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Is the most dreaded disease of aging, Alzheimer's, something we're doomed to experience by our genes? Or is Alzheimer's really a complication of life experiences, maybe toxic exposure, bombardment with electromagnetic waves, or bad diet?

Or maybe it is possible that Alzheimer's results from a combination of factors. Determining the causes of Alzheimer's has been the aim of over five decades of brain research. Dr. Gary Small of professor of Psychiatry and Aging at the School of Medicine of the University of California at Los Angeles, however, says in an interview with the Huffington Post that the most important misconception about Alzheimer's is that it is strictly genetically inheritable, and therefore something no one can prevent.

Alzheimer's can be treated, just not very well

Alzheimer's disease, Dr. Small notes, is treatable. The problem is just that the treatments for Alzheimer's disease are not as completely effective as most people might like. At least temporarily, some of the modern medications for this condition can keep people who have the disease in their own homes and out of the nursing home, maybe for a few months, and maybe for a few years. The sooner the disease is treated, the more time the treatments can buy.

Dr. Small told the Huffington Post that the most gratifying kinds of studies with which he has been involved have had to do with detecting Alzheimer's disease in its earliest stages. It had always seemed commonsensical, the researcher said, that the aging brain does not lose its normal functions all of a sudden. Alzheimer's disease, the doctor believes, is always a condition that begins very gradually. It is a process, not a single event.

Alzheimer's is the result of decades of small changes in the brain. In their advances of brain scan technology, Dr. Small and his colleagues found that the gradual changes in the structure and function of the brain, not dramatic changes in the structure and function of the brain, were definitely the case in Alzheimer's disease. The UCLA research physicians were able to detect subtle changes in the brain that indicate the future development of the condition even decades before they obviously had the disease.

While it often frightens people in their 40's and 50's to be told that they have the earliest indications of Alzheimer's, Dr. Small believes that the potential for early diagnosis really is a cause for optimism. He believes that future doctors will be able to detect people at risk for the disease. They will be able to work to protect the healthy brain rather than try to repair it once major damage is done.

Alzheimer's hard to differentiate from normal aging

The unique challenge of treating people with Alzheimer's, Dr. Small says, is that the disease is so gradual and subtle that it is almost impossible to distinguish it from normal aging. The diagnosis of Alzheimer's disease, Small believes, really comes down to the degree of the symptoms. Everybody complains about slipping memory as they get older, but if at some point the doctor says, "You've got Alzheimer's," you are not experiencing normal aging.

Dr. Small says, however, that the degree of symptoms eventually may be something that doctors are not concerned about. This could happen when medical science reaches the point that there will be blood tests and brain imaging techniques enabling doctors to do brain checks. Eventually medical technology may enable physicians to treat Alzheimer's the way doctors now deal with high cholesterol. Some kind of biological marker will be measured by blood test that will tell the physician if the patient is at high risk for Alzheimer's. Then, it is to be hoped, a medication to be prescribed to lower the risk of eventually developed full-fledged symptoms of the disease.

Taking away the stigma of Alzheimer's

This would, Professor Small says, remove the stigma associated with Alzheimer's. Right now, many people with Alzheimer's disease do not come in for medical exams until they are very late in the disease. This is because they are fearful of what they are going to find out. Alzheimer's disease is something that will affect all of us if we live long enough, so it is important to try to deal with it now.

Even now there are probably things we can do to continue to improve our brain health and lower our risk of Alzheimer's. What are some of the things we can do to prevent the onset of Alzheimer's disease?

The old saying “Use it or lose it” especially applies to the brain. The denser the circuits in the brain become earlier in life through constant mental activity, the more circuits there will be to support brain function when Alzheimer's sets in. The prestigious Journal of the American Medical Association reported a  widely publicized study of nuns that concluded that the nuns who wrote in journals in the most complex language early in life were the least likely to develop Alzheimer's disease later in life. During the first few years of Alzheimer's disease, simply  working crossword puzzles, maintaining social ties, being included in conversations and decisions, and attempting intellectual tasks can slow down Alzheimer's-related intellectual decline.

There is also evidence that inflammatory processes play a role in the genesis of Alzheimer's. The tangles of protein fibers in brain tissue found in Alzheimer's disease contain inflammatory hormones and a special subclass of white blood cells that are activated by inflammation. A study published in the New England Journal of Medicine found that people who use Aspirin, Tylenol, and similar non-steroidal anti-inflammatory drugs on a daily basis for two years or more are 80 per cent less likely to develop this disease than people who use pain relievers occasionally or not at all.

Another potential risk factor for Alzheimer's disease is exposure to aluminum. Once they get into the bloodstream, aluminum ions are "hooked on" to carrier proteins so that they "catch" proteins in the brain. They are electrostatically attracted to the coils of tau protein that causes the "tangles" in the brain that destroy neurons.

Everyone accumulates aluminum in the body with age, but autopsies have found that people with Alzheimer's disease accumulate more aluminum than people who do not have the disease. Treatment with a chelating agent usually used to remove excess iron, desferrioxamine (not the more familiar EDTA) was found in one study to have slowed the development of symptoms in 48 people who had Alzheimer's.

There are over 20 studies that have found that women who take estrogen replacement therapy are less likely to get Alzheimer's. Men who have higher bloodstream levels of estrogen, however, are more likely to develop Alzheimer's. In men, the fat cells make small amounts of estrogen and store even more. This may be the reason men who are overweight are more likely to get Alzheimer's disease.

Finally, just avoiding head injuries also helps lower the risk of developing Alzheimer's. One study blows to the head increases the risk of developing Alzheimer's over 10-fold.

  • Alzheimer's Association. 2010 Alzheimer's disease facts and figures
  • Alzheimer's & Dementia. Mar 2010,6:158-194. [Medline]
  • Hebert LE, Scherr PA, Bienias JL, Bennett DA, Evans DA. Alzheimer disease in the US population: prevalence estimates using the 2000 census. Arch Neurol. Aug 2003,60(8):1119-22
  • Plassman BL, Langa KM, Fisher GG, et al. Prevalence of dementia in the United States: the aging, demographics, and memory study. Neuroepidemiology. 2007,29(1-2):125-32

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