Before diving into the role of nutrition in disease risk and prevention, let’s first define the difference between dementia and Alzheimer’s disease. Though dementia is a characteristic of Alzheimer’s, one can have dementia without Alzheimer’s disease.
-Dementia: not a specific disorder or disease, but classified as a syndrome with progressive loss of memory and intellectual function that interferes with functional daily life activities. *May lead to decrease oral intake and malnutrition
-Alzheimer’s: a form of dementia characterized by abnormal verbal or visual memory and functional decline. *Increased risk seen with deficiencies of folic acid, B12, B6, low intakes of vitamins/minerals and high CRP levels.
The prevalence of dementia increases with increasing age, with prevalence doubling every 5 years after reaching the age of 60. Primary dementia involve damage to or wasting of the brain tissue itself, while vascular dementia involves ischemic or hemorrhagic brain lesions or is caused by cerebral ischemic0 hypoxic injury.
Symptoms of Alzheimer’s Disease Include (from 2012 Alzheimer’s Disease Facts and Figures):
- Memory loss that disrupts daily life
- Challenges in planning or solving problems
- Difficulty completing familiar tasks at home, at work, or at leisure
- Confusion with time or place
- Trouble understanding visual images and spatial relationships
- New problems with words in speaking or writing
- Misplacing things and losing ability to retrace steps
- Decreased or poor judgment
- Withdrawal from work or social activities
- Changes in mood and personality
Disease progression can be slow or rapid. How is AD diagnosed? Through wellness examination, memory/thinking assessment, blood and laboratory tests, and possible MRI, CT, and PET scans. There is not currently a single blood marker used for diagnosis or consistent appearance on imaging tests, therefore, diagnosed can be made through multiple criteria. Markers of beta-amyloid accumulation in the brain as well as damaged or degenerating nerve cells can be used in diagnosis. Something to remember- “normal people” may have some AD changes, but this may not be leading to or connected to risk of AD, as dementia and loss of memory are seen in general aging.
Stages of Alzheimer’s Disease include:
–Preclinical Alzheimer’s disease (mild/early-stage)
–Mild cognitive impairment (MCI) (moderate/mid-stage)
–Dementia due to Alzheimer’s disease (severe/late-stage)
Now the real question- What causes Alzheimer’s?
There are many potential “causative factors”, including: chronic brain inflammation, genetics, beta-amyloid plaque accumulation outside of neurons in the brain, and protein tau accumulation inside of neurons in the brain. It is though the beta amyloid accumulation interferes with neuron to neuron communication within brain synapses. In addition to these “causes”, risk factors of disease development include: Genetics, low education/low mental stimulation, poor diet, elevated homocysteine, elevated blood pressure, elevated blood glucose, menopause, aging, and inflammation. Inheritance of the genes presenlin and presenilin 2 proteins are a marker of disease risk. Those with the APOEE-4 gene are also at increased risk for disease development. However, inheritance of APOE-4 does not guarantee development of the disease.
Now how can you reduce disease risk??
Inflammation, though not proven as the cause of AD, can lead in disease progression. Oxidative stress, in which free radicals are formed which create DNA, protein, and cell damage, plays a role in the disease progression. Reducing chronic inflammation can reduce your risk! This involves incorporating physical activity, blood sugar and blood pressure control, cholesterol control, and eating a general healthy diet. You can also reduce your risk through mental stimulation, controlling blood homocysteine levels, and reducing heavy metal toxicity.
Supplements/nutrients that may play a role in reducing disease progress:
-Curcumin (an awesome free radical foreager and anti-inflammatory agent)
-Omega 3 fatty acids (increase cell membrane fluidity and play a role in reducing oxidative stress and inflammation)
-Caprylic acid (a medium chain tryglyceride that may play a role in improve cognition in patients due to its ability to provide the brain with an alternative source for fuel over glucose)
-Vitamin C and E (together maximize their benefits- 2000mg Vitamin C suggested)
-Greater adherence to the Mediterranean Diet is associated with reduced risk of disease possibly due to it’s anti-inflammatory effects. The MIND diet- a hybrid of the mediterranean and DASH diet, also may decrease the risk. ”
“Results suggests that the MIND diet that specified just two vegetable servings per day, two berry servings per week and one fish meal per week – even these modest adjustments – may help reduce the risk of AD.”–
Alzheimer’s & Dementia 2015; 1-8)
Foods/Nutrients that increase risk:
-Saturated fat (association- does not take into account quality or overall diet)
-Vitamin deficiencies (folic acid, B12, B6)
-Aluminum, Mercury, and Iron Toxicity
As previously stated, the APOE4 gene is a risk factor for late-onset Alzheimer’s disease. You can find out if you have this gene by doing a DNA test such as 23andMe! I did one and found out I don’t have the gene- or the variants in the genes BRCA1 and BRCA2 that are associated with increased cancer risk.
I hope you enjoyed this article and that it stimulated your brain a bit (;
-Morris M.C. et al. (2015). MIND diet associated with reduced incidence of Alzheimer’s disease. Alzheimers Dementi. 11(9) 1007-10014.
-Alzheimer’s Association. (2012). 2012 Alzheimer’s disease facts and figures. Alzheimers Dement. 8(2) 131-68.
-Botchway, B.O.A. et al. (2018). Nutrition: Review on the Possible Treatment for Alzheimer’s Disease. J Alzheimers Dis. 61(3) 867-883.
-Raszewski, G et al. (2016). Homocysteine, antioxidant vitamins and lipids as biomarkers of neurodegeneration in Alzheimer’s disease versus non-Alzheimer’s dementia. Ann Agric Environ Med. 23(1) 193-6.