The race to find a cure for Alzheimer’s disease has intensified in recent years. With the aging of the populations in the U.S., Japan and most of the industrialized world, over the next few decades Alzheimer’s threatens to overwhelm health care systems and exact a human cost that is almost unimaginable. To try to prevent such a disaster as well as ease the suffering of the current 12 – 15 million people worldwide now estimated to have the disease, scientists are exploring every angle in their quest to find a prevention or a cure.
So far, no one has found a “magic bullet” to stop the disease process once it has begun, nor can we prevent it altogether. But in recent years, scientists have found several ways to delay its onset and slow its course. They believe that if one adopts certain recommendations, the onset of the disease could be delayed by up to five years. While this may not be the news we’re all waiting to hear, it’s very good news nonetheless. Here’s why.
The risk of developing Alzheimer’s rises sharply the older we get. While approximately 10% of Americans over 65 have the disease, the rate of incidence after 85 is almost 50%. This means there’s a steep upward curve in risk after age 65. So let’s say that, for reasons that are still not well understood, one is destined to develop Alzheimer’s at age 70, but is able to delay its onset until age 74. At that time, one of the four currently available Alzheimer’s drugs can be started, prolonging the early stage of the disease, when the patient is still for the most part functional, for another two years.
This means the patient has added six meaningful years to his life, years that would have been overshadowed by the devastating decline caused by Alzheimer’s disease if he had not taken steps to delay it. And because these are years characterized by rising mortality due to other causes, the person may be able to avoid the particular tragedy of Alzheimer’s altogether. Loved ones will not have experienced the grief of caring for him in the advanced stages of Alzheimer’s, and placement in a nursing home may never even be a consideration.
So how can you take steps to avoid or delay Alzheimer’s disease? Alzheimer’s Disease Research, a research foundation headquartered in Clarksburg, MD, makes the following recommendations:
1. Control your blood pressure. Research has shown a higher incidence of Alzheimer’s among those with uncontrolled high blood pressure. Know your blood pressure, and if your systolic pressure is 130 or higher, limit your salt intake and take any blood pressure-lowering medications your doctor prescribes for you.
2. Maintain a low blood cholesterol level. Evidence is mounting that those who have high cholesterol from middle age onward have a four- to five-times higher risk of developing Alzheimer’s in their later years. Considering that high cholesterol levels also contribute to a risk of stroke-related dementia, too much fat and cholesterol in the diet is a definite no-no if you want to stay mentally sharp as you age. At the same time, taking a cholesterol-lowering “statin” drug is associated with a lower risk of Alzheimer’s.
3. Discuss anti-inflammatory drugs with your doctor. Some studies have suggested that these medications may lower the risk of developing AD and also may slow the progress of the disease. During the course of AD, there is an inflammatory response in the brain tissue, and it is thought that NSAIDs may help by reducing inflammation. However, liver and kidney damage, and gastrointestinal bleeding are risk factors associated with NSAID use, and new information has recently come to light about a possible cardiovascular risk.
Update: In December of 2004, the National Institutes of Health (NIH) announced that research investigators suspended, until further notice, the use of two drugs, naproxen (Aleve™) and celecoxib (Celebrex™ ). The decision was based on data from a large national Alzheimer’s disease prevention trial sponsored by the National Institute on Aging (NIA), a part of the NIH. The trial, called the Alzheimer’s Disease Anti-Inflammatory Prevention Trial (or ADAPT) was designed to assess the potential benefit of long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) in decreasing the risk of developing Alzheimer’s disease in people 70 years of age or older who were considered to be at increased risk because of family history, but did not have symptoms of the disease. The trial was stopped because the data indicated an apparent increase in cardiovascular and cerebrovascular events among the participants taking naproxen when compared with those on placebo. This step was taken as a precautionary measure to ensure the safety of the study’s participants. Further studies are needed before general recommendations can be made concerning the use of NSAIDs.
4. Get your antioxidant vitamins. There is now a significant body of research suggesting that the antioxidant vitamins, especially vitamins E and C, can prevent or delay the development of Alzheimer’s, and slow its course once it develops. Most experts agree that the best source of vitamins is in the foods we eat, but taking supplements as we age is also a good idea. Take 400 IUs (international units) of vitamin E and 500 mgs (milligrams) of vitamin C a day for prevention. If you’re having memory problems, take the same dosages twice a day, and if Alzheimer’s has already been diagnosed, up your dosage to three times a day.
5. If you have memory problems, take a cholinesterase inhibitor. This is a class of prescription drugs that includes four drugs approved by the FDA for the treatment of Alzheimer’s. These drugs increase the brain’s supply of a key neurotransmitter, called cholinesterase, and are known to slow the course of Alzheimer’s disease. The commercial names for these drugs (in order of how long they’ve been around) are Cognex, Aricept, Exelon and Reminyl. The earlier you begin taking these drugs after you develop memory problems, the more effective they can be.
6. Exercise your mind and body. For reasons that are still not well delineated, regular physical exercise seems to improve cognitive ability throughout life and is also associated with a lower risk of Alzheimer’s. And the old adage, “use it or lose it” applies equally to the brain. Any type of intellectual stimulation engaged in regularly helps—whether it involves reading, learning new skills, playing challenging games or seeking out stimulating social activities. In other words, we need to rethink our concept of retirement. Rather than making our later years a time to “drop out” of life, our brains and bodies are telling us to live fully, stay engaged, and to constantly seek out the new.