Posts Tagged Mild Cognitive Impairment

Cocoa May Slow Cognitive Impairment of Aging


Cocoa May Slow Cognitive Impairment of AgingIf there is a more pleasurable way of staving off the cognitive impairment of aging than drinking cocoa, perhaps only red wine drinkers have found it.

Flavanols are naturally occurring antioxidants found in abundance in cocoa plants. They help the body deal with free radicals that trigger negative changes in body chemistry and help prevent blood clots.

Now, a new study led by Giovambattista Desideri, M.D., study lead author and associate professor of internal medicine and public health at the University of L’Aquila in Italy, suggests ingesting cocoa flavanols daily may improve mild cognitive impairment.

Experts say that more than six percent of people aged 70 years or older develop mild cognitive impairment (MCI) annually. Moreover, MCI can progress to dementia and Alzheimer’s disease.

Researchers say flavanols may aid brain health by protecting neurons from injury, enhancing metabolism, and facilitating neuronal interaction with the molecular structures responsible for memory. They are also found in tea, grapes, red wine and apples and have been associated with a decreased risk of dementia.

Indirectly, flavanols may help by improving brain blood flow.

In the study, 90 elderly participants with mild cognitive impairment were randomized to drink daily either 990 milligrams (high), 520 mg (intermediate) or 45 mg (low) of a dairy-based cocoa flavanol drink for eight weeks.

Researchers controlled participants’ diet to eliminate other sources of flavanols from foods and beverages other than the dairy-based cocoa drink.

Cognitive function was examined by neuropsychological tests of executive function, working memory, short-term memory, long-term episodic memory, processing speed and global cognition.

Researchers found:

  • Scores significantly improved in the ability to relate visual stimuli to motor responses, working memory, task-switching and verbal memory for those drinking the high and intermediate flavanol drinks;
  • Participants drinking daily higher levels of flavanol drinks had significantly higher overall cognitive scores than those participants drinking lower-levels;
  • Insulin resistance, blood pressure and oxidative stress also decreased in those drinking high and intermediate levels of flavanols daily. Changes in insulin resistance explained about 40 percent of the composite scores for improvements in cognitive functioning.

“This study provides encouraging evidence that consuming cocoa flavanols, as a part of a calorie-controlled and nutritionally-balanced diet, could improve cognitive function,” Desideri said. However, he warns that the beneficial findings may have been influenced by a variety of factors.

“The positive effect on cognitive function may be mainly mediated (influenced) by an improvement in insulin sensitivity. It is yet unclear whether these benefits in cognition are a direct consequence of cocoa flavanols or a secondary effect of general improvements in cardiovascular function.”

Furthermore, the study population was generally in good health without known cardiovascular disease. Thus, it would not be completely representative of all mild cognitive impairment patients.

In addition, only some clinical features of mild cognitive impairment were explored in the study.

“Given the global rise in cognitive disorders, which have a true impact on an individual’s quality of life, the role of cocoa flavanols in preventing or slowing the progression of mild cognitive impairment to dementia warrants further research,” Desideri said.

“Larger studies are needed to validate the findings, figure out how long the positive effects will last and determine the levels of cocoa flavanols required for benefit.”

The research is reported in the American Heart Association’s journal Hypertension.

Source: American Heart Association

Woman drinking cocoa photo by shutterstock.

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Alzheimer’s More Aggressive in Younger Elderly


Alzheimers More Aggressive in Younger Elderly New research shows that Alzheimer’s disease hits people in their 60s and 70s harder than people who are 80 years and older.

Researchers at the University of California, San Diego School of Medicine note that the greatest risk factor for Alzheimer’s is age. In fact, by the age of 85, the likelihood of developing the dreaded neurological disorder is roughly 50 percent, they say.

But in their study, they found that the “younger elderly” — those in their 60s and 70s — showed higher rates of cognitive decline and faster rates of tissue loss in brain regions that are vulnerable during the early stages of Alzheimer’s, according to Dominic Holland, Ph.D., a researcher in the Department of Neurosciences at UC San Diego and the study’s first author.

“Additionally cerebrospinal fluid biomarker levels indicate a greater disease burden in younger than in older individuals,” he said.

Holland and his colleagues, using imaging and biomarker data from participants in the Alzheimer’s Disease Neuroimaging Initiative, examined 723 people, ages 65 to 90 years, who were categorized as either cognitively normal, with mild cognitive impairment (an intermediate stage between normal, age-related cognitive decline and dementia) or suffering from full-blown Alzheimer’s disease (AD).

The findings have implications for diagnosing the disease — which currently afflicts an estimated 5.6 million Americans, a number expected to triple by 2050 — and efforts to find new treatments, the researchers said.

At present, there is no cure for Alzheimer’s and existing therapies do not slow or stop the disease’s progression.

A key feature in the diagnosis of Alzheimer’s is its “relentless progressive course,” Holland said.

“Patients typically show marked deterioration year after year. If older patients are not showing the same deterioration from one year to the next, doctors may be hesitant to diagnose AD, and thus these patients may not receive appropriate care, which can be very important for their quality of life.”

Holland said it’s not clear why the disease is more aggressive among the younger elderly.

“It may be that patients who show onset of dementia at an older age, and are declining slowly, have been declining at that rate for a long time,” added co-author Linda McEvoy, Ph.D., associate professor of radiology. “But because of cognitive reserve or other still-unknown factors that provide ‘resistance’ against brain damage, clinical symptoms do not manifest till later age.”

Another possibility is that older patients may be suffering from mixed dementia — a combination of Alzheimer’s and other neurological conditions, Holland said. These patients might withstand the effects of Alzheimer’s until other adverse factors, such as brain lesions caused by cerebrovascular disease, take hold. At that time, Alzheimer’s can only be definitively diagnosed by an autopsy, he said.

Clinical trials to find new treatments for the disease may be affected by the differing rates of progression, researchers said.

“Our results show that if clinical trials of candidate therapies predominately enroll older elderly, who show slower rates of change over time, the ability of a therapy to successfully slow disease progression may not be recognized, leading to failure of the clinical trial,” said Holland. “It’s critical to take into account age as a factor when enrolling subjects for AD clinical trials.”

While the obvious downside of the findings is that younger patients with Alzheimer’s lose more of their productive years, “the good news in all of this is that our results indicate those who survive into the later years before showing symptoms of AD will experience a less aggressive form of the disease,” Holland concluded.

The research appears online in the journal PLOS One.

Source: University of California, San Diego

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