Alzheimer’s disease is the predominant form of dementia accounting for over 60% of all dementia cases with nearly 6.5 million adults diagnosed in the United States, which is projected to triple by the year 2050(1).
Alzheimer’s disease develops along a continuum, beginning with a long preclinical phase, where little to no cognitive abnormalities are present, before manifesting as mild cognitive impairment, then eventually, dementia(2).
Although there has been a significant effort to understand the pathology and risk factors for Alzheimer’s disease, no effective treatments have been established. There is an early window for interventional treatment during the preclinical phase because this phase precedes occurrence of cognitive decline by years to possibly decades(3).
A more thorough understanding of the mechanisms involved with preclinical Alzheimer’s disease could lead to the innovation of new strategies to delay or prevent development of Alzheimer’s disease.
Alzheimer’s disease is an age-associated disease of the brain, but evidence of loss of lean muscle tissue correlates with reductions in brain volume(4).
The loss of skeletal muscle mass with age is a common characteristic, known as sarcopenia. Additional research indicates that the loss of lean mass in patients later diagnosed with Alzheimer’s disease is more severe than in those that develop sarcopenia but remain cognitively intact(5).
Although the pathogenesis of Alzheimer’s disease is multifactorial and can be independent of a genetic predisposition, declines in skeletal muscle health are associated with the preclinical phase of Alzheimer’s disease and, therefore, may play
an underappreciated role in Alzheimer’s disease etiology.
A recent study aimed to examine whether temporalis muscle loss (which is a measure of skeletal muscle loss) is associated with an increased risk of Alzheimer’s dementia in older adults. The temporalis muscle is used for moving the lower jaw. Studies have shown that temporalis muscle thickness and area can be an indicator of total muscle loss throughout the body(6).
This multidisciplinary study used baseline brain magnetic resonance imaging exams from the Alzheimer’s Disease Neuroimaging Initiative cohort to quantify skeletal muscle loss in 621 participants without
dementia (average age 77 years).
The researchers manually segmented the bilateral temporalis muscle on magnetic resonance images and calculated the sum cross-sectional area of these muscles.
Outcomes included subsequent Alzheimer’s disease dementia incidence, change in cognitive and functional scores, and brain volume changes between the groups. Median follow-up was 5.8 years.
A smaller temporalis cross-sectional area was associated with a higher incidence risk of Alzheimer’s disease dementia. Furthermore, a smaller temporalis cross-sectional area was associated with a greater decrease in memory composite score, functional activity questionnaire score and structural brain volumes over the follow-up period.
It was found that older adults with smaller skeletal muscles are about 60% more prone to developing dementia when adjusted for other known risk factors.
A very important realization is that early detection through readily available brain magnetic resonance imaging could enable timely interventions to address skeletal muscle loss, such as physical activity, resistance training and nutritional support. These interventions may help avoid or slow down muscle loss and subsequently reduce the risk of cognitive decline and dementia. This finding highlights the potential of using existing brain magnetic resonance imaging to assess muscle loss and identify at-risk individuals early.
Interventions like physical activity and nutritional support could help mitigate muscle loss, potentially reducing dementia risk.
Key Facts:
This research presents an important diagnostic tool utilizing magnetic resonance imaging to assess overall skeletal muscle. The early diagnosis of skeletal muscle loss will allow early intervention by making sure the patient implements physical activity and especially resistance training along with nutritional support to prevent further muscle loss and/or build muscle.
This will potentially reduce the risk of dementia and Alzheimer’s disease. If you'd like to learn another simple but powerful way to improve your brain health,
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References:
1. Rajan KB, Weuve J, Barnes LL, et al: Population estimate of people with clinical Alzheimer's disease and mild cognitive impairment in the United States (2020-2060). Alzheimers Dement 17:1966-1975, 2021
2. Sperling RA, Aisen PS, Beckett LA, et al: Toward defining the preclinical stages of Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement 7:280-92, 2011
3. Buchman AS, Bennett DA: Loss of motor function in preclinical Alzheimer's disease. Expert Rev Neurother 11:665-76, 2011
4. Burns JM, Johnson DK, Watts A, et al: Reduced lean mass in early Alzheimer disease and its association with brain atrophy. Arch Neurol 67:428-33, 2010
5. Ogawa Y, Kaneko Y, Sato T, et al: Sarcopenia and Muscle Functions at Various Stages of Alzheimer Disease. Front Neurol 9:710, 2018
6. Lee B, Bae YJ, Jeong WJ, et al: Temporalis muscle thickness as an indicator of sarcopenia predicts progression-free survival in head and neck squamous cell carcinoma. Sci Rep 11:19717, 2021
