Want to do your brain a favor? Adopt the two Ms. Move & Mediterranean. No, you don’t really need to relocate to Greece (unless you really want to. I have nothing against Greece).
M & M
The first M is for Motion, as in exercise. The second M is for Mediterranean, as in diet. There is some evidence that both of these approaches can protect you from Alzheimer’s disease.
What is Alzheimer’s?
Almost everybody has heard of it. A lot of people are taking care of loved ones who are struggling with it. Most of us kind-of, sort-of know what it is. But let us make sure we know what we are talking about. Alzheimer’s is a form of dementia.
Cognition, dementia
Cognition is the group of processes which helps us to acquire knowledge and comprehension. Thinking, knowing, judging, solving problems, and remembering things fall under this umbrella. These are high level brain functions. Language, perception, planning, and imagination are all involved in this interplay between us and our environment.
Dementia is a condition characterized by a decline in mental ability. In general, this decline must be severe enough to interfere with daily life.
Types of dementia
Many medical conditions can cause a decline in brain function. 60-80% of the cases of dementia are caused by Alzheimer’s disease, with a stroke leading to vascular dementia being the next most common cause.
Thyroid disease and some vitamin deficiencies have also been linked to dementia, but are uncommon causes.
So what, then, is Alzheimer’s?
It is the commonest type of dementia. The earliest symptom is often a loss of memory, affecting information learned recently. It usually starts around age 65, but up to 5% of patients are in their 40s or 50s when symptoms start.
This disease is not a normal phenomenon associated with aging. The symptoms usually get worse with time, affecting multiple cognitive abilities.
Risk factors for Alzheimer’s
Increasing age and a positive family history increase the risk of developing this disease.
Genetics also plays a role. A variant of the gene Apolipoprotein E-e4 (APOE4) has the greatest genetic impact in elevating the risk for Alzheimer’s. Amyloid precursor protein (APP), Presenilin-1 (PS-1) and Presenilin-2 (PS-2) are other gene mutations which increase the risk of Alzheimer’s.
Serious head injury, especially repeated injuries, and Alzheimer’s also appear to be linked.
Diagnosing Alzheimer’s
This is usually done with a thorough history and physical examination, often complemented by blood tests and scans of the brain. There is no unique single test to establish the diagnosis.
Brain changes in Alzheimer’s
Nerve cells start to die all over the brain, leading to significant shrinkage of the brain over time. The hippocampus, a region which allows us to form new memories, shrinks markedly.
Under the microscope, one can see abnormal clusters of protein fragments, called plaques. These form when sticky protein pieces called beta-amyloid clump together. These clumps likely block the signals sent from one brain cell to another at their junction (called a synapse). The clumps lead to the activation of the body’s immune system, which sends out cells causing inflammation. The disabled brain cells are “eaten up” by these immune cells.
Twisted strands of another protein, called tau, are found in dead and dying nerve cells. These twisted strands are called tangles. Tau protein is important to keep nutrient transport channels in brain cells straight and orderly. When tau protein collapses into twisted strands (tangles) in patients with Alzheimer’s, the nutrient tracks fall apart. This leads to a disruption of the transport of nutrients along brain cells, which eventually die.
M is for diet
Yes, M for diet: the Mediterranean type, or something similar.
The April 2006 online issue of the Annals of Neurology reported the results of a study involving 2258 people without dementia who were placed on the Mediterranean diet. The people who had the highest level of adherence to the diet had a 39-40% drop in their risk of developing Alzheimer’s, compared to the people who had the lowest adherence to the diet.
What is the Mediterranean diet?
This diet is rich in vegetables, legumes, fruits and cereals. It encourages a moderately high intake of fish, and a high consumption of unsaturated fatty acids, consisting mainly of olive oil. It advises a low intake of saturated fatty acids, meat and poultry, and a low to moderate consumption of dairy products, such as cheese and yogurt. It recommends moderate, daily alcohol consumption, mostly wine with meals.
DASH diet
This is the short form for the Dietary Approaches to Stop Hypertension. A study conducted by researchers at Utah State University followed more than 3800 people over 11 years and analyzed their adherence to the DASH diet, and evaluated their mental skills over time. Their data presented in 2009 showed that the people with the best adherence to this diet maintained their mental skills better than other participants. This does not prove that this diet prevents Alzheimer’s disease, but any measure which helps preserve mental function has to be of value.
What is in the DASH diet?
This diet recommends that you eat 8-10 servings of fruits and vegetables daily. It also encourages eating low fat dairy, nuts, legumes, and whole grains. It advises limiting the consumption of red meat, sugar, and sodium.
The second M: Motion
Several studies have shown that regular exercise can help preserve mental skills. But recent studies have also shown the effects of exercise on the structure of the brain, which can be affected by Alzheimer’s.
A study published in May, 2014 in Frontiers in Aging Neuroscience showed that people at high risk of Alzheimer’s (with an e4 gene) who exercised regularly for 18 months had changes in their brain structure. Compared to their counterparts who did not exercise, they were able to avoid shrinkage of the hippocampus region of their brains. Shrinkage of the hippocampus occurs commonly in Alzheimer’s disease.
Another study from the University of Wisconsin published in 2014 found positive brain structure changes in people who exercised at least five days a week. They had less reduction of glucose use by the brain, less hippocampus shrinkage, less collection of beta-amyloid plaque, and fewer neurofibrillary tangles in their brains. All of these problems are commonly noted in Alzheimer’s disease. The people who exercised also had better scores on cognitive tasks than their less active counterparts.
Lifestyle intervention
So why not combine diet and exercise? Swedish researchers did just that and presented their data at the Alzheimer’s Association International Conference in July 2014. Over 1200 older people at risk for dementia were assigned to lifestyle intervention or routine health care. After 2 years the group combining diet and exercise had improvements in mental function and cognitive skills.
What are you waiting for?
Alzheimer’s disease is a devastating illness, with no known cure, and a scarcity of simple, effective medications.
A sensible diet and regular exercise appear quite effective in the fight against this dreaded disease. If diet and exercise were pills, we would all be lining up at our doctors’ offices to get our supply.