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Alzheimer's is on the Rise ; Fewer Calories and Less Saturated Fat Might Be Helpful for Preventing Alzheimer

Posted on: Thursday, 10 March 2005, 09:00 CST

Alzheimer's disease is expected to mushroom in the coming decades, as the population ages and medical advances prolong life.

The fear of this disease, of losing one's mind and presumably one's dignity, focuses public attention on research into this field - - but results come bit by bit, and are difficult to interpret.

As it stands today, there is no proven way to reduce risk of Alzheimer's disease. However, several lines of evidence point to a few preventive strategies that are largely safe.

Alzheimer's disease seems to be mostly caused by the accumulation of proteins around neurons called "amyloid plaques." These plaques in turn seem to be largely caused by inflammation and associated oxidative stress. What causes the inflammation is open to question; in fact it may be many causes that lead to the same place.

Most cases of Alzheimer's are sporadic; the disease tends not to run in families. However, there is a genetic component to the risk, probably involving many genes. Someday there may be genetic screening tests (for good or for ill), but there's nothing you can do about your genetics right now.

Other risk factors include a low educational level, head injury, eating a diet high in calories and saturated fat and low in folate, and a sedentary lifestyle. Most of these things involve increased inflammation and oxidative stress.

Risk factors are not necessarily causes. Windshield wipers are on when it rains, but it doesn't mean they cause the rain. Still, a number of lines of evidence suggest that changing these risk factors and related things might reduce the chances of Alzheimer's.

Cognitive stimulation is one: learning new things later in life, exposing yourself to new situations. By doing this you're using your brain's ability to change and grow, which works in the opposite direction from the deterioration of dementia.

In terms of diet, fewer calories and less saturated fat might be helpful for preventing Alzheimer's, and certainly will improve cardiovascular risk anyway. Food causes oxidative stress; eating anything actually stresses the body with toxic processes. One epidemiologic study has suggested that eating fish or taking supplemental fish oil may help.

You should probably use dietary changes or supplementation to increase your intake of vitamins C and E, and of folate, because deficiencies can lead to inflammation and oxidative stress. The exact dose you would need is not certain; reasonable doses might be vitamin C 500 milligrams twice a day, vitamin E 400 units once a day, and folate 1 mg once a day. Vitamin E is actually used in higher doses to treat dementia and has a modest positive effect.

The anti-cholesterol drugs called "statins" might protect against Alzheimer's, probably through their effects against inflammation. Most doctors would not consider preventing Alzheimer's a good reason to start taking one, but if your cholesterol is up anyway, this can be added motivation.

The same is true for aspirin and naproxen (Naprosyn): if you have another reason to take these drugs, you might be getting some extra benefit in preventing Alzheimer's. They are used to treat pain, but they reduce inflammation also.

There is some talk of reducing blood levels of copper and iron. These elements contribute to oxidative stress, and excess levels can be toxic. For example, excess iron absorption causes hemochromatosis, a very-difficult-to-diagnose disease that is actually rather common, at 1 percent of the population.

One interesting avenue of research currently looks at immunization against the plaque protein that causes Alzheimer's. By stimulating the body's immune system to attack these proteins, scientists hope that Alzheimer's can be prevented and even treated.

From a practical perspective, remember that Alzheimer's disease currently can be diagnosed only by a pathologist looking at tissue from a biopsy or an autopsy.

That means the diagnosis of "Alzheimer's type dementia" must always be handled with suspicion: is the dementia being caused, or contributed to, by something we can fix? Books have been written on this subject, but three things are very important to exclude. Blood tests can look for thyroid disease and vitamin B12 deficiency, and a CT scan or an MRI can look for hydrocephalus.

Dr. Mike Merrill is an internist practicing in Buffalo. E-mail your comments to him at driconoclast@yahoo.com.

Source: Buffalo News

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