Last year, the Alzheimer's Association reported that one in six women and one in 10 men age 55 and older in the (IS will develop Alzheimer's disease. (More women get Alzheimer's, in part, because they tend to live longer.) Many people think that not getting Alzheimer's is more about good genes than good health. but new research suggests that lifestyle factors, such as diet and exercise, play key roles.
Here's what you need to know about the latest scientific advances in the battle against Alzheimer's disease…
Prevention
New research shows that the primary feature of Alzheimer's—the accumulation of a protein by-product called beta-amyloid that wrecks brain cells—starts decades before symptoms begin, perhaps even in a person's 30s.
How to help prevent or slow that process…
- Statins. Researchers from the Netherlands studied nearly 7,000 people age 55 and older. They found that those who regularly took a cholesterol-lowering statin drug had a 43% lower risk for developing Alzheimer's than those who didn't take the drug.
Theory: Cholesterol may be a "cofactor" in beta amyloid production.
Bottom line: More studies are needed to show that taking a statin can prevent Alzheim-er's. so ifs premature for your doctor to prescribe the drug for that purpose. But if you take a statin to control cholesterol, you may experience this very positive "side effect."
- Weight control. Researchers at the National Institutes of Health analyzed 23 years of data from more than 2,300 people. Women who were obese at ages 30. 35 or 50, with excess belly fat, had a nearly seven times higher risk for developing Alzheimer's. Men who gained a lot of weight between ages 30 and 50 had a nearly four times higher risk.
Theory: Excess pounds increase chronic low-grade inflammation...increase insulin resistance (prediabetes)...and may increase production of amyloid precursor protein—all factors that may increase the likelihood of Alzheimer's.
Bottom line: Keep your body weight within a healthy range by controlling calories and exercising regularly.
- Fruits and vegetables. Oxidative stress—a kind of "internal rust" caused by factors such as a diet loaded with fat and refined carbohydrates...air pollution...and hormones triggered by stress—is believed to play a role in the development of Alzheimer's. In the laboratory, researchers at Cornell University exposed brain cells to oxidative stress and added extracts of apples, bananas and oranges to the mix. The extracts reduced neurotoxicity—damage to brain cells.
Theory: Fruits and vegetables are rich in cell-protecting and strengthening antioxidants that fight the oxidative stress that contributes to Alzheimer's.
Bottom line: Fruits that deliver the most antioxidants include blueberries, blackberries, cherries, red grapes, oranges, plums, raspberries and strawberries. Best vegetables include arugula, bell peppers, broccoli. bok choy, cabbage, collard greens. kale and spinach.
- Alcohol. Researchers at Stritch School of Medicine at Loyola University in Chicago re-viewed data on alcohol intake and health and found that more than half the studies showed that a moderate intake of alcohol (one drink a day for women, one to two drinks a day for men) was associated with a lower risk for cognitive decline and dementia, including Alzheimer's.
Theory: Alcohol delivers potent antioxidants, and moderate intake reduces inflammation.
Bottom line: One to two drinks a day may slightly decrease Alzheimer's risk. One drink is five ounces of wine, 12 ounces of beer or 15 ounces of an 80-proof liquor, such as vodka or gin.
- Exercise. Research shows that regular exercise can reduce Alzheimer's risk by up to 60%. A new study shows that it also may help slow the progression of the disease. Scientists at University of Kansas School of Medicine studied 57 people with early-stage Alzheimer's disease and found that those who were sedentary had four times more brain shrinkage (a sign of Alzheimer's) than those who were physically fit.
Bottom line: Aim for 30 minutes a day of exercise, such as brisk walking outdoors or on a treadmill.
Combination Treatment
Medications can slow the development of Alzheimer's symptoms. Research now shows that combining certain drugs maximizes their effectiveness. The FDA has approved two types of drugs to treat Alzheimer's—cholinesterase inhibitors, such as donepezil (Aricept), which work by slowing the breakdown of acetylcholine, a neurotransmitter that helps brain cells communicate...and memantine (Namenda), which calms excitotoxicity a type of cellular hyperactivity that harms neurons.
In a 30-month study of nearly 400 people with Alzheimer's, researchers at Harvard Medical School found that taking both drugs together is more effective in reducing Alzheimer's symptoms than taking either a cholinesterase inhibitor alone or a placebo.
Bottom line: Patients who start both drugs at the time of diagnosis may significantly slow the progress of Alzheimer's disease.
What Doesn’t Work
The following do not seem to be effective against Alzheimer's…
- NSAIDs. Some studies have linked regular intake of a nonsteroidal anti-inflammatory drug (NSAID)—such as aspirin, ibuprofen (Advil), naproxen (Aleve) and celecoxib (Celebrex)—with lower rates of Alzheimer's. But in the Alzheimer's Disease Anti-Inflammatory Prevention Trial (ADAPT)—a study conducted by more than 125 researchers, involving more than 2,000 people age 70 and older—celecoxib didn't reduce the risk for developing Alzheimer's. Naproxen had a minor effect that was out-weighed by the fact that it increased the rate of heart attacks and strokes.
- Ginkgo biloba. A team of dozens of researchers led by scientists at University of Pitts-burgh studied more than 3,000 people age 75 and older, dividing them into mvo groups. One group took a daily dose of 240 milligrams (mg) of ginkgo biloba extract, which is widely touted for invigorating the brain and improv-ing memory. A second group took a placebo. Those taking ginkgo did not have a lower rate of developing Alzheimer's.
- B vitamins. Elevated blood levels of the amino acid homocysteine have been linked to Alzheimer's. Because B vitamins can lower homocysteine, scientists wondered if B vitamins could slow the development of Alzheimer's.
Researchers in the department of neurosciences at University of California, San Diego, studied 340 people with mild-to-moderate Alzheimer's disease for about four years and found that B vitamins reduced homocysteine levels but didn't slow the progression of Alzheimer's disease.
- Antipsychotics. Alzheimer's patients of-ten develop behavioral disturbances, such as wandering, agitation, aggression, paranoia, delusions, anxiety and hallucinations. A standard treatment is an antipsychotic drug, such as Hs-peridone (Risperdal), ziprasidone (Geodon), olanzapine (Zyprexa), quetiapine (Seroquel) or aripiprazole (Ability).
New danger: For three years, researchers in England studied 165 Alzheimer's patients who had taken antipsychotics—continuing the drug in half the patients and switching the other half to placebos. After three years, 59% of those on the placebo were alive, compared with 30% on the medication. In other words, those who con-tinued the drug had twice the risk of dying.
New approach: Researchers at Indiana University Center for Aging Research reviewed nine studies on the use of a cholinesterase inhibitor to manage behavioral symptoms and found it to be a "safe and effective alternative to antipsychotic drugs.
New Medicine Prevents Alzheimer's and Even Reduces Symptoms
A recent study found that a type of blood pressure medication—angiotensin receptor blocker (ARB)—was associated with a reduced risk for dementia in seniors and slowed its progress in cases where it was already diagnosed.
A study of the medical records of five million people found that patients taking ARBs had a 35% to 40% lower chance of getting Alzheimer's disease or other forms of dementia, while patients taking ARBs who were already suffering from Alzheimer's or other forms of dementia had up to a 45% lower chance of developing delirium, being admitted to nursing homes or dying. How ARBs might produce this benefit is not certain. Consult your doctor.
Are You at Higher Risk For Alzheimer's?
People whose mothers had Alzheimer's may be at higher risk for the disease than people whose fathers had it.
Recent finding: Adult children of women who had Alzheimer's showed reductions in sugar utilization in the brain—glucose (sugar) was available, but the brain wasn't using it properly. Decreased sugar utilization is common in Alzheimer's patients.
Theory: Maternally inherited genes may alter brain metabolism. Identifying individuals at risk may enable earlier intervention.
