Preventing, Reducing and Reversing Alzheimer’s Disease
The cover story of the July/August 2016 issue of Scientific American Mind was “Banking Against Alzheimer’s.” Of course I’m intrigued by any hope of keeping my brain functioning as well as I can as I move deeper in the third chapter of my life. Most of us do care about the good health of our brains as we age, as friends age, as parents age.
The article focuses on the importance of building “cognitive reserve.” The more you have invested in education and learning, the more you have in your brain’s bank as you age and neurons begin to self-prune. But cognitive reserve is not the only factor in preventing, reducing and reversing dementia. I’ve included some of the most important research and the most practical suggestions in the Reflections and Exercises to Practice below. If you read no further than right here – “use it or lose it” – you will have gained something useful from this newsletter. Please do read on for more.
REFLECTIONS
“Banking Against Alzheimer’s” was written by David A. Bennett, M.D., director of the Rush Alzheimer’s Disease Center in Chicago, where 100 scientists are researching prevention and treatment of a variety of neurodegenerative disorders, including Alzheimer’s. Over 3,200 dementia-free adults have entered the study; they are tested annually with comprehensive physical examinations, detailed interviews, cognitive testing, blood draws and brain scans. All agree to donate their brains to the center upon death; 1,350 brains have been evaluated to date. This is an unprecedented bank of research data; some of the findings that may be helpful to us:
* Virtually all brains in old age contain some pathological signs of Alzheimer’s disease, but only some people suffer any symptoms as a result. Those who do not develop dementia appear to have greater cognitive reserve to fall back on.
* Choices we make throughout life, from learning a second language or studying music in childhood to finding purpose, can build cognitive reserve and dramatically reduce the risk of developing dementia.
* A central theme for maintaining brain health is remaining physically, intellectually and socially active in retirement, all of which are associated with reduced risk of Alzheimer’s.
“Cognitive reserve” means the more you require your brain to grow new neurons by learning, the more “surplus” brain cells you have to fall back on as neurons begin to atrophy or die with age and disease.
Perhaps one of the most critical steps toward ensuring better brain health is education. Education can help secure brain health as we age, and not just formal schooling, but all kinds of learning.
And cognitive reserve does greatly reduce the risk of Alzheimer’s.
* Bilingualism seems to delay the onset of dementia by as much as four years.
* Learning to play a musical instrument can reduce the risk of Alzheimer’s by 50%.
* More education shifts the measurable “change point” of accelerated cognitive decline to later in life.
According to studies done by Tracy Shors, a neuroscientist at Rutgers University, “Learning rescues new brain cells from death. A colossal number of brain cells, hundreds to thousands, are born each day but most die within weeks unless the brain is forced to learn something new. Then more neurons revive and sprout connections to their brethren. The harder the task, the more survivors.”
There are also other ways we can coax our brains to grow new brain cells or keep the ones we have.
EXERCISE:
Aerobic exercise, strenuous enough to break a sweat, causes the brain to release BDNF (brain-derived neurotropic factor) the brain’s growth hormone. The brain generates new neurons and stronger connections among the neurons, especially in the hippocampus, the memory center of the brain. Exercise can reverse memory decline in the elderly; it also helps reverse physical shrinkage of the brain; exercise improves memory and integration of brain functioning overall.
Exercise also protects telomeres on the ends of chromosomes (like plastic tabs on ends of shoelaces to keep them from unraveling); telomeres prevent DNA copying errors, which protects us against all disease.
And exercise “turns on” genes linked to longevity; in a study of 2400 twins, half active and half sedentary, people who exercised had brains that function as though 10 years younger.
DIET
The MIND diet (Mediterranean-Intervention for Neurodegenerative Delay) can help slow the build-up of toxic materials that cripple memory and critical thinking, preserve neuronal connections in the brain, and dramatically lower the risk of Alzheimer’s by 53%. The diet focuses on vegetables, especially leafy green vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and one glass of red wine/day. The omega-3 fatty acids found in fish, particularly DHA, are arguably the single nutrient most strongly associated with brain health.
And of course so much research data supports the drastic reduction of sugar and carbs in our diet. High sugar diets can prompt runaway inflammation and trigger a cascade of other metabolic changes that ultimately impair brain function. One researcher has found enough correlation between high-sugar diets and Alzheimer’s to characterize Alzheimer’s as “diabetes III.”
STAYING SOCIALLY ENGAGED WITH OTHER PEOPLE
Brains learn and develop best through interactions with other brains, says Dan Siegel, pioneer in the field of interpersonal neurobiology. Hanging out with healthy brains is one of the most powerful ways we have of keeping our brains healthy. People who have close relatives and friends with whom they can discuss private matters are better able to postpone the symptoms of Alzheimer’s whereas frequent but unsatisfactory interactions with their children increases dementia risk. And subjects who reported more neglect and rejection over 5 years time were more likely to show signs of cognitive impairment.
LIFE PURPOSE
Research subject who score higher on purpose in life show slower rates of cognitive decline and are 2.4 times more likely to avoid Alzheimer’s disease. And subjects who scored in the 90th percentile in conscientiousness – organization, self-discipline, dependability and a drive to achieve – had an 89% reduction in the risk for developing Alzheimer’s.
Reversing Alzheimer’s
Another research group, led by Dale Bredesen of the Easton Center for Alzheimer’s Disease Research at UCLA and funded by the Buck Institute for Research on Aging, piloted a small study that was able to reverse the impact of Alzheimer’s in 9 out of 10 patients. Six of the patients had had to discontinue working or were struggling with their jobs at the time they enrolled in the study; all were able to return to work or to continue working with improved performance. Not huge numbers, but statistically significant and hugely significant in terms of alternative treatment possibilities for Alzheimer’s patients. [See Stories to Learn from below for a video clip on interviews with patients in the study.]
Sharp Again Naturally is an organization working to educate the public and the medical community about preventable and reversible causes of dementia and Alzheimer’s disease based on the data from the Breseden study. They have identified 10 possible causes of Alzheimer’s that may be preventable or reversible:
1. Nutritional imbalances and deficiencies
2. Toxins in food, water, air, work/home environments
3. Effects of prescription medications
4. Mercury and other heavy metal toxicity
5. Hormonal imbalances
6. Inflammation from low-level infections, mold, food allergies and Lyme disease
7. Inadequate physical activity, mental stimulation and social interaction
8. Stress, especially from life transitions
9. Sleep and breathing problems related to oxygen deficiency
10.Traumatic brain injury
The causes of Alzheimer’s are complex and still somewhat mysterious to the medical establishment. Anything we can do to educate ourselves may help us to implement the lifestyle changes that can keep our brains healthy, build up that cognitive reserve, and postpone the deterioration of brain functioning from aging as long as possible. Please see Exercises to Practice below for specific ideas.
And please take good care of your brain as well as your mind and heart.
POETRY AND QUOTES TO INSPIRE
[These quotes from Michael Gelb’s latest book Brain Power: Improve Your Mind as You Age and from my February 25, 2013 e-newsletter about that book: From Retirement to Renaissance]We don’t stop playing because we grow old; we grow old because we stop playing.
– George Bernard Shaw
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Those who love deeply never grow old; they may die of old age, but they die young.
– Benjamin Franklin
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A man should hear a little music, read a little poetry, and see a fine picture every day of his life, in order that worldly cares may not obliterate the sense of the beautiful that God has implanted in the human soul.
– Johann Wolfgang von Goethe
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Anyone who keeps the ability to see beauty never grows old.
– Franz Kafka
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If I had to live my life again I would have made a rule to read some poetry and listen to some music at least once a week; for perhaps the parts of my brain now atrophied could thus have been kept active through use.
– Charles Darwin
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We must always change, renew, rejuvenate ourselves; otherwise we harden.
– Johann Wolfgang von Goethe
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The excitement of learning separates youth from old age. As long as you’re learning, you’re not old.
– Rosalyn Yalow, Nobel laureate
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It’s what you learn after you know it all that counts.
– John Wooden
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Retirement without the love of learning is a living burial.
– Seneca
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Learning a new skill can change hundreds of millions of cortical connections.
– Michael Merzenich, neuroscientist
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Just the attempt to learn a [new] language is like running different software through the brain.
– Andrew Weil, M.D., Healthy Aging
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The minute a man ceases to grow, no matter what his years, that minute he begins to be old.
– William James
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When you’re finished changing, you’re finished.
– Benjamin Franklin
STORIES TO LEARN FROM
During the course of researching this newsletter, I saw the film “My Love Affair with the Brain” a wonderful documentary about Dr. Marion Diamond, who taught integrative biology at U.C. Berkeley for 55 years. (She retired at the age of 85.) Dr. Diamond was actually the first neuroanatomist to publish research verifying neuroplasticity in mammalian brains (1964) that triggered the scientific paradigm shift about the human brain being able to change, grow and repair itself lifelong. And plasticity is proving to be an important factor in the brain’s resilience and cognitive reserve.
In the film Dr. Diamond gave the top five practices for protecting the human brain as it ages: diet, exercise, challenge, novelty, and love. Very much in agreement with what other researchers are finding, and she said very clearly, “Use it or lost it.”
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Sharp Again Naturally has produced documentaries of interviews with people who have reversed Alzheimer’s and lecture presentations of the methods used to to so. Here’s the link to a 5-minute clip of people who have “gotten their minds back.” Inspiring, poignant, and an introduction to a paradigm shift about recovering memory and brain functioning.
EXERCISES TO PRACTICE
Alzheimer’s now affects one in every nine Americans over age 65; that diagnosis rate is expecting to triple by 2050. Research data is rapidly accumulating that there are clear lifestyle choices we can make from childhood through adulthood into old age that make our brains less vulnerable to the wear and tear of aging.
EXERCISE
Those who think they have no time for bodily exercise will sooner or later have to find time for illness.
– Edward Stanley
Exercise is essential for brain health. What’s good for the heart is good for the brain. And all movement counts.
A poster in my doctor’s office has a photo of a woman walking on a sidewalk down the street carrying a bag of groceries with each arm; the headline is: Life is a gym. Walking up and down stairs, gardening, making the bed, all count.
A study was done of hotel maids, who do work hard physically in their jobs every day. Those told that they were getting good exercise scored higher on measures of physical health and well-being than the control group who believed they were just doing their job.
I like Christine Carter’s idea of a 3-minute better-than-nothing workout. The idea is to move your body, in any way that feels comfortable and yet energizing to you. It is important to the brain to move your body at least once an hour. It recommended to move your body at least 3 times a week for 20 minutes; 5 times a week for at least 30 minutes is even better.
And enjoy your movement/exercise. Exercise has been shown to be as powerful an anti-depressant as Prozac. Let yourself enjoy the dopamine, serotonin and endorphins that exercise releases in the brain.
DIET
I think Michael Pollan’s advice (author of Food Rules: An Eater’s Manual) is still the best. “Eat real food. Mostly plants. Not very much.”
Check out the MIND diet – more green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil, red wine. And reduce as much as you can the consumption of red meat, butter, cheese, pastries and sweets, fried or fast foods. Some of these changes in diet may be easier than others, but all of them backed by reliable science.
LEARNING
Learning to play a musical instrument or learning to speak a foreign language are the learning activities most often recommended by scientists to preserve brain health. But any learning that stretches the brain to cope with more complexity (not necessarily facts but processes that integrate with each other) can be helpful.
* Learn to play juggle or play chess
* Try a new recipe or make up your own
* Drive a new way to work or try cycling or public transportation
* Visit a new city on the weekend
Curiosity and playfulness are part of good learning and good brain health, too.
STAYING SOCIALLY ENGAGED WITH OTHER PEOPLE
People who are active with families, in community, in a social support network, live longer, function better, and are happier. Of course, the benefits of belonging, of having a sense of place in a tribe, are true for human beings lifelong. Choosing to maintain social ties as we age is one of the best protections we have against isolation, loneliness….and cognitive decline.
Participate in a workshop, a book club, a choir, a cycling group, a bowling league, a cooking class, a Habitat for Humanity project, whatever suits your interests, your calendar, your budget. And take in the good of feeling cared about by other people.
LIFE PURPOSE
The degree to which a person derives meaning from life experiences helps limit harmful effects of changes in the brain that are associated with Alzheimer’s disease. The benefits of meaning and purpose in life are apparent even when there is evidence of the formation of plaques and tangles that occur in people who develop Alzheimer’s disease.
You may already have found a sense of purpose and meaning in your life choices that keep you engaged with your world, learning about it and contributing to it. Millions of Americans volunteer – in schools, in churches, in libraries, coaching athletics and tutoring – for precisely that sense of purpose that helps us feel alive and needed as we age. Whatever you choose to do, nourish yourself with a sense that what you do matters, makes a contribution, counts
RESOURCES
Scientific American Mind magazine is a wonderfully accessible bi-monthly compilation of the latest research in neuroscience and mental health. It’s my favorite magazine of all time; loaded with useful information and stimulating perspectives.
Sharp Again Naturally, Preserving Memory, Restoring Minds, provides an entrée to a multi-therapeutic approach to treating and reversing Alzheimer’s disease. Provocative, cutting-edge, informative, potentially life-changing.