Can Lower Body Mass Index Be an Early Sign for Alzheimer’s Disease?

Marc Gordon, MD

Obesity, a disease in itself, is a well known cause of other diseases. Midlife obesity, in particular, has been linked with an increased risk of late-life dementia and Alzheimer's disease. Interestingly, patients who have dementia due to Alzheimer's disease are actually more likely to be underweight.

The cause of this association has been unclear. It has been speculated that loss of body mass may be the result of dementia. This makes sense because dementia sufferers may simply be forgetting to eat. Or the inherent decrease in physical activity associated with dementia leads to loss of muscle mass. There is also the possibility that anti-Alzheimer’s medications has adverse effects on appetite.

However, according to a recent study published in Neurology, the authors were able to demonstrate a correlation between lower body mass index (BMI) and the presence of biomarkers suggestive of Alzheimer’s disease pathology on brain imaging and in cerebrospinal fluid. These patients had normal cognition or mild cognitive impairment (MCI).  Lower BMI in these subjects cannot be explained as a consequence of dementia since they do not have the disease. This leads researchers to suggest that there may be systemic changes in appetite or metabolism as an early manifestation of the disease process.  



 

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Headaches after Pediatric Traumatic Brain Injury

Noah Rosen, MD

More than half a million children in the United States sustain a traumatic brain injury (TBI) every year. In a recent study published by Pediatrics, researchers analyzed the prevalence of headaches three and 12 months after mild and moderate or severe TBI in children ages 5 to 17. Three months after a mild TBI, 43 percent of children reported headache, compared to 37 percent of children who had a moderate to severe TBI, and 26 percent of children in the control group. The risk of headache was highest in adolescents and in girls. The researchers concluded that the response to and recovery from TBI is different for children, adolescents and adults and that between boys and girls, there is a difference in symptoms and recovery from TBI.
 
This study is very important for several reasons. First of all, headaches in adolescents and teenagers are often ignored by parents and teachers until it has progressed to the point of disability. This study suggests early awareness and intervention. Secondly, headache disorders during this developmental period can have long term effects because teenagers can miss fundamental information in school that they will have difficulty catching up later. Lastly, undiagnosed post traumatic headache may increase risk for further damage if the teenager continues to play sports without addressing the issue.
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