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Living with Dementia

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Alzheimer’s Disease: Risk Factors and What To Do About Them?

By Sally J. Feltner, Ph.D., RDN

The pathogenesis of Alzheimer’s Disease (AD) is very complicated. it is important to examine its etiology and to look for solutions until research can hopefully offer a cure or at least management of the disease. So far this has not happened, so a new approach is presented here. Most of the information comes from a provocative article from the December 2018 issue of Scientific American, titled Alzheimer’s Under Attack: Lifestyle Plans That Improve Brain Health.

Risk Factors Related to Cognitive Decline and AD

Poor diet
Alcohol abuse
Lack of exercise
Head trauma
Small vessel disease
Poor sleep
High blood pressure
High cholesterol
ApoE4 gene

A common myth is that AD is a normal consequence of aging and that nothing much can be done to avoid it. At this point, there are few to none effective or safe drugs for treatment. In addition, lifestyle habit changes do not often come naturally to an aging population. Often we meet the challenges of any chronic disease after symptoms begin to appear. Prevention is more effective against cognitive decline and early Alzheimer symptoms rather than after symptoms become severe. In this state, damage is beginning to show but still may be in the normal range in many cognitive tests.

What Lifestyle Changes Should be Made to Prevent AD?

Much of the research on lifestyle interventions is primarily the result of hundreds of anecdotal stories of people afflicted with some degree of cognitive decline. From the available research, the lifestyle habits for a healthy brain were consolidated into the following conclusions:

  • A whole food plant-based diet rich in fruits, vegetables, beans, whole grains and healthy fats are what the brain needs to have for optimum health.
  • Physical exercise increases both the number of brain cells (neurons) and connections between them (synapses).
  • Chronic stress puts the brain in a highly inflammatory state. This can cause damage and impairment of its capacity to clean and clear it from harmful waste products. In the case of AD, this may refer to the clumping of harmful amyloid plaques and tangles of tau proteins.
  • The process of enough restorative sleep is necessary for cognitive and overall health. During this, the brain can apply its natural cleaning capacities to prevent the back up of housecleaning duties.
  • The brain thrives on higher education and performing complex cognitive activities even later in life.
  • Social support and meaningful associations with the community helps an aging brain to maintain its cognition and functional activities.

Richard Issacson, founder and director of the Alzheimer’s Prevention Clinic at Weill Cornell Medical Center says:

“We’re trying to lay the groundwork for Alzheimer’s prevention and figure out what tools we should be using and what works best.”

  • What do we usually do?
    Lifestyle changes are not easy to follow so in response, Americans attempt to improve their health and make up for lost time by doing the following:
  • We join gyms we hardly ever go to.
  • We fall for any promise of “detoxification.” and “cleansing” schemes by consuming weird concoctions of purported nutrients to rid our bodies of unknown toxins.
  • We buy the latest “superfoods” promised by the food industry to prevent cancer, heart disease, brain health and overall well being.
  • These are obviously ineffective in maintaining our health and certainly not preventive actions.

What are the studies that support diet and AD prevention?

  • The Cardiovascular Health Study revealed that obesity in midlife increased AD dementia by 40%.
  • Columbia University researchers concluded that high insulin levels in elderly people could account for 39% of AD cases.
  • Plant-based diets consistently showed up as heart, kidney and brain protective; not a single study showed any benefits of eating meat.
  • Another study found that a Mediterranean diet reduced risks of mild cognitive Impairment (MCI) by 28% and those who did develop MCI had a 29% lower chance of progressing to AD.
  • The Framingham Longitudinal Study found that daily brisk walks resulted in a 40% lower risk of developing AD later in life.
  • Washington University research showed that sleep-deprived individuals had more amyloid plaques in their brains.
  • Rush University tested the DASH diet, Mediterranean Diet and the MIND diet. All three reduced AD risk but that even moderate adherence to the MIND diet improved brain health.
  • In a 2017 study at Columbia University, participants who ate a plant-based diet had a lower risk of cognitive decline over six years compared to those who ate a Standard American Diet.

The Blue Zone participants from Loma Linda and their lower rate of AD (5%) do not eat much meat and follow a plant-based diet as most Blue Zone residents do. This was in comparison to another adjacent community of San Bernadino, CA.

  • Conclusions
  • Any new approach is likely to be met with skepticism, especially from the medical establishment. Nutrition therapy in general is met with doubt. A clinical trial would be ideal, but almost impossible to conduct. It took at least 100 years before physicians began to believe the germ theory of disease. Dr. Ignaz Semmelweis recognized infectious disease as a factor in the high rate of women dying during childbirth in the 1800’s. He suggested that physicians wash their hands to prevent this occurrence which immediately reduced the death rate. The response from his colleagues ? — Their constant rejection of him sent him to a mental hospital where died ironically from an infection.
  • Healthy lifestyle factors appear to be successful practices in all five of the Blue Zones. Their disease rates are some of the lowest in the world as well as their longevity.  What else have we got to lose?

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