Is Alzheimer’s the Most Preventable Incurable Disease?

www.ozy.com [OZY]( OZY A Modern Media Company Share This Sh*t October 30, 2022 Share This Sh*t [The drop]( IS ALZHEIMER'S THE MOST PREVENTABLE INCURABLE DISEASE? A promising new avenue of research may change the disease that is second only to cancer as the most feared diagnosis in the U.S. If you’re over 20, read on. Sponsored by [Cariuma]( A Disease on the Rise Jennifer Ladonne [jenniferladonne.com]( 1 Common Plight — and Poorly Understood Right now nearly [6.5 million Americans]( age 65 and older are estimated to be living with Alzheimer’s, the most common type of dementia, and by 2050 that figure is projected to roughly [double](. Today, nearly[half of older adults]( (those over age 67) die with or from Alzheimer’s or another form of dementia. That’s[more than the fatalities from breast and prostate cancer]( combined, and is up 36% from[20 years ago](. Undiagnosed early-onset dementia in people under 65, and sometimes significantly younger,[is also on the rise](. These numbers are startling, especially given that Alzheimer’s remains in many regards shrouded in mystery. Who is most likely to develop the disease, the nature of its progression and what constitutes effective treatment are all poorly understood. But a promising new area of research is bringing much-needed clarity to these pressing questions. 2 Aging Not the Cause The causes of Alzheimer’s are elusive. Both Alzheimer’s and related dementias (ADRDs) are linked to the aging brain, but aging is[not the direct cause]( of either one. Researchers point to family history, since[those with a parent or sibling]( with the disease seem more likely to develop it. But [less than 1%]( of Alzheimer’s cases are caused by rare deterministic genes that cause the disease. Perhaps the most commonly held theory is that Alzheimer’s is caused by a buildup of the proteins[amyloid or tau]( in the brain, causing plaques around brain cells or tangles within them. But several studies, including [recent research]( with mice, have challenged that theory, while other studies have shown that[people with amyloid plaque buildup may never develop ADRDs](. Both Alzheimer’s and related dementias (ADRDs) are linked to the aging brain, but aging is not the direct cause of either one. While experts don’t know the definitive cause of Alzheimer’s and other dementias, researchers have identified a host of factors that increase risk.[A study released in May]( substantiated earlier findings pointing to smoking, depression, Type 2 diabetes and, surprisingly, hearing loss as conditions linked to the onset of Alzheimer’s. Three of the most prominent indicators were physical inactivity, low education and midlife obesity. Head trauma, heavy metal toxicity, thyroid dysfunction, diabetes, mental illness and environmental contamination of air and food can all raise the risk of developing the disease. But that risk also depends on who you are. 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[TAKE ME SHOPPING]( Bad News First 1 Gender, Ethnicity and Alzheimer’s According to[research](, nearly two-thirds of the millions of Americans living with ADRDs are women. And while white people make up the majority of those with Alzheimer’s and dementia, African Americans are[twice as likely as whites]( to have ADRDs, while people identifying as Hispanic are about one and a half times more likely than non-Hispanic whites. But these numbers are misleading: Studies consistently show that Black and underrepresented patients are less likely to be diagnosed in the early stages of dementia; the disease is then discovered later, when it is more advanced.[Biases]( in the diagnostic thresholds providers apply to their patients during screenings are widespread. Black and underrepresented patients are less likely to be diagnosed in the early stages of dementia; the disease is then discovered later, when it is more advanced. Women, already disproportionately affected by ADRDs, are also more likely than men to end up as caregivers. And virtually all spouses, adult children and other caregivers of people with ADRDs — who statistically [provide care longer than with other diseases]( — end up suffering a considerable toll. One study found that 18% of spouse caregivers [die before the loved one they’re caring for](. 2 Pharmaceuticals Often Ineffective Billions have been spent on drugs that have proved disappointing or have been[discredited](. Of the two kinds of Alzheimer’s drugs approved by the FDA — those that may temporarily mitigate certain Alzheimer’s symptoms but have no effect on its progression, and those designed to slow progression — two of the most recent,[aducanumab](, approved in 2021, and [crenezumab](, fast-tracked to arrive this year, can have serious side effects, including[brain swelling and hemorrhage](, with minimal or no benefit. The[cost of a year’s worth]( of aducanumab is $56,000. A Revolution in Care 1 Preventable + Reversible? While traditional medicine struggles for answers and treatments, new areas of research and new approaches to therapy are yielding exciting results. Not only have recent studies found that[Alzheimer’s may be largely preventable](, but that some dementias are [reversible](, even those caused by[head trauma](. It is now widely agreed that Alzheimer’s and other dementias have[no one single cause]( but are a result of an aggregate of physical and environmental conditions. A genre of healthcare called [functional medicine]( seeks to provide more targeted care that considers, and tests for, the many facets that can result in disease. 2 Early Detection Seen as Critical Those on the leading edge of dementia science agree that our ways of detecting and diagnosing Alzheimer’s and other dementias and their risk factors must evolve — quickly. Nowadays, many people are diagnosed long after the window for effective treatment has narrowed or closed. Mild cognitive impairment (MCI), the roughly 10-year stage once regarded as normal cognitive aging, is now regarded by some doctors as a stage of severe decline far beyond the normal aging process. Once MCI is well underway, it is harder to reverse. That’s why physicians now see the goal as starting a preventive program during the[earlier subjective stage](, long before more serious effects set in. This requires patients to acknowledge their symptoms and trust their instincts, and to seek help, while doctors need better training in identifying those symptoms as well as listening to and trusting their patients — without bias. 3 The Role of Exercise While it’s[long been recognized]( that regular[exercise of all types]( improves memory, several groundbreaking studies published in the U.S. and the U.K. in 2022 found a strong correlation between exercise and a lowered risk of dementia — and even a [reversal]( in cognitive decline. An explosive seven-year study following nearly 80,000 people published in[JAMA]( this September found that people who walked 10,000 steps per day decreased their chances of developing dementia by a whopping 51%. But even the smallest increase in steps was associated with cognitive benefits. People who walked 10,000 steps per day decreased their chances of developing dementia by a whopping 51%. - Journal of the American Medical Association 4 Lifestyle Changes Can Reduce Risk Some factors in our environment — such as air pollution — are beyond our control, while others are not. Excessive sugar, unhealthy fats, copious alcohol and smoking are all implicated in dementia, while the[Mediterranean]( and[ketogenic diets]( have been shown to increase brain health. The[harmful effects of stress]( on the nervous system have also been identified as a significant factor in how the brain changes over time. While much about Alzheimer’s remains a mystery, one thing appears quite certain: Seemingly small lifestyle changes can have outsized positive effects in preventing the disease. New [studies]( have described the relationship between [hearing loss]( and vision impairment with dementia — factors that are simple to overlook and just as easy to address. Remarkably, having a basic eye exam to adjust an eyeglass prescription actually reduces the risk of cognitive decline. Similarly, correcting for hearing loss by regularly wearing hearing aids improves your odds of avoiding Alzheimer’s or another form of dementia. While much about Alzheimer’s remains a mystery, one thing appears quite certain: Seemingly small lifestyle changes can have outsized positive effects in preventing the disease. Community Corner What other topics in health and wellness are you eager to read about? 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