Can Alzheimer’s Disease Be Prevented?
SOURCE: Medscape Medical News ~ June 24, 2013
Bret S. Stetka, MD
Reporting from The American Psychiatric Association’s 2013 Annual Meeting
“Do we have any control over our brain health as we age?”, Dr. Gary Small asked the crowd, a packed room of psychiatrists attending his “Brain Health and Alzheimer’s Prevention” talk at the 2013 Annual Meeting of the American Psychiatric Association (APA) in San Francisco, California. Nearly everyone raised their hands. “If the answer is yes,” he followed, “then what can we do to forestall the symptoms of Alzheimer’s disease (AD)?” For the next hour, conference-goers found out or, perhaps, given their line of work, brushed up.
Dr. Small is Professor of Psychiatry and Director of the UCLA Longevity Center at the Semel Institute for Neuroscience & Human Behavior. As session chair Dr. Brent Forester pointed out in his introduction, Small’s list of achievements is humbling: renowned clinician, cutting-edge researcher, author of over 400 scientific publications and 7 popular books, including his latest, The Alzheimer’s Prevention Program. His research has contributed to brain imaging methods capable of detecting AD years before symptoms are present; his healthy lifestyle and memory training programs are widely used throughout the United States. In 2002, Scientific American Magazine named Small one of the world’s top innovators in science and technology.
Up went an image of Madame Jeanne Calment, a French supercentenarian who lived to 122 years. “At 94, Calment sold her apartment to a businessman who agreed to pay her rent for the rest of her life. He died 10 years later,” said Small to the chuckling crowd. He was introducing the idea that certain lifestyles are associated with both longevity and brain health, a term encompassing our various neurologic faculties like memory, thinking, reasoning, mood, and stress responses. There are certain regions in the world — so-called “blue zones” — with abnormally high clusters of centenarians, most notably Sardinia, Italy; Loma Linda, California; and Okinawa, Japan. These regions share a number of characteristics thought to contribute to collective longevity and prolonged brain health on which Small would later expand: Namely, their inhabitants tend to be physically active, socially engaged, and eat a healthy diet high in omega-3 fats, just like the fish-heavy fare most likely enjoyed by Ms. Calment in the south of France.
With such striking epidemiologic examples, numerous lifestyle factors are now being taken seriously by researchers and clinicians as potential avenues for AD prevention, particularly given the current lack of disease-modifying treatments — in other words, the lack of a cure. Couple these insights with advances in neuroimaging and other biomarker tests that allow for early disease identification, and it appears we have at least some control over our brain health. But is lifestyle modification enough to actually prevent or significantly delay AD? Will adopting healthy habits heed results, or are other factors such as genetic influences standing in the way?
Background and Biomarkers