Alois Alzheimer was a German neurologist. He described dramatic changes in memory, mood and behaviour in a female patient over a century ago. The disease that carries his name is one of the most important health problems facing our society. Dementia, which literally means the loss of one's mind, affects over 25 million people worldwide – and it is projected to increase fourfold over the next forty years. Most people live with Alzheimer's for over a decade, making it the leading cause of disability in the world.

The growing epidemic of Alzheimer’s dementia is typically blamed on the aging of the population, but that is only part of the story. There are many lifestyle and environmental factors that have been linked to this syndrome, and their importance is growing. Thankfully, there are some powerful strategies for prevention – and treatment. These are clear when you understand what this disease really is.

What is going on in the Alzheimer brain

Before we discuss Alzheimer’s, let us be clear that it is only one of many possible causes for dementia. Although it is the most common cause – responsible for around 60% of cases – it is important to rule out other problems that can cause these changes in brain function. The next most common cause is several small strokes; vitamin deficiencies, hypothyroidism and other diseases can also cause dementia.

Many people are afraid that they might have early Alzheimer’s. Some forgetfulness is normal as we age, but a new screening tool called the Montreal cognitive assessment is the simplest way to identify early dementia.¹ Although a definite diagnosis can only be made with an autopsy after death, a new kind of PET scan available in some specialized centres can diagnose Alzheimer’s.² Currently, CT or MRI can rule out other causes so be sure to have one done at some point so you know what you are dealing with.

Next, we will clarify what happens to the brain in Alzheimer’s disease. The critical step is an increase in beta amyloid in the brain. Beta amyloid is a protein that damages nerve cells that produce acetylcholine, a key neurotransmitter – this is what we call chemicals that transmit signals from one brain cell to another. There are many factors that have been linked to excess beta amyloid – including high cholesterol, diabetes, toxic metals like lead and mercury, general inflammation and even common viral infections like the one that causes cold sores.

Some people are at greater risk of Alzheimer’s because of their genes. The familial form can strike at a younger age and is usually more severe. The most common genetic risk factor is called apoE. This stands for apolipoprotein E, which is involved in building the structural scaffolding of neurons. Interestingly, it has recently been shown that the wrong kind of apoE is much more easily damaged by mercury, which may put these people at particular risk of toxicity from mercury exposure. It is possible to be tested to find out your apoE status.

Rational treatment and prevention

Since the beta amyloid damages cells that produce acetylcholine, most drugs to treat Alzheimer’s work by increasing the amount that is released by the cells that remain. They do not actually help these cells or reverse the damage that was already done, and the truth is that they don’t make much difference. The most common of these, called donepezil, costs thousands of dollars per year and has been shown to improve symptoms of dementia very slightly – by ³ points on a scale of 0 to 70.3

The treatment that makes the most sense is preventing the beta amyloid from being formed in the first place. There is growing evidence that lowering cholesterol prevents Alzheimer’s, and this should be a priority for anyone at risk. In a recent study looking at brains of people after death who had been taking statin drugs, those brains were five times less likely to demonstrate the changes of Alzheimer’s.⁴ Statins come from red yeast rice, a Chinese nutritional supplement that may cause less side effects. Anyone using statins should take supplemental coenzyme Q10 to prevent free radical damage to the brain.

One major clinical trial showed that vitamin E slows down Alzheimer’s.⁵ This powerful antioxidant comes in several forms, and the alpha form was used in the study. Recent research shows that the gamma form is actually a much more powerful antioxidant. A high-quality vitamin E supplement should be labeled mixed tocopherols – meaning it contains both.

Turmeric may be an Alzheimer’s blockbuster. The disease is much less common in India, and turmeric may be responsible for this. The yellow spice contains a powerful healing ingredient called curcumin that does many wonderful things to the body, with antioxidant, anti-cancer and anti-inflammatory effects. Clinical trials are underway in California but there is no reason to wait. Use the spice with black pepper to increase absorption. Take supplements or add to stir-fried vegetables, eggs or even popcorn.

Turmeric is not the only plant that can benefit the brain. Many clinical trials have consistenly that Gingko biloba slows down the progression of Alzheimer’s. Another herbal medicine, called Huperzine A, comes from a club moss from China. The human trials on Huperzine are not as large as those for gingko, but they point to a much greater potential benefit.

Research linking diet and Alzheimer’s risk has provided us with powerful insights into food choices that promote brain health. Omega-3 fats are very important for the brain, as are antioxidants from fruits and vegetables. Particularly important are superfoods like blueberries, broccoli, green tea and other antioxidant-rich natural medicines.

Use it or lose it

Exercising the brain is absolutely critical. This includes brain work – like crosswords, strategy games, learning new tasks or languages, playing video games, varying your environment or simply playing games like writing with your left hand (if you are right-handed). Research consistently shows that people who use their brains more often and challenge their brains in more ways have much less risk of Alzheimer’s.

Equally important are exercises that involve the body – especially those requiring balance and hand-eye coordination like ping pong or racquet sports. This is partly because of increased blood flow to the brain, which presumably delivers nutrients and removes toxins, but also because although it feels like your body is doing all the work, the master control device is your brain; the more you do, the more it does.

An intelligent approach to diet, exercise and lifestyle, combined with a good supplement program and proper testing and treatement of underlying problems, is the best way to keep Alzheimer’s at bay. Find out if you are at risk and learn how to protect your brain – it’s the most important part of your body and preserving it is the best thing you can do to maintain the quality of life you want for as long as possible.

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3. Cummings JL. Alzheimer’s Disease. N Engl J Med. 2004;351:56-67.
4. Li G, Larson EB, Sonnen JA, Shofer JB et al. Statin therapy is associated with reduced neuropathologic changes of Alzheimer disease. Neurology. I2007;69:878-85.
5. Sano M, Ernesto C, Thomas RG, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer’s disease. N Engl J Med. 1997;336:1216-22.