Commentary - October 30th, 2013
10:19 am
Wed October 30, 2013

Alzheimer's

Good evening.  I’m Susan Kohler, CEO of Missoula Aging Services, the Area Agency on Aging for Missoula and Ravalli counties.  Tonight I want to share some information about Alzheimer’s disease which I learned at the UM Geriatric Education Center’s Conference in mid-October.  But first I’d like to say “Hats off!” to the GEC for providing this free, top notch conference broadcast to 25 sites in Montana.  What I share are snippets from a variety of the excellent speakers who discussed the latest research on treatments, and the interrelationship that lifestyle risk factors and genetic influences have on the development of Alzheimer’s.

Today Alzheimer’s affects 13 percent of the population who are 65 or older. Every 68 seconds someone develops this disease. Currently no cure exists, and medication has only marginally helped slow its progression. By the year 2050, 22 percent of the population will be affected, at a cost of $1.2 trillion to provide care. If that doesn’t grab your attention, nothing will.

Alzheimer’s disease is a public health crisis. Despite our country’s progress in decreasing the number of people who die from heart disease, breast and prostate cancer, the number of people with Alzheimer’s continues to rise. Only the UK, Sweden and Denmark have seen a 30 percent drop in Alzheimer’s. Without the benefit of detailed study, speculation is that the decrease is due to the benefits of primary preventive care for all citizens, including education about the effects of smoking, better diets and higher education. Whether such a dramatic drop in cases of Alzheimer’s could occur in the U.S. is unknown, especially considering our much higher rate of obesity.  But obviously something is working in those countries.

I came to the conference wondering if there is a clear way of knowing what causes this degenerative disease and if so, what can I, and others, do to prevent it?  Are genetics and family history the primary risk factors, or are there modifiable factors that we can control? 

What I learned is that genetic predisposition is part of the story. If one or more family members have had Alzheimer’s, or if you carry the gene E4, you have a 20 to 30 percent chance of developing it. Yet people with no genetic predisposition get Alzheimer’s, too. In these cases, lifestyle practices appear to be the key risk factors. These include smoking, psychological stress, chemical exposure and the recently highlighted effects of concussions and traumatic brain injuries.

The good news is that the lifestyle factors which increase the risk of developing Alzheimer’s are modifiable. Even those who are higher risk due to genetics can delay the onset by adopting healthy living habits. Many of these interventions are the same basic strategies used for preventing cardiovascular diseases, including good nutrition, keeping your weight down, education, medication, aerobic and resistance exercises. 

Several speakers spoke about red wine consumption as a possible way to reduce risk for those without the genetic predisposition to Alzheimer’s. This is because red wine contains the powerful antioxidant resveratrol.  So why hasn’t the focus been on consuming non-alcoholic antioxidants loaded with resveratrol, like blueberries?  Apparently it’s because one would need to ingest 29 pounds of blueberries to equal the effect of drinking two glasses of red wine.  Obviously, more study is needed to find alternative ways to reap the benefits of resveratrol. Consuming alcohol brings its own issues, among them its high level of toxicity on the brain. 

Other speakers addressed the treatment of Alzheimer’s patients who are agitated and exhibiting behavioral issues. The first line of treatment is often with antipsychotics, which tend to sedate a person. Promising research now shows that the drug Prazosin is also effective but without the sedative effects. Working with the causes of behavior rather than immediately medicating may also help curtail the widespread misuse of medication, a problem in facilities which care for people with Alzheimer’s.

At the end of a full day of information, a panel of caregivers—all spouses of persons with Alzheimer’s--brought it down to the reality of those who are affected by this dreadful disease.  These brave individuals shared their heart-wrenching stories of the overwhelming financial and emotional toll which caregivers endure.  Their stories tied it all together and convinced me that this disease is indeed a public health crisis needing more attention. I left humbled and motivated to advocate for more research toward preventing and curing Alzheimer’s.

You can learn more about the information shared at the conference at this website: www.health.umt.edu/mtgec/home.  If you missed that, my commentary is online at mtpr.org and you’ll find the link there. This is Susan Kohler, CEO of Missoula Aging Services, and as always, thanks for listening.

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