One third of all Alzheimer’s cases may be preventable.

Alzheimer’s disease is one of the most concerning health problems currently affecting the world. In the US, over 5 million people are currently living with the disease and about 500,000 people die annually from Alzheimer’s or dementia related disease. Without new prevention or treatment, it is estimated that the amount of people suffering from Alzheimer’s in the US will triple to 15 million people by 2050. There are multiple stages to Alzheimer’s progression and along the way the disease takes a toll on not only the patient but also on the family of the patient. Family members may feel guilty, lost, angry or frustrated as the patient becomes more and more removed from the person they once were. The burden on families and patients should not be understated, but the cost of treating Alzheimer’s is perhaps even more outstanding, estimated to surpass $200 billion this year and $1.2 billion in 2050 meaning Alzheimer’s is also one of the most expensive diseases to treat, more expensive than cancer. Treatments for Alzheimer’s are limited and mainly have focus on treating the symptoms of the disease, which include memory loss and behavioral changes. There is no current therapy approved to reverse the disease, although researchers are working hard. But what if we could prevent the development of Alzheimer’s altogether? Surely this is a pipe dream?

Perhaps it is not. Research out of London and published in The Lancet Neurology has suggested that 1 out of every 3 cases of Alzheimer’s worldwide (or about 9.5 million cases) may be preventable with modifications to people’s lifestyles. The study looked at modifiable risk factors, or things that can be controlled or treated, and modelled how they affected a person relative risk for developing Alzheimer’s. After combining all the risk factors and accounting for interactions between them, the researchers found that about 30% of all Alzheimer’s cases in the US, Europe and UK could be prevented if certain life style risk factors were changed. What were these factors?

1. Low educational achievement/status accounted for the highest amount of preventable risk worldwide. They found that with a greater educational achievement, 19% of all Alzheimer’s cases worldwide (or 6.4 million cases) could have been prevented. In the US and UK this was a smaller risk with only 386,000 and 93,000 cases being attributed to this risk factor respectively.

2. Physical inactivity in the US, Europe and UK accounted for the largest modifiable risk factor. Up to 20% of cases could be prevented by being more physically active. This works out to over 1,000,000 cases that could be prevented in the US and Europe and over 160,000 cases in the UK. Worldwide, this factor accounted for 4.3 million preventable cases.

3. Smoking status was another big risk factor. Worldwide, 14% of cases could be prevented through cessation of smoking. This accounts for 4,000,000 cases of Alzheimer’s worldwide and 574,000 cases in the US.

4. Other risk factors include: Diabetes (worldwide preventable cases: 969,000), Hypertension (worldwide preventable cases: 1.7 million), Obesity (worldwide preventable cases: 670,000), and Depression (worldwide preventable cases: 2.6 million).

What this research suggests is that vascular health (affected by smoking, obesity, diabetes, and physical inactivity) plays a large role in determining our Alzheimer’s risk. These are also the same risk factors that predict cardiovascular disease and so changing them would go a long way to making the population healthier. It has been estimated that physical inactivity is one of the largest risk factors for non-infectious diseases. The research also suggests that worldwide, access to affordable education is important in preventing Alzheimer’s. There are numerous other studies that have shown the importance of maintaining a lifestyle that incorporates education on preventing dementia and improving brain health. It should be a global initiative to ensure that everyone regardless of money, geographical location, race or religion has access to education.

The steps to preventing Alzheimer’s seem easy, exercise your body, exercise your mind and eat healthy or in moderation. Simple things like going for a walk every night after dinner or picking up a book to read can go a long way in ensuring your brain stays healthy. Not surprisingly, most of the risk factors for Alzheimer’s are also modifiable risk factors for other diseases like heart disease and cancer. Preventative medicine is cheaper than reactive medicine and is important in helping keep health care affordable and effective. So if you want to help ease the burden of Alzheimer’s and dementia and want to remember the things you’ve experienced when you’re older, start thinking and start moving.

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