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Treating Heart Disease Risk Factors May Slow Alzheimer's Disease,Progression

developing dementia, and also whether there is an association of weight or weight loss with the severity of Alzheimer's disease changes in the brain seen at autopsy.

537 non-demented Catholic sisters aged 75-102 who were participants in The Nun Study were followed for up to 10 years with annual clinical assessments and determinations of weight. In a subset of 363 Catholic sisters who died during the study, the associations of weight at baseline and the final weight before death with Alzheimer brain changes (as measured using Braak stages) were assessed. In the same group, age- and education-adjusted associations of baseline weight and final weight with the final MMSE score before death were evaluated.

Lower initial weight and higher rate of weight loss were significantly associated with an increased risk of developing dementia. Lower initial weight and lower final weight before death were significantly associated with more severe Alzheimer's changes in the brain. Lower initial weight and final weight also were significantly associated with lower final MMSE score before death. However, when Braak stage was added to the latter model, the association of weight with the final MMSE score was lost.

"This is the first study to show that lower weight up to 10 years before death is specifically related to the severity of Alzheimer's disease," Mortimer said. "Given its very long duration prior to onset of dementia, it is likely that weight loss is specifically associated with the Alzheimer's disease process and not to a restriction in food intake due to cognitive decline."

"In addition, unexplained weight loss late in life coupled with other biomarkers may help to identify those at risk of Alzheimer's more than a decade before symptoms start to show," Mortimer said. "Identification of people who are at high risk of Alzheimer's will be critical once agents become available that slow the disease course."

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