•African-Americans experience more severe Vitamin D deficiency and magnesium deficiency that together may promote dementia.•Hispanic Americans experience more greater exposure to herbicides and ...pesticides that may promote cognitive impairment.•Both groups experience more air, water, and soil pollution including toxic metals and organic toxicants, consume less nuts and more sugary drinks, and experience more oral dysbiosis , all of which may contribute to developing dementia.
African-Americans and Hispanic Americans experience a higher incidence and prevalence of dementia than white Americans while also experiencing more environmental, metabolic and nutritional factors potentially promoting such disparities. Greater exposure to air, water and soil pollutants including toxic metals associated with neurodegeneration accrue to both minorities, as does worse dental care than whites exposing them to periodontitis raising dementia risk. Hispanic Americans experience greater occupational exposure to herbicides and pesticides develop more non-alcoholic fatty liver disease (NAFLD) predisposing to dementia. African-Americans have a greater likelihood of both Vitamin D deficiency and magnesium deficiency increasing neuroinflammation and dementia risk. Both have greater air pollution exposure, a known dementia risk. Nutritional changes including greater nut consumption and reduced sugar drink consumption, improved dental care, and reduced toxicant exposure may help reduce this higher risk of dementia among African Americans and Hispanic Americans.
•Finland has a high dementia rate related to environmental and geological factors.•Climate contributes to mold in domiciles capable of producing neurotoxic mycotoxins.•Cyanobacteria in Finnish waters ...contribute BMAA neurotoxins.•Presence of environmental methylmercury is a factor.•Low soil levels of selenium reduce glutathione and protection against neurotoxins.
Finland has the highest death rate from dementia in the world and its environmental features can be instructive in understanding hidden causes of dementia. Environmental factors there include: 1) a climate that is both very cold and humid resulting in housing frequently harboring molds that are capable of producing a neurotoxic mycotoxin 2) the Gulf of Finland as well as Finnish lakes harbor cyanobacteria that produce the neurotoxin, beta-N-methyl amino-L-alanine, known to cause dementia and related disorders 3) the aforementioned toxins can be potentiated by the presence of mercury and methyl mercury which can be found in Finnish waters 4) soil in Finland is naturally low in selenium and selenium deficiency may reduce the quantity and effectiveness of glutathione’s ability to protect against neurotoxins. A high rate of fatal dementia could be the consequence of these environmental factors. Studies that can support or disprove this hypothesis are suggested. Such environmental toxins are likely to promote Alzheimer’s disease elsewhere in the world where such a combination of neurotoxins may also occur.
In this commentary, we offer an overview of the several environmental and metabolic factors that have been identified as contributing to the development of Alzheimer's disease (AD). Many of these ...factors involve extracranial organ systems including immune system dysfunction accompanied by neuroinflammation (inflammaging), gastrointestinal dysbiosis, insulin resistance, and hepatic dysfunction. A variety of microbial factors including mouth flora, viruses, and fungi appear to play a significant role. There is a role for the colonic microbiome becoming dysbiotic and producing toxic metabolites. Declining hepatic function contributes diminished neuronal precursors and reduces toxin elimination. Environmental toxins especially metals play an important role in impairing the blood-brain barrier and acting synergistically with biotoxins and other toxic chemicals. Prevention and treatment of AD appears to require measuring several of these biomarkers and implementing corrective actions regarding such toxicants and correcting metabolic dysfunction at early or preclinical stages of this disorder.
•Alzheimer’s Disease is influenced by dysfunction in several extra-cranial organ systems.•Hepatic dysfunction includes impaired DHA synthesis and ammonia detoxification.•Gut dysbiosis impairs the ...blood brain barrier and reduces BDNF.•Insulin resistance and DHEA deficiency are key endocrine dysfunctions.•Immune dysfunction in aging includes impaired host defenses and increased inflammation.
The development of Alzheimer’s Disease (AD) likely involves dysfunction in more than one extra-cranial organ system. AD appears to depend on several functional organ impairments that develops frequently during aging: lack of normal hepatic synthesis, defective detoxification of ammonia, gut microbiome dysbiosis, the development of insulin resistance, diminished adrenal production of dehydroepiandrosterone, nutrient depletion, impaired immune processes with persistent chronic neuro-inflammation, and persistent infectious processes are important components of this system-wide disorder.
By reviewing these abnormalities in different organ systems, this review intends to suggest that clinical research into the prevention of dementia needs to take this interplay of organ system dysfunction into account. The design of therapeutic interventions needs to address dysfunction in more than one system at a time. We have singled out one aberrant signaling pathway, NF-kB, that seems common to several of the dysfunctional organ systems and suggest some potential interventions that may be effective when combined with others.
Clinical research may need to shift from single factor interventions to studies that include multiple simultaneous interventions that restore health in multiple impaired organ systems in the aging human in order to avert future epidemics of AD.
Environmentally Mediated Health Disparities Howarth, Marilyn V.; Eiser, Arnold R.
The American journal of medicine,
June 2023, 2023-06-00, 20230601, Letnik:
136, Številka:
6
Journal Article
Recenzirano
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We describe important settings where environmental exposure leads to disease disparities. Lead exposure in urban settings disproportionately impacts the urban Black poor. Native Americans have been ...forcibly relocated to areas of the West that have arsenic-contaminated groundwater or exposure to radionuclides near mines and nuclear development. Latino farm workers are disproportionately exposed to pesticides and herbicides. These chemicals are associated with cancer, neuropsychiatric disorders, renal failure, and respiratory disorders. The rural poor, both white and of color, are disproportionately impacted by hydraulic fracturing, exposing residents to volatile organic compounds such as toluene and benzene and heavy metals such as lead and arsenic. The urban and rural poor are both exposed to air pollution that significantly impact health. Short- and long-term ambient air pollution exposure has been associated with all-cause cardiovascular disease, stroke, blood pressure, and ischemic heart disease. Cancer due to air pollution has disproportionately impacted poor communities like “Cancer Alley” where numerous industrial sources are geographically clustered. Understanding local environmental hazards and available resources to address them can enhance the quality of medical care.
Calciphylaxis is an uncommon disorder that occurs predominantly in patients with end-stage renal disease and portends a high mortality (40%-80%). Studies have implicated a potential causal ...relationship to the prescribing of warfarin in patients on dialysis and the development of calciphylaxis syndrome. Because this is the era of pay-for-performance programs, adherence to certain practice guidelines will determine the quality measures of care and thus a proportion of reimbursement under the pay-for-performance programs. Here, Eiser stresses that for patient subsets with outlier characteristics such as those on dialysis with atrial fibrillation, beware of pay-for-performance programs that drive physicians to follow the predominant practice guideline. The unintended consequences of new payment methodologies require further study and exploration.
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