Can Exercise Worsen Dementia?


Could exercise worsen dementia? The idea runs against one of the fondest hopes of patients with Alzheimer disease, their caregivers, and physicians. It contradicts some early research and tentative recommendations. But it is a key finding of one of the largest studies yet to examine the question.

In the Dementia And Physical Activity (DAPA) trial, the mean score on the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-cog) worsened more for people with dementia who were assigned to a year of vigorous exercise than for people who kept to their usual routines.[1]

The difference was small but statistically significant, says Bart Sheehan MRCPsych, MD, consultant liaison psychiatrist at the Coventry and Warwickshire Partnership Trust in Coventry, United Kingdom. “It does raise the possibility that, at this point, vigorous exercise might be damaging for people.”

The finding has experts in the field taking a harder look at what they thought they knew about the way physical activity affects a declining brain. It comes as a particular blow because no one has found a way to halt Alzheimer disease. “People are desperate for a treatment,” Sheehan said.

Until the DAPA results came out, exercise was looking like one of the most promising possibilities—if not to stop dementia, then at least to slow its progression. “Among patients with dementia or mild cognitive impairment, randomized controlled trials (RCTs) documented better cognitive scores after 6 to 12 months of exercise compared with sedentary controls,” wrote the authors of a 2011 meta-analysis.[2]

Such results were enough to prompt the Mayo Clinic website, a health information website for consumers, to advise that “Exercising several times a week for 30 to 60 minutes may… improve memory, reasoning, judgment and thinking skills (cognitive function) for people with mild Alzheimer’s disease or mild cognitive impairment.”[3]

But these findings were from relatively small trials. And negative results have also cropped up in the literature for years, including in other reviews of the literature.[1] Funded by the British government, Sheehan and his colleagues set out to settle the question with the most authoritative trial possible.

They recruited 494 people with mild to moderate dementia according to the criteria in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). All lived in the community and were able to sit on a chair and walk 10 feet without assistance. The average age was 77. Sixty-one percent were men.

The researchers randomly assigned 329 to exercise and 165 to make no change in their physical activity. The exercisers attended group sessions in a gym twice a week for 4 months under the guidance of physical therapists. Each session lasted 60-90 minutes. The researchers asked them to work out for an additional hour each week at home during this period. The sessions included cycling in place for 25 minutes of moderate to hard intensity, as well as weight training such as biceps curls, shoulder forward raise, lateral raise, and sit-to-stand using a weighted vest or waist belt.

After the 4 months, the researchers prescribed a home-based program of unsupervised exercise of 150 minutes each week. They encouraged the participants to choose activities at home that they preferred and followed up with phone calls to encourage them. Eighty-eight percent reported continuing the exercises at home. Less than 1% of the participants reported doing structured exercise outside of the trial.

The people who evaluated the patients didn’t know which ones participated in the exercise programs and which ones did not.

After 12 months, the patients improved their fitness compared with the usual-care group. But when it came to cognitive function, the researchers recorded abysmal results. On the ADAS-cog, where a higher score means worsening function, the usual-care group went from 21.4 to 23.8, a worsening of 2.4 points, as might be expected with the progressive diseases that cause dementia.

But the exercisers fared even worse, going from a mean score of 21.2 to 25.2, a worsening of 4.0. For perspective, a normal score for someone who does not have dementia is 5, while the average score of someone diagnosed with probable Alzheimer’s or mild cognitive impairment is 31.2.

The difference was statistically significant (P =.03). It’s not clear whether it has clinical significance, Sheehan says. Still, it startled the researchers.

Despite their improved physical fitness, the exercisers did not improve in activities of daily living, behavior, or health-related quality of life.

“It didn’t come as a surprise that physical exercise was not effective as a treatment for dementia, because dementia is notoriously difficult to treat,” he said. “I think what was a surprise is the very strong signal that it may make dementia worse.” They ran the statistics again and again but found no mistake.

And the finding held up regardless of the patients’ sex or mobility and regardless of whether they were diagnosed with Alzheimer’s versus other kinds of dementia, or whether they had mild versus severe cognitive impairment.

Despite their improved physical fitness, the exercisers did not improve in activities of daily living, behavior, or health-related quality of life.

The finding should influence what clinicians say to people with dementia and their caregivers, said Sheehan, who has treated many such patients. He now tells them that exercise won’t help with such core features of dementia as memory or the ability to organize oneself, and that it might actually do damage.

People who are already exercising and enjoying it shouldn’t necessarily stop, he added. But they must weigh the enjoyment and other health benefits—which are many—against the risk for harm.

Not everyone interprets the results of the DAPA trial as pessimistically as Sheehan. “We don’t have the evidence yet to be able to say that exercise is going to improve cognitive function,” said J. Carson Smith, PhD, an associate professor of public health at the University of Maryland. “But there is more evidence of a benefit in mild cognitive impairment and in people at increased risk for dementia.”

He is among the researchers whose small studies have suggested that exercise can improve cognitive ability in people with mild cognitive impairment. Epidemiologic studies measuring the benefits of long-term exercise for preventing dementia are even more impressive.

This includes a recent sample of 191 Swedish women who were 38-60 years of age in 1968 when they underwent an ergometer cycling test. Examinations of dementia were done six times up to 2010 and supplemented with information from medical records. Women with high physical fitness at middle age were nearly 90% less likely to develop dementia decades later, compared with women who were moderately fit.[4]

Smith and others have found biological differences between more and less fit people that could explain a difference in dementia risk. Lower cardiovascular fitness is associated with a smaller brain volume two decades later, for example.[5]

It’s hard to explain why exercise in healthy people might protect against cognitive decline, but exercise in people with dementia might make it worse. Sheehan theorized that already weakened brains might be too fragile to withstand the temporary loss of oxygen that comes with vigorous exercise. But there isn’t much information yet to support or refute such ideas.

Such studies can’t prove cause and effect. Not only physical activity but also genes affect physical fitness. And people who exercise may have other healthy behaviors.

But even Sheehan has not given up on the idea that physical activity can help people in their declining years. Some kinds of exercise can improve balance, for example. “People say, ‘I wish my father could recognize me,’ but they also say, ‘I wish my father didn’t fall over,'” he points out.

Fit Middle-Aged Women May Fend Off Dementia Later


You may spend a lot of time working out, but there’s a fitness reward you might not expect: better memory in your senior years.

New research finds that being physically fit around age 50 lowers a woman’s risk of developing memory-robbing dementia by almost 90 percent.

And for those physically fit women who do end up with dementia, they tend to get it much later in life — about 10 years later than others.

“Keeping yourself fit — by exercising and having a healthy diet — may decrease your risk of getting dementia in old age. It will also make you feel better and will reduce your risk of other disorders, [such as heart problems],” said senior study author Dr. Ingmar Skoog. He’s director of the Center for Ageing and Health at the University of Gothenburg in Sweden.

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How does exercise help keep the brain healthy?

“High-fitness is good for your [blood] vessels. Vascular factors have been found to be related to dementia, including Alzheimer’s disease,” Skoog explained. He also said that high levels of physical fitness may have a direct effect on nerve cells in the brain.

James Hendrix, director of global science initiatives for the Alzheimer’s Association, agreed that physical fitness is good for the blood vessels.

“We’ve talked for a while about the heart-head connection. If you’ve got good oxygenated blood, you’ll have healthier organs, and the brain is an organ,” Hendrix said.

The Swedish researchers looked at a group of nearly 200 women between the ages of 38 and 60 in 1968. Their average age was 50.

The women were asked to ride a bicycle until they were exhausted to measure their peak cardiovascular capacity. Forty women had a high-fitness level, while 92 were in the medium-fitness level. Fifty-nine women were in the low-fitness category. Some of the women were placed into the low-fitness category because they couldn’t finish the test due to high blood pressure, chest pain or other problems.

During the next 44 years, the researchers tested the women for memory and thinking problems linked to dementia.

Only 5 percent of the women who had high physical fitness in middle-age had developed dementia, the findings showed. Twenty-five percent of those in the medium-fitness group went on to have dementia, as did 32 percent of those who had low physical fitness. Nearly half — 45 percent — of those who couldn’t finish the fitness test developed dementia over the years.

But the study wasn’t designed to prove a cause-and-effect relationship. It can only show an association, according to Skoog.

What if someone comes late to exercise, beginning in their 50s or 60s? Could that still help their brain?

Skoog said he thinks it can, though he expects the effect would likely be smaller.

And, even if someone already has dementia, Hendrix said that exercise can be beneficial. “Alzheimer’s disease isn’t just a disease of memory. There’s some good evidence that other symptoms, like agitation, can be better managed if someone’s active. I know my own sleep is better when I’m exercising,” he added.

If you’re starting to exercise in middle or late life, Hendrix said it’s a good idea to check in with your doctor first.

“But, in general, it’s never too late or too early to start practicing good lifestyle approaches. And, when you try to pick an exercise to do, pick one you enjoy. Whatever exercise you’ll continue to do is the best one for you,” Hendrix said.

Findings from the study were published online March 14 in the journal Neurology.

Simple Walking Test Helps Diagnose Treatable Cause of Dementia


A simple walking test may help identify one cause of dementia that may be reversible but is often misdiagnosed, a new study suggests.

Idiopathic normal-pressure hydrocephalus (iNPH) is estimated to affect about 2.7 million people in the United States and Europe. It is caused by excess fluid in the brain and can often be reversed with the insertion of a ventriculoperitoneal shunt. However, it is usually not diagnosed because it shares symptoms with other neurologic conditions, such as walking and balance dysfunction and cognitive impairment.

The other condition most often confused with iNPH is progressive supranuclear palsy (PSP), a neurodegenerative disease with no cure.

Researchers from Germany have reported new results suggesting that these two conditions can be distinguished from each other by a dual-task walking test. This involves assessing how fast a person can walk while doing something else at the same time, such as counting backwards or carrying a tray.

The study was published online on February 21 in Neurology.

“iNPH is one of the rare causes of a potentially treatable and reversible dementia syndrome and gait disorder, but it is still underdiagnosed,” lead author, Charlotte Selge, MD, Ludwig Maximilian University of Munich, Germany, told Medscape Medical News.

“It is important that iNPH is accurately diagnosed as treatments are available,” she added. “A simple walking test may help determine if a person has iNPH or PSP relatively early in the course of the disease. Our study found that adding another task while someone walks, and evaluating how it affects their walking ability, improves accuracy of the diagnosis.”

The study included 27 patients with iNPH, 38 patients with PSP, and 38 healthy individuals matched by age and sex.

For the test, all participants walked along a 22-foot-long pressure-sensitive carpet to assess their gait. They were asked to walk at three different speeds and then to also perform another task involving cognitive function, counting backwards, or motor function (carrying a tray).

Results showed that the cognitive dual task showed a greater reduction of walking speed in those with PSP than in those with iNPH. Walking speed was reduced by 34% in those with PSP and by 17% in those with iNPH.

In addition, when patients were engaged in the motor dual task, gait worsened for those with PSP but actually improved for those with iNPH.

“People with PSP appear to be more sensitive to these dual-task walking tests than people with iNPH,” Selge said.

By just assessing gait, researchers were able to accurately differentiate between patients with PSP and those with iNPH 82% of the time. But when both dual-task tests were added to the assessment, diagnostic accuracy increased to 97%.

“Our findings suggest that adding these dual-task tests would be an inexpensive and effective way to improve diagnosis of iNPH,” Selge concluded.

“Future studies may want to increase the complexity of tasks to see if they provide even more accuracy, as well as insight into how the two diseases affect gait,” she added.

One of World’s Biggest Drug Companies Just Abandoned Alzheimer’s And Parkinson’s Research


Pfizer, the world’s third largest drug maker, has announced it is ending research to discover new medications for Alzheimer’s and Parkinson’s disease.

The move, which will eliminate hundreds of research positions across the pharmaceutical giant’s roster, casts an even darker shadow outside the company – dashing the hopes of millions affected by neurological disorders, whose dreams of finding a treatment just got that much more desperate.

“As a result of a recent comprehensive review, we have made the decision to end our neuroscience discovery and early development efforts and re-allocate [spending] to those areas where we have strong scientific leadership and that will allow us to provide the greatest impact for patients,” the company said in a statement to NPR.

Job reductions primarily in Massachusetts and Connecticut are expected to occur across the next several months, although the company is continuing research into rare neurological diseases, and plans to launch a venture fund committed to neuroscience.

To many, though, those gestures won’t replace the loss of some 300 neuroscientists and associated staff in an organisation that bills itself as “the world’s largest research-based pharmaceutical company”.

“Any decision impacting colleagues is difficult,” the company’s statement reads.

“[H]owever, we believe this will best position the company to bring meaningful new therapies to market, and will bring the most value for shareholders and patients.”

Of course, value for shareholders is one thing; but for patients, especially those affected by neurological diseases (and their families), it’s quite another, as critics of Pfizer’s new direction are eager to make clear.

“[W]ith no new drug for dementia in the last 15 years, this will come as a heavy blow to the estimated 46.8 million people currently living with the condition across the globe,” says the head of research at the UK’s Alzheimer’s Society, James Pickett.

“Every three seconds someone in the world develops dementia and, with this number set to rise, there has never been a more important time for such life-saving research.”

That’s especially so since the best, mostly ineffective medications we have for conditions like Alzheimer’s are in fact the products of research from decades ago.

While there are strong hopes they can be improved upon – and treatments for Parkinson’s and other neurological conditions too – until more research is done, a hoped-for, effective replacement won’t materialise.

“The current medication for Alzheimer’s disease is approved, essentially, because it’s better than nothing. There’s nothing else at the moment,” neuroscientist Joseph Jebelli told NPR last week.

“These drugs were pioneered in the ’70s and ’80s and they treat the symptoms, as opposed to the underlying biology.”

 Of course, one company announcing the closure of one wing of medical research doesn’t signal the end of other scientists working in that field – but in light of Pfizer’s dismaying decision, some commentators are wondering what this means for the rest of the big pharma landscape in terms of neuroscience research.

“It’s really alarming to see such a large pharmaceutical company deciding to abandon research into the brain and central nervous system,” chief scientific officer at the Parkinson’s Foundation, James Beck, told the Los Angeles Times.

“[H]aving Pfizer exit does not augur well for what other companies are likely to do.”

That’s especially so since Pfizer’s decision follows a series of clinical failures by other companies pursuing Alzheimer’s research – developments that can be extremely costly for the companies invested in the trials.

We’ll have to wait and see what happens here – and hope the companies committing to this research keep focussed on what’s really at stake here.

“[N]euroscience research is high risk, in that failure for pharmaceutical companies comes at a high price,”Alzheimer’s Research’s director of policy, Matthew Norton, told The Times.

“[But] the potential benefits of success to the millions of people around the world living with dementia are too great to ignore.”

Dear senior citizens, are you walking extra slowly? You may be at risk of dementia. 


People, who developed slow walking, showed shrinkage of their right hippocampus, the area of the brain primarily associated with memory and the ability to maintain posture.

Senior citizens
People who slow by 0.1 seconds more per year are 47% more likely to struggle cognitively, says study.

Beware! If your grandma’s walking pace has suddenly slowed down more than usual, then you may have to rush her to the doctor as it could be an early indicator of dementia, warns a study. The results suggested that participants, who walked slower over time, but those who slowed by 0.1 seconds more per year than their peers were 47 percent more likely to struggle cognitively.

Researchers from the University of Pittsburgh in Pennsylvania, US found that people, who developed slow walking, showed shrinkage of their right hippocampus. This area of the brain, which is similar in shape to a seahorse, is primarily associated with memory and the ability to maintain posture, in relation to the physical space around you when at rest and during motion.

The findings suggested that dementia could be treated earlier if doctors regularly measure the walking speeds of older patients and watch for changes over time. “Prevention and early treatment may hold the key to reducing the global burden of dementia, but the current screening approaches are too invasive and costly to be widely used,” said a researcher Andrea Rosso.

The team looked at 175 people, aged 70 to 79, who had good health and normal mental function, at the start, for 14 years. The participants were regularly assessments over the years, involving the participants walking an 18-foot stretch of hallway while they were timed.

The study found that dementia could be treated earlier if doctors regularly measure the walking speeds of older patients and looked for changes over time.

The results revealed that the right hippocampus was the only area of the brain found to shrink in relation to both gait slowing and cognitive impairment. The finding held even when the researchers took into account slowing caused by muscle weakness, knee pain and diseases, including diabetes, heart disease and hypertension.

“What we’re finding is that physicians also should consider that there may be a brain pathology driving the slowing gait and refer the patient for a cognitive evaluation,” Rosso noted.

Brain-damaging vaccines, pesticides and medicines generate nearly $800 billion a year in medical revenues.


‘The current estimated annual cost for nine of the most common neurological disorders in the U.S. was a hefty $789 billion, a recent paper revealed. According to the paper, these conditions include Alzheimer’s disease and other forms of dementia, traumatic brain injury and Parkinson’s disease, as well as epilepsy, multiple sclerosis, and spinal cord injury.

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Researchers also projected that health care costs associated with brain damage will continue to increase as the number of elderly patients were expected to double between 2011 and 2050. Data showed that medical costs related to dementia and stroke alone were estimated to be more than $600 billion by 2030.

“The findings of this report are a wake-up call for the nation, as we are facing an already incredible financial burden that is going to rapidly worsen in the coming years. Although society continues to reap the benefits of the dramatic research investments in heart disease and cancer over the last few decades, similar levels of investment are required to fund neuroscience research focused on curing devastating neurological diseases such as stroke and Alzheimer’s, both to help our patients and also to avoid costs so large they could destabilize the entire health care system and the national economy,” said lead author Dr. Clifton Gooch, ScienceDaily.com reports.’

Source:www.davidicke.com

Space travel and long term brain damage.


IN BRIEF
  • Astronauts who will travel to Mars may have a higher chance of developing dementia and long-term brain damage.
  • Despite this, NASA is optimistic in thinking it can resolve all the issues by the 2030s.

A DANGEROUS TRIP

NASA, SpaceX, Boeing, and many other parties from all over the world are dead set on reaching the next frontier of human spaceflight: Mars. In fact, NASA has started recruiting people who want to experience “The Martian” in real life.

But before you start begging NASA for a chance to go, you may want to consider this new finding. A team from UC Irvine has found that astronauts who will travel to Mars may have a higher chance of developing dementia and long-term brain damage.

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Scientific Reports/University of California, Irvine

To be fair, this news isn’t really much of a shocker. Astronauts who come from the ISS experience a whole host of bodily changes: reduced bone mass, damage to the central nervous system, sleep disturbance, even excessive flatulence. But scientists found that travel to Mars (which would involve a longer spaceflight than anybody has ever endured) could have a more disastrous effect on the brain and nervous system.

UCI’s Charles Limoli and colleagues saw that rats bombarded with charged particle irradiation had less dendrites and spines in their neurons. Moreover, they found that these effects persisted even six months after bombardment. The team also saw that the bombardment affected the “fear extinction” of the subjects. That means they couldn’t suppress memories of stressful and fearful situations.

 That means astronauts would think less clearly when confronted with an emergency or problem in the voyage.

TECHNOLOGY AND BIOLOGY

UCI’s research just underscores the fact that developing the right technology isn’t the only thing we need to get us to the red planet. We also need to understand more about how our bodies perform in space, and consider ways to keep astronauts healthy and alert.

The good news is that this problem has been anticipated by the government, and NASA has been called to add to studies on human health in space. They’ll be taking a look at the top hazards for the three-year, round-trip Mars missions including cancer, cataracts, infertility, and even how extreme isolation could lead to psychological problems. No one wants cabin fever in space.

Despite all this, Inspector General Paul Martin pointed out that the space agency is optimistic in thinking it can resolve all the issues by the 2030s. They’ve definitely got a long list to tackle.

Source:futurism.com

Study: Metformin Linked to Higher Risk of Alzheimer’s and Parkinson’s


Metformin and Alzheimer's disease

A recent study found that the use of metformin in people with diabetes increased their risk for developing dementia and Parkinson’s Disease.

This may be surprising as not too long ago, we reported on a different study which found the opposite–that using metformin might lower the risk for dementia in older men.

The study from Taiwanese researchers was presented on March 29, 2017 at The 13th International Conference on Alzheimer’s and Parkinson’s Diseases in Vienna Austria by Dr. Yi-Chun Kuan from the Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.

The researchers found that long-term use of metformin may raise the risk of neurodegenerative disease in those with type 2 diabetes.

How Harmful Might Metformin Be to the Brain?

As reported by Medscape Medical News, Yi-Chun Kuan and team conducted a cohort study to follow a total 9,300 patients with type 2 diabetes in Taiwan for up to 12 years. They checked records for these patients from the National Health research database of Taiwan including 4,651 who had metformin prescriptions and 4651 matched controls who didn’t take any metformin.

Dr. Kuan told Medscape they adjusted for age, sex, and diabetes severity and that despite this, “the cumulative incidences of Parkinson’s and dementia were significantly higher for our metformin cohort” at 12 years.

In fact, the risk for Parkinson’s disease or Alzheimer’s dementia went up over 50 percent during a 12 year period in those who took metformin when compared to those who did not. Researchers also found that “outcome risks increased progressively with higher dosage and longer duration of treatment.”

Dr. Yi-Chun Kuan said, “We’d heard about a possible protective effect from metformin. However, we found the reverse,” and she added that large-scale, prospective studies would need to be done in other countries to get clarification of the results.

Another detail the researchers noted was that outcomes increased the longer a patient was on metformin and the higher the metformin dose they took, “especially with use for more than 300 days and doses greater than 240 g.”

A limitation of the study was that the patients on metformin might also be taking other diabetes drugs like insulin or sulfonylureas and Dr. Kuan said that she and her team would like to follow up on these other possible associations.

There was also no word on what the patient’s HbA1c levels were to help indicate the state of diabetes management nor an explanation on how factors were controlled for, as medical consultant, Dr. Larry Ereshefsky told Medscape.

Could a B12 Deficiency Have Anything to Do With It?

Recently, metformin has been shown to possibly cause B12 deficiency, particularly in those who take it longterm. One of the side effects of a B12 deficiency is neuropathy, or nerve damage.

A serious B12 deficiency has been known to also cause side effects like cognitive difficulties such as memory loss.

While this study still needs a follow-up, if you are concerned about metformin or your B12 levels, talk to your health care provider who can provide testing and if needed, guidance on how to get your B12 levels up.

Source:www.diabetesdaily.com

Top Environmental Risk Factors for Dementia Identified


dementia risk

Story at-a-glance

  • Alzheimer’s currently affects an estimated 5.4 million Americans. By 2050, Alzheimer’s diagnoses are projected to triple
  • Experts have compiled a list of top environmental risk factors thought to be contributing to the epidemic. Vitamin D deficiency, air pollution and occupational pesticide exposure top this list
  • Alzheimer’s shares many risk factors with heart disease. This includes smoking, alcohol use, diabetes, high fasting blood sugar levels, insulin resistance, obesity and high blood pressure

“Dementia” is an umbrella term covering an array of neurological diseases and conditions that develop when neurons in your brain die or cease to function normally. The death or malfunction of neurons causes changes in memory, behavior and ability to think.

Alzheimer’s disease, which is the most serious form of dementia, eventually leads to the inability to carry out even the most basic of bodily functions, such as swallowing or walking. Alzheimer’s is ultimately fatal, as conventional treatment options are few and limited in effectiveness.

Disturbingly, Alzheimer’s has reached epidemic proportions, currently affecting an estimated 5.4 million Americans.1 In the next 20 years it is projected that Alzheimer’s will affect 1 in 4 Americans, rivaling the current prevalence of obesity and diabetes and by 2050, Alzheimer’s diagnoses are projected to triple.2,3

Already, more than half a million Americans die from the disease each year, making it the third leading cause of death in the U.S., right behind heart disease and cancer.4,5Considering there’s no known cure and so few treatments, prevention is key.

Top Environmental Risk Factors Identified

As with autism, it’s quite reasonable to suspect that a variety of factors are at play, collectively contributing to the rapid rise in Alzheimer’s prevalence.

Experts at the Edinburgh University’s Alzheimer Scotland Dementia Research Centre have now compiled a list of top environmental risk factors thought to be contributing to the epidemic.6,7,8 As reported by BBC News:9

“Dementia is known to be associated with lifestyle factors such as high blood pressure in mid-life, smoking, diabetes, obesity, depression and low educational attainment, as well as genetic factors.

But the Edinburgh researchers said a third of dementia risk was unexplained, and they want to determine whether other issues are at play, including the environment.”

Not surprisingly (if you’ve been paying attention to the research), vitamin D deficiency, air pollution and occupational pesticide exposure top this list. Living close to power lines also has “limited yet robust” evidence suggesting it may influence your susceptibility to dementia.

All Forms of Air Pollution Raise Your Dementia Risk

The risk factor with the most robust body of research behind it is air pollution. In fact, they couldn’t find a single study that didn’t show a link between exposure to air pollution and dementia. Particulate matter, nitric oxides, ozone and carbon monoxide have all been linked to an increased risk.

Aside from raising your risk for dementia, a recent World Health Organization (WHO) report10 on environmentally related deaths claim that 1 in 4 deaths worldwide are now related to living and working in a toxic environment — with air pollution being the greatest contributor to this risk. As noted by WHO Director-General, Dr. Margaret Chan:

“A healthy environment underpins a healthy population. If countries do not take actions to make environments where people live and work healthy, millions will continue to become ill and die too young.”

During the World Health Assembly, held in May 2016, WHO vowed it “will propose a roadmap to increase the global response by the health sector to reduce the effects of air pollution.”

Pollution, Diabetes and Dementia

American researchers have also warned that exposure to air pollution for as little as one or two months may be enough to increase your risk of diabetes — especially if you’re obese.11

Diabetes, in turn, is a significant risk factor for Alzheimer’s, doubling your chances of contracting this devastating form of dementia. Alzheimer’s was even tentatively referred to as type 3 diabetes at one time.

Recent research has also confirmed that the greater an individual’s insulin resistance, the less sugar they have in key parts of their brain, and these areas typically correspond to the areas affected by Alzheimer’s.12,13

Needless to say, the most significant contributor to insulin resistance and type 2 diabetes is not pollution but rather your diet. More specifically, eating a diet that is excessively high in net carbohydrates (total carbs minus fiber) and too low in healthy fats, which I will discuss further below, can contribute to insulin resistance.

Sensible Sun Exposure Is Important for Brain Health

The Scottish Dementia Research Centre also noted there’s a very clear link between vitamin D deficiency and dementia. Indeed, studies have shown vitamin D plays a critical role in brain health, immune function, gene expression and inflammation — all of which influence Alzheimer’s.

In a 2014 study,14 considered to be the most robust study of its kind at the time, those who were severely deficient in vitamin D had a 125 percent higher risk of developing some form of dementia compared to those with normal levels. According to the authors:

“Our results confirm that vitamin D deficiency is associated with a substantially increased risk of all-cause dementia and Alzheimer disease. This adds to the ongoing debate about the role of vitamin D in nonskeletal conditions.”

The findings also suggest there’s a threshold level of circulating vitamin D, below which your risk for dementia increases. This threshold was found to be right around 20 nanograms per milliliter (ng/ml) or 50 nanomoles per liter (nmol/L). Please recognize that higher levels are associated with better brain health.

Based on a broader view of the available science, 20 ng/ml is still far too low, as the bulk of the research suggests a healthy range is between 40 to 60 ng/ml, certainly no lower than 40 ng/ml. Sadly, a vast majority of people are severely deficient, in large part because they’ve been fooled into fearing sun exposure.

Researchers have previously estimated that half of the general population is at risk of vitamin D deficiency or insufficiency. Among seniors, that estimate reaches as high as 95 percent. This suggests vitamin D may be a very important factor for successful prevention among the general population.

A wide variety of brain tissue contains vitamin D receptors, and when they’re activated by vitamin D, it facilitates nerve growth in your brain.

Researchers also believe that optimal vitamin D levels boost levels of important brain chemicals, and protect brain cells by increasing the effectiveness of glial cells in nursing damaged neurons back to health.

Vitamin D may also exert some of its beneficial effects on your brain through its anti-inflammatory and immune-boosting properties, which are well established.

Heart and Brain Health Are Closely Linked

It may be helpful to remember that Alzheimer’s shares many risk factors with heart disease.15 This includes smoking, alcohol use, diabetes, high fasting blood sugar levels, insulin resistance and obesity.16

Arterial stiffness (atherosclerosis) is associated with a hallmark process of Alzheimer’s, namely the buildup of beta-amyloid plaque in your brain.

The American Heart Association (AHA) also warns there’s a strong association between hypertension and brain diseases such as vascular cognitive impairment (loss of brain function caused by impaired blood flow to your brain) and dementia.17

In one clinical trial, test subjects who consumed high-fructose corn syrup (HFCS) developed higher risk factors for cardiovascular disease in just two weeks, demonstrating just how influential your diet can be on your heart and brain health in the long term.

Such findings dovetail nicely with the conclusions reached by neurologist Dr. David Perlmutter, author of “Grain Brain,” and “Brain Maker,” who has concluded that anything that promotes insulin resistance will ultimately also raise your risk of Alzheimer’s.

Exercise Is Important for Alzheimer’s Prevention

The good news is that lifestyle choices such as diet, exercise and sleep can have a significant impact on your risk. As previously noted by Dr. Richard Lipton of the Albert Einstein College of Medicine — where they study healthy aging — lifestyle changes “look more promising than the drug studies so far” when it comes to addressing neurodegenerative disorders such as Alzheimer’s.18

Exercise, for example, has been shown to protect your brain from Alzheimer’s and other dementias, and also improves quality of life if you’ve already been diagnosed.19 In one study,20 patients diagnosed with mild to moderate Alzheimer’s who participated in a four-month-long supervised exercise program had significantly fewer neuropsychiatric symptoms associated with the disease (especially mental speed and attention) than the non-exercising control group.

Other studies21 have shown that aerobic exercise helps reduce tau levels in the brain. (Brain lesions known as tau tangles form when the protein tau collapses into twisted strands that ends up killing your brain cells.) According to co-author Laura Baker:

“These findings are important because they strongly suggest a potent lifestyle intervention such as aerobic exercise can impact Alzheimer’s-related changes in the brain. No currently approved medication can rival these effects.”

Cognitive function and memory22 can also be improved through regular exercise, and this effect is in part related to the effect exercise has on neurogenesis and the regrowth of brain cells. By targeting a gene pathway called brain-derived neurotrophic factor (BDNF), exercise actually promotes brain cell growth and connectivity.

In one year-long study, elderly individuals who exercised grew and expanded their brain’s memory center by as much as 2 percent per year, where typically that center shrinks with age. It’s also been suggested that exercise can trigger a change in the way the amyloid precursor protein is metabolized,23 thus slowing the onset and progression of Alzheimer’s.

Exercise also increases levels of the protein PGC-1alpha. Research24 has shown that people with Alzheimer’s have less of this protein in their brains, and that cells that contain more of the protein produce less of the toxic amyloid protein associated with Alzheimer’s.

Eating for Brain Health

Reducing your net carbs and increasing healthy fat consumption are another important part of the equation, and my optimized nutrition plan can set you on the right path in that regard.

Research25 from the Mayo Clinic reveals that diets rich in carbohydrates are associated with an 89 percent increased risk for dementia while high-fat diets are associated with a 44 percent reduced risk. Perlmutter places most of his patients on a ketogenic, high-fat and low-net-carb diet that is gluten-free, along with prescribed exercise.

One of the easiest ways to optimize your diet is to make sure you’re only eating real food. Avoid processed foods of all kinds, as they contain a number of ingredients harmful to your brain, including refined sugar, processed fructose, grains (particularly gluten), genetically engineered (GE) ingredients and pesticides like glyphosate (an herbicide thought to be worse than DDT, which has already been linked to Alzheimer’s). Opting for organic produce will help you avoid toxic pesticides.

Also choose organic grass-fed meats and animal products, as animals raised in concentrated animal feeding operations (CAFOs) are routinely fed GE grains contaminated with pesticides, along with a variety of drugs. Some researchers have even suggested Alzheimer’s may be a slow-acting form of mad cow disease, acquired by eating contaminated meats. It’s a rather compelling theory, considering mad cow disease originated in the CAFO system, where herbivores are forced to eat animal parts.

To Protect Your Heart and Brain, Trade Sugar for Healthy Fats, and Other Helpful Tips

Ideally, keep your added sugar levels to a minimum and your total fructose below 25 grams per day, or as low as 15 grams per day if you already have insulin/leptin resistance or any related disorders.

Healthy fats to add to your diet include avocados, butter made from raw, grass-fed organic milk, organic pastured egg yolks, MCT oil, coconuts and coconut oil (coconut oil, and to an even greater degree MCT oil, show particular promise against Alzheimer’s) and raw nuts such as pecans and macadamia, both of which have a near-ideal ratio of protein and healthy fats.

Avoid all trans fats or hydrogenated fats that have been modified in such a way to extend their longevity on the grocery store shelf. This includes margarine, vegetable oils and various butter-like spreads. It’s also advisable to:

  • Avoid gluten. Research shows that your blood-brain barrier is negatively affected by gluten. Gluten also makes your gut more permeable, which allows proteins to get into your bloodstream where they sensitize your immune system and promote inflammation and autoimmunity, both of which play a role in the development of Alzheimer’s.
  • Optimize your gut health by avoiding processed foods, antibiotics and antibacterial products, fluoridated and chlorinated water and by regularly eating traditionally fermented and cultured foods, along with a high-quality probiotic if needed.
  • Optimize your vitamin D. This is ideally done through sensible sun exposure, but as a last resort, vitamin D3 supplements are better than nothing. Just make sure you also increase your intake of vitamin K2 if you take an oral vitamin D supplement. As for dosage, the “right” dose is one that will keep your blood level between 40 and 60 ng/ml.
  • Improve your magnesium levels. Not only does magnesium work in tandem with vitamin D and K2, preliminary research also suggests higher levels of magnesium in the brain help decrease Alzheimer symptoms. Magnesium threonate is one of the few magnesium supplements that appears to be able to actually cross the blood brain barrier, making it my first choice.
  • Increase your intake of animal-based omega-3. I prefer krill oil to fish oil here, as krill oil also contains astaxanthin, which appears to be particularly beneficial for brain health.

Other Alzheimer’s Prevention Strategies

Besides exercise and the key dietary instructions just mentioned, the following suggestions may also be helpful for the prevention of Alzheimer’s disease:

Fasting

Ketones are mobilized when you replace nonfiber carbs with healthy fats. Intermittent fasting is a powerful tool to jumpstart your body into remembering how to burn fat and repair the insulin/leptin resistance that is a primary contributing factor for Alzheimer’s.

A folate-rich diet

Vegetables are your best form of folate, and you’d be wise to eat plenty of fresh raw veggies every day. Avoid supplements like folic acid, which is the inferior synthetic version of folate.

If you enjoy black coffee, keep the habit

While I would not encourage you to drink coffee if you’re not already a coffee drinker, if you enjoy it, there’s good news. Caffeine triggers the release of BDNF that activates brain stem cells to convert into new neurons, thereby improving your brain health.

In one study, people with mild cognitive impairment whose blood levels of caffeine were higher (due to coffee consumption) were less likely to progress to full-blown dementia compared to those who did not drink coffee.26 In another study, older women whose coffee consumption was above average had a lower risk of dementia.27

Just make sure your coffee is organic, as coffee tends to be heavily sprayed with pesticides. For more details on making your coffee habit as healthy as possible, please see my previous article, “Black Coffee in the Morning May Provide Valuable Health Benefits.”

Avoid and eliminate mercury from your body

Dental amalgam fillings, which are 50 percent mercury by weight, are one of the major sources of heavy metal toxicity. However, you really should be healthy prior to having them removed. Once you have adjusted to following the diet described in my optimized nutrition plan, you can follow the mercury detox protocol and then find a biological dentist to have your amalgams removed.

Avoid and eliminate aluminum from your body

Sources of aluminum include antiperspirants, non-stick cookware and vaccine adjuvants, just to mention some of the most common ones. For tips on how to detox aluminum, please see my article, “First Case Study to Show Direct Link between Alzheimer’s and Aluminum Toxicity.”

Avoid flu vaccinations

Most flu vaccines contain both mercury and aluminum.

Avoid statins and anticholinergic drugs

Drugs that block acetylcholine, a nervous system neurotransmitter, have been shown to increase your risk of dementia. These drugs include certain nighttime pain relievers, antihistamines, sleep aids, certain antidepressants, medications to control incontinence and certain narcotic pain relievers.

Statin drugs are particularly problematic because they suppress the synthesis of cholesterol, deplete your brain of coenzyme Q10, vitamin K2 and neurotransmitter precursors, and prevent adequate delivery of essential fatty acids and fat-soluble antioxidants to your brain by inhibiting the production of the indispensable carrier biomolecule known as low-density lipoprotein (LDL).

Get plenty of restorative sleep

Sleep is necessary for maintaining metabolic homeostasis in your brain. Wakefulness is associated with mitochondrial stress; without sufficient sleep, neuron degeneration sets in. While sleep problems are common in Alzheimer’s patients, poor sleep may also be contributing to the disease by driving the buildup of amyloid plaques in your brain.

While you sleep, your brain flushes out waste materials, and if you don’t sleep well, this natural detoxification and clean-out process will be severely hampered.

Challenge your mind daily

Mental stimulation, especially learning something new, such as learning to play an instrument or a new language, is associated with a decreased risk of Alzheimer’s. Researchers suspect that mental challenge helps to build up your brain, making it less susceptible to the lesions associated with Alzheimer’s disease.

Source:mercola.com

New Evidence Shows That Air Pollution Causes Alzheimer’s and Dementia


IN BRIEF
  • In the US, approximately 5 million people live with Alzheimer’s disease, and about 83,000 die from the illness every year
  • Some experts have equated living and breathing the air in Beijing to smoking 40 cigarettes per day

NEURODEGENERATION

Smog and soot is doing a lot more than just obscuring city skylines—according to several studies, air pollution has become so severe that it might increase a person’s risk of Alzheimer’s disease and other types of dementia.

The dangers that inhaling pollution impose on our respiratory system are well documented. Asthma, lung cancer, and even heart disease have been proven to be linked to this exposure. Now, there’s mounting evidence that what lurks in our air could also harm the brain, speeding up cognitive aging that can lead to more serious, debilitating neurological diseases.

Current research is focused on the effects that ultrafine pollutant particles in the air, referred to as PM2.5, have. The smaller these particles are, the more damage they could cause within DNA and other cellular structures.

 

According to one 11-year epidemiological study conducted by University of Southern California (USC) researchers,  exposure to above-normal levels of polluted air may double the risk of dementia. The study focused on older women who lived in places where air pollutants exceeded the Environmental Protection Agency’s (EPA) standard of safety (12 µg/m3). If these results could be shown in a larger group, they could be linked to around 21 percent of dementia cases worldwide.

Supporting USC’s findings, researchers from the University of Toronto have also reported that residents who live within 50 meters of a major thoroughfare were 12 percent more likely to develop dementia due to higher exposure to fine pollutants.

One of the earliest observations of how air pollution affects the brain was based on a study that looked at its effects in aging dogs in Mexico City. According to Neuroscientist Lilian Calderon-Garciduenas, dogs who lived in polluted areas of the city displayed disorientation and couldn’t recognize owners. When the dogs died, they found that these dogs had elevated plaque levels, similar to what is associated with Alzheimer’s disease.

In a separate study where scientists exposed mice to aerosolized pollutants, it was found that mice exposed to pollution showed signs of Alzheimer’s disease and memory loss, as well as other signs of brain damage.

THE AIR WE BREATHE

Despite the severity of these claims, experts are quick to point out that the research is still young, and the correlation between pollution and neurodegeneration has to be studied further.

Until this correlation can be supported further, it might be helpful to study the ramifications of the Anthropocene—an era marked by climate change, air pollution, population growth, and significant rainforest loss—and what we can do about our environment.

In 2013, China was forced to shut down the city of Harbin, a major city in the world’s biggest industrial nation with over 11 million residents, due to smog. Last year, NASA and the California Institute of Technology illustrated the severity of pollution originating from Asia and how it affects cloud development in regions as far as North America, strengthening tropical cyclones. And this year, Beijing and Tianjin, major urban centers in China, issued red alerts due to heavy, toxic smog that enveloped the cities.

Because of our dependence on fossil fuels, considered to be the biggest pollutant to date, it’s hard to completely eliminate air pollution. But while we are unable to control the air itself, we do have the ability to control what goes in it, and at the end of the day, we can continue working to protect ourselves. So, as research continues and the case against pollution grows, we can try to think of ways to limit our own impacts on the environment.