The most common question I get asked during conversations around memory and ageing is “How can we protect ourselves against Alzheimer’s disease?” As you know there’s a lot of concern about the growing number of people being diagnosed as a consequence of our rapidly ageing population along with the expectation that the number living with the disease will triple by 2050.
Dementia is currently the fifth biggest cause of death worldwide with Alzheimer’s disease the most common diagnosis, constituting around 70% of all dementia.
Risk factors include increasing age (over 65 yrs.), a positive family history where carrying the gene APOE e4 is an increased risk, having Down Syndrome, being diagnosed with MCI (mild cognitive impairment), past severe head trauma, poor sleep patterns and a whole raft of potentially modifiable risk factors including midlife high blood pressure, severe midlife depression, poorly controlled Type 2 diabetes, obesity, smoking, social isolation, hearing loss and lack of exercise.
It’s all a bit grim and worrying especially as we still have little understanding of the cause and have spent millions of dollars in research seeking the Holy Grail for an effective treatment.
The realisation being that we are unlikely to find a ‘cure’ in a pill.
This uncertainty has brought out a whole heap of scaremongering and in some instances downright lies about what causes Alzheimer’s.
I thought I’d heard them all until I was asked about the role of shampoo and Alzheimer’s. You what?
Before dismissing this completely as some kind of kooky mumbo-jumbo, based on the belief that all chemicals are bad, and therefore doing bad things like putting them on our body can cause us harm, I wondered where on earth did this idea come from?
And before you rush out and toss all your shampoo and personal care products in the bins consider this.
Alzheimer’s disease has been known about for a lot longer than we’ve been using modern shampoos. Yes, they contain a lot of chemicals, but the main risk appears to be skin irritation in a small population.
Shampoos and soap are used to cleanse the skin and hair and are then washed off. The amount of any chemical that could penetrate the skin would be minimal and unlikely to be sufficient to cause harm.
This is very different to the scenario where people working in certain occupations such as vineyard workers working with pesticides and herbicides where they are exposed to high levels of neurotoxins over a long period of time can become sick.
This short video from McGill University Professor Dr. Joe Schwarcz helps to explain.
It’s a bit like the aluminium scare a few years ago, when we all tossed out our aluminium saucepans and stovetop coffee makers because of the fear that aluminium was destroying our brains. Yes, aluminium is a neurotoxin but on balance current evidence shows no definite link to causing dementia.
And this is the problem.
With so much misinformation and those who wish to frighten you into buying their “cures” it’s hard to know what’s real. Even in science there can be a huge discrepancy in the quality of the research done and the interpretation of the findings.
What we do know so far is:
1. Alzheimer’s is a multifactorial disease caused by a combination of environmental and lifestyle factors (apart from the 1% who have an inherited form).
2. The amyloid and tau theory has turned out to be just that, a theory and probably incorrect. It was shown in the Nun Study that some of the Nuns with Alzheimer’s disease had no amyloid build up in their brain, yet others who died cognitively intact had brains riddled with it. The prevailing thought is now that amyloid may serve a protective effect against whatever causes the neurodegeneration.
3. It might have a bacterial connection. Researchers have shown how a bacterium Porphyromonas gingivalis associated with gum disease can invade and cause inflammation in brain regions affected by Alzheimer’s disease.
Now there’s a good reason for flossing regularly!
It’s known that the pathological changes associated with Alzheimer’s disease start several decades before symptoms occur. American research looking at human brains suggests the bacterium P. gingivalis doesn’t get into the brain as a result of Alzheimer’s but could be a possible trigger. On its own, it’s unlikely that the bacteria is the cause, because there are genetic and other factors at play, but it adds the understanding that infection and inflammation may have a significant role in the development of Alzheimer’s.
4. It might have a viral connection. Australian Rob Moir from Massachusetts’s General Hospital’s Genetics and Ageing Research has been investigating whether amyloid is produced to protect the brain from pathogens in the short-term that then becomes toxic itself in the longer term. His work in a 2016 paper drew attention to his ideas along with the findings of another study in Neuron that reported how common viral species are frequently detected in normal, ageing brains with increased levels of two human herpes viruses HHV-6A and HHV-7 found in the brains of subjects with Alzheimer’s disease. Watch this space because a Taiwanese study in 2018 showed having a Herpes Type 1 infection is associated with a x2.5 increase risk of developing dementia compared to those without the infection and how those treated with antivirals were 92% less likely to develop dementia.
As the research continues there will be continuing robust debate and disagreement about what does cause Alzheimer’s disease, but the accumulating evidence is helping to slowly build a clearer picture. Then we’ll be far better placed to embark on developing effective treatments and preventative measures.
Meanwhile, lifestyle measures as outlined by the WHO Guidelines and multi-domain studies including FINGER enable each and every one of us to adopt healthier lifestyles as found in NAMES3© that will assist in reducing potential inflammation and keeping us cognitively intact.
Brain healthy lifestyle initiatives for every age include:
Healthy nutrition: Mostly plant-based aka the Modified Mediterranean style diet with lean protein, smart carbs and good fats.
This is about adding in healthy options, an extra portion of leafy greens, enjoying a meatless meal based on legumes, adding some berries to some yoghurt and muesli or drinking an extra glass of water.
Attitude: A positive mindset open to alternatives and new ideas, ready to embrace new ways of doing to stay healthy and wise.
This is about developing the awareness of when your mindset has got stuck in fear and negativity, reluctant to have a go and try something new and choosing instead to go for it.
Mental Stretch: Prevent your brain from getting rusty by harnessing your neuroplasticity and curiosity to learn new skills and upgrade your thinking.
This is about signing up to learn a new skill set, join a class, volunteer your time and put your new skills into practice.
Exercise: Being sufficiently physically active is THE single most important activity we can undertake to keep our brain healthy, elevate mood and promote smarter thinking.
Here it’s all about seeking out opportunities to be more active in your day. Every time you catch yourself sitting ask the question, is there something else I could be doing instead that would keep me on my feet?
Sleep: Getting enough good quality uninterrupted sleep is critical to better brain health and function. Sleep deprivation is a risk for cognitive decline.
If lack of good sleep is frustrating you, it’s time to address this and get it sorted. Talk to your health provider to determine whether you have a sleep disorder and try the 20-minute challenge of going to bed twenty minutes earlier each night for 21 days.
Stress Less: Good stress ramps up mental performance. Stress per se is not the problem, it is our response to it and how effective we are at managing those stressors that appear beyond our level of coping and are chronic in nature.
Stress is normal except when it has exceeded our coping mechanisms. This is where daily stress busting activities including exercise, meditation, listening to music, socialising with friends all help.
Stay Social: Loneliness is a killer and damaging to our physical, mental and cognitive wellbeing. Human connection provides us with meaning, a sense of belonging and nurtures trust.
We thrive in the company of others. If loneliness is getting you down what could you do to write yourself a positive social prescription? This might be to make a phone call to a friend you haven’t spoken to for a while, arranging a coffee catch up or attending a community event.
When it comes to our own risk of Alzheimer’s disease, we don’t know what deck of cards we have been dealt. What counts is adopting a brain healthy lifestyle based on evidence-based research to reduce the impact of any potentially damaging risk factors and maintain a healthy scepticism towards unqualified and misleading information that is frequently designed to create fear and misplaced belief in unproven products.