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As we get older, we may notice that we're forgetting things, or we're having trouble remembering names, or... And we wonder if we're starting to "lose our mind" and developing dementia.

A recent study has good news - even in persons labeled as having Mild Cognitive Impairment (MCI), 2 1/2 years later about half had improved and no longer fit the criteria of mild cognitive impairment. Back to normal! (Other studies have similar results.)

The big question is why do so many improve, and why do others get worse?

This study conducted by Columbia University researchers was part of a long-term study looking at aging in older adults living in New York City (thus the study was "community based"). All 2903 participants (white, black, and Hispanic) did not have Mild Cognitive Impairment or dementia at the start of the study (the baseline), were followed for 6 years, and evaluated (including physical and neurological tests) every 18 to 24 months.

After an average 2.4 years follow-up after MCI diagnosis: 12.9% of individuals progressed to dementia, 9.6% declined in functioning (but did not meet the criteria for dementia), 29.6% continued to meet MCI criteria, and 47.9% no longer met MCI criteria. This last group was now "cognitively normal". (!!)

The  researchers found that the presence of the APOE4 gene (which increases the risk of Alzheimer's disease) and having more medical problems ("medical burden") increased the risk of MCI. On the other hand, more years of education, more leisure activities (e.g., reading, socializing, taking walks), and higher income decreased the risk of developing MCI. But MCI across several domains, being a carrier of the APOE4 gene, depressive symptoms, and antidepressant use increased the risk of progression to dementia

Bottom line: Older adults should try to be active, get exercise (walking counts!), have a healthy lifestyle, socialize, and be busy - it's good for mental health. Studies also find participation in arts, crafts, and using computers all lower the risk of older adults developing MCI.

From Medical Xpress: 'Mild cognitive impairment' in older age often disappears, study finds

A diagnosis of mild cognitive impairment (MCI) might worry an older adult, who could see it as a stepping stone to dementia. But a new study suggests one does not necessarily lead to the other.  ...continue reading "Mild Cognitive Impairment In Older Adults Can Improve"

Some good news - a recent study found that daily coffee and tea drinking is associated with lower rates of stroke and dementia. Just an association, not a definite cause and effect, but still... nice to hear some (more) good news for us coffee and tea drinkers.

Researchers analyzed data from a large group in the United Kingdom's Biobank (a large medical data base). The 365,682 participants (aged 50 to 74 years old) were followed for about 11 years. They found that drinking coffee and tea separately or in combination were associated with a lower risk of stroke and dementia. Coffee alone or in combination with tea was also associated with lower risk of post-stroke dementia.

Most interesting finding: Drinking 2 to 3 cups of coffee with 2 to 3 cups of tea daily was associated with a 32% lower risk of stroke and a 28% lower risk of dementia (when compared to those who do not drink coffee and tea).

How much was best in this study? Moderate amounts of coffee and tea consumption are best. Two to 3 cups of coffee per day or 3 to 5 cups of tea per day, or a combination of 4 to 6 cups of coffee and tea per day, were linked with the lowest rates of stroke and dementia.

From Science Daily: Coffee and tea drinking may be associated with reduced rates of stroke and dementia

Drinking coffee or tea may be associated with a lower risk of stroke and dementia, according to a study of healthy individuals aged 50-74 publishing Nov. 16 in the open-access journal PLOS Medicine. Drinking coffee was also associated with a lower risk of post-stroke dementia.  ...continue reading "Coffee and Tea Drinking Associated With Lower Rates of Stroke and Dementia"

A recent study found that eating higher levels of foods with flavonoids (e.g. berries, apples, and tea) may lower the risk of later development of Alzheimer's disease and other age-related dementias.

Since currently there are no effective drugs that prevent or actual medical treatments for dementia, it is great that what a person eats (the dietary pattern) long-term may be protective. Something we can do to lower our risk for Alzheimer's disease and other dementias!

Tufts University researchers followed 2801 persons (50 years and older) for 20 years and found that those with the lowest intake of flavonoid rich foods (especially 3 flavonoid classes: flavonols, anthocyanins, and flavonoid polymers) had a 20 to 40% higher chance of developing Alzheimer's disease and other dementias, when compared to those eating the most flavonoid rich foods. [Note: The lowest intake group averaged  about 1 1/2 apples, but no berries or tea per month.]

Flavonoids are naturally occurring bioactive pigments, of which there are 7 types, that are found in plant-based foods. Some good sources of different types of flavonoids include berries & red wine (anthocyanin rich), onions & apples, pears (flavonol rich), citrus fruits and juices, teas, dark chocolate, parsley, celery,and soy products.

Eating a variety of fruits and vegetables appears to be best for health benefits. There is no one super-food. Other studies also find that the Mediterranean diet, which emphasizes fruits and vegetables (thus flavonoid rich), may reduce the risk of cognitive decline and dementia, including Alzheimer's disease.

Why are flavonoid containing foods protective, specifically "neuroprotective"? Studies suggest that they do the following: antioxidant effects, protect neurons from neurotoxins and combat neuroinflammation, and favorable changes in brain blood flow,

Excerpts from Science Daily: More berries, apples and tea may have protective benefits against Alzheimer's

Older adults who consumed small amounts of flavonoid-rich foods, such as berries, apples and tea, were two to four times more likely to develop Alzheimer's disease and related dementias over 20 years compared with people whose intake was higher, according to a new study led by scientists at the Jean Mayer USDA Human Nutrition Research Center on Aging (USDA HNRCA) at Tufts University.  ...continue reading "Eating More Fruits and Berries Lowers Risk of Dementia"

Taller men have a lower rate of dementia? Apparently a number of studies have found a link between height of men and risk of dementia.

The latest is an interesting Danish study that measured the height of more than 666,000 young adult men (at the physical exam for the draft) and then looked at the rates of dementia decades later when they were between 55 to 77 years of age. They found that young men that were above average in height had about a 10% lower rate of dementia more than four decades later.

The researchers thought that the early adulthood height was an indicator of early life environment (such as nutrition and childhood diseases).

What were some of the height differences? "Above average in height" was being at least 1 standard deviation above average height. For example, the researchers found that Danish men born in 1959 who had a mean (average) height of 185.6 cm (73.07") had a 10% lower rate of dementia than men of average height (179.1 cm or 70.5").

From Medical Xpress: Study suggests taller young men may have lower dementia risk

Men who are taller in young adulthood, as an indicator of early-life circumstances, may have a lower risk of dementia in old age, suggests a study published today in eLife.   ...continue reading "Tall Men Have A Lower Rate Of Dementia?"

A recently published study found that a strong ability in languages may help reduce the risk of dementia. The study of 325 Roman Catholic nuns (75 years or older) in the United States found some differences in the 109 women (33.5%) who developed dementia later in life compared to those who didn't. They found that more years of education was protective. Those speaking 2 or more languages were less likely to develop dementia than women only speaking one language (35% developed dementia) with 4 or more languages the most protective (only 6% of these women developed dementia). However, speaking 2 or more languages did not significantly affect the age at onset of dementia.

But the strongest predictor of later developing dementia was written linguistic ability, especially "idea density". Idea density was viewed as the average number of ideas expressed per 10 written words.180 of the women provided autobiographical essays that they had written decades earlier (in early adulthood) and the researchers looked at the essays for idea density and grammatical complexity. The researchers suggested that written linguistic ability was a measure of "cognitive function" or brain health.

From Science Daily: What multilingual nuns can tell us about dementia  ...continue reading "Does Speaking Several Languages Lower the Risk of Dementia?"

Back in 2015 and 2016 some studies found a link between taking medicines that are anticholinergic and cognitive decline and dementia. Some examples of non-prescription anticholinergic medications are Chlor-Trimeton, Benadryl, Tavist, and Dimetapp. During this time a person also contacted me to report that his relative, who had Down's syndrome, had once participated in a study where he received cholinergic therapy, with the result that during the study he functioned better neurologically.

Meanwhile, I read several studies of older people that supported the result of a higher intake of foods with choline and better neurological functioning (e.g. verbal and visual memory).

A recent large study of men over a 4 year period found an association between a  higher intake of foods with choline (dietary choline) and better performance on several cognitive tests and lower risk of dementia. The research, which was conducted in Finland, found that the relationship seemed especially strong for a type of choline called phosphatidylcholine. Eggs (specifically the egg yolks) are a primary dietary source of phosphatidylcholine, and indeed, in the study, higher egg intake was associated with better performance on several measures, including verbal fluency, as well as lower risk of dementia.

Choline is an essential nutrient, found in some foods. Its role in the body is complex, but one of its roles is to produce acetylcholine, an important neurotransmitter for memory, mood, muscle control, and other brain and nervous system functions (NIH choline fact sheet). On the other hand, anticholinergic medications block the action of the neurotransmitter acetylcholine (which is involved with learning and memory). Anticholinergic medications include many common drugs, such as some antihistamines, sleeping aids, tricyclic antidepressants, medications to control overactive bladder, and drugs to relieve the symptoms of Parkinson’s disease.

What should one do? First, make sure to eat some foods rich in choline, especially eggs. The researchers themselves say that "consuming an adequate amount of foods high in choline may be an easy, effective, and affordable way to maintain cognitive functioning". Good sources of choline are meat, dairy products, poultry, and eggs - and it appears that eggs (the egg yolks) are especially beneficial. Second, one should also try to avoid non-prescription and prescription medicines known to be anti-cholinergic. For example switch from allergy medicines diphenhydramine or chlorpheniramine (Chlor-Trimeton) to one that isn't anticholinergic. [See list.]

From Science Daily: Dietary choline associates with reduced risk of dementia  ...continue reading "The Choline In Eggs Is Beneficial For the Brain"

A number of studies have found that a poor sense of smell in older adults is linked to health problems (especially Parkinson's disease and dementia) and death. Now a recent study found that a poor sense of smell in older adults is associated with an almost 50% increase in their risk of dying within 10 years—especially in individuals reporting good health. In other words, a poor sense of smell is an early sign of deteriorating health, even when it is not apparent yet to the person.

Researchers at  the Michigan State Univ. College of Human Medicine  followed 2,289 persons (aged 71 to 82) for 13 years. The generally healthy persons took a smell test of 12 common odors (e.g. onion, soap, gasoline, lemon, chocolate and rose) at the start of the study, and were scored as having good, moderate, or poor sense of smell. After 13 years 1,211 of them had died. The researchers then looked to see if there was any association between scores on the smell test and their risk of death at various points over the 13 years.

No association was found at the three- or five-year mark of the study. But those with a poor sense of smell had a 46 percent higher risk of dying by 10 years and a 30 percent higher risk by 13 years, when compared with the older adults with a good sense of smell. The researchers believe the risk was lower at 13 years because so many of the participants had already died - whether their ability to smell was initially good or poor. So how to interpret the study results? It appears that a poor sense of smell may be a sensitive early sign of deteriorating health, even when it is not apparent yet.

From Medical Xpress: Poor sense of smell associated with nearly 50 percent higher risk for death in 10 years  ...continue reading "Is A Poor Sense of Smell In Older Adults A Sign of Deteriorating Health?"

Study after study has found negative health effects from frequent heavy drinking of alcohol, including a number of cancers. On the other hand, light to moderate drinking seems to have some health benefits (here and here). Recently a large study conducted in France found that chronic heavy drinking, which has resulted in alcohol use disorders (alcohol abuse, alcohol dependence, or alcoholism), is the biggest risk factor for developing dementia, especially early onset dementia. Only people with alcohol use disorders which resulted in them being hospitalized were included in the study.

But the surprising thing was that lower levels of "chronic heavy drinking" doesn't seem so much - it's daily consumption of more than 60 grams of pure alcohol  for men, and more than 40 grams of pure alcohol for women. In the United States, a standard drink contains about 14 grams of alcohol - which is a 12 ounce (350 ml) glass of beer, a 5 ounce (150 ml) glass of 12% wine, or a 1.5 ounce (44 ml) glass of spirits. In other words, drinking 3 glasses of wine daily (or more) is heavy drinking for a woman. (Note: The Centers for Disease Control (CDC) views moderate drinking as 1 glass of wine daily for women, and 2 glasses of wine daily for men).  ...continue reading "Heavy Drinking And Risk of Dementia"

Interesting study results - being overweight (a higher body mass index or BMI) is linked to dementia more than 20 years later, but in the few years before dementia onset body mass index (BMI) is lower in those who develop dementia than in those who don't develop dementia. The researchers hypothesize that 2 processes are going on:  A higher BMI (overweight or obese) in mid-life is harmful (a direct effect), and then there is weight loss during the preclinical dementia phase. Bottom line: best is a normal weight in mid-life to try to prevent dementia later on in life. From Science Daily:

Obesity increases dementia risk

People who have a high body mass index (BMI) are more likely to develop dementia than those with a normal weight, according to a new UCL-led study. The study, published in the Alzheimer's & Dementia journal, analysed data from 1.3 million adults living in the United States and Europe. The researchers also found that people near dementia onset, who then go on to develop dementia, tend to have lower body weight than their dementia-free counterparts.

"The BMI-dementia association observed in longitudinal population studies, such as ours, is actually attributable to two processes," said lead author of the study, Professor Mika Kivimäki (UCL Institute of Epidemiology & Health). "One is an adverse effect of excess body fat on dementia risk. The other is weight loss due to pre-clinical dementia. For this reason, people who develop dementia may have a higher-than-average body mass index some 20 years before dementia onset, but close to overt dementia have a lower BMI than those who remain healthy."

In this study, researchers from across Europe pooled individual-level data from 39 longitudinal population studies from the United States, the United Kingdom, France, Sweden, and Finland. A total of 1,349,857 dementia-free adults participated in these studies and their weight and height were assessed. Dementia was ascertained using linkage to electronic health records obtained from hospitalisation, prescribed medication and death registries.

A total of 6,894 participants developed dementia during up to 38 years of follow-up. Two decades before symptomatic dementia, higher BMI predicted dementia occurrence: each 5-unit increase in BMI was associated with a 16-33% higher risk of this condition (5 BMI units is 14.5 kg for a person 5'7" (170 cm) tall, approximately the difference in weight between the overweight and normal weight categories or between the obese and overweight categories). In contrast, the mean level of BMI during pre-clinical stage close to dementia onset was lower compared to that in participants who remained healthy. [Original study.]

Interesting study finding - that both high and low levels of magnesium is associated with a higher risk of dementia. Magnesium is an essential mineral needed for more than 300 biochemical reactions in the body. According to a large study done in the Netherlands of people who were followed for about 8 years - there was a U-shaped incidence of dementia based on their levels of magnesium. The lowest incidence was in those with "in the middle" normal levels of magnesium in the blood. All the study participants were mentally healthy when the study started.

The researchers stated that magnesium levels are considered "relatively stable over time", but a limitation of the study is that they only looked at magnesium levels once - at the beginning of the study, so they could have changed over time. Of course further studies are needed. [Other posts on magnesium and health - here, here, and here.]

Magnesium is widely available in foods. Foods that are good sources of magnesium include: spinach and other dark green leafy vegetables, almonds, cashews, peanuts, bananas, soybeans, kidney and black beans (legumes), whole grains, lentils, seeds, yogurt, brown rice, potatoes, and avocados. It is recommended that magnesium is obtained from the diet, and not from supplements (due to health risks from high doses). From Science Daily:

Both high, low levels of magnesium in blood linked to risk of dementia

People with both high and low levels of magnesium in their blood may have a greater risk of developing dementia, according to a study published in the September 20, 2017, online issue of Neurology®, the medical journal of the American Academy of Neurology.

The study involved 9,569 people with an average age of 65 who did not have dementia whose blood was tested for magnesium levels. The participants were followed for an average of eight years. During that time, 823 people were diagnosed with dementia. Of those, 662 people had Alzheimer's disease. The participants were divided into five groups based on their magnesium levels. Both those with the highest and the lowest levels of magnesium had an increased risk of dementia, compared to those in the middle group.

Both the low and high groups were about 30 percent more likely to develop dementia than those in the middle group. Of the 1,771 people in the low magnesium group, 160 people developed dementia, which is a rate of 10.2 per 1,000 person-years. For the high magnesium group, 179 of the 1,748 people developed dementia, for a rate of 11.4 per 1,000 person-years. For the middle group, 102 of the 1,387 people developed dementia, for a rate of 7.8. Kieboom noted that almost all of the participants had magnesium levels in the normal range, with only 108 people with levels below normal and two people with levels above normal[Original study.]