I am a 69-year-old retired neurologist with an early stage of Alzheimer’s disease, the onset of neurodegenerative processes that will progress over time and one day kill me if nothing else brings me first.
Although I cared for many patients with Alzheimer’s disease and other dementias during my career, it never occurred to me that one day I might have it. I am now on the side of the experience patient, an inside-out expert on my own Alzheimer’s disease as he discerns his slowly growing presence in my brain.
Most Alzheimer’s patients in high-income countries are diagnosed when the symptoms of the disease manifest themselves in their behavior or cognitive functioning ̵
I found mine much earlier, in 2015. It really was a coincidence that I came across some genetic information that spurred my clinical search. It’s easy to say I’m unlucky enough to have Alzheimer’s. But I’m actually lucky to have found what I found when I found it.
I was able to gain access to cutting-edge medicine through clinical trials and other progressive treatment options. But I also made a few simple lifestyle choices about diet, exercise, and social and intellectual activity, for which evidence-based science can benefit brain health and in some cases slow the progression of Alzheimer’s disease in the early stages. stages of changes at the cellular level – 10 to 20 years before significant cognitive impairment.
At the societal level, science and statistics show an ongoing and growing storm: the spread of Alzheimer’s disease and related dementias worldwide is expected to rise to 115 million by 2050.
So much for Alzheimer’s disease throws you into uncertainty. Then these rather simple choices turn into an organized counterattack. They help to provide a structure for my thoughts and actions, hope for the future and a greater sense of happiness and well-being that feels realistic, not just optimistic.
As far as you can get a prescription, the five main strategies for fighting Alzheimer’s are:
- Aerobic exercise
- Mediterranean style diet or MIND (see below)
- Mentally stimulating activity
- Social commitment
- Good sleep, along with good control of diabetes and high blood pressure, if any
If there was a cure for Alzheimer’s disease that slowed progression by 50 percent, we would welcome it as a miracle and it would cost the pharmaceutical industry billions. We already have it, and it’s free: exercises. There is no doubt that aerobic exercise has been shown to have a positive, protective effect in the early stages of the disease. A number of research studies have shown up to a 50% drop in the development of Alzheimer’s disease among those who start the study without clinical evidence of dementia. There is also evidence that your brain is sharper during training than when you are not training. It’s mine, and it’s reliable. At most I can think clearly and creatively during and for a few hours after training, even if it’s just a walk with the dog.
Even moderate levels of exercise are helpful, but there seems to be a dose-response effect: more activity is more effective than less activity. Starting it in the 40s, if possible, is better than waiting until the 60s or 70s. I aim for at least 10,000 steps a day, but a recent study found that 8,000 steps or even less could be helpful.
Data on the beneficial effects of diet are strong, if not as stable as those on exercise. Most research shows that a Mediterranean-style diet promotes brain health as well as cardiovascular health. In 2015, the MIND diet (Mediterranean-DASH intervention for neurodegenerative retardation) was introduced specifically to slow cognitive impairment, focusing on foods that have the most evidence for brain health benefits, such as whole grains, green leafy vegetables , beans, nuts and fruits.
One study followed 923 residents of the community, ages 58 to 98, who had not suffered from Alzheimer’s disease in the early four-and-a-half years of the MIND diet. Those who adhere to the diet even moderately develop Alzheimer’s disease with a 35% lower incidence than those with poor diet. Those on high diets do even better, developing Alzheimer’s disease with a 53% lower rate.
Participation in mentally stimulating activities has long been shown to delay the onset of cognitive impairment caused by Alzheimer’s disease. Reading books five to seven days a week, using a computer three to seven days a week, participating in social activities two to four days a week and doing craft activities lead to about a 30% reduction in the development of cognitive impairment. .