09/19/18 Newsletter – The Times They A-changin’

To my Patients and Friends,

I’ve seen a plethora of new research on dementia in the last few weeks, so I thought I’d consolidate some of it for your review… and to finish, a little something on aspirin.  Enjoy!

The “germ theory” of Alzheimer’s Disease

As science delves more deeply into root causes for Alzheimer’s Disease, another theory has taken center stage.  We already know that certain conditions, such as high blood pressure and diabetes, can contribute to an increased risk for developing Alzheimer’s Disease.  Although the “germ theory” of Alzheimer’s is not new, its ability to gain traction in the research community has been slow.  More recently, a study published in the journal Neuron suggests that certain viruses that remain dormant in the human body can activate genes associated with Alzheimer’s Disease.  In particular, this study highlights two viruses in the herpes family of viruses: HHV-6 and HHV-7.  These common viruses cause a rash called Roseola in children (but not sexually transmitted diseases or rashes such as chickenpox and shingles; these are caused by other herpes strains).

In comes Dr. Leslie Norins, a retired medical publisher and infectious diseases researcher…  Dr. Norins has launched Alzheimer’s Germ Quest Inc., a public benefit corporation that will encourage deeper investigations into the “germ theory” of Alzheimer’s Disease.  Norins (and others) speculate that, in the not-too-distant future, dementia may be prevented with a vaccine, or perhaps treated with antibiotics or antiviral medications.  In fact, he’s banking on it, to the tune of a million-dollar prize to the entity that “provides persuasive evidence—within 3 years— that a particular infectious agent is the cause of most Alzheimer’s disease.”

and there’s more evidence that genes don’t tell the whole dementia story

So is Alzheimer’s disease a “perfect storm” resulting from a combination of factors, including infectious diseases, chronic illnesses, environmental triggers and genes?  Stay tuned… more answers are on the horizon.

Is aspirin all that it’s cracked up to be?

As you know, millions of Americans take a daily aspirin tablet with the hopes of preventing cancer, heart attacks, strokes and dementia.  But aspirin has been in the news lately.  A number of patients have asked about the ASPREE (Aspirin in Reducing Events in the Elderly) trial that was recently published in the New England Journal of Medicine, so I thought I’d discuss it here.  In this study of over 19,000 healthy older adults, it was found that daily aspirin did not reduce the risk of dementia, cardiovascular disease, physical disability or death.  However, major bleeding episodes and all-cause mortality (particularly from cancer) were both higher with aspirin use.

So should everyone immediately stop taking their daily aspirin?  Analysis of the data from this study is still underway, and longer-term effects of aspirin therapy on risk for cancer and dementia have yet to be determined.  So the best answer for now is maybe, and medical guidelines related to daily aspirin therapy have not changed in response to the study.  However, for those at lower risk for cardiovascular disease (for instance, less than 20% risk over the next decade- check out this risk calculator), the harms of taking a daily aspirin may outweigh the benefits.  Talk to your doctor.

That’s all for  now… be well, more to come.

Happy Jewish New Year to all those out there celebrating!