There is little known about the causes and cure of dementia despite the fact that the ailment has grown to be a leading cause of death affecting nearly a million people worldwide. It is for this reason that we find researchers invested in attempting to understand the ailment.
It is because of efforts like these that Brenda C.T. Kieboom, MD, Department of Epidemiology, Erasmus Medical Center, The Netherlands, and her team have been able to make a ground-breaking discovery in this domain. They have unveiled that both high and low levels of serum magnesium is associated with the risk of dementia. The identification of this U-shaped relationship is game changing to say the least, and has opened up numerous avenues for future research.
Overview
During their study, Dr. Keiboom analysed over 9500 individuals who were part of an ongoing research titled ‘Rotterdam Study‘. The participants were healthy and did not have any type of baseline all-cause dementia, including vascular dementia, Alzheimer’s disease and Parkinson’s disease.
However, when they were observed over an eight-year assessment, it was observed that individuals with high (0.90 mmol/L or more) and low (0.79 mmol/L or less) levels of magnesium had a 30% greater propensity of developing dementia.
Background of the research
Prior to research, this area showed a protective effect of magnesium on the learning ability of dementia inflicted rates. Whereas, until now, human-specific data in this regard was only limited to a few studies, which had conflicting results. These studies included 4 few small scale case-control studies and a randomized trial that indicated enhanced working memory and executive function in people with mild-cognitive impairment. The control-case studies included two studies that exhibited high serum magnesium levels in patients of Alzheimer’s disease. Whereas, the other two indicated low magnesium levels respectively.
The cause behind the conflicting results was thought to be varying diagnostic criteria i.e. NINCDS-ADRDA or DSM. It was therefore concluded that the relationship between dementia and serum magnesium is likely to be u-shaped as opposed to linear. This made it imperative to have a focused research on the effect of serum magnesium levels on dementia.
Methodology used
The study analysed 9569 participants that included 56.6% women with a mean age of 64.9 years. The study used the following methodology:
- The blood samples of the participants were collected and examined using an analyser from Roche Diagnostics at the Erasmus Medical Center.
- Then, the participants were followed over a period of 7.8 years to see if they had developed dementia.
- At the end of this duration, 823 individuals had developed dementia out of which 662 had Alzheimer’s disease.
- The study then compared the participants with low and highest levels of drum magnesium with those that had mid-range levels (0.84 – 0.85 mmol/L).
- Finally, the results of the study were adjusted for gender, age, qualification level, BMI, comorbidities, smoking status and alcohol consumption.
Findings
It was found that high and low levels of serum magnesium were strongly associated with the propensity of all-cause dementia. Here is a brief snapshot of the study’s findings:
- Among the sample 1,771 participants had low levels of serum magnesium, out of which 160 developed dementia. This accumulates to a rate of 10.2 per 1,000 person-years.
- 1,748 of the participants reported high magnesium levels. Out of these, 179 developed dementia, which adds up to a rate of 11.4 per 1,000 person-years.
- 1,387 participants of the study had medium range magnesium levels. Out of these, 102 developed dementia, which adds up to a rate of 7.8 per 1,000 person-years.
- The relationship between Alzheimer’s and serum magnesium was found to be similar to all-cause dementia, despite the fact that they did not reach statistically significant scores in the sensitivity analysis.
- Low levels of magnesium and electrolyte disturbances were acknowledged as a risk factor for dementia. It was also found that low levels of serum magnesium enhance the propensity of developing depression, migraine and epilepsy.
- The findings of the researchers are quite intriguing, however, they need to be replicated by additional researches.
- Moreover, to conclusively prove that high and low levels of magnesium does in fact cause dementia, future research needs to assess whether supplements can reduce the risk of dementia.
Limitations
The limitations of the study were as follows:
- The levels of magnesium were measured only once and therefore need not necessarily represent its level within the whole body.
- Since the levels of serum magnesium lied in the normal range, the research was not able to assess the impact of hyper or hypomagnesemia on the development and progression of dementia.
Implications
This research has opened multiple avenues for future research and development. A few crucial ones include:
- Dr. Keiboom stated that ‘the investigators were expecting to find a linear association and therefore they were surprised to find that even high magnesium levels were associated with the risk of dementia’. She explained that this finding had been observed previously in a case-control study. The biology behind it, however, was not fully understood. According to Dr. Keiboom, low levels of magnesium are of particular concern as far as the risk of dementia goes.
- She also stressed on the importance of the levels of serum magnesium in patients who are at-risk of hypomagnesemia. This is because magnesium levels are commonly not measured as part of routine clinical practice.
- She recommends such an examination for all those people who use diuretics and proton-pump inhibitors. Moreover, it is also advisable for individuals whose diet lacks in magnesium rich foods like green vegetables, whole grains and nuts
- It is important to note, however, that this study does not support a cause-effect relationship between the two factors. Such a relationship requires further researchers in the domain.
- These findings, however, have paved the way for advances in the area of dementia prevention and cure. Additionally, it has also laid the groundwork for the development of a diagnostic tool for the reliable detection of dementia.
This research is a breath of fresh air for all those suffering from the ailment or having a family history of dementia. The reason for this is that the signs of the disease are subtle and resemble natural ageing in many forms. Therefore, people often didn’t seek an early diagnosis or go for a dementia test. For such individuals, it is recommended that they make use of reliable detection apps such as Brain Test that are able to detect early signs of mild cognitive impairment. Also, with further research, we may also be able to assess an individual’s risk of dementia via a routine blood test.