Experts Finally Agree Dementia Can Be Prevented!

In case you did not get the word, last month at the International Conference on Alzheimer’s  in London, a report was presented by the Lancet Commission on Dementia Prevention, Intervention, and Care (Lancet is perhaps the most prestigious medical journal in the world), wherein they noted at least 35% of dementia cases can be attributed to 9 modifiable or preventable risk factors to include a lack of education, physical activity, and social interaction, smoking, hypertension, diabetes, obesity, depression  and hearing impairment. Therefore, they note “… more than a third of dementia cases might theoretically be preventable,” by simply “acting now on what we already know.”

Moreover, they note “We have not incorporated other potential risk factors, such as diet, alcohol, living near major roads, or sleep, which could be relevant. Therefore, the potentially preventable fraction of dementia might be underestimated in our figures.” Other significant potentially preventable risk factors not mentioned here due to a perceived paucity of controlled studies include prolonged stress, head injuries, heavy metal exposure – like lead, mercury or aluminum, illegal drugs, over 200 legal medications, some viruses, some anesthesias, some chemotherapies, and exposure to other neuro toxins like paint thinners and pesticides.

This supports our view and that of others, that a much higher percentage of cases could be prevented.  For example, they mentioned diet, and no less than 3 other studies presented at the conference noted the importance of diet in Alzheimer’s and dementia prevention. In one study from Rush University strict adherence to a modified Mediterranean diet alone showed a 53% reduction in Alzheimer’s Risk over a 5 year period.

Two studies were presented at the conference on the impact of prolonged stress on cognitive functioning, memory and dementia risk. “Stressful experiences are known to have an impact on brain function, which could then lead to dementia in the longer term.” Although this particular research could not establish a direct link between stress and an increased risk for dementia we know that stress increases cortisol in the hippocampus, which can in time damage the delicate cells in this the memory center of the brain. And this is precisely the region where Alzheimer’s is most often known to begin.

Three studies illustrated the importance of sleep. They showed that individuals with interrupted or inadequate sleep  as from sleep apnea, or shallow breathing, had higher accumulations of  beta-amyloid plaque and tau, classic hallmark signs of Alzheimer’s disease.  Other studies have shown that during sleep cerebral spinal fluid is able to flush out such debris from the brain, but with inadequate sleep this cannot adequately occur which could account for this increased accumulation. So sleep is definitely critical to brain health and Alzheimer’s prevention.

The Lancet report is one of the first major studies to identify “hearing impairment” as a major risk factor for dementia. This was largely based on the research of Dr. Frank Lin at Johns Hopkins.  However, at the conference another study was presented supporting this connection.  In this study conducted by the University of Wisconsin they looked at 783 individuals in their 50’s and found that those reporting a diagnosis of hearing loss performed worse on a variety of tests of cognitive skills. In addition, when they were examined not more than four years later, those with hearing loss were more than three times more likely than their peers with normal hearing to be diagnosed with mild cognitive impairment. The relationship between hearing loss and dementia however, is less clear.

Dr. Lin theorized that, in addition to loud noises, there are likely biological factors associated with an aging brain, that underlie both hearing loss and cognitive decline. These may include oxidative stress, nutritional deficits, and reduced blood flow.

As the Lancet experts noted  “Hearing loss in humans might therefore result in uniquely interrelated and detrimental social, cognitive, and brain effects.” And although ideal controlled studies are lacking they concluded that at least available studies suggest “hearing aids sometimes help” reduce this risk as well. (For additional insights into the connection between hearing loss and dementia and how hearing aids may help, hearing professionals reading this, who are members of IHS may want to read the article Dr. Douglas Beck of Oticon and I wrote published in this month’s edition of The Hearing Professional.  If you are not a member of the International Hearing Society and would like a copy of this report you can email me and I will send you our pre-publication copy.)

For those of you who are Speech professionals, Another study of individuals at risk for dementia, over time, found those with mild cognitive impairment used more “halting speech and pauses,” and “increasingly used simpler words as they described objects, people and places… They used more pronouns — he, she, it and they — and fewer nouns that would have been more specific.”  I noticed this in my brother-in-law at a family reunion a year or so before he was diagnosed with Alzheimer’s. Such difficulties are of course more a result of cognitive decline than a contributor. However, the FINGER study and Lancet report suggest that if such patterns are identified early enough actions could be taken that may enable at least some of these individuals to reverse this decline.

So these studies and the Lancet reports emphasis on modifiable or avoidable risk factors is a major step in making the public aware of the fact that YES indeed, Alzheimer’s and other forms of dementia or memory loss CAN be prevented, or at least in many if not most cases delayed, if appropriate actions are taken soon enough.

Moreover, it’s interesting to note that studies like the FINGER study in Finland, the Wales Caerphilly study, the EPIC study in Germany, as well as studies by Dr. Shea, at UMass, Dr. Bredesen’s at UCLA and Dr. Fotuhi’s in Virginia, all suggest a combined or synergistic approach like the one we advocate with the American Brain Council , can have a much more powerful effect, reducing risk by up to 84% (shown in the Fotuhi study) even in individuals with mild cognitive impairment.

While many have the impression Alzheimer’s is primarily caused by genetic factors, the Lancet report noted the primary AD gene APoE4 only accounts for about 7% of the equation, and Dr. Shea’s studies showed his simple Perceptiv™ formulation, or likely Memoryze™, plus SAMe which I discussed in my last newsletter, could in most cases, help compensate  for that gene form.

So bottom line, we now have all the evidence we need to press forward with the news that dementia can indeed be prevented and moreover, we already know how!  And the American Brain Council, of which I am now a part, has in fact a plan and a package that in most cases can dramatically reduce a person’s risk, improve their memory, cognitive function and quality of life. As the Lancet researchers note: “Effective dementia prevention, intervention, and care could transform the future for society and vastly improve living and dying for individuals… and their families.” And if you have been reading these newsletters you know enough (even if you have not taken our training) to play a major role in making that happen for families NOW!  But for more information or a list of the top 15 risk factors you can email me at David@abcbrain.org or call me at 801-529-8238.