Taking Anticholinergic Medications Raises the Risk of Alzheimer's & Other Dementias

Older adults should read  the labels before buying 

over-the counter antihistamines and sleep aids.

An Annotated Bibliography Linking Anticholinergic Medications & the Risk of Developing Dementia 

Evelyn E. Smith

M. S. in Library Science, University of North Texas (2012)

When Shelly Gray and her fellow researchers at the University of Washington published a study linking the cumulative use of anticholinergic drugs and dementia in the January 2015 issue of the Journal of the American Medical Association Internal Medicine, this not only confirmed the results of earlier research, but it also excited much commentary on the adverse effects of widely used over-the counter drugs. However, this research is best reviewed in its historical context, which warrants an analysis of previous studies that have associated the use of prescription and over-the-counter medications that block the acetycholine transmitter with an increased risk of developing Alzheimer's and other dementias. However, physicians shouldn''t ask older adults to throw away their Sominex, Benadryl, and Oxybutynin without coming up  with some alternative remedies as well as asking their patients to disclose all the prescription and over-the-counter medications they are taking. At the very least, consumers should check to see if  the over-the-counter medications they are thinking of buying contain anticholimergic ingredients like diphenhydramine before purchasing an antihistamine to dry up a runny nose or a sleep aid to get a good night's sleep.

Campbell, Noll L. & Boustani, Malaz, A. (2015, January 26). Adverse cognitive effects of medications: Turning attention to reversibility. [Invited commentary]. JAMA Internal Medicine. doi: 10.1001/jamainternmed.2014.7667. {First page only]. Retrieved from http://archinte.jamanetwork.com/article.aspx?articleid=2091742

Shelly Gray and her colleagues at the University of Washington School of Pharmacy have published an observational analysis that equates a high risk of dementia with increasing doses and long-term use of anticholimergic drugs. Other studies also show similar results.  However, researchers haven't addressed the reversibility of these adverse cognitive effects (Campbell, 2015, January 26, para. 1). Admittedly, University of Washington researchers took special care to reduce recall and protopathic biases while relying on clinical diagnoses of dementia taken from consensus panels of experts (Campbell, 2015, January 26, para.2).

But in addition to recognizing anticholimergic drugs as inappropriate for older adults, the American Geriatric Association also recognizes the dangers posed when older adults take benzodiazepines and antihistamines, so the careful research methods that the University of Washington researchers applied to their analysis of the effects of anticholimergic medications on older adults should be applied to all medications with adverse cognitive side effects (Campbell, 2015, January 26, para.4).

Campbell and Boustani acknowledge that their own research has previously found a link between anticholimergics and Mild Cognitive Impairment after only accessing one year of pharmaceutical dispensing records and found results similar to Gray's study, although their research showed a stronger association between anticholimergic drugs and MCI, raising the possibility that their adverse effects might be reversed (Campbell, 2015, January 26, para. 5-6). They thus believed that “it makes clinical sense to minimize exposure to these medications among older adults”, even though no evidence—as yet--"supports the hypothesis that discontinuing improves cognitive ability (Campbell, 2015, January 26, para 8).

However, discontinuing these drugs also means that physicians must tailor treatments to fit each individual patient's needs. While completing a Randomized Clinical Trial would take the better part of two decades, clinical interventions might prevent the onset of dementia within a much shorter time period (Campbell, 2015, January 26, para 9).

Campbell, N. L. ,Boustani, M. A., & Lane, K. A., et al. (2010, July 13). Use of anticholinergics and the risk of cognitive impairment in an African American population. Neurology, 75(2), 152-159. doi: 10.121WNL.0b013e3181e712ab [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2905930/

Researchers observed 1,652 “community-dwelling” African American over age 79 over a six-year period, who were enrolled in the Indianapolis-Ibadan Dementia Project, who at the beginning of this longitudinal study had normal cognitive functioning: 53 percent of this population had possibly taken anticholinergic drugs while 11 percent had definitely taken them. Researchers associated an increased risk of dementia with definite anticholinergic users of 1.46 percent while possible anticholinergic users didn't increase their risk of developing dementia. Furthermore, the risk of cognitive impairment increased for anticholinergic users if their weren't APOE ε4 allele carriers by 1.77 percent.

Carrière, Isabelle, Fourrier-Reglat, Annie, & Dartigues, Jean-François, et al. (2009, July 27). Drugs with antiicholinergic properties,cognitive decline, and dementia in an elderly general population: The 3-city study. Archives of Internal Medicine [JAMA Internal Medicine], 169 (14), 1317-1324. doi:10.1001/archintermed.2009.229. [Abstract for Free Article]. Retrieved from http://archinte.jamanetwork.com/article.aspx?articleid=224695&resultClick=3

Researchers evaluated 4,128 women and 2,784 men age 65 or older from three French cities, assessing cognitive performance as well as anticholinergic use at base line and then at two and four years later. 7.5 percent of the participants reported using anticholinergic drugs at baseline. Women who reported using anticholinergic drug use at the beginning of the study showed a decline in verbal fluency of 1.41 percent an global cognitive functioning of 1.41 percent over women not taking anticholinergic drugs. Men who reported using anticholinergic drugs experienced a decline in visual memory of 1.63 percent and executive function of 1.47 percent. Women who continuously used anticholinergic drugs experienced a steeper cognitive decline than those who had discontinued their use. Researchers therefore concluded that taking anticholinergic drugs increases the risk of cognitive decline and dementia while discontinuing their use decreases their rise. Accordingly, physicians should reconsider giving prescriptions of anticholinergic drugs to older adults.

Fox, Chris, Smith, Toby & Maident, Ian, et al. (2014, August 25).  Effect of medications with anti-cholinergic properties on cognitive function, delirium,physical function and mortality:  A systematic review.  Age and Aging.  British Geriatric Society. [Abstract only].  Retrieved from  http://ageing.oxfordjournals.org/content/early/2014/07/19/ageing.afu096

After reviewing 46 studying with 60,944 participants, researchers found that 77 percent of the studies reported a significant decline in cognitive function accompanied an increased anti-cholinergic load Four out of five studies, however, reported no link between an increasing anti-cholinergic load and delirium while five out of eight studies associated a decline in physical function with the use of anti-cholinergics. An increased in morbidity shown in three out of nine studies wasn't “statistically significant”.

Fox, Chris, Livingston, Gill, & Maidment, Ian D., et al. (2011). The impact of anticholinergic burden in Alzheimer's dementia. Age and Ageing, 40 (6), 730-735. British Geriatric Society. Medscape Multispecialty. Retrieved from http://www.medscape.com/viewarticle/752637

A sampling taken from July 2002 to January 2003 of 224 British Alzheimer's patients, 71.4 percent of whom were women and whose average age was 81.0 years, found no difference in cognitive functioning using the Mini-Mental State Exam, the Severe Impairment Battery, and the Alzheimer's Disease Assessment Battery at 6 and 18 months after adjusting for their baseline cognitive function, age, gender, and using of cholinesterase inhibitors with and without a high anticholinergenic load (Fox, 2011, Abstract). This finding contradicts the finding that the elderly are “particularly sensitive” to the effects of anticholinergic medications because cholinergeric neurons in the brain decrease with age while the elderly are more likely to be taking medications with anticholinergice effects. Between 20 to 50 percent of the elderly in the United States take at least one anticholinergic medication, and earlier studies have implicated cholinergic medications as a cause of delirium (Fox, 2011, para. 1-5).

Results

Study participants took a mean 3.64 number of medications, and their anticholinergic load was 1.1. At baseline, 47 percent of them were taking cholinesterase inhibitors, but after 18 months, 56 percent were taking cholinesterase inhibitors, confirming a correlation between declining cognitive scores and the total of medications these patients were taking. However, the study didn't show any significant causal link between Agitated Behavior Scale scores at cognition at baseline, 6 or 18 months. Furthermore, no link existed between the baseline anticholinergic load and changes in the MMSE and the SIB. The lack of effect on the ABS scores might because advanced cognitive impairment decreases sensitivity or because they any already taken a sufficient amount of anticholinergic medications over such a prolonged time period that this had alread effected their cognitive functioning (Fox, 2011, para. 10-13).

Limitations

The data set only contained drugs prescribed at a single point in time, so researchers weren't able to collect cumulative ABS scores. The research also didn't consider other factors, like institutionalization, diabetes, hypertension, smoking, and alcohol use, that might lower the scores on the MMSB. Furthermore, taking cholinesterase medications may mask the effect of anticholinergic medications (Fox, 2011, para. 15 & 17).

Researchers, however, concluded that taking a single low dose ananticholinergic medication doesn't predict rapid cognitive decline in patients already diagnosed with Alzheimer's over the next 6 to 18 months (Fox, 2011, para. 18).

Gray, S. L., Anderson, M. L., & Dublin, S. et al. Cumulative use of strong anticholinergics and incident dementia: A prospective cohort study. (2015, January 26), JAMA Internal Medicine. doi: 10.1001/jamainternmed.2014.7663.[Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25621434

Researchers associated higher cumulative anticholinergic use with an increased risk for dementia, so they advise physicians of older patients to minimize their anticholinergic medication use over time. From 2004 through September 2012, the Seattle, Washington, study followed 3,34 participants age 65 or older with no initial signs of dementia, using data from the Adult Changes in Thought study in Group Health. “Computerized pharmacy dispensing data” confirmed cumulative anticholinergic exposure. Using standard diagnostic criteria, 797 participants, or 23.2 percent of those studied, developed dementia while 79.9 percent developed Alzheimer disease.

Online Sources Publicize a Link Between Anticholinergic Drugs & Alzheimer's

 

Try turning to natural remedies before 

automatically popping a pill.

Not only should older adults avoid the habitual use and high dosage levels of anticholinergic drugs, but they also shouldn't take any drugs, including all antihistamines, barbiturates, Central Nervous System stimulants, benzdiazepines, muscle relaxants, and tricylic antidepressants that are known to produce adverse cognitive effects in older adults, or at the very least prescribe the lowest effective dosage for a limited period of time only after cataloging all the prescription and over-the-counter mediications the individual has taken in the last decade. Consumers similarly should look for natural cures. like using melatonin as a sleep aid, quercetin as a substitute for antihistamines, and St. John's Wort to treat mild depression after checking with a physician, or when possible turning to behavior modification therapy. For example, sleep problems should first be treated by keeping a regular routine, getting plenty of exercise.

Anticholinergic warning. (2015, February 1). Alzheimer's & Dementia Weekly. Retrieved from http://www.alzheimersweekly.com/2015/02/anticholinergic-warning.html

Alzheimer's & Dementia Weekly provides readers with a synopsis of the latest research detailing a link between taking anticholinergic medications and dementia as well as presenting this information in a video and providing them with a Anticholinergic pocket reference card (Anticholinergic-warning, 2015, February para. 1).

The Seattle University study assessing the “Cumulative Use of Srong Anticholinergic Medications” uses more rigorous research methods, a longer-follow-up period than earlier similar studies have, and it also used pharmaceutical records to confirm the findings of previous studies that had linked a higher risk for dementia with taking anticholinergic drugs. It is also the first study to correlate dementia risk with dosage levels as well as the first research that suggests that cognitive damage caused by taking anticholinergic medication may not be reversible even when individuals stop taking anticholinergic drugs (Anticholinergic warning, 2015, February 1, para. 2).

Because older adults take over-the counter medications with strong anticholinergic effects, the study's head researcher, Shelly Gray urges older adults to share their over-the-counter drug use with their physicians, even though she also cautions that patients shouldn't stop taking any drugs without first consulting a health-care provider. At this point, physicians can find an alternative medication (Anticholinergic warning, 2015, February 1, para. 4).

Alzheimer's Weekly also identified the most common anticholinergic antidepresseants, antihistamines, and antimuscrines as well as SSRIs in the study:

• Tricyclic antidepressants like doxepin (Sinequan)

• First-generation antihistamines like chlorpheniramine (Chlor-Trimeton)

• Second-generation antihistamines like loratadine (Claritin) for allergies.

• Antimuscarines for bladder control like oxybutvnin (Ditropan)

• Selective serotonin re-uptake inhibitors (SSRI) like citalopram (Celexa) or fluoxitene (Prozac) for depression

(Anticholinergic Warning, 2015, February 1, para. 5)

Although medications for urinary incontinence are harded to come by than those for other medical conditions for which anticholinergic drugs are prescribed, behavior modification therapy can help control this problem (Anticholinergic Warning, 2015, February 1, para. 6).

However, if physicians prescribe a anticholinergic drug because it's the “best therapy”, they should prescribe the lowest effective dosage and monitor its use to see if it's effective. Anticholinergic drugs are harmful because they block a neurotransmitter called acetycholine. In addition to causing memory loss, anticholinergic drugs cause drowsiness, constipation, the retention of urine, and dry mouth and eyes (Anticholinergic Warning, 2015, February 1, para. 7).

The Anticholinergic Pocket Reference lists the following types of conditions for which physicans routinely prescribe anticholinergic drugs:

• Allergy cough and cold medicines (antihistamines)

• Anxiety

• Asthma & C.O.P.D.

• Bladder incontinence (antispasmodics)

• Insomnia/sleep disorders

• Motion sickness/ dizziness & nausea

• Movement disorder

• Muscle spasm and pain

• Seizure/mood disorders

• Psychosis (antipsychotics)

• Stomach & G.I. Tract disorders (antispasmodic medicines)

Behavioral symptoms. (2015). Alzheimer's Association. Retrieved from http://www.alz.org/professionals_and_researchers_behavioral_symptoms_pr.asp

Physicians recommend that individuals diagnosed with dementia do not take over-the-counter sleep remedies and antihistamines, such as Benadryl, whose main ingredient is diphenhyramine. Diphenhydramine suppresses a chemical that Alzheimer's also reduces (Behavioral symptoms, 2015, para. 25).

Over-the-counter sleep aids that contain diphenhyramine include Compoz, Nytol, Sominex, and Unisom, while diphenhyramine is also a key ingredient in many night time versions of popular pain relievers and cold and sinus remedies (Behavioral symptoms, 2015, para 26).

Harding, Anne. (2015, January 26). Widely used drugs tied to greater dementia risk for seniors. Live Science. Retrieved from http://www.livescience.com/49581-anticholinergic-drugs-dementia-risk.html

Recently published research confirms that adults aged 65 and older who regular take over-the-counter sleeping pills, antihistamines and over active bladder medications that produce anticholinergic effects also increase their risk of dementia, even though they have long known that even a single dose of drugs that block the acetycholine transmitter reduces one's ability to concentrate, While researchers at the University of Washington School of Pharmacy thought this was reversible if an individual stopped taking antichlinergic medications, they have now determined that dosage and length of time taking these drugs greatly increases the chance of developing dementia (Harding, 2015, para. 1-4).

Up to 37 percent of all senior adults use anticholinergic medications, and while previous research has linked them to “permanent cognitive changes”, this research has failed to take into consideration the fact that physicians often prescribe anticholinergic durgs to treat early warning signs of dementia like depression and insomnia (Harding, 2015, para. 5-6).

Shelly Gray and her fellow researchers analyzed data from the pharmaceutical records of 3,415 senior adult aged 65 and older who were free from dementia at baseline, but over the next seven years, as neurologists diagnosed 797 study participants (or 23.2 percent) with dementia, researchers found that the higher the cumulative dosage of anticholinergic medications was over the ten years before a participant entered the study, the greater his or her risk of developing Alzheimer's (Harding, 2015, January 26, para. 8-9). Thus, taking 10 milligrams of doxepin for three years increased the risk of dementia as did taking 4 milligrams of cholrpehnramine daily or 5 milligrams of oxybutrin daily (Harding, 2015, January 26, para. 11).

To control for the effect of anticholinergic sleep aids and antidepressants prescribed to treat the early signs of dementia, researchers intentionally omitted the pharmaceutical records of participants during the first two years before they were diagnosed with Alzheimer's or other dementia disease (Harding, 2015, January 26, para.10).

Shelly Gray, the head researcher in the University of Washington study warned older adults not to stop taking any of their medication without taking with a health-care provider, but she also asks them to go over the list of all the prescription and over-the-counter medications they have been taking (Harding, 2015, January 26, para 12).

Noll Campbell and Malaz Boulaini, who wrote a commentary that appeared along with the study in the JAMA Internal Medicine argued that it might be possible to reverse adverse cognitive effects of anticholinergic drugs if individuals stop taking them early enough since a stronger association links anticholinergic medications to mild cognitive impairment than dementia (Harding, 2015, January 26, para. 13-14).

Hughes, Sue. (2015, January 27). 'Strongest evidence yet' links anticholinergic drugs, dementia. Medscape Medical News>Neurology. Retrieved from http://www.medscape.com/viewarticle/838788

A University of Washington, Seattle longitudinal study implicates anticholinergic drugs taken by approximately 20 percent of the older adult population, including over-the counter antihistamines and sleep aids as well as medications for an over-active bladder,and anti-depressant, finding “an obvious dose-response relationship between anticholinergic drug use and risk of developing dementia.” (Hughes, 2015, January 27, para. 1-4).

Even Low Doses Implicated

Moreover, individuals taking “just the minimum effect dose” for prolonged period stood a greater risk of developing dementia compared with those who didn't take anticholinergic medications, even though research Shelly Gray emphasized, “This is not excessive use. Many of these agents are used chronically, and chronic use—even at low doses—would put you in the highest risk category (Hughes, 2015, January 27, para. 5-7).

Because anticholinergic drugs have other side effects,such as dry mouth, constipation, and urinary retention, they aren't as popular as they once were, but physicians still commonly prescribe them, and many of these medications can be bought over-the-counter (Hughes, 2015, January 27, para. 8). Even so, the study doesn't prove causality, because researcher is still based on observational data. Thus, Dr. Gray adds, “I would say that we haven't proven these drugs cause dementia, but our results certain reinforce concerns about this issue” (Hughes, 2014, January 27, para. 8-10). While physicians and pharmacists are aware that anticholinergic drugs cause short-term drowsiness and confusion, their long-term effect aren't so well known (Hughes, 2014, January 27, para. 11).

The Seattle study followed 3,434 older adults whose average age was 73 years over a ten-year period, tracking their medications from pharmacy records. Followup examinations added another 7.3 years to study that screen for dementia every two years. About 20 percent of the population used anticholinergic drugs while researchers determined a minimum effective dosage for each drug and then calculative the participants' calculated cumulative exposure (Hughes, 2015, January 27, para. 13-14). During the follow up period, 797 participants (or 23.2 percent) developed dementia,and 79.9 percent of these were diagnosed with Alzheimer's. Taking an anticholinergic medication, such as Benadryl, every day for three years put participants in the highest risk category as did taking the minimum effective dosage sporadically over a longer period or a higher dosage for a shorter period (Hughes, 2015, January 27, para. 15-16).

"Very Credible Data"

Noll L. Campbell, of the Purdue University College of Pharmacy, notes that this study provides “the strongest evidence to date that anticholinergic drugs cause dementia”since the Seattle observational study furnishes the longest record of medication history (Hughes, 2015, January 27, para. 17-18).

Campbell noted that several studies have associated anticholinergic medications with cognitive problems. He also explained that future studies would try to understand the biochemical mechanism that underlies this link since the patients in the Seattle study have granted researchers the permission to autopsy their brains (Hughes,2015, January 27, para. 20 & 22).

However, the next step in research equating the use of anticholinergic drug use with a higher risk dementia could be a randomized study of anticholinergic drug users that upon the researchers' request continue to take them or stop their use (Hughes, 2015, January 27, para. 23).

Medications to be avoided. (2015). Frontotemporal dementia. UCSF University of California San Francisco. Retrieved from http://memory.ucsf.edu/ftd/medical/treatment/avoid/multiple

The Memory and Aging Center at the University of California San Francisco while noting medications that shouldn't be prescribed for frontotemporal lobe patients reminds physicians, pharmacists, and the elderly that many different classes of medications shouldn't be prescribed for long-term use, and when possible all patients should be treated with alternative medications and non-prescription therapies:

• Anticholinergic medications
• Antihistamines
• Barbiturates
• Benzodiazepines
• CNS stimulants
• Muscle relaxants
• Tricylic antidepressants

Anticholinergic medications

Anticholinergics while leveling out the production of dopamine and aceycholine decrease acelylcholine activity, so physicians in the past have routinely prescribed them to treat incontinence, depression, and sleep disorders. However, anticholinergic medications also cause acute cognitive impairment and possible confusion and hallucinations. Additionally, they might “antigonize” any cholinesterase inhibiting medications (USCF, 2015, para. 1).

Nevertheless, the number of anticholinergic drugs prescribed and their dosages as well as the patient's baseline cognitive function and his or her sensitivity to medications also influence the potency of anticholinergic medications (USCF, 2015, para. 2).

Thus, physicians and patients' family members should evaluate an anticholinergic medications as well as its benefits while coming up with alternatives to control a condition; for example, with incontinence, they should determine whether incontinence is functional or urge based and then implement scheduled toileting, check post void residuals, and reduce the anticholinergic medication, discontinuing its use if continence doesn't improve within six weeks (USCF, 2015, para 3-4).

Antihistamines

Antihistamines block histamine, a substance that produces allergic symptoms. Examples of histamines containing cholinergics include diphenhydramine, including the over-the-counter brand names Benadryl and Sominex (USCF, 2015, para. 5).

Barbiturates

Barbiturates help patients relax and sleep, but their continuous use may cause memory loss, decrease alertness, and diminish interpersonal functioning (USCF, 2015, para. 6).

Benzodiazepones

Observational studies link benzodiazepenes with memory loss and confusion as well as falling in elderly patients. When prescribed for FTL disorder patients, they cause amnesia, hostility, irritability, and disquieting dreams, so if prescribed, they should be taken for only a short time. Instead of prescribing benzodiazepones, like Valium, to relieve stress, try “non-pharmacological supportive strategies”, When used to treat sleep problems, try increasing physical activity during the day or taking melatonin, or trazodone (USCF, 2015, para. 7-8).

CNS stimulants

FTD increases sensitivity to medications affecting the central nervous system, like Fluoxetine (Prozac), thus impairing memory and delaying psychomotor performance (USCF, 2015, para. 8-9).

Muscle relaxants

Even though muscle relaxants treat muscle spasms associated with spinal cord injuries, stroke, multiple sclerosis, and cerebral palsy, the use of some muscle relaxants can cause liver damage (USCF, 2015, para. 10).

Tricyclic antidepressants

Instead of prescribing tricyclic antidepressants that may worsen memory problems and “antagonize” the effects of cholinesterase inhibitors, physicians should consider alternative medications that produce the least anticholinergic side effects (USCF, 2015, para. 11-12).

Mertz, Beverly. (2015, January 28). Common anticholinergic drugs like Benadryl linked to increased dementia. Risk. Harvard Health Blog. Retrieved from http://ww"w.health.harvard.edu/blog/common-anticholinergic-drugs-like-benadryl-linked-increased-dementia-risk-201501287667

A study that the JAMA Internal Medicine issued in mid-January “offers compelling evidence of a link between long-term use of anticholinergic medications like Benadryl and dementia” (Mertz, 2015, January 28, para. 2). Anticholinergic drugs block acetylcholine, a chemical substance that carries messages in the nervous system. Acetylcholine transmits messages within the brain necessary for learning and memory while elsewhere in the body it stimulates muscle contractions. Thus, anticholinergic drugs include some antihistamines, tricyclic antidepressants, and drugs that control an overactive bladder or relieve Parkinson's symptoms (Mertz, 2015, January 28, para. 3).

What the study found

Tracking pharmacy records for the ten years before 3,500 older men and women became part of the Adult Changes in Thoughts longitudinal study conducted by the University of Washington and Group Health, a Seattle health care system, a team of researchers at the University of Washington's School of Pharmacy discovered that 800 of these volunteers developed dementia. They also found that those who used anticholinergic medications were more likely to develop dementia than those who didn't take take them. What's more, their risk of developing dementia increased with each cumulative dose—taking an anticholinergic drug for three years increased the changes of developing dementia 54 percent compared with those individuals who took the same dosage for three months or less (Mertz, 2015, January 28, para.4).

Since the production of acetycholine decreases with age, taking anticholinergics “delivers a double whammy” because taking anticholinergic medications interferes with short-term memory and reasoning (Mertz, 2015, January 28, para. 5).

The University of Washington is the first to assess the effects of over-the-counter medications as well as “the possibility that people were taking a tricyclic antidepressant to alleviate early symptoms of undiagnosed dementia” since 'the risk associated with bladder medications was just as high” (Mertz, 2015, January 28, para. 6).

The study should also serve as a reminder to re-evaluate the medications older adults are taking to see if they are working as they should be since many medications have a stronger effect on senior adults since their kidneys and livers don't flush the chemicals from the body as they would if they were younger, and since fat and muscle mass distribution changes with age, the way the body breaks down these medications drugs and apportions them to body tissues differs (Mertz, 2015, January 28, para. 7).

What should you do?

Fortunately, alternatives to anticholinergic medications now exist: Selective serotonin re-uptake inhibitors (SSR) like citalopram (Celexa) or fluoxetine (Prozac) successfully treat depression while antihistamines like loratadinne (Claritin) can take the place or diphenhydramien or cholorpheniramine (Chlor-Trimeton).  Behavioral modification therapy and Botox injections can alleviate incontinence problems (Metz, 2014, January 28, para. 8). However, Mertz urges patients to clear continuing to take all prescription and non-prescription medications with a primary care physician (Metz, 2014, January 28, para. 9).

Roberts, Michelle. (2015, January 27). Dementia 'linked' to common over-the-counter drugs. Health. BBC News. Retrieved from http://www.bbc.com/news/health-30988643

A study published in the JAMA Internal Medicine has linked the prolonged use of three or more years of over-the-counter medications that treat insomnia, hay-fever to dementia in the elderly to medications that block a acetylcholline neurotransmitter However, researchers caution that patients should not stop taking any medications without checking with a primary-care physician (Roberts, 2015, January 27, para. 1-6).

Side-effects

Researchers have linked the prolonged use of anticholinergic medications with an increased chance of developing dementia, so a spokesperson for the United Kingdom's Alzheimer's Society urges physicians and pharmacists “to be aware of this potential link” , although patient information leaflets currently issued with anticholinergic medications already caution consumers that their side effects include reduced attention spans and memory problems (Roberts, 2015, January 27, para 7-9).

Drugs in the study

Researchers are the University of Washington determined that 797 study participants developed dementia upon following 3,434 adults age 65 or older while also tabulating and analyzing their pharmacy records, including medications that had an anticholinergic effect, although study participants only purchased 1/5 of these drugs as over-the-counter medications:

• Tricyclic antidepressants for treating depression

• Antihistamines used to treat hay-fever and allergies

• Antimuscarinics for treating urinary incontinence

(Roberts, 2015, January 27, para. 10-14)

The most common anticholinergic drugs treat depression, sleep deprivation, allergies and hay fever and urinary incontinence (Roberts, 2015, January 27, para. 13).

The most commonly used anticholinergic-type drugs were medicines for treating depression, antihistamines for allergies such as hay-fever or to aid sleep/promote drowsiness, and drugs to treat urinary incontinence.

'Not causal'

Researchers concluded that study participants taking at least 10 milligrams a day of the antidepressant doxepin, four milligrams daily of the sleep aid diphenhydramine, or five milligrams a day of the urinary incontinence medication oxybutynin for more than three years showed a greater risk of developing dementia (Roberts, 2015,January 27, para. 15).

Accordingly, researchers urged physicians and pharmacists to find alternatives to these medications or else if no alternative is possible to issue the lowest effective dosage, although physicians will also have to look at brain pathologies (Roberts, 2015, January 27, para. 16 & 18).

The head of research at Alzheimer's Research UK labeled the study “interesting but not definitive” while the representative of the UK's Alzheimer's Society talked about “concerns” that the prolongued use of anticholinergic medications can increase the risk of dementia under certain circumstances (Roberts, 2015, January 27, para. 19-20).

Like their US counterparts, British authorities cautioned against stopping any medications without talking with a GP (Roberts, 2015, January 27, para. 22).

The UK representative for a trade association that manufactures over-the-counter drugs also warned that non-prescription allergy medications and sleeping aids aren't meant to be taken over a long period of time (Roberts, 2015, January 27, para. 26).

Smith, Natalie. (2013, May 22). Clinical information: The case of Benadryl causing dementia. Clinical Corrections. Retrieved from http://www.clinicalcorrelations.org/?p=6162

A six-year longitudinal study, “Use of anticholinergics and the risk of cognitive impairment in an African American population”, published in the July 2010 issue of Neurology by N. L. Campbell and M. A. Boustani, et al, found that taking anticholinergic drugs possibly raises the risk of dementia slightly after reviewing the cognitive functioning of 1,600 African American over age 70 over a six-year period (Smith, 2013, May 22, para.4). Eleven percent or 179 participants definitely had taken anticholinergic medications, so researchers calculated the ratio for their developing dementia at 1:46. They concluded that data didn't support the hypothesis that taking anticholinergic drugs increases the risk of Alzheimeer's, although the study “suggested” that such a link might exist (Smith,2013, May 22, para. 6).

Steinbuch, Yaron. (2015, January 27). Alzheimer's risk elevated by such-over-the-counter drugs as Benadryl and Nyton: Study. Market Watch. New York Post. Retrieved from http://www.marketwatch.com/story/alzheimers-risk-elevated-by-such-over-the-counter-drugs-as-benadryl-and-nytol-study-2015-01-27

Bottom Line: Using anticholinergic drug increases the odds that an individual might develop dementia, but research at this point in time can't determine if anticholinergic drugs cause dementia (Steinbuch, 2015, January 27, para. 12).

Quoting the middle-class, British tabloid, The Daily Mail, Steinbuch links Nytol, a sleeping pill, and allergy medications, Benadryl and Piriton, along with some antidepressants with a small, increased risk of dementia since these medications contain anticholinergic substances that block acetylcholine, a key chemical messenger within the brain. Moreover, they theorized that the risk of developing dementia increases when individuals take repeated doses of these drugs over several years (Steinbuch, 2015, January 27, para. 2-4). Steinbuch thus cautions that primary care physicians should regularly review their older patients' drug regimes, including any over the counter medications they might be taking. However, these same patients should consult their physicians before they stop taking these medications (Steinbuch, 2015, January 27, para. 5-6).

The study that appeared in the January issue of JAMA Internal Medicine, researchers monitored 3,434 men and women over age 65 for seven years as they used anticholinergic medications. During the course of the study, 637 subjects developed Alzheimer's and 160 patients went on to be diagnosed with another type of dementia. Researchers noted that those who took the highest doses of anticholinergic drugs had a 54 percent greater risk of succumbing to dementia than those who didn't take any anticholinergic drugs while their risk of diagnosed eventually with Alzheimer's was 63 percent higher. Those with the highest risk of developing dementia took at least 10 milligrams a day of the antidepressant doxepin, or 4 milligrams daily of diphenhydramine found in Nytol and Benadryl, and 5 milligrams daily of oxybutyn in the over-active bladder medication Ditropan for at least three years (Steinbuch, 2015,January 27, para.7-10).

Williams, Sean. (2015, February 7). These common medications may put you at a greater risk of developing dementia. The Motley Fool. Retrieved from http://www.fool.com/investing/general/2015/02/07/these-common-medications-may-put-you-at-a-greater.aspx

A fresh study from the Group Health Research Institute published in JAMA Internal Medicine pinpoints some very common nonprescription medications that could increase the risk of dementia (Williams, 2015, February 7, para. 4).

These medications may increase your risk of dementia

From 2004 to 2012, the Group Health Research Institute followed 3, 434 participants starting at age 65 assessed Adult Changes in Thought in a study designed to assess whether anticholinergic drugs building up in the body lead to an increase risk in dementia and found that this indeed might be the case: 797 participants (or 23.2 percent of study participants) went on to the diagnosed with dementia), although the study didn't provide a control group incidence rate for dementia. Additionally, even when the patients stopped taking anticholinergic drugs, researchers could offer no guarantees that their adverse effects were reversible (Williams, 2015, February 7, para. 6-7).

Anticholinergic drugs are those drugs that block the antilcholinergic neurotransmitter in the drug, helping them treat incontinence, asthma, muscular spasms, depression, and sleep disorders. Examples of anticholinergic drugs included over-the-counter medications like Dramaine, Benadryl, and Advil PM as well as prescription medications Wellbutrin, Zyban, and Unisom (Williams, 2015, February 7, para. 8).

Because of this threat to mental health, researchers urge seniors to share their history of taking Over the Counter medications with their primary care physician as well as asking him or her to prescribe alternative medications to these anticholinergic drugs or if necessary prescribe the lowest possible dose (Williams, 2015, February 7, para. 9). However, they also advise consulting a physician before stopping taking these well-known drugs cold-turkey (Williams, 2015, February 7, para.10).

Some study participants have agreed to let researchers autopsy their brains upon death to see if pre-existing pathologies predisposed these patients to develop dementia, or if taking anticholinergic drugs spurred on the development of Alzheimer's or other dementias (Williams, 2015, February 7, para. 11).

___________

The links furnished on this Web page represent the opinions of their authors, so they complement—not substitute—for a physician’s advice.

___________

Home Remedies for Allergies

WebMD recommends drinking green tea and eating hot spicy foods like cayenne pepper as well as onions and garlic to clear the sinuses without taking any medications.

http://www.webmd.com/allergies/features/relieve-allergies-natural-way

Home Remedies for Life recommends such cures as taking Vitamin C and eating the fruits and vegetables rich in it, breathing steaming salt water, acupressure, the use of saline spray, and massaging the temples.

http://homeremediesforlife.com/sinus-headache/

Drinking Coffee May Reduce the Incidence of Skin Cancer

   Caffeine in Coffee Lessens

     the Risk of  Skin Cancer

Evelyn  E. Smith

M. S. in Library Science, University of North Texas (2012)

Research Links Coffee with Reduced Skin Cancer Rates

Researchers theorize that the more coffee an individual drinks, the lower his or her risk of basal cell carcinoma after controlling for other risks factors like sun exposure and skin pigment. Similarly, the caffeine in coffee acts as a barrier against UVB (short wave) rays just as lots of coffee drinking reduces or delays the onset of Alzheimer's Disease.  However, the optimal dosage is three or more cups of regular coffee daily, for drinking only a cup daily produced only a minimal therapeutic effect.   But that doesn't mean that sun-worshiping coffee-lovers can use tanning booths without any guilt or go out in the sun without sunscreen. Moreover, drinking four or more cups daily only provides a minimal amount of protection in older adults when compared with their counterparts who don't drink any coffee.

Bottom Line:  Drinking coffee isn't a cure all for preventing skin cancer, but it does provide more protection than abstaining from drinking any coffee. Furthermore, scientific research studies should always be studied in their historical context.

Abel, E. L., Hendrix, S. O, & McNeeley, S. G. (2007 October). Daily coffee consumption and prevalence of nonmelanoma skin cancer in Caucasian women. European Journal of Cancer Prevention, 446-52. [Abstract only]. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17923816

Researchers from the Department of Obstretrics and Gynecology at Wayne State University after conducting a cross-sectional analysis of Caucasian women enrolled in a Women's Health Initiative Observational Study found that when compared with those white women who abstained from drinking coffee, those who self-reported that they drank coffee daily showed a 10.8 lower incidence of non-melanoma skin cancer. Moreover, drinking six or more cups of coffee daily reduced the chances of developing nonmelanoma skin cancer 30 percent after adjusted by demographic and life-style variables.  

Conney, A. H., Lu, Y. P., & Lou, Y. R., et al. (2013, June 17). Mechanisms of Caffeine-Induced Inhibition of UVB Carcinogenesis. Frontiers in Oncology, 3: 144. doi: 10.3389/fonc.2013.00144. ECollection 2013. [Abstract only]. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23785666

The caffeine in coffee inhibits ATR and UVB-induced carcinogenesis, according to studies conducted on UVB-induced skin cancer in mice and epidemiological studies that show that coffee drinking inhibits non-melanoma skin cancer in humans. Apparently, caffeine produces a sunscreen that inhibits sunburn lesions in the epidermis, or the outer layer of skin, in mice as well as the UVB-induced formation of thymine dimers, or chemically-bonded, adjacent thymine bases in DNA.  [When cancerous cells start to repair themselves, thymine dimers produce malignant cell mutations]. In addition, caffeine raises the rate of cell death, or apoptosis, in tumors, and enhances UVB-induced cell apoptosis, thereby increasing the removal of damaged precancerous cells.

Transgenic mice irradiated chronically with UVB had 69 percent fewer tumors at the end of the study when administered caffeine that inhibited ATR when compared with irradiated controls with normal ATR function.

Ferrucci, L. M. Cartmel, B., & Molinaro, A. M., et al. (2014, July 23). Tea, coffee, and caffeine and early-onset basal cell carcinoma in a case-control study. European Journal of Cancer Prevention. 4, 296-302. doi: 10.1097/CEJ.0000000000000037. [Abstract only]. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24841641

A Yale University study has found that “combined regular consumption of caffeinated coffee and hot tea is inversely associated with the early onset of basal cell carcinoma.” In other words, those study participants who drank the most caffeinated coffee and hot tea reduced their risk of developing basal cell carcinoma 43 percent when compared with individuals who don't drink coffee and tea. After evaluating data from 767 non-Hispanic whites under age 30, this case-control study randomly samples individuals in Yale's dermato-pathology database for benign skin diagnoses and frequency matched to cases for age, sex, and biopsy data whereupon study participants completed an in person interview assessing their intake of coffee and hot tea. Researchers theorize that the caffeine in the coffee and hot tea may produce this protective effect.

Fortes, C., Mastroeni, S., & Boffetta, P., et al. (2013, October 24). The protective effect of coffee consumption on cutaneous melanoma risk and the role of GSTM1 and GSTT1 polymorphisms. Cancer, Causes & Control: CCC. 10, 1779-87. doi: 10.1007/s10552-013-0255-4. Epub 2013 Jul 17. [Abstract only]. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23860951

A case-control study that took place within the inpatient wards of the IDI-San Carlo in Rome, Italy, examined 304 cases of cutaneous melanoma and 305 controls, collecting information of their socio-demographic characteristics, medical history, smoking habits, amount of sun exposure, skin pigment, and diets. Researchers found that drinking a cup of coffee at least once daily compared with drinking coffee less than five times weekly produced a small “protective effect that guarded against cutaneous melanoma (OR 0.46; 95 % CI 0.31-0.68) after taking into consideration the individual's gender, age, education, hair color, birthmarks, skin phototype, and sunburn episodes in childhood.

Kang, N. J., Lee, K. W., & Shin, B. J., et al. Caffeic acid, a phenolic phytochemical in coffee, directly inhibits Fyn kinase activity and UVB-induced COX-2 expression. (2009, February). Carcinogenenesis, 30(2), 321-30. doi: 10.1093/carcin/bgn282. Epub 2008 Dec 10. [Abstract only]. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19073879

Researchers at the Hormel Institute at the University of Minnesota note that in-vivo data from mice epideral skin supports the hypothesis that caffeic acid suppresses UVB-induced COX-2 expression by blocking Fyn kinase activity. Fyn, a non-receptor protein ember of the tyrosine kinase family, is necessary for ultraviolet (UV B-induced cyclooxygenase-2 (COX-2 expression.  However, caffeic acid checks UVB-induced skin carcinogenesis by directly blocking Fyn kinase activity.

Loftfield, Erikka, Freedman, Neal D., & Graubard, Barry L. (2015, January 13). Coffee drinking and cutaneous melanoma risk in the HIH-AARP Diet and Health Study. Journal of the National Cancer Institute, 107(2). doi: 10.1093/jnci/dju421. [Full text]. Retrieved from http://jnci.oxfordjournals.org/content/107/2/dju421.full

In a decade-long study of 447,357 non-Hispanic whites, high coffee intake of four or more cups of coffee daily correlates with a modest decrease in the risk of melanoma when researchers who compared study participants  who drank large amounts of coffee with non coffee-drinkers (≥4 cups/day: HR = 0.75, 95% CI = 0.64 to 0.89, P _trend = .01), but they didn't find a link between drinking decaffeinated coffee and a reduced risk of skin cancer (Loftfield, 2014, November 25, para. 1-4).

Lu, Y. P., Lou, Y. R., & Peng, Q. Y., et al. (2011, July). Caffeine decreases phospho-Chk1 (Ser317) and increases mitotic cells with cyclin B1 and caspase 3 in tumors from UVB-treated mice. Cancer Prevention Research (Philadelphia, Pa.), 4(7), 1118-25. doi: 10.1158/1940-6207.CAPR-11-0116. Epub 2011 Apr 19. [Abstract only]. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21505179

Giving mice doses of caffeine significantly impairs phospho-Chk1 (Ser317) staining and an increased the number of mitotic cells that develop cyclin B1 and caspase 3 in tumors that are consistent with selectively-produced, lethal mitosis in tumors. Researchers hypothesize that caffeine can induce selective cell death, or apoptosis, in UVB tumors by inhibiting ATR/Chk1 pathways, thus promoting lethal mitosis. Therefore, caffeinated coffee and tea intake correlates with a decreased incidence of non-melanoma skin cancer.

Miura, K., Hughes, M. C., & Green, A.C. (2014). Caffeine intake and risk of basal cell and squamous cell carcinomas of the skin in an 11-year prospective study. European Journal of Nutrition, 53(2), 511-20. doi: 10.1007/s00394-013-0556-0. Epub 2013 Jul 4. [Abstract only]. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23824258

Researchers found no link between total caffeine intake and the incidence of basal cell carcinoma and squamous cell carcinoma in a study that assessed the consumption of coffee in 1992, 1994, and 1996 in 1,325 randomly selected adult living in a subtropical Australian community.  However, individuals who had had prior skin cancers experienced a 25 percent lower risk of developing basal cell carcinoma if they drank four cups of coffee daily. Thus, a “relatively high” intake of caffeine may reduce the development of basal cell carcinoma in those individuals who have previously been diagnosed with skin cancer.

Song, F., Qureshi, A. A., & Han, J. (2012, July 1). Increased caffeine intake is associated with reduced risk of basal cell carcinoma of the skin. Cancer Research, 72(13), 3282-9. [Abstract only]. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22752299

Using data from the Nurses' Health Study and Health Professionals Follow-up Study, Harvard  University researchers examined the risks after analyzing 22,786 cases of basal cell carcinoma, 1,953 cases of squamous cell carcinoma , and 741 cases of melanoma  in relation to caffeine intake. The highest quintile of coffee drinkers in both men and women had the lowest risk of developing skin cancer (RR, 0.82 in women; 95% CI:,0.77-0.86 and RR, 0.87 in men; 95% CI, 0.81-0.94; Ptrend<0.0001 in both).

Women who drank more than three cups of coffee daily experienced the lowest risk when compared with women who drank less than one cup of coffee a month. Other sources of caffeine in tea, cola, and coffee as well as decaffeinated coffee also lowered the risk of developing basal cell carcinoma.

Yang, G., Fu, Y. & Malakhova, M., et al. (2014, October 7). Caffeic acid directly targets ERK1/2 to attenuate solar UV-induced skin carcinogenesis. Cancer Prevention Research. 10, 1056-66. doi:10.1158/1940-6207. [Abstract only]. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25104643

The Caffeic acid (3,4-dihydroxycinnamic acid) found in coffee “significantly inhibits colony formation of human skin cancer cells and EGF-induced neoplastic transformation of HaCaT cells dose-dependently.” Even though researchers as yet don't understand why topical application of caffeic acid reduces tumors, after they induced skin carcinogeneisis in mice, treating skin topically with caffeic acid great suppressed the occurrence and volume of tumors.

A case-control study that took place within the inpatient wards of the IDI-San Carlo in Rome, Italy, examined 304 cases of cutaneous melanoma and 305 controls, collecting information about their socio-demographic characteristics, medical history, smoking habits, amount of sun exposure, skin pigment, and diets. Researchers found that drinking a cup of coffee at least once daily compared with drinking coffee less than five times weekly produced a small “protective effect that guarded against cutaneous melanoma (OR 0.46; 95 % CI 0.31-0.68) after taking into consideration the individual's gender, age, education, hair color, birthmarks, skin phototype, and sunburn episodes in childhood.

              Popular Articles Tout Coffee 

           Caffeine's Suppression of Cancer

Staying out of the sun is a more effective means of preventing 

skin cancer than drinking lots of coffee.

Drinking four cups of coffee daily might lower the risk of melanoma 20 percent, according to a just released National Cancer Institute/AARP study, but as the Prevention Magazine warns, it also increases the production of cortisol that might lead to heart disease. That means that older adults should be able to enjoy three cups of coffee a day, which also might protect or delay Alzheimer's disease, but they shouldn't overdo their coffee drinking. The Loftfield study also contradicts a much-cited 2012 Brigham and Women's Hospital and Harvard University study that found that drinking three cups of coffee daily, particularly on sunny days, destroys precancerous cells that might develop into basal cell carcinoma, but it doesn't suppress squamous cell carcinomas or melanomas. All researchers, however emphasize that drinking lots of coffee doesn't mean that sunbathers should go out in the sun without applying sunscreen and wearing protective clothing.

Bakalar, Nicholas. (2015, January 22). Coffee may cut melanoma risk. Well. New York Times. Retrieved from http://well.blogs.nytimes.com/2015/01/22/coffee-may-cut-melanoma-risk/?_r=0

A ten-year study conducted by the National Cancer Institute links drinking four or more cups of coffee daily with a 20 percent reduction in risk for developing melanoma in non-Hispanic whites aged 50 to 71 when compared with their counterparts who don't drink any coffee (Bakalar, 2015, January 22, para. 1-3). 

All the same, the study's lead researcher, Erikka Loftfield, a graduate student at the Yale School of Public Health, cautions that the best way individuals can still reduce their reduce the risk of skin cancer is to stay out of the sun and avoid ultra violet light exposure (Bakalar, 2015 January 22, para. 4). The study controlled for age, gender, education, smoking, physical activity, and alcohol consumption, but it didn't control for possible “unknown variables” that might influence this connection (Bakalr, 205, January 22, para. 5).

Park, Alice. (2015, January 20). This drink could protect you from skin cancer. Health/Cancer. Time. Retrieved from http://time.com/3675152/this-drink-could-protect-you-from-skin-cancer/

A National Institute of Health/AARP study released Tuesday, January 13, 2015, theorizes that drinking more than four cups of coffee daily lowers the  chance of developing melanoma 20 percent [compared to those who abstain entirely from coffee] (Park, 2015, January 20, para. 3). Erikka Loftfield and her fellow researchers surveyed 447,000 individuals [aged 51 to 71] who answered a 124-item food questionnaire and also allowed  researchers to access their medical records. The researchers then adjusted their findings to allow for such adverse effects as age, smoking, alcohol use, a family history of cancer, but these factors couldn't break the link between heavy coffee drinking and a lower risk of melanoma (Park, 2015, January 20, para. 4).


Loftfield explained that coffee's roasting process releases vitamin derivative that protect against UV damage, so the caffeine in coffee possibly acts as a molecular sunscreen that absorbs UV rays. Loftfield, however,cautioned that other researchers will need to repeat the study to confirm its results (Park, 2015, January 20, para. 6).


Taylor, Marygrace. (2015). 4 cups of coffee could lower your skin cancer risk 20 %. Preventon News. Prevention. Retrieved from http://www.prevention.com/food/food-remedies/coffee-lowers-skin-cancer-risk-20

Drinking lots of coffee may lower the risk of melanoma, according to new researched released by the National Cancer Institute, whose researchers tracked the coffee-drinking habits and skin cancer rates of “nearly 450,000 older adults for over 10 years, finding that that study participants who drank four cups of caffeinated coffee daily had a 20 percent lower risk of developing cancer. Taylor explains that the caffeine and polyphenols in coffee block ultra-violet induced tumors wile the coffee-roasting process might serve as a molecular sunscreen ( 2014, para. 1-3).

Indulging in four cups of coffee daily, however, can increase the production of cortisol, which, in turn, causes weight gain, digestive problems, and heart disease as well as anxiety, irritability, and headaches.   Accordingly, Taylor counsels readers to drink only two cups of coffee daily as well as to read a 12-ounce glass of water both before and afterward to protect against caffeine's dehydrating effect (Taylor, 2014, para. 3-4)
.

Walton, Alice G. (2015, January 23). Study: Coffee may reduce risk of melanoma. Forbes. Retrieved from http://www.forbes.com/sites/alicegwalton/2015/01/23/can-coffee-reduce-the-risk-of-skin-cancer/

Drinking four or more cups of coffee daily may reduce the risk of melanoma--the leading cause of skin cancer death. Previous research shows that compounds in coffee have lessened the risk of skin cancer in lab mice, but in human studies other variables may determine the individual's chances of developing melanoma (Walton, 2015, January 23, para. 1-2).

National Cancer Institute researchers discovered that the risk of malignant melanoma fell 20 percent if study participants drank four cups of coffee daily while they were looking for a connection between diet and skin cancer in a sample size of 447,000 cancer-free, older adults at a beginning of a ten-year longitudinal study in which 2,900 senior adults developed malignant melanoma, and 1,900 developed melanoma (Walton, 2015, January 23, para. 1-2).

Previous studies of lab mice and skin cell cultures has shown that compounds in coffee affect molecular pathways that cut the risk of UV-related skin cancer by reducing inflammation, oxidative stress, and DNA damage in cells (Walton, 2015, January 23, para. 5).   Researchers, nevertheless, admit that earlier longitudinal studies of human populations have produced less convincing results, for example, one study [Song, Qureshi, & Han, et al, 2012] found that drinking coffee reduced the risk of skin cancer in women, but not in men (Walton, 2015, January 23, para. 6).

Then again, a Mayo Clinic study has determined that adults under the age of 55 who drank four or more cups of coffee daily had an increased mortality rate.

See:

Nelson, Jennifer K. & Zeratsky, Katherine. (2013, September 11). Heavy coffee consumption—risky in younger adults. Nutrition and Healthy Eating. Mayo Clinic. Retrieved from http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/expert-blog/coffee-and-young-adults/BGP-20056124

Men under age 55 who drink more than 28 cups of coffee weekly or average drinking four cups a day may increase their risk of premature death (Nelson, 2013, September 11, para. 2). The report, however, doesn't account for dietary or socioeconomic variables, although it does consider smoking, exercise and chronic diseases like diabetes and high blood pressure (Nelson, 2013, September 11, para. 3).

Even so, heavy coffee drinker might need to reassess their lifestyle choices to determine if their drinking large quantities of coffee compensates for not enough sleep, if the sugar they add to their coffee causes weight gain, and if they substitute coffee breaks for healthy meals and snacks (Nelson, 2013, September 11, para. 4).

------------

Warner, Jennifer. (2011, October 24). Coffee fights common skin cancer: Coffee drinkers less likely to develop most common types of skin cancer. Melanoma/Skin Cancer Health Center. Web MD. Retrieved from http://www.webmd.com/melanoma-skin-cancer/news/20111024/coffee-fights-common-skin-cancer?page=1


According to a Brigham and Women Hospital and Harvard University Medical study [Song, Qureshi, & Han, 2012), women who drink more than three cups of coffee daily lower their risk of basal cell carcinoma 20 percent more than those women who drank coffee less than once a month while men who drank more than three cups of coffee daily were 9 percent less likely to develop basal cell carcinoma cancer (Warner, 2011, October 24, para. 2-3). But drinking decaffeinated coffee didn't reduce skin cancer at all, a finding that led researchers to speculate that caffeine is the primary ingredient in coffee that reduces skin cancer (Warner, 2011, October 24, para. 4). All the same, researchers suggested that avoiding a sunburn is a better way to reduce the risk of skin cancer (Warner, 2011, October 24, para. 7).

Caffeine Cuts Skin Cancer Risk

Researchers claim that their look at more than 110,000 participants in the Nurses' Health Study and a Health Professionals' Follow-Up made up the first “large, prospective study” to analyze the effect of coffee drinking on basal cell carcinoma, squamous cell carcinoma, and melanoma, although they admit that previous studies hint that drinking coffee might prevent non-melanoma skin cancer (Warner, 2011, October 24, para. 8-11).

Researchers followed their study's participants for 22 to 24 years, during which time, participants reported 22,786 cases of basal cell carcinoma, 1,953 incidences of squamous cell carcinomas, and 741 melanomas whereupon researchers concluded that drinking coffee decreased the risk of developing basal cell carcinoma compared to participants who abstained from coffee, but the caffeine in coffee didn't effect other types of cancer. Women who drank the most coffee lowers their risk of developing basal cell carcinoma 18 percent, and coffee guzzling men lowered their risk nine percent (Warner, 2011, para. 12-14).

Coffee Better Than the Beach

These results, however, surprised Allan Conney, the Director of the Susan Lehman Cullman Laboratory, who had expected to see coffee lower the risk of developing squamous cell carcinomas that animal models had predicted (Warner, 2011, para. 15). Paul Nghiem, an associate professor at the University of Washington, Seattle, theorizes that the caffeine in coffee prevents basal cell carcinoma by killing a small number of precancerous cell damaged by sunlight particularly on a day when someone exposes him or herself to lots of UV-rays, so the cumulative effects of coffee drinking simply don't count. Accordingly, Nghiem is looking into the possibility of adding caffeine to sunscreen (Warner, 2011, para 16-20).

___________

 

The links furnished on this Web page represent the opinions of their authors, so they complement—not substitute—for a physician’s advice.

Drinking Three Cups of Coffee Daily May Delay or Prevent Alzheimer's Disease

Go Ahead & Have That 

Third Cup of Coffee: 

It Might Be Good for You

Evelyn E. Smith

M.S. in Library Science, University of North Texas (2012)

Research indicates that drinking three to five cups of coffee a day, or two lattes or cappuccinos, may help prevent or delay the onset of Alzheimer's disease particularly if middle-aged and older coffee drinkers couple this habit with a healthy lifestyle (following a Mediterranean diet that features olive oil, fresh fruits and vegetables, and two or more servings of omega-3 fatty fish weekly, performing 30 minutes of aerobic exercise at least five days a week as well as exercising their minds, watching their weight, and not smoking). Admittedly, however, researchers also confess that it's hard to determine whether moderate to heavy coffee drinkers have a more active lifestyle than their less invigorated counterparts whose Mild Cognitive Disorder gradually slips into Alzheimer's Disease.

Research Online Points to the Possibility that Drinking Coffee Protects Against Alzheimer's Disease

Drinking 3 to 5 cups of coffee may delay or possibly prevent Alzheimer's.

Arendash, G. W. & Cao, C. (2010). Caffeine and coffee as therapeutics against Alzheimer's disease. Journal of Alzheimer's Disease: JAD, 20 Suppl 1:S117-26. doi. 10.3233/JAD-2010-091249 [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20182037

When researchers gave mice bred to develop dementia caffeine in their drinking water from young adulthood into old age, this lowered the level of amyloid beta protein in their brains. Moreover, “aged” and “cognitively-impaired” mice had lower levels of amyloid beta protein in their brains following only one to two months of caffeine treatment. Indeed, only one oral caffeine treatment reduced both brain and plasma amyloid beta levels. Arendash and Cao conjecture that the cognitive benefits of caffeine result from the caffeine itself and not from the metabolites, or the byproducts, of caffeine. Thus, Arendash and Cao suggest that drinking five cups of coffee daily will protect against the development of Alzheimer's.

Basurto-Islas, G., Blanchard, J, & Tung, Y.C., et al. (2014, December). Therapeutic benefits of a component of coffee in a rat model of Alzheimer's Disease. Neurobiology of Aging. 35(12), 2701-12. doi: 10.1016/j.neurobiolaging.2014.06.012. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25034344

In a lab rat's model for Alzheimer's Disease, a supposedly “minor component” of coffee not related to caffeine, eicosanoyl-5-hydroxytryptamide (EHT), ameliorated the effects of cognitive impairment after researchers supplemented the rat's diet with EHT for six to twelve months.

Cao, C., Lowenstein, D. A., & Lin, X. (2012). High blood caffeine levels in MCI linked to lack of progression to dementia. Journal of Alzheimer's Disease: JAD. 20(3), 559-72. doi: 10.3233/JAD-2012-111781. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22430531

In a case-controlled study over a two to four year period, plasma caffeine bio-marker levels were 51 percent lower in seniors aged 65 to 88 years old that went on to develop Alzheimer's Disease after first being diagnosed with Mild Cognitive Impairment that those whose plasma caffeine bio-marker levels were above 1200 ng/ml. Coffee was the major or primary source of caffeine for the stable MCI patients. “This case-control study provides the first direct evidence that caffeine/coffee intake is associated with a reduced risk of dementia, or delayed onset, particularly for those who already have MCI.”

Carman, A. H., Dacks, P. A., & Lane, R. F., et al. (2014, April). Current evidence for the use of coffee and caffeine to prevent age-related cognitive decline and Alzheimer's disease. The Journal of Nutrition, Health, and Aging. 18 (4), 383-92. doi: 10.1007/s12603-014-0021-7. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24676319

While research has long established that drinking coffee and other drinks containing caffeine improves short-term memory, limited research also suggests that drinking coffee might also protect against the “cognitive decline” that results in Alzheimer's Disease. In vitro and pre-clinical animal models have discovered “plausible neuroprotective mechanisms” in both caffeine and other bio-active components found in coffee; however, epidemiolgy research has come up with “mixed results”: Some studies show a link between caffeine and the ability to guard against dementia, but some research doesn't show that caffeine produces any benefit. Furthermore, the researchers know of no randomized controlled trials to test this hypothesis. Thus, researchers need to carry out short-term clinical trials to validate findings from pre-clinical models as well as to conduct epidemiological studies that incorporate more standardized methods of data collection and analysis.

Chu, Y. F., Chang, W. H., & Black, R. M. (2012, December 1). Crude caffeine reduces memory impairmemt and amyloid β (1014) Levels in an Alzheimer's mouse model. Food Chemistry. 135(3), 2095-2102. oi: 10.1016/j.foodchem.2012.04.148. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22953961

Crude caffeine, or the byproduct of decaffeinated coffee, exhibits a “potent hydrophilic antioxidant activity” that may reduce the inflammatory processes associated with Alzheimer's Disease--or at least two months of administering crude caffeine to mice bred to develop dementia reduces their Aβ(1-42) levels and the number of amyloid plaques in their hippocampuses, guarding primary neurons against Aβ-induced cell death and inhibiting Aβ-induced caspase-3 activity.

Eskelinen, M. H. & Kivipelto, M. (2010). Caffeine as a protective factor in dementia and Alzheimer's disease. Journal of Alzheimer's Disease: JAD, 20 Suppl. 1: S167-75. doi: 10.3233/JAD-2010-1404. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20182054

Three out of five longitudinal and epidemiological studies on caffeine and coffee and tea consumption and dementia support the idea that drinking coffee protects against cognitive decline. Two studies also note that drinking both coffee and tea helps prevent [or delay] dementia, although the benefits of drinking tea are “less evident” than those of drinking coffee. The CAIDE study associates drinking between three to five cups of coffee daily from midlife on with a 65 percent decrease in the risk of dementia later in life.

Gelber, R. P., Petrovitch, H., & Masaki, K. H., et al. (2011). Coffee intake in midlife and risk of dementia and its neuropathologic correlates. Journal of Alzheimer's Disease: JAD. 23(4), 607-15. doi: 10.5487/TR.2011.27.1.007. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21157028

After following 3,494 men whose average age was 52 in 1965-1968 until 1991 to 1993 and afterwards examining 418 brain autopsies, researchers have determined that coffee and caffeine intake in midlife lowers the odds of having any types of brain lesions upon autopsy. However,they didn't find any association between caffeine intake and the risk of cognitive impairment. Men who consumed the most caffeine were less likely to develop brain lesions of any type than those who consumed the least caffeine.

Santos, C., Luent, N., & Azevedo, A., et al. (2010). Caffeine intake is associated with a lower risk of cognitive decline: A cohort study from Portugal. Journal of Alzheimer's Disease: JAD. 20 Suppl 1:S175-85. doi: 10.3233/JAD-2010-091303. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20182036

Researchers associated with the Department of Hygiene and Epidemiology at the Porto University Medical School and Institute of Public Health found that caffeine intake of more than 62 milligrams. a day lowered the risk of cognitive decline in women, but not in men, after conducting a longitudinal study of 648 men and women 65 years or over between 1993 to 2003 and then conducting a follow-up study between 2005-2008. Researchers evaluated the seniors' cognitive health by administering a Mini-Mental State Examination and adjusted for risk factors, such as age, educational level, smoking, drinking habits, body mass index, hypertension, and diabetes.

You, D. C., Kim, Y. S., & Ha, A. W. et al. (2011,March). Possible health effects of caffeinated coffee consumption on Alzheimer's disease and cardiovascular disease. Toxicological Research. 27(1), 7-10. doi: 10.5487/TR.2011.27.1.007. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24278543

A South Korean review of epidemiological and experimental studies shows  that moderate doses of caffeine provide some protection against both cardiovascular disease and Alzheimer's.

Zhang, L. F., Zhou, Z. W., &Wang, Z. H. et al. (2014, December 24). Coffee and caffeine potentiate the antiamyloidogenic activity of melatonin via inhibition of Aβ oligomerization and modulation of the Tau-mediated pathway in N2a/APP cells. Drug Design, Development and Therapy, 9:241-72. doi: 10.2147/DDDT.S71106. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25565776

Since previous animal research indicates that coffee caffeine, and melatonin individually are beneficial in the treatment of Alzheimer's, researchers examined whether or not combining coffee (or caffeine) and melatonin produced a synergistic/addictive effect on amyloid-β (Aβ) protein. When researchers treated amyloid-(APP) cells with coffee or caffeine for 12 hours daily followed by melatonin for 12 hours each night, this significantly reduced extra-cellular levels of Aβ40/42 and Aβ42 oligomers. 

 However, when they treated the cells with coffee, or caffeine, plus melatonin for 24 hours from 7 a. m. to 7 a. m. the next day, this didn't remarkably effect the cells, and when when they treated the cells with coffee, or caffeine, plus melatonin for five consecutive days, this produced less of an antiamyloidogenic effect compared than the first experiment that only treated cells with caffeine during the day and with melatonin during the evening.

Popular Online Articles Explain How Coffee Protects Against Alzheimer's

Coffee has medicinal properties!

Aubrey, Allison. (2010, June 28). Nervous about Alzheimer's? Coffee may help. NPR. Retrieved from http://www.npr.org/templates/story/story.php?storyId=128110552

Although several studies suggest that caffeine may protect against Alzheimer's, a cup or two a day isn't enough—500 milligrams of caffeine, or the equivalent of five cups of regular coffee, remains the recommended dosage (Aubrey, 2010, June 28, para.1).

Five Cups a Day

Gary Arendash, a researcher at the Florida Alzheimer's Disease Research Center at Florida State University, drinks five cups of coffee daily, convinced that this habit defends against the ravages of Alzheimer's (Aubrey, 2010, June 28, para. 3). When Arendash and his fellow researchers added caffeinated water to their Alzheimer's Disease-bred rats, the lab rats if administered enough caffeine performed better running mazes, and they also ended up with a 50 percent reduction in amyloid proteins in their brains (Aubrey, 2010, June 28, para. 4, 6, & 10).

The average American coffee drinker, however, imbibes only about one and a half cups of coffee daily--far below the level that might “confer protective benefits” (Aubrey, 2010, June 28, para. 7).

Not that the therapeutic results of any caffeine given animals necessarily translates into similar results in humans, although animal studies are “a good starting point” if scientists wish to research whether or not drinking lots of coffee reduces the risk of  developing Alzheimer's Disease (Aubrey, 2010, June 28, para. 8-9).

Observations of Coffee-loving Middle-Aged Folks

While Florida State University researchers have been studying the effects of caffeine on lab rats, other scientists have been collecting research that indicates that drinking lots of coffee is beneficial for middle-aged and older adults. For example, a Finnish study that followed 1,400 coffee drinkers for two decades found that those coffee lovers who drank between three to five cups of coffee daily in their 40s and 50's had a 65 to 70 percent reduced risk of developing Alzheimer's in their 70's (Aubrey, 2010, June 28, para. 12-14).

All the same, although smaller longitudinal studies have found similar results, Reisa Sperling, an Alzheimer's Researcher at Harvard University''s Brigham and Women's Hospital, hesitates before suggesting that epidemiological evidence proves that coffee prevents Alzheimer's since other factors might influence an individual's susceptibility. For instance, active, middle-aged adults might be drinking more coffee than couch potatoes (Aubrey, 2010, June 28, para. 15-17).

Coffee Drinking Can't Offset Genetic Risk

While regular exercise and proper nutrition gives some protection from Alzheimer's, no behavior or diet can completely cancel the risk of developing what is a genetic disease (Aubrey, 2010, June 28, para. 18).

Coffee and Caffeine. (2014, January 16). Alzheimer's Drug Discovery Foundation. Retrieved from http://www.alzdiscovery.org/cognitive-vitality/report/coffee-and-caffeine

Senior adults who drink “moderate” amounts of coffee (between three and five cups) are less likely to develop dementia as evidenced by studies of isolated cells, research on lab rats, and  longitudinal research on human subjects. However, it's best to consult a physician before starting a dietary regime that drastically increases coffee consumption (Alzheimer's Drug Discovery, 2014, January 16, para. 1).

Caffeine and Coffee

Because it's difficult to determine whether the caffeine in coffee or coffee's other components is more beneficial, drinking either regular or decaffeinated coffee may decrease the risk of death from cardiovascular disease (Alzheimer's Drug Discovery, 2014, January 16, para. 3).

Sources of Coffee and Caffeine

Almost all observational research on caffeine studies the effect of coffee on the brain: A cup of coffee contains between 60 to 18 milligrams of caffeine while a cup of tea contains just 30 to 45 milligrams; an ounce of chocolate contains one to 30 milligrams, and 12-ounce cans of energy drinks have between 25 to 60 milligrams of caffeine. Research, however has proven that energy drinks might produce “adverse health results”. Caffeine is also available as a dietary supplement is doses of 100 milligrams (Alzheimer's Drug Discovery, 2014, January 16, para. 5).

How Coffee and Caffeine Might Benefit the Brain

Caffeine temporarily increases the brain's activity by stimulating the central nervous system. Thus, moderate amounts of caffeine increase alertness and muscle coordination. Caffeinated and decaffeinated coffee both have antioxident and anti-inflammatory properties, so they may both protect against Alzheimer's (Alzheimer's Drug Discovery, 2014, January 16, para. 7).

Can It Prevent Dementia?

Although researchers haven't conducted any randomized trials, limited evidence suggests that drinking between three to five cups of coffee daily lowers the incidence of Alzheimer's disease in older adults, even though some studies haven't established any links between drinking coffee and preventing dementia. It's also not possible to determine whether an individual's lifestyle choices and hereditary is more likely to determine if he or she develops Alzheimer's Disease (Alzheimer's Drug Discovery, 2014, January 16, para. 8).

Can It Benefit Someone with Dementia or Mild Cognitive Disorder?

One longitudinal study that measured the blood caffeine levels in senior adults diagnosed with M.C.I. over a two to four-year period tentatively showed that those patients whose blood contained higher levels of caffeine were 50 percent less likely to develop dementia than those with lower levels of caffeine in their blood. However, these results didn't conclusively prove that drinking lots of coffee prevented them from developing Alzheimer's Disease, for other characteristics shared by those M.C.I. patients who didn't succumb to Alzheimer's might have produced this result (Alzheimer's Drug Discovery, 2014, January 16, para. 9-10).

Can It Slow or Delay Death?

Several large observational studies indicate that drinking coffee bestows cardiovascular benefits and helps prevent Type 2 diabetes, or else it ameliorate its effects, so drinking coffee might result in a longer life. On the other hand, some studies suggest that when an older adult drinks more than three cups of coffee daily, this raises the risk of death (Alzheimer's Drug Discovery, 2014, January 16, para. 11).

Is It Safe to Use as Directed?

Drinking two to four cups of coffee daily ordinarily is safe for healthy adults, although adults diagnosed with cardiovascular disease or high blood pressure should ask their doctor how much coffee they can safely drink each day. Pregnant women shouldn't consume more than 200 milligrams of coffee daily and those taking the muscle relaxant tizanidine (Zanaflex) or the anti-depressant fluvoxamine (Luvox) shouldn't drink any coffee. Coffee [particularly when drunk at night] can interfere with sleep patterns (Alzheimer's Drug Discovery, 2014, January 16, para. 12-13).

If You Are Considering Taking Coffee and Caffeine

Before drastically upping their coffee consumption, seniors should talk to their physician (Alzheimer's Drug Discovery, 2014, January 16, para. 14).

Coffee 'may reverse Alzheimer's'. (2009, July 5). BBC News. Retrieved from http://news.bbc.co.uk/2/hi/health/8132122.stm

Drinking 5 cups of coffee may reverse memory problems found in Alzheimer's disease (2009, July 5, para. 1).

Research with mice suggests that ingesting  caffeine restrains the development of the protein plaques that characterize Alzheimer's Disease. Even so, British experts advise that this doesn't mean that dementia patients should start taking caffeine supplements (2009, July 5, para. 2 & 4).

To determine whether the 55 mice aged 18 to 19 months old (or about 70 in human years) bred to develop dementia, showed signs of memory impairment, University of South Florida researchers administered behavioral tests before giving half the mice caffeine in their drinking water and half the mice plain water (2009, July 5, para. 5-6). The researchers then gave the caffeine-fed mice  the lab-rat equivalent of five, eight-ounce cups of coffee daily, or about the same amount of caffeine found in two latte or cappuccino cups of coffee, 14 cups of tea, or 20 soft drinks (2009, July 5, para. 7).

When researchers tested the two groups of Alzheimer's bred mice two months later, those mice with caffeinated water performed about the same as mice  that didn't show any signs of dementia and much better on memory tests [running mazes] than the Alzheimer's bred mice given plain water (2009, July 5, para. 8-9). The brains of those mice who received caffeine in their water also showed a nearly 50 percent decrease in their levels of beta amyloid protein (2009, July 5, para. 10).

Additional research indicates that caffeine reduces the creation of enzymes necessary to make beta amyloid protein as well as inhibiting inflammatory changes that over produce it. Moreover, when younger mice bred to develop Alzheimer's received caffeine in their drinking water from early adulthood, this prevented them from having memory problems (2009, July 5, para. 11-13).

'Safe Drug'

Gary Arendash, who led the University of South Florida research, claims that these results furnish evidence that caffeine might be a “viable treatment” for already diagnosed Alzheimer's Disease rather than just a preventive measure. Hence, his team of researchers hopes to replicate the results of their mice trials in humans (2009, July 5, para. 14).

4 surprising benefits of coffee. (2014, April 9). Alzheimer's.net. Retrieved from http://www.alzheimers.net/2014-04-09/benefits-of-coffee/

Coffee Can Delay the Onset of Alzheimer's

Even in senior adults showing signs of “mild dementia”, drinking three cups of coffee daily can delay Alzheimer's onset since caffeine blocks inflammation of the brain as shown in the brains of adults over age 65 who had high levels of caffeine in their blood (4 Surprising Benefits, 2014, April 9, para. 1-3).

Coffee Positively Affects Key Protein in Alzheimer's Disease.

Because caffeine is an adenosine receptor antagonist, it blocks receptors in the brain that contribute to the development and entanglement of tau protein, a protein that kills brain cells (4 Surprising Benefits, 2014, April 9, para. 4-5).

Coffee Boosts Brain Function and Memory.

A 2014 stud from the University of California found that adults who consumed 200 milligrams of coffee before taking a memory test scored much higher than controls. However participants given 300 milligrams of caffeine didn't do any better than those who consumed 200 milligrams of caffeine (4 Surprising Benefits, April 9, para. 6-9).

Coffee Can Protect Against Type 2 Diabetes, Which Can Lead to Alzheimer's

Compared with those individuals who didn't drink any coffee, those that drank six cups of either regular or de-caffinated coffee daily significantly lowered their risk of Type 2 diabetes. For every cup of regular coffee drunk daily, the risk of developing Type 2 diabetes decreases nine percent while for every cup of decaffinated coffee drunk daily, the risk of developing Type 2 diabetes drops six percent (4 Surprising Benefits, April 9, para. 9-10).

Mann, Denise. (2012, June 7). Drinking coffee may delay Alzheimer's disease. Web M. D. Retrieved from http://www.webmd.com/alzheimers/news/20120607/coffee-may-help-turn-tide-on-alzheimers-disease?page=2

Drinking three cups of coffee daily may delay Alzheimer's in adults over age 65 who are already showing signs of memory problems, so they develop Alzheimer's two to four years later than seniors with lower caffeine levels in their blood (Mann, 2012, June 7, para 1-2).

The study, which appears in the Journal of Alzheimer's Disease, looked at 124 adults aged 65 to 88 diagnosed with Mild Cognitive Impairment since 15 percent of seniors diagnosed with MCI go on to develop Alzheimer's each year (Mann, 2012, June 7, para. 3-4).

Levels of caffeine the the blood were 50 percent lower among seniors diagnosed with Alzheimer's compared to those who didn't go on to develop this disease. However, in this study, coffee remained the main, or only, source of caffeine (Mann, 2012, June 7, para. 5).

No participants diagnosed with MCI whose initial blood levels contained above 1,2000 ng/ml of caffeine, or equal to about three cups of coffee daily, went on to develop Alzheimer's (Mann, 2012, June 7, para. 6).

Chuanhai, Cao, a researcher at the University of South Florida's College of Pharmacy and the Byrd Alzheimer's Institute in Tampa, Florida, thus urges adults beginning in their mid-30's to start drinking at least three, eight-ounce cups of coffee each morning  (Mann, 2012, June 7, para. 7-8).

Coffee May Lower Alzheimer's Risk

Cao theorizes that with advancing age, the brain no longer metabolizes beta amyloid protein, so it builds up in the brain. Caffeine, however, inhibits the growth of this protein, so the brain absorbs it without turning it into plaque (Mann, 2012, June 7, para. 9-13). Research also shows that drinking significant amounts of coffee reduces the risk of Parkinson's, stroke, Type 2 Diabetes, and cancer (Mann, 2012, June 7, para. 14).

Could It Be Adult ADHD?

Sam Grundy a researcher at the Mount Sinai School of Medicine in New York City, makes the educated guess that Alzheimer's might be the senior adult equivalent of ADHD. Therefore, since caffeine increases attention, Grundy maintains that it improves memory while elevating cyclic AMP levels that reduce the accumulation of amyloid protein (Mann, 2012, June 7, para. 19).

Reynolds, Gretchen. (2013, June 6). This is your brain on coffee. Well. New York Times. Retrieved from http://well.blogs.nytimes.com/2013/06/06/this-is-your-brain-on-coffee/?_r=0

A University of Illinois at Urbana-Champaign study published in 2012 briefly deprived mice of oxygen, causing them to lose their ability to form memories.  At this point, half the mice received a dose of caffeine equal to several cups of coffee. Mice rejuvenated with caffeine regained their ability to make new memories 33 percent faster than a control group that didn't receive any caffeine. Autopsies showed that caffeine disrupted the chemical reactions caused by adenosine, which can “jump start“ a biochemical cascade leading to inflammation when illness or accident injuries brain cells or if the brain is under stress (Reynolds, G., 2013, June 6, para. 3).

A 2012 study conducted by the University of South Florida and the University of Miami researchers tested blood levels in seniors with Mild Cognitive Disorder and then re-evaluated their mental health two to four years later and found that adults who in the original study had little or no levels of caffeine circulating in their blood stream had progressed to “full-blown" Alzheimer's compared with those seniors who drank three cups of coffee daily (Reynolds, G., 2013, June 6, para. 4).

In a 2011 study, University of South Florida researchers also found that mice bred to develop Alzheimer's and then given caffeine alone did less well on memory tests than those mice that drank coffee (Reynolds, G.,2013, June 6, para. 5).

Reynolds, Mark. (2014, November 27). Just THREE cups of coffee delay could clash the risk of Alzheimer's study finds. Express. Retrieved from http://www.express.co.uk/life-style/health/540506/Drinking-Coffee-Fights-Alzheimer-s-Risk

In a paper originally presented at the Alzheimer's Europe Conference in Glasgow, Scotland, in October 2014, researchers from the Institute for Scientific Information on Coffee linked “regular, lifelong moderate coffee consumption” with a reduced risk of developing Alzheimer's Disease (Reynolds, M., 2014, November 27, para. 2-5).

Researchers defined moderate coffee consumption as drinking from three to five cups daily, a dose necessary to achieve coffee's “optimum protective effect”, reducing the risk of developing Alzheimer's disease by 20 percent for a four-year period, presumably after showing signs of Mild Cognitive Disorder (Reynolds, M., 2014, November 27, para. 6-7).

Scientists theorize that the caffeine and polyphenol compounds found in coffee reduce inflammation and prevent the formation of amyloid plaque and its accompanying deterioration of the brain cells in the hippocampus and the cortex (Reynolds, M. 2014, November 27, para. 8-9). Nevertheless, Jess Smith, a researcher for the United Kingdom's Alzheimer's Society, cautions that this evidence is still inconclusive, so neuoscientists need to conduct additional clinical trials to determine how coffee can protect against Alzheimer's over a long period of time (Reynolds, M., 2014, November 27, para. 11).

Smith also warns that such factors as exercising regularly, eating a well-balanced diet, not smoking or drinking in excess, and managing health conditions all play a part in reducing the risk of developing Alzheimer's Disease, although Alzheimer's is a progressive disease with symptoms gradually becoming worse while strokes also cause dementia (Reynolds, M., 2014, November 27,para. 13-14).

Shah, Yagana. (2014, November 11). Regular coffee consumption could keep Alzheimer's at bay report says. Post 50. Huffington Post. Retrieved from http://www.huffingtonpost.com/2014/11/26/coffee-alzheimers-disease-risk-_n_6221436.html

Drinking coffee might curb the risk of Alzheimer's Disease on a short-term basis, according to a report issued by the Institute for Scientific Information on Coffee presented at Alzheimer's Europe Conference (Shah, 2014, November 11, para. 2). Researchers attribute coffee's antioxidant effect that reduces inflammation to the caffeine and polyphenol compounds found in coffee since they prevent the build up of protein that creates the plaque associated with Alzheimer's Disease (Shah, 2014, November 11, para. 4).

The study followed 5,000 participants between 1989 and 1991 and then followed-up on this research between 1997 and 2011, finding that those who drank more than three cups of coffee daily were less likely to develop dementia, although this protective effect weakened as the years went by (Shah, 2014, November 11, para. 5). A similar study published in 2012 found that while drinking three cups of coffee daily can't completely stop senior adults from developing Alzheimer's, it can slow the mental decline of patients diagnosed with Mild Cognitive Impairment (Shah, 2014, November 11, para. 8).

So What If I Don't Always Manage to Drink Three Cups of Coffee Daily? 


Added January 25, 2015

For those who don't get their coffee quota of three cups of coffee daily, drinking coffee is just one way to cut down one's risk of developing Alzheimer's Disease.  Moreover, drinking lots of coffee "isn't a get out of jail free" card since middle aged and older adults also need to adhere to a healthy diet, watch their weight, get in 30 minutes of aerobic exercise daily, and continue to exercise their minds.  Finally, remember that preventing dementia starts in childhood.

Forget Alzheimer's Disease: Remember these tips to avoid memory loss. (2013). The Daniel Plan. Retrieved from http://www.danielplan.com/healthyhabits/preventingalzheimers/

___________





The links furnished on this Web page represent the opinions of their authors, so they complement—not substitute—for a physician’s advice.

Warning: Consult an Oncologist Before Self-Medicating with Complementary & Alternative Medicines

Herbs, Special Diets, & Vitamin Supplements May Interfere with Chemotherapy

Consult a physician before using complementary and alternative medical treatments.

Evelyn E. Smith

M.S. in Library Science, University of North Texas (2012)

Cancer patients are increasingly turning to complementary and alternative medical (CAM) treatments, such as diet and vitamins, to augment their cancer treatments. Even if patients fear that their physician might try to persuade them not to use CAM, patients need to tell their oncologist about the non-prescription supplements they are taking and the diets they are following since these may interact adversely with chemotherapy. Conversely, all their physicians also need to ask them  if they are taking supplements and herbs or engaging in any complementary or alternative treatments. Indeed, anytime any patient takes herbal supplements, vitamins, or follows a special diet whatever his or her medical condition, he or she needs to check with a physician since these may interfere with a prescribed medication.


Different studies give contradictory evidence as to whether treatments like acupuncture and yoga helped relieve fatigue in cancer patients following chemotherapy treatments. Moderate to vigorous exercise might also help alleviate fatigue, depression, or anxiety. Almost all studies point out, however, that cancer patients with a university education are more likely to use CAM perhaps because this treatment helps them feel more in control of their well-being. Since most oncologists now accept that their well-educated patients are open to trying CAM, they usually work with them to integrate complimentary diet and exercise regimes with surgical, radiation, or chemotherapy treatments.

Alsanad, S. M., Williamson E. M., and Howard, R. L. (2014, August 26). Cancer patients at risk of herb/food supplement-drug interactions: A systematic review. Phytotherapy Research: PTR. doi: 10:1002/PTR.5213. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25158128

A survey of 818 articles using key words as well as a questionnaire submitted to 806 cancer patients determined that 53.7 percent were take some combination of supplements and drugs and that 167 incidents of risk had affected 13.9 percent of those surveyed.

Anderson, M.R., Sweet, E., and Lowe, K. A., et al. (2013, August). Dangerous combinations: ingestible CAM supplement use during chemotherapy in patients with ovarian cancer. Journal of Alternative and Complementary Medicine (New York, New York), 19(8) 714-20. doi: 10.1089/acm.2012.0295. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23445210

Of 200 women in this study who reported using chemotherapy to treat ovarian cancer, 40 percent reported using one or more complementary or alternative medicine (CAM) supplements that could adversely interact with one or more of the chemotherapy medications they were also taking. Those who took multiple CAM supplements were of particular concern since these might cause adverse side effects, increase the toxicity of chemotherapy, or reduce its effectiveness.

Ernst, Edward. (2013, April 18). Cancer patients who use alternative medicines die sooner. Retrieved from http://edzardernst.com/2013/04/cancer-patients-who-use-alternative-medicine-die-sooner/

Studies show that cancer patients who use complementary and alternative (CAM) treatments to supplement traditional cancer therapies don't have [necessarily] higher survival rates than those who only follow regimes prescribed by their physicians. Instead a Korean study of 481 terminal cancer patients between July 2005 to October 2006 found that those who sought out CAM reported “worse cognitive functioning and fatigue (Ernst, 2013, April 18, para. 1 & 2). A Norwegian study of 515 terminal cancer patients over a five-year-period published in 2003 similarly found a higher death rate of 79 percent in patients who supplemented their treatments with CAM compared with a 65 percent death rate for those who didn't use CAM (Ernst, 2013, April 18, para. 3). Several reasons might account for these results: 1) Patients might ineffectively self-medicate with CAM; 2) some treatments [interacting with chemotherapy] might cause direct harm, and 3) those patients who use CAM “might, on average, suffer from more advanced cancers (Ernst, 2013, April 18, para. 4).

Finnegan, John J., Molassiotis, A., & Richardson, A., et al. (2013, July). A systematic review of complementary and alternative interventions for the management of cancer related fatigue. Integrative Cancer Therapies, 12(4): 276-90. doi: 10.1177/1534735413485816. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23632236

A systematic review of CAM interventions to relieve cancer-related fatigue after examining acupuncture, massage, yoga, and relaxation training offers limited evidence that hypnosis and ginseng might prevent the rise of cancer-related fatigue while acupuncture and bio-field healing may possibly reduced fatigue in the aftermath of cancer treatments. Taking multivitamins, however, has proved ineffective in relieving fatigue.

Fouladbakhsh, Judith M., Balneaves, Lynda, and Jenuwine, Elizabeth. (2013, September 1). Understanding CAM natural health products: Implications of use among cancer patients and survivors. Journal of the Advanced Practitioner in Oncology, 4(5): 289-306. [full text Online]. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093439/

Cancer patients are increasingly turning to herbs, vitamins, and natural health products to ease pain, fatigue, insomnia, anxiety, and depression while not necessarily informing health care providers, thus leaving them prey to adverse interactions between complementary and alternative medications (CAM) and prescribed medication. Accordingly, the RN's authoring this informative article furnish an overview of alternative medications and their potential interactions (Abstract).

Garland,S. N., Valentine, D., and Desai, K;, et al. (2013, November). Complementary and alternative medicine use and benefit among cancer patients. Journal of Alternative and Complementary Medicine (New York, New York), 19(11): 876-81. doi: 10.1089/acm.2012.0964. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23777242

A cross-sectional survey of 316 oncology patients indicates that 61.3 percent used complementary and/or alternative medications following their diagnosis. Factors most associated with CAM use were a college education, a breast cancer diagnosis, and being 12 to 36 months past the initial diagnosis. According to those surveyed, “energy healing” and “the healing arts” were the most beneficial treatments while special diets, herbal remedies, vitamins, and massage yielded fewer benefits. Acupuncture, chiropractic treatment, homeopathy, relaxation techniques, yoga, and ta chi didn't contribute to the patients' well being (Abstract).

Huebner, J., Prott, F. J.,and Micke, O., et al. (2014, May 12). Online survey of cancer patients on complementary and alternative medicine. Oncology Research and Treatment, 37(6), 304-308. doi: 10.1159/000362616. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24903760

An Online survey of German cancer patients found that 77 percent of those surveyed were using complementary and alternative medicine (CAM) with 63 percent of them informing their oncologist of this use. However, in 74 percent of these cases, the oncologist didn't take the time to discuss the use of these non-prescribed treatments. The patients most commonly used biologically-based therapies (supplements, herbs, and special diets), relaxation techniques, prayer, and medication to complement cancer treatment, seeking to reduce side effects of chemo- or radiation-therapy, “boost the immune system”, or “get active” (Abstract).

Kabel, A (2014, November 14). Fighting for wellness: Strategies of mid-to-older women living with cancer. Journal of Cross-culture Gerontology. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25391218

A significant percentage of older adult cancer patients rely of complementary and alternative (CAM) treatments particularly as they transition to a post-[chemotherapy and/or surgical] treatment phase of their cancer.

Mishra, Si, Scherer, R. W., and Snyder C., et al. (2012, August) Exercise interventions on health-related quality of life for people with cancer during active treatment. The Cochrane Database of Systematic Reviews, 15(8): CDD08465. doi: 10.1002/14651858.CD008465.pub 2. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23632236

Searching citations through the Cochrane Central Register of Controlled Trials, as well as publication like Pub Med/ MEDLINE as well as the Web of Science and Scopus, from their inception to November 2011, researchers determined that moderate and/or vigorous exercise was most likely to relieve anxiety in breast cancer survivors, although depression, fatigue, and sleep disturbances were more likely to decrease in cancers other than breast cancer.

Nissen, N. , Lunde, A., Pedersen, C. G., et al. (2014, October 10). The use of complementary and alternative medicine after the completion of hospital treatment for colorectal cancer: Findings from a questionnaire in Denmark. BMC Complementary and Alternative Medicine, 14 (388). doi: 10.1186/1472-6882-14-388. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25304122

A Danish study of patients who had completed hospital treatment for colorectal cancer found that of the 247 patients questioned, 49.4 percent had used some form of complimentary and alternative medicine (CAM) in the past month; and of these, 49.2 percent had used natural medications or dietary supplements only while 32 percent had also consulted an alternative therapist, and 18.9 percent had sought both treatments. Users of CAM were more likely to be women with high education levels who used these alternative treatments without the prompting of a physician. Indeed, 51 percent didn't disclose the use of CAM to their physicians while a physician only asked the patient about whether he or she was using CAM in only 8.5 percent of the cases (Nissen, 2014, October 10, Abstract).

Patel, V. H. (2014, November 14). Nutrition and prostate cancer: An overview. Expert Review of Anti-cancer Therapy, 14(11), 1295-304. doi: 10.1586/14737140.2014.972946. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25367323

Physicians have discovered a link between nutrition, lifestyle, and the development and progression of prostate cancer; for example, obesity and metabolic syndrome are key risk factors for prostate cancer as are the consumption of saturated and trans fats. At the same time, prostate patients are increasingly turning to complementary and alternative (CAM) treatments like vitamins and special diets. Thus, nutraceuticals and supplements have proved beneficial in the prevention and the recovery from prostate cancer (Patel, 2014, November 14, Abstract).

Smith, P. J., Clavarino, A., and Long, J. et al. (2014, March). Why do some cancer patients receiving chemotherapy choose to take complementary and alternative medicines and what are the risks? Asia-Pacific Journal of Clinical Oncology, 10 (1), 1-10. doi: 10.1111/ajco.12115. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23910177

Complementary and alternative medicine (CAM), such as herbs, vitamins, and special diets, that the body systematically absorbs are most likely to interfere with chemotherapy and potentially harm cancer patients. Cancer patients are most likely to ingest CAM to lessen chemotherapy's side effects, manage symptoms, or treat medical conditions unrelated to the diagnosis of cancer while a small percentage of patients decide to use CAM instead of chemotherapy, thus delaying conventional treatment. Family, friends, casual acquaintances, and even practitioners all may encourage the use of CAM. However, when researchers tested their use of these complementary or alternative treatments in rigorous chemical trials, no CAM alone showed any benefit beyond the use of a placebo, and with the exception of the use of ginger to treat chemotherapy-induced nausea, no compelling reason exists to override the risk of using CAM while undergoing chemotherapy, However, evidence exists that complementary mind-body therapies provide supportive care during chemotherapy.

Templeton,, A. J., Thurlmann, B., and Bauman, M., et al. (2013, March). Cross-sectional study of self-reported physical activity, eating habits and use of complementary medicine in breast cancer survivors. BMC Cancer, 13, 153. doi: 10.1186/1471-2407-13-153. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23530694

A cross-sectional study of Swiss breast cancer survivors whose breast cancer was caught early indicated that 69 percent reported the were physically active more than once weekly, taking a brisk 30-minute walk; 87 percent paid special attention to nutrition and were following a low-fat diet, and 46 percent had adopted complementary and alternative medicine (CAM) treatments. Factors influencing regularly taking part in physical exercise included using CAM, an older age, and fewer worries about the future whereas regular physical activity along with a university-level education were indicative of special attention to diet and routine brisk exercise. A university education and a lower age also pointed to the use of CAM. About half the patients questions were interested in learning more about complementary and alternative medical treatments and were also willing to take part in institutionally-sponsored, wellness programs.

___________


 

The links furnished on this Web page represent the opinions of their authors, so they complement—not substitute—for a physician’s advice.