Insight into Alzheimer’s ‘Prevention through Delay’

Some of you might have caught my BlogTalkRadio interview last week with Dr. William R. Shankle, neurologist, author of Preventing Alzheimer’s: Ways to Help Prevent, Delay, Detect, and Even Halt Alzheimer’s Disease and OtherForms of Memory Loss
and medical director of The Shankle Clinic.  I want to share some of the ‘new’ information I learned in that interview.

I’ll digress just a moment to share a few statistics.  The Alzheimer’s Association’s  2009 Report states there are 5.3 million with Alzheimer’s in this country.  In 20 years, they predict the number will grow to 8 million.  The statistics really hit home when you realize Alzheimer’s touches one out of every 2 families in the US.  Alzheimer’s patients spend, on average, the last 4 years of their lives in a nursing home.   While there are a few drugs that are used in its early stage to delay progression, there is no known cure.   People either  seem obsessed by the disease because of close personal experience with elderly parents….or, they do not want to talk or even think about it.

But, we absolutely must think about it and talk about it.  Each person has the power to prevent or delay the disease in themselves.

“Alzheimer’s disease begins an average of 30 years before the first symptoms.” What can we do in those 30 years to prevent the build-up of beta amyloid plaques and tau proteins responsible for Alzheimer’s?  Dr. Shankle describes genetic and environmental risk factors.  Of course, we cannot change our genes but we do have control over environmental risk factors.

All chronic diseases of aging increase the risk of Alzheimer’s.  We must keep blood pressure, blood sugar and cholesterol levels in the normal range.  Look at the way abnormalities affect risk of Alzheimer’s:

• HDL < 45 doubles the risk.
• LDL > 100 doubles the risk.
• Coronary artery disease doubles the risk.
• Small strokes increases the risk by a factor of 10.
• Traumatic brain injuries greatly increase the risk.

I was surprised to learn that young people with brain injuries from football or even soccer (doing header shots) will immediately have damage/reduced activity in the frontal lobe of the brain.  If these same young people carry the apoE4 gene for Alzheimer’s, their risk increases by a factor of 10!

When I asked Dr. Shankle about genetic testing, he said we each have to ask ourselves, “Will the results of such testing alter my behavior?”  If we intend to take every preventive action we can, eat right, exercise, follow a healthy lifestyle, and have regular physical exams, then genetic testing is not necessary.  He did point out, if a person chooses to have genetic testing, to be sure the results are kept private and out of their medical record.

The “prevention through delay” concept is familiar to all of us when it comes to blood pressure, blood sugar and heart disease.  Even though we have no symptoms, we are regularly monitored and any problems are addressed through lifestyle changes or prescription drugs.  Dr. Shankle believes a baseline memory screening should be done at age 50.  That’s the age at which we have greatest chance for an accurate baseline.  There is a simple 10 minute screening that can be administered by the primary care physician at a normal office visit.  It has 96-97% accuracy.  See the website below for more information.

In his final minutes of the interview, Dr. Shankle advised

• Be aware that symptoms (of Alzheimer’s) can be caused by other illnesses, such as depression, generalized anxiety disorder, strokes…  It is very important to rule out other illnesses.
• Know your risks and reduce them.  See the Prevention Report at the link below.
• Do not be afraid of Alzheimer’s being detected in you.  Preventive strategies delay onset by 3 years.  Early detection and proper treatment slow the disease by 2 to 5 years.  That’s a total delay of 5 to 8 years.

Taking preventive action early could allow you to live at home and avoid the usual 4 years (of later stage Alzheimer’s)  in a nursing home.  More importantly, it will preserve quality of life for you and your family.

Tagged as: Aging Parent, Alzheimer's, Caregiver, Caregiving, Dementia, Eldercare, Elderly, Memory