Alzheimer's Disease

By Dr. David Lipschitz

November 4, 2011 5 min read

Alzheimer's disease is the most feared illness after cancer.

There are many misconceptions about the disease both in Europe and the United States.

In polls, more than half the people questioned believe that there is a reliable test to diagnose Alzheimer's and that there are effective therapies to treat the disease. And 32 percent of respondents are not aware that the disease is fatal.

At a recent international conference sponsored by the Alzheimer's Association, encouraging information showed that imaging studies and blood tests may be able to identify those at increased risk of developing Alzheimer's 10 to 20 years before symptoms develop. These tests involve detecting abnormal proteins (beta amyloid and tau proteins) that accumulate in the brain of a patient with the disease.

A cure will be possible only if the disease is identified long before symptoms develop. Much research is under way to more accurately define mechanisms leading to the disease, and drugs are being designed that will either arrest or reverse the gradual brain damage produced by Alzheimer's.

With no effective therapies, the expensive tests now used to try to identify at-risk individuals offer no benefit. Though those who develop the disease have ongoing damage to the brain, there is much that can be done to keep the brain healthy, making it possible to delay the onset of symptoms for many years. These tactics benefit our general health, whether we be at high risk or low risk for Alzheimer's.

By age 85, half the population will have memory loss that is severe enough to interfere with quality of life and the ability to live independently without assistance. Delaying the onset by a few years may allow someone to live a full life without ever becoming significantly forgetful.

Because of the prevalence of the disease, everyone who is 50 or older should do all he can to reduce his risk of Alzheimer's. Those at greater risk must be even more vigilant.

Age is the most important risk factor for the disease, but Alzheimer's is also likelier if more than one family member has the disease or if a relative develops the disease while younger than 70.

Head injuries, high blood pressure and heart attacks are also risk factors for the disease. There are also certain genes associated with a higher risk of the disease. The most prevalent is apolipoprotein E4, which increases the risk of Alzheimer's disease by 50 to 100 percent, depending on whether an individual has one copy of the gene or two.

The most effective way of decreasing risk is by living a heart-healthy lifestyle. Eating right, maintaining an ideal weight and exercise have been shown to protect memory. Important, too, is appropriate treatment of high blood pressure, diabetes, elevated cholesterol and heart disease. And for those who have no evidence of heart disease but are at an increased risk of Alzheimer's, some -- but not all -- experts recommend being treated as if you have had a heart attack.

This involves making sure that blood pressure is always in the normal range, ensuring that the bad cholesterol, or LDL, is below 70, and being treated with a medication called an ACE inhibitor, which not only reduces risk of heart attacks but also may delay Alzheimer's symptoms.

Preventing damage to blood vessels in the brain by reducing cholesterol deposits and preventing blockage that leads to mini-strokes ensures that as much of the brain as possible remains healthy as the inexorable and irreversible damage to brain cells occurs as Alzheimer's slowly progresses.

Exercising the mind is most important. The more educated one is the later the age at which Alzheimer's develops. The likely mechanism is an increased intellectual acuity that helps adapt to the damage of the brain that leads to memory loss.

Though anyone may retire from his job, he must not retire from a life that should be filled with passion, learning and excitement. The more engaged and active -- physically and intellectually -- you are the less likely the development of Alzheimer's disease.

Being a lifelong learner, continuing to read avidly, solving crossword and sudoku puzzles, and attending classes at a community college are all worthwhile endeavors. Playing bridge, which combines socialization with intellectual stimulation, is a powerful way to protect the mind.

In the long term, it all comes around to a commitment to health. If you wait until a disease or symptoms develop, it will be far too late.

David Lipschitz's weekly column, "Lifelong Health," is on

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