The Power of Memories
There are very few things more frightening than losing a lifetime of memories, but for hundreds of thousands of Canadian families affected by Alzheimer’s disease, this is their reality. Mothers, fathers, sisters, brothers, grandparents and even younger adults; this mysterious and incurable disease can strike just about anyone, anywhere and at any time. The Power of Memories investigates how we’re getting closer to understanding Alzheimer’s through brain research, and how capturing our photos and stories can help us preserve the memories we have now.
Five Facts about Alzheimer’s
Alzheimer’s is still a mystery to most Canadians. Understanding five important facts about the disease will help you think differently about the brain health of those you love, including yourself.
Sallie watched her mother’s memories fade away far too quickly. She opens up about this difficult chapter in her life as she tries to prevent the disease from striking herself and her own children.
Recently, doctors have developed a “brain-healthy” diet that appears to reduce the risk of developing Alzheimer’s disease by as much as 53 per cent. There is even a bonus; you can follow the diet in moderation and still benefit from its effects. This new eating plan is called the MIND Diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) and it borrows elements from the heart-healthy Mediterranean Diet and the blood pressure-lowering DASH Diet (which stands for Dietary Approaches to Stop Hypertension).
All three diets are essentially plant-based and low in high-fat foods. But the MIND Diet places a specific focus on foods and nutrients linked to optimal brain health, including berries and green leafy vegetables.
The science behind the foods
The study, developed by researchers at Chicago’s Rush University Medical Center, aimed to better understand how nutrition could improve brain health and lessen the cognitive decline and memory deterioration that comes with Alzheimer’s disease and other forms of dementia. “Past studies have yielded evidence that suggests that what we eat may play a significant role in determining who gets Alzheimer’s disease and who doesn’t,” says Rush Nutritional Epidemiologist Martha Clare Morris.
According to the study, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, researchers collected data on the food intake of 923 Chicago residents between the ages of 58 and 98. The participants’ eating habits were tracked on how closely they followed one of three diet plans: the MIND Diet, the Mediterranean Diet, or the DASH Diet.
The MIND Diet demonstrates a lessoned chance of getting Alzheimer’s
The results revealed that strict adherence to any of the three diets lessened the chances of getting Alzheimer’s. The risk of decline for participants following the MIND Diet was a 53 per cent decrease, while those following the Mediterranean Diet experienced a drop of 54 per cent, and individuals under DASH saw a 39 per cent decline in risk. “One of the more exciting things about this [study] is that people who adhered even moderately to the MIND Diet had a reduction in their risk of Alzheimer’s disease,” says Morris. “I think that will motivate people.”
Foods to eat and to avoid
The MIND Diet consists of 15 dietary components, including 10 “brain-healthy food groups” and five “unhealthy-brain” food groups. The healthy groups include berries, green leafy vegetables as well as other vegetables, whole grains, nuts, beans, fish, poultry, olive oil and wine. The unhealthy groups are red meats, butter and stick margarine, cheese, pastries and sweets, and fried or fast food.
What’s more interesting is that the MIND Diet is easier to follow than the Mediterranean Diet, which calls for daily consumption of fish and three to four servings of both fruits and vegetables, Morris says. And where the Mediterranean and DASH diet plans promote fruit intake in general, berries are the only recommended fruit as part of the MIND Diet. “Blueberries are one of the more potent foods in terms of protecting the brain,“ says Morris, and strawberries have also performed well in past studies examining the effects of food on cognitive function.
The MIND Diet is most effective over a long timeframe
These new discoveries also suggest that the protection against Alzheimer’s disease is greater for those participants who adhere to the MIND Diet for longer periods of time. As is the case with many health-related habits, including physical exercise, Morris says, “You’ll be healthier if you’ve been doing the right thing for a long time.” The results of the MIND Diet study indicate strong preliminary evidence that brain-boosting benefits can be found in food intake and diet regimens. More importantly, we now have clear evidence of the fact that the early adoption of new “brain healthy” eating habits, even in moderation, can boost brain health and lessen the risks of cognitive decline.
Lynn Posluns is Founder and President of Women’s Brain Health Initiative, the global charitable foundation raising money for research and education to combat brain-aging diseases that affect women.
Treatments for Alzheimer’s disease: the disease is relentless, but so are we
Alzheimer’s disease (AD) is the leading cause of dementia worldwide. The cruelty of the disease is that it robs us of our loved ones while they are still alive. In progressively eroding the cognitive abilities and independence of its victims, AD is relentless – but so is our collective pursuit for new insights and innovation. With each passing year, doctors and researchers, supported by countless patients, families, and communities, are moving us forward, bit by unyielding bit, toward cracking this problem. Individually, our contributions may be mere drops in the ocean of scientific knowledge, but together, we can be the shoulders upon which future generations will stand and finally see a lasting, effective treatment for this disease.
Since the dawn of the new millennium, we have been able to offer our patients anticholinesterase medications (Donepezil, Rivastigmine, Galantamine) and Memantine, which act on relevant signalling molecules in the brain (“neurotransmitters”). These medications have a modest effect on improving symptoms in patients with mild to moderate dementia, although they do not change the progressive course of the disease. In the 15 years since, the idea of using the immune system to help treat AD (immunotherapy) has also taken off, with the antibody Aducanumab recently showing particularly promising reductions of the amyloid plaques that build up in AD brains. The results of large immunotherapy studies currently underway are expected in 2020.
However, one of the biggest insights that we have gained about AD is that treatment must be started at the earliest possible opportunity to have any truly meaningful impact on the disease course. Well before the onset of any symptoms of dementia, individuals with AD exhibit a long symptom-free phase of several decades, during which disease-related (neurodegenerative) changes in the brain build up. Future trials will need to identify patients even before they have symptoms, but in order to do this, we will need to find reliable biomarkers (or surrogate indicators) of AD. As such, there is a lot of work underway looking for blood-based biomarkers for AD, in combination with imaging techniques.
In addition, we now have some promising opportunities for meaningful preventative treatment. This includes the control of vascular risk factors such as hypertension and diabetes, as we now recognize that there is great overlap between AD and so-called “vascular” dementia related to poor blood flow to the brain. We also know that diet and physical activity are as important for dementia prevention as they are for cardiovascular disease. Recently, the MIND diet (a hybrid of the Mediterranean and low-sodium DASH diets) has been associated with slower cognitive decline and lower dementia risk, while an aerobic exercise program has shown modest benefits in improving cognition in early-stage patients. In many older adults, new depression appears to herald the onset of dementia and/or accelerate cognitive decline, potentially representing another treatable factor.
However, even as our understanding of this disease grows, so does the need for healthy scepticism on the part of patients and their families when it comes to purported cures for the disease. This is made especially difficult by the fact that the options advertised have become flashier, despite the lack of evidence. The snake-oil salesmen of the past now sell stem cells and have a social media following. Physicians are just as vulnerable to these biases, and we must continue to hold each other accountable to the highest standards of evidence and ethical practice to ensure that our patients are not harmed by needlessly risky or expensive treatments.
I remain optimistic that we will find more effective treatments for AD in our lifetimes, supported by real hard evidence, and I remain ever grateful for the opportunity to care for the patients and families affected by this condition. You continue to inspire us all.
Dr. Aravind Ganesh is a neurology resident-physician with the University of Calgary. He is also a clinical researcher and a Rhodes Scholar, currently working with the University of Oxford’s Centre for Prevention of Stroke and Dementia. Part of his work involves investigating blood-based biomarkers for Alzheimer’s disease.