November is national Alzheimer’s disease awareness month, and there’s good reason for members of Gen X and Gen Y to pay attention. Though not marked by nearly as many ribbons or races, Alzheimer’s is looking a lot like it could be the next cancer where public health is concerned. Like cancer, Alzheimer’s was once very stigmatized but is now being addressed more openly. Like cancer, it can cause the body to turn on itself. Like cancer, it’s deadly – currently the sixth-leading cause of death in the United States. And, like with cancer, it’s looking as if prevention is a much better bet than an Alzheimer’s cure.
Alzheimer’s isn’t genetic. It isn’t random. And it isn’t a normal part of aging. In other words: We have more control over it than you think.
But you should probably start thinking about it now.
Alzheimer’s is what’s known as a progressive, degenerative disorder, a disease of the central nervous system in which your brain is literally dysfunctioning. Plaques and tangles build up over time, nerve cells die, the brain actually shrinks.
All of this takes quite a while. The things we recognize as “Alzheimer’s disease”–memory loss, confusion, etc.–are actually just the final stage of what doctors now define as a spectrum disorder. People in the first stage show brain damage indicative of Alzheimer’s disease but no symptoms. This damage has taken years, perhaps decades, to accumulate. And it could take years or even decades more to manifest as symptoms.
The path to Alzheimer’s disease is a long one. There are lots of chances to intervene, but it helps to intervene early. By middle age, the brain damage that triggers the disease could already be underway.
There’s a growing awareness of this — and I’m sure we can expect a growing number of confusing news reports and confusing products dedicated to Alzheimer’s prevention, too (like with cancer). But talking about Alzheimer’s “causes” or prevention measures is tricky. The vast majority of Alzheimer’s cases are not “genetic,” as in involving an inherited genetic mutation. Only 1% to 3% of all Alzheimer’s cases are genetic; this is a specific type, known as familial or early-onset Alzheimer’s disease.
While certain gene variants may up your risk, they’re not determinative — having one doesn’t mean you will get Alzheimer’s disease. Alzheimer’s is multifactorial, meaning it can be triggered by many factors — some genetic, some environmental and, fortunately, many related to diet and lifestyle.
You may have even heard lately that Alzheimer’s is “a form of diabetes.” What that means is just that Alzheimer’s and diabetes share several triggers (sugar, processed food) and several key biological processes (insulin resistance, inflammation). Having type 2 diabetes also increases your chance of developing Alzheimer’s disease — as does depression, obesity, heart disease, high blood pressure and high cholesterol. Most cases of Alzheimer’s won’t strike until after 65, as far as symptoms go. But the presence of any metabolic syndrome conditions in middle age is a major predictor of whether or not you’ll eventually get the disease.
Right now, the biggest known risk factors for Alzheimer’s (aside from age) are metabolic syndrome, type 2 diabetes, the ApoE4 gene variant, depression, head trauma, obesity, pesticide exposure, poor diet and current smoking.
There’s an ever-growing list of evidence-backed ways to reduce Alzheimer’s risk. Some of the most well-supported are:
- Staying socially engaged
- Staying cognitively engaged (work that interests you, lifelong learning, crossword puzzles, etc.)
- Overall “Mediterranean-style” diet
- Light to moderate alcohol consumption, especially red wine consumption
- Omega-3 fatty acids / fish oil
- Spices such as cinnamon, turmeric, cloves and nutmeg