Friday December 6, 2019

Healthy Lifestyle Can Cut Risk of Developing Alzheimer Even if You Have High Genetic Risk: Study

After about eight years of study, 1.8% of those with high genetic risk and poor lifestyles had developed dementia versus 0.6% of folks with low genetic risk and healthy habits

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Living a healthy lifestyle can reduce the risk of Alzheimer's or other dementia, even if you have a genetic risk, a large study found. VOA

A healthy lifestyle can cut your risk of developing Alzheimer’s or other forms of dementia even if you have genes that raise your risk for these mind-destroying diseases, a large study has found.

People with high genetic risk and poor health habits were about three times more likely to develop dementia versus those with low genetic risk and good habits, researchers reported Sunday. Regardless of how much genetic risk someone had, a good diet, adequate exercise, limiting alcohol and not smoking made dementia less likely.

“I consider that good news,” said John Haaga of the U.S. National Institute on Aging, one of the study’s many sponsors. “No one can guarantee you’ll escape this awful disease” but you can tip the odds in your favor with clean living, he said. Results were discussed at the Alzheimer’s Association International Conference in Los Angeles and published online by the Journal of the American Medical Association.

50 million people

About 50 million people have dementia, and Alzheimer’s disease is the most common type. Genes and lifestyle contribute to many diseases, but researchers only recently have had the tools and information to do large studies to see how much each factor matters.

healthy lifestyle, alzheimer
After about eight years of study, 1.8% of those with high genetic risk and poor lifestyles had developed dementia versus 0.6% of folks with low genetic risk and healthy habits. Pixabay

One such study a few years ago found that healthy living could help overcome genetic risk for heart disease. Now researchers have shown the same to be true for dementia.

Dr. Elzbieta Kuzma and colleagues at the University of Exeter Medical School in England used the UK Biobank to study nearly 200,000 people 60 or older with no signs or symptoms of dementia at the start. Their genetic risk was classified as high, medium or low based on dozens of mutations known to affect dementia. They also were grouped by lifestyle factors.

By the numbers

After about eight years of study, 1.8% of those with high genetic risk and poor lifestyles had developed dementia versus 0.6% of folks with low genetic risk and healthy habits. Among those with the highest genetic risk, just more than 1% of those with favorable lifestyles developed dementia compared to nearly 2% of those with poor lifestyles.

One limitation: Researchers only had information on mutations affecting people of European ancestry, so it’s not known whether the same is true for other racial or ethnic groups.

alzheimer, healthy lifestyle
Among those with the highest genetic risk, just more than 1% of those with favorable lifestyles developed dementia compared to nearly 2% of those with poor lifestyles. Pixabay

Genes are not destiny

The results should give encouragement to people who fear that gene mutations alone determine their destiny, said Dr. Rudy Tanzi, a genetics expert at Massachusetts General Hospital. Less than 5% of the ones tied to Alzheimer’s are “fully penetrant,” meaning that they guarantee you’ll get the disease, he said.

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“That means that with 95% of the mutations, your lifestyle will make a difference,” Tanzi said. “Don’t be too worried about your genetics. Spend more time being mindful of living a healthy life.”

One previous study in Sweden and Finland rigorously tested the effect of a healthy lifestyle by assigning one group to follow one and included a comparison group that did not. It concluded that healthy habits could help prevent mental decline. The Alzheimer’s Association is sponsoring a similar study underway now in the United States. Healthy living also is the focus of new dementia prevention guidelines that the World Health Organization released in February. (VOA)

Next Story

Research Finds That Drug Can Curb Dementia’s Delusions

About 8 million Americans have dementia, and studies suggest that up to 30% of them develop psychosis.

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Television actor Barbara Windsor and her husband Scott Mitchell talks about Drugs
Television actor Barbara Windsor and her husband Scott Mitchell pose with a placard in front of Downing Street ahead of a meeting with Britain's Prime Minister Boris Johnson in London, Britain. VOA

A drug that curbs delusions in Parkinson’s patients did the same for people with Alzheimer’s disease and other forms of dementia in a study that was stopped early because the benefit seemed clear.

If regulators agree, the drug could become the first treatment specifically for dementia-related psychosis and the first new medicine for Alzheimer’s in nearly two decades. It targets some of the most troubling symptoms that patients and caregivers face — hallucinations that often lead to anxiety, aggression, and physical and verbal abuse.

Results were disclosed Wednesday at a conference in San Diego.

Unmet need for treatment

“This would be a very important advance,” said one independent expert, Dr. Howard Fillit, chief science officer of the Alzheimer’s Drug Discovery Foundation.

Although the field is focused on finding a cure for dementia and preventing future cases, “there is a huge unmet need for better treatment” for those who have it now, said Maria Carrillo, the Alzheimer’s Association’s chief science officer.

The drug is pimavanserin, a daily pill sold as Nuplazid by Acadia Pharmaceuticals Inc. It was approved for Parkinson’s-related psychosis in 2016 and is thought to work by blocking a brain chemical that seems to spur delusions.

Dementia Drugs
Dementia is a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. Pixabay

About 8 million Americans have dementia, and studies suggest that up to 30% of them develop psychosis.

“It’s terrifying,” said Dr. Jeffrey Cummings of the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas. “You believe that people might be trying to hurt you. You believe that people are stealing from you. You believe that your spouse is unfaithful to you. Those are the three most common false beliefs.”

How the study worked

He consults for Acadia and helped lead the study, which included about 400 people with dementia and psychosis. All were given a low dose of the drug for three months, and those who seemed to respond or benefit were then split into two groups. Half continued on the drug and the others were given dummy pills for six months or until they had a relapse or worsening of symptoms. Neither the patients nor their doctors knew who was getting what.

Independent monitors stopped the study when they saw that those on dummy pills were more than twice as likely as those on the drug to relapse or worsen — 28% versus nearly 13%.

There were relatively few serious side effects — 5% in the drug group and 4% in the others. Headaches and urinary tract infections were more common among those on the drug. Two deaths occurred, but study leaders said neither was related to the drug.

The drug could become the first treatment for dementia
The drug could become the first treatment specifically for dementia-related psychosis. Pixabay

Carrillo said the study was small, but the drug’s effect seemed large, and it’s not known whether the federal Food and Drug Administration would want more evidence to approve a new use.

Risk of death

Current anti-psychotic medicines have some major drawbacks and are not approved for dementia patients.

“They’re often used off label because we have very few other options,” Fillit said.

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All carry warnings that they can raise the risk of death in elderly patients, as does Nuplazid.

Cost could be an issue — about $3,000 a month. What patients pay can vary depending on insurance coverage. (VOA)