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Prevent Alzheimer's With Healthy Living

Strategies to Reduce Risk of Heart Disease and Stroke May Help Prevent
Dementia

By Sid Kirchheimer WebMD Medical News
Reviewed By Michael Smith, MD
Friday, September 12, 2003

Sept. 11, 2003 (Philadelphia) -- New discoveries suggest that the war
against Alzheimer's disease may be better fought on a different front --
by launching an offensive attack in trying to prevent the disease
decades before symptoms appear, often with the same offensive strategy
used to fight heart disease and stoke.

The same risk factors linked to heart disease and stroke -- high blood
pressure, high cholesterol, sedentary lifestyle, smoking, and diabetes
-- also increase the risk of Alzheimer's disease, which currently
affects about 4 1/2 million Americans, including half of those over age
85, and is expected to triple by 2050.

In fact, within only three months of having a stroke, about one in four
patients develop memory and other thought impairments, and two in three
eventually develop Alzheimer's disease, says Vladimir Hachinski, MD,
professor of neurology at the University of Western Ontario in Canada
and editor-in-chief of the medical journal Stroke.

"The key is prevention," he tells WebMD. "And the time to do it is
middle age. By taking measures to reduce your risk of stroke and heart
disease, you can also reduce the risk of Alzheimer's."

At the American Medical Association's annual Science Reporters
Conference, Hachinski and another neurologist, Samuel Gandy, MD, of
Thomas Jefferson University, reviewed some recent discoveries that
indicate a connection between the three conditions and are leading to
more emphasis on preventing, rather than treating, Alzheimer's disease,
just as is done with heart disease and stroke.

Currently, many Alzheimer's disease patients are now treated with drugs
such as Aricept, Reminyl, and Cognex. The so-called "cholinesterase
inhibitors" increase the level of a chemical acetylcholine, which helps
nerve cells in the brain communicate with each other. People with
Alzheimer's disease and related conditions have decreased brain levels
of this chemical.

"But the drugs we use today are only modestly effective," says
Alzheimer's disease specialist Samuel E. Gandy, MD, PhD, director of the
Farber Institute for Neurosciences at Thomas Jefferson University. They
slow progression of the disease but do not stop it.

Several studies have suggested that statins, the same drugs used to
lower high cholesterol in an effort to reduce risk of heart disease and
stroke, offer promise. That's because statins, and in particular,
Lipitor, help destroy the other telltale sign of Alzheimer's disease --
increased levels of amyloid, a sticky substance not unlike cholesterol
that forms plaques in the brain.

Some of these studies indicate that people who currently take statins
are less likely to develop Alzheimer's disease, and one suggested the
popular cholesterol-lowering drugs, by themselves, might reduce the risk
of developing Alzheimer's disease by as much as 39%.

But Gandy says that an experimental drug, known as PI3KI, may double the
positive effects of statins. However, that drug is still being studied,
and Gandy doesn't advocate people take statins specifically to lower
their risk of Alzheimer's disease.

So what can you do now to reduce your later risk of Alzheimer's disease?

The same often-preached advice is a good start. "Exercise regularly, eat
a low-fat diet, and manage your blood pressure and cholesterol levels,"
says Hachinski.

Among the less obvious preventative strategies:

* Enroll in a clinical trial. "The first advice I would offer is to
enroll in a clinical trial studying stroke or Alzheimer's," he tells
WebMD. In these trials, patients often get experimental drugs that have
initially proven to show promise in disease treatment or prevention.
"Even if you get a placebo, you'll undergo close medical evaluation and
monitoring."
* Deal with depression, now. "Depression in middle age is a big
predictor of Alzheimer's and possibly stroke," he says. In fact, a study
published in May indicates that people with a history of symptoms of
depression are twice as likely to develop Alzheimer's disease.
* Try to limit "free radical" damage. A type of fat called isoprostanes
may be an indicator of amyloid plaque, says Gandy. And environmental
pollutants, smoking, and a high-fat diet are known to play a role in the
development these isoprostanes. Perhaps this is why some previous
research has suggested that vitamins C and E, considered among the most
powerful antioxidant nutrients, seem to offer some protection against
Alzheimer's disease.

http://my.webmd.com/content/article/73/88956.htm