My dad had Alzheimer's disease. My family bore witness to the limitations of managing an aging parent with AD as we quietly wondered if our final years would be less tarnished--more golden. The rush to identify diagnostic biomarkers for early treatment or cures that haven't materialized seems counterproductive or at least aspirant.
There is real data that suggests meaningful correlations between social determinants of health and risk of chronic diseases in old age such as diabetes and Alzheimer's disease. I would like to see more research focused here for the societal benefit as well as real actionable behaviors toward prevention.
There is real data that suggests meaningful correlations between social determinants of health and risk of chronic diseases in old age such as diabetes and Alzheimer's disease. I would like to see more research focused here for the societal benefit as well as real actionable behaviors toward prevention.
Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Conditions (e.g., social, economic, and physical) in these various environments and settings (e.g., school, church, workplace, and neighborhood) have been referred to as “place.”5 In addition to the more material attributes of “place,” the patterns of social engagement and sense of security and well-being are also affected by where people live. Resources that enhance quality of life can have a significant influence on population health outcomes. Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins--Healthypeople.gov
Willette and colleagues examined insulin signaling impairment in late middle-aged participants at risk for AD. Details of the population-based, cross-sectional study (n=150) can be found here. The important key take-away is higher peripheral insulin resistance (HOMA-IR) was associated with lower cerebral glucose metabolism. Lower glucose metabolism was correlated with worse performance on immediate memory and delayed memory factor scores--"midlife may be a critical period for initiating treatments to lower peripheral insulin resistance to maintain neural metabolism and cognitive function."--JAMA Neurology
Association of Insulin-Resistance with Cerebral Glucose Uptake in Late Middle-Aged Adults at Risk for Alzheimer Disease
Peripheral insulin resistance has been characterized as having an active role in the brain and correlated with higher risk for AD. A voxel is a 3-dimensional pixel, HOMA-IR, APOE e4 genotype, and parental AD history were used to investigate glucose metabolism in temporal, parietal, and frontal regions of the brain.
The prevalence of AD continues to grow, and midlifemay be a critical period for initiating treatments aimed at preventing or delaying the onset of AD. Accumulating evidence suggests that treatments targeting mechanisms involved in insulin signaling may affect central glucose metabolism and should be investigated in the context of presymptomatic AD.--JAMA Neurology
Both diabetes type 2 and Alzheimer's disease are characterized by mitochnodrial vulnerability and dysfunction. We do know that correlation is not causation but it is interesting that in this current study, HOMA-IR predicted the rate of glucose metabolism "more strongly" than APOE e4 genotype. Ongoing research may clarify the findings that HOMA-IR appears associated with a nontrivial risk for AD in midlife. Like I tell my audiences--the plural of anecdote is data.
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Many of you have written about the curated resources/library I am creating. Here is a new one that just made my list of books I have to read. The Man Who Wasn't There, describes how memory evolves with a distorted sense of a narrative sense.
You can head over to the collection to see what else is new or preview the book over at Amazon. If you finish the book before I do I would love to hear what you think. As a quick aside, I went to the estate sale of Maya Angelou today nearby in Winston Salem, NC. Her home library was incredibly extensive. I found a book on Chaucer's Modern Essays in Criticism, Walden by Thoreau, and a few others that I immediately added to my collection. Honestly I could have spent my entire day in that room. You can tell so much about a person's mind by looking at their books.
You can head over to the collection to see what else is new or preview the book over at Amazon. If you finish the book before I do I would love to hear what you think. As a quick aside, I went to the estate sale of Maya Angelou today nearby in Winston Salem, NC. Her home library was incredibly extensive. I found a book on Chaucer's Modern Essays in Criticism, Walden by Thoreau, and a few others that I immediately added to my collection. Honestly I could have spent my entire day in that room. You can tell so much about a person's mind by looking at their books.
