VIRGINIA FAMILY CAREGIVER FORUM

Alzheimer’s Disease and Dementia: Living Well to Care for and Preserve Cognition

"Alzheimer’s disease is NOT a normal part of aging..."

As we get older, many worry about the “losing their minds”, losing their independence or getting Alzheimer’s disease. It is important to point out that Alzheimer’s disease is not a normal part of aging; however the number of individuals who are affected increases from about 5% at age 65 to about 40% for individuals 85 and over. Therefore, risk factors and preservation strategies may be useful tools to ensure a lifetime of cognitive abilities and independence.

Risk factors for Alzheimer’s disease are of two categories: non-modifiable and modifiable.

Non-modifiable risk factors include:

age
female gender
apo E4 genotype
family history
genetics, and
Down’s syndrome.

Modifiable risk factors are:

head injury
psychological stress
high cholesterol
hypertension
diabetes
smoking, and
increased fat around the abdomen.

It is no accident that the risk factors associated with heart disease and type 2 diabetes are associated with Alzheimer’s disease. Keep in mind that the human body is an organism, and factors that affect the heart, as in heart disease, are likely to exert influence on other organs or organ systems within the organism. Recently, in the medical literature, Alzheimer’s disease has been referred to as type III diabetes.

"Engaging in 30 minutes of moderate intensity aerobic exercise is beneficial..."

So, what to do to preserve optimal cognitive functioning throughout the lifespan? Anything that decreases risk of other chronic diseases of the vascular system would reduce your risk. A natural starting point would be to engage in regular activity eat a well balanced diet. It has been demonstrated that exercise protects against cognitive decline in a specific manner. It decreases amyloid precursor protein (APP). This is the precursor to the beta amyloid plaques which are part of the characteristic pathology of Alzheimer’s disease. Exercise also increases naprilysin, an enzyme that degrades beta amyloid plaques. Although there isn’t an exercise recommendation specific to cognition, engaging in 30 minutes of moderate intensity aerobic exercise is beneficial. It has also been suggested that varying the mode of aerobic exercise may enhance the benefits.

Because excess calories are suspect when it comes to abdominal fat, consuming less is an improvement. However, there are certain foods that should not be eliminated, as they have been demonstrated to benefit cognition over the lifespan. Daily consumption of fruits and vegetables should be increased, thus providing an antioxidant rich diet. It has been demonstrated that individuals who eat the greatest number of servings of especially vegetables, have a much lower risk of dementia. The recommended daily allowance for vegetables is 3-5 servings per day and 2-4 servings per day for fruits. Regular consumption of fish (two servings per week) and the use of monosaturated fats have also been shown to reduce the risk of Alzheimer’s and dementia. Accompanying your meals with a glass of red wine has been shown to be beneficial. Resveratrol, the polyphenol found in the skin of red grapes, can decrease the oxidative stress causing beta amyloid plaques. So have a European meal! It will not only protect your heart, but your brain as well!

Living well also includes engaging in a lifetime intellectual activities. This includes, but is not limited to, learning a new hobby, writing, playing games or resolving puzzles or reading things that are different from your comfort zone. There are even computer programs that are designed to improve your “cognitive fitness.” By engaging in cognitive challenges, spatial memory, neuronal development and neurotropin growth factor increases. This protects against cognitive decline in a manner that is different from exercise or diet. Therefore, living well to preserve cognition should involve a 3 pronged approach: eat well, exercise and keep on learning!