8/10: Preventing Alzheimer's Disease
As an older adult, perhaps you have grown a little more concerned about the possibility of acquiring a neurodegenerative disease, like Alzheimer’s, that might compromise the quality of your life and affect your lifespan. It is natural, as we get older and are more aware of our mortality, to become more concerned about our health and take measures to preserve it. Our Brain Fitness classes are designed to educate, inform, and help you learn how you can change your lifestyle in ways that will help preserve your brain health. Although we talk about things that affect our brains in both good and bad ways, we always conclude with a message of hope and concrete steps on how we can best maintain optimal brain health.
This lesson is one of hope. In this lesson, we focus on Alzheimer’s disease, a neurodegenerative disease that to many seems hopeless. But we will focus on the emerging consensus among scientists and the medical community that Alzheimer’s disease may indeed be preventable. This is one of the greatest messages of hope we can hear.
Activity
Leading neurologist and CNN chief medical correspondent Dr. Sanjay Gupta recently wrote an article that was published in the April 1, 2020 AARP magazine. Titled, “Sanjay Gupta’s Prescription for Brain Health,” the article claims that lifestyle changes are the key to resilience when it comes to Alzheimer’s disease. In other words—prevention is not only possible, but perhaps our best hope! Dr. Gupta discusses his thoughts about Alzheimer’s disease prevention, conclusions he came to after years of working in the field of neuroscience and medicine. We encourage you to read the article before continuing with the lesson.
After you have finished reading, please consider the following questions:
What did you think of Dr. Gupta’s article?
Is there something you learned or took away from reading it?
Please think about these questions and be prepared to discuss your thoughts during our final Zoom session this week.
Alzheimer’s Disease
Let’s start with a brief review of Alzheimer’s disease. Alzheimer’s is a neurodegenerative disease that impacts the brain, and is the most common form of dementia. It affects about 5 million people in the United States, typically older people over the age of 60.
In 1906, Dr. Alois Alzheimer, a German psychiatrist and neuroanatomist, diagnosed what would be the first official Alzheimer’s patient, a 50-year-old woman who had dementia. When Dr. Alzheimer autopsied his patient’s brain, he found strange plaques and twisted tangles. Since that discovery, those two features have been considered the defining features of Alzheimer’s disease.
Though there are many logical theories as to its origin, including the plaques and tangles theory, the cause of Alzheimer’s disease is still unclear. Scientists today believe, however, it is likely the result of numerous factors, including age, genetic profile, and possibly education, diet, and environment, among other things.
Some of the Latest Research
In a new study, primary author Dr. Caterina Scuderi, Assistant Professor of pharmacology and toxicology from Sapienza University of Rome, Italy, postulated that there are three “hallmarks” of Alzheimer’s disease in a person’s brain. These are: beta‐amyloid peptide deposits in the space around neurons; protein buildup inside neurons; and neuroinflammation. Speaking of neuroinflammation, Prof. Michael T. Heneka, of the Department of Neurology, University Hospital Bonn, Germany, found evidence in 2015 of “early and substantial involvement of inflammation in the pathogenesis of the disease” (Huzar, 2020). Dr. Seth Love, professor of pathology at the University of Bristol in England, noted that a core feature of Alzheimer’s is also a reduction in blood flow through the cerebrum of the brain, suggesting that the precipitating factor to Alzheimer’s is diminished blood flow to the brain (Kolata, 2019). This is likely occurring from 15 to 20 years before the onset of symptoms.
All of these studies suggest that early interventions could either slow the progression of Alzheimer’s disease, or significantly reduce it (Huzar, 2020). That is precisely what scientists, neurologists, and doctors are seeing more and more—that early intervention—in essence, prevention—can reduce the risk of ever getting this devastating disease.
Watch this short video (0:58 minutes) where Albert Hofman, MD, Ph.D., of the Harvard T.H. Chan School of Public Health, reflects on prevention being important in the fight against Alzheimer’s disease as we continue to seek future treatments for those who have it.
Sanjay Gupta, M.D.
Now let’s meet Dr. Sanjay Gupta. Dr. Gupta did not grow up wanting to be a doctor, and especially not a brain surgeon. What determined his career path was when his grandfather suffered a stroke while he was still a boy. Gupta became fascinated with how the brain functioned, how it could recover and adapt, and he developed a strong desire to unravel its mysteries. He later became a doctor and has been a surgeon and health journalist for more than 20 years. Today, he is CNN’s Emmy Award-winning chief medical correspondent. He is also an associate professor of neurosurgery at the Emory University School of Medicine in Atlanta, Georgia. During all his years working with the brain, Dr. Gupta has become convinced of a very profound fact--that the brain can change (we call that brain plasticity) and can be enhanced throughout our lives.
A Turning Point
Dr. Gupta tells the story about being on call in an emergency room several years ago, and treating a 93-year-old man who was brought in with a brain bleed. Thinking this man’s age would make operating too risky, Dr. Gupta talked with his family, expecting them to agree. But their reaction surprised him. Though the operation would be risky, the family all agreed it should be done. The man and his wife of 70 years were in perfect health. In fact, he received his injury when he fell from his roof while blowing leaves. His family attested to his mental agility, activity, and love of life. So Dr. Gupta agreed to do the craniotomy.
After the procedure, he took a few moments to look at this 93-year-old’s brain before closing up the surgical site and was surprised at what he saw. Having learned from the family how cognitively sharp and healthy this man was, he expected to see a robust and healthy looking brain to match. But what he saw was a brain that looked like it was 93-years-old—shriveled, sunken, and with deep wrinkles. That surprised Dr. Gupta. Having seen this man’s brain, Dr. Gupta would have expected him to be compromised in his cognitive abilities. But he was not. Dr. Gupta learned that day that it didn’t matter what the brain looked like; what mattered was how it performed. And this man’s brain performed robustly.
When Dr. Gupta visited this man in his hospital room after the operation, he found him reading his smartphone (and without reading glasses!) and recovering well. Dr. Gupta asked him about this experience and what he thought about it all. The man smiled and said, “The biggest lesson in all of this is no more trying to blow the leaves off the roof” (Gupta, 2020).
Prevention of Alzheimer’s Disease—Is it Possible?
This experience, combined with others, led Dr. Gupta to undergo a profound change in his thinking as a lifelong student of the brain. He began to care more about preventing disease from developing than treating it. He hoped to be able to say to his patients one day, “Yes, you have Alzheimer’s disease, but it will never cause you any symptoms” because of the person’s healthy lifestyle, choices, and habits (Gupta, 2020).
In his article, Dr. Gupta mentioned that scientists are finding that changes to the brain leading to diseases like Alzheimer’s probably begin long before symptoms develop. Many people could have the classic pathological signs of the disease (amyloid plaques, tangles, etc.), but not know it because they experience no symptoms. Knowing this helped Dr. Gupta realize how important focusing on prevention really is.
Dr. Gupta’s Personal Preventative Habits
In the article, Dr. Gupta outlined several things he personally changed in his own life since he turned 50 in an effort to build up the resiliency of his brain. Some of the changes Dr. Gupta made (and some we should consider) were:
Socializing. Rather than thinking of socializing with others as something that is just fun to do, Dr. Gupta began to look at socializing as a brain-building activity that is crucial for building a more resilient brain. We have learned in our Brain Fitness class how important good relationships and a strong supportive network is to our brain health. Dr. Gupta confirms this. He states that by interacting with others socially, we strengthen our prefrontal cortex, the area of the brain where judgment and decision-making occur. When our prefrontal cortex is stronger and more robust, it decreases the amount of activity in the limbic system (the emotional center of the brain). That means we process situations longer in the prefrontal cortex and less in the limbic system, and make better, more logical decisions. This leads to further resilience in the brain and a better ability to handle challenges that come to us.
Decisiveness. According to Dr. Gupta, when we are more decisive and take action rather than letting problems linger without resolving them, it builds better resilience in the brain. Decisiveness moves us toward our goals, and we gain confidence and a more positive view of ourselves as we make even small strides toward our personal goals.
Gratitude. Dr. Gupta mentions that practicing the expression of gratitude on a regular basis helps build a resilient brain. It floods the brain with reward chemicals, naturally decreases stress, and lessons anxiety and depression—all things that build resilience in the brain.
Sleep. Dr. Gupta changed his attitude about sleep from getting by on as little as possible to making sleep a priority in his life. He confirms what we have learned about sleep in this class—that it is a time when the brain organizes what it has learned during the day, consolidates memories, and clears the waste it has accumulated. It is critical to good brain health.
Self-Discovery. Dr. Gupta tries to learn something new about himself every day, believing this is one way to develop greater appreciation and gratitude in life. He also believes it gives perspective and a means to enhance what is good in our lives, and better handle that which is not good.
On the changes he has personally made in his life to build a more resilient brain, Dr. Gupta boldly states, “it's up to me to protect and preserve my brain and its memories. All it really takes are some basic lifestyle strategies” (Gupta, 2020). He believes that is true for all of us.
Dr. Gupta’s Visit to our Brain Fitness Class
Those of you who were in the Brain Fitness afternoon classes a few years back have a soft spot in their hearts for Dr. Sanjay Gupta. He and his crew from CNN spent a few days in San Diego interviewing and filming one of our long-time Brain Fitness students, Kathy Lasky, and visiting our class. We found him to be intelligent, personable, and very committed to what he does. Watch the video clip produced and broadcast by CNN worldwide about their visit with Kathy and our Brain Fitness class, and about how BrainHQ plays such an important part in optimizing brain health. Below are a few pictures from his visit.
Interested in Learning More?
If the notion of preventing Alzheimer’s disease is of interest to you and you would like to explore it further, please consider signing up for a new course being offered this Fall called “Alzheimer’s: The Science of Prevention.” It is an online class taught by Debbie Flores and is based on a groundbreaking documentary series of the same name. Broadcast in 2019, it features input from more than 20 recognized experts in the field of neuroscience and medicine as they discuss this most important health challenge facing older adults today. The course will explore the bold claim that Alzheimer's disease can be prevented and provides a framework for students to analyze the data and make meaningful changes in their lives that could lead to the prevention of Alzheimer's disease. Contact Debbie Flores for more information (dsflores@sdccd.edu).
Conclusion
We have explored a message of hope—that Alzheimer’s disease may be preventable when we change our habits and follow a healthier lifestyle. We’ve learned about some of the recent research about Alzheimer’s disease, and about Dr. Sanjay Gupta’s belief that lifestyle changes are the key to resilience when it comes to fighting it. We hope you will seriously consider this information and how you can live a healthier life. We also hope you will consider learning more by taking the new class on Alzheimer’s prevention in the Fall semester!
Works Cited
Gupta, S. (April 2, 2020). Sanjay Gupta’s prescription for brain health. AARP [Online]. Retrieved from: https://www.aarp.org/health/brain-health/info-2020/sanjay-gupta-brain-health.html
Huzar, T. (May 7, 2020). Targeting early brain inflammation may slow down Alzheimer’s. Medical News Today. Retrieved from: https://www.medicalnewstoday.com/articles/targeting-early-brain-inflammation-may-slow-down-alzheimers#Alzheimers-disease
Kolata, G. (April 8, 2019). It’s not just Alzheimer’s. Brain Fitness News (Posit Science). Retrieved from: https://mailchi.mp/brainhq/brain-fitness-news-april-2019?e=0cd9c7bc8e