A Memorable Discovery for Dementia?

Having recently celebrated my 30^th anniversary at the University of Maryland School of Medicine and upon hearing the Beatle’s tune, “In My Life”, I was struck by the verse “and these memories lose their meaning”.  Though highly unlikely that John (Lennon) wrote this verse with “dementia” in mind, the words can certainly be consistent with memory loss.

Yet while tremendous strides have unfolded in treating cardiovascular disease (heart attacks, strokes, etc) in recent decades, the pace of progress has been slower when it comes to prevention/treatment of Alzheimer’s disease and other forms of dementia.  The initial exhuberance following FDA’s approval of Biogen’s Alzheimer’s disease drug, (aducanumab or  “Aduhelm”) last month, despite mixed study results, was met with immediate skepticism and calls for a federal investigation as to whether there was sufficient justification to warrant approval.   Undoubtedly, stakes are high with an estimated 6.2 million Americans (~1 in 9) aged 65 and older having some form of dementia.

However, hope may be on the horizon as a new study out this week sheds important insights into how memory loss may be reversed.  The study conducted in the United Kingdom examined PNNs (perineuronal nets), highly specialized structures involved in regulating neuroplasticity (the way the adaptive brain learns and develops new memories).  In early childhood, there is increased neuroplasticity but as the brain ages, PNNs decrease and neuroplasticity wanes. An important compound in PNNs that promotes neuroplasticity is chondroitin-6-sulfate (C6S).  The new study found that administration of C6S to aged mice restored their ability to quickly recognize objects at levels similarly observed in younger mice.

Bottom Line: while more animal studies are required to confirm the effects of C6S on memory before progressing to human trials, the new study may turn out to be a memorable discovery for dementia.

In the meantime, listed below are lifestyle related tools that may help sharpen your memory:

1. Reduce Sugary Beverages: Drinking more than 1 sugared beverage (soda, juice) daily was associated with reduced memory and lower brain volume compared to minimal or no sugary beverage intake.
2. Add Blueberries: 1 cup of fresh blueberries daily is associated with fewer learning errors and improved cognition in men and women aged 60 years and older.
3. Practice Mind–Body Exercises: Participating in mind-body exercises such as Tai Chi, yoga and dancing mindfulness movements improve learning, memory and adaptable brain responses (neuroplasticity). 
4. Aerobic Activity: Moderate aerobic activity (walking at a pace of 3-5 mph) was shown to improve cerebral blood flow and cognitive function in men and women with mild cognitive impairment over a 12-month period.
5. Sneak in an Afternoon Nap: Power napping for as little as 30 minutes in the afternoon is associated with improved memory and cognitive function.
6. Stay Hydrated: Dehydration is associated with impaired cognitive function. Drinking  6 ounces of water each hour over a 10 hour period will help keep your mind sharp.

Dr. Michael Miller is Professor of Medicine at the University of Maryland School of Medicine.

The New Sleep Study that is Outrightly Nightmarish

Upon awakening (and before your caffeine fix), if you can say the title of this post three times perfectly in less than 10 seconds (go ahead, give it a shot…), odds are that you just slept like a baby!

In all seriousness, I was taken aback upon reading the newly published study that found men and women aged 50 and over who (on average), slept just 6 hours (or less) per night saw an  increased risk of dementia by 30% compared to those whose average sleep duration was at least 7 hours.    Other studies showed similar findings though most were conducted over a shorter follow-up period (generally less than 10 years).

We still don’t know whether sleep deprivation that begins at an earlier age has a similar effect.  Suffice it to say that during our medical or surgical residency training, we were chronically tired having been subjected to 36 hour shifts every 3^rd or 4^th night over multiple years.  Fortunately, today’s trainees are not afforded the rigorous sleep deprivation of previous generations.  As a result, the amount of time during medical training where 6 or fewer hours of sleep occurs is a lot lower than in years past.  Still, physicians are commonly assigned on-call overnight shifts where fewer than 6 hours slept has been the rule rather than exception.  Mechanisms proposed to account for the relationship between poor sleep and dementia include inflammation of the brain with buildup of cholesterol plaques in the lining of brain vessels as well as impaired processing of proteins (such as beta amyloid).

For my patients who have difficulty getting a good 7-8 hours of restful sleep not due to a medical condition (such as sleep apnea), I make the following recommendations.

1. Try to complete your dinner meal 4 hours prior to bedtime because a large part of digestion occurs during this period. Going to bed after a large meal is not conducive to a good night’s sleep if your body has to work overtime.
2. Take a 20-30 minute walk after dinner. Physical activity not only helps in digesting sugars and fat but also enables a more restful sleep.
3. Turn off the TV (or other stimulating activities) 1-2 hours before bedtime.
4. Try a cup of valerian tea or 2-4 ounces of tart cherry juice 1 hour before bedtime.
5. Engage in a relaxation activity (restorative yoga, meditation, lavender bath) 30 min-1 hour before bedtime.

Check out my heart health tips each day on twitter (https://twitter.com/mmillermd1) or Facebook: (healyourheartbook).

Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland.