The End of Alzheimer’s Disease (AD) Starts With Lifestyle Medicine

Across the globe, Alzheimer’s Disease (AD) is stealing the golden years from our elders and leaving the family members of those that suffer from the disease in a state of panic about whether they will follow in the footsteps of their loved ones.   On the whole, we’re losing the fight against AD and it may well bankrupt our medical system if the statistics don’t start improving soon.  

According to the Alzheimer’s Association, in the US

• One in 10 people (10%) age 65 and older has Alzheimer’s dementia
• Two-thirds of people with AD are women
• Older black/African Americans are twice as likely to develop AD as older whites
• Older Hispanics are 1.5 times more likely to develop AD as older whites
• By 2025, the number of people age 65 and older with AD is projected to reach 7.1 million — almost a 22% increase from the 5.8 million age 65 and older affected in 2020
• One in three seniors dies with AD or other dementia
• Family members and friends provided $244 billion in caregiving support to AD patients in 2019

These statistics are a lot to take in and yet they confirm what I have experienced personally and professionally: this disease’s web of influence spreads deep and wide.  When I am talking to groups about healthy brain aging and ask who among them has a family member or friend with AD, more than half the room invariably raises their hands.  As a witness and a person with a family history, any sign of cognitive decline or even mention of the possibility can send shivers of fear up my spine.  My natural tendency is to find something, anything, that I can do to reduce my risk of AD and I am happy to report that in my work as an integrative nutritionist, I have found that there are actually many things that I can do to make it less likely that I follow in my grandfather’s footsteps- albeit I am happy that I got his sense of humor.

While there are many areas of disease care where modern medicine has found a solution, unfortunately, AD is not one of them.   

“None of the pharmacologic treatments (medications) available today for Alzheimer’s dementia slow or stop the damage and destruction of neurons that cause Alzheimer’s symptoms and make the disease fatal.”

Many of my AD patients report that their annual trips to the neurologist function primarily to chart their cognitive decline.  No solutions are offered because there are none.  And yet, I am full of hope about my long term brain health because more and more research is supporting the role of integrative medicine in improving cognition.   In their 2019 report, the World Health Organization (WHO) found compelling evidence that managing ‘modifiable risk factors’ would decrease a person’s risk of developing cognitive decline.  Cognitive decline often, but not always, progresses to AD.  This means that there is a big benefit from improving your lifestyle that will directly reduce your risk such as:

• Regular physical activity
• Smoking cessation
• Cardiovascular health (cholesterol, blood pressure, and diabetes)
• Normalizing weight
• Eating a healthy diet
• Lifelong learning and cognitive training
• Enjoying positive social connections

The bottom line?  There are things that we can do every day to improve our brain health and drastically reduce the chances of developing cognitive decline or AD!  The catch- and yes, there’s always a catch- is that because the changes to the brain that result in the disease we call AD start 15-20 years before symptoms pop up that would bring you into a doctors office, we need to start dialing in our lifestyle in our 40’s and 50’s.  Of course, the rub is that this is exactly the time when we find ourselves either in the midst of an intense career, raising a family, or caring for elders (and sometimes all of these at once).  Making these changes is hard but an experienced nutritionist or trained practitioner can support your efforts to make them a priority. 

When we pay attention to what and how we eat, how much we move, how much we sleep, how connected we feel to others, and how we manage our stressors, we position ourselves for optimal wellness which means we give our body the best possible chance to age gracefully with a healthy mind and body.

Is AD a Women’s Issue?

While Alzheimer’s Disease is not a female disease, there are some interesting statistics that should give us pause to consider if it’s a woman’s issue:

• Almost two-thirds of American’s with Alzheimer’s Disease are women.
• Approximately two-thirds of caregivers are women; more specifically, over one-third of dementia caregivers are daughters of the patient.
• Approximately one out of every four dementia caregivers are “sandwich generation” caregivers — meaning that they care not only for an aging parent but also for children under age 18. (www.alz.org)

One way to start answering the larger question of why Alzheimer’s Disease impacts women more than men is to consider some of the reasons why these statistics that I pulled from the Alzheimer’s Foundation’s website might exist:

• Women are often the primary caretakers for the family which means years and even decades of interrupted sleep caring for young children and sick family members. Sleep deprivation is a primary risk factor for cognitive decline.

• As women progress through menopause, the decline in estrogen can have a marked impact on cognition with brain fog being a primary symptom for many women. Estrogen is a ‘tropic factor’ which means it stimulates growth. A lack of estrogen can lead to a predominance in atrophic factors that on balance lead to decline.
• Caretakers are less likely to have time to take care of themselves as they prioritize the care of loved ones, thus the essential lifestyle habits that reduce the risk of cognitive decline (healthy diet, sleep, exercise, stress management, social connections) are more likely to be put on hold.

As mothers, daughters, and spouses, and as the men that support these important roles, we need to think about how we can provide support so that they do not fall into these higher-risk categories.  What that looks like for each of us will be different and yet American society as a whole needs to collectively do more to provide more day-to-day support for mothers and caregivers, especially if they are part of the sandwich generation that asks them to care for their parents as well as their young children most often in the context of a full-time job outside of the home.   

Here are some easy ways to support the caregivers in your life and help them reduce their risk of developing AD:

• Drop off a meal, snack, or just a bottle of their favorite flavor of kombucha
• Ask if they need anything from the store when you are going
• Be an emotional support, check-in on their day, and provide a listening ear
• Help care for their kids by inviting them out for a bike ride to give mom a break
• Drop off flowers to brighten their table
• Include them in group exercise opportunities like a long walk or run
• If you are the manager of a woman who is juggling all of this, provide the flexibility that will allow her to manage better like work from home or flex-time
• Send a card that lets her know you are thinking about her and she is an amazing person

What Can You Do?

1. Get the support that you need to align your lifestyle to address the key modifiable risk factors 
   1. Get 30-60 minutes of physical activity 5-6 days per week
   2. Reduce the time you sit as much as possible if you have a sedentary job ask for a standing desk
   3. Look at your diet and nutrition and make the most of what you put in your mouth
   4. Try intermittent fasting
   5. Add in supplements to support your health goals
   6. Manage your stress with meditation, breathwork, laughter, and simplifying your life
   7. Connect with friends and family as much as you can, make this a priority as it directly impacts your brain health
   8. Address any chronic disease until it is well managed preferably with lifestyle changes and medication if needed
   9. Engage in brain stimulation whether through your job or recreation activities
2. If you are experiencing symptoms of cognitive decline, get help!  The sooner the underlying issue is addressed, the more likely you are to change the progression of the decline.
3. Read Dr. Dale Bredesen’s book, The End of Alzheimer’s: The first program to prevent and reverse cognitive decline.
4. Support those around you that exhibit symptoms of cognitive decline so that they can get help sooner rather than later.