June is Alzheimer’s awareness month. With the ever increasing number of people suffering from cognitive decline, it’s an important topic to discuss. Current estimates state at least 6.2 million Americans are living with dementia, and that number is expected to almost quadruple by 2060!
Cognitive Decline is a complex, multi-faceted disease process that leads to destruction of brain function over time. The increased difficulty with this disease are the multiple contributing factors, making it harder to understand and even harder to treat. Contributing factors fall into several major categories, and while we are continually learning more about the disease process, much more research is needed.
So you’re concerned about developing this horrible disease, but what can you do? The best offense is really a good defense- understanding your unique risk factors and working with a professional to minimize them!
Let’s look at risk factors that can be impacted by changes the average patient can make to prevent development of cognitive symptoms and to improve symptoms of cognitive decline. Like any disease process, the earlier you intervene, the better the outcomes. Patients at high risk for developing dementia can benefit from understanding their individual risk factors and making changes to reduce those risks.
I am certified in the Bredesen Protocol, a unique Functional style approach to addressing cognitive decline. My practice uses the Bredesen Protocol coupled with a Functional Medicine approach to comprehensively evaluate patients with cognitive concerns or those wishing to prevent cognitive decline. This blog series will highlight health categories most often related to cognitive decline, and discuss preventative actions you can take.
Major categories of health that can influence your risk for cognitive decline and dementia include;
- Genetic Risk
- Family History
- Dietary Intake
- Multiple Comorbidities
- Hormonal imbalances
- Sex hormones
- Micronutrient Deficiencies
- Certain Medications
Let’s start with genetic risk. Research shows us that the majority of cases of dementia (encompassing all forms of cognitive decline) are not genetic in origin. That said, there are specific genes that can increase risk, most commonly mentioned among them is APOE4. Dr. Dale Bredesen (A pioneer in cognitive decline research) recommends that we test for this gene when evaluating our patients for cognitive decline. APOE is a lipoprotein that is a major carrier of cholesterol in the brain. APOE4 plays a role in formation of amyloid plaque, a key finding in many patients with dementia. Pharmaceuticals that block APOE4 are being studied, with no real successes to date.
If you are an APOE4 carrier, recommendations include limiting consumption of animal fats as well as supplementation with good quality Omega-3’s to maintain a 1:1 ratio between Omega 3 and Omega 6. And you may want to avoid high intensity exercise, opting instead for moderate exercise regimens. Studies show us that APOE4 carriers engaging in high intensity exercise produce higher levels of troponins (a protein that measures damage to the heart) than non-carriers. There is much more to APOE4 carrier status, but suffice it to say it is an important risk factor.
APOE is a relatively inexpensive test for those who wish to determine whether this risk factor is present.
What about Family History? According to multiple studies, having a first degree relative with dementia increases your risk by as much as 75%. In fact, it is one of the strongest risk factors for dementia. That said, it’s important to understand, to the extent possible, the disease process as it relates to your relative with dementia. For example, were they an alcoholic, did they have a history of environmental exposure, or did they have multiple diseases in addition to dementia? All of the factors that contributed to their disease can help us determine the level of risk to you, and can help guide our prevention strategy.
Adopting a healthy lifestyle (healthy diet, moderate exercise, reduced stress and exposure) can greatly reduce your risk of developing dementia, even if you have a direct family member with the disease.
If you have a family member who has suffered from dementia, it is important to contact your healthcare professional to conduct a detailed history, quantify risk factors, and take action to address risk- the earlier the better.
If you are interested in understanding your unique risk for cognitive decline, Health Partners LLC offers a number of approaches to help you. We offer standard diagnostic packages or can develop a custom package for your needs. Packages include diagnostics and a follow up meeting to review those diagnostics and discuss your personal risk. We place great value on educating our patients about what specific risks mean. Contact us today to discuss your individual needs.
My next post will cover environmental and lifestyle risk. I welcome your comments as well as suggestions for future blogs- please feel free to email a response. Be well and be blessed.