheifets remains not cited by further Alzheimer studies while (Garcia, 2008) is cited by (Huss,2009) and other AD studies[21][22]. (García, 2008) was a development of (Santibáñez, 2007), one author (García) is the same of both studies, so the 2008 updated study should be considered instead. Kheifets uses the Garcia former study (Santibáñez, 2007) for his conclusions, so his study is based on the outdated version of that same author. About your proposal I disagree about combining EMF with ELF-EMF since recent studies and their conclusions have separated both. Only case control studies were inconsistent.(Garcia, 2008)(Roosli, 2007)(Huss, 2009). Santibáñez is an old version of (Garcia, 2008), Keiffets "low quality" critics can be included but a better definition of what that "low quality" is and who he cites for that is necessary, since many later studies weren't included in his review. And we should cite studies as by their authors which means "Several cohort scientific studies have consistently showed an increased risk of developing AD associated with exposure to extremely low frequency electromagnetic fields for men".[17][18]</ref>[19][20] and whatever you can add after that, like inconsistency of case control studies, weak relation with general EMF and Keiffets "low quality" critics.--Nutriveg (talk) 14:24, 13 August 2009 (UTC)
LeadSongDog we are talking about ELF-EMF for now, while you can keep the solvents/aluminum part of the text the way you want.--Nutriveg (talk) 14:24, 13 August 2009 (UTC)
I would agree since that the sources are reasonably consistent in treating ELF-EMF distinctly from higher frequencies we should not lump all EMF together. Further, I don't particularly "want" the current version, if we can find better I'm open to improvements, but let's tackle one topic at a time.LeadSongDog come howl 14:46, 13 August 2009 (UTC)
Far too many sources are being brought into play here that don't meet WP:MEDRS, which favors review papers and discourages use of primary research studies. This dispute would be a lot easier to follow if the poor sources were taken out of play and discussion restricted to the small number of sources that are possibly good. Looie496 (talk) 15:08, 13 August 2009 (UTC)
(Garcia, 2008) and (Davanipour, 2009) are review papers. (Huss, 2009) reviews (Garcia, 2008) within his study. I don't see your point here.--Nutriveg (talk) 15:15, 13 August 2009 (UTC)
There's a simple approach we can take to that - for each source, check pubmed's XML <Publication Type> tag. It has values like "Journal Article", "Review" or "Meta Analysis". We can add that parenthetically after the cites and inside the ref tags. Example shown with this edit. It's then clear what kind of source each is.LeadSongDog come howl 15:52, 13 August 2009 (UTC)
It's useless since one should read at least the abstract anyway and is unclear from that single description what it reviews: AD or "any disease", ELF-EMF or another/all kind, high quality studies or any study, ... And some articles develop on top of those reviews, like (Huss, 2009).--16:19, 13 August 2009 (UTC)
(to Nutriveg) My point related to all the other papers that are cluttering up this thread. Looie496 (talk) 16:00, 13 August 2009 (UTC)
I think it's important to cite primary sources when they later confirm (or contradict) secondary sources conclusions.--Nutriveg (talk) 16:19, 13 August 2009 (UTC)
WP:MEDRS doesn't rule out the use of primary sources, but they need to be used with extra caution. The first step is to know what we're dealing with. If you think I've mislabled a review as an article, please strike through my lable and add the correct one, don't just delete it.LeadSongDog come howl 17:28, 13 August 2009 (UTC)
Sorry guys but you completely failed to provide updated reliable sources to support your POV, so I'm putting my edit back.--Nutriveg (talk) 02:35, 14 August 2009 (UTC)

Use of the term 'patient'

The term 'patient' is used a number of times in this article, I think the article would read better if the word was avoided and replaced with other wording, re:WP:MEDMOS 'sounds like it is written for (other) healthcare professionals'. L∴V 23:52, 19 August 2009 (UTC)

Classification of secondary sources

As a measure to ease discussion on sources I have eliminated the reference section at the end of the article (If readded sources would appear again). I post here the review articles (including meta-analysis) we have at the moment on both subjects (EMF and VLF-EMF and dementia-AD): Today I do not have time to look at them to separate them between EMF and VLF-EMF, feel anybody free to do it. The aim of my change is to leave here only the highest quality sources per WP:MEDRS. Additionally I agree with Nutriveg that for the moment we could concentrate on EMF or VLF-EMF and then advance into other subjects.--Garrondo (talk) 18:33, 13 August 2009 (UTC)

First of all it's ELF-EMF, not VLF. That reference section was helpful because my edits cited some of them like (Huss, 2009). It would be much more helpful if you had continued the discussion above instead.--Nutriveg (talk) 19:22, 13 August 2009 (UTC)


Preliminary selection of review or meta-analysis articles on EMF


EMF (include here those of above that do not separate between electromagnetic fields and very low frequency electromagnetic fields when reviewing articles)

ELF-EMF (include here those of above that specifically review studies on extreme low frequency electromagnetic fields)


Discussion

The latest of these, PMID 19278839, is an August 2009 epub ahead of print (e.g. too new to be trusted), and contains some blatant errors, such as referring to "AC/DC transformers". If someone can show me a working DC transformer (barring superconductors) I'll eat my hat.LeadSongDog come howl 18:57, 13 August 2009 (UTC)

PMID is broken, [2] works. I think they meant: AC to AC, AC to DC, DC to AC. It's interesting though that you pose no criticism to a single review that said to have analyzed "any (all) health issues".(Kheifets, 2008)--Nutriveg (talk) 19:22, 13 August 2009 (UTC)
Can't do everything all at once, but that misnomer jumped out at me because I deal with transformers routinely. All transformers are AC/AC, it's an intrinsic property of the device. AC/DC conversion is done by a device called a rectifier, DC/AC by a power inverter or (historically) by a motor/generator set. The PMID link works fine for me, but you may have a local access problem. Pubmed still shows <MedlineCitation Owner="NLM" Status="In-Data-Review"> on the XML display for that article. LeadSongDog come howl 21:07, 13 August 2009 (UTC)
Many AC/DC converters use transformers in their design, as a Flyback converter. What about that "any (all) health issues" review? --Nutriveg (talk) 21:36, 13 August 2009 (UTC)
What about those competing interests then? Leeka Kheifets "works with the Electric Power Research Institute] in Palo Alto, California, and consults with utilities." [3]--Nutriveg (talk) 22:00, 13 August 2009 (UTC)
You should also object the listing of the "Journal of Occupational and Environmental Medicine" as a questionable source--Nutriveg (talk) 22:16, 13 August 2009 (UTC)
Not sure why you think I should object to them, but feel free to do so yourself if you think it's necessary. A declared competing interest is just that, declared. We normally assume good faith here, it's a more productive way to work. A flyback circuit isn't normally used at extremely low frequencies for efficiency reasons.LeadSongDog come howl 22:47, 13 August 2009 (UTC)
Because you have nothing else to hold your critics since I don't accept that source as a reliable source, less yet under WP:MEDRS. Seek Wikipedia:Reliable sources/Noticeboard if you think otherwise.--Nutriveg (talk) 02:24, 14 August 2009 (UTC)
About the flyback the conclusion of that article was "It is important to mitigate ELF and RF MF"--03:02, 14 August 2009 (UTC)

I have critics? I didn't know I was that notable! Seriously, the actual conclusion in PMID 19278839 was

It is important to mitigate ELF and RF MF exposures through equipment design changes and environmental placement of electrical equipment, e.g., AC/DC transformers. Further research related to these proposed and other biological processes is required.

A more complete reading makes it clear that they are finding that "there is evidence" that high level long term occupational exposure affects two processes which in turn "may lead to" AD. That's a very long way from establishing causality of the processes or the disease, but, if the paper is correct, it would be enough of a reason for prudently applying the precautionary principle, mitigating exposure as the paper's conclusion advocates. In fact, the need to limit RF exposure is hardly news. You may be familiar with the microwave oven or induction cooker.

It appears you are confusing Occup Environ Med with the similarly named J Occup Environ Med published by a different group in a different country. An understandable error. Please see the listings LeadSongDog come howl 05:55, 14 August 2009 (UTC)

Kheifets vs. García

We have different discussions here: One of the main ones seems assuming that two of the newest secondary sources we have are of different or similar quality (with that serving Nutriveg POV of course being the one he/she proposes to be better). My reasoning is that both are of similar quality. The consequence is that if both are considered of similar quality since the conclussions from both differ we will have to say that there is no agreement due to disparity in the results. On the other hand if the Garcia article is considered a better one we would have to say that evidence indicates some effect of ELF-EMF.

Additionally I will ask Nutriveg to wait for the discussion to end: His/her point will be tried to be addressed, but sometimes we have have lifes outside wiki that make it impossible to adress questions the same day.

I am going to try to address some of the points raised.

  • Kheifets was published later it doesn't cite the meta-analysis (García, 2008), so one can't say it's newer
True regarding when it was written, not true regarding publication. Keifets was published later but I agree that both use similar sources and can be considered of similar "age".
  • Kheifets is about general diseases, not Alzheimer's specific, so lower quality is presumed than (García, 2008) that analysed it in a much more detailed level
I completely disagree. This may not be the case even for similar articles (longer does not directly mean better); but since the articles here use different techniques (One is a meta-analysis and the other a review) this is clearly not the case. A review can easily summarize 10 articles in two or three paragraphs; while a metanalysis has to give a lot of statistical data. No higher quality can be assummed here.
  • Kheifets remains not cited by further Alzheimer studies
This can neither be used as a sign of higher or lower quality: Journals; as opposed to wikipedia, prefer primary articles as sources. Therefore reviews are hardly ever used as sources while a metanalyisis which is half way between a primary source and a secondary has much more possibilities of being cited in a journal. Additionally since Kheifets was published more recently it has also had less time to be cited.
  • (García, 2008) was a development of (Santibáñez, 2007), one author (García) is the same of both studies, so the 2008 updated study should be considered instead.
Your conclussion is simply OR: The fact that one author is the same does not automatically mean that the second article superseeds the first. This is only the case whith articles such as the Cochrane reviews when articles are simply updated. Here we have a very different thing: The two García articles study related but different things: In one they are doing a review on quality, while the second is a metanalysis on the effect. It is a problem that do not have access to the Garcia article, since we could see which articles and why were eliminated for the metaanalysis and which were not.
  • Kheifets uses the Garcia former study (Santibáñez, 2007) for his conclusions, so his study is based on the outdated version of that same author.
He uses a Garcia study which is different from the second García article not an outdated version.
  • Conflict of interest
We are not the ones to decide weather a published article within a peer-review journal is to be used or not due to an author COI: the fact that it has passed a peer review should be enough to give it credibility.
  • Journal quality
Of all your many critics this is the only reasonable one from my point of view. If the journal is considered as not a reliable source then the article should not really be used. However it seems hard to believe that a journal with an impact factor higher of 3 is not reliable: it is considered a reliable journal by a whole bunch of people to get that IF...
Addressed by leadsongdog above(I quote from him:It appears you are confusing Occup Environ Med with the similarly named J Occup Environ Med published by a different group in a different country. An understandable error. Please see the listings.): it is a reliable journal.--Garrondo (talk) 08:31, 14 August 2009 (UTC)

More imput from other editors would be interesting. As already said if no consensus is reached Wikipedia:Reliable sources/Noticeboard would be the place to look for further comments. Before that I am going to ask for imput in the medicine project Bests.--Garrondo (talk) 08:18, 14 August 2009 (UTC)

I have posted a request for comment in the medicine project talk page.--Garrondo (talk) 08:32, 14 August 2009 (UTC)
Please remove any source that do not follow WP:MEDRS from the discussion. I don't see how a review (Kheifets,2008) that assumes to supposedly review "any health issue" which the leading author "consults with utilities" and "works with the Electric Power Research Institute" fills "A good secondary source from a reputable publisher will be written by an expert in the field". Good luck proving expertise in "any health issue".
Garcia on the other hand is the author of two extensively cited "Alzheimer's ELF-EMF" reviews (Santibáñez, 2007)(Garcia, 2008) and I don't see why we should favor her former review instead of the later. Herself defines her later work as a review ("For this review a wide variety of sources and databases were explored", "This review includes 12 papers—with results from"), there's no OR here.
Garcia,2008 is free full text, so I don't see how you don't have access to it or haven't realized that until now at the same time you had no restriction to cite (Santibañez, 2007) by presumption "Although I can not access Santibañez article I suspect that some of the articles they critizise will be the same".--Nutriveg (talk) 13:07, 14 August 2009 (UTC)
Oddly, we haven't yet mentioned that PMID 18245151 (Garcia 2008) drew a prompt and strongly negative comment from Röösli in the same issue of IJE, PMID 18276625 (doi:10.1093/ije/dyn024). LeadSongDog come howl 15:09, 14 August 2009 (UTC)
It's a "comment" and Röösli later work (Huss, 2009) further finds associated risk.--Nutriveg (talk) 15:36, 14 August 2009 (UTC)
I think you'll find both papers were in work at about the same time (January-April 2008). Huss 2009 was received for publication May 5, 2008 and concludes in part:

There was a dose-response relation with respect to years of residence in the immediate vicinity of power lines and Alzheimer's disease: Persons living at least 5 years within 50 m had an adjusted hazard ratio of 1.51 (95% CI: 0.91, 2.51), increasing to 1.78 (95% CI: 1.07, 2.96) with at least 10 years and to 2.00 (95% CI: 1.21, 3.33) with at least 15 years.

but without stating who constituted the control group. (e.g. Did they live in nearby homes of similar value for similar durations?) By comparison, Röösli 2008 was received for publication 14 January 2008 and published online (advanced access) a month later. If he had changed his mind that abruptly don't you think he'd have said so and (more important) why? It is apparent (at least to me) that he recognized the studies were all methodologically weak and inconclusive. But his email address is on the paper, feel free to ask him to clarify.LeadSongDog come howl 18:07, 14 August 2009 (UTC)
Röösli 2008 is a commentary! He expresses his own opinions about generalities without making any specific conclusions: "It is hard to believe", "I give most credit to studies where", "Unfortunately, there are reasons to believe". The little time between submission and publication also doesn't reflect the nature of a peer reviewed article. It's not reliable under WP:MEDRS.--Nutriveg (talk) 18:47, 14 August 2009 (UTC)
Yes, a commentary that the editors saw fit to publish in the same issue, as a direct response. WP:RS tells us "There is sometimes no single prevailing view because the available evidence does not yet point to a single answer. Because Wikipedia not only aims to be accurate, but also useful, it tries to explain the theories and empirical justification for each school of thought, with reference to published sources." LeadSongDog come howl 19:41, 14 August 2009 (UTC)
We are talking about WP:MEDRS here, please cite where it support the citation of such commentary and how that should be done.--Nutriveg (talk) 20:04, 14 August 2009 (UTC)
I see nothing in WP:MEDRS that takes special exception to that general principle in WP:RS. Do you? LeadSongDog come howl 04:23, 16 August 2009 (UTC)
First of all that phrase you cited is not in WP:RS, but in an essay. Even so yes, WP:MEDRS takes special care about "sources appropriate for medical and health-related articles" and how they should be cited. That commentary doesn't fill anywhere in there, unless you say "where WP:MEDRS support the citation of such commentary and how that should be done". If you have problems understanding that please consult the Wikipedia:Reliable sources/Noticeboard.--Nutriveg (talk) 14:35, 16 August 2009 (UTC)

(unindent) Commentaries are basically reviews and are fine, so long as they are peer-reviewed, which should be true of any commentary in a medical journal. What MEDRS asks us to avoid are primary research publications, that is, publications whose main purpose is to present new data. Looie496 (talk) 17:28, 16 August 2009 (UTC)

I don't see what kind of review that would be, please define it. The wording is inappropriate, he makes no specific conclusions and there's no evidence of peer review, it's weaker than primary source. That commentary was defined as an "editorial" by the journal it was published in.[4]
WP:MEDRS distinguishes both, "Peer-reviewed medical journals are a natural choice as a source for up-to-date information for medical articles.(...) Although almost all such material will count as a reliable source, not all the material is equally useful. Journal articles come in many types: original research, reviews, editorials, advocacy pieces, speculation,". WP:MEDRS is more complex than your definition.--Nutriveg (talk) 18:02, 16 August 2009 (UTC)
I'll wait the discussion on the Noticeboard to end before accepting the inclusion of Roosli, 2008 commentary. But for while I'd like to know exactly what you want to extract from that commentary. As I read it Roosli contest the methodology used to assess the occupational quantitative associated risk, but doesn't question the occupational associated risk, which he instead seems to agree as when he discuss "whether ELF-MF causes Alzheimer's disease" he uses the "occupational association" as an argument supporting causation theory. One may use that commentary as a source to question causation, but we have better sources for that, and it would be useless since the text is supposed to be include in the prevention, not the cause section of the Wikipedia article.--Nutriveg (talk) 14:48, 17 August 2009 (UTC)
I would suggest that the nugget of Röösli 2008 comes down to "...the question of whether ELF-MF causes Alzheimer's disease remains open." "Nevertheless, a potential association between ELF-MF and Alzheimer's disease merits our attention" with "well-designed studies that can overcome previous methodological limitations." LeadSongDog come howl 16:59, 17 August 2009 (UTC)
The first phrase is OK. The second is your interpretation, a single author self published opinion (by the noticeboard) and should be reported that way, and with due balance (not so detailed). It's not specific about "occupational association" (the proposed text) and may contradict his later study (Huss, 2009) where he addresses critics present on that commentary.
If we decide to use his self published commentary to criticize the "general exposure" association, I'll have to give proportional balance to primary sources and lower quality secondary sources that support that "general exposure" claim and are not reflected by my proposed text, that doesn't cite that claim.--Nutriveg (talk) 17:20, 17 August 2009 (UTC)
My use of quotation marks was careful. The words in quotes all came from his conclusionspaper, they are not mine. They certainly were not self published, they were published by Int J Epidemiol. Are you challenging the validity of that journal?LeadSongDog come howl 18:05, 17 August 2009 (UTC)
Your quotation is a synthesis: you limit the subject of "attention", ommits Roosli appreciation of critical reviews like Garcia and Roosli says nowhere that such examples will bring the issue to an end.
So far his commentary was given equal weight as a self-published source by the noticeboard. My others observations remain pertinent.--Nutriveg (talk) 18:59, 17 August 2009 (UTC)
I'm prepared to wait for the noticeboard to come to a conclusion, but please don't put words in my mouth. You asked at 14:48 what I would include and I offered a suggested version. Please don't twist that into something more than it was.LeadSongDog come howl 19:23, 17 August 2009 (UTC)
You took two separated phrases to make one, and took others out of context. So you used author the words to write something that doesn't necessarily reflect his ideas. I asked what you guys wanted to cite from that commentary, so we could work from that, I didn't say I was going to accept anything without discussion.--Nutriveg (talk) 20:07, 17 August 2009 (UTC)
I'm done with this discussion until the noticeboard's had more time. LeadSongDog come howl 20:43, 17 August 2009 (UTC)
I have asked for further imput specifically in Keiffets review since discussion there was centred in the use of the commentary. As a summary: Since we seem to agree now that the journal is a reputable one my reasoning has been that a person with 46 articles in epidemiological aspects of EMF exposure in peer-reviewed journals is clearly an expert in the field. Let's see what people at the noticeboard have to say. Bests.--Garrondo (talk) 11:13, 18 August 2009 (UTC)
Some imput in the noticeboard here by any editors who have not commented yet would be greatly welcomed.--Garrondo (talk) 07:57, 20 August 2009 (UTC)

Since there's little concern about the quality of the sources used to support that text I don't have nothing to do here since it's condemned to be unreliable anyway.--Nutriveg (talk) 20:27, 20 August 2009 (UTC)


For the record I leave here the link to the archived discussion in the reliable sources noticeboard about sources on the prevention-electromagnetic fields section so it is easier to find it in the future if needed.--Garrondo (talk) 08:10, 2 September 2009 (UTC)

Time to move forward

My new proposal including all relevant sources we have at the moment is as follows:

Electromagnetic fields (EMF) have also been proposed to be related to AD by some experts, [2][23] but not others.[24] Regarding extremely low frequency EMFs, while a metanalysis found that exposed people had more than two-fold probabilities of having the disease, [17] reviews do not agree on weather studies point towards a relationship,[20] or not.[25] Doubts on how to interpret the statistically significant results of the metaanalysis have been raised.[26]

Diberri's tool is not working at the moment so I have only included the name of the first author in brackets. Once we agree on content I'll format manually the references. Bests.--Garrondo (talk) 09:20, 21 August 2009 (UTC)

I have formatted citations. I am going to add it to the article--Garrondo (talk) 14:42, 25 August 2009 (UTC)
Agree. Minor nitpick - "weather" should read "whether the". LeadSongDog come howl 16:27, 25 August 2009 (UTC)
Uuuppssss...I always make that mistake. Corrected.--Garrondo (talk) 07:15, 26 August 2009 (UTC)

BDNF

A few days ago this was added and edited:

There is a correlation with low levels of brain-derived neurotrophic factor (BDNF), but it is unclear whether this is a cause or a symptom.[27]

I have a few problems with this addition and its reference. Main one at this point is that the article used as reference does not support the claim, since it is a primary article studying Brain-derived neurotrophic factor gene polymorphisms in AD and not the protein levels. Additionally the fact that it is a primary article is not very good either. Finally I have made a fast search in pubmed and I have not found many secondary articles on this issue (AD and BDNF) which would lead me to think that it is of secondary importance at the moment. A ref specifically supporting the sentence of the article has to be found, and it would be much better if it was a secondary source. Its insertion in the causes section is also problematic: unless a secondary source debates the possible causal role of BDNF in my opinion it should be at the very least moved to the pathophisiology section. Bests.--Garrondo (talk) 14:30, 4 September 2009 (UTC)

That same sentence was added in mass-production fashion to eight articles, and has caused trouble all around, see Talk:Schizophrenia for example. Anyway, I agree with you. Looie496 (talk) 16:53, 4 September 2009 (UTC)
Also see WT:WikiProject Medicine#BDNF associated with many conditions ?. Looie496 (talk) 16:55, 4 September 2009 (UTC)
[5][6]-Nutriveg (talk) 20:21, 4 September 2009 (UTC)
I am going to add the first reference provided by Nutriveg (thanks for those), reword according to source, and move it to the pathophisiology section; instead of causes.Bests
On second thought I only eliminated it temporarily: I believe that it better fits inclusion in the secondary article Biochemistry of Alzheimer's disease instead of the primary article; since there is much less literature than for example on amyloid; but I am not really sure. Any comments or suggestions? --Garrondo (talk) 07:53, 7 September 2009 (UTC)
[7][8]--Nutriveg (talk) 12:34, 7 September 2009 (UTC)
With references provided as the only comment I believe it merits inclusion. Thanks.--Garrondo (talk) 07:50, 8 September 2009 (UTC)

New results in Nature Genetics

See Herald D; et al. (6 September 2009). "Genome-wide association study identifies variants at CLU and PICALM associated with Alzheimer's disease". Nature Genetics. doi:10.1038/ng.440. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |laysummary= ignored (help) and Lambert Jean-Charles (6 September 2009). "Genome-wide association study identifies variants at CLU and CR1 associated with Alzheimer's disease". Nature Genetics. doi:10.1038/ng.439. for recent findings on genetics linked to late-onset Alzheimer's disease and to Amyloid beta clearance. These are just letters, but clearly will be significant. LeadSongDog come howl 15:55, 25 September 2009 (UTC)

Familial and Sporadic AD

The article poorly differentiates familial and sporadic AD and I don't see how that could be fixed without making big changes in some sections, like causes. So I'm bringing this issue to the talk page first.--Nutriveg (talk) 15:20, 14 October 2009 (UTC)

What parts do you feel that are not clearly explained? Point them out and I am sure that some people will try to improve them with your help. On the other hand I have edited your last editions to try to avoid fourth level subsections. I have also left the mention to the Apoe4 gene. Bests.--Garrondo (talk) 08:00, 15 October 2009 (UTC)
The causes are different, as well the role played by genetics. You removing that separation on genetics that I inserted mix the two kinds. You undoing that change is an indication of lack of interest in making those changes or you're unaware how the two kinds are different. --Nutriveg (talk) 13:22, 15 October 2009 (UTC)
I did not eliminate the separation but inserted it into the text. I did like your separation, but fourth level subsections are not very recommended since they are hard to differentiate from third level. On the other hand: of course I am quite aware on their differences. Moreover I have added references from a high quality review on how do they differ instead of using primary sources. Nevertheless it is true that I am no expert in genetics and pathophisiology so if you still feel that differences between early-onset/ late onset and their genetics are not clear we can work to improve them. (I have to say however that next Friday I'll take a wiki-break of a month due to personal affairs).--Garrondo (talk) 15:49, 15 October 2009 (UTC)

Boxing

I'm not qualified to asses this but it seems peculiar that so many of all classical boxers have had AD: e.g. Ingemar Johansson, Sugar Ray Robinson and Floyd Patterson. See also Dementia pugilistica. —Preceding unsigned comment added by 80.216.104.83 (talk) 22:33, 3 December 2009 (UTC)

Souvenaid

I read about souvenaid at CNN.com on Jan. 11, 2010. It is being tested as a treatment for Alzheimer's. Should it be added to the article, or is it too new? Here is the link to the CNN article that discusses it. http://www.cnn.com/2010/HEALTH/01/08/alzheimer.drink.scan/index.html 204.80.61.110 (talk) 20:50, 11 January 2010 (UTC)Bennett Turk

Far too new. When there's a serious review of a phase III trial published, we can look at it, but the details suggested in the CNN story indicate that they've only done a brief study with a small cadre. The best related reviews I could find were PMID 19703213 and PMID 19703214, but both predate the study that CNN talks about. Interesting hints, though.LeadSongDog come howl 04:37, 14 January 2010 (UTC)

Old timer's disease

I note that "Alzheimer's disease/Archive 8" sounds very much like "Old timer's disease". What a coincidence. Jidanni (talk) 02:40, 14 January 2010 (UTC)

There are discussions of this in archives Talk:Alzheimer's disease/Archive 3#Mispronunciation as "old timer's disease" and Talk:Alzheimer's disease/Archive 7#"Old timers". Regards, Looie496 (talk) 17:35, 14 January 2010 (UTC)

New diagnosis method?

There is a study in progress in the UK that might be of some interest. —Preceding unsigned comment added by 72.152.135.149 (talk) 15:54, 14 January 2010 (UTC)

Very interesting, but we generally want more validation of something before including it in a Wikipedia article. Looie496 (talk) 17:39, 14 January 2010 (UTC)

Causes

Currently, this § begins with a statement that there are 3 major theories of causation, the first "Cholinergic", which it says is the oldest appears to be the only one explicitly named. I presume "Amyloid Plaque Formation" and "Inflammation" are the other two but very unclear at first reading. 72.228.150.44 (talk) 04:57, 26 January 2010 (UTC)

OK, I see what it is, text is stated to have 3 causative hypotheses, but in fact there are two. The three would be "cholinergic hypothesis", "amyloid hypothesis", and "tau hypothesis". Hovever one of these is a misnomer. There's no longer, if there ever was, an "amyloid hypothesis". Plaque formation and the generation of the substance from which they're formed are a common observation of the disease and in early research, as apparently now, there was a failure to explain conclusively their formation, and perhaps (early on) a failure to associate them (or tangles) unequivocally with the disease. "Amyloid hypothesis", therefore, actually refers to attempts to remedy that failure, which may or may not, and text currently indicates it probably would not, necessarily produce a theory of causation, correct or otherwise. So one of these things is not like the others. 72.228.150.44 (talk) 05:25, 26 January 2010 (UTC)

The Amyloid Cascade Hypothesis (the formal name for the amyloid theory) is still a very active field of research. --Biophysik (talk) 22:41, 26 January 2010 (UTC)

Also this indicates the kind of meta methodological analysis which would be applied to the classes of actual causative theories (like the 2 above) to obtain the correct one(s) but the margins of this Wiki are too small for such OR. 72.228.150.44 (talk) 05:31, 26 January 2010 (UTC)
Feel free to improve the article if you would like to. Looie496 (talk) 17:07, 26 January 2010 (UTC)


Alzheimers Prevalence

"The prevalence of Alzheimer's is thought to reach approximately 900 trillion people by 2050" - clearly this is wrong. —Preceding unsigned comment added by 88.7.142.80 (talk) 19:44, 2 February 2010 (UTC)

That was recent vandalism, and has already been undone. Looie496 (talk) 20:15, 2 February 2010 (UTC)

Reference bombing

This article has so many references that it takes an age to load. Would anybody object if I make an attempt to work the number down a bit? A quick glance shows that at least some are primary research studies, which are undesirable per WP:MEDRS. Looie496 (talk) 20:17, 2 February 2010 (UTC)

The load time issue is being worked on, though I remain unconvinced that the refs make much difference. Still, if we can support statements from reviews it is certainly an improvement to do so. That said, I'm reluctant to do anything abruptly given the high profile of this article. Would you mind terribly pointing out the offending refs here first? LeadSongDog come howl 22:35, 2 February 2010 (UTC)
high quality reviews to replace primary references will always be welcome.--Garrondo (talk) 07:13, 3 February 2010 (UTC)

(Crossposted to Talk:Down syndrome) See:

  • Granic A, Padmanabhan J, Norden M, Potter H (23 Dec 2009). "Alzheimer Ab peptide induces chromosome mis-segregation and aneuploidy, including trisomy 21; requirement for tau and APP". Molecular Biology of the Cell. doi:10.1091/mbc.E09-10-0850. PMID 20032300. {{cite journal}}: Unknown parameter |laysummary= ignored (help)CS1 maint: multiple names: authors list (link)
  • Abisambra JF, Fiorella T, Padmanabhan J, Neame P, Wefes I, Potter H (1 January 2010). "LDLR expression and localization are altered in mouse and human cell culture models of Alzheimer's disease". PLoS ONE. 5 (1): e8556. PMID 20049331. {{cite journal}}: Unknown parameter |laysummary= ignored (help); Unknown parameter |pmcid= ignored (|pmc= suggested) (help)CS1 maint: multiple names: authors list (link)

Watching for reviews. LeadSongDog come howl 18:22, 10 February 2010 (UTC)

Instead of a citing a primary, ahead-of-print reference, please consider instead using a review such as: Eikelenboom P, Veerhuis R, Scheper W, Rozemuller AJ, van Gool WA, Hoozemans JJ. (2006 Nov). "The significance of neuroinflammation in understanding Alzheimer's disease". J Neural Transm. 113 (11): 1685–95. PMID 17036175. ...amyloid plaques are indeed co-localized with a broad variety of inflammation-related proteins ... and clusters of activated microglia. ... Recent neuropathological studies show a close relationship between fibrillar A beta deposits, inflammation and neuroregeneration in relatively early stages of AD pathology preceding late AD stages characterized by extensive tau-related neurofibrillary changes. {{cite journal}}: Check date values in: |date= (help)CS1 maint: multiple names: authors list (link) ..or related.User:LeadSongDog come howl 20:14, 18 February 2010 (UTC)

It is a review, it's accessible online and is updated. I don't see how removing it helps in any way, if you want to add another reference do it.--Nutriveg (talk) 20:51, 18 February 2010 (UTC)
That's odd, the PubMed data must have it mis-catalogued. It shows:
<PublicationTypeList> <PublicationType>JOURNAL ARTICLE</PublicationType> </PublicationTypeList>
With no mention of it being a review.User:LeadSongDog come howl 23:17, 18 February 2010 (UTC)

Dimebon

Medivation and Pfizer just had a press release that indicated dimebon (latrepirdine) did not meet any of its primary or secondary endpoints in Phase 3. "Pfizer And Medivation Announce Results From Two Phase 3 Studies In Dimebon (latrepirdine*) Alzheimer's Disease Clinical Development Program". Medivation, Inc. 2010-03-03.Given the history of failed phase 3 programs (tramiprosate, tarenflurbil, xaliproden), I would recommend that we keep the research directions at the level of mechanism of action of programs in Phase 3 and not anything earlier. --Chrispounds (talk) 15:20, 3 March 2010 (UTC)

As with all other sections what I think we should do is find a reliable secondary source that says which compounds are more interesting at the moment (independently of their research stage)... We could try to find such article. Recently I did look for that kind of article in the Multiple sclerosis research directions section with good results.--Garrondo (talk) 16:43, 3 March 2010 (UTC)

Deletion of sources

With this edit, sources were again deleted without discussion, inserting a new source at the same time. This new source was evidently added for the part of its conclusions based on its updated findings in para 3.5.4.1, which update is in turn is based on two papers:

  • Röösli M, Lörtscher M, Egger M, Pfluger D, Schreier N, Lörtscher E, et al. Mortality from

neurodegenerative disease and exposure to extremely low-frequency magnetic fields: 31 years of observations on Swiss railway employees. Neuroepidemiology 2007; 28(4):197-206.

  • Huss A, Spoerri A, Egger M, Röösli M. For the Swiss National Cohort Study. Residence Near Power

Lines and Mortality From Neurodegenerative Diseases: Longitudinal Study of the Swiss Population. Am J Epidemiol 2009; 169:167-75. Unfortunately, left in place, that edit would also create the mistaken impression that recent reviews all agree on the significance of the hypothesized association between ELFE fields and AD. While the new review may supplement earlier ones, it certainly should not supplant them. LeadSongDog come howl 07:19, 24 April 2010 (UTC)

You're unable to see what the change was about
The former text, that was an interpretation made by wikipedia editors, was replaced by a position statement of an internationally reputable expert body
The update of the former opinion of 21 March 2007 wasn't based on just two studies, the text doesn't say that, it says those two studies *confirm* other epidemiological studies. It is also unlikely they could have based their former opinion in (Garcia,2008), cited in the current document, which was accepted for publication later, in December 2007.
Beyond, that opinion wasn't solely based on epidemiological studies but also in laboratory studies.
But that discussion is useless we don't redo studies to check their conclusions, we only cite the conclusion, which in this case is in item 4, page 62:
New epidemiological studies indicate a possible increase in Alzheimer's disease arising from exposure to ELF. Further epidemiological and laboratory investigations of this observation are needed.
There's no recent comprehensive review that disagrees with that opinion.--Nutriveg (talk) 10:42, 24 April 2010 (UTC)
Not now that you deleted them. Please restore until you can explain why you think that reviews in 2008 and 2009 are invalidated by this one to the satisfaction of your fellow editors. LeadSongDog come howl 18:02, 25 April 2010 (UTC)
My argumentation is above please cite the "recent comprehensive review that disagrees with that opinion" if that's your point.--Nutriveg (talk) 18:32, 25 April 2010 (UTC)
Your deletion was of these sources:
Of these, the first three are recent reviews, while the fourth is a published comment by Roosli on another review (Garcia et al. PMID 18245151) We discussed including this material at great length as recently as /Archive 8 What makes you believe the recent review (that so far as I can tell hasn't yet been published in a refereed journal, just on a government website) justifies deleting them? LeadSongDog come howl 19:33, 25 April 2010 (UTC)
(Hardell,2008) doesn't disagree with the current source, it supports it. But it's earlier and lower quality so I see no reason to cite it.
(Feychting, 2005) is not new, it's outdated and I can't see its conclusion about Alzheimer's neither.
(Kheifets, 2009) although published in 2009, describes itself as a 2006 review: "At a 2006 workshop we reviewed studies of". It doesn't talk about the same "New epidemiological studies" reflected in that opinion position. It doesn't cite any of them: (Hug et al. 2006),(Garcia et al. 2008), (Röösli et al. 2007) and (Huss et al. 2009). It can't be talking about the same thing, it's not recent, it's outdated.
(Roosli, 2008) is a commentary, not a review, and I don't see how it disagrees with that position statement in a relevant way.
I didn't change my opinion about the issue so far, but now we have a much better source, that encompasses the recent epidemiological and laboratory studies on the field, much better than a conclusion made up by two wikipedia editors supporting the same POV.
That opinion is not a journal review, but a position statement from an "internationally reputable expert body", which qualifies as an ideal source for medical articles.--Nutriveg (talk) 03:21, 26 April 2010 (UTC)
Thank you for stating your reasons. For future reference, edits such as this are far less problematic when they deal with adding or removing just one ref at a time, so that they can be individually discussed without confusion.
I am not arguing for the exclusion of your new source, though I would certainly prefer that it was in a properly published verifiable source rather than on a transient web page. But to exclude other, verifiable, sources based on a transient one is more problematic. I think you will agree that Kheifets and Roosli are leading expert proponents who have taken opposing viewpoints on this topic. Both have published many peer-reviewed papers in the field. Both are eminently suited to provide commentary on papers from the opposing perspective. It might be worth re-reading Wikipedia:Reliable_sources/Noticeboard/Archive_41#Usability_of_Keiffets_review. Cheers, LeadSongDog come howl 17:01, 26 April 2010 (UTC)
It's not a transient web page, that referenced document is the published opinion of the "Scientific Committee on Emerging and Newly Identified Health Risks" based on a compreehensive updated review of epidemiologic and laboratory studies.
I repeat what I said above Kheifets 2006 review is outdated. It doesn't take into account the recent studies that made SCHENIR change its previous 2007 opinion. That discussion on the noticeboard was mainly about the reliability of the author and didn't took this new scenario into account.
(Roosli, 2008) is a mere commentary and I don't see how it disagrees with that opinion in a relevant way--Nutriveg (talk) 18:34, 26 April 2010 (UTC)
"Transient" as in "not archival". That website could take down the page tomorrow. The reason we covet publication is that it makes the content permanent and subject to inspection by other writers. I think you know this, but we seem to be having trouble communicating on basic terminology, so I'm trying to be very explicit.
As far as I can see, this SCENHIR didn't have any newer epidemiology papers to review, just some new candidate etiologies based on in vitro studies. Did I miss something significant in their list of papers?
"Mere commentary" ignores the fact that Roosli 2008 was an invited commentary concurrent with the publication of Garcia 2008 in the same issue of that journal. The editors of Int J Epidemiol deliberately posed those publications against each other to provide better balanced understanding of the issues. LeadSongDog come howl 19:25, 26 April 2010 (UTC)
That's a published document, having an online version doesn't change that. SCHENIR documents have been pretty stable so far and it was approved in a plenary.
SCENIR reviewed at least these recent epidemiologic studies since it's former opinion in March 2007: (Hug et al. 2006),(Garcia et al. 2008), (Röösli et al. 2007) and (Huss et al. 2009). No other review did the same, it's the most update review available. Beyond that it also reviewed laboratory studies. It's the most complete review so far.
Roosli is a mere commentary (about a specific article) it doesn't hold any value by itself. Your views about it are your own interpretation and I don't see it disagreeing with the SCENIR opinion in any relevant way.--Nutriveg (talk) 19:44, 26 April 2010 (UTC)

:No, I meant really published. With an honest-to-goodness PMID, DOI, and all that, so that other writers' papers can refer to it, analyze its strengths and weaknesses and build on them. You know, out in the open, like science is supposed to work?

You're just guessing at my views. I'm pretty careful not to let them colour my editing. In point of fact I'm reasonably sure the whole lot of them (on both sides) are barking up the wrong tree, but none the less they are the published experts, not me, so I defer to their publications. What I'm not prepared to see is a single WP editor censor them based on a single recent review that other experts have not yet had an opportunity to critique - because it has yet to even be properly published. LeadSongDog come howl 20:35, 26 April 2010 (UTC)
You're asking for a source published in a journal. There's not such restriction in WP:MEDRS. Beyond that SCENHIR documents are cited by many scientific studies, there's no problem with them.
I'm only commenting about what you said here, like that view of yours of the Roosli commentary as if it was against a specific POV.
That SCENHIR opinion summarizes current scientific knowledge on this issue so we should stick to it instead of citing old studies or making own conclusions.--Nutriveg (talk) 02:31, 27 April 2010 (UTC)

I agree with Nutriveg; this time he/she has come here with a review source from a reputable health organization which summarizes current knowledge and it is of higher quality than those we had. I have reworded the sentence so as not to exactly match the source. Additionally I am going to eliminate the primary study since it is of no need when there is a secondary source. Finally the syntax of the reference should be changed since the document is not a web site, but a true published document that is avalailable on-line (similarly to journals). Nevertheless the source only rises the possibility of a connection, while it adds that there is no explanatory mechanism...we will see in the future. Bests.--Garrondo (talk) 10:23, 27 April 2010 (UTC)

Thank you for weighing in. The SCENIHR committee may be very reputable individually, but they've only one prior collective publication listed on PubMed, PMID 18453044, which is a news item from 2008. Certainly some of their prior preliminary papers have drawn scathing criticism, e.g. here. In the 14 months since February 2009 one would think they could have taken care of the little detail of getting notice of their work to the NLM. Still, if you too are prepared to use it I'll set aside my objection for now. If it still hasn't gotten archived in another 3 months, I may want to re-address. LeadSongDog come howl 17:46, 27 April 2010 (UTC)
They were criticized by an advocate group about a complete unrelated issue and document. Some organizations are reliable by themselves and don't need to be published by others.-Nutriveg (talk)
No group that calls itself scientific should object to publication and commentary on its work. Its fundamental to the process of science. If I were paying taxes in Europe, I'd be writing my MEP to find out why they're not.LeadSongDog come howl 18:33, 27 April 2010 (UTC)
It's published by themselves.--Nutriveg (talk) 18:36, 27 April 2010 (UTC)
Sure, but where is it archived?LeadSongDog come howl 21:32, 27 April 2010 (UTC)
SCENIHR current and previous opinions are archived by the European Commission--Nutriveg (talk) 11:32, 28 April 2010 (UTC)
If they were their own publishers it would not be a valid publication; the important thing here is that such document has been published as the opinion of a board of experts by the European Commission. On a side note: I have reformatted the citation, so it is not considered a web, but a document. Bests. --Garrondo (talk) 12:33, 28 April 2010 (UTC)
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