Can we prevent or delay Alzheimer's?

Hobnobbing, as I now do, with people who are in touch with the latest findings (geriatric specialist, researchers, community nurses) I can say a cautious yes. I think it rather depends on when you start — although I would also quote those well-known adages: ‘better late than never’, and ‘every little helps’.

What I’ve learned is that, like so many other conditions, it’s at least in part — large part! — a matter of lifestyle.

For a healthy old age, follow these steps:

1. Know and control your blood pressure.
2. Know and control your blood sugar.
3. Know and control your cholesterol.
4. Control obesity.
5. Exercise for physical fitness.
6. Healthy eating.
7. Mind your mind (exercise the brain). At least 2 hours a day is recommended, e.g. crosswords, card games, chess.
8. Don’t smoke.
9. Don’t drink alcohol — or drink very little. The geriatric specialist told me that every drop of alcohol kills a brain cell! ‘Take a cell and add one drop of alcohol, the cell dies.’ He added, ‘Fortunately the good Lord gave us lots of neurones.‘ Nevertheless he advised extreme moderation.
10. Social interaction.
11. Avoidance of stress / stress release techniques.
12. Positive thinking. (When you catch yourself in negative thoughts, switch.)

I've heard this summed up as attention to spiritual, physical, mental-emotional and social wellbeing. I would want to take spiritual a bit further, but I guess we all have to work out those details for ourselves.

One study says, ‘Mental and physical exercise are most important because they influence the others, by keeping weight and blood pressure down, reducing the risk of diabetes and depression.’

The latest findings are that social interaction is even better for the brain than doing crosswords and Sudoko.

‘The older you get after 50,’ I was told, ‘The more it’s about prevention’. The chances of getting Alzheimer’s doubles each decade. In your sixties it’s 5 in 100, in your seventies 10 in 100, in your eighties 20 in 100.

‘However,’ this researcher pointed out, ’That’s still a small percentage of the population. The majority of people won’t get it. Ninety people in a hundred who are in their seventies won’t get it.’

There can be a genetic predispositon but it’s not necessarily cause for alarm. Some people who have that gene don’t get it, and some who don’t have the gene do. Of those who do have the gene, the percentage who will get the condition increases only slightly: in their sixties, it goes up from 5 to 7.5 in 100, in their seventies, it’s 15 in 100. It’s still a relatively small risk.

The healthy lifestyle practices listed above don't guarantee you'll never get it, but they increase your chances. They are probabilities.

Early assessment

The medical people agree that the earlier it's diagnosed, the better your chance of effective treatment. And there are treatment options available. I was recently surprised when a friend expressed the opinion that, ‘There’s nothing you can do about it‘ — temporarily forgetting it wasn’t so long ago that I myself discovered otherwise. There is not yet any known cure, but my Dear Husband is on medication which can slow down the deterioration. It takes about six months to know how well it’s working; if it appears not to be, there are other medications which can be tried.

All the same, I’m sorry we didn’t get him diagnosed sooner. One reason for that was that he wouldn’t entertain the idea, even though his Mum got Alzheimer’s fairly early. He held to the New Agey notion that if you don’t acknowledge the possibility, you don’t manifest it ... or something like that. Even when his forgetfulness and confusion became more apparent, it was very hard to tell whether they were symptoms of dementia or of high blood sugar. There’s no doubt even now that when his blood sugar was out of control, that seriously exacerbated his mental disorientation. Switching him from diabetic meds to insulin helped enormously in regulating his blood sugar; then it became clear that wasn’t the only thing affecting his brain.

Alzheimer’s is in my family too, on my fathers side. With hindsight I realise my Dad had the early stages in his fifties, only was adept at disguising it. In old age it became so pronouned that he had to go into care. His uncle had it, and tales of Uncle Alf’s behaviour were legendary in the family. Also my father’s great-aunt had it, and one of his brothers got it very late in life. Now one of my paternal cousins has just been diagnosed. Observing at close quarters the effect on DH, I thought it best to act early and requested assessment for myself.

I passed the initial tests with flying colours, which indeed I expected to do, and if it wasn’t for the family history the specialist would not have taken things further. As far as he could tell, my cognitive function is fine. (He did add, though, that with intelligent, educated people, it is much harder even for professionals to discern ‘subtle memory loss’ because they are good at compensating.) Because of the family history, he ordered blood tests which I have now had, and scans which I am getting soon. I had the option to test for the gene, which costs $70 and yields no useful information — given that some people with the gene don’t get Alzheimer’s and some without it do, and in any case it makes no difference to treatment. But I am beset with the sin (?) of curiosity, so I had it. I won’t get any of the results until the end of May.

A couple of heavy drinking periods I had decades ago are a bit of a worry, but I wasn’t addicted and was able to stop at what the specialist considers the right time. I told him that since then I have sometimes drunk a little, and he recommended it be as little as possible. That’s no great problem, except on days when life with DH is particularly stressful. Then one or two small glasses (half the standard size) can take the edge off, so I haven’t stopped altogether — though over the years I have had long periods of not drinking at all. The other concern is that I smoked fairly heavily for 32 years (a packet and a half a day for most of that time) but there’s nothing I can do about that now, except be glad I stopped in 1987.

Meanwhile I remind myself that in my mother’s family people tend to remain mentally sharp right up until their deaths, and are typically long-lived.

Note: There is also a condition called Vascular Dementia, but as it leads to Alzheimer’s, I’m not discussing it separately.