(Some questions published here have been edited, and not all questions can be answered.)
The doctor’s answers are meant for educational purposes and are not meant to be a substitute for advice from your own doctor. Readers should contact their physician before making health care decisions.
Q. What practical steps can a baby boomer take to stave off dementia of any type? — Canoe9, Hawaii
Q. My dad’s family has a history of Alzheimer’s disease: my grandfather and many of his brothers have either passed away from the disease, or are currently suffering from it. The disease can be traced back for many generations. My father has not yet started to show symptoms. Are there any medications he can take as a preventative measure? What are the best diet and lifestyle choices a person can make who has an increased risk of developing the disease? — VB, Canada
Q. Both of my inlaws have Alzheimer’s. What steps can my husband and his brothers take now to delay/prevent the disease? And should he be monitored at an Alzheimer’s center? — lbs, New Jersey
Q. My mother, two older brothers and two older sisters all had progressive mental dementia (I believe Alzheimer’s ) before age of 65. I am 64 and had extensive mental exam that found no symptoms. For prevention I am doing it as follows. 1. Have become a Vegan with very little use of vegetable oils after reading China Study by Campbell and Starch Solution by McDougall. 2. I use lots of turmeric, ginger, cinnamon in my food. 3. I have run 20 to 30 miles a week for the last 10 years. 4. I retired to reduce work related stress. Is there any other preventive measures you recommend? — Jaque, Champaign, Ill.
Q. My mother had a form or dementia, not sure if it was Alzheimer’s, and she lived to 96. And what can I do to improve my chances? I work out and am not overweight and am in good health otherwise. — Mitchellmcg, New York
A. There are dozens of causes of dementia and steps for prevention are different for each one. We have no proven preventive strategies for Alzheimer’s. The decision to monitor people at risk is made on a case by case basis, but I don’t usually recommend any monitoring until someone is about five years within the age their relative developed it; or they note changes in their memory. My top strategies to keep your brain healthy are listed below.
1. Vascular risks: Minimize your risk for strokes, heart disease and diabetes (keep your body weight, blood pressure, cholesterol and sugar in normal range). Studies find strong links between vascular risks and Alzheimer’s.
2. Exercise regularly: Regular aerobic activities, such as walking, may reduce risk for dementia by keeping the brain’s blood vessels healthy, boosting nerve growth chemicals and slowing age-related brain shrinkage.
3. Stimulate your mind: Socialize actively, make new friends, try new activities, travel to new places and be passionate about learning new things. Adult brains can grow new brain cell connections and developing a greater cognitive reserve might help the buffer against dementia pathology.
4. Heart healthy diet: follow a heart healthy diet such as a Mediterranean diet but heed the old Okinawan saying Hari Hachi Bu – eat only till you are 80 percent full; drink in moderation (but not till you cannot remember what happened the prior night!)
5. Minimize your risk for head injury by wearing helmets. (The Hovding is a new invisible helmet that promises to keeps your hair looking pretty and your head safe!)
6. Take part in clinical trials – pros are that trials may offer regular check-ups and you are helping science; cons are that there are safety risks. Our book, The Alzheimer’s Action Plan gives a step-by-step guide to evaluate which clinical trials are best for you. You might enjoy reading the new book, “Super Brain.” It’s coauthored by the dementia scientist Rudolf Tanzi and the mind-body guru, Deepak Chopra.
Q. I can´t find a Spanish version of “The Alzheimer’s Action Plan.” Will we have it soon? — Marisabel Neuman, Orlando, Fla.
A. Not yet, but we are open to it if you know an interested publisher! But your question does highlight the fact that many Spanish only speakers in the United States and elsewhere are often left out of the mainstream of information on Alzheimer’s. Hispanics in the United States may be at a slightly greater risk for Alzheimer’s due to higher rates of heart disease. Gracias por su interes!
Q. Since my mother developed Alzheimer’s in her mid-80’s, presumably I am at greater risk than the general population, should I live to a similar age. What is your best guess about the likelihood of preventative medications or treatments being developed in the next 25 years? — Beth, Singapore
A. The track record of scientists at predicting a “cure” is not very good (about the same as that of stock analysts predicting the market). The last dozen or so experimental medicines for Alzheimer’s (all touted as the next big thing) have not only failed but results have often been the opposite of what was predicted.
That said, in the next 5-10 years, we will have the results from over 25 trials testing a broad range of strategies such as drugs targeting plaques, drugs targeting tangles, drugs boosting brain memory chemicals, aerobic exercise, different types of diets and medical foods, gene therapy, as well as novel devices to stimulate the brain’s memory centers. (You can check clinicaltrials.org or adcs.org for more information). So the odds are quite good that we will have one or more new treatments by 2025. But even if a cure were in a test tube today, it would take ten years to get to the market. That’s why it’s critical that individuals, such as yourself, sign up for clinical trials.
You may be surprised to learn that one type of “cure” is already available. About 10 years ago, a woman with familial early onset Alzheimer’s successfully conceived a healthy baby free of the harmful APP gene mutation through a technique called preimplantation genetic diagnosis (PGD) at a fertility clinic run by the doctor, Yuri Verlinski. That baby, who would now be 10 years old, has hopefully been cured of familial Alzheimer’s and will in turn be able to have risk free children.
Q. My father, his mother, his mother’s sister, my maternal grandmother and her sister and my maternal aunt all had or have Alzheimer’s - symptomatic onset at 70 and in the early 80’s. I have just turned 60 and think I’d be a great research subject in terms of lifestyle. Can you suggest any research projects that might use me? I understand that some very important studies are being run through Duke. — Kristin Pop’s daughter, Ithaca.
Q. Kristin’s background, age, concerns, and interest in research studies mirror mine - which I have posted. Please inform us of potential studies. I am willing to travel, even to Duke, which she mentioned in her post. —Mary Christian Madden, East Greenwich, RI
A. Thanks for the offer! Most research studies require people to come for multiple visits over several months/years which would be difficult for people living far away. A university affiliated medical center closer to your home might be more ideal. Clinicaltrials.gov has a listing of all ongoing prevention studies. Many such studies are also advertised in pages of local newspapers. The Alzheimer’s Association chapter in your home town may be able to guide you to find a suitable research study in your town. Don’t sign up for a trial just because you have a spare half day. Make sure you thoroughly research the pros and cons. Fewer than 1 percent of drug trials are positive, but 100 percent of all drug trials carry risks. So the odds of you personally benefiting are the same as in a lottery.
Q. Her whole life my mother drank four cups of tea every day, read two to three books a week, ate mostly vegetables, didn’t smoke, drank wine moderately, and stayed slim. She started showing signs of Alzheimers in her mid 50’s and has been steadly declining for 15 years now. Although a bad lifestyle can cause dementia in many people, it is more complicated than that. — Joseph, Fla.
Ask an Expert: Ask and Expert About Alzheimer’s, Part 3
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Ask an Expert: Ask and Expert About Alzheimer’s, Part 3
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Ask an Expert: Ask and Expert About Alzheimer’s, Part 3
