Be Bold: Beat Dementia and Alzheimer's Disease!

You are dead wrong if you think only old people get dementia.

By the time you finish reading this article, at least 120 people will have developed the disease, (five of them in the US), since every 3 seconds, someone in the world gets dementia.

Dementia and Alzheimer’s disease is a neurodegenerative disease of the brain due to the depositing of amyloid plaques, with progressive deterioration of cognitive function and memory, and the loss of ability to perform activities of daily living and function independently.

In 2015, more than 18 million caregivers provided 18 billion unpaid hours of care in the US for dementia sufferers alone. The personal and societal cost is astronomical.

This past weekend (April 21-24), was the annual international conference of Alzheimer’s Disease International in Budapest. The goal was to obtain a global perspective and offer local solutions for dealing with dementia. How best we, as society, caregivers, dementia patients, clinicians and scientists can impact the disease.

One in three seniors will die with dementia. It is the 6th leading cause of death in the US. It kills more people in the US than breast and prostate cancer combined. Over 48 million people worldwide live with dementia: 5 million in the US, 750,000 in Canada and over 800,000 in the UK. This number doubles every 20 years. In the US alone, the economic cost of dementia is $ 236 billion, and the global economic cost will reach $ 1 trillion in 2018.

The types of dementia in people over 65 years of age:

• Alzheimer’s disease (AD) – 62%
• Vascular dementia – 17%
• Mixed dementia – 10%
• Lewy-body dementia – 4%
• Fronto-temporal dementia (FTD)- 2 %
• Parkinson’s – 2%
• Other – 3%

In people < 65 of age with dementia, AD drops to 54 % and FTD rises to 16%.

The prevalence of dementia in young people, aged 30 – 64, is 54/100,000. It is not something only seniors develop, although we do see an upswing among the elderly as people live longer due to modern medicine and better living standards.

The degeneration that takes place in the brain is due to chronic inflammation throughout the body (this is not due to infection), such as seen with insulin resistance, type 2 diabetes, obesity, inactivity and smoking.

The amyloid plaques lead to disruption of the neuronal mitochondria and along with neurofibrillary tangles, increase the damage by reactive oxidative species. Left untreated and without aggressive reduction of risk factors, neuron degeneration continuous and a vicious cycle of amyloid depositing and decrease of new blood vessel formation takes place. This leads to death of brain cells, atrophy, and loss of brain mass and the eventual loss of neuroplasticity.

Regular exercise releases growth factors in the brain (BDNF), which has neuroprotective effects, new blood vessels in the brain are formed and more and stronger synapsis are established. The inflammation is reduced and brain mass and plasticity improve, along with memory—even when people are 90 years and beyond.

A 2016 German study identified seven risk factors we can control to decrease the prevalence of dementia:

• Physical inactivity
• Diabetes mellitus
• Hypertension (High blood pressure)
• Obesity
• Depression
• Smoking (and excess alcohol)
• Limited education and mental stimulation

So we can prevent dementia and Alzheimer’s?

What can we do?

1. Live healthy. Yes, it’s the old story of exercise, eating healthy and getting enough sleep. We’ve heard it a 1,000 times. But this time, it’s more serious. Research is showing—lifestyle and personal choices make all the difference. The recent ADI conference confirmed this reality: there’s a tsunami of dementia worldwide. And, there’s much we can do about it. Take action.
2. Age healthy. We are talking about 30-something individuals and older, and until you’re a 100. Look after your heart and brain-health. A healthy heart and a healthy brain, with a stimulating lifestyle, will keep most chronic diseases away, including dementia. You can listen to a short podcast interview with Graham Stokes by Paul Zollinger-Read from Bupa, about healthy aging and dementia.
3. Become active. Become fit. Studies have shown aerobic exercise to have a bigger positive impact on staying off dementia, but strength training should not be neglected.
• Moderate to high-intensity aerobic exercise: 45-60 minutes 3-5x/week
• If unfit start with a 10-minute walk, every day. Add 5 minutes/week
• Walk, jog, bike or swim (or all of them!)
• Add strength training 2-3x/week (upper and lower body, 10 reps and 3 sets of each)
• Resistance bands can work, but resistance machines, free weights and body-weight exercises can be more effective
• Make getting and staying fit FUN. Spice it up. Challenge yourself.
• Do it with friends. Join a group. Train and go on a biking challenge, or sail!
4. If you have pre-diabetes, insulin resistance or type 2 diabetes, become seriously fit. Do combinations of cardio and resistance exercise. (see # 3)
5. Eat yourself healthy. Eat brain-friendly foods. Don’t skip breakfast. Small portions.
• Follow the MIND meal plan:
• Mediterranean (diet) and
• Intervention for
• Neurodegenerative
• Delay
• DASH diet: Dietary Advice to Stop Hypertension.
• The MIND meal plan includes 10 food groups which are recommended:
• Green leafy vegetables (six servings per week)
• Other vegetables daily (go for color – frozen is fine)
• Berries (at least 3 – 5 x/week – frozen is fine)
• Beans: (3x/week – good source of protein/inexpensive)
• Nuts: 5 x/week
• Fish: 3 – 5x /week (not deep-fried)
• Poultry (Chicken/turkey – white meat better, not skin) 3 – 5 x/week
• Healthy fats: avocado, virgin olive oil – use as cooking oil
• Whole grains – can add a serving daily
• Wine: half to one glass daily (red is better.) But not more.
• Limit fast food as well as junk food to ONE serving per week. Want to see how your brain cringes when you do? Also read Dr. John La Puma’s recent culinary advice for dementia. 
• Your mom was right: drink your 6 – 8 glasses of water daily
6. Treat your blood pressure. Treatment consists of: lifestyle, medication and the DASH diet. You and your doctor don’t “keep an eye on the blood pressure” without treating it. We want normal pressures. We aim for 139/85 and below. If diabetic, even closer to normal pressures: 120/80 and below.
• Become seriously fit (see # 3)
• Rule out sleep apnea (get a sleep study if indicated)
• Work toward a healthier weight
7. Weighty matters: Obesity. The focus must be to become fit and eating healthy.
• Start with a written goal, a written plan & an accountability partner
• Start with a food log
• Follow # 3 (exercise) and # 5 (MIND meal plan) above
• By becoming fitter and eating healthier, you will also address other common comorbidities, such as diabetes, hypertension and depression
• Consider a sleep study to rule out sleep apnea
• There is much more detail in my free eBook (Prepare Better, Do Better.)
8. Treat depression and anxiety. Research has shown that regular, moderate to intense exercise to be effective as stand alone treatment or in combination with medication. Read more about this exciting field by Dr. John J. Ratey in his book,
9. Quit smoking. Nicotine damages blood vessels, which deprives your brain and vital organs of oxygen. Quitting is not easy. Learn how habits work. Get help. You will never regret the decision!
10. Stimulate your brain.
• Challenge your brain daily and remain involved in your community
• Read more – newspapers, fiction, but especially nonfiction
• Play mind games: Sudoku, chess, crossword puzzles
• Learn another language – this will be a super boost for your brain
• Learn to play a musical instrument
• Dance 3 x/week (Complex exercise – excellent for body and brain)
• Try a new hobby

Dementia is a silent killer and robs people of many good and productive years. The personal and societal costs are incredible, the suffering immense, and the impact worldwide.

Dementia is not a disease of only old people!

Become informed. Learn how we can better take care of ourselves and of dementia sufferers. A shift in focus to a more person-directed dementia care is vital, as well as improving their quality of life.

Take action today.

Reduce your own risk factors: healthy heart, healthy brain!

Start today. Go do it.

If the article resonated with you, please share and leave a comment. We can impact this disease!

(Note: By no means did I try to make light of the devastation of dementia and Alzheimer’s with this article.)

References:

1. Chen WW et al. Role of physical exercise in Alzheimer’s Disease. Biomed Rep. 2016 Apr;4(4): 403-407
2. Paul Zollinger-Read: Bupa’s CMO on aging and dementia. 
3. Stokes l, Combes H, Stokes G. The Dementia diagnosis: a literature review of information, understanding, and attributions. Psychogeriatrics. Vol. 15, 3, 218-225, Sep 2015.
4. US stats about Alzheimer’s. 

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