Tag Archives: dementia

Dementia risk increased with calcium supplements in women with cerebrovascular disease

Posted on August 18, 2016 | Comments Off on Dementia risk increased with calcium supplements in women with cerebrovascular disease
He's not worried about adequate dietary calcium

He’s not worried about adequate dietary calcium

The paleo diet is relatively low in calcium content. So is that a reason to take a calcium supplement? Probably not. Calcium supplements are problematic. They may increase the risk of heart attacks. They may raise the odds of premature cardiac death in men. High calcium consumption increased the risk of death in Swedish women.

MedicalNewsToday has a brief report on dementia in women with cerebrovascular disease and calcium supplements:

“Calcium supplements may increase the risk of developing dementia in senior women with cerebrovascular disease, finds a study published in Neurology, the medical journal of the American Academy of Neurology.

Women who took calcium supplements were twice as likely to develop dementia.Cerebrovascular diseases are conditions caused by problems that affect the blood supply to the brain. The four most common types of cerebrovascular disease are stroke, transient ischemic attack (TIA), subarachnoid hemorrhage, and vascular dementia.”

Source: Dementia risk increased with calcium supplements in certain women – Medical News Today

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Seafood May Lower Your Risk of Dementia

Posted on June 11, 2016 | Comments Off on Seafood May Lower Your Risk of Dementia

…according to an article at the Journal of the American Medical Association. The study involved Chicago-area residents who had provided information about their eating habits. After death, their brains were biopsied, looking for typical pathological findings of Alzheimers Disease.

fresh salmon and lobsters

Rich sources of omega-3 fatty acids include salmon, sardines, herring, trout, and mackerel

Participants who ate seafood at least once a week had fewer Alzheimers lesions in their brains, but only if they were carriers of a particular gene the predisposes to Alzheimers. The gene is called apolipoprotein E or APOE ε4.

You’ve heard that seafood may be contaminated with mercury, right? The seafood eaters in this study indeed had higher brain levels of mercury, but it didn’t cause any visible brain damage.

The Mediterranean diet, relatively rich in seafood, has long been linked to a lower risk of dementia.

A weakness of the study is that the researchers didn’t report results of clinical testing for dementia in these participants before they died. You can have microscopic evidence of Alzheimers disease on a biopsy, yet no clinical diagnosis of dementia.

Steve Parker, M.D.

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Are Your Computers Giving You E-mentia?

Posted on March 3, 2015 | Comments Off on Are Your Computers Giving You E-mentia?
Thinking about it...

Exercise your brain

I saw a patient at the hospital a couple years ago who had been brought in by ambulance after suffering some trauma (not to his brain). He couldn’t call any friends or relatives to let them know what was going on because he didn’t have his cellphone. His phone had all his contact numbers so he had no reason to memorize any. Would you be in the same boat?

DailyMail has an interesting article on whether our use of technology is making us dumber. If we turn over mental tasks like navigation and math to computers, do our brains waste away? Will we be seeing more and earlier cases of age-related dementia? E-mentia?

This is worth keeping an eye on.

Steve Parker, M.D.

PS: The five other members of my household all have cellphones. The only number I’ve memorized is my wife’s.

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Pioglitazone May Prevent Dementia

Posted on December 5, 2014 | Comments Off on Pioglitazone May Prevent Dementia

MP900178842[1]

Pioglitazone (aka Actos) is a type 2 diabetes drug in the TZD class. You could call it an “insulin sensitizer.” A recent report out of Germany suggests that pioglitazone prevents dementia, but it’s not a very strong linkage. If it works, I wonder if it’s simply related to better control of blood sugar, which could be accomplished with a variety of means. 

The best popular press report I’ve seen is at Bloomberg.

German researchers went fishing for associations in a huge database of patients and drug usage. Their formal report hasn’t even been published yet. A five-year study was recently initiated to further investigate the possibility that piogoitazone prevents dementia. I doubt this will pan out.

Steve Parker, M.D.

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Omega-3 Supplements Fail to Prevent Age-Related Cognitive Decline

Posted on September 16, 2013 | 4 comments
I like fish, but cold whole dead fish leave me cold

Consumption of omega-4 fatty acids, mainly from fish, is thought to prevent dementia and certain types of heart disease such as heart attacks and dangerous rhythm disturbances. For those who don’t like fish or can’t afford it, would taking omega-3 fatty acid supplements be just as effective?

Unfortunately, supplementation does not help prevent age-related cognitive decline and dementia, according to an article at MedPage Today.

The respected Cochrane organization did a meta-analysis of three pertinent studies done in several countries (Holland, UK, and ?).

The investigators leave open the possibility that longer-term studies—over three years—may show some benefit.

I leave you with a quote from the MedPage Today article:

And while cognitive benefits were not demonstrated in this review, Sydenham and colleagues emphasized that consumption of two servings of fish each week, with one being an oily fish such as salmon or sardines, is widely recommended for overall health benefits.

Consumption of cold-water fatty fish also helps return our dietary omega-6/omega-3 fatty acid ratio toward our ancestral level.

Steve Parker, M.D.

Reference:
Sydenham E, et al “Omega 3 fatty acid for the prevention of cognitive decline and dementia” Cochrane Database of Systematic Reviews 2012; DOI: 10.1002/14651858.CD005379.pub3.

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High Blood Sugars Again Linked to Dementia

Posted on August 25, 2013 | Comments Off on High Blood Sugars Again Linked to Dementia
dementia, memory loss, Mediterranean diet, low-carb diet, glycemic index, dementia memory loss

“Let’s work on getting those blood sugars down, honey.”

On the heels of a report finding no association between Alzheimer’s disease and abnormal blood sugar metabolism, MedPageToday features a new study linking high blood sugars to future development of dementia. And diabetics with sugar levels higher than other diabetics were more prone to develop dementia.

Some of you have already noted that not all cases of dementia are Alzheimer’s dementia. But Alzheimer’s accounts for a solid majority of dementia cases.

Some quotes from MedPageToday:

During a median follow-up of 6.8 years, 524 participants [of the 2,000 total] developed dementia, consisting of 74 with diabetes and 450 without. Patients without diabetes and who developed dementia had significantly higher average glucose levels in the 5 years before diagnosis of dementia (P=0.01). The difference translated into a hazard ratio of 1.18 (95% CI 1.04-1.33).

…

Among the patients with diabetes, glucose levels averaged 190 mg/dL in those who developed dementia versus 160 mg/dL in those who did not. The difference represented a 40% increase in the hazard for dementia (HR 1.40, 95% CI 1.12-1.76).

—Steve Parker, M.D.

Reference: Crane PK et al. “Glucose Levels and Risk of Dementia” N Engl J Med 2013; 369: 540-548.

Reminder: Conquer Diabetes and Prediabetes is now available on Kindle.

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Do Vegetables and Fruits Prevent Disease?

Posted on June 29, 2013 | Comments Off on Do Vegetables and Fruits Prevent Disease?
Switching to the paleo diet often leads to increased vegetable and fruit consumption

Switching to the paleo diet often leads to increased vegetable and fruit consumption

Potential answers are in the American Journal of Clinical Nutrition (2012).  I quote:

For hypertension, coronary heart disease, and stroke, there is convincing evidence that increasing the consumption of vegetables and fruit reduces the risk of disease. There is probable evidence that the risk of cancer in general is inversely associated with the consumption of vegetables and fruit. In addition, there is possible evidence that an increased consumption of vegetables and fruit may prevent body weight gain. As overweight is the most important risk factor for type 2 diabetes mellitus, an increased consumption of vegetables and fruit therefore might indirectly reduces the incidence of type 2 diabetes mellitus. Independent of overweight, there is probable evidence that there is no influence of increased consumption on the risk of type 2 diabetes mellitus. There is possible evidence that increasing the consumption of vegetables and fruit lowers the risk of certain eye diseases, dementia and the risk of osteoporosis. Likewise, current data on asthma, chronic obstructive pulmonary disease, and rheumatoid arthritis indicate that an increase in vegetable and fruit consumption may contribute to the prevention of these diseases. For inflammatory bowel disease, glaucoma, and diabetic retinopathy, there was insufficient evidence regarding an association with the consumption of vegetables and fruit.

It bothers me that vegetables and fruits are lumped together: they’re not the same.

The paleo diet is unfairly characterized as meat-centric. It can certainly provide beaucoup vegetables and fruits. Diabetics should be careful which ones they choose, to avoid spikes in blood sugar.

Steve Parker, M.D.

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Do High Insulin Levels Cause Memory Loss and Dementia?

Posted on May 29, 2013 | Comments Off on Do High Insulin Levels Cause Memory Loss and Dementia?
dementia, memory loss, Mediterranean diet, low-carb diet, glycemic index, dementia memory loss

Don’t wait to take action until it’s too late

Insulin resistance and high blood insulin levels promote age-related degeneration of the brain, leading to memory loss and dementia according to Robert Krikorian, Ph.D. He’s a professor in the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center.  He has an article in a recent issue of Current Psychiatry – Online.

Proper insulin signaling in the brain is important for healthy functioning of our brains’ memory centers.  This signaling breaks down in the setting of insulin resistance and the associated high insulin levels.  Dr. Krikorian makes much of the fact that high insulin levels and insulin resistance are closely tied to obesity.  He writes that:

Waist circumference of ≥100 cm (39 inches) is a sensitive, specific, and independent predictor of hyperinsulinemia for men and women and a stronger predictor than body mass index, waist-to-hip ratio, and other measures of body fat.

Take-Home Points

Dr. Krikorian thinks that dietary approaches to the prevention of dementia are effective yet underutilized.  He mentions reduction of insulin levels by restricting calories or a ketogenic diet: they’ve been linked with improved memory in middle-aged and older adults. His theory is also consistent with the commonly seen association of type 2 diabetes with dementia: overweight and obese type 2’s quite often have high insulin levels, at least in the early years.

Dr. K suggests the following measures to prevent dementia and memory loss:

  • eliminate high-glycemic foods like processed carbohydrates and sweets
  • replace high-glycemic foods with fruits and vegetables (the higher polyphenol intake may help by itself)
  • certain polyphenols, such as those found in berries, may be particularly helpful in improving brain metabolic function
  • keep your waist size under 39 inches (99 cm), or aim for that if you’re higher and overweight

Nearly all popular versions of the paleo diet would qualify as being low glycemic index.

I must mention that many dementia experts, probably most, are not as confident  as Dr. Krikorian that these dietary changes are effective.  I think they are, to a degree.

The Mediterranean diet is high in fruits and vegetables and relatively low-glycemic.  It’s usually mentioned by experts as the diet that may prevent dementia and slow its progression.

Read the full article.

I’ve written before about how blood sugars in the upper normal range are linked to brain degeneration.  Dr. Krikorian’s recommendations would tend to keep blood sugar levels in the lower end of the normal range.

Steve Parker, M.D.

PS: Speaking of dementia and ketogenic, have you ever heard of the Ketogenic Mediterranean Diet?  (Free condensed version here.)

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Will Low Normal Blood Sugars Prevent Brain Degeneration?

Posted on April 26, 2013 | 4 comments
MRI scan of brain

MRI scan of brain

Our bodies keep blood sugar levels in a fairly narrow range.  You might think you’re fine if you’re anywhere within the defined normal range.

Think again.

Australian researchers found that people with fasting blood sugars toward the upper end of the normal range had more degeneration (atrophy) in parts of the brain called the hippocampus and amygdala, compared to those in the low normal range.  Degeneration in those areas is often manifested as dementia.

The hippocampus is critical for learning and memory formation and retention.  The amygdala is also involved in memory as well as emotion.  The two areas are intimately connected, literally.

How Was the Study Done?

Over 250 study participants aged 60 to 64 years had normal brains at baseline and were free of diabetes and prediabetes.  Nearly all were caucasian.  MRI brain scans were done at baseline and again four years later.  Significant atrophy (shrinkage) was seen in the hippocampus and amygdala over time, with greater atrophy seen in those with higher baseline fasting glucose levels.

Fasting blood sugar was measured only once, at the start, and ranged from 58 to 108 mg/dl (3.2 to 6.0 mmol/l).  (Fasting glucose of 108 would be prediabetes according to the American Diabetes Association, but not by the World Health Organization.)  Participants weren’t tested for deterioration of cognition.

So What?

The results of the study at hand are consistent with others that link higher rates of dementia with diabetes.  Diabetics, even when under treatment, usually have higher average blood sugars than non-diabetics.  The study authors speculate that damage from higher blood sugars may be mediated by inflammation and abnormal blood clotting (prothrombotic factors and platelet activation).

The Mayo Clinic recently reported that diets high in carbohydrates and sugar increase the odds of developing cognitive impairment in the elderly years.

It’s interesting to contemplate whether non-diabetics and diabetics would have less risk of developing dementia if blood sugars could be kept in the lower end of the normal range.  How could you do that?  Possibilities include:

  • avoid sugars and other refined carbohydrates
  • limit all carbohydrates
  • favor low-glycemic-index foods over high-GI
  • regular exercise, which helps maintain insulin sensitivity (insulin is a major blood sugar regulator)
  • avoid overweight and obesity, which helps maintain insulin sensitivity
  • for diabetics: all of the above plus drugs that control blood sugar

Steve Parker, M.D.

Reference:  Cherbuin, Nicolas, et al.  Higher normal fasting plasma glucose is associated with hippocampal atrophy: The PATH Study.  Neurology, September 4, 2012, vol. 79, No. 10, pp: 1,010-1,026.  doi:10.1212/WNL.0b013e31826846de

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Carbohydrates and Sugar Increase Risk of Elderly Cognitive Impairment

Posted on January 6, 2013 | 1 comment

 

How many brain cells with this roll kill?

How many brain cells with this roll kill?

The Mayo Clinic recently reported that diets high in carbohydrates and sugar increase the odds of developing cognitive impairment in the elderly years.

Mild cognitive impairment is often a precursor to incurable dementia.  Many authorities think dementia develops more often in people with diabetes, although some studies refute the linkage.

Researchers followed 940 patients with normal baseline cognitive functioning over the course of four years. Diet was assessed via questionnaire. Study participants were ages 70 to 89. As the years passed, 200 of them developed mild cognitive impairment.

Compared with those eating at the lowest level of carbohydrate consumption, those eating at the highest levels were almost twice as likely to go to develop mild cognitive impairment.

The scientists note that those eating lower on the carbohydrate continuum were eating more fats and proteins.

Steve Parker, M.D.

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