Glucose Levels and Risk of Dementia
Paul K. Crane, M.D., M.P.H., Rod Walker, M.S., Rebecca A. Hubbard, Ph.D., Ge Li, M.D., Ph.D., David M. Nathan, M.D., Hui Zheng, Ph.D., Sebastien Haneuse, Ph.D., Suzanne Craft, Ph.D., Thomas J. Montine, M.D., Ph.D., Steven E. Kahn, M.B., Ch.B., Wayne McCormick, M.D., M.P.H., Susan M. McCurry, Ph.D., James D. Bowen, M.D., and Eric B. Larson, M.D., M.P.H.
N Engl J Med 2013; 369:540-548August 8, 2013DOI: 10.1056/NEJMoa1215740
Our results suggest that higher glucose levels may be a risk factor for dementia, even among persons without diabetes. (Funded by the National Institutes of Health.)
Omega 3 fatty acid for the prevention of cognitive decline and dementia
Sydenham, Emma, Dangour, Alan D., & Lim, Wee-Shiong. (2012). Omega 3 fatty acid for the prevention of cognitive decline and dementia. Sao Paulo Medical Journal, 130(6), 419. Retrieved April 28, 2014, from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802012000600013&lng=en&tlng=en. 10.1590/S1516-31802012000600013.
AUTHORS’ CONCLUSIONS: Direct evidence on the effect of omega-3 PUFA on incident dementia is lacking. The available trials showed no benefit of omega-3 PUFA supplementation on cognitive function in cognitively healthy older people. Omega-3 PUFA supplementation is generally well tolerated with the most commonly reported side-effect being mild gastrointestinal problems. Further studies of longer duration are required. Longer-term studies may identify greater change in cognitive function in study participants which may enhance the ability to detect the possible effects of omega-3 PUFA supplementation in preventing cognitive decline in older people.
Midlife overweight and obesity increase late-life dementia risk
A population-based twin study
W.L. Xu, MD, PhD, A.R. Atti, MD, PhD, M. Gatz, PhD, N.L. Pedersen, PhD, B. Johansson, PhD and L. Fratiglioni, MD, PhD
Conclusions: Both overweight and obesity at midlife independently increase the risk of dementia, AD, and VaD. (Alzheimer disease (AD), and vascular dementia (VaD) Genetic and early-life environmental factors may contribute to the midlife high adiposity–dementia association.
Possible Role of Vascular Risk Factors in Alzheimer’s Disease and Vascular Dementia.
The contribution of vascular risk factors to Alzheimer-vascular spectrum dementias is increasingly being recognized. We provide an overview of recent literature on this subject. Overweight and obesity as well as underweight during midlife predict cognitive decline and dementia later in life. Hypertension during midlife is also associated with dementia later in life and the association is stronger for untreated hypertension. Calcium channel blockers, angiotensin converting enzyme inhibitors, and angiotensin-1 receptor-blockers may be particularly beneficial in diminishing the risk of dementia associated with hypertension. Studies have fairly consistently shown that type 2 diabetes is a risk factor for dementia. Episodes of hypoglycemia add to this risk. Regular physical exercise during any point in the lifespan protects against cognitive decline and dementia. Most benefit is realized with physical exercise during early and midlife. Dyslipidemia also increases the risk of dementia but the findings are less consistent. Findings on the possible benefit of lipid-lowering agents (statins) are conflicting. Earlier studies identified smoking as protective of dementia but recent better designed studies have consistently shown that smoking increases the risk of dementia. The association of vascular risk factors with dementia is more robust for vascular dementia than Alzheimer’s disease. Heterogeneity of studies and lack of trials specifically designed to assess cognition as an endpoint make firm conclusions difficult. But considering the expected global burden of dementia and projected attributable risk of vascular risk factors to it, there is sufficient evidence to promote vascular risk factor reduction strategies as dementia prevention interventions.
Yaffe K, Laffan AM, Harrison S, et al. Sleep-Disordered Breathing, Hypoxia, and Risk of Mild Cognitive Impairment and Dementia in Older Women. JAMA. 2011;306(6):613-619. doi:10.1001/jama.2011.1115.
Context Sleep-disordered breathing (characterized by recurrent arousals from sleep and intermittent hypoxemia) is common among older adults. Cross-sectional studies have linked sleep-disordered breathing to poor cognition; however, it remains unclear whether sleep-disordered breathing precedes cognitive impairment in older adults.
Objectives To determine the prospective relationship between sleep-disordered breathing and cognitive impairment and to investigate potential mechanisms of this association
Conclusion Among older women, those with sleep-disordered breathing compared with those without sleep-disordered breathing had an increased risk of developing cognitive impairment.