Vitamin D Tied to Women's Cognitive Performance

Two new studies appearing in the Journals of Gerontology Series A: Biological Sciences and Medical Sciences show that vitamin D may be a vital component for the cognitive health of women as they age.

Higher vitamin D dietary intake is associated with a lower risk of developing Alzheimer's disease, according to research conducted by a team led by Cedric Annweiler, MD, PhD, at the Angers University Hospital in France.

Similarly, investigators led by Yelena Slinin, MD, MS, at the VA Medical Center in Minneapolis found that low vitamin D levels among older women are associated with higher odds of global cognitive impairment and a higher risk of global cognitive decline.

Slinin's group based its analysis on 6,257 community-dwelling older women who had vitamin D levels measured during the Study of Osteopathic Fractures and whose cognitive function was tested by the Mini-Mental State Examination and/or Trail Making Test Part B.

Very low levels of vitamin D (less than 10 nanograms per milliliter of blood serum) among older women were associated with higher odds of global cognitive impairment at baseline, and low vitamin D levels (less than 20 nanograms per milliliter) among cognitively-impaired women were associated with a higher risk of incident global cognitive decline, as measured by performance on the Mini-Mental State Examination.

Annweieler's team's findings were based on data from 498 community-dwelling women who participated in the Toulouse cohort of the Epidemiology of Osteoporosis study.

Among this population, women who developed Alzheimer's disease had lower baseline vitamin D intakes (an average of 50.3 micrograms per week) than those who developed other dementias (an average of 63.6 micrograms per week) or no dementia at all (an average of 59.0 micrograms per week).

These reports follow an article published in the Journals of Gerontology Series A earlier this year that found that both men and women who don't get enough vitamin D -- either from diet, supplements, or sun exposure -- may be at increased risk of developing mobility limitations and disability.

Brief Exercise Immediately Enhances Memory: Results Apply to Older Adults Both With and Without Cognitive Deficits

A short burst of moderate exercise enhances the consolidation of memories in both healthy older adults and those with mild cognitive impairment, scientists with UC Irvine's Center for the Neurobiology of Learning & Memory have discovered.

Most research has focused on the benefits of a long-term exercise program on overall health and cognitive function with age. But the UCI work is the first to examine the immediate effects of a brief bout of exercise on memory.

In their study, post-doctoral researcher Sabrina Segal and neurobiologists Carl Cotman and Lawrence Cahill had people 50 to 85 years old with and without memory deficits view pleasant images -- such as photos of nature and animals -- and then exercise on a stationary bicycle for six minutes at 70 percent of their maximum capacity immediately afterward.

One hour later, the participants were given a surprise recall test on the previously viewed images. Results showed a striking enhancement of memory by exercise in both the healthy and cognitively impaired adults, compared with subjects who did not ride the bike.

"We found that a single, short instance of moderately intense exercise particularly improved memory in individuals with memory deficits," Segal said. "Because of its implications and the need to better understand the mechanism by which exercise may enhance memory, we're following up this study with an investigation of potential underlying biological factors."

She believes the improved memory may be related to the exercise-induced release of norepinephrine, a chemical messenger in the brain known to play a strong role in memory modulation. This hypothesis is based on previous work demonstrating that increasing norepinephrine through pharmacological manipulation sharpens memory and that blocking norepinephrine impairs memory.

In the more recent research, Segal and her colleagues discovered that levels of salivary alpha amylase, a biomarker that reflects norepinephrine activity in the brain, significantly increased in participants after exercise. This correlation was especially strong in people with memory impairment.

"The current findings offer a natural and relatively safe alternative to pharmacological interventions for memory enhancement in healthy older individuals as well as those who suffer from cognitive deficits," Segal noted. "With a growing population of the aged, the need for improvement of quality of life and prevention of mental decline is more important than ever before."

Study results appear in the November, 2012 issue (Volume 32, Number 4) of the Journal of Alzheimer's Disease.

Active Lifestyle Boosts Brain Structure and Slows Alzheimer’s Disease

An active lifestyle helps preserve gray matter in the brains of older adults and could reduce the burden of dementia and Alzheimer's disease (AD), according to a study presented at the 2012 annual meeting of the Radiological Society of North America (RSNA).

Dementia exacts a staggering toll on society. More than 35 million people worldwide are living with the disease, according to the World Health Organization, and the prevalence is expected to double by 2030. AD is the most common cause of dementia and currently has no cure.

Cyrus Raji, M.D., Ph.D., radiology resident at the University of California in Los Angeles, and colleagues recently examined how an active lifestyle can influence brain structure in 876 adults, average age 78 years, drawn from the multisite Cardiovascular Health Study. The patients' condition ranged from normal cognition to Alzheimer's dementia.

"We had 20 years of clinical data on this group, including body mass index and lifestyle habits," Dr. Raji said. "We drew our patients from four sites across the country, and we were able to assess energy output in the form of kilocalories per week."

The lifestyle factors examined included recreational sports, gardening and yard work, bicycling, dancing and riding an exercise cycle.

The researchers used magnetic resonance imaging (MRI) and a technique called voxel-based morphometry to model the relationships between energy output and gray matter volume.

"Voxel-based morphometry is an advanced method that allows a computer to analyze an MR image and build a mathematical model that helps us to understand the relationship between active lifestyle and gray matter volume," Dr. Raji said. "Gray matter volume is a key marker of brain health. Larger gray matter volume means a healthier brain. Shrinking volume is seen in Alzheimer's disease."

After controlling for age, head size, cognitive impairment, gender, body mass index, education, study site location and white matter disease, the researchers found a strong association between energy output and gray matter volumes in areas of the brain crucial for cognitive function. Greater caloric expenditure was related to larger gray matter volumes in the frontal, temporal and parietal lobes, including the hippocampus, posterior cingulate and basal ganglia. There was a strong association between high energy output and greater gray matter volume in patients with mild cognitive impairment and AD.

"Gray matter includes neurons that function in cognition and higher order cognitive processes," Dr. Raji said. "The areas of the brain that benefited from an active lifestyle are the ones that consume the most energy and are very sensitive to damage."

A key aspect of the study was its focus on having variety in lifestyle choices, Dr. Raji noted.

"What struck me most about the study results is that it is not one but a combination of lifestyle choices and activities that benefit the brain," he said.

Dr. Raji said the positive influence of an active lifestyle on the brain was likely due to improved vascular health.

"Virtually all of the physical activities examined in this study are some variation of aerobic physical activity, which we know from other work can improve cerebral blood flow and strengthen neuronal connections," he said.

"Additional work needs to be done," Dr. Raji added. "However, our initial results show that brain aging can be alleviated through an active lifestyle."

Reading, Writing and Playing Games May Help Aging Brains Stay Healthy

Mental activities like reading and writing can preserve structural integrity in the brains of older people, according to a new study presented at the 2012 annual meeting of the Radiological Society of North America (RSNA).

While previous research has shown an association between late-life cognitive activity and better mental acuity, the new study from Konstantinos Arfanakis, Ph.D., and colleagues from Rush University Medical Center and Illinois Institute of Technology in Chicago studied what effect late-life cognitive activity might have on the brain's white matter, which is composed of nerve fibers, or axons, that transmit information throughout the brain.

"Reading the newspaper, writing letters, visiting a library, attending a play or playing games, such as chess or checkers, are all simple activities that can contribute to a healthier brain," Dr. Arfanakis said.

The researchers used a magnetic resonance imaging (MRI) method known as diffusion tensor imaging (DTI) to generate data on diffusion anisotropy, a measure of how water molecules move through the brain. In white matter, diffusion anisotropy exploits the fact that water moves more easily in a direction parallel to the brain's axons, and less easily perpendicular to the axons, because it is impeded by structures such as axonal membranes and myelin. "This difference in the diffusion rates along different directions increases diffusion anisotropy values," Dr. Arfanakis said. "Diffusion anisotropy is higher when more diffusion is happening in one direction compared to others."

The anisotropy values in white matter drop, however, with aging, injury and disease.

"In healthy white matter tissue, water can't move as much in directions perpendicular to the nerve fibers," Dr. Arfanakis said. "But if, for example, you have lower neuronal density or less myelin, then the water has more freedom to move perpendicular to the fibers, so you would have reduced diffusion anisotropy. Lower diffusion anisotropy values are consistent with aging."

The study included 152 elderly participants, mean age 81 years, from the Rush Memory and Aging Project, a large-scale study looking at risk factors for Alzheimer's disease. Participants were without dementia or mild cognitive impairment, based on a detailed clinical evaluation. Researchers asked the participants to rate on a scale of 1 to 5 the frequency with which they participated in a list of mentally engaging activities during the last year. Among the activities were reading newspapers and magazines, writing letters and playing cards and board games.

Participants underwent brain MRI using a 1.5-T scanner within one year of clinical evaluation. The researchers collected anatomical and DTI data and used it to generate diffusion anisotropy maps.

Data analysis revealed significant associations between the frequency of cognitive activity in later life and higher diffusion anisotropy values in the brain.

"Several areas throughout the brain, including regions quite important to cognition, showed higher microstructural integrity with more frequent cognitive activity in late life," said Dr. Arfanakis. "Keeping the brain occupied late in life has positive outcomes."

According to Dr. Arfanakis, diffusion anisotropy drops gradually beginning at around age 30. "Higher diffusion anisotropy in elderly patients who engage in frequent cognitive activity suggests that these people have brain properties similar to those of younger individuals," he said.

Bad air means bad news for seniors' brainpower

Living in areas of high air pollution can lead to decreased cognitive function in older adults, according to new research presented in San Diego at The Gerontological Society of America's (GSA) 65th Annual Scientific Meeting.
This finding is based on data from the U.S. Environmental Protection Agency and the Health and Retirement Study. The analysis was conducted by Jennifer Ailshire, PhD, a National Institute on Aging postdoctoral fellow in the Center for Biodemography and Population Health and the Andrus Gerontology Center at the University of Southern California.
"As a result of age-related declines in health and functioning, older adults are particularly vulnerable to the hazards of exposure to unhealthy air," Ailshire said. "Air pollution has been linked to increased cardiovascular and respiratory problems, and even premature death, in older populations, and there is emerging evidence that exposure to particulate air pollution may have adverse effects on brain health and functioning as well."
This is the first study to show how exposure to air pollution influences cognitive function in a national sample of older men and women. It suggests that fine air particulate matter — composed of particles that are 2.5 micrometers in diameter and smaller, thought to be sufficiently small that if inhaled they can deposit deep in the lung and possibly the brain — may be an important environmental risk factor for reduced cognitive function.
The study sample included 14,793 white, black, and Hispanic men and women aged 50 and older who participated in the 2004 Health and Retirement Study (a nationally representative survey of older adults). Individual data were linked with data on 2004 annual average levels of fine air particulate matter from the Environmental Protection Agency's Air Quality System monitors across the country. Cognitive function was measured on a scale of 1 to 35 and consisted of tests assessing word recall, knowledge, language, and orientation.
Ailshire discovered that those living in areas with high levels of fine air particulate matter scored poorer on the cognitive function tests. The association even remained after accounting for several factors, including age, race/ethnicity, education, smoking behavior, and respiratory and cardiovascular conditions.
Fine air particulate matter exposures ranged from 4.1 to 20.7 micrograms per cubic meter, and every ten point increase was associated with a 0.36 point drop in cognitive function score. In comparison, this effect was roughly equal to that of aging three years; among all study subjects, a one-year increase in age was associated with a drop 0.13 in cognitive function score.

Regular Physical Activity Reduces Risk of Dementia in Older People

In a new study published in the American Heart Association journal Stroke, older, non-disabled people who regularly engaged in physical activity reduced their risk of vascular-related dementia by 40 percent and cognitive impairment of any etiology by 60 percent.

The protective effect of regular physical activity remained regardless of age, education, changes in the brain's white matter and even previous history of stroke or diabetes, researchers said.

The findings are based on a prospective multinational European study that included yearly comprehensive cognitive assessments for three years. The results are part of increasing evidence that regular physical activity promotes brain health, researchers said.

"We strongly suggest physical activity of moderate intensity at least 30 minutes three times a week to prevent cognitive impairment," said Ana Verdelho, M.D., lead author of the study and a neuroscience researcher at the University of Lisbon, Santa Maria Hospital in Portugal. "This is particularly important for people with vascular risk factors such as hypertension, stroke or diabetes."

The analysis included 639 people in their 60s and 70s; 55 percent were women and almost 64 percent said they were active at least 30 minutes a day three times a week. The activity included gym classes, walking and biking.

The American Heart Association recommends at least 150 minutes of moderate exercise every week or 75 minutes of vigorous exercise for optimal health.

Researchers performed magnetic resonance imaging (MRI) tests at the beginning and end of the study to gauge white matter changes in the brain, an indicator of possible cognitive decline.

"Damage of the cerebral white matter is implicated in cognitive problems including depression, walking difficulties and urinary complaints," Verdelho said. "White matter changes are very common in older people and mainly associated with vascular risk factors like hypertension and stroke."

Throughout the study, researchers asked participants in phone interviews and clinical visits about depression, quality of life and performing everyday activities.

At the end of the follow-up, 90 patients had dementia, including 54 with vascular dementia in which impaired blood flow to the brain causes cognitive decline, and 34 patients met criteria for Alzheimer's disease. Another 147 patients developed cognitive impairment, but not dementia.

Aspirin May Slow Brain Decline


Low dose aspirin may ward off cognitive decline in elderly women with a high risk of cardiovascular diseases such as heart disease and stroke, conclude researchers from the University of Gothenburg in Sweden who write about their five-year study in a paper published 3 October in the online journal BMJ Open.

In their introduction, corresponding author Anne Börjesson-Hanson and colleagues explain that many studies have looked at the effect of non-steroidal anti- inflammatory drugs (NSAID) on cognitive decline and dementia, but few have looked at the effect of aspirin on these conditions.

Yet, while researchers have proposed that inflammation might be important in the development of cognitive decline and cardiovascular diseases, and low dose aspirin is widely prescribed to prevent cardiovascular disease, no study has yet examined the effect of aspirin on cognitive function in people at high cardiovascular risk.

For their study, the researchers followed 681 women aged between 70 and 92 for five years. 129 of the women were already taking aspirin at daily doses ranging from 75 and 160 mg, and after undergoing baseline assessments, 601 were classed as having high cardiovascular risk.

Over the study period, the participants underwent more tests of cognitive and thinking skills, including one commonly used in the UK to diagnose dementia, the Mini Mental State Examination (MMSE).

The results showed that while the MMSE scores for the overall group fell over the five years of the study, it fell less for those women taking aspirin.

But although other tests of memory and thinking showed a similar pattern, those results were not statistically significant.

By the end of the study, 41 of the participants developed dementia, but the rate was no different between those on aspirin and those who weren't.

In discussing the possible limitations of their study, the authors say they can't rule out that people with incipient cognitive decline might be less likely to take aspirin anyway.

They conclude that low-dose aspirin treatment "may have a neuroprotective effect in elderly women at high cardiovascular risk".

Simon Ridley, Head of Research at Alzheimer's Research UK, says in a press release:

"The results provide interesting insight into the importance of cardiovascular health on cognition, but we would urge people not to self-medicate with aspirin to try to stave off dementia."

He points out the study found no benefit from aspirin on overall dementia rates, and that previous trials investigating potential benefits of drugs like aspirin for dementia have been negative.

"We know that keeping our heart healthy through regular exercise, a healthy diet, not smoking and keeping our blood pressure and cholesterol in check, can help to reduce the risk of dementia," says Ridley, adding that research into risk factors for cognitive decline must nevertheless become a top priority in the UK because of its increasingly aging population.


Vitamin C and beta-carotene might protect against dementia

Study examines the influence of antioxidants on the pathogenesis of Alzheimer's disease

Forgetfulness, lack of orientation, cognitive decline… about 700, 000 Germans suffer from Alzheimer's disease (AD). Now researchers from the University of Ulm, among them the Epidemiologist Professor Gabriele Nagel and the Neurologist Professor Christine von Arnim, have discovered that the serum-concentration of the antioxidants vitamin C and beta-carotene are significantly lower in patients with mild dementia than in control persons. It might thus be possible to influence the pathogenesis of AD by a person's diet or dietary antioxidants. 74 AD-patients and 158 healthy controls were examined for the study that has been published in the "Journal of Alzheimer's Disease" (JAD).

AD is a neurodegenerative disease: Alterations in the brain caused by amyloid-beta-plaques, degeneration of fibrillae and a loss of synapses are held responsible for the characteristic symptoms. Oxidative stress, which constrains the exploitation of oxygen in the human body, is suspected to promote the development of AD. Whereas so called antioxidants might protect against neurodegeneration. In their study, the researchers have investigated whether the serum-levels of vitamin C, vitamin E, beta-carotene as well as lycopene and coenzyme Q10 are significantly lower in the blood of AD-patients. "In order to possibly influence the onset and development of Alzheimer's disease, we need to be aware of potential risk factors", says Gabriele Nagel.

Participants were recruited from the cross-sectional study IMCA ActiFE (Activity and Function in the Elderly in Ulm) for which a representative population-based sample of about 1,500 senior citizens has been examined. The 65 to 90 years old seniors from Ulm and the surrounding area underwent neuropsychological testing and answered questions regarding their lifestyle. What is more, their blood has been examined and their body mass index (BMI) was calculated. For the present study, scientists have compared 74 patients with mild dementia (average age 78.9 years) with a control group consisting of 158 healthy, gender-matched persons of the same age.

Results are quite interesting: The concentration of vitamin C and beta-carotene in the serum of AD-patients was significantly lower than in the blood of control subjects. Whereas no such difference between the groups could be found for the other antioxidants (vitamin E, lycopene, coenzyme Q10). Potential confounding factors such as education, civil status, BMI, consumption of alcohol and tobacco have been considered in the statistical analysis. Nevertheless, additional parameters such as the storage and preparation of food as well as stressors in the life of participants might have influenced the findings. Therefore, results need to be confirmed in prospective surveys.

"Longitudinal studies with more participants are necessary to confirm the result that vitamin C and beta-carotene might prevent the onset and development of Alzheimer's disease", says Gabriele Nagel. Vitamin C can for example be found in citrus fruits; beta-carotene in carrots, spinach or apricots.

Cocoa may enhance brain function

Eating cocoa flavanols daily may improve mild cognitive impairment, according to new research in the American Heart Association's journal Hypertension.

Each year, more than six percent of people aged 70 years or older develop mild cognitive impairment, a condition involving memory loss that can progress to dementia and Alzheimer's disease.

Flavanols can be found in tea, grapes, red wine, apples and cocoa products and have been associated with a decreased risk of dementia. They may act on the brain structure and function directly by protecting neurons from injury, improving metabolism and their interaction with the molecular structure responsible for memory researchers said. Indirectly, flavanols may help by improving brain blood flow.

In this study, 90 elderly participants with mild cognitive impairment were randomized to drink daily either 990 milligrams (high), 520 mg (intermediate) or 45 mg (low) of a dairy-based cocoa flavanol drink for eight weeks. The diet was restricted to eliminate other sources of flavanols from foods and beverages other than the dairy-based cocoa drink. Cognitive function was examined by neuro-psychological tests of executive function, working memory, short-term memory, long-term episodic memory, processing speed and global cognition.

Researchers found

: • Scores significantly improved in the ability to relate visual stimuli to motor responses, working memory, task-switching and verbal memory for those drinking the high and intermediate flavanol drinks.
• Participants drinking daily higher levels of flavanol drinks had significantly higher overall cognitive scores than those participants drinking lower-levels.
• Insulin resistance, blood pressure and oxidative stress also decreased in those drinking high and intermediate levels of flavanols daily. Changes in insulin resistance explained about 40 percent of the composite scores for improvements in cognitive functioning.


"This study provides encouraging evidence that consuming cocoa flavanols, as a part of a calorie-controlled and nutritionally-balanced diet, could improve cognitive function," said Giovambattista Desideri, M.D., study lead author and director of Geriatric Division, Department of Life, Health and Environmental Sciences, University of L'Aquila in Italy. "The positive effect on cognitive function may be mainly mediated by an improvement in insulin sensitivity. It is yet unclear whether these benefits in cognition are a direct consequence of cocoa flavanols or a secondary effect of general improvements in cardiovascular function."

The study population was generally in good health without known cardiovascular disease. Thus, it would not be completely representative of all mild cognitive impairment patients. In addition, only some clinical features of mild cognitive impairment were explored in the study.

"Given the global rise in cognitive disorders, which have a true impact on an individual's quality of life, the role of cocoa flavanols in preventing or slowing the progression of mild cognitive impairment to dementia warrants further research," Desideri said. "Larger studies are needed to validate the findings, figure out how long the positive effects will last and determine the levels of cocoa flavanols required for benefit."


High blood caffeine levels linked to avoidance of Alzheimer's disease

Those cups of coffee that you drink every day to keep alert appear to have an extra perk – especially if you're an older adult. A recent study monitoring the memory and thinking processes of people older than 65 found that all those with higher blood caffeine levels avoided the onset of Alzheimer's disease in the two-to-four years of study follow-up. Moreover, coffee appeared to be the major or only source of caffeine for these individuals.

Researchers from the University of South Florida (www.usf.edu) and the University of Miami (www.miami.edu)say the case control study provides the first direct evidence that caffeine/coffee intake is associated with a reduced risk of dementia or delayed onset. Their findings will appear in the online version of an article to be published June 5 in the Journal of Alzheimer's Disease, published by IOS Press (http://health.usf.edu/nocms/publicaffairs/now/pdfs/JAD111781.pdf). The collaborative study involved 124 people, ages 65 to 88, in Tampa and Miami.

"These intriguing results suggest that older adults with mild memory impairment who drink moderate levels of coffee -- about 3 cups a day -- will not convert to Alzheimer's disease -- or at least will experience a substantial delay before converting to Alzheimer's," said study lead author Dr. Chuanhai Cao, a neuroscientist at the USF College of Pharmacy (http://health.usf.edu/nocms/pharmacy/) and the USF Health Byrd Alzheimer's Institute (http://health.usf.edu/nocms/byrd/). "The results from this study, along with our earlier studies in Alzheimer's mice, are very consistent in indicating that moderate daily caffeine/coffee intake throughout adulthood should appreciably protect against Alzheimer's disease later in life."

The study shows this protection probably occurs even in older people with early signs of the disease, called mild cognitive impairment, or MCI. Patients with MCI already experience some short-term memory loss and initial Alzheimer's pathology in their brains. Each year, about 15 percent of MCI patients progress to full-blown Alzheimer's disease. The researchers focused on study participants with MCI, because many were destined to develop Alzheimer's within a few years.

Blood caffeine levels at the study's onset were substantially lower (51 percent less) in participants diagnosed with MCI who progressed to dementia during the two-to-four year follow-up than in those whose mild cognitive impairment remained stable over the same period.

No one with MCI who later developed Alzheimer's had initial blood caffeine levels above a critical level of 1200 ng/ml – equivalent to drinking several cups of coffee a few hours before the blood sample was drawn. In contrast, many with stable MCI had blood caffeine levels higher than this critical level.

"We found that 100 percent of the MCI patients with plasma caffeine levels above the critical level experienced no conversion to Alzheimer's disease during the two-to-four year follow-up period," said study co-author Dr. Gary Arendash.

The researchers believe higher blood caffeine levels indicate habitually higher caffeine intake, most probably through coffee. Caffeinated coffee appeared to be the main, if not exclusive, source of caffeine in the memory-protected MCI patients, because they had the same profile of blood immune markers as Alzheimer's mice given caffeinated coffee. Alzheimer's mice given caffeine alone or decaffeinated coffee had a very different immune marker profile.

Since 2006, USF's Dr. Cao and Dr. Arendash have published several studies investigating the effects of caffeine/coffee administered to Alzheimer's mice. Most recently, they reported that caffeine interacts with a yet unidentified component of coffee to boost blood levels of a critical growth factor that seems to fight off the Alzheimer's disease process.

"We are not saying that moderate coffee consumption will completely protect people from Alzheimer's disease," Dr. Cao cautioned. "However, we firmly believe that moderate coffee consumption can appreciably reduce your risk of Alzheimer's or delay its onset."

Alzheimer's pathology is a process in which plaques and tangles accumulate in the brain, killing nerve cells, destroying neural connections, and ultimately leading to progressive and irreversible memory loss. Since the neurodegenerative disease starts one or two decades before cognitive decline becomes apparent, the study authors point out, any intervention to cut the risk of Alzheimer's should ideally begin that far in advance of symptoms.

"Moderate daily consumption of caffeinated coffee appears to be the best dietary option for long-term protection against Alzheimer's memory loss," Dr. Arendash said. "Coffee is inexpensive, readily available, easily gets into the brain, and has few side-effects for most of us. Moreover, our studies show that caffeine and coffee appear to directly attack the Alzheimer's disease process."

In addition to Alzheimer's disease, moderate caffeine/coffee intake appears to reduce the risk of several other diseases of aging, including Parkinson's disease, stroke, Type II diabetes, and breast cancer. However, supporting studies for these benefits have all been observational (uncontrolled), and controlled clinical trials are needed to definitively demonstrate therapeutic value.

A study tracking the health and coffee consumption of more than 400,000 older adults for 13 years, and published earlier this year in the New England Journal of Medicine, found that coffee drinkers reduced their risk of dying from heart disease, lung disease, pneumonia, stroke, diabetes, infections, and even injuries and accidents.

With new Alzheimer's diagnostic guidelines encompassing the full continuum of the disease, approximately 10 million Americans now fall within one of three developmental stages of Alzheimer's disease -- Alzheimer's disease brain pathology only, MCI, or diagnosed Alzheimer's disease. That number is expected to climb even higher as the baby-boomer generation continues to enter older age, unless an effective and proven preventive measure is identified.

"If we could conduct a large cohort study to look into the mechanisms of how and why coffee and caffeine can delay or prevent Alzheimer's disease, it might result in billions of dollars in savings each year in addition to improved quality of life," Dr. Cao said.

Light-to-moderate alcohol consumption, in comparison with abstinence, was associated with approximately 35-45% lower risk of cognitive decline or dementia


Alzheimer's disease (AD) and other types of dementia are most common in the very elderly, and are associated with huge health costs. With a rapidly ageing population throughout the world, factors that affect the risk of cognitive decline and dementia are of great importance. A review paper by Kim JW et al published in Psychiatry Investig 2012;9:8-16 on the association between alcohol consumption and cognition in the elderly provides an excellent summary of the potential ways in which alcohol may affect cognitive function and the risk of dementia, both adversely and favourably as alcohol may have both a neuro toxic and neuro protective effect, depending on the dose and drinking pattern. Longitudinal and brain imaging studies in the elderly show that excessive alcohol consumption may increase the risk of cognitive dysfunction and dementia, but regular low to moderate alcohol intake may protect against cognitive decline and dementia and provide cardiovascular benefits.

Studies published from 1971 to 2011 related to alcohol and cognition in the elderly were reviewed using a PubMed search. At present, there are no proven agents to prevent cognitive decline or dementia, although a number of prospective epidemiologic studies have shown a lower risk of such conditions among light to moderate drinkers in comparison with non-drinkers. Other studies have found that beneficial effects are seen only among certain sub-groups of subjects. A recent meta-analysis by Peters et al of subjects over the age of 65 in longitudinal studies concluded that light-to-moderate alcohol consumption, in comparison with abstinence, was associated with approximately 35-45% lower risk of cognitive decline or dementia.

This paper provides a summary of what is known about the mechanisms by which alcohol consumption, especially heavy drinking, can be neurotoxic, and how light-to-moderate drinking may help protect against cognitive decline and dementia. The authors state that their intent is to determine if there is an "optimal pattern of drinking" that may protect the elderly against such conditions.

At present, the mechanisms by which the moderate intake of wine and other alcoholic beverages reduces the risk of cardiovascular diseases are much better defined than they are for cognition. Forum members agree with the authors that further research is needed to evaluate a potential role that alcohol may play in reducing the risk of dementia.

Forum members also agree that, at present, the specific mechanisms of such putative protection are not well defined, and it would be premature to recommend light-to-moderate drinking for reducing the risk of dementia. On the other hand, current biomedical data supports the concept that regular, moderate intake of ethanol is not simply less dangerous for cognitive function, but is positively protective. This is the same conclusion reached by epidemiologic studies."



With fat: What's good or bad for the heart, may be the same for the brain


It has been known for years that eating too many foods containing "bad" fats, such as saturated fats or trans fats, isn't healthy for your heart. However, according to new research from Brigham and Women's Hospital (BWH), one "bad" fat—saturated fat—was found to be associated with worse overall cognitive function and memory in women over time. By contrast, a "good" fat—mono-unsaturated fat was associated with better overall cognitive function and memory.

This study is published online by Annals of Neurology, a journal of the American Neurological Association and Child Neurology Society, on May 18, 2012.

The research team analyzed data from the Women's Health Study—originally a cohort of nearly 40,000 women, 45 years and older. The researchers focused on data from a subset of 6,000 women, all over the age of 65. The women participated in three cognitive function tests, which were spaced out every two years for an average testing span of four years. These women filled out very detailed food frequency surveys at the start of the Women's Health Study, prior to the cognitive testing.

"When looking at changes in cognitive function, what we found is that the total amount of fat intake did not really matter, but the type of fat did," explained Olivia Okereke, MD, MS, BWH Department of Psychiatry.

Women who consumed the highest amounts of saturated fat, which can come from animal fats such as red meat and butter, compared to those who consumed the lowest amounts, had worse overall cognition and memory over the four years of testing. Women who ate the most of the monounsaturated fats, which can be found in olive oil, had better patterns of cognitive scores over time.

"Our findings have significant public health implications," said Okereke. "Substituting in the good fat in place of the bad fat is a fairly simple dietary modification that could help prevent decline in memory."

Okereke notes that strategies to prevent cognitive decline in older people are particularly important. Even subtle declines in cognitive functioning can lead to higher risk of developing more serious problems, like dementia and Alzheimer disease.


Resistance-training, can alter the trajectory of cognitive decline


Cognitive decline is a pressing global health care issue. Worldwide, one case of dementia is detected every seven seconds. Mild cognitive impairment is a well recognized risk factor for dementia, and represents a critical window of opportunity for intervening and altering the trajectory of cognitive decline in seniors.

A new study by researchers at the Centre for Hip Health and Mobility at Vancouver Coastal Health and the University of British Columbia shows that implementing a seniors' exercise program, specifically one using resistance-training, can alter the trajectory of decline. Perhaps most importantly, the program improved the executive cognitive process of selective attention and conflict resolution as well as associative memory, which are robust predictors of conversion from mild cognitive impairment to dementia.

The research led by Teresa Liu-Ambrose, principal investigator with the Centre for Hip Health and Mobility and the Brain Research Centre at VCH and UBC, and co-investigators from the Department of Psychology and Division of Geriatric Medicine at UBC, and Department of Psychology, University of Iowa, was published today in the Archives of Internal Medicine.

Over the course of six months, the study team followed 86 senior women with probable mild cognitive impairment. The randomized controlled trial is the first to compare the efficacy of both resistance and aerobic training to improve executive cognitive functions - such as attention, memory, problem solving and decision making - necessary for independent living. The trial also assessed the effect of both types of exercise on associative memory performance and corresponding functional brain plasticity.

Both types of exercise were performed twice weekly for six months. Participants were measured with a series of cognitive tests and brain plasticity was assessed using functional MRI. The results showed resistance-training significantly improved executive cognitive functions, associative memory performance, and functional brain plasticity. In contrast to previous studies in healthy older adults, aerobic training did not demonstrate any significant effect for cognitive and brain plasticity.

"There is much debate as to whether cognitive function can be improved once there is noticeable impairment," says Liu-Ambrose, "What our results show is that resistance training can indeed improve both your cognitive performance and your brain function. What is key is that it will improve two processes that are highly sensitive to the effects of aging and neurodegeneration: executive function and associative memory -- often impaired in early stages of Alzheimer's disease."

This work builds on the same researcher team's Brain Power Study, published in the January 2010 issue of Archives of Internal Medicine and July 2011 issue of Neurobiology of Aging, which demonstrated that 12 months of once-weekly or twice-weekly progressive strength training improved executive cognitive function and functional brain plasticity in healthy women aged 65- to 75- years- old and provided lasting benefits.


"Exercise is attractive as an prevention strategy for dementia as it is universally accessible and cost-effective," says Liu-Ambrose, who is who is also an assistant professor, in the Department of Physical Therapy at UBC and a Michael Smith Foundation for Health Research and CIHR New Investigator scholar. "By developing this YouTube video we can help translate our findings directly to the senior population and fitness instructors who are working with them."

Eating Fish, Chicken, Nuts May Lower Risk of Alzheimer's Disease

A new study suggests that eating foods that contain omega-3 fatty acids, such as fish, chicken, salad dressing and nuts, may be associated with lower blood levels of a protein related to Alzheimer's disease and memory problems. The research is published in the May 2, 2012, online issue of Neurology®, the medical journal of the American Academy of Neurology.

"While it's not easy to measure the level of beta-amyloid deposits in the brain in this type of study, it is relatively easy to measure the levels of beta-amyloid in the blood, which, to a certain degree, relates to the level in the brain," said study author Nikolaos Scarmeas, MD, MS, with Columbia University Medical Center in New York and a member of the American Academy of Neurology.

For the study, 1,219 people older than age 65, free of dementia, provided information about their diet for an average of 1.2 years before their blood was tested for the beta-amyloid. Researchers looked specifically at 10 nutrients, including saturated fatty acids, omega-3 and omega-6 polyunsaturated fatty acids, mono-unsaturated fatty acid, vitamin E, vitamin C, beta-carotene, vitamin B12, folate and vitamin D.

The study found that the more omega-3 fatty acids a person took in, the lower their blood beta-amyloid levels. Consuming one gram of omega-3 per day (equal to approximately half a fillet of salmon per week) more than the average omega-3 consumed by people in the study is associated with 20 to 30 percent lower blood beta-amyloid levels.

Other nutrients were not associated with plasma beta-amyloid levels. The results stayed the same after adjusting for age, education, gender, ethnicity, amount of calories consumed and whether a participant had the APOE gene, a risk factor for Alzheimer's disease.

"Determining through further research whether omega-3 fatty acids or other nutrients relate to spinal fluid or brain beta-amyloid levels or levels of other Alzheimer's disease related proteins can strengthen our confidence on beneficial effects of parts of our diet in preventing dementia," said Scarmeas.

Exercise Lowers Alzheimer's Risk, Even If You Start Late

Doing exercise every day can considerably reduce your risk of developing Alzheimer's disease, even if you start becoming physically active after 80 years of age, researchers from Rush University Medical Center reported in the journal Neurology. Increased physical activity may include becoming involved in daily chores, such as housework, the authors added.

Lead author, Dr. Aron S. Buchman, said:

"The results of our study indicate that all physical activities including exercise as well as other activities such as cooking, washing the dishes, and cleaning are associated with a reduced risk of Alzheimer's disease. These results provide support for efforts to encourage all types of physical activity even in very old adults who might not be able to participate in formal exercise, but can still benefit from a more active lifestyle.

This is the first study to use an objective measurement of physical activity in addition to self-reporting. This is important because people may not be able to remember the details correctly."

Dr. Buchman and team set out to measure total daily non-exercise and exercise physical activities among 716 seniors, with an average age of 82 years. They were all from the Rush Memory and Aging Project. None of them had any signs of dementia. They all wore a device which monitors their physical activity, called an actigraph. The device is worn on the dominant wrist. The participants wore the actigraph for 10 days.

The researchers recorded data on all their exercise and non-exercise physical activities. The seniors also underwent yearly cognitive tests (the study was ongoing) to measure their thinking abilities and memory. The study-participants also reported on their social and physical activities.

Over an average period of 41 months, 71 seniors developed AD (Alzheimer's disease).
Total exercise as well as exercise intensity affect Alzheimer's risk
The authors found that the 10% least physically active seniors in their study were 2.3 times as likely to develop Alzheimer's disease, compared to the 10% most active.

They also found that exercise intensity impacted on Alzheimer's risk. Those in the bottom 10% of physical activity intensity were 2.8 times as likely to develop AD, compared to those in the top 10%.

Dr. Buchman said:

"Since the actigraph was attached to the wrist, activities like cooking, washing the dishes, playing cards and even moving a wheelchair with a person's arms were beneficial. These are low-cost, easily accessible and side-effect free activities people can do at any age, including very old age, to possibly prevent Alzheimer's."

The researchers said that by 2030, the number of people in the USA over 65 years of age will double to 80 million.

Dr. Buchman said:

"Our study shows that physical activity, which is an easily modifiable risk factor, is associated with cognitive decline and Alzheimer's disease. This has important public health consequences."

Mind Games Help Healthy Older People Too

Cognitive training including puzzles, handicrafts and life skills are known to reduce the risk, and help slow down the progress, of dementia amongst the elderly. A new study published in BioMed Central's open access journal BMC Medicine showed that cognitive training was able to improve reasoning, memory, language and hand eye co-ordination of healthy, older adults.

It is estimated that by 2050 the number of people over 65 years old will have increased to 1.1 billion worldwide, and that 37 million of these will suffer from dementia. Research has already shown that mental activity can reduce a person's risk of dementia but the effect of mental training on healthy people is less well understood. To address this researchers from China have investigated the use of cognitive training as a defence against mental decline for healthy older adults who live independently.

To be recruited onto the trial participants had to be between 65 and 75 years old, and have good enough eyesight, hearing, and communication skills, to be able to complete all parts of the training. The hour long training sessions occurred twice a week, for 12 weeks, and the subjects were provided with homework. Training included a multi-approach system tackling memory, reasoning, problem solving, map reading, handicrafts, health education and exercise, or focusing on reasoning only. The effect of booster training, provided six months later, was also tested.

The results of the study were positive. Profs Chunbo Li and Wenyuan Wu who led the research explained, "Compared to the control group, who received no training, both levels of cognitive training improved mental ability, although the multifaceted training had more of a long term effect. The more detailed training also improved memory, even when measured a year later and booster training had an additional improvement on mental ability scores."

This study shows that cognitive training therapy may prevent mental decline amongst healthy older people and help them to continue independent living longer in their advancing years.

Low levels of omega-3 fatty acids may cause memory problems

A diet lacking in omega-3 fatty acids, nutrients commonly found in fish, may cause your brain to age faster and lose some of its memory and thinking abilities, according to a study published in the February 28, 2012, print issue of Neurology®, the medical journal of the American Academy of Neurology. Omega-3 fatty acids include the nutrients called docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).

"People with lower blood levels of omega-3 fatty acids had lower brain volumes that were equivalent to about two years of structural brain aging," said study author Zaldy S. Tan, MD, MPH, of the Easton Center for Alzheimer's Disease Research and the Division of Geriatrics, University of California at Los Angeles.

For the study, 1,575 people with an average age of 67 and free of dementia underwent MRI brain scans. They were also given tests that measured mental function, body mass and the omega-3 fatty acid levels in their red blood cells.

The researchers found that people whose DHA levels were among the bottom 25 percent of the participants had lower brain volume compared to people who had higher DHA levels. Similarly, participants with levels of all omega-3 fatty acids in the bottom 25 percent also scored lower on tests of visual memory and executive function, such as problem solving and multi-tasking and abstract thinking.

Overeating may double risk of memory loss

New research suggests that consuming between 2,100 and 6,000 calories per day may double the risk of memory loss, or mild cognitive impairment (MCI), among people age 70 and older. The study was released today and will be presented at the American Academy of Neurology's 64th Annual Meeting in New Orleans April 21 to April 28, 2012. MCI is the stage between normal memory loss that comes with aging and early Alzheimer's disease.

"We observed a dose-response pattern which simply means; the higher the amount of calories consumed each day, the higher the risk of MCI," said study author Yonas E. Geda, MD, MSc, with the Mayo Clinic in Scottsdale, Arizona and a member of the American Academy of Neurology.

The study involved 1,233 people between the ages of 70 and 89 and free of dementia residing in Olmsted County, Minn. Of those, 163 had MCI. Participants reported the amount of calories they ate or drank in a food questionnaire and were divided into three equal groups based on their daily caloric consumption. One-third of the participants consumed between 600 and 1,526 calories per day, one-third between 1,526 and 2,143 and one-third consumed between 2,143 and 6,000 calories per day.

The odds of having MCI more than doubled for those in the highest calorie-consuming group compared to those in the lowest calorie-consuming group. The results were the same after adjusting for history of stroke, diabetes, amount of education, and other factors that can affect risk of memory loss. There was no significant difference in risk for the middle group.

"Cutting calories and eating foods that make up a healthy diet may be a simpler way to prevent memory loss as we age," said Geda.

Morning Exercise Better


Waking later and being active later put people at greater risk of dementia

Older women with weaker circadian rhythms, who are less physically active or are more active later in the day are more likely to develop dementia or mild cognitive impairment than women who have a more robust circadian rhythm or are more physically active earlier in the day. That’s the finding of a new study in the latest issue of the Annals of Neurology.

“We’ve known for some time that circadian rhythms, what people often refer to as the “body clock”, can have an impact on our brain and our ability to function normally,” says Greg Tranah, PhD., a scientist at the California Pacific Medical Center Research Institute – part of the Sutter Health network – and the lead author of the study. “What our findings suggest is that future interventions such as increased physical activity or using light exposure interventions to influence circadian rhythms, could help influence cognitive outcomes in older women.”

The researchers collected data on activity and circadian rhythm from 1,282 healthy women, all over the age of 75, who were taking part in the Study of Osteoporotic Fractures. All the women underwent a series of neuropsychological tests to ensure they had no evidence of cognitive or brain problems. At the end of five years 15 percent of the women had developed dementia and 24 percent had some form of mild cognitive impairment (MCI). Those women who had weaker circadian rhythm activity, lower levels of activity, or whose peak level of activity was later in the day, were at highest risk of developing dementia or MCI.

“This was not a small difference, but a rather sizable, statistically significant one,” says Tranah. “Those who had the later wake times, whose activity was later in the day, were 80 percent more likely to develop MCI or dementia compared to women who had earlier wake times and earlier activity.”

Circadian rhythms play an important role in the control of sleep-wake cycles and there is considerable evidence to show they also play a role in regulating certain brain functions, such as alertness, learning and memory. As people get older the activity level of those rhythms – how strong they are - often change, bringing with it changes in sleep patterns and levels of physical activity.

“To our knowledge this is the first study to show such a strong connection between circadian activity rhythm and the subsequent development of dementia or MCI,” says Tranah. “The reasons why this is so are not yet clear. The changes in circadian rhythm may directly influence the onset of dementia or MCI, or the decrease in activity may be a consequence, a warning sign if you like, that changes are already taking place in the brain. Identifying what the reason is could help us develop therapies to delay, or slow down, the development of brain problems in the elderly.”

In an accompanying commentary in the journal, Andrew Lim and Clifford Saper of the Department of Neurology at Harvard Medical School, say the study “represents a significant advance” in understanding the connection between circadian rhythm activity and dementia. “By showing that variations in rest-activity patterns precede the development of cognitive impairment and dementia, Tranah and colleagues have identified both a novel predictor of and a potential therapeutic target for incident cognitive deterioration and dementia.”

Eating fish reduces risk of Alzheimer's disease


People who eat baked or broiled fish on a weekly basis may be improving their brain health and reducing their risk of developing mild cognitive impairment (MCI) and Alzheimer's disease, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

"This is the first study to establish a direct relationship between fish consumption, brain structure and Alzheimer's risk," said Cyrus Raji, M.D., Ph.D., from the University of Pittsburgh Medical Center and the University of Pittsburgh School of Medicine. "The results showed that people who consumed baked or broiled fish at least one time per week had better preservation of gray matter volume on MRI in brain areas at risk for Alzheimer's disease."

Alzheimer's disease is an incurable, progressive brain disease that slowly destroys memory and cognitive skills. According to the National Institute on Aging, as many as 5.1 million Americans may have Alzheimer's disease. In MCI, memory loss is present but to a lesser extent than in Alzheimer's disease. People with MCI often go on to develop Alzheimer's disease.

For the study, 260 cognitively normal individuals were selected from the Cardiovascular Health Study. Information on fish consumption was gathered using the National Cancer Institute Food Frequency Questionnaire. There were 163 patients who consumed fish on a weekly basis, and the majority ate fish one to four times per week. Each patient underwent 3-D volumetric MRI of the brain. Voxel-based morphometry, a brain mapping technique that measures gray matter volume, was used to model the relationship between weekly fish consumption at baseline and brain structure 10 years later. The data were then analyzed to determine if gray matter volume preservation associated with fish consumption reduced risk for Alzheimer's disease. The study controlled for age, gender, education, race, obesity, physical activity, and the presence or absence of apolipoprotein E4 (ApoE4), a gene that increases the risk of developing Alzheimer's.

Gray matter volume is crucial to brain health. When it remains higher, brain health is being maintained. Decreases in gray matter volume indicate that brain cells are shrinking.

The findings showed that consumption of baked or broiled fish on a weekly basis was positively associated with gray matter volumes in several areas of the brain. Greater hippocampal, posterior cingulate and orbital frontal cortex volumes in relation to fish consumption reduced the risk for five-year decline to MCI or Alzheimer's by almost five-fold.

"Consuming baked or broiled fish promotes stronger neurons in the brain's gray matter by making them larger and healthier," Dr. Raji said. "This simple lifestyle choice increases the brain's resistance to Alzheimer's disease and lowers risk for the disorder."

The results also demonstrated increased levels of cognition in people who ate baked or broiled fish.

"Working memory, which allows people to focus on tasks and commit information to short-term memory, is one of the most important cognitive domains," Dr. Raji said. "Working memory is destroyed by Alzheimer's disease. We found higher levels of working memory in people who ate baked or broiled fish on a weekly basis, even when accounting for other factors, such as education, age, gender and physical activity."

Eating fried fish, on the other hand, was not shown to increase brain volume or protect against cognitive decline.

More on Alzheimer's:

According to statistics from the National Institute on Aging, Alzheimer’s disease is the most common form of dementia in older people. Alzheimer’s is a progressive brain disease; it is irreversible and causes a decline in memory and cognitive skills.
Alzheimer’s disease is the seventh leading cause of death in the United States. It is the only cause of death among the top 10 that cannot be prevented, cured or even significantly arrested. Two-thirds of people over the age of 65 who have the disease are women. This is a startling statistic, and one that requires increased attention and research.

“Clearly, this is an illness of women more than men,” said Victor Henderson, MD, MS, Professor of Epidemiology and Neurology and Neurological Sciences at Stanford University. “In part, it has to do with the fact that women live longer than men. There are real differences in longevity.”

Researchers have long studied the relationship between the hormone estrogen and Alzheimer's disease, but the results have been inconclusive thus far. “There are other risk factors that may come into play,” said Henderson, “which can further explain why women may be predisposed to Alzheimer’s disease.” Some of these factors include: family history, genetics, and some evidence suggests heart disease.

One of the first signs of Alzheimer’s disease may be forgetfulness and difficulty remembering newly learned information. But the disease gradually gets worse. According to the National Alzheimer’s Association in Chicago, other symptoms develop over time and may include:
• Challenges in planning or problem solving.
• Difficulty completing familiar tasks at home, at work, or at leisure.
• Confusion with time or place.
• Trouble understanding visual images and spatial relationships.
• New problems with words in speech or writing.
• Misplacing objects and losing the ability to retrace steps.
• Decreased or poor judgment.
• Withdrawal from work or social activities.
• Changes in mood and personality.

Reducing iron may lower age-related brain disease risk


The human body has a love-hate relationship with iron. Just the right amount is needed for proper cell function, yet too much is associated with brain diseases like Alzheimer's and Parkinson's.

Science knows that men have more iron in their bodies and brains than women. These higher levels may be part of the explanation for why men develop these age-related neurodegenerative diseases at a younger age.

But why do women have less iron in their systems than men? One possible explanation for the gender difference is that during menstruation, iron is eliminated through the loss of blood.

Now, a new study by UCLA researchers confirms this suspicion and suggests strategies to reduce excess iron levels in both men and women. Dr. George Bartzokis, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA, and colleagues compared iron levels in women who had undergone a hysterectomy before menopause -- and thus, did not menstruate and lose iron -- with levels in postmenopausal women who had not had a premenopausal hysterectomy. They found the women who had undergone a hysterectomy had higher levels of iron in their brains than the women who hadn't, and further, they had levels that were comparable to men.

The research is reported in the current online edition of the journal Neurobiology of Aging.

The researchers used an MRI technique that can measure the amount of ferritin iron in the brain (ferritin is a protein that stores iron). They examined 39 postmenopausal women, 15 of whom had undergone a premenopausal hysterectomy. They looked at several areas in the brain three white-matter regions and and five gray-matter regions. Fifty-four male subjects were also imaged for comparison.

The researchers found that among the women, the 15 who had undergone a hysterectomy had concentrations of iron in the white-matter regions of the brain's frontal lobe that did not differ from the men's levels. Further, both the women who had a hysterectomy and the men had significantly higher amounts of iron than the women who had not undergone a hysterectomy. (Gray matter areas showed slight increases that were not statistically significant.)

Hysterectomy is the most common non-obstetrical surgery among women in the United States, with one in three having had a hysterectomy by age 60, said Bartzokis, who is also a member of the UCLA Laboratory of Neuro Imaging and the UCLA Brain Research Institute.

The results of this study, he said, suggest that menstruation-associated blood loss may explain gender differences in brain iron. And of interest to both men and women, he said, is that it's possible that brain iron can be influenced by peripheral iron levels -- that is, iron levels throughout the body -- and may thus be a modifiable risk factor for age-related degenerative diseases.

"Iron accumulates in our bodies as we age," Bartzokis said, "and in the brain contributes to the development of abnormal deposits of proteins associated with several prevalent neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease and dementia with Lewy bodies. Higher brain iron levels in men may be part of the explanation for why men develop these age-related neurodegenerative diseases at a younger age, compared to women."

Bartzokis suggests it may be possible to reduce age-related brain iron accumulations by reducing the levels of iron throughout the body. This may have health benefits, especially in men, and may help counteract the negative effects of aging on the brain by reducing the iron available to catalyze, or speed up, damaging free-radical reactions.

There are a few ways body stores of iron can be reduced naturally, especially for premenopausal women. Menstruation leads to the elimination of iron through loss of blood. During pregnancy, iron is transferred from the woman to the fetus, and when women breast-feed, iron is transferred to the baby through the mother's milk.

"But there are things postmenopausal women and especially men can do to reduce their iron levels through relatively simple actions," Bartzokis said. "These include not overloading themselves with over-the-counter supplements that contain iron, unless recommended by their doctor; eating less red meat, which contains high levels of iron; donating blood; and possibly taking natural iron-chelating substances, molecules that bind to and remove iron, such as curcumin or green tea, that may have positive health consequences."


Small Amount of Exercise Could Protect Against Memory Loss

A new University of Colorado Boulder study shows that a small amount of physical exercise could profoundly protect the elderly from long-term memory loss that can happen suddenly following infection, illnesses or injury in old age.

In the study, CU-Boulder Research Associate Ruth Barrientos and her colleagues showed that aging rats that ran just over half a kilometer each week were protected against infection-induced memory loss.

"Our research shows that a small amount of physical exercise by late middle-aged rats profoundly protects against exaggerated inflammation in the brain and long-lasting memory impairments that follow a serious bacterial infection," said Barrientos of the psychology and neuroscience department.

The results of the study will appear in the Aug. 10 edition of The Journal of Neuroscience.

"Strikingly, this small amount of running was sufficient to confer robust benefits for those that ran over those that did not run," Barrientos said. "This is an important finding because those of advanced age are more vulnerable to memory impairments following immune challenges such as bacterial infections or surgery. With baby boomers currently at retirement age, the risk of diminished memory function in this population is of great concern. Thus, effective noninvasive therapies are of substantial clinical value."

Past research has shown that exercise in humans protects against declines in cognitive function associated with aging and protects against dementia. Researchers also have shown that dementia is often preceded by bacterial infections, such as pneumonia, or other immune challenges.

"To the best of our knowledge, this is the first study to show that voluntary exercise in rats reduces aging-induced susceptibility to the cognitive impairments that follow a bacterial infection, and the processes thought to underlie these impairments," Barrientos said.

In the study, the researchers found that rats infected with E. coli bacteria experienced detrimental effects on the hippocampus, an area of the brain that mediates learning and memory.

Monounsaturated Fatty Acids = Less Cognitive Decline

A diet high in monounsaturated fatty acids may be associated with less cognitive decline in older healthy women, according to a study published in the Journal of the American Geriatrics Society. Previous research has linked cognitive decline with cardiovascular disease, and certain types of dietary fatty acids (saturated and trans) are a known risk factor for cardiovascular disease. However, in this study, no association was found between cognitive decline and saturated or trans fatty acids. Monounsaturated fats are found in olive and canola oils, and saturated fats are found in coconut and palm oils as well as in butter, cheese, milk, and fatty meats. Trans fats are found in some margarines, commercial baked goods, and other foods made with or fried in partially hydrogenated oil.

Researchers analyzed the dietary intake of 482 women aged 60 and older from a food frequency questionnaire, and assessed their cognitive function—memory, vision, executive function, language, and attention—upon enrollment and again after 3 years. The study is part of a larger observational study that examined associations between dietary and lifestyle factors and cognitive function in older women without dementia.

The researchers found that a higher intake of dietary monounsaturated fatty acids was associated with less cognitive decline over a 3-year period. Further, after testing for associations between monounsaturated fatty acids and individual components of cognitive function, the researchers found that greater intake of monounsaturated fatty acids was associated with less decline in visual-spatial ability and memory after adjusting for other factors (i.e., age, education, reading ability). In addition, higher intakes of saturated fatty acids, trans-fatty acids, and dietary cholesterol were not associated with cognitive decline after adjusting for other factors.

The researchers noted that monounsaturated fatty acids have anti-inflammatory effects and suggested that these effects may provide one explanation for their protection against cognitive decline (as chronic inflammation appears to be one contributor to Alzheimer’s disease). Limitations of this observational analysis include the small sample size and the use of a study population consisting primarily of healthy, educated Caucasian women, which the researchers noted may limit the generalizability of findings to other populations.

Previous research has shown that immune cells of the brain, called microglia, become more reactive with age. When the older rats in the study encountered a bacterial infection, these immune cells released inflammatory molecules called cytokines in an exaggerated and prolonged manner.

"In the current study we found that small amounts of voluntary exercise prevented the priming of microglia, the exaggerated inflammation in the brain, and the decrease of growth factors," Barrientos said.

The next step of this research is to examine the role that stress hormones may play in sensitizing microglia, and whether physical exercise slows these hormones in older rats, she said.

Link between high cholesterol and Alzheimer's disease

People with high cholesterol may have a higher risk of developing Alzheimer's disease, according to a study published in the September 13, 2011, issue of Neurology®, the medical journal of the American Academy of Neurology.

"We found that high cholesterol levels were significantly related to brain plaques associated with Alzheimer's disease," said study author Kensuke Sasaki, MD, PhD, of Kyushu University in Fukuoka, Japan.

For the study, the cholesterol levels were tested for 2,587 people age 40 to 79 who had no signs of Alzheimer's disease. Then they examined 147 autopsied people who died after a long observation period (10 to 15 years). Of those, 50 people, or 34 percent, had been diagnosed with dementia before death.

The autopsies looked for plaques and tangles in the brain, both known to be trademark signs of Alzheimer's disease. Plaques are an accumulation of a form of the protein amyloid, which occurs between nerve cells. Tangles are an accumulation of a different protein, called tau, which occurs inside nerve cells.

People with high cholesterol levels, defined by a reading of more than 5.8 mmol/L, had significantly more brain plaques when compared to those with normal or lower cholesterol levels. A total of 86 percent of people with high cholesterol had brain plaques, compared with only 62 percent of people with low cholesterol levels.

The study found no link between high cholesterol and the tangles that develop in the brain with Alzheimer's disease.

In addition to high cholesterol increasing the risk of Alzheimer's disease, Sasaki previously found that insulin resistance, a sign of diabetes, may be another risk factor for brain plaques associated with Alzheimer's disease.

"Our study clearly makes the point that high cholesterol may contribute directly or indirectly to plaques in the brain," Sasaki said, "but failed treatment trials of cholesterol-lowering drugs in Alzheimer's disease means there is no simple link between lowering cholesterol and preventing Alzheimer's."

Aerobic Exercise May Reduce the Risk of Dementia

Any exercise that gets the heart pumping may reduce the risk of dementia and slow the condition’s progression once it starts, reported a Mayo Clinic study published this month in Mayo Clinic Proceedings. Researchers examined the role of aerobic exercise in preserving cognitive abilities and concluded that it should not be overlooked as an important therapy against dementia.

The researchers broadly defined exercise as enough aerobic physical activity to raise the heart rate and increase the body’s need for oxygen. Examples include walking, gym workouts and activities at home such as shoveling snow or raking leaves.

“We culled through all the scientific literature we could find on the subject of exercise and cognition, including animal studies and observational studies, reviewing over 1,600 papers, with 130 bearing directly on this issue. We attempted to put together a balanced view of the subject,” says J. Eric Ahlskog, M.D., Ph.D., a neurologist at Mayo Clinic. “We concluded that you can make a very compelling argument for exercise as a disease-modifying strategy to prevent dementia and mild cognitive impairment, and for favorably modifying these processes once they have developed.”

The researchers note that brain imaging studies have consistently revealed objective evidence of favorable effects of exercise on human brain integrity. Also, they note, animal research has shown that exercise generates trophic factors that improve brain functioning, plus exercise facilitates brain connections (neuroplasticity).

More research is needed on the relationship between exercise and cognitive function, the study’s authors say, but they encourage exercise, in general, especially for those with or worried about cognitive issues.

Alcohol and Dementia

Advising healthy people aged 65 years or older who are moderate, responsible drinkers to stop drinking or to markedly reduce their intake would not be in their best health interests, especially in terms of their risk of cardiovascular diseases. Forum reviewers thought that advice to lower limits of drinking for everyone in this age group is not based on reliable research, and would certainly not apply to all in this age group. Of more importance, the absolute risk for cardiovascular diseases increases markedly with age, and therefore the beneficial or protective effect of light to moderate drinking on cardiovascular diseases is greater in the elderly than in younger people.

Evidence is also accumulating that shows that the risk of Alzheimer's disease and other types of dementia is lower among moderate drinkers than among abstainers. Neurodegenerative disorders are key causes of disability and death among elderly people. Epidemiological studies have suggested that moderate alcohol consumption, may reduce the incidence of certain age-related neurological disorders including Alzheimer's disease. Regular dietary intake of flavonoid-rich foods and/or beverages has been associated with 50% reduction in the risk of dementia, a preservation of cognitive performance with ageing,a delay in the onset of Alzheimer's disease and a reduction in the risk of developing Parkinson's disease.

Mystery ingredient in coffee boosts protection against Alzheimer's disease

A yet unidentified component of coffee interacts with the beverage's caffeine, which could be a surprising reason why daily coffee intake protects against Alzheimer's disease. A new Alzheimer's mouse study by researchers at the University of South Florida found that this interaction boosts blood levels of a critical growth factor that seems to fight off the Alzheimer's disease process.

The findings appear in the early online version of an article to be published June 28 in the Journal of Alzheimer's Disease. Using mice bred to develop symptoms mimicking Alzheimer's disease, the USF team presents the first evidence that caffeinated coffee offers protection against the memory-robbing disease that is not possible with other caffeine-containing drinks or decaffeinated coffee.

Previous observational studies in humans reported that daily coffee/caffeine intake during mid-life and in older age decreases the risk of Alzheimer's disease. The USF researchers' earlier studies in Alzheimer's mice indicated that caffeine was likely the ingredient in coffee that provides this protection because it decreases brain production of the abnormal protein beta-amyloid, which is thought to cause the disease.

The new study does not diminish the importance of caffeine to protect against Alzheimer's. Rather it shows that caffeinated coffee induces an increase in blood levels of a growth factor called GCSF (granulocyte colony stimulating factor). GCSF is a substance greatly decreased in patients with Alzheimer's disease and demonstrated to improve memory in Alzheimer's mice. A just-completed clinical trial at the USF Health Byrd Alzheimer's Institute is investigating GCSF treatment to prevent full-blown Alzheimer's in patients with mild cognitive impairment, a condition preceding the disease. The results of that trial are currently being evaluated and should be known soon.

"Caffeinated coffee provides a natural increase in blood GCSF levels," said USF neuroscientist Dr. Chuanhai Cao, lead author of the study. "The exact way that this occurs is not understood. There is a synergistic interaction between caffeine and some mystery component of coffee that provides this beneficial increase in blood GCSF levels."

The researchers would like to identify this yet unknown component so that coffee and other beverages could be enriched with it to provide long-term protection against Alzheimer's.

In their study, the researchers compared the effects of caffeinated and decaffeinated coffee to those of caffeine alone. In both Alzheimer's mice and normal mice, treatment with caffeinated coffee greatly increased blood levels of GCSF; neither caffeine alone or decaffeinated coffee provided this effect. The researchers caution that, since they used only "drip" coffee in their studies, they do not know whether "instant" caffeinated coffee would provide the same GCSF response.

The boost in GCSF levels is important, because the researchers also reported that long-term treatment with coffee (but not decaffeinated coffee) enhances memory in Alzheimer's mice. Higher blood GCSF levels due to coffee intake were associated with better memory. The researchers identified three ways that GCSF seems to improve memory performance in the Alzheimer's mice. First, GCSF recruits stem cells from bone marrow to enter the brain and remove the harmful beta-amyloid protein that initiates the disease. GCSF also creates new connections between brain cells and increases the birth of new neurons in the brain.

"All three mechanisms could complement caffeine's ability to suppress beta amyloid production in the brain" Dr. Cao said, "Together these actions appear to give coffee an amazing potential to protect against Alzheimer's -- but only if you drink moderate amounts of caffeinated coffee."

Although the present study was performed in Alzheimer's mice, the researchers indicated that they've gathered clinical evidence of caffeine/coffee's ability to protect humans against Alzheimer's and will soon publish those findings.

Coffee is safe for most Americans to consume in the moderate amounts (4 to 5 cups a day) that appear necessary to protect against Alzheimer's disease. The USF researchers previously reported this level of coffee/caffeine intake was needed to counteract the brain pathology and memory impairment in Alzheimer's mice. The average American drinks 1_ to 2 cups of coffee a day, considerably less than the amount the researchers believe protects against Alzheimer's.

"No synthetic drugs have yet been developed to treat the underlying Alzheimer's disease process" said Dr. Gary Arendash, the study's other lead author. "We see no reason why an inherently natural product such as coffee cannot be more beneficial and safer than medications, especially to protect against a disease that takes decades to become apparent after it starts in the brain."

The researchers believe that moderate daily coffee intake starting at least by middle age (30s – 50s) is optimal for providing protection against Alzheimer's disease, although starting even in older age appears protective from their studies. "We are not saying that daily moderate coffee consumption will completely protect people from getting Alzheimer's disease," Dr. Cao said. "However, we do believe that moderate coffee consumption can appreciably reduce your risk of this dreaded disease or delay its onset."

The researchers conclude that coffee is the best source of caffeine to counteract the cognitive decline of Alzheimer's because its yet unidentified component synergizes with caffeine to increase blood GCSF levels. Other sources of caffeine, such as carbonated drinks, energy drinks, and tea, would not provide the same level of protection against Alzheimer's as coffee, they said.

Coffee also contains many ingredients other than caffeine that potentially offer cognitive benefits against Alzheimer's disease. "The average American gets most of their daily antioxidants intake through coffee," Dr. Cao said. "Coffee is high in anti-inflammatory compounds that also may provide protective benefits against Alzheimer's disease."

An increasing body of scientific literature indicates that moderate consumption of coffee decreases the risk of several diseases of aging, including Parkinson's disease, Type II diabetes and stroke. Just within the last few months, new studies have reported that drinking coffee in moderation may also significantly reduce the risk of breast and prostate cancers.

"Now is the time to aggressively pursue the protective benefits of coffee against Alzheimer's disease," Dr. Arendash said. "Hopefully, the coffee industry will soon become an active partner with Alzheimer's researchers to find the protective ingredient in coffee and concentrate it in dietary sources."

New Alzheimer's diagnostic guidelines, now encompassing the full continuum of the disease from no overt symptoms to mild impairment to clear cognitive decline, could double the number of Americans with some form of the disease to more than 10 million. With the baby-boomer generation entering older age, these numbers will climb even more unless an effective preventive measure is identified.

"Because Alzheimer's starts in the brain several decades before it is diagnosed, any protective therapy would obviously need to be taken for decades," Dr. Cao said. "We believe moderate daily consumption of caffeinated coffee is the best current option for long-term protection against Alzheimer's memory loss. Coffee is inexpensive, readily available, easily gets into the brain, appears to directly attack the disease process, and has few side-effects for most of us."

According to the researchers, no other Alzheimer's therapy being developed comes close to meeting all these criteria.

"Aside from coffee, two other lifestyle choices -- physical and cognitive activity -- appear to reduce the risk of dementia. Combining regular physical and mental exercise with moderate coffee consumption would seem to be an excellent multi-faceted approach to reducing risk or delaying Alzheimer's," Dr. Arendash said. "With pharmaceutical companies spending millions of dollars trying to develop drugs against Alzheimer's disease, there may very well be an effective preventive right under our noses every morning – caffeinated coffee."

Dietary changes appear to lower risk of Alzheimer's disease

Following a low¬–saturated fat and low–glycemic index diet appears to modulate the risk of developing dementia that proceeds to Alzheimer’s disease (AD), and making a switch to this dietary pattern may provide some benefit to those who are already experiencing cognitive difficulty, according to a report in the June issue of Archives of Neurology, one of the JAMA/Archives journals.

Previous research has suggested multiple links between diet and cognitive ability, the authors note as background information. Health conditions in which insulin resistance (the body’s inability to use insulin effectively) is a factor—obesity, type 2 diabetes, cardiovascular disease and high cholesterol levels—have also been associated with “pathological brain aging.” However, studies of specific foods have not found conclusive evidence of an influence on Alzheimer’s risk. “Thus,” the authors write, “a more promising approach to the study of dietary factors in AD might entail the use of whole-diet interventions, which have greater ecologic validity and preserve the nutritional milieu in which fat and carbohydrate consumption occurs.”

Jennifer L. Bayer-Carter, M.S., from Veterans Affairs Puget Sound Health Care System, Seattle, and colleagues sought to compare a high–saturated fat/high–simple carbohydrate diet (a macronutrient pattern associated with type 2 diabetes and insulin resistance) with a low–saturated fat/low–simple carbohydrate diet; the interventions were named HIGH and LOW, respectively. The authors evaluated the effects of these diets in 20 older adults who were healthy and 29 older adults who had amnestic mild cognitive impairment (aMCI), meaning they experienced some memory problems; the latter condition is often considered a precursor to AD. In a four-week randomized, controlled trial, 24 participants followed the HIGH diet and 25 followed the LOW diet. The researchers studied participants’ performance on memory tests as well as their levels of biomarkers (biological substances indicative of AD), such as insulin, cholesterol, blood glucose levels, blood lipid levels and components of cerebrospinal fluid (CSF).

Results of the study were different for the group that had aMCI and the group of healthy participants. In the latter group, the LOW diet decreased some CSF biomarkers of AD as well as total cholesterol levels. However, among individuals with aMCI, the LOW diet increased levels of these biomarkers. Some changes to biomarkers, such as CSF insulin levels, were observed in both groups. Additionally, the LOW diet improved performance on delayed visual recall tests for both healthy and memory-impaired participants, but did not affect scores on other cognitive measures.

The findings indicate that “for healthy adults, the HIGH diet moved CSF biomarkers in a direction that may characterize a presymptomatic stage of AD,” explain the authors. They believe that the different results of the unhealthy diet in participants with aMCI may be due to the diet’s short duration. “The therapeutic effects of longer-term dietary intervention may be a promising avenue of exploration,” the authors conclude. “In addition, identification of the pathophysiologic changes underlying dietary effects may reveal important therapeutic targets that can be modulated through targeted dietary or pharmacologic intervention.”

Higher levels of social activity decrease the risk of cognitive decline

If you want to keep your brain healthy, it turns out that visiting friends, attending parties, and even going to church might be just as good for you as crossword puzzles.

According to research conducted at Rush University Medical Center, frequent social activity may help to prevent or delay cognitive decline in old age. The study has just been posted online in the Journal of the International Neuropsychological Society.

The researchers were especially careful in their analysis to try to rule out the possibility that cognitive decline precedes, or causes, social isolation, and not the reverse.

"It's logical to think that when someone's cognitive abilities break down, they are less likely to go out and meet friends, enjoy a camping trip, or participate in community clubs. If memory and thinking capabilities fail, socializing becomes difficult," said lead researcher Bryan James, PhD, postdoctoral fellow in the epidemiology of aging and dementia in the Rush Alzheimer's Disease Center. "But our findings suggest that social inactivity itself leads to cognitive impairments."

The study included 1,138 older adults with a mean age of 80 who are participating in the Rush Memory and Aging Project, an ongoing longitudinal study of common chronic conditions of aging. They each underwent yearly evaluations that included a medical history and neuropsychological tests.

Social activity was measured based on a questionnaire that asked participants whether, and how often, in the previous year they had engaged in activities that involve social interaction—for example, whether they went to restaurants, sporting events or the teletract (off-track betting) or played bingo; went on day trips or overnight trips; did volunteer work; visited relatives or friends; participated in groups such as the Knights of Columbus; or attended religious services.

Cognitive function was assessed using a battery of 19 tests for various types of memory (episodic, semantic and working memory), as well as perceptual speed and visuospatial ability.

At the start of the investigation, all participants were free of any signs of cognitive impairment. Over an average of five years, however, those who were more socially active showed reduced rates of cognitive decline. On average, those who had the highest levels of social activity (the 90th percentile) experienced only one quarter of the rate of cognitive decline experienced by the least socially active individuals. Other variables that might have accounted for the increase in cognitive decline—such as age, physical exercise, and health—were all ruled out in the analysis.

Alcohol consumption helps stave off dementia

Experts agree that long-term alcohol abuse is detrimental to memory function and can cause neuro-degenerative disease. However, according to a study published in Age and Ageing by Oxford University Press today, there is evidence that light-to-moderate alcohol consumption may decrease the risk of cognitive decline or dementia.

Estimates from various studies have suggested the prevalence of alcohol-related dementia to be about 10% of all cases of dementia. Now researchers have found after analyzing 23 longitudinal studies of subjects aged 65 years and older that the impact of small amounts of alcohol was associated with lower incidence rates of overall dementia and Alzheimer dementia, but not of vascular dementia and cognitive decline. It is still an open question whether different alcoholic beverages, such as beer, wine, and spirits, all have a similar effect. Some studies have shown a positive effect of wine only, which may be due either to the level of ethanol, the complex mixture that comprises wine, or to the healthier life-style ascribed to wine drinkers.

A total of 3,327 patients were interviewed in their homes by trained investigators (physicians, psychologists, gerontologists) and reassessed one and a half years and three years later. Information on the cognitive status of those who had died in the interim was collected from family members, caregivers or primary care physicians.

Among the 3,327 patients interviewed at baseline, 84.8% (n=2,820) could be personally interviewed one and a half years later and 73.9% (n=2,460) three years later. For the vast majority of subjects who could not be personally interviewed, systematic assessments (follow-up 1: 482; follow-up 2: 336) focusing particularly on dementia could be obtained from GPs, relatives or caregivers. Within three years, follow-up assessments were unavailable for only 49 subjects (1.5%). Proxy information could be obtained for 98.0% (n=295) of the 301 patients who had died in the interim. Since dementia is associated with a higher mortality rate, proxy information is particularly important in order to avoid underestimation of incident dementia cases.

At baseline there were 3,202 persons without dementia. Alcohol consumption information was available for 3,180 subjects:

50.0% were abstinent
24.8% consumed less than one drink (10 grams of alcohol) per day
12.8% consumed 10-19 grams of alcohol per day
12.4% consumed 20 or more grams per day
A small subgroup of 25 participants fulfilled the criteria of harmful drinking (>60 grams of alcohol per day for men, respectively >40 grams for women)
One man (>120 grams of alcohol per day) and one woman (>80 grams of alcohol per day) reported an extremely high consumption of alcohol
Among the consumers of alcohol almost half (48.6%) drank wine only
29.0% drank beer only
22.4% drank mixed alcohol beverages (wine, beer, or spirits)
Alcohol consumption was significantly associated with male gender, younger age, higher level of education, not living alone, and not being depressed.

The calculation of incident cases of dementia is based on 3,202 subjects who had no dementia at baseline. Within the follow-up period of three years:

217 cases of dementia (6.8%) were diagnosed, whereby 111 subjects (3.5%) suffered from Alzheimer dementia. Due to the relatively small numbers, other subgroups of dementia (vascular dementia: n=42; other specific dementia, e.g. dementia in Parkinson's disease, Lewy body dementia, alcohol dementia: n=14; dementia with unknown aetiology: n=50) were not considered in the following analyses.

Univariate and multivariate analyses revealed that alcohol consumption was significantly associated with a lower incidence of overall dementia and Alzheimer dementia. In line with a large-scale study also based on GP attenders aged 75 years and older, the study found that light-to-moderate alcohol consumption was associated with relatively good physical and mental health. This three-year follow-up study included, at baseline, only those subjects 75 years of age and older, the mean age was 80.2 years, much higher than that in most other studies.


Alcohol Abstinence = Increased Risk of Cognitive Impairment

Previous research regarding the association between alcohol consumption and dementia or cognitive impairment in later life suggests that mild to moderate alcohol consumption might be protective of dementia. However, most of the research has been conducted on subjects already rather elderly at the start of the follow-up.

A new study published in the December issue of the Journal of Alzheimer's Disease addresses this problem with a follow-up of more than two decades.

The study, conducted at the University of Turku, University of Helsinki and National Institute for Health and Welfare in Finland based on subjects from the Finnish Twin Cohort, shows that midlife alcohol consumption is related to the risk of dementia assessed some 20 years later. The study indicates that both abstainers and subjects consuming large amounts of alcohol have a greater risk for cognitive impairment than light drinkers.

"Our finding is significant as the changes typical of Alzheimer's disease -- the most common dementia syndrome -- are thought to start appearing two to three decades before clinical manifestation and therefore identification of early risk factors is imperative," states Jyri Virta, researcher at University of Turku, Finland.

Regularly drinking green tea could protect against Alzheimer's and other forms of dementia

Regularly drinking green tea could protect the brain against developing Alzheimer's and other forms of dementia, according to latest research by scientists at Newcastle University.

The study, published in the academic journal Phytomedicine, also suggests this ancient Chinese remedy could play a vital role in protecting the body against cancer.

Led by Dr Ed Okello, the Newcastle team wanted to know if the protective properties of green tea – which have previously been shown to be present in the undigested, freshly brewed form of the drink – were still active once the tea had been digested.

Digestion is a vital process which provides our bodies with the nutrients we need to survive. But, says Dr Okello, it also means that just because the food we put into our mouths is generally accepted to contain health-boosting properties, we can't assume these compounds will ever be absorbed by the body.

"What was really exciting about this study was that we found when green tea is digested by enzymes in the gut, the resulting chemicals are actually more effective against key triggers of Alzheimer's development than the undigested form of the tea," explains Dr Okello, based in the School of Agriculture, Food and Rural Development at Newcastle University.

"In addition to this, we also found the digested compounds had anti-cancer properties, significantly slowing down the growth of the tumour cells which we were using in our experiments."

As part of the research, the Newcastle team worked in collaboration with Dr Gordon McDougall of the Plant Products and Food Quality Group at the Scottish Crop Research Institute in Dundee, who developed technology which simulates the human digestive system.

It is this which made it possible for the team to analyse the protective properties of the products of digestion.

Two compounds are known to play a significant role in the development of Alzheimer's disease – hydrogen peroxide and a protein known as beta-amyloid.

Previous studies have shown that compounds known as polyphenols, present in black and green tea, possess neuroprotective properties, binding with the toxic compounds and protecting the brain cells.

When ingested, the polyphenols are broken down to produce a mix of compounds and it was these the Newcastle team tested in their latest research.

"It's one of the reasons why we have to be so careful when we make claims about the health benefits of various foods and supplements," explains Dr Okello.

"There are certain chemicals we know to be beneficial and we can identify foods which are rich in them but what happens during the digestion process is crucial to whether these foods are actually doing us any good."

Carrying out the experiments in the lab using a tumour cell model, they exposed the cells to varying concentrations of the different toxins and the digested green tea compounds.

Dr Okello explained: "The digested chemicals protected the cells, preventing the toxins from destroying the cells.

"We also saw them affecting the cancer cells, significantly slowing down their growth.

"Green tea has been used in Traditional Chinese medicine for centuries and what we have here provides the scientific evidence why it may be effective against some of the key diseases we face today."

The next step is to discover whether the beneficial compounds are produced during digestion after healthy human volunteers consume tea polyphenols. The team has already received funding from the Biotechnology and Biological Sciences Research Council (BBSRC) to take this forward.

Dr Okello adds: "There are obviously many factors which together have an influence on diseases such as cancer and dementia - a good diet, plenty of exercise and a healthy lifestyle are all important."

Walking slows progression of Alzheimer's



Walking may slow cognitive decline in adults with mild cognitive impairment (MCI) and Alzheimer's disease, as well as in healthy adults, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

"We found that walking five miles per week protects the brain structure over 10 years in people with Alzheimer's and MCI, especially in areas of the brain's key memory and learning centers," said Cyrus Raji, Ph.D., from the Department of Radiology at the University of Pittsburgh in Pennsylvania. "We also found that these people had a slower decline in memory loss over five years."

Alzheimer's disease is an irreversible, progressive brain disease that slowly destroys memory and cognitive skills. According to the National Institute on Aging, between 2.4 million and 5.1 million Americans have Alzheimer's disease. Based on current population trends, that number is expected to increase significantly over the next decade.

In cases of MCI, a person has cognitive or memory problems exceeding typical age-related memory loss, but not yet as severe as those found in Alzheimer's disease. About half of the people with MCI progress to Alzheimer's disease.

"Because a cure for Alzheimer's is not yet a reality, we hope to find ways of alleviating disease progression or symptoms in people who are already cognitively impaired," Dr. Raji said.

For the ongoing 20-year study, Dr. Raji and colleagues analyzed the relationship between physical activity and brain structure in 426 people, including 299 healthy adults (mean age 78), and 127 cognitively impaired adults (mean age 81), including 83 adults with MCI and 44 adults with Alzheimer's dementia.

Patients were recruited from the Cardiovascular Health Study. The researchers monitored how far each of the patients walked in a week. After 10 years, all patients underwent 3-D MRI exams to identify changes in brain volume.

"Volume is a vital sign for the brain," Dr. Raji said. "When it decreases, that means brain cells are dying. But when it remains higher, brain health is being maintained."

In addition, patients were given the mini-mental state exam (MMSE) to track cognitive decline over five years. Physical activity levels were correlated with MRI and MMSE results. The analysis adjusted for age, gender, body fat composition, head size, education and other factors.

The findings showed across the board that greater amounts of physical activity were associated with greater brain volume. Cognitively impaired people needed to walk at least 58 city blocks, or approximately five miles, per week to maintain brain volume and slow cognitive decline. The healthy adults needed to walk at least 72 city blocks, or six miles, per week to maintain brain volume and significantly reduce their risk for cognitive decline.

Over five years, MMSE scores decreased by an average of five points in cognitively impaired patients who did not engage in a sufficient level of physical activity, compared with a decrease of only one point in patients who met the physical activity requirement.

"Alzheimer's is a devastating illness, and unfortunately, walking is not a cure," Dr. Raji said. "But walking can improve your brain's resistance to the disease and reduce memory loss over time."

Vitamin B12 May Reduce Risk of Alzheimer's Disease

A new study shows that vitamin B12 may protect against Alzheimer's disease, adding more evidence to the scientific debate about whether the vitamin is effective in reducing the risk of memory loss.

The research will be published in the October 19, 2010, issue of Neurology®, the medical journal of the American Academy of Neurology.

"Our findings show the need for further research on the role of vitamin B12 as a marker for identifying people who are at increased risk of Alzheimer's disease," said study author Babak Hooshmand, MD, MSc, with Karolinska Institutet in Stockholm, Sweden. "Low levels of vitamin B12 are surprisingly common in the elderly. However, the few studies that have investigated the usefulness of vitamin B12 supplements to reduce the risk of memory loss have had mixed results."

For the seven-year study, researchers took blood samples from 271 Finnish people age 65 to 79 who did not have dementia at the start of the study. During that time, 17 people developed Alzheimer's disease. Blood samples were tested for levels for homocysteine, an amino acid associated with vitamin B12, and for levels of the active portion of the vitamin, called holotranscobalamin. Too much homocysteine in the blood has been linked to negative effects on the brain, such as stroke. However, higher levels of vitamin B12 can lower homocysteine.

The study found that for each micromolar increase in the concentration of homocysteine, the risk of Alzheimer's disease increased by 16 percent, whereas each picomolar increase in concentration of the active form of vitamin B12 reduced risk by two percent. The results stayed the same after taking into account other factors, such as age, gender, education, smoking status, blood pressure and body mass index. The addition of folate did not appear to raise or lower the risk of Alzheimer's disease.

"More research is needed to confirm these findings before vitamin B12 should be used solely as a supplement to help protect memory," said Hooshmand.

Vitamin B12 can be found in fish, poultry and other meat products.

Moderate drinking, especially wine, associated with better cognitive function

A large prospective study of 5033 men and women in the Tromsø Study in northern Norway has reported that moderate wine consumption is independently associated with better performance on cognitive tests. The subjects (average age 58 and free of stroke) were followed over 7 years during which they were tested with a range of cognitive function tests. Among women, there was a lower risk of a poor testing score for those who consumed wine at least 4 or more times over two weeks in comparison with those who drink < 1 time during this period The expected associations between other risk factors for poor cognitive functioning were seen, i.e. lower testing scores among people who were older, less educated, smokers, and those with depression, diabetes, or hypertension. It has long been known that "moderate people do moderate things." The authors state the same thing: "A positive effect of wine . . . could also be due to confounders such as socio-economic status and more favourable dietary and other lifestyle habits. The authors also reported that not drinking was associated with significantly lower cognitive performance in women. As noted by the authors, in any observational study there is the possibility of other lifestyle habits affecting cognitive function, and the present study was not able to adjust for certain ones (such as diet, income, or profession) but did adjust for age, education, weight, depression, and cardiovascular disease as its major risk factors. The results of this study support findings from previous research on the topic: In the last three decades, the association between moderate alcohol intake and cognitive function has been investigated in 68 studies comprising 145,308 men and women from various populations with various drinking patterns. Most studies show an association between light to moderate alcohol consumption and better cognitive function and reduced risk of dementia, including both vascular dementia and Alzheimer's Disease. Such effects could relate to the presence in wine of a number of polyphenols (antioxidants) and other micro elements that may help reduce the risk of cognitive decline with ageing. Mechanisms that have been suggested for alcohol itself being protective against cognitive decline include effects on atherosclerosis ( hardening of the arteries), coagulation ( thickening of the blood and clotting), and reducing inflammation ( of artery walls, improving blood flow). Eating foods rich in vitamin E associated with lower dementia risk Consuming more vitamin E through the diet appears to be associated with a lower risk of dementia and Alzheimer's disease, according to a report in the July issue of Archives of Neurology, one of the JAMA/Archives journals. Oxidative stress—damage to the cells from oxygen exposure—is thought to play a role in the development of Alzheimer's disease, according to background information in the article. Experimental data suggest that antioxidants, nutrients that help repair this damage, may protect against the degeneration of nervous system cells. "Although clinical trials have shown no benefit of antioxidant supplements for Alzheimer's disease, the wider variety of antioxidants in food sources is not well studied relative to dementia risk; a few studies, with varying lengths of follow-up, have yielded inconsistent results," the authors write. Elizabeth E. Devore, Sc.D., of Erasmus Medical Center, Rotterdam, the Netherlands, and colleagues assessed 5,395 participants 55 years and older who did not have dementia between 1990 and 1993. Participants underwent a home interview and two clinical examinations at the beginning of the study, and provided dietary information through a two-step process involving a meal-based checklist and a food questionnaire. The researchers focused on four antioxidants: vitamin E, vitamin C, beta carotene and flavonoids. The major food sources of vitamin E were margarine, sunflower oil, butter, cooking fat, soybean oil and mayonnaise; vitamin C came mainly from oranges, kiwi, grapefruit juice, grapefruit, cauliflower, red bell peppers and red cabbage; beta carotene, from carrots, spinach, vegetable soup, endive and tomato; and flavonoids from tea, onions, apples and carrots. Over an average of 9.6 years of follow-up, 465 participants developed dementia; 365 of those were diagnosed with Alzheimer's disease. After adjusting for other potentially related factors, the one-third of individuals who consumed the most vitamin E (a median or midpoint of 18.5 milligrams per day) were 25 percent less likely to develop dementia than the one-third of participants who consumed the least (a median of 9 milligrams per day). Dietary intake levels of vitamin C, beta carotene and flavonoids were not associated with dementia risk. Results were similar when only the participants diagnosed with Alzheimer's disease were assessed. "The brain is a site of high metabolic activity, which makes it vulnerable to oxidative damage, and slow accumulation of such damage over a lifetime may contribute to the development of dementia," the authors write. "In particular, when beta-amyloid (a hallmark of pathologic Alzheimer's disease) accumulates in the brain, an inflammatory response is likely evoked that produces nitric oxide radicals and downstream neurodegenerative effects. Vitamin E is a powerful fat-soluble antioxidant that may help to inhibit the pathogenesis of dementia." Future studies are needed to evaluate dietary intake of antioxidants and dietary risks, including different points at which consuming more antioxidants might reduce risk, the authors conclude. High blood levels of vitamin E reduces risk of Alzheimer's High levels of several vitamin E components in the blood are associated with a decreased risk for Alzheimer's disease (AD) in advanced age, suggesting that vitamin E may help prevent cognitive deterioration in elderly people. This is the conclusion reached in a Swedish study published in the July 2010 issue of the Journal of Alzheimer s Disease. "Vitamin E is a family of eight natural components, but most studies related to Alzheimer s disease investigate only one of these components, ±-tocopherol", says Dr. Francesca Mangialasche, who led the study. "We hypothesized that all the vitamin E family members could be important in protecting against AD. If confirmed, this result has implications for both individuals and society, as 70 percent of all dementia cases in the general population occur in people over 75 years of age, and the study suggests a protective effect of vitamin E against AD in individuals aged 80+." The study was conducted at the Aging Research Center (ARC), Karolinska Institutet, Stockholm, Sweden, in collaboration with the Institute of Gerontology and Geriatrics, University of Perugia, Italy. The study included a sample of 232 participants from the Kungsholmen Project, a population-based longitudinal study on aging and dementia in Stockholm (Kungsholmen parish). All participants were aged 80+ years and were dementia-free at the beginning of the study (baseline). After 6-years of follow-up, 57 AD cases were identified. The blood levels of all eight natural vitamin E components were measured at the beginning of the study. Subjects with higher blood levels (highest tertile) were compared with subjects who had lower blood levels (lowest tertile) to verify whether these two groups developed dementia at different rates. The study found that subjects with higher blood levels of all the vitamin E family forms had a reduced risk of developing AD, compared to subjects with lower levels. After adjusting for various confounders, the risk was reduced by 45-54%, depending on the vitamin E component. Dr Mangialasche notes that the protective effect of vitamin E seems to be related to the combination of the different forms. Another recent study indicated that supplements containing high doses of the E vitamin form ±-tocopherol may increase mortality, emphasizing that such dietary supplements, if not used in a balanced way, may be more harmful than previously thought. Physical activity reduces risk of cognitive impairment in later life Women who are physically active at any point over the life course (teenage, age 30, age 50, late life) have lower risk of cognitive impairment in late-life compared to those who are inactive, but teenage physical activity appears to be most important. This is the key finding of a study of over nine thousand women published today in the Journal of the American Geriatrics Society. There is growing evidence to suggest that people who are physically active in mid- and late life have lower chance of dementia and more minor forms of cognitive impairment in old age. However, there is a poorer understanding of the importance of early life physical activity and the relative importance of physical activity at different ages. Researchers led by Laura Middleton, PhD, of Sunnybrook Health Sciences Centre, Canada, compared the physical activity at teenage, age 30, age 50, and late life against cognition of 9,344 women from Maryland, Minnesota, Oregon and Pennsylvania to investigate the effectiveness of activity at different life stages. Of the participants, 15.5%, 29.7%, 28.1%, and 21.1% reported being physically inactive at teenage, at 30 years, at 50 years, and in late life respectively; the increase in cognitive impairment for those who were inactive was between 50% and 100% at each time point. When physical activity measures for all four ages were entered into a single model and adjusted for variables such as age, education, marital status, diabetes, hypertension, depressive symptoms, smoking, and BMI, only teenage physical activity status remained significantly associated with cognitive performance in old age. "Our study shows that women who are regularly physically active at any age have lower risk of cognitive impairment than those who are inactive but that being physically active at teenage is most important in preventing cognitive impairment," said Middleton. The researchers also found that women who were physically inactive at teenage but became physically active at age 30 and age 50 had significantly reduced odds of cognitive impairment relative to those who remained physically inactive. In contrast, being physically active at age 30 and age 50 was not significantly associated with rates of cognitive impairment in those women who were already physically active at teenage. Middleton added, "As a result, to minimize the risk of dementia, physical activity should be encouraged from early life. Not to be without hope, people who were inactive at teenage can reduce their risk of cognitive impairment by becoming active in later life." The researchers concluded that the mechanisms by which physical activity across the life course is related to late life cognition are likely to be multi-factorial. There is evidence to suggest that physical activity has a positive effect on brain plasticity and cognition and in addition, physical activity reduces the rates and severity of vascular risk factors, such as hypertension, obesity, and type II diabetes, which are each associated with increased risk of cognitive impairment. "Low physical activity levels in today's youth may mean increased dementia rates in the future. Dementia prevention programs and other health promotion programs encouraging physical activity should target people starting at very young ages, not just in mid- and late life," said Middleton. "Elderly people as a group are large consumers of vitamin E supplements, which usually contain only ±-tocopherol, and this often at high doses", says Dr Mangialasche. "Our findings need to be confirmed by other studies, but they open up for the possibility that the balanced presence of different vitamin E forms can have an important neuroprotective effect." Vitamin D Promotes Mental Agility in Elders At a time when consumer interest in health-enhancing foods is high, Agricultural Research Service (ARS)-funded scientists have contributed to a limited but growing body of evidence of a link between vitamin D and cognitive function. Cognitive function is measured by the level at which the brain is able to manage and use available information for activities of daily life. Alzheimer's disease, the most common form of age-related dementia, affects about 47 percent of adults aged 85 years or older in the United States. Identifying nutritional factors that lower cognitive dysfunction and help preserve independent living provides economic and public health benefits, according to authors. The study, which was supported by ARS, the National Institutes of Health, and others, was led by epidemiologist Katherine Tucker with the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University in Boston, Mass. Tucker collaborated with HNRCA laboratory directors Irwin Rosenberg, Bess Dawson-Hughes and colleagues. Metabolic pathways for vitamin D have been found in the hippocampus and cerebellum areas of the brain involved in planning, processing, and forming new memories. This suggests that vitamin D may be implicated in cognitive processes. The study involved more than 1,000 participants receiving home care. The researchers evaluated associations between measured vitamin D blood concentrations and neuropsychological tests. Elders requiring home care have a higher risk of not getting enough vitamin D because of limited sunlight exposure and other factors. The participants, ages 65 to 99 years, were grouped by their vitamin D status, which was categorized as deficient, insufficient, or sufficient. Only 35 percent had sufficient vitamin D blood levels. They had better cognitive performance on the tests than those in the deficient and insufficient categories, particularly on measures of "executive performance," such as cognitive flexibility, perceptual complexity, and reasoning. The associations persisted after taking into consideration other variables that could also affect cognitive performance. The 2009 study appears in the Journals of Gerontology, Series A, Biological Sciences and Medical Sciences. Abdominal fat at middle age associated with greater risk of dementia Study confirms that obesity is associated with lower total brain volume Researchers from Boston University School of Medicine determined that excess abdominal fat places otherwise healthy, middle-aged people at risk for dementia later in life. Preliminary findings suggest a relationship between obesity and dementia that could lead to promising prevention strategies in the future. Results of this study are published early online in Annals of Neurology, a journal of the American Neurological Association. A 2005 World Health Organization (WHO) report estimated that 24.3 million people have some form of dementia, with 4.6 million new cases annually. Individuals with dementia exhibit a decline in short-term and long-term memory, language processing, problem solving capabilities, and other cognitive function. Clinical diagnosis of dementia is made when two or more brain functions are significantly impaired. Symptoms of dementia can be attributed to irreversible causes such Alzheimer's disease, vascular dementia, and Huntington's disease, or caused by treatable conditions such as brain tumor, medication reaction, or metabolic issues. For the current study, Sudha Seshadri, M.D. and colleagues recruited participants from the Framingham Heart Study Offspring Cohort. The sample included 733 community participants who had a mean age of 60 years with roughly 70% of the study group comprised of women. Researchers examined the association between Body Mass Index (BMI), waist circumference, waist to hip ratio, CT-based measures of abdominal fat, with MRI measures of total brain volume (TCBV), temporal horn volume (THV), white matter hyperintensity volume (WMHV) and brain infarcts in the middle-aged participants. "Our results confirm the inverse association of increasing BMI with lower brain volumes in older adults and with younger, middle-aged adults and extends the findings to a much larger study sample," noted Dr. Seshadri. Prior studies were conducted in cohorts with less than 300 participants and the current study includes over 700 individuals. "More importantly our data suggests a stronger connection between central obesity, particularly the visceral fat component of abdominal obesity, and risk of dementia and Alzheimer's disease," Dr. Seshadri added. The research showed the association between VAT and TCBV was most robust and was also independent of BMI and insulin resistance. Researchers did not observe a statistically significant correlation between CT-based abdominal fat measures and THV, WMHV or BI. "Our findings, while preliminary, provide greater understanding of the mechanisms underlying the link between obesity and dementia," concluded Dr. Seshadri. "Further studies will add to our knowledge and offer important methods of prevention." Caffeine may slow Alzheimer's disease and other dementias, restore cognitive function Although caffeine is the most widely consumed psychoactive drug worldwide, its potential beneficial effect for maintenance of proper brain functioning has only recently begun to be adequately appreciated. Substantial evidence from epidemiological studies and fundamental research in animal models suggests that caffeine may be protective against the cognitive decline seen in dementia and Alzheimer's disease (AD). A special supplement to the Journal of Alzheimer's Disease, "Therapeutic Opportunities for Caffeine in Alzheimer's Disease and Other Neurodegenerative Diseases," sheds new light on this topic and presents key findings. Guest editors Alexandre de Mendonça, Institute of Molecular Medicine and Faculty of Medicine, University of Lisbon, Portugal, and Rodrigo A. Cunha, Center for Neuroscience and Cell Biology of Coimbra and Faculty of Medicine, University of Coimbra, Portugal, have assembled a group of international experts to explore the effects of caffeine on the brain. The resulting collection of original studies conveys multiple perspectives on topics ranging from molecular targets of caffeine, neurophysiological modifications and adaptations, to the potential mechanisms underlying the behavioral and neuroprotective actions of caffeine in distinct brain pathologies. "Epidemiological studies first revealed an inverse association between the chronic consumption of caffeine and the incidence of Parkinson's disease," according to Mendonça and Cunha. "This was paralleled by animal studies of Parkinson's disease showing that caffeine prevented motor deficits as well as neurodegeneration "Later a few epidemiological studies showed that the consumption of moderate amounts of caffeine was inversely associated with the cognitive decline associated with aging as well as the incidence of Alzheimer's disease. Again, this was paralleled by animal studies showing that chronic caffeine administration prevented memory deterioration and neurodegeneration in animal models of aging and of Alzheimer's disease." Exercise associated with preventing, improving mild cognitive impairment Moderate physical activity performed in midlife or later appears to be associated with a reduced risk of mild cognitive impairment, whereas a six-month high-intensity aerobic exercise program may improve cognitive function in individuals who already have the condition, according to two reports in the January issue of Archives of Neurology, one of the JAMA/Archives journals. Mild cognitive impairment is an intermediate state between the normal thinking, learning and memory changes that occur with age and dementia, according to background information in one of the articles. Each year, 10 percent to 15 percent of individuals with mild cognitive impairment will develop dementia, as compared with 1 percent to 2 percent of the general population. Previous studies in animals and humans have suggested that exercise may improve cognitive function. In one article, Laura D. Baker, Ph.D., of the University of Washington School of Medicine and Veterans Affairs Puget Sound Health Care System, Seattle, and colleagues report the results of a randomized, controlled clinical trial involving 33 adults with mild cognitive impairment (17 women, average age 70). A group of 23 were randomly assigned to an aerobic exercise group and exercised at high intensity levels under the supervision of a trainer for 45 to 60 minutes per day, four days per week. The control group of 10 individuals performed supervised stretching exercises according to the same schedule but kept their heart rate low. Fitness testing, body fat analysis, blood tests of metabolic markers and cognitive functions were assessed before, during and after the six-month trial. A total of 29 participants completed the study. Overall, the patients in the high-intensity aerobic exercise group experienced improved cognitive function compared with those in the control group. These effects were more pronounced in women than in men, despite similar increases in fitness. The sex differences may be related to the metabolic effects of exercise, as changes to the body's use and production of insulin, glucose and the stress hormone cortisol differed in men and women. "Aerobic exercise is a cost-effective practice that is associated with numerous physical benefits. The results of this study suggest that exercise also provides a cognitive benefit for some adults with mild cognitive impairment," the authors conclude. "Six months of a behavioral intervention involving regular intervals of increased heart rate was sufficient to improve cognitive performance for an at-risk group without the cost and adverse effects associated with most pharmaceutical therapies." In another report, Yonas E. Geda, M.D., M.Sc., and colleagues at Mayo Clinic, Rochester, Minn., studied 1,324 individuals without dementia who were part of the Mayo Clinic Study of Aging. Participants completed a physical exercise questionnaire between 2006 and 2008. They were then assessed by an expert consensus panel, who classified each as having normal cognition or mild cognitive impairment. A total of 198 participants (median or midpoint age, 83 years) were determined to have mild cognitive impairment and 1,126 (median age 80) had normal cognition. Those who reported performing moderate exercise—such as brisk walking, aerobics, yoga, strength training or swimming—during midlife or late life were less likely to have mild cognitive impairment. Midlife moderate exercise was associated with 39 percent reduction in the odds of developing the condition, and moderate exercise in late life was associated with a 32 percent reduction. The findings were consistent among men and women. Light exercise (such as bowling, slow dancing or golfing with a cart) or vigorous exercise (including jogging, skiing and racquetball) were not independently associated with reduced risk for mild cognitive impairment. Physical exercise may protect against mild cognitive impairment via the production of nerve-protecting compounds, greater blood flow to the brain, improved development and survival of neurons and the decreased risk of heart and blood vessel diseases, the authors note. "A second possibility is that physical exercise may be a marker for a healthy lifestyle," they write. "A subject who engages in regular physical exercise may also show the same type of discipline in dietary habits, accident prevention, adherence to preventive intervention, compliance with medical care and similar health-promoting behaviors." Future study is needed to confirm whether exercise is associated with the decreased risk of mild cognitive impairment and provide additional information on cause and effect relationships, they conclude. High fruit and vegetable intake positively correlated with cognitive performance Researchers at the Institute of Biochemistry and Molecular Biology I of the Heinrich-Heine University, Düsseldorf, Germany, investigated the relationship between fruit and vegetable intake, plasma antioxidant micronutrient status and cognitive performance in healthy subjects aged 45 to 102 years. Their results, published in the August issue of the Journal of Alzheimer's Disease, indicated higher cognitive performance in individuals with high daily intake of fruits and vegetables. Subjects with a high daily intake (about 400 g) of fruits and vegetables had higher antioxidant levels, lower indicators of free radical-induced damage against lipids as well as better cognitive performance compared to healthy subjects of any age consuming low amounts (< 100 g/day) of fruits and vegetables. Modification of nutritional habits aimed at increasing intake of fruits and vegetables, therefore, should be encouraged to lower the prevalence of cognitive impairment. The work was performed in collaboration with the Department of Pharmacology at Temple University in Philadelphia, Pennsylvania, the Department of Geriatrics at Perugia University, Italy, and the Department of Neurology of the St. Elisabeth Hospital in Cologne, Germany. Dr. M. Cristina Polidori, currently at the Department of Geriatrics, Marienhospital Herne, Ruhr-University of Bochum, Germany, explains: "It is known that there is a strong association between fruit and vegetable intake and the natural antioxidant defenses of the body against free radicals. It is also known that bad nutritional habits increase the risk of developing cognitive impairment with and without dementia. With this work we show a multiple link between fruit and vegetable intake, antioxidant defenses and cognitive performance, in the absence of disease and independent of age. Among other lifestyle habits, it is recommended to improve nutrition in general and fruit and vegetable intake in particular at any age, beginning as early as possible. This may increase our chances to remain free of dementia in advanced age." These findings are independentof age, gender, body mass index, level of education, lipid profile and albumin levels, all factors able to influence cognitive and antioxidant status. The relevance of the findings is also strengthened by the large sample that included 193 healthy subjects. Further studies are planned that will include larger subject cohorts, patients with Alzheimer's disease at different stages and patients with mild cognitive impairment without dementia. Mediterranean Diet = Slower Cognitive Decline In an examination of the association between adherence to a Mediterranean-type diet and cognitive performance and risk of dementia, researchers found that high adherence to the diet was associated with slower decline in some measures of cognitive function but was not associated with decreased risk for dementia, according to a study in the August 12 , 2009 issue of JAMA. Higher adherence to a Mediterranean-type diet is linked to lower risk for mortality and chronic diseases, and "might also have protective effects against cognitive decline in older individuals, because it combines several foods and nutrients potentially protective against cognitive dysfunction or dementia, such as fish, monounsaturated fatty acids, vitamins B12 and folate, antioxidants (vitamin E, carotenoids, flavonoids), and moderate amounts of alcohol," the authors write. But its association with cognitive decline has been unclear. Catherine Féart, Ph.D., of the Université Victor Ségalen Bordeaux 2, Bordeaux, France, and colleagues examined whether adherence to a Mediterranean diet was associated with change in cognitive performance and with lower risk of all-cause dementia or Alzheimer disease. The study included 1,410 individuals (age 65 years or older) from Bordeaux, France, who were part of the Three-City cohort in 2001-2002 (a study of vascular risk factors of dementia) and were re-examined at least once over 5 years. Adherence to a Mediterranean diet (scored as 0 to 9) was computed from a food frequency questionnaire and 24-hour recall. Cognitive performance was assessed on 4 neuropsychological tests: the Mini-Mental State Examination (MMSE), Isaacs Set Test (IST), Benton Visual Retention Test (BVRT), and Free and Cued Selective Reminding Test (FCSRT). New cases of dementia (n = 99) were validated by an independent expert committee of neurologists. After adjusting for age, sex, education, marital status, energy intake, physical activity, depressive symptomatology, taking 5 medications/day or more, apolipoprotein E genotype, cardiovascular risk factors, and stroke, the researchers found that higher Mediterranean diet score was associated with fewer MMSE errors. But performance on the IST, BVRT, or FCSRT over time was not significantly associated with Mediterranean diet adherence, especially in those who remained free from dementia over 5 years. Mediterranean diet adherence was not associated with the risk for incident dementia, although the statistical strength of the data to detect a difference was limited. "The Mediterranean diet pattern probably does not fully explain the better health of persons who adhere to it, but it may contribute directly. A Mediterranean diet also may indirectly constitute an indicator of a complex set of favorable social and lifestyle factors that contribute to better health. Further research is needed to allow the generalization of these results to other populations and to establish whether a Mediterranean diet slows cognitive decline or reduces incident dementia in addition to its cardiovascular benefits," the authors conclude. Mediterranean diet, exercise fight Alzheimer disease Elderly individuals who had a diet that included higher consumption of fruits, vegetables, legumes, cereal and fish and was low in red meat and poultry and who were physically active had an associated lower risk of Alzheimer disease, according to a study in the August 12. 2009 issue of JAMA. Research regarding the effect physical activity can have on the risk of Alzheimer disease (AD) or dementia has shown mixed results, as has the effect of dietary habits. Their combined association has not been investigated, according to background information in the article. Nikolaos Scarmeas, M.D., of Columbia University Medical Center, New York, and colleagues examined the association between physical activity and risk of AD and also the effect of physical activity and adherence to a Mediterranean-type diet on AD risk. The study included 2 groups that consisted of 1,880 community-dwelling elderly residents of New York city without dementia at the start of the study, for whom there was both diet and physical activity information available. Standardized neurological and neuropsychological measures were administered approximately every 1.5 years from 1992 through 2006. The participants received measurements of their adherence to a Mediterranean-type diet (scale of 0-9; categorized as low, middle, or high) and their physical activity (sum of weekly participation in various physical activities, weighted by the type of physical activity [light, moderate, vigorous]; categorized into no physical activity, some, or much, also low or high), separately and combined. A higher score for diet was obtained with higher consumption of fruits, vegetables, legumes, cereals, and fish; lower consumption of meat and dairy products; a higher ratio of monounsaturated fats to saturated fats and mild to moderate alcohol consumption. Individuals were followed up for an average of 5.4 years, during which a total of 282 developed AD. In considering only physical activity, the researchers found that more physical activity was associated with lower risk for developing AD. "Compared with physically inactive individuals, report of some physical activity was associated with a 29 percent to 41 percent lower risk of developing AD, while report of much physical activity was associated with a 37 percent to 50 percent lower risk," the authors write. When considered simultaneously, both physical activity and Mediterranean diet adherence were significantly associated with AD incidence. According to the researchers, "Belonging to the middle diet adherence tertile was associated with a 2 percent to 14 percent risk reduction, while belonging to the highest diet adherence tertile was associated with a 32 percent to 40 percent reduced risk. Similarly, compared with individuals with no physical activity, individuals reporting some physical activity had a 25 percent to 38 percent lower risk for AD, while individuals reporting much physical activity had a 33 percent to 48 percent lower risk for AD." The authors also write, "Compared with individuals with low physical activity plus low adherence to a diet (absolute AD risk, 19 percent), high physical activity plus high diet adherence was associated with a 35 percent to 44 percent relative risk reduction (absolute AD risk, 12 percent). … Absolute AD risks declined from 21 percent in the group with no physical activity plus low diet adherence to 9 percent in the group with much physical activity plus high diet adherence." "In summary, our results support the potentially independent and important role of both physical activity and dietary habits in relation to AD risk. These findings should be further evaluated in other populations." High cholesterol in midlife raises risk of late-life dementia Elevated cholesterol levels in midlife – even levels considered only borderline elevated – significantly increase the risk of Alzheimer's disease and vascular dementia later in life, according to a new study by researchers at Kaiser Permanente's Division of Research and the University of Kuopio in Finland. The study appears in the journal Dementia & Geriatric Cognitive Disorders. The four-decade study of 9,844 men and women found that having high cholesterol in midlife (240 or higher milligrams per deciliter of blood) increases, by 66 percent, the risk for Alzheimer's disease later in life. Even borderline cholesterol levels (200 – 239 mg/dL) in midlife raised risk for late-life vascular dementia by nearly the same amount: 52 percent. Vascular dementia, the second most common form of dementia after Alzheimer's disease, is a group of dementia syndromes caused by conditions affecting the blood supply to the brain. Scientists are still trying to pinpoint the genetic factors and lifestyle causes for Alzheimer's disease. By measuring cholesterol levels in 1964 to 1973 based on the 2002 Adult Treatment Panel III guidelines (the current practice standard) when the Kaiser Permanente Northern California members were 40 to 45 years old, then following the participants for 40 years, this study is the largest long-term study with the most diverse population to examine the midlife cholesterol levels and late-life dementia. It is also the first study to look at borderline high cholesterol levels and vascular dementia, rather than just Alzheimer's disease. "Our study shows that even moderately high cholesterol levels in your 40s puts people at greater risk for Alzheimer's disease and vascular dementia decades later," said the study's senior author. Rachel Whitmer, Ph.D., a research scientist and epidemiologist at the Kaiser Permanente Division of Research in Oakland, Calif. "Considering that nearly 100 million Americans have either high or borderline cholesterol levels, this is a disturbing finding. The good news here is that what is good for the heart is also good for the mind, and this is an early risk factor for dementia that can be modified and managed by lowering cholesterol through healthy lifestyle changes." This study, funded by the National Institutes of Health, adds to other research emphasizing the importance of addressing dementia risk factors in midlife, before an underlying disease or symptoms appear, the researchers said. "Our findings add to the existing body of evidence on a degree of overlap between two dementia types in terms of risk factors, symptoms and neuropathology," said the study's lead author, Alina Solomon, MD, a researcher with the Department of Neurology at the University of Kuopio, Finland. "Dementia and cardiovascular disease are common major health problems, share several risk factors and often occur simultaneously, interacting with one another. A holistic approach that addresses multiple major health problems simultaneously is needed to effectively manage these disorders." The study tracked members of Kaiser Permanente's Northern California Medical Group from 1967 to 2007 by using the multiphasic testing records pioneered by Kaiser Permanente founding physician Morris Collen, MD, who is widely regarded worldwide as a health care informatics pioneer. Of the original 9,844 participants, 598 were diagnosed with Alzheimer's disease or vascular dementia between 1994 and 2007, when the participants were between 61 and 88 years old. This epidemiological study did not examine the mechanism of the link between cholesterol levels and dementia. This study is part of an ongoing body of research at Kaiser Permanente to better understand the risk and protective factors for dementia. Dr. Whitmer recently authored two dementia-related studies: one that found a larger abdomen in midlife increases risk of late-life dementia, and one that showed that low blood sugar events in elderly patients with type 2 diabetes increase their risk for dementia. Another Kaiser Permanente study, led by Valerie Crooks of Kaiser Permanente in Southern California, found that having a strong social network of friends and family appears to decrease risk for dementia. Dietary Approaches to Stop Hypertension (DASH) Eating Pattern May Reduce Age-Related Cognitive Decline The Dietary Approaches to Stop Hypertension (DASH) diet is often recommended by physicians to people with high blood pressure or pre-hypertension. The DASH diet eating plan has been proven to lower blood pressure in studies sponsored by the National Institutes of Health. High blood pressure is considered a risk factor for Alzheimer's and dementia. Heidi Wengreen, RD, PhD, Assistant Professor of Nutrition at Utah State University, and colleagues examined associations between how closely people adhered to the DASH diet and risk of cognitive decline and dementia among older participants in the Cache County Study on Memory, Health and Aging. In 1995, 3,831 study participants 65 years of age or older completed a survey that included a food frequency questionnaire and cognitive assessment. Cognitive function was checked again during four assessments over 11 years using the Modified Mini-Mental State examination (3MS), which is graded on a 100 point scale. A DASH diet adherence score was created based on consumption levels of nine food-group/nutrient components -- fruit, vegetables, nut/legumes, whole grains, low-fat dairy, sodium, sweets, non-fish meat, and fish. Participants were ranked by DASH score into five groups, or quintiles. The researchers found that higher DASH scores were associated with higher scores for cognitive functioning at the beginning of the study and over time. Those in the highest quintile scored 1.42 points higher at baseline and 1.81 points higher after 11 years on the 3MS than did those in the lowest quintile of the DASH score (p-values < 0.001). They also found that four of the nine food-group/nutrient components used to create the DASH score were independently associated with 3MS scores -- vegetables, whole grains, low-fat dairy, nut/legumes. The scientists created a diet adherence score based on just these four components which they then tested for association with changes in cognitive abilities on the 3MS. Those in the highest quintile scored 1.72 points higher at baseline and 3.73 points higher after 11 years than did those in the lowest quintile of the four-component score (p-values < 0.001). "Our results suggest that including whole grains, vegetables, low-fat dairy foods, and nuts in one's diet may offer benefits for cognition in late life," Wengreen said. "However, we need more research before we can confidently say how much of these foods to include in your diet to experience some benefit." Maintaining or Increasing Activity Levels May Slow Cognitive Decline in Elderly Studies have found that older adults who are physically active may experience slower rates of cognitive decline. Less is known about the impact of changes in physical activity levels on rate of cognitive decline. Deborah E. Barnes, PhD, MPH, Assistant Professor of Psychiatry at the University of California, San Francisco, and a geriatrics researcher at the San Francisco VA Medical Center, and colleagues studied changes in levels of both physical activity and cognitive function over seven years in 3,075 white and black elders aged 70-79 years in the Health, Aging and Body Composition Study. Physical activity was assessed based on self-reported number of minutes walked per week at the beginning of the study and after two, four, and seven years of follow-up. Participants were classified at each time point as sedentary (0 minutes per week), low (less than 150 minutes per week) or high (150 minutes per week or more). Changes over time were classified as consistently sedentary, maintaining (low or high), decreasing, or increasing/fluctuating. Cognitive function was assessed using the 3MS. The researchers found that 21% of study participants were consistently sedentary, 12% maintained their activity levels, 26% had declining levels, and 41% had increasing or fluctuating levels. After adjustment for age, sex, race, education, study site, diabetes, hypertension, smoking, alcohol consumption and baseline 3MS score, they found that the mean rate of decline in 3MS scores was 0.62 points/year in those who were consistently sedentary, 0.54 points/year (p=0.30) in those with declining activity levels, 0.44 points/year (p=0.01) in those with increasing/fluctuating activity levels, and 0.40 points/year (p=0.04) in those who maintained their activity levels. "We found that older adults who were sedentary throughout the study had the lowest levels of cognitive function at the beginning and experienced the fastest rate of cognitive decline," Barnes said. "Cognitive decline also was faster in those whose physical activity levels consistently declined during the study period." According to the researchers, sedentary elders who began new aerobic exercise programs experienced improvements in cognitive function, especially the ability to process complex information quickly. "Sedentary individuals should be encouraged to engage in physical activity at least occasionally," Barnes said. "People who are currently active should be encouraged to maintain or increase their activity levels." Moderate Long-Term Physical Activity May Improve Late Life Cognition; Long-Term Strenuous Activity May Increase Risk of Cognitive Impairment Long-term strenuous physical activity has been shown to decrease lifetime exposure to ovarian hormones in women and has been found to play a protective role against breast cancer. However reduction in ovarian hormone exposure has been associated with increased risk of cognitive impairment. At the same time, long-term physical activity is associated with improved cognition but the intensity required to preserve cognition is not known. Mary C. Tierney, PhD, CPsych, Professor of Family and Community Medicine at the University of Toronto, and Senior Scientist and Director, Geriatric Research Unit, Brain Sciences Program at Sunnybrook Health Sciences Centre, and colleagues sought to examine the associations between both long-term strenuous and moderate activity levels and cognition in recently postmenopausal women. Study participants were 90 women aged 50-63 years, one to 10 years post natural menopause, with no history of breast cancer, HRT use, psychiatric disorder, dementia or other neurological condition. Participants gave details on the amount of their strenuous and moderate physical recreational activities from high school to menopause. Eight memory and brain function tests were administered to all participants. After adjusting for age, education, reproductive years, cigarette smoking, alcohol consumption, parity, and periods of amenorrhea, the researchers found that long-term strenuous activity was consistently associated with poorer performance on all eight of the tests; with statistically significant results on tests of semantic memory, working memory, delayed verbal recall, and sustained attention (p < 0.05). Moderate physical activity was consistently associated with better performance on all eight of the tests, with statistically significant results on cognitive flexibility, working memory, and sustained attention (p < 0.05). "Our results suggest that long-term strenuous activity may increase the risk of cognitive impairment in recently postmenopausal women," Tierney said. "On the other hand, moderate long-term physical activity may improve later life cognition. These preliminary findings have important implications for women's health and support the need for large-scale studies including both women and men." Moderate alcohol intake has cognitive benefits A glass of wine here, a nightcap there – new research out of Wake Forest University School of Medicine suggests that moderate alcohol intake offers long-term cognitive protection and reduces the risk of dementia in older adults. The study is being presented at the Alzheimer's Association 2009 International Conference on Alzheimer's Disease (ICAD), in Vienna on July 13. While previous studies have shown that moderate alcohol intake, particularly wine, is linked with lower risk of heart attacks and dementia, most of the studies have been done in middle-aged people, and it has remained unclear if the benefits of alcohol also apply to older adults in general or to older adults who might already have some mild memory problems. This is the largest, longest U.S. study to look at the effects of regular alcohol intake on dementia in seniors, both with and without memory problems. "As of yet, we still have no cure for Alzheimer's disease and other dementias, so it is important to look for things that might help people prevent the disease," said Kaycee Sink, M.D., M.A.S (Masters of Advanced Studies in clinical research), a geriatrician and senior author of the paper. Moderate alcohol intake has been linked to lower risk of heart attacks, stroke, dementia, and death in middle-aged adults, but there is still controversy about alcohol intake in older adults." For the study, researchers began by examining and interviewing 3,069 individuals, 75 years or older and most without any memory or thinking problems, about their drinking habits. Participants were asked about beer, wine, and liquor. The investigators then categorized the individuals as abstainers (non-drinkers), light drinkers (one to seven drinks per week), moderate drinkers (eight to 14 drinks per week), or heavy drinkers (more than 14 drinks per week). All types of alcohol were included. The study subjects were then examined and interviewed every six months for six years to determine changes in their memory or thinking abilities and to monitor who developed dementia. Researchers found that individuals who had no cognitive impairment at the start of the study and drank eight to 14 alcoholic beverages per week, or one to two per day, experienced an average 37 percent reduction in risk of developing dementia compared to individuals who did not drink at all and were classified as abstainers. The type of alcohol consumed did not matter. For older adults who started the study with mild cognitive impairment, however, consumption of alcohol, at any amount, was associated with faster rates of cognitive decline. In addition, those who were classified in the heavy drinker category, consuming more than 14 drinks per week, were almost twice as likely to develop dementia during the study compared to non-drinkers with mild cognitive impairment. "We were excited to see that even in older adults, moderate alcohol intake decreases the risk of dementia," Sink said. "It is important to note, however, that our study found a significantly higher risk of dementia for heavy drinkers who started the study with mild cognitive impairment." The results are consistent with previous studies of middle-aged adults that suggest mild to moderate alcohol intake may reduce the risk of dementia, except in the case of individuals who already have mild to moderate cognitive impairment. The researchers' findings support current recommendations not to exceed one drink per day for women and two for men. It is unclear from this study whether an abstainer who begins drinking moderately in his/her 70s will experience the same benefit or if the benefit is associated with a long pattern of moderate alcohol intake that continues on into old age. "Our results suggest that older adults who are normal cognitively and drink moderately do not need to change their drinking behavior," Sink said. "If you have mild cognitive impairment however, it might benefit you to restrict your drinking and certainly not exceed one drink a day for women and two drinks a day for men. "The participants in this study self-reported their alcohol intake at the start, but it is unusual for people to start drinking in their 70s, so we assume that the habits they reported at the start of the study reflect stable drinking habits," Sink added. "Without scientific data showing that it is beneficial, I wouldn't recommend that non-drinkers start drinking in their 70s. "We are starting to make progress in understanding how to prevent and treat Alzheimer's and other dementias," she said. "It is a very exciting time to be involved in geriatrics research." Aspirin can reduce risk of Alzheimer's disease Ibuprofen, aspirin, naproxen may be equally effective at reducing risk of Alzheimer's disease Different types of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and aspirin, appear to be equally effective in lowering the risk of Alzheimer’s disease, according to the largest study of its kind published in the May 28, 2008, online issue of Neurology®, the medical journal of the American Academy of Neurology. Experts have debated whether a certain group of NSAIDs that includes ibuprofen may be more beneficial than another group that includes naproxen and aspirin. Using information from six different studies, researchers examined data on NSAID use in 13,499 people without dementia. Over the course of these six studies, 820 participants developed Alzheimer’s disease. Researchers found that people who used NSAIDs had 23 percent lower risk of developing Alzheimer’s disease compared to those who never used NSAIDs. The risk reduction did not appear to depend upon the type of NSAID taken. “This is an interesting finding because it seems to challenge a current theory that the NSAID group which includes ibuprofen may work better in reducing a person’s risk of Alzheimer’s,” said study author Peter P. Zandi, PhD, with Johns Hopkins Bloomberg School of Public Health in Baltimore, MD. “The NSAID group that includes ibuprofen was thought to target a certain type of plaque in the brain found in Alzheimer’s patients. But our results suggest there may be other reasons why these drugs may reduce the risk of Alzheimer’s.” The study’s lead author Chris Szekely, PhD, with Cedars Sinai Medical Center in Los Angeles, says the discrepancy between studies such as this one and the negative clinical trials of NSAIDs in treatment or prevention of Alzheimer’s need to be further explored. Vasectomy may put men at risk for type of dementia Northwestern University researchers have discovered men with an unusual form of dementia have a higher rate of vasectomy than men the same age who are cognitively normal. The dementia is Primary Progressive Aphasia (PPA), a neurological disease in which people have trouble recalling and understanding words. In PPA, people lose the ability to express themselves and understand speech. It differs from typical Alzheimer's disease in which a person's memory becomes impaired. Sandra Weintraub, principal investigator and professor of psychiatry and behavioral sciences and of neurology at Northwestern's Feinberg School of Medicine, began investigating a possible link between the surgery and PPA when one of her male patients connected the onset of his language problem at age 43 to the period after his vasectomy. At a twice-yearly Chicago support group for PPA patients Weintraub sees from around the country, the male patient rushed into the room and asked the men sitting there, "OK, guys, how many of you have PPA?" Nine hands went up. "How many of you had a vasectomy?" he demanded next. Eight hands shot up. Weintraub and her team of researchers surveyed 47 men with PPA who were being treated at Northwestern's Cognitive Neurology and Alzheimer's Disease Center and 57 men with no cognitive impairment who were community volunteers. They ranged from 55 to 80 years old. Of the non-impaired men, 16 percent had undergone a vasectomy. In contrast, 40 percent of the men with PPA had had the surgery. "That's a huge difference," said Weintraub, director of neuropsychology in the Cognitive Neurology and Alzheimer's Disease Center. "It doesn't mean having a vasectomy will give you this disease, but it may be a risk factor to increase your chance of getting it." In addition, the men who had undergone a vasectomy developed PPA at a younger age (58 years) than men with PPA who hadn't had one (62 years.) While PPA robs people of their ability to speak and understand language, an unusual twist of the disease is patients are still able to maintain their hobbies and perform other complicated tasks for a number of years before other symptoms develop. Some people garden, build cabinets and even navigate a city subway system. By contrast, Alzheimer's patients lose interest in their hobbies, family life and may become idle. As PPA progresses over a number of years, however, patients eventually lose their ability to function independently. Preliminary evidence from the study also seemed to connect another form of dementia to a vasectomy. In a smaller group of 30 men with a dementia called frontotemporal dementia (FTD,) 37 percent had undergone a vasectomy. The earliest symptoms of FTD are personality changes, lack of judgment and bizarre behavior. As in PPA, FTD usually starts at an earlier age, in the 40s and 50s. One of Weintraub's patients with FTD was eating lunch in a restaurant with his family and excused himself to go to the bathroom. When he hadn't returned after 10 minutes, his sons went to investigate. They found him doing pushups on the bathroom floor. Other FTD patients begin shoplifting, compulsively gambling, misspending large amounts of money or become sexually demanding. The most common form of dementia caused by brain deterioration in individuals over age 65 is Alzheimer's disease. Weintraub did not find an increased rate of vasectomy in patients with Alzheimer's. Many patients with FTD and PPA share a common brain disease that is completely different from Alzheimer's. Whether a patient will get the behavioral or language problems depends on where the disease causes the most destruction in the brain. In FTD, most of the damage is in the frontal lobes; in PPA, it's in the language centers of the left hemisphere of the brain. Weintraub theorizes a vasectomy may raise the risk of PPA (and possibly FTD) because the surgery breeches the protective barrier between the blood and the testes, called the blood-testis barrier. Certain organs – including the testes and the brain – exist in what is the equivalent of a gated community in the body. Tiny tubes within the testes (in which sperm are produced) are protected by a physical barrier of Sertoli cells. The tight connections between these cells prevent blood-borne infections and poisonous molecules from entering the semen. After a vasectomy, however, the protective barrier is broken and semen mixes into the blood. The immune system recognizes the sperm as invading foreign agents and produces anti-sperm antibodies in 60 to 70 percent of men. Weintraub said these antibodies might cross the blood-brain-barrier and cause damage resulting in dementia. "There are other neurological models of disease which you can use as a parallel," Weintraub said. Certain malignant tumors produce antibodies that reach the brain and cause an illness similar to encephalitis, she noted. The next step in Weintraub's research will be to launch a national study to see if her results will be confirmed in a larger population. "I don't want to scare anyone away from getting a vasectomy," Weintraub stressed. "It's obviously a major birth control alternative. This is just a correlational observation," she said of the dementia connection. "We need to do more research to find out." Higher folate levels linked to reduced risk for Alzheimer's disease Individuals who take in higher levels of the nutrient folate through both diet and supplements may have a reduced risk of developing Alzheimer's disease, according to a report in the January issue of Archives of Neurology, one of the JAMA/Archives journals. By the year 2047, the prevalence of Alzheimer's disease is expected to quadruple, according to background information in the article. Delaying the onset of this neurodegenerative disease would significantly reduce the burden it causes. Researchers suspect that elevated levels of the amino acid homocysteine in the blood, which is linked to a higher risk for cardiovascular disease and stroke, may also increase the risk for Alzheimer's disease. Folate, vitamin B12 and vitamin B6, are important in the body's processing of homocysteine--therefore, deficiencies in these nutrients increase homocysteine levels and may contribute to cardiovascular disease, stroke and dementia. José A. Luchsinger, M.D., Columbia University Medical Center, New York, and colleagues examined, interviewed and assessed the diets of 965 individuals without dementia between 1992 and 1994 and then followed them for an average of 6.1 years to see if they developed Alzheimer's disease. The participants had an average age of 75.8 and 70.2 percent were women, 32.6 percent African-American, 45.3 percent Hispanic and 22.1 percent white. During the follow-up period, 192 of the participants developed Alzheimer's disease. When the individuals were divided into four groups based on the total level of folate they took in through food and supplements and the analysis was adjusted for patient characteristics, comorbid diseases and B12 and B6 intake, the risk of Alzheimer's disease was lower in the groups with higher intake. Neither dietary folate nor supplements alone were significantly linked to Alzheimer's disease risk; only the two in combination appeared to produce an effect. Levels of the vitamins B12 and B6 were not associated with Alzheimer's disease risk. Higher folate intake was modestly correlated with lower homocysteine levels, "indirectly suggesting that a lower homocysteine level is a potential mechanism for the association between higher folate intake and a lower Alzheimer's disease risk," the authors write. Definitive conclusions about the role of folate in the development of Alzheimer's disease cannot yet be made, they continue. The findings of this study are in contrast to those of some other research, and other compounds (such as hormones) perceived to reduce the risk for dementia in observational studies did not do so in randomized trials. "Thus, the decision to increase folate intake to prevent Alzheimer's disease should await clinical trials," they conclude. Red wine again linked to slowing Alzheimer's A Mount Sinai School of Medicine study found giving mice with amyloid plaques red wine slows their memory loss and brain cell death - adding to a body of science linking compounds in the beverage to slowing the Alzheimer's disease-related symptom. In the study - set to for publication in November's Federation of American Societies for Experimental Biology Journal - wine-drinking mice learned to escape from a maze significantly faster than mice drinking alcohol-spiked water or water. The results could have implications for formulators in the production of supplements for age-related conditions. According to the Alzheimers Society, there are nearly 18 million people in the world with dementia. Around 55 percent of those who suffer from dementia have Alzheimer's. In the Mount Sinai study, the mice's wine intake was aligned to what is the equivalent of moderate consumption in humans - a five-ounce glass per day for women and two for men. In the past, both alcohol and a red wine compound, resveratrol, have been linked to a reduction in the onset of dementia. For several months, the Mount Sinai mice were given cabernet sauvignon or ethanol in their drinking water, while another group of mice drank plain water. All the mice had amyloid plaques in their brains that occur in humans with Alzheimer's disease. The research team, led by Dr. Giulio Maria Pasinetti, assessed the mice's memory by testing their ability to get out of a maze. The wine-drinking mice were able to exit the maze significantly faster than those drinking alcohol-spiked water or water only, the scientists found. The study only advocates moderate red wine consumption as part of an overall healthy lifestyle. Midlife Coffee And Tea Drinking May Protect Against Late-life Dementia Midlife coffee drinking can decrease the risk of dementia/Alzheimer's disease (AD) later in life. This conclusion is made in a Finnish Cardiovascular Risk Factors, Aging and Dementia (CAIDE) Study published in the Journal of Alzheimer's Disease. This study has been conducted at the University of Kuopio, Finland in collaboration with Karolinska Institutet, Stockholm, Sweden, and the National Public Health Institute, Helsinki, Finland. The study included participants from the survivors of population-based cohorts previously surveyed within the North Karelia Project and the FINMONICA study in 1972, 1977, 1982 or 1987 (midlife visit). After an average follow-up of 21 years, 1409 individuals (71%) aged 65 to 79 completed the re-examination in 1998. A total of 61 cases were identified as demented (48 with AD). "We aimed to study the association between coffee and tea consumption at midlife and dementia/AD risk in late-life, because the long-term impact of caffeine on the central nervous system was still unknown, and as the pathologic processes leading to Alzheimer's disease may start decades before the clinical manifestation of the disease," says lead researcher, associate professor Miia Kivipelto, from the University of Kuopio, Finland and Karolinska Institutet, Stockholm, Sweden. At the midlife examination, the consumption of coffee and tea was assessed with a previously validated semi-quantitative food-frequency questionnaire. Coffee drinking was categorized into three groups: 0-2 cups (low), 3-5 cups (moderate) and >5 cups (high) per day. Further, the question concerning tea consumption was dichotomized into those not drinking tea (0 cup/day) vs. those drinking tea (≥1 cup/day).

The study found that coffee drinkers at midlife had lower risk for dementia and AD later in life compared to those drinking no or only little coffee. The lowest risk (65% decreased) was found among moderate coffee drinkers (drinking 3-5 cups of coffee/day). Adjustments for various confounders did not change the results. Tea drinking was relatively uncommon and was not associated with dementia/AD.

Kivipelto also notes that, "Given the large amount of coffee consumption globally, the results might have important implications for the prevention of or delaying the onset of dementia/AD. The finding needs to be confirmed by other studies, but it opens the possibility that dietary interventions could modify the risk of dementia/AD. Also, identification of mechanisms of how coffee exerts its protection against dementia/AD might help in the development of new therapies for these diseases."

In women, caffeine may protect memory

Caffeine may help older women protect their thinking skills, according to a study published in the August 7, 2007, issue of Neurology, the medical journal of the American Academy of Neurology.

The study found that women age 65 and older who drank more than three cups of coffee (or the equivalent in tea) per day had less decline over time on tests of memory than women who drank one cup or less of coffee or tea per day. The results held up even after researchers adjusted for other factors that could affect memory abilities, such as age, education, disability, depression, high blood pressure, medications, cardiovascular disease, and other chronic illnesses.

“Caffeine is a psychostimulant which appears to reduce cognitive decline in women,” said study author Karen Ritchie,. “While we have some ideas as to how this works biologically, we need to have a better understanding of how caffeine affects the brain before we can start promoting caffeine intake as a way to reduce cognitive decline. But the results are interesting – caffeine use is already widespread and it has fewer side effects than other treatments for cognitive decline, and it requires a relatively small amount for a beneficial effect.”

The study involved 7,000 people whose cognitive abilities and caffeine consumption were evaluated over four years. Compared to women who drank one cup or less of coffee per day, those who drank over three cups were less likely to show as much decline in memory. Moreover, the benefits increased with age – coffee drinkers being 30 percent less likely to have memory decline at age 65 and rising to 70 percent less likely over age 80.


Coffee could protect against Alzheimer's disease

A daily dose of caffeine blocks the disruptive effects of high cholesterol that scientists have linked to Alzheimer's disease. A study in the open access publication, Journal of Neuroinflammation revealed that caffeine equivalent to just one cup of coffee a day could protect the blood-brain barrier (BBB) from damage that occurred with a high-fat diet.
The BBB protects the central nervous system from the rest of the body's circulation, providing the brain with its own regulated microenvironment. Previous studies have shown that high levels of cholesterol break down the BBB which can then no longer protect the central nervous system from the damage caused by blood borne contamination. BBB leakage occurs in a variety of neurological disorders such as Alzheimer's disease.

In this study, researchers from the University of North Dakota School of Medicine and Health Sciences gave rabbits 3 mg caffeine each day – the equivalent of a daily cup of coffee for an average-sized person. The rabbits were fed a cholesterol-enriched diet during this time.

After 12 weeks a number of laboratory tests showed that the BBB was significantly more intact in rabbits receiving a daily dose of caffeine.

“Caffeine appears to block several of the disruptive effects of cholesterol that make the blood-brain barrier leaky,” says Jonathan Geiger, University of North Dakota School of Medicine and Health Sciences. “High levels of cholesterol are a risk factor for Alzheimer's disease, perhaps by compromising the protective nature of the blood-brain barrier. For the first time we have shown that chronic ingestion of caffeine protects the BBB from cholesterol-induced leakage.”

Caffeine appears to protect BBB breakdown by maintaining the expression levels of tight junction proteins. These proteins bind the cells of the BBB tightly to each other to stop unwanted molecules crossing into the central nervous system.

The findings confirm and extend results from other studies showing that caffeine intake protects against memory loss in aging and in Alzheimer’s disease.

“Caffeine is a safe and readily available drug and its ability to stabilise the blood-brain barrier means it could have an important part to play in therapies against neurological disorders,” says Geiger.


New study provides further evidence that apple juice can delay onset of Alzheimer's disease

A growing body of evidence demonstrates that we can take steps to delay age-related cognitive decline, including in some cases that which accompanies Alzheimer's disease, according to a study published in the January 2009 issue of the Journal of Alzheimer's Disease.

Thomas B. Shea, PhD, of the Center for Cellular Neurobiology; Neurodegeneration Research University of Massachusetts, Lowell and his research team have carried out a number of laboratory studies demonstrating that drinking apple juice helped mice perform better than normal in maze trials, and prevented the decline in performance that was otherwise observed as these mice aged.

In the most recent study Shea and his team demonstrated that mice receiving the human equivalent of 2 glasses of apple juice per day for 1 month produced less of a small protein fragment, called "beta-amyloid" that is responsible for forming the "senile plaques" that are commonly found in brains of individuals suffering from Alzheimer's disease.

Dr. Shea commented that "These findings provide further evidence linking nutritional and genetic risk factors for age-related neurodegeneration and suggest that regular consumption of apple juice can not only help to keep one's mind functioning at its best, but may also be able to delay key aspects of Alzheimer's disease and augment therapeutic approaches."

The article is "Dietary Supplementation with Apple Juice Decreases Endogenous Amyloid-_ Levels in Murine Brain" by Amy Chan and Thomas B. Shea. It is published in the Journal of Alzheimer's Disease 16:1 (January 2009).

Exercise helps prevent age-related brain changes in older adults

Older adults who exercise regularly show increased cerebral blood flow and a greater number of small blood vessels in the brain, according to findings presented at the annual meeting of the Radiological Society of North America (RSNA).

The study, conducted at the University of North Carolina (UNC) – Chapel Hill, is the first to compare brain scans of older adults who exercise to brain scans of those who do not.

"Our results show that exercise may reduce age-related changes in brain vasculature and blood flow," said presenter Feraz Rahman, M.S., currently a medical student at Jefferson Medical College in Philadelphia. "Other studies have shown that exercise prevents cognitive decline in the elderly. The blood vessel and flow differences may be one reason."

The researchers recruited 12 healthy adults, age 60 to 76. Six of the adults had participated in aerobic exercise for three or more hours per week over the last 10 years, and six exercised less than one hour per week. All of the volunteers underwent MRI to determine cerebral blood flow and MR angiography to depict blood vessels in the brain.

Using a novel method of three-dimensional (3-D) computer reconstruction developed in their lab, the researchers were able to make 3-D models of the blood vessels and examine them for shape and size. They then compared the blood vessel characteristics and how they related to blood flow in both the active and inactive groups.

The results showed that the inactive group exhibited fewer small blood vessels in the brain, along with more unpredictable blood flow through the brain.

"The active adults had more small blood vessels and improved cerebral blood flow," said the study's senior author, J. Keith Smith, M.D., Ph.D., associate professor of radiology at UNC School of Medicine. "These findings further point out the importance of regular exercise to healthy aging."

Red wine: How it fights Alzheimer's

Alzheimer's researchers at UCLA, in collaboration with Mt. Sinai School of Medicine in New York, have discovered how red wine may reduce the incidence of the disease. Reporting in the Nov. 21 issue of the Journal of Biological Chemistry, David Teplow, a UCLA professor of neurology, and colleagues show how naturally occurring compounds in red wine called polyphenols block the formation of proteins that build the toxic plaques thought to destroy brain cells, and further, how they reduce the toxicity of existing plaques, thus reducing cognitive deterioration.

Polyphenols comprise a chemical class with more than 8,000 members, many of which are found in high concentrations in wine, tea, nuts, berries, cocoa and various plants. Past research has suggested that such polyphenols may inhibit or prevent the buildup of toxic fibers composed primarily of two proteins — Aß40 and Aß42 — that deposit in the brain and form the plaques which have long been associated with Alzheimer's. Until now, however, no one understood the mechanics of how polyphenols worked.

Teplow's lab has been studying how amyloid beta (Aß) is involved in causing Alzheimer's. In this work, researchers monitored how Aß40 and Aß42 proteins folded up and stuck to each other to produce aggregates that killed nerve cells in mice. They then treated the proteins with a polyphenol compound extracted from grape seeds. They discovered that polyphenols carried a one-two punch: They blocked the formation of the toxic aggregates of Aß and also decreased toxicity when they were combined with Aß before it was added to brain cells.

"What we found is pretty straightforward," Teplow said. "If the Aß proteins can't assemble, toxic aggregates can't form, and thus there is no toxicity. Our work in the laboratory, and Mt. Sinai's Dr. Giulio Pasinetti's work in mice, suggest that administration of the compound to Alzheimer's patients might block the development of these toxic aggregates, prevent disease development and also ameliorate existing disease."

Human clinical trials are next.

"No disease-modifying treatments of Alzheimer's now exist, and initial clinical trials of a number of different candidate drugs have been disappointing," Teplow said. "So we believe that this is an important next step."