By Emily Woodruff | April 16th, 2019

Scientists still don’t know why some people get Alzheimer’s and others can recall facts and memories well into their 90s, but they believe it’s a combination of genetics and environmental risk factors. And while you can’t change your genes, you can control your lifestyle—which, in turn, might keep the genes that encourage Alzheimer’s from triggering.

Researchers from the University of Alberta in Canada found that there are concrete ways people can help influence good brain health. The results of their study, published in the Journal of Alzheimer’s Disease,suggest people might be able to stave off Alzheimer’s through early prevention efforts for people over the age of 55.

“We found different risk factors for stable memory and for rapidly declining memory,” said Peggy McFall, lead author and research associate in the Department of Psychology. “It may be possible to use these factors to improve outcomes for older adults.”

McFall and her team analyzed data from 882 adults between the ages of 53 and 95 using machine learning to track patterns. Adults with a healthy memory were more likely to:

• Be female
• Have a higher education
• Engage in social activities like dinner parties
• Participate in novel cognitive activities like using a computer, learning a second language or doing taxes

For adults ages 55 to 75, healthy memory was also associated with a lower heart rate, higher body mass index, more self-maintenance activities (think: making dinner), and having a live-in companion. Adults over the age of 75 with healthy memories walked faster and were less depressed than their counterparts with poorer memories.

While not all of those factors are controllable, most are—and many are related to maintaining an active lifestyle through exercise and diet.

“These modifiable risk and protective factors may be converted to potential intervention targets for the dual purpose of promoting healthy memory aging or preventing or delaying accelerated decline, impairment, and perhaps dementia,” said McFall.

Researchers envision a future that might include encouraging cognitive activities at a doctor’s appointment for people between the ages of 55 and 75 or exercises to improve gait speed for people over the age of 75.

Here are some actionable steps you can take that science says may lower your risk for cognitive problems:

• A healthy diet: The MIND diet, based on the Mediterranean diet, has been shown to not only actually lower a person’s risk of Alzheimer’s, but may also actually slow cognitive decline.
• Exercise: Neuroscientist Wendy Suzuki says exercise can lower your risk for dementia by between 30 and 90 percent, depending on the type and intensity of exercise.
• Social engagement: Feeling lonely can increase your risk of dementia by 40 percent, according to a study by Florida State University. People who are married or have close friendships have a 60 percent lower risk of dementia.
• Engage in meaningful activities: Seniors with a strong sense of purpose showed fewer signs of aging, according to one study. For some people, that means continuing to work past their retirement age, but for others, it can be taking care of a pet or spending time with family.
• Sleep: Deep sleep is necessary for the brain to maintain itself and get rid of toxins associated with Alzheimer’s. Those who don’t get deep sleep actually have more signs of Alzheimer’s in the brain, decades before symptoms like memory loss appear.
• Stress: Long-term feelings of stress can actually change the structure of the brain, and it can increase cortisol and inflammation—which is tied to the development of Alzheimer’s. Experts suggest mindfulness-based stress relief exercises for chronically stressed people.

Alzheimer’sbrainhealthlifestyleprevention

A course for those who love and care for people living with Dementia

By Emily Woodruff | April 2nd, 2019

An under-utilized tool could help correctly diagnose and manage dementia, leading to better care, according to a new study.

The study, published in the Journal of the American Medical Association (JAMA), found that giving patients a PET scan to get more information about the state of their brains resulted in an altered diagnosis for one in three study participants with dementia or memory problems and changed managment—medications, therapy, counseling, etc.—in two-thirds of patients.

Right now, PET scans are not typically used to confirm an Alzheimer’s diagnosis because they are costly and not covered by insurance. The PET scan can identify beta-amyloid plaques, a build-up of toxic proteins in the brain that is a biomarker for Alzheimer’s. Instead, doctors rely on symptoms like memory loss, word games and family testimony to diagnose Alzheimer’s. But those methods have been proven to be unreliable and biased in the past, doling our inaccurate diagnoses.

Amyloid-positive (left) and amyloid-negative (right) PET scans can respectively be used to diagnose or rule out Alzheimer’s disease in individuals with memory loss or cognitive decline. Image: UCSF Memory and Aging Center

Researchers from the American College of Radiology, the Alzheimer’s Association, UC San Francisco, Brown University School of Public Health, Virginia Commonwealth University School of Public Health, Washington University School of Medicine in St. Louis, UC Davis School of Medicine, and the Kaiser Permanente Division of Research all worked on the study, which analyzed data from more than 11,000 Medicare patients.

“We are impressed by the magnitude of these results, which make it clear that amyloid PET imaging can have a major impact on how we diagnose and care for patients with Alzheimer’s disease and other forms of cognitive decline,” said study lead author Gil Rabinovici, M.D., of the  UCSF Memory and Aging Center.

Medicare does not currently pay for such scans on the basis that Alzheimer’s is incurable and getting the scan would not alter the course of the disease or treatment.

But these results show that a scan can make a big difference—both for people who were incorrectly diagnosed with Alzheimer’s and are actually experiencing symptoms from another cause and those who do have the signs of Alzheimer’s, but are not given a definitive diagnosis that would allow them to pursue the right therapies or enter a clinical trial.

“These results present highly credible, large-scale evidence that amyloid PET imaging can be a powerful tool to improve the accuracy of Alzheimer’s diagnosis and lead to better medical management, especially in difficult-to-diagnose cases,” said Maria C. Carrillo, Ph.D., Alzheimer’s Association chief science officer and a co-author of the study. “It is important that amyloid PET imaging be more broadly accessible to those who need it.”

The PET scan measures amyloid by injecting patients with molecules that stick to the amyloid plaques so that scientists can see them on a scan. Having amyloid in the brain does not necessarily mean someone has Alzheimer’s, but the absence of amyloid certainly indicates their memory problems are the symptoms of something else—something that might be curable.

And while some people might question whether an early diagnosis is beneficial, studies show that knowing more about the status of your brain can help patients have more healthy years, because they have access to appropriate therapies, and also costs less over time, because patients and their families are able to plan financially.

This study was launched in 2016 in order to measure whether PET scans could change how doctors approach diagnosing and treating Alzheimer’s. They enrolled more 16,000 patients with dementia and mild cognitive impairment at 595 sites across the U.S. The Centers for Medicare and Medicaid Services footed a large portion of the bill for the study.

“This was a uniquely real-world study that looked at the impact of amyloid PET imaging in community clinics and other non-academic settings, and demonstrates for the first time how much impact this technology has in real-world dementia care,” Rabinovici said.

The new data also affected how patients’ physicians referred them to clinical trials, which is one of the only ways a patient might get access to a drug with the potential to slow down or stop the disease.

And the images of amyloid convening in the patients’ brains also changed the prescription practices of doctors. For people with mild cognitive impairment, often a precursor to Alzheimer’s but sometimes a sign of a different illness, doctors who confirmed that a patient had the amyloid plaques doubled their Alzheimer’s drug prescriptions: 40 percent prior to imaging rose to 82 percent after imaging.

For patients with dementia, PET scans convinced doctors to up their Alzheimer’s prescriptions of drugs like Aricept to 91 percent from 63 percent.

About a third of patients previously diagnosed with Alzheimer’s were able to rule out the disease based on a lack of amyloid buildup. Half of patients who had not been diagnosed with Alzheimer’s received a new diagnosis based on the PET scan.

“Accurate diagnoses are critical to ensure patients are receiving the most appropriate treatments. In particular, Alzheimer’s medications can worsen cognitive decline in people with other brain diseases,” said Rabinovici. “But perhaps more fundamentally, people who come into the clinic with concerns about memory problems want answers. An early, definitive diagnosis may allow individuals to be part of planning for the next phase of their lives and to make decisions that otherwise would eventually need to be made by others.”

By Emily Woodruff | March 20th, 2019

When we open the pantry or fridge for a snack, we usually mindlessly grab whatever is easy and visible. But reaching for nuts over, say, chips or cookies, could result in a big brain payoff, according to new research from the University of South Australia.

According to a report published in The Journal of Nutrition, Health and Aging, older adults could benefit from high nut consumption.

How Many Nuts Are Necessary for Improved Brain Health?

Researchers studied almost 5,000 Chinese adults over the age of 55 over 22 years. They found that those who ate over 10 grams of nuts per day—the equivalent of about 9 almonds—had better mental functioning, including improved thinking, reasoning and memory.

Researchers said information like this could provide key health insights for an aging population facing brain diseases like dementia, which has no cure.

Why Diet Is Currently the Best Weapon Against Dementia

“Population aging is one of the most substantial challenges of the twenty-first century. Not only are people living longer, but as they age, they require additional health support which is placing unprecedented pressure on aged-care and health services,” said Dr. Ming Li, lead researcher.

“In China, this is a massive issue, as the population is aging far more rapidly than almost any other country in the world,” he added. By 2050, it’s predicted that 330 million Chinese will be over age 65, and 90.4 million will be over age 80, representing the world’s largest population of this most elderly age group. Worldwide, the number of people aged 60 years and older will outnumber children younger than five years old by 2020, according to the  World Health Organization.

“Improved and preventative health care—including dietary modifications—can help address the challenges that an aging population presents,” said Li.

One of those diet modifications, it turns out, could be adding a daily handful of nuts to your diet.

“By eating more than 10 grams (or two teaspoons) of nuts per day, older people could improve their cognitive function by up to 60 percent compared to those not eating nuts, effectively warding off what would normally be experienced as a natural two-year cognition decline,” said Li.

Why Nuts Are Good for Brain Health

The data was extracted from the China Health Nutrition Survey and found that 17 percent of participants ate nuts—peanuts, for the most part—on the daily. Peanuts have specific anti-inflammatory and antioxidant effects which can alleviate and reduce cognitive decline, according to the researchers.

“Nuts are known to be high in healthy fats, protein and fiber with nutritional properties that can lower cholesterol and improve cognitive health,” said Li.

Adding brain-healthy elements to diet may be one way that the risk for dementia may be lowered in the absence of a treatment or cure.

“As people age, they naturally experience changes to conceptual reasoning, memory, and processing speed. This is all part of the normal aging process. But age is also the strongest known risk factor for cognitive disease,” said Li. “If we can find ways to help older people retain their cognitive health and independence for longer—even by modifying their diet—then this absolutely worth the effort.”

By Emily Woodruff | January 30th, 2019

It’s usually not until the later decades that adults start worrying about memory loss. But everyone, even 20-year-olds, can relate to feeling like their memory just isn’t what it used to be.

But what if you could turn back the clock on your brain’s capacity by 10 or even 20 years? Researchers from Columbia University in the City of New York studying the effect of exercise on the brain say it’s possible with one simple, free change to your lifestyle: aerobic exercise.

Participants between the ages of 20 and 67 without memory problems signed up for the study, which involved a random assignment of either aerobic exercise (think: the elliptical, treadmill or stationary bike) or a stretching and toning regimen for six months. All of the people tested in the study were considered to have “below-average fitness” at the start of the study and did not exercise.

Participants were given access to a fitness center and coaches who monitored their progress. Those who were in the aerobic group used their own heart rates as a guide for how much to push themselves, starting at an intensity that gradually increased from 55 percent of their maximum heart rate during week one to 75 percent of their maximum heart rate by week five, where the intensity level remained for the next five months.

Going from a sedentary lifestyle to 75 percent maximum heart rate isn’t as difficult as it sounds in the long run. According to study author Yaakov Stern, Ph.D., participants worked out for 30 to 40 minutes, with a 10 to 15 minutes warm up and cool down. “By the time they got to 75 percent, they could do the exercise without being winded,” said Stern.

When researchers compared the brain scans and cognitive tests of the participants in both the aerobic and stretching group, they saw that while thickness in the brain increased in both groups over six months, those in the aerobic group also significantly improved on their thinking skills test. That test measures executive function, or the ability to make decisions, reason and multitask—some of the first skills stolen by diseases like dementia.

The aerobic group was able to improve thinking skills by .50 points compared to .25 points in the stretching group. The difference in thinking skill scores only widened as the participants went up in age.

“The people who exercised were testing as if they were about 10 years younger at age 40 and about 20 years younger at age 60,” Stern said.

The study was small, however, with just 132 participants. Larger and longer studies are needed to confirm the findings.

“Since thinking skills at the start of the study were poorer for participants who were older, our findings suggest that aerobic exercise is more likely to improve age-related declines in thinking skills rather than improve performance in those without a decline,” he added.

But all adults, even the 20-year-olds, experienced an increase in the thickness of the left frontal outer layer of the brain.

“Our research confirms that exercise can be beneficial to adults of any age,” said Stern. The study was published in the journal Neurology.