Discuss Ways of Preventing Alzheimer’s Disease .
Ways of Preventing Alzheimer’s Essay
The scientific understanding of dementia has only recently shifted from that of a late-life disease to that of a lifelong process which is affected by factors throughout life.
A recent analysis found that as much as half of risk for Alzheimer’s disease is due to potentially modifiable factors (Barnes & Yaffe 2011). The effect of these factors can be considerably reduced, either by making changes in lifestyle, or by making sure that disorders such as depression and diabetes do not go undetected and untreated.Ways of Preventing Alzheimer’s Essay
That dementia is, in part, preventable is an important public health message (Barnett et al. 2013). Here we review the seven key modifiable risk factors which can help prevent Alzheimer’s throughout life
1. Detect and treat depression
While we don’t yet know how to prevent depression, we do know that many people with depression do not get adequate treatment, and that untreated depression can significantly increase risk for Alzheimer’s disease.The links between depression and dementia are complex. Many cognitive functions such as attention, memory and planning can be affected in depression (Porter et al. 2003), and in older patients, it can be unclear whether a cognitive problem is a symptom of depression, dementia, or both. It is thought that untreated depression can significantly increase risk for Alzheimer’s disease – for example the MIRAGE study found a significant association between depression and Alzheimer’s disease (Green et al. 2003).Ways of Preventing Alzheimer’s Essay
2. Increase exercise/physical activity
We all know that exercise and physical activity supports a healthy heart and increasingly it is recognised as crucial too for healthy brain function, including cognitive function, throughout life. There is also emerging evidence that exercise can improve cognition in people who already have cognitive impairment. For example, exercise has been reported to improve mild cognitive impairment (Barnes 2015), and in 2011 CANTAB was used to show that non-aerobic movement over 6 weeks produced significant improvement in sustained attention and visual memory in AD (Yágüez et al. 2010). Following this (Farina et al. 2014) found using CANTAB that physical activity can have a positive effect on cognitive decline in AD.
3. Detect and treat high blood pressure
Raised blood pressure or hypertension is a huge risk factor for stroke and cerebrovascular disease. Its role as a pre-cursor to other neurological conditions, including Alzheimer’s, is sometimes overlooked despite there being clear links between hypertension and impaired cognitive function (Duron & Hanon 2008; Louis et al. 1999; Kilander et al. 1998).Ways of Preventing Alzheimer’s Essay
4. Eat healthily
As with physical activity, what’s good for the heart is good for the head: so it probably comes as no surprise that being very overweight increases risk for Alzheimer’s and other dementia-related diseases. But it is perhaps more surprising that the specific types of food we eat can affect our risk of Alzheimer’s disease, particularly the Mediterranean diet – a diet rich in fruits, vegetables, legumes and cereals and low in meat, sugar and saturated fat which is thought to considerably reduce risk (Sofi et al. 2010; Scarmeas et al. 2009).
5. Keep learning
Research has shown that those with fewer years of formal education are at higher risk for Alzheimer’s and other dementias than those with more years of formal education. (Sando et al. 2008; Stern n.d.) Scientists believe that having more years of education helps to create a “cognitive reserve” that enables patients to better compensate for changes in the brain resulting from Alzheimer’s or other neurological diseases, essentially masking the symptoms for longer than in people with less education.Ways of Preventing Alzheimer’s Essay
6. Quit the habit
It’s well known that smoking is bad for your health, but perhaps less well known that it is associated with risk for Alzheimer’s. And a meta-analysis of 19 studies of people with dementia followed for at least one year showed that those who smoked at baseline showed greater cognitive decline at follow up. (Anstey et al. 2007).
7. Detect and treat diabetes
Diabetes, and its treatments, can impact the brain and cognitive function, making it another risk factor for Alzheimer’s disease. A systematic review and meta-analysis of studies showed that people with diabetes are at higher risk of Alzheimer’s (Lu et al. 2009). If drugs were available to improve cognitive deficits, could this slow decline?
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So what next?
Whilst these are not a complete or final list of the many risk factors of Alzheimer’s disease, they are reasonable places to start in adjusting lifestyles to lower risk for Alzheimer’s disease. Clearly, further studies are still needed to understand how these and other lifestyle factors affect risk of Alzheimer’s disease, and how reduction in these risk factors among those who already have some impairment might lower the conversion rates to Alzheimer’s and other dementias.Ways of Preventing Alzheimer’s Essay
We believe that a key factor in preventing the onset, or worsening, of Alzheimer’s and other dementias is the ability to accurately monitor memory and other cognitive functions throughout later life. CANTAB Mobile is a simple to use medical app available to GPs to objectively assess memory in older adults who are worried about their risk for dementia. While no cures are yet available, there are a number of reasons why detecting mild cognitive impairment early may be useful to patients and families – including helping them to put plans in place for the future.Ways of Preventing Alzheimer’s Essay
Can Alzheimer’s and dementia be prevented?
Alzheimer’s Disease is one of the biggest concerns many of us have as we get older. The thought of developing the disease can be a frightening prospect, especially if you’ve witnessed a loved one affected by dementia. While you may have been told that all you can do is hope for the best and wait for a pharmaceutical cure, the truth is much more encouraging. Promising research shows that you can reduce your risk of Alzheimer’s and other dementias through a combination of simple but effective lifestyle changes.
By identify and controlling your personal risk factors and leading a brain-healthy lifestyle, you can maximize your chances of lifelong brain health and preserve your cognitive abilities. These steps may prevent the symptoms of Alzheimer’s disease and slow down the process of deterioration.Ways of Preventing Alzheimer’s Essay
Alzheimer’s is a complex disease with multiple risk factors. Some, like your age and genetics, are outside your control. However, there are seven pillars for a brain-healthy lifestyle that are within your control:
Regular exercise
Social engagement
Healthy diet
Mental stimulation
Quality sleep
Stress management
Vascular health
Experts now believe that the risk of Alzheimer’s is not limited to old age, but in fact can start in the brain long before symptoms are detected, often in middle age. That means that it’s never too early to start taking care of your brain health. The more you strengthen each of the seven pillars in your daily life, the longer—and stronger—your brain will stay working and the more likely you’ll be able to reduce your risk of developing Alzheimer’s or another dementia.Ways of Preventing Alzheimer’s Essay
Pillar #1: Regular exercise
Women walking for exercise talking
According to the Alzheimer’s Research & Prevention Foundation, regular physical exercise can reduce your risk of developing Alzheimer’s disease by up to 50 percent. What’s more, exercise can also slow further deterioration in those who have already started to develop cognitive problems. Exercise protects against Alzheimer’s and other types of dementia by stimulating the brain’s ability to maintain old connections as well as make new ones.
Aim for at least 150 minutes of moderate intensity exercise each week. The ideal plan involves a combination of cardio exercise and strength training. Good activities for beginners include walking and swimming.
Build muscle to pump up your brain. Moderate levels of weight and resistance training not only increase muscle mass, they help you maintain brain health. For those over 65, adding 2-3 strength sessions to your weekly routine may cut your risk of Alzheimer’s in half.
Include balance and coordination exercises. Head injuries from falls are an increasing risk as you age, which in turn increase your risk for Alzheimer’s disease and dementia. As well as protecting your head when you exercise (wearing a sports helmet when cycling, for example), balance and coordination exercises can help you stay agile and avoid spills. Try yoga, Tai Chi, or exercises using balance balls.Ways of Preventing Alzheimer’s Essay
Tips for starting and sticking with an exercise plan
If you’ve been inactive for a while, starting an exercise program can be intimidating. But remember: a little exercise is better than none. In fact, adding just modest amounts of physical activity to your weekly routine can have a profound effect on your health. Choose activities you enjoy and start small—a 10-minute walk a few times a day, for example—and allow yourself to gradually build up your momentum and self-confidence.
Pillar #2: Social engagement
Women connecting smiling
Human beings are highly social creatures. We don’t thrive in isolation, and neither do our brains. Staying socially engaged may even protect against Alzheimer’s disease and dementia in later life, so make developing and maintaining a strong network of friends a priority.
You don’t need to be a social butterfly or the life of the party, but you do need to regularly connect face-to-face with someone who cares about you and makes you feel heard. While many of us become more isolated as we get older, it’s never too late to meet others and develop new friendships:Ways of Preventing Alzheimer’s Essay
In Alzheimer’s disease, inflammation and insulin resistance injure neurons and inhibit communication between brain cells. Alzheimer’s is sometimes described as “diabetes of the brain,” and a growing body of research suggests a strong link between metabolic disorders and the signal processing systems. By adjusting your eating habits, however, you can help reduce inflammation and protect your brain.
Manage your weight. Extra pounds are a risk factor for Alzheimer’s disease and other types of dementia. A major study found that people who were overweight in midlife were twice as likely to develop Alzheimer’s down the line, and those who were obese had three times the risk. Losing weight can go a long way to protecting your brain.
Cut down on sugar. Sugary foods and refined carbs such as white flour, white rice, and pasta can lead to dramatic spikes in blood sugar which inflame your brain. Watch out for hidden sugar in all kinds of packaged foods from cereals and bread to pasta sauce and low or no-fat products.Ways of Preventing Alzheimer’s Essay
Enjoy a Mediterranean diet. Several epidemiological studies show that eating a Mediterranean diet dramatically reduces the risk of cognitive impairment and Alzheimer’s disease. That means plenty of vegetables, beans, whole grains, fish and olive oil—and limited processed food.
Get plenty of omega-3 fats. Evidence suggests that the DHA found in these healthy fats may help prevent Alzheimer’s disease and dementia by reducing beta-amyloid plaques. Food sources include cold-water fish such as salmon, tuna, trout, mackerel, seaweed, and sardines. You can also supplement with fish oil.
Stock up on fruit and vegetables. When it comes to fruits and vegetables, the more the better. Eat up across the color spectrum to maximize protective antioxidants and vitamins, including green leafy vegetables, berries, and cruciferous vegetables such as broccoli.
Cook at home often. By cooking at home, you can ensure that you’re eating fresh, wholesome meals that are high in brain-healthy nutrients and low in sugar, salt, unhealthy fat, and additives.
Drink only in moderation. While there appear to be brain benefits in consuming red wine in moderation,heavy alcohol consumption can dramatically raise the risk of Alzheimer’s and accelerate brain aging.Ways of Preventing Alzheimer’s Essay
Pillar #4: Mental stimulation
Man playing chess
Those who continue learning new things and challenging their brains throughout life are less likely to develop Alzheimer’s disease and dementia. In essence, you need to “use it or lose it.” In the groundbreaking NIH ACTIVE study, older adults who received as few as 10 sessions of mental training not only improved their cognitive functioning in daily activities in the months after the training, but continued to show long-lasting improvements 10 years later.
Activities involving multiple tasks or requiring communication, interaction, and organization offer the greatest protection. Set aside time each day to stimulate your brain:
Learn something new. Study a foreign language, practice a musical instrument, or learn to paint or sew. One of the best ways to take up a new hobby is to sign up for a class and then schedule regular times for practicing. The greater the novelty, complexity, and challenge, the greater the benefit.Ways of Preventing Alzheimer’s Essay
Raise the bar for an existing activity. If you’re not keen on learning something new, you can still challenge your brain by increasing your skills and knowledge of something you already do. For example, if you can play the piano and don’t want to learn a new instrument, commit to learning a new piece of music or improving how well you play your favorite piece.
Practice memorization techniques. For example, make up a sentence in which the first letter of each word represents the initial of what you want to remember, such as using the sentence “Every good boy does fine” to memorize the notes of the treble clef, E, G, B, D, and F. Creating rhymes and patterns can strengthen your memory connections.
Enjoy strategy games, puzzles, and riddles. Brain teasers and strategy games provide a great mental workout and build your capacity to form and retain cognitive associations. Do a crossword puzzle, play board games, cards, or word and number games such as Scrabble or Sudoku.
Follow the road less traveled. Take a new route or eat with your non-dominant hand. Vary your habits regularly to create new brain pathways.Ways of Preventing Alzheimer’s Essay
There are a number of links between poor sleep patterns and the development of Alzheimer’s and dementia. Some studies have emphasized the importance of quality sleep for flushing out toxins in the brain. Others have linked poor sleep to higher levels of beta-amyloid in the brain, a sticky protein that can further disrupt the deep sleep necessary for memory formation.
If nightly sleep deprivation is slowing your thinking and or affecting your mood, you may be at greater risk of developing symptoms of Alzheimer’s disease. To help improve your sleep:
Establish a regular sleep schedule. Going to bed and getting up at the same time reinforces your natural circadian rhythms. Your brain’s clock responds to regularity.
Set the mood. Reserve your bed for sleep and sex, and ban television and computers from the bedroom (both are stimulating and may lead to difficulties falling asleep).
Create a relaxing bedtime ritual. Take a hot bath, do some light stretches, listen to relaxing music, or dim the lights. As it becomes habit, your nightly ritual will send a powerful signal to your brain that it’s time for deep restorative sleep.Ways of Preventing Alzheimer’s Essay
Quiet your inner chatter. When stress, anxiety, or worrying keeps you awake, get out of bed. Try reading or relaxing in another room for twenty minutes then hop back in.
Get screened for sleep apnea. If you’ve received complaints about your snoring, you may want to get tested for sleep apnea, a potentially dangerous condition where breathing is disrupted during sleep. Treatment can make a huge difference in both your health and sleep quality.
Pillar #6: Stress management
Stress free woman with earbuds in her ears
Chronic or persistent stress can take a heavy toll on the brain, leading to shrinkage in a key memory area, hampering nerve cell growth, and increasing the risk of Alzheimer’s disease and dementia. Yet simple stress management tools can minimize its harmful effects.
Schedule daily relaxation activities. Keeping stress under control requires regular effort. Learning relaxation techniques such as meditation, progressive muscle relaxation, or yoga can help you unwind and reverse the damaging effects of stress.
Nourish inner peace. Regular meditation, prayer, reflection, and religious practice may immunize you against the damaging effects of stress.
Make fun a priority. All work and no play is not good for your stress levels or your brain. Make time for leisure activities that bring you joy, whether it be stargazing, playing the piano, or working on your bike.Ways of Preventing Alzheimer’s Essay
Keep your sense of humor. This includes the ability to laugh at yourself. The act of laughing helps your body fight stress.
Pillar #7: Vascular health
Senior couple measure their blood pressure
There’s more and more evidence to indicate that what’s good for your heart is also good for your brain. Maintaining your cardiovascular health can be crucial in lowering your risk for different types of dementia, including Alzheimer’s disease and vascular dementia. And of course, addressing heart-health issues can also help you to lower your risk for a future heart attack or stroke.
Control your blood pressure
Hypertension or high blood pressure is strongly associated with an increased risk of dementia. High blood pressure can damage tiny blood vessels in the parts of the brain responsible for cognition and memory. The latest American Heart Association guidelines class blood pressure readings of 130/80 mm Hg and above as the start of high blood pressure.Ways of Preventing Alzheimer’s Essay
Check your blood pressure at home. A study in the Netherlands found that a large variation in blood pressure readings over a period of years was associated with an increased risk of dementia. Inexpensive monitors that wrap around your upper arm can help you keep track of your blood pressure throughout the day and pick up on any variations. Some devices even send the results to your phone so you can easily track your readings or share them with your doctor.
Make healthy diet and lifestyle changes. Exercising, trimming your waistline, lowering your stress, and reducing your salt, caffeine, and alcohol intake can all help to lower your blood pressure. Try to cut back on takeout, canned, and processed food which tend to be high in sodium and replace them with fresh vegetables and fruit.
The DASH diet for lowering blood pressure
The Dietary Approaches to Stop Hypertension, or DASH diet, is a specially designed eating plan to help you lower your blood pressure. When combined with a reduction in salt, the DASH diet may help lower your blood pressure without the need for medication. See “Get more help” below.
Take any medication your doctor recommends. Research from Johns Hopkins found that those prescribed antihypertensive medication to control high blood pressure lowered their dementia risk by about a third.
Don’t ignore low blood pressure. While it affects far fewer of us, low blood pressure (hypotension) can also reduce blood flow to the brain. While the American Heart Association offers no specific measurement for when blood pressure is considered too low, symptoms such as dizziness, blurred vision, and unsteadiness when standing may indicate a problem.Ways of Preventing Alzheimer’s Essay
Other vascular health tips
Watch your cholesterol levels. Studies also suggests there may be a connection between high cholesterol and the risk for Alzheimer’s and dementia, especially having high cholesterol levels in mid-life. Improving your levels can be good for both your brain and your heart.
Stop smoking. Smoking is one of the most preventable risk factors for Alzheimer’s disease and dementia. One study found that smokers over the age of 65 have a nearly 80% higher risk of Alzheimer’s than those who have never smoked. When you stop smoking, the brain benefits from improved circulation almost immediately.
Women and Alzheimer’s risk
Women are about twice as likely as men to develop Alzheimer’s disease. Researchers believe this higher risk can be linked to a decrease in fertility and the onset of menopause in middle age. As a woman, the drop in estrogen not only triggers symptoms such as hot flashes and night sweats, but it can also affect your brain. Since estrogen protects brain cells from aging, a large decrease during menopause may make you more vulnerable to Alzheimer’s later in life.
Hormone replacement therapy can carry risks, but there’s evidence to suggest that taking supplemental estrogen before menopause may help lower your chances of developing dementia. Using the seven pillars in middle age can also be beneficial, especially adopting a healthy diet. Eating foods rich in antioxidants such as fruit, leafy green vegetables, and nuts may help protect your brain, while flaxseeds, soy, nuts, red wine, and fruits such as strawberries, peaches, and apricots can help naturally boost estrogen levels.Ways of Preventing Alzheimer’s Essay
One third of people in the United States over age 85 suffer from Alzheimer’s. The medications used for Alzheimer’s so far, while beneficial in targeting symptoms, are often not used widely due to their side effect profile, and do not prevent Alzheimer’s disease from occurring.
Nevertheless, as ongoing research is showing, there are a number of preventative measures that could be worth taking. Here are some of them.
1. Plant-based compounds: A new study by Shal and colleagues that came out within the last month showed the neuroprotective properties of various plant-based compounds that might help prevent the neurodegeneration of Alzheimer’s disease.1 The authors of this latest study note that phytochemicals such as Quercetin (in mulberry fruit), Oxyresveratrol (in white mulberry), Cucurmin (found in turmeric), and different compounds found in ginger root, green tea, citrus fruits, gingko biloba, and ginseng have strong anti-inflammatory and/or anti-oxidant properties that are neuroprotective and have potential for benefit in Alzheimer’s disease.1 Some of these compounds, such as ginger, cucurmin, and gingko have been used for thousands of years for their medicinal properties in China, India, and other parts of the world.1 Gingko has shown slowed cognitive decline in studies involving thousands of patients.2 Ways of Preventing Alzheimer’s Essay
Alzheimer’s is a severe, progressive, neurodegenerative disease involving brain inflammation that has no cure to date. However, research involving many of the above-mentioned compounds so far has focused on animal brain models in which protective and preventative effects have been proven. More research is needed to further establish similar neuroprotective efficacy for Alzheimer’s disease in human brains.
Also worth noting is that anything that has an effect (or benefit) can have a side effect. Although from what we know so far, side effects associated with the above-mentioned compounds are much lesser than those associated with prescription medications for Alzheimer’s. However, side effects can occur. For instance, compounds such as gingko can increase risk of bleeding, which is especially significant and important if you are already taking a blood-thinning medication, have a bleeding disorder, or have an upcoming surgery.3 In any case, you should not use any of these agents without consulting with your doctor as the risk of interactions and adverse effects is there, especially as elderly people often have many medical problems and a greater number of medications that can increase risk of interactions.Ways of Preventing Alzheimer’s Essay
2. Address vascular risk factors such as hypertension and high cholesterol: Another new study by Larsson and Markus that just came out this month shows that antihypertensive treatment and statins may lower likelihood of developing dementia and Alzheimer’s disease.4 This meta-analysis is based on a review of eight randomized controlled trials and 52 prospective trials.4 Hypertension and high cholesterol have been recognized as ‘vascular risk factors’ for Alzheimer’s disease. We know that statins have been associated with controversy about their risks-versus-benefit profile. However, these results are especially worth noting as they shed light on a different aspect of statin use.Ways of Preventing Alzheimer’s Essay
3. Aerobic Exercise: Moderate aerobic exercise has the strongest evidence for protective effects on brain health and in reducing risk of Alzheimer’s disease.5 A study showed that walking was associated with increased volume of the hippocampus, the part of the brain most involved in memory.5 Exercise achieves these benefits by strengthening neural cell connections, decreasing inflammation and oxidative damage and increasing levels of brain-derived neurotrophic factor (BDNF), which has been linked with a reduced risk of Alzheimer’s disease.5
Alzheimer’s disease is the most common form of dementia. The frequency of Alzheimer’s disease is increasing as the New Zealand population ages. It has been estimated that the number of New Zealanders living with Alzheimer’s disease will reach 70,000 by 2031 (from 28,000 in 2006).Ways of Preventing Alzheimer’s Essay
There is no cure for Alzheimer’s disease, nor any proven ways to prevent its onset. Treatment focuses on support and managing symptoms to maximize a person’s ability to function and maintain independence for as long as possible. The condition is ultimately fatal.
Causes
In Alzheimer’s disease, brain cells start to deteriorate. The body attempts to stop this process by producing a protein called amyloid. However, amyloid deposits build up in the brain, leading to further deterioration. These deposits of amyloid are referred to as “plaques” and cause the brain cells to shrivel up and form “tangles”, which in turn lead to changes in the brain structure and cause the brain cells to die. The formation of plaques and tangles also prevents the production of some important brain chemicals, called neurotransmitters (eg: acetylcholine, which is important in memory function). Over time the loss of brain cells causes the brain to shrink.
While there is no known cause for Alzheimer’s disease, some research studies have indicated that the following factors may play an important role in the development of the condition:Ways of Preventing Alzheimer’s Essay
Genetic factors, such as the presence of, or changes to, certain genes
Environmental factors, such as long-term exposure to some environmental solvents (eg: pesticides, glues and paints) or infection with certain viruses or bacteria
Lifestyle factors, such as a lack of exercise, poor-quality sleep and a diet lacking fruit and vegetables.
Researchers now believe that a combination of these lifestyle, environmental and genetic risk factors trigger an abnormal biological process in the brain that, over decades, results in Alzheimer-type dementia. Identified risk factors for developing the condition include:
Increasing age
Down syndrome
History of a head injury
Risk factors for blood vessel disease such as smoking
Family history of Alzheimer’s disease
Obesity
High blood pressure
High cholesterol
Insulin resistance.
There is some evidence of a slightly higher prevalence of Alzheimer’s disease in females than males, but this may reflect their longer life expectancy.
Signs and symptoms
The degenerative changes that occur with Alzheimer’s disease affect the areas of the brain that control thought, memory and language resulting in gradual signs and symptoms related to a person’s behaviour and mental function. Often, physical functions such as bowel and bladder control are also affected.Ways of Preventing Alzheimer’s Essay
With Alzheimer’s disease there is great individual variability as to the nature of symptoms experienced and the speed at which deterioration occurs. The types of behaviour change and the length of time symptoms are present are different for each person. The symptoms of Alzheimer’s disease typically develop quite slowly. The time between the onset of the disease and death can range from five to 20 years.
Symptoms commonly experienced during the early stages of Alzheimer’s disease include:
Mild forgetfulness – especially short-term memory loss
Mood changes, including irritability and anxiety
Difficulty processing new information and learning new things
Loss of spontaneity and initiative
Confusion about time and place
Communication difficulties
Decline in ability to perform routine tasks.
As Alzheimer’s disease progresses the following symptoms may develop:Ways of Preventing Alzheimer’s Essay
Increasing short-term memory loss and confusion
Difficulty recognising family and friends
Shorter attention span and feelings of restlessness
Difficulty with reading, writing and numbers
Possibly neglectful of hygiene
Loss of appetite
Personality changes (eg: aggression, significant mood swings)
Requires increasing assistance with daily tasks.
Towards the later stages of the disease the following symptoms may be experienced:
Inability to understand or use speech
Incontinence of urine / faeces
Inability to recognise self or family
Severe disorientation
Increasing immobility and sleep time.
The changes brought about by Alzheimer’s disease can be increasingly difficult for family members and friends as the person’s condition deteriorates and they become unable to recognise loved ones.Ways of Preventing Alzheimer’s Essay
Although a person loses many abilities as the disease progresses, it is often helpful to focus on the abilities that do remain, such as the senses of touch and hearing and the ability to respond to emotion.
Diagnosis
There is a no single test to diagnose Alzheimer’s disease. Diagnosis involves a full assessment of medical and psychiatric history to rule out other possible causes. Therefore, a variety of tests are required to obtain a conclusive diagnosis, which may include:
A neurological and physical examination
Blood and urine tests
Brain scans
Mental status assessment to determine the level of mental deterioration
Caregiver interview to determine the level of dependency.
Scans to check brain structure and function may be recommended. The different types of scans used may include CT scanning (computerised tomography), MRI (magnetic resonance imaging) and PET (positron emission tomography).
Treatment
As there is no known cure for Alzheimer’s disease, treatment focuses on managing symptoms and supporting the person and their family. This may include:Ways of Preventing Alzheimer’s Essay
Treating medical conditions that may contribute to confusion or physical decline eg: lung disease or anaemia
Encouraging stimulating activities in order to encourage the person to continue their normal activities as much as possible
Providing memory aids and memory triggers such as calendars and written reminders
Encouraging social interaction to help prevent feelings of loneliness and depression
Contacting support groups that may be able to offer family/caregivers assistance
Encouraging regular routine to reduce confusion
Not smoking.
Medications
Medications such as sleeping tablets and tranquillisers may help to control symptoms such as sleeplessness and agitation. However, they often cause increased confusion, so their use should be limited.
A group of medications called cholinesterase inhibitors have shown some effectiveness in slowing the progression of the condition in some people. These medications help prevent the breakdown of acetylcholine, a neurotransmitter responsible for memory. Cholinesterase inhibitor medications that are available in New Zealand include donepezil, rivastigmine and galantamine.
More recently, another drug – memantine – has become available in New Zealand. Memantine works in a different way to the cholinesterase inhibitors, aiming to prevent the entry of an excess amount of calcium into brain cells. Higher than normal levels of calcium in the brain cells causes damage to them and also prevents them from receiving signals from other brain cells. Ways of Preventing Alzheimer’s Essay
Research continues into the development of other medications for the treatment of Alzheimer’s disease. Medications being investigated include those that prevent the build-up of amyloid deposits in the brain, as well as looking at the use of some anti-inflammatory and hormone medications. Research also continues into the use of alternative therapies such as anti-oxidants like Vitamin E, curcumin, selenium and some herbal extracts (ginko balboas in particular).
Prevention / risk reduction
There are no proven ways to prevent the development of Alzheimer’s disease. However, there is epidemiological evidence to suggest that leading a healthy lifestyle can reduce the risk of Alzheimer’s disease. Regular physical activity and exercise may have a general protective effect on brain health and may slow progression of Alzheimer’s disease. Although there are no specific dietary specifications for Alzheimer’s, a Mediterranean-style diet (ie: plant foods such as vegetables, fruits, beans, whole grains, nuts, olives and olive oil, along with some cheeses, yoghurt, fish, poultry and eggs) may reduce the risk of Alzheimer’s disease, and has the added benefit of lowering cardiovascular disease and type 2 diabetes risk. For more diet information, refer to our Healthy heart diet Ways of Preventing Alzheimer’s Essay
The aging of the population is a worldwide phenomenon, and studying age-related diseases has become a relevant issue from both a scientific and a public health perspective. Dementia is a syndrome characterised by loss of cognitive abilities in multiple domains that results in impairment in normal activities of daily living and loss of independence [1]. Both prevalence and incidence of dementia rise exponentially with advancing age, and 70% of all dementia cases occur in people aged 75+ years [2]. The worldwide increase in the number of older adults, more pronounced in the 80+ age group, explains the epidemic proportions assumed by dementia. According to the World Alzheimer Report, there were 35.6 million people living with dementia worldwide in 2010, a number that will increase to 65.7 million by 2030 and 115.4 million by 2050 unless effective means reducing the disease incidence are introduced [3]. Dementia is a major cause of disability and institutionalization of elderly people and because of its increased prevalence this disorder is becoming an emerging public health issue not only in developed countries but also in less developed regions of the world. The total estimated worldwide costs of dementia were US$604 billion in 2010, including the costs of informal care (unpaid care provided by family and others), direct costs of social care (provided by community care professionals, and in residential home settings) and the direct costs of medical care (the costs of treating dementia and other conditions in primary and secondary care) [3].Ways of Preventing Alzheimer’s Essay
Alzheimer’s disease (AD) is considered the most common cause of dementia, accounting for 60–70% of all dementia cases. The hallmarks of AD neuropathology in the brain are the presence of extracellular plaques composed of amyloid-β (Aβ) and intracellular neurofibrillary tangles (NFTs) composed of hyperphosphorylated aggregates of the microtubule-associated tau protein [4].
Vascular dementia (VaD), mainly due to cerebrovascular diseases (CVD), is the second most frequent type of dementia [5, 6]. This current classification of dementia types is being reconsidered in light of recent neuropathological and neuroimaging studies, which have shown a range of dementia-associated brain abnormalities from pure vascular lesions at one end to pure AD pathologies at the other, with most dementia cases being attributable to both CVD and AD. In fact, AD and CVD-related changes often coexist in the brain of older adults with dementia and mild cognitive impairment (MCI) [7, 8]. Also, both types of lesions are detected in the brain of cognitively normal elderly people, highlighting the importance of mixed pathologies in increasing the risk of late-life dementia [9]. The co-occurrence of AD and CVD is consistent with the evidence that AD and VaD share several risk and protective factors, including cardiovascular and lifestyle related factors. Overall, this implies that dementia syndrome is a valid target for prevention, especially from the public health perspective.Ways of Preventing Alzheimer’s Essay
Prevention is traditionally divided into three levels: primary, secondary, and tertiary prevention. Primary prevention aims to reduce the incidence of the disease by eliminating or treating specific risk factors, which may decrease or delay the development of dementia. Secondary prevention aims to early detection of the disease, before any symptom has emerged, when treatment could stop its progression. Tertiary prevention aims to reduce the impact of complications and disability of long-term diseases.
Regarding primary prevention, both observational and interventional epidemiological studies have been conducted for dementia and AD. On the other hand, in the field of AD the development of pharmacological interventions has been mainly limited to a tertiary prevention level, since the diagnostic criteria currently in use for AD (National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association, NINCDS-ADRDA – criteria) identify the presence of the disease only when AD is severe enough to cause a dementia syndrome [10]. Thus, the majority of anti-AD drugs have been tested in subjects already in the symptomatic stage of the disease, and so far no drug has shown the ability to stop the disease progression (i.e. disease-modifying effect) [11]. However, several studies have shown that the pathophysiological process of AD begins years, if not decades, before the diagnosis of Alzheimer’s dementia and individuals generally experience a gradual impairment of cognitive functions, which can progress to a dementia syndrome Ways of Preventing Alzheimer’s Essay
Recent advances in neuroimaging, cerebrospinal fluid (CSF) assays, and other techniques now provide the ability to detect evidence of the AD pathophysiological process in vivo, but the diagnostic criteria currently in use do not take into account these biomarkers. Three international workgroups promoted by the American National Institute of Aging (NIA) and the American Alzheimer’s Association recently proposed new diagnostic guidelines to identify dementia due to AD, MCI due to AD, and preclinical AD [15-17]. These new criteria formalize the different clinical stages of AD and incorporate biomarkers (genetic, biochemical, neuroimaging) that can be detected in vivo and are believed to reflect AD pathology. These diagnostic criteria are now being validated and can be revised as long as new findings from research on biomarkers in AD will clarify the link between AD pathophysiology and the AD clinical syndrome. These criteria offer the opportunity to identify subjects who can be target of secondary prevention in order to halt the progression of the brain damage and prevent or delay the onset of cognitive symptoms. A step in this direction has been done by planning randomized controlled trials (RCTs) testing anti-amyloid drugs in older adults with evidence of brain amyloid accumulation. The same type of intervention will also be tested in subjects at risk of early onset AD due to genetic mutations associated with familial AD.Ways of Preventing Alzheimer’s Essay
This chapter summarizes the major findings concerning primary prevention of late onset dementia and AD, based on current epidemiological evidence from observational and interventional studies. Preventive strategies for early onset AD are also mentioned. Although many aspects of the dementias are still unclear, some risk and protective factors have been identified. It is also possible to delineate some preventative strategies. Ongoing interventional studies testing the effect of preventive measures for dementia and AD are discussed, and methodological challenges in designing dementia prevention trials are summarized.
2. Observational studies
Several community-based prospective studies of aging and health have been carried out in different countries since the 80s’. These studies have provided relevant information on the aetiology of dementia and AD, and have led to the identification of possible preventive strategies. Evidence from these observational studies has shown that dementia is a multifactorial disorder caused by several interrelated mechanisms in which the interaction of genetic and environmental factors plays the major role (Table 1). The pathways that lead from different risk factors to dementia are not fully understood, but several etiological hypotheses have been proposed: the vascular hypothesis, inflammatory hypothesis, oxidative-stress hypothesis, toxic hypothesis and psychosocial hypothesis [18, 19]. These theories highlight potential links of various risk factors to both the vascular and the neurodegenerative brain pathologies that can cause dementia, supporting the validity of dementia syndrome as target for prevention [6, 20].Ways of Preventing Alzheimer’s Essay
2.1. Non-modifiable risk factors for Alzheimer’s disease
Both modifiable and non-modifiable risk factors have been identified for dementia and AD, and while for some factors the scientific evidence is quite robust, for others the results are still inconclusive.
2.1.1. Age
Increasing age is a well-established risk factor for dementia, which is a common disorders after 75 years of age, but rare before age 60. The incidence rates of dementia increase exponentially with advancing age. In Europe, approximately two per 1,000 person-years become demented among people aged 65-69 years, and the incidence increases to 70 to 80 per 1,000 person-years for people 90 years or over [21, 22]. It is still unclear if the incidence of dementia continues to increase even in the oldest old or reaches a plateau at a certain age. The Cache County Study found that the incidence of dementia increased with age, peaked, and then started to decline at extreme old ages for both men and women. However, some meta-analyses and large-scale studies in Europe provided no evidence for the potential decline in the incidence of dementia among the oldest old Ways of Preventing Alzheimer’s Essay
Check with your doctor what level of physical exercise is recommended for you, based on your health and any other medical conditions. See U.S. Department of Health and Human Services physical activity guidelines for Americans here.5
4. Lower stress: High stress levels have been associated with oxidative damage that is linked with not only increased risk of cancer but also Alzheimer’s disease. Mindfulness-based exercises, along with other interventions, such as exercise and psychotherapy, can help reduce stress levels.
5. Sleep well: Sleep is a crucial component of optimal brain health. Amyloid matter, the accumulation of which leads to Alzheimer’s, is wiped out during sleep. Studies find that adequate sleep as well as good-quality sleep are important to prevent Alzheimer’s disease.5
6. Address depression: Depression is a risk factor for Alzheimer’s disease. Effective treatment of depression may help reduce risk of Alzheimer’s dementia.Ways of Preventing Alzheimer’s Essay
7. Mediterranean diet: A diet rich in legumes, yogurt, cheeses, fish, and olive oil has been associated with a lower risk of Alzheimer’s disease.5
There are not enough words to describe the pain and despair that patients with Alzheimer’s disease and their family members go through, so preventative steps are important. While genetic risk factors for Alzheimer’s may be beyond your control, the above-mentioned factors are in your hands. Ways of Preventing Alzheimer’s Essay
