Interesting: Alzheimer's Association Annual Report

On March 20, the Alzheimer’s Association released its annual Alzheimer’s Disease Facts and Figures report.  (The pdf is here.)  It makes some important points.  Here are a few:

• Approximately 484,000 Americans will develop dementia from Alzheimer’s disease (AD) this year.
  

• While hopes for a drug cure arise regularly, these hopes have been dashed when drug trials fail to reverse, stop, or even slow the progress of the disease.
  

• The lifetime cost for caring for someone with AD is estimated to be about $341,840.  The cost of AD to the nation in 2018 is estimated to be $277 billion, but it will likely rise to $1.1 trillion by 2050.
  

• AD is a deadly disease, and it is the fifth leading cause of death for Americans 65 years of age and older.   (I like to say that most of us know a cancer survivor, but none of us knows an AD survivor.)
  

The report discussed a new distinction between "Alzheimer's disease" and "Alzheimer's dementia."  Historically, someone has been said to have Alzheimer's disease after they were clearly in a state of dementia.  But the disease had actually begun years, perhaps decades before.  Now the medical community will refer to the actual disease as "Alzheimer's disease" regardless of how advanced the symptoms are.  The term "Alzheimer's dementia" will refer to dementia caused by the disease -- what we used to call Alzheimer's disease.

News on Traumatic Brain Injury

I saw this article in this weeks issue of ALZFORUM.  It cited two important recent studies of large populations that correlated traumatic brain injury (TBI) with the advent of dementia.  (A TBI may be a concussion or result in a coma.)   One notable finding was that a single TBI may increase the probability of the later onset of dementia by 22%.  The study with this finding did not determine whether the dementia was due to Alzheimer's disease or something else. 

Kale

My sister, who is a professor at Tufts University, sent me a link to this article.  It cites research on green leafy vegetables and cognitive decline published in the journal Neurology.  Conclusion: "... consumption of green leafy vegetables was associated with slower cognitive decline ..." 

More About New Brain Cells

In my April 14 post, "More in the News," I cited a newspaper article comparing the results of two different studies on neurogenesis.  One study seemed to confirm a consensus viewpoint that new neurons continue to form in hippocampus of aging brains, while the other concluded that neurogenesis ended in the teen years.  The recent edition of the ALZFORUM weekly newsletter carried an article that also compared both studies. 

ALZFORUM is more sophisticated than the local paper, and it added detail to the comparison that I had not seen before.  I wouldn't say that ALZFORUM tried to reconcile the two different conclusions, nor did they favor one over the other.  But they did indicate that the Columbia study supports an emerging consensus that new neurons can form in the hippocampus even late in life.  This is what I was learning in my own reading and discussions with researchers.

I suspect that we'll hear more about these.

 

Stand, Don't Sit!

This recent article in the LA Times reported on research from the UCLA Semel Institute Center for Cognitive Neuroscience.  The research found a connection between time spent sitting and atrophy of the cortex of the brain's medial temporal lobe.  The research found that this part of the brain atrophies more rapidly in people who spend more time sitting, but it couldn't find a connection with physical exercise.  That was surprising.

While the hippocampus is the part of the brain's medial temporal lobe that processes short-term memories, it's the surrounding medial temporal cortex actually stores the memories long term.  (Short term memories are stored in the pre-frontal lobe.)  The research found that people who sit more experience more atrophy of the medial temporal cortex.  While this is an area of active research, it appears that this atrophy affects long-term memory. 

One of the first casualties of AD is the hippocampus, where, among other things, short-term memories from the pre-frontal lobe are processed for long-term storage in the medial temporal lobe cortex.  So it would appear that physical aerobic exercise benefits the hippocampus and memory formation, but less sitting and more standing benefits the areas of the brain responsible for, among other things, storage of long-term memory. 

More in the News

In addition to the parade article mentioned in the previous post, my wife saved me an article from the April 8 edition of the LA Times, "Surprise!  Scientists find signs of new brain cells in adults as old as 79."  Except, I wasn't that surprised based on some research cited in Beating the Dementia Monster.  The article is about research conducted at Columbia University that investigated neurogenesis of hippocampus brain cells in humans, contrasted with mice and non-human primates.  The study appeared to find that neurogenesis continues at least to age 79 in humans, although new blood vessels to support the new cells didn't appear to develop as readily in older people.

The article contrasted another study published in Nature that failed to find any evidence of neurogenesis after the age of 14.  This research was conducted at the University of California, San Francisco.  This finding surprised me, considering other research cited in Beating the Dementia Monster that found evidence of neurogenesis encouraged by aerobic exercise. 

In discussion, the article quoted the lead Columbia University investigator who believes that differences in how brain sample were preserved between the death of the subject and the study laboratory may explain why the second study couldn't identify new brain cells. 

The newspaper article concluded, "The debate continues."  

In the News

When I got back from Japan, my wife had saved a couple of articles for me about AD.  One that at first stimulated me but then disappointed was from the April 8 edition of Parade magazine.  It was the "Cheater's Guide to Beating Alzheimer's," by Paula Spencer Scott.  While it touched most of the lifestyle bases on dealing with AD, it missed the most important one: aerobic exercise!  This was inexplicable to me, except that I sense that the onerousness of getting to the gym everyday causes people to avoid that vital piece of the puzzle.

Appended to the article was a notice about recruiting for an upcoming study for asymptomatic people.  The intent will be to study the influence of lifestyle on vulnerability to developing AD.  The notice says that it will be the largest study of its kind at 2,500 participants.  You are encouraged to check it out at the ALZ web site.  Apparently it will be looking hard at physical exercise.

Food: What the heck should I eat?

I was at Costco today, and I picked up the new book by Mark Hayman, MD.  Sanjay Gupta's recommendation is "A clear roadmap for the confused eater."  I've read enough of it to conclude that it's excellent.  The main theme is not brain health, but what Hayman says is consistent with everything being said right now about the diets that are good for brain health.

A couple of themes:

1. Keep carbohydrates as low as you can.  No news there, but it's a good reminder.
2. Sugar is bad.  If sugar has been added to something, stay away.
3. All calories are not equal.  Some are metabolized differently than others and have different consequences.
4. We are finally getting over fat-phobia.  (My language.)  Even red meat with fat is OK (or at least not as bad as previously advertised).  But all meat consumption should be minimized.   He discusses the seriously misguided direction we got in the 1980s and 90s telling us to reduce fat.  He says there was no science behind those recommendations.  Real science now is saying fat is OK, the problem is carbs.  But trans-fats are still very bad.  (They're in your chips.)
5. Dietary cholesterol is not a significant consideration.  Your genetic predispositions are more important than your diet.  Eggs are fine.
6. There is little nutritional advantage in dairy (although butter has advantages).  He says that the promotion of nutrition through diary products is politically motivated and is the work of the farm lobby.  Organic goat's milk is better than production commercial milk.  Grass-fed is much better.
7. He downplays beans.  (This surprised me.)  He says they have too much carbohydrate content and not nearly as much protein as advertised.
8. Fruit juices are flavored, sugar water.  Fruit is good, juice is not.  Stay away from fruit juice, notably orange juice.
9. Fish is good, but beware of labeling fraud, mercury content, and farmed fish.  Alaskan salmon gets high marks.
10. Tree nuts are excellent, peanuts no so much.  Peanut butter is loaded with carbs and not recommended.

Japan

I'm returning from a trip to Japan -- will be home very soon.  Unfortunately, I don't think it was good for my brain-health discipline.  There were a couple of reasons.

1. Japanese food is carbohydrate-intensive.  Not so much because of the terrible excesses of sugar in American food, but because rice is so ubiquitous.  And it was very hard to find leafy green vegetables in any quantity.  On the other hand, there was plenty of fish, and I like sashimi.  I'll say this -- I usually don't care for Japanese food, at least as I find it in the US.  But the I really enjoyed the food in Japan.  I put on several pounds.
2. Of the six or so hotels we stayed in Japan, only three had an exercise room with a treadmill.  One cost about $6 (which I took advantage of) and the others cost $30+ for one visit.  I couldn't quite bring myself to pay that much.  Fortunately, we did a lot of walking on the tour.
3. I rarely slept well.  Jet lag was a problem, but the unfamiliar environment likely interfered as well.  We also discovered that it's a good idea to turn off you cell phone at night.  We were awakened by couple of scam calls from sources believing we were in a US time zone.  It was hard to get back to sleep.  The plane flights were very long, and I can't sleep on a plane.
4. I had some disruptions in my insulin schedule.  This was mostly around air travel.  On the assumption that the insulin is helping, I'm hoping that irregular application won't hurt my progress.

On the way home, I stopped in Hawaii where I was able to use a relative's treadmill to try to catch up on aerobic exercise.

The trip was a lot of fun, and I took a lot of pictures.