As part of National Alzheimer’s Awareness Month, the editors of Health they spoke with Fawad Yousuf, MD, a neurologist with the Marcus Neuroscience Institute at Boca Raton Regional Hospital, which is part of Baptist Health South Florida. Dr. Yousuf spoke about the disease, its causes… and the steps you can take to prevent it.
Health: What Causes Alzheimer’s Disease?
Dr. Yousuf: Alzheimer’s disease (AD) is a gradual and progressive neurodegenerative disorder caused by the accumulation of abnormal proteins in the brain. This leads to neuroinflammation and the loss of neurons. Aging is the most common risk factor for AD. A genetic role in early-onset and late-onset AD has been identified. Other factors include traumatic head / brain injuries, hypertension, depression, and a family history of dementia.
Health: Is Alzheimer’s considered to be a hereditary or lifestyle disease?
Dr. Yousuf: Certainly genetic factors play a role: about 60% of AD is familial. Alzheimer’s also appears to be associated with Down syndrome, which is a genetic disease. Lifestyle factors such as smoking, obesity, diabetes and insulin resistance, poor diet, and excessive consumption of processed foods also play a role.
Health: What is the difference between normal memory loss due to aging and memory loss associated with Alzheimer’s disease?
Dr. Yousuf: Most of us get a little more forgetful as we get older and need a little more time to remember things, or have difficulty doing some tasks, which is seen mostly from middle age, between 40 and 60 years. However, AD dementia is not a normal part of aging. Although memory loss is the most common sign of AD, people can experience problems with thinking, reasoning, language, visual perception, and attention, and they can show personality changes. They may forget everyday tasks and lose track of time, or have trouble remembering words or having conversations. These problems can be perceived both by the patient and by their relatives or caregivers.
Health: What are the most common symptoms of Alzheimer’s disease?
Dr. Yousuf: The most common symptoms are memory loss, forgetting events, losing or misplacing things, repeating things when speaking, and any type of memory loss that disrupts daily life. Other common symptoms are problems managing finances, maintaining personal hygiene, caring for pets or driving a car, shopping, and other activities of daily living. Getting angry easily, having poor judgment, or experiencing sudden mood swings are also red flags.
Health: What is the most common age for patients to be diagnosed with Alzheimer’s disease? And does it affect men more than women?
Dr. Yousuf: The majority of people diagnosed with AD are over the age of sixty: one in 14 is over 65 and one in six is over 80. Patients with familial AD present signs of the disease before the age of 65. More than two-thirds of Alzheimer’s disease cases are among women. The risk for AD is associated with the loss of hormones during menopause, so women who develop AD may experience worse symptoms than men.
Health: Is there any breakthrough on the horizon to treat Alzheimer’s disease?
Dr. Yousuf: Unfortunately, there is no cure for AD. However, there are symptomatic treatments. There are half a dozen cognitive stimulants in phase two and phase three clinical trials, and there has been a lot of talk about different drugs to treat Alzheimer’s in recent years, but we haven’t seen much action yet.
Health: Can Alzheimer’s disease be prevented? If so, what steps can a person take right now?
Dr. Yousuf: Risk factors that can be modified are high blood pressure, high cholesterol, smoking, being overweight, and diabetes. Studies show that up to 80% of AD patients have cardiovascular disease, so modifying cardiovascular risk factors is a good place to start. Exercise helps increase blood and oxygen flow to the brain, which is beneficial in preventing AD. A healthy, low-sodium, Mediterranean diet rich in fruits, vegetables, and seafood can be beneficial. Avoid sugars and foods rich in carbohydrates, which contribute to all kinds of disease processes.
Health: What are the most important things that Alzheimer’s patients or their caregivers can do to help manage their symptoms?
Dr. Yousuf: There are eight simple steps anyone can take to minimize their chance of developing Alzheimer’s disease or to support a loved one with the disease. These are:
1. Keeping your mind awake: To prevent memory loss or mental decline that occurs with AD, I recommend doing “brain aerobic activities.” The most important thing patients can do is read, which not only helps to learn new information, but also forces the mind to think outside of everyday tasks. Crossword puzzles, card games, music, and crafts are also great activities, because they stimulate the brain and give it a good workout. Learning to play an instrument not only helps patients stay on task, it can help them learn new tasks and improve memory and attention. All of these activities are beneficial because they force patients to think outside of everyday tasks, help them multitask, and can also create new neural pathways and connections in the brain.
2. Exercise daily: A Columbia University study found that people who exercised on a treadmill for 30 minutes a day grew new cells in the dentate gyrus, a part of the brain’s hippocampus in the temporal lobe that is related to memory function. As exercise increases blood flow to the brain, it helps fuel the growth of these new brain cells, which are vital for improving or maintaining memory function. Regular exercise has also been shown to decrease stress and improve mood, even if it’s just going for a walk every day.
3. Eat fruit and vegetables: According to US government estimates, approximately 75 percent of Americans do not consume adequate amounts of fruits and vegetables. So I recommend reducing the amount of red meat in your diet and increasing the consumption of seeds, vegetables and fruits.
4. Take supplements: Taking supplements like omega-3s, coenzyme 10, and other multivitamins have been shown to help decrease oxidative stress.
5. Nurture the mind-body connection: Activities such as yoga and meditation are calming for the patient and create opportunities to connect with others, which can be especially beneficial for AD patients. Social connections and interactive activities are especially important. Having a friend or someone to talk to also stimulates positive emotions and helps with memory, concentration, attention, speech and language, and makes it a bit easier for them to adjust to life with AD.
6. Keep changes to a minimum: Staying in a familiar environment can be very comforting and helps the patient stay focused. Even small changes in their environment can trigger distress for a person with AD.
7. Maintain the routine: AD patients need to know what to expect, and when, throughout the day. Whether it’s having a cup of coffee and watching TV, sitting on the patio and reading the newspaper, talking to the family on the phone, or taking care of a pet, they need to have daily routines. When they move away from their routines or their familiar surroundings is when they can become confused and agitated.
8. Offer calmness calmly: For patients with AD it is very important to listen to someone they trust who tells them that everything is going to be fine, in a non-confrontational way.