Is Alzheimer’s Disease Preventable?

Amy Doneen, DNP
10/05/2019

Every 65 seconds, an American develops Alzheimer’s disease (AD), the most common form of dementia in older adults. This progressive, memory-robbing disorder affects one in ten U.S. adults ages 65 and up, and one in three of those ages 85 and up. Globally, AD and other forms of dementia affect 47 million people — and this figure is expected to triple by 2050, unless a cure is discovered. The good news, however, is that AD and other forms of dementia may be preventable, according to new guidelines for risk reduction of cognitive decline and dementia issued by the World Health Organization (WHO).

Based on a rigorous review of the latest scientific evidence, WHO lists specific recommendations for healthcare providers and patients. The guidelines add to a landmark 2018 report by 24 leading experts identifying nine potentially reversible lifestyle risk factors. The report, published in Lancet, suggests that by eliminating these risks, up to 35% of dementia cases may be preventable. Here are the best ways to keep your brain and memory sharp while also enhancing the health of your heart and arteries.

A Three-Step Prevention Plan to Protect Your Brain

The authors of the Lancet report identify three potential strategies for dementia prevention: 1) reducing brain damage; 2) reducing brain inflammation; and 3) increasing the brain’s “cognitive reserve.” Drawing on the report, the WHO guidelines, and other recent peer-reviewed research, the BaleDoneen Method recommends the following steps, all of which will help you achieve these goals:

Step One: Optimize Your Cardiovascular Wellness

Healthy blood vessels are essential to your brain’s well-being. Although your brain only accounts for about 2% of your body weight, it is powered by 25% of your blood flow, which supplies it with about 20% of the oxygen you breathe and 25% of the calories you consume. Your brain contains about 100 billion ineurons (also called nerve cells), about half the number of stars in the Milky Way galaxy. Each neuron has 100 to 1,000 connections with other neurons, collectively comprising the wiring the brain uses to send signals to the rest of the body.

Neurons also play a role in memory. In fact, an intriguing study found that the brain contains specific neurons that light up when we hear the names of celebrities (including Oprah and Whoopi Goldberg), movie characters (such as Luke Skywalker) or famous places (such as the Eiffel Tower). Each neuron has its own blood supply: capillaries smaller than human hairs, with walls that are only one endothelial cell thick. These micro-vessels ferry blood between the body’s smallest arteries and veins, meaning they both nourish your neurons and cleanse them of wastes.

So important is blood-vessel health to brain function that most of the new recommendations for the prevention of AD and other dementias are similar to those for the prevention of cardiovascular disease (CVD), the leading killer of American men and women. Specifically, patients are advised to take the following actions to avoid vascular and oxidative stress and associated brain injuries, including stroke (the leading cause of vascular dementia):

Avoid nicotine use and exposure to secondhand smoke. Nicotine exposure damages the cardiovascular system and reduces oxygen flow to the brain. Magnifying the danger to your most important organ: Cigarette smoke and nicotine contain neurotoxins that increase oxidative stress, inflammation and risk for strokes and smaller bleeds in the brain, all of which are risk factors for dementia. Kicking the habit — and avoiding secondhand smoke — have been shown to lower risk dramatically, while continuing to use nicotine in any form has been shown to raise the threat of memory loss by up to 220%!
Get high blood pressure under control. One in three U.S. adults has high blood pressure, a condition that is more dangerous to arterial health than smoking or obesity. That’s dangerous because high blood pressure is the leading risk factor for stroke, which in turn can lead to vascular dementia. Large studies have shown that high blood pressure in midlife can double risk for Alzheimer’s in old age — and the higher your blood pressure is, the greater the threat. Although high blood pressure is the leading cause of death and disability worldwide, it is also one of the most preventable. In addition, as we recently reported, five healthy lifestyle steps can reduce stroke risk by 90%.
Keep your blood sugar in check. Abnormal blood sugar levels are the root cause of about 70% of heart attacks and such a powerful risk factor for memory loss that some experts have proposed renaming Alzheimer’s disease “type 3 diabetes.” One explanation is that having type 2 diabetes or prediabetes may reduce flow of blood and essential nutrients to the brain by damaging blood vessels. As we recently reported, one in three adults — 84 million Americans — have prediabetes, and 90% of them are undiagnosed, magnifying their risk for heart attack, stroke and dementia. Talk to your medical provider about getting the most accurate screening test for blood sugar abnormalities: the two-hour oral glucose tolerance test.
Get checked for all forms of dangerous cholesterol. About one in three Americans have elevated levels of LDL (bad) cholesterol, a major risk factor for developing atherosclerosis (plaque in the arteries). As we recently reported, there are new guidelines for the management of this condition, as well as new treatment options. Also talk to your healthcare provider about being tested for elevated levels of lipoprotein (a), or Lp(a), an inherited cholesterol disorder that triples risk for heart attacks. Also have your levels of apolipoprotein B-100 (ApoB) checked: Widespread use of this $20 blood test, which is available through almost all medical labs, could prevent 500,000 heart attacks and strokes, according to a recent paper published in Journal of the American College of Cardiology.

Step Two: Take Action to Avoid Fire in Your Arteries and Your Brain

You’ve probably seen recent headlines about “the biggest breakthrough since statins” for treating arterial disease and a “revolutionary new approach” to heart attack and stroke prevention: targeting chronic inflammation. Actually, the BaleDoneen Method has been doing exactly that for nearly 20 years. As discussed more fully in the BaleDoneen book, Beat the Heart Attack Gene, our evidence-based method uses a “fire panel” of inexpensive, widely available lab tests to check for this fiery process.

A large body of research has shown that Inflammation, which we call “fire,” actually causes arterial disease — and is more dangerous to your arteries than having high cholesterol!

Heart attacks and strokes are triggered when a diseased artery becomes so inflamed that it can no longer contain the plaque smoldering inside. Like a volcano spewing molten lava, inflammation causes a breech in the artery wall, leading to the formation of a clot that blocks blood flow.

Inflammation and oxidative stress have also been linked to the buildup of brain deposits of beta-amyloid. Many scientists believe that accumulation of this sticky compound in the brain is the primary cause of AD, with the buildup initially disrupting communication between neurons and ultimately killing them. According to this theory, known as “the amyloid hypothesis,” the development of the amyloid plaques that are the hallmark of AD activates immune cells, leading to inflammation that eventually destroys brain cells. Proven strategies to prevent inflammation include the following:

Maintain a healthy weight. Nearly 40% of Americans — about 100 million people — are obese. Defined as a body mass index (BMI) of 30 or higher, obesity raises risk for dementia by up to 92%, the Lancet study reported. Excess weight also greatly magnifies risk for chronic inflammation, CVD, type 2 diabetes, several forms of cancer and joint disorders. However, the wonderful news is that even modest weight loss can significantly improve your arterial and overall wellness. Try our seven science-backed strategies to get rid of unwanted pounds and boost brain health.
Ask your dental provider to check you for gum disease and oral bacteria. In a 2016 study, people with severe gum disease were 70% more likely to develop AD, while another 2016 study found that in people who already had the memory-robbing disorder, cognitive decline progressed six times faster in those with PD. A landmark, peer-reviewed BaleDoneen study, published in Postgraduate Medical Journal, was the first to identify high-risk oral bacteria from PD — and the systemic inflammation they cause — as a contributing cause of arterial disease, while other studies have shown that taking excellent care of your teeth and gums can add years to your life. Follow our easy, four-step plan to optimize your oral-systemic health.
Get depression treated. It’s not yet known if depression contributes to dementia or whether the memory-robbing disorder increases risk for depression. However, the Lancet researchers contend that it’s “biologically plausible” that depression could be a dementia risk because it “affects stress hormones, neuronal growth factors, and hippocampus (brain) volume.” Recent studies also show that chronic inflammation plays a major role in depression and also influences patients’ response to antidepressant medications.
Move more. Regular exercise trims your waistline and keeps your wits sharp. Columbia researchers reported that older adults who exercised vigorously 1.3 hours a week were 33% less likely to develop Alzheimer’s, compared to couch potatoes of the same age. But those who combined physical activity, such as jogging, hiking, or biking, with the Mediterranean diet got even greater benefit, whittling their AD risk by 60% over the 5½-year study. In a recent analysis of studies that included nearly 200,000 people, those who exercised the most had a 38% lower risk for cognitive decline.
Eat anti-inflammatory foods. Research suggests that a diet that’s high in fruit and vegetables, with moderate amounts of omega-3 rich oily fish (such as salmon, tuna or herring), and low in red meat and sweets, helps lower risk for dementia, heart attacks, strokes, diabetes and other diseases. There is also some evidence that this type of eating plan reduces risk for AD. For the best cardiovascular protection, the BaleDoneen Method recommends following a diet based on your DNA.

Step Three: Stay mentally and socially engaged.

Like your body, your mind needs exercise to stay fit. The Lancet paper and other research show that highly educated people are less likely to suffer memory loss, possibly because keeping the brain active boosts its “cognitive reserve,” allowing it to work efficiently even if some of its neurons are damaged. A wide range of activities provide healthy mental stimulation, including the following:

Rev up your brain. A study of older nuns and priests found that those who spent the most time listening to the radio, reading the newspaper, going to museums and doing puzzles had a 47% lower rate of AD. Other brain-boosters include learning a foreign language, taking courses at a community college and playing games, such as bridge or Scrabble.
Consider brain training. The WHO guidelines advise healthcare providers to offer cognitive training (also known as brain training) to older adults to reduce their risk for cognitive decline and/or dementia. Although brain training, including software products, has exploded into a $1.3 billion industry in the U.S., these programs vary widely in quality — and many have no peer-reviewed evidence of their efficacy. Ask your healthcare provider if brain training is right for you and which program(s) he or she recommends.
Keep in touch with friends. Get-togethers with friends, neighbors or family can have a surprising payoff, Harvard researchers report. In their study of people in their 50s and 60s, those who were the most socially connected had half the rate of memory loss during the six-year study as those who were socially isolated.

Have your hearing checked. A surprising new discovery: Several studies report that even mild hearing loss raises dementia risk, while more severe hearing loss doubles or triples the threat. Hearing may be important to protecting memory because of what the Lancet paper’s lead author, University College London professor Gill Livingston, calls “the use it or lose it” model. “We get a lot of intellectual stimulation through hearing,” she told Vox. Researchers theorize that hearing aids may help reduce dementia risk, but further study is needed to find out for sure.

Is Alzheimer’s Disease Preventable?

A Three-Step Prevention Plan to Protect Your Brain

Step One: Optimize Your Cardiovascular Wellness

Step Two: Take Action to Avoid Fire in Your Arteries and Your Brain

Step Three: Stay mentally and socially engaged.

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