Dementia/PD + role of nutrition 2 Flashcards
What is the total % of modifiable risk factors in dementia?
40%
What are the most potential nutrients (prevention dementia)?
And food groups?
B vitamins: B6, B12, Folate
Antioxidants: E, flavonoids
Vit D
MAcronutrients: omega-3-FA
Alcohol: dose & type
Coffee & tea
Fish + seafood
Veg + fruits (gr leafy + berries)
Mind diet combines the ….. and ….. diets
DASH
Mediterranean
MIND diet adherence: better cognition + larger brain volume
ok
multidomain interventions have..
▪ At least 2 combined interventions in 1 study
FINGER trial: what is it?
Finland, 2 years, group with CVD risk: social activity, physical exercise, vascular + metabolic monitoring, active diet, cognitive training.
+25% overall cognition
FINGER now also in NL. Ongoing. What lifestyle interventions are people undergoing?
Dietary counseling (mind + vit D)
Fortasyn connect (muliti-nutrient drink)
Physical exercise
Cognitive training
Sleep counselling
Stress management
Vascular risk management
Social acitivies
What is the fortasyn connect drink (souvenaid) supplied with?
- Supplied with precursors for neurotransmitters, such as choline, Vit B, phospholipids, DHA (=omega-3)
What are the two most important omega-3-FA?
DHA and EPA
What is the mechanism of action of DHA and EPA?
- brain cell membranes
- inflammation
- oxidative stress
- vascular factors
- cerebral blood flow
- Seafood consumption (1 or more/week): significantly correlated with less AD pathology
Only among APOE4 carriers - Seafood consumption not correlated with brain infarcts or with Lewy bodies
- Seafood consumption correlated with higher brain levels of mercury
Higher mercury levels not correlated with increased brain neuropathology
ok
Why would a ketogenic diet help in neurodegenerative disease?
They are characterized by a detoriation of glucose metabolism. Increase ketone availability: proposed protective mechanism
What are aspects to consider in human gut-brain studies?
causality
Small sample size
Corrections for multiple testing lacking
Adjustments for confounding: diet
What are Methodological challenges in nutr/ brain studies?
- Method of nutritional status assessment is difficult (memory, FFQ have fixed list of nutrients)
- Timing of assessment: changes visible after years (duration of follow-up)
- Confounding of non-dietary factors
- Sample selection
- Multidimensionality of diet
- Multidimensionality of underlying mechanisms
- Multidimensionality of cognitive function
How long does it take before parkinson’s symptoms occur when the substantia nigra starts to be degraded?
20 yrs after degradation
Signs of PD?
- Slowness
- Rigidity (range of motion decreased)
- Tremor
- Postural abnormalities
Not only in the brain, but also peripherally (heart, gut): PD gives rise to many non-motor symptoms. Recall them
- sleep
- autonomous (urinary problems, hypotension)
- GI (swalling, delayed gastric emptying, constipation)
- sensory
Which is more predictive of QoL (quality of life) in PD: motor or non-motor symptoms?
non-motor
Pathophysiology
- Abnormal deposition of alpha-synuclein (lewy bodies) -> spectated to be the cause
- Neuronal loss in the substantia nigra
- Loss of dopamine in the striatum
- First motor symptoms appear after loss of 50-70% of substantia nigra (nigral projection)
ok
What is the theory of alpha-synuclein spread as a prion?
- Defected neuron with pathological alpha synuclein
- Excrete pathological alpha-nsynuclein
- Infects healthy neurons
- Alpha-syn in healthy neuron: abnormal configuration and become pathological
What are problems in treating PD?
- not one single disease entitiy, but syndrome
- treating one mechanism doomed to fail
What may contribute to increase of PD?
Pesticides may contribute to increase of PD
