Monday, 17 October 2016

Prevent Alzheimer’s? Yes, We Can! What did we learn at the Smith Lecture on Dementia?

Professor Emeritus A. David Smith of the University of Oxford has worked at the frontiers of neuroscience for more than 50 years.In particular he has been at the forefront of research into novel treatments and techniques for Alzheimer’s disease and dementia. 

A packed audience sat enthralled as Emeritus Professor A. David Smith (University of Oxford, UK) spoke of his research into novel treatments and techniques for Alzheimer’s disease and Dementia during the BRNZ Inaugural Public Lecture on 3 February 2016 sponsored by the Neurological Foundation and Brain Research New Zealand.

Then came this question from the audience:
“Can we prevent Alzheimer’s?”

“Yes, we can!” was Prof. Smith’s resounding reply.

Here’s How:

Prof. A. David Smith’s recommendations:

·                Stop smoking.
·                30 minutes of brisk exercise each day (enough to get you puffing and sweating).
·                If you have diabetes and/or high blood pressure, take drugs that effectively treat these.
·                Increase the Mediterranean elements of your diet, especially your 5+ a day of fruit and vegetables.
·                Eat fish once or more a week.
·                Watch your blood glucose.
·                Make sure your vitamin D and B12 status is good.
·                If you do have memory problems, get your homocysteine checked.  (Homocysteine is a common amino acid in your blood. You get it mostly from eating meat. High levels of it are linked to early development of heart disease. In fact, a high level of homocysteine is a risk factor for heart disease. It's associated with low levels of vitamins B6, B12, and folate, as well as renal disease.)
·                If it’s high, take B vitamins in consultation with your GP.
·                Keep mentally and socially active

Here’s Why

Prof. Smith cited, (among others), the Caerphilly Cohort Study.  Read the full study
Twenty-five years ago, 2,235 men between the ages of 45 and 59 agreed to take part in a longitudinal study.  They were tested again in 2013.

The group who had adopted these healthy behaviours:

·                Non-smoking
·                Consuming more than 3 portions of fruit / vegetables a day
·                Consuming less than 30% of calories as fat
·                Taking daily exercise
·                Drinking less than 3 units of alcohol per day

had a 64% lower risk of dementia.  It’s as simple as that!  (Visit the Neurological Foundation for a full coverage of Professor Smith’s presentation.)

Is Alzheimer’s inherited?
When asked if Alzheimer’s Disease is caused by our genes, Prof. Smith dispelled that myth.

‘Less than 1% of dementia cases are entirely genetic’.

About 20% of the population has common gene mutations (called susceptibility genes) which may slightly increase the risk of developing dementia, but in 99% of all cases, dementia does not have genetic causes.

Most common risk factors for dementia are NOT genetic. Here they are:

·                Age
·                Smoking
·                Mid-life high blood pressure, high cholesterol and obesity
·                Depression
·                Low social activity
·                Physical inactivity
·                Low education
·                Diabetes and high blood sugar
·                Low intake of omega-3 fatty acids
·                High blood homocysteine (due to low levels of B vitamins)

Here’s the best news! Dementia CAN be prevented.

Please find below links to an overview of Professor Smith's lecture on Dementia and his presentation.

1.   Click here for Professor Smith's presentation

2.   Click here for an overview of Professor Smith lecture

Science Note:

What’s the difference between Dementia and Alzheimer’s Disease?

Dementia is an umbrella term used to describe a group of conditions that affect how well our brains work.

The most common form of dementia is Alzheimer’s disease – which around two-thirds of people with dementia have.

The symptoms each person experiences depends on the parts of the brain that are affected. However, the most common dementia symptoms include changes in memory, thinking, behaviour, personality and emotions. These changes affect a person’s ability to perform everyday tasks and interfere with their everyday lives.

Why does Alzheimer’s affect people differently?

QUESTION: Both my mother and my father-in-law suffer from Alzheimer’s disease. We’re told that they both seem to be at about the same point in the physical progression of the disease. But my father-in-law has remained fairly lucid, while my mother is more confused and forgetful. What could account for this?

Harvard Medical School’s Adviser gives the answer:

ANSWER: The tremendous number of nerve cells and connections between cells in a healthy brain provide a seemingly infinite capacity for processing information. It also provides a margin of safety in case some cells are damaged. In Alzheimer’s disease, however, the wholesale destruction of nerve cells eliminates this safety net, especially in the brain areas involved in memory and cognition.

But as you’ve noted, the disease doesn’t always affect people in the same way or with similar severity. Consider two older people with the same amount of Alzheimer’s disease–related plaques and tangles in their brains. One person has some memory miscues now and then, but continues to lead a relatively normal life. The other has the severe loss of memory and other cognitive deficits that typify Alzheimer’s disease.

Why the difference? One explanation is that they had differing amounts of cognitive reserve. Cognitive reserve can protect you from the effects of Alzheimer’s and other diseases that affect the brain.

Cognitive reserve can be thought of as having two parts, hardware and software. The hardware consists of brain cells, or neurons, and connections between those brain cells, which are called synapses. The theory is that people with more brain cells and synapses at their disposal are better able to maintain cognitive functions even after important brain cells are damaged.

The software is the brain’s capacity for finding alternative circuits and neural networks if disease or injury is blocking the usual ones. People’s cognitive abilities can stay roughly the same if their brains are adept at these workarounds.

Brain reserve capacity — the term sometimes used for the hardware — is, in large part, genetically determined. But the human brain is capable of generating new synapses and neurons throughout life, and the input of stimulating experiences has been shown to alter brain structure.

There is plenty of research to back up this idea. Brain scans of people learning to juggle show increases in the size of brain structures linked with the visual processing of movement. MRIs of the brains of London taxi drivers have shown that they have larger-than-normal posterior hippocampi, an area of the brain involved in spatial memory.

Formal educational achievement is an important factor, but virtually any mentally challenging or engaging activity seems to have a positive effect on cognitive reserve.

Some research has found that crossword puzzles, Sudoku and other “brain exercise” activities have a narrow effect: That is, if you do Sudoku puzzles, you become better at doing Sudoku puzzles and little else.

But a study showed that Sudoku and other puzzles also made older people more open to trying new things, so there’s still much more to be learned in this area.

Physical activity may be just as important as mental activity for brain health and building up cognitive reserve. Dozens of studies have shown it to have a pronounced effect, and aerobic exercise that gets your heart rate up may be especially important.

Exercise seems to affect the brain directly, increasing the number of synapses and enhancing the action of neurotransmitters, the chemicals that make brain cell-to-brain cell communication possible. It also increases the production of brain-derived neurotrophic factor (BDNF), a “brain juice” protein that promotes the production of new brain cells and the survival of existing ones.

Physical activity also has indirect effects. If your heart and lungs are strong and healthy, more oxygen-rich blood will circulate to the brain. And exercise controls and reduces the risk of conditions like diabetes and high blood pressure that can put brain cells in harm’s way.

For the brain and the rest of the body, the wisdom of Hippocrates may be as true today as it was 2,400 years ago: That which is used develops that which is not used, wastes away.

Start your brain training today!

(Sources:  Memory Foundation, 8 April 2012, Neurological Foundation of New Zealand, 3 February 2016))