Stiff Aorta Predicts Dementia

  From the Cardiovascular Health Study, researchers found that individuals with high carotid-femoral pulse wave velocities (consistent with increased aortic stiffness) were 60% more likely to develop dementia during the following 15 years.
J Alzheimers Dis. 2018;66(1):297-306

Want a Large Family ? There May be an Increased Risk of Alzheimer's in Women

  According to researchers in South Korea, women who have given birth to more than five children have a much higher risk of having Alzheimer's disease compared to those with fewer children or no children.
  Women who had five or more complete pregnancies demonstrated a 1.7-fold greater risk of AD than those that completed one to four completed pregnancies or no completed pregnancies.
  High levels of estrogen during pregnancy and the abrupt withdrawal of estrogen after childbirth may be harmful to neurons and decrease cognitive reserve.
  Based on this result, researchers are planning to develop pulse hormone replacement therapy that can induce similar hormonal changes to those in the first trimester of pregnancy to evaluate it's effectiveness in reducing the risk of Alzheimer's in women.
  This reviewer does not advocate having fewer or no children as a consequence of this study.
Neurology 2018 Epub July 18

Ambien and Alzheimer's Linked

  Cumulative doses of Zolpidem (Ambien), a common sleep drug, are associated with a greater risk for developing Alzheimer's in elderly patients (65 and older) according to a retrospective study.
J Am Geriatr Soc, doi:10.111/jgs.15018

Midlife Risk Factors for Alzheimer's Revisited

  A recent review indicates that lifestyle and demographic factors in midlife could potentially modify the risk of dementia in late adulthood.
  As expected, advancing age was strongly associated with dementia. But the study also identified widowed status, lower BMI, and less sleep at midlife as risk factors for dementia.
J Alzheimers Dis. 2018;63(3):1119-1127

APOE4 Re-visited : Greater Role in Women than Men

  Researchers studying biomarkers in the spinal fluid of 1,798 patients found a statistically significant interaction between APOE-e4 and sex on CSF total tau and phosphorylated tau.
  Meaning there is a stronger association between APOE-e4 and spinal fluid tau levels among women than among men.
  Alzheimer's disease is associated with increased total tau and phosphorylated tau in spinal fluid.
  Therefore, having one copy of the genetic mutation APOE-e4 is associated with 3 times the risk of developing Alzheimer's in women compared to the general population whereas one copy in men have a risk similar to the general population. Two copies of APOE-e4 is associated with 15 times the risk of developing AD.
JAMA Neurol. 2018 May 7

Think POSITIVE, CHILL OUT: Decrease Dementia Risk !

  Older people who hold positive beliefs about old age from their culture are less likely to develop dementia. Further, people with APOE4 (associated with a genetic increased risk of Alzheimer's) with positive age beliefs are 49.8% less likely to develop dementia than those with negative cultural beliefs. 
  Therefore, positive age beliefs (a modifiable thing) reduces stress and can be neuro-protective.
PLoS One. 2018 Feb 7;13(2):e0191004

MEMORY : New Science to Improve Memory in Older Folks !

  Researchers at UC Irvine have discovered the ability to create lasting memories is linked to a newly discovered process: an enzyme blocking the release of of a gene called Period1 in the hippocampus of our brains. When we're young, turning this gene on is easy but as we get older this becomes harder.
  In each cell in our body there is 6 feet of DNA. As we age this spooled up length of DNA becomes less flexible (like our joints, eh?). This stiffness in our DNA is due to a "molecular brake pad" called HDAC3 that has become over-active in the aged brain and is compacting DNA too much and blocks the release of Period1.
  Removing the HDCA3 restores the flexibility and allows internal cell machinery to access Period1 to begin to form new memories.
  New drugs that target HDCA3 could allow older persons to improve memory formation ! 
  

Action Video Games to Boost Brain Power : NOPE

  Researchers in Montreal found that habitual players of action video games have less gray matter in their hippocampus (a part of the brain that regulates emotions and is associated with long-term memory and spatial navigation).
  The greater the hippocampal atrophy the greater the risk of Alzheimer's disease as well as depression, schizophrenia and post-traumatic stress disorder.
 Interestingly, researchers found that 90 hours of playing action video games (Call of Duty, Killzone, and Borderlands 2) led to hippocampal atrophy (shrinkage) while 90 hours of playing 3D-platform video games led to an INCREASE in gray matter within the hippocampus.
Mol Psychiatry. 2017 Aug 8

Tumeric to Improve Memory

  From researchers at UCLA, daily oral curcumin (tumeric) may improve memory, mood and attention in cognitively normal middle-age and older adults. 
  Previous studies suggested that curcumin's anti-oxidant, anti-inflammatory, anti-amyloid and possible anti-tau properties may offer neuro-protective benefits. Prior human trials regarding the effects of circumin have been heretofore inconclusive.
  Doses tested of curcumin were 90 mg twice daily.
  GI side effects are possible such as abdominal pain and gastritis.
2017 Alzheimer's association International Conference

Alzheimer's Prevention: The Latest Recommendations

  From the recent report of the National Academy of Sciences, Engineering and Medicine come general recommendations.
  Cognitive Training: there is currently no evidence to support a conclusion that cognitive training can prevent or delay mild cognitive impairment or Alzheimer's.
  Hypertension: manage blood pressure in those with hypertension (particularly in mid-life i.e.. 35-65) to prevent, delay or slow the progression of Alzheimer's.
  Physical activity: studies fail to demonstrate increasing physical activity prevents, delays or slows mild cognitive impairment or Alzheimer's. However, the report noted the other health benefits of increased physical activity such as lowering the risk of hypertension, stroke and obesity as well as symptoms of depression.
  Contrastly,to improve your life overall: consider the FINGER study out of Finland which found that targeting diet, exercise, vascular risk factors and brain training slowed cognitive decline in older adults.
Downloadable report: nationalacademies.org/Dementia

Icelandic Genetic Mutation Found to be Protective Against Alzheimer's

  Researchers studied 1,795 Icelanders and found a coding mutation (A673T) in the APP gene that protects against Alzheimer's disease and decline in memory.
  This finding provides proof of principle for the hypothesis that reducing Beta-cleavage of APP may protect against the disease.
Nature 488, 96-99 Aug 2

Vascular Risk Factors : Narrowing Arteries in the Head = Alzheimer's Risk Increase

  Researchers from the Atherosclerosis Risk in Communities (ARIC) Neurocognitive study demonstrated that hardening of the arteries in the head is associated with mild cognitive impairment and dementia.
  In MCI and dementia patients with posterior (back of the brain) cerebral watery plaque had 44% higher prevalence of MCI than without it. Dementia risk was increased threefold in those with anterior cerebral (front of the brain) artery plaque and twofold in those with narrowing > 70% or involvement of > vascular territories.
  Again, as per my last review, decreasing vascular risk factors (obesity, diabetes, hypertension and high cholesterol) decreases hardening if arteries inside the head and decreases cognitive impairment.
Neurology 2017 Apr 18;88:1156

Take Care in Mid-Life to Reduce the Risk of Alzheimer's

  Vascular risk factors are known to be associated with Alzheimer's i.e., obesity (BMI > 30), smoking, hypertension, diabetes and high cholesterol. In this study, researchers found that those with vascular risk factors in middle age (especially those that are APOE4 allele positive) had a greater amyloid (the protein found in excess in Alzheimer's brains) burden in their brains later in life. 
  However, late-life vascular risk factors were NOT associated with an increased risk later in life.
  Therefore, treatment of vascular risk factors in MIDLIFE while likely to be asymptomatic, may be critical in reducing the development of an underlying AD process.
JAMA 2017 April 11;317:1443

Get Fat Late in Life to Decrease Amyloid in your Brain IF YOU'RE NOT A APOE4 CARRIER

  From the Harvard aging brain study, greater amyloid deposits in brain were seen in individuals with LOW BMI (thin folks). However, those that were APOE4 carriers (increased risk with each APOE4 mutation you carry), NORMAL BMI (normal weight) was associated with greater amyloid burden in brains.
  Amyloid at high levels is toxic to our brains.
Journal of Alzheimer's Disease June 18 2016

Decrease Risk of Alzheimer's with Frequent Sauna Bathing

  2,000 men from Finland in a 20 year follow-up as a part of the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD) that took a sauna 4-7 times per week were found to have a 66% decreased risk of dementia than those that took a sauna once a week.
Age Aging. 2016 Dec 7

Hope for Alzheimer's Patients and Their Families ?

  As reported by Researchers Against Alzheimer's (RA2) there are 57 drugs in mid-stage testing (phase II) and 23 drugs in late-stage testing (phase III). These drugs could prevent or delay the symptoms of dementia. Phase II/III treatments include AC-1204, an oral drug for patients with mild to moderate Alzheimer's whose mechanism of action is to improve mitochondrial metabolism through chronic ketosis. Also, a combination of albumin and immunoglobulin administered IV with possible anti-amyloid antibodies and albumin binding capacity is in mid/late stage development to treat mild to moderate Alzheimer's disease.

Cummings J Alzheimers Res Ther. 2016;8;39

Treat Hypertension Mid-life to Preserve Late-life Brain Function

  According to a review of the literature by a panel of experts, treatment of hypertension in mid-life preserves late-life cognitive function.
  Hypertension disrupts the function and structure of cerebral blood vessels which leads to ischemic damage (as a result of decreased blood flow to brain cell's) of white matter regions critical for cognitive function and may promote Alzheimer pathology.
Hypertension Oct 10 2016
  As previously reported, treatment of elevated blood pressure in the oldest of the old should be more conservative than treatment of younger patients.

Caspase-2 a NEW potential Target in the Treatment of Alzheimer's

  Researchers at the University of Minnesota reported that capsase-2 , cuts the full length TAU protein (which accumulates in the brains of patients with AD and is neurotoxic) into fragments. These pieces of protein adversely affect synaptic signaling in dendritic spines directly leading to cognitive impairments in mice. These fragments PRECEDE the formation of aggregated TAU suggesting that the tangles seen are NOT the cause of AD. In fact the memory problems seen in these experimental mice occur BEFORE brain loss suggesting that blocking caspase-2 could be used to treat Alzheimer's disease.
Nat Med 2015:Epub 2016 Oct 10

Experimental Trials for Alzheimer's

   Experimental trials worth mentioning include but are not exclusively : 
1. Infusion therapies to recruit the immune system : solanezumab, aducanumab.
2. To prevent destruction of brain connections : saracatinib which  turns off Fyn, a brain protein which when over-activated triggers destruction of connections between brain cells ( ie. synapses). 
3. Beta-amyloid production blockers such as beta- and gamma- secretase inhibitors. 
4. Tau aggregation inhibitors and tau vaccines to prevent tau from forming the tangles seen in Alzheimer's. 
5. Reduce chronic, low-level inflammation eg. pioglitazone (Actos). 
6. Insulin nasal spray to alter insulin changes in Alzheimer brains. 
7. Modulating known risk factors eg. hypertension, diabetes, stroke, high cholesterol and heart disease. 
8. Estrogen-based hormone therapy to protect women with a higher risk of Alzheimer's.

Modest Seafood intake Decreased Alzheimer's Risk

  Even a single seafood serving a week had a neuroprotective benefit against the development of neurofibrillary tangles and amyloid deposits in people that carry the apolipoprotein e4 risk gene for Alzheimer's. The same is NOT true for those that do not carry the APOE e4 gene. 
  Interestingly, that same population studied also were found to have increased mercury in their brains WITHOUT an adverse effect pathologically.
JAMA 2016;315(5):465-466