Decreasing the Risk of Dementia and Alzheimer's

Stimulate the Brain

Numerous studies have established a link between mental activity and education level and the risk of contracting Alzheimer's. One study of nuns found that the more educated women had fewer cases of Alzheimer's disease. Autopsy analysis found that even though amyloid deposits were evident in individuals who did not have Alzheimer's, those who were active mentally or highly educated seemed not to have been afflicted by symptoms. Amyloid deposits in brain tissue are currently used as a marker for identifying Alzheimer's disease. Other studies have found similar results. Individuals who keep their brains stimulated have a lower risk of developing Alzheimer's disease.

Another study found that people who remain engaged reading or playing games throughout their life have a lower level of amyloid deposits in the brain. Other strategies for lessening the risk include being involved in occupational, recreational and social activities that require using our brains.

A long-term study recently published in the "Archives of Neurology" followed a number of aging seniors over a period of years. Imaging equipment tested the level of amyloid deposits in the participant's brains. Neuropsychological tests were also conducted to see what effect cognitive stimulation had on Alzheimer's risk and that was correlated with deposits of beta amyloid protein. The researchers found that people who engaged in brain stimulating activities, particularly when they were young and middle-aged, had the least amount of beta amyloid. Those who were most active mentally had the least amount of amyloid while those who were less active mentally had amyloid levels similar to Alzheimer's patients. Empirical testing and interviews to determine the level of cognitive stimulation correlated with higher amyloid levels and Alzheimer's symptoms in participants who were less active mentally.

This study would tend to suggest that there is a physiological process going on where stimulating the brain through activities such as reading, playing games, engaging in social interaction, learning a new language, learning new information and so on seems to create a cellular response where deposition of toxic amyloid protein in the brain is reduced.

Remain Physically Active

In one study, published in Lancet Neurology, researchers followed the lifestyles of people in Finland from when they were 50 to when they were 70 years old. Those who were active, meaning that they exercised more than twice a week for 20-30 minutes to the point of breathlessness and sweating, reduced their risk of Alzheimer's by 60 percent. Turning this around, this means that given 100 people who would eventually develop dementia, engaging and vigorous exercise would result in only 40 of those people developing dementia. The age of the participants in the study indicates that it's never too late to get started with physical activity.

Another more appealing physical activity might be dancing. Experts at the University of Stirling's Dementia Services Development Centre suggest that seniors who don't like the pressure of having to exercise regularly may find it easier to engage in ballroom dancing. This not only provides a form of exercise but also helps to stimulate the brain through learning activities.

Reduce Stress

A recently released study from researchers in Sweden followed 800 women ages 38 to 54. Beginning in 1968, the study tracked their health over 38 years. The participants were periodically given neuropsychiatric exams and a battery of standardized tests. The data collected included information on 18 common stressors, including divorce, serious illness or death of a child or spouse, mental illness or alcohol abuse in a close relative and job loss or other work-related problems. The researchers also collected information on symptoms of distress the women experienced, including irritability, fear and sleep problems.

During the period of the study, over half of the women died - 425 of them. During the next 38 years, 153 of the women developed dementia, at an average age of 78, including 104 cases of Alzheimer's disease. Those who had experienced the most stress in midlife were 15 percent more likely than the others to have developed any type of dementia, and 21 percent more likely to have developed Alzheimer's nearly four decades later.

Although the study cannot conclusively correlate stress to the development of dementia, other studies on the impact of stress on health support the idea there is a linkage. The study did not go into any detail on what type of stress may have had an impact on developing dementia or whether stress relieving strategies had an effect. Drawing conclusions before more detailed studies have been done, might be premature; however, there does appear to be a relationship between stress and the development of dementia.

If this is the case, then using strategies to reduce stress, might have a profound effect on the risk of developing dementia or Alzheimer's. In addition, stress reduction activities have been shown by other studies to reduce the impact of health problems in later years and to slow down the process of aging. There is a decided advantage in using stress reduction strategies not only to potentially reduce the risk of dementia but also to improve health.

Lose Weight

Researchers at Rush University Medical Center have found that middle-aged people with high abdominal fat are 3.6 times as likely to suffer from memory loss and dementia later in life as those who are thinner. A protein responsible for metabolizing fat in the liver is the same protein found in the part of the brain that controls memory and learning. The researchers found that people with higher abdominal fat deplete this fat metabolizing protein.

Researching with mice, the staff found that mice deficient in the protein are poor with memory and learning capabilities. Injecting the protein into the brains of the mice improved learning and memory. The researchers hypothesize that mice and humans share the same physiological traits when it comes to fat and memory proteins. The assumption is that weight loss can improve the risk of not developing dementia in later life.

In addition, high levels of abdominal fat are also correlated with developing high blood sugar and contracting type II diabetes. As we discuss below, there is a link between blood sugar, diabetes and the risk of developing dementia in later life.

Maintain Proper Sleep

A study from the Stanford Sleep Medicine Center has found that when we sleep, our brains rid themselves of harmful chemicals that accumulate while we are awake. This cleaning process was detected in the brains of sleeping mice, but researchers indicate that there is no reason to doubt that it can happen in people as well. If so, this finding may indicate that adequate sleep could help slow the process of people with dementia or other brain disorders.

It is a well-established fact that individuals who don't get enough sleep have trouble learning and making decisions and are slower to react. Although the purpose for sleep has not yet been determined in humans or other animals, one reason might be the need to flush out harmful chemicals that interfere with proper operation of the brain. Research at the University of Rochester Medical Center also substantiates this theory. These researchers found that injecting beta amyloid - the protein directly related to the development of Alzheimer's disease - into the brains of mice did result in symptoms of Alzheimer's. They also found that amyloid was removed faster from the brains of sleeping mice than from the brains of mice that were awake.

Another study from Johns Hopkins Bloomberg School of Public health published in JAMA Neurology followed 70 senior adults who slept five hours or less or who reported poor sleep quality. The average age was 76. Brain scans revealed abnormal amyloid deposits found in Alzheimer's disease. Whether the sleep was a result of the abnormal amyloid or whether the amyloid resulted in poor sleep needs further investigation.

Ironically, oversleeping may also contribute to the risk for developing cognitive impairment. It looks like we just can't win either way. A Spanish study involving 2,700 participants in their 60s and 70s, over a three-year period, analyzed the changes in brain function for these participants who detailed records of their sleeping patterns including how much time they spent in bed.

Prior to starting the study, all participants took the Mini-Mental State Examination to assess their cognitive state. After the study was completed all participants took the same examination. Beginning assessments were compared with ending assessments. Those individuals who slept more than nine hours a day did more poorly than did the individuals who slept 6 to 8 hours a day. This study does not necessarily prove that oversleeping can lead to dementia, but it does make us aware that sleep is an important issue in mental function.

Strive for Proper Heart Health

The risk of developing Alzheimer's or vascular dementia appears to increase as a result of many conditions that damage the heart or blood vessels. These include high blood pressure, heart disease, stroke, diabetes and high cholesterol. Some autopsy studies show that as many as 80% of individuals with Alzheimer's disease also have cardiovascular disease.

A longstanding question is why some people develop hallmark Alzheimer's plaques and tangles but do not develop the symptoms of Alzheimer's. Vascular disease may help researchers eventually find an answer. Autopsy studies suggest that plaques and tangles may be present in the brain without causing symptoms of cognitive decline unless the brain also shows evidence of vascular disease. Many experts believe that controlling cardiovascular risk factors may be the most cost-effective and helpful approach to protecting brain health.

Considerable evidence also suggests that Alzheimer's disease could be considered primarily a vascular disorder in which the brain does not receive enough blood flow to function optimally. This hypothesis is supported by numerous observations: 1) impaired blood flow to the brain can set in motion cognitive and neurodegenerative changes similar to those seen in Alzheimer's disease; 2) medications that improve cerebral blood flow improve Alzheimer's disease symptoms; and 3) decreased cerebral blood flow may be detectable even before symptoms of Alzheimer's disease manifest.

A recent report in the Proceedings of the New York Academy of Sciences has shown that hypoxia-the reduction in oxygen received by the brain due to decreased blood flow-may be a "trigger" that contributes to the pathogenesis of Alzheimer's disease. The authors of this important research have shown that hypoxia increases the activity of a gene called BACE1, which is involved in the production of damaging amyloid-beta plaques found in the brains of Alzheimer's patients. The researchers found that hypoxia markedly increased amyloid-beta deposition and plaque formation in central neurons. Since a decrease in the amount of oxygen delivered to the brain may very well set off a cascade of events that culminates in Alzheimer's disease, conditions like heart disease-a cause of brain hypoxia-provide a stark connection between heart disease and Alzheimer's.

Maintaining a healthy heart and cardiovascular system is compatible with all of the other activities that can be done to reduce risk of developing dementia. This includes proper nutrition, proper hydration, exercise, reducing chronic stress which causes inflammation of the arteries, maintaining a proper weight and controlling blood pressure. All of these activities for a healthy cardiovascular system have also been proven individually to reduce the risk of Alzheimer's.

Control Blood Sugar

High blood sugar as either a precursor to diabetes or as full-blown type II diabetes contributes to cardiovascular disease. As mentioned in the section above, cardiovascular disease is linked to an increased risk for vascular dementia and possibly Alzheimer's disease. Many people with diabetes also have brain changes that are hallmarks of both Alzheimer's disease and vascular dementia. Some researchers think that each condition - Alzheimer's and vascular dementia - fuels the damage caused by the other.

Research also points to a direct link between high blood sugar, dementia and the inability of the body to respond to insulin to use that blood sugar. There may be some triggering mechanism associated with insulin resistance in the brain. A recent study examined a medication used to treat type II diabetes to determine whether the medication would also improve cognitive function in people with mild Alzheimer's disease. Results showed a positive change in cognitive function.

A study involving 2,067 people 65 and older was conducted by the Group Health Cooperative - a Seattle-area health care system. At the start, 232 participants had diabetes; the rest did not. They each had at least five blood-sugar tests within a few years of starting the study and more after it was underway. Researchers averaged these levels over time to even out spikes and dips from testing at various times of day or before or after a meal.

Participants were given standard tests for thinking skills every two years and asked about smoking, exercise and other things that affect dementia risk.

After nearly seven years of follow-up, 524, or one quarter of the cohort, had developed dementia - mostly Alzheimer's disease. Among participants who started out without diabetes, those with higher glucose levels over the previous five years had an 18 percent greater risk of developing dementia than those with lower glucose levels.

Among participants with diabetes at the outset, those with higher blood sugar were 40 percent more likely to develop dementia than diabetics at the lower end of the glucose spectrum.

The effect of blood sugar on dementia risk was seen even when researchers took into account whether participants had the apoE4 gene, which raises the risk for Alzheimer's.

At least for diabetics, the results suggest that good blood-sugar control is important for cognition.

For those without diabetes, it may be that with the brain, every additional bit of blood sugar that shows up as above normal is associated with higher risk. It changes how we think about thresholds, how we think about what is normal and what is abnormal.

The results of this study would indicate that all individuals should have blood sugar tests done on a regular basis and if blood sugar is high, even though diabetes is not yet diagnosed, steps should be taken to lower that blood sugar level. This can be done through diet, exercise and weight loss.

Get Checked for Anemia

Anemia is common in adults 65 and older and has been linked to early death. Now it's also being linked to a higher risk of dementia.

In a recent study, more than 2,500 seniors, ages 70 to 79 were checked for anemia, then put through a series of thinking tests for more than a decade.

393 of the participants had anemia at the start of the study. By the end, 23% of them had developed dementia compared to just 17% of the people who did not have anemia.

Drilling deeper, the data showed that people who had anemia at the start had a nearly 41% higher risk of developing dementia than those who did not.

Anemia is when the blood has a lower-than-normal number of red blood cells, or less Hemoglobin, affecting delivery of oxygen to your body and brain. The researchers say this could have an impact on memory and thinking.

If an individual has anemia, the blood does not carry enough oxygen to the rest of the body. The most common cause of anemia is not having enough iron. The body needs iron to make hemoglobin. Hemoglobin is an iron-rich protein that gives the red color to blood. It carries oxygen from the lungs to the rest of the body.

Anemia has three main causes: blood loss, lack of red blood cell production, and high rates of red blood cell destruction.

Conditions that may lead to anemia include

• Ulcers
• Colon polyps or colon cancer
• Inherited disorders
• A diet that does not have enough iron, folic acid or vitamin B12
• Blood disorders such as sickle cell anemia and thalassemia, or cancer
• Aplastic anemia, a condition that can be inherited or acquired
• G6PD deficiency, a metabolic disorder

Symptoms of anemia include feeling tired, cold, dizzy, and irritable. The person may be short of breath or have a headache. Anemia is diagnosed through a physical exam and blood tests. Treatment is often simple but may depend on the type of anemia.

Eliminate the Use of Tobacco

The following was taken from the WebMD website

By Bill Hendrick
WebMD Health News
Reviewed by Laura J. Martin, MD

Oct. 25, 2010 -- People who are heavy smokers in their midlife years are more than doubling their risk of developing Alzheimer's disease or other forms of dementia two decades later, a new study shows.

While smoking has long been known to increase the risk of dying from cancer and heart disease, researchers in Finland say they've found strong reason to believe that smoking more than two packs of cigarettes daily from age 50 to 60 increases risk of dementia later in life.

Scientists at the University of Eastern Finland and at Kuopio University Hospital, Finland, analyzed data from 21,123 members of a health care system who took part in a survey between 1978 and 1985, when they were between ages 50 and 60.

Diagnoses of dementia, Alzheimer's disease, and vascular dementia were tracked from Jan. 1, 1994, when participants were 71.6 years old, on average, through July 31, 2008.

Among the key findings:

• 25.4% of the participants, or 5,367 people, were diagnosed with dementia an average of 23 years later.
• Of patients with dementia, 1,136 were diagnosed with Alzheimer's disease and 416 with vascular dementia.

Researchers say that people who smoked more than two packs of cigarettes a day in middle age had an elevated risk of dementia overall and also of each subtype, Alzheimer's and vascular dementia, compared with nonsmokers.

On the other hand, former smokers or people who smoked less than half a pack per day did not appear to be at increased risk of developing dementia. And associations between dementia and smoking did not vary by race or sex.

Smoking is considered a well-established risk factor for stroke and may contribute to the risk of vascular dementia through similar mechanisms, the researchers say.

In addition, they say that smoking contributes to oxidative stress and inflammation, which are believed to be important in the development of Alzheimer's disease.

"It is possible that smoking affects the development of dementia via vascular and neurodegenerative pathways," the researchers write.

Previously, a link between smoking and the risk of Alzheimer's disease has been considered controversial, with some studies even suggesting that smoking reduces the risk of cognitive impairment, Parkinson's disease, and other neurodegenerative conditions.

Although smoking's ill effect on public health has been well established, the researcher say, this study shows its impact is likely to become even greater as the population ages and dementia prevalence increases.

The study shows heavy smoking was found to be associated with a greater than 100% increase in risk of dementia and its forms 20 years after midlife, and that the brain is thus "not immune to long-term consequences of heavy smoking."