Alzheimer's Archive

If you are noticing problems in yourself or a loved one, here's where to turn for help and support.

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You're talking with a friend about a movie you saw recently, but can't remember the actor's name. Last week you found yourself upstairs, but couldn't remember what you came up to look for. Your keys are always missing. You worry: are these normal memory lapses or early signs of Alzheimer's disease or another form of dementia?

"Because there has been so much attention paid lately to the aging baby boomer population, I think Alzheimer's disease is getting a lot of attention, which is leading a lot of people to believe they may have the condition," says Dr. Suzanne Salamon, associate chief of the gerontology division at Beth Israel Deaconess Medical Center and assistant professor of medicine at Harvard Medical School.

News briefs

You've probably heard about tests to measure chemicals in the blood that indicate chronic inflammation in the body. They are sometimes used to estimate risk for heart disease. But what about using these kinds of biomarkers to gauge your risk for declining brain health? A study published Nov. 1, 2017, in Neurology found that having certain inflammatory markers in midlife was associated with brain shrinkage and poor memory in older age.

Researchers measured five inflammation biomarkers in about 1,600 middle-aged people and gave them brain scans and a memory test about 25 years later. Compared with people with no elevated inflammation markers, people with high levels of three or more biomarkers scored lower on the memory test and had about 5% shrinkage in the hippocampus and other parts of the brain associated with Alzheimer's disease.

Research we're watching

Among people who have atrial fibrillation (afib), those who take anti-clotting medications may be less likely to develop dementia later in life than those who don't take the drugs, a new study finds.

Afib, a disorder marked by a rapid, irregular heartbeat, raises the risk of stroke as well as dementia. Anti-clotting drugs are known to lower the risk of stroke, but the drugs' effects on dementia weren't clear. So Swedish researchers examined hospital and pharmacy registry data from nearly half a million people who were diagnosed with afib between 2006 and 2014.

In the journals

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If you have persistent trouble detecting or identifying odors, that may be an early sign of dementia, according to a study in the Sept. 25, 2017, Journal of the American Geriatrics Society. Almost 3,000 older adults, ages 57 to 85, who did not have dementia were asked to detect and identify five common odors like peppermint, fish, orange, rose, and leather. Five years later, the researchers found that almost half of those who performed poorly on the smell test (were either unable to detect the odors or unable to identify what the smells were) had been diagnosed with dementia. In comparison, 79% of those who scored high on the smell test did not have dementia.

The results only show an association between poor sense of smell and dementia, but the researchers noted that a smell test could be a simple way to identify high-risk people. It isn't clear how sense of smell and dementia may be linked, but the researchers speculated that underlying causes of dementia, like amyloid plaque buildup and tau tangles in the brain, also may affect the olfactory (sense of smell) system.

MCI can be tough to identify, but there may be ways to postpone, and possibly prevent, its impact on memory and thinking.

Everyone has the occasional bout of forgetfulness, whether it's misplacing your keys or blanking out on a name. But if these episodes become frequent or interfere with daily life, you may have mild cognitive impairment, or MCI.

MCI falls somewhere between the usual cognitive decline of normal aging and the more serious signs of dementia and Alzheimer's disease. An estimated 10% to 20% of adults older than 65 have MCI, according to the Alzheimer's Association. But this gray area of brain health is often difficult to detect.

Factors that harm your heart may be bad for your brain.

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During middle age, factors that leave you prone to a heart attack or stroke — high blood pressure, diabetes, and smoking — may raise your risk of developing dementia a quarter-century later, new research suggests. All three things affect your vascular (blood vessel) health.

The recent study, which adds to the growing evidence linking heart health to brain health, has elements that make findings especially reliable, says Dr. Gad Marshall, a Harvard Medical School assistant professor of neurology. "For understanding the vascular risks for dementia, this study is as close to definitive as we can get," he says.

On call

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Q. I have been seeing a lot about brain training programs to improve memory. Do they really work?

A. Brain training programs promise to preserve cognitive abilities, but so far research has not found they can delay or prevent brain decline.

Research we're watching

Last month, Harvard Women's Health Watch talked about how high blood pressure can cause a series of tiny strokes that damage your brain, increasing your risk of dementia and cognitive changes. A study in the August 8 issue of Circulation shows that this might not be the only concern when it comes to blood pressure and your mind. Researchers in Japan found that large and frequent fluctuations in blood pressure — not just high blood pressure — was associated with an increased risk of both Alzheimer's disease and vascular dementia.

The study authors asked 1,674 dementia-free participants ages 60 and older to measure their blood pressure at home, three times every morning, for about four weeks. They followed up about five years later to see who went on to develop dementia.

Want to keep your mind sharp? Be aggressive about treating your high blood pressure.

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If you're like a lot of people, you probably think of your heart when you think about blood pressure. But you should also think about your mind.

"High blood pressure is not just a disease or condition. It's actually a risk factor. It's a risk factor for heart disease and stroke, and it's a risk factor for cognitive decline and dementia," says Dr. Natalia Rost, a stroke neurologist at Massachusetts General Hospital and associate professor of neurology at Harvard Medical School.

Can getting quality sleep help prevent the disease?

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A good night's sleep does more than rejuvenate you for the next day. It may help protect you against Alzheimer's disease. Research has begun to show an association between poor sleep and a higher risk of accumulating beta-amyloid protein plaque in the brain, one of the hallmarks of the disease.

"Observational studies have found that adults over age 65 with amyloid plaques in their brain have reduced slow-wave sleep, which is thought to play an important role in memory function, even though these people do not yet show signs of Alzheimer's, like memory loss and cognitive decline," says Dr. Brad Dickerson, associate professor of neurology at Harvard Medical School. "It may be that quality sleep could play a role in who may get Alzheimer's."