There's more evidence that cardiovascular problems help drive Alzheimer's disease, scientists say, and that treating the heart might help protect the brain.

The findings "represent hope that interventions with well-known drugs can interfere with the disease's progression," said lead investigator Yan Deschaintre, a neurologist and research fellow at the University Regional Hospital Center in Lille, France.

In fact, cognitive impairment, as measured by a standard test, stayed in the low end of the mild range over 36 months for Alzheimer's patients who got treatments for both the neurological disease and their cardiovascular problems, the researchers reported.

In contrast, Alzheimer's patients with vascular trouble who did not receive these medications experienced declines in cognition that approached the severe level, Deschaintre's team found.

They were slated to present the findings Sunday at the Alzheimer Association's International Conference on Prevention of Dementia, in Washington, D.C.

According to the National Institute on Aging, about 4.5 million Americans have Alzheimer's disease. Rates rise steadily with age, and experts estimate that "nearly half of those 85 and older may have the disease." One recent study from the World Health Organization, released this week, warned that Alzheimer's -- which currently has no cure -- could affect 100 million people worldwide by 2050.

The new study was based on chart reviews of 891 French patients diagnosed with either Alzheimer's disease, cardiovascular disease plus Alzheimer's disease, or vascular dementia. The cognitive risk factors included in the study were high blood pressure, diabetes, high cholesterol, atherosclerotic disease and tobacco smoking.

Treatment was defined as receiving an antihypertensive drug, insulin or drugs to lower blood sugar, a cholesterol-lowering statin, or anti-clotting medications. The patients with Alzheimer's disease typically received medications aimed at temporarily curbing their symptomsthat included Aricept, Exelon or Reminyl.

Deschaintre's findings represent "pretty exciting work," because cardiovascular risk factors are "something we can do something about," said Dr. Sam Gandy, director of Emory University's Center for Neurodegenerative Diseases. Gandy also is chairman of the Alzheimer's Association's National Medical and Scientific Advisory Council.

The work done by Deschaintre's team is consistent "with what we've been hearing over the past three to five years" about vascular risk factors increasing the risk for Alzheimer's, Gandy said. The new study, "really nails that down by looking at the other side of the coin by establishing that treating vascular risk factors slows the progression of cognitive decline," he added.

He suggested that physicians begin to take vascular risk factors seriously as they treat patients with Alzheimer's. The vascular risk factors for early Alzheimer's patients "certainly should be treated" because it "seems to slow progression," Gandy said.

Another expert agreed.

The Lille results "reinforce the treatment guidelines for these vascular conditions, such as hypertension and diabetes, and emphasize that Alzheimer's and demented patients should be treated, too," said Hugh C. Hendrie, a professor of psychiatry at the Indiana University Medical School and a scientist at its Center for Aging Research.

However, Deschaintre and Hendrie both noted that physicians at times may not treat vascular risk factors in Alzheimer's patients, for a variety of reasons. For example, Alzheimer's disease often leaves patients apathetic, so they may neglect to tell their physicians about vascular symptoms, Hendrie said.

And Deschaintre noted that, in the clinic where the research was done, patients with Alzheimer's were less likely than other patients to be treated for vascular risk factors. The reverse was true, as well -- patients with vascular dementia were more likely to be treated for heart risk factors, but not for Alzheimer's.

But, "since the majority of patients have both Alzheimer's disease and cerebrovascular disease, and since patients with pure Alzheimer's do seem to benefit from treatment of vascular risk factors, the message is to treat both conditions rather than to focus only on one," he said.

Hendrie remained cautious about the scientific impact of Deschaintre's study, however. He said results from a clinical epidemiological study, such as the Lille research, aren't as conclusive or compelling as those from randomized, controlled clinical trials.

Two other studies scheduled for release at the Alzheimer's conference on Sunday also emphasized the role of the brain-body connection in cognitive impairment and dementia.

Weight loss may signal the onset of Alzheimer's, and the rate of weight loss could be early warning of dementia severity, according to a new review of data from what's known as the Nun's Study. That effort followed health outcomes for a group of 537 non-demented Catholic sisters, aged 75 to 102, for 10 years.

In the study, a team led by Dr. James Mortimer, a professor of epidemiology and biostatistics at the University of South Florida, Tampa, found that unexplained weight loss late in life was often linked to Alzheimer's neuropathology in the brain and not to any change in eating habits linked to Alzheimer's.

Mortimer explained that, "early weight loss appears to result from the Alzheimer's disease process itself before that process leads to dementia. That's why it is a marker of impending dementia."

In a third study, a team from the Mayo Clinic in Rochester, Minn., found an increased risk of mild cognitive impairment (MCI) or dementia among 70- to 89-year-olds who have had a carotid endarterectomy (surgical clearance of the carotid artery, which brings blood to the brain) or a stroke or "mini-stroke," also known as a transient ischemic attack (TIA).

In the study, the team compared the medical histories of 295 people with MCI and 590 age and sex-matched controls. "Elderly subjects who have had a carotid endarterectomy or stroke or TIA are about two times more likely to have MCI," lead researcher Dr. Rosebud O. Roberts, a Mayo epidemiologist, said in a prepared statement.

More information

For more on Alzheimer's disease, visit the Alzheimer's Association.

Vietnam's first human bird flu case in a year and a half left hospital on Monday, doctors said, as the country tries to control numerous outbreaks of the virus in poultry.

The Animal Health Department said four bird flu cases in poultry were found at the weekend in the northern province of Bac Giang and near Haiphong city. Both have been on the government's bird flu watchlist along with 13 other provinces and a city.

A 30-year-old man was admitted to a Hanoi hospital on May 15 after he helped slaughter chickens at a friend's wedding. Vietnamese doctors confirmed he had the H5N1 bird flu virus, the first human case since November 2005.

Doctors at the Bach Mai hospital who treated the man said they increased the dosage of anti-viral drug Tamiflu to 10 days from seven days. They detected the virus in the man's saliva, in his stomach as well as in his excrement.

The patient eventually recovered and was discharged on Monday morning, state-run VnMedia e-newspaper (www.vnmedia.vn) said.

Doctors were still treating a second patient, a slaughterhouse worker from outside Hanoi who became sick late last month. The patient was recovering well, they said.

Bird flu has killed 42 people out of 95 known infections in Vietnam since late 2003. The World Health Organization (WHO) has not confirmed the two most recent infections in Vietnam.

Globally, the H5N1 virus has killed 189 people out of 310 known cases, according to the WHO. Hundreds of millions of birds have died or been slaughtered, including more than 100,000 in Vietnam's latest outbreaks since early May.

A brutal triple slaying in this remote corner of the vast Navajo reservation brought home what experts have seen coming for years: an explosion in crime on tribal lands linked to the cheap, potent and highly addictive stimulant methamphetamine.

"Meth is the biggest scourge," says Francis Bradley, the chief of police for the Hualapai reservation in northern Arizona, located on the high desert flanking the south rim of the Grand Canyon.

Alcohol is a big issue, too. But when you look at meth, it has a far more devastating effect.

In 2001, the Indian Health Service, the U.S. agency that treats Indians and Alaska natives, recorded 2,980 emergency room visits and paramedic calls on reservations related to the drug, which is also known as speed, crank, ice, crystal and glass.

By 2006, that number had mushroomed to 8,873.

"Alcohol continues to be a bigger destroyer of lives than meth," said James Stone, acting director in IHS's division of behavior. "But meth makes more of an impact because of the, frankly, wild behavior it triggers."

TRIPLE SLAYING

The savageness of the Hogback slayings in November 2005 provided an all-too-vivid illustration of that. The three victims, all tribal members, were each shot multiple times -- one 14 times. The government alleges the four suspects, also tribal members, were meth dealers bent on revenge. All four await trial in Albuquerque on first degree murder charges.

Last year, in the wake of the Hogback killings and other signs of the impact meth was having on reservations, the Bureau of Indian Affairs surveyed tribal law enforcement agencies across the country about drug threats on their lands.

Three quarters identified meth as their No. 1 problem and linked it to a rise in domestic violence, assaults, burglaries and child abuse and child neglect.

"So people are not only destroying their own lives by using this illegal substance, but they're perpetrating new crimes, primarily violent crimes," says Chris Chaney, the deputy director of the office of justice services at the bureau. "That's the even more tragic story. It's drawing in innocent victims."

SPILLOVER FROM OUTSIDE WORLD

The meth problem isn't confined to Indian lands. The drug has been identified by the U.S. Drug Enforcement Agency as the greatest threat to small-town America.

One reason: Unlike heroin and marijuana, meth is easily manufactured using common chemicals found in household products or over-the-counter medicines.

First-time users of the drug, which can be smoked, snorted or injected, experience a long-lasting high and feeling of euphoria and excitement. But long-term use often leads to a dramatic and devastating deterioration in the user's physical and mental health, characterized by anxiety, psychotic behavior, risky sexual behaviors and violence.

TRIBES VULNERABLE

But while its use in the general population is falling, it appears to be rising in the 500 Native American tribes from Alaska to New England.

Experts say a number of factors -- including the long use of hallucinogens like peyote for rituals and herbs for medicines by the tribes as well as a more recent problem of alcohol abuse -- help account for the rise in meth use.

In addition, many reservations are located in remote, rural areas. As a result, they are places of underemployment, grinding poverty and reliance on government assistance, where residents live in aged mobile homes or poorly constructed conventional houses.

The bureau's Chaney said there was also evidence that meth dealers are now specifically targeting Indian communities.

"They know that on many reservations there are high levels of substance abuse already," he says. "So some drug cartels figure they can move in and take advantage of that addictive behavior and replace whatever the substance being abused -- alcohol, marijuana or something else -- with meth addiction."

To combat the problem, the bureau has asked for an additional $16 million in its 2008 budget to battle the rise of methamphetamine on reservations. But Dirk Kempthorne, the U.S. Secretary of the Interior, which oversees bureau, earlier this year warned that the problem was approaching crisis.

"It has the potential of wiping out an entire generation of Native American youth," he said.

(additional reporting by Nick Carey and Tim Gaynor)

India's injecting drug problem may be worse than thought, a new survey of the country's breadbasket region shows, worrying health experts and activists who say it could fuel the spread of HIV and AIDS.

The UNAIDS-backed survey by the Society for Promotion of Youth and Masses (SPYM) -- a group fighting drug abuse -- showed that nearly 60 percent of 3,300 drug users in 10 cities and towns in the northern states of Punjab and Haryana shared needles and syringes.

The prosperous region -- home to around 50 million people -- was not known for injecting drug users (IDUs), and the survey is the first large-scale mapping in the area.

"This shows the problem of IDUs has been underestimated in mainland India, as most of the problem was thought to be in the northeast," Denis Broun, the India head of UNAIDS, the United Nations AIDS agency, told Reuters.

Official estimates say there are about 200,000 IDUs in India, a figure activists say is a huge underestimate. The problem is seen as most acute in the remote northeast, which borders Myanmar and the opium-producing Golden Triangle.

India has the world's largest number of people living with HIV with 5.7 million people thought to be infected, although findings of a new population-based national survey have indicated that the actual figure could be lower.

In other parts of Asia, injecting drug use has fuelled the HIV epidemic. But India's state-run National AIDS Control Organization (NACO) says drug users are responsible for just 2.2 percent of HIV transmissions.

UNAIDS says this number may now need to be looked at again.

"This survey points out that the IDU transmission figure is likely to be higher than 2.2 percent," Broun said. "The percentage for IDU transmissions may be relatively small but if there are more IDUs than thought, it could be a major transmission route in the future."

Many drug users in India are married or visit sex workers, presenting an HIV risk to their partners, Broun added.

"WAKE UP CALL"

In Jind, a small town of 135,000 people in Haryana, nestled amid wheat and rice fields, ignorance about HIV seems common among drug users.

"HIV? AIDS? What's that?" asked 23-year-old Jasvinder, who can barely move his right arm because of his injecting habit, at the sole drug rehabilitation centre in the town, 130 km (80 miles) northwest of New Delhi.

"This is a wake up call for the country which, till now, has focused on the northeast and big cities," said Atul Ambekar, a drug rehabilitation expert who is analyzing the survey data.

Official data shows that more than 10 percent of intravenous drug users have HIV, a higher prevalence than among prostitutes, while the overall national average is about 0.9 percent for those aged between 15 and 49.

While efforts to combat the spread of HIV among drug addicts have concentrated on the northeast and in big cities, the SPYM survey reveals India's rural heartland is no longer immune from the threat.

In Ludhiana, an industrial city in Punjab, official data shows 21 percent of injecting drug users are HIV-positive. Yet many are unaware of the risks of injecting.

"I know AIDS is a disease that can cause death but I never dreamed it can come through a needle," said 23-year-old Jagdev Singh, a farmer who regularly shoots morphine into his veins with the same needle his friends use.

In Jind, the rehab centre's director, Dilbag Duhan, said he was struggling to deal with the number of addicts coming for help. "This is becoming a huge headache," he said.

On the other hand, a crackdown on narcotics has pushed people to inject legal painkillers like morphine and sedatives, which are available without a prescription, further fuelling injecting drug use, said Rajesh Kumar, the head of SPYM.

NACO chief Sujatha Rao said the government planned to step up efforts to stop HIV transmission through drug use in Haryana and Punjab by promoting oral drug substitutes and by setting up more testing, drug counseling and rehab centers.

"We have to watch this trend very carefully ... as cheap pharmaceuticals are available over the counter, people have money and little to do, and there is peer pressure," she said.

Thousands of families that allege vaccines caused their children's autism are preparing for their day in court, which could bring them vindication and compensation.

Since 1999, more than 4,800 families have filed claims with the government alleging their children developed autism as a result of routine vaccinations. Most contend that a preservative called thimerosal is to blame for the impaired social interaction typical of the disorder.

Previously, large scientific studies have found no association between autism and vaccines containing thimerosal.

But many parents say their children's symptoms did not show up until after their children received the vaccines, required by many states for admission to school. If they prevail in the courts, the families are entitled to compensation from a multibillion-dollar trust fund.

The first of what eventually could be nine test cases from those claims is the subject of the hearing opening Monday in the U.S. Court of Federal Claims. Three special masters appointed by the court will preside over the hearing, expected to last through June 29.

The court is being asked to decide whether there is a link between autism and childhood vaccines. If it finds one exists, the families could be eligible for compensation under the Vaccine Injury Compensation Fund, a program established by Congress to ensure an adequate supply of vaccines by safeguarding manufacturers from lawsuits. Under the program, people injured by vaccines receive compensation through a special trust fund.

Autism is characterized by impaired social interaction. Those affected often have trouble communicating, and they exhibit unusual or severely limited activities and interests. Classic symptoms of mercury poisoning include anxiety, fatigue and abnormal irritation, as well as cognitive and motor dysfunction.

Monday's case addresses the theory that the cause of autism is the measles, mumps and rubella vaccine in combination with other vaccines containing thimerosal. The preservative, about 50 percent mercury by weight, is no longer found in routine childhood vaccines but is used in some flu shots.

In July 1999, the U.S. government asked vaccine manufacturers to eliminate or reduce, as expeditiously as possible, the mercury content of their vaccines to avoid any possibility of infants who receive vaccines being exposed to more mercury than is recommended by federal guidelines.

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On the Net:

U.S. Court of Federal Claims: http://www.uscfc.uscourts.gov

Eighteen big hospitals in northeastern China have been using fake human albumin, or plasma protein, to treat patients, state television reported in the latest food and medicine scandal to hit the country.

In regular checks made by the food and drug administration in Jilin province, seven of 36 batches of the albumin, fed into the bloodstream by drip, contained zero protein.

"There was no protein component," Xu Fei, deputy chief of Jilin food and drug inspection department, told China Central Television. "It will not have the benefit it should have. We can say it is an out-and-out fake product."

Experts said that use of the fake drip could put lives at risk for those already seriously ill.

Eighteen hospitals and 39 drug trading companies were found to be using the fake human albumin, which led to huge profits because of its low production cost.

The State Food and Drug Administration said the Jilin probe was part of a wider, national crackdown on fake human albumin, a concentrate of plasma proteins used to treat shock from blood loss, burns and low protein levels in the body.

"After several months of hard work, the project to bring order to the human albumin (market) has now achieved results," it said in a statement on its Web site (www.sda.gov.cn).

"Jilin, Shanxi, Qinghai, Hubei, Shandong, Liaoning, Chongqing and Xinjiang have investigated a series of fake albumin cases, and have effectively cleaned up the market," the statement added, referring to the parts of China where the probe focused on.

It did not say if anyone had died or fallen ill from using the fake products, and provided details of the crackdown only for Jilin.

There, it said, an underground network selling the fake plasma had been smashed.

Some of the hospitals called by Reuters were not immediately available for comment.

Billions of dollars worth of counterfeit and substandard goods, from fake liquor and medicines to luxury handbags, are produced every year in China.

In the most recent scandal, U.S. consumers were alarmed by a spate of pet deaths blamed on tainted wheat gluten and rice protein exported from China, as well as reports of toxins and disease in other Chinese exports.

A Chinese-made medicine ingredient also killed at least 100 people in Panama, according to a report in the New York Times.

In one of the most highly publicized scandals, China revealed in 2004 that at least 13 babies had died from malnutrition in the eastern province of Anhui after being fed fake baby formula.

Nearly 200,000 people die each year in China from improper use of legitimate drugs, according to Jin Shiming, a committee member of the Guangdong Provincial Science and Technological Association.

Developing countries in Southeast Asia need to use tough laws in their fight against dengue, a leading expert said, so that homes and building sites do not provide breeding grounds for disease-carrying mosquitoes.

Duane J. Gubler, director of Asia-Pacific Institute of Tropical Medicine and Infectious Diseases, said Singapore's use of inspections and fines had helped reduce the incidence of dengue in the city-state and set an example for other countries.

If every country in the region could control mosquitoes like Singapore has, I doubt you will see a problem," Gubler said in a phone interview from Hawaii, where he is based.

Fumigation of mosquito breeding grounds and public co-operation are both key to reducing dengue, he said.

Dengue is endemic in several countries in the region including Malaysia, Thailand, the Philippines, Indonesia, Vietnam, Cambodia and Myanmar.

Singapore conducts spot checks of construction sites and homes, and contractors and residents can be punished if any mosquito larvae are found on the premises, with fines ranging from S$100 ($66) to S$20,000 ($13,100).

The city-state also conducts public health programs to ensure that people do not allow water to collect in places where mosquitoes can breed.

This has cut the incidence of homes where mosquitoes were found to less than 2 percent from 60 percent in the 1960s.

Gubler, 68, who has advised the World Health Organization (WHO) on dengue for about 25 years, has had dengue three times himself. On one occasion, he contracted the disease after a lab experiment in which he tried to get an infected mosquito to suck blood from a monkey, but was instead bitten himself.

Gubler said most Asian governments only set aside a "pittance" to tackle dengue, saying "these countries have not taken dengue seriously."

While Singapore has the best anti-dengue program in the world along with Cuba, according to Gubler, the city-state has still not managed to stamp put dengue.

Gubler, who has advised Singapore's anti-dengue efforts since 2005, said that as people travel more frequently and more widely, they are more likely to spread the disease across borders.

The number of dengue cases in Singapore this month is nearly three times the number in the same period a year ago, according to the government, which says warmer weather is partly to blame.

Between May 13 and May 19, the city-state reported 210 dengue cases, the highest weekly figure this year, but below the weekly record of 714 cases which was reported in September in 2005.

Dengue occurs mainly in the tropics and is transmitted by the female Aedes aegypti mosquito. The virus spreads across borders when infected travelers are bitten by local mosquitoes that go on to bite someone else.

The disease affects about 50 million people around the world every year, according to WHO. There are no vaccines for dengue, which has flu-like symptoms such as fever and pain in the joints, and can be fatal.