Karen L. Gilbert
The pathology of Alzheimer’s disease was identified in 1906. We remain with neither cure nor treatments that reverse symptoms or stop disease progression. Recently approved treatments have succeeded in reducing the rate of cognitive decline but only for those with early-stage disease. Patients with other medical conditions may not be able to take either medication.
The lack of a cure or significant disease-modifying treatment that all patients can take advantage of, inspires focus on approaches that are not medications and which carry essentially no risk of adverse side effects. Preventing disease is always a better approach than attempting to treat or cure a disease, particularly one for which decades of research has failed to cure or reverse.
Research has shown that lifestyle choices have significant influence on how the brain ages. Though two risk factors, age and genetics, cannot be modified, there are numerous lifestyle choices that research has shown can protect and preserve brain health.
The elephant in the room is the damaging impact on brain health of type 2 diabetes and high blood pressure. Both conditions are epidemic in the United States. The Centers for Disease Control and Prevention reports that following years of progress, the control of both blood sugar and blood pressure has declined. Both conditions result in damage to blood vessels, including those in the brain, and are now suspected of leading to the development of dementia, or “vascular dementia,” with type 2 diabetes specifically said to contribute to development of Alzheimer’s pathology by promoting development of amyloid plaques in the brain.
Diabetes and high blood pressure are largely preventable for many people. The number of people in the U.S. at risk for dementia due to these two conditions continues to grow. The CDC estimates that about 35 million adults have type 2 diabetes. Though it is often thought of as adult-onset diabetes, a growing number of children, teenagers, and young adults are developing type 2 diabetes, putting their long-term brain health at significant risk. Close to 50% of U.S. adults (120 million) are estimated to have high blood pressure with fewer than 25% of these adults achieving adequate control of their blood pressure.
It is time to take advantage of the protective lifestyle strategies instead of hoping for the cure. It should be reassuring and inspiring to know that there are so many proactive approaches.
A Mediterranean-style diet, regular exercise, and weight loss help to prevent or reverse both type 2 diabetes and high blood pressure. A waist to height ratio of 50% or less reduces the risk of both conditions as well. This is a measure anyone can self-evaluate and endeavor to improve.
Other protective lifestyle strategies include: addressing vision and hearing loss, getting 7-8 hours of sleep with about 1.5-2 hours in deep sleep or dream states, staying socially active, responding to stress in ways that are calming, learning new skills or new types of puzzles, reading about new and challenging topics, maintaining dental health, protecting from head injury by wearing car seat belts, helmets for activities such as biking, and avoiding or limiting alcohol.
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Additionally, finding moments of quiet with deep, slow breathing, creating a meditative state, is believed to strengthen the areas of the brain involved in learning and memory and help with responding to stress in a healthier way.
Using one’s non-dominant hand for everyday tasks stimulates the opposite side of the brain to learn new movements and skills, and is believed to foster new connections between neurons which facilitates the learning of new skills and maintenance of cognitive functions.
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Finally, finding and pursuing purpose in life is said to support cognitive function and protect against cognitive decline.
It is time for our health care and education systems to share this information and inspire individuals to be robust participants in proactive approaches to preserve health.
Dr. Karen L. Gilbert, based in West Palm Beach, is vice president, education and quality assurance, for Alzheimer’s Community Care.
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