Alzheimer’s Expert Panel Discussion and Summary: How to reduce risk, what to look for as a caregiver, genetic factors, and nutrition for brain health
NeuroReserve founder Dr. Ed Park was recently joined by a panel of medical experts and advocates for an Instagram Live to spread awareness and education on Alzheimer’s and related dementias. The panel included Dr. Thomas Holland, a physician at Rush University Medical Center, nutrition expert, and neuro-epidemiologist, Dr. Annie Fenn, founder of the Brain Health Kitchen, Elizabeth Humphreys, founder and executive director of Mind What Matters nonprofit, and Nikki Deloach, an actress, producer and brain health advocate and activist. Here, we provide highlights of the discussion driven by questions from the community on topics such as prevention, nutrition, genetics, caregiving, and more.
Prevention (Skip to 06:45)
The panel discussed several things we can actively do each day to reduce our risk of Alzheimer’s.
- From a dietary perspective, the MIND, Mediterranean, and DASH diets have all been associated with a reduced risk of Alzheimer’s in observational studies.1
- Physical activity was emphasized which includes aerobic, strength training, and stretching.2
- Cognitive activities and cognitive training can also have a big impact on brain health as we get older, especially learning new things and using the brain in different ways.
- Getting good quality and quantity of sleep gives the body time to relax, reset, and offers anti-inflammatory benefits.3
- Stress reduction is another key element to supporting brain health as stress can induce inflammation in the brain.4
- Having a good social life is also important for your brain. In fact, studies have shown that a more active social life is associated with a reduced risk of cognitive decline.5
- Checking on general health measures including eyesight, hearing, cholesterol, glucose, dental health and regularly seeing a PCP can help identify any other health issues that may be taking a toll on the brain.
Nutrition (Skip to 12:00)
Dr. Annie Fenn and the group dove deeper into nutrition, explaining how the MIND diet encourages regular consumption of berries, leafy greens, vegetables, nuts/seeds, fish, legumes, whole grains, and olive oil.6 Some advice on how to start with a brain-healthy diet is to keep it simple by eating more of the foods that you enjoy that are also neuroprotective. For example, if you pick 3 food groups – such as berries, fish/seafood, and leafy greens/vegetables - pick one food you like from each group and try to have it once a week.
Dr. Holland specifically noted that we should be aware that it takes time for the body to catch up when you change your diet. The microbiome can take a month to adjust to a new way of eating and it can cause some GI upset during the transition phase, but it doesn’t mean these foods are bad for you. Start small and build up with what you can tolerate. The microbiome is complex, and it is closely linked to the brain, so having good gut health helps the brain utilize powerful nutrients to stave off disease.
Caregiving (Skip to 27:15)
Liz Humphreys explained that personality changes can start years before a diagnosis and can cause a lot of challenges within families. Different family members may disagree about what to do about it or if it’s a sign of a larger problem at all. Some early signs may be small like not enjoying activities they’ve always loved, or may be more obvious like suddenly lacking empathy. When faced with these challenges, it’s important to get help and seek counseling.
On the grief side of caregiving, Nikki DeLoach emphasized that you begin to grieve the moment you get the diagnosis, or even before. You have to be patient with yourself and others and come to terms with the fact that other people may not understand what you’re going through. Grief is a long process, and you will always live with grief after a loss, but you find ways to live with it.
Genetics (Skip to 38:18)
APOE is a gene that codes for the protein apolipoprotein E which, among other things, is involved in breaking down fats. There are several forms (or alleles) of the protein, and one form called APOE e4 is associated with a higher risk of developing Alzheimer’s Disease. APOE e2 is thought to be protective against Alzheimer’s and APOE e3 is a “neutral” allele.7 You inherit one allele from each parent, so you may have one or two alleles for APO e4, which can increase your risk of Alzheimer’s. For instance, you may have one allele of APO e4 and one allele APO e3, which would increase your risk. And if you have two alleles of APO e4, it increases your risk even more. Regardless of what alleles you have, it is not a definitive gene that causes Alzheimer’s. It’s just a risk factor, and lifestyle choices like nutrition and exercise and the other factors mentioned at the beginning of the discussion allow you to make up for the added risk.
In fact, in one part of Italy, having the APO e4 allele doesn’t increase your risk of Alzheimer’s at all. This may be due to lifestyle factors, and this provides strong evidence that those people with a genetic susceptibility are not necessarily destined to get the disease.
Women's Risk (Skip to 45:20)
To wrap up our discussion, we get into women’s risk. Women with APOE e4 tend to have an accelerated path (up to 5 years faster) to Alzheimer’s compared to men. Research from Dr. Lisa Mosconi at Weill Cornell Medicine has shown that at the time of menopause women’s brains change and become more vulnerable to Alzheimer’s.8 This is thought to be related to why Alzheimer’s is more common in women compared to men.
However, the brain is resilient. Get into a brain health mindset where you acknowledge how important your brain is and what you want to focus on to protect it. As the panel discussed, there are many things you can do today for long-lasting brain health.
Thank you to our panel guests for this wonderful discussion!
- van den Brink, A. C., Brouwer-Brolsma, E. M., Berendsen, A. A. M., and van de Rest, O., The Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) Diets Are Associated with Less Cognitive Decline and a Lower Risk of Alzheimer’s Disease—A Review. Adv. Nutr., 2019, 10, 1040–1065.
- Chapman, S. B., Aslan, S., Spence, J. S., et al., Shorter term aerobic exercise improves brain, cognition, and cardiovascular fitness in aging. Front. Aging Neurosci., 2013, 5, 1–9.
- Bubu, O. M., Brannick, M., Mortimer, J., et al., Sleep , Cognitive impairment , and Alzheimer ’ s disease : A Systematic Review and Meta-Analysis. Sleep, 2017, 40, 1–18.
- Munhoz, C. D., García-Bueno, B., Madrigal, J. L. M., Lepsch, L. B., Scavone, C., and Leza, J. C., Stress-induced neuroinflammation: Mechanisms and new pharmacological targets. Brazilian J. Med. Biol. Res., 2008, pp. 1037–1046.
- James, B. D., Wilson, R. S., Barnes, L. L., and Bennett, D. A., Late-Life Social Activity and Cognitive Decline in Old Age. J Int Neuropsychol Soc., 2011, 711–716.
- Morris, M. C., Tangney, C. C., Wang, Y., Sacks, F. M., Bennett, D. A., and Aggarwal, N. T., MIND diet associated with reduced incidence of Alzheimer’s disease. Alzheimer’s Dement., 2015, 11, 1007–1014.
- Yassine, H. N. and Finch, C. E., APOE Alleles and Diet in Brain Aging and Alzheimer’s Disease. Front. Aging Neurosci., 2020, 12, 1–19.
- Mosconi, L., Berti, V., Quinn, C., et al., Sex differences in Alzheimer risk. Neurology, 2017, 89, 1382 LP – 1390.