Alzheimer's Disease, Dementias and Healthy Aging

June Newsletter

Ten Ways to Love your Brain

The course of Alzheimer’s disease and other dementias should be viewed as a continuum across the life course that begins with healthy cognitive functioning. Over many years, physiological changes occur in the brain that are pre-symptomatic but eventually can result in mild cognitive impairment (MCI), when changes in memory or thinking become noticeable to persons affected, loved ones, colleagues, and friends. While a person with mild cognitive impairment is at greater risk of developing dementia, this is not inevitable. Healthy behaviors, which have been shown to prevent cancer, diabetes, and cardiovascular disease, may also reduce risk for cognitive decline and possibly dementia. It is important to protect our brain across the lifespan to reduce dementia risk.

All of Us Research Program

The All of Us Research Program is a historic effort to collect and study data from one million or more people living in the United States. The goal of the program is to improve health care through research. Unlike research studies that focus on one disease or group of people, All of Us is building a diverse database that can inform thousands of studies on a variety of health conditions. This creates more opportunities to:

• Know the risk factors for certain diseases
• Figure out which treatments work best for people of different backgrounds
• Connect people with the right clinical studies for their needs
• Learn how technologies can help us take steps to be healthier

Impact of Chronic Kidney Disease on

Brain Structure and Function

Neurocognitive deficits, such as dementias, are common in individuals with chronic kidney disease (CKD) and end-stage kidney disease (ESKD).  The exact mechanism for neurocognitive dysfunction in CKD is not known, however it is likely brought about by the multi-systemic effects of CKD such as metabolic acidosis, proteinuria, anemia, hypertension, and longer duration of kidney disease. Even subtle brain changes have negative impacts on quality of life. The cognitive complications of CKD may be linked to an aberrant “kidney-brain axis” brought about by decreased kidney function, cardiovascular disease, and inflammation which all negatively impact the brain, leading to increased risk of cognitive impairment in parallel with CKD progression. This review addresses existing literature specific to the impact of CKD on brain structure and function.

Medications for Memory, Cognition

and Dementia-Related Behaviors

FDA approved medications fall into two categories. The first are drugs that change disease progression. Drugs in this category slow disease progression by going after the underlying biology of the disease process. These anti-amyloid treatments work by attaching to and removing beta-amyloid, a protein that accumulates forming plaques in the brain. Such drugs aim to slow the decline of memory and thinking, as well as function, in people living with Alzheimer's disease.

The second category includes drugs that may temporarily mitigate some symptoms of Alzheimer's dementia. Drugs that target symptoms of Alzheimer's may help lessen or stabilize those symptoms for a limited time by affecting certain chemicals involved in carrying messages among and between the brain's nerve cells. While symptoms may improve in individuals using these treatments, they do not impact underlying disease progression in any way.

Poor Oral Health may Impact Brain Health

Taking care of your teeth and gums may offer benefits beyond good oral health such as improving brain health. Studies have shown that gum disease, missing teeth and other signs of poor oral health, as well as poor brushing habits and lack of plaque removal, increase risk for heart disease, high blood pressure and stroke. Between 2014 and 2021, researchers in a study conducted in the United Kingdom analyzed the potential link between oral health and brain health among about 40,000 adults without a history of stroke. Participants were screened for genetic variants known to predispose persons to have cavities, dentures and missing teeth later in life. Researchers examined the relationship between the burden of these genetic risk factors for poor oral health and brain health.

Check out the Vermont Department of Health's oral health web pages for resources for families, schools and worksites.