New guidelines for latest Alzheimer's medications
Also: Olive oil may help protect from dementia
September 1, 2023 | View PDF
Olive oil packs powerful punch against dementia
Switching your cooking oils to olive oil may have important hidden brain benefits. A new study is suggesting that incorporating olive oil into your diet may help reduce the risk of dying from dementia. As many countries face rising rates of Alzheimer’s disease and other forms of dementia, the study offers hope that healthy lifestyle factors such as diet can help to prevent or slow the progression of brain deterioration.
“Our study reinforces dietary guidelines recommending vegetable oils such as olive oil and suggests that these recommendations not only support heart health, but potentially brain health,” said Anne-Julie Tessier, a postdoctoral fellow at the Harvard T.H. Chan School of Public Health, Boston, Mass. “Opting for olive oil, a natural product, instead of fats such as margarine and commercial mayonnaise is a safe choice and may reduce the risk of fatal dementia.”
Dementia includes a range of conditions in which impairments in thinking or memory affect a person’s daily activities. Alzheimer’s disease, a progressive and fatal disease affecting an estimated 5.7 million Americans, is the most common form of dementia. This new study is the first to investigate the relationship between diet and dementia-related death. Scientists analyzed dietary questionnaires and death records collected from more than 90,000 Americans over three decades. During the study period, 4,749 participants died from dementia.
The study showed that people who consumed more than half a tablespoon of olive oil per day had a 28% lower risk of dying from dementia compared with those who never or rarely consumed olive oil. In addition, replacing just one teaspoon of margarine and mayonnaise with the equivalent amount of olive oil per day was associated with an 8 to 14% lower risk of dying from dementia.
Research suggests that people who regularly use olive oil instead of processed or animal fats tend to have healthier diets overall. However, Tessier noted that the relationship between olive oil and dementia mortality risk in this study was independent of overall diet quality, suggesting that olive oil has properties that are uniquely beneficial for brain health.
“Some antioxidant compounds in olive oil can cross the blood-brain barrier, potentially having a direct effect on the brain,” said Tessier. “It is also possible that olive oil has an indirect effect on brain health by benefiting cardiovascular health.”
Previous studies have linked higher olive oil intake with a lower risk of heart disease. Incorporating olive oil as part of a Mediterranean dietary pattern has also been shown to help protect against cognitive decline. Tessier cautioned that the research is observational and does not prove that olive oil is the cause of the reduced risk of fatal dementia.
Additional studies such as randomized controlled trials will be needed to confirm the effects and determine the optimal quantity of olive oil to consume in order to reap these benefits. Overall, however, the study aligns with dietary recommendations and bolsters the evidence for using olive oil in place of other oils.
New guidance on latest treatments for early Alzheimer’s disease
New therapies for early Alzheimer’s disease are changing how patients are being managed. Monoclonal antibodies that remove amyloid-β plaques in the brain are bringing new hope to people whose lives have been affected by Alzheimer’s disease. Now, the American Academy of Neurology (AAN) has developed new guidelines for patients. The guidelines are derived from expert consensus about new and emerging therapies.
“Neurologists care for millions of people with Alzheimer’s disease and many people with early forms of dementia are eager to learn if these new therapies could help them,” said AAN president Dr. Carlayne E. Jackson. “To help neurologists provide the highest quality care, experts with the American Academy of Neurology have summarized the available evidence on anti-amyloid monoclonal antibodies so that neurologists, patients and their caregivers can make informed decisions together about possible treatment with these therapies.”
The guidelines provide the latest available information on lecanemab, aducanumab and donanemab. “Recent data on lecanemab and other monoclonal antibody infusions targeting amyloid-β protein make clear that new agents are highly likely to be part of the toolkit for neurologists caring for people with Alzheimer’s disease,” said Dr. Vijay K. Ramanan with the Mayo Clinic in Rochester, Minnesota.
Lecanemab received traditional FDA approval on July 6, 2023. Aducanumab received accelerated approval from the FDA in June 2021, but has not yet received traditional approval. Aducanumab is available only to individuals participating in a clinical trial. Donanemab is not yet approved, but a decision on traditional FDA approval is expected within the next four months. All of these agents are administered through regular infusions and monitoring with multiple brain scans.
Currently, only individuals with early symptomatic forms of the disease, mild cognitive impairment or mild dementia due to Alzheimer’s disease, may qualify to receive lecanemab. There is a concern that some patients may take these drugs inappropriately out of desperation. Neurologists says all older adults should be counseled about certain genetic risk factors and must not have a history of strokes.
If a person is taking certain anticoagulant medications that are commonly prescribed to older adults, they may not be eligible. The goal of using these therapies is to remove amyloid-β plaques and slow cognitive decline. These new therapies are not a cure for the disease. There is reason for optimism as there are dozens of very promising new agents in the development stage.
John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at firstname.lastname@example.org.