Nearly 1 in 10 Americans over the age of 65 have dementia, and as the U.S. struggles with an aging population, the proportion of elderly people with Alzheimer’s and other neurodegenerative diseases is bound to increase. But in the Amazon basin, where some indigenous people still employ a subsistence lifestyle as they have for hundreds of years isolated from industrialized society, the rate of dementia hovers at around just 1%. These findings, reported by a new study from the University of South California, suggest that the Western lifestyle may be seriously putting people at risk of dementia in old age.
“Something about the pre-industrial subsistence lifestyle appears to protect older Tsimane and Moseten from dementia,” said Margaret Gatz, the lead study author and professor of psychology, gerontology and preventive medicine at the University of South California.
Gatz and colleagues traveled to the Bolivian Amazon jungle, where they closely studied the elderly of the Tsimane’ and Mosetén tribes — two indigenous peoples that have remained largely isolated from urban life elsewhere in the country.
The Tsimane’ number about 16,000 people living in mostly riverbank villages scattered across about 3,000 square miles of the Amazon jungle. They are forager-farmers who fish, hunt, and cut down trees with machetes, which keeps everyone very physically active throughout their lifetimes.
The neighboring Mosetén, which number around 3,000 and have close cultural ties with the Tsimane’, also reside in rural villages and rely on subsistence agricultural work. However, they live closer to towns, have schools, and access to health posts, as well as access to roads and electricity. Within the last decade, the Mosetén have also received cell phone service and running water.
Researchers employed computer tomography (CT) brain scans, cognitive and neurological tests, and questionnaires to assess the mental health among the Tsimane’ and Mosetén aged 60 and over.
According to the results, the study found just 5 cases of dementia among 435 Tsimane’ and one case among 169 Mosetén, which is much less than the rate of incidence in Western countries. Previously, studies of indigenous populations in Australia, North America, Guam, and Brazil found dementia prevalence ranging from 0.5% to 20%. The authors note that the apparent higher rate of dementia among older adults from indigenous tribes elsewhere in the world could be due to their higher contact with their industrialized neighbors, and subsequent adoption of more sedentary lifestyles.
In the same over-60 groups, the researchers also diagnosed about 8% of elderly Tsimane’ and 10% of Mosetén with mild cognitive impairment (MCI) — the stage between the expected cognitive decline of normal aging and the more serious decline of dementia. This condition is characterized by memory loss and a decline in cognitive abilities, such as language and spatial reasoning. The MCI rates were comparable to those encountered in high-income countries.
In high-income countries with high rates of dementia among older adults, the population generally does not engage in the recommended amount of physical activity and has a diet rich in sugars and fats. As a result, older adults are more susceptible to heart disease and brain aging. In contrast, the Tsimane’ people have unusually healthy hearts for their age. That’s not surprising considering they also have the lowest prevalence of coronary atherosclerosis of any population in the world.
Alzheimer’s has been previously associated with hypertension, diabetes, cardiovascular diseases, physical inactivity, and even air pollution. It’s no coincidence that these chronic diseases and health problems are staples of modern Western lifestyles.
In 2021, the same team from the University of South California found that the Tsimane indigenous people of the Bolivian Amazon experience less brain atrophy than their American and European peers. Their decrease in brain volume happened at a rate that was 70% lower than in Western populations.
“We’re in a race for solutions to the growing prevalence of Alzheimer’s disease and related dementias,” said Hillard Kaplan, a study co-author and professor of health economics and anthropology at Chapman University who has studied the Tsimane for two decades. “Looking at these diverse populations augments and accelerates our understanding of these diseases and generates new insights.”
If the Tsimane’ and Mosetén offer any indication, a pre-industrial lifestyle can offer significant protection against dementia. But that doesn’t mean we can all revert to foraging in the woods and living under the stars. In case someone is romanticizing life in the Amazon jungle, bear in mind that the Tsimane’ have an average of nine children per family who live an average of just over 50 years compared to the world average of 71.5 years. So while it may be true that indigenous Amazon people rarely suffer from dementia at old age, what’s certain is that even fewer actually make it that far.
The findings were published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.
Regular use of word and number puzzles may help keep our brains working better for longer. According to a pair of studies, adults aged 50 and over who are in the habit of solving crosswords and Sudoku scored much higher on cognitive tests, such as those that assess problem-solving and memory, than those who didn’t. In some instances, the differences were quite dramatic: people who regularly do puzzles had the cognitive abilities of those eight years younger, on average, compared to those who didn’t.
Researchers led by Dr. Anne Corbett of the University of Exeter Medical School surveyed participants in the PROTECT study, a large online cohort of over 22,000 older adults between the ages of 50 and 96, about how frequently they engage in word and number puzzles. The participants then had to undertake a battery of cognitive tests whose results are supposed to measure age-related changes in brain function. These include tasks that assess attention, reasoning, and memory. The results were striking.
Those who engage in crosswords had a brain function equivalent to ten years younger than their biological age on tests assessing grammatical reasoning and eight years younger than their age on tests measuring short-term memory.
“The improvements are particularly clear in the speed and accuracy of their performance. In some areas the improvement was quite dramatic — on measures of problem-solving, people who regularly do these puzzles performed equivalent to an average of eight years younger compared to those who don’t. We can’t say that playing these puzzles necessarily reduces the risk of dementia in later life but this research supports previous findings that indicate regular use of word and number puzzles helps keep our brains working better for longer,” Corbett said in a statement.
PROTECT is designed as a 25-year study and participants are followed-up yearly to assess how their brain ages and what lifestyle choices might influence the risk of dementia later in life. Despite tremendous progress, we still know little about how the brain ages or what causes debilitating neurodegenerative diseases like Alzheimer’s or Parkinson’s. PROTECT may offer exciting research opportunities in the year to come.
The two studies published in the International Journal of Geriatric Psychiatry don’t necessarily conclude that solving puzzles will necessarily reduce the risk of dementia and keep your brain sharper. The findings are observational and it could just be that people who have a natural ability to preserve their brain function with age also have a tendency to use word and numbers puzzles. In other words, the study established a correlation but did not define causation.
However, the findings are consistent with previous studies. A 2011 experiment with participants from the Bronx Aging Study found regularly solving crosswords is associated with a delay in the onset of cognitive decline. Other studies came to totally different conclusions. When Scottish researchers tested nearly 500 participants, all born in 1936, and found a tricky crossword or a challenging puzzle will not fend off age-related mental decline. However, they did note that although brain games like jigsaw puzzles may not prevent dementia, regularly challenging yourself mentally seems to improve the brain’s ability to cope with neurodegenerative disease.
“We know that what is good for the heart is good for the head, and there are other ways we can reduce our risk of developing dementia,” James Pickett, head of research at the UK’s Alzheimer’s Society, toldCNN, “by taking steps towards a healthy lifestyle, eating a balanced diet, avoiding smoking and heavy drinking, and exercising regularly.”
If you want to keep your brain healthy, paying attention to your diet is clearly shown to help, but the occasional puzzle can’t hurt either.
Although better education and access to health services in developed countries have and will keep reducing the incidence of dementia, the number of people who suffer from it worldwide will triple by 2050, according to new estimates.
New research from the Health Metrics and Evaluation at the University of Washington School of Medicine estimates that the incidence of dementia worldwide will triple by 2050, with most new cases being concentrated in sub-Saharan Africa, North Africa, and the Middle East. Smoking, high body mass index, and high blood sugar will be the leading causes of this rise, it explains, while improved living conditions in developed countries will lower overall incidence in these areas.
All in all, dementia cases by 2050 would reach more than 152 million worldwide, according to the estimates.
“Improvements in lifestyle in adults in developed countries and other places — including increasing access to education and greater attention to heart health issues — have reduced incidence in recent years, but total numbers with dementia are still going up because of the aging of the population,” said Maria C. Carrillo, Ph.D., Alzheimer’s Association chief science officer. “In addition, obesity, diabetes and sedentary lifestyles in younger people are rising quickly, and these are risk factors for dementia.”
Today, roughly 1 in every 10,000 people worldwide develops early-onset dementia, which is dementia that sets in before the age of 65. This corresponds to roughly 350,000 new cases per year globally. But its effects are not evenly distributed: even in countries such as the US, the mortality rate from Alzheimer’s (the leading cause of dementia) is highest in rural areas compared to the richer, more developed urban centers.
But it’s not a US-only problem. In order to estimate future trends in dementia onset on a country-by-country basis, the team used data from 1999 to 2019 from the Global Burden of Disease (GBD) study, which estimated health trends worldwide and aimed, in part, to improve previous forecasts by incorporating information on trends in dementia risk factors.
According to them, dementia cases will increase from an estimated 57.4 (50.4 to 65.1) million cases globally in 2019 to an estimated 152.8 (130.8 to 175.6) million cases in 2050. Sub-Saharan Africa, North Africa, and the Middle East will likely see the greatest increases. Overall, however, most of these new cases will come down to population growth and an overall higher average age. Lifestyle factors such as smoking, high body mass index (BMI), and high blood sugar will also increase the prevalence of dementia, to the tune of an estimated 6.8 million cases worldwide by 2050. However, improvements in education levels, healthcare quality, and healthcare access will mostly cancel these out, removing an estimated 6.2 million possible cases.
“These estimates will allow policymakers and decision makers to better understand the expected increases in the number of individuals with dementia as well as the drivers of these increases in a given geographical setting,” Nichols said. “The large anticipated increase in the number of individuals with dementia emphasizes the vital need for research focused on the discovery of disease-modifying treatments and effective low-cost interventions for the prevention or delay of dementia onset.”
“Without effective treatments to stop, slow or prevent Alzheimer’s and all dementia, this number will grow beyond 2050 and continue to impact individuals, caregivers, health systems and governments globally,” said Maria C. Carrillo, Ph.D., Alzheimer’s Association chief science officer. “In addition to therapeutics, it’s critical to uncover culturally-tailored interventions that reduce dementia risk through lifestyle factors like education, diet and exercise.”
With lengthening lifespans around the world, the influence of education and healthcare on the incidence of Alzheimer’s and dementia becomes ever-more powerful. The team reports that there is “an increasing discrepancy in Alzheimer’s mortality” between urban and rural areas of the US and, very likely, in other areas of the world. Lower socioeconomic status, higher average levels of chronic disease, limited availability of internet services, and less access to health services (including primary care) account for most of this difference, the team explains.
We can deduce from here that there is also a disparity in incidence between developed and developing countries from similar, if not the same, causes.
The paper “Estimating the global mortality from Alzheimer’s disease and other dementias: A new method and results from the Global Burden of Disease study 2019” has been published in the journal Alzheimer’s & Dementia.
Researchers at the University of Oxford found evidence that elderly people showing difficulty hearing spoken conversations in relatively noisy environments, such as a bustling street or pub, may face an up to 91% increased risk of dementia later in life.
According to the World Health Organization (WHO), up to 1.5 billion individuals suffer from some form of hearing impairment. Approximately 30 percent of adults aged 65 and older, and 55 percent older than 80 years show some degree of hearing loss. Besides affecting their quality of life, this disability may also contribute to the risk of dementia.
In a 2015 study, researchers at Johns Hopkins found that mild hearing loss doubled dementia risk and moderate loss tripled the risk. People with a severe hearing impairment were five times more likely to develop dementia.
“Brain scans show us that hearing loss may contribute to a faster rate of atrophy in the brain,” said Frank Lin, the director of the Cochlear Center for Hearing and Public Health at Johns Hopkins . “Hearing loss also contributes to social isolation. You may not want to be with people as much, and when you are you may not engage in conversation as much. These factors may contribute to dementia.”
Although the exact association between hearing loss and dementia is unclear, emerging research suggests that poor hearing may impact memory care drastically in the coming years.
A hallmark of hearing impairment is difficulty understanding speech in noisy environments, which scientists refer to as speech-in-noise hearing impairment. However, up until very recently, it was unclear if this particular facet of hearing impairment was associated with developing dementia. Turns out it is, according to researchers at the University of Oxford’s Nuffield Department of Population Health.
“Difficulty hearing speech in background noise is one of the most common problems for people with age-related hearing impairment. This is the first study to investigate its association with dementia in a large population,” said Dr. Jonathan Stevenson, lead author of the new study.
Stevenson and colleagues surveyed 82,000 men and women aged 60 years or older who enrolled in the UK Biobank program. The participants had to identify certain spoken words against a background of white noise. Based on their scores, they were divided into three distinct groups: normal, insufficient, and poor speech-in-noise hearing.
Over 11 years of follow-up, 1,285 participants developed or were in the course of developing dementia. When the researchers modeled their hearing loss scores and adjusted for other factors, they were stunned to find insufficient and poor speech-in-noise hearing were associated with a 61% and 91% increased risk of developing dementia, compared to normal speech-in-noise hearing, respectively.
In order to explain how hearing impairment may lead to dementia, some have suggested that hearing impairment could lead to social isolation and depression, and it is these factors that actually later contribute to dementia. However, this new research found no such evidence.
“While most people think of memory problems when we hear the word dementia, this is far from the whole story. Many people with dementia will experience difficultly following speech in a noisy environment – a symptom sometimes called the ‘cocktail party problem’. This study suggests that these hearing changes may not just be a symptom of dementia, but a risk factor that could potentially be treated,” Dr. Katy Stubbs from Alzheimer’s Research UK said in a statement.
The good news is that speech-in-noise hearing impairment is very easy to diagnose, so it could provide people with an early warning sign that dementia may be looming. Although there is no cure for dementia, it can be postponed and managed as long as precautions are taken years in advance.
“Dementia affects millions of individuals worldwide, with the number of cases projected to treble in the next few decades. However, there is growing evidence that developing dementia is not inevitable and that the risk could be reduced by treating pre-existing conditions. Whilst preliminary, these results suggest speech-in-noise hearing impairment could represent a promising target for dementia prevention,” said Dr. Thomas Littlejohns, senior epidemiologist in the Nuffield Department of Population Health(NDPH), and senior author of the study.
The findings appeared in the journal Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association..
A coffee each morning can work as a quick pick-me-up. But don’t go overboard, researchers from the University of South Australia warn, as it could negatively impact your brain’s health.
One of the largest studies of its kind reports that high coffee consumption is associated with an increased risk of dementia and smaller total brain volumes. The study included data from 17,702 UK Biobank participants aged 37-73, finding that those who drank six or more cups of coffee per day had a 53% increased risk of dementia, and showed reduced volumes in their overall brains, white matter, gray matter, and their hippocampus.
“Coffee is among the most popular drinks in the world. Yet with global consumption being more than nine billion kilograms a year, it’s critical that we understand any potential health implications,” says Kitty Pham, lead researcher on the paper and a Ph.D. candidate at the University of South Australia (UniSA). “This is the most extensive investigation into the connections between coffee, brain volume measurements, the risks of dementia, and the risks of stroke—it’s also the largest study to consider volumetric brain imaging data and a wide range of confounding factors.
“Accounting for all possible permutations, we consistently found that higher coffee consumption was significantly associated with reduced brain volume—essentially, drinking more than six cups of coffee a day may be putting you at risk of brain diseases such as dementia and stroke.”
Although I personally know nobody who actually drinks six or more cups of coffee a day, there are certainly a few out there. As such, the findings could be quite important for public health, pointing to a source of preventable brain damage, including stroke and dementia.
Dementia affects about 50 million people worldwide, affecting an individual’s ability to think, their memory, impacting their behavior, and their ability to perform even everyday tasks. It’s a degenerative brain condition and a sizeable cause of death worldwide.
Strokes involve the disruption of blood flow to the brain, usually through blood clots or the rupturing of blood vessels, and end up starving areas of the brain of oxygen. This, in turn, leads to (usually significant) brain damage and loss of function. They’re surprisingly common, affecting one in four adults over the age of 25 worldwide.
The team explains that the exact mechanism through which excessive caffeine can impact brain health is not yet known but these results — along with previous research on the topic — make a strong argument that it does have such an effect. Still, this doesn’t mean you have to put your cup down for good. Moderation is the name of the game, the team explains.
“This research provides vital insights about heavy coffee consumption and brain health, but as with many things in life, moderation is the key,” says Professor Elina Hyppönen, senior investigator and Director of UniSA’s Australian Centre for Precision Health.
“Together with other genetic evidence and a randomized controlled trial, these data strongly suggest that high coffee consumption can adversely affect brain health. While the exact mechanisms are not known, one simple thing we can do is to keep hydrated and remember to drink a bit of water alongside that cup of coffee.
People typically consume between one and two cups of coffee per day, the team adds, which is not a very accurate measure, as cups are quite variable. Still, such low levels of intake should be fine. As long as you’re not closing in on five of six cups a day, they conclude, you should be safe.
The paper “High coffee consumption, brain volume and risk of dementia and stroke” has been published in the journal Nutritional Neuroscience.
Researchers found that improving vascular health in people aged 50 or older could also have benefits for the brain. According to an exciting new study, patients who underwent intense treatment for hypertension were less likely to develop minor cognitive and memory problems — the kind that often progresses into dementia at old age — than patients who received standard care.
The research was part of a broader cardiovascular study called Sprint, which began in 2010 and involved more than 9,000 people with hypertension across 102 sites in the United States. High blood pressure, also called hypertension, is dangerous because it makes the heart work harder to pump blood out to the body. The condition is diagnosed when a person has a systolic blood pressure between 130 and 180 and, if left unchecked, can lead to hardening of the arteries, stroke, heart failure, and other medical problems
The main goal of Sprint was to see whether people who received intensive treatment that lowered their blood pressure to 120 were doing significantly better than those who received standard treatment which lowered their blood pressure to around 140. These participants were also cognitively assessed.
In the three years following the study, those who had blood pressure below 120 were 19% less likely to develop mild cognitive impairment than those who received standard care. Additionally, blood pressure treatments significantly lowered the risk of stroke and death, as reported in the Journal of the American Medical Association (JAMA).
Dementia is the loss of cognitive functioning — thinking, remembering, and reasoning — and behavioral abilities to such an extent that it interferes with a person’s quality of life. One of the most important diseases that cause dementia is Alzheimer’s, which affects 6 million Americans.
There is no cure for Alzheimer’s but since the disease is preceded by mild cognitive impairment, the new findings suggest that keeping blood pressure in optimal parameters might stave off dementia or at least delay it considerably. Researchers might know for sure in future studies that follow patients who have received blood pressure treatment for a longer time.
Until then, patients with blood pressure over 130 shouldn’t hurry to talk to their doctors about lowering it even further. There is still much we need to find out about how results differ by age and the side effects. But, since the results have been so promising, the Alzheimer’s Association announced that it will award more than $800,000 to support a follow-up trial. In 2019, another research team found convincing evidence that gum disease may be gradually causing Alzheimer’s.
If you were to travel 40 years into the past, you’d rarely see people talk about dementia. It was often regarded as a fact of life — instances of incapacity and memory loss were usually considered as a normal part of aging for which ‘nothing’ could be done. Today, things are different and that’s just not good enough.
As the stigma associated with mental illnesses is slowly challenged, increased awareness and interest from health services have brought dementia more and more into the spotlight, which is an important driver for finding new ways of treating and dealing with dementia.
The fatalistic view that surrounds dementia
The way society thinks about a disease is pretty important. When you think there is no cure for it, what’s the point in doing something about it? That’s an unfortunate way of looking at things, which can have significant repercussions in the long run.
Although there is no technical cure for dementia, that doesn’t mean there is no way to prevent or manage this disease. Better diet, enhanced cardiovascular health and better educational qualifications are all good options to reduce your risk of dementia. Having an overall healthy lifestyle is generally the best way to go about it.
Other scientific findings suggest that the prevalence of dementia can be indicative of public health in general. Though we don’t know the impact of all the involved factors, studying the impact of physical inactivity, obesity and diabetes on dementia would well give us a point towards a certain direction. Research has shown that diabetes can increase the risk of developing both Alzheimer’s disease and vascular dementia, and the two are often interrelated.
Although dementia awareness is moving into a generally positive direction, we should also be careful and consider the devastating consequences of this disease and the dire need of assisted care till the end of life. People are living longer than ever, and as a result, the rates of dementia are also increasing. No matter what the figures may suggest about declining figures of dementia prevalence, it is certainly true that dementia is on the rise as there will be a large number of older people suffering from it in the near future.
What Causes Dementia – The Science
The exact mechanisms of dementia still hold some secrets, but researchers have a pretty good idea of how it works. Toxic levels of urea inside the brain are mainly responsible for damaging the parts of the brain which leads to dementia — a neurodegenerative disorder that causes cognitive impairment.
Urea is a by-product of protein metabolism that is produced within the liver in order to filter ammonia from the human body. It is excreted from the body in the form of urine after it is filtered by kidneys.
However, the causes of dementia are much more varied, and include things such as vascular impairment, Parkinson’s disease, and most commonly, Alzheimer’s. But that’s hardly all.
According to a study recently published by scientists from Australia, UK, US, and New Zealand, Huntington’s disease is one of the 7 major forms of dementia that is associated with aging. This disease has got a direct link to the human brain’s urea levels and also the metabolic processes. In fact, there was another study in 2016 that linked urea with the development of Alzheimer’s.
However, scientists also added that there is way more research needed to have a clear idea on the way the urea levels elevate. The present study was done on the brains of human beings that were generously donated by families for medical reasons, as well as on the brains of sheep that were modified genetically. The study included scientists from the University of Auckland, Manchester, New Zealand, and the South Australian Research and Development Institute.
Dementia is a killer
There’s currently no cure for vascular dementia. There is also no way to reverse any damage that occurred before the treatment commenced — but there is a treatment. Sometimes, the treatment can be effective at slowing down the damage and tackling the underlying cause of dementia.
Nevertheless, dementia is a killer.
Both directly and indirectly, dementia can claim lives. Since it is essentially a degeneration in the cerebral cortex, the part of the brain responsible for thoughts, memories, actions, and personality, it can cause numerous cascading issues down the road.
Migraines are also connected
Recent research has also found that migraines are an important risk factor for dementia. Multiple reports from different sources have said that migraine attacks are one of the main issues for Americans, Brits, and Australians but the long term impact on this health condition is still unknown. There are several results that show that focusing attention to migraines in dementia and Alzheimer’s is warranted to get a full clear idea about what migraine is and how it sets the stage for dementia if it is not treated in the long run.
A survey involving 680 seniors who didn’t have any past experience of cognitive issues asked them about their history of migraines. More than half of the respondents of the survey were women and their average age was 76. After they were tracked for 5 years, researchers found that 55 among them developed dementia. If other factors like age and education were taken into account, those who had Alzheimer’s and dementia were 5 times more likely to have experienced migraine attacks.
On the other hand, people with a history of migraines were thrice more likely to develop a kind of dementia and more than 4 times more likely to develop Alzheimer’s, which is one of the biggest causes of dementia. Moreover, the reason that was figured out for linking dementia with migraine attacks were poor lifestyle decisions, not spending an active life and not following a healthy diet. These are already known reasons for aggravating dementia risk.
Scientists need more research to conclude whether or not the disruption in various lifestyle factors like diet, exercising, and mental stimulation also plays a pivotal role in raising the risk of dementia. Not taking proper care of cardiovascular health is yet another reason that can heighten the chances of dementia in the long run.
Effective treatments for dementia – Is it possible to find a cure?
Researchers, from all over the globe, are all working together to develop the most effective treatments that could treat dementia, if not to find out a proper cure.
Currently, there is no potential cure for Alzheimer’s disease. But the medicines that are available now can not only improve the quality of life but also stop the progress of dementia. In the following part of this post, we’ll discuss the few treatments that are associated with Alzheimer’s disease.
#1: Immunotherapy and Alzheimer’s vaccine
Researchers have been trying hard for more than a decade to develop an effective vaccine that could prevent Alzheimer’s disease. As long as immunotherapy is concerned, the strategy behind this is to utilize the immune system of the body to destroy beta-amyloid plaques. An approach to developing a vaccine is by utilizing immunoglobulin which consists of antibodies. This has been shown to be successful among people who had mild Alzheimer’s disease, in the earlier stages of the condition. Though this trial can be deemed to be too small, it suggests that immunoglobulin therapy may have safety benefits over other techniques of vaccination.
No, there is still no medicine that could cure dementia but there are definitely some that might help a patient with treating some symptoms for some time. Doctors might recommend other medicines to treat issues brought in by dementia, such as insomnia, depression or extreme irritation without any reason. A physician might recommend:
Memantine controls a chemical in the brain that is required for memory and learning. They often combine it with donepezil for treating moderate to severe dementia.
Anxiolyticslike Ativan or Serax can ease off restlessness and anxiety
Antidepressants, particularly selective serotonin reuptake inhibitors can reduce irritability and bad mood issues
Antipsychotic medicines like Abilify, Haldol, Risperdal, Zyprexa can exert control on behaviors and feelings like agitation, aggression, hallucinations, and delusions.
#3: Therapeutic treatments
The therapeutic approaches can jolt your ailing family member’s memory and improve their thinking abilities. The therapies usually make sure that anything that they try will keep them from feeling frustrated or overwhelmed.
Reminisce therapy: This includes speaking with your family members and friends about your school days, hometown, favorite hobbies, and pleasant memories from work life. This therapy can both be done one-on-one or in a group.
Cognitive stimulation therapy: CST is a rather structured program that helps people who are suffering from the mild-to-moderate stage of dementia. The therapist engages you in activities, like speaking on current events, singing songs, cooking by looking at a recipe, playing word games or crossword puzzles.
Reality orientation training: This therapy deals with basic information like the person’s name, the time and date of the day. There are few patients that find this therapy to be too very patronizing. In case you see this method to not work on your loved one, don’t force it on him.
Reverse memory loss – Few changes to bring about in your daily life
You can’t remember where you kept your car keys? Did you just forget what you had to buy from the grocery store? You can’t remember the name of your physical trainer whom you spoke to three days back at the gym? If yes, you’re not alone. While everyone forgets things at times yet memory loss shouldn’t be taken too lightly especially when it is linked with dementia.
Don’t forget to include physical activity in your routine
Physical activity boosts blood flow to your entire body and brain and this keeps your memory sharp. The Department of Health and Human Services advise you to spend at least 150 minutes in a week in some form of activity like brisk walking, aerobic activity, jogging or 75 minutes of vigorous activity. If you’re too busy and you don’t have time for a full session of workout, you should take out 10 minutes for walking every day.
Socialize and stay in touch with people
Just as we all know that social interaction is something that wards of stress and depression, it can also work wonders in curing memory loss. Watch out for opportunities to socialize with your friends, loved ones and others. Stay away from living alone as they say, ‘an idle mind is a devil’s workshop.’
Try to stay mentally active
Physical activity helps your body stay in shape, but there are other mentally stimulating tasks that can also keep your brain in proper shape and help you reverse memory loss. You can play card games like bridge or crossword puzzles. While driving to a destination, take alternate routes so that you can tax your brain in finding new ways. Volunteer at a school organization and community.
Stay organized and systematic
When your home is cluttered, you’ll most likely forget things more than what you would have if your home was organized. You have to bring about a slight change in your lifestyle by getting systematic with things so that you keep yourself from forgetting. If you have appointments, note them down, write down a to-do list every morning or use an electronic planner that can remind you things. Tick off the items that you’ve already completed and try to keep your to-do lists current.
Opt for a healthy diet
This is not the first time we’re talking about the benefits of a healthy diet, and it’s no coincidence. While it is definitely good for your physical health, it is equally good for your mental health. Try and choose low-fat sources of protein like beans, fish and skinless poultry. Don’t drink too much alcohol as this can lead to memory loss.
Dementia is on the rise in many countries all over the globe — taking steps to reduce its risk is crucial. The sooner you start, the more effective it is.
Lifestyle choices can help reduce an individual’s genetic risk of dementia, a new paper reports.
Image credits Matan Ray Vizel.
New research led by researchers from the University of Exeter found that people with a high genetic risk of dementia has a 32% lower risk of developing the syndrome if they followed a healthy lifestyle, compared with their counterparts who had an unhealthy lifestyle. Participants with high genetic risk and an unfavourable lifestyle were almost three times more likely to develop dementia than those with a low genetic risk and a favourable lifestyle (a 2.83 increased occurrence of dementia from any cause).
Do good, be good
“This research delivers a really important message that undermines a fatalistic view of dementia,” says co-lead author Dr. David Llewellyn, from the University of Exeter Medical School and the Alan Turing Institute.
“Some people believe it’s inevitable they’ll develop dementia because of their genetics. However it appears that you may be able to substantially reduce your dementia risk by living a healthy lifestyle.”
The team worked with data from 196,383 adults of European ancestry aged 60 and older from UK Biobank. Out of this sample, the team identified 1,769 cases of dementia over the follow-up period of eight years. They then grouped all participants into three groups: those with high, intermediate, and low genetic risk for dementia.
“Our findings are exciting as they show that we can take action to try to offset our genetic risk for dementia,” says Joint lead author Dr Elzbieta Kuzma. “Sticking to a healthy lifestyle was associated with a reduced risk of dementia, regardless of the genetic risk.”
In order to assess genetic risk for dementia, the team looked at previous research to identify all currently-known genetic risk factors for Alzheimer’s disease. Each genetic risk factor was weighted according to the strength of its association with the disease.
To assess lifestyle, the team defined three groups based on their self-reported diet, physical activity, smoking, and alcohol consumption: favorable, intermediate, and unfavorable. People who didn’t currently smoke, engaged in regular physical activity, had a healthy diet, and only had moderate levels of alcohol intake were considered to be part of the ‘favorable’ group. A healthy lifestyle was associated with a reduced risk of dementia across all the genetic risk groups.
The paper “Association of Lifestyle and Genetic Risk With Incidence of Dementia” has been published in the journal JAMA
Researchers successfully tested a vaccine that targets a protein that builds up in the brains of people affected by Alzheimer’s. The vaccine has so far been tested only a mice but the researchers hope that their highly positive results will help them receive fundings for a clinical trial involving humans soon.
Finally, a vaccine for Alzheimer’s disease?
After a certain age, the human brain starts to shrink considerably but surprisingly, not too many neurons die in the process. In the Alzheimer’s diseased brain, however, many neurons stop functioning, lose connections with other neurons, and eventually die. The progressive disorder is the main cause of dementia and affects a third of senior citizens, or roughly 43 million people worldwide.
In the early stage, the damage is confined to the entorhinal cortex and hippocampus, two areas associated with memory, navigation, and perception of time. This sort of degeneration leads to memory loss and disorientation associated with the condition — though it has to be noted that Alzheimer’s starts damaging brain cells well before the first symptoms kick in.
Alzheimer’s disease is widely believed to be caused by the accumulation of beta-amyloid proteins which clump together to form plaques between neurons and disrupt cell function. Another physical characteristic of the Alzheimer’s diseased brain is the buildup of tau proteins, which tangle inside neurons, blocking their transport system.
Since 2013, researchers at the University of New Mexico (UNM) led by Dr. Kiran Bhaskar have been working on a vaccine that targets tau proteins, in the hope that it might prevent the progression of Alzheimer’s.
The vaccine was used on a group of mice that had Alzheimer’s-like symptoms. The vaccine’s antibodies seem to have cleared out pathological tau which tangles the brains of patients with Alzheimers’ disease. This response lasted for months, the researchers reported in the journal NPJ Vaccines.
Tau proteins are normally a stabilizing structure in the brain — it’s the long tangles that disrupt the ability of neurons to communicate with one another.
“We’re excited by these findings, because they seem to suggest that we can use the body’s own immune system to make antibodies against these tangles,” said Nicole Maphis, a Ph.D. candidate in UNM’s Biomedical Sciences Graduate Program.
In order to determine the vaccine’s efficacy, the researchers had mice go through maze-like tests. The rodents that received the vaccine were significantly better at navigating the mazes than those that didn’t receive the vaccine.
Scientists had also used monkeys and rabbits in their testing and hope to soon to validate the vaccine on humans if they receive enough funding. It’s common for drugs that work on mice or other animals not to have the same effect in humans, so a healthy dose of skepticism is advised.
“We have to make sure that we have a clinical version of the vaccine so that we can test in people,” Bhaskar said.
Dementia refers to the decline in mental ability that is severe enough to impair a person’s ability to perform everyday activities. It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Around 50 million people worldwide have dementia with Alzheimer’s disease as the most common type. And every year brings 10 million new cases, says the report recently released by the World Health Organization (WHO).
“In the next 30 years, the number of people with dementia is expected to triple,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “We need to do everything we can to reduce our risk of dementia. The scientific evidence gathered for these guidelines confirms what we have suspected for some time, that what is good for our heart, is also good for our brain.”
Age is a risk factor so the older you are, the more likely you are to develop dementia. Certain genetic factors are involved with some more unusual forms of dementia — for the most part, dementia develops as a combination of genetic and “environmental” factors (i.e. smoking, lack of regular exercise). Although age is the top risk factor, “dementia is not a natural or inevitable consequence of aging,” the report says.
The report outlined what in WHO’s expert opinion think will and won’t help reduce the risk of dementia. So, if you want to save your brain, here are the do’s and don’ts from the new WHO guidelines for preventing dementia.
Exercise. The role of exercise is especially important. A physically active lifestyle is linked to brain health. A recent study of more than 1,600 people over age 65 found that those who spent more time sitting had the same risk of developing dementia as people who carry a genetic mutation that puts them at higher risk of Alzheimer’s. Weight loss could indirectly reduce the risk of dementia by improving a variety of metabolic factors linked with cognitive impairment and dementia (i.e. glucose tolerance, insulin sensitivity, blood pressure, oxidative stress, and inflammation).
Continue Learning. You’ve heard the saying: “use it or lose it.” Studies show that those who utilize their brains more by learning a new language or musical instrument, or furthering their education tend to have lower rates of dementia and problems with their thinking later in life.
Eat well. A healthy diet contains fruits, vegetables, legumes, nuts, and whole grains. In particular, committing to a Mediterranean diet (plant-based cooking, little meat and a heavy emphasis on olive oil) could help. The Mediterranean diet is the most extensively studied dietary approach, in general as well as in relation to cognitive function. Several systematic reviews of observational studies have concluded that high adherence to this diet is associated with decreased risk of mild cognitive impairment and Alzheimer’s Disease, but modest adherence is not.
Socialize. Socialization is important for all of us. Engaging with other people in social situations help patients suffering from Alzheimer’s disease and other forms of dementia and may even slow the progress of these conditions. The Lancet Commission on Dementia Prevention, Intervention, and Care identified social engagement as an intervention that could be used to prevent dementia
Lower Blood Pressure. Lowering blood pressure may help protect memory and thinking skills later in life. A large blood pressure study, called Systolic Blood Pressure Intervention Trial, or SPRINT, looked at over 9,000 people over the age of 50 years old and found that those who lowered their blood pressure to 120 (systolic blood pressure) were 19 percent less likely to develop cognitive impairment. Results were published in the Journal of the American Medical Association (JAMA).
Don’t Smoke. There is strong evidence that smoking is associated with an increased risk of dementia. The toxins in cigarette smoke increase oxidative stress and inflammation, which have both been linked to developing of Alzheimer’s disease. Tobacco cessation is associated with reduced depression, anxiety and stress, and improved mood and quality of life compared with continuing to smoke.
Don’t drink too much. Excessive alcohol consumption leads to numerous health problems such as liver damage, stomach issues, impaired cognitive function, and more. If alcoholic beverages are consumed in large quantities over a relatively short period of times, most health problems can be cured relatively easily using special treatment and by quitting drinking. However, if one abuses alcohol throughout many years, this doesn’t only lead to liver cirrhosis, but also a condition called alcoholic dementia. There is extensive evidence on excessive alcohol as a risk factor for dementia and cognitive decline.
Don’t waste money on supplements. There is currently no evidence to show that taking supplements (i.e. B vitamins, antioxidants, omega-3 ginkgo) reduces the risk of cognitive decline and dementia. In fact, scientific evidence shows that in high doses these supplements may be harmful.
These potentially modifiable risk factors mean that prevention of dementia is possible through a public health approach, including key interventions that delay or slow cognitive decline or dementia. Much of the WHO’s advice is common sense and aligns with what the US National Institute on Aging advises.
Tiny blood vessels in the back of the eye, which are thinner than a human hair, may signal the presence of Alzheimer’s disease. A new eye scan test, developed by researchers at the Duke Eye Center, suggests this connection can be exploited to detect the neurodegenerative disease before symptoms become too severe to respond to treatment.
Diagnosing Alzheimer’s disease is tricky. Symptoms progress slowly over several years and can be easily confused with other conditions that may initially be attributed to old age. By the time it’s obvious that a person has Alzheimer’s it’s already too late, as the disease has already eaten away too many brain cells.
There is no cure for Alzheimer’s but research suggest that it is possible to delay its onset by several years if the condition is diagnosed early on. Some techniques, such as brain scans or spinal taps, can theoretically detect Alzheimer’s fairly early, however, they can’t be scaled to screen the millions of people who are vulnerable to the disease. An early diagnosis also gives patients and their families some valuable time to plan for the future.
This is why this latest study is so exciting — it suggests that it’s possible to detect Alzheimer’s simply by imaging the back of the eye. The non-invasive imaging technique, called optical coherence tomography angiography (OCTA), is based on the idea that since the retina is an extension of the brain, the two also share similar features.
In order to investigate whether damage to the retina may mirror changes in the brain’s blood vessels, researchers compared 70 eyes of 39 Alzheimer’s patients with 72 eyes of 37 people with mild cognitive impairment, as well as 254 eyes of 133 cognitively healthy people. According to the results, the Alzheimer’s group had lost some of their retinal blood vessels in the back of the eye. A specific layer of the retina was also thinner in this group compared to people with mild cognitive impairment or healthy individuals.
In the future, this technique could prove to be a quick, noninvasive, and inexpensive way to detect Alzheimer’s at the earliest stages.
“Early diagnosis of Alzheimer’s disease is a huge unmet need,” Sharon Fekrat, M.D., Professor of Ophthalmology at Duke, said in a statement. “It’s not possible for current techniques like a brain scan or lumbar puncture (spinal tap) to screen the number of patients with this disease. It is possible that these changes in blood vessel density in the retina may mirror what’s going on in the tiny blood vessels in the brain. Our work is not done. If we can detect these blood vessel changes in the retina before any changes in cognition, that would be a game changer.”
A promising study carried out in Australia managed to reverse dementia symptoms in mice. Now, the researchers have received $10 million in federal funding and are set to start human trials.
Credits: Nick Youngston.
Dementia is the loss of cognitive function (such as thinking, reasoning, or remembering) and behavioral capacity. Although it is much more common in older people, it is not a part of normal aging, and many people live to 100 years and beyond without ever suffering from dementia. The most common type of dementia is Alzheimer’s disease, which makes up 50% to 70% of cases. The two are often used interchangeably, but they mean different things. However, both are associated with the buildup of plaques in the brain. Now, researchers led by Professor Jurgen Gotz at the University of Queensland believe they might have a solution.
Essentially, they were able to “inject” microbubbles into the brain. In conjunction with ultrasound, this method was sufficient to restore cognitive functions to the brains of mice.
“What we found was that ultrasound works together with microbubbles, which are commonly used as a contrast agent in imaging,” Gotz explained in a recent AMA on Reddit. “What the ultrasound does is interact with the microbubbles, causing them to oscillate and open the blood-brain barrier by exerting a mechanical force onto the blood vessels. What’s then happening is that blood-borne factors enter the brain and stimulate microglia cells to take up and digest toxic amyloid protein. As a consequence, cognitive functions including memory and learning is restored.”
Now, Gotz and colleagues will receive $10 million in funding to continue their research and make the crucial (and very difficult) jump to humans.
Ideally, they would start the trials with people undergoing the early phases of dementia. That’s when the treatment seems to be most effective. The more advanced the dementia is, the more difficult it is to treat.
While very potent, ultrasound can also be very dangerous, so all the trials need to be very carefully designed and carried out, to ensure their safety above everything else.
“Ultrasound is highly tuneable and with too much pressure it’s possible to cause damage such as bleeding, which we have avoided in the animal experiments and which we obviously want to avoid in any human trials,” Gotz explains.
“This funding will ensure we keep some of the world’s brightest minds focused on finding a cure for dementia,” he added.
However, before we get overly excited, it should be said that Alzheimer’s and dementia treatments have a history of performing well on mice and then not delivering the same results on humans. Many pharmaceutical companies have withdrawn funding to this type of treatment, particularly due to the high number of mice studies that did not perform well on humans.
There are currently no available treatments to stop or reverse the progression of dementia, although some medicine can improve symptoms. Dementias affect over 50 million people worldwide, according to the World Health Organization.
A team of researchers at the University of Texas Southwestern Medical Center may have found a way to prevent Alzheimer’s disease from clogging brain tissue. Their novel approach could be turned into a drug or vaccine that would prevent the debilitating disease in 50 to 80% of at-risk adults.
Alzheimer’s is the leading cause of dementia. The neurodegenerative disease affects cognitive and thinking abilities, making day-to-day life incredibly challenging in its most advanced stages.
After a certain age, the human brain starts to shrink considerably but surprisingly, not too many neurons die in the process. In the Alzheimer’s diseased brain, however, many neurons stop functioning, lose connections with other neurons, and eventually die.
In the early stage, the damage is confined to the entorhinal cortex and hippocampus, two areas associated with memory, navigation, and perception of time. This sort of degeneration leads to memory loss and disorientation associated with the condition — though it has to be noted that Alzheimer’s starts damaging brain cells well even before the first symptoms kick in.
Later on, the disease starts to hit the cerebral cortex responsible for language, reasoning, and social behavior, from where it eventually spreads to other brain areas.
Research has shown that individuals with Alzheimer’s disease accumulate beta-amyloid proteins which clump together to form plaques between neurons and disrupt cell function. Another physical characteristic of the Alzheimer’s diseased brain is the buildup of tau proteins. which tangle inside neurons blocking the cells’ transport system.
Currently, there is no available cure for Alzheimer’s disease. Most research efforts are focused on findings ways to halt the progress of the disease and reduce its symptoms. However, molecular biologist Joachim Herz and colleagues at UT Southwestern have embarked on a different route: instead of looking for ways to stop the spread of amyloid and tau accumulation when the process has already set in, the researchers are looking to prevent the buildup from happening in the first place. In other words, they want to prevent the disease rather than treat it.
There are three major forms of Apolipoprotein E (ApoE) proteins that play a vital role in the brain tissue repair by carrying lipids and cholesterol around the brain. However, individuals who carry ApoE4 are up to 10 times more likely to get Alzheimer’s than those with the ApoE2 and ApoE3 forms.
Herz and colleagues claim that ApoE4 causes “traffic jams” inside neuron cells, thereby leading to inefficient recycling of intracellular endosomal transport vesicles. Their research on mice found that lowering the pH of these endosomes (making them more acidic) cleared the traffic jams. Specifically, the ApoE4-induced blockages were reversed by inhibiting the NHE6 protein, which is responsible for making endosomal vesicles less acidic.
“Our approach in this study was to stop the overall degeneration process earlier; that is, before the formation of these aggregates [i.e. amyloid and tau protein],” Dr. Herz said in a statement.
The findings provide a new therapeutic pathway that could prevent Alzheimer’s in 50% to 80% of at-risk adults. A vaccine or drug that selectively blocks NHE6 could be administered before age 40, providing a lifetime of Alzheimer’s protection. Developing such tailor-made molecules is the next step for the UT Southwestern researchers.
“The beauty of NHE inhibitors is that these are small molecules that can be produced inexpensively and thus made widely available, in contrast to the more elaborate antibody-based therapies that are currently being evaluated in clinical trials. A simple pill could someday neutralize the risk of late-onset Alzheimer’s disease just as readily available statins are able to reduce the risk of cardiovascular disease,” Dr. Herz said.
Air pollution seems to increase the risk of developing neurodegenerative diseases, a new study reveals.
High air pollution in London. Image credits David Holt / Flickr.
Nobody likes dirty air — though most of us are breathing exactly that. Air pollution has been established as a risk factor for heart disease, stroke, and respiratory disease. Whether or not it has a part to play in neurodegenerative diseases such as dementia, however, remained unclear until now.
For the study, the team produced estimates of air and noise pollution levels across the Greater London area, which they used to assess potential links with new dementia diagnoses.
Data on the latter was obtained from anonymized patient health records of the Clinical Practice Research Datalink (CPRD), which has been collecting data from participating general practices across the UK since 1987. The team worked with the records of under 131,000 patients: those aged 50 to 79 (in 2004), who had not been diagnosed with dementia, and were registered at either one of 75 general practices located within the London orbital M25 motorway.
Based on each patient’s postcode, the team then estimated their annual exposure to air pollutants, especially nitrogen dioxide (NO2), fine particulate matter (PM2.5), and ozone (O3). The team also estimated each patient’s proximity to heavy traffic and exposure to road noise using modeling methods and on-site measurements.
The team tracked each patient’s health until they received a diagnosis of dementia, de-registered from their practice, or died — whichever came first. Over the study period, 2181 patients (1.7%) were diagnosed with dementia, including Alzheimer’s disease.
Those patients living in the top 20% areas by NO2 levels had a massive 40% higher risk of being diagnosed with dementia compared to those living in the bottom 20%. A similar increase in risk was observed for high levels of PM2.5. These links were consistent and couldn’t be explained by any other factors the team had access to, such as smoking or diabetes. However, when restricted to specific types of dementia, the association only held for patients diagnosed with Alzheimer’s disease.
Caution to the wise, however: this is an observational study and, as such, the findings cannot be used to establish a cause-effect relationship; the findings may also only be applicable to the London area. Many factors may be involved in the development of dementia, the exact cause of which is still not known, the researchers point out.
“Traffic related air pollution has been linked to poorer cognitive development in young children, and continued significant exposure may produce neuroinflammation and altered brain innate immune responses in early adulthood,” the authors conclude.
Still, even if air pollution had a relatively modest contribution to the development of neurodegenerative diseases, overall public health gains would be significant if we made an effort to limit both it and exposure to it.
The paper “Are noise and air pollution related to the incidence of dementia? A cohort study in London, England” has been published in the journal BMJ.
A new study has found that women with high physical fitness are 90% less likely to develop dementia, compared to women who were moderately fit.
Image credits: Ayo Ogunseinde / Unsplash.
Although it might seem counterintuitive, dementia and physical activity are strongly intertwined. Study after study has found that staying physically fit greatly reduces the chances of developing dementia later in life. A new study strongly confirms this idea, reporting that women who are physically fit are much less likely do develop dementia — and when they do, they develop it much later in life (on average, at age 90, compared to age 79 for moderately fit women).
“These findings are exciting because it’s possible that improving people’s cardiovascular fitness in middle age could delay or even prevent them from developing dementia,” said study author Helena Hörder, PhD, of the University of Gothenburg in Gothenburg, Sweden. “However, this study does not show cause and effect between cardiovascular fitness and dementia, it only shows an association. More research is needed to see if improved fitness could have a positive effect on the risk of dementia and also to look at when during a lifetime a high fitness level is most important.”
The study recruited 191 women volunteers, average age 50. They had the women carry out a physical test (bicycle exercise) to measure their peak cardiovascular capacity. The average peak workload was 103 watts, and c for high fitness was considered to be 120 watts — 40 women were able to meet this criterion. Another 93 women were in the medium fitness category, while 59 women were in the low fitness category, defined as peak workload below 80 watts (or unable to complete the test due to high blood pressure or other physical problems). The women were then followed for 44 years, being tested for dementia 6 times. Here are the results:
Among the women who had to stop the exercise test due to problems, 45 percent developed dementia decades later.
“This indicates that negative cardiovascular processes may be happening in midlife that could increase the risk of dementia much later in life,” Hörder said.
The results show a very strong correlation between physical activity and dementia onset. However, there are three main drawbacks to this study.
First of all, while the study was carried out over a long period of time, 191 is a fairly low sample size. Also, all of the participants were Swedish, so there’s no guarantee that findings carry out for other populations. Lastly, their fitness level was measured only once, and there’s a reasonable chance it might have changed (either for the better or for the worse) over the course of the study.
Despite a few minor upsides, we’ve known for a while that alcohol is bad for you — and especially for your brain. Now, a new nationwide study found that heavy use of alcohol is the most significant promoter of dementia, and even doctors are underestimating the negative effect of those extra drinks.
Image credits: kimerydavis / Flickr.
Researchers in France analyzed the effect of alcohol use on dementia. They analyzed over one million people diagnosed with dementia, trying to see what the underlying causes were. They found that on average, heavy alcohol consumption shortens life expectancy by more than 20 years and dementia is one of the main causes.
Out of all the preventable factors, alcohol reigned supreme. Overall, people who were chronic drinkers were three times more likely to suffer from dementia than others. Strikingly, 57% of all early-onset dementia cases were associated with heavy chronic drinking. There was also an important gender gap: while overall, most dementia patients were women, 64.9% of early-onset patients were men.
[alert style=”alert-success” close=”false”]The World Health Organization defines chronic heavy drinking as consuming more than 60 grams pure alcohol on average per day for men and 40 grams for women. For reference, a beer contains around 20-25 grams of pure alcohol, as does a glass of wine.[/alert]
“The findings indicate that heavy drinking and alcohol use disorders are the most important risk factors for dementia, and especially important for those types of dementia which start before age 65, and which lead to premature deaths,” says study co-author and Director of the CAMH Institute for Mental Health Policy Research Dr. Jürgen Rehm. “Alcohol-induced brain damage and dementia are preventable, and known-effective preventive and policy measures can make a dent into premature dementia deaths.”
However, this was just an observational study, and no causation was established. This means that there are other factors associated with drinking that influence the dementia rate. For instance, heavy drinkers also tend to be smokers, which also has an important effect on dementia — and it’s not just dementia.
Heavy drinkers were also more likely to be depressed and had an increased risk of high blood pressure, diabetes, stroke and heart failure, which can also influence dementia.
But the bottom line is clear as day: alcohol is bad for you. Low consumption of alcohol is still dangerous, but heavy consumption can be extremely damaging. The researchers also suggest a list of measures which can help reduce consumption, including increased alcohol taxes and advertising bans.
“If all these measures are implemented widely, they could not only reduce dementia incidence or delay dementia onset, but also reduce all alcohol-attributable morbidity and mortality,” they wrote.
Dementia is a prevalent condition, affecting 5–7% of people aged 60 years and older, and a leading cause of disability in people aged 60 years and older globally, researchers write.
Journal Reference: Schwarzinger et al. “Contribution of alcohol use disorders to the burden of dementia in France 2008–13: a nationwide retrospective cohort study”. Lancet, DOI: https://doi.org/10.1016/S2468-2667(18)30022-7
There is often confusion and misunderstanding surrounding the terms Alzheimer’s disease and dementia. Though the two are certainly related there are significant differences that people should know.
Main differences between Alzheimer’s disease and dementia
Dementia is a syndrome while Alzheimer’s is a disease that causes dementia symptoms akin to HIV vs AIDS. You may also hear dementia described as a condition.
Alzheimer’s disease is the best known of these diseases and the most common cause of dementia. There are, however, over 200 types of dementia besides Alzheimer’s.
What is dementia
Dementia represents “a general term for a decline in mental ability severe enough to interfere with daily life,” according to the American non-profit Alzheimer’s Association. A wide set of symptoms can apply, but there are certain smoking guns, like poor judgment or memory loss. Simplifying things, a disease like Alzheimer’s damages the brain and too much damage will impair its ability to function. This translates to observable symptoms that tend to develop hand in hand as the physiological damage worsens in the brain. It’s this set of symptoms that we refer to as “dementia.”
Alzheimer’s is far from being the sole culprit, though. While Alzheimer’s accounts for 60-70 percent of dementia cases, other causes include Vascular dementia, Parkinson’s disease, dementia with Lewy Bodies and Frontotemporal dementia.
The onset of early dementia can be difficult to spot. At first, people can have simple episodes of forgetfulness, which can happen to anyone. These bouts of trouble remembering people and events can persist for a long time though and that’s when it starts becoming a problem. Steadily, people with dementia will find it increasingly difficult to keep track of time or navigate familiar settings.
Confusion and forgetfulness become more prevalent, as well. Ultimately, in the more advanced stage of dementia, most patients become unable to care for themselves.
During the early stages of dementia, there can be some clear differences in symptoms based on the underlying disease. In patients with Lewy Bodies, the second most common cause of dementia, early symptoms are more about lowered attention span, visual hallucinations, and fluctuations in bouts of lucidity and confusion.
Diagnosing the underlying disease, however, becomes challenging as it advances and affects more parts of the brain. These differences become so subtle that doctors can sometimes misdiagnose. Screening methods include blood tests, mental status evaluation and, as of more recently, brain scans. Dementia-causing diseases, such as Alzheimer’s, can only be diagnosed with complete accuracy after death by examining the brain tissue for signs of plaques and tangles.
What is Alzheimer’s disease
Brain scans showing the differing distribution of amyloid plaques and tau tangles in patients with Alzheimer’s disease. Credit: University of California.
Alzheimer’s disease is a brain disorder that affects memory and thinking skills. Symptoms typically develop slowly but progressively get worse over time. Eventually, the disease can disrupt the ability to carry out even the simplest of tasks. Alzheimer’s impact is irreversible. There is no cure.
After a certain age, the human brain starts to shrink considerably but surprisingly not too many neurons die. In the Alzheimer’s diseased brain, however, many neurons stop functioning, lose connections with other neurons, and die.
In the early stage, the damage is confined to the entorhinal cortex and hippocampus. The first functions as a hub in a widespread network for memory and navigation while the latter is one of the most important brain components where long-term memories are stored. This sort of degeneration leads to the memory loss and disorientation associated with the condition though it has to be noted that Alzheimer’s starts damaging brain cells well before the first symptoms kick in.
Later, the disease starts to hit the cerebral cortex responsible for language, reasoning, and social behavior, from where it eventually spreads to other brain areas.
Decades of research show that Alzheimer’s causes molecular and cellular changes in the brain. These are evident in tissue samples collected from deceased patients.
One common physical characteristic in brains affected by the condition is the accumulation of beta-amyloid proteins which clump together to form plaques between neurons and disrupt cell function. There are many forms of beta-amyloid proteins and researchers are still busy unraveling the many threads.
Another notable characteristic is abnormal accumulations of a protein called tau that builds up inside neurons. In a healthy brain, tau normally binds to and stabilizes microtubules, which are internal structures that support the neuron and guide nutrients and molecules from the cell body to the axon and dendrites. Abnormal chemical changes inside the Alzheimer’s brain, however, cause tau to detach from microtubules and stick to other tau molecules. Eventually, these tangle inside the cell blocking the neuron’s transport system.
Alzheimer’s is more common as people grow older but it’s definitely not a normal part of aging. What’s more, you don’t necessarily have to reach a ripe old age to be at risk of Alzheimer’s. Approximately 200,000 Americans under the age of 65 develop Alzheimer’s disease (also known as early-onset Alzheimer’s). In fact, one study found Alzheimer’s can affect people in their 20s.
Those with Alzheimer’s live an average of eight years after their symptoms become noticeable to others, but survival can range from four to 20 years, depending on age and other health conditions.
While there is currently no cure, there are available treatments that can slow the worsening of the dementia symptoms. Scientists are relentlessly pursuing, however, novel treatments and methods to delay its onset and prevent it from developing.
Doctors diagnose Alzheimer’s using a barrage of medical tests, which include:
mental health evaluations
brain scans (only in some cases)
Alzheimer’s severely shrinks brain volume, a phenomenon called brain atrophy. Credit: Wikimedia Commons.
It’s normal to occasionally find it difficult to remember certain things or think slowly. Persistently feeling confused and serious memory loss may be signs of brain cell failure.
The most common early symptom of Alzheimer’s is failing to remember newly acquired information. As the disease progresses irremediably, more severe symptoms will crop out such as:
mood and behavior swings;
confusing events, time, and places;
trouble remembering names and faces;
unfounded suspicions about family, friends, and caregivers;
serious memory loss;
difficulty speaking, swallowing and walking.
What makes Alzheimer’s particularly stressing, especially for the patient’s family and caregivers, is that patients may not recognize they have a problem.
Alzheimer’s research and future outlook
Since there is no cure for Alzheimer’s, early diagnosis is critical in order to delay the onset of severe dementia symptoms.
Research is making good progress, though, and one day it might be possible to prevent Alzheimer’s altogether. In 2016, scientists at the Baylor College of Medicine, Texas Children’s Hospital, and Johns Hopkins University School of Medicine, inhibited an enzyme which consistently resulted in lower levels of tau in both human cells and fruit flies. Drugs designed to block this enzyme could thus prevent Alzheimer’s from settling in.
Neuroscientists Case Western Reserve University School of Medicine discovered that bexarotene, a skin cancer drug, astonishingly also appears to reverse cognitive and memory deficits, commonly associated with Alzheimer’s when tested on lab mice. The drug seems to clear amyloid proteins in the brain, whose build-up is closely related to Alzheimer’s progression. Mice inflicted with Alzheimer’s were given the drug, and all showed clear signs of cognitive recovery.
Other studies, though not as spectacular, provide helpful insight. For instance, one recent peer-reviewed paper found men who frequent saunas are less likely to be diagnosed with dementia later in life. Another correlative study found extra-virgin oil might protect your brain from Alzheimer’s and improves synapses. Olive oil reduces brain inflammation and activates the autophagy process, cleaning some of the intracellular debris and toxins in the process.
Alzheimer’s is still a devastating disease to this moment, unfortunately. Families and friends of patients can at least live with the comfort that countless dedicated professionals are working on ways to curb the disease. Maybe, one day, it’s Alzheimer’s and other dementia that will become a fading memory instead of people’s most precious moments.
Dementia isn’t a mandatory sentence. Targeting nine risk factors (including smoking, physical inactivity, and lack of education) during childhood could drastically reduce dementia incidence, a new study reports.
By 2050, it’s estimated that 131 million people could be living with dementia globally, three times more than the 47 million people battling the condition today. It’s largely a consequence of life expectancy increasing in many parts of the world, and more people reaching old age. But it’s also a consequence of our lifestyle.
The two — old age and dementia — have danced a tight dance, with the former long thought to cause the other. But more and more evidence seems to indicate that the correlation between them might not be as strong as we once thought. While many aspects of dementia are still unknown, our understanding of the condition has greatly increased, and doctors have proposed several prevention and treatment strategies.
Now for the first time, a new study has modeled the impact of risk factors at all stages of life, quantifying how these risk factors, sometimes unexpected, contribute to the onset of dementia.
“Although dementia is diagnosed in later life, the brain changes usually begin to develop years before, with risk factors for developing the disease occurring throughout life, not just in old age. We believe that a broader approach to prevention of dementia which reflects these changing risk factors will benefit our ageing societies and help to prevent the rising number of dementia cases globally,” says lead author Professor Gill Livingston, University College London, UK.
Starting in childhood
The nine significant risk factors (some of which can be tackled since early days) the team identified are:
Mid-life hearing loss – responsible for 9% of the risk
Failing to complete secondary education – 8%
Smoking – 5%
Failing to seek early treatment for depression – 4%
Physical inactivity – 3%
Social isolation – 2%
High blood pressure – 2%
Obesity – 1%
Type 2 diabetes – 1%
In total, this adds up to 35% modifiable impact factors early on. This challenges the belief that dementia is all about old age. That’s much more than the main genetic factor, the apolipoprotein E (ApoE) ε4 allele, which would prevent less than one in 10 (7%) cases.
“Acting now will vastly improve life for people with dementia and their families, and in doing so, will transform the future of society,” Gill adds.
Some of these might seem perfectly normal, especially education. The study estimates that if all people would stay in school until at least 15, dementia would drop by 8%. Smoking is also quite expected. Smoking can be a culprit for pretty much everything that goes wrong with the body, and dementia is no exception.
But others, like hearing loss, are perhaps less intuitive. While this is a factor for later in life, reducing hearing loss in mid-life was the most impactful risk factor, at 9%.
If you’re worried about dementia for yourself or your loved ones, you don’t have to memorize the risk factors or start focusing on this or that. It can all be summed up largely by this: stay healthy. A previous study has found that regular physical activity can do wonders in fighting dementia. Take care of your body, take care of your mind, and your odds will significantly improve.
As most of the new dementia cases will be in underdeveloped and developing countries, focusing on education and health. Dementia tends to selectively affect the old and frail, the women, and the socioeconomically disadvantaged, Professor Martin Prince of King’s College London says. We are set to face what can only be classified as a dementia pandemic and much of it can be prevented through simple things — but it’s important that these healthy habits start as soon as possible. Of course, it’s not just all about prevention. Treatment and management options exist but once again, we must tackle things as soon as possible, and support those in need.
“Society must engage in ways to reduce dementia risk throughout life, and improve the care and treatment for those with the disease. This includes providing safe and effective social and health-care interventions in order to integrate people with dementia within their communities. Hopefully this will also ensure that people with dementia, their families and caregivers, encounter a society that accepts and supports them.” says co-author Professor Lon Schneider, Keck School of Medicine of the University of Southern California, USA.
The bottom line is dementia is not an inevitable consequence of aging. We can fight it.
Two drugs — one a licensed antidepressant, the other an anti-cancer substance currently in trial — could halt the growth of misfolded proteins that trigger Alzheimer’s or Parkinson’s. The side effects are minimal according to tests ran on mice and seeing how one of the drugs is already licensed and safe for humans, clinical trials meant to gauge the efficacy of the drugs for preventing dementia in humans could start very soon. The two compounds are considered the most promising weapons against dementia we’ve found to date.
Credit: Max Pixel.
Worldwide, there are some 47.5 million reported cases of dementia, with 7.7 new cases reported every year. Dementia usually onsets at old age. It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Alzheimer’s disease is the most common form of dementia and may contribute to 60–70% of cases.
Most neurodegenerative diseases such as Alzheimer’s or Parkinson’s are caused by the buildup of misfolded proteins in the brain. Their presence triggers a natural defense mechanism which switches off the production of new proteins in brain cells. In time, the brain, specifically the cerebral cortex, literally shrinks, connections between brain cells are severed and fewer neurotransmitter chemicals are available to relay signals between brain cells.
In 2013, scientists from the UK Medical Research Council (MRC) made waves after they showed a drug could switch the vital protein production back on. The mice’s brain cells stopped dying but later the experimental drug was found to be toxic to the pancreas. Yet another promising solution to an incurable disease which, sadly, was found to be unsuitable for humans.
But that’s not the case with trazodone, which is already taken by patients with depression, and dibenzoylmethane, a compound being trialed as an anti-cancer drug. The two drugs were found to be effective at blocking dementia onset after a team working at the same MRC screened 1,040 compounds. Each compound was first tested on C. elegans worms, which have functioning nervous systems, then in mammalian cells. This initial round produced a short-list of candidate compounds which could be tested in mouse models of prion disease and frontotemporal dementia.
Of all the drugs, the trazodone/dibenzoylmethane pair was found to be the most effective at blocking the pathway linked to brain cell death caused by prion disorders. Of the two, trazodone is not only a licensed drug but also a treatment for the symptoms of patients in later stages of dementia.
“We know that trazodone is safe to use in humans, so a clinical trial is now possible to test whether the protective effects of the drug we see on brain cells in mice with neurodegeneration also applies to people in the early stages of Alzheimer’s disease and other dementias,” said Professor Giovanna Mallucci, who led the team from the Medical Research Council’s Toxicology Unit in Leicester and Cambridge University.
“We could know in two to three years whether this approach can slow down disease progression, which would be a very exciting first step in treating these disorders.”
Despite all of these advantages, people shouldn’t get their hopes up too much. The drugs may stop dementia in mice but there’s nothing to guarantee it will also work in humans. It’s rare to find such promising drugs, however, that are already at least partially vetted for human consumption.
“We’re excited by the potential of these findings. They show that a treatment approach originally discovered in mice with prion disease might also work to prevent the death of brain cells in some forms of dementia. This research is at a very early stage and has not yet been tested in people – but as one of the drugs is already available as a treatment for depression, the time taken to get from the lab to the pharmacy could be dramatically reduced,” said Dr Doug Brown, Director of Research and Development at the Alzheimer’s Society in a statement.
Scientific reference: Mark Halliday et al. Repurposed drugs targeting eIF2α-P-mediated translational repression prevent neurodegeneration in mice, Brain (2017). DOI: 10.1093/brain/awx074.
Elderly participants in a recent study, who lacked a high school degree and constantly slept for nine hours or more every night, had six times the risk of developing dementia. Previously, research suggested that too little sleep significantly increases the risk of developing a form of dementia like Alzheimer’s but this is the first study to suggest too much sleep can have similar consequences.
Consistently failing to get enough sleep, which is considered six hours or less per night, may make it easier for dementia-linked proteins to infiltrate the brain and form a plaque. For instance, a protein linked with Alzheimer’s called Beta-amyloid has been found in higher concentrations in the brains of those who sleep poorly. To make matters worse, the plaque build-up affects sleep quality which might cause some patients to sleep even less thus fueling a dementia feedback cycle.
Dr. Sudha Seshadri and other neuroscientists from the Boston University School of Medicine Alzheimer’s Disease Center (BUSM) wanted to investigate whether too much sleep can also increase the risk of developing dementia. They worked with a dataset which followed 2,500 participants, now with an average age of 72, who self-reported their sleeping habits. Some 13 years later, they were interviewed again about their sleeping habits. Since their first interview, 234 cases of all-cause dementia and 181 Alzheimer’s cases were recorded.
When the researchers correlated the participants’ dementia incidence with their self-report sleep durations, they found some disturbing trends. Those who slept excessively for more than nine hours a night had smaller brain volumes and poor executive function. The most at risk patients were those without a high school degree — these were six times likelier to develop dementia than those who slept less than nine hours a night but more than six hours a night.
“Collectively, these results suggest that long sleep duration serves as an early biological marker of neurodegeneration, especially in those with low educational attainment,” the researchers concluded in the journal Neurology.
“Self-reported sleep duration may be a useful clinical tool to help predict persons at risk of progressing to clinical dementia within 10 years. Persons reporting long sleep time may warrant assessment and monitoring for problems with thinking and memory,” added co-corresponding author Matthew Pase.
If you’re not an early riser, to use a euphemism, you should not necessarily feel distressed. For one, excessive sleep may be a symptom rather than a cause of the brain changes that occur with dementia so it’s likely you won’t reduce the dementia risk if you decide to cut down sleeping hours. That being said, the best protection against dementia — something that’s been highlighted by countless studies — is education.
These results suggest that being highly educated may protect against dementia in the presence of long sleep duration,” Seshadri said.
For each additional year of education, there is an 11% decrease in risk of developing dementia, a University of Cambridge study reported in 2010. According to the researchers, people with more education are better able to compensate for the effects of dementia. That’s not to say, however, that simply having a college degree can help keep dementia at bay. Rather, any form of active learning helps, whether it’s learning how to make pottery or solve advanced math. The important thing is to make learning a lifelong process.