A Multi-Targeted Approach to Reduce the Risk of Alzheimer’s DiseaseApril 2016
By Hernando Latorre, MD, MSC
LE: I’m concerned about Alzheimer’s disease, as it “runs” in my family. Am I at risk?
HL: Characterized by a decline in cognitive function, Alzheimer’s disease is a neurodegenerative disorder that affects millions of individuals and families worldwide. Research finds this devastating disease to be the consequence of multiple factors including inflammation, mitochondrial dysfunction, accumulation of toxic proteins, and oxidative stress. Others stress the implications of chronic infection both in the development and progression of Alzheimer’s disease. In addition, age-related changes in vascular function and declining hormone levels are thought to contribute to the disease.
It is clear that multiple factors influence the risk of Alzheimer’s disease. Some of the factors associated with Alzheimer’s disease like obesity and nutrient deficiencies are modifiable, but others, such as carrying the ApoE4 gene, are not. Family history, aging, and certain infections, as well as diseases like diabetes and hypertension, also increase the risk. This is just a small list of the most common factors associated with an increased risk of Alzheimer’s disease.
More important is to look at the specific individual when it comes to the risk factors, such as if an aging adult has a parent with Alzheimer’s disease and/or if this person has a history of high blood pressure. The appropriate approach would be to look at blood pressure first. What usually happens at this point when the causes of high blood pressure are explored, risk factors like elevated cholesterol or homocysteine arise.
HL: As mentioned previously, the importance of identifying the root problem(s) is crucial and usually results in a better outcome. When it comes to risk factors, think of them like a loaded gun, meaning that we are all at risk and it’s up to the individual to fire the gun or not. For example, if someone has a strong family history of diabetes but follows a strict diet, the likelihood of developing diabetes is greatly reduced. Contrary to this is the individual with family history of high blood pressure who smokes and follows a sedentary lifestyle and consumes a diet high in sodium.
When talking about Alzheimer’s disease risk factors and a useful way to reduce them, the same applies. A detailed medical history (both family and personal), current medications (as many deplete the body of key nutrients), and information about social habits, exercise, and diet is a good start. Based on this, a recommendation of comprehensive blood testing to identify additional risks (that will vary from person to person) is made. With all this information in hand, a specific regimen to correct root problem(s) is suggested.
We’ll use the same example described previously about the individual with a family history of Alzheimer’s disease and high blood pressure: Commonly prescribed medications for high blood pressure include diuretics like hydrochlorothiazide or furosemide that deplete the body of key nutrients such as coenzyme Q10 (CoQ10), magnesium, calcium, phosphorus, and vitamins B and C, all of which are important in brain function and cognition. With this in mind and with the goal of reducing risk factors and ensuring proper blood pressure control, it’s suggested that an individual keep a blood pressure log and replace those nutrients depleted by the medication. This is also the time in which a conversation about diet (low sodium) and exercise (at least 30 minutes three or four times a week) takes place.
The next step is to identify additional risk factors by looking at blood work. Life Extension®’s Male and Female Panels do a great job as they are comprehensive tests that look at different areas including markers for diabetes (glucose and HbA1c) and inflammation (C-reactive protein and homocysteine) as well as male/female hormones, lipid panel, vitamin D, complete blood count (CBC), and blood chemistry.
Let’s assume that the results from the blood test reveal elevated homocysteine and cholesterol levels, blood markers associated with an increased risk for both high blood pressure and Alzheimer’s disease. The proper approach for this individual would be to correct nutrient deficiencies caused by a medication (as this might be related to the increase in homocysteine due to depletion of B vitamins) followed by strict blood pressure control, dietary modifications, an exercise program, and nutrients like red yeast rice and omega-3s to aid healthy cholesterol metabolism. Due to the individual’s family history of Alzheimer’s disease, preventive approaches with nutrients like acetyl-L-carnitine, vitamin D, CoQ10, N-acetyl cysteine (NAC), curcumin, and R-lipoic acid could be suggested.
LE: I have been told that my memory is good, so how can I preserve it?
HL: Nutritional approaches should be combined together with diet and exercise to successfully preserve memory in aging adults. Remember that cognitive decline if left unchecked can develop into more serious conditions like Alzheimer’s disease.
If someone does an internet search for memory and supplements, they would be overwhelmed with the amount of information that is provided. For those concerned about memory, the top nutrients to incorporate into a regimen may include:
Fish oil: Helps ease inflammation and support the integrity of cell membranes that are crucial for brain function. Numerous studies indicate that supplementation optimizes cognitive health.
Phosphatidylserine (PS): Important for cell membrane integrity and facilitates cell communication between neurons in the brain.
Alpha-glyceryl phosphoryl choline (A-GPC): This form of choline supports healthy acetylcholine levels, an essential neurotransmitter that allows brain cells to communicate and is involved in memory and learning.
Vinpocetine: Derived from the peri-winkle plant, it supports healthy cerebral blood flow.
Acetyl-L-carnitine: This form of carnitine crosses the blood-brain barrier and supports mitochondrial health.
Taurine: Promotes new brain cell formation.
Ashwagandha: Targets the enzyme that breaks down acetylcholine in the brain.
Be aware that these are not the only nutrients that may support brain function. The most important component of any supplement regimen is to identify the underlying factors that contribute to the problem and correct it. Other key nutrients that aging adults may consider and that are specific to Alzheimer’s disease are summarized in the table below.
LE: Are there any dietary or lifestyle strategies to reduce the risk of Alzheimer’s?
HL: Several studies have demonstrated a reduction in neurodegenerative diseases including Alzheimer’s disease in those that follow a Mediterranean or MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet. Incorporating “good fats,” especially omega-3s and olive oil, multi-colored vegetables and fruits, nuts, legumes, and fish along with a lower intake of sweets, meats, and high-fat dairy may help reduce the risk of Alzheimer’s disease and several other diseases. Other researchers have reported that a low-calorie diet is also beneficial to reduce the risks of cognitive decline and Alzheimer’s disease.
Physical exercise is known to enhance cognitive function in humans. Research has identified a signaling protein called brain-derived neurotrophic factor that is key to brain health as it facilitates the growth of new neurons (brain cells). Regular exercise is associated with an increase in brain-derived neurotrophic factor.
For those concerned about cognitive decline and Alzheimer’s disease, a combination of a low-calorie Mediterranean/MIND diet along with an exercise regimen that includes 30 minutes of physical activity at least three or four times a week may be useful.
Remember that addressing the underlying cause(s) of Alzheimer’s disease is perhaps the most valuable and important approach to prevent such a devastating disease. Currently, there is no magic bullet to reduce the risk for this condition and it is crucial to build a multi-targeted regimen around diet, exercise, and nutrients to reduce the risks.
If you have any questions on the scientific content of this article, please call a Life Extension® Health Advisor at 1-866-864-3027.
Hernando Latorre, MD, MSc, is the medical editor for Life Extension® magazine.