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).
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Presented by Sarah Dulaney, RN, CNS, a nurse at the UCSF Memory and Aging Center, and Helen Medsger, a family caregiver and LBD support group leader, as part of the Lewy Body Dementia Caregiver Webinar Series supported by the UCSF Memory and Aging Center and the Administration for Community Living.
From a JAMA Network Open online release (February 21, 2020):
Across the 6 studies of 8699 participants, mean age ranged between 70 and 74 years and mean gait speed ranged between 1.05 and 1.26 m/s. Incident dementia ranged from 5 to 21 per 1000 person-years. Compared with usual agers, participants with only memory decline had 2.2 to 4.6 times higher risk for developing dementia…
Those with only gait decline had 2.1 to 3.6 times higher risk. Those with dual decline had 5.2 to 11.7 times the risk…
Impaired mobility, such as slow gait, is associated with an increased risk of dementia, but the effect size of this association is generally modest.1–6 Identifying persons who experience both mobility decline and memory decline, a main symptom in the early stage of dementia, may have a greater prognostic value in assessing risk of dementia because the combination could identify a group in whom gait speed decline is at least in part caused by neurodegenerative pathologic conditions of the central nervous system rather than local musculoskeletal problems, such as sarcopenia or osteoarthritis.7–9 A recent study of 154 participants with mild cognitive impairment reported that those who declined in both cognition and gait speed had the highest risk of dementia.
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From a Wall Street Journal Opinion article (Feb 10, 2020):
How to address the elder-care crisis? Ideally, doctors would screen older patients for dementia. An early diagnosis helps patients understand treatment options, plan for the future and receive appropriate care in the hospital.
Other steps include: more preventive care, changes to Medicare’s rehabilitation policies, adopting new reimbursement methods, and developing new measures of success. Primary-care offices can prevent hospital visits, but Americans seeking primary care face an average wait time of 24 days. This might not be a problem for a patient in need of an annual physical, but conditions like chest pain or infections require prompt treatment. Primary-care offices that offer same-day sick visits, home visits for bed-bound older adults, or at-home monitoring of conditions could reduce emergency department volumes.
Read full article by Elizabeth Goldberg MD
From the Brain Plasticity Journal (Dec 26, 2019):
In conclusion, increased CRF (cardiorespiratory fitness) following this six-month intervention was associated with enhanced brain glucose metabolism in the PCC (posterior cingulate cortex), a region linked to AD, and cognition among late-middle-aged individuals at risk for AD. If these findings are supported by a larger-scale study, this would provide strong evidence that adults at risk for AD may enhance brain function and cognition by engaging in aerobic exercise training.
PCC glucose metabolism correlated positively with change in VO2peak (the highest value of VO2 attained upon an incremental or other high-intensity exercise test, designed to bring the sub- ject to the limit of tolerance)…Improvement in executive function correlated with increased VO2peak. Favorable CRF adaptation after 26 weeks of aerobic exercise training was associated with improvements in PCC glucose metabolism and executive function, important markers of AD.
Aerobic exercise has been associated with reduced burden of brain and cognitive changes related to Alzheimer’s disease (AD). However, it is unknown whether exercise training in asymptomatic individuals harboring risk for AD improves outcomes associated with AD. We investigated the effect of 26 weeks of supervised aerobic treadmill exercise training on brain glucose metabolism and cognition among 23 late-middle-aged adults from a cohort enriched with familial and genetic risk of AD.
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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.
From a PLOS Medicine online study:
Depression is associated with increased odds of dementia, even more than 20 years after diagnosis of depression, and the association remains after adjustment for familial factors. Further research is needed to investigate whether successful prevention and treatment of depression decrease the risk of dementia.
The risk of dementia is increased for decades after a diagnosis of depression, where those diagnosed with especially severe depressions are at increased risk.
Dementia is common among the elderly, causing severe individual suffering as well as societal strain. As the proportion of people aged 65 years and above is rapidly increasing in the world population, the number of individuals with dementia is expected to double within 20 years, and this condition was estimated to have a worldwide cost of US$604 billion in 2010. Effective treatments for dementia remain scarce; however, a preventive approach may be possible through the identification of high-risk individuals and potentially modifiable risk factors.
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From a New York Times online article:
…the researchers demonstrated that the biggest drop in cognitive ability occurs at the slightest level of hearing loss — a decline from zero to the “normal” level of 25 decibels, with smaller cognitive losses occurring when hearing deficits rise from 25 to 50 decibels.
Hearing loss is now known to be the largest modifiable risk factor for developing dementia, exceeding that of smoking, high blood pressure, lack of exercise and social isolation, according to an international analysis published in The Lancet in 2017.
the new findings on cognitive losses linked to subclinical hearing loss, gleaned from among 6,451 people age 50 or older, suggest that any degree of hearing loss can take a toll.
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