- Fly to Kona, Big Island, Hawaii.
- Run on the beach, mainly to find a coffee stand and eatery with a view.
- Drink some local coffee while enjoying grilled fish and pasta and pineapple, along with the sun and sand.
- Exercise your brain by reading the paper (click here) which shows that drinking lots of coffee may help prevent your brain from looking like it has dementia under the microscope, after death, but may not really prevent clinical dementia: um…what? huh? Kinda like the numerous studies that show anti-amyloid therapies can improve biomarker PET scan images, but not really improve cognitive performance or prevent cognitive decline? Another paper that shows that a lack of autopsy brain findings doesn’t always correlate with cognitive problems, or vice versa?
The authors of the paper were writing from the Univ Hawaii and VA Hospital in Honolulu. It’s a longitudinal study over 25 years, a “natural experiment” in which the subjects are self-selected into high and low caffeine groups by their own recalled preferences at mid life (~age 52). They don’t specify Kona coffee, espresso, drip or iced, or the beach, or running, but one can imagine the ideal scenario, throw in some other prevailing ideas about prevention, even “cognitive stimulation” by reading that article, all part of dementia risk reduction.
What AlzGadfly liked about the rigorous Hawaii paper: 1) it’s a study over decades, over 3000 men, comprehensively tested, including clinical cognitive tests, in midlife for a baseline; by age 71-93, 418 also had brain autopsy data; 2) the subjects were ethnically homogenous, Asian, perhaps more used to tea, which probably made coffee use a choice, but the authors also tease out total caffeine; 3) they used specific neuropathology criteria for Alzheimer’s, vascular dementia, and other lesions. What seemed to be missing: not one mention of factors like consumption of poke (fish), coconuts, or macadamia nuts (just kidding, but presumably those were also exposures in the control group; multivariate analysis did include many factors including HBP, smoking, BMI and even APOE e4 status).
If I read the Odds Ratios (OR) correctly, the highest caffeine group had about a 55% chance of having a better looking brain autopsy, lacking any specific lesions, than the lowest group (“the highest quartile of caffeine intake (≥411.0 mg/d) were less likely than men in the lowest quartile (≤137.0 mg) to have any of the lesion types (adjusted-OR, 0.45; 95% CI, 0.23–0.89; p , trend = 0.04),” as stated in the abstract).
In the bigger data set, caffeine level didn’t seem to alter the risk of clinical dementia. However, in Table 2, the adjusted-OR for high coffee intake for reducing Alzheimer’s looks good (~0.59), while that group’s adjusted-OR for vascular dementia looks bad (1.96); it makes one take another sip of coffee and think about one’s own deficits in statistics. BTW, these subjects were part of a larger group, and some of these same investigators previously found that increased coffee use was associated with a lower incidence of Parkinson disease.
The headline above does say the “nicest way,” to do something for your brain, from my perspective on a cold rainy day in Seattle, not the most effective or proven way to prevent dementia. However, buried in text of the 2019 WHO Guidelines for dementia risk reduction:
“Concerning individual foods and nutrients, consumption of fruit and vegetables… are most consistently associated with decreased risk of dementia. Higher fish consumption has been linked to lower memory decline among healthy participants in many studies …. Other foods and nutrients that have been associated with reduced risk of dementia or cognitive impairment are nuts, olive oil and coffee (Solfrizzi et al., 2017)….” [page 19, bold italics for coffee added]
The WHO Guidelines specifically recommend avoiding alcohol [page 23], so it’s interesting to see that the one beverage they cite as positive is coffee. They don’t mention whether the coffee should have cream or sugar or some totally artificial liquid unnatural additive like “soy or almond milk.” I won’t mention the meta-analysis reviews which don’t show much association with coffee and prevention of dementia, but those studies (easily found on PubMed) of pooled data tend to dilute findings, doncha think, like having a weak and percolated brew.
It’s still winter, and you can have your Venti Mocha on a ski slope, but why not use up those airline miles you’ve been saving to savor a local Hawaiian roaster where it might make your brain look better! Almost makes me want to get an early biomarker diagnosis (I’ve blogged about my dislike of the strategy of early diagnosis of dementia when you currently can’t do anything about it); maybe I could get a tax deduction for the trip as a medical expense. And it might be cheaper than a single dose of an anti-amyloid monoclonal antibody!