Blood Pressure And Dementia
The relationship between blood pressure and cognitive capacity still remains controversial with disparate conclusions from different studies. While some evidence suggested that severity of cognitive decline was associated with increased blood pressure, others indicated that cognitive impairment was not correlated with blood pressure at all or a U-shaped curve relationship between blood pressure and cognitive level . In short, hypertension has been considered as the most predominant vascular risk factor in AD progression, since it may aggravate atherosclerosis and arterial stiffness in the long term, while extreme low blood pressure may also be responsible for the onset and development of dementia due to cerebral hypoperfusion . Meanwhile, diastolic blood pressure seems to have bigger influence on small arteries, and therefore high DBP may lead to ischemic lesions in white matter and deteriorated age-related cognitive decline .
Atrial Fibrillation And Dementia
Atrial fibrillation is the most common cardiac arrhythmia and has been associated with the occurrence of clinical or silent cardioembolic stroke , leading to dementia . In support of this hypothesis, a meta-analysis showed a close relationship between AF and a higher risk of dementia, though it was restricted to individuals with stroke . By contrast, another study found that stroke-free individuals with AF performed worse on memory and learning tasks and had a reduced hippocampal volume .
Both memory function and hippocampal volume are strongly related to AD this suggests that there might be additional pathways that explain the association between AF and AD . It has been hypothesized that AF might also cause dementia through cerebral hypoperfusion. A low cardiac output may induce cerebral hypoperfusion, even if transient, thereby determining vascular dementia , regardless of whether AF leads to ischemic stroke. Cerebral hypoperfusion causes damage to nerve cells, thereby contributing to the aetiology of AD . In addition, cerebral hypoperfusion may accelerate the three major pathological hallmarks of AD, namely, senile plaques , cerebral amyloid angiopathy , and neurofibrillary tangles .
Furthermore, in this study, a direct comparison between nonvitamin K antagonist oral anticoagulants and vitamin K antagonist showed no difference in terms of the lowered risk of dementia .
Vinpocetine Protects Against Hypoxia Vascular Dementia
Vinpocetine, a botanical agent derived from the periwinkle flower Vinca minor, has been used to help manage disorders of the central nervous system for several decades. Vinpocetine is remarkable in its ability to increase the flow of oxygen-rich blood to the brain and enhance the brains utilization of glucose as fuel.35 These characteristics strongly suggest that vinpocetine could have applications in fighting conditions associated with diminished blood flow, including heart disease and possibly Alzheimers disease.
Vinpocetine works via several different mechanisms of action, all of which may have important benefits for managing vascular conditions. A potent antioxidant, vinpocetine works as a vasodilator to relax the smooth muscles lining blood vessels, thus enhancing blood flow. Vinpocetine also decreases platelet and red blood cell aggregation while increasing the membrane flexibility of red blood cells, effects that could help prevent blood clots that can trigger heart attack or stroke. Vinpocetine likewise displays powerful neuroprotective effects, protecting cells against damage induced by hypoxia.36
Double-blind studies have shown that vinpocetine supplementation yields improvements in patients with mild to moderate vascular dementia .37-39 In Europe and Japan, vinpocetine is widely used as an adjunct therapy to treat ischemic stroke, a condition in which the brain suffers from low levels of oxygen.40
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Alzheimers And Heart Disease The Head And The Heart
In the literary sense, the head and the heart are often figuratively disconnected. But in the biological sense, there is increasing evidence of a significant link between Alzheimers and heart disease.
While patients with heart failure often present cognitive impairment, theres more to it, explained Federica del Monte, MD, PhD, with the Department of Medicine in the Medical University of South Carolinas Division of Cardiology. She has been researching the connection in hopes of finding more answers to the incurable disease.
According to Dr. del Monte, the same pathology that characterizes Alzheimers disease specifically amyloid plaques in the brain is also present in the hearts of some patients with primary cardiomyopathy and leads to heart failure.
We studied the hearts of patients with Alzheimers disease and found that the same plaques, made of the same protein material, deposit in the heart of those patients, she said.
The new found connecting link between the head and the heart is now opening up a realm of possibilities in terms of further research of both diseases.
Strengths And Limitations Of This Study
The strengths of this study include the prospective cohort design, the large sample size , and a long follow-up period . In addition, evaluating the association of different durations of low-dose ASA use was possible due to utilizing the primary care data. This analysis is not biased by the issue that older study participants are more likely to have both longer exposure probability towards low-dose ASA and a higher chance to be diagnosed with dementia during follow-up because first, the analysis was adjusted for age, and second, it is plausible that even some study participants with the minimum age included in our cohorts of 55 years have used low-dose ASA for more than 10 years because of some start with this therapy in their 40s in adherence with the current guideline for CVD prevention .
This study also has some limitations. As with any observational study, residual confounding remains possible, and causation cannot be tested like in RCTs. However, by applying the inverse probability of treatment weighting using a propensity score including all main cardiovascular risk factors, we were able to balance the distribution of CVD risk factors between low-dose ASA users and non-users, and thus, were able to adjust for confounding by indication comprehensively.
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Vascular Disease Unmasking Subclinical Alzheimers Disease
Although theoretical mechanisms exist by which cerebrovascular and Alzheimers pathologies may interact, it is also possible that the two processes may be parallel and unrelated at a pathological level but interacting in their clinical effects. The Nun study examined 678 female subjects aged 75102 years with a cognitive battery and dementia screen and reported necropsy findings on 102 subjects who had died 2 to 4 years later. Of those who met neuropathological criteria for Alzheimers disease, 39% had evidence of infarction. This was associated with increased prevalence of dementia and with worse cognitive performance in those with Alzheimers disease although not with worse cognitive performance in those without dementia. Counts of neurofibrillary tangles in the neocortex were found to correlate strongly with cognitive performance. However, in those with infarcts the effects of tangle counts on cognitive performance were enhanced and less tangles were seen in association with Alzheimers disease than in those without infarction. Infarcts were not associated with increased Alzheimers disease pathology in the whole group examined. These findings suggest that the two processes may be independent but that cerebrovascular disease acts to precipitate clinical Alzheimers disease at pathological stages where it would not otherwise become clinically apparent.
What Is Known About Reducing Your Risk Of Alzheimers Disease
The science on risk reduction is quickly evolving, and major breakthroughs are within reach. For example, there is growing evidence that people who adopt healthy lifestyle habits like regular exercise and blood pressure management can lower their risk of dementia. There is growing scientific evidence that healthy behaviors, which have been shown to prevent cancer, diabetes, and heart disease, may also reduce risk for subjective cognitive decline. To learn more about the current state of evidence on dementia risk factors and the implications for public health, please read the following summaries on Cardiovascular Health, Exercise, Diabetes and Obesity, Traumatic Brain Injury , Tobacco and Alcohol, Diet and Nutrition, Sleep, Sensory Impairment, and Social Engagement or the Compiled Report .
Aging
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Direct Effects Of Vascular Disease On The Pathology Of Alzheimers Disease
Severe coronary artery disease has been associated with increased senile plaque counts and hypertension with increased plaque and neurofibrillary tangle densities in a necropsy series of subjects without dementia, suggesting that the burden of Alzheimers pathology may be increased by systemic vascular disease, possibly to a threshold beyond which it becomes progressive and self generating. Increased amyloid precursor protein activity and -amyloid production have been found in the hippocampi of rodents after severe but transient ischaemia, a process which is probably a non-specific response to cerebral trauma. These subclinical processes may involve small areas of cortical or subcortical infarction or may be related to disturbances in cerebral perfusion possibly exacerbated by pre-existing microvascular abnormalities associated with Alzheimers disease. One means of ascertaining whether the origin of amyloid in Alzheimers disease is neuronal or vascular has been to examine its distribution relative to neurons or blood vessels. The complex anatomy of these structures in the cortex, however, has limited the conclusions that can be drawn. A recent study attempting to resolve this problem by examining amyloid deposition in white matter has reported distributions of amyloid to be particularly related to blood vessels, suggesting a vascular rather than neuronal source.
How Alzheimers Disease Can Affect Heart Health
Alzheimers disease is the most prevalent type of dementia, making up 60-80 percent of dementia cases. While it mostly affects people later in life, this condition can occur at any age. The disease is primarily categorized by the gradual loss of memory and other cognitive abilities. For this reason, it is primarily thought of as a condition that affects the mind. However, a new study has revealed that Alzheimers disease does not just affect the brain, it can affect the entire body, including the cardiovascular system.
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Whats Good For The Heart Is Good For The Brain
Report Highlights:
- While heart disease remains the #1 cause of death worldwide, authors of the American Heart Associations Heart Disease and Stroke Statistics – 2022 Update noted that diseases of the brain especially Alzheimers disease and dementia are substantially increasing, and they are often associated with many of the same risk factors that cause heart disease, including high blood pressure, obesity, diabetes and tobacco use.
- The global death rates attributed to Alzheimers disease and other dementias in the past ten years is more than double the increase in the death rates from heart disease during that same time.
- Over the past 30 years , the global prevalence of Alzheimers disease and other dementias has increased by more than 144% and deaths have increased by more than 184%.
- Gender, racial and ethnic disparities also are prevalent among people who have poor brain health.
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Optimal brain health includes the functional ability to perform all the diverse tasks for which the brain is responsible, including movement, perception, learning and memory, communication, problem solving, judgment, decision making and emotion. Cognitive decline and dementia are often seen following stroke and cerebrovascular disease and indicate a decline in brain health. Conversely, studies show maintaining good vascular health is associated with healthy aging and retained cognitive function.
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Alzheimers And Cardiovascular Disease Share Common Genetics In Some Patients
Study of 1.5 Million Individuals Suggests Potential for Early Diagnosis and Hope for Precision Medicine Approach to Preventive Therapies
Genetics may predispose some people to both Alzheimers disease and high levels of blood lipids such as cholesterol, a common feature of cardiovascular disease, according to a new study by an international team of researchers led by scientists at UC San Francisco and Washington University School of Medicine in St. Louis.
The research analyzed genome-wide data from over 1.5 million individuals, making it one of the largest-ever studies of Alzheimers genetics. The authors hope the findings will lead to improved early diagnosis and potentially new preventative strategies for Alzheimers disease, which currently affects 5.7 million people in the U.S. and has no cure.
The new study, published Nov. 9, 2018, in Acta Neuropathologica, shows that Alzheimers and cardiovascular disease do share common genetics in some individuals, raising new questions about whether this shared biology could be targeted to slow down or prevent both diseases.
Ultimately Desikans team was able to analyze the combined impact of such genetic markers on both cardiovascular disease risk based on five GWAS studies of more than one million individuals and on Alzheimers risk based on three GWAS studies of nearly 30,000 Alzheimers patients and more than 50,000 age-matched controls.
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What Causes Vascular Dementia
Vascular dementia is caused by a lack of blood supply to your brain. This causes the surrounding cells to die. The causes of a reduced blood supply to your brain include:
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small vessel disease narrowing of small blood vessels deep inside your brain
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a stroke where the blood supply to part of your brain is suddenly cut off, due to a blood clot or haemorrhage
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mini-strokes known as transient ischaemic attacks . These can cause tiny but widespread damage over time.
Risk Factors For Heart Disease And Stroke Also Tied To Alzheimers
By Lisa Rapaport, Reuters Health
5 Min Read
– Middle-aged people with risk factors for heart attacks and stroke are also more likely to develop changes in the brain that can lead to Alzheimers disease, a new study suggests.
Previous research has linked so-called vascular risk factors, including obesity, diabetes, smoking, high cholesterol and elevated blood pressure, to higher odds of dementia, cognitive decline and Alzheimers disease.
But its been unclear whether these factors contribute indirectly by restricting blood flow in the brain, or if they directly cause a buildup of amyloid protein fragments that are linked to Alzheimers.
In our study, we found an association between the number of risk factors that people without dementia had when they were middle-aged and the risk of having amyloid in their brain when they were older, said lead study author Dr. Rebecca Gottesman of Johns Hopkins University School of Medicine in Baltimore.
Each alone may not be enough to increase the risk of Alzheimers disease, but having a number of these risk factors appears to be associated with an even higher risk, Gottesman said by email. Although this doesnt prove causation, it suggests that vascular risk factors might directly impact Alzheimers changes in the brain.
At the start of the study, one in five participants had no vascular risk factors, while 38 percent had one and 42 percent had at least two.
SOURCE: bit.ly/2eRKuCu JAMA, online April 11, 2017.
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What Is Alzheimers Disease
- Alzheimers disease is the most common type of dementia.
- It is a progressive disease beginning with mild memory loss and possibly leading to loss of the ability to carry on a conversation and respond to the environment.
- Alzheimers disease involves parts of the brain that control thought, memory, and language.
- It can seriously affect a persons ability to carry out daily activities.
Ginkgo Provides Multifaceted Neuroprotection
Another supplement that I have recommended to many of my patients as a front-line agent in the fight against Alzheimers is Ginkgo biloba. Ginkgo has been used for at least 5,000 years in the management of numerous health concerns, including age-related memory loss.22 Multiple studies have demonstrated that ginkgo extracts can provide remarkable protection against some of the most common pathological changes seen in the brains of Alzheimers patients.
As noted earlier, maintaining optimal levels of acetylcholine is one way to fight Alzheimers disease. A report published in 2000 showed that standardized ginkgo extract promotes the uptake of the acetylcholine precursor choline in an area of the brain associated with memory function. Furthermore, the ginkgo extract protected the brain against the age-related loss of cholinergic neurons, which communicate using acetylcholine.23 In addition, multiple studies have been shown that ginkgo extracts can protect brain cells against amyloid-beta-induced death.24,25
Ginkgo extracts also confer powerful antioxidant properties. Recent studies have shown that standardized ginkgo extract effectively increased levels of antioxidant enzymes in the hippocampus, the brains essential memory center. This likely has the effect of protecting against the free-radical-induced damage that is so prevalent in the brains of Alzheimers sufferers.26
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How Will This Project Help People With Dementia
This study could produce a reliable new method of selecting people for clinical trials to prevent dementia. People with a low CVR could be included into trials for exercise intervention to reduce dementia risk.CVR could also be used as a valuable marker to monitor progress in trials that are aimed at improving blood flow to the brain. Dementia risk scores could be used to identify people at high risk of dementia for treatments to delay or prevent the condition.
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Dementia Associated With Cardiovascular Diseases
On the other side of the coin, a series of cohort studies have shown that patients with cardiovascular diseases are more prone to cognitive decline and dementia, mainly due to increased incidence of stroke and cerebral hypoperfusion over time. Many shared risk factors including diabetes mellitus, hypertension, atherosclerosis, obesity, metabolic syndrome, smoking, inflammation, oxidative stress, and APOE polymorphisms are involved in the pathogenesis of dementia .
Figure 1
Interrelationship between cardiovascular diseases and dementia Patients with AD have a higher risk of cardiac diastolic dysfunction, possibly due to A and tau protein aggregation and PSEN gene mutations. On the other hand, arterial fibrillation, heart failure, and hypertension may also increase the risk of vascular dementia and AD through complicated mechanisms. Meanwhile, many shared vascular risk factors, 4 allele of APOE gene, platelet overactivation, and systemic inflammation may be the common changes between cardiovascular and neurodegenerative diseases.
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‘following Grandma’s Heart’: Victoria Man Joins Walk To End Alzheimer’s To Honor Grandmother’s Memory
On Saturday morning, participants donned purple and sported flowers that represented their connection to Alzheimers at Victoria College.
The Alzheimers Association hosted their annual Walk to End Alzheimers where 250 participants came out early in the morning to honor those who deal with Alzheimers and raise support for a cure for the disease.
At the opening ceremony, participants were given Promise Garden flowers with different colors to represent their connection to the disease. The Promise Garden is a part of The Alzheimers Association mission to end Alzheimers where participants at these walks show their dedication to their loved ones in their lives who deal with this disease.
Before the walk, there was a short zumba session to get people active and ready for the walk around Victoria College.