When Krystal Allan saw Alzheimer’s disease running through her family, her outlook on life changed.
“On my father’s side, several relatives, including my grandmother, had Alzheimer’s,” said Allan, an award-winning anchor at News 3 Las Vegas. “I’ve seen first hand what it was like – for the patient and the caregivers.”
This family history led to a sense of the inevitability of her own future.
“When your loved ones fail and your family members become caretakers, there’s a nagging fear that ‘that’s probably going to happen to me,'” Allan said.
Watching someone you love suffer from Alzheimer’s sees it fade away little by little. After going through this devastating experience, Allan began preventive care at the Women’s Alzheimer’s Movement (WAM) Prevention Center at the Cleveland Clinic. Initially, her primary focus was educating others. But what she learned changed her entire perspective. “I was shocked to find out that 40% of the [Alzheimer’s] Cases could be delayed or avoided altogether by making healthy lifestyle changes early on,” Allan said. “It was such a positive change to experience that my family history doesn’t necessarily dictate the trajectory of my brain health.”
Fighting the devastation of Alzheimer’s disease
Educating women that they can take steps to prevent Alzheimer’s, currently the seventh leading cause of death in the country, is the core message of WAM, whose goal is to help women reduce their risk. “Family history is extremely important because it tells us a lot about risk and motivates many women to seek preventative care,” said Jessica Caldwell, Ph.D., director of the WAM Prevention Center at the Cleveland Clinic. “Our work advances our knowledge of women who are most at risk, who seek preparedness, and the factors that put them at risk. This is the kind of data that will help us develop more effective treatment and prevention protocols.”
It can’t come a moment too soon.
In the United States, approximately one in ten people over the age of 65 have Alzheimer’s. And almost two out of three of those people are women. While we don’t know all of the factors that put women at higher risk, research shows that menopause and the associated drop in estrogen lead to reduced activity and energy in the brain. Gender-specific differences in certain genes and in connections between brain regions can also contribute to an increased risk for women.
Forgetfulness vs Dementia
Everyone knows what it’s like to forget a piece of information, e.g. B. where you left your keys or why you just entered a room. Forgetfulness is part of everyday life. As we age, it is normal for these moments of forgetfulness to increase.
However, dementia is different from these moments of forgetfulness.
“It’s a normal moment to forget where you left the keys. Forgetting what keys are is different,” said Heather Snyder, Ph.D., vice president of medical and scientific relations at the Alzheimer’s Association. “Dementia is an umbrella term for changes in memory, thinking, and thinking that affect our day-to-day functioning and our ability to be independent.”
Stop Alzheimer’s before it starts
Some of the key risk factors for Alzheimer’s — such as age, genetics, and family history — are uncontrollable. But other factors that people can control have also come into the focus of Alzheimer’s prevention.
WAM uses evidence-based prevention and collects clinical data to learn how prevention strategies can be improved. “We work with women to improve the risk factors that they can [improve]’ Caldwell explained. “For example, there are avoidable risk factors like diabetes, and we can make changes to reduce their impact. Others are controllable lifestyle factors that can have a big impact, such as smoking, drinking, diet, mood, stress and sleep.”
This type of preventive research and clinical trials go a long way in understanding how controlling these factors can help prevent Alzheimer’s.
“There are all kinds of studies out there, and they’re such an important aspect of moving forward,” Snyder said. “There are drug trials, as well as trials testing biomarkers, looking at new measures of underlying biology, looking at nursing interventions, risk reduction, and behavioral interventions.”
One of the most important studies led by the Alzheimer’s Association is a lifestyle intervention study called US POINTER. This study is part of a global network expanding the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) clinical trial, which demonstrated that lifestyle interventions—such as diet, exercise, and cognitive training—can help preserve cognitive function. It is the first of its kind in the US and remains open to participants.
The Wisconsin Registry for Alzheimer’s Prevention (WRAP), operated by the Wisconsin Alzheimer’s Institute at the University of Wisconsin-Madison, is one of the longest-running and largest studies of Alzheimer’s worldwide. By building a registry of volunteers, WRAP was able to create a comprehensive dataset tracking lifestyle, fitness, biomarkers, genetics and more to understand what and how these factors affect Alzheimer’s risk. While the study is ongoing (and open to new participants), it found that certain biomarkers are associated with cognitive decline, while healthier lifestyle choices are linked to better cognition and brain structure.
Currently, the National Institute for Aging (NIA) supports over 400 active studies on Alzheimer’s and dementia. While some are drug trials, most are not. There are 139 studies that focus on intervention modalities such as exercise, cognitive training, sleep, and diet.
Finding hope beyond limited treatments
The most promising research focuses on earlier diagnosis and preventative measures to slow – and perhaps stop – the progression of Alzheimer’s disease before plaque forms. It is particularly important for women to recognize the underlying factors as early as possible. “If we can offer people a longer period of prevention and treatment in the early stages, that’s going to benefit them,” Snyder said.
A brain imaging research study by the Weill Cornell Women’s Brain Initiative (WBI) is investigating the link between declining estrogen levels and increased risk of Alzheimer’s in women. Other current research aims to identify specific prevention approaches that can then be translated into clinical trials. For example, recent studies indicate that taking a daily multivitamin, lowering blood pressure, timely treatment of depression, maintaining physical fitness, and improving sleep habits all play a role. If that seems like a lot, agree: A recent study on dietary changes found that red wine and cheese helped protect cognitive function.
Prevention and early detection are important as there is no consensus on a single cause of Alzheimer’s. It is very likely that a variety of complex interactions are to blame. With no clear cause, treatment is very limited for the 6 million people living with the disease. “There are drugs that treat the symptoms but don’t stop the progression of the disease itself, so at some point even those drugs aren’t helpful anymore,” Caldwell said. “The only drugs that attack a fundamental cause are very new and not really accessible yet. While they can help reduce or eliminate some plaque build-up, they’re also quite limited.”
Get involved in a healthier future
The more clinical trials we have – and the more diverse the participants – the better. As more women get involved, there is hope for making preventative care available and effective for all at-risk individuals.
Getting started is as easy as finding a locally available trial and verifying its credentials. The Alzheimer’s Association offers a service called TrialMatch to help people find and participate in clinical trials. The NIA and Mayo Clinic offer other tools for finding clinical trials. Large research centers, universities, and hospitals involved in Alzheimer’s research usually offer a list of open trials as well.
The real first step is the decision to get involved. “When you’re on a plane, they always say put your mask on first before helping anyone else. I look at it like putting on my oxygen mask,” Allan said. “I take care of myself first because I know that when I’m better, the people around me are better too. That affects us all.”
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