Can You Reduce The Risk Of Alzheimers Disease
Alzheimers disease is likely a result of multiple factors such as genetics, age, lifestyle, and environment. Researchers are currently working on identifying some of the genetic risk factors for Alzheimers.
For now, everyone can take steps to control the known lifestyle risk factors for Alzheimers disease. These include:
How Does The Drug Work
Aducanumab is a monoclonal antibody engineered in a laboratory to stick to the amyloid molecule that forms plaques in the brains of people with Alzheimers. Most researchers believe that the plaques form first and damage brain cells, causing tau tangles to form inside them, killing the cells. Once aducanumab has stuck to the plaque, your bodys immune system will come in and remove the plaque, thinking its a foreign invader. The hope and expectation are that, once the plaques are removed, the brain cells will stop dying, and thinking, memory, function, and behavior will stop deteriorating.
What Medications Can Help
The FDA has approved the drug aducanumab-avwa as the first therapy that targets the fundamental pathophysiology of the disease by reducing amyloid beta plaques in the brain. It is not without controversy because of concerns it may cause swelling of bleeding in the brain.
Some drugs curb the breakdown of a chemical in the brain, called acetylcholine, thatâs important for memory and learning. They may slow down how fast symptoms get worse for about half of people who take them. The effect lasts for a limited time, on average 6 to 12 months. Common side effects are usually mild for these medications and include diarrhea, vomiting, nausea, fatigue, insomnia, loss of appetite, and weight loss. There are three drugs of this type: donepezil , galantamine , and rivastigmine .
Doctors can also prescribe medicines for other health problems that happen along with the disease, including depression, sleeplessness, and behavior problems like agitation and aggression.
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Alternatives To Pharmaceutical Treatments
There have been many natural remedies to aging-related memory issues throughout history, and European and Eastern countries continue to refer patients experiencing memory loss-related troubles to a variety of holistic treatments, including:
- Huperzia serrata, a moss, is a traditional Chinese medicine. It is now being researched in pharmacology as the drug Huperzine A. Its been shown as both a powerful AChE inhibitor, as well as a protectant against further cellular damage due to various functions of dementia-type diseases. This supplement should not be taken in conjunction with other AChE inhibitors, for risk of serious side effects.
- Dietary changes like increasing the intake of healthy foods such as avocados, blueberries, and the spice turmeric, have been researched and shown to slow the cognitive decline brought about by dementia
- Exercise has been shown to produce a hormone known to battle dementia, named brain-derived-neurotrophic-factor, or BDNF, that greatly improves cognitive ability. Recent studies show that people with higher levels of BDNF have 33% less cognitive defects than those with lower levels of the hormone. See our list of the top 25 exercise videos and equipment for seniors to find tools to help you increase your BDNF levels safely at home, alone or with company.
Fdas Accelerated Approval Program
Aducanumab was approved through the FDAs Accelerated Approval Program, which provides a path for earlier approval of drugs that treat certain serious conditions. This helps people living with the disease gain earlier access to the treatment. The approval of aducanumab was based on the ability of the drug to reduce amyloid in the brain. When using the accelerated approval pathway, drug companies are required to conduct additional studies to determine whether there is in fact clinical benefit after the drug is approved. If the follow-up trial fails to verify clinical benefit, the FDA may withdraw approval of the drug. Results of the phase 4 clinical trial for aducanumab are expected to be available by early 2030.
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What Are Cholinesterase Inhibitors
If your loved one has Alzheimerâs disease that isnât too severe yet, their doctor might prescribe them a cholinesterase inhibitor. If they have another type of dementia, their doctor may consider it, too.
What they do: Scientists think these help prevent a âmessenger chemicalâ in our brains called acetylcholine from breaking down. Acetylcholine is important in learning, memory, and mood. Cholinesterase inhibitors also appear to delay the worsening of Alzheimerâs symptoms.
These medicines include:
What to expect: Most people with Alzheimerâs who take one of these medications get some benefit from it, including less anxiety, improved motivation, and better concentration and memory. And some are able to continue with their regular activities.
But the improvements donât seem to last long — about 6 to 12 months. They mainly delay the worsening of the disease for a period of time.
All three medicines work similarly, but one might work better for your loved one than it does for someone else.
Side effects: Most people donât have side effects when they take cholinesterase inhibitors, but some do have:
Keep Up With Doctors Appointments
Your doctor is up to date with all the latest treatment options for dementia and dementia-related diseases. Its important to maintain appointments not only for checkups but regular testing too.
The ability to chart the progression of the disease helps the doctor determine the right methodology for treatment. If you hear of new dementia medications or treatments, bring them up with your doctor to see if they are right for you or your loved one.
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What Are The Stages Of Alzheimers Disease
Alzheimers disease organizations and healthcare providers use various terms to describe the stages of Alzheimers disease based on symptoms.
While the terms vary, the stages all follow the same pattern AD symptoms progressively worsen over time.
No two people experience AD in the same way, though. Each person with Alzheimers disease will progress through the stages at different speeds. Not all changes will occur in each person. It can sometimes be difficult for providers to place a person with AD in a specific stage as stages may overlap.
Some organizations and providers frame the stages of Alzheimers disease in terms of dementia:
- Preclinical Alzheimers disease.
- Mild cognitive impairment due to Alzheimers disease.
- Mild dementia due to Alzheimers disease.
- Moderate dementia due to Alzheimers disease
- Severe dementia due to Alzheimers disease.
Other organizations and providers more broadly explain the stages as:
Dont be afraid to ask your healthcare provider or your loved ones provider what they mean when they use certain words to describe the stages of Alzheimers.
What is preclinical Alzheimers disease?
Providers typically only reference the preclinical stage in research on Alzheimers disease. People with AD in the preclinical stage typically have no symptoms .
There are now brain imaging tests that can detect deposits of a protein in your brain called amyloid that interfere with your brains communication system before symptoms start.
How Is Alzheimers Disease Diagnosed
Healthcare providers use several methods to determine if a person with memory issues has Alzheimers disease. This is because many other conditions, especially neurological conditions, can cause dementia and other symptoms of Alzheimers.
In the beginning steps of an Alzheimers diagnosis, a provider will ask questions to better understand your health and daily living. Your provider may also ask someone close to you, like a family member or caregiver, for insight into your symptoms. Theyll ask about:
- Overall health.
- Ability to carry out daily activities.
- Changes in mood, behavior and personality.
A provider will also:
- Perform a physical exam and a neurological exam.
- Perform a mental status exam, which includes tests to assess memory, problem-solving, attention, basic math and language.
- Order standard medical tests, such as blood and urine tests, to rule out other possible causes of the symptoms.
- Order brain imaging tests, such as a brain CT, brain MRI or positron emission tomography, to support an Alzheimers diagnosis or to rule out other possible conditions.
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Treating The Accompanying Symptoms Of Dementia
Dementia often causes a number of behavioural and psychological symptoms which can be very distressing.
These may include depression, anxiety, sleeplessness, hallucinations, ideas of persecution, misidentification of relatives or places, agitation and aggressive behaviour. These symptoms may respond to reassurance, a change in the environment or removal of the source of any distress such as pain. However, sometimes medication may be required for relief.
Major tranquillisers
Major tranquillisers, also known as neuroleptics or anti-psychotics, are used to control agitation, aggression, delusions and hallucinations. Haloperidol is one commonly used drug. In modest doses this drug tends to cause symptoms similar to Parkinsons disease such as stiffness, shuffling gait and shakiness, and older people are very prone to these side effects. Some are unable to tolerate even low doses of Haloperidol.
Newer tranquillisers such as Risperidone have fewer Parkinsons like side effects and have been studied more intensively in people with dementia than Haloperidol has. Risperidone appears to be helpful for the treatment of aggression and psychosis, but may be associated with a slight increase in risk of stroke.
Olanzapine and Quetiapine are sometimes used, but have been less comprehensively studied in the treatment of dementia, and there is some evidence that Olanzapine may also be associated with increased risk of stroke.
Drugs for treating depression
Drugs for treating anxiety
Medications For Severe Alzheimers Disease Symptoms
The FDA has approved one medication, memantine , to help with moderate to severe Alzheimers disease symptoms.
Memantine may help delay problems with memory, attention, language, and doing simple tasks. For example, it may help a person with Alzheimers disease be able to go to the bathroom alone for a few extra months. That can make a big difference for caregivers as well as patients.
The medication works by regulating a brain chemical called glutamate. Glutamate is important for learning and memory. With Alzheimers disease, however, damaged brain cells can release too much glutamate. This can speed up damage to the brain.
Memantine can be taken with cholinesterase inhibitors since the medications work in different ways. Two medications combine memantine with donepezil: Aricept and Namzaric. They are FDA-approved to treat moderate to severe Alzheimers disease symptoms.
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Questions To Ask The Doctor If Drugs Are Prescribed
- What are the potential benefits of taking this drug?
- How long before improvement may be noticed?
- What action should be taken if a dose is missed?
- What are the known side effects?
- If there are side effects, should the drug be stopped?
- If the drug is stopped suddenly, what happens?
- What drugs might interact with the medication?
- How might this drug affect other medical conditions?
- Are there any changes that should be reported immediately?
- How often will a visit to the doctor who prescribed the drug be needed?
- Is the drug available at a subsidised rate?
See Lawmakers Request Information About Alzheimers Drug Approval
Lecanemab follows on the heels of Aduhelm, another Alzheimers drug developed by Biogen and Eisai, which also targets amyloid plaques in the brain but has largely been considered a failure following its controversial FDA approval, the Associated Press reports, due to weak and conflicting clinical data and many insurers declining to foot the bill of $56,000 per year for treatments. Though experts who spoke to the Times and the Post expressed caution about making predictions based on preliminary results, they generally expect lecanemab to fare better than Aduhelm did.
A 27 percent slowing of deterioration seems like a modest effect, but for patients with Alzheimers, this could be very meaningful, University of California, San Francisco, neurologist Gil Rabinovici, who wasnt involved in the drugs development, tells the Post.
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Adopt A Mediterranean Diet
Although more research is needed to confirm a relationship between a healthy diet and dementia, data is emerging that suggests adopting a Mediterranean diet may help slow the progression of Alzheimers disease. A Mediterranean diet is filled with fruits, nuts, fish, vegetables, eggs, dairy, and poultry. In addition, new research from various studies indicates a relationship between an excess consumption of red meat and mental health. Decreasing the total amount of red meat you consume will help you decrease the probability of encountering cardiac arrest and other types of medical conditions that are linked to the formation of Alzheimers disease.
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Add Unsaturated Fats To Your Diet
There are good fats and there are bad fats. To maintain your physical health, its important to monitor your consumption of saturated fats and trans fats. A fast way to improve your physical health is to replace saturated fats with unsaturated fats such as monounsaturated or polyunsaturated fats.
Eating an optimal amount of foods with unsaturated fats will decrease your risk of developing a heart attack and indirectly slow the progression of Alzheimers disease. Learn new ways to incorporate good types of fats into your diet. As the brain is mostly made up of fats, the beneficial ones will assist your brain in remaining healthy. Various types of foods that include healthy fats are fish, olive oil, avocados and nuts.
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Other Vascular Health Tips
Watch your cholesterol levels. Studies also suggests there may be a connection between high cholesterol and Alzheimers and dementia, especially having high cholesterol levels in mid-life. Improving your levels can be good for both your brain and your heart.
Stop smoking. Smoking is one of the most preventable risk factors for Alzheimers disease and dementia. One study found that smokers over the age of 65 have a nearly 80% higher risk of Alzheimers than those who have never smoked. When you stop smoking, the brain benefits from improved circulation almost immediately.
Cholinesterase Inhibitors And Memantine
Those who have mild to moderate symptoms of Alzheimers disease, Lewy body dementia, or vascular dementia may be given a cholinesterase inhibitor, a type of medication that boosts levels of acetylcholine, a brain chemical that plays a role in memory and learning. For about half of the people who take them, cholinesterase inhibitors, such as donepezil, or Aricept®, among others, can slow the worsening of memory loss and confusion for 6 to 12 months, on average. Side effects include nausea, vomiting, and loss of appetite.
As dementia progresses, additional medications such as memantine, or Namenda®, may be prescribed. Memantine blocks glutamate, a brain chemical that in excessive amounts may worsen memory function. Side effects include dizziness, diarrhea, and headache.
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Supplements For Alzheimers Disease
There are many supplements and products that claim to be able to slow down, reverse, cure, prevent, or treat Alzheimers disease. None of these claims are backed by research or supported by the FDA.
Currently, there are only two supplements that have any studied benefit:
Omega-3 fatty acids
Studies have shown that docosahexaenoic acid , the omega-3 fatty acid found in certain kinds of fish, might reduce the risk of cognitive decline and Alzheimers.
However, there havent been enough studies to fully support this claim, and the FDA doesnt recommend DHA as a treatment or as a preventive supplement against Alzheimers.
Phosphatidylserine
Phosphatidylserine is a lipid or fat found in the membranes around nerve cells. Like DHA, a few small studies have shown promising results, but they dont offer enough evidence to support it as a treatment or preventive option for Alzheimers.
Currently, the FDA allows products with phosphatidylserine to carry the following
Questions To Ask The Doctor
If your loved one’s doctor prescribes a new medication, you could ask:
- What is its name? Does it go by any other names?
- Why have you prescribed this?
- Do they have to take this medication? Are there any alternatives?
- How often and at what time of day should they take it?
- Should they take it with food or on an empty stomach?
- Are there any side effects that I should watch for?
- How much does it cost? Are there less costly or free alternatives?
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Pillar #: Quality Sleep
There are a number of links between poor sleep patterns and the development of Alzheimers and dementia. Some studies have emphasized the importance of quality sleep for flushing out toxins in the brain. Others have linked poor sleep to higher levels of beta-amyloid in the brain, a sticky protein that can further disrupt the deep sleep necessary for memory formation.
If nightly sleep deprivation is slowing your thinking and or affecting your mood, you may be at greater risk of developing or deteriorating symptoms of Alzheimers disease. To help improve your sleep:
Establish a regular sleep schedule. Going to bed and getting up at the same time reinforces your natural circadian rhythms. Your brain’s clock responds to regularity.
Set the mood. Reserve your bed for sleep and sex, and ban television and computers from the bedroom .
Create a relaxing bedtime ritual. Take a hot bath, do some light stretches, listen to relaxing music, or dim the lights. As it becomes habit, your nightly ritual will send a powerful signal to your brain that it’s time for deep restorative sleep.
Quiet your inner chatter. When stress, anxiety, or worrying keeps you awake, get out of bed. Try reading or relaxing in another room for twenty minutes then hop back in.
Reminiscence And Life Story Work
Reminiscence work involves talking about things and events from your past. It usually involves using props such as photos, favourite possessions or music.
Life story work involves a compilation of photos, notes and keepsakes from your childhood to the present day. It can be either a physical book or a digital version.
These approaches are sometimes combined. Evidence shows they can improve mood and wellbeing.
Find out how to live well with dementia and more useful information in the NHS Dementia Guide.
Page last reviewed: 05 July 2021 Next review due: 05 July 2024
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