Category: Blog Post

Approximately 6 million people 65 and older in the United States have Alzheimer’s [1]. The fact that women make up nearly two-thirds of them has long been a source of puzzlement for scientists, who have long linked the difference to factors like heredity and longer life expectancies [2]. However, there is increasing agreement that menopause may also be a significant risk factor for dementia later in life.

Women who enter the life phase—clinically described as the point at which fertility ends—experience numerous changes in their brains in addition to their ovaries. The majority of women adapt to these changes without experiencing long-term health problems, but in the decades that follow, 20% of them will develop dementia [3].

Is There any Link Between Menopause and Dementia

The areas of the female brain that regulate mood, memory, sleep, and body temperature are especially abundant in estrogen receptors, and these areas function optimally when levels of estrogen are stable and high. Estrogen is also essential for the brain’s ability to protect itself from aging and damage [4].

The distinctive reduction in estrogen during menopause impacts the functioning of specific brain regions and is believed to change the brain structure. Scans reveal decreased brain volume in menopausal women compared to the brains of men of the same age and pre-menopausal women [5].

These brain changes may be the cause of some menopausal symptoms, such as hot flashes, mood swings, and a mild, generally transitory loss in memory and cognition.

They also bear similarities to pre-dementia brain alterations. Although the exact relationship between the two is unclear, several brain regions affected by menopause are also affected by Alzheimer’s.

Research has also linked menopause symptoms, including insomnia and hot flashes, to dementia. A study published in 2022 discovered that hot flashes were associated with an increase in the number of tiny lesions in the brain, which are a sign of declining brain health, according to Dr. Pauline Maki, a professor of psychiatry and director of the Women’s Mental Health Research Program at the University of Illinois at Chicago and co-author of the study [6]. A more recent study found that hot flashes during sleep were linked to a rise in blood-based biomarkers for Alzheimer’s disease, which act as early warning signs of the condition [7].

Although the findings of this research may seem concerning, most women’s brains and cognitive abilities stabilize after menopause.

Beyond that, there are other actions you may take to support your well-being and mental capacity despite decreasing estrogen.

How can you protect your brain?

According to experts, three factors, in particular, are likely to have the most significant effect on women going through menopause since they address both the immediate symptoms and the long-term risk of dementia.

1. Hormone Therapy on Time

For many years, scientists were worried that hormone therapy for menopausal symptoms would raise an older woman’s risk of dementia. However, more recent research looks more thoroughly at the therapy’s timing and paints a more complex picture. According to one such study that examined the results of over 50 studies, hormone therapy initiated around the time menopausal symptoms appeared was connected with a lower incidence of Alzheimer’s disease and dementia [8].

Other studies have revealed that hormone therapy does not affect dementia or Alzheimer’s risk but is successful at treating hot flashes and night sweats while also increasing quality of life, all of which are critical predictors of brain health [9][10].

2. Regular Exercise

Women are more likely than men to develop neurodegenerative disorders as a result of physical inactivity [11].

A 2018 study that tracked over 200 middle-aged women for 44 years discovered that the higher their fitness level at the beginning of the study, the lower their risk of acquiring dementia later in life [12]. Middle-aged women who were physically active showed fewer signs of Alzheimer’s disease in their brain scans than their inactive peers.

3. Healthy Diet

Recent studies have revealed a link between a lower incidence of dementia in both men and women with specific diets, such as the Mediterranean diet and the MIND diet, which focus on fruits, vegetables, whole grains, lean proteins, and healthy fats.

These plant-rich diets may also offer some additional advantages to women. According to a preliminary study, eating a diet high in plants can support specific gut bacteria that may help balance the body’s estrogen levels [13].

References

1. Alzheimer’s Disease Facts and Figures. Alzheimer’s Association. https://www.alz.org/alzheimers-dementia/facts-figures. Accessed: 11th January, 2024.
2. Rajan, K.B., Weuve, J., Barnes, L.L., McAninch, E.A., Wilson, R.S. and Evans, D.A., 2021. Population estimate of people with clinical Alzheimer’s disease and mild cognitive impairment in the United States (2020–2060). Alzheimer’s & dementia, 17(12), pp.1966-1975.
3. Chêne, G., Beiser, A., Au, R., Preis, S.R., Wolf, P.A., Dufouil, C. and Seshadri, S., 2015. Gender and incidence of dementia in the Framingham Heart Study from mid-adult life. Alzheimer’s & Dementia, 11(3), pp.310-320.
4. Spence, R.D., Hamby, M.E., Umeda, E., Itoh, N., Du, S., Wisdom, A.J., Cao, Y., Bondar, G., Lam, J., Ao, Y. and Sandoval, F., 2011. Neuroprotection mediated through estrogen receptor-α in astrocytes. Proceedings of the National Academy of Sciences, 108(21), pp.8867-8872.
5. Than, S., Moran, C., Beare, R., Vincent, A.J., Collyer, T.A., Wang, W., Callisaya, M.L., Thomson, R., Phan, T.G., Fornito, A. and Srikanth, V.K., 2021. Interactions between age, sex, menopause, and brain structure at midlife: a UK Biobank study. The Journal of Clinical Endocrinology & Metabolism, 106(2), pp.410-420.
6. Thurston, R.C., Wu, M., Chang, Y.F., Aizenstein, H.J., Derby, C.A., Barinas-Mitchell, E.A. and Maki, P., 2023. Menopausal vasomotor symptoms and white matter hyperintensities in midlife women. Neurology, 100(2), pp.e133-e141.
7. Thurston, R.C., Maki, P., Chang, Y., Wu, M., Aizenstein, H.J., Derby, C.A. and Karikari, T.K., 2023. Menopausal vasomotor symptoms and plasma Alzheimer disease biomarkers. American Journal of Obstetrics and Gynecology.
8. Nerattini, M., Jett, S., Andy, C., Carlton, C., Zarate, C., Boneu, C., Battista, M., Pahlajani, S., Loeb-Zeitlin, S., Havryulik, Y. and Williams, S., 2023. Systematic review and meta-analysis of the effects of menopause hormone therapy on risk of Alzheimer’s disease and dementia. Frontiers in Aging Neuroscience, 15, p.1260427.
9. Henderson, V.W., St. John, J.A., Hodis, H.N., McCleary, C.A., Stanczyk, F.Z., Shoupe, D., Kono, N., Dustin, L., Allayee, H. and Mack, W.J., 2016. Cognitive effects of estradiol after menopause: a randomized trial of the timing hypothesis. Neurology, 87(7), pp.699-708.
10. Faubion, S.S., Crandall, C.J., Davis, L., El Khoudary, S.R., Hodis, H.N., Lobo, R.A., Maki, P.M., Manson, J.E., Pinkerton, J.V., Santoro, N.F. and Shifren, J.L., 2022. The 2022 hormone therapy position statement of the North American Menopause Society. Menopause, 29(7), pp.767-794.
11. Nianogo, R.A., Rosenwohl-Mack, A., Yaffe, K., Carrasco, A., Hoffmann, C.M. and Barnes, D.E., 2022. Risk factors associated with Alzheimer disease and related dementias by sex and race and ethnicity in the US. JAMA neurology, 79(6), pp.584-591.
12. Hörder, H., Johansson, L., Guo, X., Grimby, G., Kern, S., Östling, S. and Skoog, I., 2018. Midlife cardiovascular fitness and dementia: a 44-year longitudinal population study in women. Neurology, 90(15), pp.e1298-e1305.
13. Baker, J.M., Al-Nakkash, L. and Herbst-Kralovetz, M.M., 2017. Estrogen–gut microbiome axis: Physiological and clinical implications. Maturitas, 103, pp.45-53.
14. Gupta, A.H., How Menopause Changes the Brain. The New York Times. https://www.nytimes.com/2023/11/21/well/mind/menopause-dementia-risk-estrogen.html. Published Online: 21st November, 2023. Accessed: 11th January, 2024.

Researchers from the Radiological Society of North America have connected a specific kind of body fat to the development of Alzheimer’s. There is a correlation between increased amounts of proteins that disrupt brain function and visceral fat in the belly. According to researchers, methods for evaluating visceral fat may help identify Alzheimer’s early on.

There may be an increased risk of Alzheimer’s in middle-aged persons who have a specific kind of fat around their internal organs in their bellies.

Researchers examined visceral fat, a specific fat type that accounts for a tiny percentage of a person’s body mass but is critically situated in the abdominal cavity, close to numerous vital organs. Due to its external imperceptibility, visceral fat is also called hidden fat.

Such fat deposits may cause alterations in the brain related to Alzheimer’s as early as age 50 and up to 15 years before the neurological disease’s symptoms manifest, according to research presented at the Radiological Society of North America annual meeting [1].

The results are yet to be peer-reviewed.

The Research Details: Hidden Fat and Brain

In the study, the research team attempted to identify connections between amyloid and tau proteins (which disrupt neural communication) and high body mass index (BMI) scores, obesity, insulin resistance, and fatty abdominal tissue in middle-aged people who showed no signs of cognitive problems [2].

Researchers examined data from 54 people, ages 40 to 60, in order to carry out the study. With an average body mass index (BMI) of 32, all of the subjects were clinically obese but in good cognitive health. The team measured the quantity of visceral and subcutaneous fat (the more prevalent form of fat located beneath the skin) in the abdominal cavity by taking pictures with MRI scans.

The researchers also obtained MRI brain images to investigate any connections between brain volume and visceral fat. The thickness of the cortex, which regulates critical processes including language, thinking, and memory, is of particular significance.

As Alzheimer’s advances, it is known to damage neurons and their connections in the brain’s cortex, leading to the loss of volume or “shrinking.”

The scientists also employed a variety of other pertinent tests that might reveal alterations in the brain or biomarkers for inflammation and the onset of Alzheimer’s disease, such as insulin resistance tests for glucose tolerance and PET scans that target tau tangles and amyloid plaques, the hallmarks of the disease.

According to a previous study by Dr. Mahsa Dolatshahi, a post-doctoral research fellow at the Mallinckrodt Institute of Radiology (MIR) at Washington University School of Medicine in St. Louis, and the team, a higher visceral to subcutaneous fat ratio in the belly was associated with a higher presence of amyloids in the precuneus cortex, a brain region known to be affected early by amyloid pathology in Alzheimer’s [3].

The Connection of the Fat and Brain Inflammation

PET scans revealed higher concentrations of tau and amyloid proteins in the brains of participants with larger ratios of visceral fat to subcutaneous fat. A higher visceral fat proportion has also been linked to increased inflammation, which is another Alzheimer’s risk factor.

Dr. Dolatshahi stated that inflammatory secretions of visceral fat may cause inflammation in the brain, which is one of the primary causes of Alzheimer’s.

According to Dr. Cyrus A. Raji, MD, PhD, an Associate Professor of Radiology and Neurology and Director of Neuromagnetic Resonance Imaging at the Washington University School of Medicine, although other studies have associated BMI with brain atrophy or even a higher dementia risk, no previous research has linked a particular kind of fat to the actual abnormal Alzheimer’s protein in cognitively normal people up to 25 years before they show the first symptoms of the disease.

How this study may aid in the diagnosis of Alzheimer’s

According to researchers, the results may help identify Alzheimer’s disease early in a population that is at risk. The research not only contributes to our understanding of one of the biochemical processes associated with Alzheimer’s, but it also supports the crucial idea that some of these risk factors are modifiable and discoverable early in life.

Dr. Raji stated that by going beyond BMI to better characterize the structural distribution of body fat on MRI, we now have a significantly better knowledge of why this factor may raise Alzheimer’s risk.

He further stated that these first results have them thrilled, and they anticipate further research and cooperation in this field with an emphasis on brain health. The image of how different bodily parts relate to brain health is changing, and researchers are eager to investigate any potential processes that may exist between these entities.

References

1. Radiological Society of North America. RSNA. https://www.rsna.org/annual-meeting. Accessed: 5th January, 2024.
2. Hidden Belly Fat in Midlife Linked to Alzheimer’s Disease. RSNA Radiological Society of North America. RSNA Press Release. https://press.rsna.org/timssnet/media/pressreleases/14_pr_target.cfm?id=2467. Released: 20th November, 2023. Accessed: 5th January, 2024.
3. Dolatshahi, M., Commean, P.K., Rahmani, F., Liu, J., Lloyd, L., Nguyen, C., Hantler, N., Ly, M., Yu, G., Ippolito, J.E. and Sirlin, C., 2023. Alzheimer Disease Pathology and Neurodegeneration in Midlife Obesity: A Pilot Study. Aging and Disease.
4. Hidden Belly Fat in Midlife Linked to Alzheimer’s Disease. Medical News Today. https://www.medicalnewstoday.com/articles/hidden-belly-fat-in-midlife-linked-to-alzheimers-disease. Published Online: 20th November, 2023. Accessed: 5th Janray, 2024.
5. This Type of Hidden Belly Fat Linked to Higher Alzheimer’s Disease Risk. Healthline. https://www.healthline.com/health-news/this-type-of-hidden-belly-fat-linked-to-higher-alzheimers-disease-risk. Published Online: 20th November, 2023. Accessed: 5th Janray, 2024.

Researchers discovered that vaccines may lower the risk of getting Alzheimer’s and associated disorders by increasing the immune system.

There are several reasons to get a flu vaccination. However, there is one reason that might surprise you! A recent study suggests that flu shots may protect your brain.

According to the study, getting regular vaccines against influenza and other infectious illnesses, including whooping cough, shingles, pneumococcal pneumonia, tetanus, and diphtheria, may lower the risk of Alzheimer’s disease and associated dementias [1]. Paul E. Schulz, professor of neurology and director of the Neurocognitive Disorders Center at McGovern Medical School at UTHealth Houston, led the study.

The Recent Study

In the study, after tracking two groups for up to eight years—one vaccinated against the flu, the other not—the researchers discovered a statistically significant disparity in the incidence of Alzheimer’s.

The researchers obtained individuals from a national patient database, dividing them into two groups of 935,887 each, one vaccinated and the other not. The scientists ensured that both groups had a number of similar characteristics, including age, gender, frequency of medical visits, and specific medical conditions like high blood pressure and elevated cholesterol, to minimize the possibility of different factors influencing the results.
The research team discovered that receiving an annual flu vaccination for three years in a row decreased the chance of dementia by 20% during the ensuing four to eight years while receiving six doses doubled the reduction to 40%.

According to Schulz, the number of dementia cases in the vaccinated group was 47,889, whereas the number in the unvaccinated group was 79,630. There is a difference of over 30,000 cases.

Similar results of other vaccines

Schulz team also saw comparable outcomes with vaccinations against other infectious illnesses, such as pneumococcal pneumonia, shingles, and Tdap, which is a mix of tetanus, diphtheria, and pertussis (whooping cough), or tetanus and diphtheria without the pertussis component.

Shingles Vaccine

The researchers compared 198,847 individuals who had the shingles vaccines—Zostavax, the first shingles vaccine, and Shingrix, the most current one—against an equivalent number of patients who did not receive the vaccinations. During the eight-year follow-up, 16,106 vaccinated individuals had Alzheimer’s disease, compared to 21,417 unvaccinated patients — or 5,311 fewer people in the vaccinated group experienced dementia.

Tdap and Td Vaccines

The researchers studied two groups of 116,400 patients each, one vaccinated and the other not, using the Tdap and Td vaccinations. Over eight years, 8,370 vaccinated people had dementia, compared to 11,857 unvaccinated people — 3,487 fewer cases overall.

Pneumococcal Vaccine

Using pneumococcal vaccination, researchers examined two groups of 260,037 individuals, one vaccinated and the other unvaccinated. After eight years, they found 20,583 instances of dementia among the vaccinated, compared with 28,558 unvaccinated individuals – 7,975 fewer patients in the vaccinated group.

Results from other studies

Stanford University researchers discovered comparable outcomes in two UK-based studies that are currently unpublished and undergoing peer review. The first, conducted over seven years in an older population in Wales, indicates that vaccination with Zostavax prevented an estimated 1 in 5 new cases of dementia, according to the study’s lead researcher, Pascal Geldsetzer, an assistant professor of medicine at Stanford University’s division of primary care and population health [2].

The second study examined mortality statistics for Wales and England and discovered a five percent difference in the likelihood of dying from dementia over a nine-year follow-up, or one in twenty deaths prevented [3].

For both studies, the researchers divided the participants into two groups for comparative reasons based on the country’s birth date qualifying requirements. Those who turned 80 shortly before the program started were not eligible for the vaccination and remained so. However, those who became 80 shortly after the program commenced were eligible for the vaccine, which they got for free over the subsequent year.

Geldsetzer stated that the likelihood of receiving the shingles vaccination varied significantly between the two comparison groups, presumably due to a tiny age difference. This sets the study apart from other studies that only compare those who receive vaccinations with those who do not. According to the researchers, the results of this particular natural randomization imply a causal link.

How can the vaccine help against dementia?

A multitude of studies have revealed that people who receive flu and other infectious disease vaccines are less likely to develop dementia than the unvaccinated [2][4]. However, the experts are unsure about the reason. According to some, vaccinations minimize or lessen the chance of contracting infectious agents, which may have a role in the development of Alzheimer’s.

In contrast, Schulz believes that vaccines could reduce the immune system’s response to amyloid plaque – a naturally occurring protein that is present in unusually high levels in Alzheimer’s patients. The immune system perceives plaque as a foreign intruder and attacks it, resulting in persistent brain inflammation and the death of adjacent neurons, leading to dementia.

Vaccines may rescue brain cells that the body’s immune system might otherwise kill by suppressing the immunological reaction to amyloid. Additionally, vaccinations may enhance the immune system’s capacity to eliminate plaque. Fewer plaques result in reduced inflammation and brain cell death.

Schulz further added that they are unsure what the process is yet, but something is happening with the brain and immune system that appears to be making a significant effect.

According to experts, more research is needed to evaluate the vaccine’s effects on the brain.

References

1. Harris, K., Ling, Y., Bukhbinder, A.S., Chen, L., Phelps, K.N., Cruz, G., Thomas, J., Kim, Y., Jiang, X. and Schulz, P.E., 2023. The impact of routine vaccinations on Alzheimer’s disease risk in persons 65 years and older: a claims-based cohort study using propensity score matching. Journal of Alzheimer’s Disease, (Preprint), pp.1-16.
2. Eyting, M., Xie, M., Heβ, S. and Geldsetzer, P., 2023. Causal evidence that herpes zoster vaccination prevents a proportion of dementia cases. medRxiv.
3. Michalik, F., Xie, M., Eyting, M., Heß, S., Chung, S. and Geldsetzer, P., 2023. The effect of herpes zoster vaccination on the occurrence of deaths due to dementia in England and Wales. medRxiv, pp.2023-09.
4. Wiemken, T.L., Salas, J., Hoft, D.F., Jacobs, C., Morley, J.E. and Scherrer, J.F., 2021. Dementia risk following influenza vaccination in a large veteran cohort. Vaccine, 39(39), pp.5524-5531.
5. Cimons, M. Flu shots may protect against the risk of Alzheimer’s, related dementias. The Washington Post. https://www.washingtonpost.com/wellness/2023/10/25/flu-shots-alzheimers-dementias-vaccinations-infectious-diseases/. Published Online: 25th October, 2023. Accessed: 7th December, 2023.
6. Simpson, M.L. Flu Shots Might Lower Your Risk of Alzheimer’s and Other Dementias. People. https://people.com/flu-shots-could-lower-risk-of-dementia-8383636. Published Online: 27th October, 2023. Accessed: 7th December, 2023.

The holidays are almost here. Spending time with loved ones during this wonderful time of year is just delightful. However, it may be a challenging time of year for the family caregivers, especially for the primary caregiver.

Many caregivers of Alzheimer’s patients find the holidays to be stressful and hard. The challenges of the present contrast with the joyful recollections of the past, and further demands on time and energy might feel overwhelming.

Besides emotional strain, they may also experience financial strain, which adds to the holiday stress. Financial stress can exacerbate during the holiday season, especially when there is pressure to purchase gifts, prepare for a celebration, or engage in costly activities.

We can help relieve some of their burden, but how exactly can we accomplish that? Before getting to the answer, we will look at some significant statistics about Alzheimer’s caregivers.

Alzheimer’s Caregivers & Financial Burden: Facts and Figures

Alzheimer’s is a progressive disease that worsens with time to the point that the patient becomes completely dependent on the caregiver for even basic everyday activities. As the symptoms worsen, caregivers may face increased levels of emotional stress and depression, new or worsening health issues, and diminished income and finances as a result of job disruptions and the cost of providing care and other services for both the dementia patient and themselves. Caregivers of individuals with dementia report more significant emotional, financial, and physical challenges than caregivers of persons without dementia.

The following statistics highlight the financial stress that the caregivers of Alzheimer’s patients experience [1].

• In the United States, family, friends, and other unpaid caregivers provide 83% of the assistance to older persons.
• Almost half of all caregivers (48%) who assist older persons do so for someone with Alzheimer’s or another dementia.
• Over 11 million Americans offer unpaid care to people with Alzheimer’s disease or other dementias.
• Unpaid caregivers provided an estimated 18 billion hours of care worth $339.5 billion in 2022.
• About 25% of caregivers for dementia patients are “sandwich generation” caregivers, which means they look after at least one kid in addition to an aged parent.
• The household income of 41% of caregivers is $50,000 or less.
• Families bear 70% of the lifetime cost of caring for a person with dementia, either via unpaid care or through out-of-pocket health and long-term care expenditures.

How can we help caregivers of Alzheimer’s patients?

Alzheimer’s has a severe impact on caregivers. Two times as many caregivers of those with dementia report significant emotional, financial, and physical challenges as caregivers of individuals without dementia.

Holidays are a time to rejoice, but caregivers often feel more emotional and financial pressure during these days. The least we can do is to support them in any way we can! If you know someone who is taking care of their aging parents, try to support them by offering to help them with holiday celebrations and household chores and assist with some caregiving tasks if you can so that the caregiver can have a respite. You can also provide them with monetary support.

Another way to help caregivers is by donating to non-profit organizations such as the Alzheimer’s Research Association, which is committed to helping caregivers via helpful resources and grants. Your donations will make the caregivers of Alzheimer’s patients feel a bit lighter by relieving some of their financial burden.

Alzheimer’s Research Association: What do we do?

The Alzheimer’s Research Association is a non-profit organization devoted to delivering the most recent advances in innovation and technology to caregivers and their families coping with dementia and Alzheimer’s. Our mission is to ease the caregiver’s burden by offering grants, educational resources, and support services.

Our goal is to raise awareness of Alzheimer’s disease by offering a wealth of information, such as the latest research and news, to assist family caregivers whose loved ones are living with dementia or Alzheimer’s. As part of our mission, we provide grants from donations to caregivers to assist them in overcoming the financial, emotional, and physical challenges that come with being a caregiver.

At the Alzheimer’s Research Association, we are or have been Alzheimer’s patient caregivers in the past. We want to offer a resource where you can get the answers to your most pressing issues about Alzheimer’s care based on our research and experiences.

Donate to Alzheimer’s Research Association: Where do your donations go?

Many caregivers are unable to enjoy the holidays due to emotional and financial pressure. You can help them ease some of their worries associated with this season by donating to us. Your contribution will support our ongoing initiatives to assist those who care for persons with dementia and Alzheimer’s.

So, where will your donations go? Your donations will be used as caregiver grants or for caregiver respite care programs. The Alzheimer’s Research Association takes pride in supporting caregivers, and we will continue to work tirelessly to achieve our goal! Our hard work pays off every time we know we are a source of relief for someone!

“Thank you so much for the grant gift. It will be used for the extra cost of groceries during the holiday season as well as warm clothing for my mom. Thank you! Thank you!”
Judy, A Caregiver Grant Recipient

This Christmas, your donations may help a caregiver cover extra costs of groceries, buy gifts, purchase warm clothes or accessories for the loved one they care for, or fulfill any critical necessity. Donations – no matter how small – can make a big difference in someone’s life!

Support the caregivers by donating before Christmas vacation: https://www.staging.alzra.org/donate-now/

Dear caregivers, you can apply for caregiver grants here: https://www.staging.alzra.org/grant-applications/.

References

1. 2023 Alzheimer’s Disease Facts and Figures. Alzheimer’s Association. https://www.alz.org/media/documents/alzheimers-facts-and-figures.pdf. Alzheimer’s Dementia. 2023 Apr;19(4):1598-1695.
2. How caregivers and older adults can cope with holiday stress. Good Samaritan Society. https://www.good-sam.com/resources/how-caregivers-and-older-adults-can-cope-with-holiday-stress. Posted Online: 22nd November, 2023. Accessed: 7th December, 2023.
3. Alzheimer’s Research Association. https://www.staging.alzra.org/. Accessed: 7th December, 2023.