The first event in our Lab Notes online series features two researchers from our South Coast Network Centre talking about early brain changes in Alzheimer’s. Dr Karen Marshall shares her work studying how waste disposal and recycling systems in nerve cells cause damage in Alzheimer’s disease, and whether there could be ways to rescue cells from this. Dr Mariana Vargas-Caballero speaks about her research into brain cell connections and how they are affected in Alzheimer’s. The event is chaired by Dr Katy Stubbs from Alzheimer’s Research UK, and also features a Q&A session.
The number of older people, including those living with dementia, is rising, as younger age mortality declines. However, the age-specific incidence of dementia has fallen in many countries, probably because of improvements in education, nutrition, health care, and lifestyle changes.
Overall, a growing body of evidence supports the nine potentially modifiable risk factors for dementia modelled by the 2017 Lancet Commission on dementia prevention, intervention, and care: less education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and low social contact.
We now add three more risk factors for dementia with newer, convincing evidence. These factors are excessive alcohol consumption, traumatic brain injury, and air pollution. We have completed new reviews and meta-analyses and incorporated these into an updated 12 risk factor life-course model of dementia prevention. Together the 12 modifiable risk factors account for around 40% of worldwide dementias, which consequently could theoretically be prevented or delayed.
The potential for prevention is high and might be higher in low-income and middle-income countries (LMIC) where more dementias occur. Our new life-course model and evidence synthesis has paramount worldwide policy implications. It is never too early and never too late in the life course for dementia prevention. Early-life (younger than 45 years) risks, such as less education, affect cognitive reserve; midlife (45–65 years), and later-life (older than 65 years) risk factors influence reserve and triggering of neuropathological developments.
Culture, poverty, and inequality are key drivers of the need for change. Individuals who are most deprived need these changes the most and will derive the highest benefit.
From the American Journal of Clinical Nutrition (April 22, 2020):
Our findings imply that higher long-term dietary intakes of flavonoids are associated with lower risks of ADRD and AD in US adults.
Our findings provide new evidence that diets higher in flavonols, anthocyanins, and flavonoid polymers are associated with a lower risk of developing ADRD. These associations were sustained after accounting for a variety of potential confounders including key nutrients related to ADRD risk and overall diet quality. Similar findings were seen with AD risk for flavonols and anthocyanins but the association with flavonoid polymers was no longer statistically significant.
Along with improvements in healthcare and medical technology, the aging of the baby boom generation will result in an unprecedented rise in the number of older Americans (1, 2). Currently, there are >50 million Americans aged ≥65 y, and that is projected to more than double by 2060 (3). A consequence of this increase in older adults is the escalation of age-related diseases (4, 5). Alzheimer disease (AD) and related dementias (ADRD), a group of symptoms in which there is progressive deterioration in cognitive function severe enough to interfere with a person’s daily living activities, are regarded as among the most significant public health challenges largely affecting adults aged >65 y (6). AD is the most common form of dementia, making up ∼60–80% of dementia cases. Currently, 5.8 million Americans are living with AD, and by 2050 that is projected to escalate to 14 million (7).
An estimated 80 million people live with a neurodegenerative disease, with this number expected to double by 2050. Despite decades of research and billions in funding, there are no medications that can slow, much less stop, the progress of these diseases. The time to rethink degenerative brain disorders has come. With no biological boundaries between neurodegenerative diseases, illnesses such as Parkinson’s and Alzheimer’s result from a large spectrum of biological abnormalities, hampering effective treatment.
Acclaimed neurologist Dr Alberto Espay and Parkinson’s advocate Benjamin Stecher present compelling evidence that these diseases should be targeted according to genetic and molecular signatures rather than clinical diagnoses. There is no Parkinson’s or Alzheimer’s, simply people with Parkinson’s or Alzheimer’s. An incredibly important story never before told, Brain Fables is a wakeup call to the scientific community and society, explaining why we have no effective disease-modifying treatments, and how we can get back on track.
From a Rush University Medical Center online article:
The study found that participants in the group with the highest flavonol consumption were 48% less likely to develop Alzheimer’s dementia later on in life than participants with the lowest level. Of the 186 people in the highest group, 28 people, or 15%, developed Alzheimer’s dementia, compared to 54 people, or 30%, of the 182 people in the lowest group.
People who eat or drink more foods with flavonol, which is found in nearly all fruits and vegetables, plus tea and wine, may be less likely to develop Alzheimer’s dementia, according to the Rush researchers. They published the results of their study in the Jan. 29 online issue of Neurology.
Flavonols are a type of flavonoid, a group of phytochemicals found in plant pigments. They are known for their beneficial effects on health due to their antioxidant and anti-inflammatory properties.
A total of 921 people with an average age of 81 participated in the Neurology study. These participants did not have Alzheimer’s dementia when starting the study.