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3 New Findings in Geriatric Psychiatry
Lifestyle changes-more exercise, taking omega-3 supplements-may help those with dementia, and a protein found in the brain may be a marker for Parkinson disease. Details here.
Higher dementia risk is linked to poorer fitness; innate immunity in Alzheimer disease can be modulated by omega-3 fatty acids; and levels of the protein alpha-synuclein in spinal fluid correlate to posture and gait difficulty in Parkinson disease. Scroll through the slides for an overview of 3 new studies.
Higher levels of cardiorespiratory fitness are associated with better white matter fiber integrity in the brain, which in turn correlates with better executive function in patients with mild cognitive impairment (MCI).
Source: Ding K, Tarumi T, Zhu DC, et al. Cardiorespiratory Fitness and White Matter Neuronal Fiber Integrity in Mild Cognitive Impairment. J Alzheimer's Dis. 2018;61:729-739.
Cognitively normal older adults and MCI patients were not different in global white matter fiber integrity and VO2 max. However, those with lower fitness levels were associated with weaker white matter, which in turn correlated with lower brain function.
Clinical implications for Study 1: “This research supports the hypothesis that improving people’s fitness may improve their brain health and slow down the aging process,” said lead author Kan Ding, MD, a neurologist at University of Texas Southwestern Medical Center in Dallas.
The innate immune system of patients with Alzheimer's disease and MCI is dysregulated. Macrophages with defective amyloid beta function in these individuals may recover phagocytic function with omega-3 fatty acids.
Source: Olivia-Perez HM, Lam L, Dang J, et. al. Omega-3 fatty acids increase the unfolded protein response and improve amyloid-β phagocytosis by macrophages of patients with mild cognitive impairment. FASEB J. 2017;31:4359-4369. doi: 10.1096/fj.201700290R.
Clinical implications for Study 2: Omega-3 supplements appear to enhance amyloid beta phagocytosis and decrease apoptosis, thus improving clearance of amyloid beta by macrophages in the brain of Alzheimer’s disease patients.
Levels of the protein alpha-synuclein are significantly lower than normal in cerebrospinal fluid collected from patients with Parkinson’s disease (PD) who have postural instability and gait difficulty.
Source: Goldman JG, Andrews H, Amara A, et. al. Cerebrospinal fluid, plasma, and saliva in the BioFIND study: Relationships among biomarkers and Parkinson's disease Features. Mov Disord. 2018;33:282-288. doi: 10.1002/mds.27232. Epub 2017 Dec 4.
Clinical implications for Study 3: “These are important insights for the ongoing pursuit of accessible biomarker tests to diagnose and track the disease. For example, people with Parkinson’s and lower beta-amyloid may be more likely to develop memory problems and therefore would benefit more from a cognitive therapy. Enrolling this population in trials can help us see a treatment effect more clearly than testing the therapy on people who will not have this symptom,” said lead author Jennifer G. Goldman, MD, a movement disorders neurologist at Rush University Medical Center in Chicago.