An international study published in the Surgical Neurology International Journal
in August concludes that people are developing dementia ten years earlier than just two decades ago. Colin Pritchard from Bournemouth University, who led the study, said the problem is particularly acute in the U.S. where dementia-related deaths in women more than age 75 have increased more than fivefold, while deaths in men in that age group nearly tripled.
The study found that between 1989 and 2010 in the 21 Western countries studied, not only were far more people being diagnosed with and dying of dementia, it was being diagnosed at earlier ages with early-onset dementia hitting people in their late 40s.
The study postulates that the increase is due to pollution.
“A relationship between environmental pollutants and dementia has been suggested in a few other studies and certainly warrants both basic research studies to determine the responsible mechanism(s), as well as clinical and epidemiological studies to determine both patient and societal impacts,” said W. Sue T. Griffin, PhD, vice chairman of research, Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences (UAMS). “Such findings as those reported by Pritchard’s group, together with studies tying increases in obesity and type II diabetes to the development of Alzheimer’s disease, would have both societal and economical import for our country.”
The Alzheimer’s Association predicts costs for Alzheimer’s care will expand six fold from $172 billion at present to more than $1.08 trillion per year in 2050.
“The cost of paying for Alzheimer’s care, lost productivity of family care givers, lost tax revenue from people leaving work to care for Alzheimer’s patients, and the whole raft of cost associated with nursing homes is comparable to the cost of recent war activities,” Griffin said. “If we don’t find a way to prevent it, Alzheimer’s disease is what is going to break the bank in the U.S.”
Even though Alzheimer’s is the most expensive condition regarding cost of care, there is inadequate funding for Alzheimer’s research.
“Money is being taken away from research, may be due to the fact that people no longer see the importance of scientific research,” Griffin said. “We need to be finding some preventatives for this disease. We are working hard every day in our lab to devise compounds that will help. All over the country, scientists are trying to do this. The problem is that research funds for Alzheimer’s disease are so small, especially compared to other diseases that are less costly. I would really like to get the message out about what Alzheimer’s is doing not just to our people, but to our country’s economy. It is devastating our budget.”
Griffin published a landmark study in 1989 showing that trauma by Alzheimer’s disease to the neurons can provoke an out-of-control immune response where neurons traumatized by the disease direct the release of interleukin-1 (IL-1), a small signaling molecule, or cytokine. IL-1 has been identified as a driving factor in Alzheimer’s disease, which ultimately leading to the formation of plaques made of beta-amyloid lying outside the neurons and tangles of a small protein called tau inside of neurons. Both of these lead to the dysfunction and loss of neurons.
“The brain has no way to get rid of these plaques and tangles,” Griffin said. “So you end up with tangles inside the neurons. There is no evidence that getting rid of the plaques or the tangles has benefits in improving brain cognitive function. So, really, the whole thing in Alzheimer’s research is going to be about prevention because you don’t want to be in stage one or two where you can’t be in charge of yourself, hop in the car to get groceries, or fix Thanksgiving dinner.”
Right now with a cure so elusive, Griffin said keeping the inflammatory index just right in the brain is critical.
“Of course, keeping this inflammatory index just right in the body is important for other conditions such as inflammatory bowel disease, heart disease, and strokes, which are themselves risk factors for Alzheimer’s disease,” said Griffin, who is editor-in-chief of the internationally recognized, peer-reviewed, online scientific journal, Journal of Neuroinflammation.
A large study conducted by the Veterans Administration showed that people who took the anti-inflammatory drugs ibuprofen or naproxen had a significantly lower risk of being in the Alzheimer’s group after five years.
“It is amazing,” she said. “They found out that if you had been taking ibuprofen for five years for things like pain or arthritis, your chances of getting Alzheimer’s was decreased almost 50 percent.”
For a variety of reasons, unlike baby aspirin for heart disease, it has not become the standard for physicians to recommend ibuprofen as a preventive for Alzheimer’s.
Griffin advocates more being done to prevent head injuries.
“Head injury is an important risk factor for development of Alzheimer’s disease, so we also need to stop sending people into harm’s way, for example in wars with exposure to blast injuries, or in high impact sports,” Griffin said. “They might not have external injury you can see, but the brain’s nerve cells may have taken a real beating. Stop putting kids in harm’s way. The prospect for stopping war doesn’t seem very good, but the way kids do sports could be modified. I love sports. Kids should be playing. It is good exercise. But they shouldn’t be trained as if all will be in the Olympics and they should not be exposing their head to multiple traumas like you can see in practice sessions for soccer or football.”
A factor that increases the risk for far more people than head injury is obesity. Griffin is alarmed by the trend towards increasing childhood obesity. Much more needs to be done to encourage healthy eating habits and exercise starting in childhood.
One of the biggest risk factors for Alzheimer’s disease is Type II diabetes. One in three adults in Arkansas is obese, and Type II diabetes has reached epidemic levels in Arkansas.
“It used to be okay to eat Southern cooking like people did in the past because they also did a lot of physical labor,” Griffin said. “But now the lack of exercise makes that kind of diet a killer. We must have some way to keep an account so that we don’t gain weight. There just seems to be too much food around everyone all the time, and there is a failure to recognize what is happening.”
Griffin said extreme type of diets are hard for people to stay on. Instead, she advocates eating less.
“It would be better if people never ate anything they didn’t really want,” she said. “Rather, you should eat what you really want so that you’ll be satisfied, and won’t try to get satisfaction by over-eating what you don’t really want. The problem is they make it so hard. Our society makes everything so tempting. It is right in front of you and mostly you can afford it.”
Glucose is the sugar that feeds neurons, and Griffin agrees that Alzheimer’s involves a failure of glucose availability to neurons.
“If a neuron is doing well, it is not having problems taking in enough glucose to thrive,” she said. “If a neuron, because of the change in insulin receptors, releases downstream proteins, you can see this neuron is insulin resistant, meaning the neuron is deprived of glucose it needs, creating further stress on the neuron.”
However, not all Alzheimer’s can be pegged to lifestyle choices.
“There are people who have lived their whole lives perfectly with a good diet and exercise, and they still get Alzheimer’s,” she said. “That is the confounding part, highlighting the importance of research into genetic factors that increase risk for Alzheimer’s. This is a major focus in the Griffin research group at UAMS.”
For more visit: Journal of Neuroinflammation
Photo 1. Sue T. Griffin mugshot.
Photo 2.