Alzheimer’s disease (AD) is the most common type of dementia. Dementia is a generic term for conditions that occur when the brain no longer functions properly. Worldwide, at least 44 million people are living with dementia, making the disease a global health crisis. Like me, you probably know someone who has been affected by this condition.
What’s surprising is that this isn’t a disease of ageing and that only 1% of cases are caused by genes. Scientists now know a lot about AD, and preventive therapies probably aren’t far off. But even when they become available, such therapies will almost certainly be very costly and involve drugs with probable side effects.
You can actually start lowering your risk of Alzheimer’s quite easily. A study published last July in Lancet Neurology examined pre-existing Alzheimer’s risk-factor research around the world, and estimated that about one-third of the Alzheimer’s cases in Western countries are attributable to just seven lifestyle-related “modifiable risk factors” (1) I’ve listed these below and added a few more based on my own knowledge and research. This suggests that, while some cases may be unavoidable, a great many may be preventable via simple changes in diet and lifestyle. In principle, the earlier in life a person starts making these changes to minimise Alzheimer’s risk factors, the better the preventative effect will be.
10 Steps to Preventing Alzheimer’s
1. Keep learning and get out of your comfort zone by continually “exercising” the brain.
Why: building cognitive reserves is a lifelong process that begins in childhood as we expand reading skills etc. During the early developmental stages of life, the human brain forms an enormous number of neurons, or nerve cells, but many of these cells also die. The neurons that survive do so by connecting with other neurons during the rapid-growth stage of the nervous system that occurs in childhood and adolescence. However, beyond this age, you can help form new neural connections.
Reading progressively more challenging books, learning a musical instrument or language, creating art, playing chess and engaging in any mental activity – even doing things differently. For example, taking a different route into work – all help form these vital neural connections that can last a lifetime, and appear to buffer people from cognitive decline later on.
2. Address depression and stress
According to the Lancet Neurology study, after physical activity, depression ranks second in apparent risk-increasing effect. A study last year in the British Journal of Psychiatry quantified this effect as a 65% increase in risk.
How depression promotes Alzheimer’s isn’t yet clear. However, one possibility is that chronic stress, which is known to cause depression, ends up weakening the brain in a way that leaves it more vulnerable to Alzheimer’s. Depression causes lower signalling of serotonin, which in turn, has been linked to increased inflammation (more on inflammation below). (2)
3. Find a sense of purpose
A study last year linked “eudaimonic well-being” (a sense of purpose to you and me) to a reduced expression of stress and inflammation-related markers. UCLA researcher Steven Cole, author of that study, suggests that having a sense of ‘higher purpose—feeling’ and that one is part of a cause greater than one’s self—makes one more resistant to the stresses of ordinary life and their adverse health consequences. “People with high levels of eudaimonic well-being may be less stressed by things that threaten them personally because the things they care most about lie in the world outside them”, he says. (3)
4. Be active
Lack of exercise remains the most important risk factor in developing Alzheimer’s. By increasing our daily exercise not only can we improve cognitive function but, additionally, gentle exercise both lowers stress levels and high blood pressure – both of which can be contributing factors to the onset of cognitive deterioration. An easy and affordable way to improve on daily activity would be to purchase a pedometer and ensure you are reaching the recommended steps per day.
5. Add a vitamin K supplement to your diet
Known as “the forgotten vitamin,” vitamin K plays a crucial role in anti-aging and may prevent Alzheimer’s. Because vitamin K is not found in most multivitamins many people consume it through green leafy vegetables or a vitamin K supplement. (4, 5). We recommend being tested for vitamin K levels before taking it.
6. Reduce stress
Many studies have linked anxiety with the development of Alzheimer’s, especially in people who are already at risk from the disease. A recent study showed that people who had mild cognitive impairment and reported high levels of anxiety were 135% more likely to develop Alzheimer’s.
7. Check your blood homocysteine level
Homocysteine is an amino acid that is naturally created within our bodies, but if certain important chemical pathways in our bodies are not working optimally, due to factors including genetics, lifestyle and diet, then levels of this amino acid can build up. High levels can have a toxic effect on our bodies, they are a known risk factor for AD and there is strong evidence that lowering homocysteine levels can help in the prevention of cognitive decline. Approximately 30% of the general population, and half those over 65, have high levels. Levels can be measured simply through a blood test, and can be naturally reduced through dietary modifications and supplementation of B vitamins.(6, 7). This is a test we regularly run in clinic.
I added these extra recommendations:
8. Ensure a good level of omega 3 fats in your diet
Omega 3 fats are essential fats that we have to obtain through our diet or supplementation. Good sources to add into your daily meals are dark green leafy vegetables such as kale, broccoli and spinach, flaxseeds, chia seeds, walnuts and, most of all, oily fish; in fact eating just one serving of oily fish a week is associated with halving the risk of AD. For those that do not eat fish, an omega 3 supplement would be recommended. See our delicious Salmon and Ginger Parcel recipe here.
9. Increase your intake of polyphenol rich foods
Polyphenols are the active substances found in plants which have antioxidant properties. Antioxidants can help protect our bodies against oxidative stress, which refers to the damage that harmful chemicals can do to our bodies and that are linked to a number of illnesses, including neurodegenerative diseases, such as AD. By increasing consumption of these foods we can help lower the risk of cognitive decline and ill-health. Foods that are naturally high in polyphenols include seasonings such as cloves, peppermint, rosemary and star anise, raw cacao, flaxseed and chestnuts. It is also recommended to include a wide range of fruit such as berries and vegetables in your diet to optimise as many different variations of polyphenols as possible. (8)
10. Be aware of the effect that mid-life smoking can have on your health
There is evidence to suggest that both mid-life smoking and smoking in general can contribute to the development of dementia in later years. Furthermore, by eliminating smoking, general health and well-being can be improved with the added benefits of increased energy levels, less stress and the risk of other serious health conditions, such as cancer and heart disease. (9)
To give you an idea of how modifying these risk factors can be of benefit, it is predicted that if the factors with the strongest risk – high homocysteine, low physical activity and mid-life smoking – are eliminated, then one in three cases of AD can be avoided. Wow!
Cognitive Function Test
Here’s an online screening tool which helps to identify the early signs of cognitive impairment. If you are concerned about any of the issues outlined in our newsletter, please see your GP or get in touch with us firstname.lastname@example.org.
Food for the brain recipe: Salmon and Ginger Parcels
Your brain is really fat! In fact, 60% of it is made up of fatty acids, these are the long snake-like building blocks of fat molecules required for proper brain structure and function. Fatty acids come in many varieties, yet the brain has a clear favourite — and salmon is full of it. More than two-thirds of the brain’s fatty acids are docosahexaenoic acid (DHA), an omega-3 fatty acid found primarily in oily fish, although some vegetarian sources exist as well. We are metabolically incapable of making DHA on our own and must, therefore, get it from our diet.
DHA is like a warm winter coat for your neurons, or brain cells, making up a majority of their cell membrane, the cell’s outer coating. Just as my Mother would never let me leave the house without my coat in Winter, you wouldn’t want to starve your brain cells of DHA. This essential fatty acid protects neurons from injury, reduces cerebral inflammation, helps produce neurotransmitters that tell cells what to do and is essential for quick information transfer down the axon, the neuron’s highway.
Click on the picture for the recipe.
(1) D E Barnes, K Yaffe “The Projected Effect of Risk factor Reduction on Alzheimer’s Disease Prevalence”, The Lancet Neurology, July 19, 2011.
(2) B S Diniz, M A Butters, S M Albert, M A Dew, C F Reynolds “Late-life depression and risk of vascular dementia and Alzheimer’s disease: systematic review and meta-analysis of community-based cohort studies”, British Journal of Psychiatry, 2013 May;202(5):329-35.
(3) B L Fredrickson, K M Grewen, K A Coffey, S B Algoe, A M Firestine, J M Arevalo, J Ma, S W Cole “A functional genomic perspective on human well-being”, Proceedings: National Academy of Sciences USA, 2013 Aug 13;110(33):13684-9.
(4) A C Allison, “The possible role of vitamin K deficiency in the pathogenesis of Alzheimer’s disease and in augmenting brain damage associated with cardiovascular disease” Medical Hypotheses, 2001 Aug;57(2):151-5.
(5) N Presse, B Shatenstein, M J Kergoat, G J Ferland,”Low vitamin K intakes in community-dwelling elders at an early stage of Alzheimer’s disease” American Dietetic Association 2008 Dec;108(12):2095-9.
(6) D S Wald, A Kasturiratne, M Simmonds “Serum homocysteine and dementia: meta-analysis of eight cohort studies including 8669 participants” Alzheimers Dementia, 2011 Jul;7(4):412-7.
(7) S Seshadri, A Beiser, J Selhub, P F Jacques, I H Rosenberg, R B D’Agostino, P W F Wilson, P A Wolf “Plasma Homocysteine as a Risk Factor for Dementia and Alzheimer’s Disease”,
New England Journal of Medicine 2002; 346:476-483 February 14.
(8) K B Pandey, S I Rizvi “Plant polyphenols as dietary antioxidants in human health and disease” Oxidative Medicine and Cellular Longevity, 2009 Nov-Dec; 2(5): 270–278.
(9) S L Tyas, L R White, H Petrovitch, G Webster-Ross, D J Foley, H K Heimovitz, L J Launer “Mid-life smoking and late-life dementia: the Honolulu-Asia Aging Study”, Neurobiology of Aging Journal, 2003 Jul-Aug;24(4):589-96.