Preventing Alzheimer’s Disease: What Do We Know?
As they get older, many people worry about developing Alzheimer’s disease or a related dementia. If they have a family member with Alzheimer’s, they may wonder about their family history and genetic risk. As many as 5.5 million Americans age 65 and older live with Alzheimer’s. Many more are expected to develop the disease as the population ages—unless ways to prevent or delay it are found.
Although scientists have conducted many studies, and more are ongoing, so far nothing has been proven to prevent or delay dementia caused by Alzheimer’s disease. But researchers have identified promising strategies and are learning more about what might—and might not—work.
We know that changes in the brain can occur many years before the first symptoms of Alzheimer’s appear. These early brain changes point to a possible window of opportunity to prevent or delay debilitating memory loss and other symptoms of dementia. While research may identify specific interventions that will prevent or delay the disease in some people, it’s likely that many individuals may need a combination of treatments based on their own risk factors.
Researchers are studying many approaches to prevent or delay Alzheimer’s. Some focus on drugs, some on lifestyle or other changes. Let’s look at the most promising interventions to date and what we know about them.
Evaluating the Latest Alzheimer’s Disease Prevention Research
A recent review of research looked carefully at the evidence on ways to prevent or delay Alzheimer’s dementia or age-related cognitive decline. Led by a committee of experts from the National Academies of Sciences, Engineering, and Medicine (NASEM), the review found “encouraging but inconclusive” evidence for three types of interventions:
The evidence for other interventions, such as medications and diet, was not as strong. However, scientists are continuing to explore these and other possible preventions.
Can Increasing Physical Activity Prevent Alzheimer’s Disease?
Physical activity has many health benefits, such as reducing falls, maintaining mobility and independence, and reducing the risk of chronic conditions like depression, diabetes, and high blood pressure. Based on research to date, there’s not enough evidence to recommend exercise as a way to prevent Alzheimer’s dementia or mild cognitive impairment (MCI), a condition of mild memory problems that often leads to Alzheimer’s dementia.
Years of animal and human observational studies suggest the possible benefits of exercise for the brain. Some studies have shown that people who exercise have a lower risk of cognitive decline than those who don’t. Exercise has also been associated with fewer Alzheimer’s plaques and tangles in the brain and better performance on certain cognitive tests.
While clinical trials suggest that exercise may help delay or slow age-related cognitive decline, there is not enough evidence to conclude that it can prevent or slow MCI or Alzheimer’s dementia. One study compared high-intensity aerobic exercise, such as walking or running on a treadmill, to low-intensity stretching and balance exercises in 65 volunteers with MCI and prediabetes. After 6 months, researchers found that the aerobic group had better executive function—the ability to plan and organize—than the stretching/balance group, but not better short-term memory.
Several other clinical trials are testing aerobic and nonaerobic exercise to see if they may help prevent or delay Alzheimer’s dementia. Many questions remain to be answered: Can exercise or physical activity prevent age-related cognitive decline, MCI, or Alzheimer’s dementia? If so, what types of physical activity are most beneficial? How much and how often should a person exercise? How does exercise affect the brains of people with no or mild symptoms?
Until scientists know more, experts encourage exercise for its many other benefits. Learn more about exercise and physical activity for older adults.
Can Controlling High Blood Pressure Prevent Alzheimer’s Disease?
Controlling high blood pressure is known to reduce a person’s risk for heart disease and stroke. The NASEM committee of experts concluded that managing blood pressure when it’s high, particularly for middle-aged adults, also might help prevent or delay Alzheimer’s dementia.
Many types of studies show a connection between high blood pressure, cerebrovascular disease (a disease of the blood vessels supplying the brain), and dementia. For example, it’s common for people with Alzheimer’s-related changes in the brain to also have signs of vascular damage in the brain, autopsy studies show. In addition, observational studies have found that high blood pressure in middle age, along with other cerebrovascular risk factors such as diabetes and smoking, increase the risk of developing dementia.
Clinical trials—the gold standard of medical proof—are underway to determine whether managing high blood pressure in individuals with hypertension can prevent Alzheimer’s dementia or cognitive decline.
One large clinical trial—called SPRINT-MIND (Systolic Blood Pressure Intervention Trial–Memory and Cognition in Decreased Hypertension)—found that lowering systolic blood pressure (the top number) to less than 120 mmHg, compared to a target of less than 140 mmHg, did not significantly reduce the risk of dementia. Participants were adults age 50 and older who were at high risk of cardiovascular disease but had no history of stroke or diabetes.
However, the multiyear study did show that this intensive blood pressure lowering significantly reduced the risk of MCI, a common precursor of Alzheimer’s, in the participants. In addition, researchers found that it was safe for the brain.
The results of SPRINT-MIND provide further evidence of the connection between cardiovascular health and brain health. Further studies are needed to determine which people, at what age, might benefit most from particular blood pressure management approaches, and how these approaches affect the risk of dementia, including Alzheimer’s disease.
While research continues, experts recommend that people control high blood pressure to lower their risk of serious health problems, including heart disease and stroke. Learn more about ways to control your blood pressure.
Can Cognitive Training Prevent Alzheimer’s Disease?
Cognitive training involves structured activities designed to enhance memory, reasoning, and speed of processing. There is encouraging but inconclusive evidence that a specific, computer-based cognitive training may help delay or slow age-related cognitive decline. However, there is no evidence that it can prevent or delay Alzheimer’s-related cognitive impairment.
Studies show that cognitive training can improve the type of cognition a person is trained in. For example, older adults who received 10 hours of practice designed to enhance their speed and accuracy in responding to pictures presented briefly on a computer screen (“speed of processing” training) got faster and better at this specific task and other tasks in which enhanced speed of processing is important. Similarly, older adults who received several hours of instruction on effective memory strategies showed improved memory when using those strategies. The important question is whether such training has long-term benefits or translates into improved performance on daily activities like driving and remembering to take medicine.
Some of the strongest evidence that this might be the case comes from the NIA-sponsored Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial. In this trial, healthy adults age 65 and older participated in 10 sessions of memory, reasoning, or speed-of-processing training with certified trainers during 5 to 6 weeks, with “booster sessions” made available to some participants 11 months and 3 years after initial training. The sessions improved participants’ mental skills in the area in which they were trained (but not in other areas), and improvements persisted years after the training was completed. In addition, participants in all three groups reported that they could perform daily activities with greater independence as many as 10 years later, although there was no objective data to support this.
Findings from long-term observational studies—in which researchers observed behavior but did not influence or change it—also suggest that informal cognitively stimulating activities, such as reading or playing games, may lower risk of Alzheimer’s-related cognitive impairment and dementia. For example, a study of nearly 2,000 cognitively normal adults 70 and older found that participating in games, crafts, computer use, and social activities for about 4 years was associated with a lower risk of MCI.
Scientists think that some of these activities may protect the brain by establishing “reserve,” the brain’s ability to operate effectively even when it is damaged or some brain function is disrupted. Another theory is that such activities may help the brain become more adaptable in some mental functions so it can compensate for declines in others. Scientists do not know if particular types of cognitive training—or elements of the training such as instruction or social interaction—work better than others, but many studies are ongoing.
Can Eating Certain Foods or Diets Prevent Alzheimer’s Disease?
People often wonder if a certain diet or specific foods can help prevent Alzheimer’s disease. The recent NASEM review of research did not find enough evidence to recommend a certain diet to prevent cognitive decline or Alzheimer’s. However, certain diets and healthy eating patterns have been associated with cognitive benefits. Studies of diets, such as the Mediterranean diet and the MIND diet—a combination of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets—are underway. Learn more about what we know about diet and the prevention of Alzheimer’s disease.
For more information, read What Do We Know About Diet and Alzheimer’s Prevention?
Targets of Alzheimer’s Disease Prevention Research
Researchers are exploring these and other interventions that may help prevent, delay, or slow Alzheimer’s dementia or age-related cognitive decline. Other research targets include:
Be Cautious About Alzheimer’s “Cures”
Because Alzheimer’s disease is so devastating, some people are tempted by untried or unproven “cures.” Check with your doctor before trying pills or any other treatment or supplement that promises to prevent Alzheimer’s. These “treatments” might be unsafe, a waste of money, or both. They might even interfere with other medical treatments that have been prescribed.
What’s the Bottom Line on Alzheimer’s Prevention?
Alzheimer’s disease is complex, and the best strategy to prevent or delay it may turn out to be a combination of measures. In the meantime, you can do many things that may keep your brain healthy and your body fit.
You also can help scientists learn more by volunteering to participate in research. Clinical trials and studies are looking for all kinds of people—healthy volunteers, cognitively normal participants with a family history of Alzheimer’s, people with MCI, and people diagnosed with Alzheimer’s disease or a related dementia.
Concerned About Constipation?
Nearly everyone becomes constipated at one time or another. Older people are more likely than younger people to become constipated, but most of the time it’s not serious.
Constipation is a symptom, not a disease. You may be constipated if you are having fewer bowel movements than usual, it takes a long time to pass stools, and the stools are hard.
Some people worry too much about having a bowel movement every day. There is no right number of daily or weekly bowel movements. Being regular is different for each person. For some, it can mean bowel movements twice a day. For others, having movements three times a week is normal.
Questions to Ask
Some doctors suggest asking these questions to decide if you are constipated:
Did you answer “yes” to one or more of these questions? If so, you may have a constipation problem. Otherwise, you probably don’t.
What Causes Constipation?
Doctors do not always know what causes constipation. It may be a poor diet, not getting enough exercise, or using laxatives too often. Reasons for constipation include:
Many older people don’t drink enough water and other fluids. This often is the case when they’re not eating regular meals. Water and other liquids may help people stay regular.
Treatment
If you think you are constipated, talk to your doctor to rule out a more serious problem. If tests show no disease or blockage, and if your doctor approves, try these changes:
If these changes don’t work, talk to your doctor about laxatives. There are different kinds of laxatives, and each has its pros and cons. Your doctor can help you decide which laxatives may be best for you.
When Should You See a Doctor?
See your doctor or other healthcare professional if:
Choosing Healthy Meals As You Get Older
Making healthy food choices is a smart thing to do — no matter how old you are! Your body changes through your 60s, 70s, 80s, and beyond. Food provides nutrients you need as you age. Use these tips to choose foods and beverages for better health at each stage of life.
Read and share this infographic to get information and tips about living longer and healthier.
With age, you may lose some of your sense of thirst. Drink water often. Low-fat or fat-free milk or 100% juice also helps you stay hydrated. Limit beverages that have lots of added sugars or salt. Learn which liquids are healthier choices.
Meals are more enjoyable when you eat with others. Invite a friend to join you or take part in a potluck at least twice a week. A senior center or place of worship may offer meals that are shared with others. There are many ways to make mealtimes pleasing.
Social Events during COVID-19
During the COVID-19 pandemic, make sure any activities you plan follow CDC guidelines. Instead of having a meal at a senior center or place of worship, consider hosting a virtual dinner party or joining an online cooking class.
Read and share this infographic to learn about making smart food choices for healthy aging.
Find trusted nutrition information from ChooseMyPlate.gov and the National Institute on Aging. Get advice on what to eat, how much to eat, and which foods to choose, all based on the Dietary Guidelines for Americans. Find sensible, flexible ways to choose and prepare tasty meals so you can eat foods you need.
Learn to recognize how much to eat so you can control portion size. When eating out, pack part of your meal to eat later. One restaurant dish might be enough for two meals or more.
Include a variety of different colored, flavored, and textured vegetables. Most vegetables are a low-calorie source of nutrients. Vegetables are also a good source of fiber.
Read and share this infographic to learn more about lifestyle changes you can make today for healthier aging.
Many people find that their teeth and gums change as they age. People with dental problems sometimes find it hard to chew fruits, vegetables, or meats. Don’t miss out on needed nutrients! Eating softer foods can help. Try cooked or canned foods like unsweetened fruit, low-sodium soups, or canned tuna.
Foods may seem to lose their flavor as you age. If favorite dishes taste different, it may not be the cook! Maybe your sense of smell, sense of taste, or both have changed. Medicines may also change how foods taste. Add flavor to your meals with herbs and spices.
Don’t take a chance with your health. A food-related illness can be life threatening for an older person. Throw out food that might not be safe. Avoid certain foods that are always risky for an older person, such as unpasteurized dairy foods. Other foods can be harmful to you when they are raw or undercooked, such as eggs, sprouts, fish, shellfish, meat, or poultry.
Make the right choices when buying food. Pay attention to important nutrients to know as well as calories, fats, sodium, and the rest of the Nutrition Facts label. Ask your doctor if there are ingredients and nutrients you might need to limit or to increase.
Food is the best way to get nutrients you need. Should you take vitamins or other pills or powders with herbs and minerals? These are called dietary supplements. Your doctor will know if you need them. More may not be better. Some can interfere with your medicines or affect your medical conditions.
Getting Enough Fluids
It’s important for your body to have plenty of fluids each day. Water helps you digest your food, absorb nutrients from food, and then get rid of the unused waste. Water is found in foods—both solids and liquids, as well as in its natural state.
With age, you might lose some of your sense of thirst. To further complicate matters, some medicines might make it even more important to have plenty of fluids.
Remember, water is a good way to add fluids to your daily routine without adding calories.
Try these tips for getting enough fluids:
CINTAA Elder care shares useful information regarding healthcare on weekly basis. The post is only for information purpose only. Please check with your health care professional before using this information. To keep yourself updated with many other health tips, stay with us. We provide certified caregivers for seniors at home. If you need any help regarding eldercare, please feel free to call us today at 561-963-1915.
