This month’s newsletter deals with several recent articles on preventing brain aging, a concept that will get more and more attention. The system still emphasizes treatment with ineffective, expensive drugs, but, the only rational approach to cognitive decline is to teach people at a young age that diseases like Alzheimer’s are better prevented than treated. For instance, did you know that dairy increases the risk of Parkinsonism, as many environmental toxins do, especially pesticides? Fortunately, a plant-based diet, learning new skills, and exercising lower the risk of neurologic deterioration. Hugo Rodier, MD
Coverage from the Alzheimer’s Association International Conference (AAIC) 2017
Abstract P2-552, presented Monday July 17, 2017. Inflammatory Dietary Pattern Linked to Brain Aging. LONDON – Researchers believe they have uncovered a key piece of the puzzle in the connection between diet and dementia. They linked a specific dietary pattern to blood markers of inflammation. In addition, they showed that in elderly adults who followed such a dietary pattern, brain gray matter volume was less, and they had worse visuospatial cognitive function. “We found that people who consume less omega 3, less calcium, vitamin E, vitamin D, and vitamin B5 and B2 have more inflammatory biomarkers,” study investigator Yian Gu, PhD, Columbia University and the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, New York City, told Medscape Medical News.
An inflammatory dietary pattern, said Dr Gu, “is bad for both the brain and cognition.” Evidence cited by Dr Gu suggests that dietary factors such as fish, nuts, omega-3 polyunsaturated fatty acids, and folate, as well Mediterranean-type diets, are associated with lower risk for Alzheimer’s disease (AD) and better brain health in the elderly. Other evidence, she said, shows that many foods and nutrients modulate inflammatory processes. Other studies have linked chronic inflammation to an increased risk for AD. Dr Gu’s group previously showed an association between increased C-reactive protein (CRP) and interleukin-6 (IL6) levels and worse cognition and smaller brain volumes. But none of this research addressed whether diet affects brain and cognitive health by modulating inflammation. “No study has formally tested whether the relationship of diet with cognition, or with the brain, is actually because of inflammation,” said Dr Gu.The new cross-sectional study included 330 elderly adults from the Washington Heights–Inwood Community Aging Project imaging study. In these participants, researchers carried out structural MRI scans and measured levels of the inflammatory biomarkers CRP and IL6. Study participants completed a 61-item food frequency questionnaire that asked about nutrient intake during the past year. From this information, the researchers used a statistical model to create the inflammation-related nutrient pattern (INP).
“The INP is basically a linear combination of 24 nutrients, each with a different weight on the INP,” said Dr Gu. “For example, omega-3 is negatively ‘loaded’ – which is similar to ‘correlated’ – on this pattern. Lower consumption of omega-3 will contribute to a higher INP score.” Study participants also underwent neuropsychological testing that assessed memory, language, executive speed, and visuospatial function. From these test scores, the researchers calculated a composite mean cognition score for each participant. The study showed that the INP was positively correlated with CRP level (P = .009) and IL6 level (P < .0001). Those with fewer years of education had a relatively high INP. The INP was higher for African Americans (P < .0001) and Hispanics (P = .003) compared to whites.
The researchers determined that having a smaller brain gray matter volume might help explain why those who consume more inflammatory nutrients have worse visuospatial cognition. This study is important because “now you have a linkage to measurable biological differences,” said Keith Fargo, PhD, director of scientific programs at the Alzheimer’s Association. “If your cognition is poor, we know something has to be going on.” These new findings suggest that interventions that decrease inflammatory markers may be helpful. “It gives us some ideas of what pathways might be involved,” said Dr Fargo. Once that is known, it may be possible to intervene, not just through a healthier diet but perhaps also with medications. “At least, there may be some targets to work with,” said Dr Fargo.
Healthy older adults who follow the Mediterranean or MIND diet may lower their risk of dementia, studies suggest
CNN (7/17, Lamotte) reports two large studies suggest that “healthy older adults who followed the Mediterranean or the similar” Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) “diet lowered their risk of dementia by a third.” Both studies were presented at the Alzheimer’s Association International Conference.
HealthDay (7/17, Thompson) reports that “seniors who carefully followed the MIND diet had a 35 percent lower risk of declining brain function as they aged.”
Lifestyle changes may delay, slow dementia
ABC World News Tonight (6/22, story 11, 0:20, Muir) reported, “The National Academies of Sciences” has concluded “that there is no proven way to stop Alzheimer’s, but certain lifestyle decisions may help.”
NBC Nightly News (6/22, story 9, 2:00, Holt) reported, “There hasn’t been solid proof that there’s anything you can do to reduce your risk, but tonight a new report finds there are three good habits you should be practicing now that could delay memory loss.”
The AP (6/22, Neergaard) reports that even though “there are no proven ways to stave off mental decline or dementia…a new report says there are hints that exercise, controlling blood pressure and some forms of brain training might offer help.” In the absence of proof, “the government should not begin a public health campaign pushing strategies for aging brain health, the National Academies of Sciences, Engineering and Medicine said in a report released” June 22 that came in response to a National Institute on Aging (NIA) request.
USA Today (6/22, Toy) reports, “The report’s findings line up with the Alzheimer’s Association’s findings from two years ago, said Keith N. Fargo, the association’s director of Scientific Programs and Outreach.” At that time, “the organization published its own review and identified two things that could help minimize the risk of cognitive decline.” Those two things were “‘increasing physical activity and improving cardiovascular health,’ he said.”