5 ms·

Midlife Vascular Risk Burden and Dementia-Free Survival Years

85 points by bookofjoe 3mo ago

brandonb 3mo ago
Previous studies have shown that heart health at 50 predicts brain health at 75. This study is interesting in that it quantifies the benefit as 12.5 extra dementia-free years. People with 0 risk factors had 30 years of dementia-free survival, vs 17.5 years for people with all 3 risk factors measured. The risk factors in this specific study are blood pressure, diabetes (HbA1c), and smoking. You could reasonably also include cholesterol/ApoB, inflammation (hs-CRP), and perhaps Lp(a) as potential risk factors.
asdfman123 3mo ago
Yes. The time to fix your health is now. Any unhealthy habits put time on the biological clock, and they'll just get harder to undo later. This is true if you're 20, 40, or 60. Plaque even starts building up on the arteries of healthy teenagers. It all adds up. But don't read this and panic or beat yourself up, that's a waste of energy. That's choosing the punishment instead of the fix. Instead, quietly start doing one small healthy habit. If you stop, don't revert to self-punishment again. Just quietly get back to it. Stubbornly persist until you've won.
- throwawalien 3mo ago
  yep. eat healthy food as much as possible. walk. exercise. and SLEEP.
  - asdfman123 3mo ago
    IMO developing good sleep hygiene is by far the most important habit to cultivate. It has lots of benefits, but the most important one is it replenishes your willpower. If you're trying to develop other healthy habits, it's 10x harder if you haven't slept well.
    - mattv8 3mo ago
      It's also the easiest to implement, imo. But there is a tradeoff: fewer waking hours during your best years cognitively for more years when you're older...
      - Centigonal 3mo ago
        Waking hours is both a quantity game and a quality game. I don't remember too much from the parts of my life where I was very sleep deprived
      - Touche 3mo ago
        Poor sleep is a widespread problem and very few of those people are cognitively doing it intentionally as some sort of "tradeoff". The number of people "grinding on a startup" is tiny compared to the population of people who suffer from this problem. Instead it's caused by things like general anxiety, too much screen time before bed, or not having consistent sleep schedules. And other health related reasons that compound the problem.
        sersi 3mo ago
        You can add having a child to the list. Nothing has caused more disruption to my sleep as my son has done
      - drop_star 3mo ago
        Have some kids and tell me how easy it is. I havnt had an uniterupted sleep in 4 years
        asdfman123 3mo ago
        Orphanages are always an option
  - lukan 3mo ago
    "eat healthy food as much as possible." I usually stop, if my body signals me I had enough. (might seem like pedantery, but I know some people do believe it literally, that it is healthy to just fill themself up with "healthy food", but it is not).
    - bookofjoe 3mo ago
      I think the commenter meant such that as much as possible of your diet consists of healthy rather than unhealthy food — NOT as great a quantity as you can take in.
      - lukan 3mo ago
        I know, I took the literal meaning because I know some do live by that.
        bookofjoe 3mo ago
        Fair enough! Just because I don't doesn't mean I shouldn't broaden my scope.
    - throwawalien 3mo ago
      haha yeah I meant like choose to cook the chicken in your freezer with some veggies over going through the drive-thru
- asmodeuslucifer 3mo ago
  I just watched this video by a doctor, and his point was every one of his ER patients had a problem that was years in the making (except for 1, a little girl who swallowed a battery) I Saw 120 Patients This Week. Here's Why They Were Actually Sick. https://www.youtube.com/watch?v=UiVKh97rJsg https://www.youtube.com/watch?v=UiVKh97rJsg
  - scottious 3mo ago
    It is a bit crazy that everybody seems to agree that diet and exercise are important, and yet it seems like society is hell bent on making those things very hard to do well. I went to the mall recently (big mistake) and I had to get lunch at the food court. I don't think there was a single gram of fiber across the 10 or so restaurants. So much of America is drive-thru garbage. Yup -- you don't even have to stand up to get your Big Mac. You can endanger other people by eating it while you drive. We tell people to get exercise and then force them to have 9-5 desk jobs that have a 45 minute car-commute each way. And what's so much worse is that people are paying a ton of money for that car that's slowly killing them. It's not entirely their fault though -- that's just the way our society is set up. Walkability is a luxury only the rich can afford. Then, 20 years later you show up to the doctor and the standard course of action is to prescribe a bunch of medications. The doctor says "you should exercise more and eat better" and many people just don't. So much is broken.
    - WarmWash 3mo ago
      Exercise is taxing, and healthy food isn't as tasty or easy as junk food. Humans are natural experts in min-maxing calories spent vs calories consumed. Then we solved food ~100 years ago and its been a kid in a candy shop ever since.
      - Insanity 3mo ago
        Gotta find exercise that is fun though. Don’t just try one thing and give up, it takes time to find what you enjoy. I’ve been swimming for 15 years, but only got into bouldering 1.5 years ago. I tried running and cycling but it always felt like a chore so I could not stick with it. The food problem is much harder to solve for IMO, even shops are designed to get you to impulse-buy junk. Although one minor tip is to do groceries when you’re full, not when you’re hungry.
sublinear 3mo ago
> Hypertension was defined as a systolic blood pressure of 140 mm Hg or higher, a diastolic blood pressure of 90 mm Hg or higher, or the utilization of blood pressure-lowering medications. Whoever defined this, thank you for having common sense! This stood out to me because there are so many lunatics defining it as 121/80 or even 121/70 with the backwards idea that the systolic is more important. Worse still is when they insist that something as low as 100/65 is optimal despite complaints of dizziness. All the while hammering home that you should chug a million gallons of water and deprive yourself of sodium. It's like they're trying to make people miserable.
- hombre_fatal 3mo ago
  The 120/80 benchmark isn't lunacy. Most people in the west have issues with hypertension because that's the direction it goes due to the common risk factors. If you're at 135/85, and you're middle aged / younger, and your diet and lifestyle aren't already optimized, it's something you should probably care about, not look for the next highest rung on the ladder so that you can celebrate for being below it.
  - sublinear 3mo ago
    You're completely missing the point. There's a significant amount of people middle aged and younger with numbers something like 125/75. They may have that same blood pressure never change from about 20 years old until their 70s. Elsewhere they'd be borderline normal, but "in the west" (really just the USA) they're considered stage 1 hypertension and it's anyone's guess what wild nonsense the doctor will tell them once that's in their chart. It's a total circus. Covering your own ass and screwing the patient over by assuming the worst is not preventative medicine. Overprescribing medication would cause harm if the patient is too naive for their own good despite doing everything else right. Nobody in their right mind should listen to that kind of doctor or take the medication.
    - deleted 3mo ago
      [deleted]
    - 3mo ago
johsole 3mo ago
The importance of walking can not be overstated. Walking for 30 mins every other day will dramatically improve your life if you are sedentary. If you can't do 30 minutes, start with 15.
- sublinear 3mo ago
  Lifting weights also helps. I'd argue that if someone wants to go beyond walking into running or even jogging, they ought to get their strength up so they don't have blood sugar crashes or cramps. It's never a bad idea to gain some muscle.
  - intrasight 3mo ago
    And don't drink alcohol
    - steve_adams_86 3mo ago
      I'm not a drinker, but I think we shouldn't be so strict about it. I usually have a drink once every few months or so, and frankly I don't really care about the impact it has on my health. I suspect it's so minuscule as to not matter at all in the scheme of things. Same with eating deep fried food. Especially if it's a food that's otherwise quite healthy. A bit of hot oil isn't going to be your undoing. Just don't make these things a habit. Enjoy a bit of indulgence, but be honest with yourself: is this once per month thing becoming a once per week thing, or a once every few days thing? Daily? Don't do that. Recognize vice. But don't be so strict that you never allow anything remotely unhealthy. Humans aren't great at abstinence. Having said that, there's a reason I don't drink more often and it's because it really is terrible for you. I agree, haha. Just, don't pretend you'll never do bad things ever again. Unless you have far more willpower than I do — that's entirely possible.
      - intrasight 3mo ago
        It is an issue of moderation. The problem is that the science says the only safe level is none and people are not so good at moderating. My current level is one beer a week. My goal is to scale that back to one a month.
Aurornis 3mo ago
> Maintaining optimal midlife vascular health was associated with up to 12.6 additional dementia-free survival years, Stay on top of your cardiovascular health. Even moderate diet and lifestyle changes can have a significant impact on the last decade of your life. These things compound over decades.
- criddell 3mo ago
  Being human, I think more about the number of dementia years than number of dementia-free years. Could having good dietary, sleep, and exercise habits result in living longer with dementia? I've hard about cognitive reserve and how healthy lifestyle choices can build that. But I never read about ways to minimize the number of years you have to live with dementia. I wish I could sign an order that would grant me a dignified death once I'm deemed no longer fit to make that decision.
  - Aurornis 3mo ago
    You're looking at this from the wrong angle. The dementia risk and longevity have overlapping factors. Lifestyle choices correlated with shorter lifespan are also correlated with earlier dementia onset. They're not perfectly proportional, but getting earlier dementia and also living shorter is lose-lose. Technically there's an extreme version of this where someone's lifestyle is so bad that they're unlikely to live past 60, but the last 10-20 years of that life would not be fun.
    - criddell 3mo ago
      > getting earlier dementia and also living shorter is lose-lose That depends. I'd rather die at 70 after a year of dementia than live to 85 where the last five of those I have dementia. I want to minimize the number of years with dementia, not maximize the number of years without.
  - jonfromsf 3mo ago
    This is indeed a problem. My mom had excellent cardiovascular health (she walked hours a day, ate a mostly vegetarian diet, etc). She got Alzheimers at 65 and is now 82. She's been completely gone as a person for the last decade, but her body hasn't died yet. It's tragic.
ajx1001 3mo ago
The work of Dr. Rick Johnson is perhaps relevant. He links the effects of fructose on the mitochondria, which then affects the neurons in the brain, over time. This hypothesis makes much more sense to me when you think to the associated diseases (diabetes, heart disease etc...) You can get a overview of his research on this podcast (approx 75min): https://www.youtube.com/watch?v=59Oje6n2JLU https://www.youtube.com/watch?v=59Oje6n2JLU
- n8henrie 3mo ago
  In the context of TFA, what hypothesis makes much more sense to you than what alternative?
  - ajx1001 3mo ago
    TFA? Not sure what you mean. The hypothesis (I'm paraphrasing) is the fructose severely downgrades the mitochondria (this is well established). The part that is really interesting to me is that patients with alzheimer's have huge amounts of fructose in their brains (that's covered the in the podcast). So, lots of fructose, mitochondria impacted, thus neurons degraded. Makes sense to me. As far as alternative hypothesis, there aren't any good ones that I'm aware of.
    - n8henrie 3mo ago
      TFA: https://news.ycombinator.com/item?id=19781756 https://news.ycombinator.com/item?id=19781756 Alzheimer's disease is a specific subtype of dementia; this article seems to be more focused on vascular dementia (or at least vascular risk factors) -- why I was curious about the relationship between e.g. smoking and fructose. The association of fructose has been studied directly in the context of AD, and the hazard ratio is modest (and not necessarily dose-dependent) [0]: > After adjustment for sex, age, MMSE at baseline, education level, SBP, treatment of hypertension, LDL, uric acid, prevalent diabetes mellitus, current smoking, alcohol consumption, dietary fiber intake, total energy intake, sugar in beverage, seafood, red meat, fried foods, animal fat, personal income, marital status, physical activity index, and BMI in the Cox regression model, participants with consumption of fructose more than 7 servings/week showed a higher risk of all-cause dementia and AD dementia (HR: 1.49, 95% CI: 1.14–1.84, P for trend < 0.001 for all-cause dementia; HR: 1.60, 95% CI: 1.22–2.01, P-trend < 0.001 for AD dementia) than subjects with no consumption for fructose. And the results remained comparable for participants with medium consumption of fructose (HR: 1.46, 95% CI: 1.30–1.79, for all-cause dementia; HR: 1.52, 95% CI: 1.14–1.91, for AD dementia) (see Table 2). I haven't seen anything about the fructose content of brains of AD patients; do you have a (preferably non-video) reference / source? [0]: https://www.sciencedirect.com/science/article/pii/S2274580724002267/pdfft?md5=ffa8ff65e0529bacec3267f66bb701f5&pid=1-s2.0-S2274580724002267-main.pdf https://www.sciencedirect.com/science/article/pii/S227458072...
_wire_ 3mo ago
You are going to die, and it's a painful ugly business. The right to die humanely is the single most under-regarded and under-valued aspect of life hygiene.
- tejohnso 3mo ago
  Fortunately some jurisdictions are death wise enough to provide humane means that we can request from a health practitioner.
  - switchbak 3mo ago
    That cuts both ways though, and I have quite direct knowledge of how this has been misused in really gross ways. But that said, I would still bias towards more freedom than less, and hope that we can get a handle on the more extreme cases.
John7878781 3mo ago
I have always had a very low blood pressure, below what's considered "normal." I never feel dizzy when standing up, though. Is this still a risk factor for dementia?
- organsnyder 3mo ago
  This is a question for your doctor.
sys32768 3mo ago
It's mostly luck and genetics, but good sleep matters. My mother died from Alzheimer's at 77 but wrote down her symptoms as early as 60, a full six years before her diagnosis. Prior to her diagnosis, she walked her dog two miles a day, had an ideal weight, ate organic, never drank or smoke, used her brain constantly, and enjoyed a happy social life. The only problem I saw with her was she was a very light sleeper. Her aunt also died from Alzheimer's and was super healthy when diagnosed too. Meanwhile the 103-year-old lady at my mother's former care facility is still sharp as a tack and reads daily without needing glasses.
- highfrequency 3mo ago
  Are you aware of her APOE3/APOE4 status?
  - sys32768 3mo ago
    Nope. I have one APOE4. Her mother didn't get Alzheimer's until her mid-80s.
nickjj 3mo ago
If anyone wants to go down a rabbit hole, go search for topics around fructose corn syrup, visceral fat and artery plaque. It can play a substantial role in vascular health. I'm not a doctor but there's a bunch of studies posted online about this and my doctor also agreed when I asked him about it. Avoiding fructose corn syrup is a really good idea. It's in a ton of sugary drinks. It really messes with inflammation in your body and your liver materializes it in a very similar way as alcohol. Basically both are bad and can cause similar issues. For me personally I walk a few miles a day for 15+ years and I'm in ok shape. Cutting out Arizona iced tea (has a lot of fructose corn syrup) has made a material difference in how my body operates, I used to drink 1-2 cans a day for a while. Nowadays going 18 hours without food is no problem, I don't have mid-day tired spikes and I didn't change what I eat. I can't explain it but it feels like it reset something. When I've been on vacation in other countries outside of the US for a few weeks, I noticed the same thing (less hungry, more energy, etc.) and a commonality there is I also didn't drink large amounts of fructose corn syrup. There's a lot of variables I'm sure but I can say I feel a difference for the better after stopping and I've now repeated these feelings when doing normal things locally.
hps79 3mo ago
Microplastics are a huge issue-- reducing your exposure is of the utmost importance imo. I go to a longevity clinic that tests, and was recommended this product MicroCleanse by Hazel's. Have seen a material reduction in level 2 build up.

85 points by bookofjoe 3mo ago

Previous studies have shown that heart health at 50 predicts brain health at 75. This study is interesting in that it quantifies the benefit as 12.5 extra dementia-free years. People with 0 risk factors had 30 years of dementia-free survival, vs 17.5 years for people with all 3 risk factors measured. The risk factors in this specific study are blood pressure, diabetes (HbA1c), and smoking. You could reasonably also include cholesterol/ApoB, inflammation (hs-CRP), and perhaps Lp(a) as potential risk factors.

asdfman123 3mo ago

Yes. The time to fix your health is now. Any unhealthy habits put time on the biological clock, and they'll just get harder to undo later. This is true if you're 20, 40, or 60. Plaque even starts building up on the arteries of healthy teenagers. It all adds up. But don't read this and panic or beat yourself up, that's a waste of energy. That's choosing the punishment instead of the fix. Instead, quietly start doing one small healthy habit. If you stop, don't revert to self-punishment again. Just quietly get back to it. Stubbornly persist until you've won.

throwawalien 3mo ago
yep. eat healthy food as much as possible. walk. exercise. and SLEEP.
- asdfman123 3mo ago
  IMO developing good sleep hygiene is by far the most important habit to cultivate. It has lots of benefits, but the most important one is it replenishes your willpower. If you're trying to develop other healthy habits, it's 10x harder if you haven't slept well.
  - mattv8 3mo ago
    It's also the easiest to implement, imo. But there is a tradeoff: fewer waking hours during your best years cognitively for more years when you're older...
    - Centigonal 3mo ago
      Waking hours is both a quantity game and a quality game. I don't remember too much from the parts of my life where I was very sleep deprived
    - Touche 3mo ago
      Poor sleep is a widespread problem and very few of those people are cognitively doing it intentionally as some sort of "tradeoff". The number of people "grinding on a startup" is tiny compared to the population of people who suffer from this problem. Instead it's caused by things like general anxiety, too much screen time before bed, or not having consistent sleep schedules. And other health related reasons that compound the problem.
      - sersi 3mo ago
        You can add having a child to the list. Nothing has caused more disruption to my sleep as my son has done
    - drop_star 3mo ago
      Have some kids and tell me how easy it is. I havnt had an uniterupted sleep in 4 years
      - asdfman123 3mo ago
        Orphanages are always an option
- lukan 3mo ago
  "eat healthy food as much as possible." I usually stop, if my body signals me I had enough. (might seem like pedantery, but I know some people do believe it literally, that it is healthy to just fill themself up with "healthy food", but it is not).
  - bookofjoe 3mo ago
    I think the commenter meant such that as much as possible of your diet consists of healthy rather than unhealthy food — NOT as great a quantity as you can take in.
    - lukan 3mo ago
      I know, I took the literal meaning because I know some do live by that.
      - bookofjoe 3mo ago
        Fair enough! Just because I don't doesn't mean I shouldn't broaden my scope.
  - throwawalien 3mo ago
    haha yeah I meant like choose to cook the chicken in your freezer with some veggies over going through the drive-thru
asmodeuslucifer 3mo ago
I just watched this video by a doctor, and his point was every one of his ER patients had a problem that was years in the making (except for 1, a little girl who swallowed a battery) I Saw 120 Patients This Week. Here's Why They Were Actually Sick. https://www.youtube.com/watch?v=UiVKh97rJsg https://www.youtube.com/watch?v=UiVKh97rJsg
- scottious 3mo ago
  It is a bit crazy that everybody seems to agree that diet and exercise are important, and yet it seems like society is hell bent on making those things very hard to do well. I went to the mall recently (big mistake) and I had to get lunch at the food court. I don't think there was a single gram of fiber across the 10 or so restaurants. So much of America is drive-thru garbage. Yup -- you don't even have to stand up to get your Big Mac. You can endanger other people by eating it while you drive. We tell people to get exercise and then force them to have 9-5 desk jobs that have a 45 minute car-commute each way. And what's so much worse is that people are paying a ton of money for that car that's slowly killing them. It's not entirely their fault though -- that's just the way our society is set up. Walkability is a luxury only the rich can afford. Then, 20 years later you show up to the doctor and the standard course of action is to prescribe a bunch of medications. The doctor says "you should exercise more and eat better" and many people just don't. So much is broken.
  - WarmWash 3mo ago
    Exercise is taxing, and healthy food isn't as tasty or easy as junk food. Humans are natural experts in min-maxing calories spent vs calories consumed. Then we solved food ~100 years ago and its been a kid in a candy shop ever since.
    - Insanity 3mo ago
      Gotta find exercise that is fun though. Don’t just try one thing and give up, it takes time to find what you enjoy. I’ve been swimming for 15 years, but only got into bouldering 1.5 years ago. I tried running and cycling but it always felt like a chore so I could not stick with it. The food problem is much harder to solve for IMO, even shops are designed to get you to impulse-buy junk. Although one minor tip is to do groceries when you’re full, not when you’re hungry.

sublinear 3mo ago

> Hypertension was defined as a systolic blood pressure of 140 mm Hg or higher, a diastolic blood pressure of 90 mm Hg or higher, or the utilization of blood pressure-lowering medications. Whoever defined this, thank you for having common sense! This stood out to me because there are so many lunatics defining it as 121/80 or even 121/70 with the backwards idea that the systolic is more important. Worse still is when they insist that something as low as 100/65 is optimal despite complaints of dizziness. All the while hammering home that you should chug a million gallons of water and deprive yourself of sodium. It's like they're trying to make people miserable.

hombre_fatal 3mo ago
The 120/80 benchmark isn't lunacy. Most people in the west have issues with hypertension because that's the direction it goes due to the common risk factors. If you're at 135/85, and you're middle aged / younger, and your diet and lifestyle aren't already optimized, it's something you should probably care about, not look for the next highest rung on the ladder so that you can celebrate for being below it.
- sublinear 3mo ago
  You're completely missing the point. There's a significant amount of people middle aged and younger with numbers something like 125/75. They may have that same blood pressure never change from about 20 years old until their 70s. Elsewhere they'd be borderline normal, but "in the west" (really just the USA) they're considered stage 1 hypertension and it's anyone's guess what wild nonsense the doctor will tell them once that's in their chart. It's a total circus. Covering your own ass and screwing the patient over by assuming the worst is not preventative medicine. Overprescribing medication would cause harm if the patient is too naive for their own good despite doing everything else right. Nobody in their right mind should listen to that kind of doctor or take the medication.
  - deleted 3mo ago
    [deleted]
  - 3mo ago

johsole 3mo ago

The importance of walking can not be overstated. Walking for 30 mins every other day will dramatically improve your life if you are sedentary. If you can't do 30 minutes, start with 15.

sublinear 3mo ago
Lifting weights also helps. I'd argue that if someone wants to go beyond walking into running or even jogging, they ought to get their strength up so they don't have blood sugar crashes or cramps. It's never a bad idea to gain some muscle.
- intrasight 3mo ago
  And don't drink alcohol
  - steve_adams_86 3mo ago
    I'm not a drinker, but I think we shouldn't be so strict about it. I usually have a drink once every few months or so, and frankly I don't really care about the impact it has on my health. I suspect it's so minuscule as to not matter at all in the scheme of things. Same with eating deep fried food. Especially if it's a food that's otherwise quite healthy. A bit of hot oil isn't going to be your undoing. Just don't make these things a habit. Enjoy a bit of indulgence, but be honest with yourself: is this once per month thing becoming a once per week thing, or a once every few days thing? Daily? Don't do that. Recognize vice. But don't be so strict that you never allow anything remotely unhealthy. Humans aren't great at abstinence. Having said that, there's a reason I don't drink more often and it's because it really is terrible for you. I agree, haha. Just, don't pretend you'll never do bad things ever again. Unless you have far more willpower than I do — that's entirely possible.
    - intrasight 3mo ago
      It is an issue of moderation. The problem is that the science says the only safe level is none and people are not so good at moderating. My current level is one beer a week. My goal is to scale that back to one a month.

Aurornis 3mo ago

> Maintaining optimal midlife vascular health was associated with up to 12.6 additional dementia-free survival years, Stay on top of your cardiovascular health. Even moderate diet and lifestyle changes can have a significant impact on the last decade of your life. These things compound over decades.

criddell 3mo ago
Being human, I think more about the number of dementia years than number of dementia-free years. Could having good dietary, sleep, and exercise habits result in living longer with dementia? I've hard about cognitive reserve and how healthy lifestyle choices can build that. But I never read about ways to minimize the number of years you have to live with dementia. I wish I could sign an order that would grant me a dignified death once I'm deemed no longer fit to make that decision.
- Aurornis 3mo ago
  You're looking at this from the wrong angle. The dementia risk and longevity have overlapping factors. Lifestyle choices correlated with shorter lifespan are also correlated with earlier dementia onset. They're not perfectly proportional, but getting earlier dementia and also living shorter is lose-lose. Technically there's an extreme version of this where someone's lifestyle is so bad that they're unlikely to live past 60, but the last 10-20 years of that life would not be fun.
  - criddell 3mo ago
    > getting earlier dementia and also living shorter is lose-lose That depends. I'd rather die at 70 after a year of dementia than live to 85 where the last five of those I have dementia. I want to minimize the number of years with dementia, not maximize the number of years without.
- jonfromsf 3mo ago
  This is indeed a problem. My mom had excellent cardiovascular health (she walked hours a day, ate a mostly vegetarian diet, etc). She got Alzheimers at 65 and is now 82. She's been completely gone as a person for the last decade, but her body hasn't died yet. It's tragic.

ajx1001 3mo ago

The work of Dr. Rick Johnson is perhaps relevant. He links the effects of fructose on the mitochondria, which then affects the neurons in the brain, over time. This hypothesis makes much more sense to me when you think to the associated diseases (diabetes, heart disease etc...) You can get a overview of his research on this podcast (approx 75min): https://www.youtube.com/watch?v=59Oje6n2JLU https://www.youtube.com/watch?v=59Oje6n2JLU

n8henrie 3mo ago
In the context of TFA, what hypothesis makes much more sense to you than what alternative?
- ajx1001 3mo ago
  TFA? Not sure what you mean. The hypothesis (I'm paraphrasing) is the fructose severely downgrades the mitochondria (this is well established). The part that is really interesting to me is that patients with alzheimer's have huge amounts of fructose in their brains (that's covered the in the podcast). So, lots of fructose, mitochondria impacted, thus neurons degraded. Makes sense to me. As far as alternative hypothesis, there aren't any good ones that I'm aware of.
  - n8henrie 3mo ago
    TFA: https://news.ycombinator.com/item?id=19781756 https://news.ycombinator.com/item?id=19781756 Alzheimer's disease is a specific subtype of dementia; this article seems to be more focused on vascular dementia (or at least vascular risk factors) -- why I was curious about the relationship between e.g. smoking and fructose. The association of fructose has been studied directly in the context of AD, and the hazard ratio is modest (and not necessarily dose-dependent) [0]: > After adjustment for sex, age, MMSE at baseline, education level, SBP, treatment of hypertension, LDL, uric acid, prevalent diabetes mellitus, current smoking, alcohol consumption, dietary fiber intake, total energy intake, sugar in beverage, seafood, red meat, fried foods, animal fat, personal income, marital status, physical activity index, and BMI in the Cox regression model, participants with consumption of fructose more than 7 servings/week showed a higher risk of all-cause dementia and AD dementia (HR: 1.49, 95% CI: 1.14–1.84, P for trend < 0.001 for all-cause dementia; HR: 1.60, 95% CI: 1.22–2.01, P-trend < 0.001 for AD dementia) than subjects with no consumption for fructose. And the results remained comparable for participants with medium consumption of fructose (HR: 1.46, 95% CI: 1.30–1.79, for all-cause dementia; HR: 1.52, 95% CI: 1.14–1.91, for AD dementia) (see Table 2). I haven't seen anything about the fructose content of brains of AD patients; do you have a (preferably non-video) reference / source? [0]: https://www.sciencedirect.com/science/article/pii/S2274580724002267/pdfft?md5=ffa8ff65e0529bacec3267f66bb701f5&pid=1-s2.0-S2274580724002267-main.pdf https://www.sciencedirect.com/science/article/pii/S227458072...

_wire_ 3mo ago

You are going to die, and it's a painful ugly business. The right to die humanely is the single most under-regarded and under-valued aspect of life hygiene.

tejohnso 3mo ago
Fortunately some jurisdictions are death wise enough to provide humane means that we can request from a health practitioner.
- switchbak 3mo ago
  That cuts both ways though, and I have quite direct knowledge of how this has been misused in really gross ways. But that said, I would still bias towards more freedom than less, and hope that we can get a handle on the more extreme cases.

John7878781 3mo ago

I have always had a very low blood pressure, below what's considered "normal." I never feel dizzy when standing up, though. Is this still a risk factor for dementia?

organsnyder 3mo ago
This is a question for your doctor.

sys32768 3mo ago

It's mostly luck and genetics, but good sleep matters. My mother died from Alzheimer's at 77 but wrote down her symptoms as early as 60, a full six years before her diagnosis. Prior to her diagnosis, she walked her dog two miles a day, had an ideal weight, ate organic, never drank or smoke, used her brain constantly, and enjoyed a happy social life. The only problem I saw with her was she was a very light sleeper. Her aunt also died from Alzheimer's and was super healthy when diagnosed too. Meanwhile the 103-year-old lady at my mother's former care facility is still sharp as a tack and reads daily without needing glasses.

highfrequency 3mo ago
Are you aware of her APOE3/APOE4 status?
- sys32768 3mo ago
  Nope. I have one APOE4. Her mother didn't get Alzheimer's until her mid-80s.

nickjj 3mo ago

If anyone wants to go down a rabbit hole, go search for topics around fructose corn syrup, visceral fat and artery plaque. It can play a substantial role in vascular health. I'm not a doctor but there's a bunch of studies posted online about this and my doctor also agreed when I asked him about it. Avoiding fructose corn syrup is a really good idea. It's in a ton of sugary drinks. It really messes with inflammation in your body and your liver materializes it in a very similar way as alcohol. Basically both are bad and can cause similar issues. For me personally I walk a few miles a day for 15+ years and I'm in ok shape. Cutting out Arizona iced tea (has a lot of fructose corn syrup) has made a material difference in how my body operates, I used to drink 1-2 cans a day for a while. Nowadays going 18 hours without food is no problem, I don't have mid-day tired spikes and I didn't change what I eat. I can't explain it but it feels like it reset something. When I've been on vacation in other countries outside of the US for a few weeks, I noticed the same thing (less hungry, more energy, etc.) and a commonality there is I also didn't drink large amounts of fructose corn syrup. There's a lot of variables I'm sure but I can say I feel a difference for the better after stopping and I've now repeated these feelings when doing normal things locally.

hps79 3mo ago

Microplastics are a huge issue-- reducing your exposure is of the utmost importance imo. I go to a longevity clinic that tests, and was recommended this product MicroCleanse by Hazel's. Have seen a material reduction in level 2 build up.