Alzheimer's is a progressive brain disease that slowly eats away at memory and cognition. It is the most common form of dementia, a general term for memory loss and other types of cognitive impairment that are serious enough to interfere with daily life. Alzheimer's disease accounts for 50 to 80% of dementia cases. While the majority of people with Alzheimer's are 65 and older, up to 5% of people with the disease have early-onset Alzheimer's, which often appears when someone is in their 40s or 50s. Researchers from around the world are now hard at work at finding new ways to treat and prevent the disease. A whopping 5.4 million people in the US have Alzheimer’s disease, and someone develops the disease every 69 seconds, according to the Alzheimer’s Association. That number could more triple by 2050. Here, get the facts on Alzheimer's, and find out what you can do to boost your brain health.
What causes Alzheimer's disease and what are the symptoms?
Scientists aren’t exactly sure what causes the brain changes linked to Alzheimer's disease (AD), but the main culprit is thought to be an excess of beta-amyloid, a protein that clumps in the brain, interfering with crucial functions. Many experts believe it is a combination of having certain genes, such as APOE ε4; environmental factors, such as lack of a strong social network; and lifestyle or health factors, such as having high blood pressure. People who develop AD have cognitive impairments years before diagnosis, according to a Swedish meta-analysis of 47 peer-reviewed studies. Among the people who developed AD, large deficits in cognitive ability, episodic memory, perceptual speed, and executive functions like planning and multitasking showed up in the years before they were diagnosed, along with less marked deficits in verbal ability, visual-spatial skill, and attention.
The Alzheimer’s Association outlines 10 specific warning signs to look for:
1. Memory changes that disrupt daily life apart from forgetting the occasional name or appointment.
2. Challenges in planning or solving problems, such as keeping track of monthly bills.
3. Difficulty completing familiar tasks, such as remembering the rules of their favorite game.
4. Confusion with time or place, such as forgetting where they are.
5. Trouble understanding visual images and spatial relationships, such as misjudging distances.
6. New problems with words in speaking or writing, like having trouble following a conversation.
7. Misplacing things and losing the ability to retrace steps, like putting their keys in the refrigerator.
8. Decreased or poor judgment, as well as paying less attention to grooming themselves than normal.
9. Withdrawal from work or social activities, such as not wanting to go to a party or sports game when they used to love attending.
10. Changes in mood and personality, like becoming confused or anxious.
What are the risk factors?
If you have a parent or sibling with this type of dementia, you are 2 to 3 times more likely to develop the disease. But family history is only part of the story. Risk factors for Alzheimer's, which affects 13% of people over age 65 and nearly 50% of those over 85, include a combination of genetics, advancing age, and environmental triggers. And although there is no definitive way to prevent the disease, many experts believe that you may be able to lower your chances by socializing, exercising every day, eating a balanced diet, and challenging your mind with reading, writing, puzzles, and other mentally stimulating activities. An unexpected risk factor might be arm length: Women with the shortest arm spans were 1½ times more likely to develop Alzheimer’s disease than those with longer reaches, found a 2008 study in the journal Neurology. (Find yours by spreading your arms parallel to the floor and having someone measure fingertips to fingertips; the shortest spans were less than 60 inches.) Nutritional or other deficits during the critical growing years, possibly responsible for shorter arms, may also predispose a person to cognitive decline later in life, say Tufts University researchers.
How is Alzheimer’s diagnosed?
The National Institute on Aging says that doctors use several tools to diagnose AD. Doctors may ask questions about your changes in behavior and personality or your ability to carry out normal, daily tasks. They may test your memory, problem solving, attention, counting, and language skills, as well as do medical tests, such as blood and urine tests, to identify other possible causes of your symptoms. Doctors may also perform brain scans, such as computed tomography (CT) or magnetic resonance imaging (MRI), to try to pinpoint that it is Alzheimer’s rather other possible causes for symptoms, like stroke or tumor. While a 100 percent reliable test for Alzheimer's disease has never existed, multiple labs around the country broke through that diagnosis barrier. A method of analyzing MRI images developed at the Mayo Clinic pinpoints changes in the brain with up to 80% accuracy. At UCLA, researchers have developed a blood test for AD. But the most accurate and promising technique is a skin test developed at the Blanchette Rockefeller Neurosciences Institute at West Virginia University: With the prick of a finger, it detects defective enzymes involved with memory function that are found in both brain and skin cells. Test results proved 98% accurate at detecting Alzheimer's, says Daniel Alkon, MD, the institute's scientific director.
What are some ways to prevent Alzheimer's?
If you don't take a supplement, eat foods high in folate. High levels of homocysteine may be associated with poor cognitive function. Some findings indicate that reducing homocysteine with folic acid may increase cognitive function. Also, be sure to control your blood pressure. Hypertension appears to be associated with an increased risk of both vascular dementia and Alzheimer’s disease. Having a strong social support also helps: Findings indicate that an active social life and strong network of friends may help prevent AD later in life. Getting a move on can also help safeguard your brain. Exercise produces large quantities of brain-derived neurotrophic factor (BDNF), a protein that helps neurons survive and encourages the growth of new ones. "I call it Miracle-Gro® for the brain," says John Ratey, MD, a clinical associate professor of psychiatry at Harvard Medical School and author of Spark: The Revolutionary New Science of Exercise and the Brain. "It helps the cells grow and makes them better and more resilient to future stresses." Brains with more BDNF have a greater capacity for knowledge. To boost BDNF levels, Ratey recommends moderate- to high-intensity aerobic exercise, incorporating interval training. Other research shows that just walking brings substantial benefits. Best bet: Include a 10-minute speedwalk in your daily stroll. Lastly, seek out novelty. Your brain is a thrill seeker. New experiences stimulate the area that produces dopamine, a chemical involved in learning and memory. It also loves a brand-new workout. Studies show that doing new things builds brain mass and increases mental agility. The absence of novelty, however, causes dopamine-producing areas of the brain to shrink. To keep your brain lithe and strong, take up a language, hobby, sport, or musical instrument--any regular pastime that offers continual fresh challenge. Even if you're not good at your new pursuit, you'll still get the benefits.
Which foods can boost brainpower?
Research shows that by keeping your brain healthy with the right diet you can boost memory and brainpower. Here are some top brain-boosting foods:
Avocado, Oils, Nuts, and Seeds. They all contain another important antioxidant: vitamin E. In one study, researchers found that people who consumed moderate amounts vitamin E—from food, not supplements—lowered their risk of AD by 67%. Eat it: Frequently; shoot for 15 mg of E a day, the equivalent of 2 ounces of almonds.
Curry. Go for Thai or Indian takeout; these cuisines often use the potent spice known to fight inflammation. Animal studies have shown that curry’s active ingredient, curcumin, actually clears away Alzheimer’s-causing proteins in the brain called amyloid plaques (though more research is needed in humans). Eat it as an ingredient in pasta sauces, salad dressings, or meat marinades. Curcumin tends to be poorly absorbed, so you'll need to mix it with black pepper to increase its absorption up to 2,000%.
Alcohol (in moderation). While chronic, heavy drinking can cause serious dementia, research shows that imbibing lightly may protect the brain. In one JAMA study, people who had one to six drinks a week were 54% less likely to develop dementia than teetotalers. Experts aren’t sure why, but some doctors point out that moderate drinkers have reduced rates of heart disease too. Small amounts of alcohol may protect both the heart and brain by preventing blockages in blood vessels. Drink it once a day or less—and have no more than one drink. If you have a family history of breast cancer, talk to your doctor.
Fruits and vegetables. A population-based cohort study of 1,836 older Japanese-Americans found that consumption of fruit and vegetable juices was associated with decreased incidence of Alzheimer’s over seven to nine years of follow-up.
Berries. Berries contain high levels of biologically active components, including a class of compounds called anthocyanosides, which fight memory impairment associated with free radicals and beta-amyloid plaques in the brain. Eat berries each day for maximum benefit.
Omega-3s. Found in fish such as salmon, halibut, and sardines, omega-3 fatty acids are involved in nerve cell communication. Recent research shows that they help protect against the cell damage that leads to Alzheimer's. Consider getting your omega-3s in pill form: Unlike whole fish, supplements have been found to be free of mercury and PCBs, according to analyses by ConsumerLab.com.
How is Alzheimer's treated?
AD is an irreversible disease and there is no cure, but there are treatment options that can help delay the disease’s progression or better manage symptoms. Drugs that help maintain cognitive abilities by regulating the chemicals that transmit messages between neurons include:
- Donepezil (Aricept)
- rivastigmine (Exelon)
- alantamine (Razadyne)
- Memantine (Namenda)
Researchers have also discovered that low doses of the chemotherapy drug bryostatin reactivate defective enzymes. "We can actually rewire broken connections in the brain and restore memory," says Dr. Alkon. "That's extraordinarily exciting because it could be used to reverse the dreadful consequences of many brain diseases." Clinical trials in people have been approved by the FDA and should begin soon. Current clinical trials are also looking at cognitive training, physical activity, antioxidants, and the effects of cardiovascular and diabetes treatments. To find a clinical trial that’s investigating more AD treatment breakthroughs, check out TrialMatch.
Where can I find out more?