In this video, Dr. David Perlmutter presents a recent Neurology study titled “Systemic Inflammation During Midlife and Cognitive Change Over 20 Years,” which followed more than 12,000 adults (average age 57) for two decades. Participants had blood tests measuring an inflammation composite (fibrinogen, white‑blood‑cell count, von Willebrand factor, factor VIII) and, at a later visit, C‑reactive protein (CRP). Cognitive performance—memory, executive function, language—was assessed three times over 20 years. The study found that individuals in the highest quartile of midlife inflammation, especially those with elevated CRP, experienced significantly greater cognitive decline later in life. Dr. Perlmutter uses these findings to argue that waiting for overt memory problems is too late; the pathogenic process begins decades earlier, potentially even in prenatal development. He stresses that lifestyle choices, maternal diet, antibiotic use, and delivery method may set the stage for future brain health. The video concludes with a call to start an Alzheimer’s prevention program now, rather than waiting for symptoms to appear.
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Hey everybody, Dr. David Perlmutter here. Got an interesting study I want to present to you today, and I'm going to do it in the context of some events that have occurred for me in the past couple of weeks. We've been filming experts from around the country in Alzheimer's disease for an upcoming documentary that we're going to be making available to everybody. And one of the interesting themes that made itself really very evident while we were filming these experts is the notion that it's not reasonable to wait for people to suddenly become cognitively impaired to start doing something. And in fact, I've presented information to everyone before with respect to various studies that have demonstrated that inflammation early on in life is the harbinger to troubles with the brain decades later. So we now recognize that this process of inflammation that can be occurring in our 20s, 30s, and 40s may well set the stage for Alzheimer's when we are older, a disease for which there is no treatment. I have presented in blog form interesting data in the past that correlates levels of inflammation with memory dysfunction later on, 20 to 30 years later, as well as shrinkage of the brain. And now there's a very new interesting study that we're going to look at in just a moment that relates earlier life inflammation to actually risk of cognitive decline. Let's have a look. The study is called Systemic Inflammation During Midlife and Cognitive Change Over 20 Years, and this was recently published in the journal Neurology. Now, the study looked at over 12,000 participants whose average age was 57, and again, it looks like about half of them were women. And at their first visit, and again, this was many years ago, they were given a blood test that determined their inflammation composite score. A number of factors were looked at, including fibrinogen, white blood cell count, von Willebrand factor, and factor VIII, and on their second visit, perhaps an inflammation marker that you might be more familiar with called C-reactive protein. Then these individuals underwent an assessment of their cognitive function 3 times over the ensuing 20 years. This looked at things like memory, executive function, and language, and then they ranked these individuals with respect to where they landed on the inflammation composite scale, the lowest quartile versus the highest quartile, and plotted that against cognitive decline. And what they found was really quite interesting, that those 20 years before who had the highest level of inflammation had the greatest degree of cognitive decline. So again, this sets the stage for our understanding That, you know, we can't really wait until suddenly we're beginning to fail cognitively. This shows us that issues, in this case 20 years prior, are associated with cognitive decline. When looking at the C-reactive protein, again, that's a marker that many of you may be familiar with. It's certainly a blood test you can get even today at your doctor's office, that this relationship was even more profound. That having an elevated C-reactive protein 20 years prior is associated with a pretty darn significant increased risk for cognitive decline. The authors stated that the current study provides support for an association between midlife systemic inflammation and subsequent cognitive decline, and in so— in doing so provides additional evidence for an early pathogenic role of systemic inflammation in late-life neurocognitive impairment. So this is really very important information, isn't it? It's telling us that, again, we can't wait until you— a person suddenly becomes cognitively impaired, begins to have difficulties with memory and executive function and things like that to begin to act, that really the stage is already beginning to be set earlier in life. And as this study would report, you know, this is 20 to 30 years prior to— well, this study, 20 years prior to the onset of what we call clinical manifestations. Those are the observed cognitive issues. But the question then becomes, when should we be really paying attention to those important lifestyle choices that have a bearing on future brain function? And I would submit it's not in our 20s and 30s. It isn't in our teens. It's actually not even in our adolescence or childhood, but may very well be occurring during prenatal times when mother's dietary choices, for example, usage of things like antibiotics, and even method of delivery may have a bearing on the future health of that child and future adult. So this is interesting information. Thanks for watching. I'm Dr. David Perlmutter. Bye for now.
