Posted by on November 23, 2014 - 5:33pm

The cognitive decline associated with Alzheimer's Disease (AD) may be related to the particular pathology of this disease which researchers continue to study.  One study at Stanford suggests that if you slow the pathology (biologic)  progression it could slow the path to full dementia.   In other words, if you stay healthier, you may slow the biological process that causes the progression of dementia.  Some suggested tactics:

  • Improve brain health by reducing cardiovascular risks caused by hypertension, diabetes, smoking, and high cholesterol
  • Enhance cognitive reserve through mental stimulation (working, leisure activities and social engagement)
  • Reduce the burden of AD pathology with regular aerobic exercise.

While we haven't found a "cure" for AD yet, it makes sense to try whatever possible to "slow" its devastating effects.   All of these activities have many health benefits, so why not??? Source:  Henderson VW.  Climacteric 2013:17(suppl 2) 38-46.

Posted by on May 7, 2014 - 9:57pm

The average age of menopause in the United States is around 51 years old, but the onset can widely vary. Premature menopause refers to menopause of onset at or before 40 years of age. This can occur because of  a variety of causes, including surgery (i.e. bilateral oophorectomy, removal of ovaries), chemotherapy or pelvic radiation treatments for cancer, chromosomal or genetic defects, and spontaneous premature ovarian failure.

For women undergoing premature menopause, symptoms can be similar to those of regular menopause. Symptoms include  hot flashes, night sweats, vaginal dryness, and mood changes. Longitudinally, however, the symptoms may different between those who undergo premature menopause and those who undergo menopause at roughly the average age. New research shows that premature menopause may be associated with long-term negative effects on cognitive function.

A study based on a sample of 4868 women tested cognition at baseline, two, four, and seven years, and it also looked at the effects of the type of menopause, whether natural or surgical, could play a role.

Natural menopause was reported by 79% of the 4868 participants, 10% underwent menopause from surgical causes, and 11% reported menopause from other treatment causes including radiation or chemotherapy. Approximately 7.6% of the women in the study had a premature menopause, and the study further delineated 12.8% of the women had an early menopause (between 41 and 45 years of age).

Results showed that women who underwent premature menopause had a more than 40% increased risk of poor performance on verbal fluency and visual memory tasks, compared to those who experienced menopause at or after the age of 50. Women who underwent premature menopause also were associated with a 35% increased risk of decline in psychomotor speed. There was no significant association with the risk of dementia.

Both premature menopause secondary to surgery and premature ovarian failure, were associated with long-term negative effects on cognitive function, which cannot entirely be answered by hormone therapy. Researchers agree more studying needs to be done to better understand the potential benefits using hormone therapy.

Healthcare professionals should be aware of the potentially significant impact premature menopause can have on cognitive function in later life. Professionals should also consider these effects when aiding younger women in the decision-making process of undergoing oophorectomy. To learn more about how menopause can affect you long-term, visit Northwestern's menopause website here.

Source: J Ryan, J Scali, I Carrière, H Amieva, O Rouaud, C Berr, K Ritchie, M-L Ancelin.Impact of a premature menopause on cognitive function in later lifeBJOG: An International Journal of Obstetrics & Gynaecology, 2014; DOI: 10.1111/1471-0528.12828

Posted by on January 2, 2014 - 11:23pm

Do hormone levels in postmenopausal women affect cognitive function? New research sheds light on the postmenopausal brain.

In a recently published study, researchers found that estrogen levels after menopause may have no impact on cognitive skills, but progesterone levels might. Progesterone had some association with global cognition and verbal memory among newly postmenopausal women.

643 healthy postmenopausal women were part of the study, ranging from 41 to 84 years old. Neuropsychological tests were done to assess cognition and memory, and hormone levels were determined including estradiol, estrone, progesterone, and testosterone. The findings showed no association between estrogen and cognitive skills. However, women with higher levels of progesterone had better outcomes on the verbal memory and global cognition tests, particularly in those who had started menopause less than six years prior. None of the hormones appeared to have any association with depression or mood either.

More research must be done to confirm the new findings regarding progesterone levels. Also, there is no way to directly measure hormone concentrations at the brain level, but this research implies that estrogen therapy may not have a significant effect on cognitive skills. To learn more about when hormone therapy is beneficial , visit Northwestern's menopause website here.


Source reference: Henderson VW, et al "Cognition, mood, and physiological concentrations of sex hormones in the early and late menopause" PNAS 2013; DOI: 10.1073/pnas.1312353110.

Posted by on September 10, 2012 - 9:04am

New research shows that women with Alzheimer’s disease show worse mental deterioration than men, even when at the same stage of the the disease.

According to researchers at the University of Hertfordshire, men with Alzheimer’s consistently performed better than women across the five cognitive areas they examined.

Most remarkably, the verbal skills of women with Alzheimer’s are worse when compared to men with the disease.   This finding is a striking difference to the profile for the healthy population where females have a distinct advantage.

Led by Keith Laws, Ph.D., the research team completed a meta-analysis of neurocognitive data from 15 published studies, which revealed a consistent male advantage on verbal and visuospatial tasks, as well as on tests of both episodic memory and semantic memory.

Episodic memory describes our ability to recall specific events of our own past, accompanied by the feeling of remembering. Semantic memory is knowledge that we acquire that is purely factual without any personal feeling or history attached.

“Unlike mental decline associated with normal aging, something about Alzheimer’s specifically disadvantages women,” said Laws, a psychology professor.

The influence of hormones might be a possible explanation, he said, pointing to a loss of estrogen in women. Another theory is that men have a “greater cognitive reserve” that protects against the disease, he said.  Further analysis of the data showed that age, education level and dementia severity did not explain the advantage that men with the disease have over women, he added.

Alzheimer’s disease, a progressive condition affecting memory, thinking, behavior and emotion, is the most common form of dementia.

Alzheimer’s Disease International estimates that there are currently 30 million people in the world with dementia, with 4.6 million new cases every year. The incidence of Alzheimer’s is greater among women than men, with the difference increasing with age, researchers note.

The new study was published in the Journal of Clinical and Experimental Neuropsychology.

Source: University of Hertfordshire

Posted by on January 2, 2012 - 7:42am

Eating fish at least once a week could help lower older patients' risk of developing dementia, according to Cyrus Raji, MD, PhD, from the University of Pittsburgh and colleagues reported at the Nov. 2011 Radiological Society of North America meeting.

Those who ate baked or broiled -- but not fried -- fish on a weekly basis had a greater volume of gray matter in areas of the brain associated with Alzheimer's disease than people who didn't eat fish as often.  Preserving brain volume was also associated with lower rates of developing cognitive impairment, he said.

"Fish consumption benefits gray matter volume, potentially reducing the risk of [Alzheimer's disease and dementia] long-term," Raji said during a press briefing.

Although a National Institutes of Health panel decided last year that nothing conclusively prevents Alzheimer's disease, researchers continue to investigate whether a healthy diet, or specific components thereof, can have any beneficial effects.

For their study, Raji and colleagues assessed 260 people, mean age 71, when they enrolled in the Cardiovascular Health Study between 1989 and 1990. At that time, they filled out questionnaires on dietary intake; 163 reported eating fish at least weekly, and some did so as often as four times a week.

All patients had an MRI 10 years later to assess brain volume, and then had follow-up cognitive testing between 2002 and 2003.

The researchers found that patients who ate fish at least once a week had greater volume in the frontal lobes and the temporal lobes, areas responsible for memory and learning, which are severely affected in Alzheimer's disease, Raji said.

Five years after the MRI, they found that 30.8% of patients who had low fish intake had developed mild cognitive impairment or dementia, compared with just 3.2% of those who had the highest fish intake and the greatest preservation of brain volume.

They also saw that 47% of patients with brain atrophy who didn't eat fish had abnormal cognition five years later compared with 28% of those who ate more fish and had more gray matter volume, Raji reported. "That's an impressive reduction in the risk of developing mild cognitive impairment of Alzheimer's," Raji said.

In further analyses, the researchers found that mean scores for working memory -- a function severely impaired in Alzheimer's disease -- were significantly higher among those who ate fish weekly and those findings persisted even after accounting for potential confounders.

This "simple lifestyle choice" of eating more fish increases the brain's "resistance" to Alzheimer's disease, Raji said, potentially via a few mechanisms: Fish are rich in omega-3 fatty acids, which can help increase blood flow to the brain and can also act as an antioxidant, thereby reducing inflammation, he said.

Omega-3s may also prevent the accumulation of amyloid plaques in the brain, he added.   He noted that fatty fish like salmon have more omega-3s, while smaller fish, such as cod, have less.

Although dietary intake of fish was measured only twice -- once at baseline and again in 1995 -- Raji said patients tended to maintain their levels of consumption, and he suspects that the observed benefits "are more likely to be observed if eating fish is a long-term habit as opposed to a short-term approach."

Mary Mahoney, MD, of the University of Cincinnati, who was not involved in the study, said that future studies should investigate whether omega-3s specifically are leading to benefits in brain volume.

"We're making the assumption" that fish is a marker for healthy lifestyle, she said. "If we could just cut to the chase and look at the protective mechanism, that would be better."

It's important to note  that the findings are preliminary and should be replicated in a larger sample and sex differences should be included since Altzeimer's is more prevalent in women.  In the meantime, it can't hurt to add fish to your diet...for many reasons!

Source reference:
Raji C, et al "Fish consumption, brain structure, and risk of Alzheimer's disease" RSNA 2011.

Posted by on June 24, 2011 - 10:07am
Testosterone Molecule

Testosterone might protect the memory of healthy aging women, according to a small open-label pilot study reported at the Endocrine Society 93rd Annual Meeting held in June 2011.  Nine postmenopausal women who used a transdermal testosterone spray for about 6 months saw improvements over baseline in verbal learning and memory. A group of matched untreated women saw no change from baseline in their test results. The study was small and further exploration is needed but the idea has merit.

"The results of our study offer a potential therapy, where none currently exists, to slow cognitive decline in women," said lead investigator Sonia Louise Davison, MD, PhD, from the Women's Health Research Program at Monash University in Melbourne, Australia. "Testosterone should be further studied in randomized placebo-controlled trials to determine whether it improves cognitive performance in postmenopausal women," she added.

At a press briefing, Dr. Davison said predictions of the number of people who will develop dementia in the coming years are "pretty worrying." Dementia is set to become an "enormous" and costly public health problem. Women develop dementia at double the rate of men; lower testosterone levels in women might play a role in this sex difference.

Dr. Davison's team explored the effects of testosterone on cognitive performance in 9 nondepressed cognitively normal women. The women were between 47 and 60 years of age (mean age, 55 years) and were receiving stable-dose hormone replacement therapy that was not administered orally. They applied the testosterone spray to the abdomen once daily for 26 weeks. A control group of 30 women provided normative data for comparison.At baseline and 26 weeks, all of study subjects took a computerized cognitive test battery, called CogState, which is capable of detecting small changes in cognitive performance, Dr. Davison explained.

There were no differences between the 2 groups in any parameter at baseline.After 26 weeks, "significant improvements" from baseline were observed in learning (verbal and visual) and memory in the testosterone group. In contrast, there were no significant differences between baseline and 26 weeks in the control group.

Support for the Neuroprotective Effects of Testosterone

Dr. Davison called these results "exciting," and said they provide more evidence that testosterone exerts neuroprotective effects.In men, age-related declines in testosterone increase the risk for Alzheimer's disease, she said. It's been shown that healthy older men and men with mild cognitive impairment and early dementia have demonstrated improvements in cognitive performance, including memory, after testosterone treatment.

"There obviously is some important link between testosterone and cognition that needs to be explored further," Dr. Davison said.

The testosterone spray used in the study is "novel," she noted, "in that it uses a propellant of sunscreen to introduce the testosterone into the skin."

Source:   Medscape Medical News for ENDO 2011: The Endocrine Society 93rd Annual Meeting: Abstract P1-314. Presented June 4, 2011.

Posted by on April 12, 2011 - 9:02am

Scientists have discovered four new genes associated with an increased risk of late-onset Alzheimer’s disease. The findings will help researchers explore new therapies and allow doctors to better predict who will develop the disease.

The Alzheimer’s Disease Genetics Consortium conducted the research in collaboration with 44 different universities and research centers, including Northwestern University. The study, published in the current issue of Nature Genetics, is the largest of its kind.

The results of the study double the number of genes currently known to contribute to Alzheimer’s. Of the four genes previously confirmed, the gene for apolopoprotein E-e4, called APOE-e4, has the largest effect on risk. The genes discovered in this study are called MS4A, CD2AP, CD33 and EPHA1.

Alzheimer’s disease affects more than 13 percent of people age 65 and older and nearly half of those 85 and older. Women are more likely than men to have this common form of dementia, possibly because women have a higher life expectancy.

Although there are currently no effective treatments or preventative measures for Alzheimer’s, the ability to predict who will develop the disease will be important when preventative steps become available. The findings will also help researchers identify the disease’s earliest stages and understand the events leading to brain damage. Alzheimer’s is associated with the destruction of large parts of the brain and is characterized by the loss of cognitive abilities, including memory loss and intellectual decline.

Posted by on December 17, 2010 - 6:04pm

Hormone Therapy Use May Increase Or Decrease Dementia Risk Depending Upon Timing

Compared to women never on hormone therapy, those taking hormone therapy only at midlife had a 26 percent decreased risk of dementia; while women taking HT only in late life had a 48 percent increased risk of dementia, according to Kaiser Permanente researchers.   Women taking HT at both midlife (mean age 48.7 years) and late life had a similar risk of dementia as women not on HT, according to the study which appears in the Annals of Neurology. The study was funded in part by the National Institutes of Health.

Although previous research has shown that initiation of postmenopausal estrogen hormone therapy in late life increases the risk of dementia, animal studies and some observational studies have suggested that midlife use of HT may be beneficial. This is the first observational, long-term study to directly compare the effect of hormone therapy status in both midlife and late life on risk of dementia.

"This study is unique because we had a group of women who were on HT in midlife only and could look at their dementia risk over time, and we found a modest, protective association. We also found that if you start HT late in life, you have a 50 percent increased risk of dementia, which is consistent with other studies," said study lead author Rachel Whitmer, PhD, a research scientist with the Kaiser Permanente Division of Research in Oakland, Calif. "Women should speak with their doctor about what's best for their individual situation, however it appears from this study that women who are on short-term HT in midlife may benefit from a modest protective association, while initiation in late-life can cause harm."

Adjustment for high cholesterol, hypertension and stroke did not reduce the magnitude of the effect of late life HT on increased risk of dementia, according to the researchers. It's also possible that in the group of women who used HT both in midlife and late life; the potential modest benefit of midlife use was counteracted by a negative effect of late life use, they explained.

This study is part of an ongoing body of research at Kaiser Permanente to better understand the modifiable risk factors for dementia.

Limitations of this most recent study include the fact that HT information in midlife was self-reported and therefore researchers do not know the dose or type of HT involved. Also, because the pharmacy database was initiated in 1994, researchers do not have information on the duration of midlife HT.

Source: Kaiser Permanente

Posted by on November 12, 2010 - 10:59am

Alzheimer's disease affects twice as many women as it does men, according to a new report that portrays women as being "under siege" by the dreaded condition.

Created in conjunction with California first lady Maria Shriver, "The Shriver Report: A Woman's Nation Takes on Alzheimer's" shows that two-thirds of the people living with Alzheimer's are women, and 60 percent of Alzheimer's caregivers are women.  Shriver became involved in the issue when her father, Sargent Shriver, 94, was diagnosed with the disease in 2003.

The report finds that primary caregivers to Alzheimer's patients are six times more likely to develop the disease, or other forms of dementia, themselves, in part because of the emotional stress and physical demands of providing care to relatives and loved ones.

The estimated societal impact of the disease on government and businesses is $300 billion a year, according to the report.

Scripps Howard News Service

Posted by on September 24, 2010 - 2:47pm

Older men may be at risk of developing mild cognitive impairment (MCI), often a precursor to Alzheimer’s disease, earlier in life than older women, according to a study appearing today in Neurology. The study raises the question of whether there may be a gender difference in the development and progression of MCI.

Scientists evaluated the cognitive health of 1,969 dementia-free older people and found 16 percent showed signs of MCI, a condition usually marked by memory problems or other cognitive problems greater than those expected for their age. Prevalence was greater among the older participants, and it was consistently higher in men than women across all age ranges.

Ronald C. Petersen, Ph.D., M.D., and his team at the Mayo Clinic, Rochester, Minn., conducted the research.

"Because evidence indicates that Alzheimer's disease may cause changes in the brain one or two decades before the first symptoms appear, there is intense interest in investigating MCI and the earliest stages of cognitive decline," said National Institute on Aging (NIA)  Director Richard J. Hodes, M.D. "While more research is needed, these findings indicate that we may want to investigate differences in the way men and women develop MCI, similar to the way stroke and cardiovascular disease risk factors and outcomes vary between the sexes."

The researchers conducted in-person evaluations of 1,969 randomly selected people from all 70- to 89-year-olds living in Olmsted County, Minn. Results of the study indicated that:

  • Overall, MCI was more prevalent in men (19 percent) than in women (14 percent), even after adjusting for several demographic variables and clinical factors, such as hypertension and coronary artery disease.
  • Of the 16 percent affected with MCI, over twice as many people had the amnestic form that usually progresses to Alzheimer’s disease and the prevalence rate was higher in men than in women.
  • MCI prevalence was higher among people with the APOE e4 gene, a known risk factor for late-onset Alzheimer's, a form of the disease that usually occurs at age 65 or older.
  • A greater number of years spent in school was significantly associated with decreased MCI prevalence, from 30 percent among participants with less than nine years of education to just 11 percent in those with more than 16 years of education.
  • MCI prevalence was higher in participants who never married, as opposed to those currently or previously married.

The researchers noted that estimates of MCI prevalence vary in studies conducted around the world but generally fall into a range of 11 to 20 percent. The Mayo team's evaluation of participants included detailed in-person assessments that helped to capture the subtle changes in daily function that may mark the onset of MCI, Petersen said. The researchers also noted that the study’s limitations include a relatively low participation rate by Olmstead County residents and the fact that the population is predominantly white. Thus, these findings may not apply to other ethnic groups.

Source:  NIH National Institute on Aging