What You Can Do To Prevent Alzheimer’s Disease

My mother's symptoms were very subtle at first – the occasional retelling of a story or the inability to remember the name of a common object. All things that could be chalked up to fatigue or not remembering who had heard the story the first time.

After a while, though, it became clear that it was more than an occasional memory lapse and as a physician and a daughter, I had to face the fact that my mother had Alzheimer’s disease.

Knowing the journey ahead for both my mother and my siblings was both sad and daunting.

Mom was started on the usual medications that help to stall the progress of the tangles that would eventually replace her normal brain. My siblings and I try to provide emotional support and ensure she's safe as her memory loss progresses.

As I look into her eyes, which occasionally still have the twinkle that spoke of a sparkling wit, I can’t help but wonder if I'm looking into the eyes of my own fate.

Alzheimer’s disease affects 4 million people in the US and is the leading cause of institutionalization. There are 360,000 new cases diagnosed each year. Luckily, less than 1% of cases are hereditary and are associated with early onset dementia (before age 60).

As my mother did not have symptoms until she was in her 70s and we have no other family members with this diagnosis, I feel that I have a chance to avoid this fate and like most people, would like to lessen my risk.

Risk factors

Alzheimer’s has been associated with several known risk factors, the greatest of which is age. The risk of developing dementia doubles every five years after the age of 65. It's estimated that 20 to 30% of people at age 85 have Alzheimer’s disease. Or, to put it more optimistically: 70 to 80% of them don’t. How do they do that?

Other risk factors for the development of Alzheimer’s disease have been identified. While none of them is a direct cause, the association can be strong and if a person has more than one, they can increase the risk.

Some of them, like age, cannot be changed. It's known that women are affected at an increased rate, as are some ethnic minorities such as African Americans and Hispanics. We also know that patients who have pre-existing brain diseases such as Down’s syndrome or Parkinson’s disease have an increased risk of developing Alzheimer’s. These risk factors can't be modified, but there are several others that can be addressed with lifestyle changes.

Researchers at UC San Francisco have identified seven modifiable risk factors that seem to be highly associated with the development of Alzheimer’s disease. The study was published online in Lancet Neurology.

Here are the risk factors that they identified:

  1. Sedentary Lifestyle
  2. Depression
  3. Low Educational Level
  4. Hypertension
  5. Smoking
  6. Diabetes
  7. Obesity

In addition, other data suggests that greater than 13 alcoholic drinks per week and head trauma (especially previous concussions) have been associated with an increased risk.

The good news is that most of these risk factors can be addressed with simple lifestyle modifications.

Here are 9 ways to prevent Alzheimer's disease: 

1. MOVE! Get off the couch and participate in aerobic activities. The current guidelines suggest that adults should participate in at least 150 minutes/week of moderate activity or 75 minutes/week of vigorous activity.

2. Stop smoking.

3. Be treated for depression, hypertension and diabetes.

4. Maintain a normal body weight.

5. Moderate alcohol intake.

6. Engage in new and stimulating activities – learn a new language, play chess, do cross-word puzzles.

There has been no evidence that products sold for this specific purpose will improve your memory. Any challenging activity will help to build your brain reserves.

7. Stay socially engaged with those around you. Volunteer if you no longer work. Be involved in your community. Get a pet.

8. Eat a Mediterranean diet. Not only has this been associated with improved brain health, but it will help you to lose weight and improve your heart health which is directly associated with your brain health.

9. Wear a helmet when participating in activities that are associated with the likelihood of head trauma. Make your kids wear one too! Wear your seatbelt consistently to protect you when drive. For older folks who are frail, make sure your environment is safe and will protect you from falls.

There are some things that have been tried but do NOT work! 

Anti-inflammatory medications. It was thought that the problems in the brain may be from inflammation and perhaps taking medications would lessen the effect. There has been no data that suggests it works and as with all medications, there are some potential side effects. Take them if you need them for other problems, but not to protect your brain.

Statins. While lowering your cholesterol has benefits for your heart, treating people with statins for Alzheimer’s has not been shown to work.

Estrogens. Again the data suggests that there is no benefit as far as Alzheimer’s prevention. There may be other reasons that you and your doctor decide it’s right for you, but the current data suggests it won’t protect your brain.

There is still a lot that we don’t know about why people get Alzheimer’s disease or how to prevent it. All we can do is try to live healthy and hope that one day we will be able to better treat it.

For now, I’m going to eat a tomato with olive oil on it before I go for a run while learning to speak Spanish!

Ciao!

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