Now espresso fights Alzheimer's disease?

Maybe you saw it in the news, but a new study found that chemical compounds in espresso (including caffeine) interfere with the formation of tau protein tangles, and may therefore protect against Alzheimer's disease.  Speaking as a major coffee lover, this sounds too good to be true.  (But we can at least pretend to be sure it is.)

On July 19, the research was published by the American Chemical Society in their journal Agricultural and Food Chemistry.  Long story short, researchers from the University of Verona in Italy collected commercial samples of espresso and extracted certain chemicals from them, including the caffeine.  In the laboratory, they then exposed brain tissue samples to the chemicals and found that tau proteins formed shorter fibrils, and did not agglomerate as readily.  This apparently inhibited their ability to spread the disease throughout the brain.

Okay, to understand this, we need to go back to Beating the Dementia Monster and review some of the things we said there.  We discussed tau tangles -- clumps of tau protein that aggregated when defective tau protein lost its strength and couldn't hold the microtubules together.  The microtubules are like the skeleton of the brain cell.  In Alzheimer's disease, they lose their strength and collapse into a "tau tangle."  The brain cell then dies.  Alois Alzheimer saw these tangles, along with amyloid plaques, in the brain of his deceased patient, Auguste Deter.

We also said that Alzheimer's disease can proceed for as many as 15 years before the first symptoms appear.  Apparently, at about 15 years, there is a "tipping point."  At the tipping point, defective tau protein is abruptly seeded throughout the brain, spreading the disease and creating disruptions in cognition and memory.  The researchers concluded that the shorter fibrils would not spread through the brain, and the espresso might stop the disease from advancing.

At least that's what happens in a petri dish.  Does that also happen in the human brain?  As usual, they tell us, "More research is necessary." 

I'm not waiting for more research.  I'm going to continue consuming my coffee.  Unfortunately, the caffeine also aggravates my insomnia, primarily through nocturia.  According to my urologist, the caffeine irritates the bladder at night creating a sensation of needing to void.  If I'm off caffeine, I'll get up 2 or 3 times per night.  If I've had too much, even several days previously, I could be up more than 5 times.

Integrity issues in biologic research take down Stanford president

A year ago, we wrote about a scandal in which a researcher had fraudulently "photoshopped" some images used in research that misdirected some Alzheimer's research for perhaps a decade.  But, as it turns out, this was not an isolated situation.  Apparently quite a few research papers have been based on inappropriately altered images, and amateur detectives have been out finding them.  At least some of them.

This week, Stanford President Marc Tessier-Lavigne resigned due to questions about some of his published research, research in which some images had been inappropriately manipulated.  Tessier-Lavigne was a neurologist known for research in Alzheimer's disease, although image manipulation does not appear to have been involved in that research.

For me, what stands out here is damage to the public perception of the legitimacy of scientific research.  Especially after concerns about politicized covid information during the pandemic, my sense is that public trust has fallen dramatically.

So how's the insomnia cure going?

It's early to tell for sure, but the sleep restriction cognitive behavior therapy I've been trying does seem to be helping.  I am usually able to sleep the whole night through with 4 or 5 awakenings.  These are usually fairly short.  But I"m still often getting less than five hours a night, and naps aren't permitted.  But I do feel well about how things are going.

They say you shouldn't try this on your own; you should be supervised by a therapist.  Then they say good luck finding a therapist.  There aren't many of them.  So I'm doing it on my own.

I have graduated from phase 1 to phase 2.  Phase 1 had me going to bed at midnight even though I was unable to sleep beyond 5 a.m.  I'd been going to bed at 8:30 or 9 to find time during the night to get more sleep.  But I've found that, in the end, I get no more sleep by going to be so early.

The first week of going to bed at midnight (phase 1) was just awful, but I was amazed on night 6 when I actually stopped waking up at 2 or 3.  So after a week in phase 1, I rolled my bed time back to 11.  (My goal is to form a habit of going to bed at 10 and waking up at 5.  This seems doable.)  I'm still getting up earlier than I would like, but only once have I awakened around 3 and been unable to get back to sleep.  

I'm using my Fitbit along with the CBT-i Coach app to track my sleep.  The app creates a nice graph to show my progress ... or lack thereof.  

I'm not ready to graduate to phase 3.  I'd like at least a full week of sleeping through the night and awakening at 5 or later.  (Too often I'm fully awake at about 4:30 or so.)  Then I think I can roll my bed time back to 10.  The concept is that I'm creating a habit of sleeping to 5 regardless of bed time.  And because I was so sleep-deprived when I went to bed in phase 1, I seem to have broke the habit of awakening at 2 every night.  

So why am I having this problem when I'd been able to sleep nicely throughout most of my life?  According to Dr. Matthew Walker in his book Why We Sleep, the control center for our sleep is atrophying as we age and becoming more easily confused.  With neurodegnerative diseases, like Alzheimer's disease, this atrophy is accelerated.  So people in memory care are walking the halls all night.  The double-whammy is that poor sleep accelerates Alzheimer's disease.

I am optimistic about this.  Maybe I'm just getting used to surviving on 5 hours of sleep, but I feel well enough during the day, and I seem to be fully functional.  I look forward to feeling comfortable about rolling bed time back to 10. 

Can gut bacteria tell if Alzheimer's is developing?

One of the most amazing features of the human body is the gut-brain axis.  As we discussed last summer, microorganisms in the intestines have a signaling network with the brain such that the microorganisms exercise a significant level of control over what happens in the brain.  Bizarre, I know.  Nevertheless, good gut health contributes to good neurologic health.

Doctors often refer to "gut flora," meaning gut plants.  This hearkens back to the 1950s, in my late elementary school days, when the biological sciences were trying hard to sort all life as either plant or animal.  And they were trying hard to force fit bacteria into the plant kingdom.  That didn't work out very well.  It turns out that bacteria are more different from plants than plants are from animals.

And so more sophisticated folks will refer to "gut bacteria."  But that's not quite right either.  Many of the microorganisms in your gut are archaea.  Archaea are often referred to as bacteria, partly because, like bacteria, their cells have no nuclei.  They are the organisms that can live under extreme conditions, such as near volcanic vents on the sea floor.  They stain the glaciers on Mount Rainier pink, they allow goats to digest cellulose, and they give the hot water pools in Yellowstone their beautiful colors.  But there are ways in which they are significantly more different from bacteria than plants are from animals.

So we will refer to the gut microbiome and skip worrying about whether their citizens are plants, animals, bacteria, or archaea.  

Now since the gut microbiome plays such an important role in how the brain functions, it may also play a role in how Alzheimer's disease develops.  Therefore, logic says that you should be able to see the development of Alzheimer's disease somehow reflected in the gut microbiome.  Can you?  Maybe so.  

There was a new study published in the June 14, 2023 edition of the journal Science Translational Medicine, "Gut microbiome composition may be an indicator of preclinical Alzheimer’s disease."  As indicated in the title, the research explored the idea that Alzheimer's disease might be detected by analyzing changes in the gut microbiome during the preclinical phase of the disease.  This is before any symptoms develop.

The researchers studied 164 cognitively normal people, 49 of whom had evidence of preclinical Alzheimer's disease.  In other words, the 49 passed cognitive tests OK, but they had other evidence that the disease had already begun.  As we said in Beating the Dementia Monster, the preclinical stage normally lasts about 15 years, only ending when the first symptoms appear.  Usually it is simply undetected during that stage. 

So what did the research find?  "The gut microbiomes of people with preclinical Alzheimer's disease (indicated by altered brain amyloid and tau proteins) had a different composition from that of healthy individuals."  This means that examining fecal matter may turn out to be a less invasive method for diagnosing Alzheimer's disease than, say, the spinal tap that I underwent. 

On the other hand, if the blood tests we've been anticipating turn out to be as reliable as they appear, they may end up being the preferred diagnostic tool.  The gut microbiome researchers compared their approach to the spinal tap rather than the blood test.

Aside from perhaps using changes in your gut microbiome to diagnose Alzheimer's disease, some believe that supporting good gut health supports good brain health.  That may or may not be true, but I still do things thought to support the gut microbiome.  I eat yogurt (without all the sugar), fermented foods like kimchi, and fiber supplements.

This idea of resisting Alzheimer's disease by caring for your gut underscores something we've said before: this is an incredibly complex disease, and we just don't understand it well at all.