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Bones and Alzheimer’s

Bones and Alzheimer’s

Whoever would have thought that bone health could impact the development of dementia?  Until I learned about new research in this regard, I wouldn’t have connected the two.  The operant word here is “health” and that is a function of exercise.  Now, if you’ve read these newsletters in the past you’re probably thinking; Oh boy, here comes another sermon on the value of exercise.  And guess what?  You’re right!

The research connecting the two is from the fields of neuroscience and endocrinology.  It turns out that our bones are an endocrine organ that produces a hormone called osteocalcin.  Osteocalcin acts on many organs in the body including the brain but also on gene expression (the functionality of genes).  Regular exercise promotes bone mass (helping prevent fracture) and the increased mass leads to higher output of osteocalcin. 

At a brain level osteocalcin improves the production of serotonin, dopamine, GABA and other neurotransmitters.  These chemicals are vital to establishing new memories and maintaining previous memories. 

At a genetic level osteocalcin ramps up gene expression (function) of RbAp48.  This gene is critical for protein formation that allows the brain to convert short term memory to long term memory. Research in mice demonstrated that a normal part of aging is reduced osteocalcin production which is also true in humans hence the usual “benign senescent forgetfulness” which is not dementia.  But in mice, experiments knocking out the RbAp48 gene led to very early and rapid onset of dementia.  Injecting RbAp48 into these young, demented mice allowed recovery of memory function.  The next step will be to extend these findings to humans

CrossFit vs Crosswords

CrossFit vs Crosswords

By: Sasha Klemawesch, MD

A few years ago, I wrote about a potential vaccine for Alzheimers. We are still a while away from having one on the market, especially since the initial trials had to be aborted due to brain swelling and other unwanted side effects. (Don’t lose hope though, a new formulation is in development and undergoing clinical validation studies.)

But in the meantime, there are many non-pharmacologic things you can do to keep your brain healthy.

When asked, “What’s the best thing to do to keep your mind sharp and ward off dementia?” Most people (myself included) would answer “crosswords” or some other sort of brain teaser. Turns out…. Yes … and/but … No.

In his new book, “Keep Sharp”, Dr Sanjay Gupta discusses strategies for preserving brain function, and he talks about the myth of the crossword puzzle. If you are someone who does crosswords, or sudoku’s, or some other form of mental exercise every day, you might not be getting as much benefit from them as you had hoped. Over time it becomes a ‘practice-makes-perfect’ phenomenon, where your brain learns how to perform the task and therefore it is no longer a struggle to complete it. The key to enhancing cognitive function (at any age) is to challenge the brain. You want to create new neural connections and force it to forge new pathways. By doing so you literally and figuratively grow your brain size. But the only way to form new neuronal paths is to engage in new activities.

If you love crosswords, by all means, keep doing them. But add in different sorts of puzzles, like cryptograms or kakuros. Even better, do something physically stimulating rather than just mentally so. Physical activity is one of THE most important aspects of maintaining a healthy brain. And despite the name of this article, you do not have to start dead-lifting 300 lbs. or running triathlons. A little exercise goes a long way.

If you spend a good deal of the day watching TV, simply standing at each commercial – yes, just standing up – will have enormous benefits. Better yet, stand and do squats. If you are more a book reader, get up at the end of each

chapter and walk around the kitchen island 10 times or march in place for 1 minute. It might sound inconsequential, but those little things will add up. Even better than doing a few minutes here and there inside your house would be to get outside in the fresh air for a walk. And if you can do it with a friend, all the better. Dr Gupta calls that a “brain trifecta.” By (1) moving, (2) socializing and (3) destressing, you “measurably detoxify” your brain, and the spontaneity inherent to friendly conversations means your brain can’t anticipate what will come up during the interaction, so you end up engaging multiple regions of it. Also, research has shown that there is an inverse proportion between your risk of cognitive decline and the size of your social network.

Finally, don’t waste your time on supplements. There is no magic pill that can prevent cognitive decay. Eating a healthy balanced diet with lots of fresh fruits and veggies, while limiting refined sugar and saturated fats will get you the antioxidants and brain food you need.

An allergy shot for Alzheimer’s? In the pipeline. . .

An allergy shot for Alzheimer’s? In the pipeline. . .

By:  Sasha Klemawesch, RN, MD

Well…sort of.  Alzheimer’s has been and continues to be one of the most frustrating diseases for researchers, patients, and caregivers alike.  But there may be hope on the horizon.

A new immune therapy called Aducanumab – an antibody against B-Amyloid – is undergoing human testing right now.  B-Amyloid leads to plaque creation and deposition in the brain, and those plaques, along with neurofibrillary tangles  caused by the Tau protein, are the two key pathologic findings in the neuro-degeneration seen in Alzheimer’s.

The early data is promising; the drug has shown to significantly decrease plaque burden in the recipients’ brains, and many of those same patients showed delay in cognitive decline based on a simple mental status test.  However, they did not have similar clinical improvements in cognition scores on more complex/comprehensive testing.  It is also not known whether this drug may be able  to prevent high-risk populations from developing the disease in the first place.

Obviously, more testing needs to be done, but this drug has been hailed by many Alzheimer’s researchers as “very exciting”  and overall, the best news we’ve had in 25 years of Alzheimer’s clinical research.

In the meantime, there are a few basic things you can do that have already been proven to help decrease your risk for dementia:

Exercise: Staying active helps in several ways; angiogenesis neurogenesis, and synaptogenesis.  In lay terms, exercise improves blood flow (and therefore oxygen) to and in the brain, helps prevent brain cell loss and improves the connection between brain cells.

Sleep:  The B-Amyloid we just talked about?  The body normally clears it out while you sleep, and studies have shown that even one night of sleep deprivation can lead to an increase in that protein.

Wear a helmet:  sustaining certain types of traumatic brain injuries may increase the risk for developing Alzheimer’s and other forms of dementia.

Eat right:  heart healthy diets like the DASH or Mediterranean diets are good, not only for your heart, but evidence has shown they can protect the brain as well.

Don’t worry, be happy:  multiple studies have shown that older adults who are depressed are more than 50% more likely to develop dementia.