Friday, June 15, 2018

The Menopause-Alzheimer’s Connection



By Lisa Mosconi
Dr. Mosconi is a neuroscientist.
April 18, 2018

In the next three minutes, three people will develop Alzheimer’s disease. Two of them will be women.

There are 5.7 million Alzheimer’s patients in the United States. By 2050, there will probably be as many as 14 million, and twice as many women as men will have the disease.
And yet research into “women’s health” remains largely focused on reproductive fitness and breast cancer. We need to be paying much more attention to the most important aspect of any woman’s future: her ability to think, to recall, to imagine — her brain.

When I first started in the field, Alzheimer’s was thought of as the inevitable consequence of bad genes, aging or both. Today we understand that Alzheimer’s has compound causes, such as age, genetics, high blood pressure and aspects of lifestyle, including diet and exercise. There is also scientific consensus that Alzheimer’s is not always a disease of old age but can start in the brain when people are in their 40s and 50s.

What we are only beginning to understand is why women are more susceptible. What factors differentiate women from men, specifically as we reach middle age?
The first and most obvious thing is fertility. Women are diverse, but we all experience the decline in fertility and the beginning of menopause.

It turns out that menopause affects far more than our childbearing potential. Symptoms like night sweats, hot flashes and depression originate not in the ovaries but largely in the brain. These symptoms are all caused by an ebb in estrogen. The latest research, including my own work, indicates that estrogen serves to protect the female brain from aging. It stimulates neural activity and may help prevent the build up of plaques that are connected to the onset of Alzheimer’s disease. When estrogen levels decline, the female brain becomes much more vulnerable.

To determine this, my colleagues and I used a brain imaging technique called PET on a group of healthy middle-aged women. This allowed us to measure neural activity and the presence of Alzheimer’s plaques. The tests revealed that the women who were postmenopausal had less brain activity and more Alzheimer’s plaques than premenopausal women. More surprising, this was also the case for perimenopausal women — those who were just starting to experience symptoms of menopause. And both groups’ brains showed even more drastic differences when compared with those of healthy men of the same age.

The good news is that as women mature into their 40s and 50s, there seems to be a window of opportunity when it is possible to detect early signs of higher Alzheimer’s risk — by doing a brain-imaging test, as we did — and to take action to reduce that risk.

There is increasing evidence that hormone replacement therapies — mainly, giving women supplemental estrogen — can help to alleviate symptoms if given before menopause. We need much more research to test the efficacy and safety of hormone therapy, which has been tied to an increased risk of heart disease, blood clots and breast cancer in some cases.

Perhaps in the next decade it will become the norm for middle-aged women to receive preventive testing and treatment for Alzheimer’s disease, just as they get mammograms today. In the meantime, research shows that diet can alleviate and mitigate the effects of menopause in women which could minimize the risk of Alzheimer’s.

Many foods naturally boost estrogen production, including soy, flax seeds, chickpeas, garlic and fruit like apricots. Women in particular also need antioxidant nutrients like vitamin C and vitamin E, found in berries, citrus fruits, almonds, raw cacao, Brazil nuts and many leafy green vegetables.

These are first steps, for women and for doctors. But the more we learn about what kicks off and accelerates dementia, the clearer it becomes that we need to take better care of women’s brains. A comprehensive evaluation of women’s health demands thorough investigations of the aging brain, the function of estrogen in protecting it and strategies to prevent Alzheimer’s in women specifically.

No one needs to be reminded that many things make a woman unique. We are working to help make sure that the risk of Alzheimer’s is not one of them.

Lisa Mosconi is the associate director of the Alzheimer’s Prevention Clinic at Weill Cornell Medical College and the author of “Brain Food: The Surprising Science of Eating for Cognitive Power.”

Friday, June 1, 2018

2017 Profile of Older Americans


Reprinted from: ALCA Members Digest, April 30, 2018

A Profile of Older Americans: 2017, an annual summary of the latest statistics on the older population compiled primarily from U.S. Census data, is now available as a web-based publication in a user friendly format along with data tables and charts in Microsoft Excel spreadsheets. Here are some highlights from the 2017 Profile of Older Americans:
  1. Over the past 10 years, the population age 65 and over increased from 37.2 million in 2006 to 49.2 million in 2016 (a 33% increase) and is projected to almost double to 98 million in 2060.
  2. Between 2006 and 2016 the population age 60 and over increased 36% from 50.7 million to 68.7 million.
  3. The 85 and over population is projected to more than double from 6.4 million in 2016 to 14.6 million in 2040 (a 129% increase).
  4. Racial and ethnic minority populations have increased from 6.9 million in 2006 (19% of the older adult population) to 11.1 million in 2016 (23% of older adults) and are projected to increase to 21.1 million in 2030 (28% of older adults).
  5. The number of Americans aged 45-64 – who will reach age 65 over the next two decades – increased by 12% between 2006 and 2016.
  6. About one in every seven, or 15.2%, of the population is an older American.
  7. Persons reaching age 65 have an average life expectancy of an additional 19.4 years (20.6 years for females and 18 years for males).
  8. There were 81,896 persons age 100 and over in 2016 (0.2% of the total age 65 and over population).
  9. Older women outnumber older men at 27.5 million older women to 21.8 million older men.
  10. In 2016, 23% of persons age 65 and over were members of racial or ethnic minority populations -- 9% were African-Americans (not Hispanic), 4% were Asian or Pacific Islander (not Hispanic), 0.5% were Native American (not Hispanic), 0.1% were Native Hawaiian/Pacific Islander, (not Hispanic), and 0.7% of persons 65+ identified themselves as being of two or more races. Persons of Hispanic origin (who maybe of any race) represented 8% of the older population.
  11. A larger percentage of older men are married as compared with older women---70% of men, 46% of women. In 2017, 33% older women were widows.
  12. About 28% (13.8 million) of noninstitutionalized older persons lived alone (9.3 million women, 4.5 million men).
  13. Almost half of older women (45%) age 75 and over lived alone.
  14. The median income of older persons in 2016 was $31,618 for males and $18,380 for females. The real median income (after adjusting for inflation) of all households headed by older people increased by 2.1% (which was not statistically significant) between 2015 and 2016. Households containing families headed by persons age 65 and over reported a median income in 2016 of $58,559.
  15. The major sources of income as reported by older persons in 2015 were Social Security (reported by 84% of older persons), income from assets (reported by 63%), earnings (reported by 29%), private pensions (reported by 37%), and government employee pensions (reported by 16%).


Notes:
Principal sources of data for the Profile are the U.S. Census Bureau, the National Center for Health Statistics, and the Bureau of Labor Statistics. The Profile incorporates the latest data available but not all items are updated on an annual basis.
This report includes data on the 65 and over population unless otherwise noted. The phrases “older adults” or “older persons” refer to the population age 65 and over.
Numbers in this report may not add up due to rounding.