By Neelum T. Aggarwal, MD
The passing of the actor Gene Wilder — remembered by many for his lovable portrayal of Willy Wonka — further reinforced that fact that Alzheimer’s disease does not spare anyone. Many people were no doubt surprised to hear about his diagnosis and that he died from complications of Alzheimer’s disease. After all, Gene Wilder was wildly talented, engaged in creative activities all of his life, appeared physically spry and had a wonderful imagination. How could this happen to him?
Indeed, Alzheimer’s disease dementia can happen to anyone, and crosses race/ethnicity and social economic status. More than 5.5 million people in the United States officially have Alzheimer’s disease dementia, which is an underestimation, as many people live with the disease never receive a diagnosis.
Minorities, African-Americans and Latinos are appearing to be hit harder with Alzheimer’s disease and dementia. African-Americans are at least 1.5 times more likely to develop the disease, and the data suggests the same for Latinos. Recent data is also confirming that sex and gender differences are present in Alzheimer’s disease — women are developing the disease more than men.
Lifestyle factors that may increase Alzheimer’s risk
Comorbid medical conditions such as heart disease, diabetes, nutritional deficiencies and depression all can lead to poor cognitive function and can be risk factors of Alzheimer’s disease. People with a history of hypertension also may have a greater risk for Alzheimer’s disease dementia and other dementias. In addition, people who have decreased heart function are two to three times more likely to develop significant memory loss compared to those with better heart function. Lastly, those with multiple cardiovascular risk factors were more likely to have impairment in learning, memory and verbal fluency tests and worsened over time.
Because Alzheimer’s disease comes on slowly, many of the early signs of forgetfulness are missed by the patient, or family and friends. Lifestyle factors — which are potentially modifiable — are often not addressed early on. For example, unhealthy levels of cholesterol may cause formation of the amyloid plaque in the brain that we see in Alzheimer patients. Research has also suggested that higher levels of HDL cholesterol may actually lower your risk for Alzheimer’s disease. More research studies in this area is ongoing.
What you can do to protect yourself
Here are some details about Alzheimer’s disease dementia risks and what you can do to protect yourself from the disease.
Depression: Establishing a cause-and-effect relationship between depression and dementia has been difficult. What we do know is that depression may be a risk factor for dementia, depression may be an early sign of dementia, and depression and dementia may share common causes. Maintaining good mental health, relieving stress through exercise and meditation and treating depression is extremely important for cognitive function.
Diabetes causes numerous complications — including stroke, nerve damage, kidney disease and blindness — in addition to dementia. The brains of people with diabetes often show changes that are consistent with what is seen in dementia patients’ brains. In addition, some research is showing that the duration of diabetes is important risk factor in dementia. Diabetes impairs the brain’s ability to take in glucose from the blood; the brain is in a diabetic state, maybe due to decreased insulin levels, or has insulin hypersensitivity. Because diabetes is so prevalent globally, it makes it one of the most important modifiable risk factor for dementia.
Nutrition has emerged as a key factor for not only good heart health but brain health. Key nutrients as found in the MIND diet — 10 brain-healthy foods, and five unhealthy brain foods — appear to drop the risk of developing Alzheimer’s disease. These exciting results suggest that brain-boosting benefits can be found in food intake and diet regimens.
Exercise is showing promising results in multiple studies. Exercise, specifically aerobic exercise, appears to have an overall benefit to cognitive function, especially memory, but also increases whole brain volume and hippocampal (the memory and learning center of the brain) volumes. Not only does blood flow to specific areas increase, the blood flow increases in areas of the brain that have shown to have decreases with age and the development of Alzheimer’s disease dementia.
Rush is here to help
Presently, there are many interdisciplinary activities on going at Rush that are addressing all of these areas and promoting overall brain health in our patients and families. The Rush Heart Center for Women has a multidisciplinary practice that promotes a comprehensive approach to brain and cardiovascular health for its patients. The center’s services include the Cardio Cognitive Clinic, nutrition and dietary evaluations, integrative and preventive cardiology assessments and treatment plans, in addition to cardiovascular genetic counseling services.
In addition, patients from the Heart Center for Women are actively recruited for observational, preventive and clinical trials conducted through the Rush Alzheimer’s Disease Center and other Rush departments.
All of these activities are vital to strengthening and maintaining the Heart and Brain health of women across their lifespan.