Jed A. Levine
Executive Vice President, Director of
Programs & Services
Welcome to 2018! A New Year; a new beginning. Many of us make New Year’s resolutions, which by the time you are reading this, might have already been broken or perhaps a little bent.
Many resolutions have to do with lifestyle; exercise regularly, eat more healthfully, get more sleep, meditate, go for that annual check-up or other activities that promise better health. And, I know that many of our readers are concerned about brain health. With Alzheimer’s disease and other dementias as the costliest of the top 10 causes of death in the U.S. without a way to effectively treat, slow down, or prevent them, we are all looking for that “magic bullet” that can do just those things.
The landscape is a confusing one, but I advise you to be an educated consumer of health education. Be skeptical; if it sounds too good to be true, it probably is.
A few tips when reading about scientific research:
Understand the difference between “cause” and “association.”
- Bacterial infections cause pneumonia.
- Poor sanitation, ventilation, and living in close quarters are associated with an increased risk of developing tuberculosis.
Understand the difference between “risk-reduction” and “prevention.”
- With risk-reduction, you are lowering the chance of something happening: e.g. wearing a helmet or seatbelt reduces the chance of head injury.
- In prevention you are eliminating the chance that something will happen: e.g. if you get the polio vaccine, you will not get the disease.
Understand the difference between epidemiological studies and clinical trials.
- Epidemiological studies report on findings in large populations and create theories based on those findings.
- Clinical trials test a drug for safety and effectiveness.
Know which studies have good evidence, are published in peer-reviewed journals, and are based on rigorous science. See if they are double-blind (neither the researcher nor the patient knows whether they are receiving the drug being tested), and if participants are randomly assigned to either the treatment or control/comparison group.
In studies regarding Alzheimer’s and other dementias, there are lots of theories about what contributes to developing the disease, and what changes we can make that might reduce the risk. It can be confusing and difficult to sort these out. In this issue of the CaringKind newsletter, (our first fully digital issue) we have asked several experts in the field to present their understanding of the state of risk-reduction and what we know now.
A little perspective helps:
The brain uses 20 percent or more of the blood that is pumped by the heart, so it makes sense to keep the heart in shape. It is safe to say that what is good for the heart is good for the brain.
Know your numbers:
- Weight /BMI
- Blood Pressure
- Blood Glucose (sugar levels)
Keeping these in normal levels are good for your heart and therefore good for your brain. However, as Dr. Richard Isaacson, head of New York Presbyterian Weill Cornell’s Alzheimer’s Prevention Institute often says, one size will not fit all. The most effective approach will be a highly personalized one, which takes into account many factors; individual biology, history, exercise, level of education, genetics, and more.
It’s hard to say how much effect each component of a healthy lifestyle has on brain health; i.e. diet vs. exercise or sleep. Or, if one is genetically pre-disposed to develop late-onset (after 65 years of age) Alzheimer’s, how much any of these activities will reduce the risk. There is some evidence that some activities might delay the onset. And, as we know that the changes in the brain happen much earlier than we had thought, well before the onset of forgetfulness or confusion. Given this, it makes sense that early interventions may be helpful.
However, it takes self-discipline and control to commit to a lifestyle of healthy eating, regular exercise and good sleep habits. So, be realistic in what you can achieve. Make small changes and build on those. And forgive yourself if you slip up; there’s always tomorrow.
In the meantime, until we have sufficient evidence that specific things are effective in reducing the risk of developing dementia, you can rely on us to provide information, resources and referrals to help if you are a dementia caregiver. There is solid evidence that this support makes a difference. Call the 24-hour Helpline at 646-744-2900 or visit our website at www.caringkindnyc.org. We are here to help!