Anti-herpetic Medications and Reduced Risk of Dementia in Patients with Herpes Simplex Virus Infections—a Nationwide, Population-Based Cohort Study in Taiwan

This retrospective cohort study is to investigate the association
between herpes simplex virus (HSV) infections and dementia, and the
effects of anti-herpetic medications on the risk involved, using
Taiwan’s National Health Insurance Research Database (NHIRD). We
enrolled a total of 33,448 subjects, and identified 8362 with newly
diagnosed HSV infections and 25,086 randomly selected sex- and
age-matched controls without HSV infections in a ratio of 1:3, selected
from January 1, to December 31, 2000. A multivariable Cox proportional
hazards regression model was used to evaluate the risk of developing
dementia in the HSV cohort. This analysis revealed an adjusted hazard
ratio of 2.564 (95% CI: 2.351-2.795, P < 0.001)
for the development of dementia in the HSV-infected cohort relative to
the non-HSV cohort. Thus, patients with HSV infections may have a
2.56-fold increased risk of developing dementia. A risk reduction of
dementia development in patients affected by HSV infections was found
upon treatment with anti-herpetic medications (adjusted HR = 0.092 [95%
CI 0.079-0.108], P < 0.001).
Theusage of anti-herpetic medications in the treatment of HSV infections
was associated with a decreased risk of dementia. These findings could
be a signal to clinicians caring for patients with HSV infections.
Further research is, therefore, necessary to explore the underlying
mechanism(s) of these associations.

Half of all dementias start with damaged 'gatekeeper cells': Once the cells are compromised, the brain's protective fort becomes leaky and allows blood toxins to trespass into the brain, damaging critical connections between brain areas, esearchers say. -- ScienceDaily

Half of all dementias start with damaged 'gatekeeper cells', or Pericytes: Once the cells are compromised, the brain's protective fort becomes leaky and allows blood toxins to trespass into the brain, damaging critical connections between brain areas, researchers say. -- ScienceDaily

Could lupus raise dementia risk?

 The researchers identified 4,886 individuals who had received a
diagnosis of systemic lupus erythematosus , and these were matched by age and sex in a 1:5 ratio
to 24,430 people without the condition (the controls). The incidence of
dementia was assessed for each group.
The study revealed that people with SLE were 51 percent more
likely to develop dementia than people without SLE, and this association
persisted across all age groups.
Based on their results, the researchers conclude that "systemic lupus erythematosus is significantly associated with dementia."

Lithium in Drinking Water May Lower Dementia Risk

  "Higher long-term lithium exposure from drinking water may be associated with a lower incidence of dementia, a large population-based study suggests.
"This is the first study ever investigating the association between lithium in drinking water and onset of dementia," Lars Vedel Kessing, MD, DMSc, from the University of Copenhagen, Denmark, told Medscape Medical News.
"If confirmed by others, tablets of lithium in microdose could be used among individuals at high risk of developing Alzheimer's disease, including those with a family history or certain genetic variations," Dr Kessing added.
The study was published online August 23 in JAMA Psychiatry."


However, Lithium in drug form does not appear to affect Alzheimer's disease

See:-

Association Between Lithium Use and Risk of Alzheimer's Disease.

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Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia | Stroke

"Background and Purpose—Sugar- and artificially-sweetened beverage intake have been linked to cardiometabolic risk factors, which increase the risk of cerebrovascular disease and dementia. We examined whether sugar- or artificially sweetened beverage consumption was associated with the prospective risks of incident stroke or dementia in the community-based Framingham Heart Study Offspring cohort.

 Methods—We studied 2888 participants aged >45 years for incident stroke (mean age 62 [SD, 9] years; 45% men) and 1484 participants aged >60 years for incident dementia (mean age 69 [SD, 6] years; 46% men). Beverage intake was quantified using a food-frequency questionnaire at cohort examinations 5 (1991–1995), 6 (1995–1998), and 7 (1998–2001). We quantified recent consumption at examination 7 and cumulative consumption by averaging across examinations. Surveillance for incident events commenced at examination 7 and continued for 10 years. We observed 97 cases of incident stroke (82 ischemic) and 81 cases of incident dementia (63 consistent with Alzheimer’s disease)



Results—After adjustments for age, sex, education (for analysis of dementia), caloric intake, diet quality, physical activity, and smoking, higher recent and higher cumulative intake of artificially sweetened soft drinks were associated with an increased risk of ischemic stroke, all-cause dementia, and Alzheimer’s disease dementia. When comparing daily cumulative intake to 0 per week (reference), the hazard ratios were 2.96 (95% confidence interval, 1.26–6.97) for ischemic stroke and 2.89 (95% confidence interval, 1.18–7.07) for Alzheimer’s disease. Sugar-sweetened beverages were not associated with stroke or dementia.

 Conclusions—Artificially sweetened soft drink consumption was associated with a higher risk of stroke and dementia."



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Stroke and dementia risk linked to artificial sweeteners, study suggests | Society | The Guardian

Consuming a can a day of low- or no-sugar soft drink is associated with a much higher risk of having a stroke or developing dementia, researchers claim.

Their findings have prompted renewed questions about whether drinks flavoured with artificial sweeteners can increase the risk of serious illness, as heavily sugared drinks have already been shown to do.

“Drinking at least one artificially sweetened beverage daily was associated with almost three times the risk of developing stroke or dementia compared to those who drank artificially sweetened beverages less than once a week,” according to the American researchers who carried out a study published in Stroke, the journal of the American Heart Association."


Here's the paper :-

Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia

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Living near major roads and the incidence of dementia, Parkinson's disease, and multiple sclerosis: a population-based cohort study - The Lancet

Background
Emerging evidence suggests that living near major roads might adversely affect cognition. However, little is known about its relationship with the incidence of dementia, Parkinson's disease, and multiple sclerosis. We aimed to investigate the association between residential proximity to major roadways and the incidence of these three neurological diseases in Ontario, Canada.

Methods 

In this population-based cohort study, we assembled two population-based cohorts including all adults aged 20–50 years (about 4·4 million; multiple sclerosis cohort) and all adults aged 55–85 years (about 2·2 million; dementia or Parkinson's disease cohort) who resided in Ontario, Canada on April 1, 2001. Eligible patients were free of these neurological diseases, Ontario residents for 5 years or longer, and Canadian-born. We ascertained the individual's proximity to major roadways based on their residential postal-code address in 1996, 5 years before cohort inception. Incident diagnoses of dementia, Parkinson's disease, and multiple sclerosis were ascertained from provincial health administrative databases with validated algorithms. We assessed the associations between traffic proximity and incident dementia, Parkinson's disease, and multiple sclerosis using Cox proportional hazards models, adjusting for individual and contextual factors such as diabetes, brain injury, and neighbourhood income. We did various sensitivity analyses, such as adjusting for access to neurologists and exposure to selected air pollutants, and restricting to never movers and urban dwellers.
Findings
Between 2001, and 2012, we identified 243 611 incident cases of dementia, 31 577 cases of Parkinson's disease, and 9247 cases of multiple sclerosis. The adjusted hazard ratio (HR) of incident dementia was 1·07 for people living less than 50 m from a major traffic road (95% CI 1·06–1·08), 1·04 (1·02–1·05) for 50–100 m, 1·02 (1·01–1·03) for 101–200 m, and 1·00 (0·99–1·01) for 201–300 m versus further than 300 m (p for trend=0·0349). The associations were robust to sensitivity analyses and seemed stronger among urban residents, especially those who lived in major cities (HR 1·12, 95% CI 1·10–1·14 for people living <50 m from a major traffic road), and who never moved (1·12, 1·10–1·14 for people living <50 m from a major traffic road). No association was found with Parkinson's disease or multiple sclerosis.

Interpretation
In this large population-based cohort, living close to heavy traffic was associated with a higher incidence of dementia, but not with Parkinson's disease or multiple sclerosis."



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Environmental risk factors for dementia: a systematic review | BMC Geriatrics | Full Text

Dementia risk reduction is a major and growing public health priority. While certain modifiable risk factors for dementia have been identified, there remains a substantial proportion of unexplained risk. There is evidence that environmental risk factors may explain some of this risk. Thus, we present the first comprehensive systematic review of environmental risk factors for dementia.

Methods 

We searched the PubMed and Web of Science databases from their inception to January 2016, bibliographies of review articles, and articles related to publically available environmental data. Articles were included if they examined the association between an environmental risk factor and dementia. Studies with another outcome (for example, cognition), a physiological measure of the exposure, case studies, animal studies, and studies of nutrition were excluded. Data were extracted from individual studies which were, in turn, appraised for methodological quality. The strength and consistency of the overall evidence for each risk factor identified was assessed.

Results

We screened 4784 studies and included 60 in the review. Risk factors were considered in six categories: air quality, toxic heavy metals, other metals, other trace elements, occupational-related exposures, and miscellaneous environmental factors. Few studies took a life course approach. There is at least moderate evidence implicating the following risk factors: air pollution; aluminium; silicon; selenium; pesticides; vitamin D deficiency; and electric and magnetic fields.

 Conclusions

Studies varied widely in size and quality and therefore we must be circumspect in our conclusions. Nevertheless, this extensive review suggests that future research could focus on a short list of environmental risk factors for dementia. Furthermore, further robust, longitudinal studies with repeated measures of environmental exposures are required to confirm these associations."

A Systematic Review and Meta-Analysis of the Association between Helicobacterpylori Infection and Dementia - IOS Press

A positive association between Helicobacter pylori infection and dementia has been reported, yet findings are inconsistent.

Objective:To examine the association between H. pylori infection and dementia. Methods:A literature search was performed using the databases OVID-Medline, Institute of Scientific Information Web of Science, and EMBASE. The meta-analysis was conducted using the random effects model. The primary analysis included studies in which the exposure variable was presence of H. pylori infection (yes versus no) and the outcome was incident dementia (yes versus no), which was pre-selected as the end-result of gradual cognitive decline overtime. Publication bias was explored using funnel plot and the Egger regression intercept.

Results:A total of 260 records were identified; 13 addressed cognition and/or dementia in relation to H. pylori infection, of which only seven were included in the meta-analysis. The primary analysis showed a significant positive association between H. pylori infection and dementia; pooled odds ratio 1.71 (95% CI 1.17–2.49) (pv = 0.01). No significant evidence of publication bias was found. Conclusions:H. pylori may play a role in the etiology of dementia. Identification of the biological mechanisms of such association is needed, as well as assessment of the impact of H. pylori therapy on the risk and progression of dementia."



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Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis

Importance  Medications that influence the risk of dementia in the elderly can be relevant for dementia prevention. Proton pump inhibitors (PPIs) are widely used for the treatment of gastrointestinal diseases but have also been shown to be potentially involved in cognitive decline.

Objective  To examine the association between the use of PPIs and the risk of incident dementia in the elderly.

Design, Setting, and Participants  We conducted a prospective cohort study using observational data from 2004 to 2011, derived from the largest German statutory health insurer, Allgemeine Ortskrankenkassen (AOK). Data on inpatient and outpatient diagnoses (coded by the German modification of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision) and drug prescriptions (categorized according to the Anatomical Therapeutic Chemical Classification System) were available on a quarterly basis. Data analysis was performed from August to November 2015.

Exposures  Prescription of omeprazole, pantoprazole, lansoprazole, esomeprazole, or rabeprazole.

Main Outcomes and Measures  The main outcome was a diagnosis of incident dementia coded by the German modification of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. The association between PPI use and dementia was analyzed using time-dependent Cox regression. The model was adjusted for potential confounding factors, including age, sex, comorbidities, and polypharmacy.

Results  A total of 73 679 participants 75 years of age or older and free of dementia at baseline were analyzed. The patients receiving regular PPI medication (n = 2950; mean [SD] age, 83.8 [5.4] years; 77.9% female) had a significantly increased risk of incident dementia compared with the patients not receiving PPI medication (n = 70 729; mean [SD] age, 83.0 [5.6] years; 73.6% female) (hazard ratio, 1.44 [95% CI, 1.36-1.52]; P < .001).

Conclusions and Relevance  The avoidance of PPI medication may prevent the development of dementia. This finding is supported by recent pharmacoepidemiological analyses on primary data and is in line with mouse models in which the use of PPIs increased the levels of β-amyloid in the brains of mice. Randomized, prospective clinical trials are needed to examine this connection in more detail.

Obese-type Gut Microbiota Induce Neurobehavioral Changes in the Absence of Obesity - Biological Psychiatry

Background

The prevalence of mental illness, particularly depression and dementia, is increased by obesity.
Here, we test the hypothesis that obesity-associated changes in gut microbiota are intrinsically able to impair neurocognitive behavior in mice.

Methods

Conventionally housed, nonobese, adult male C57BL/6 mice maintained on a normal chow diet were
subjected to a microbiome depletion/transplantation paradigm using microbiota isolated from donors on either a high-fat diet (HFD) or control diet. Following re-colonization, mice were subjected to
comprehensive behavioral and biochemical analyses.

Results

The mice given HFD microbiota had significant and selective disruptions in
exploratory, cognitive, and stereotypical behavior compared with mice
with control diet microbiota in the absence of significant differences
in body weight. Sequencing-based phylogenetic analysis confirmed the
presence of distinct core microbiota between groups, with alterations in
α- and β-diversity, modulation in taxonomic distribution, and
statistically significant alterations to metabolically active taxa. HFD
microbiota also disrupted markers of intestinal barrier function,
increased circulating endotoxin, and increased lymphocyte expression of
ionized calcium-binding adapter molecule 1, toll-like receptor 2, and
toll-like receptor 4. Finally, evaluation of brain homogenates revealed
that HFD-shaped microbiota increased neuroinflammation and disrupted
cerebrovascular homeostasis.

Conclusions

Collectively, these data reinforce the link between gut dysbiosis and neurologic dysfunction and suggest that dietary and/or pharmacologic manipulation of gut microbiota could attenuate the neurologic complications of obesity.

JAMA Internal Medicine | Cumulative Use of Strong Anticholinergics and Incident Dementia: A Prospective Cohort Study

Importance  Many medications have anticholinergic effects. In general, anticholinergic-induced cognitive impairment is considered reversible on discontinuation of anticholinergic therapy. However, a few studies suggest that anticholinergics may be associated with an increased risk for dementia.

Objective  To examine whether cumulative anticholinergic use is associated with a higher risk for incident dementia.

Design, Setting, and Participants  Prospective population-based cohort study using data from the Adult Changes in Thought study in Group Health, an integrated health care delivery system in Seattle, Washington. We included 3434 participants 65 years or older with no dementia at study entry. Initial recruitment occurred from 1994 through 1996 and from 2000 through 2003. Beginning in 2004, continuous replacement for deaths occurred. All participants were followed up every 2 years. Data through September 30, 2012, were included in these analyses.

Exposures  Computerized pharmacy dispensing data were used to ascertain cumulative anticholinergic exposure, which was defined as the total standardized daily doses (TSDDs) dispensed in the past 10 years. The most recent 12 months of use was excluded to avoid use related to prodromal symptoms. Cumulative exposure was updated as participants were followed up over time.

Main Outcomes and Measures  Incident dementia and Alzheimer disease using standard diagnostic criteria. Statistical analysis used Cox proportional hazards regression models adjusted for demographic characteristics, health behaviors, and health status, including comorbidities.

Results  The most common anticholinergic classes used were tricyclic antidepressants, first-generation antihistamines, and bladder antimuscarinics. During a mean follow-up of 7.3 years, 797 participants (23.2%) developed dementia (637 of these [79.9%] developed Alzheimer disease). A 10-year cumulative dose-response relationship was observed for dementia and Alzheimer disease (test for trend, P < .001). For dementia, adjusted hazard ratios for cumulative anticholinergic use compared with nonuse were 0.92 (95% CI, 0.74-1.16) for TSDDs of 1 to 90; 1.19 (95% CI, 0.94-1.51) for TSDDs of 91 to 365; 1.23 (95% CI, 0.94-1.62) for TSDDs of 366 to 1095; and 1.54 (95% CI, 1.21-1.96) for TSDDs greater than 1095. A similar pattern of results was noted for Alzheimer disease. Results were robust in secondary, sensitivity, and post hoc analyses.

Conclusions and Relevance  Higher cumulative anticholinergic use is associated with an increased risk for dementia. Efforts to increase awareness among health care professionals and older adults about this potential medication-related risk are important to minimize anticholinergic use over time.

Study suggests sleeping drugs can increase risk of Alzheimer’s | Society | The Guardian

Over-the-counter sleeping aids and hayfever treatments can increase the risk of Alzheimer’s disease, a study has found. The sleeping medication Nytol and anti-allergy pills Benadryl and Piriton all belong to a class of drug highlighted in a warning from researchers.

Each of these drugs has “anticholinergic” blocking effects on the nervous system that are said – at higher doses – to raise the likelihood of developing Alzheimer’s and other forms of dementia significantly over several years.

Other drugs on the risk list include older “tricyclic” antidepressants such as doxepin, and the bladder control treatment Ditropan (oxybutynin). Many of these medicines are taken by vulnerable older people, according to the scientists, who say their findings have public health implications.

Healthy midlife diet may prevent dementia later -- ScienceDaily

The researchers assessed the link between diet and dementia using a
healthy diet index based on the consumption of a variety of foods.
Vegetables, berries and fruits, fish and unsaturated fats from milk
products and spreads were some of the healthy components, whereas
sausages, eggs, sweets, sugary drinks, salty fish and saturated fats
from milk products and spreads were indicated as unhealthy.

Hepatitis C viral infection and the risk of dementia.

BACKGROUND AND PURPOSE:

Hepatitis C virus (HCV) infection may cause cognitive impairment, but no studies have focused specifically on cognitive impairment stemming from HCV. The purpose of this study was to investigate the potential increased risk for dementia in HCV-infected patients.

METHODS:

A population-based cohort study based on the Taiwan National Health Insurance Research Database was conducted. From all potential participants aged 50 years or more, a total of 58 570 matched (1:1) pairs of HCV-infected patients and non-HCV-infected patients were included. Each subject was individually tracked from 1997 to 2009 to identify incident cases of dementia (onset in 1999 or later). Cox proportional hazards regressions were employed to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between HCV infection and dementia.

RESULTS:

There were 2989 dementia cases from the HCV-infected cohort during the follow-up period of 533 861.1 person-years; the overall incidence rates of dementia differed from the non-HCV cohort (56.0 vs. 47.7 cases per 10 000 person-years, P < 0.05). The adjusted HR for dementia was 1.36 (95% CI 1.27-1.42) for HCV-infected patients after adjusting for alcohol-related disease, liver cirrhosis, hepatic encephalopathy and hepatocellular carcinoma.

CONCLUSIONS:

HCV infection may increase the risk for dementia. Further mechanistic research is needed.

Longer use of statins may prevent dementia and memory loss

A review of dozens of studies on the use of statin medications to prevent heart attacks shows that the commonly prescribed drugs pose no threat to short-term memory, and that they may even protect against dementia when taken for more than one year. The Johns Hopkins researchers who conducted the systematic review say the results should offer more clarity and reassurance to patients and the doctors who prescribe the statin medications.

Risk of dementia doubles for elderly patients hospitalized with infections, study finds

 "Elderly patients who were hospitalized with infections, such as pneumonia, were more than twice as likely to develop dementia than those who did not have an infection, according to a University of Pittsburgh study, which also found that patients with dementia may be more susceptible to infection. The results of the study, funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, are available online and published in the September 1st edition of the American Journal of Respiratory and Critical Care Medicine."

High dose statins prevents dementia, study suggests

"High doses of statins prevent dementia in older people, according to research presented at the ESC Congress today by Dr. Tin-Tse Lin from Taiwan. The study of nearly 58,000 patients found that high potency statins had the strongest protective effects against dementia."
 Almost all the statins (except lovastatin) decreased the risk for new onset dementia when taken at higher daily doses. A high mean daily dosage of lovastatin was positively associated with the development of dementia, possibly because lovastatin is a lipophilic statin while the anti-inflammatory cholesterol lowering effect of lovastatin is not comparable to that of atorvastatin and simvastatin

Early-onset dementia linked to adolescent risk factors

A Swedish study involving military men identifies nine risk factors, many of which may be preventable for adolescents, that are associated with young-onset dementia - dementia diagnosed before the age of 65. 

Results from the study show that the major risk factors associated with the early-onset disease included:

• Alcohol intoxication, 
• Stroke; 
• Use of antipsychotics; 
• Depression; 
• Father's dementia; 
• Drug intoxication; 
• Low cognitive function at enlistment; 
• Low height at enlistment; 
• High systolic blood pressure at enlistment.

Anemia linked to increased risk of dementia

  "There are several explanations for why anemia may be linked to dementia. For example, anemia may be a marker for poor health in general, or low oxygen levels resulting from anemia may play a role in the connection. Reductions in oxygen to the brain have been shown to reduce memory and thinking abilities and may contribute to damage to neurons,"