Is Alzheimer’s a disease of choice?

Certainly none of us would consciously and deliberately choose Alzheimer’s disease, but by the same token, none of us would choose heart disease, cancer, diabetes, or a host of other diseases that are life threatening or otherwise impede our quality of life. And yet, many of us make those choices every day! It is not that any of us actively embrace the disease; indeed, many of us never truly consider the risks. But we often adopt a lifestyle that increases our chances of developing cancer or heart disease, certain respiratory diseases, and who knows what else? The question then becomes, can we prevent Alzheimer’s disease by changing some bad habits?

How Can We Prevent Alzheimer’s Disease?

Lifestyle choices can increase the risk of Alzheimer’s disease

We have known for some time that diet and certain other lifestyle choices can greatly influence our susceptibility to certain diseases. Tobacco use is perhaps the best known and most sinister health risks. Cigarette smoking accounts for nearly a half a million deaths each year in the United States alone. According to the Center for Disease Control smoking is complicit not only in the rise of lung cancer but also coronary and heart disease including stroke, respiratory disease, and cancers other than lung cancer.
A recent study (Journal of the American College of Cardiology, Sept 2014) found that changes in lifestyle can potentially prevent 4 out of 5 heart attacks. It is no surprise that giving up tobacco is the most beneficial change; other recommendations of the research team include:

• Exercise
• A diet including a lot of vegetables, fruit, fish, nuts legumes, and low-fat dairy products
• Limit alcohol consumption

I mention this study to emphasize the fact that the choices we make every day can greatly influence our health, but also because we know that things that improve our heart health also protect us from most types of dementia.
But is Alzheimer’s a product of our lifestyle. And can we prevent Alzheimer’s disease? The simple answer is we don’t know—not for sure. On the other hand, we are noticing more and more a strong correlation between certain environmental factors and dementia. For example, a study in the British Medical Journal (September 2014) found that the use of benzodiazepines, a drug prescribed for anxiety and sleep problems can significantly increase a person’s chances of developing Alzheimer’s disease. Benzodiazepines are among the most frequently prescribed drugs in industrialized countries.

Researchers have long noticed correlations between diet, exercise, and certain other “habits”, and the risk of cognitive disorder including dementia. The banner at the top of this article helps to illustrate my point. First, I wish to thank Alzheimer’s Disease International for making this illustration available. The purpose of the graphic is to observe World Alzheimer’s Month, which is September each year. The purpose of the graphic is to bring attention to the fact that we very well may be able to increase our resistance to Alzheimer’s disease by changing just a few things. Notice the similarities between the suggestions implied by the banner and the suggestions for decreasing the risk of heart attack.
These are not recommendations that Alzheimer’s Disease International made up out of thin air. Research supporting their contention goes back quite a few years. In fact, and not to toot my own horn, I wrote an article early in 2010 that made these same suggestions, plus a few, so the information has been available for some time. Now, even Dr. Oz is on board. I have seen several recent articles that quote him touting lifestyle changes to minimize the risk of Alzheimer’s disease.
ADI didn’t specifically recommend quitting smoking on its banner; if you smoke it’s the first thing to do if you are contemplating a lifestyle change for health.

(note from Doctor Dementia:  Take what Dr. Oz says with a grain of salt – a scientific study published in the British Medical Journal reports that his advice is accurate LESS THAN 50% of the time!)

Even The Alzheimer’s Drug Discovery Foundation, whose mission it is “to rapidly accelerate the discovery of drugs to prevent, treat and cure Alzheimer’s disease”, has a page devoted to lifestyle changes; non-pharmacological considerations that may impact how we treat the threat of Alzheimer’s. The ADDF references the Finnish Geriatric Study to Prevent Cognitive Impairment and Disability (FINGER), one of several investigations underway in Europe that are looking for correlations between lifestyle and cognitive health. According to lead author Miia Kivipelto , “multidomain lifestyle intervention that included nutritional guidance, physical activity, cognitive training and social activities, and monitoring and management of all metabolic and vascular risk factors, including hypertension, dyslipidemia, obesity, and impaired glucose tolerance,” FINGER is slated to wrap up at the end of 2014 but already is already garnering positive results. In other words, maybe lifestyle choices may help us prevent Alzheimer’s disease.

Environmental factors and Alzheimer’s disease

If poor lifestyle choices can negatively influence our resistance to Alzheimer’s disease, what impact are environmental factors, over which we have very little control, having on us? A healthy diet of fresh fruits and vegetables, fish high in omega-3 oils, nuts, (more below) is one of the recommendations on most “prevent Alzheimer’s” lists. But if our food is contaminated by chemical herbicides and pesticides, is it potentially doing more harm than good? If fish consumption is lessening our chances of dementia, but the fish is contaminated with mercury and other byproducts of civilization, should we be eating that fish? If food quality is corrupted by unnatural genetic modifications can we assume that it will provide the same protection as will its natural counterpart?

Researchers reporting in JAMA (The Journal of the American Medical Association) in January 2014 found a strong association between DDT and Alzheimer’s disease. DDT was banned in the United States in the early 1970’s, but its use before that was widespread, and it is still legal in some countries. Most of the people who today have Alzheimer’s were young in the years that DDT was used legally—and it was used extensively. Other environmental contaminants that have been implicated in Alzheimer’s and other neurodegenerative disorders include lead, aluminum, air pollution, PCB’s,  and herbicides and insecticides including DDT. (Environmental Threats to Healthy Aging)

In some ways, environmental hazards are less egregious than in the recent past. Thanks to regulations our air and water contain less of certain contaminates than they did just fifty years ago.  But deregulation of certain industries may change that positive trend. A new onslaught of pollutants will likely bring more risk for disease including dementia.

It is possible that the “right” lifestyle could eliminate the risk of developing Alzheimer’s, but we should be realistic in our hopes and expectations. More likely a positive change in lifestyle would delay Alzheimer’s disease, and probably dementia from almost all causes. But even delaying onset by five years across the board could in time cut the incidence of dementia in half. (Dementia Risk Reduction) This decrease would have an enormous impact on the cost of the disease to society, to say nothing of the benefit to quality of life this would provide to the people who do eventually develop dementia five years later than they might have otherwise.

Recommendations for decreasing your risk of Alzheimer’s disease

The lifestyle changes thought to improve our resistance to Alzheimer’s disease (positive risk factors) include:

• Diet
  • Fresh fruits and vegetables – there is, and always will be, disagreement, but I think that organically grown produce is preferable to those grown with chemical fertilizers and in the presence of chemical pesticides and herbicides. I am reading more frequently that organic fruit and vegetables contain more nutrients, and the chemical residue of “conventional” farming can’t be good for health.
  • Certain wild (not farm raised) cold water fish like salmon, mackerel, herring and anchovies; as well as other foods that are high in omega-3 fatty acids, including flaxseed, chia seed, nuts, basil, and others.
  • There are a number of other dietary substances that are worth considering, which we will be writing more about soon, including turmeric, coconut oil, Vitamin D, and diatomaceous earth.
• Exercise
• Keep an active mind
• Monitor medication carefully – there is growing evidence of a causal connection between certain prescription, even no-prescription, drugs and dementia.
• Moderate alcohol use – this is one that provokes a lot of discussion, but it won’t go away. But moderate means moderate. No more than the equivalent of two glasses of wine per day. Some advocates say that the form of the alcohol doesn’t matter; others say that red wine is the only drink that has any real benefit.
• There are a couple of other possible treatments are coming to the fore that will certainly garner criticism. THC, the active ingredient found in marijuana, may be able to stop or even reverse the progression of Alzheimer’s disease; and psilocybin, the compound that gives “magic mushrooms” their psychedelic properties, may be able to grow new brain cells. More on these in upcoming posts.

There are a number of factors that could increase the risk of Alzheimer’s disease (negative risk factors) over which we have, at least, some control including:

• General health considerations that can be monitored and modified through pharmaceutical and non-pharmaceutical means
  • Cardiovascular disease including hypertension
  • Diabetes
• Smoking and tobacco use – if you smoke, stop. This is probably the number one recommendation regarding almost any health-related lifestyle change.

All of the suggestions above relate directly to improved health. Even if dementia is not a concern, adopting some or all of these will improve your general quality of life. Our original question was, can we prevent Alzheimer’s disease by changing some bad habits? Maybe not, but it is looking more like we can at least delay it; and who knows, maybe someday it is this avenue that will lead us to a cure.