---

Alzheimer's:

Prevention, Treatment, and Slowing Down

What lifestyle changes can prevent Alzheimer's disease or slow down its progression if I already have it?

A family history of Alzheimer's and increasing age are considered risk factors for development of Alzheimer’s disease, but they don’t always lead to memory loss or dementia:

• Lifestyle and environment seem to be more influential than genes for some individuals.
• There is growing evidence that regardless of age, a healthy lifestyle promotes a healthy brain.
• Recent studies confirm older people can improve their memory and problem-solving skills with practice.
• Brain cells may die as we age, but research shows that mental and social activities promote new connections between cells.
• There are countless examples of productive people continuing to do great work decades beyond age 60—proof positive that aging and mental deterioration don’t necessarily go together.

Scientists are not yet sure how or why good health habits work to overcome a predisposition to Alzheimer's; and since we don’t fully understand the causes of this disease, we can’t be sure that everyone can avoid getting it.  What we do know is that people can reduce some of their risk factors.  

The latest medical research suggests that the best hope for preventing or slowing down Alzheimer's is to adopt a lifestyle that includes the following:

• Eat a healthy diet and get regular exercise
• Avoid jarring your brain
• Stay engaged in social activities with friends, family and others
• Exercise your mind to keep your brain in tone

If you don’t currently follow the above health habits, read on for ideas about how to make these lifestyle changes. 

Keeping your heart healthy

Scientific evidence points to a relationship between the health of your brain and the health of your cardiovascular system.  It seems helpful to focus on diet and exercise. A lifestyle that is healthy for your heart (and brain) includes:

• Regular exercise. Thirty minutes of brisk walking on most days of the week should be sufficient to keep the heart and brain healthy. Since exercise promotes good blood flow to the brain and encourages growth of new brain cells, it probably lowers the risk of getting Alzheimer's disease and slows cognitive decline in people who already have Alzheimer's.  
   
  Alzheimer's studies suggest that a variety of types of exercise is especially helpful to the brain. Besides walking, try workouts (strength training), get involved in a sport, join a hiking club, or go dancing.
• Eat a diet low in cholesterol, saturated fat, sugar, and salt.
• Eat a diet high in dietary fiber (such as oats and beans), fruits, vegetables, whole grains (such as whole wheat bread and pasta, and brown rice), other complex carbohydrates, potassium, calcium, and magnesium.
• Particularly eat antioxidant-rich fruits and vegetables, which contain Vitamin E and beta-carotene. Vitamin-E-rich foods are blueberries, cranberries, grapes, fresh apples (especially the skins, and red are better), papaya, green leafy vegetables, onions, legumes, nuts, seeds, and whole grains. Beta-carotene-rich foods include dark orange, red, and dark green fruits and vegetables.
• Eat plenty of omega-3 fatty acids. These beneficial fats are found in salmon, lake trout, sardines, mackerel, albacore tuna, and herring, flax oil, and spinach. Not only do these fatty acids help the heart, they also seem to prevent the build-up of plaques in the brain.
• Limit your alcohol intake to one or two drinks per day. A small amount of alcohol may be related to a healthy heart, and one study showed that red wine might decrease the risk for developing Alzheimer's. The habit of excessive drinking has been linked to many health problems.  Alcohol damages brain cells.
• Lose weight if you are overweight.
• If you are a smoker, quit smoking.
• Control hypertension and high blood pressure by limiting your intake of salt, alcohol, and too many calories.
• Avoid diabetes with weight control and exercise.
• Relax and reduce your stress.  Find a method of reducing stress that works for you as part of your daily life, such as relaxation exercises, meditation, yoga, prayer, or self-hypnosis. Under prolonged stress, hormones are released that can damage the brain.
• If you suffer from depression or anxiety, seek treatment. Depression and anxiety interfere with how your brain processes memories.  Depression in older people has been associated with a higher rate of dementia in some studies.

Until we know the exact cause or causes of Alzheimer’s, we can’t be sure that diet and exercise will help everyone to prevent or slow Alzheimer’s.  Even so, there is a growing body of research that shows a connection between rates of dementia and a lifestyle that includes a healthy diet and regular exercise.

Avoid jarring your brain

Many people who have developed Alzheimer’s disease also have a history of repeated mild trauma to the head.  It makes good sense to guard the health of your brain by protecting it from injury as one means of preventing or delaying the onset of dementia:

• wear a helmet if you bicycle or ski
• wear seatbelts in a car
• clear your home of obstructions and slippery places to prevent hitting your head or falling and suffering a head injury

Socializing

Active involvement with family and a wide network of friends is likely to lower your risk of dementia. Besides stimulating your brain, socializing lessens depression that can result from isolation. Regardless of whether you have many friends or few, it’s also helpful to continue finding other ways to be with people: join a club or civic group, attend classes, continue working, or do volunteer work. 

Mental exercise

Stimulating your brain can:

• increase the number of brain cells and the connections between the brain cells
• strengthen your current brain cells and connections between them

Mental exercise has been associated with a reduced risk of getting Alzheimer's. Do something different or learn something new every day or engage in a challenging activity that will exercise your brain:

• Learn to play a musical instrument; learn a foreign language; start a new hobby
• Play memory games to improve or train your memory
• Visit museums; attend lectures or performances; take a class
• Read, especially challenging material
• Join a book discussion group
• Write.  If not a book or article, write in a diary, write letters or emails, or start your memoirs
• Do crossword puzzles, sudoku, jigsaw puzzles
• Play board games, card games, other strategy games
• Learn a kind of dance that is new to you, which will also give you some exercise
• Debate or discuss topics with people
• Practice using the opposite hand for something you usually do with your dominant hand

We can’t emphasize enough that it is variety and newness that keep the mind sharp and promote a healthy brain.  While it’s important to stay connected with old friends and to engage in comfortable routines, it’s just as important to stretch yourself mentally and socially by seeking out new friends, new experiences and activities. See Helpguide’s

What does brain plasticity have to do with slowing or preventing Alzheimer's?

Having an active social, mental, and physical lifestyle affects the brain in a surprising way: a busy life actually seems to change the brain. This notion of brain plasticity is getting more and more support in scientific studies. Animal studies have shown that mental and physical stimulation actually increases the number of neurons in the brain: keeping your mind active may counteract the tendency to lose brain cells as you get older. In addition, new forms of mental stimulation build new neural pathways. 

Brain autopsies of people who died late in life have found some individuals who had the brain disease of a person with Alzheimer's, but few symptoms of the disease during life.  This provides the hope that memory training early in the course of Alzheimer's disease, when a person can still learn, will help some people to improve the health of their brain and slow the progression of symptoms.   A large prospective study showed that the variety of leisure and physical activities engaged in is more important than the frequency, duration, or intensity of activity.  Seek out ways to nourish your brain with new mental challenges, a widening social circle, and different kinds of physical exercise--as a healthy strategy that could delay, slow down, or even prevent Alzheimer's.  Keeping a healthy brain can be fun!

Can medications prevent or slow down Alzheimer's Disease?

Some drugs do seem to prevent or slow down Alzheimer's.  Experts can help you find a combination of pharmaceutical treatments plus lifestyle changes and caregiving strategies tailored to individual needs. See your doctor for recommendations and prescriptions. Do not begin a regimen of taking over-the-counter drugs or diet supplements without discussing the plan with your doctor. 

Drugs to prevent Alzheimer's Disease

Ongoing research hints that people who take the following medications may be protected against developing Alzheimer's:

• Aspirin or nonsteroidal anti-inflammatory drugs (such as ibuprofen or Celebrex) over a long period, even in small doses 
• Cholesterol-reducing drugs (statins)

Research is preliminary and further studies are needed.  All medications can have potentially serious side effects and can affect people in different ways.  In fact, sometimes dementia-like symptoms are caused by side effects or drug interactions, so ask your doctor about using medications as a way to prevent Alzheimer's. 

Drugs to slow down the progression of Alzheimer's

Doctors currently prescribe two types of drugs to slow down Alzheimer's:

• Cholinesterase inhibitors may slow down the decline in cognitive capabilities such as memory and learning in the early stages of Alzheimer's.
• NMDA receptor antagonists sometimes slow down the decline in cognitive functions necessary for the activities of daily living, such as dressing and eating, in the later stages of Alzheimer's.

Talk to your doctor about the best pharmaceutical approach for your loved one. Find out about any side effects or long-term effects of the drugs.  Ask about any harmful drug interactions if several medications are being used. If you do go ahead with a medication protocol, keep abreast of the latest news about Alzheimer's drugs.

Are there effective alternative treatments outside of traditional medicine? 

A number of alternative healing methods have been put forth as memory enhancers or preventatives against Alzheimer's. These include treatment approaches such as:

• Counseling and psychotherapy
• Music therapy, aroma therapy
• Acupuncture, acupressure

Other alternatives are herbal remedies and nutritional supplements, which appeal to some people because they come from natural ingredients.  However, not much scientific testing has been done so that:

• they might not be effective
• they may not be manufactured consistently by all vendors
• they don’t always contain the ingredients listed on the label
• they sometimes interact with prescription medications in harmful ways

Always tell your doctor what steps you are taking on your own to deal with the symptoms of Alzheimer's.  If you feel strongly about seeking out alternative methods, find a respected alternative health care practitioner--preferably an MD-- who can work closely with your primary physician.
 

Doug Russell, L.C.S.W., Jeanne Segal, Ph.D., and Monika White, Ph.D., contributed to this article.

Mind your head

Maintaining your brain

The Four Pillars of Prevention

Be Good to Your Heart, and Your Brain May Thank You

Drug treatments for Alzheimer's disease—Aricept, Exelon, Reminyl and Ebixa

Alzheimer's drugs: Real benefits despite limitations

Alternative Treatments for Alzheimer's

Complementary therapies and dementia

Tea could improve memory, study shows