I am a 69 year old retired neurologist with Alzheimer’s disease at an early stage, the beginning of neurodegenerative processes that will develop over time and one day kill me if something else does not get me first.
Although I cared for many patients with Alzheimer’s and other dementias during my career, it never occurred to me that I might one day get it too. Now I am on the patient side of the experience, an expert inside and out on my own Alzheimer’s as it unfolds its slowly growing presence in my brain.
Most Alzheimer’s patients in high-income countries are diagnosed when symptoms of the disease appear in their behavior or cognitive function ̵
I found mine much earlier, in 2015. It was really a fluke that I stumbled upon some genetic information that got my clinical search. It’s easy to say I’m unlucky with Alzheimer’s. But in truth, I’m lucky to have found what I found when I found it.
I have been able to access advanced medicine through clinical trials and other progressive treatment options. But I have also made some simple lifestyle choices about diet, exercise, and social and intellectual activity that evidence-based science has found can benefit brain health and in some cases slow the development of Alzheimer’s in the early stages of cell-level change. the 10 to 20 years before significant cognitive impairment.
At a societal level, science and statistics show a perfect storm that is underway and growing: worldwide prevalence of Alzheimer’s disease and related dementia is expected to rise to 115 million by 2050.
So much about Alzheimer’s throws you into uncertainty. These rather simple choices then become an organized counterattack. They help provide structure to my thoughts and actions, hope for the future and a greater sense of happiness and well-being that feels realistic, not just optimistic.
As close to a prescription as you can get are the five most important anti-Alzheimer’s strategies:
- Aerobic training
- A Mediterranean style or MIND diet (see below)
- Mentally stimulating activity
- Social engagement
- Good sleep along with good control of diabetes and high blood pressure if present
If there was a drug for Alzheimer’s disease that would slow the progression by 50 percent, we would hail it as a miracle and it would be worth billions to the pharmaceutical industry. We already have it and it’s free: exercise. Aerobic exercise has been shown to have a positive, protective effect in the early stages of the disease. A number of research studies have shown a decrease of up to 50 percent in the rate of development of Alzheimer’s among those who start the study without clinical evidence of dementia. There is also evidence that your brain is sharper during exercise than when you are not exercising. Mine is it and reliable. I am mostly able to think clearly and creatively during and for a few hours after training, even if it’s just walking the dog.
Even modest training levels are useful, but there seems to be a dose-response effect: more activity is more effective than less activity. Starting it in the 40s, if possible, is better than waiting until the 60s or 70s. I aim for at least 10,000 steps a day, but recent research has shown that 8,000 steps or even less can be beneficial.
The data for a beneficial effect of diet are strong, if not as robust yet as for exercise. Most studies have shown that a Mediterranean diet promotes brain health as well as cardiovascular health. In 2015, the MIND (Mediterranean – DASH Intervention for Neurodegenerative Delay) diet was introduced to specifically target the slowing down of cognitive impairment, focusing on foods that have the most evidence for brain health benefits, such as whole grains, green leafy vegetables, beans, nuts and berries. .
A study followed 923 residents of the community aged 58 to 98 who did not have Alzheimer’s at the onset of an average of four and a half years on the MIND diet. Those who stuck to the diet even developed moderate Alzheimer’s disease at a 35 percent lower rate than those with poor diet. Those with high dietary adherence did even better and developed Alzheimer’s at a 53 percent lower rate.
Participation in mentally stimulating activity has long been shown to delay the onset of cognitive impairment caused by Alzheimer’s disease. Reading books five to seven days a week, using a computer three to seven days a week, participating in social activities two to four days a week, and performing craft activities all lead to about a 30 percent reduction in the rate of developing cognitive impairment.