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Alzheimer's: What You Can Do

people dancing
Photo: VPM | "Revolutionizing Dementia Care" 2018.

As we age, we occasionally find ourselves questioning the cognitive abilities of ourselves or our loved ones. Researchers have recently shown that we can implement simple, everyday practices to potentially forestall the onset of Alzheimer’s and other related forms of dementia.

“Everyone is afraid of the ‘A’ word: Alzheimer’s,” says Dr. Gayatri Devi, Director of Park Avenue Neurology in New York City. “The story always is that there's nothing that can be done for Alzheimer’s, nothing that can be done for dementia.” Dr. Devi emphasizes that each of us can implement positive lifestyle changes in order to make a difference. “There are many things you can do about dementia and Alzheimer's that are effective and available now to help change your life story going forward.”

Neurologists around the world now understand the influence of genes on the formation of Alzheimer’s and dementia. As a graduate student, Dr. Rudy Tanzi, Vice Chair of Neurology at Harvard, mapped chromosome 21. He correctly speculated the gene helped produce Alzheimer’s, and specifically that it was the gene that created amyloid plaques, sticky boulder-like materials that accumulate around nerve cells in the brain of early onset Alzheimer's patients.

Dr. Tanzi
Dr. Rudy Tanzi speaks with researcher. (Photo: VPM | "Alzheimer's: What You Can Do" 2021)

“For most of us, you have to ask, how do I keep my brain resilient?” Tanzi reflects. The current trend is to treat high risk patients, people in their fifties and sixties, with drugs before they show symptoms of the disease. But Tanzi indicates that drugs are not always the best solution because, “some people get plaques and tangles and never get the disease.” Luckily only 2 or 3% of Alzheimer's is due to specific hardwired genes that cause early onset. In 97 to 98% of Alzheimer’s cases, Tanzi points out, “it's the interplay of genetic susceptibility…and your lifestyle.”

The first step is to get tested. “People have thought, there's nothing you can do about it. Therefore, you better not check,” Dr. Dale Bredesen, Chief Science Officer at Apollo Health admits, but then he asks, “Why would you stick your head in the sand?” Bredesen and other neurologists have developed a variety of genetic, blood, and cognitive tests to determine a patient’s risk for dementia. Bredesen uses the data from these tests to create a precision protocol, a personalized course of action, for a patient with cognitive decline.

“Imagine that you have a roof with 36 holes in it. You’ve got to patch all the holes to have a big effect,” Bredesen explains. These 36 holes represent deficient areas where an individual can optimize programmable genes for better cognitive health. The programming can be influenced by anyone using everyday methods.

Dr. Rudy Tanzi has developed the acronym S.H.I.E.L.D. for these common methods:

Sleep:
Getting enough sleep supports good cognition. Doctors recommend eight or nine hours every night. Tanzi reveals that, “during deep sleep, you are cleaning your brain. All this debris that accumulates in your brain [like plaques], especially after 40 years old…during deep sleep, you actually get rid of them. So, you need as much sleep as possible to clean your brain. Because if you don't clean your brain, that debris will someday at some point, go on to cause neuroinflammation. And that's when you go down the slippery slope.” But if you, like many, can’t sleep through the night, no worries, you can catch up during the day with a nap.

Handling Stress:
“Stress increases the production of a chemical called cortisol, which is over a long period of time, directly damaging to the brain's memory center called the hippocampus,” says neurologist and author Dr. David Perlmutter. “Research shows [with] as little as 12 minutes a day, being involved in meditation, practicing mindfulness, or even religious prayer, you gain powerful brain benefits.” Rudy Tanzi often hears patient’s concerns about meditation, “People say, ‘I don't have time to meditate.’ Anybody [who] says that need’s meditation the most. And ‘I don't know how to meditate.’ You don't have to sit in the Lotus position. Sit in a chair…keep your spine straight, close your eyes...We have a very simple term. If you're meditating, you're doing it right.”

Interact with Others:
It’s well known that when people retire, they can lose purpose, they get depressed, and descend into sickness. Having a task, caring for other people, engaging in the arts and creativity, taking care of your home and your body, joining a club or a decision making committee, plus many other forms of interaction and engagement promote purpose, a meaningful life, and help stave off dementia.

Exercise:
In 2017, the journal Neurology released a study about the most effective drugs neurologists should give to their patients. Instead of promoting any drug, they made one alternate recommendation: exercise for thirty minutes each day. “There are really two kinds of exercise that we emphasize,” says Dr. Anne Hathaway of San Rafael California, “one is interval training, warming up and then exercising as hard as you can for 20 to 60 seconds, and then relaxing until you can do it again. [Also], strength training is important.” Exercise is essential to brain health since it changes the DNA expression (i.e., reprograms genes) in a person’s body to turn on something called brain derived neurotrophic function, or BDNF which grows new brain cells where we need it the most, the hippocampus: the brain’s memory center.

Learning New Things:
Alzheimer’s disease and dementia correlate with a loss of synapses: the connections between nerve cells. Challenging mental activities push the brain to focus and pay attention. Every time you learn something new you reinforce old connections and create new pathways. “When you’re doing anything complex, you involve all of the brain,” say Drs. Dean and Ayesha Sherzai of Loma Linda California. “Challenging mental activity is complexity; write a book, learn a new language, learn a musical instrument. That’s a brain challenged at the highest level.”

Diet:
But, Dean Sherzai adds, “food is the most important. The best studies show that if you eat well, [and eat a] plant centered [diet], your risk [of Alzheimer’s] goes down.” If you eat junk food or food with high sugar content and you have bad genes, your risk for dementia goes up.” Good food: leafy greens, broccoli, nuts and sparing amounts of fruits and meats, reduces that risk. “It's that significant. It's poison versus medicine. That's food and its relationship to your brain.”

Considering these methods as a whole, Ann Hathaway explains, “The reason the protocol works is because we cast such a wide net, and you have to look at this as a puzzle with potentially lots of different pieces.” Dale Bredesen adds, “You don't have to be perfect. You just have to keep at it until you start seeing improvement and then keep tweaking and keep optimizing.”

“I don't have an answer to what people should be doing to find out what chances they have of getting dementia, or if they've already got it.” Dr, John Zeisel, CEO of Hearthstone Alzheimer Care concedes. “Now, if it's to change your life and eat better, sleep longer, have less stress, do more exercise and maintain purpose in your life. I'm all in favor, but I don't need to know I have a chance of dementia to do those five things. We should do those things anyway.”

This article was written based on recorded interviews with nationally recognized Alzheimer's researchers for a new VPM documentary to premiere in the spring of 2021. Alzheimer's: What You Can Do explores the everyday methods that are being proven to help ward off types of dementia. The excerpts here do not tell the full story, but we encourage you to learn more and develop strategies that you can implement in your own life. Adopting healthy habits at any age is beneficial, but doing it earlier in life can make a huge difference as we grow older.

To learn more about this film and to view Alzheimer's: The Caregiver's Perspective and Revolutionizing Dementia Care be sure to watch VPM’s Alzheimer’s documentaries at vpm.org/dementia documentaries.

References:

The Spectrum of Hope: An Optimistic and New Approach to Alzheimer’s Disease and Other Dementias [Gayatri Devi, MD]

Super Genes: Unlock the Astonishing Power of Your DNA for Optimum Health and Well-Being [Rudolph E Tanzi and Deepak Chopra]

Grain Brain: The Surprising Truth about Wheat, Carbs and Sugar—Your Brain’s Silent Killers [David Perlmutter, MD with Kristin Loberg]

The Alzheimer’s Solution: A Breakthrough Program to Prevent and Reverse The Symptoms of Cognitive Decline at Every Age [Dean & Ayesha Sherzai, MD]

The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline [Dale E. Bredesen, MD]

I’m Still Here: A New Philosophy of Alzheimer’s Care [John Zeisel, Ph.D.]