Studies show that women responded better to early interventions in Alzheimer’s disease than men – Boston news, weather, and sports.

(CNN) — After age and genetics, being a woman is the only most important risk factor for developing Alzheimer’s disease, experts say.

“Two-thirds of the brain affected by Alzheimer’s disease is the female brain,” said Dr. Richard Isaacson, director of the Alzheimer’s Prevention Clinic at the Brain Health Center at Florida Atlantic University’s Schmidt Medical College.

Now, new research has good news about giving women the opportunity to reduce their increased risk. Individual lifestyle interventions such as diet, exercise, stress relief, and sleep hygiene were able to reduce risk factors for Alzheimer’s disease in both men and women, but were even more effective in women.

“Our individually tailored interventions have led to significant improvements in women compared to men across the risk scale for Alzheimer’s disease and cardiovascular disease,” said Isaacson, co-author of the paper.

Women also showed greater improvements than men in biomarkers such as hypoglycemia, low LDL, or low-density lipoprotein, which is “bad” cholesterol.

Rudy Tanji, a professor of neurology at Harvard Medical School, said: He is the Director of the Genetics and Aging Research Unit at Massachusetts General Hospital in Boston.

“We aim to find a way to stop the disease at the bud stage, so we need to know if preventive and therapeutic strategies work equally well in both men and women. This new study Obviously it takes us a big step towards that goal, “said Tanzi, who was not involved in the study.

Impact of personalized intervention
The new study tracked a subset of people who participated in a 10-year study designed to test the impact of personal recommendations on cognitive function and risk factors for dementia. The comparative efficacy study for dementia and Alzheimer’s disease, initiated in 2018, is being conducted at the New York Presbyterian Church / Weil Cornell Medical Center in New York City.

After complete blood, physical, cognitive and genetic work-up, the patient received individual genetic counseling and education. Medicines, vitamins and supplements have also been tailored to each person’s unique results. In addition, all participants received personalized lifestyle interventions such as exercise, diet, blood pressure control, sleep hygiene, and stress relief counseling.

All of the CEDAR trials have a family history of Alzheimer’s disease, but when the study began, the majority had no signs of cognitive decline, Isaacson said. Of the 154 men and women who participated in the study, 35 were diagnosed with mild cognitive impairment (MCI) due to Alzheimer’s disease, but not as seriously as “affecting their daily lives.” was.

The main findings of the original study were published in 2019. MCI people have found that following at least 60% of lifestyle recommendations (at least 12 out of 21 on average) improves cognitive test performance in memory and thinking by nearly 5 points. Various recommendations) 18 months.

However, a 2019 study found that people with mild cognitive impairment who followed less than 60% of the proposals showed no improvement in cognition. In fact, they continued to decline by an average of 6 points.

Cognitively normal patients with a family history of Alzheimer’s disease, called preventive groups, can obtain an average of 4.5 points of “equally impressive” cognitive boost by following at least some of the lifestyle recommendations. I did. It didn’t seem to matter if they followed less than 60% of them, Isaacson said.

“The good news from our study is that there was actually a cognitive improvement in 18 months for both women and men when compared to the control population,” Isaacson said. “Many drugs that have been studied aim to delay the decline in cognitive function, but it is difficult to show improvement in cognitive ability over time.”

About half of CEDAR participants carry at least one APOE gene, which may increase their risk of developing Alzheimer’s disease. However, the study found no difference in the cognitive benefits of interventions between those with one or two copies of APOE and those without the gene, so “it was also reassuring,” Isaacson said. ..

Impact on women vs. men
A new study published in the Journal of Alzheimer’s Disease Prevention on Tuesday analyzed a subset of participants to see if there were differences between men and women in how well lifestyle interventions worked. , A job that takes the original 2019 research one step further.

“Women have unique risk factors that are very different from men with dementia,” Isaacson said. “Women have a 39% increased risk of dementia when they have central fat buildup.

“And the rapid decline in estrogen during the perimenopausal transition may actually be one of the most influential risk factors for developing Alzheimer’s disease in the brain,” he said. Said.

In a new analysis, women in the prevention group who started the trial without cognitive problems showed greater improvement than men in two areas: one of the two cardiovascular risk scales and good cholesterol, HDL, or high. Density lipoprotein levels prevent heart disease.

Women with mild cognitive decline, called the early treatment group, showed greater improvements in mean blood glucose levels and two cardiovascular risk scales than men. This female cohort also showed more significant improvements in some important cholesterol (or lipid) biomarkers than men in the initial treatment group.

Complying with the additional 10% of personalized recommendations for all participants improved the cognitive test by 0.9 points for women and 0.41 points for men.

How Does Reducing Cardiovascular Risk Affect Future Cognition? Experts say that what is good for the heart is good for the brain.

“Vascular risk factors such as high blood pressure, high cholesterol, hyperglycemia, and diabetes may not be the cause of Alzheimer’s disease, but it can fast forward Alzheimer’s disease,” Isaacson said. “I prefer to brake rather than spin the engine on the road to cognitive decline.”

The discovery that women were able to reduce their risk more than men is welcome news, Isaacson said.

“We have shown that treating people in a safe and evidence-based way and using multiple lifestyles and medical interventions can really affect brain health,” he said. ..

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