The latest advice in avoiding Alzheimer's

CorrespondentMarch 4, 2013 

  • Want to know more • General information about Alzheimer’s disease, including information about diagnosis and the latest in research: Alzheimer’s Foundation of America, at www.humanbrainmapping.org. • Brain mapping: Organization for Human Brain Mapping, at www.humanbrainmapping.org. • Dr. Hermanth Rao’s Neurological Institute in Charlotte, at www.neuro-institute.com. • “The Alzheimer’s Action Plan: What You Need to Know – and What You Can Do – About Memory Problems, from Prevention to Early Intervention and Care,” by Dr. P. Murali Doraiswamy and Lisa P. Gwyther, with Tina Adler, at http://bit.ly/YKLZs8 • Brain mapping project: http://nyti.ms/VxHBf0

If ever there were a disease begging for a cure, it would be Alzheimer’s.

According to the Alzheimer’s Foundation of America the disease affects an estimated 5.1 million Americans, and the likelihood of getting it increases exponentially once you pass 65.

Within as few as two years of diagnosis it can turn a healthy adult into a ghost, incapable of recalling basic information, unable to communicate the simplest of thoughts. It is among the 10 leading causes of death in the United States and accounts for more than $100 billion a year in health-care costs.

While the disease is a topic of intense research and the driver behind President Obama’s plan to map the human brain, there is no known cure.

“There is no magic bullet and no strategy that has been proven to prevent Alzheimer’s,” says Dr. P. Murali Doraiswamy, professor of psychiatry at Duke University Medical Center and coauthor of “The Alzheimer’s Action Plan.”

“I would be very leery of any treatments that promise a cure or great success rates in treating this disease, especially if these treatments have not been studied by the FDA,” adds Dr. Hermanth Rao, medical director of the Neurological Institute in Charlotte, who has worked with dementia and Alzheimer’s patients for more than 20 years.

We asked Doraiswamy and Rao about several of the more prominent treatments that have gained attention.

Advice: Exercise

“Studies have shown an association (between exercise and Alzheimer’s) but it is still not proven to be a cause and effect relationship,” says Doraiswamy. “Exercise probably affects hundreds of chemicals and processes in the brain and studies suggest it can possibly even rewire the brain and increase the size of memory centers (neurogenesis). It boosts blood supply, reduces risk for strokes, boost levels of nerve growth factors (fertilizers for the brain) and spurs the brain to strengthen its connections.”

Advice: Stimulate your brain by doing crossword puzzles, playing board games, reading, etc.

The idea has gotten lots of attention, but there’s no definitive proof yet that it works. But the premise makes sense. “Brain training takes advantage of the brain’s neuroplasticity to enhance its cognitive reserve,” says Doraiswamy. “This is analogous to having multiple cellphone towers so that if one tower is damaged your phone can easily switch over to another tower and not drop a call. ... Studies do suggest that keeping your brain active and engaged may postpone symptoms of dementia.”

Rao adds that staying engaged through volunteering and in church and community activities may also be helpful.

Advice: Avoid a diet high in trans-fat and saturated fat.

“We don’t yet fully understand the connection between fat and brain but I think it’s somewhat also dependent upon one’s genes,” says Doraiswamy.

Too much saturated fat can lead to increased risk for strokes and deposits of amyloid plaques, naturally occurring protein fragments that, in the brains of Alzheimer’s patients, clump together to form insoluble plaques.

“Obesity and diabetes have been indirectly linked to greater risk for Alzheimer’s but this is not fully proven,” says Doraiswamy. “Overall,” he adds, “this is a smart strategy since it will definitely lower your risk for strokes, which is a major risk for age-related memory problems.”

Advice: Load your diet with lean proteins (fish, chicken, turkey, soy) and complex carbohydrates (fresh vegetables, whole grains, legumes, fresh fruits). Stress superfoods for their antioxidants.

“Lean proteins and complex carbs can reduce one’s risk for obesity and diabetes,” says Doraiswamy, “which is good for the brain. But all animal products in general probably raise one’s risk for dementia compared to a vegetarian diet.”

Adds Rao, “The Mediterranean heart diet that emphasizes eating more whole-grain, fruits and vegetables along with seafood and less red meat is thought to reduce the likelihood of developing Alzheimer’s or retarding the progression of the disease.”

Advice: Take high-potency multiple vitamins?

“B vitamins are probably the only ones I recommend,” says Doraiswamy. “All others are a waste of money.” Rao says supplements – including coenzyme Q10, alpha lipoic acid, ginkgo biloba, phosphatidylserine, DHA and acetyl-L-carnitine, turmeric and coconut oil – “may have significant benefit.”

Advice: Avoid stress

“Managing emotional and physical stress is also very important,” says Rao. “Adequate sleep and rest are key components in this regard.” While Doraiswamy notes that stress is not a direct cause of Alzheimer’s, it can put one at greater risk of depression or post traumatic stress syndrome, which could make the brain more vulnerable to Alzheimer’s. “This again,” he cautions, “is still not fully proven.” Recommended ways to deal with stress: leisure activities, meditation, exercise, family interaction and socialization.

Drug treatment options

To date, four drugs have been approved by the Food and Drug Administration for treatment of Alzheimer’s, according to the National Alzheimer’s Foundation:

• donepezil hydrochloride (Aricept), approved for all stages of Alzheimer’s;

• rivastigmine (Exelon), approved in pill and patch form for mild to moderate cases;

• galantamine hydrobromide (Razadyne), approved for mild to moderate cases; and

• memantine HCI (Namenda) for the treatment of moderate to severe Alzheimer’s disease.

“Trials of about a dozen other medications targeting the build-up of plaques in the last two years have all been negative, suggesting that we still really don’t fully understand what causes” Alzheimer’s, says Doraiswamy, who notes his ties to the industry in the form of grants received and playing an advisory role, in addition to owning stock in companies involved in the field.

In short, Doraiswamy says of Alzheimer’s treatments at this point, “If it sounds too good to be true, then yes” that’s likely the case.

Joe Miller writes about health, fitness and outdoor adventure in North Carolina. Read his blog at GetGoingNC.com.

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