Alzheimer's Disease is now called Major Neurocognitive Disorder due to Alzheimer's Disease. It is the terminology chosen by the authors of the newest version of the Diagnostic and Statistical Manual of the APA. It is the most common form of dementia in the United States.
Unfortunately, we don't yet have any curative treatments although there are medications that can slow down the progression of symptoms even though the underlying disease progresses downward.
Prevention is the best option at this time. There are risk factors that cannot be changed including genetic susceptibility, aging, and menopause. However, there are some risk factors that we have some control over.
One factor is having a head injury. While this may occur despite being careful, the risk can be reduced by driving safely (no texting while driving, for example), wearing helmets when riding a bicycle or motorcycle, wearing seat belts in cars, and not engaging in activities with a high risk of head injury such as boxing.
A balanced diet is thought to be somewhat protective, and there is an association with Alzheimer's Disease and obesity. There is also an association between diabetes and Alzheimer's. There is evidence that Alzheimer's increases insulin resistance, which is a major factor in Type II Diabetes.
Exercise, especially aerobic exercise helps lower the risk of getting Alzheimer's. Exercise would also help reduce the risk of obesity and diabetes. Depression is a risk factor so that rapid recognition and treatment are important. Also, aerobic exercise can help alleviate mild to moderate depression. Thus, exercise has multiple beneficial effects.
The higher the educational level is attained, the lower the risk of Alzheimer's. There is probably the best evidence for continuing use of he brain to prevent Alzheimer's. Good examples include learning a new language, doing challenging crossword puzzles, learning a new skill, and the like. Just like muscle, you must use your brain or risk "losing" it.
Finally, having strong social networks lowers the risk of dementia. Having a group of family and friends that are there for you is beneficial for reducing the harmful effects of stress, which is also a risk factor for Alzheimer's Disease.
The bottom line is that we do not have a cure for Alzheimer's Disease, and it is quite common, especially as we age. Baby boomers are entering an age range when the incidence of Alzheimer's increases. Prevention is the best approach. In all candor, even doing all the right things may not prevent Alzheimer's since there are non-modifiable factors that may trump preventive efforts. However, it is well worth doing what you can to reduce the risk.
Peter M. Hartmann, MD
