The Alzheimer’s Association International Conference (AAIC) is the largest and most influential international meeting dedicated to advancing dementia science. Each year, AAIC convenes the world’s leading basic science and clinical researchers, next-generation investigators, clinicians and the care research community to share research discoveries that’ll lead to methods of prevention and treatment and improvements in the diagnosis of Alzheimer’s disease. Access highlights from other days here.
Florida Researcher Spotlight
Christian Lachner, of the Mayo Clinic presented, Depression is associated with dementia and accelerated cognitive decline in African Americans.
What was the focus of your research? Our research focused on modifiable risk factors for dementia in a diverse population and evaluated dementia risk factors in African Americans and non-Hispanic White individuals participating in Alzheimer’s disease research at the Mayo Clinic Florida ADRC. African Americans comprise 12% of the U.S. population 65 years-old or older, but represent close to 20% of those with dementia. Inequalities in social determinants of health and modifiable factors may influence dementia risk. Accordingly, reducing risk factors in African American individuals may improve disparities and decrease dementia risk. We evaluated dementia risk factors in African Americans and non-Hispanic White individuals participating in Alzheimer’s disease research at the Mayo Clinic Florida ADRC. We then evaluated the association between these risk factors and cognitive impairment, as well as decline. We found that modifiable risk factors were common in both African Americans and non-Hispanic White individuals but overrepresented in African Americans, who had greater socioeconomic deprivation. We also found that depression was associated with cognitive impairment and rate of cognitive decline in AA participants, who were less frequently treated for depression compared to nHW.
How does your research impact someone living with Alzheimer’s? Our research should inform people about the importance of treating modifiable risk factors for dementia, including high blood pressure, cholesterol, diabetes and depression, as these are very common in persons with cognitive impairment. It also emphasizes how African American individuals may have greater socioeconomic and environmental deprivation leading to higher dementia risk factors and dementia. Access to healthcare is very important to treat modifiable risk factors and improve dementia prevention. In our group, treating depression was especially important, as it was associated with cognitive impairment in both African American and non-Hispanic White, but also worsened decline in impaired African American individuals.
What made you want to get into dementia research? I have worked with many patients with dementia and have seen the burden these illnesses pose on the patient and their families. I also have great curiosity and admiration for the brain, the organ that allows us to be who we are. These factors, and the motivation to contribute to science attempting to find better prevention strategies, diagnostic tools and treatment alternatives for patients with dementia and their families, led me to pursue dementia research.
Idly Velez Uribe, from Florida Atlantic University presented, Cognitive Assessment of Monolingual and Bilingual US Older Latino Populations that addressed the disparities in dementia risk, early detection and care in US Latino populations.
How does your work impact those living with Alzheimer’s? Our work advances our knowledge about the early detection of Alzheimer’s disease and other dementias, which may result in better opportunities to seek healthcare options that benefit patients and their families. I also have the fortune of having daily interactions with our research participants and their caregivers. Our efforts include recommending beneficial interventions for the patient and the caregiver at the behavioral, social and physical (diet and exercise) levels.
What made you want to get into dementia research? I started my research career in cross-cultural neuropsychology by conducting studies with student populations. When the opportunity arose to collaborate with the 1Florida ADRC, I did not hesitate to move on to work on research that would have a more significant impact on people’s lives, especially those vulnerable to or already suffering from neurodegenerative disorders.
What gives you hope? My hope comes from knowing that so many scientists and practitioners are committed to finding strategies to help patients and their families, whether from the pharmacological, behavioral, neurological, governmental, or social practice fields.
Mary Newport, of Spring Hill Neonatology, Inc. presented, Personalized nutritional ketosis through a whole-food low-carb diet, medium chain triglycerides, and other ketogenic strategies for people with mild cognitive impairment and Alzheimer’s disease.
How does your research impact someone living with Alzheimer’s and/or their caregivers? My research is about a dietary intervention that can easily be incorporated into everyday meals and has been shown in a number of small and medium-sized clinical trials to improve memory and cognition in many people with Alzheimer’s and mild cognitive impairment. This intervention is available in the grocery store and is inexpensive, especially compared to the newest Alzheimer’s drugs.
What made you want to get into dementia research? My husband Steve Newport was diagnosed with early-onset Alzheimer’s at age 54 in 2004, and I was his primary caregiver for 12 years. Steve had a dramatic response to adding ketogenic oils, those containing medium-chain triglycerides, to his diet, first as coconut oil and then with a mixture of coconut and MCT oils, along with a low-carb diet. His memory and cognition improved, his tremors and stiff gait went away, he was able to read again after several months, and also provide much more of his personal care without step-by-step supervision. Two years later, he received a ketone ester developed by Dr. Richard Veech at the NIH in a pilot study of one person and improved from a setback, then was stable for 20 more months. Steve developed serious seizures in 2013 with a related head injury and became dependent after that. Steve passed away at home in hospice care from Alzheimer’s and Lewy body dementia at age 65 in 2016. Overall, Steve gained nearly four better quality years than the year before he started coconut oil. He was also quite far along, between stages 5 and 6 when we began using coconut oil in his diet, so this could potentially help some people who are at the moderate and later stages as well. Ketones can help because they are an alternative fuel for the brain and can help someone with Alzheimer’s because there is a problem of abnormal glucose uptake as fuel into brain cells. Ketones do not require insulin and are taken up normally in the areas of the brain affected by Alzheimer’s. It is like a car in that many neurons seem to be lying dormant and providing them with fuel will allow them to function again.
What gives you hope? What gives me hope is that numerous small to medium-size studies of MCT oil and/or ketogenic diet and a couple of studies using coconut oil have reported improved memory and cognition in people with Alzheimer’s and mild cognitive impairment. Many of these studies are detailed in my poster on personalized nutritional ketosis. More studies are currently in progress on MCT oil, ketone salts, and ketogenic diet with and without MCT oil, as well as a large study of the ketone ester in older people with metabolic syndrome that often leads to dementia. None of the existing drugs, even the newest approved drugs, claim to improve memory or cognition, and nutritional ketosis offers hope to at least improve symptoms in many people. As reported in my second poster for the conference, I collected 288 cases of people with Alzheimer’s or other memory impairment between 2008 and 2014 whose caregivers had written to me, and almost 90% reported one or more improvements (3/4 taking just coconut oil and the rest coconut and MCT oil.) Some people have stayed in touch for years and have reported up to 10 years of improvement followed by stabilization.
At any given moment, research is happening. Right now, @alzassociation has over $310M invested in more than 950 research projects in 48 countries, spanning 6 continents. Visit alz.org/anygivenmoment to learn more.
National Dementia Research News
Hearing Aids Slow Cognitive Decline in Older Adults with Hearing Loss and at Risk for Cognitive Decline
The largest clinical trial to date investigated whether a hearing loss treatment intervention can reduce risk of cognitive decline. In the study, in a subgroup of older adults with hearing loss who were at higher risk of cognitive decline, using hearing aids for three years cut cognitive decline in half. Learn more.
New Use of Opioids Increases Risk of Death Elevenfold in Older Adults with Dementia
New opioid use in older adults with dementia is associated with a significantly increased risk of death, including an elevenfold increase in the first two weeks, according to research first reported today at AAIC. A study of everyone diagnosed with Alzheimer’s disease in Denmark in a 10-year period found one-third died within 180 days after their first opioid dose, five times as many as those with the disease who didn’t take opioids. Learn more.