Richard Issacson’s Top Tips to Prevent Alzheimer’s
Richard Issacson, on multiple occasions has maintained that “anyone with a brain is at risk for Alzheimer’s, but also that at least one in three cases of Alzheimer’s can be prevented, and so it is vitally important to take care of the most important part of the human body - our brain. It is important to note that risk-reduction is never a ‘one size fits all’. Where possible, it needs to be comprehensive, tailored to the individual and supervised by a doctor. There are, however, general lifestyle choices that you can make to manage your own, or your patient’s Alzheimer’s risk:
Know your numbers - specifically your blood pressure, cholesterol levels, and body fat percentages. It is also very important to know your sleep numbers - how long are you sleeping, how many of those hours are good-quality, deep sleep? On several occasions, Issacosn has mentioned that he uses devices such as the Oura Ring to track his sleep.
Keeping blood sugar and weight in check to avoid diabetes. Many people with diabetes have brain changes that are hallmarks of both Alzheimer's disease and vascular dementia.
Cholesterol management is essential as high cholesterol accelerates the development of dementia/Alzheimer’s disease. This involves a variety of steps, including monitoring your cholesterol levels regularly - especially if high cholesterol history runs in your family, regularly reading nutritional content on food packages to limit overall fat intake to 25-30% of your total calories, and limiting the intake of trans and saturated fat.
Maintaining weight at a healthy level, typically below a body mass index (BMI) of 25. Although the precise link between adiposity and cognitive impairment isn’t one hundred percent clear, it seems that this may be in part due to vascular defects, impaired insulin metabolism and signalling pathway or a defect in glucose transport mechanisms in the brain.
Avoiding head trauma (such as concussions). This could mean wearing helmets for bike and motorcycle rides, avoiding head strikes while playing sports, especially contact sports, and generally being aware of activities that may cause head injuries.
Staying cognitively active by reading and learning new things. People who actively learn new skills and challenge themselves mentally are also stimulating and training their brain to enhance the connectivity between cells which in turn helps to build brain reserve, and increase neuroplasticity, which is the brain’s ability to adapt.
Avoiding or managing depression. Recurrent depression was linked to an increased risk for vascular impairment.
Managing bad stress that raises cortisol levels. The clinical study found that elevated cortisol was associated with poorer overall cognitive functioning, as well as with poorer episodic memory, executive functioning, language, spatial memory, processing speed, and social cognition.
Treating orthostatic hypotension when you regularly feel light headed or dizzy when standing up from sitting. This is a disorder in which you regularly feel light-headed or dizzy when you stand up from sitting. It has been associated with an increase in long-term risk of dementia, and Alzheimer's.
Keep blood pressure under control in midlife.
Avoiding high levels of homocysteine, an amino acid that can contribute to blood clots in your blood vessels and artery damage. Homocysteine levels are measured in the blood by taking a blood sample. Normal levels are in the range between 5 to 15 micromoles. Here’s a good list of how you can keep your homocysteine levels low. Issacson often suggests B-complex vitamins to combat elevated homocysteine levels.
According to Issacson physical exercise is by far the most powerful antidote to a genetic predisposition to Alzheimer. A recent study showed that exercise can specifically reduce shrinkage of the memory centre in the brain in people with the earliest symptomatic stage of Alzheimer’s disease. Issacson believes in practising everything he recommends to his patients, he exercises at least three days a week, at least twice with high-intensity interval training (like spinning classes), and once a week he does resistance training.
Eliminating obesity in midlife. Having said that, it’s important to avoid weight loss in late life.
Drinking alcohol in moderation. In an interview, Dr. Issacosn said, “The science behind alcohol and Alzheimer’s is still evolving, but in my clinical practice I advise that women drink no more than 4-7 servings, and men drink no more than 7-10 servings, per week. Moderation is essential, and when in doubt, less is more.”
Not smoking and avoiding secondhand smoke. Smoking has more of a detrimental effect on people with the APOE gene.
Getting plenty of good quality sleep, and tracking it. 7.5-8 hours is recommended. Issacson recommends using white noise if you have trouble falling asleep and completely avoiding screens at least an hour before bedtime.
Avoiding cerebrovascular disease, which includes stroke and diseases that affect the blood flow in the brain. Regular check-ups and controlling your blood pressure is critical when it comes to cerebrovascular disease prevention. Every lifestyle change recommended above has a trickle down effect in helping prevent cerebrovascular disease.
Listening to - or better yet - playing music. There is a growing body of research on music’s many benefits to the brain, whether starting early in life or in midlife. Isaacson plays the bass guitar and joined a band called the Regenerates with several of his neuroscience colleagues.
Managing atrial fibrillation, which is an irregular, rapid heart rate due to chaotic electrical signals in the heart. The NHS has a useful guide managing atrial fibrillation.
Eating foods with vitamin C or taking supplements. Having Vitamin rich foods like citrus fruits, berries, vegetables like spinach, peppers, tomatoes, broccoli etc. keeps capillaries strong, so they are less likely to break and leak blood into the brain tissues.
Finally, weaker evidence indicates that acetylcholinesterase inhibitors -- drugs like donepezil and galantamine, which are often prescribed to treat memory loss in people with Alzheimer's disease -- should not be used as a prevention tactic as Issacson mentions that these drugs are for symptomatic people and there is no proof that they slow down disease progression.