Benadryl and other Alzheimer’s Disease RisksJanuary 28, 2015 January 28, 2015
Higher dementia risk linked to more use of common drugs
A large study links a significantly increased risk for developing dementia, including Alzheimer’s disease, to taking commonly used medications with anticholinergic effects at higher doses or for a longer time. Many older people take these medications, which include nonprescription diphenhydramine (Benadryl). JAMA Internal Medicine published the report, called “Cumulative Use of Strong Anticholinergics and Incident Dementia.”
The study used more rigorous methods, longer follow-up (more than seven years), and better assessment of medication use via pharmacy records (including substantial nonprescription use) to confirm this previously reported link. It is the first study to show a dose response: linking more risk for developing dementia to higher use of anticholinergic medications. And it is also the first to suggest that dementia risk linked to anticholinergic medications may persist—and may not be reversible even years after people stop taking these drugs.
“Older adults should be aware that many medications—including some available without a prescription, such as over-the-counter sleep aids—have strong anticholinergic effects,” said Shelly Gray, PharmD, MS, the first author of the report, which tracks nearly 3,500 Group Health seniors participating in the long-running Adult Changes in Thought (ACT), a joint Group Health–University of Washington (UW) study funded by the National Institute on Aging. “And they should tell their health care providers about all their over-the-counter use,” she added.
Sleep and mental activity
Doctors recently reported that participation in activities that promote mental activity, and moderate physical activity in middle age, may help protect against the development of Alzheimer’s disease and dementia in later life. The research was presented at the Alzheimer’s Association International Conference® 2014 (AAIC® 2014) in Copenhagen.
Research reported at AAIC 2014 also showed that sleep problems – especially when combined with post-traumatic stress disorder (PTSD) – may increase dementia risk in veterans. Additionally, in a population of people age 90 and older, high blood pressure was seen to help protect against cognitive decline. This is counter intuitive as heart health risk factors, including hypertension, are generally considered to elevate risk of Alzheimer’s and other dementias.
“Determining more specifically the factors that raise and lower risk of Alzheimer’s disease and other dementias is an essential component in our battle against the Alzheimer’s epidemic,” said Heather Snyder, Ph.D., Alzheimer’s Association director of Medical and Scientific Operations. “We are now getting a more clear idea of the opportunities for risk reduction through behavior changes and other health factors. We’re learning that Alzheimer’s risk and protective factors may change over the course of our lives.”
“These studies from AAIC 2014 underscore the need to fund larger, longer-term studies in different and diverse populations to enable us to develop helpful ‘prescriptions’ for lifestyle change – for example, which foods to eat and avoid, how much physical activity and what types – and to learn more specifically about how Alzheimer’s and dementia risk factors change as we age,” Snyder added. Read more findings here.
Do nutrients play a role in delirium
Lifestyle changes are at the core of our treatment protocolos for Alzheimer’s Disease. Recently we wrote about doctors who asked: Do nutrients play a role in delirium? Delirium, characterized by an acute change in mental status along with diminished awareness and attention and disturbances in memory, language, or perception, can be difficult to both diagnose and treat. Although the cause of delirium is often multifactorial, nutrition can play an important role (i.e., B vitamins, antioxidants, glucose, water, lipids) which have been shown to alter the way one thinks and restoring the balance in many of these nutrients can lead to resolution of delirium.1
While the medical science community fears the overwhelming numbers of delirium and Alzheimer’s Disease on a global scale, doctors in clinical practice fear it for their patients and seek options to prevent the disease and help their patients already diagnosed with Alzheimer’s Disease.
Alzheimer’s Disease is the most common form of dementia, along with vascular dementia, it is the most feared highly disabling age-related conditions of our time. The use of antioxidants is treatment is often come with mixed results. 2
Low levels of Vitamin C and Beta-carotene seen in Dementia.
Researchers from the University of Ulm, among them the Epidemiologist Professor Gabriele Nagel and the Neurologist Professor Christine von Arnim, have discovered that the serum-concentration of the antioxidants vitamin C and beta-carotene are significantly lower in patients with mild dementia than in control persons. It might thus be possible to influence the pathogenesis of Alzheimer’s disease by a person’s diet or dietary antioxidants. Seventy-four Alzheimer’s disease-patients and 158 healthy controls were examined for the study that has been published in the Journal of Alzheimer’s Disease (JAD).
Alzheimer’s disease is a neurodegenerative disease: Alterations in the brain caused by amyloid-beta-plaques, degeneration of fibrillae and a loss of synapses are held responsible for the characteristic symptoms.
Oxidative stress, which constrains the exploitation of oxygen in the human body, is suspected to promote the development of Alzheimer’s diseas. Whereas so called antioxidants might protect against neurodegeneration.
In their study, the researchers have investigated whether the serum-levels of vitamin C, vitamin E, beta-carotene as well as lycopene and coenzyme Q10 are significantly lower in the blood of Alzheimer’s-patients. “In order to possibly influence the onset and development of Alzheimer’s disease, we need to be aware of potential risk factors”, says Gabriele Nagel.
Participants were recruited from the cross-sectional study IMCA ActiFE (Activity and Function in the Elderly in Ulm) for which a representative population-based sample of about 1,500 senior citizens has been examined.
The 65 to 90 years old seniors from Ulm and the surrounding area underwent neuropsychological testing and answered questions regarding their lifestyle. What is more, their blood has been examined and their body mass index (BMI) was calculated.
For the present study, scientists have compared 74 patients with mild dementia (average age 78.9 years) with a control group consisting of 158 healthy, gender-matched persons of the same age.
Results are quite interesting: The concentration of vitamin C and beta-carotene in the serum of Alzheimer’s-patients was significantly lower than in the blood of control subjects. Whereas no such difference between the groups could be found for the other antioxidants (vitamin E, lycopene, coenzyme Q10).
“Longitudinal studies with more participants are necessary to confirm the result that vitamin C and beta-carotene might prevent the onset and development of Alzheimer’s disease”, says Gabriele Nagel. Vitamin C can for example be found in citrus fruits; beta-carotene in carrots, spinach or apricots. (3,4)
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1. Sanford AM, Flaherty JH. Do nutrients play a role in delirium? Curr Opin Clin Nutr Metab Care. 2014 Jan;17(1):45-50. doi: 10.1097/MCO.0000000000000022.
2. Polidori MC, Nelles G. Antioxidant Clinical Trials in Mild Cognitive Impairment and Alzheimer’s Disease – Challenges and Perspectives. Curr Pharm Des. 2013 Sep 27. [Epub ahead of print]
3. von Arnim CA, Herbolsheimer F, Nikolaus T, Peter R, Biesalski HK, Ludolph AC, Riepe M, Nagel G; ActiFE Ulm Study Group. Dietary antioxidants and dementia in a population-based case-control study among older people in south Germany. J Alzheimers Dis. 2012;31(4):717-24. doi: 10.3233/JAD-2012-120634.
4. IOS Press release http://www.alphagalileo.org/ViewItem.aspx?ItemId=123926&CultureCode=en