| Is Alzheimer’s Your Destiny? Alzheimer's disease affects about one in 10 people over age 65 and nearly half of people over age 85. Unlike the other top 10 diseases, there is no cure for Alzheimer‘s. The best we have are a few drugs that help manage symptoms, palliative care as the disease progresses and an accumulating body of research that points to lifestyle as a possible way of preventing Alzheimer’s if begun early enough. Alzheimer's is becoming one of the biggest medical and social challenges we will face. National cost for managing Alzheimer‘s is estimated at about $259 billion in 2017. With an aging population, the cost is estimated to rise by a factor of five to well over a trillion dollars a year by 2050. Alzheimer's is already a leading cause of disability, the sixth-leading cause of death in the United States and the fifth-leading cause of death among those ages 65 and older. While cancer and Alzheimer's result in similar numbers of deaths, ten times more is still spent on cancer research. Increasing funding for Alzheimer’s research makes sense. Before this can happen, public perception of where research funds should best be spent will need to change. For additional perspective on this issue view Samuel Cohen‘s Ted Talk, “Alzheimer’s Is Not Normal Aging — And We Can Cure It.” For reason not fully understood, the prevalence of Alzheimer’s varies by gender and ethnic origin. Almost two-thirds of Americans with Alzheimer's are women. Among African- Americans and Hispanics, Alzheimer's is often twice as prevalent. Over 5 million Americans of all ages have Alzheimer's disease. Regardless of gender or race, Alzheimer's takes an emotional, financial and physical toll on caregivers that is far greater than experienced when caring for patients without dementia. Complicating matters, many caregivers fall into the "sandwich generation" and assist both aging parents and children. Genetics does play a role in Alzheimer’s. Acquiring the APOE4 gene from one parent doubles the risk of Alzheimer’s. Acquiring the same gene from both parents increases the risk by 15 times. Fortunately, genetics is not destiny. There is accumulating research pointing to lifestyle as the key for preventing Alzheimer’s in spite of genetics. However, waiting until symptoms appear to make lifestyle changes is unlikely to reverse the effects of genetics. A common thread of most Alzheimer’s research is an expectation that lifestyle can be a significant preventative measure. In summary, here is what researchers suggest as proactive ways for reducing the risk of Alzheimer’s: • Get adequate deep sleep. Deep sleep is when the brain does its house cleaning. Removing the constantly accumulating waste keeps the brain healthy. • To the extent possible, seek treatments to minimize poor cardiovascular health, high blood pressure, diabetes, obesity, smoking, and high cholesterol. These conditions all have a strong positive correlation with the likelihood of developing Alzheimer’s. • Aerobic Exercise has been shown to decrease amyloid beta, a signature indication of Alzheimer’s. However, as a cure for Alzheimer’s exercise falls short of the mark. • Diets similar to the Mediterranean diet are usually advised. In “Power Foods for the Brain”, Dr. Neal Barnard provides studies that recommend a whole food vegan diet rich in colorful vegetables and fruits. He also recommends avoiding excess copper and iron. The problem is that by the time symptoms appear, these measures are unlikely to stop progression of the disease. Dr. Barnard also offers research that explains why brisk walking can also be preventative. In a few studies, ketogenic diets (high-fat, adequate-protein, low- carbohydrate ) have been shown to provided small temporary improvements. Michele Sullivan provides more about these possibilities in, “Fueling the Alzheimer’s Brain with Fat.” • Some researchers believe fasting is beneficial because it creates stresses that force the brain to build alternate neural pathways. The idea is analogous to stressing muscles to increase their strength. Mark Mattson provides insights into the possibility of using fasting as a preventative measure in, “Why fasting bolsters brain power.” Interestingly, fasting offers many more health benefits. What’s to lose if he’s wrong? Perhaps only a few inches around the waist? • Cognitive reserves appear to delay the symptoms of Alzheimer’s. The idea is that additional education or other cognitive activities build redundant neural connections that provide reserve mental capacity as Alzheimer’s progresses. Unfortunately, these activities appear to only be preventative - not a cure. Once symptoms are diagnosed, engaging in mentally stimulating activities like learning a second language, reading, meeting new people, or learning a new subject offer little help. Lisa Genova explains the possibilities and limitations in, “What you can do to prevent Alzheimer's.” Some researchers believe Alzheimer’s is related to insulin deficiency based an observation that people overweight or having Type 2 diabetes have a much higher likelihood for developing Alzheimer’s. Because of this connection, in research, Alzheimer’s is sometimes referred to as Type 3 diabetes. In a wide range of studies, lifestyle (esp. diet and exercise) is implicated as the likely cause of Alzheimer’s although the most devastating symptoms may take 40 or more years to manifest. For more about this promising research, follow along as Dr. Bu discusses the link between diabetes and Alzheimer's. A strategy for minimizing your risk of Alzheimer’s is also a strategy for having the best quality of life in your retirement years. While a cure for Alzheimer’s is what we want, the best we have for now is a strategy for minimizing our risk based on helping our body help us. To make it work requires attention to four needs: sleep, diet, exercise and stress. A daily walk is definitely a step in the right direction. If not into a daily exercise program, then let’s get started Saturday morning. I look forward to having you join me. Nancy Neighbors, MD Huntsville, Alabama To Learn More about Alzheimer’s browse the website www.alz.org. |