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  • Writer's pictureSue Bentsen

Alzheimer's Prevention: Plugging the Holes in the Roof While the Sun is Still Shining

Why addressing brain health early in life is crucial in the prevention of cognitive decline.

"As many as 45 million Americans are currently living with Alzheimer’s dementia. By 2050 that number is projected to increase to 130 million – the equivalent of LA, NY, and Chicago combined.” - Lisa Mosconi Phd

If you haven’t heard the latest buzz, it’s all about brain health and the potential of preventing what has become an all too common occurrence of neurodegenerative disease among the elderly and increasingly, those in their middle ages alike.

Recent evidence in the field of Alzheimer’s Disease research is prompting us to re-examine how we think about brain health. What was once thought of an incurable, debilitating disease is proving to be “exceptionally preventable” and in some cases, might even be reversible with early identification and intervention, even among those with an increased genetic risk!

At least one third, if not more, cases of Alzheimer’s disease are preventable.

What we are learning from recent advances in brain imaging and genomic sciences is that at least one third, if not more, cases of Alzheimer’s disease are preventable. And what is becoming strikingly clear is that changes in the brain occur as early as much as 2 to 3 decades before the onset of symptoms. The importance of implementing screening and prevention measures is needed much earlier in life than we ever considered. Many of these underlying brain changes, if identified and corrected early, can alter the course of an individual’s cognitive health for life. I am going to share a secret with you. The accumulation of ‘amyloid plaque,’ (the protein that is associated with Alzheimer’s disease), is occurring in each and everyone’s brain every day, for some at a faster rate than others. How and why it is accumulating is different for different people. This is based on factors including underlying health issues, genes, and your environment, ie, diet, exercise, stress, and sleep. While it is important to realize that many of these factors are ‘modifiable,’ the significance of chronic health issues (such as poorly controlled diabetes, inflammatory conditions, hormone imbalances, poor stress or sleep habits) will most assuredly contribute to more rapid cognitive decline. Make no mistake, health issues ignored in your early and middle adulthood can profoundly affect brain health as early as in your 50’s, significantly impacting you and your family for the rest of your life. Health issues, ignored in your early and middle adulthood, can profoundly affect brain health as early as in your 50’s With over 30 years of research, including the publication of over 220 papers, Dr. Dale Bredesen recently published his findings for the public to embrace. Making it to #5 on the NY Times’ bestseller list, The End of Alzheimer’s highlights a program that he and fellow researchers designed with the intention to "leave no stone unturned." His research and many others, courageous enough to challenge previous theories on the development of AD, point to the fact that many risk factors contribute to development of disease and when corrected early, can be crucial in reversing this disease. He is joined by thought leaders, researchers, and health care practitioners, across the globe who agree, prevention is key and the time to educate the public, as well as savvy clinicians, is now. Addressing brain health early in life is crucial to prevent cognitive issues. The research generated by Dr. Bredesen and his team of researchers and clinicians prompted the development of a Functional Medicine protocol aptly referred to as “ReCODE” (Reversing Cognitive Decline). What makes this protocol unique is that it takes into account the many potentially contributing factors that can compromise brain health. Dr. Bredesen refers to these contributing factors as “36 holes in the roof.” These metaphorical ‘holes in the roof’ can include nutrient deficiencies, metabolic and hormone imbalances, decreased synaptic support, toxicity, genetic risk, and immune dysregulation as in the case of chronic inflammatory conditions. Dr. Bredesen describes six sub-types of Alzheimer’s that represent varied clinical presentations. The first of which is referred to as “hot” as it is related to chronic inflammation in the body. An additional subtype 1.5 is referred to as “sweet”, related to poor blood sugar regulation and symptoms surrounding glucotoxicity. Type 2 has been labeled “cold” for its association with declining trophic factors that regulate hormones, thyroid function and cellular energy production. Type 3 is termed “toxic” due to its association with accumulated environmental neurotoxins. Type 4 is termed “pale” and is related to cardiovascular impairment. Whereas Type 5 is termed “dazed” due the relationship with traumatic brain injurie(s). Each subtype has its own optimal treatment, and each person’s profile dictates a specific treatment plan. In many cases there can be some overlap of more than one subtype, or changes in underlying health conditions that prompt different subtypes to develop. It is important to realize each case is unique and the significance of diagnostic assessments to identify key contributors (aka “holes in the roof”) before embarking on a treatment plan cannot be over emphasized. John F. Kennedy once said, “the time to fix the roof is when the sun is shining,” that quote couldn’t be truer than in Alzheimer’s prevention. One of the things we are learning from those that have enrolled in the ReCODE protocol is that it is far easier to make improvements in brain health before symptoms of degeneration have occurred.

The time to repair the ‘holes in the roof’ is when 'the sun is shining' - before symptoms occur That is where the ReCODE Protocol comes in. A comprehensive assessment that incorporates evaluation of biometrics, genetics, cognitive function, and in some cases, brain imaging: it’s success is potentiated by early detection and intervention. With the commercial availability of gene testing, (such as in retail markets and online, many people have become focused on the ApoE variant. While having the ApoE4 gene variant does influence disease risk, it does not determine that you will get the disease. It should be understood, that while helpful ApoE genetic testing on its own does not provide enough information to assume that all dietary recommendations targeted at ApoE4 gene carriers are right for you. An effective AD prevention plan is not ‘one size fits all.’ Because everyone is unique in their biochemistry, family history, environmental exposures as well as comprehensive genetic makeup, interventions and action plans must be tailored to address each individual’s unique risk factors. Where some general recommendations are beneficial to all such as adhering to a anti-inflammatory, whole food diet as well as incorporating exercise, healthy sleep habits and stress management techniques into your daily routine, specific treatment recommendations including therapeutic food plans, exercise prescriptions, and in many cases further diagnostic investigations are needed to adequately identify and address a person’s unique “holes in the roof.” Preventing AD relies on personalized treatment and action plans to meet each individual’s unique disease risk profile. The results of a comprehensive ReCODE assessment are provided in a 15+ page report outlining risk factors, interventions, resources, diet and lifestyle recommendations that you can share with your health care provider. Often partnering with a diverse set of health professionals such as nutritionists, health coaches, mental health professionals, and integrative physicians - who are as equally committed to Alzheimer’s prevention – is most beneficial when embarking on a comprehensive program like this. We have at our disposal a growing number of sophisticated lab tests to assess multiple systems and cellular status within the body. When it comes to Alzheimer’s prevention, know your numbers! Get baseline lab testing done now to understand your disease risk and ways to proactively ensure optimal brain health.

And, if you are noticing cognitive changes, get checked! Dr. Bredesen highlights a short list of symptoms that should expedite seeking professional help:

  • Mental fatigue as the day progresses

  • Depression

  • Sleep disruption

  • Anxiety over everyday activities

  • Difficulty speaking a foreign language, or playing an instrument that you have been proficient in.

  • Decreased interest in reading, following complex conversations or plot lines in movies

  • Delayed word recall, inappropriate use of vocabulary or mixing up of words

  • Decreased processing speed, calculations, or understanding of information

  • Inability to recognize face(s) of someone familiar

For those that are interested in preventing Alzheimer’s, remember: The goal of the ReCODE Protocol is to identify contributors unique to each individual and develop a personalized approach to correct imbalances and optimize function. The earlier in one’s life you make changes to improve your health and wellness the greater the outcome for success, even among those who have an increased genetic risk. It is not a “one-size-fits-all” approach; interventions must be personalized to address your unique biochemistry and biometrics.

Cognitive decline and dementia are powerfully preventable: the earlier you begin - the greater your success! ReCode Nutrition is dedicated to championing a community that encourages better brain and body wellness! If you are thinking of embracing changes in your diet and lifestyle to support better brain health why not, start now! Hungry for more information on Alzheimer’s prevention? Presentations/Interviews Lisa Mosconi Phd Robin Patrick Phd interview Dr. Dale Bredesen Websites AHNP Precision Health - ReCODE Protocol by Dale Bredesen, MD The Alzheimer’s Gene Resource Alzheimer’s Prevention Clinic, Weill Cornell Medicine AARP Brain Health & Wellness BrainHQ, Brain Training Exercises Healthy Brains by Cleveland Clinic Books The End of Alzheimer’s, Dale Bredesen, MD Why Isn’t My Brain Working, Dr Datis Kharrazian Brain Food, Lisa Mosconi, Phd

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