Alzheimer’s disease is influenced by lifestyle choices

Alzheimer’s patients and their families received devastating news earlier this year when one of the most promising drugs, Aducanumab, failed to show a positive outcome. The drug, which had shown early results of cognitive improvement and the ability to get rid of amyloid from the brain, was one of the most hopeful drug prospects we had.

The National Institutes of Health has spent billions of dollars on Alzheimer’s research. Between 2002 and 2012, 244 compounds were tested in a total of 413 trials but none of the drugs were found to stop or reverse the progression of Alzheimer’s disease. The reality is that our current therapeutic approach only slows down the process for a short period of time.

We learned last week that the drug company Pfizer knew that their drug Enbrel demonstrated a potential 64 percent reduction in Alzheimer’s risk in those using it long-term for arthritis, yet they chose not to pursue further research or to share this information. There was no guarantee that the clinical trial would have shown positive results, but many experts feel it is unethical not to disclose such results, especially when there aren’t any promising pharmaceutical interventions in the pipelines. There is the question if the analysis on the potential return from a drug that was about to go generic played any role in Pfizer’s decision not to pursue the research.

The Alzheimer's Association is hosting "Healthy Living: Pathway to Hope" 8 a.m.-4 p.m. June 20 at the Carrasco Room at Midland College.

The conference will focus on healthy lifestyle choices and will offer presentations on physical activity, stress management, nutrition, humor and sleep. The event is free, but registration is required. Lunch will be served. CEUs are available.

For more information contact Janet Cross at jcross@alz.org or 570-9191, ext. 8031.

Let’s face reality: When it comes to stopping or reversing Alzheimer’s disease, the current success rate is zero. Some experts believe it’s wrong to focus on developing a cure in the form of a single drug. Alzheimer’s is a complex chronic disease of aging, and a single agent may not be adequate.

Also, the focus on targeting amyloid and tau have not shown any positive results because by the time amyloid and tau are accumulated in brain, hundreds of thousands of neurons have already died, which means it may be too late to improve symptoms. Also, amyloid doesn’t explain the full story; not everyone with amyloid plaques in the brain has the disease.

Despite the billions of dollars spent on research, there is still no cure. It’s been 15 years since a drug was approved for Alzheimer’s. This forces us to ask: Do we really have a comprehensive understanding of what causes Alzheimer’s disease?

Is there anything we can do to prevent this deadly disease until new drugs are developed that could intervene before irreversible brain damage occurs?

The answer is “yes.”

There is compelling data that Alzheimer’s is deeply influenced by lifestyle choices we make every day, such as, what we eat, how often we exercise, the quality of our sleep and how we respond to stress.

--Diet

Diets that are rich in plant foods and minimize animal fats, such as a Mediterranean diet, have been associated with slower cognitive decline and a lower risk of Alzheimer’s. These diets are high is vegetable content and have a lower ratio of saturated to unsaturated fats.

In a Harvard women’s health study, higher saturated fat intake -- predominantly from dairy, meat and processed foods -- was associated with a significantly worse trajectory of cognition and memory. Women with the highest saturated fat intake had a 60 percent to 70 percent greater chance of cognitive deterioration over time. Women with the lowest saturated fat intake had the brain function, on average, of women six years younger.

"While it may be easier to blame a devastating disease like Alzheimer's on a single gene, this false belief is killing millions. The truth is much harder to accept -- that we are bringing Alzheimer's disease into our households through the choices we make every day."

--Drs. Dean and Ayesha Sherzai co-directors of the Brain Health and Alzheimer's Prevention Program at Loma Linda University Medical Center

Antioxidant properties of berries and dark green leafy vegetables make them the brain foods of the fruit and vegetable kingdom. In addition, studies have shown the benefits of turmeric and saffron as well.

Animal studies have shown that Alzheimer’s is a disease of old carnivores (animals that feed on flesh), whereas old herbivores (animals that feed on plants) do not get Alzheimer’s disease. Considering that it takes decades to develop this disease, it’s never too early to start eating healthier.

Remember, what is good for your heart is also good for your brain.

--Exercise:

There have been many studies and trials to prove that exercise lowers the risk for Alzheimer’s disease. In a study published in 2010 in the Archives of Neurology, a group of people with mild cognitive impairment was put on aerobic exercise for 40 to 60 minutes a day, four days a week, for six months. The control group was instructed to simply stretch during these time periods. Results showed that in the control group, cognition function continued to decline. But the people in the group that exercised got better. They got more answers correct after six months, indicating their memory had improved.

Subsequent studies using MRI scans found that aerobic exercise can reverse age-related shrinkage in the memory centers of the brain. No such effect was found in the stretching and toning groups or a nonaerobic strength training group. Aerobic exercise can help improve cerebral flow and memory performance and help preserve brain tissue.

--Quality sleep

Studies have shown that in deep sleep, amyloid production is turned off. Deep sleep also helps to consolidate short-term memories into long-term memories, and it’s when the brain sort of “cleans” itself. To get into deep sleep, you have to sleep for more than just four to five hours.

--Reduce stress

Managing your day-to-day stress better is good for the entire body, especially the brain. Stress management techniques such as yoga, meditation and visualization could help you manage your stress.

--Social interaction

Studies suggest that loneliness can lead to additional stress and may be a risk factor for Alzheimer’s disease. Prioritize social engagement and stay in touch with family members and friends.

--Learn new things

Mental exercise is just as important in preventing and delaying the onset of cognitive decline. Learning new skills can build new nerve connections that maintain optimal brain health. Experts say it is more than just a crossword puzzle; try adopting a new hobby, learning a new language or playing a new musical instrument.

Dr. Padmaja Patel is medical director of the Lifestyle Medicine Center.

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