Alzheimer’s is a progressive disease that slowly destroys brain cells. It wipes out memory, cripples speech, impairs thinking, planning and judgement skills; messes with orientation and motor skills—and is irreversible. Everyone knows someone with Alzheimer’s because the disease is staggeringly common.

According to a 2014 World Health Organization (WHO) report, a new person with dementia (Alzheimer’s is the most common form of dementia) is reported worldwide every 4 seconds. In 2010 there were about 36 million people living with dementia; by 2050, the number is expected to go up to 115 million.

Most of us don’t think about the disease because we know it occurs only in old age, and well, what can be done about that? Besides, there is no known cure, or a way to slow down the nerve damage within the brain. There are only some medications which help slow down some of the symptoms of progression. But we forget that the impact of Alzheimer’s takes a massive toll on not just the patient, but also their family and caregivers. Besides, new research shows that we need to think about Alzheimer’s in our 30s, because the lifestyle choices made at this stage could help prevent the disease. “Our brain has great plasticity, and we can control it to an extent through the diet and lifestyle choices we make," says Sushma Sharma, consultant neurologist, Asian Institute of Medical Sciences, Faridabad, Haryana. And this is the only real weapon we have against Alzheimer’s right now.

Address your weight

“As our belly grows, the brain tends to shrink. There is a direct correlation between obesity and a shrinking of our hippocampus (the part of the brain that consolidates information from short-term memory into long-term memory)," says Manjari Tripathi, president, Alzheimer’s and Related Disorder Society of India, Delhi Chapter.

If you are obese in your 30s, your risk of dementia in later life increases threefold, according to a study published last month in the British Medical Journal. The researchers found that the age at which a person is obese seems to be a key factor, and those who are obese in their 30s are most at risk. A person is considered obese when their body mass index (calculated by dividing weight in kilograms by the square of the height in metres) is above 30.

Another study, published in 2011 in the journal Neurology, on a survey conducted in Sweden found similar results. “Our results contribute to the growing evidence that controlling body weight or losing weight in middle age could reduce your risk of dementia," wrote its researchers.

Yet another research by Sweden’s University of Gothenburg, and published in Neurology in 2009, reported that women with fat around their waist in middle age are more than twice as likely to develop dementia when they get older. The study surveyed 1,500 women in the age group 38-60. “Clearly the evidence against weight gain is piling up and should be enough impetus for those who are overweight to pay heed," says Dr Tripathi.

Quit smoking

Smokers have a 45% higher risk of developing dementia than non-smokers, according to information published in July by WHO, in collaboration with Alzheimer’s Disease International. WHO says that the more a person smokes, the higher the risk. It estimates that 14% of Alzheimer’s disease cases worldwide are potentially attributable to smoking, and lists the studies that show a positive correlation.

“Smoking causes problems in many ways: It leads to the narrowing of blood vessels in the brain (and heart), which deprives the brain from getting enough nutrients and oxygen, and it also increases total plasma homocysteine, a risk factor for cognitive decline," says Sunil Bandishti, consultant, neurology, Columbia Asia hospital, Pune.

Restrict your drinking

A July study, published in the American Journal Of Geriatric Psychiatry, which surveyed 6,542 middle-aged people, suggests that middle-aged adults with a history of problem drinking are more than twice as likely to suffer from severe memory impairment later in life; problems which may place them at a high risk of developing dementia. The study clearly indicates a connection between dementia and drinking (at any stage of life), according to Iain Lang, lead researcher and National Institute for Health Research Knowledge Mobilisation Research Fellow at Medical School, University of Exeter, UK.

Counter depression

In July, neuropsychiatric researchers from the US’ Rush University Medical Center reported that those with depression are more likely to develop dementia later in life. “This study (it surveyed 1,764 people) offers a clear insight into the relationship between depression and dementia, and indicates that preventing or treating depression and excess stress can go a long way in helping people prevent Alzheimer’s at a later age. So it is advisable to take help to treat your depression at the earliest," says Dr Sharma.

Check your vitamin D level

The connect between people with low vitamin D levels and cognitive problems is fairly well established. A study published in Neurology in August has confirmed that vitamin D deficiency also translates into a substantial increase in the risk of Alzheimer’s and dementia.

Researchers discovered that adults in the study—1,658—who were moderately deficient in vitamin D (25-50 nmol/L) had a 53% increased risk of developing dementia of any kind, and the risk increased to 125% in those who were severely deficient (below 25 nmol/L). Their findings confirm that vitamin D levels above 50 nmol/L are most strongly associated with good brain health. “Indians are particularly deficient in vitamin D, so a test to determine the vitamin D status and then appropriate action (supplementation if required) is extremely important," says Dr Sharma. “Meanwhile, spending 15-20 minutes in the direct sun every day is a good idea to ensure that enough vitamin D is formed in the body."

Take care of your heart

It seems there is a strong connection between your heart’s state and brain’s health. Researchers from the University of California, San Francisco, have shown that when cardiovascular risk factors such as elevated glucose and high blood pressure begin in early adulthood, they lead to significantly worse cognitive function in middle age. Researchers across a 25-year study found that those whose blood pressure and glucose levels exceeded recommended levels performed badly on executive function, cognitive processing speed and verbal memory. And those with high cholesterol levels showed poor verbal memory. This study was published in the online journal Circulation in March. Still another study, published last month in the journal JAMA Neurology, shows that mid-life hypertension is a risk factor for cognitive change and dementia.

There’s good news though: Cardiorespiratory exercises (like running) improve thinking and memory in young adults. A study published in April in Neurology has shown young adults who take part in cardiorespiratory exercise may be more likely to have better thinking and memory skills in middle age. This study was done over 25 years by a team at the University of Minnesota, US, where the researchers followed 2,747 people, in the age group 18-30, who were enrolled in the coronary artery risk development in young adults (Cardia) study.

By Kavita Devgan

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Early symptoms

Some of the warning signs of Alzheimer’s

u Long-term memories remain intact till the end, while short-term and immediate
memories become sketchy early—the person forgets recent conversations, events and places

u Trouble remembering names

u Confusion and behavioural changes

u Mood swings

u Struggle to remember common words, to read and write

u Change in personality, like he/she might be more lost or indifferent

—by Manjari Tripathi, president, Alzheimer’s and Related Disorder Society of India, Delhi Chapter.