Fighting Alzheimer's Disease Before It Strikes
What do you envision when you think about your later years? Do you picture yourself surrounded by friends and family, with enough money to maintain a comfortable lifestyle and active social life?
What about your health? You probably count on being spry enough to go a round on the golf course or keep up with your grandchildren.
What you probably don't envision is becoming bedridden, unable to recognize your own spouse or children, or to enjoy all your favorite hobbies and interests. You probably don't envision having Alzheimer's disease (AD).
But for more than four million Americans—a number the Alzheimer's Association says could increase to more than 14 million in a few decades—AD is a devastating part of everyday life.
Although its cause is unknown, researchers have targeted several factors in AD development, including neurochemical deficiencies, vascular changes, environmental exposures, and infections.
Symptoms include memory loss, sleep pattern changes, personality changes, incontinence, functional impairment and cognitive impairments. A clinical diagnosis is typically given based on history, physical examination, and pattern of symptom progression.
Rays of Hope
Unfortunately, a cure has eluded researchers thus far, although there has been some progress toward developing drugs to treat the symptoms of AD. But with no clear cause and no cure on the horizon, the best approach may be prevention.
From eating a healthful diet to keeping your mind and body active, there are things you can do today that may help decrease your chances of developing AD tomorrow.
In a study presented at the American Academy of Neurology, researchers found that people who kept active physically or mentally—through hobbies such as gardening, exercise, reading, painting, or playing board games—were less likely to develop AD later in life than those who engaged in "passive" activities, like watching television.
"People who were less active were more than three times more likely to have Alzheimer's disease as compared to those who were more active," reports Robert Friedland, MD, the study's primary author and a neurologist at Case Western Reserve University School of Medicine and University Hospitals of Cleveland.
Gene Cohen, MD, PhD, Director of the Center on Aging, Health, and the Humanities at George Washington University, says that while there's currently no proof that it is possible to completely prevent AD, research shows that certain changes in behavior can help build up the brain to counteract the effects of aging on the brain and possibly delay the onset of AD and/or minimize its effects.
"Those [people] who have challenged their brains more than others have built up more reserves, and that may actually delay the onset of Alzheimer's," reports Dr. Cohen, author of The Creative Age: Awakening Human Potential in the Second Half of Life .
The significance of such a delay should not be underestimated. A five-year delay in the onset of AD across the entire population would "cut the incidence of the disease in half," reports Dr. Cohen. This would reduce the resources spent on medical care and free family members who would otherwise be affected by the negative emotional impact of AD.
However, because this was only an observational study, it does not show cause and effect. In other words, it does not actually prove that changing behavior will prevent Alzheimer’s disease. It is also possible that people who are more likely to develop Alzheimer’s disease have other characteristics that make them less active earlier in life.
The Mind-Body Connection
Rather than recommending AD-specific techniques, experts suggest adopting a lifestyle that increases general brain health and vitality. By creating a healthful environment, you'll be able to fight off a variety of age-related mental conditions—not just AD—and possibly increase your overall immunity to disease as well.
Dr. Cohen says the foundation for a healthy brain is in stimulation. It's true that "you lose a certain number of cells with aging," he says, but by challenging your brain, you might be able to compensate for the brain cell loss of Alzheimer's disease by building up other areas of the brain.
By increasing brain activity, you stimulate neurons (a type of cell that receives and sends messages between the brain and body) to build more branches, called dendrites, making it easier for neurons to communicate with each other.
"In Alzheimer's disease, you're losing cells and you're losing connections and synapses," says Dr. Cohen.
Stay Mentally Active
While you don't need to sign up for classes in differential equations and biophysics, experts do recommend making an effort to expand your mental horizons. Something as simple as doing crosswords, putting together a jigsaw puzzle, learning a new language, or taking up photography can get your brain moving in new directions.
Dr. Cohen encourages balancing activities between those you do with other people and those you can pursue by yourself, as well as trying both "high mobility and low mobility" choices. This variety ensures that you'll have an assortment of options, and that you won't need to curtail your activity level in the future because of illness or loss of a partner.
Physical Health Is Important, Too
While intellectual stimulation is important, don't overlook diet and exercise, says Maria Sulindro, MD, a physical medicine and rehabilitation specialist who is also board-certified in anti-aging medicine.
Dr. Sulindro recommends complementing mental activity with a balanced, low-fat diet and a regular program of physical activity, including strength-training. She suggests 2-2½ hours of exercise per week, of which approximately one-third is strength-training.
"By exercising, you improve muscle condition and hormonal condition in the brain," she says. And while "you can't say that diet can prevent Alzheimer's," a good dietary plan can help lead to overall good health—and that includes what happens above your neck.
It's Never Too Late to Start
What if you're entering the high-risk age range for AD—is it too late to make a change for the better? While Dr. Friedland's study suggests that people would benefit by increasing their activity level as early as age 20, he says it's never too late to get started. Dr. Cohen agrees, stating that the brain's ability to build new dendritic trees continues "without regard to age."
The important thing is to implement changes as soon as possible. Whatever your starting point, you can make improvements that will affect your physical and mental well-being. By starting now, you'll be positioned to make the most of whatever level you're at.
Alzheimer Society of Canada
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Evans, DA, Funkenstein, HH, Albert, MS, et al. Prevalence of Alzheimer's disease in a community population of older persons. Higher than previously reported. JAMA. 1989; 262:2551.
Hebert, LE, Scherr, PA, Bienias, JL, et al. Alzheimer disease in the US population: prevalence estimates using the 2000 census. Arch Neurol. 2003; 60:1119.
Last reviewed March 2008 by Marcin Chwistek, MD
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