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 Eating several servings of seafood (especially fish) weekly has beneficial health effects throughout life, and now research finds another benefit in older adults. Seafood contains both EPA and DHA, which are two types of omega-3 fatty acids. DHA or docosahexanoic acid has "neuroprotective qualities" and is found in both the gray and white matter of the brain. Higher DHA levels (measured in the blood) was associated with better memory, less brain atrophy (better brain volume), and fewer amyloid plaques (which are associated with Alzheimer's) in cognitively healthy older adults. From Medscape:

Higher Serum DHA Linked to Less Amyloid, Better Memory

New research supports neuroprotectant effects of docosahexaenoic acid (DHA) in the aging brain. In a small cross-sectional study of cognitively healthy older adults, higher serum DHA levels were associated with less cerebral amyloidosis, better memory scores, and less regional brain atrophy.

"The interesting finding was the association of low serum DHA levels with cerebral amyloidosis (amyloid plaques) in older adults without evidence of dementia," Hussein N. Yassine, MD, Department of Medicine, University of Southern California, Los Angeles, told Medscape Medical News. "This association was predominantly driven by persons at the lowest quartile of serum DHA levels who likely have limited intake of seafood." "This study adds to the existing evidence on the benefit of seafood consumption on [Alzheimer's disease] AD risk factors," Dr Yassine added.

The study was published online August 8 in JAMA Neurology. In a linked editorial, Joseph F. Quinn, MD, Department of Neurology, Oregon Health and Science University, Portland, notes that DHA is "the most abundant polyunsaturated fatty acid in the brain, playing an important structural role in synapses while also modulating a number of signaling pathways. "Brain DHA levels are also modulated by dietary intake, so it is plausible for dietary DHA to alter brain concentrations and affect downstream targets including brain pathology and function."

Dr Yassine and colleagues assessed serum DHA levels, measures of amyloid burden based on positron emission tomography with Pittsburgh compound B, brain volume, and neuropsychological test scores in 61 adults without dementia in the Aging Brain Study.

They found that serum DHA levels (percentage of total fatty acids) were 23% lower in those with cerebral amyloidosis relative to those without. Serum DHA levels were inversely correlated with brain amyloid load, independent of age, sex, years of education, and apolipoprotein E genotype. They also noted a positive correlation between serum DHA levels and brain volume in several subregions affected by AD, in particular the left subiculum and the left entorhinal volumes.

Clinically, there was a significant association between serum DHA levels and nonverbal memory. This association persisted after adjustment for age but not after adjustment for apolipoprotein E genotype. Serum DHA levels were not associated with measures of global cognition, executive function, or verbal memory scores.

Get out there and start getting active NOW - the earlier you start in life, the better for your brain decades later. All physical activity or exercise is good, including regular walks. From Medical Xpress:

Regular exercise protects against cognitive decline in later years

Regular exercise in middle age is the best lifestyle change a person can make to prevent cognitive decline in the later years, a landmark 20-year study has found.

University of Melbourne researchers followed 387 Australian women from the Women's Healthy Ageing Project for two decades. The women were aged 45 to 55-years-old when the study began in 1992. The research team made note of their lifestyle factors, including exercise and diet, education, marital and employment status, number of children, mood, physical activity and smoking....They were also asked to learn a list of 10 unrelated words and attempt to recall them half an hour later, known as an Episodic Verbal Memory test.

When measuring the amount of memory loss over 20 years, frequent physical activity, normal blood pressure and high good cholesterol were all strongly associated with better recall of the words. Study author Associate Professor Cassandra Szoeke, who leads the Women's Healthy Ageing Project, said once dementia occurs, it is irreversible. "In our study more weekly exercise was associated with better memory." 

"We now know that brain changes associated with dementia take 20 to 30 years to develop," Associate Professor Szoeke said. "The evolution of cognitive decline is slow and steady, so we needed to study people over a long time period. We used a verbal memory test because that's one of the first things to decline when you develop Alzheimer's Disease."
Regular exercise of any type, from walking the dog to mountain climbing, emerged as the number one protective factor against memory loss. Asoc Prof Szoeke said that the best effects came from cumulative exercise, that is, how much you do and how often over the course of your life.  (Original study)

A study by researchers showing troubling effects from certain pesticides (especially a class of fungicides) raises all sorts of questions: What is the long-term effect of chronic low doses of these fungicides in the foods we eat? How much of these chemicals are we getting exposed to? The Univ. of North Carolina researchers studied the effect of 294 chemicals (all common food-use pesticides or other environmental chemicals) on "mouse cortical neurons" (mouse brain cells). They found that one group of chemicals, which they referred to as "cluster 2", "mimics brain disorders" such as autism, advanced age, Alzheimer's, Parkinson's disease, and other neurodegenerative disorders. The chemicals (all pesticides, and mainly fungicides) causing these effects are: fenamidone, pyraclostrobin, famoxadone, trifloxystrobin, fenpyroximate, azoxystrobin, fluoxastrobin pyridaben and rotenone. Even though this study was done on mouse cortical neurons (in vitro), it is meaningful because of the similarities with human brain cells.

Very little is known about human exposure to these chemicals (how much is our exposure?) and their effects on humans, but the data suggest effects similar to that in neurological disorders. The researchers point out that many of the chemical residues in this cluster were found on conventionally raised foods, especially leafy green vegetables, and were detected at relatively high levels, especially pyraclostrobin. Most of these fungicides only came into use after 2000 and usage of these fungicides has been increasing in the U.S, with the exception of pyridaben (decreasing use) and rotenone (very low use). "These data suggest significant human exposure potential to many of the chemicals in cluster 2".

They point out that these fungicide residues have not been detected on organically produced foods (EPA and USDA data), which suggests a way to minimize exposure. None of these chemicals can be used by organic farmers in the U.S. Possible exposure is also from gardens and lawns (if used), contaminated water, and for farm workers in conventional agriculture. From Science Daily:

Could new class of fungicides play a role in autism, neurodegenerative diseases?

Scientists at the UNC School of Medicine have found a class of commonly used fungicides that produce gene expression changes similar to those in people with autism and neurodegenerative conditions, including Alzheimer's disease and Huntington's disease.

Mark Zylka, PhD, senior author of the study and associate professor of cell biology and physiology at UNC, and his team exposed mouse neurons to approximately 300 different chemicals.... "Based on RNA sequencing, we describe six groups of chemicals," Zylka said. "We found that chemicals within each group altered expression in a common manner. One of these groups of chemicals altered the levels of many of the same genes that are altered in the brains of people with autism or Alzheimer's disease." Chemicals in this group included the pesticides rotenone, pyridaben, and fenpyroximate, and a new class of fungicides that includes pyraclostrobin, trifloxystrobin, fenamidone, and famoxadone. Azoxystrobin, fluoxastrobin, and kresoxim-methyl are also in this fungicide class.

"We cannot say that these chemicals cause these conditions in people," Zylka cautioned. "Many additional studies will be needed to determine if any of these chemicals represent real risks to the human brain." Zylka, a member of the UNC Neuroscience Center, and his group found that these chemicals reduced the expression of genes involved in synaptic transmission -- the connections important for communication between neurons. If these genes are not expressed properly, then our brains cannot function normally. Also, these chemicals caused an elevated expression of genes associated with inflammation in the nervous system. This so-called neuroinflammation is commonly seen in autism and neurodegenerative conditions.

The researchers also found that these chemicals stimulated the production of free radicals -- particles that can damage the basic building blocks of cells and that have been implicated in a number of brain diseases. The chemicals also disrupted neuron microtubules. "Disrupting microtubules affects the function of synapses in mature neurons and can impair the movement of cells as the brain develops," Zylka said. "We know that deficits in neuron migration can lead to neurodevelopmental abnormalities. We have not yet evaluated whether these chemicals impair brain development in animal models or people."

Jeannie T. Lee, MD, PhD, professor of genetics at Harvard Medical School and Massachusetts General Hospital, who was not involved in this research, said, "This is a very important study that should serve as a wake-up call to regulatory agencies and the general medical community. The work is timely and has wide-ranging implications not only for diseases like autism, Parkinson's, and cancer, but also for the health of future generations. I suspect that a number of these chemicals will turn out to have effects on transgenerational inheritance."

Zylka's group also analyzed information from the U.S. Geological Survey, which monitors countywide pesticide usage, as well as the Food and Drug Administration and the U.S. Department of Agriculture, which test foodstuffs yearly for pesticide residues. Of the chemicals Zylka's team studied, only the usage of pyridaben has decreased since 2000. Rotenone use has remained the same since 2000. However, the use of all the fungicides in this group has increased dramatically over the past decade.

Indeed, a study from the Environmental Protection Agency found that pyraclostrobin is found on foods at levels that could potentially affect human biology, and another study linked pyraclostrobin usage to honeybee colony collapse disorder. The pesticide rotenone was previously implicated in Parkinson's disease through replicated animal experiments and through human epidemiological studies.....Previous work has also shown that a single dose of the fungicide trifloxystrobin reduced motor activity for several hours in female rats and for days in male rats. Disrupted motor function is a common symptom of Parkinson's disease and other neurological disorders. The related fungicide picoxystrobin impaired motor activity in rats at the lowest dose tested.

Zylka added, "The real tough question is: if you eat fruits, vegetables or cereals that contain these chemicals, do they get into your blood stream and at what concentration? That information doesn't exist." Also, given their presence on a variety of foodstuffs, might long term exposure to these chemicals -- even at low doses -- have a cumulative effect on the brain?

Zylka noted that conventionally grown leafy green vegetables such as lettuce, spinach, and kale have the highest levels of these fungicides. But due to each chemical's effectiveness at reducing fungal blights and rust, crop yields have increased and farmers are expanding their use of these chemicals to include many additional types of food crops.

Zylka's team hopes their research will encourage other scientists and regulatory agencies to take a closer look at these fungicides and follow up with epidemiological studies. "Virtually nothing is known about how these chemicals impact the developing or adult brain," Zylka said. "Yet these chemicals are being used at increasing levels on many of the foods we eat."

Applying fungicide to apple orchard. Credit: Univ. of Kentucky Agriculture Extension

 Two articles about the link between Alzheimer's disease (AD) and microbes this past week: a study linking periodontal disease and Alzheimer's, and the other a journal editorial (written by an international team of 31 researchers) suggesting that we need to more closely look at the role of microbes in Alzheimer's disease, especially herpes virus, chlamydia and spirochaete bacteria.

This team is suggesting an "infectious cause" for Alzheimer's, an example being the reactivation of herpes simplex virus type 1 (HSV1) in the person. The researchers state that "regarding HSV1, about 100 publications by many groups indicate directly or indirectly that this virus is a major factor in the disease".  The team also mentions the possibility of fungi infection in some cases (see my November 6, 2015 post about a study finding fungal involvement). Both articles mention that treatment of the diseases with some form of antimicrobials or antivirals could possibly treat Alzheimer's disease, and that trails now need to be done.

From Science Daily: Link between gum disease and cognitive decline in Alzheimer’s

A new study has found a link between gum disease and greater rates of cognitive decline in people with early stages of Alzheimer's Disease. Periodontitis or gum disease is common in older people and may become more common in Alzheimer's disease because of a reduced ability to take care of oral hygiene as the disease progresses. Higher levels of antibodies to periodontal bacteria are associated with an increase in levels of inflammatory molecules elsewhere in the body, which in turn has been linked to greater rates of cognitive decline in Alzheimer's disease in previous studies.

The presence of gum disease at baseline was associated with a six-fold increase in the rate of cognitive decline in participants over the six-month follow-up period of the study. Periodontitis at baseline was also associated with a relative increase in the pro-inflammatory state over the six-month follow-up period. The authors conclude that gum disease is associated with an increase in cognitive decline in Alzheimer's Disease, possibly via mechanisms linked to the body's inflammatory response.....However, growing evidence from a number of studies links the body's inflammatory response to increased rates of cognitive decline, suggesting that it would be worth exploring whether the treatment of gum disease might also benefit the treatment of dementia and Alzheimer's Disease.

From Journal of Alzheimer's Disease: Microbes and Alzheimer’s Disease

We are researchers and clinicians working on Alzheimer’s disease (AD) or related topics, and we write to express our concern that one particular aspect of the disease has been neglected, even though treatment based on it might slow or arrest AD progression. We refer to the many studies, mainly on humans, implicating specific microbes in the elderly brain, notably herpes simplex virus type 1 (HSV1), Chlamydia pneumoniae, and several types of spirochaete, in the etiology of AD [1–4]. Fungal infection of AD brain [5, 6] has also been described, as well as abnormal microbiota in AD patient blood [7]. The first observations of HSV1 in AD brain were reported almost three decades ago [8]. The ever-increasing number of these studies (now about 100 on HSV1 alone) warrants re-evaluation of the infection and AD concept.

AD is associated with neuronal loss and progressive synaptic dysfunction, accompanied by the deposition of amyloid-β (Aβ) peptide, a cleavage product of the amyloid-β protein precursor (AβPP), and abnormal forms of tau protein, markers that have been used as diagnostic criteria for the disease [9, 10]. These constitute the hallmarks of AD, but whether they are causes of AD or consequences is unknown. We suggest that these are indicators of an infectious etiology. In the case of AD, it is often not realized that microbes can cause chronic as well as acute diseases; that some microbes can remain latent in the body with the potential for reactivation, the effects of which might occur years after initial infection; and that people can be infected but not necessarily affected, such that ‘controls’, even if infected, are asymptomatic [2].

Regarding HSV1, about 100 publications by many groups indicate directly or indirectly that this virus is a major factor in the disease....The only opposing reports, two not detecting HSV1 DNA in elderly brains and another not finding an HSV1–APOE association, were published over a decade ago [76–78]. However, despite all the supportive evidence, the topic is often dismissed as ‘controversial’. One recalls the widespread opposition initially to data showing that viruses cause some types of cancer, and that a bacterium causes stomach ulcers.

In summary, we propose that infectious agents, including HSV1, Chlamydia pneumonia, and spirochetes, reach the CNS and remain there in latent form. These agents can undergo reactivation in the brain during aging, as the immune system declines, and during different types of stress (which similarly reactivate HSV1 in the periphery). The consequent neuronal damage— caused by direct viral action and by virus-induced inflammation— occurs recurrently, leading to (or acting as a cofactor for) progressive synaptic dysfunction, neuronal loss, and ultimately AD.

AD causes great emotional and physical harm to sufferers and their carers, as well as having enormously damaging economic consequences. Given the failure of the 413 trials of other types of therapy for AD carried out in the period 2002–2012 [79], antiviral/antimicrobial treatment of AD patients, notably those who are APOE ɛ 4 carriers, could rectify the ‘no drug works’ impasse. We propose that further research on the role of infectious agents in AD causation, including prospective trials of antimicrobial therapy, is now justified.

New research has found that low vitamin D levels among older adults is associated with accelerated cognitive decline and impaired performance (particularly in areas of memory and executive function). The next research in this area will have to look at whether vitamin D supplementation will change (slow down) the decline. Please note that it is widely accepted that an average daily intake of 1000 IU  of D3 daily is safe. The best source of  vitamin D is sunlight. From Science Daily:

Low vitamin D among elderly associated with decline in cognition, dementia

Vitamin D insufficiency among the elderly is highly correlated with accelerated cognitive decline and impaired performance, particularly in domains such as memory loss that are associated with Alzheimer's disease and dementia, researchers with the UC Davis Alzheimer's Disease Center and Rutgers University have found. The effect is "substantial," with individuals with low vitamin D declining at a rate three times faster than those with adequate vitamin D levels

The researchers said their findings amplify the importance of identifying vitamin D insufficiency among the elderly, particularly high-risk groups such as African-Americans and Hispanics, who are less able to absorb the nutrient from its most plentiful source: sunshine. Among those groups and other darker-skinned individuals, low vitamin D should be considered a risk factor for dementia, they said. "Independent of race or ethnicity, baseline cognitive abilities and a host of other risk factors, vitamin D insufficiency was associated with significantly faster declines in both episodic memory and executive function performance," said Joshua Miller...

The large, longitudinal study was conducted in nearly 400 racially and ethnically diverse men and women in Northern California participating in longitudinal research at the Alzheimer's Disease Center in Sacramento, Calif. Fifty percent of participants were Caucasian and 50 percent were African-American or Hispanic. The participants had a mean age of 76 and were either cognitively normal, had mild cognitive impairment, or dementia.The participants' serum vitamin D status was measured at the beginning of the study.... Overall, 26 percent were deficient and 35 percent were insufficient. Among Caucasians, 54 percent had low vitamin D, compared with 70 percent of African-Americans and Hispanics.

Over five years of follow-up, vitamin D deficient individuals experienced cognitive declines that were two-to-three times faster than those with adequate serum vitamin D levels. In other words it took only two years for the deficient individuals to decline as much as their counterparts with adequate Vitamin D declined during the five-year follow-up period.

Exposing the skin to sunlight is the major source of vitamin D. Racial and some ethnic minorities are at greater risk of low vitamin D because the higher concentration of melanin that makes their skin darker -- and protects against skin cancer in sunny climates -- also inhibits synthesis of vitamin D. Diet is the other major source of vitamin D. Dietary vitamin D is obtained particularly through dairy consumption. The intake of dairy products is especially low among minority groups, with only 6.5 percent of African-Americans and 11 percent of Mexican-Americans nationwide consuming the recommended three daily servings of dairy products, the study says.

Another study finds health benefits to eating a Mediterranean based diet (here combined with the DASH diet) - the MIND diet. The researchers found that the older adults who followed the diet best were about 7.5 years younger cognitively than those who followed it least, thus suggesting that it may slow the cognitive decline of aging. Earlier research had suggested that it may reduce a person's risk in developing Alzheimer's disease. Foods to eat: fruits, vegetables, berries, whole grains, legumes (beans), nuts, fish, a little wine, and some chicken. Foods to limit on this diet: butter, red meat, margarine, sweets and pastries, whole fat cheese, and fried or fast food. From Medical Xpress:

Eating away at cognitive decline: MIND diet may slow brain from aging by 7.5 years

While cognitive abilities naturally diminish as part of the normal aging process, it may be possible to take a bite out of this expected decline. Eating a group of specific foods known as the MIND diet may slow cognitive decline among aging adults, even when the person is not at risk of developing Alzheimer's disease, according to researchers at Rush University Medical Center. This finding is in addition to a previous study by the research team that found that the MIND diet may reduce a person's risk in developing Alzheimer's disease.

The recent study shows that older adults who followed the MIND diet more rigorously showed an equivalent of being 7.5 years younger cognitively than those who followed the diet least. The results of the study recently were published online in the journal Alzheimer's & Dementia: The Journal of the Alzheimer's Association.

The National Institute of Aging funded study evaluated cognitive change over a period of 4.7 years among 960 older adults who were free of dementia on enrollment. Averaging 81.4 years in age....residents of more than 40 retirement communities and senior public housing units in the Chicago area. .... Martha Clare Morris, ScD, a nutritional epidemiologist, and colleagues developed the diet, whose full name is the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay. As the name suggests, the MIND diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. Both diets have been found to reduce the risk of cardiovascular conditions, like hypertension, heart attack and stroke.

"Everyone experiences decline with aging; and Alzheimer's disease is now the sixth leading cause of death in the U.S., which accounts for 60 to 80 percent of dementia cases. Therefore, prevention of cognitive decline, the defining feature of dementia, is now more important than ever," Morris says.

The MIND diet has 15 dietary components, including 10 "brain-healthy food groups" and five unhealthy groups - red meat, butter and stick margarine, cheese, pastries and sweets, and fried or fast food. To adhere to and benefit from the MIND diet, a person would need to eat at least three servings of whole grains, a green leafy vegetable and one other vegetable every day—along with a glass of wine—snack most days on nuts, have beans every other day or so, eat poultry and berries at least twice a week and fish at least once a week. In addition, the study found that to have a real shot at avoiding the devastating effects of cognitive decline, he or she must limit intake of the designated unhealthy foods, especially butter (less than 1 tablespoon a day), sweets and pastries, whole fat cheese, and fried or fast food (less than a serving a week for any of the three).

Berries are the only fruit specifically to be included in the MIND diet. "Blueberries are one of the more potent foods in terms of protecting the brain," Morris says, and strawberries also have performed well in past studies of the effect of food on cognitive function.

An observational study of older adults found that the Mediterranean diet may help preserve the connections between neurons in the brain, by preserving the microstructure in the white matter of the brain. This appeared to have a strong cognitive benefit - equal up to 10 years of delayed cognitive aging in those who adhered to the Mediterranean diet most closely. So if you haven't started already, try eating what the Mediterranean diet stresses: fruits, vegetables, whole grains, seeds, nuts, legumes, olive oil, some fish, and some wine. And cut back on highly processed foods, meat, and high fat foods. It's not one or two foods, but overall diet that is important. From Medscape:

Mediterranean Diet May Preserve Brain Structural Connectivity

The Mediterranean diet may help preserve structural connectivity in the brain in older adults, results of a French study hint. Greater adherence to the Mediterranean diet was associated with preserved microstructure in extensive areas of the white matter up to a decade later, the study team found. And this appeared to be related to strong cognitive benefit, equal to up to 10 years of delayed cognitive aging for those with the greatest adherence, they say....The study was published online July 16 in Alzheimer's & Dementia. The Mediterranean diet has been associated with a lower risk for Alzheimer's disease, but the underlying mechanisms have been unclear.

The new findings are based on 146 nondemented older adults in the Bordeaux Three-City study, a prospective cohort initiated in 1999-2000 to study vascular risk factors for dementia. Participants provided information on their diet in 2001-2002 (at a mean age of 73 years), underwent brain MRI an average of 9 years later (including diffusion tensor imaging)...On the basis of dietary assessment, 26% of participants had a low Mediterranean diet (MedDi) score of 0 to 3, indicating poor adherence to the diet; 47% had medium scores (4 or 5); and 27% had higher scores (6 to 8) representing the best adherence to the diet.

In adjusted analysis, there was no significant association between the MedDi score and grey matter or white matter volume. However, there was a strong association between the MedDi and diffusion tensor imaging patterns, suggesting that higher MeDi adherence was associated with a "general pattern of preserved WM [white matter] microstructure in multiple bundles," the researchers say. And preserved white matter microstructure with higher adherence to the MedDi "appeared to delay cognitive aging by up to 10 years."

"Our results suggest that the Mediterranean diet helps preserve the connections between neurons, which appear to be damaged with aging, vascular brain diseases and neurodegenerative diseases such as Alzheimer's dementia," Dr Samieri told Medscape Medical News. "In addition, the regions which appeared preserved with greater adherence to the Mediterranean diet were extended and were not specific to a particular disease, suggesting that the Mediterranean diet may have the potential to prevent not only stroke (as previously demonstrated with the PREDIMED [Prevención con Dieta Mediterránea] trial) but also multiple age-related brain pathologies," she added.

The added finding that none of the individual components of the Mediterranean diet was strongly associated with imaging results "supports our hypothesis that overall diet quality may be more important to preserve brain structure than any single food," they write.

Finding an increased risk of dementia and Alzheimer's with so many common over-the-counter medications such as Benadryl and  Chlortrimeton (the first generation allergy drug that so many people took for years) was an unpleasant surprise. Note: they found the link with high doses or heavy use (3 or more years). Some examples of common anticholinergics (from Wikipedia) are: atropine, benztropine (Cogentin), chlorpheniramine (Chlor-Trimeton), dimenhydrinate (Dramamine), diphenhydramine (Benadryl, Sominex, Advil PM, etc.), doxylamine (Unisom), hydroxyzine (Atarax, Vistaril), ipratropium (Atrovent), oxybutynin (Ditropan, Driptane, Lyrinel XL), tolterodine (Detrol, Detrusitol), tiotropium (Spiriva), and bupropion (Zyban, Wellbutrin). The message here: only take medications when absolutely needed and for as little a time as necessary. The study was done on older adults, so now the question is: what about children or young adults who take these drugs for years? Is there a similar increased risk later in life? From Medical Daily:

Common Over-The-Counter Anticholinergic Drugs Like Benadryl May Increase Your Risk Of Alzheimer's

Anticholinergic medications span a range of common drugs and include antihistamines, sleep aids, antidepressants, cardiovascular meds, gastrointestinal drugs (for diarrhea, incontinence, diverticulitis, and ulcers), and muscle relaxants. Now, a new study confirms the link between these everyday medications and dementia. Taking anticholinergic drugs at high doses or for a long time may significantly increase your risk for developing Alzheimer's disease and other dementias, say researchers from University of Washington School of Pharmacy.

“If providers need to prescribe a medication with anticholinergic effects because it is the best therapy for their patient, they should use the lowest effective dose, monitor the therapy regularly to ensure it's working, and stop the therapy if it's ineffective,” Dr. Shelly Gray, a professor and director of the geriatric pharmacy program at the UW School of Pharmacy said in a release.

On average, older people take four or five prescription drugs and two over-the-counter drugs each day. Clearly, drugs are an important part of medical care for older people; however, older people are more sensitive to the effects of many pills, including anticholinergics, which block the neurotransmitter acetylcholine and so effect the nervous system. While the drugs are too numerous to mention, those with anticholinergic effects — and these effects are sometimes dependent on the dose include Benadryl, Sominex, Xanax, Ativan, Valium, Luminal, Skelaxin, Limbitrol, and Tavist.

For the current study, the researchers investigated a previously reported link between anticholinergics, both prescription strength and over-the-counter, and dementia by employing more rigorous methods than in the past. Specifically, the researchers conducted a longer follow-up of more than seven years and more accurate use assessment via pharmacy records, which included nonprescription choices. The team tracked nearly 3,500 seniors participating in a long-running study, the Adult Changes in Thought (ACT), a joint project of UW and the National Institute on Aging.

The most commonly used medications in the study, the researchers discovered, were tricyclic antidepressants like doxepin (Sinequan), antihistamines like chlorpheniramine (Chlor-Trimeton), and antimuscarinics for bladder control like oxybutynin (Ditropan). People taking at least 10 mg/day of doxepin, 4 mg/day of diphenhydramine, or 5 mg/day of oxybutynin for more than three years, the researchers estimated, would be at greater risk for developing dementia. Importantly, substitutes are available for some of these drugs.  

While this study is the first to show a dose response — meaning, the more you use anticholinergic medications the greater your risk of developing Alzheimer’s — it also is the first to suggest this higher risk may persist, and may not be reversible, even years after you stop taking these drugs. 

Source: Gray S, Crane P, Dublin S, et al. Cumulative Use of Strong Anticholinergic Medications and Incident Dementia. JAMA Internal Medicine. 2015.

Great news for coffee lovers, especially for those drinking 3 to 5 cups daily! From Medical Daily:

Drinking Coffee Can Lower Alzheimer's Risk By 20%, All It Takes Is 3 Cups A Day

As if you weren’t already drinking a lot of coffee, a review of several studies has found drinking three to five cups a day could reduce risk of Alzheimer’s disease by 20 percent.

The research was presented at the 2014 Alzheimer Europe Annual Congress, and found that people who drank coffee regularly — all you lifers out there — were less likely to develop the debilitating disease. Alzheimer’s, perhaps the worst type of dementia, is a progressive disease that works slowly, first making it difficult to remember newly learned things, and later on making it difficult to remember early memories and family member’s faces, while also causing hallucinations. The biggest risk factor for the disease is being over 65 years old.

Roughly 83 percent of American adults drink coffee, according to the National Coffee Association. What many of these Americans don’t know, however, is that inside that cup of Joe is a wealth of polyphenols, which you probably know as antioxidants. These antioxidants — researchers said they’re the same ones found in the Mediterranean diet — prevent the formation of a hallmark of Alzheimer’s disease known as amyloid plaques and neurofibrillary tangles, the study found. They also reduce inflammation and deterioration of brain cells, particularly in the areas of the brain (the hippocampus and cortex) responsible for memory.

Along with prevention of Alzheimer’s, coffee has been linked to a reduced risk of liver cancer and other liver conditions, a lower risk of type 2 diabetes; it prevents eye damage and Parkinson’s disease; and even boosts endurance. But even then, drinking too much isn’t good, either. As the researchers noted, three to five cups is optimal; anything over that, and you might find yourself with some problems.

An assortment of vitamin and health articles from the past year. (Note: Some other major Vitamin D study results were posted earlier this year, as well as today - search Vitamin D). Whether one should take vitamins is still being debated, with the most support being for supplementation with Vitamin D (specifically D3).The first summary is from pubmed.gov:

Taking vitamin D with the largest meal improves absorptioncally D3) and results in higher serum levels of 25-hydroxyvitamin D.

Many patients treated for vitamin D deficiency fail to achieve an adequate serum level of 25-hydroxyvitamin D [25(OH)D] despite high doses of ergo- or cholecalciferol. The objective of this study was to determine whether administration of vitamin D supplement with the largest meal of the day would improve absorption and increase serum levels of 25(OH)D.... it is concluded that taking vitamin D with the largest meal improves absorption and results in about a 50% increase in serum levels of 25(OH)D levels achieved. Similar increases were observed in a wide range of vitamin D doses taken for a variety of medical conditions.

 The following are all from Science Daily:

Long-term daily multivitamin supplement use decreases cataract risk in men, study finds

Long-term daily multivitamin supplement use may lower cataract risk in men, according to a study of nearly 15,000 male physicians. Half took a common daily multivitamin, as well as vitamin C, vitamin E and beta carotene supplements. The other half took a placebo. The researchers followed the participants to identify how many participants in each group developed new cases of two common eye diseases: cataract and age-related macular degeneration. Results showed a 9 percent decrease in risk for those that took the supplements.

Taking B vitamins won't prevent Alzheimer's disease, researchers conclude

Taking B vitamins doesn't slow mental decline as we age, nor is it likely to prevent Alzheimer's disease, conclude researchers who have assembled all the best clinical trial data involving 22,000 people to offer a final answer on this debate. When looking at measures of global cognitive function -- or scores for specific mental processes such as memory, speed or executive function -- there was no difference between those on B vitamins and those receiving placebo to a high degree of accuracy.

Children who drink non-cow's milk are twice as likely to have low vitamin D

Children who drink non-cow's milk such as rice, almond, soy or goat's milk, have lower levels of vitamin D in their blood than those who drink cow's milk, according to a new study. In North America, every 100 millilitres of cow's milk is required to be fortified with 40 units of vitamin D. Adding vitamin D to non-cow's milk, however, is voluntary.

Vitamin E intake critical during 'the first 1,000 days'

Amid conflicting reports about the need for vitamin E and how much is enough, a new analysis published today suggests that adequate levels of this essential micronutrient are especially critical for the very young, the elderly, and women who are or may become pregnant... "It's important all of your life, but the most compelling evidence about vitamin E is about a 1000-day window that begins at conception," Traber said. "Vitamin E is critical to neurologic and brain development that can only happen during that period. It's not something you can make up for later." Some of the best dietary sources of vitamin E -- nuts, seeds, spinach, wheat germ and sunflower oil -- don't generally make the highlight list of an average American diet. 

Vitamin D deficiency linked to higher risk of cardiovascular, cancer death

Analysis of pooled data showed a strong association between low vitamin D levels and risk of death in general death from cardiovascular diseases, death in from cancer, at least in older people with a history of cancer. "Going into our study, the effect of vitamin D supplementation on risk of death was not clear," said the lead investigator. "Our analysis confirms the protective nature of this substance especially in elderly patients."

High-dose vitamin D for ICU patients who are vitamin D deficient does not improve outcomes

Administration of high-dose vitamin D3 compared with placebo did not reduce hospital length of stay, intensive care unit length of stay, hospital mortality, or the risk of death at 6 months among patients with vitamin D deficiency who were critically ill, according to a study.