Tag Archives: diabetes

How to Reduce Your Dementia Risk in 2017

2017 is almost upon us, and that means it’s time for New Year’s resolutions. Many of us resolve to lose weight, quit smoking, or spend less money. However, I’d like to suggest a new resolution for you to try out this year: improving the health of your brain. Though Alzheimer’s disease and other dementias are not completely preventable, there are a variety of steps you can take to substantially reduce your risk. The younger an age you start implementing these simple lifestyle changes, the more benefits you will reap, but it’s never too late to start protecting your brain.

Tip #1: Improve Your Oral Hygiene

Nearly half of all adults in America have periodontitis, a severe form of gum disease that gradually destroys the bone sockets holding your teeth in place, resulting in tooth loss. Recent evidence suggests that the bacteria  that cause periodontitis may be able to enter the brain, and their presence has been correlated with reduced cognitive function. Protect your mouth and your brain by brushing twice per day, flossing once per day, and visiting the dentist twice per year. To read more see How Oral Hygiene Protects Your Brain From Dementia

Tip #2: Get Your Daily Dose of Vitamin D

A recent meta-analysis concluded that vitamin D deficiency is a strong risk factor for dementia. Vitamin D is not easily obtained through food, but our bodies can synthesize it when our bare skin (without sunscreen) is exposed to sunlight. The time required to meet your daily dose of vitamin D depends on your skin tone, the amount of sunlight available, and how much skin you have exposed. On a sunny summer day, 10-15 minutes is often enough. You may want to consider taking vitamin D supplements during the winter, if you live in an often-cloudy area, or if you do not go outside every day.

Tip #3: Reduce Your Risk of Diabetes

Nearly 30 million Americans (around 10% of the total population) have diabetes, and another 86 million are prediabetic. People with diabetes have an approximately 54% higher risk of Alzheimer’s disease. According to the NIH’s Diabetes Prevention Program, even people at high risk of diabetes can prevent the disease through a combination of weight loss (5-7% of your total body weight), a healthy diet, and regular exercise. The National Diabetes Education Program offers lots of great tips for transitioning to a healthier lifestyle. To read more see Alzheimer’s Disease: Diabetes of the Brain?

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The impact of dietary choices on the risk of type 2 diabetes. Source

Tip #4: Get Your Brain Health Checkup

Healthy Brains is a website created by the Cleveland Clinic Lou Ruvo Center for Brain Health. The website is centered around the six pillars of brain health: physical exercise, food/nutrition, medical health, sleep/relaxation, mental fitness, and social interaction. One of my favorite parts about the site is the Brain Health Checkup, a free quiz that takes around 20 minutes to complete. After taking the quiz, you can read personalized tips on how to improve your brain health. Click here to check it out.

 Tip #5: Get Enough Sleep

You’ve probably heard a million times about the health consequences of sleep deprivation, but did you know that it may also increase the risk of Alzheimer’s? The Baltimore Longitudinal Study on Aging found that people over the age of 70 who report little sleep or low-quality sleep have higher levels of amyloid beta (a toxic protein linked to Alzheimer’s disease) in their brains. Additionally, a 2013 study found that amyloid beta and other toxic substances can actually be flushed out of the brain during sleep.

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Age-based recommendations from the National Sleep Foundation. Source

Tip #6: Adopt the Mediterranean Diet

The Mediterranean diet is often praised for its cardiovascular benefits, but recent studies show that it’s also great for your brain. This diet, commonly consumed in places like Italy and Greece, has been linked to a reduced risk of Alzheimer’s and improved cognitive function in older adults, as well as a longer average lifespan. The Mediterranean diet is characterized by high consumption of plant-based foods including fruits, vegetables (especially leafy greens), whole grains, legumes, and nuts. Red meat and dairy are consumed no more than a few times per month, replaced instead by poultry or fish.

Tip #7: Be Socially Active

Engaging in social interactions is a great way to stimulate your brain, and having a large social network is correlated with a reduced risk of dementia. While a causal relationship is difficult to determine, social engagement has also been shown to improve overall quality of life, especially for older adults. For introverts, there are many ways to be socially active besides going out with friends. These could include adopting a pet, conversing on social media websites, volunteering, or joining a community group.

Tip #8: Get More Exercise

This one might already on your list of resolutions, but here’s one more reason to get off the couch. Studies have consistently shown that people who get regular physical exercise have a substantially lower risk of Alzheimer’s disease and other dementias. Aerobic exercise, such as walking, jogging, biking, or dancing, seem to have the biggest protective effect on brain health. The CDC recommends that adults get 2.5 hours of moderate aerobic activity or 1.25 hours of vigorous aerobic activity each week, plus at least two sessions of muscle strength training.

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The many benefits of exercise for your brain. Source

Tip #9: Protect Your Brain From Injuries

Traumatic brain injuries (TBI’s), which may be the result of contact sports, falls, or car accidents, affect nearly 1.7 million Americans each year. TBI’s, including mild injuries that do not necessarily cause a concussion, have been repeatedly linked to an increased risk of Alzheimer’s disease. TBI’s are especially damaging in children, whose brains are still in the process of developing. Minimize your risk of a TBI by wearing a helmet when playing contact sports, installing house fixtures to protect from falls, and always wearing a seatbelt while driving.

Tip #10: Never Stop Learning

Lifelong education, whether formal or informal, is vital for keeping your brain active and maintaining proper cognitive function. Formal education could include taking classes at a nearby community college or online, teaching yourself a new language, or learning to play an instrument. More informal types of mental stimulation could include reading, doing crossword puzzles, social interaction, or attending musical or theatrical performances.

 

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Alzheimer’s Disease: Diabetes of the Brain?

When I first heard an argument for Alzheimer’s disease to be considered a form of diabetes, I was pretty skeptical. The two diseases seem at first glance to be completely unrelated. But the more I delved into the science behind the hypothesis, the more parallels arose. Understanding the complex relationship between Alzheimer’s and diabetes is incredibly important for people who have or are at risk of either disease. Whether they are considered distinct diseases or parts of a single spectrum, the interplay between Alzheimer’s and diabetes has far-reaching consequences for how we view our health and lifestyle.

A Quick Intro to Diabetes

Just as the term “cancer” refers to a wide spectrum of conditions, diabetes mellitus (or just diabetes for short) is not one but several diseases that all lead to chronic high blood sugar, or hyperglycemia. Normally, when blood sugar levels get too high, cells in the pancreas release a hormone called insulin, which tells other cells in the body to absorb the sugar and use it for energy. However, in people with diabetes, there is a disruption of proper insulin signaling, causing blood sugar levels to rise unchecked. Nearly 30 million Americans (around 10% of the total population) have diabetes, and another 86 million are prediabetic.

Around 90% of diabetes cases are type 2. People with type 2 diabetes can usually produce insulin just fine, but their muscle, fat, and liver cells are desensitized to insulin signaling. Despite the pancreas releasing insulin to tell to the rest of the body that blood sugar levels are too high, the cells aren’t absorbing enough sugar in response to that insulin. This condition is referred to as insulin resistance. Susceptibility to type 2 diabetes can be influenced by genetics, but the biggest risk factors are obesity and physical inactivity.

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Insulin resistance in type 2 diabetes. Source

Could Diabetes Cause Alzheimer’s?

Due to mechanistic similarities between the Alzheimer’s and diabetes, many scientists have proposed that the two diseases may interact. A recent meta-analysis concluded that people with diabetes are at an increased risk of Alzheimer’s disease, even after correcting for the effects of obesity. Diabetes also increases the risk of non-dementia cognitive impairment, and it has been associated with poorer performance in multiple cognitive domains including verbal memory, working memory, processing speed, and attention.

Several mechanisms have been proposed to explain how type 2 diabetes might lead to the development of Alzheimer’s. The predominant view is that diabetes alone is not sufficient to cause Alzheimer’s directly. This is supported by multiple studies showing that the cellular pathologies associated with Alzheimer’s disease (i.e., the buildup of certain toxic proteins in the brain) are not increased in diabetic people if other variables are accounted for. However, when other risk factors such as obesity, aging, and high blood pressure are combined with diabetes, evidence suggests that they can work together to contribute to the development of Alzheimer’s disease.

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Schematic showing how T2DM (type 2 diabetes mellitus) might lead to Alzheimer’s through interactions with other risk factors. Source

Type 3 Diabetes

In the brain, insulin functions differently than in the rest of the body. Rather than primarily regulating sugar metabolism, insulin signaling in the brain mediates multiple complex processes that are necessary for neuronal survival and function. If the brain were to become insulin-resistant, these vital processes could be perturbed.

In 2005, a team of researchers led by Dr. Susan de la Monte discovered that the brains of people with Alzheimer’s have greatly reduced genetic expression of insulin and a related molecule called insulin-like growth factor (IGF), as well as the cellular receptors for insulin and IGF. This condition resembled the insulin resistance that’s found in muscle, fat, and liver cells in type 2 diabetes. In addition, the insulin-mediated pathways that regulate neuronal survival, energy metabolism, mitochondrial function, and gene expression were disrupted in the patients’ brains.

de la Monte proposed that neuronal insulin resistance contributes to the development of Alzheimer’s disease. She and her team coined the term “type 3 diabetes” to describe this condition of brain insulin resistance/deficiency, describing it as similar to but distinct from diabetes mellitus. Essentially, rather than suggesting that type 2 diabetes could lead to Alzheimer’s (as some other scientists had previously proposed), these researchers instead argued that Alzheimer’s itself is a form of diabetes.

Growing Support for the Hypothesis

Since the 2005 study was published, new evidence has emerged to offer support for the type 3 diabetes hypothesis. de la Monte’s team later demonstrated that deficits in insulin and IGF signaling begin in the earliest stages of Alzheimer’s and gradually deteriorate with the clinical progression of the disease.

Another study investigated causal evidence for the link between brain insulin resistance and Alzheimer’s using a drug called streptozotocin. When streptozotocin is injected into rats’ abdominal cavity, the drug travels to the pancreas and kills the insulin-producing cells, leading to diabetes. de la Monte and her team wondered what would happen if streptozotocin was instead injected directly into the rats’ brains. They found that the rats did not develop the symptoms of diabetes mellitus, since the drug was localized to the brain and could not reach the pancreas. However, since streptozotocin blocked all insulin and IGF signaling in the brain, the rats developed many symptoms resembling Alzheimer’s disease, including reduced brain volume, increased neuronal and glial cell death, and accumulation of toxic protein species (tau and amyloid-beta). This study demonstrated that brain insulin/IGF depletion and oxidative stress are together sufficient to cause an Alzheimer’s-like condition in rats.

What Does This Mean For You?

If Alzheimer’s is indeed a form of diabetes, this suggests that antidiabetic drugs could be useful in treating Alzheimer’s. The studies of this concept are limited, but early results are promising. de la Monte’s team found that when their rats were treated with a type of antidiabetic drug called a peroxisome proliforator-activated receptor (PPAR) agonist, the rats’ brain insulin resistance was resolved and they did not develop the Alzheimer’s-like neurodegeneration that had been observed previously. Additional studies are currently in the works to further test this idea.

Additionally, the relationship between type 2 diabetes and Alzheimer’s risk is widely accepted in the scientific community, as strong evidence demonstrates that being diabetic can substantially increase the risk of cognitive impairment in conjunction with other risk factors. This is a vital concept for the general public to be aware of, as type 2 diabetes is considered a preventable condition. According to the NIH’s Diabetes Prevention Program, even people at high risk of diabetes can prevent the disease through a combination of weight loss (5-7% of your total body weight), a healthy diet, and regular exercise. The National Diabetes Education Program offers lots of great tips for transitioning to a healthier lifestyle.

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The impact of dietary choices on the risk of type 2 diabetes. Source

 

Final Thoughts

Reducing your risk of diabetes, or properly managing the diabetes you already have, will help you live longer by reducing your risk of Alzheimer’s and protecting you from other diabetes-related complications including cardiovascular disease, blindness, kidney failure, and amputations. In addition, this new research suggests that preventing brain insulin resistance can also reduce your risk of Alzheimer’s and cognitive impairment, ensuring that your mind is intact through your later years to watch your children and grandchildren grow up and to experience life to the fullest. Even small steps can make a big difference for protecting the health of your brain and body.

 

Additional Reading

“Alzheimer’s Disease is Type 3 Diabetes–Evidence Reviewed” by Susan de la Monte
“Is Alzheimer’s Type 3 Diabetes?” by Mark Bittman
“Alzheimer’s Disease and Type 2 Diabetes: A growing connection” by the Alzheimer’s Association

 

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