Two breakthroughs on dementia (maybe)

So when it comes to dementia and the aging brain, any news is good news. And this week we had not one but two hopeful news items. One that’s useful to us right now, and the other that suggests something potentially very big down the road.

Let’s start with the one useful here and now. Some fascinating new research out of the University of California Riverside suggests we really can make our aging brain younger again, and lower the number of those senior moments, at later ages than previously realized.

Remember how quick your brain was when you were young? Like most people, I’ve just assumed that was because my brain was neurologically new back then and presumably more agile. And there’s something to that.

But some scientists have been theorizing that it’s also because of the school environment. Back then we are stuck in a classroom all day every day, concurrently learning multiple different skills from composition to trigonometry. We have teachers, and we are in a social environment with other children learning the same stuff at the same time.

Some scientists have wondered if we could make our minds more agile again, even at more advanced ages, if we tried to replicate some of that environment.

So that’s what the researchers did at UC Riverside. And it worked.

In two separate studies, seniors spent 7 hours a week learning three different skills over 3 to 3 ½ months. The participants had average ages of 66 in the first study and 69 in the second. The skills included Spanish language, photography, drawing, music composition, and operating an iPad. They spent two hours per week on each, along with a one-hour discussion each week on one of the subjects. Critically, for each participant these were new skills. Nobody was relearning something they already knew.

Overall, the time and commitment for those 12 or 15 weeks “was similar to a full undergraduate course load,” the researchers report. “Our intervention included novel skill learning, motivational lectures, and peer social support, as we originally intended to closely mimic rich, encouraging learning environments provided to children, adolescents and young adults.”

Here’s the payoff: Participants in the study showed dramatic improvements—and not simply in the three new skills they’d learned. They also showed “significant increases” in mental skills across a battery of tests designed to measure the broad set of cognitive abilities, the researchers report. That includes tests of both thinking skills and memory.

And these improvements weren’t just temporary. While participants in the studies showed cognitive gains during the program and at the end of it, they also showed further gains for up to a full year afterward.

“Older adults continued to increase their cognitive abilities even after one year from the end of the intervention,” the researchers report. “The present study revealed significant improvements up to a year following the end of the learning intervention.” The findings indicate “that a multi-skill learning intervention has the potential to induce long-lasting cognitive improvements in older adults.”

Wow.

One caveat is that the two studies were small: six people in one, 27 in another. Another is that the groups of participants were not ethnically diverse. We’ll have to see if other, broader studies replicate the findings.

But the studies suggest that signing up for programs at your local adult education center won’t just teach you Spanish, or oil painting, or Thai cooking and get you out of the house. They also rejuvenate your brain long term.

Meanwhile, there was some other hopeful news on dementia. Scientists have long known that people who end up developing Alzheimer’s or other forms of dementia are more likely to experience sleep problems in the years before the disease becomes apparent. The connection isn’t fully known: Does the disrupted sleep cause the brain decay, or vice versa?

But researchers at the Washington University School of Medicine in St. Louis have made a small, but potentially huge, discovery.

A sleeping pill already available could help.

A small number of patients who took the pill Suvorexant, which is made by Merck
MRK,
+1.05%
and marketed under the brand name Belsomra, saw sharp and immediate reductions in the two key biological markers of Alzheimer’s.

Those markers are the “amyloid-beta” and “tau” proteins that show up in the brains of people with dementia.

The research involved 38 people aged 45 to 65. Some were given a higher, 20 milligram dose of the sleep aid before going to sleep. Others were given 10 milligrams. Others were given a placebo. The researchers then took a spinal tap every two hours to analyze their cerebrospinal fluid.

“In the cerebrospinal fluid of people who had received the high dose of suvorexant, amyloid levels dropped 10% to 20% and levels of a key form of tau known as hyperphosphorylated tau dropped 10% to 15%, compared with people who had received placebo,” the researchers report. They repeated the test over a second night, with the same result.

What does it mean? Maybe nothing. Maybe an enormous amount.

“This is a small, proof-of-concept study,” warned the study’s senior author, Brendan Lucey, a Washington University neurology professor and the director of the sleep medicine center, in a statement. “It would be premature for people who are worried about developing Alzheimer’s to interpret it as a reason to start taking suvorexant every night.”

That said, he said these results were “very encouraging. This drug is already available and proven safe, and now we have evidence that it affects the levels of proteins that are critical for driving Alzheimer’s disease.”

There are many potential breakthroughs on Alzheimer’s, and so far none of them has panned out. There is currently no cure and very little we can do to slow the disease, let alone stop it. A new drug which can slow the progression early on is expensive, and currently isn’t covered by Medicare.

But if it turns out that the right sleep aids can make a difference—that would be huge. Stay tuned.