When asked to write an article about Alzheimer's disease it really made me think that this is a frightening topic for a lot of people as they age. I am hoping to dispel some of the fear, look at the facts, bust some of the myths and offer viable and doable means of prevention.
Alzheimer's disease is devastating to patients and absolutely heart wrenching to those who love and care for them. It is a tragic, neurodegenerative disorder that steals the wisdom, the memories and the essence of an individual. Alzheimer's disease has no cure and the treatments, although improving, are not very effective. Therefore doing everything we possibly can to prevent its development is paramount. There are so many myths around this disease, let's look at the facts.
Fact: Alzheimer's disease is not a normal aging process. It is an age related neurodegenerative disease.
Fact: The prevalence of Alzheimer's disease is only 1.6% in the 65 to 74 age group, but the prevalence increases as we age.
Fact: Normal memory lapses are unlikely to represent Alzheimer's disease.
Many of my patient's exhibit moments of memory lapse and become frightened that they may be "losing it". When we forget appointments, misplace items or forget something we were about to say it is important to know that this is very normal and happens to all of us. Alzheimer's disease is not forgetting where you placed your car keys; it is forgetting what the car keys are for. Studies show that fear of memory loss can actually hasten memory decline. So its important to relax. There are healthy aging practices that we can follow to prevent Alzheimer's disease and also help prevent the more typical mild age related memory decline. None of the research that I have encountered convinced me that declining cognitive function is the normal consequence of aging. I think we can prevent it as well as decrease the chances of Alzheimer's by doing some of the following practical and simple steps requiring action and contemplation. None call for special shoes, a note from your doctor, or a new haircut.
1. Follow an anti-inflammatory diet.
There is a radically new and exciting hypothesis about age related disease. Much of it may be the result of abnormal inflammation or abnormal activity that promotes inflammation. My work in cancer research years ago was specifically on the link between inflammation and bladder cancer. We were looking at a model to explain how inflammation leads to cancer. It appears that inflammation leads to many types of age related diseases. Curb inflammation and you can often curb disease. The structural changes that occur in Alzheimer's, specifically the plaques of protein outside the nerve cells and tangles of filament within the nerve cells seem to all be preceded by inflammation. Drugs that tackle inflammation like Ibuprofen seems to reduce the risk of developing this devastating neurodegenerative disease. But due to the potential for gastrointestinal issues, such as bleeding ulcers, taking daily Ibuprofen to prevent Alzheimer's is not really advocated unless there is a significant family history evident.
Therefore, consuming what we call an anti-inflammatory diet can be very beneficial. Dr. Andrew Weil, who is an expert on healthy aging, has devised a diet called The Anti-Inflammatory Diet. The aim of the diet is to consume a variety of fresh foods, to minimize your consumption of processed and fast foods, and to eat an abundance of fruit and vegetables.
2. Stress Reduction.
Cortisol, the main stress hormone released from the adrenal gland is known to be toxic to neurons in the area of the brain that is responsible for emotion and memory, specifically the hippocampus. Neutralizing and reducing stress in one's life with simple techniques can help to minimize age related deficits in mental function and possibly even decrease the risk of Alzheimer's disease.
The lesson here is simple: Try as much as you can to let the unavoidable everyday stresses roll off your shoulders. Deep breathing exercises, in through the nose and out through the mouth for four long breaths can significantly decrease your stress in any given situation. For more long term stress relief you can try Tai Chi, exercising, practice meditation, and yoga.
3. Physical activity.
Regular exercise is so critical for ongoing health and wellness. Doing regular cardiovascular and strength exercises decreases the risk of many age-related diseases by reducing stress and keeping your risk of cardiovascular disease down.
4. Selected Supplements.
Something in the body called oxidative stress has been studied for many years as one of the most significant causes of age related disease and age related cognitive decline. A number of oxidative stresses to our bodies can be counteracted by an anti-inflammatory diet and exercise as well as stress reduction. Some of these supplements have been talked about in the literature as potentially decreasing the risk of many age-related diseases, more specifically Alzheimer's. The first one of these supplements is Gingko Biloba. This is an extract of the leaves of the Gingko tree. It increases blood flow to the brain and is shown to slow the progression of dementia and early onset Alzheimer's. It is likely only effective in someone with impaired circulation to the brain. The second one is Acetyl-L-Carnitine (ALCAR). This is an amino acid derivative that is expensive and the studies on it are inconclusive. The third supplement is Phosphatidyl Serine (PS), which is a naturally occurring lipid that acts as a brain cell nutrient. It is thought to have a positive effect on memory and concentration and is known to be non-toxic. The actual effect of many of these supplements is somewhat controversial and they are probably not the entire answer to prevention.
5. Proper Rest, good sleep and meditation.
All of these will help to decrease the stresses in your life and allow your body to adequately repair itself decreasing the risk of age related cognitive decline.
6. Controlling cardiovascular risk factors.
High blood pressure and high cholesterol should be monitored by your doctor and controlled with either diet and exercise modification or with medications.
The more education you have (either formally or self-taught) the less likely you are to develop Alzheimer's or to experience the more normal mental decline that is associated with aging. The reason being that the more new things we learn, the more neuroconnections develop between nerve cells and the brain. Therefore you have what is called neuro redundancy, which in part means that more connections can be lost or damaged without apparent loss of function. Being mentally sharp means that not only can you remember where your car keys are but you can also keep some diseases at bay including Alzheimer's.
Studies have found that something as simple as playing bridge on a regular basis can decrease the risk of Alzheimer's. The two activities that appear to have the largest impact or are considered to be the greatest mental workouts are learning a new language or a new computer program. Adopt the habit of lifelong learning. Be careful not to say no to life itself and the things you love. It is the no that ages us.
No, I am not advocating that we all go out and start smoking. It is interesting though that Nicotine appears to be protective against Alzheimer's disease. The problem is that smoking is so bad for you given its general health effects on the cardiovascular system and brain that any benefits nicotine incurs from smoking are offset by the addictive nature and the far greater health risks. Researchers are currently searching for less toxic analogs of Nicotine that could be used for the treatment and prevention of Alzheimer's.
It is tough to know that there are challenges associated with growing older such as loss of mobility, compromised eyesight and hearing, loneliness and sometimes loss of memory. We should not only focus on preventing the development of these but must also focus on relaying strategies and tactics to deal with them effectively if they should develop. Denying aging will not help us cope, but embracing and appreciating aging, while at the same time providing proven strategies to decrease the risk of age related diseases will enable us to deal more effectively with the challenges of living longer.
I am a very strong proponent of doing all we can from a lifestyle perspective to prevent age related diseases and to help us to live happier, longer and better quality lives. I think as we embrace and appreciate aging and all the wisdom it brings we should keep all preventative knowledge at our disposal to combine the wisdom of aging with the biology of youth, which in turn will see more of us tap dancing into the triple digits with all our faculties intact.
For those of you interested in more information on Dr. Andrew Weil's "The Anti-inflammatory Diet" log on to Dr. Anderson's website at www.impowerage.com and click on the Health and Wellness Section.