Our genetic vulnerability to dementia, and specifically Alzheimer's disease, varies as reflected at least partly in our family medical histories. If you have older relatives with Alzheimer's, your risk may be higher than average. But variation in genetic vulnerability to disease is not destiny as long as there are opportunities to defend ourselves, and change our fate. There is defense against dementia.

That point got relatively little attention in a report issued by the Alzheimer's Association, "2008 Alzheimer's Disease Facts & Figures."

Above age 55, up to 21 percent of women and 14 percent of men will develop dementia, roughly 60 percent to 80 percent of which is due to Alzheimer's.

Doing the math for Baby Boomers suggests that roughly 14 million people will develop Alzheimer's in their lifetimes. At present, some 5.2 million Americans are affected.

The new report highlights the significance of this trend from both the human and societal perspective.

Most of us already know something of the pain and suffering Alzheimer's can impose on a family, so the prospect of many more families contending with that burden is rather grim.

In addition, the long-term care required by those with advanced dementia has the potential to overwhelm the health care system, exceeding capacity in both facilities and finances.

The objective of the Alzheimer Association report was clearly to alert us all to the burgeoning problem of dementia in an aging population, and the need to make preparations.

This is good advice, and well heeded. But if ever an ounce of prevention was worth a pound of cure, it is here and now. Much of the predicted Alzheimer burden need not occur.

Heart Health and Brain Health
The association between dementia risk and risk factors for heart disease is quite strong. Available evidence suggests that controlling cardiac risk factors can lower dementia risk by 50 percent or more.

See a doctor at regular intervals to have your blood pressure and cholesterol monitored.

High cholesterol can contribute to dementia by accelerating the development of atherosclerosis; controlling blood lipid levels with diet or medication can protect against this.

High blood pressure can damage the blood supply to the brain in several ways, and is the leading risk factor for stroke. At least one European study suggests that treatment of high blood pressure all by itself can cut dementia risk in half.

While the scientific evidence linking cigarettes to dementia per se is equivocal, the link between smoking and vascular disease is clear, and strong. So avoid tobacco to protect your brain by protecting the blood vessels that nourish it.

Food for Your Brain
There is some evidence to support what most of us have heard about "brain foods."

Fish consumption appears to protect brain function, most likely by contributing omega-3 fatty acids to the diet. A fish oil supplement, 1 to 2 grams daily, is an alternative. Antioxidants in food appear to be protective as well, contributing to the reputations of blueberries, red wine and green tea.

But while an inventory of potential brain foods can be assembled, the evidence is much stronger for the importance of the overall dietary pattern. Eating well is as important to the brain as it is to the heart. Lower your risk of Alzheimer's with plenty of vegetables and fruits, whole grains, beans and lentils, olives and avocado, nuts and seeds.

Limit consumption of highly processed foods, fast foods, sugar, salt, saturated and trans fat. Physical activity, too, nurturers the health of body and mind alike.

There is some evidence that poorly controlled stress, lack of sleep, and various nutrient deficiencies -- vitamin E, vitamin C, and vitamins B12 and B6 in particular -- may increase the risk of dementia. Controlling stress, getting adequate sleep and a balanced diet with or without a multinutrient supplement may all confer protection.

Brain Exercise
Finally, population studies consistently suggest that those who exercise their brains protect their minds from dementia.

Crossword puzzles and Sudoku are aerobics for your brain.

Just as physical activity defends the body against aging and infirmity, mental activity seems to help preserve the vitality of the brain. For a summary of defenses against dementia, visit http://www.alzheimersprevention.org/index.html.

As we enter the genomic age, we are learning more and more about the vulnerabilities housed in our genes. But more knowledge about the effects of genes on health is not the same as knowledge about more effects of genes on health. What we knew before about disease prevention through lifestyle intervention is still valid.

Dementia risk is not the same as destiny. We should prepare for the public health burden of more dementia as the population ages.

But by applying what we know about prevention, we should be able to create a future in which grim predictions about the rate of Alzheimer's Disease don't come true.

Dr. David L. Katz can be reached at www.davidkatzmd.com.

Source: New Haven Register. Provided by ProQuest Information and Learning. Powered by YellowBrix.

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