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Higher blood levels of inflammatory markers at midlife were badociated with greater cognitive decline many years later in the decades leading up to adulthood, according to a new study.
"Our results suggest that maintaining health and hence reducing inflammation in the middle age can have positive effects on brain health in the elderly," commented the researcher. Author, Keenan Walker, PhD, Department of Neurology, Johns Hopkins University, Baltimore, Maryland, commented: Medscape Medical News.
The study was published online on February 13 in Neurology.
Walker noted that Alzheimer's disease and dementia have already been shown to be badociated with higher levels of inflammatory markers in the blood and cerebrospinal fluid and brain tissue at autopsy. However, the vast majority of this work has been done in the elderly.
"We wanted to determine if inflammatory markers much earlier in life were related to cognitive decline in older years," he said. "This gives us a temporal relationship and suggests much more causality."
In the present study, the researchers measured several inflammatory markers in blood samples taken from cognitively healthy individuals in mid-adulthood, aged 40 to 50 years. They then followed these people for the next two decades and measured cognitive decline.
They found that people with higher levels of inflammatory markers at midlife had higher rates of cognitive decline over the next 20 years.
Walker believes that it is one of the first studies to examine this badociation that starts so early in life. It also has one of the longest follow-up periods.
"What has the most impact in this study, is that it suggests that inflammation could have a detrimental effect on later cognition much earlier in life than we do." What we do in our forties and fifties seems to affect our cognitive health in our seventies and eighties, "he said.
"What's interesting in this study is that in addition to showing a temporal relationship, we compared the cognitive function of people to their own base, so we eliminated a lot of the biases that may occur in observational studies, "added Walker.
He says that while it is not possible to conclusively confirm that inflammation causes a decline in memory from these data, this strongly suggests that this is the case.
"The fact that we were observing inflammation at higher levels several years before the decline in memory makes me believe that there is a causal link here."
Walker points out that the leading causes of inflammation include heart disease, diabetes, obesity, and hypertension. Avoiding these conditions can reduce the levels of inflammation in the body.
It is also known that exercise and diet are important. "Exercise reduces inflammation and we know that certain foods, such as saturated fats and sugar – are at the origin of inflammation. It has been proven that the & réduit et et et et………………. Mediterranean diet reduced inflammation and was badociated with a reduced risk of dementia, "he said.
"We are not yet at the recommendation stage of anti-inflammatory drugs as a preventive strategy of cognitive decline, as we have no test data on this," he said. said Walker, "but I think we can say that it's a good idea to lead a healthy life and avoid becoming hypertensive, diabetic or obese, which should reduce our risk of developing dementia later in life . "
It is known that avoiding diabetes, hypertension and obesity reduces the risk of developing vascular disease, but now it is becoming increasingly clear that this could also prevent cognitive decline, he added. "This is another reason to make these lifestyle changes as soon as possible."
For this study, the researchers badyzed blood samples taken from 12,336 people (21% black women and 56% women) participating in the atherosclerosis risk cohort study in communities (ARIC) (mean of initial age of 56 years between 1987 and 1989).
The participants were badessed in person during five visits up to 2011-2013 and were the subject of a serial cognitive evaluation using measures of memory, executive function and performance. language during visits 2, 4 and 5 over 20 years.
A composite inflammation score was created using four biomarkers measured at visit 1 (fibrinogen, white blood cell count, von Willebrand factor, and factor VIII); and C-reactive protein (CRP) was measured at visit 2.
The results showed that after adjusting for demographic variables, vascular risk factors, and co-morbidities, each increase in the standard deviation (SD) of the composite life-stage inflammation score was badociated with an additional drop of -0.035 SD in the cognitive composite score over 20 years.
They found a similar badociation between each SD increase in CRP level in mid-life and an additional 20-year cognitive decline (-0.038 SD).
Having a composite score of inflammation in the 2nd, 3rd and 4th quartiles was badociated with cognitive declines of 7.5%, 7.7% and 8.9% more pronounced, respectively, than those of the 1st quartile.
A higher 2nd, 3rd, and 4th quartile CRP level was badociated with a more pronounced decline in the composite cognitive score of 9.7%, 8.5%, and 12.3%, respectively, compared to the first quartile CRP.
In specific cognitive domain badyzes, inflammatory markers in high quarantine were most consistently badociated with memory decline.
The authors note that the additional absolute level of cognitive change badociated with systemic inflammation was modest overall, but comparable to that badociated with vascular risk factors such as hypertension and diabetes.
The authors of the study pointed out: "Since the neuropathological processes badociated with dementia, such as β-amyloid deposition, would begin at half life, decades before the onset of clinical symptoms, the current results corroborate the idea that systemic inflammation may have an early pathological role in driving or accelerating some of the pathological processes underlying cognitive decline at the end of life. "
However, they point out that it is also possible that systemic inflammation during quarantine is a marker and not a cause of neurodegenerative disease.
The ARIC study was funded by the National Institute of Heart, Lung and Blood; the National Institute of Aging; and the National Institute of Diabetes and Digestive and Kidney Diseases. Walker did not reveal any relevant financial relationship.
Neurology. Posted online February 13, 2019. Abstract.
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