Nipping Alzheimer’s In The Bud: 7 Lifestyle Changes That Prevent Alzheimer’s

By Dr. Hira Shaheen

The famous novel-turned-movie "The Notebook" begins with an elderly woman staring outside her room's window. As the movie progresses in retrospect, the young Allie, played by Rachel McAdams, is full of life. Her past self loves playing piano and painted passionately, but not anymore. Living in a nursing home with short and long-term memory loss and unable to function properly, she feels like a stranger among her children and grandchildren.

Her husband, Noah, reads old journals to her, hoping that she might recognize him, but all she considers him is a benevolent stranger. At one point, she does remember him, but the memory lapses quickly. It leaves Allie scared and agitated, and Noah distraught. It is perhaps the most melancholic and accurate description of Alzheimer's. The movie successfully highlights the toll dementia takes on the sufferers and their caregivers. 

Approximately 1 in every ten individuals above 65 years of age has dementia. This proportion reaches up to 50% at 85 years, becoming a significant health dilemma in the developed world.

Out of many dementia manifestations, Alzheimer's emerges as the most common and quite difficult to detect. Evidence suggests that it is the fourth leading cause of death among American seniors. It is expected to rise rapidly in coming years, and experts largely blame it on lifestyle choices.

Busting The Myth Of Cognitive Decline With Aging

We often take our memory lapses or inability to perform something as a part of aging. While sometimes it may be suitable to assume so, the differentiation between the usual "aging factor" and dementia often becomes hard.

Many experts argue that considering Alzheimer's as an evident consequence of aging lacks a scientific basis. The cumulative evidence suggests that aging does not automatically translate into cognitive decline. Many individuals retain a healthy cognition in their advanced years because of their lifestyles.

The idea that Alzheimer's is uncontrollable is seated into a myopic view of disease and scientific reductionism. While research studies have explored various aspects of the diseases, most focus on plaque formation and β-amyloid accumulation.

There is no denying that these molecules are cornerstones of pathogenesis that underlies Alzheimer's, but the factors that culminate into this are indeed beyond abnormal protein accumulation or aging.

The Genetic Conundrum

The association of Alzheimer's with genetics is another limiting aspect of our understanding of the disease. While many diseases are exclusively genetic in nature, it is hard to pinpoint a single gene responsible for Alzheimer's.

The genetic prism that represents protein accumulation does not act in isolation and is rather multifactorial. The proof lies in the fact that approximately half of the individuals with a genetic tendency of protein accumulation in the brain often do not develop Alzheimer's. The research has identified more than thirty genes that appear to contribute to the risk and development of Alzheimer's.

However, the interesting fact is that most of these genes control energy production, metabolism, and other physiological processes in our body.  The insults incurred on these genes due to lifestyle choices and dietary patterns often influence their expression.

Therefore, it won't be wrong to say that Alzheimer's is a preventable disease and can be managed by curating a lifestyle that alleviates neurodegenerative alterations.

Tweaking a Lifestyle to Prevent Alzheimer's  

When it comes to lifestyle modifications, there is plenty of information on the internet. It is overwhelming and can quickly become confusing. The biggest problem is not the availability of information but the insight of lifestyle being a stakeholder in Alzheimer's.

Most people never make choices keeping the risk of Alzheimer's in mind because they are hardly told about a possible connection. Then emerge behavioral issues that infest every aspect of human life. Making a habit takes time, and this flexibility or adaptability shrinks significantly with age. Therefore, if you want to go into advanced years with a robust cognition, you should start living right early.

In a 2019 paper Preventing Alzheimer's: Our Most Urgent Health Care Priority, authors have devised an acronym "NEURO" to describe the critical modifiable elements to prevent Alzheimer's. The components of NEURO are:

N- Nutrition

E- Exercise

U- Unwind (stress management)

R- Restoration (healthy sleep)

O- Optimization (mental stimulation)

Each of these components has an in-depth relationship with the risk of progressive dementia. An insight into their role and suitable interventions can open new avenues to stop the imminent prevalence of Alzheimer's. It should be encouraging for you to know that none of these interventions are unrealistic or need extensive medical supervision. In fact, they allow YOU to take charge of your brain health and enter into your advanced years without pills or dependency.

These five pillars to prevent Alzheimer's translate into the following lifestyle interventions:

Intervention #1: Eat The Right Food

Your relationship with food is perhaps the most intimate and long-lasting one. You eat two to three times a day (or even more if you are a true American) and seven days a week for 80 or so years of your life. If you look at it, food is perhaps your most constant consort in life. Needless to say, it is also one of the essential factors in determining your brain health.

The food you eat breaks down into nutritional components in your body. You drive energy out of this process, and the by-products take part in your metabolism. As a result, your body generates highly reactive and damaging free radicals. Taking a diet rich in anti-oxidants assists you in combating this radical burden and alleviating the pathological mechanism of Alzheimer's. The dietary approaches also modulate immunity and determine the extent of inflammation in your body.

The experts at Rush University examined the impact of diet on Alzheimer's risk, and the results were encouraging. A specially tweaked "Mind diet" that contained healthy constituents (low fat, more plant-based elements) was administered to participants for more than four years. The strict adherence to it led to a 53% decrease in risk of Alzheimer's, while moderate compliance resulted in a risk reduction of 35%.  

It makes the role of nutrition in Alzheimer's evident and provides an opportunity to explore this territory further.

Intervention # 2: Break A Sweat Daily

You may be thinking that exercise seems to be the solution to every other problem you read about. Because it literally is!

It does not imply that you can cure anything with exercise, but longevity without physical activity is nearly impossible.

In the context of brain health, exercise plays a vital role. Your brain has trillions of intricate connections that make it a complex cognitive organ. These connections materialize your daily function, memories, thought processes, emotional responses, and intelligence. Aerobic exercise strengthens these pathways and protects them against wear and tear.

A 2017 systemic review analyzes evidence available about exercise and its relationship with cognition and memory. It concludes that sedentary behavior is negatively associated with the development and progression of Alzheimer's. It further provides evidence that aerobic exercises and strength training promote brain health and reduce the possibility of neurodegenerative diseases.

So, it would be best to prioritize exercise in your daily routine for robust memory and brain health.

Intervention # 3: Take Care Of Your Vascular Health

Vascular health refers to your heart and circulatory system. The idea of maintaining vascular health for preventing Alzheimer's provides validation to the role of diet and exercise.

When you eat fats in abundance, the excess clogs your arteries and makes them narrow. It leads to high blood pressure, heart diseases, and stroke. While there is a type of dementia called vascular dementia, which solely occurs due to poor vascular health, Alzheimer's also becomes likely.

It points out that your heart and brain can be on the same side, after all. The reason behind this connection is the possible role of cholesterol in the pathogenesis of Alzheimer's.

The evidence suggests that high cholesterol levels can accelerate the accumulation of β- amyloid proteins in the brain.  It is because cholesterol accumulation aggravates inflammation in your body. Therefore, keeping your heart and vessels free from fats is crucial, and diet and exercise allow you to achieve it.

Intervention # 4: Be Mindful And Manage Stress

Stress has a profound impact on your brain and physical health. It causes disarray in your neurochemical balance and weakens your neural connections.

The prolonged stress exposure releases cortisol hormone that changes your brain structure as well. The research shows that high cortisol levels reduce the hippocampus volume and other areas related to memory. It also inhibits new neuronal connections and slows down the brain's immune system that clears amyloid plaques.

Incorporating meditation or other stress-relieving techniques proves effective because they cause neuroplasticity. The brain can form new neural pathways and rehabilitate damage inflicted by prolonged stress levels. It is why stress management should be a lifestyle choice for you to control the onset of Alzheimer's.

Intervention # 5: Take Restorative Sleep Everyday

Sleep is your brain's reset button. When you sleep, your brain consolidates memories and puts them in long-term storage. Your neural pathways get time to catch a breath and perform the much-needed cleaning. Your microglial cells activate and collect trash (read amyloid and other proteins) from your brain.

However, sleep deprivation has an unexpected impact on these microglia cells. In response to chronic sleep deprivation, your brain undergoes sustained microglial activation to a point where they start destroying healthy neurons. It leads to a significant increase in Alzheimer's risk.

Moreover, many studies indicate that those who suffer from sleep disorders like sleep apnea have a 70% higher risk of developing Alzheimer's due to chronic sleep disruption. This evidence confirms the importance of regular and restorative sleep, which has undoubtedly become scarce nowadays.

Intervention # 6: Perform Mental Stimulation

The idea of mental stimulation and its efficiency in preventing Alzheimer's originates from the concept of cognitive reserve. It is a miraculous phenomenon that represents your ability to resist brain damage. The individual capacity to cope with cognitive decline varies and it is why many people do not experience Alzheimer's despite having beta-amyloid protein accumulation.

Your neurons stay at the top of their shape and continue building new connections if you provide them with sufficient stimulation. It strengthens your neural pathways and allows your brain to resist age-induced degeneration.

Those who perform complex jobs or learn new skills frequently seem to have a low risk of neurodegeneration, including Alzheimer's disease.

 An interesting study conducted on London Taxi drivers concludes that jobs that require navigation or mental stimulation improve memory and cognitive skills. It provides you with the "Optimize" part of "NEURO" interventions. You can challenge your brain with speaking multiple languages, playing chess, or learning musical instruments to increase your cognitive reserve.

Intervention # 7: Avoid Smoking And Alcohol

Smoking is a hazard because it accelerates inflammatory processes in your body. It also enhances your cardiovascular and stroke risk by causing clots in your vessels. The cholesterol plaques anchor into your blood vessels due to inflammatory mechanisms triggered by tobacco and cut off your blood supply. So, it indirectly increases the risk of Alzheimer's by damaging your vascular health.

The relationship between alcohol and Alzheimer's is controversial. While excessive drinking is detrimental, moderate usage of alcohol warrants further research.

However, it is always ideal to stay free of smoking and use alcohol in moderation.

The Final Verdict

Alzheimer's takes a tremendous toll on patients as well as their caregivers and needs immediate attention. While there is an adequate emphasis on pathogenesis and treatment of Alzheimer's, a preventive approach is missing. We can counter this dilemma by shedding light on risk factors related to lifestyle. With the help of available literature, you can design a lifestyle that prevents Alzheimer's and assures a robust cognition in senior years.