Can You Prevent Alzheimer's Disease?
Dr. Daniel Press, Neurologist and Alzheimer’s specialist at Beth Israel Deaconess Medical Center, answers commonly asked questions.
Are there medications that can prevent Alzheimer’s disease?
There’s a great interest in how to prevent Alzheimer’s disease in those at risk. To date, trials of anti-inflammatory medications, hormonal therapy and vitamin E have not found any to be effective. The good news is that there are other factors such as diet, exercise, and mental activity that have showed great promise in both the lab and in studies in people.
What are some of the dietary factors that may play a role in prevention?
In general, a “heart healthy” diet, which emphasizes fruits and vegetables while avoiding saturated fats, is our best recommendation. A number of studies suggest that the Mediterranean diet, high in fish, olive oil, and vegetables is associated with a lower risk of dementia. Whether it actually prevents dementia will take a randomized study, where people are randomly assigned to alter their diet in a specific fashion.
Obesity, elevated cholesterol and diabetes are all recognized risk factors for dementia, so dietary and lifestyle changes that address these issues are likely to lower one’s risk of dementia.
How might exercise help?
Regular exercise may help prevent Alzheimer’s in a number of ways. Mostly, it keeps blood flowing to the brain and encourages the development of new brain cells. The best types of exercise are aerobic activities like walking, biking – even gardening. The Alzheimer’s Association suggests 30 minutes of this type of exercise per day to get the body moving and the heart pumping.
The great news – you don’t have to do the 30 minutes all at once. Research has shown that breaking this time into even three episodes of 10 minutes each (walk the dog, park far away at the mall and take a brisk walk over, climb a couple flights of stairs at lunchtime or as a work break etc) can be beneficial.
Talk about mental activity – what kind? And how might this be beneficial?
It doesn’t have to be one specific activity. Patients often ask me if there’s one specific activity computer program they should do, whether they should do Sudoku or crossword puzzles. I tell them to stay mentally active doing whatever they enjoy. The main point is, that old adage of ‘use it or lose it,’ seems to hold true for the brain just as it does for other parts of the body.
How might heart disease prevention play a role in keeping the brain sharp?
Risk factors for heart disease such as high blood pressure, diabetes or high cholesterol, also increase the risk for developing Alzheimer’s disease. So while we try to take good care of our heart, we might also be helping to prevent Alzheimer’s disease. We’re starting to understand at even a molecular level why that might be. There’s an intimate relationship between vascular problems and the proteins that build up in Alzheimer’s disease. If someone has just some vascular disease and just a little bit of Alzheimer’s disease, it could cause them much more cognitive problems than if they didn’t have any vascular disease at all.
It’s interesting that a lot of people can have a fair bit of Alzheimer’s changes in their brain and have no symptoms at all and their memory can be fine. It may well be that those are the people who have particularly good blood vessels and good vascular health. They seem to be able to tolerate a far bigger burden of Alzheimer’s disease in the brain without it causing them major symptoms.
Above content provided by Beth Israel Deaconess Medical Center.
For advice about your medical care, consult your doctor.
Posted December 2008
Are there medications that can prevent Alzheimer’s disease?
There’s a great interest in how to prevent Alzheimer’s disease in those at risk. To date, trials of anti-inflammatory medications, hormonal therapy and vitamin E have not found any to be effective. The good news is that there are other factors such as diet, exercise, and mental activity that have showed great promise in both the lab and in studies in people.
What are some of the dietary factors that may play a role in prevention?
In general, a “heart healthy” diet, which emphasizes fruits and vegetables while avoiding saturated fats, is our best recommendation. A number of studies suggest that the Mediterranean diet, high in fish, olive oil, and vegetables is associated with a lower risk of dementia. Whether it actually prevents dementia will take a randomized study, where people are randomly assigned to alter their diet in a specific fashion.
Obesity, elevated cholesterol and diabetes are all recognized risk factors for dementia, so dietary and lifestyle changes that address these issues are likely to lower one’s risk of dementia.
How might exercise help?
Regular exercise may help prevent Alzheimer’s in a number of ways. Mostly, it keeps blood flowing to the brain and encourages the development of new brain cells. The best types of exercise are aerobic activities like walking, biking – even gardening. The Alzheimer’s Association suggests 30 minutes of this type of exercise per day to get the body moving and the heart pumping.
The great news – you don’t have to do the 30 minutes all at once. Research has shown that breaking this time into even three episodes of 10 minutes each (walk the dog, park far away at the mall and take a brisk walk over, climb a couple flights of stairs at lunchtime or as a work break etc) can be beneficial.
Talk about mental activity – what kind? And how might this be beneficial?
It doesn’t have to be one specific activity. Patients often ask me if there’s one specific activity computer program they should do, whether they should do Sudoku or crossword puzzles. I tell them to stay mentally active doing whatever they enjoy. The main point is, that old adage of ‘use it or lose it,’ seems to hold true for the brain just as it does for other parts of the body.
How might heart disease prevention play a role in keeping the brain sharp?
Risk factors for heart disease such as high blood pressure, diabetes or high cholesterol, also increase the risk for developing Alzheimer’s disease. So while we try to take good care of our heart, we might also be helping to prevent Alzheimer’s disease. We’re starting to understand at even a molecular level why that might be. There’s an intimate relationship between vascular problems and the proteins that build up in Alzheimer’s disease. If someone has just some vascular disease and just a little bit of Alzheimer’s disease, it could cause them much more cognitive problems than if they didn’t have any vascular disease at all.
It’s interesting that a lot of people can have a fair bit of Alzheimer’s changes in their brain and have no symptoms at all and their memory can be fine. It may well be that those are the people who have particularly good blood vessels and good vascular health. They seem to be able to tolerate a far bigger burden of Alzheimer’s disease in the brain without it causing them major symptoms.
Above content provided by Beth Israel Deaconess Medical Center.
For advice about your medical care, consult your doctor.
Posted December 2008
