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Diabetes Drug Linked to Lower Risk of Dementia, Study Finds

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New research this week is the latest to suggest that some drugs meant to treat type 2 diabetes might also help prevent dementia in high-risk groups. The study found that older people who used a relatively older class of antidiabetic medication were less likely to develop dementia than those who used other common antidiabetic drugs. The findings might warrant new clinical trials to confirm the untapped potential of these drugs, the authors say.

Dementia is the progressive and ultimately fatal loss of cognitive function, which steadily impairs a person’s ability to remember, reason, and eventually perform basic tasks like eating. There are several different forms of dementia and many different factors that make people more vulnerable to developing it, including our genetics. One major suspected contributor to dementia risk is type 2 diabetes. And that’s led some researchers to wonder if drugs that can successfully manage diabetes can also lower a person’s risk of dementia.

Unfortunately, the research on this connection has been mixed, with some studies showing that popular diabetes drugs like metformin are linked to a lower risk of dementia, but other studies show no potential benefit. In this new research, the researchers decided to look at a class of diabetes drug that’s received less attention in the field of dementia research, drugs known as thiazolidinediones, or TZDs.

The team analyzed the medical records of over a half million people with type 2 diabetes aged 60 and older who were given care through Veterans Affairs, the largest interconnected healthcare system in the U.S. They compared the long-term outcomes of people who took at least one year of TZDs to people taking other diabetes drugs like metformin and another class of drugs called sulfonylureas. These people were diagnosed free of dementia before they started the medication, and were tracked for an average length of nearly seven years. People taking only metformin were used as the control group since the drug is the most common front-line option for type 2 diabetes and people who haven’t been prescribed medication for their diabetes tend to be healthier than the typical patient.

Over the study period, those taking TZDs alone were 22% less likely to be diagnosed with any form of dementia when compared to those taking only metformin. They also found that these people were 11% less likely to be diagnosed specifically with Alzheimer’s disease, the most common form of dementia. Additionally, patients were 57% less likely to develop vascular dementia, which accounts for about 10% of cases. The findings were published Tuesday in BMJ Open Diabetes Research & Care.

There can be many different causes of dementia, and it’s likely that any preventive effect from TZDs or other drugs would be complicated as well. But circulation problems are common for diabetes patients and are a known risk factor for vascular dementia and Alzheimer’s, so the researchers argue that TZDs might mainly work to prevent dementia by helping promote healthier circulation.

These results show a correlation between taking TZDs and a lower risk of dementia, but not a definitive cause-and-effect. And TZDs aren’t free of their own concerns. These drugs were developed in the 1990s and are still often used today—but most often as a second-line option. In the mid-2000s, some research suggested that certain TZDs could raise the risk of heart attacks, which led to the Food and Drug Administration attaching a warning label to the TZD drug rosiglitazone. Later studies failed to confirm this connection and the warning label was eventually removed. But more recent research has reignited this debate, and the drugs are still not recommended for patients at higher risk of heart failure.

All that said, the authors say that the findings should spur more research into the potential benefits of these drugs for dementia, including clinical trials. And assuming that they’re validated, the research could inform how doctors treat diabetes patients at high risk of dementia. The team found, for instance, that people taking sulfonylureas alone were actually more likely to develop dementia than those taking metformin or TZDs. If these drugs do somehow increase the odds of dementia, the researchers say, then it might be worth pairing them with metformin or TZDs to offset that risk. The possible effect of TZDs in preventing dementia was also larger in people who were overweight or obese, suggesting that these patients would benefit the most. Other, newer diabetes drugs are also being studied for their potential in preventing dementia.

“Our findings provide additional information to aid clinicians’ selection of [antidiabetic medications] for patients with mild or moderate type 2 diabetes and are at high risk of dementia,” the authors wrote.

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Here Are the Signs You Might Have Adult Dyslexia (and What to Do About It)

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Most dyslexic people are diagnosed in childhood, but the disorder can be overlooked and remain untreated into adulthood, which can lead to a different set of symptoms and struggles. There’s more to dyslexia than the common assumption that it simply makes people mirror or flip letters in their brains. Numerous other symptoms impact memory, attention, speech, and organization—and make it harder to diagnose as a result, since adults with these symptoms may never realize they could have dyslexia at all.

The longer the disorder goes undiagnosed—and untreated—the longer adults with dyslexia have to struggle with symptoms for no reason. Here are a few signs you might have dyslexia and what you can do about it.

What is dyslexia?

Most people are probably a little familiar with the basics of what dyslexia is thanks to television and film, where the disorder crops up among characters from Beverly Hills 90210 to Grey’s Anatomy. Like anything, there is some truth to the depiction of dyslexia in entertainment and media, but there’s more to the disorder, too.

“By definition, dyslexia is an unexpected difficulty in learning to read and spell words. It’s unexpected because other areas of learning and even other areas of reading (e.g., making inferences, understanding metaphors) may be fine or even advanced,” said Dr. Rebecca Wisehart, associate professor and assistant chair in communication sciences and disorders at St. John’s University. “It’s referred to as a neurodevelopmental disorder because people with dyslexia are born with cortical differences that make learning to read and spell particularly difficult.”

How are adult dyslexia diagnoses different from diagnoses in kids?

Estimates of the dyslexic population vary broadly, from 5%-20%. Part of this discrepancy comes from how unclear psychologists’ diagnoses of dyslexia in adults really are. The main model for a dyslexia diagnosis is designed for and based on children, which can cause problems and confusion for adults who may be struggling unknowingly. While reading and spelling difficulties could be a more obvious symptom in dyslexic children, it is more complicated to diagnose adults who have found ways to compensate for their deficits over the years.

Those who suspect they might have dyslexia, per Wisehart, “may have to look back at their school history to pick up on some early classic signs of dyslexia, such as slow or laborious reading or unexpectedly poor spelling. Co-occurring problems with math (especially memorizing multiplication tables) or handwriting are also common

She added that other signs dyslexia was present all along include problems learning a second language, persistent typos, or a lack of interest in reading for pleasure. Moreover, according to Wisehart, dyslexia is genetic—which means many adults only realize they have the disorder when their kids are diagnosed.

What dyslexia symptoms should adults look out for?

While dyslexia is well known to affect reading abilities, the most common symptom is actually related to speech. Phonological decoding refers to the ability to decode words and apply that to speech. Simply speaking, phonological decoding is about correctly pronouncing words. This process, while unconscious and automatic, is disrupted by dyslexia. Research shows that those with dyslexia have reduced activity in certain parts of the brain, the two most notable being the parietal lobe—which is involved in description and comprehension—as well as the occipital lobe, which is related more to the ability of seeing and reading fluently. However, these are not the only areas of the brain that can be affected—or, in turn, produce telltale symptoms. Further research suggests that those with dyslexia do not have a distorted idea of speech sound formation, but rather may have problems within their neural connections, which help us assemble and produce sounds.

All of this is to say that dyslexia can impact a person in a variety of ways. If you’re an adult and think you might have the disorder, these are the notable symptoms you should look for and consider asking a licensed professional about:

  • You confuse visually similar words (think tag and lag)
  • You read something “correctly” silently, but mispronounce it out loud
  • You find it difficult to concentrate
  • You have difficulty skimming words
  • You have difficulty organizing thoughts onto paper
  • You need to re-read paragraphs often to understand them
  • You make erratic spelling errors
  • You confuse left and right or struggle with spatial reasoning (like reading a map)
  • You have trouble recalling and retrieving the words needed to express yourself

What happens after an adult dyslexia diagnosis?

If you get diagnosed with dyslexia, there can be some relief, as with any diagnosis. You finally have an answer to why you’ve been experiencing symptoms, and that’s great. The mystery is solved. Unfortunately, that relief also comes with a new kind of worry: What do you do now?

Here is some good news. Dyslexia, while not curable, is manageable. Dr. Tiffany Hogan, professor at MGH Institute of Health Professionals, told Lifehacker, “Adults with dyslexia often need to give themselves extra time to read. Remember that listening to books on tape is still reading and may be more enjoyable for some adults with dyslexia. They will also want to check their spelling because your brain may not ‘see’ spelling errors. Adults with dyslexia may feel worried about their reading difficulties.”

Many adults who suffer from dyslexia will find other ways of coping, such as drawing pictures or using charts and diagrams to help remember information.

In a professional or learning environment, plan for extra time and stay organized as best as you can. When you are already struggling with a learning disability, stress can be especially detrimental and overwhelming. Identify your unique symptoms, then develop specialized and effective coping strategies around them.

There are also a few different services for adults to receive support and develop effective skills. According to Hogan, many of these services are also covered by health insurance. Additionally, employers, by law, have to provide accommodations for employees who have dyslexia. A formal diagnosis may be necessary for them to comply, so if you think you might be dyslexic, and want accommodations, see a professional sooner rather than later. It might be difficult to find a licensed professional who can offer treatment for dyslexia, but there are a number of directories that filter by state, so start with the International Dyslexia Association and the Center for Effective Reading Instruction.

Finally, don’t be afraid to seek out a diagnosis. In addition to the fact that your employer or institution will have to accommodate your disorder, you deserve the peace of knowing what is causing your symptoms and the opportunity to address your issues. It can be frustrating to struggle with no known reason, so a diagnosis will ease the burden of not understanding your own behavior or inabilities. Just remember you aren’t alone in this—and check out some online communities for others who’ve been diagnosed.

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Exercise Can Boost Brain Health Even in People Who Already Have Signs of Dementia

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New research adds to evidence that exercise can improve cognition, especially later in life. The study found that older people who regularly exercised had greater levels of proteins crucial to their brain’s health, compared to those who didn’t exercise. These differences were apparent even in people whose brains otherwise showed possible signs of dementia, suggesting that exercise could slow down the progression of cognitive decline.

The study was conducted by scientists in the U.S., Canada, and Spain. They analyzed data from an existing research project of older adults, the Memory and Aging Project run out of Rush University in Illinois. As part of the project, volunteers undergo yearly medical tests, including a measurement of their physical activity. And upon death, they also agree to have their organs, including their brain, donated for further research.

The team looked at more than 400 volunteers in their 70s and 80s who had their physical activity measured over the years and had donated their brains for study. In addition to checking for signs of neurological disorders like Alzheimer’s disease, they examined the brain tissue for the presence of proteins important to synaptic function, which is needed for nerve cells to communicate with one another and with other cells.

Overall, they found that adults with greater levels of physical activity tended to have higher levels of these synaptic proteins. This association was seen even in people whose brains had markers of Alzheimer’s and other forms of dementia, like plaques and tangles. The study’s findings were published this month in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

“The more physical activity, the higher the synaptic protein levels in brain tissue. This suggests that every movement counts when it comes to brain health,” study author Kaitlin Casaletto, an assistant professor of neurology in the Memory and Aging Center at the University of California San Francisco, told CNN.

This kind of research can only show an association between exercise and brain health, not demonstrate a true cause-and-effect. But other studies have suggested that regular exercise in mid to later life can possibly prevent or delay the symptoms of cognitive decline. The team’s findings, Casaletto said, might indicate that one way exercise helps is by keeping our synaptic function steady as we grow older.

The optimal amount of exercise is thought to be at least 150 minutes a week. But this and other research seems to find that any amount of physical activity can do the aging brain good, so long as it can be done regularly.

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5 Unexpected Things That Seem to Lower Dementia Risk

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5. Viagra (sildenafil)

A tablet of Pfizer’s Viagra, next to its generic equivalent. Both contain the active ingredient sildenafil
Photo: Richard Drew (Getty Images)

This is the most speculative thing on the list, but it’s one that could have some important implications.

Just this week, Cleveland researchers published a study claiming to show that sildenafil, the active ingredient in the erectile dysfunction drug Viagra, may help prevent or treat Alzheimer’s disease. In brain tissue collected from Alzheimer’s patients, they found evidence that high doses of sildenafil can boost the growth of brain cells and reduce the expression of amyloid and tau proteins. And when they looked at insurance claims data, they also found that people prescribed Viagra were 69% less likely to be later diagnosed with Alzheimer’s.

One of the main ways that sildenafil affects the body is by relaxing our blood vessels, and it’s already used to treat certain forms of high blood pressure. So it’s plausible that its effects on circulation could also reduce dementia risk. Even before this study, there had been evidence in animals that sildenafil could reduce the risk of vascular dementia, a condition closely linked to blood clots and circulation problems.

For the time being, though, not even the authors of this study are claiming that sildenafil should be taken for dementia. But given these findings, and the relatively low cost of sildenafil now that it’s become generic, it’s certainly worth studying further.

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Coffee and Tea Linked to Lower Risk of Stroke and Dementia in 11-Year Study

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New research out this week suggests that a tea or coffee habit in your later years could help your brain stay in tip-top shape. The study found that healthy older adults in the UK who regularly drank coffee and/or tea were less likely to develop stroke and dementia over an 11-year period than those who drank neither. Though these findings can’t confirm a cause-and-effect link, they are the latest to indicate that these brewed drinks have some health benefits.

Dementia is a progressive and currently incurable loss of cognitive function that becomes more common as we age. It’s poised to be an ever larger health problem in the future, thanks to people living longer. Strokes, which happen when blood flow in the brain is interrupted, account for about 10% of deaths globally every year. Stroke survivors can also be left with many lingering complications, including dementia. So any possible way to reduce the odds of developing these debilitating diseases would be a boon.

While tea has long been considered a healthy beverage, coffee has been more controversial. Lately, however, it’s become clear that coffee isn’t the devil’s drink and that it may even do some good. Recent studies have suggested that regular coffee consumption is linked to a lower risk of cardiovascular disease, certain cancers, and early death in general. But according to the authors of this new study, published Tuesday in PLOS Medicine, there remains a debate over the benefits, if any, that coffee and tea may have in reducing the risk of stroke and dementia.

The researchers, based in China, looked at data from the UK Biobank, a long-running research project that’s been tracking the health of volunteers in the United Kingdom since the mid-2000s. They specifically focused on 365,682 people between the ages of 50 and 74 with no pre-existing stroke or dementia, who had been followed for a median length of 11.4 years, up till 2020. At the start of the study, the participants were asked how often they drank coffee and/or tea.

Overall, there were 5,079 cases of dementia and 10,053 cases of stroke diagnosed during that time, based on hospital records. And across different groups of reported coffee and tea consumption, those who said they drank either two to three cups of coffee a day, three to five cups of tea a day, or a combination of four to six cups of coffee and tea were the least likely to develop either dementia or stroke. Compared to non-consumers, these individuals had a 28% lower risk of dementia and a 32% lower risk of stroke.

Other studies have found a relationship between tea and coffee consumption and lower stroke/dementia risk. But the authors say theirs is one of the first to account for those who regularly drink both tea and coffee, as opposed to one or the other.

“Our findings suggested that moderate consumption of coffee and tea separately or in combination were associated with lower risk of stroke and dementia,” they wrote.

These sorts of observational studies can’t be used to prove causation, the authors caution. They also note that UK Biobank volunteers tend to be in good shape, which could mean the findings would be less applicable to the general population. The study only looked at a snapshot of people’s diets, meaning we can’t be sure that people in the study remained coffee/tea drinkers or abstainers the entire time. But the findings do add to the growing pile of research showing a positive effect on stroke risk from these drinks.

Other studies have suggested that coffee and tea can improve the overall functioning of our blood vessels, which may explain why these drinks seemed to lower risk of ischemic strokes specifically, rather than hemorrhagic strokes. Ischemic strokes are caused by blood clot blockages, while hemorrhagic strokes are the result of vessels breaking and bleeding out into the brain (about 80% of strokes are ischemic). Still, there might be other protective factors that should be investigated in future studies, such as the antioxidant benefits of caffeine, the authors say. More research is also needed to know whether it’s really possible to prevent cases of stroke and dementia by telling people to start drinking coffee and tea if they aren’t already regular drinkers.

“Our findings support an association between moderate coffee and tea consumption and risk of stroke and dementia. However, whether the provision of such information can improve stroke and dementia outcomes remains to be determined,” the study authors wrote.

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Processed Meat Linked to Increased Dementia Risk, Study Finds

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People’s love of processed meat might come back to bite them in the long run, new research from the UK suggests. The study found a link between greater consumption of processed meat and higher rates of Alzheimer’s disease and other forms of dementia. At the same time, it also found a possible link between eating unprocessed meats and a lower risk of dementia.

Processed meats such as bacon, jerky, and hot dogs don’t exactly have a reputation for being healthy in the first place. Other research has suggested that diets high in these foods are linked to chronic conditions such as type 2 diabetes, cardiovascular disease, and some types of cancer. Some studies have even pointed to a link between processed meats and the increased risk of neuropsychiatric symptoms, such as episodes of bipolar depression.

There’s been mixed evidence that a diet high in meat could raise a person’s risk of dementia in their later years. But according to the authors of this new study, published Monday in The American Journal of Clinical Nutrition, there’s been less work to separate out the possible dementia risk from different types of meats (processed versus not) and whether genetics may play a role in that risk.

The study relied on population data from the UK Biobank, an ongoing research project that’s collected health and genetic information from around a half million residents, ages 40 to 69, between 2006 and 2010. As part of the project, volunteers filled out a questionnaire about their diet at the start of their enrollment and in periodic online surveys for up to 16 months after. Because of the UK’s nationalized health system, the researchers were then able to track the health outcomes of these participants, including whether they developed or died from dementia.

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About 2,900 cases of dementia were diagnosed in the entire group, during an average eight-year follow-up period. And when the researchers tried to account for people’s diets, they found a clear association between processed meat and the risk of dementia, but they didn’t see the correlation when it came to other types of meat.

For example, the associated risk of dementia rose by 44% for every 25 grams of processed meat eaten daily. But there was no significant link found between dementia risk and total meat consumption or between dementia risk and a person’s daily intake of chicken. Meanwhile, the associated risk of dementia actually declined slightly for those who regularly ate unprocessed red meat (cooked beef, veal, pork, etc.). The risk of dementia increased for those who carried the APOE ε4 genetic variation, as expected, but this risk wasn’t affected by meat consumption.

“Our findings suggest that consumption of processed meat may increase risk of incident dementia, and unprocessed red meat intake may be associated with lower risks,” the authors wrote.

Nutritional studies like this one have their limitations, of course. For instance, they can’t show a direct cause-and-effect relationship between any two things, only a correlation. Studying people’s diets is hard in general, since we aren’t the greatest at remembering what and how much of any given food we eat regularly. And of course, a person’s diet at 40 or 50 might still change significantly between then and the time of their dementia diagnosis years or decades later.

Any single study shouldn’t be seen as the final verdict on a topic. More research will have to be done to tease out the potential effects of a diet high in processed meats on our dementia risk and how these diets may be causing it. That said, as mentioned earlier, this wouldn’t be the first study tying processed meats to worsening health. So while the specifics still need to be worked on, it’s likely in many of our best interests to cut down on bacon or sausage anyway.

“Worldwide, the prevalence of dementia is increasing and diet as a modifiable factor could play a role,” said lead author Huifeng Zhang, a PhD student from the University of Leeds’ School of Food Science and Nutrition, in a statement released by the UK-based university. “Our research adds to the growing body of evidence linking processed meat consumption, to increased risk of a range of non-transmissible diseases.”

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Watchdog: UK patients with learning disabilities given do not resuscitate orders if they had COVID-19

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A watchdog group has said that patients in the United Kingdom with learning disabilities who contracted the coronavirus were given unnecessary “do not resuscitate” orders. 

Mencap, a  watchdog group aimed at helping those with learning disabilities, has said they received multiple reports from coronavirus patients with learning disabilities who were told they would not be resuscitated if their health deteriorated, according to a report from The Guardian. 

“Throughout the pandemic many people with a learning disability have faced shocking discrimination and obstacles to accessing healthcare, with inappropriate Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) notices put on their files and cuts made to their social care support,” Edel Harris, Mencap’s chief executive, told The Guardian.

The do not resuscitate orders might have cost lives during the pandemic last year, according to The Care Quality Commission, a health care regulator in the U.K., said.

According to the news source it is not immediately clear why these orders were placed on people with learning disabilities. Do not resuscitate orders are usually administered to people who cannot withstand CPR. 

New evidence also suggests that people with learning disabilities are more likely to have severe negative health consequences from the virus, according to The Guardian. 

The UK is under lockdown again as the country continues to combat the new, more infectious, UK variant of the coronavirus virus. 

In the first five weeks of their most current lockdown, the National Health Service, the UK’s publicly funded healthcare system, has found that 65 percent of COVID-19 deaths have been linked to those with disabilities, the Guardian reported. 

And despite evidence of disproportionate effects, there has been debate in the country over whether those with learning disabilities should be a priority to receive vaccinations. 

“It’s unacceptable that within a group of people hit so hard by the pandemic, and who even before Covid died on average over 20 years younger than the general population, many are left feeling scared and wondering why they have been left out,” Harris said. 

The Hill has reached out to Mencap for comment.



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