Lifestyle Changes to Avoid Dementia

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Welcome to the Answers for Elders radio show. Meet the trusted experts who will give you straight answers and will help guide you on the path of later life care. Now here's your host, founder, caregiver, and CEO, Suzanne Newman.

And welcome back everyone to Answers for Elders Radio Network. And we are talking with Dr. Paul Winner, who is the senior director of the Premier Research Institute and the director of the Memory Disorder Center. And Dr. Winner, we're talking— thank you for being with us today as we're talking about Alzheimer's disease, how it comes on, what happens, and all of those crazy things that go on in our world regarding this illness. So thank you for being with us.

Thank you. I appreciate the invitation to address this incredibly important topic. But a key issue is we— it's changing quickly. We're learning a lot more about the illness and we are starting to see medications that look very promising. But the first step is recognizing that there's a problem. The second step is to find out, is that problem Alzheimer's or is it something else?

Yeah.

That's a key issue here.

Yeah.

Patients present to us with various symptoms that could be consistent with dementia. And again, we have to figure out what that is. First of all, is it truly a dementia problem or is it something that is something else medically? It could be as simple as a vitamin deficiency, which is Unfortunately, not too common, but we do see it once or twice a year. Or something as simple as medication adjustments. Again, when we see a very short or a quick change in memory, someone's only had a problem for 3 or 4 months and it's significant, that's usually not a dementia of Alzheimer's type because Alzheimer's takes so long to take place, 10, 15, 20, 22 years plus. To present itself. It's a very slowly progressive disorder. So the timing of it, the history of it. But I think if people are concerned, one of the key issues, they have to get to a doctor. They have to get to someone who's familiar with this disorder. In the past, a lot of doctors haven't spent a lot of time on this because we didn't have any really good effective treatments called disease-modifying therapies. Where we could actually change the course of the illness, at least of the disease we call Alzheimer's. But that's changing. There's many types of dementias. We're studying many. We're doing studies in various forms, Parkinsonian dementias, in Alzheimer's dementia where we have our major studies, but even other aspects, Lewy bodies dementias, vascular dementias, there are things that can be done just to diagnose and also to consider some early treatment. Some of the key things that people have to recognize we call risk factors. You want to, first of all, avoid this as best you can. You don't want this to happen. Even if you're predisposed genetically to develop it, there are some things you can do to help yourself. Now, one of those is really simple: have your hearing checked. It's so easy to find out if you have a hearing deficit and to correct it today with hearing aids. That goes a long way. The other is correct your vision. If you have visual impairments, you want the best input into your brain so your computer functions properly as best it can. The other is if you've got metabolic syndrome, get it under control. If you have diabetes, control it as best you can. Check your blood pressure. Studies have shown that the Sprint Mind Study showed that controlling blood pressure clearly reduced the development of dementias. What am I saying about controlling blood pressure? You want your blood pressure at 120 over 70 or less. Now, obviously, if you're symptomatic with a low blood pressure, you can't do that, but most patients can, and you wanna do that as soon as you possibly can. Everything I've just told you is so simple and so easy to do. In our country, unfortunately, we are not getting thinner. We seem to always getting a little on the other side. Overweight, obesity is another risk factor. Hard to control. I surely don't have all the answers for that one. And we haven't figured that all out, but you do your best to avoid certain foods. So diet is important. Again, you don't wanna wait till you have the symptoms, wait till you have the disease. You wanna get in front of it. As best you possibly can. Alcohol consumption. There's a lot of question about, is it safe? What's the right amount? Basically, none is the best. But if you're going to use it, it needs to be small quantities. The exact quantities are not clear. Remember, what do we use alcohol for in a clinical practice? We use it to clean off our tables to kill viruses and bacteria. It is a caustic substance. So is it caustic inside us? Well, it cleans tables really well. So I'll leave that for your own devices. Head trauma. Please don't do things that'll ultimately result in you having a head injury, especially after the age of 40. If you're predisposed to develop that toxic amyloid genetically and you hit your head, you're going to accelerate that process. Do not go fix the roof if you're 40 or 50. Hire someone to do that.

Exactly.

I can't tell you how many patients I have taken care of that have fallen off ladders when they were fixing gutters or the roof. Get someone to do that for you if at all possible. Avoid things that'll cause— wear a helmet on your bicycle. If you've got problems with balance, use a stationary bike inside a protected area. There's some things you can do. Don't wait till you get a subdural. I lost a good friend because unfortunately he had an injury resulted in a subdural, clearly could have been prevented. And he's not with us anymore. It accelerated the dementia aggressively. And within a matter of years, he was no longer alive. And that is a preventable issue.

Yeah. And especially, I can only imagine, because I know that early onset tends to progress quicker. Is that true? First of all, that's what I've learned anyway. I don't know if— I'm not speaking as an expert here.

It can be true for an individual because Alzheimer's dementia is not one entity. There are multiple gene issues. Every patient's a little different. I've seen some patients when we've diagnosed them in the early dementia stage and they've only lived 5 or 6 years. I've had others that have lived 10 to 15. So it is dependent upon the individual and their genetic, genetic factors. One of the simplest things we do, we have tests called ApoE, and we can test whether someone has number 4, which is not the one you want to have. That's a higher risk factor for developing AIDS, genetic risk factor, or 3, which is average, and 2. Which is protective. So we are essentially maturing most of the younger people. In fact, we test our own patients here. Just about every patient over 65 has been tested. It's important to know that it's a risk factor. We can counsel them. It's very important to know for new treatment algorithms.

And of course, my mom, she had vascular dementia, which was brought on, she was a heavy smoker for many years. She got COPD, she had vascular issues in her, you know, legs and all kinds of things. And so what happens is as she got older, obviously that dementia progressed in her. So I'm going to just throw out there, I bet that smoking is part of it. And life, when you talked about diet, I am betting that there's other things that we can do better.

Yeah, smoking is definitely low-hanging fruit there. You want to— again, it's not easy for someone who's been smoking for decades to quit, but even if they reduce the smoking, that's a positive. And you've talked about issues of diet. You know, we have societies around not only our own practices, but there's the, you know, Alzheimer's Association. There are national and local chapters that can help you. There's many organizations out there, American Academy of Neurology, There are many medical and non-medical organizations that can give you some ideas about diet. Diet is complex. There are— there's a DASH diet, there's a Finger diet, there's the Mediterranean diet. The diet that you can handle, that you can do, is the right one for you. There are some that statistically seem a little better, but some simple things is if you— most Americans can kind of do the Mediterranean diet, but you may want to limit some of the saturated fats, like some of the cheeses. Maybe switch to some of the vegetarian options. You don't have to completely drop all of cheese, but try to limit it a little bit. You know, the oils are important. Try to use a good olive oil, is again an avocado for some of the saturated and unsaturated fat options. There are little things you can do with the Mediterranean diet that can help you to make it even better, more like the more difficult diets are hard. They're almost like you have to go to school to really learn how to do them properly. It is worth it if you can do that.

Right.

The Mediterranean diet's pretty simple, and that's a simple thing. And again, the societies can help you. I didn't mention exercise, but controlling your blood pressure, exercise are the two single best things you can do outside of getting your hearing in.

Oh, absolutely.

Exercise.

And cholesterol, probably too. Yeah.

Yeah. Well, that, yes.

Yeah, with diet. So, obviously, you conduct clinical trials, and we're gonna talk a little bit about this later in the hour, but, you know, if somebody, how do they get tested? Do they go to their primary doctor? What is that process like?

The best way to do this, and now that we have medications that are clinically functioning, in a way, yeah, I don't wanna be too optimistic here 'cause we're still doing the research and this is early data, But it's very positive on our side. And I'll talk about numbers in a few minutes. We need to get the diagnosis correct, which means just getting a simple, essentially, evaluation, a history and physical. That's not enough anymore. You need a neurobehavioral test administered by people who are very good at doing this. That's a basic assessment. Then you're going to have to get into much more detail medically to actually get the diagnosis right. Because my— out— essentially, Alzheimer's is about 60 to 70% of the dementias. Well, you mentioned vascular dementia. That could be about 20%. They can coexist, or you can have Alzheimer's and vascular. You have to understand that. In fact, the majority of them are mixed when we actually see autopsies, but there is a predominant version on top of that.

Yeah.

So you need to go to a center who's familiar with that. And everything's changing very quickly. We should have FDA-approved medications. We have one right now that is disease-modifying, but we should have several very soon available.

Yeah. So in the meantime, Dr. Winner, how do we reach you?

Well, the simplest way is to use— is call me by phone. It's area code 561. 851-9400. That's 851-9400. Or to use a website connection, Premier Research Institute. That's premieresearchinstitute.com.

Fabulous. And next segment, we're going to talk about how is, is Alzheimer's disease diagnosed and how accurate is the testing? We're going to go into what those look like right after this. We at Answers for Elders thank you for listening. Did you know that you can discover hundreds of podcasts in our library on senior care? So visit our website and discover our decision guides that will help you also navigate decision-making. Find us at answers4elders.com.

Hi, I'm Laurie LeBay, and I wanted to tell you about Alzheimer Speaks, which is another great podcast. You see, my own mother lived with dementia for 30 years, and I felt lost. Did you know every 3 seconds someone in the world is being diagnosed with dementia? Odds are it's going to hit your families too. We want to help you connect to services, products, tools, research, and stories so you can be prepared. Please subscribe to Alzheimer Speaks on your favorite podcast platform.