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Protecting Yourself From Alzheimer’s and Dementia

An older friend of mine once told me that he had just written a check to the Alzheimer’s Foundation, but then forgot to mail it. I laughed at the time, but as I get older, marching toward the age when Alzheimer’s Disease most commonly afflicts millions, that story has taken on a more sobering tone. I seem to now be more conscious of situations in my own life that challenge my memory: silly little episodes like putting the cantaloupe in the pantry, forgetting someone’s name, or searching for a word on the tip of my tongue. Now, instead, I’ll pause and wonder if they are harbingers of that terrifying diagnosis. That’s when I began trying to figure out how to protect myself. But how?

Currently, Alzheimer’s Disease affects one in ten Americans ages 65 and older, or 5.8 million people, of which two thirds are women. The number is projected to grow to 13.8 million by 2050. The disease falls under the general umbrella of dementia, which also includes frontotemporal dementia, ALS, Parkinson’s, Lewy body dementia, and vascular dementia. It’s one of the top causes of death in the US yet it is generally accepted that there is no cure and current medications are relatively ineffective at slowing the course of the disease. This is daunting data, enough to make any one of us panic as we hit a time in our lives when we had expectations of a happy retirement and quality time with family and friends. And for those already experiencing the effects of Alzheimer’s through loved ones, it’s a daily reminder that getting older can take some unexpected and unwanted twists and turns.

Recognizing the importance of educating its members about Alzheimer’s, the Bigelow Senior Center in Fairfield invited Dr. Jaime Grutzendler from Yale School of Medicine to come and speak this past May. Dr. Gruzendler is a professor of neurology and neuroscience and director of experimental neuroimaging at Yale. He clearly and concisely explained that Alzheimer’s begins with the development of a sticky substance that accumulates in the brain, called amyloid plaque (a protein molecule), which gunks up the spaces between brain neurons. Subsequently, that plaque disrupts the electrical conduction that occurs between those neurons. As a result, synapses stop effectively firing, which adversely affects cognition. This process sometimes begins 20 to 30 years before symptoms develop. How does the plaque get there? Besides being assigned some genes that might place you at higher risk for Alzheimer’s (APO4 is an example), long-term bad habits also play a role. “Diabetes and hypertension must be treated,” explains Dr. Grutzendler, “because patients—especially after cardiovascular surgeries—can develop cognitive decline.”

Other positive changes can be made at any point in life to help deter dementia and Alzheimer’s disease. As previously mentioned, management of diabetes is critical, as well as other health conditions that improve vascular activity such as exercise, weight management, and kicking the smoking habit; this is crucial for neuronal and synaptic health. Controlling hypertension (high blood pressure) early in life is another critical strategy.

While depression doesn’t cause dementia, there is a significant overlap between the two, because dementia can cause depression and depression can exacerbate dementia. This relationship is also present in sleep disorders, which Dr. Grutzendler noted is quite common in people with a variety of dementias; current studies may result in a correlation between lack of sleep and dementia. Additionally, elderly individuals who are even mildly cognitively compromised may see a worsening of symptoms after some types of infections, so it’s important to make sure these are treated promptly.

There may not yet be a magic bullet yet for curing Alzheimer’s Disease, but gene research appears promising, especially for one isolated gene called Trem2. “There has also been a lot of progress in the diagnostic tools used and a lot of progress in clinical trials,” says Dr. Grutzendler, adding, “It is only a matter of time until something will work to slow down the disease.” Until that science is perfected, it seems that the best prevention for dementia may start with good lifestyle choices in your 30s, 40s, and beyond.

Alzheimer’s or Just Aging?

Here’s the difference, says the Alzheimer’s Association

Typical Age-Related Changes

›› Making a bad decision once in a while

›› Missing a monthly payment

›› Forgetting which day it is and remembering later

›› Sometimes forgetting which word to use

›› Losing things from time to time

›› Vision changes due to cataracts

Signs of Alzheimer’s/Dementia

›› Poor judgment

›› Inability to manage a budget

›› Losing track of the date or the season

›› Difficulty having a conversation

›› Misplacing things and being unable to retrace steps to find them

›› Trouble understanding visual images and spatial relationships



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