Recent Press on Preventing Alzheimer's

 Contributed by: Dennis Fortier, President, Medical Care Corporation



There is no hope? 

Eating well, staying fit, and using your brain have no effect on your risk for Alzheimer's?  Many headlines have implied this dire message over the past 24 hours.

The source of these headlines is an article published in the Archives of Neurology, online edition.  The article reviewed the evidence that actively managing modifiable factors could reduce the risk of AD, and concluded that only a low level of evidence suggests a relationship between the risks and the disease.

Let's be sure not to misunderstand this.

What is a "Low Level" of Evidence?
The authors classified the level of evidence for each risk factor in accordance with accepted scientific standards.  These standards allow for three levels of evidence: low, medium, and high. 

Importantly, a "low" level of evidence means that real research, conducted with sound methods, that was published in peer-reviewed medical journals, showed an association between the risk factor being studied and the incidence of AD.  Perhaps the association was not overly strong, perhaps the sample size was small, perhaps similar studies have not been completed to verify the result, but even a "low" level of evidence is a pretty good start in finding a meaningful association.

The panel authoring this paper, on behalf of the National Institutes of Health, found a low level of evidence that diabetes, high cholesterol, and tobacco use all confer a higher risk of Alzheimer's disease.  Sure we want more evidence and a higher level of confidence, but all work so far suggests that these are real risks that need to be managed.

The panel also found a low level of evidence that a Mediterranean diet, folic acid intake, light alcohol consumption, cognitive activity, and physical activity all reduced risks of Alzheimer's.  That's more good news.

This review constitutes unbiased, expert confirmation that many modifiable risk factors should in fact be managed to reduce the risk of AD.  The evidence is not as strong as we would all like, but it has reached a minimum threshold of scientific scrutiny to establish a likely association.

The problem here is the massive and consistent misinterpretation of these findings by the press.  In every day jargon, a "low level of evidence" is a negative testimonial as to the likelihood of an association.  But in the scientific world, where facts are closely scrutinized before they qualify as "evidence", a low level of evidence connotes a pretty good start toward proving a point.  It is a shame that this is not understood by the major media outlets and is not more clearly represented in their publications.

6 Ways to Keep Your Brain Healthy

Contributed by: Dennis Fortier, President, Medical Care Corporation
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There is some great advice in the Huffington Post regarding 6 well-validated approaches to maintaining a healthy brain.  Each of these has been covered to some extent in past posts here, but this is a nice presentation of the evidence in one article.

While I would recommend that you click through and read the full article, the 6 tips are listed here as an overview:

1. Manage chronic conditions under your control
2. Incorporate Mediterranian diet
3. Stay physically active
4. Avoid Tobacco Smoke
5. Stay intellectually and socially active
6. Watch for signs of Depression

Each of these is well within your control and proven to reduce your risks for cognitive decline.

Metabolic Syndrome and Memory Loss

Contributed by: Dennis Fortier, President, Medical Care Corporation
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While better education and higher awareness about Alzheimer's disease are key themes in this blog, we also emphasize the many other medical conditions that are also associated with memory loss.  Among those conditions is Metabolic Syndrome.

As per a recent article posted on WebMD, Metabolic syndrome is a common condition characterized by a cluster of symptoms that can include high blood pressure, too much weight around the waist, elevated blood sugar levels, low levels of HDL “good” cholesterol, and high levels of tryglycerides, a type of unhealthy fat found in the blood.

According to a study published yesterday in Neurology, subjects with metabolic syndrome, are more prone to cognitive decline in their later years.  While this group was previously known to have higher risk for heart disease, it is now more clear that they face an increased cognitive risk as well.

Given a large body of evidence showing that active management of blood pressure, blood sugar, cholesterol, and body fat can reduce the risk of heart disease, it is reasonable to speculate that such practices might also reduce the risk of cognitive decline.  Certainly, it couldn't hurt.
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A better understanding and more awareness of Alzheimer's related issues can impact personal health decisions and generate significant impact across a population of aging individuals. Please use the share buttons below to spread this educational message as widely as possible.

Understanding Cholesterol and Alzheimer's Risk

Contributed by: Dennis Fortier, President, Medical Care Corporation
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As we have often noted, cardiovascular risk factors including high blood pressure, obesity, and high overall cholesterol can increase the likelihood of getting Alzheimer's disease (AD). A study published earlier this week in the Archives of Neurology may have shed more particular light on the relationship between cholesterol and AD.

According to researchers at Columbia University, high levels of HDL cholesterol (the "good" form), are 60% less likely to develop AD. They followed 1,130 seniors with no history of memory loss or dementia and measured their cholesterol levels every 18 months for four years. Their findings supported the theory that high levels of HDL cholesterol are correlated with lower incidence of AD.

While this has excellent face validity in that high HDL levels have been correlated with better cardiovascular heatlh in other studies, there is no compelling biological explanation of how or why elevated HDL's would reduce risk for AD. Also, earlier studies on HDL's and AD, conducted by the National Institute on Aging, showed the opposite result. That is, high HDL cholesterol was correlated with a higher risk of AD.

The relationship between cholesterol and AD risk is an area of ongoing study with many questions yet unanswered. However, based on the well documented vascular benefits of controlled cholesterol, it is wise to keep overall cholesterol and HDL cholesterol within the established ranges of good health.

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A better understanding and more awareness of Alzheimer's related issues can impact personal health decisions and generate significant impact across a population of aging individuals. Please use the share button below to spread this educational message as widely as possible.

Managing Risks for Dementia

Contributed by: Dennis Fortier, President, Medical Care Corporation
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One of my favorite types of scientific research is the "review paper" when authors collect and review the literature in a certain field and report on the depth and breadth of findings in the targeted area of study. As such, I was happy to see a recent report by the BBC that the Alzheimer's Society had chaired a panel of experts and reviewed more than 70 research papers on reducing the risk of dementia.

The report contained some elements that may be as surprising as they are important. Notably, they suggested that age 35 is probably the right time to start managing known risks in an effort to ward off dementia later in life.

I strongly suggest you click to read the BBC's synopsis of the report but the highlights are noted here:

Strong Evidence in support of:
- Get Physical Exercise
- Don't Be Obese
- Bring Down High Blood Pressure
- Reduce High Cholesterol
- Don't Smoke

Some Evidence in support of:
- Drink Modest Amounts of Alcohol
- Eat a Mediterranean Diet
- Remain or Become Socially Active

The Jury is out on:
- Brain Training
- Vitamin Supplements

The importance of this review, and other similarly scientific reviews, can not be overstated in this era of aggressive commercialization of unregulated health care solutions. There is a lot of hype in the press that has not yet been scientifically validated. Some of it might ultimately prove to be worthwhile but this review let's you know the current state of the science.

The Unseen Side Effects of a Healthy Heart

Contributed by: Dennis Fortier, President, Medical Care Corporation
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Do you know the chances of surviving a heart attack? According to WebMD, they’re actually pretty good at about 85%.

That doesn’t mean that anyone wants to test the statistics personally nor does “survival” guarantee a high quality of life thereafter. But it may be true that as public awareness grows about heart attack victims who fully recover and live well, the prospect of heart failure becomes less of a deterrent from an unhealthy life style.

In fact, WebMD also notes that survival has become more likely despite the fact that heart attack victims are in generally worse cardio-vascular health (more high blood pressure and diabetes) than in the past. This suggests that the better survival rate is due to better medical techniques, not to a general trend toward improved vascular health.

Healthy Hearts Maintain Healthy Brains
Importantly, there are other, less obvious but perhaps more compelling reasons to care for your heart. Mainly, good vascular health is extremely important to maintaining a healthy brain. While most of us accept the fact that our tennis serve will likely slow as we age, few are so willing to accept the prospect of diminishing cognitive capacity. The good news is that cognitive decline is far from inevitable and we probably don’t need to accept it.

So how does one take good care of their heart and reap the brain related benefits? What exactly should one do? The answer is to focus on managing those risks that are known to be associated with poor heart health.

These risks include monitoring and controlling blood pressure, cholesterol, and body mass. Making the heart work extra hard to pump blood through the body is a strain that, when considered cumulatively across many years, can greatly increase the likelihood of emergent problems. The primary behaviors one should adopt are well known and should not come as a surprise; they are sensible diet and regular physical exercise.

In terms of diet, there are many helpful resources available including a very good one at the Mayo Clinic. In general, one should be sure to get the necessary proteins, vitamins, and minerals while avoiding high calorie foods containing unhealthy amounts of saturated and trans fats.

Regarding physical exercise, it needn’t be overly rigorous as much as it should be regular. Walking may be the most under-rated form of exercise but its benefits to the heart and brain are well documented. Starting each day with a 30-40 minute walk at a pace slightly faster than leisurely is easy on muscles and joints but beneficially demanding on the heart and lungs.

The Unseen Side Effects
The unseen but well established side effects of taking care of one’s heart include a healthier brain and better cognition. Evidence has been pouring in for the last year that these benefits may be much greater than many of us initially understood. In the last few months alone, our knowledge of the link between vascular health and cognitive health has increased significantly.

For example, a study at UCLA showed a strong link between obesity and brain shrinkage, a study published in the journal Neurology showed that high blood pressure is associated with memory loss, and Kaiser Permanente published that even borderline high-cholesterol increases the risk for dementia.

There is no doubt that keeping an oxygen-rich supply of blood flowing freely to the brain is key to maintaining good intellectual health and to aging with cognitive vitality. You can accomplish this through all of the well-established approaches to vascular health that we’ve all been hearing about for decades. The good news is that everything you can do to keep your heart healthy will also benefit your brain.

The purpose of this blog is to spread useful information as broadly as possible. If you found this article worthwhile, please share it with your online networks using the share button below.

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Poor Vascular Health is Bad for Your Brain

Contributed by: Dennis Fortier, President, Medical Care Corporation
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We are virtually swimming (if not drowning) in the evidence that managing your vascular health may be the best approach to maintaining a healthy brain. In the past few days, I have blogged about several studies on this topic and many more have been published in the scientific literature.

To emphasize this important theme, here is a quick review of the very recent evidence:

• This study out of UCLA and published in Human Brain Mapping showed a strong link between obesity and less brain tissue.
• According to Helpguide.org and many other sources, vascular disease follows Alzheimer's disease as the second leading cause of dementia.
• As described in this post about strokes, one may be quite different from another but all impair cognition and vascular risk factors almost always play a role.
• Diet and exercise matter for both vascular and cognitive health. This has been repeatedly verified through careful research and will continue to be a popular theme in the news.
• This study out of the University of Alabama and published in Neurology showed that high blood pressure is linked to memory loss.
• In surprising news, Kaiser Permanente published research showing that even borderline high cholesterol significantly raised the risk of dementia.

The facts are abundant. Please take care of your vascular health and keep that brain functioning at a high level.

A better understanding and more awareness of Alzheimer's related issues can impact personal health decisions and generate significant impact across a population of aging individuals. Please use the share button below to spread this educational message as widely as possible.

Forget "High" Cholesterol, Even Borderline Levels Increase Risk for Dementia

Contributed by: Dennis Fortier, President, Medical Care Corporation
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With today's release of a study from Kaiser Permanente, published in the journal Dementia & Geriatrics Cognitive Disorders, we have strong evidence that even borderline high cholesterol in mid-life (aged 40-45) significantly raises the risk of dementia in later life (aged 65+).

For high cholesterol, defined as 240 or higher milligrams per deciliter of blood, risk for dementia was increased by 66%. More alarming was the finding that even moderately high cholesterol (200+ milligrams per deciliter) increased risk by 52%.

The Kaiser study looked at 9,844 men and women who were 40 to 45 years old between 1964 and 1973 when their cholesterol levels were first collected. Of the total participants, 469 were diagnosed with Alzheimer's disease between 1994 and 2007 when the members were between 61 and 88 years old, and 127 developed vascular dementia.

The good news is that cholesterol levels can often be modified through diet, exercise and lifestyle changes in addition to cholesterol lowering drugs. This news should serve as additional evidence about the importance of maintaining good cardiovascular health as a means of reducing risk for dementia.