The study found that women responded better than men to early Alzheimer’s intervention 2022-04-26 08:45:54


“Two out of three Alzheimer’s brains are women’s,” said Dr. Richard Isaacson, director of the Alzheimer’s Prevention Clinic in the Center for Brain Health at Florida Atlantic University’s Schmidt School of Medicine.

Now, there’s good news for a new study when it comes to giving women a chance to reduce the increased risk. Personal lifestyle interventions — such as diet, exercise, stress reduction, and sleep hygiene — were able to reduce Alzheimer’s risk factors in both sexes, but they worked best for women.

“Our individually tailored interventions led to greater improvements in women than in men across measures of Alzheimer’s and cardiovascular disease risk,” said Isaacson, who co-authored the research paper.

Women also showed greater improvement than men in biomarkers such as lower blood sugar and lower LDL, or low-density lipoprotein, the “bad” cholesterol.

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“This study clearly reinforces the need for additional, larger studies to be able to better predict the baseline cognitive pathway in older females versus males,” said Rudi Tanzi. Professor of Neurology at Harvard Medical School. he is He is director of the Genetics and Aging Research Unit at Massachusetts General Hospital in Boston.

“As we aim to find ways to eradicate this disease in the bud stage, we will need to know if prevention and treatment strategies will work equally for both men and women. Clearly, this new study brings us a big step closer to that goal,” Tanzi said. who did not participate in the study.

The effect of personal interventions

The new study followed a subset of people participating in a 10-year study designed to test the effect of personal recommendations on cognitive function and risk factors for dementia. The Efficacy of comparing dementia and Alzheimer’s score The trial, which began in 2018, is taking place at NewYork-Presbyterian / Weill Cornell Medical Center in New York City.
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After complete blood, physical, cognitive and genetic examinations, patients were provided with counseling and individual genetic education. Medications, vitamins, and supplements are tailored to each person’s unique outcomes, too. In addition, all participants received personalized lifestyle interventions, such as advice on exercise, diet, blood pressure control, sleep hygiene, and stress reduction.

Everyone in the Cedar trial had a family history of Alzheimer’s disease, Isaacson said, but the majority did not show signs of cognitive decline when the study began. Of the 154 men and women who participated in the research, 35 were He was diagnosed with mild cognitive impairment, or MCI, due to Alzheimer’s disease, but it wasn’t severe enough to “affect their daily lives,” he said.

original study The main results were published in 2019. People with MCI note that their performance on cognitive tests of memory and thinking skills improves by about 5 points. When they followed at least 60% of their lifestyle recommendations (on average, at least 12 out of 21 different recommendations) for 18 months.
However, the Study 2019 It found that people with mild cognitive impairment who followed less than 60% of the suggestions showed no cognitive improvement – in fact, they continued to drop by 6 points on average.

Cognitively normal patients with a family history of Alzheimer’s disease, called the prevention group, were able to have an “equally impressive” cognitive enhancement. Average of 4.5 points By following at least some lifestyle recommendations. Isaacson said it didn’t seem to matter if they followed less than 60% of them.

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“The good news from our study is that there were indeed cognitive improvements at 18 months of age in both women and men when compared to the control group,” Isaacson said. “A lot of the drugs that have been studied are aimed at delaying cognitive decline, but it is difficult to show that cognition improves over time.”

Nearly half of CEDAR participants carry at least one APOE gene, which may increase the risk of Alzheimer’s disease. However, the study found no difference in the cognitive benefits of the intervention for those with one or two copies of APOE compared to those with It was also reassuring, said Isaacson, of those without the gene.

Impact on women versus men

The new study Published Tuesday in the Journal of Alzheimer’s Disease Prevention, The original 2019 study took it a step further by analyzing a subset of participants to see if There was no difference between men and women when it came to how successful the lifestyle interventions were.

“Women have very different and unique risk factors for developing dementia,” Isaacson said. “Women are 39% more likely to develop dementia if they have a buildup of fat around their midsection.

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“The rapid decline in estrogen during the perimenopause transition could actually be one of the most influential risk factors for developing Alzheimer’s disease in the brain,” he said.

In the new analysis, women in the prevention group, who started the experiment without cognitive problems, The men showed greater improvement in two areas: one of two measures of cardiovascular risk and levels of good cholesterol, HDL, or high-density lipoprotein, which protects against heart disease.

Women with mild cognitive decline, called the early treatment group, showed greater improvement than men when it came to average blood sugar levels. and two cardiovascular risk scales. This female group also had more significant improvements in several important cholesterol (or lipid) biomarkers compared to the men in the early treatment group.

For all participants, compliance with an additional 10% of subjective recommendations resulted in an additional 0.9 point improvement for women and 0.41 point improvement for men on cognitive tests.

How does reducing the risk of cardiovascular disease affect cognition in the future? Because what’s good for the heart is good for the brain, experts say.

Vascular risk factors such as high blood pressure, high cholesterol, high blood sugar, or diabetes may not be a cause of Alzheimer’s disease, but they can. “Rapid progression in Alzheimer’s pathology,” Isaacson said. “I’d rather be on the brakes than accelerating the motor down the path of cognitive decline.”

The discovery that women can reduce their risk even more than men is welcome news, Isaacson said, as it provides a promising area for future study and offers hope that women can turn the battle against Alzheimer’s disease in their favour.

“By treating people in an evidence-based but safe way, using multiple lifestyle and medical interventions, we’ve shown that you can really make an impact on brain health,” he said.