Lifelong Health by Dr. David Lipschitz

Simple strategies promoting health can delay Alzheimer's disease by many years.

A healthy lifestyle including exercise, eating right and controlling stress reduces not only the risk of a heart attack and stroke but also the risk of Alzheimer's disease.

Alzheimer's disease is a degenerative disorder of the brain associated with relentless and insidiously progressive damage to brain cells. Abnormalities are present in the brain 20 years before symptoms develop. Initially, an abnormal protein called beta amyloid precursor protein accumulates in and around brain cells. The protein causes a subtle inflammation that damages and destroys the cells. When destruction of the brain becomes severe enough, symptoms develop.

Alzheimer's disease initially affects that part of the brain responsible for short-term memory. Thus, the earliest symptoms include forgetting appointments, repeating yourself and having difficulties remembering recent events.

Abnormalities characteristic of Alzheimer's can be found in well over 50 percent of brains examined at autopsy, even though many die with no memory problems. When symptoms initially develop is dependent not only on the severity of the degeneration but also on the health of the unaffected brain. High blood pressure, cholesterol deposits in arteries, major or multiple minor strokes, diabetes and a host of other problems all impair brain function. This decline in function reduces the ability of the brain to compensate for the degeneration caused by Alzheimer's, resulting in the development of symptoms at an earlier age.

It is not surprising, therefore, that compelling research shows that strategies to reduce the risk of heart disease are more effective at slowing the rate of progression of Alzheimer's than any of the current medications used to treat the disease. Furthermore, if heart disease is not present, the brain is likely to be healthier and more able to adapt to changes in the brain caused by Alzheimer's. Only if this person lives well past age 90 would memory loss develop.

If Alzheimer's pathology is present in the brain, nothing is more important than delaying the time at which memory loss occurs and the rate at which it progresses. This will assure additional years of independent life, delaying the need for caregiving and nursing home placement.

This offers the potential of substantial reductions in the emotional and financial burdens of the disease while improving the quality of life of families.

The vast majority of baby boomers will reach the age of 85, at which time half will have memory problems severe enough to prevent them from living alone without assistance. At middle age and beyond, the best strategy to maintain a robust memory throughout life is to eat right, exercise and prevent high blood pressure, elevated cholesterol and diabetes. And for those with heart disease, treatment with medications that include aspirin, statins to lower cholesterol, beta-blockers and the angiotensin-converting-enzyme inhibitors better known as ACE inhibitors (drugs used to treat high blood pressure) not only prevent worsening heart problems but also reduce the risk of memory loss.

Research indicates that the more active the brain, the lower risk of Alzheimer's. Studies of twins have shown that the person with the higher degree and a history of lifelong learning is far less likely to develop memory loss than his identical twin who is less educated. Keeping your mind keen and active helps maintain a healthy brain. These individuals are far better able to compensate for Alzheimer's-induced brain damage.

However, keeping the mind active does not prevent the relentless progression of Alzheimer's so that when the disease finally manifests it is more advanced and appears to progress more rapidly.

While age is the most important risk factor for Alzheimer's, the second most important is family history. If more than one close family member has been diagnosed with the disease, the risk in younger family members is 50 percent higher. For these individuals, some experts believe that in addition to a healthy lifestyle, beginning at an age that is 20 years younger than symptoms developed in their affected relative, they should be treated as if they have had a heart attack. This includes lowering the bad or LDL cholesterol to below 70, aggressively maintaining normal blood pressure and being treated with a low dose of an ACE inhibitor.

We must all hope that in the near future there will be a cure for Alzheimer's. The size of the coming epidemic makes it ever more important to emphasize strategies to improve both heart and brain health.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at: www.drdavidhealth.com

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