Tag: dementia

Lifestyle Changes Shown to Reduce Risk of Dementia

Photo by Ketut Subiyanto from Pexels

After almost two decades, a new drug for Alzheimer’s disease has been approved in the US. However, some experts say it doesn’t really work — only treating amyloid plaques which are thought to cause the disease — and worry that it may cost a lot.

The amount of attention around this news reflects the importance of preventing dementia, with its devastating toll on families and patients. But millions of adults could lower their chances of needing such a drug by taking preventative measures.

That’s why a national panel of experts including the University of Michigan’s Deborah Levine, MD, MPH, recently published a guide for primary care providers on this topic as an official Scientific Statement from the American Heart Association.

People dread Alzheimer’s disease, she said. Helping people understand that they can prevent or slow future dementia by taking specific steps now could motivate them to increase their healthy behaviours for a positive effect.

The first step is to recognise that dementia risk is higher among people with seven major modifiable risk factors.

These are: depression, hypertension, physical inactivity, diabetes, obesity, hyperlipidaemia, poor diet, smoking, social isolation, excessive alcohol use, sleep disorders and hearing loss. Addressing each of these factors can, to varying extents, help reduce the risk of developing dementia, a fact backed by decades of research.

The second step is using medication, lifestyle change and other interventions to help patients reduce their dementia risk.

“Dementia is not inevitable,” said Dr Levine, a primary care provider at the University of Michigan Health, part of Michigan Medicine. “Evidence is growing that people can better maintain brain health and prevent dementia by following healthy behaviours and controlling vascular risk factors.”

These strategies can help preserve cognitive function and lower risk for heart attacks and strokes, said Dr Levine, who heads the Cognitive Health Services Research Program and sees patients at the Frankel Cardiovascular Center.

“We need to address the significant disparities that lead women, Black, Hispanic and less-educated Americans to have a much higher risk of dementia,” said Levine, a member of the U-M Institute for Healthcare Policy and Innovation.

She added that it’s never too late in life to start working on cognitive risk factor control.

“We have no treatments that will halt dementia – so it’s important to protect your brain health.”

Source: University of Michigan

Tooth Loss may Decrease the Capacity to Perform Everyday Tasks

Photo by Yusuf Belek on Unsplash

Older adults with more natural teeth are better able to perform everyday tasks such as cooking a meal, making a telephone call or going shopping, according to a new study. 

The study, conducted by researchers from UCL and the Tokyo Medical and Dental University, was published in the Journal of American Geriatrics Society, The researchers analysed data from 5631 adults from the English Longitudinal Study of Ageing (ELSA) with ages between 50 and 70 years old.

Previous research had established a link between tooth loss and various reductions in capacity, such as cognitive decline. However, such research could not tease out any kind of causal link: did the tooth loss cause the decline, or did the decline result in tooth loss?

In this study the research team wanted to investigate the causal effect of tooth loss on someone’s ability to carry out daily activities. After controlling for factors such as participants’ socioeconomic status and health status, they nevertheless found evidence of an independent link between tooth loss and the ability to carry out everyday tasks.

The participants in the study were asked how many natural teeth they had, with older adults usually having up to 32 natural teeth that are lost over time. Using data gathered in 2014-2015, the researchers measured how tooth loss affected people’s ability to carry out key instrumental activities of daily living (IADL). The activities included preparing a hot meal, shopping for groceries, making telephone calls, taking medications, doing work around the house or garden, or managing money.

Senior author Georgios Tsakos, professor at UCL Institute of Epidemiology and Health, explained: “We know from previous studies that tooth loss is associated with reduced functional capacity, but this study is the first to provide evidence about the causal effect of tooth loss on the instrumental activities of daily living (IADL) among older adults in England. And this effect is considerable.

“For example, older adults with 10 natural teeth are 30% more likely to have difficulties with key activities of daily living such as shopping for groceries or working around the house or garden compared to those with 20 natural teeth.

“Even after taking in factors such as participant’s education qualification, self-rated health and their parent’s education level for example, we still found a positive association between the number of natural teeth a person had and their functional ability.”

The researchers had a number of possible explanations for this relationship, noting that having more natural teeth is linked to delaying the onset of disability and death and that tooth loss can also hamper social interactions, which is also linked to poorer quality of life. Tooth loss could be linked to having a poorer diet with less nutrients, they suggested.

However the researchers cautioned that the results should be considered carefully due to the study’s complex design. Further studies are needed to investigate the causal relationship between tooth loss and functional ability.

First author, Dr Yusuke Matsuyama, at Tokyo Medical and Dental University, said: “Preventing tooth loss is important for maintaining functional capacity among older adults in England. Given the high prevalence of tooth loss, this effect is considerable and maintaining good oral health throughout the life course could be one strategy to prevent or delay loss of functional competence.

“The health gain from retaining natural teeth may not be limited to oral health outcomes but have wider relevance for promoting functional capacity and improving overall quality of life.”

Source: University College London

Journal information: Yusuke Matsuyama et al, Causal Effect of Tooth Loss on Functional Capacity in Older Adults in England: A Natural Experiment, Journal of the American Geriatrics Society (2021). DOI: 10.1111/jgs.17021

High Blood Pressure Dementia Risk Found for Women

Image by Steve Buissinne from Pixabay

Differences in blood pressure’s influence on dementia risk in men and women may provide clues to help slow the rapid progress of the disease, according to new research.

In a study involving half a million people, researchers found that although the link between several mid-life cardiovascular risk factors and dementia was similar for both sexes, for blood pressure it was not. Low and high blood pressure were both shown to be associated with a greater risk of dementia in men, but for women the risk of dementia increased as blood pressure went up.

Lead author Jessica Gong said that while more research was needed to verify these findings, they may point to better ways of managing risk.

“Our results suggest a more tailored approach to treating high blood pressure could be more effective at preventing future cases of dementia,” she said.

Dementia is fast becoming a global epidemic, currently affecting an estimated 50 million people worldwide. This is projected to triple by 2050 – mainly driven by aging populations. Rates of dementia and associated deaths are both known to be higher in women than men.

In 2016 it overtook heart disease as the leading cause of death in Australian women and it is the second leading cause of death for all Australians.

With no treatment breakthroughs of any significance, the focus has therefore been on cutting the risk of developing the disease. Cardiovascular risk factors are increasingly recognised as contributors to different types of dementia.

To explore differences in major cardiovascular risk factors for dementia between the sexes, George Institute researchers accessed data from the UK Biobank, a large-scale biomedical database that recruited 502 489 dementia-free Britons 40-69 years old between 2006 and 2010.

They found that, to a similar degree in women and men, smoking , diabetes, high body fat levels, prior stroke history, and low socio-economic status were all linked to a greater risk of dementia.

But when it came to blood pressure, the relationship with dementia risk between the sexes was different. Although the reason for this wasn’t clear, the authors proposed some possible explanations.

“Biological differences between women and men may account for the sex differences we saw in the relationship between blood pressure and the risk of dementia,” said Ms Gong.

“But there may also be differences in medical treatment for hypertension. For example, women are less likely to take medication as prescribed by their healthcare provider than men and may be taking more medications and experiencing more side effects.”

While there are no effective treatments for dementia, trying to reduce the burden of the disease by encouraging healthier lifestyles is the priority, and the strongest evidence points to blood pressure management.

“Our study suggests that a more individualised approach to treating blood pressure in men compared to women may result in even greater protection against the development of dementia,” said study co-author Professor Mark Woodward.

“It also shows the importance of ensuring sufficient numbers of women and men are recruited into studies and that the data for women and men should be analysed separately,” he added.

Source: George Institute

Sleep Apnoea Treatment May Reduce Risk of Dementia

Older adults receiving positive airway pressure therapy for obstructive sleep apnoea (OSA) may have a lower risk of developing Alzheimer’s disease and other kinds of dementia, according to a new study.

In a nationally representative study, Researchers from Michigan Medicine’s Sleep Disorders Centers analysed Medicare claims of over 50 000 Medicare beneficiaries 65 and older with OSA. They sought to find out whether people using positive airway pressure therapy had less risk of receiving a new diagnosis of dementia or mild cognitive impairment over the next 3 years, compared to those not using positive airway pressure therapy.

“We found a significant association between positive airway pressure use and lower risk of Alzheimer’s and other types of dementia over three years, suggesting that positive airway pressure may be protective against dementia risk in people with OSA,” said lead author Galit Levi Dunietz, PhD, MPH, an assistant professor of neurology and sleep epidemiologist.

The findings stress the impact of sleep on cognitive function. “If a causal pathway exists between OSA treatment and dementia risk, as our findings suggest, diagnosis and effective treatment of OSA could play a key role in the cognitive health of older adults,” said principal investigator Tiffany J. Braley, MD, MS, associate professor of neurology.

Obstructive sleep apnoea is a condition where there are episodes of complete or partial collapse of the airway with an associated decrease in oxygen saturation or arousal from sleep. This disturbance results in fragmented, nonrestorative sleep, and is associated with a variety of other neurological and cardiovascular conditions. Many older adults are at high risk for OSA. Dementia is prevalent as well, with roughly 5.8 million Americans currently living with it, said Prof Braley.

Source: Medical Xpress

Journal information: G L Dunietz et al, Obstructive Sleep Apnea Treatment and Dementia Risk in Older Adults, Sleep (2021). DOI: 10.1093/sleep/zsab076