About Alzheimer's & Dementia
Prevention and Risk Reduction
Sedentary lifestyle is the greatest modifiable risk factor
As a result of the aging population, dementia rates are expected to soar within the next 30 years; with no cure for the disease, developing prevention methods is imperative.
The single biggest risk factor for dementia is age, but genetics and lifestyle factors also play a role. Presence of the mutation for apolipoprotein E (APOE) E4 is the strongest genetic predictor of developing dementia, and sedentary lifestyle is the greatest modifiable risk factor.
A study from McMaster University in Hamilton recently examined the association between physical activity and dementia.They found that exercise does not mitigate dementia risk for adults with a genetic predisposition to the disease. Physical activity does, however, lower dementia risk in adults that do not possess the APOE E4 gene. This is notable because the vast majority of the adult population is not genetically predisposed.
The important message here is that being inactive may completely negate the protective effects of a healthy set of genes. The most common form of exercise reported in the study was walking, suggesting that taking a walk three times per week may be beneficial to brain health.
SOURCE: Medical News Today
A sensor devised to detect for vitamin B12 deficiency.
A lack of this vitamin has been linked with a higher risk of dementia and Alzheimer's disease. The new optical sensor has been devised by University of Adelaide scientists. The test requires a sample of a patient’s blood, which is then diluted. The device is said to be the world’s first portable vitamin B12 deficiency test.
While some studies indicate low vitamin B12 levels are associated with an increased risk of dementia; taking supplementation with B vitamins does not appear to improve brain function or symptoms of memory loss. In other words, B12 may play a part in preventing the development of Alzheimer’s but it cannot reverse it. The new sensor has been developed by the ARC Centre of Excellence for Nanoscale BioPhotonics together with the Institute for Photonics and Advanced Sensing and the Schools of Physical Sciences and Medicine. The device measures vitamin B12 levels in less than one minute and it is based on the optical process called Raman spectroscopy. This process produces an optical fingerprint of a target molecule.
Less Salmon More Plaques? Link between Omega 3 and Amyloid beta
A new study may reinvigorate interest in the fish oils and their protective effect on the aging brain. Researchers led by Helena Chui at the University of Southern California have used PET and MRI scans to correlate markers of Alzheimer’s disease with blood levels of the essential fatty acid docosahexaenoic acid (DHA). They report that people with the least amount of DHA have the most amyloid and atrophy in brain regions associated with AD. The findings, published August 8 in JAMA Neurology, do not prove that DHA blocks AD pathology, however they do mesh well with animal studies suggesting the fatty acid thwarts Aβ accumulation.
New MIND diet may significantly protect against Alzheimer’s disease
A new diet, appropriately known by the acronym MIND, could significantly lower a person’s risk of developing Alzheimer’s disease, even if the diet is not meticulously followed, according to a paper published online for subscribers in March in the journal Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.
Rush nutritional epidemiologist Martha Clare Morris, PhD, and colleagues developed the “Mediterranean DASH Intervention for Neurodegenerative Delay” (MIND) diet. The study shows that the MIND diet lowered the risk of AD by as much as 53 percent in participants who adhered to the diet rigorously, and by about 35 percent in those who followed it moderately well. Morris and her colleagues developed the MIND diet based on information that has accrued from years’ worth of past research about what foods and nutrients have good, and bad, effects on the functioning of the brain over time.
The MIND diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets, both of which have been found to reduce the risk of cardiovascular conditions, like hypertension, heart attack and stroke. In the latest study, the MIND diet was compared with the two other diets. People with high adherence to the DASH and Mediterranean diets also had reductions in AD — 39 percent with the DASH diet and 54 percent with the Mediterranean diet — but got negligible benefits from moderate adherence to either of the two other diets. The MIND diet is also easier to follow than the Mediterranean diet, which calls for daily consumption of fish and three to four daily servings of each of fruits and vegetables.
The MIND diet has 15 dietary components, including 10 “brain healthy food groups” — green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and wine – and five unhealthy groups that comprise red meats, butter and stick margarine, cheese, pastries and sweets, and fried or fast food.
The MIND diet includes at least three servings of whole grains, a salad and one other vegetable every day — along with a glass of wine. It also involves snacking most days on nuts and eating beans every other day or so, poultry and berries at least twice a week and fish at least once a week. Dieters must limit eating the designated unhealthy foods, especially butter (less than 1 tablespoon a day), cheese, and fried or fast food (less than a serving a week for any of the three), to have a real shot at avoiding the devastating effects of Alzheimer's disease.
Source: By Nancy Di Fiore. Rush University Medical Centre.
EXERCISE May Prevent Alzheimer’s Disease and Delay Its Progression
While the idea that exercise can prevent, delay, and manage Alzheimer’s disease is widely accepted and researched, many public health messages do not use epidemiological evidence to back this claim up.
University of British Columbia researchers from the Okanagan campus conducted a study that reviewed the current research in the field and explored how to incorporate this evidence into health promotion messages. They reviewed over 150 research papers, including seven articles about the role of exercise in preventing Alzheimer’s disease and 20 concerning symptom management through physical activity, coming to the conclusion that “regular participation in physical activity is associated with a reduced risk of developing Alzheimer’s disease. Among older adults with Alzheimer’s disease and other dementias, regular physical activity can improve performance of activities of daily living and mobility, and may improve general cognition and balance.”
The team urges public health and health promotion organizations to use this statement, which is backed up by extensive research, in their promotional materials and educational resources. Recognizing the need for more than just a statement to motivate at-risk individuals, the researchers also collaborated with the Ontario Brain Institute to create Boost Your Brain and Body Power – Physical Activity and Alzheimer’s Disease, a resource that pairs the cognitive and physical challenges of people living with dementia with examples of appropriate exercise, safety considerations, and tips to stay motivated under the guidelines of the evidence-based statement.
Walking Improves Cognitive Function in Older Adults
Vascular cognitive impairment refers to impaired brain function due to blood vessel damage in the brain, and is the second leading cause of dementia after Alzheimer’s disease.
“It is well established that regular aerobic exercise improves cardiovascular health and cerebrovascular health,” lead author Teresa Liu-Ambrose wrote, explaining that hypertension, Type 2 Diabetes, and high cholesterol can harm blood flow to the brain; the risk of developing these disorders can be decreased by engaging in moderate-intensity physical activity.
A small study conducted by the University of British Columbia suggests that a regular walking program may lessen the symptoms of vascular dementia. They found that when 38 older adults with vascular dementia were assigned to a treatment or a control group, the treatment group showed that walking at a moderate intensity for three hours a week over a six month period improved cognitive function. In addition, both groups had functional MRI scans to indicate level of brain activity, with only the treatment group showing increased activity levels. There are some limitations to the study: it had a small sample size and there could be other factors contributing to the cognitive benefits, such as previous health status and the social aspect of the exercise. But the authors are hopeful: “While more research is needed to better understand how it brings about its benefits and what factors may impact the degree of benefit observed, there is minimal negative consequence of exercising,” Liu-Ambrose stated.
Source: The Globe and Mail, May 18 2017
Drinking tea may boost cognition and ward off dementia – Singapore study suggests
Drinking tea may lower the risk of developing Alzheimer’s disease and other neurocognitive ailments, concludes a study that followed elderly adults in Singapore.
Since objectively measurable markers of tea consumption are now available, researchers at the National University of Singapore urge more efforts to examine the individual compounds in tea responsible for this effect.
The researchers, using information from the Singapore Longitudinal Aging Study — which follows healthy older adults over time — noted that 69 percent of the study’s 957 participants were regular tea drinkers. The team collected data on tea consumption from 2003 to 2005, and the rate of new dementia cases between 2006 and 2010, a period that saw 72 new diagnoses.
Tea intake was linked to higher cognitive scores and a lower risk of neurocognitive disease. Green, black and oolong tea were all equally likely to reduce that risk. Moreover, those who did get sick tended to be older, with less schooling, more heart disease and less frequent social and productive activities.
Yet the other risk factors had no influence on the link between tea and neurocognitive disease; in fact, the more tea a person drank, the stronger its protective effect. However, researchers saw that effect only in people who were regular tea drinkers both at the beginning of the study and at follow-up.
Analyzing the risks in various patient groups, the team noticed the reduced risk really only in women and in people with the APOE4 gene, a known risk factor for Alzheimer’s. These links could not be proven when analyzing the entire group, and researchers suggest future studies in order to analyze those factors in greater detail.
Source: Alzheimers News Today
Vascular Disease in 50s Begets Dementia in 70s
In one of the largest studies of its type, researchers confirm a link between midlife vascular disease and late-life dementia. As reported in the April 11 Journal of the American Medical Association, 50-year-olds with two or more vascular risk factors were almost three times more likely to have amyloid in the brain in their 70s as were those with no signs of cardiovascular disease in middle age. Researchers said that the study, led by Rebecca Gottesman at Johns Hopkins University School of Medicine, Baltimore, was impressive for the number of subjects and its prospective design. However, scientists are still unsure how vascular disease begets amyloid.
Source: Alzforum, April 14 2017
Top Researchers Believe Prevention is the Future of Alzheimer’s Research
The Alzheimer’s disease scientific community is changing its research focus from treatment to prevention, according to researchers from the University of Alabama at Birmingham (UAB).
The shift has been driven by increased insights into the mechanisms of the disease, as well as better tools to study Alzheimer’s-associated brain changes in living people.
“In my experience, Alzheimer’s disease is the most feared disease in people over 65,” said David Geldmacher, MD, the director of the Division of Memory Disorders in the Department of Neurology at the UAB. Geldmacher’s remarks were made to Bob Shepard of UAB News in an article about the University’s research efforts.
“And while it’s true that efforts to find a cure for AD [Alzheimer’s disease] have not yet proved successful, much of that fear may be misplaced, since we have learned so much about the disease in the last several decades,” he said.
According to Geldmacher, these insights suggest that prevention is a more likely scenario than a cure.
Despite what many might believe, Alzheimer’s is not an inevitable fate for those at risk; even when someone has plenty of amyloid plaque in his brain, other factors determine if he will develop Alzheimer’s.
“We focus on the reversible risk factors,” Geldmacher said. “So many people facing dementia focus on the irreversible risk factors, such as ‘I’m getting older’ or ‘My dad or mom had dementia.’ We can’t change those things, but we can change things like levels of physical activity and cholesterol counts and blood-pressure numbers.”
Numerous studies show that those factors are large contributors to Alzheimer’s development. Reducing these risk factors can have a major effect in preventing disease, according to Geldmacher.
Source: Alzheimer's News Today April 13 2017
Volunteering reduces the risk of dementia in older adults
Researchers from the University of Calgary conducted a study exploring the cognitive benefits of volunteering for seniors; volunteering, in this case, is a voluntary activity for which the individual is not paid.
The team hypothesized that volunteering would provide social, physical, and cognitive benefits to seniors. They monitored over 1000 retirees’ general and cognitive health over 5 years, performing assessments regularly. They split participants into three groups according to their level of involvement in volunteering: the first group volunteered at least one hour per week; the second group volunteered intermittently; the third group did not volunteer.
They found that people who did not volunteer were 2.4 times more likely to develop dementia than those who volunteered regularly. In addition, volunteering intermittently provided no cognitive benefits; for this group there are no differences than with the group that never volunteered. The lead researcher Dr. Yannik Griep also explained that these advantages are likely due to the fact that “volunteering brings a structure to the day… It offers social contact with people outside of the family. It provides the social status we get with a job title. It makes us feel like we’re making a meaningful contribution to society.”
The team strongly recommends volunteering in retirement as an effective, inexpensive way to reduce dementia risk that benefits the seniors as well as the wider community.
Source: University of Calgary: May 11 2017
Cognitive stimulation through a variety of new challenging activities
A majority of epidemiologic studies that have examined cognitive stimulation as a lifestyle adaptation have found slower rates of cognitive decline among those who routinely engage in more cognitively demanding tasks compared to those with a more mentally sedentary lifestyle. Many of these same studies have also shown a reduced risk for Alzheimer’s Disease (AD) and other dementias among more cognitively active persons.
Though older adults with higher level of education and occupational history of cognitively engaging jobs have a higher cognitive reserve than their less educated peers with less stimulating jobs, one major epidemiologic study found that frequency of recent cognitive leisure activity had a stronger link to AD risk than either education or occupational level. Based on their review of recent training studies, Green and Bavelier confirm that lasting, generalized cognitive benefits are unlikely to come from brain-training regimes that focus on one type of task, and that more durable, generalized benefits may come from tasks that are complex and tap many systems in parallel. Hence daily cognitive stimulation through a variety of challenging new activities, has been recommeded as a strategy to improve cognitive functioning.
Reading, discussing, crossword puzzles, board games, learning a new sport (or a skill or a hobby such as learning to play a musical instrument, joining a theatre group or an art class, etc.) or learning a new language are all recommended as beneficial activities to stimulate the brain.
Source: Green CS, Bavelier D. Exercising your brain: a review of human brain plasticity and training-induced learning. Psychol Aging 2008;23: 692-701.
Alzheimer's disease possibly worsened by anxiety
A large study completed in Toronto, ON has focused on how anxiety might affect the development of Alzheimer’s disease. The 376 participants were assessed and those who were determined to have mild anxiety were at a 33% higher risk of getting Alzheimer’s disease than someone without the condition.
In addition, participants with anxiety at a severe level were as much as 135% more likely to get Alzheimer’s disease. Researchers believe this is because of a hormone that the body makes in response to stress, which can damage the area of the brain that controls memory.
The results of this study suggest that stress relief is a preventative measure against dementia. It is also mentioned that decreasing stress by making lifestyle changes could be more beneficial for some people than reducing stress with anti-anxiety medications. It is important to recognize that anxiety can also be a symptom of dementia, not just a factor that causes the disease. This has been supported by other scientists across Canada who have recognized the importance of the subject as a whole as well as the results of this particular study.
SOURCE: The Globe & Mail, Adriana Barton, November 13, 2014
A life of cognitive enrichment may fend off dementia
A paper published in June 23 JAMA Neurology by Clifford Jack’s group at the Mayo Clinic in Rochester, Minnesota reports that a life filled with intellectual enrichment delays the onset of cognitive impairment by several years. Another study published on June 18 in the Journal of Neuroscience linked a cognitively stimulating life to lower beta amyloid accumulation in the brain, at least in people who carry the ApoE4 allele. How cognitive exercises protect the brain is still up for debate. However, both studies support the idea that those who make lifelong contributions to their cerebral nest egg could reap the benefits in old age.
The researchers suggest that for people with average levels of education and occupation—such as a high school graduate who worked in a sales job—taking part in cognitively stimulating activities in mid- to late life could delay the onset of cognitive impairment by more than seven years. For those carrying the ApoE4 allele, the predicted delay was more than three years.
According to other researchers, lifetime enrichment staves off cognitive impairment by boosting the person’s overall level of cognitive performance. Lifetime intellectual enrichment builds up cognitive reserve -it may not change the underlying pathology, but the cognitive reserve could decrease your sensitivity to it.
Whether cognitive enrichment staves off dementia by boosting reserve, reinforcing synaptic networks, fighting on the front lines of the beta amyloid battle (or all of the above), researchers agree on at least one thing about the brain: those who don’t use it may be the first to lose it.
Sources: Vemuri P, Lesnick TG, Przybelski SA, Machulda M, Knopman DS, Mielke MM, Roberts RO, Geda YE, Rocca WA, Petersen RC, Jack CR. Association of lifetime intellectual enrichment with cognitive decline in the older population. JAMA Neurology. 2014 Jun 23.
La Rue, A. Healthy brain aging: Role of cognitive reserve, cognitive stimulation and cognitive exercises. In A. K. Desai (Ed.), The healthy aging brain: Evidence based methods to preserve brain function and prevent dementia, Clinics in Geriatric Medicine, 2010, 26, 99–111.
Vitamin D deficiency linked to increased risk of dementia
Low levels of Vitamin D has been linked to substantially increased risk of all types of dementia, including Alzheimer’s Disease, according to a study published in the American Academy of Neurology Journal published in August 2014.
It is suggested that Vitamin D deficiency increases the risk of dementia through neurodegenerative and vascular mechanisms. Vitamin D may be neuroprotective and Vitamin D level of 50nmole/L is suggested as the optimum level. Levels below 25-50 nmole/L are associated with significant risk of dementia.
Source: Vitamin D and the risk of dementia and Alzheimer’s Disease (Thomas J.Littlejohns, William E.Henley, Ian A.Lang.et.al) American Academy of Neurology Journal August 2014
Exposure to pesticides
Exposure to dichlorodiphenyltrichloroethane (DDT) may heighten the risk of developing Alzheimer’s disease, according to a small study published in the January 27 JAMA Neurology online. Researchers led by Jason Richardson at Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey, found that older adults with high levels of a DDT metabolite in their blood were four times more likely to have AD than were those with low levels. This resembles the risk conferred by ApoE4, the main genetic risk factor for sporadic AD. Moreover, the authors report that adding DDT to a neuronal cell line increased amyloid precursor protein levels, hinting that the chemical might directly contribute to pathogenesis.
If these findings are confirmed by larger studies, they could have implications for the use of DDT worldwide. Though the chemical has been banned in the United States since 1972, many countries still use it, and the World Health Organization recommends it to combat malaria.
Sleep issues and dementia
As people get older, particularly those living with Alzheimer’s disease, getting a good night's sleep may become increasing difficult. Researchers at the Beth Israel Deaconess Medical Center, University of Toronto and Sunnybrook believe changes in the brain may be the cause.
After analyzing data from almost 1,000 participants and 45 brain samples from the Rush Memory and Aging Project, researchers found a relationship between sleep issues, deteriorated brain neurons, a person’s age and an Alzheimer’s disease diagnosis. Researchers found that elderly subjects and those with Alzheimer’s disease had less inhibitory neurons called ventrolateral preoptic neurons, and that these subjects also experienced more fragmented sleep. The relationship between sleep impairment and neuron loss was found to be strongest with study subjects who had Alzheimer’s disease.
Researchers believe these findings explain why seniors may be experiencing sleeping issues, and that the relationship between these neurons, age, and an Alzheimer’s disease diagnosis can be used to develop therapies to reduce sleep problems in the future. At the same time, researchers noted that it is not yet clear whether sleep problems are the cause of dementia, or just the effect of dementia, and more research is required in that direction.
Learning a new language could have positive effects on your memory
A study completed at Northwestern University in Chicago, IL has investigated the memories of people who are bilingual versus those that speak a single language. The testing involved having participants remember a particular word after other similar words and pictures were presented. The expectation was that bilingual participants would perform better on the memory tests because they mimic the constant process of remembering a correct word against others that occurs in the brain when someone knows multiple languages.
The results of the study are as expected, but also reveal that there are important memory benefits from simply knowing a language (without being fluent). This encourages people to try learning a new language, even partially, to benefit brain health. The researchers of this study suggest that this is can be a prevention method against Alzheimer’s disease.
SOURCE: Panorama Am, AUTHOR: Panorama Am, November 15, 2014
Physical exercise on brain health
Physical exercise has been shown to benefit not only physical health but also brain health. Several studies have documented a significantly reduced risk of dementia and mild cognitive impairment in later years associated with midlife exercise. Among patients with dementia or mild cognitive impairment, randomized controlled trials (RCTs) documented better cognitive scores after 6 to 12 months of exercise compared with sedentary controls. Meta-analyses of RCTs of aerobic exercise in healthy adults were also associated with significantly higher cognitive scores. One year of aerobic exercise in a large RCT of seniors was associated with significantly larger hippocampal volumes and better spatial memory; other RCTs in seniors documented diminution of age-related gray matter volume loss with aerobic exercise. Besides a neuro-protective effect, physical exercise may also attenuate cognitive decline via reduction of cerebrovascular risk, including the contribution of small vessel disease to dementia.
Source: J. Eric Ahlskog, PhD, MD; Yonas E. Geda, MD, MSc; Neill R. Graff-Radford, MBBCh, FRCP, and Ronald C. Petersen, PhD, MD; Physical Exercise as a Preventive or Disease-Modifying Treatment of Dementia and Brain Aging; September 2011
Stress reduction and active relaxation
It is now well-documented that exposure to unavoidable and unpredictable stress in adulthood can have profound effects on brain and behavior. Evidence from human and animal studies indicates that stress interferes with subsequent performances on a variety of hippocampal-dependent memory tasks.
Animal studies and recent studies on post-traumatic stress disorder (PTSD) have shown that persistent and long-term stress can actually cause shrinkage of both right and left hippocampus. Since the hippocampus is involved with formation and organization of new memories and learning, its shrinkage can contribute to cognitive decline. Several causes have been suggested including an increase in cortisol, with its adverse effect on new learning, a decrease in Brain-Derived Neurotrophic Factor (BDNF), and /or elevated glutamate levels and inhibition of neurogenesis. By reducing the harmful effects of stress on your body, you improve your brain health and may reduce your risk of developing Alzheimer’s disease.
Activities such as Tai-chi, meditation, deep breathing exercises, music therapy and art therapy are beneficial for stress reduction and active relaxation. The key is to explore a variety of techniques and find those that help you manage stress.
Sources: Dr. Bremner, Douglas, J. (2006) Traumatic Stress and Effects on the brain, in Dialogues in Clinical Neuroscience. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181836/
Healthy lifestyle and brain health
A nutritious meal plan, regular exercise and other behaviors boost mental acuity, according to early results from a 1,260-person study reported at the Alzheimer’s Association International Conference in Copenhagen, Denmark, July 12-17. Miia Kivipelto of the Karolinska Institutet in Stockholm presented the first data out of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability. The FINGER study is a randomized controlled trial that showed a multipart lifestyle intervention improved cognitive scores and, by inference, perhaps curtailed the risk of future Alzheimer’s disease.
The two-year intervention period ended earlier this year and the researchers have calculated their primary outcome measure, a composite score from the standard Neuropsychological Test Battery (NTB). Scores in the intervention group were about 40 percent higher than those in the control segment, according to the researchers. Specifically, people in the arm with the intensive modifications performed better on tests of memory, executive function, and speed of thought. Additionally, vascular risk factors declined among the intervention group, indicating that their likelihood of future dementia also diminished.