Alzheimer and Dementia Prevention

The U.S. Food and Drug Administration (FDA) renewed the hopes of people with Alzheimer’s after granting accelerated approval for a new drug to treat Alzheimer’s disease, a progressive brain disorder that affects more than 6.5 million Americans.

Leqembi (lecanemab) removes amyloid-beta plaque, a protein that builds up in the brain and is thought to be one of the main causes of Alzheimer’s. Leqembi is a monoclonal antibody infusion given every two weeks to people with mild cognitive impairment or early Alzheimer’s disease.

“This treatment option is the latest therapy to target and affect the underlying disease process of Alzheimer’s, instead of only treating the symptoms of the disease,” Dr. Billy Dunn, director of the Office of Neuroscience in the FDA’s Center for Drug Evaluation and Research said in a news release.

Leqembi was approved through the FDA’s “Accelerated Approval Pathway,” which allows early approval for new drugs that “fill an unmet medical need.” Drug manufacturers, however, are required to continue studies to confirm the drug’s benefit.

Before its approval, Leqembi was tested in a study of 856 people with mild cognitive impairment or mild dementia. Patients who received the approved dosage of 10 milligrams of Leqembi every two weeks had a statistically significant reduction in brain amyloid plaque by the end of the trial’s 79th week. There was no reduction of amyloid beta plaque in patients who took a placebo.

According to the FDA, the most common side effects of Leqembi were headache and infusion-related reactions, and amyloid-related imaging abnormalities (ARIA), which have several symptoms but commonly present as temporary swelling in areas of the brain that usually resolves over time.

Can Hormone Replacement Therapy Prevent Alzheimer’s Disease in Women?
A new study suggests Hormone Replacement Therapy (HRT) could help to prevent Alzheimer’s in women at risk for developing the disease. Health experts say women are nearly twice as likely as men to develop Alzheimer’s, and this is partly due to women living longer than men and the decrease of estrogen as they age.

The study by researchers at the University of East Anglia (UEA) involved 1,178 women participating in the European Prevention of Alzheimer’s Dementia, an initiative designed to study participants’ brain health over time. While participants were over 50 and did not have dementia, some of the women were carriers of the APOE4 gene, which increases a person’s risk of developing Alzheimer’s disease.

The study showed that HRT use was linked to improved memory, cognition, and larger brain volumes among the APOE4 gene carriers. HRT was most effective against Alzheimer’s when introduced during perimenopause, the time leading up to menopause, according to Dr. Rasha Saleh, a senior research associate at UEA’s Norwich Medical School.

“This is really important because there have been very limited drug options for Alzheimer’s disease for 20 years, and there is an urgent need for new treatments,” Dr. Saleh said in a news release about the study, published in Alzheimer’s Research and Therapy in January.

6 Ways to Slow Memory Decline

A growing number of studies are finding that regular physical exercise and living an overall healthy lifestyle can lower the rate of dementia and slow the rate of memory decline in older adults. A new study conducted in China between 2009 and 2019 added to these findings. The study, published in The BMJ in January, tracked the progress or decline of more than 29,000 participants 60 years old and older.

Participants were surveyed about their daily habits, and based on their lifestyle, they were placed into three groups: Favorable, average, and unfavorable. The six lifestyle factors researchers included were:

• Physical exercise:

• Diet:

• Drinking: Drinking alcohol only on occasion or never

• Smoking: Being a former smoker who quit or never having smoked

• Cognitive activity: Doing something to exercise the brain at least twice a week, such as reading or playing games

• Social engagement: Connecting with other people at least twice a week by attending community meetings or visiting friends or relatives, for example.

Over the study period, researchers made the following discoveries:

• People in the favorable group with at least four healthy habits were also less likely to progress to mild cognitive impairment and dementia.

The results held true even for people with the APOE4 gene, which is believed to increase the risk of Alzheimer’s.

“These results provide an optimistic outlook, as they suggest that although the genetic risk is not modifiable, a combination of more healthy lifestyle factors are associated with a slower rate of memory decline, regardless of the genetic risk,” the study authors said in the report.

Study Shows Extra Minutes of Movement Boosts Brain Power

A new study shows that replacing as little as six to nine minutes of sedentary behavior daily with moderate or vigorous physical activity could significantly boost brain power in older adults.

The study, published in the Journal of Epidemiology & Community Health, found that more intense exercise is better for working memory and mental processes, such as planning and organization. Conversely, sedentary behavior, such as time spent sitting down or sleeping, or doing light-intensity activity, reduces brain power.

“We identified that individuals spending even small amounts of more time in more vigorous activities—as little as [around] 6-9 minutes—compared to sitting, sleeping or gentle activities had higher cognition scores,” Dr. John Mitchell of UCL Institute of Epidemiology and Health Care and the study’s lead author, told Medical News Today.

For the study, researchers in the United Kingdom used data from 4,481 participants in the 1970 British Cohort Study, consisting of people born across England, Scotland, and Wales in 1970 whose health was tracked throughout childhood and adulthood. Participants were given detailed questionnaires to answer and an activity tracker to wear for up to seven days, 10 consecutive hours a day.

After analyzing the data and predicting the cognitive effects of reallocating time from one movement activity to another, researchers found that:

• Cognition scores improved after replacing sedentary behavior for 37 minutes of light-intensity physical activity or 56 minutes of sleep.

• Cognition performance began to theoretically decline after eight minutes of moderate or vigorous physical activity was replaced by sedentary behavior, six minutes by light physical activity, and seven minutes by sleep.

According to Mitchell: “This robust method corroborates a critical role for moderate to vigorous physical activity in supporting cognition, and efforts should be made to bolster this component of daily movement.”

Source Links:

https://www.fda.gov/news-events/press-announcements/fda-grants-accelerated-approval-alzheimers-disease-treatment
https://www.medicalnewstoday.com/articles/can-hormone-replacement-therapy-affect-alzheimers-risk-in-women
https://www.washingtonpost.com/wellness/2023/01/26/dementia-memory-loss-lifestyle-habits/
https://www.medicalnewstoday.com/articles/can-being-active-an-extra-7-9-minutes-per-day-boost-your-brain
https://www.ucl.ac.uk/news/2023/jan/moderate-and-vigorous-physical-activity-most-critical-factor-boosting-mid-life-brain-power