Lifestyle

Higher coffee consumption linked to lower dementia risk in women

  • A large study adds to evidence that caffeine helps older women fight cognitive impairment and dementia.
  • This is supported by two animal studies showing precisely how caffeine is valuable for keeping the brain healthy.

Data from the Women's Health Initiative Memory Study, involving 6,467 postmenopausal women (65+) who reported some level of caffeine consumption, has found that those who consumed above average amounts of coffee had a lower risk of developing dementia.

Caffeine intake was estimated from a questionnaire. The median intake was 172 mg per day (an 8-ounce cup of brewed coffee contains 95mg of caffeine, 8-ounces of brewed black tea contains 47mg, so slightly less than 2 cups of coffee or less than 4 cups of tea). The women were cognitively assessed annually.

Over ten years, 388 were diagnosed with probable dementia (209) or MCI (179). Those who consumed above the median amount of caffeine had a 36% reduction in risk. The average intake in this group was 261 mg (3 cups of coffee), while the average intake for those below the median was 64 mg per day (less than one cup).

Risk factors such as hormone therapy, age, race, education, body mass index, sleep quality, depression, hypertension, prior cardiovascular disease, diabetes, smoking, and alcohol consumption, were taken into account.

The findings are consistent with other research finding a benefit for older women. It should not be assumed that the findings apply to men. It also appears that there may be a difference depending on education level. This sample had a high proportion of college-educated women.

It should also be noted that there was no clear dose-response effect — we could put more weight on the results if there was a clear relationship between amount of caffeine and benefit. Part of the problem here, however, is that it’s difficult to accurately assess the amount of caffeine, given that it’s based on self-report intake of coffee and tea, and the amount of caffeine in different beverages varies significantly.

Moreover, we do have a couple of mechanisms for caffeine to help fight age-related cognitive decline.

A recent study using rats modified to have impaired receptors for the adenosine A2A produced rats showing typical characteristics of an aging brain. In humans, too, age-related cognitive decline has been associated with over-activation of these receptors and dysfunction in glucocorticoid receptors.

The rat study shows that over-activation of the adenosine A2A receptors reduces the levels of glucocorticoid receptors in the hippocampus, which in turn impairs synaptic plasticity and cognition. In other words, it is the over-activation of the adenosine receptors that triggers a process that ends with cognitive impairment.

The point of all this is that caffeine inhibits the adenosine A2A receptors, and when the rats were given a caffeine analogue, their memory deficits returned to normal.

Another more recent study has found that caffeine increases the production of an enzyme that helps prevent tau tangles.

Building on previous research finding that an enzyme called NMNAT2 not only protects neurons from stress, but also helps prevent misfolded tau proteins (linked to Alzheimer’s, and other neurodegenerative disorders), the study identified 24 compounds (out of 1,280 tested) as having potential to increase the production of NMNAT2. One of the most effective of these was caffeine.

When caffeine was given to mice modified to produce lower levels of NMNAT2, the mice began to produce the same levels of the enzyme as normal mice.

https://www.eurekalert.org/pub_releases/2016-10/oupu-fwc100316.php

https://www.eurekalert.org/pub_releases/2016-08/ind-cai083016.php

https://www.eurekalert.org/pub_releases/2017-03/iu-cbe030717.php

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Being overweight linked to poorer memory

  • A study of younger adults adds to evidence that higher BMI is associated with poorer cognition, and points to a specific impairment in memory integration.

A small study involving 50 younger adults (18-35; average age 24) has found that those with a higher BMI performed significantly worse on a computerised memory test called the “Treasure Hunt Task”.

The task involved moving food items around complex scenes (e.g., a desert with palm trees), hiding them in various locations, and indicating afterward where and when they had hidden them. The test was designed to disentangle object, location, and temporal order memory, and the ability to integrate those separate bits of information.

Those with higher BMI were poorer at all aspects of this task. There was no difference, however, in reaction times, or time taken at encoding. In other words, they weren't slower, or less careful when they were learning. Analysis of the errors made indicated that the problem was not with spatial memory, but rather with the binding of the various elements into one coherent memory.

The results could suggest that overweight people are less able to vividly relive details of past events. This in turn might make it harder for them to keep track of what they'd eaten, perhaps making overeating more likely.

The 50 participants included 27 with BMI below 25, 24 with BMI 25-30 (overweight), and 8 with BMI over 30 (obese). 72% were female. None were diagnosed diabetics. However, the researchers didn't take other health conditions which often co-occur with obesity, such as hypertension and sleep apnea, into account.

This is a preliminary study only, and further research is needed to validate its findings. However, it's significant in that it adds to growing evidence that the cognitive impairments that accompany obesity are present early in adult life and are not driven by diabetes.

The finding is also consistent with previous research linking obesity with dysfunction of the hippocampus and the frontal lobe.

http://www.eurekalert.org/pub_releases/2016-02/uoc-bol022616.php

https://www.theguardian.com/science/neurophilosophy/2016/mar/03/obesity-linked-to-memory-deficits

Reference: 

[4183] Cheke LG, Simons JS, Clayton NS. Higher body mass index is associated with episodic memory deficits in young adults. The Quarterly Journal of Experimental Psychology [Internet]. 2015 :1 - 12. Available from: http://dx.doi.org/10.1080/17470218.2015.1099163

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Physical activity linked to better memory for names and faces among older adults

  • A small study adds to evidence that walking improves memory in older adults, and indicates that this is particularly helpful for memory tasks the seniors find challenging.

A small study that fitted 29 young adults (18-31) and 31 older adults (55-82) with a device that recorded steps taken and the vigor and speed with which they were made, has found that those older adults with a higher step rate performed better on memory tasks than those who were more sedentary. There was no such effect seen among the younger adults.

Improved memory was found for both visual and episodic memory, and was strongest with the episodic memory task. This required recalling which name went with a person's face — an everyday task that older adults often have difficulty with.

However, the effect on visual memory had more to do with time spent sedentary than step rate. With the face-name task, both time spent sedentary and step rate were significant factors, and both factors had a greater effect than they had on visual memory.

Depression and hypertension were both adjusted for in the analysis.

There was no significant difference in executive function related to physical activity, although previous studies have found an effect. Less surprisingly, there was also no significant effect on verbal memory.

Both findings might be explained in terms of cognitive demand. The evidence suggests that the effect of physical exercise is only seen when the task is sufficiently cognitively demanding. No surprise that verbal memory (which tends to be much less affected by age) didn't meet that challenge, but interestingly, the older adults in this study were also less impaired on executive function than on visual memory. This is unusual, and reminds us that, especially with small studies, you cannot ignore the individual differences.

This general principle may also account for the lack of effect among younger adults. It is interesting to speculate whether physical activity effects would be found if the younger adults were given much more challenging tasks (either by increasing their difficulty, or selecting a group who were less capable).

Step Rate was calculated by total steps taken divided by the total minutes in light, moderate, and vigorous activities, based on the notion that this would provide an independent indicator of physical activity intensity (how briskly one is walking). Sedentary Time was the total minutes spent sedentary.

http://www.eurekalert.org/pub_releases/2015-11/bumc-slp112415.php

Reference: 

[4045] Hayes SM, Alosco ML, Hayes JP, Cadden M, Peterson KM, Allsup K, Forman DE, Sperling RA, Verfaellie M. Physical Activity Is Positively Associated with Episodic Memory in Aging. Journal of the International Neuropsychological Society [Internet]. 2015 ;21(Special Issue 10):780 - 790. Available from: http://journals.cambridge.org/article_S1355617715000910

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Omega 3 levels affect whether B vitamins can slow brain's decline

  • B vitamins can help many older adults with mild cognitive impairment, but only if they have good levels of omega-3 fatty acids.

A study involving 266 people with mild cognitive impairment (aged 70+) has found that B vitamins are more effective in slowing cognitive decline when people have higher omega 3 levels.

Participants were randomly selected to receive either a B-vitamin supplement (folic acid, vitamins B6 and B12) or a placebo pill for two years. The vitamins had little to no effect for those with low levels of omega-3 fatty acids, but were very effective for those with high baseline omega-3 levels.

Levels of DHA appeared to be more important than levels of EPA, but more research is needed to confirm that.

The finding may help to explain why research looking at the effects of B vitamins, or the effects of omega-3 oils, have produced inconsistent findings.

The study followed research showing that B vitamins can slow or prevent brain atrophy and memory decline in people with MCI, and they were most effective in those who had above average blood levels of homocysteine.

http://www.eurekalert.org/pub_releases/2016-01/uoo-ola011916.php

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How hard your brain works depends on the season

  • A small study shows that it's not only daily biological rhythms that affect brain activity, but longer seasonal ones also.

A sleep study involving 28 participants had them follow a controlled sleep/wake schedule for three weeks before staying in a sleep laboratory for 4.5 days, during which time they experienced a cycle of sleep deprivation and recovery in the absence of seasonal cues such as natural light, time information and social interaction. The same participants went through this entire procedure several times over some 18 months. Brain activity was assessed while participants undertook an n-back working memory task, and a task that tested sustained attention.

While performance on these tasks didn't change with the seasons, the amount of effort needed to accomplish them did. Brain activity involved in sustained attention (especially in the thalamus, amygdala and hippocampus) was highest in the summer and lowest in the winter. Brain activity associated with working memory (especially the pulvinar, insula, prefrontal and frontopolar regions), was higher in the fall and lower in the spring.

Seasonality, therefore, could be one factor in cognitive differences that occur for an individual tested at different times.

The finding is consistent with previous research showing seasonal variation in the levels and concentrations of certain compounds associated with mood (including dopamine and serotonin).

Participants were healthy young adults; it would be interesting to see if the same results are found in older adults. It's possible that the effects are greater.

http://www.scientificamerican.com/article/brain-activity-for-attention-and-memory-tasks-changes-with-the-seasons/

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[4059] Meyer C, Muto V, Jaspar M, Kussé C, Lambot E, Chellappa SL, Degueldre C, Balteau E, Luxen A, Middleton B, et al. Seasonality in human cognitive brain responses. Proceedings of the National Academy of Sciences [Internet]. 2016 :201518129. Available from: http://www.pnas.org/content/early/2016/02/04/1518129113

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Mediterranean diet reduces brain shrinkage in old age

  • The Mediterranean diet is the diet most associated with cognitive and health benefits in older adults.
  • A new study has found larger brain volumes among those following this sort of diet, equivalent to that of brains five years younger.
  • Much of this was associated with two components of the diet in particular: eating fish regularly, and eating less meat.

Another study adds to the growing evidence that a Mediterranean diet is good for the aging brain.

The New York study used data from 674 non-demented older adults (average age 80). It found that those who closely followed such a diet showed significantly less brain shrinkage. Specifically, total brain volume was an average 13.11 milliliters greater, with grey matter volume 5 millilitres greater, and white matter 6.4 millilitres greater.

Eating at least five of the recommended Mediterranean diet components was associated with benefits equivalent to five years of age. By far the most important of these components was regular fish and reduced meat intake — at least 3 to 5 ounces of fish weekly; no more than 3.5 ounces of meat daily.

This is consistent with a considerable amount of research indicating the benefits of fish in fighting age-related cognitive decline.

http://www.theguardian.com/lifeandstyle/2015/oct/21/mediterranean-diet-may-slow-the-ageing-process-by-five-years

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Physical activity linked to greater mental flexibility in older adults

  • A correlation has been found between physical activity in healthy older adults and more variable resting-state brain activity.
  • More variable resting-state activity in older adults has previously been linked to better cognition.
  • No such correlation was found between cardiorespiratory fitness and resting-state brain activity.
  • The finding supports previous evidence linking higher levels of physical activity in old age with better cognition and brain health.

A study involving 100 healthy older adults (aged 60-80) has found that those with higher levels of physical activity showed more variable spontaneous brain activity in certain brain regions (including the precuneus, hippocampus, medial and lateral prefrontal, and temporal cortices). Moreover, this relationship was positively associated with better white-matter structure.

Higher rates of activity when the brain is “at rest” have previously been shown to be associated with better cognitive performance in older adults, especially in IQ and memory.

The brain regions showing this relationship all play an important role in major resting-state networks, including the default mode network, the motor network, and networks associated with executive control and salience detection. They are all highly connected.

Participants' physical activity over a week was measured using accelerometers. Cardiorespiratory fitness was also assessed. Participants were generally not very active and not very fit.

The findings add to evidence linking higher fitness and physical activity with greater brain integrity and higher cognitive performance. They are also consistent with previous studies showing an increase in such brain signal fluctuations among older adults participating in physical exercise programs.

Interestingly, level of brain activity fluctuations was only correlated with physical activity, not with cardiorespiratory fitness. This indicates that CRF and physical exercise cannot be considered as functional equivalents — there must be some aspects of physical activity not captured by a measure of cardiorespiratory fitness.

It's also worth noting that there wasn't a significant correlation between sedentary time and resting-state brain activity fluctuations, although this may be because the participants all showed not-very-dissimilar levels of sedentary time.

http://www.eurekalert.org/pub_releases/2015-08/uoia-slp082415.php

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Burzynska AZ, Wong CN, Voss MW, Cooke GE, Gothe NP, Fanning J, et al. (2015) Physical Activity Is Linked to Greater Moment-To-Moment Variability in Spontaneous Brain Activity in Older Adults. PLoS ONE 10(8): e0134819. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0134819

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No benefit in omega-3 supplements for cognitive decline

  • A large study of older adults with age-related macular degeneration found no cognitive benefit from taking omega-3 supplements, or supplements of lutein and zeaxanthin.

A large, five-year study challenges the idea that omega-3 fatty acids can slow age-related cognitive decline. The study, involving 4,000 older adults, was part of the Age-Related Eye Disease Study (AREDS), which established that daily high doses of certain antioxidants and minerals can help slow the progression of age-related macular degeneration. However, a follow-up study found the addition of omega-3 fatty acids to the AREDS formula made no difference.

Omega-3 fatty acids are believed to be responsible for the health benefits associated with regularly eating fish, which is associated with lower rates of AMD, cardiovascular disease, and possibly dementia.

In this study, participants from the AREDS study, all of whom had early or intermediate AMD, were randomly assigned to either omega-3, or lutein and zeaxanthin (nutrients found in large amounts in green leafy vegetables), or both, or a placebo. As they all had AMD, participants also took the AREDS formula, which includes vitamins C, E, beta carotene, and zinc. Cognitive testing took place at the beginning, at 2 years, and at 4 years.

There was no benefit to these supplements: all groups showed a similar rate of cognitive decline over the study period.

The researchers speculate that the failure to find a benefit may lie in the age of the participants — it may be that supplements, to be of benefit, need to be started earlier. The other possibility (and the one I myself give greater weight to, although both factors may well be influential) is that these nutrients need to be taken in food to be effective.

It should be noted that the omega-3 fatty acids taken were those found in fish, not those found in plant foods such as flaxseed, walnuts, soy products, and canola and soybean oils.

http://www.eurekalert.org/pub_releases/2015-08/nei-nss082115.php

http://www.eurekalert.org/pub_releases/2015-08/tjnj-eop082115.php

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Limited benefit of physical activity for preventing cognitive decline

  • A large study of older adults (70+) found no cognitive benefit from a regular exercise program, compared to another social & mental intervention.
  • However, a subset of participants (those over 80, and those with poor physical function at the beginning of the study) did show improvement in executive function.
  • Participants in both programs showed no cognitive decline over the two-year period, suggesting both interventions were helpful.

A large, two-year study challenges the evidence that regular exercise helps prevent age-related cognitive decline.

The study involved 1,635 older adults (70-89) who were enrolled in the Lifestyle Interventions and Independence for Elders (LIFE) study. They were sedentary adults who were at risk for mobility disability but able to walk about a quarter mile. Participants had no significant cognitive impairment (as measured by the MMSE) at the beginning of the study. Around 90% (1476) made it to the end of the study, and were included in the analysis.

Half the participants were randomly assigned to a structured, moderate-intensity physical activity program that included walking, resistance training, and flexibility exercises, and the other half to a health education program of educational workshops and upper-extremity stretching.

In the physical activity condition, participants were expected to attend 2 center-based visits per week and perform home-based activity 3 to 4 times per week. The sessions progressed toward a goal of 30 minutes of walking at moderate intensity, 10 minutes of primarily lower-extremity strength training with ankle weights, and 10 minutes of balance training and large muscle group flexibility exercises.

The health education group attended weekly health education workshops during the first 26 weeks of the intervention and at least monthly sessions thereafter. Sessions lasted 60 to 90 minutes and consisted of interactive and didactic presentations, facilitator demonstrations, guest speakers, or field trips. Sessions included approximately 10 minutes of group discussion and interaction and 5 to 10 minutes of upper-extremity stretching and flexibility exercises.

Cognitive assessments were made at the beginning of the study and at 24 months, as well as a computerized assessment at either 18 or 30 months.

At the end of the study, there was no significant difference in cognitive score, or incidence of MCI or dementia, between the two groups. However, those in the exercise group who were 80 years or older ( 307) and those with poorer baseline physical performance ( 328) did show significantly better performance in executive function.

Executive function is not only a critical function in retaining the ability to live independently, research has also shown that it is the most sensitive cognitive domain to physical exercise.

Note also that there was no absolute control group — that is, people who received no intervention. Both groups showed remarkably stable cognitive scores over the two years, suggesting that both interventions were in fact effective in “holding the line”.

While this finding is disappointing and a little surprising, it is not entirely inconsistent with the research. Studies into the benefits of physical exercise for fighting age-related cognitive decline and dementia have produced mixed results. It does seem clear that the relationship is not a simple one, and what's needed is a better understanding of the complexities of the relationship. For example, elements of exercise that are critical, and the types of people (genes; health; previous social, physical, and cognitive attributes) that may benefit.

http://www.eurekalert.org/pub_releases/2015-08/tjnj-eop082115.php

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Sleeping on your side best for clearing waste from brain

  • Waste products accumulate as the brain functions.
  • The process of clearing this waste is most effective during sleep.
  • Accumulation of waste products such as amyloid-beta and tau proteins are involved in Alzheimer's.
  • Rat study shows sleeping on your side is best for removing waste from the brain.

This sounds like pseudoscience, but it appears in Journal of Neuroscience, so … Weirdly, a rat study has found that sleeping on the side (the most common posture for humans and other animals) is the best position for efficiently removing waste from the brain.

Brain waste includes amyloid-beta and tau proteins, whose build-up is a critical factor in the development of Alzheimer's disease.

The study used imaging of the glymphatic pathway, which clears waste products from the brain by filtering cerebrospinal fluid through the brain and exchanging it with interstitial fluid. The process is most efficient during sleep, and its efficiency is affected by the level of consciousness. The researchers compared glymphatic transport during sleep when anesthetized rodents’ brains were in three positions—lateral (side), prone (down), and supine (up).

Of course, these findings need to be confirmed in humans (which might be tricky!), but there is, after all, no harm in changing your sleep position, if you don't already sleep on your side (though I concede it can be a difficult thing to change).

Apart from providing a practical tip for fighting age-related cognitive decline and dementia, the finding also supports the idea that one of the purposes of sleep is to ‘clean up’ the mess that accumulates while we are awake.

The finding is also consistent with increasing evidence that sleep disturbances are a factor in the development and progression of dementia.

http://www.futurity.org/side-sleeping-brains-979872/

Reference: 

[3956] Lee H, Xie L, Yu M, Kang H, Feng T, Deane R, Logan J, Nedergaard M, Benveniste H. The Effect of Body Posture on Brain Glymphatic Transport. The Journal of Neuroscience [Internet]. 2015 ;35(31):11034 - 11044. Available from: http://www.jneurosci.org/content/35/31/11034

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