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Spinal Cord Injury May Increase the Risk of Alzheimer’s Disease

It may be surprising to some people to learn that physical injuries can contribute to neurodegenerative diseases. In mice, traumatic brain injuries have been previously shown to induce an Alzheimer’s-like condition, complete with amyloid plaques and neuroinflammation. In a study published this week in the journal¬†Spinal Cord, researchers from the National Taiwan University investigated whether a similar connection exists between spinal cord injuries (SCI) and Alzheimer’s disease.

The researchers utilized medical records from Taiwan’s National Health Insurance Research Database. Their analyses included 9,257 individuals with an SCI and 37,028 non-SCI individuals, with an average age of approximately 63 years.¬†When selecting the subjects for the study, the researchers applied an algorithm that would correct for the effects of other Alzheimer’s disease risk factors, such as age, sex, and cardiovascular health.

Over the course of a three-year period, a total of 25 SCI inviduals and 57 non-SCI individuals were diagnosed with Alzheimer’s. These numbers are quite low, possible due to the difficulty in diagnosing Alzheimer’s with high certainty, since its symptoms are similar to other forms of dementia. Cumulatively, the incidence of an Alzheimer’s diagnosis during the three-year study period was 71% higher in people with a SCI compared to people without a SCI. (I want to emphasize that this does not mean SCI patients are 71% more likely to get Alzheimer’s over their entire lifetime; this number only applies to the three-year period examined in this study.)

This figure from the paper shows the incidence of Alzheimer’s disease over a three-year period. The SCI individuals had an increased risk of Alzheimer’s than the non-SCI individuals.

This study is the first large-scale, longitudinal analysis to demonstrate a correlation between SCI and Alzeimer’s disease. Future research is warranted to determine what might be causing this connection. The authors suggested several possible explanations. It has been previously shown that tau and the amyloid precursor protein are deposited throughout the spinal cord following a SCI. These proteins are both closely linked to the pathogenesis of Alzheimer’s disease, so this could be a possible disease mechanism. Another possibility is that the widespread inflammation triggered by a SCI could perturb the delicate chemistry of molecules within the brain.

There are several important caveats to note with this study. For one thing, while the researchers accounted for health-related Alzheimer’s risk factors, including various medical conditions like diabetes and stroke, their records did not include information about lifestyle-related risk factors, such as smoking or exercise. These factors could have potentially skewed the analysis. Also, since the follow-up period was only three years, the data does not give us information about any longer-term effects of SCI. Finally, while the total sample size was large, only a small subset of subjects were diagnosed with Alzheimer’s, reducing the statistical power of the analysis. Future studies will need to address these problems in order to provide further insight into the emerging connection between SCI and Alzheimer’s disease.

 

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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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