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Alzheimer's Disease (AD) Prevention



Why is this a big deal?

Currently 5.8 million people in the US have AD, and it is expected to rise up to 14 million by 2050.9 It is the 6th leading cause of death in the United States, killing more individuals than breast and prostate cancer combined.9 Further, 1 in 3 seniors die with AD or another dementia.[9]

The Takeaway

Up to 1/3 of AD cases may be prevented by lifestyle modifications including:

  • Mediterranean / DASH diet

  • These are the most well-studied diets with respect to preventing Alzheimer’s disease. However, there are other promising diets, especially restriction diets.

  • Regular Exercise

  • Sauna Use

  • Sleep

  • Smoking Cessation

  • Controlling/preventing chronic diseases

  • Avoiding hearing loss

  • Avoiding TBI

Discussion

Why is lifestyle so important for prevention?

There has been continuous failure of drug trials for treating AD. However, there is renewed interest in prevention of AD – and that is through lifestyle modifications! This means it is up to you on a DAILY basis to try to prevent yourself from developing AD. This cannot be done once or twice a week or with intermittent health diets and bouts of exercise. Rather, it is an entirely new lifestyle.


What are the non-modifiable and modifiable risk factors for AD?

There are two major non-modifiable risk factors: age and genes. Thankfully, you can work to optimize your chances even if you are genetically predisposed to develop AD by altering/avoiding the modifiable risk factors below:

1. Central obesity, hyperlipidemia, HTN, insulin resistance, Diabetes, smoking, MDD, CAD, CVD, physical inactivity, elevated homocysteine, low B12, and low education [1, 2, 3]

2. Hearing loss [6]

3. Insomnia or excess sleep (>9 hrs in adults) [4,5]

4. Sometime modifiable risk factor – Traumatic brain injuries, the number and age at which they occur matter [6]

Studies

Antihypertensive meds may result in 19-55% reduction in cognitive decline, vascular dementia, and AD2. Additionally, it is thought that up to 1/3 of AD cases may be prevented by controlling the above factors![3]


Try to prevent the following from #1 with Mediterranean/DASH diet2 (although potentially numerous other healthy diets that have just not been studied…), Cognitive training (learning languages, higher education), Sauna (significant results seen with 4x or more per week) have a hazard ratio for dementia and AD 0.34 (95% CI: 0.16–0.71 P = 0.004) and 0.35 (95% CI: 0.16–0.90 P = 0.029), respectively, sleeping close to 8 hours/day, and regular exercise.[7] Another plus to sauna is that it reduces blood pressure and increases vascular compliance (a full post on sauna will be done later).[8]


More information

I have a powerpoint presentation that was posted to the University of Florida’s Institute on Aging Department of Aging & Geriatric Research. If you would like to see more in depth discussion and the specific studies that were reviewed, see below: https://aging.ufl.edu/education/the-4th-year-required-geriatrrehabilitation-clerkship/student-presentations/

References:

  1. https://www.frontiersin.org/articles/10.3389/fnagi.2014.00282/full

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546647/

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5596480/

  4. https://www.ncbi.nlm.nih.gov/pubmed/25188896

  5. https://www.ncbi.nlm.nih.gov/pubmed/30030112

  6. https://www.nature.com/articles/d41586-018-05724-7

  7. https://academic.oup.com/ageing/article/46/2/245/2654230

  8. https://www.nature.com/articles/s41371-017-0008-z

  9. https://www.alz.org/alzheimers-dementia/facts-figures

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