Warning all Millenials -- Start Caring for Yourself Now!

If you are now in your mid-30s and you want a full sized brain in your 70s, you need to get busy.  And let me tell you, that 70 sneaks up on you really fast!

This week's ALZForum carried an interesting story about research correlating control of cardiovascular risk factors in the mid-30s with brain size when someone was 70 or older.  Specifically, poor vascular health at age 36 signaled a smaller brain and greater white matter damage at 70.  The upshot of the story was that poorly controlled cardiovascular risk factors led to greater brain atrophy.

The study noted that this was unrelated to increased levels of beta amyloid and tau protein, the hallmarks of Alzheimer's disease.  So, while poor cardiovascular health can be a risk factor for Alzheimer's disease, it doesn't need Alzheimer's disease to damage your brain.

So how did they figure this out?  It's an interesting story.

In 1946 the British government identified every baby born during the week of March 3-9 in England, Scotland, and Wales and interviewed their mothers.  This was 13,687 babies and their mothers.  From this group, they selected a cohort of 5,000 to follow through their lives.  When some of these were more recently gathered (2014), some were in wheel chairs and others were talking about the marathon they had just completed.  Of course, some of their classmates had died.  Genes have a lot to do with these distinctions, but so does lifestyle.  (No news here...)

The 5,000 were tracked for educational attainment, socioeconomic status, diet, and exercise.  When they were all 36 (in 1982) they began tracking the cohort more specifically for cardiovascular risk, notably blood pressure.  Then in 2014, "egged on" by members of the cohort, the researchers began imaging the brains of about 500 of them at 2-year intervals.  This was both MRI and PET scan imaging.  The PET scans looked specifically for amyloid accumulation in the brain.

What surprised me the most was that they could not correlate an increase in beta amyloid and tau accumulation (meaning Alzheimer's disease) with cases of poor vascular health.  The surprise is that we have been saying that vascular disease is a risk factor for Alzheimer's disease, and these results seem to contradict that.  The article briefly quoted different authorities commenting inconclusively on this.  One authority suggested the incongruous result might be explained by the design of the research, while another said we just might be wrong about the relationship between Alzheimer's disease and cardiovascular risk factors.  I struggled with both explanations.

Something that Millennials should note is that they compared different ages at which cardiovascular risk factors went out of whack leading to greater brain atrophy.  The strongest correlation was at age 36.  Of course, that was the age of the cohort when the researchers started explicitly measuring those elements.  And so, likely at age 70, these subjects had hypertension etc. for the longest period of time.   Nevertheless, if you are 36 or older, it's time -- or past time -- to assess your cardiovascular risk factors and make any necessary lifestyle amendments!  Lifestyle factors -- notably diet and exercise -- are the biggest controllable contributors to cardiovascular health.

The researchers made an effort to correlate their findings with the ongoing Framingham Heart Study.  The Alzheimer's Association sees the British research with its rich cohort of study subjects to be worthy of further funding.  So they are chipping in $7 million to expand the British research.