80% of Alzheimer’s cases can be prevented

 

Normal brain vs Alzheimer brain

For many, alzheimer’s and dementia are viewed as inevitable diseases of old age. However in a way, experts suggest that shifting focus to brain health early in life could significantly alter this perspective. While clinical manifestations often appear in the 60s, 70s, and 80s, the contributing habits and lifestyles are often established in our 20s and 30s.

Dementia is an umbrella term, similar to cancer, encompassing various conditions, with Alzheimer's constituting about 60% to 70% of all dementias. Other forms include frontal temporal lobe dementia, Lewy body dementia, Parkinson's dementia, Huntington's dementia, metabolic dementias, and alcohol-related dementias, each potentially having different pathways. Surprisingly, even Alzheimer's itself is seen as a spectrum with different subtypes and pathways leading to the same outcome.From what I've seen, a significant takeaway is the potential for preventing a large proportion of dementia cases. 𝗪𝗵𝗶𝗹𝗲 𝘀𝗼𝗺𝗲 𝗱𝗶𝘀𝗲𝗮𝘀𝗲𝘀 𝗮𝗿𝗲 𝟭𝟬𝟬% 𝗴𝗲𝗻𝗲𝘁𝗶𝗰𝗮𝗹𝗹𝘆 𝗱𝗿𝗶𝘃𝗲𝗻, 𝗼𝗻𝗹𝘆 𝟯% 𝗼𝗳 𝗮𝗹𝗹 𝗔𝗹𝘇𝗵𝗲𝗶𝗺𝗲𝗿'𝘀 𝗰𝗮𝘀𝗲𝘀 𝗮𝗿𝗲 𝗮𝗰𝗰𝗼𝘂𝗻𝘁𝗲𝗱 𝗳𝗼𝗿 𝗯𝘆 𝟭𝟬𝟬% 𝗴𝗲𝗻𝗲 𝗽𝗲𝗻𝗲𝘁𝗿𝗮𝗻𝘁 𝗴𝗲𝗻𝗲𝘀 like prelin 1, prelin 2, and APOE (though APOE has varying penetrance).In my experience, for the vast majority of alzheimer's, it is an 𝗶𝗻𝘁𝗲𝗿𝗽𝗹𝗮𝘆 𝗯𝗲𝘁𝘄𝗲𝗲𝗻 𝗴𝗲𝗻𝗲𝘀 𝗮𝗻𝗱 𝗲𝗻𝘃𝗶𝗿𝗼𝗻𝗺𝗲𝗻𝘁, with the environment determining the manifestation of the disease. Having high-risk genes like two APOE4 alleles increases risk (up to 12 times compared to baseline), but it doesn't mean you are guaranteed to get the disease; lifestyle plays a significant role. This in a way reinforces the idea that predisposition does not equal predetermination.

There is significant optimism regarding the preventability of dementia through lifestyle changes. Extrapolations from large data suggest that as much as 80% of dementias could potentially be prevented if focus starts early on cognitive health. Even a more conservative approach, like the 2024 Lancet commission report based on raw data, suggested that 45% of Alzheimer's dementia cases could be prevented through lifestyle changes. This 45% figure alone is considered highly significant; if a drug could reduce risk by that much, it would be immensely valuable. The you could say difference in percentages highlights the impact of optimal lifestyle interventions compared to marginally beneficial data used in conservative reports.

Over the past decade, the medical field's view on dementia prevention has shifted dramatically, moving from being "woo-woo" to having dedicated sections and even plenary sessions at major conferences presenting objective evidence of preventability.

𝗞𝗲𝘆 𝗺𝗼𝗱𝗶𝗳𝗶𝗮𝗯𝗹𝗲 𝗿𝗶𝘀𝗸 𝗳𝗮𝗰𝘁𝗼𝗿𝘀 𝗶𝗱𝗲𝗻𝘁𝗶𝗳𝗶𝗲𝗱

• 𝗡𝘂𝘁𝗿𝗶𝘁𝗶𝗼𝗻: Eating better, including increasing fiber, cutting saturated fats, and ensuring adequate long-chain omega-3 fatty acids (DHA).

• 𝗘𝘅𝗲𝗿𝗰𝗶𝘀𝗲: Regular physical activity, such as brisk walking, can reduce the risk of Alzheimer's by as much as 40%.

• 𝗠𝗮𝗻𝗮𝗴𝗶𝗻𝗴 𝗩𝗮𝘀𝗰𝘂𝗹𝗮𝗿 𝗥𝗶𝘀𝗸 𝗙𝗮𝗰𝘁𝗼𝗿𝘀: Keeping an eye on and addressing blood pressure and cholesterol is crucial. Uncontrolled sort of total cholesterol and specifically LDL cholesterol, particularly in midlife, are significant risk factors. Addressing insulin resistance and uncontrolled diabetes also profoundly influences cognitive state.

• 𝗦𝗹𝗲𝗲𝗽: getting sufficient and quality sleep is vital for memory consolidation and the brain's glymphatic system, which is its garbage disposal. Sleep disorders like obstructive sleep apnea and restless leg syndrome can significantly increase risk. Treating kind of sleep apnea, for instance, can disrupt its relationship with increased Alzheimer's risk.

• 𝗦𝘁𝗿𝗲𝘀𝘀 𝗠𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁: Managing stress is one of the five key elements for brain health.

• 𝗠𝗲𝗻𝘁𝗮𝗹/𝗰𝗼𝗴𝗻𝗶𝘁𝗶𝘃𝗲 𝗮𝗰𝘁𝗶𝘃𝗶𝘁𝘆: Challenging your brain throughout life builds cognitive resilience and protection. Education level is often used as a proxy for mental activity and is a known protective factor. This concept relates to "idea density" – the complexity of thought and activity.

• 𝗦𝗼𝗰𝗶𝗮𝗹 𝗘𝗻𝗴𝗮𝗴𝗲𝗺𝗲𝗻𝘁: Maintaining meaningful relationships is another key element.

• 𝗢𝗿𝗮𝗹 𝗵𝗲𝗮𝗹𝘁𝗵: emerging data suggests a relationship between oral and dental health, including issues like tooth loss, gum problems, and chronic gingivitis, and cognitive impairment later on. This may involve the oral microbiome and systemic inflammation. Simple practices like flossing, brushing, and regular dental check-ups are encouraged.

• 𝗔𝗱𝗱𝗿𝗲𝘀𝘀𝗶𝗻𝗴 𝗠𝗶𝗰𝗿𝗼𝗻𝘂𝘁𝗿𝗶𝗲𝗻𝘁 𝗗𝗲𝗳𝗶𝗰𝗶𝗲𝗻𝗰𝗶𝗲𝘀: Being proactive about potential deficiencies in essential nutrients like B12, Vitamin D, and Omega-3 (DHA) is important, especially as we "cheat evolution" and don't live only 39 years.From what I've seen, fortification of food with nutrients like iodine has shown national iq increases.

𝗪𝗵𝗶𝗹𝗲 𝗽𝗿𝗲𝘃𝗲𝗻𝘁𝗶𝗼𝗻 𝘁𝗵𝗿𝗼𝘂𝗴𝗵 𝗹𝗶𝗳𝗲𝘀𝘁𝘆𝗹𝗲 𝗶𝘀 𝗮 𝗺𝗮𝗷𝗼𝗿 𝗮𝗿𝗲𝗮 𝗼𝗳 𝗵𝗼𝗽𝗲, 𝗿𝗲𝘃𝗲𝗿𝘀𝗶𝗻𝗴 𝗲𝘀𝘁𝗮𝗯𝗹𝗶𝘀𝗵𝗲𝗱 𝗔𝗹𝘇𝗵𝗲𝗶𝗺𝗲𝗿'𝘀 𝗽𝗮𝘁𝗵𝗼𝗹𝗼𝗴𝘆 𝗼𝗻𝗰𝗲 𝗶𝘁'𝘀 𝘀𝗲𝘁 𝗶𝗻 𝗶𝘀 𝗰𝘂𝗿𝗿𝗲𝗻𝘁𝗹𝘆 𝗻𝗼𝘁 𝗽𝗼𝘀𝘀𝗶𝗯𝗹𝗲 𝘁𝗵𝗿𝗼𝘂𝗴𝗵 𝗹𝗶𝗳𝗲𝘀𝘁𝘆𝗹𝗲. Once the destructive cascade involving amyloid and tau proteins has begun, pulling back is extremely difficult. However, there is optimism about future pharmaceutical drugs that could target these downstream processes, potentially detaching or disintegrating tau pathology.Truth is, experts are hopeful that within the next decade, remarkable preventive and potentially curative medications will emerge, especially for those identified at high risk early on.

Emerging research areas include the potential impact of GLP-1 agonists (like semaglutide and tirzepatide), known for improving metabolic profiles, on reducing Alzheimer's incidence. These drugs may affect inflammation and oxidation pathways related to the disease.

It's important to be cautious about misinformation, particularly regarding supplements and "superfoods" claiming to prevent or cure Alzheimer's. While some substances are being investigated (like creatine for muscle recovery with limited data on significant cognitive benefits), many claims lack robust, high-quality evidence and may be driven by salesmanship. Relying on anecdote is misleading; science requires repeatable, directional data based on agreed-upon methods.

The higher rates of Alzheimer's diagnoses in women (nearly two-thirds) are an area of ongoing investigation. Potential more or less factors include differences in how women's bodies respond to vascular risk factors like abnormal cholesterol, physiological changes during the perimenopausal period where estrogen plays a crucial role in brain health, and historical lack of opportunities for cognitive challenges due to societal roles, potentially affecting cognitive reserve. Women kind of also tend to live 5 to 7 years longer, and these later years can contribute to the manifestation of disease. While hormone replacement therapy (HRT) can help manage perimenopausal symptoms, current high-quality human trials do not strongly suggest it offsets cognitive decline, though personalized approaches are important.

Ultimately, there is significant hope and empowerment in the fact that many risk factors for dementia are modifiable. Very simple, actionable steps taken early and consistently throughout life can profoundly improve brain health and potentially change one's destiny regarding this devastating disease. It's a call to action that starts today.

#Alzheimer #AlzheimersAwareness #alzheimersdisease #dementia #dementiaawareness #dementiacare