The incidence of Alzheimer’s disease (AD) is rising and the associated costs are increasing by the day. Prevalence of this debilitating condition increases with age over 65, with the risk of developing the disease doubling every 5 years after age 65. Named after a German Psychiatrist, Dr.Alois Alzheimer, the absolute number of Alzheimer’s patients is far more than that in the popular perception. In the US, 1 in 8 over 65 age are diagnosed every year, with women at higher risk. Though it is much less in developing world, the Global Prevalence is set to triple by 2050.
Rapidly progressing Dementia is the hallmark. There is no cure and there will be no cure for the neuronal networks and the associated cognition get impacted irreversibly. So only way is to explore ways of preventing it. However, is it preventable? No definite answers; no large-scale studies so far, though promising research is underway. AD is amongst the costliest diseases to manage in western countries, with a significant strain on caregivers. The patients die within 8-10 years post the onset.
The interplay of genetic, environmental, and lifestyle factors leads to the onset and progress of complex conditions such as diabetes, cardio-cerebrovascular disease and Alzheimer’s. Each of the risk factors compounds the disease risk over several years of onset, not in isolation, but in a complex interplay with other factors. Some of these risk factors such as environment, diet, and lifestyle can be controlled; while some such as age, genetic make-up etc are beyond our control. A small percentage of people with Alzheimer’s disease (less than 1 percent) have an early-onset type, called Familial Alzheimer’s, associated with genetic mutations. Individuals who have these genetic mutations are guaranteed to develop the disease and cannot prevent it. The other adult-onset variant is called sporadic late-onset Alzheimer’s, which is increasingly being referred to as Type-III Diabetes. It is this variant that can be prevented eminently.
Though b-amyloid is long held as the crux of the degenerative AD process, the hypothesis is being reviewed, as almost all drugs targeting this have failed or even worsened dementia. Some studies postulate that b-amyloid could actually be protective anti-oxidant and is the brain’s response to infection. It is the combination of dietary carbohydrate overload coupled with lack of physical activity, classical underpinnings of Type-II Diabetes, that is becoming the crux of AD pathogenesis.
Preventing a complex disease such as Alzheimer’s is a challenge and requires substantial discipline and awareness. Healthy lifestyle comprising of right diet, exercise, maintaining an appropriate weight, avoiding smoking and excessive alcohol can maintain and improve overall health and well-being. These measures are known to delay the onset or slow the progress of Alzheimer’s for a significant period of time, perhaps years and decades.
Ref: Alzheimers Res Ther. 2017; 9: 71.