Act now to reduce your Alzheimer's risk
Checkup on Health
This is an excerpt from a presentation delivered by Bruce Reed, Ph.D., a neuropsychologist and associate director of the UC Davis Alzheimer's Disease Center, at a Nov. 2014 caregivers workshop.
Click here to view the full presentation or other lectures from the center's community lecture series.
Our view of Alzheimer’s disease has changed a lot in recent years.
First, we know now that the disease develops over a very long period of time. There’s a long period before irreversible brain damage occurs. In a sense that’s good, because it gives us a long period to intervene and try to do something to head off the bad effects.
Most Alzheimer’s also occurs in older people who have experienced multiple kinds of brain injury which most of the time are small strokes.
The vascular factors – the things that cause our blood vessels to clog or hemorrhage – are especially important. That also offers us a chance to act now, because we know a lot about stroke risk factors and are making progress in treating them through things such as smoking cessation, blood pressure medications and cholesterol medications.
All of this really leads to the view that anything you can do to protect the general health of your brain will reduce your odds of developing Alzheimer’s disease. It’s not perfect and it’s not a cure, but it helps and can delay the onset, we think. That is real progress.
The most practical and useful thing you can do now to reduce dementia risk is to reduce vascular risk. That means exercise and diet. Neither is a popular word, but these things probably make a difference in avoiding heart disease, stroke and dementia.
The miracle drug
Learn more about dementia risk and research from KVIE Public Television and the UC Davis Alzheimer's Disease Center in the new KVIE Viewfinder documentary Fading Away: Alzheimer's. http://vids.kvie.org/video/2365420727
If I could sell you a drug that would treat diabetes and high blood pressure, reduce the plaques and tangles of Alzheimer’s disease, make your brain bigger and improve brain function, how much would you pay?
Lots. But you can do that with exercise. And it’s not that hard. There are studies that examined people before and after starting exercise, and they show increases in the volume of parts of the brain that are particularly important to memory function, and that physical exercise seems to improve memory. So it’s a really powerful kind of intervention.
And they’re not talking about really high-intensity exercise. It’s exercise a level that will get your heart rate up a little bit. There all kinds of things that will do it – walking, dancing, gardening, biking, Tai Chi, yoga – with kind of a half-hour target.
When you look at the studies, generally the biggest positive effects of exercise occur when you shift from “doing nothing” to “doing something”. And the additional positive effects of doing “a lot” are not that big. But just getting off the couch and getting out and doing something regularly, those benefits are pretty clear.
So I always tell people that the best exercise is the one that you will actually do, and you just have to stick with it. It’s kind of whatever works for you and that you find pleasant and can build into a routine. That’s one area where you can make progress in preventing Alzheimer’s and a host of other health problems.
A major study of thousands of people in Spain published in The New England Journal of Medicine compared a low-fat diet with the so-called Mediterranean diet in people who were developing atherosclerosis and at risk of heart attack.
They learned a couple things. First, you can’t get people to stay on a low-fat diet. It literally fails.
People will do the Mediterranean diet, however. So the study ended up being a comparison of the Mediterranean versus a normal diet. And then they stopped the study early, because the Mediterranean diet was so effective.
People were having so many fewer heart attacks that they needed to let people know about this and help the people on the normal diet change over. The effects were pretty clear pretty fast.
So the Mediterranean diet has positive vascular effects. And the good thing is, it’s a pretty sustainable diet.
One of the reasons is it emphasizes what you should eat vs what you shouldn’t eat – and the choices are not that bad. It suggests that people use more olive oil, and asks people to eat more nuts. They want people to use lots of olive oil and eat fruits, veggies, nuts and grains, with some proteins, particularly lean proteins.
Interestingly, the diet also included some wine and chocolate. The only things they really wanted people to cut back on were red meat, dairy and [higher-fat/higher-sugar] bakery goods.
If you think about what you can eat on the Mediterranean diet, there are a lot of good choices – so it’s a sustainable thing. The leaders of the study were able to get people to shift to this diet and maintain it for 2-3 years, where it was really making a difference in their health.