Alzheimer's Disease Archive

News briefs

We often tell you about using aerobic exercise and a healthy diet to try to stave off dementia. But will those approaches help if you already have the slight but noticeable change in memory and thinking known as mild cognitive impairment (MCI)? A small randomized trial (the gold standard type of study) published online Dec. 19, 2018, by Neurology suggests the combination of diet and exercise may indeed help. Researchers studied 160 sedentary older adults who had MCI as well as one or more cardiovascular disease risk factors, such as high cholesterol. Participants were randomly assigned to do aerobic exercise, to follow a heart-healthy diet (the Dietary Approaches to Stop Hypertension, or DASH, diet), to do a combination of aerobic exercise and the DASH diet, or to just get weekly heart health education. After six months, people who just exercised several times a week got a little bump in executive function (thinking skills that help us plan and organize), but the biggest change was seen in people who both followed the DASH diet and did aerobic training three times a week. Their improved planning skills were equivalent to reversing nearly 10 years of brain aging, compared with study participants who didn't exercise or improve their diets. The findings demonstrate that it's never too late to start exercising and eating right.

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But these remedies aren't the best choice if you have frequent heartburn.

You feel the familiar sensation in your chest: heartburn. Again, you find yourself reaching for the bottle of antacids in the medicine cabinet. It's something you've done a few times a week for the past six months. Is it okay to keep popping over-the-counter acid reducers, or is it time to see a doctor?

We asked two experts, Dr. Jennifer Nayor and Dr. Molly Linn Perencevich, both instructors in medicine at Harvard Medical School, for their thoughts on heartburn, including when it's okay to use over-the-counter antacids and when you should seek other treatments. Below are their responses.

At 70 years and counting, the Framingham Heart Study continues to help doctors better understand stroke, dementia, and heart disease.

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In 1948, more than 5,200 people living in a town just west of Boston volunteered for what has evolved into the longest running and best-known study of the causes of heart disease. But the multigenerational Framingham Heart Study has also revealed important clues about brain disorders — most notably stroke but also cognitive decline and dementia (see "Framingham's brain health findings").

In the early 1960s, Framingham researchers coined the term "risk factor," which refers to a characteristic or exposure that raises a person's odds of developing a disease. Over the following decades, they uncovered many such factors for heart disease, including cigarette smoking, obesity, lack of physical activity, and high blood pressure. These habits and conditions also turned out to predispose people to stroke and dementia, thereby establishing that what harms the heart is also bad for the brain.

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In the journals

People with atrial fibrillation, or afib, a type of irregular heartbeat that is linked with stroke, also may have a greater risk of dementia than those without the condition, according to a study published online Oct. 10, 2018, by Neurology.

Researchers recorded medical data from 2,685 people, average age 73. None of them had dementia and 243 had afib. After nine years, another 279 people developed afib. The researchers found that people with afib showed a faster rate of decline in thinking and memory skills than those without the condition, and were 40% more likely to develop dementia.

Certain eye conditions offer clues to your chances of developing dementia.

It's long been said that the eyes are the windows to the soul, but can they also provide a view of your brain's future? Researchers increasingly say yes. Studies have identified links between common eye conditions and Alzheimer's disease and other forms of dementia.

One study, published in the July 2018 issue of Alzheimer's & Dementia, appeared to validate past findings that linked three eye diseases — glaucoma, age-related macular degeneration, and diabetic retinopathy — to an increased risk of Alzheimer's disease.

In the journals

Are you excessively sleepy during the day? If so, you may have a higher risk of Alzheimer's disease, according to a recent study published online Sept. 5, 2018, by the journal Sleep.

Scientists asked 124 healthy older adults, average age 60, about how often they felt drowsy or fell asleep during the day when they would rather be awake, as well as their napping habits. The group then had regular PET scans over the next 15 years to look for beta-amyloid in the brain, high amounts of which are a hallmark for Alzheimer's.

News briefs

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A French study published Aug. 21, 2018, in The Journal of the American Medical Association suggests that the more steps you take to boost your heart health, the lower your risk for developing dementia. Researchers evaluated health and lifestyle data for more than 6,000 men free of dementia and heart disease men in their 70s to see how they were doing when it came to following seven steps recommended by the American Heart Association: not smoking; controlling weight; getting regular physical activity; eating a healthy diet (that included fish twice a week or more, and fruits and vegetables at least three times per day); and maintaining healthy blood pressure, cholesterol, and blood sugar levels. Researchers also conducted psychological testing on participants at various times. After eight years, it appeared that men who followed five to seven of the healthy habits had the least risk (8%) for developing dementia during the study, compared with men who followed two or fewer habits (they had a 13% risk). The study was observational and doesn't prove that following heart-healthy habits will lower your dementia risk. But many other studies have made similar connections. The takeaway: It's not too late to try to prevent dementia.

In the journals

Previous research has linked excess body fat with a higher risk of cognitive decline. In the past, most studies have gauged body fat based on body mass index (BMI). However, waist size may be a better way to predict possible cognitive impairment among older adults, according to a study in the Sept. 14, 2018, issue of the British Journal of Nutrition.

Researchers examined health data on 5,186 people ages 60 and older. They found that a larger waist size was associated with reduced performance in such mental abilities as attention and visuospatial skills (the ability to perceive the differences and similarities between objects). The study participants also scored lower on memory tests.

Ask the doctor

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Q. I know that some viruses live permanently inside us, but only make trouble now and then. I even heard recently that they might be a cause of Alzheimer's disease. Why do they sometimes cause disease, and can we keep that from happening?

A. We live all of our lives with various microorganisms on us and inside us. One example is the herpes family of viruses. Out of more than a hundred herpesviruses, there are nine that infect humans. Once we get infected with these viruses — usually early in life — they remain with us, "asleep" inside some of our cells. But periodically, they "wake up" (reactivate), start producing multiple copies of themselves, and infect other cells. That's what's happening when a cold sore suddenly forms on your lip.

Research we're watching

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Aggressively treating high blood pressure might help ward off cognitive changes, according to findings presented at the Alzheimer's Association International Conference in July. Researchers from the Systolic Blood Pressure Intervention Trial compared two strategies to manage high blood pressure in more than 9,300 older adults (average age about 68). One strategy aims to achieve the standard treatment level for high systolic blood pressure (the first number in a blood pressure reading), keeping it under 140 mm Hg. The more aggressive strategy sets a goal of less than 120 mm Hg. The aggressive strategy reduced not only heart risks, but seemed to protect the brain.

People in the more aggressively controlled blood pressure group were 19% less likely than those in the standard treatment group to develop new cases of mild cognitive impairment (often a forerunner to dementia). They were also 15% less likely to develop any form of dementia or mild cognitive impairment. This study provides another reason to work with your doctor to reduce high blood pressure.