Leading the fight against Alzheimer’s

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“Although people with Alzheimer’s disease may forget us, we as a society must remember them.”

— Scott Kirschenbaum, filmmaker

Alzheimer’s disease is a debilitating neurological condition that was identified by German psychiatrist and neuropathologist Alois Alzheimer in 1906 when he analyzed the brain of the late Auguste Deter, a patient at an asylum in Frankfurt, Germany, who had showed signs of memory loss and language and behavior problems. (Some reviewers later concluded she may have been suffering from something else, including vascular dementia, caused by problems with blood flow to the brain, such as mini-strokes or metachromatic leukodystrophy, enzyme deficiency .)

Dementia — an umbrella term for a group of disorders resulting from disease, injury and/or genetic factors and characterized by devastating cognitive impairment — is a leading cause of addiction, disability and death. Current estimates suggest that 44 million people are living with dementia worldwide. This figure is expected to more than triple by 2050 as the population ages, when the annual cost of dementia in the United States alone could exceed $600 billion. (The cost to caregivers, many of whom receive little financial or psychological support, is incalculable.) Low- and middle-income populations appear to be most at risk of experiencing the largest increases, as they exhibit higher patterns of diabetes and cardiovascular disorders. diseases such as high blood pressure, which affect certain types of dementia.

Alzheimer’s disease, which can only be truly diagnosed by autopsy, is now the most common type of dementia in the United States, accounting for 50-60% of all cases, again with a disproportionate effect on populations. minority. Alzheimer’s disease is characterized by certain changes in the brain, in particular – the deposition of amyloid plaque and neurofibrillary tangles (NFTs) of hyperphosphorylated tau.

Interestingly, Alzheimer’s disease begins deep in the brain, so these pathophysiological features may begin to appear as early as 10 to 20 years before symptoms appear, and then gradually spread to other parts of the brain. The main symptoms of Alzheimer’s disease and other forms of dementia include a gradual increase in memory loss, shortening of attention span, personality changes, feeling unwell in new situations and having difficulty organizing thoughts, learning new things, writing, reading, using numbers and even speaking.

It is estimated that 5.4 million Americans have Alzheimer’s disease. Today, one person in the country develops Alzheimer’s disease every 66 seconds. According to the Alzheimer’s Association, by 2050 a new case of Alzheimer’s is expected to develop in half the time, resulting in nearly one million new cases per year or 13.8 million, fueled largely by aging baby boom generation.

Treatment

Unfortunately, there are still no disease-modifying treatments. That said, the best intervention strategies are those that detect dementia early. Epidemiological evidence suggests education and exercise may protect against certain types of dementia, while hypertension and middle-aged diabetes influence the risk of something like vascular dementia. Low-cost lifestyle measures that promote brain health, arrest ongoing degeneration, repair neuronal damage, and prevent cognitive impairment are at the forefront of the dementia prevention discussion. Many interventional studies focus on cognitively healthy people at risk of developing Alzheimer’s disease and other forms of dementia (before irreversible, irreversible neural network dysfunction and loss, associated with overt clinical symptoms, occur) as the best strategy to reduce disease incidence and prevalence.

From a nutritional perspective, the Mediterranean diet and DASH (Dietary Approach to Systolic Hypertension) have been shown to slow cognitive decline. The MIND (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay) and DASH) are known to recommend a high intake of leafy green vegetables as well as nuts, berries, beans, seafood, and poultry, among other foods.

something to think about

If our society really wants to face this problem head-on, we must meet it early on and even well into its pre-stages. Making healthy lifestyle choices – eating nutritious foods and exercising more – at an early age is a start. Complicating matters is that as individuals age, they may put less effort into healthy behaviors, such as exercise, due to pain, discomfort, or underlying beliefs. -optimal.

But it’s not just about eating well and moving well, especially in the digital age of anxiety. Stress can play a role. (See page 68.) The biggest challenge, however, may lie in technology that seemingly does everything for us, skewing our brain patterns and attention spans in the process. According to a recent New York Times interview with Richard Restak, MD, a neurologist and clinical professor at the George Washington Hospital University School of Medicine and Health and author of “The Complete Guide to Memory: The Science of Strengthening Your Mind,” the lack of retention — the memory loss that is the attribute most associated with dementia — is partly a lack of attention. And paying attention is hard for those who want it all at once in short internet bursts. (He also recommends doing something fewer people do — reading books, especially novels, that force you to focus and remember deadlines.)

The most effective strategy we can employ is to move from treatment to prevention. Even if the onset of dementia can only be delayed for a few years, it would greatly affect our society and its health. Exploring how lifestyle choices influence risk is more important than ever.

The author in front of the statue of New York Mets ace Tom Seaver at Citi Field in Queens. A cultured and sophisticated man – knowledgeable about the art and later a California winemaker – Seaver died of complications from Lewy body dementia and Covid-19 on August 31, 2020 at the age of 75. Courtesy of Roselli Fitness.

Contact Giovanni at giovanniroselli.com.

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