Review article on AD risk factors: so many studies, so many conflicting or inconclusive results

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karelena
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Review article on AD risk factors: so many studies, so many conflicting or inconclusive results

Postby karelena » Fri Sep 06, 2019 6:52 pm

This is a long article with a few surprises. It is interesting that so many studies had contradictory results. They conclude that niacin may be protective, but results do not support the benefit of any other vitamins. Although increased fruit and vegetable intake is probably helpful (but not flavinoids or PUFA). They refer to a study that showed increased mercury (3rd and 4th quartiles) is associated with a lower risk of AD (!).

I wish there were studies about effect of all these factors specifically for APOE4. Maybe then we would have a better idea of what may work for us.

This is exactly what is frustrating about ReCODE, I have no idea where most of the recommendations come from, notably the long list of recommended supplements. I had assumed there were studies, but alas, apparently not.

1-s2.0-S0161813X17300554-main.pdf
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Re: Review article on AD risk factors: so many studies, so many conflicting or inconclusive results

Postby NF52 » Fri Sep 06, 2019 8:36 pm

karelena wrote:This is a long article with a few surprises. It is interesting that so many studies had contradictory results. ...

1-s2.0-S0161813X17300554-main.pdf

Hi Karelena,

I agree that it's frustrating to have consensus only around what seem like obvious recommendations: Exercise is important, a Mediterranean-style diet is better than the "Standard American Diet"; avoiding serious or repetitive head injuries is a good idea, avoiding diabetes is preferable, etc. Even some of the conclusions of previous studies are now being re-interpreted. For example, the abstract notes that a higher educational level is associated with a faster cognitive decline. Note that it doesn't say "earlier"; it says "faster". Scientists have now charted that decline over time with longitudinal studies and it appears that what is happening is that people with higher education levels or "higher cognitive reserve", can compensate or show "resilience" to observable signs of reduced connectivity in the brains, or vascular damage, or hippocampus atrophy, by using their cognitive strengths--until they can't, and then they show a more rapid decline. So that's one example of how something that is "associated" with cognitive decline is not really a sign of a risk factor, but more a sign of the brain's actions to fight off decline.

From sitting in on meetings of scientists who work on basic research in Alzheimer's, it is clear that the understanding of the mechanisms of pathology are complex, and vary across people probably due to their history (TBI, diabetes, vascular issues), their individual genome (not just ApoE 4, but other risk and protective genes); their microbiome, their brain's inherent structure and resiliency and yes, their use of various supplements, like B-12, among others.

It's also clear that Alzheimer's may be a much more complex disease than was first thought, and it may be that a significant minority (maybe a third) of the cases identified as "Alzheimer's" in past studies were actually mixed dementias, or vascular or Lewy Body dementias, or something else.

But the research is still making great strides, and the imaging and use of machine learning, using massive data sets to have computers find subtle patterns in genome-wide-association-studies (GWAS) and in records of individuals are both expanding the rate and degree of learning. Scientists are also using sophistivated statistical models to study both plant-based and genetically-engineered possible interventions, and identifying "targets" throughout the brain's processes that might allow prevention to occur.

It's very hard to study dozens of supplements at once; so for now, I think people make their best calculation about what their risks and targets for their own personalized approach will be. I hope that is working for you.
4/4 and still an optimist!

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Re: Review article on AD risk factors: so many studies, so many conflicting or inconclusive results

Postby karelena » Sat Sep 07, 2019 6:26 pm

Thanks for your reply NF52. As a fellow 4/4, it just bothers me that we do not know what we are doing and whether it will help. We have daunting odds as 4/4s, 11-15X the normal risk (for 3/3). So even if there is a way to reduce the odds/risk as described by some studies, by 30% or 60% (for the general population, most of whom are 3/3 or 3/4), pick any number even 100% and we are still stuck with 10-14X. I just wish we knew more about how to tackle 4/4. We are in uncharted territory.

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Re: Review article on AD risk factors: so many studies, so many conflicting or inconclusive results

Postby laurie » Tue Oct 15, 2019 2:19 pm

karelena wrote: I have no idea where most of the recommendations come from, notably the long list of recommended supplements. I had assumed there were studies, but alas, apparently not.

1-s2.0-S0161813X17300554-main.pdf


Karlena if you are interested in learning about supplements to take to prevent Alzheimer's and improve brain health, my husband Dennis N Crouse has written an evidenced based book recommending 7 Supplements. With each of the supplements he presents the research which backs the recommendation he makes. Here is a link to a write up on one of the supplements PQQ. https://www.blogger.com/blogger.g?blogI ... c=postname
"True prevention is only possible by first discovering the cause of a disease such as Alzheimer's."
Dennis N Crouse

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Re: Review article on AD risk factors: so many studies, so many conflicting or inconclusive results

Postby Emerald » Tue Oct 15, 2019 8:32 pm

This is why - at the age of 29 - I refuse to give up cheese (which I have a slice of once or twice daily), other dairy products like all natural half and half creamer, alcohol, etc. I'll follow the obvious recommendations, but I'm not going to give up everything I enjoy when it's not 100% proven. As long as my basic biometrics including my BMI, blood pressure, glucose, and cholesterol are okay, I'm not worrying.

Truthfully, I'm at the point where I live as healthily as I can, but if eating organic cheese or drinking wine means I get Alzheimer's many decades from now, so be it. I can't limit my entire life over having a single APOE4 copy. I went from handling the news pretty well initially to being completely traumatized when I realized how strict the recommendations were a year later to now just shrugging it off. Every single person on this planet is at risk of some type of dementia. Sure, I'm at a higher risk for Alzheimer's, but it's not guaranteed, and I need to have some fun.

I'm at the point where I'm starting to feel resentful toward recommendations that make it seem like having an APOE 3/4 status means giving up everything more than I'm afraid of Alzheimer's.
Last edited by Emerald on Thu Oct 17, 2019 6:03 pm, edited 2 times in total.

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Re: Review article on AD risk factors: so many studies, so many conflicting or inconclusive results

Postby Fiver » Wed Oct 16, 2019 7:44 am

Yes, it's frustrating. Incomplete data about what works, for who, and at what ages. Few practical ways to monitor our status to know if our efforts are working. And unnecessary challenges for arranging long-term care and making end-of-life decisions. I agree.

But we can address these issues by aggressively advocating for increased funding for research. We can insist that policies be changed to address healthcare issues. Along the way, we can do the best we can, support each other, and do some good!
Concerned, but hopeful. Introverted, but will talk about science.


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