The sixth leading cause is less obvious, though. It’s Alzheimer’s disease, and it’s on the rise, according to the presenter of our recent Glenmeadow Learning program, “Dementia and Brain Health: Risk Factors, Interventions, Research.”
Kelsey Gosselin, the manager of medical and scientific research engagement for the Alzheimer’s Association’s Massachusetts/New Hampshire chapter, led a two-hour talk at Glenmeadow on causes of the disease, prevention, and treatments.
She told our audience of roughly 75 people that Alzheimer’s disease affects 5.7 million Americans, with deaths from Alzheimer’s increasing by a remarkable 123 percent from 2000 to 2015.
The news isn’t all bad though, Kelsey said. In the wake of the increasing impact of Alzheimer’s, there’s been breakthroughs in the study of the disease that have given rise to better detection methods and more effective therapies.
“We don’t currently have treatments that stop the disease,” Kelsey said. “But it’s so important to be diagnosed early because it allows people to access available treatments that might improve quality of life, build a care plan, get support, and participate in clinical trials.”
While the terms “Alzheimer’s” and “dementia” are often used interchangeably, Kelsey explained that dementia is the umbrella term referring to the symptoms shown by individuals with cognitive impairment that interferes with their independence. Alzheimer’s, in turn, is the disease that most commonly causes those symptoms.
“When we think of Alzheimer’s disease, we think of someone having issues with memory or attention, but that’s not exactly what Alzheimer’s is,” she said. “Those symptoms are actually referred to as dementia, while Alzheimer’s disease is really the underlying brain change causing the symptoms we call dementia.”
Kelsey said not all changes in memory are cause for alarm. “Memory change is normal as we age,” she said. “When it becomes abnormal is when the change starts to interfere in your daily life, and you’re unable to complete tasks you could have done ordinarily.”
The disease forms because of changes in the brain’s blood vessels, disruption of critical brain cell processes or widespread inflammation in the cells, and the erroneous formation of proteins. In Alzheimer’s patients, these changes alter the hippocampus, the brain’s memory center.
Scientists’ understanding of the disease’s pathology has translated into better detection methods. Biological markers are reliable measures that help detect the disease, Kelsey said, with the most common being neuroimaging.
PET imaging allows doctors to pinpoint higher protein levels, and traditional MRIs can help doctors determine what form of dementia patients have by observing the brain’s size and density.
Once Alzheimer’s disease has been detected, its symptoms can be managed. Kelsey said disease-modifying therapy, which targets the underlying brain changes and either stops or slows them, is the best option.
“A disease-modifying therapy would actually change the course of the disease and allow the patient to maintain cognitive functioning for a long period of time,” she said. “That’s the goal.”
However, Kelsey noted that all disease-modifying drugs are still undergoing clinical trials. Since none have been approved by the FDA yet, symptomatic therapies that boost neuronal signaling in the brain, targeting the symptoms rather than the disease itself, are the next best thing.
There are ways to reduce the risk of Alzheimer’s, despite the primary risk factors of age (with the risk doubling every five years after age 65) and family history.
“There’s more evidence now that modifying your diet and staying socially engaged have a higher impact when it comes to avoiding cognitive decline,” Kelsey began. “For example, it’s been found that Mediterranean diets, which emphasize plant-based foods, may reduce the risk of cognitive decline by 30 to 35 percent.”
Regular exercise is also key, as it releases growth factors in the brain that enhance thinking and memory. Those who smoke tend to be more susceptible to Alzheimer’s, while those who exhibit good cardiovascular health put themselves at a lower risk.
“Keeping our body healthy is very important for keeping our brain healthy,” Kelsey said, adding that it is important to keep cognitive challenges in one’s daily routine.
Spending quality time with family and friends, and good sleep habits are also important in brain health, she said.
Kelsey said there continues to be a need for patients to participate in clinical trials that could one day lead to a cure. To learn more about local research and how to participate in a clinical trial, visit www.alz.org/trialmatch.