In 9 out of 10 cases of Alzheimer’s disease, there is no inheritance or familial component. To be sure, the compounding incidence of this manifestation is too damning for Generation X, my millennial’s, Generation Z, and those that will proceed us not to pay attention. While the jury is still out on the multitude of factors that cause age-related dementia, our ability to leverage the data at our disposal today offers a tremendous advantage over previous generations in understanding the incidence and impact on our population. In Part 1 of this series, we discussed the impact of Alzheimer’s on a patient and caregivers quality of life. So, what are the brightest people studying this disease saying are the foundations of longevity against Alzheimer’s?
The following 4 recommendations plus a topic for research (nutrition) seem to be unifying rallying cries with those “in the know” that we can immediately implement at little to no cost.
[Education] [Sleep] [Exercise] [Biomarkers] [Nutrition (No FDA clearance here)]
The most critical component of managing Alzheimer’s is education. The pathology of Alzheimer’s disease (AD) is characterized by cerebral atrophy in frontal, temporal, and parietal regions. Nobody chooses their parents or environment. However, the amount of information that is at our finger tips in the United States allows for unlimited opportunities to build cognitive reserve. This concept indicates that higher educational attainment throughout life creates resiliency against the bio-chemical effects of Alzheimer’s on the brain. Once the disease takes hold, we start to see a much sharper cognitive decline: people with high cognitive reserve are more resistant to the effects of the amyloid beta burden. Think of cognitive reserve as credits in a bank that compound over a lifetime.
As we evaluate looking for social solutions to this problem, a recommendation is Snakes and Latte’s (disclosure, there are only 4 cafes in North America and I would be a benefactor of your patronage). That said, creating community through board games is a great catalyst for building cognitive reserve and the concept of logotherapy that Victor Frankl describes in, “A Man’s Search for Meaning”. Community and challenging the mind are natural catalyst’s for fulfilment and cognitive reserve, two main drivers for healthspan.
On the topic of sleep. Matthew Walker just released “Why We Sleep” and his latest research on the importance of getting enough sleep cannot be overstated. The cliff notes version of this podcast episode sum up why re-evaluating our priorities when it comes to sleep is a safe bet. That episode is the first in a three-part series where episode two further describes why we should make our loved one’s sleep (especially children for those that have them) just as much of a priority. Also, check out this video to offer some real-world perspective on what sleep deprivation does to our brain:
When we compromise circulation to the brain, we are always going to get a neurological deficit. The only thing we can do right now if we have amyloid beta in our brain to reduce it, or slow the accumulation, is exercise on a regular basis. To that end, if sleep is critical for resetting our internal network, exercise helps to catalyze the bio-chemical processes that sleep kicks-off in order to reset our brain. Further, regular exercise of our vascular system is thought to have significant down-stream effects on blood flow and inflammation within our neurocircuitry.
The aforementioned advent of technology has given us the ability to analyze data across populations going back generations. In a previous post, we discussed how the United States of America was propelled towards digital health records circa 2009. The combination of the HITECH Act and Moore’s Law is helping individual consumers to capture their personal biomarkers for monitoring. The following are the tell-tale biomarkers that have been identified as the keys to monitoring and understanding where we are on the longevity spectrum for Alzheimer’s:
[Blood Pressure] [Pulse] [Weight] [Lipoprotein] [Blood Sugar] [Body Fat] [Muscle Mass]
Understanding and maintaining the recommended ranges of each biomarker is for another conversation. It’s pretty clear though that getting lipoproteins, diabetes, and blood pressure under control is critical to the success of staving off chronic and age-related diseases.
Individual consumers becoming responsible for creating cognitive resiliency is fundamental to reducing the personal and financial costs of Alzheimer’s. Accountability, baby! This is a microcosm of the goals that Health Savings Accounts (HSAs) and Accountable Care Organizations (ACOs) are jockeying for in reducing over consumption and increasing quality output within the United States healthcare system. I will spare the soap-box around why there should be some sort of Nudge into HSAs. I will concede given the stance on opt-in and opt-out at this point, it’s a touchy subject.
For my money, building cognitive reserve density today is what will create impact for our current generations. So, pick up a book or a Sudoku puzzle the next time binge watching reruns of Breaking Bad is on tap. This will create credits in our brain bank with some runway for compound interest to do its thing. Something to leave everyone with, apologies in the advance for the candor, Robin Williams choose not to put his family through managing Lewy Body dementia. The second most common form of dementia behind Alzheimer’s.
Is there is any doubt why he chose that route after reading this article?
Never stop learning!
The obligatory disclaimer: I am so far from being a doctor it’s silly. This post is a compilation of recommendations from some pretty-forward thinking individuals and it does steer away from any nutritional advice altogether.