One of the most dreaded neurocognitive disorders was unpacked in Amsterdam this week at the annual Alzheimer’s Association international research conference. Close to 6 million Americans have that form of dementia and the number keeps growing. Another 11 million people are unpaid caregivers for Alzheimer’s and other dementias, which in the U.S. will cost about $345 billion this year alone.

Here are four findings that may surprise you, fresh from the conference newsroom:

Volunteering can lower risk of developing Alzheimer’s

Folks who volunteer have better memory and executive function. Research from University of California Davis says voluntarism is associated with better baseline scores for executive function and verbal episodic memory, even after adjusting for age, sex, education, income and other factors. Volunteering more often — several times a week — is linked to the highest executive function scores.

“Volunteering may be important for better cognition in late life and could serve as a simple intervention in all older adults to protect against risk for Alzheimer’s disease and associated dementias,” Yi Lor, epidemiology doctoral student at UC-Davis, said in the study release. “Our next steps are to examine whether volunteering is protective against cognitive impairment and how physical and mental health may impact this relationship.”

Last year, researchers from the University of Colorado Denver said working and volunteering both benefit older adults and buffer risk of cognitive decline. 

“Not every job is created equal,” said Ronica Rooks, professor of health and behavioral sciences at the University of Colorado Denver. “Those that are people-oriented or service-oriented provide that connectivity with people and goal-setting that are (cognitively) more beneficial. Manual labor would be less likely to give people that beneficial connectivity.”

Those researchers said volunteering may be more brain-protective than work because it’s mentally and emotionally rewarding or people wouldn’t do it. Not all jobs are.

Alzheimer’s diagnosis may soon be a finger prick away

Right now the diagnostic tests are expensive specialized imaging or examination of spinal fluid.

The simple finger prick blood test — similar to how diabetics check their blood sugar — could be a game changer, available at home or in a doctor’s office. The association said blood tests are already being used in drug trials to examine their effectiveness. And they could prove especially valuable by simplifying diagnosis so that people with early Alzheimer’s disease can receive treatment or participate in clinical studies.

Diagnosis for most is typically a doctor’s call, based on a series of factors like behavior and memory tests. Researchers in Sweden working on blood tests for diagnosis say theirs are 85% accurate, compared to a study at 17 Swedish primary care centers that showed doctors got it right about 55% of the time.

“... It is currently very difficult for primary care doctors to identify Alzheimer’s disease, even among patients with cognitive impairment,” said Dr. Sebastian Palmqvist of the Clinical Memory Research Unit at Lund University in Sweden. “This too often leads to diagnostic uncertainty and inappropriate treatment. Blood tests for Alzheimer’s disease have great potential for improving diagnostic accuracy and proper treatment.”

There are other blood tests in development, as well. Earlier this year, Wasatch BioLabs in Utah — which started as a collaboration of researchers at Brigham Young University and the University of Utah — said its blood test for Alzheimer’s based on detecting neuronal cell death is nearly ready for market.

Strong link between chronic constipation and dementia

Having bowel movements every three days or less often could worsen cognition. Research released at the conference found a link between healthy guts and healthy brains — as well as the reverse.

A big study is ongoing, but the association recommends people who are frequently constipated talk to their doctor about whether ingesting more dietary fiber and water will help. “Eating well and taking care of your gut may be a pathway to reduce risk of dementia,” said Heather M. Snyder, association vice president of medical and scientific relations.

Just over 1 in 6 people worldwide reportedly deal with constipation, the number higher among older adults. 

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Research from Harvard Medical School, Brigham and Women’s Hospital and University of Massachusetts Amherst found constipated individuals had “significantly worse” cognition, equal to at least three of years cognitive aging, compared to those with daily bowel movements. There was also a small increased risk of cognitive decline in those who have three or more bowel movements daily.

Separately, researchers at the University of Texas Health San Antonio in mouse models found links between beta-amyloid buildup in the brain and levels of certain microbes in the digestive tract. High levels of amyloid and tau tangles — thought to be key players in Alzheimer’s — were linked to lower levels of gut bacteria Butyricicoccus and Ruminococcus, which might be neuroprotective, and higher levels of Cytophaga and Alistipes.

Gene editing may lower genetic risk, reduce brain plaque

The technology, commonly called CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats), “is emerging as one of the most powerful tools in the search for new drugs,” per a conference news release that said it could hasten identification of drug targets.

In an Alzheimer’s mouse model, University of California San Diego researchers used the technology to reduce the amyloid brain plaques and related inflammation in ways researcher Brent Aulston says are likely “safe and efficacious” as potential treatment.

CRISPR also has potential to alter an apolipoprotein gene, APOE-e4, that creates significant risk for Alzheimer’s. One copy boosts dementia risk two- to threefold; two copies eight- to 12-fold.

Researchers at Duke University’s Center for Advanced Genomic Technologies have devised a gene-editing process that “robustly” decreases levels of APOE-e4 without changing APOE variants believed to be harmless or protective.

“The findings are incredibly exciting,” Boris Kantor, associate professor of neurobiology and a faculty member at the center, said in a release. “They provide proof of concept evidence supporting our approach with a high-potential new strategy to treat and possibly even prevent Alzheimer’s disease.”