Category Archives: Dementia

Diabetes and Alzheimer’s Dementia: What’s the Connection?

Posted on April 23, 2016 | Comments Off on Diabetes and Alzheimer’s Dementia: What’s the Connection?
dementia, memory loss, Mediterranean diet, low-carb diet, glycemic index, dementia memory loss

“More basic research is critical.”

Several scientific studies, but not all, link type 2 diabetes with Alzheimer’s disease. Some go so far as to say Alzheimer’s is type 3 diabetes.

My Twitter feed brought to my attention a scientific article I thought would clarify the relationships between diabetes, carbohydrate consumption, and Alzheimer’s dementia (full text).

It didn’t.

Click the full text link to read all about insulin, amylin, insulin degrading enzyme, amyloid–β, and other factors that might explain the relationship between type 2 diabetes and Alzheimer’s dementia. You’ll also find a comprehensive annotated list of the scientific studies investigating the link between diabetes and Alzheimer’s.

Bottom line: We still don’t know the fundamental cause of Alzheimer’s disease. A cure and highly effective preventive measures are far in the future.

Action Plan For You

You may be able to reduce your risk of Alzheimer’s disease by:

  • avoiding type 2 diabetes
  • preventing progression of prediabetes to diabetes
  • avoiding obesity
  • exercising regularly
  • eating a Mediterranean-style diet

Carbohydrate restriction helps some folks prevent or resolve obesity, prediabetes, and type 2 diabetes. A low-carb Mediterranean diet is an option in my Advanced Mediterranean Diet (2nd edition).

Steve Parker, M.D.

Reference: Schilling, Melissa. Unraveling Alzheimer’s: Making Sense of the Relationship Between Diabetes and Alzheimer’s Disease. Journal of Alzheimer’s Disease, 51 (2016): 961-977.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

 

 

 

 

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Seafood Consumption May Protect Against Alzheimers Dementia

Posted on February 5, 2016 | Comments Off on Seafood Consumption May Protect Against Alzheimers 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 clinically diagnosis of dementia.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

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How to Preserve Brain Function Despite Aging

Posted on March 10, 2014 | Comments Off on How to Preserve Brain Function Despite Aging

There are ways of slowing or reversing losses in cognitive function. The most effective discovered so far is physical exercise, which protects the brain by protecting the body’s cardiovascular health. Mental exercise, often called brain training, is widely promoted, but it boosts only the particular skill that is practised – its narrow impact mirroring that of educational interventions at other ages. Various drugs are being investigated for their value in staving off normal cognitive decline, but for now preventive maintenance is still the best bet – avoid smoking, drinking to excess, head injuries and the like.

Don’t forget regular exercise. Also, I think the Mediterranean diet helps preserve brain function, but it’s difficult to prove.

MRI scan of brain

MRI scan of brain

That quotes from an Instant Expert paper on intelligence. It’s full of interesting facts such as the typical difference in IQ between strangers is 17 points. It answers the question whether an enriched school or home environment can increase intelligence.

The article mentions overload of patients’ brains when medical care is too complicated:

Given the complexity of self-care regimes, it is hardly surprising that some people make dangerous errors or fail to comply. The effective management of diabetes, for example, requires a person to keep blood sugar levels within a healthy range, which means coordinating diet, exercise and medication throughout the day, which in turn requires planning for contingencies, recognising when blood sugar is veering too high or low, knowing how to regain control and conceptualising the imperceptible but cumulative damage caused by failing to maintain control. There is no set recipe for people with diabetes to follow – their bodies and circumstances differ. Moreover, they get little training, virtually no supervision and no days off. Effectively managing your diabetes is a cognitively complex job and poor performance has serious consequences, including emergency room visits, lost limbs or eyesight, and even death. The lower the diabetic person’s IQ, the greater the risks.

You’ll also learn about the Flynn effect and possible explanations for it:

Over the past century, each successive generation has answered more IQ test items correctly than the last, the rise being equivalent to around 3 IQ points per decade in developed nations. This is dubbed the “Flynn effect” after the political scientist James Flynn, who most thoroughly documented it. Are humans getting smarter, and if so, why? 

I’m more inclined to think Idiocracy describes our future.

Steve Parker, M.D.

h/t James Fulford

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Mediterranean Diet Helps Preserve Brain Function

Posted on February 21, 2014 | Comments Off on Mediterranean Diet Helps Preserve Brain Function

Well, perhaps that’s a bit of an overstatement. Preserved brain function and the Mediterranean diet were  positively associated in a study involving Americans in Utah. This fits with prior observations that the Mediterranean diet prevents dementia.

Macadamia nuts

In the study at hand, the DASH diet (Dietary Approaches to Stop Hypertension) also protected the brain:

Higher levels of accordance [compliance] with both the DASH and Mediterranean dietary patterns were associated with consistently higher levels of cognitive function in elderly men and women over an 11-year period. Whole grains and nuts and legumes were positively associated with higher cognitive functions and may be core neuroprotective foods common to various healthy plant-centered diets around the globe.

See the American Journal of Clinical Nutrition for details.

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Mediterranean Diet Once Again LInked to Reduced Age-Related Brain Decline

Posted on November 14, 2013 | Comments Off on Mediterranean Diet Once Again LInked to Reduced Age-Related Brain Decline

…particularly in Australian men at high genetic risk for Alzheimer’s disease. MedPageToday has the details.

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Higher Blood Sugar Levels Once Again Linked to Dementia

Posted on August 7, 2013 | 4 comments
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 an 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 2000 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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Alzheimer’s Disease NOT Related to Abnormal Blood Sugar Metabolism….This Week Anyway

Posted on July 29, 2013 | 2 comments
MRI scan of brain

MRI scan of brain

Several studies over the last few years have pointed to a positive association between Alzheimer’s dementia and abnormal glucose metabolism, such as diabetes, elevated blood sugars, and insulin resistance.

A new study finds no such linkage. See JAMA Neurology for details. The study at hand even included autopsy results. We don’t see that very often these days.

MedPageToday has a write-up also.

When I see multiple conflicting reports on a clinical issue over a number of years, it makes me think the reported association is weak or nonexistent.

Steve Parker, M.D.

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ACE Inhibitors May Slow Rate of Decline in Dementia

Posted on July 26, 2013 | Comments Off on ACE Inhibitors May Slow Rate of Decline in Dementia

Larry Huston has the details. ACE inhibitors are commonly used to treat high blood pressure.

The ACE inhibitors in the study were perindopril, ramipril, trandolapril, captopril, fosinopril, lisinopril, prinivil and monopril.

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Protect Your Aging Hippocampus (and Memory) With Exercise

Posted on July 16, 2013 | Comments Off on Protect Your Aging Hippocampus (and Memory) With Exercise

…according to an article at MedPageToday. The 317 study participants were at high risk of Alzheimer’s dementia due to family history. The protective dose of exercise was at least 7.7 MET per hour/week. Please comment if you can translate that into something practical!

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Insulin Resistance Linked to Brain Shrinkage (Atrophy)

Posted on May 29, 2013 | Comments Off on Insulin Resistance Linked to Brain Shrinkage (Atrophy)
MRI scan of brain

MRI scan of brain

…according to a new report in Diabetes Care.  As if that weren’t bad enough, brain functioning was also adversely affected! The next question is: Would prevention or reversal of insulin resistance preserve the brain?  Stay tuned, because nobody knows yet.

Only a few of the study participants had diabetes.  The study at hand supports others that suggest diabetes predisposes to dementia.

What Can I Do About It Now?

You could have your doctor order some expensive blood tests to see if you’re insulin resistant. (Insurance may not pay for them, either.) Or you can measure your waist size. If your waist circumference is over 39 inches (99 cm) and you’re overweight or obese, odds are good that you have some insulin resistance.

A couple ways to improve your insulin sensitivity (reduce insulin resistance) are:

  • lose your excess fat weight
  • start a regular exercise program

Steve Parker, M.D.

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