Imagine not being able to remember any of your life, your loved ones, or even yourself....
The incidence of Alzheimer’s Disease (AD) continues to grow at alarming rates, and the disease currently affects over 5 million people.
This is a particularly important health issue for women because over two-thirds of all AD patients are female. In fact, women over 60 are twice as likely to be diagnosed with AD than with breast cancer.
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AD is the 6th leading cause of deaths in the U.S.
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Between 2008 and 2018, death rates from AD increased 146%.
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Over the next 30 years, the rate of AD is expected to triple.
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50% of primary care doctors say the U.S. healthcare system is not ready for the growing number of people with AD.
What is Alzheimer’s Disease?
Alzheimer’s disease is an irreversible neurological condition which causes progressive deterioration of the areas of the brain controlling thought, memory, and language. It is the most common cause of dementia, accounting for over 80% of all cases. Unfortunately, most patients with AD die from complications within ten years of their diagnosis.
There are two types of AD, early onset and late onset. Early onset AD is rare (< 5%), occurs in patients less than 65 years of age, and is most commonly caused by genetic factors. Late onset AD is much more common and occurs in patients 65 years of age and older.
Scientists are still unraveling the complex factors which lead to the development of AD. The adult brain has about 100 billion neurons which require the ability to communicate with each other as well as a continuous supply of blood and essential nutrients to survive.
Neurons in AD patients accumulate abnormal proteins inside the neurons (tau protein tangles) and outside the neurons (beta amyloid plaques). These proteins not only affect the function of neurons but also prevent neurons from communicating with each other.
What are the Symptoms of Alzheimer’s Disease?
Even though increasing age is the biggest risk factor for developing AD, AD is not a normal part of aging.
The earliest symptom of AD is memory loss, usually experienced as forgetting names, familiar places, and the location of frequently used items (i.e. keys). As AD progresses, patients have trouble with tasks which require more thinking and concentration, such as paying their bills. Mood issues (i.e. depression) and changes in normal behavior are also inevitable symptoms of AD.
The majority of AD patients typically die within 5 to 8 years of their diagnosis. Death is usually not directly caused by AD but rather by the mental and physical limitations it imposes. For example, AD patients are more vulnerable to accidents and infections. In the final stages of the disease, AD patients have difficulty eating and drinking and are often bedridden which increases their chances of developing pneumonia and other infections.
Increasing age, genetic predisposition, and female gender are three major AD risk factors that can’t be controlled. But…even though you can’t change your DNA or biological gender or turn back time, you can protect yourself against developing AD by knowing about the risk factors you can do something about.
Many of the health conditions associated with increased AD risk are fueled by the same three underlying problems:
- Inflammation
- Oxidation (‘internal rusting of cells’)
- Abnormal blood sugar control.
Therefore, the key to prevention is to steer clear of the ‘big three’…not only to avoid getting AD but also to prevent other medical conditions which increase AD risk. Here are some of the most common conditions which increase the risk of developing AD:
- High blood pressure
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High cholesterol
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Type 2 diabetes
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Obesity
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Sleep disorders
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Depression
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Smoking
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Excessive alcohol consumption
As is true for most health conditions, gender matters….
Women have a greater lifetime risk of developing AD, and approximately one in five women develop AD compared to only one in ten men. One reason for this is because women tend to live longer than men. However, there is more to the story….
The primary female sex hormone is estrogen. Not only does estrogen protect the heart and build bone, but it is also a critically important brain health hormone. These are just some of the things that estrogen does to promote brain health:
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Reduces inflammation
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Serves as an anti-oxidant
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Normalizes blood sugar control
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Promotes normal production and function of neurotransmitters (i.e. serotonin)
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Promotes the formation of new neurons
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Surgical menopause (i.e. removal of both ovaries) has been associated with higher rates of AD, especially if done at an earlier age.
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A woman’s brain changes as she progresses through perimenopause as fluctuating estrogen levels cause impaired neuron communication and neuron degeneration.
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Women who initiate HT early in the menopausal transition or at a younger age have a lower risk of AD than women who initiate HT later.
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Many studies have reported significant risk reductions in AD risk linked to hormone use, some by as much as 44%.
The good news is there are proactive things women can do to help reduce their heightened risk for developing AD. Read on to find out what they are….
How is AD Treated?
There is currently no cure for AD, so the conventional medical approach is to use medications which may improve or delay symptoms. Treatment is more effective if started in patients with mild AD symptoms.
The most commonly prescribed medications for mild to moderate AD are called cholinesterase inhibitors (i.e. Aricept and Exelon). These drugs work by preventing the breakdown of acetylcholine, a key neurotransmitter involved in memory, thought, and behavior. Unfortunately, these medications become less effective as the aging brain makes less acetylcholine.
Patients with moderate to severe AD are treated with a medication called Namenda. This drug’s main effect is to decrease symptoms thereby allowing patients the ability to maintain some daily functions longer than they otherwise would be able to. Namenda works by affecting glutamate, a neurotransmitter which causes neuron death if produced in excess. Namenda can be combined with cholinesterase inhibitors to treat different aspects of AD since they work differently.
There is excellent research supporting the use of some nutritional supplements to promote brain health and reduce the incidence and severity of AD. These have the most scientific backing:
1. Omega 3 Fatty Acids. Omega‐3 fatty acids (i.e fish oil) are essential components of neurons and play a major role in intelligence, brain health, and neurotransmitter metabolism. This makes sense since 60% of the brain is made up of fat cells. Supplementation with omega 3 fatty acids has been shown to reduce oxidation and increase the levels of glutathione and other protective molecules. In so doing, they not only in prevent AD but may also be therapeutic.
2. Vitamin D. Vitamin D serves many functions, not only as a vitamin but also as a hormone. Not only is it an anti-oxidant and anti-inflammatory molecule, it promotes the break down of beta-amyloid, one of the two abnormal proteins found in AD neurons (see above).
3. B6, B12, and Folate. Supplementation with these B vitamins improves cognitive function and reduces AD risk by improving the brain’s structural integrity, neurotransmitter function, and indirectly by reducing homocysteine levels (a toxic amino acid).
4. Anti-oxidants. Vitamin C, Vitamin E, CoQ-10, Quercetin, and Glutathione are all examples of anti-oxidant supplements. Through their ability to reduce and prevent inflammation and oxidation, they have been shown to protect neurons from damage and death.
One critically important thing to understand about nutritional supplements is quality matters. There are excellent pharmaceutical grade ‘brain health’ supplements available which combine many of the above ingredients into one capsule.
It’s worth paying a bit more for these supplements because they are guaranteed to work and don’t contain many of the additives, preservatives, and harmful fillers found in most of the regular over the counter supplements. Moreover, most over the counter vitamins don’t even contain the nutrients listed on their labels. You can shop for pharmaceutical grade brain health vitamins HERE.
What Can You Do to Prevent AD?
1. Use your brain. Staying mentally active and engaging in activities that require thought, focus, and concentration, keep your brain cells healthy and has been shown to reduce the risk of developing AD and other forms of dementia.
2. Get off the couch. Physical activity reduces blood pressure, promotes weight loss, improves cholesterol, and lowers inflammation (see above AD risk factors). It also reduces brain inflammation and oxidation by improving blood flow (and hence oxygen flow) to neurons.
Scientific studies have found physical activity can reduce the risk of AD by 45%.
3. Get enough sleep at the right time. As you read in my last newsletter, at least seven hours of uninterrupted sleep is considered optimal. Timing also matters…in bed sleeping no later than 11:00 pm and up between 6:00 and 8:00 am (remember the circadian rhythm?) Insomnia, sleep apnea, and other sleep disorders have been associated with an increased risk of developing AD. If you're having trouble sleeping, you can try adding natural supplements like melatonin. Prescription sleeping pills promote memory loss and prevent REM sleep.
4. Don’t feed the fire. As Hippocrates recommended years ago, “Let food be thy medicine”. Now that you know what fuels AD (and other diseases), inflammation, oxidation, and abnormal blood sugar, you know what to eat, and not eat, to keep your brain cells happy. Diets high in healthy fats, like omega 3, and anti-oxidant containing fruits and vegetables have been shown to reduce AD risk. The Mediterranean Diet has been shown to be especially protective. Caloric restriction has also shown significant promise in reducing AD risk.
5. Mind your mindset. Chronic negative emotions make neurons unhappy. In fact, depression during midlife is believed to increase the risk of AD by as much as 70%.
6. Enjoy life. Studies show that people who engage in activities for fun and pleasure have a lower risk of developing AD.
7. Put down the pack. Stop smoking…you already know how bad it is for you, right? It fuels the ‘big three’ (see above) which fuel all diseases, including AD.
8. Stress less. Chronic stress = higher cortisol levels. Cortisol is the body’s key stress hormone which in the short-term promotes survival but in the long term can damage cells and tissues…especially neurons. Consider adding nutritional supplements which help promote a healthy stress response and normalize cortisol levels. You can find some great ones HERE.
9. Essential estrogen. This one can be tricky because of the widespread misunderstanding and misuse of hormone replacement therapy. Estrogen is essential for normal brain function, and this is a key reason why postmenopausal women are at such high risk. If you are considering hormone replacement, you should only work with an experienced, properly credentialed hormone expert to determine if you are a candidate for properly dosed and monitored bio-identical hormone replacement therapy.
Over 95% of your health is in your hands.
It can be hard to choose healthy, especially if you don't feel the physical effects of your unhealthy habits right away. The key is to think long term and stay focused on the prize...maintaining your health so you live a longer and healthier life. You only have one body to live in during your lifetime, so invest in taking the best care of it you possibly can.
By: Dr. Lena Edwards