Tag Archives: mild cognitive impairment

Gait Related to Cognitive Decline

A new study furthers the evidence that our motor system (the system that controls our movements) is related to higher centers of brain function that control how we think, remember and interact with the world.  This study examines the link between how we walk and the risk for developing dementia. Check it out below!

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Coffee Wards Off Dementia!

In a new study published in the Journal of Alzheimer’s Disease participants with mild cognitive impairment who had a certain level of caffeine in their blood did not go on to develop dementia.  This is the first study to attempt to isolate whether it’s just coffee that’s protective in dementia or if it is indeed the caffeine that imparts the benefit. In this case, the caffeine seems to be the protective variable.  See the video below for more.

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Genes, Alzheimer’s Disease and Your Choice

PET scan of a human brain with Alzheimer's disease

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New genes have been discovered that seem to be linked to Alzheimer’s Disease (AD).  AD currently affects over 5 million Americans and that number is expected to increase substantially by the year 2029.

This year the first baby boomers will reach their 65th birthdays. By 2029, all baby boomers will be at least 65 years old.  Ninety-five percent of all AD is in people 65 and older.

The discovery of new genes linked to AD is a step in the right direction.  Every bit of information that help scientists unlock the mystery of why this occurs puts us closer to being able to effectively treat AD.

Let’s pretend that we know every gene that is involved in the production of AD.  Let’s also pretend a test that exists to specifically detect all of these genes in you.  Would you want to find out?  What would you do if you had all of the genes linked to AD?

The truth of it is, there is nothing you could do to change your genes.  Your genes are your genes.  They are there and you can’t remove them.  What you can do, however, is change how they are expressed.  Just because a person has a specific gene does not mean it has to be expressed.  The expression of many of our genes is closely related to our environment.  Diet, exercise, smoking, pollution and stress are just a few things that can negatively or positively affect the expression of our genes.

So back to my first question.  What would you do if you had all the genes linked to AD?  You can’t change your genes, but you can change your risk factors.

There are many known risk factor that increase the risk of AD, independent of your genetic potential.  The number one risk is aging.  Unfortunately, there isn’t much that can be done about that.  We are all going to get older which is not necessarily a bad thing.  It is much better than the alternative!

Known risk factors for AD that are controllable are as follows:

You will notice that these risk factors significantly overlap with one another.  You will also notice that when you control one risk factor you will impact another.  If you can control these risk factors in your life you will significantly reduce your risk of developing AD regardless of your genetic potential.
Cardiovascular health is perhaps the most important.  Cardiovascular disease causes a chronic, low grade reduction in blood delivery to the brain.  This is known as hypoperfusion.  This hypoperfusion is responsible for protein synthesis defects that later result in the classic AD neurodegenerative lesions.

To keep your cardiovascular system as healthy as possible make sure you eat an anti-inflammatory diet and exercise.  Fish oil is also something you should consider.  Fish oil, which contains omega-3 fatty acids, has been shown to reduce cardiovascular disease mortality better than any other substance known.

Reduction of high blood pressure is also very important.  When blood pressure is too high it fuels a kind of scarring linked to later development of Alzheimer’s disease and other dementias.  Controlling your blood pressure is actually very simple.  You must maintain a healthy weight first and foremost.  This, of course, means diet and exercise.  Increasing waistlines mean more tissue and blood vessels for your heart to push blood through. This puts a strain on the heart and increases the resistance the heart must push against.

Keeping a healthy cholesterol profile is essential.  However, the traditional tests from your doctor are probably not enough to tell whether you are at risk or not.  Traditional tests examine total cholesterol, HDL (“good”), LDL (“bad”) and triglycerides.  These are of some value, but they don’t tell the whole story.  What you must find out is the particle size.  In a nut shell, large and buoyant molecules of cholesterol are not as problematic as small and dense particles.  Your traditional test does not distinguish between the two.  Your traditional test might look very good, but a more advanced test may show that you are still very much at risk.  See my blog entry from last summer for more detailed information.

Diabetes is also extremely important to control.  Some references are referring to Alzheimer’s as Type III diabetes because of the biochemical similarities. Even being borderline diabetic raises the risk of developing Alzheimer’s or dementia by 70%!  Diabetes’ hallmark is high blood sugar.  This high blood sugar leads to a phenomenon called advanced glycation end products or AGEs.  AGEs adversely affect the structure and function of proteins. In combination with oxidative stress brain function is easily affected.  Advanced glycation end products have been found to be much more prevalent in the brains of Alzheimer’s patients than in healthy controls. This process begins early on in the course of Alzheimer’s and there is also evidence that AGEs assist in the formation of plaques seen in AD.  Diet and exercise are the best ways to prevent diabetes and reduce your risk of AD.

While the study for a purely genetic link to AD will continue, a cure is likely many years away if one can even be found.  What we can control, however, are our lifestyle choices that activate our genes.  If we choose poorly, we are much more likely to activate unfavorable genes that cause disease.  If we choose wisely, we are more likely to activate genes that are favorable and reduce our risk of further disease.  The choice is yours.  Make the right one.

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Want a better brain? Lift Weights!

Free weights

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Exercise has long been known to increase brain function.  Most of the research, however, focused on the benefits of purely cardiovascular exercises like running.  New research shows that weight training has the same effect.

Conventional wisdom has stated that the benefits of cardiovascular exercise on brain function was from the significant increase in blood flow to the brain during aerobic type exercises.  It was concluded that because weight training didn’t cause this to happen for extended periods of time, it would not have the same benefit.

The creation of new brain cells, or neurogenesis, is thought to be dependent on a spike of blood flow to the brain. In fact, running and other aerobic exercises have been shown to increase neuron production in the areas of the brain associated with memory and thinking in both mice and humans.  However, this was thought not to apply to resistance training.  That is changing.

“In a study presented at the annual meeting of the Society for Neuroscience in November, researchers from Brazil secured weights to the tails of a group of rats and had them climb a ladder five sessions a week. Other rats on the same schedule ran on a treadmill, and a third group just sat around. After eight weeks, the running rats had much higher levels of brain-derived neurotrophic factor (B.D.N.F.), a growth factor that is thought to help spark neurogenesis, than the sedentary rats. So did the rats with weights tied to their tails. The weight-­bearing rats, like the runners, did well on tests of rodent learning and memory, like rapidly negotiating a water maze. Both endurance and weight training seemed to make the rats smarter.” (From The NY Times)

A similar study from Japan at the same conference came to the same conclusions.

“The animals that were assigned to the loaded wheels showed significantly increased levels of gene activity and B.D.N.F. levels within their brains. The higher the workload the animals managed to complete, the greater the genetic activity within their brains.” (From The NY Times)

The genetic activity is important.  That’s precisely how the human brain adapts.  It changes the expression of certain genes in order to respond to certain environmental input.  That input may be in the form of exercise like weight training or it may be more cognitively based like learning to play the piano.  Whatever the input may be, the brain changes in response to the activity being performed.  This is a phenomenon called plasticity.  And the brain remains plastic our entire lives!  That means it can change right up to the day we die.

Just how does this resistance training increase brain function?  No one knows for sure, but there are theories.  The researchers propose that because weight training reduces many cardiovascular risk factors and does increase the strength of the heart it may also help the brain through similar mechanisms that aerobic exercise does.

I have another theory.  Ninety percent, yes that’s 90%, of the input that comes into our brains during any given day comes from the receptors in our muscles and joints.  That means that if we take into account all of the sensory input that our brains receive during the day – light, sound, touch, smell, proprioception – a full 90% of that input is coming from our muscles and joints.  If the body requires that much input from our musculoskeletal system it must be important, right?  It is.  This input keeps the brain functioning normally and maintains the health of just about every type of neuron in the brain.

Resistance training makes this input more efficient.  By training the muscles with weights they send more regulatory information to the brain and you also increase the amount of information coming from the joints.  The stronger your muscles the more force is applied through your joints.  This combination is a winning one in terms of brain function.

The best type of exercise program is one that includes both cardiovascular and resistance type training.  People are often hesitant to start a weight training program because of lack of knowledge on how to properly do it.  If you are concerned hire a knowledgeable trainer to show you how to do it.  The benefits will far outweigh your hesitance to start.

 

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Reducing Your Risk of Alzheimer’s Disease Naturally

PET scan of a human brain with Alzheimer's disease

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As of next year the first of the baby boomers will reach 65 years old and by 2029 all of them will be at least 65.  This is significant because as we age certain diseases become more and more prominent.  One of them is Alzheimer’s disease.  This disease robs people of the faculties much too soon and causes heartache and financial hardship for families across the US.

Just How Big Is The Problem?

About 24 million people worldwide are known to be affected with dementia. This number is expected to balloon to 84 million by the year 2040.  These numbers include all forms of dementia, but up to 80% of dementia is caused by Alzheimer’s disease (AD).  In the US alone 5.3 million American’s have Alzheimer’s Disease and 96% of them are over the age of 65.  In just five years the number of Americans with Alzheimer’s will jump to 7.7 million and by 2050 the number is projected to more than double to 16 million.  The numbers truly are staggering.  As a matter of fact, AD has recently passed diabetes, yes diabetes, as the 6th most common cause of death in the US.  As our population continues to grow older because people are living longer, the problem is likely to get worse.  Current statistics show that just over 50% of people who are over 85 will go on to develop AD.

AD is also a very expensive problem for the United States.  In 2005, total Medicare spending was $91 billion and the total US cost was $172 billion for AD.  AD patients make up roughly 13% of Medicare enrollees but account for more than 1/3 of its spending.  The problem will only grow as our population ages.

So What Can I Do To Reduce My Risk?

The best way to treat AD is to prevent it in the first place.  There is very good research behind several nutritional supplements that can significantly reduce your risk of developing dementia as you age.

Vitamin E

Here’s what one study found on vitamin E:

“Among MCI-AD patients, the longitudinal decrease in cellular vitamin E was associated with the deterioration in cognitive performance. These results suggest that accumulation of oxidative damage may start in pre-symptomatic phases of AD pathology and that progression to AD might be related to depletion of antioxidant defenses.”

-J Alzheimers Dis. 2010 Aug 6.

So what does that mean.  Basically what this study found was that among patients who has mild cognitive impairment (MCI) or AD, people with the lowest levels of vitamin E had poorest performance on mental testing.  Oxidative damage is the process by which our brain tissue is broken down in AD.  Vitamin E helps fight this process.

Another study concluded:

“In conclusion, high plasma levels of vitamin E are associated with a reduced risk of AD in advanced age. The neuroprotective effect of vitamin E seems to be related to the combination of different forms, rather than to alpha-tocopherol alone.”

-J Alzheimers Dis. 2010;20(4):1029-37.

This is saying that higher levels of vitamin E in the blood were associated with a significant reduction in AD with advanced age.  It also says that when taking vitamin E you should be taking a combination of forms, not a singular type.  When you look at the back of your vitamin E supplement be sure that it says ‘mixed tocopherols.”  That will provide you with the most benefit.

Vitamin D

Vitamin D is the supplement of the hour right now.  It is being studied by everyone and just about everyone has found that it is critically important for overall health.  New research also shows it helps prevent AD.

“Vitamin D insufficiency and deficiency was associated with all-cause dementia, Alzheimer disease, stroke (with and without dementia symptoms), and MRI indicators of cerebrovascular disease. These findings suggest a potential vasculoprotective role of vitamin D.”

-Neurology. 2010 Jan 5;74(1):18-26. Epub 2009 Nov 25

This study is telling us that vitamin D insufficiency and deficiency was associated with higher risk for dementia and AD.  What this means is that even having levels that are slightly decreased (insufficiency) are associated with higher risk.  Keeping vitamin D levels up not only is important for bone health, cancer reduction and fall prevention but also reduces your risk of AD.  Pretty amazing stuff.

Another study on vitamin D found that:

“Clinical data suggest that vitamin D insufficiency is associated with an increased risk of several CNS diseases, including multiple sclerosis, Alzheimer’s and Parkinson’s disease, seasonal affective disorder and schizophrenia.  Overall, imbalances in the calcipherol system appear to cause abnormal function, including premature aging, of the CNS.”

– Psychoneuroendocrinology. 2009 Dec;34 Suppl 1:S278-86

This study is particularly interesting in that it shows that low vitamin D levels are associated with an increased risk of several CNS or central nervous system diseases including AD.  It also concluded that imbalances in the calcipherol, or vitamin D, system causes premature aging of the brain and central nervous system.  Why is this problematic?  Remember, the number one risk factor for AD is aging.  If we can slow this process, particularly in the brain, we can slow the onset of AD.  Vitamin D can do this for you.

Omega-3 Fatty Acids (Fish Oil)

“A plethora of in vitro, animal model, and human data, gathered over the past decade, highlight the important role DHA may play in the development of a variety of neurological and psychiatric disorders, including AD. Cross sectional and prospective cohort data have demonstrated that reduced dietary intake or low brain levels of DHA are associated with accelerated cognitive decline or the development of incipient dementia, including AD.”

-Clin Interv Aging. 2010 Apr 7;5:45-61.

DHA is a particular form of omega-3 fatty acid or fish oil.  This study concluded that low intake of this particular fatty acid or low brain levels of it are associated with cognitive decline and accelerated development of AD.  This is of particular interest because of all of the wonderful other benefits that omega-3’s give us.  You can prevent or reduce the risk of many other diseases simply by supplementing with fish oil.

There was this study as well:

“Plasma DHA was associated with slower decline on BVRT (Benton Visual Retention Test) performances in ApoE-epsilon4 carriers only. EPA and DHA may contribute to delaying decline in visual working memory in ApoE-epsilon4 carriers.”

-Neurobiol Aging. 2010 Jun 4.

This study was done on people who have the gene that is linked to an increased risk of AD.  What it concluded was very exciting.  Basically it found that the higher the omega-3 DHA was in the plasma the slower the decline in memory in people that were genetically predisposed to getting AD.  That’s wonderful news!  Many people think that their genetics are their destiny, but this study showed otherwise.

In Summary

This is just the tip of the iceberg in terms of research that is available on how to combat and reduce your risk of developing AD.  What we did not touch on in this article is that keeping your heart healthy and controlling your blood sugar is of utmost importance.  Do those things and take the supplements listed above and you can significantly reduce your risk of Alzheimer’s disease.

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How to protect your brain – ward off dementia with these simple steps

Well it’s been some time since I have been able to post here on our blog.  The fourth of July holiday and some time away from the office kept me from posting the latest in health information for you.  However, I am back with new information regarding dementia.

Dementia is a scary disease that affects millions of Americans and the numbers are expected to sky rocket as the baby boomer generation approaches retirement age.  Dementia robs people of their faculties long before their time.  It can go on for many years and cause heartbreak and hardship for family members.  It is eventually fatal, but it is a long, slow process that destroys lives and relationships along the way.

For years it was thought that genetics played the most important role in determining who developed dementia and who did not.  It was almost a role of the dice, or so was thought.  In the last 5 years research has been mounting that dietary supplements and exercise can significantly reduce the risk of developing dementia.  A new study just released confirms some of those findings.

In a recent study people who exercised, regularly consumed tea and had the highest levels of vitamin D had the lowest risk of developing dementia.  This truly is great news.  There is something you can do to significantly reduce your risk of developing this disease.

Exercise

The first piece of this equation is about exercise.  Exercise has been shown to improve almost every single factor related to health that has been studied.  If you are not exercising, you are not truly taking care of yourself.  With respect to dementia, researchers looked at participants from the Framingham cardiovascular study.  They looked at 1,200 elderly people over 20 years, 242 of whom developed dementia.  They found that participants who had moderate to heavy levels of physical activity had about a 40% lower risk of developing any type of dementia. Those who reported the least amount of activity were 45% more likely to develop dementia compared with those who had higher levels of activity.

Regular Consumption of Tea

In a second study, including data on more than 4,800 men and women ages 65 and older, participants were followed for up to 14 years. Tea drinkers had less mental decline than non-tea drinkers. Those who drank tea one to four times a week had average annual rates of decline 37% lower than people who didn’t drink tea.  The results did not appear to be related to caffeine, however, because coffee drinkers did not see the same benefit except in people who drank coffee heavily (and that has it’s own problems).  Some teas, like green tea, are loaded with antioxidants and that is likely the mechanism of this protection.

Vitamin D

In a third study, British researchers looked at vitamin D’s effect on brain health. They examined data from 3,325 U.S. adults ages 65 and older from the NHANES III study. Vitamin D levels were measured by blood test, and cognitive tests were administered. Odds of cognitive impairment were about 42% higher in those deficient in vitamin D, and 394% higher in people severely deficient.  The research continues to mount on vitamin D.  It truly is amazing just how potent a weapon vitamin D is.  It is also clear to me that the current medical recommendations are far too low and that current sun safety guidelines are actually creating a society of people that are deficient in this life saving nutrient.

The benefit of these three things do not change your genetic make up.  They change the expression of those genes.  This is the study of epigenetics.  Essentially, each gene has a switch on it – an epigene.  These determine which genes get switched on and which do not.  Exercise, the antioxidants from tea and vitamin D seem to have a favorable affect on the epigenes.  They keep the bad genes turned ‘off’ and the good ones turned ‘on.’

Recommendations

Exercise at least three times per week.  Exercise should include weight training and cardiovascular work done in interval style training.  Exercise improves blood flow to the brain, reduces inflammation, increases necessary feed back to the brain and improves the efficiency of many metabolic pathways.  For more information visit www.bendearman.com.  Ben is a trainer that I work with and he’s got a great handle on how to exercise properly.

Take EGCG.  EGCG is the extract from green tea.  It has been studied rigorously and has been shown to be neuroprotective.  I recommend at least 500mg per day.  If you decide to start it please consult someone trained in functional medicine so they can provide you with a quality supplement.

Take vitamin D.  I have many blogs on my site that discuss the huge benefits of vitamin D.  If you’d like to read more about it please click vitamin D in our word cloud to the right or simply type it into our search feature.  It should be taken daily by just about everyone.  I recommend that people take anywhere from 2,000-4,000 IUs per day for maintenance.  Individually one may need even more depending on your condition.  It should be monitored with blood tests and you should shoot for a level no lower than 55 ng/ml.  Just about everyone will require supplementation to reach that level.

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Diet Linked to Lower Risk of Alzheimer’s Disease.

New research published online April 12 by the journal Archives of Neurology is reporting that diets high in fish, poultry, fruit, nuts, dark leafy greens, vegetables like broccoli and cauliflower, and oil-and-vinegar dressing lowers the risk of developing Alzheimer’s disease by more than a third.

The study reported on findings in 2,148 older adults (average age 77) living in northern Manhattan, none of whom had dementia at the beginning of the study period. Four years later, 253 had developed Alzheimer’s disease.

People who ate diets rich in the food listed above were more than 33% less likely to develop Alzheimer’s.  So what’s the key?  The key is an anti-inflammatory diet.

The pathway of inflammation in the body. (Souce: National Institute of Health, Neuroscience Division)

(A) Arachidonic acid is a fatty acid.  It is present in every cell in the body and is used to produce inflammation.  Inflammation is a necessary evil.  It helps us heal and signals that there has been damage.  However, in high amounts it can have very damaging effects.  Arachidonic acid is found preformed in many foods.  It is also synthesized from omega-6 fatty acids that are consumed.  This is the real problem.  Too many people eat foods that are exceptionally high in omega-6 fatty acids and it is these omega-6 fatty acids that are funneled into the arachidonic acid cascade.  How is it shifted there?  This is done so by the hormone insulin.  Insulin increase an enzyme in the body called                   delta-5-destaturase.  This forces all those essential omega-6’s into the pro-inflammatory pathway contributing to the vast majority of diseases in this country.

So what is high in omega-6’s you ask?  Things like soy, anything made from grain, canola or corn oil and anything processed to name a few.  The trick is actually to control insulin.  Remember, insulin is secreted in high amounts when you consume anything that contains large amounts of carbohydrates.  So the key is to eat a diet low in carbohydrates and high in things like low glycemic fruit, vegetables, protein and high quality fats.  Doing so controls insulin and therefore controls inflammation.

(B) NSAIDs or non-steriodal anti-inflammatory drugs are an enormous class of drugs that are wildly successful.  They include things like Aspirin, Aleve, and Ibuprofen.  It is not depicted well above, but NSAIDs block the COX class of enzymes (see above illustration) there by preventing the formation of the pro-inflammatory prostaglandins and thromboxanes (figures C and D).  This is effective for many things including pain and fever reduction for which this class of drugs is mostly used.

You may have noticed that people are now taking Aspirin “for their hearts.”  You know, that baby aspirin your doctor keeps pushing?  That’s because heart disease is increasingly becoming an inflammatory disease and Big Pharma wants a piece of the inflammatory puzzle.  This, however, is playing a losing game.  By disrupting the COX class of enzymes you are disrupting a normal physiologic process that is helpful in certain circumstances.  It is the blockage of this enzyme that allows ulcers to develop in users of this class of drugs.  It is also unnecessary to do this is a prophylactic measurement when it is as simple a watching your intake of carbohydrates.  If you do this you can significantly reduce your risk of many debilitating diseases (see figure E).

Increasingly we are seeing that diet is the key to preventing most diseases in humankind.  Will every single case be prevented by a healthy diet?  Probably not, but we can significantly reduce the risk and total numbers and definitely ease the suffering of perhaps millions of people.  The research is starting to catch up in terms of how detrimental inflammation is on overall health.  The answer, however, is not more drugs.  Simple dietary changes work more effectively and are more cost effective in the long run.

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