inflammation

Low levels of alcohol good for the brain

A mouse study found that high levels of alcohol over a long period of time were associated with high levels of a marker for inflammation, along with impaired cognition and motor skills.

However, those exposed to low levels of alcohol consumption, analogous to approximately 2 ½ drinks per day, actually showed less inflammation in the brain and their glymphatic system was more efficient in moving CSF through the brain and removing waste, compared to control mice who were not exposed to alcohol. Their cognitive performance also matched that of the controls.

The finding adds to a growing body of research that point to the health benefits of low doses of alcohol. While excessive consumption of alcohol is a well-documented health hazard, many studies have linked lower levels of drinking with a reduced risk of cardiovascular diseases as well as a number of cancers.

Reference: 

Lundgaard, I., Wang, W., Eberhardt, A., Vinitsky, H. S., Reeves, B. C., Peng, S., Lou, N., Hussain, R., & Nedergaard, M. (2018). Beneficial effects of low alcohol exposure, but adverse effects of high alcohol intake on glymphatic function. Scientific Reports, 8(1), 2246. https://doi.org/10.1038/s41598-018-20424-y

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Inflammation linked to brain health

  • Study indicates APOE4 carriers are only at greater Alzheimer's risk if they have chronic inflammation.
  • Large study finds increasing inflammation linked to more white matter damage.
  • Common causes of chronic inflammation include cardiovascular disease, heart failure, diabetes, high blood pressure and infections.

Link found between chronic inflammation and Alzheimer's gene risk

Data from the Framingham Heart Study has found carriers of the ApoE4 gene were much more likely to develop Alzheimer’s if they also had chronic low-grade inflammation. Indeed, the researchers suggest that, in the absence of inflammation, there might be no difference of Alzheimer's risk between ApoE4 and non-ApoE4 carriers.

https://www.eurekalert.org/pub_releases/2018-10/buso-lfb101818.php

Mid- to late-life increases in chronic inflammation age brain

Data from 1,532 participants in a long-running study, in which participants were tested five times every 3 years (on average), found that those who showed increasing inflammation had greater abnormalities in the brain's white matter structure.

90 people transitioned from low to persistently elevated C-reactive protein during midlife, indicating increasing inflammation. Their brains appear similar to that of a person 16 years older, researchers estimate.

Common causes of chronic inflammation include cardiovascular disease, heart failure, diabetes, high blood pressure and infections such as hepatitis C or HIV.

61% of participants were women, and 28% were African-American. At the final visit, participants were an average age of 76.

https://www.eurekalert.org/pub_releases/2018-07/jhm-mtl070218.php

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Can targeting inflammation ease chemo brain?

  • A small pilot study has confirmed that inflammation in the blood plays a role in chemobrain.

A pilot study involving 22 breast cancer patients currently receiving chemotherapy (mean age 54), has found that those with higher levels of inflammatory biomarkers did significantly worse on tests for short-term visual memory. One particular biomarker — tumor necrosis factor-alpha (as reflected through its two soluble receptors, TNFRI and TNFRII) — was the strongest indicator of cognitive problems.

The findings are consistent with an earlier study involving 174 breast cancer patients evaluated before chemotherapy, which found that higher levels of those biomarkers were associated with worse memory, and another study of 49 patients, which found that higher levels of sTNFRII were associated with more memory complaints after chemotherapy.

Cognition was assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB), looking at those domains previously reported to be affected in cancer survivors: visual memory, executive functioning, attention, verbal memory, and cognitive processing.

Almost all the patients were Caucasian and college-educated.

http://www.futurity.org/chemo-brain-cancer-1631232-2/

Reference: 

Williams, AnnaLynn M. et al. 2018. Associations between inflammatory markers and cognitive function in breast cancer patients receiving chemotherapy. Journal of Neuroimmunology, 314, 17-23. Full text available at https://www.jni-journal.com/article/S0165-5728(17)30198-4/fulltext

Patel, S.K., Wong, A.L., Wong, F.L., Breen, E.C., Hurria, A., Smith, M. et al. 2015. Inflammatory biomarkers, comorbidity, and neurocognition in women with newly diagnosed breast cancer. J. Natl. Cancer Inst., 107.

Ganz, P.A., Bower, J.E., Kwan, L., Castellon, S.A., Silverman, D.H., Geist, C. et al. 2013. Does tumor necrosis factor-alpha (TNF-alpha) play a role in post-chemotherapy cerebral dysfunction?. Brain Behav. Immun., 30, S99–108.

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How risky is surgery for older adults' cognitive function?

Several studies suggest that post-operative cognitive decline in older adults is due to several factors:

  • the stress of hospitalization, if unexpected
  • brain inflammation caused by an immune response from the brain’s microglia
  • post-operative delirium.

It also seems that higher levels of cognitive function, higher levels of engagement in certain cognitive activities, and better cerebrovascular health, all protect against such decline.

Unplanned hospitalizations accelerate cognitive decline in older adults

Data from the Rush Memory and Aging Project has found that emergency and urgent hospitalizations are associated with an increased rate of cognitive decline in older adults.

Non-elective hospitalizations were associated with an approximately 60% acceleration in the rate of cognitive decline from before hospitalization. Elective hospitalizations, however, were not associated with acceleration in the rate of decline at all.

Of the 930 participants (average age 81), 613 were hospitalized at least once over an average of almost five years of observation. Of those who were hospitalized, 260 (28%) had at least one elective hospital admission, and 553 (60%) had at least one non-elective hospital admission. These groups included 200 participants (22%) who had both types of hospitalizations.

The data was presented at the Alzheimer's Association International Conference in London on July 17.

https://www.eurekalert.org/pub_releases/2017-07/rumc-hac071717.php

Inflammation triggered by brain's own immune cells behind post-surgical decline

There is growing evidence that inflammation might be responsible for the cognitive decline seen in many older adults after surgery. Now a mouse study provides evidence that brain inflammation and cognitive decline following surgery are triggered by the brain's microglia.

When mice had their microglia temporarily depleted before surgery, they didn’t show any cognitive decline several days after surgery. They also had much lower levels of inflammatory molecules in the hippocampus. Controls — those not receiving the experimental drug to deplete microglia to around 5% of normal levels — did typically show a drop in cognitive performance.

Microglia levels returned to normal within two days after the treatment was stopped, and there was no sign of any impairment in surgical wound healing as a result of the intervention.

https://www.eurekalert.org/pub_releases/2017-04/uoc--cda040517.php

Delirium in older patients after surgery linked to long-term cognitive decline

A 3-year study looking at short-term and long-term cognitive decline in older patients following a surgery found that those who experienced delirium after the surgery showed significantly greater decline than those who didn’t suffer such post-surgical confusion.

The study involved 560 patients (70+), of whom 134 experienced delirium. Both groups showed a significant cognitive decline at one month, followed by a return to their previous level of cognitive function at two months and then a gradual decline for the next 34 months. However, the rate of decline over the three year follow-up was not significant for those who hadn’t experienced delirium.

Those who suffered delirium also had significantly lower cognitive function before surgery.

The odd finding that even the delirium group recovered their cognitive function at two months, before once again declining, suggests that something about the delirium triggers a cascade of events which leads to progressive, long-lasting effects.

http://www.eurekalert.org/pub_releases/2016-07/hsif-dio071416.php

Who’s more likely to develop delirium after surgery?

Delirium after surgery can lead to long-term cognitive decline in older adults — but not always. So what makes the difference?

A preliminary study involving 126 older adults suggests the answer lies in their cognitive function before surgery. Their global cognition score explained the most variation, with other significant factors including: IQCODE score, cognitive independent activities of daily living impairment, living alone, cerebrovascular disease, Charlson comorbidity index score, and exhaustion level. Taken together, these factors explained 32% of the variation in people’s outcome.

Delirium, an acute state of confusion, is a common condition affecting up to 50% of hospitalized older adults.

https://www.eurekalert.org/pub_releases/2017-03/hsif-plc031417.php

Certain leisure activities may reduce post-surgical delirium among older adults

A study of 142 older adults who underwent elective surgery found that greater participation in cognitive activities was linked with a lower incidence and lower severity of delirium.

Nearly a third of the patients (average age 71) developed post-operative delirium. Those who did had participated in fewer leisure activities before surgery compared with people who didn't experience delirium.

Out of all the activities, reading books, using email, and playing computer games reduced the risk of delirium. Playing computer games and singing were the only two activities that predicted lower severity of delirium.

The protection afforded was dose-dependent, with each additional leisure activity reducing post-operative delirium by 8%.

http://www.eurekalert.org/pub_releases/2016-06/ags-cla062116.php

http://www.eurekalert.org/pub_releases/2016-06/w-crm062216.php

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