Improving glycemic control via heat therapy in older adults at risk for Alzheimer's disease (FIGHT-AD): a pilot study

Impaired glycemic control increases the risk of type 2 diabetes (T2D) and Alzheimer's disease (AD). Heat therapy (HT), via hot water immersion (HWI), has shown promise in improving shared mechanisms implicated in both T2D and AD, like blood glucose regulation, insulin sensitivity, and inflammation. The potential for HT to improve brain health in individuals at risk for AD has not been examined. This pilot study aimed to assess the feasibility and adherence of using HT in cognitively healthy older individuals at risk for AD due to existing metabolic risk factors. Participants underwent 4 wk of HT (three sessions/week) via HWI, alongside cognitive screening, self-reported sleep characterization, glucose tolerance tests, and MRI scans pre- and postintervention. A total of 18 participants (9 males, 9 females; mean age: 71.1 ± 3.9 yr), demonstrating metabolic risk, completed the intervention. Participant adherence for the study was 96% (8 missed sessions out of 216 total sessions), with one study-related mild adverse event (mild dizziness/nausea). Overall, the research participants responded to a postintervention survey saying they enjoyed participating in the study and it was not a burden on their schedules. Secondary outcomes of the HT intervention demonstrated significant changes in mean arterial pressure, diastolic blood pressure, and cerebral blood flow (P < 0.05), with a trend toward improved body mass index (P = 0.06). Future studies, including longer durations and a thermoneutral control group, are needed to fully understand heat therapy's impact on glucose homeostasis and the potential to improve brain health.NEW & NOTEWORTHY Our pilot study demonstrated promising results for heat therapy (HT) via hot water immersion in older adults at risk for Alzheimer's disease due to metabolic factors. Despite a relatively short intervention, significant improvements in mean arterial pressure, diastolic blood pressure, and cerebral blood flow postintervention were observed. High participant adherence, overall satisfaction, and minimal adverse events suggest HT's feasibility. These findings highlight HT's potential as an effective alternative intervention for cardiometabolic dysfunction in at-risk populations.

Changes in Alzheimer's disease blood biomarkers in kidney failure before and after kidney transplant

INTRODUCTION

Alzheimer's disease (AD) blood biomarkers show promise for clinical diagnosis but their reliability in chronic kidney disease (CKD) is debated. This study investigates the impact of kidney transplant (KT) on AD biomarkers in CKD.

METHODS

We assessed AD biomarkers in 46 CKD patients pre-KT, at 12 weeks and 12 months post-KT, with baseline measures from 13 non-CKD controls. Using linear mixed models, we examined associations with participant groups, estimated glomerular filtration rate (eGFR) and cognition.

RESULTS

CKD patients showed elevated levels of neurofilament light (117 ± 72 vs. 11 ± 5 pg/mL), phosphorylated tau 181 (75 ± 42 vs. 13 ± 8 pg/mL), glial fibrillary acidic protein (193 ± 127 vs. 94 ± 39 pg/mL), amyloid β 42 (17 ± 5 vs. 5 ± 1 pg/mL), and amyloid β 40 (259 ± 96 vs. 72 ± 17 pg/mL) compared to controls. Post-KT, biomarker levels approached normal with improved eGFR, paralleled by enhanced cognitive function.

DISCUSSION

AD blood biomarker elevations in CKD are reversible with improved kidney function through KT.

Highlights

AD biomarker levels are extremely high in severe CKD.AD biomarker levels are higher in patients with kidney failure on dialysis when compared to CKD patients not on dialysis.These elevations in AD biomarker levels in kidney failure are reversable and decrease dramatically after kidney transplantation.The change in biomarker levels after transplantation align with changes in kidney function.The change in biomarker levels after transplantation align with changes in cognitive function.