Updates in time for World Alzheimer's Month

“Never too early, never too late.” That's the theme for September's World Alzheimer's Month campaign, which is sponsored by Alzheimer's Disease International (www.alzint.org). The idea is that you can start anytime to mitigate risk factors for Alzheimer's and dementia, even if you've already received a diagnosis.

So I'm devoting this column to some of the latest Alzheimer's research, both into treatments and what we can all do to reduce our risk. With the global number of people living with dementia expected to triple by 2050, it's important to understand and respond to risk factors.

Lowering your risk

There's no avoiding the major risk factor for Alzheimer's and dementia — getting old. The longer you live, the greater the risk. According to the Alzheimer's Association, “A person who is aged over 75 is more likely to develop dementia than someone who is under 75.” Gender and environment also play a role, as does genetics.

But what about risk factors you can control? It's estimated that 40% of Alzheimer's cases may be avoided if we practice some healthy habits, such as not smoking, drinking moderately and eating healthfully. Another good habit is to stay actively engaged in work, volunteering, hobbies — even puzzle solving — to maintain your “cognitive reserve.” Social isolation is another risk factor, which is why we saw the incidence of dementia rise during the COVID-19 pandemic restrictions.

Maintaining cardiovascular health is also important, something we have a lot of control over. In addition to not drinking too much and not smoking at all, activity and controlling blood pressure are important.

Speaking of activity, walking has been shown to reduce risk, according to studies. And you can do yourself a favor and support research by joining a “Walk to End Alzheimer's” this fall. The Alzheimer's Association (www.alz.org) is sponsoring events around Chicago and suburbs during September and October. You can find a list on their website.

Emerging research on risk factors

Scientists are constantly looking for ways to reduce the risk of Alzheimer's and dementia. UCLA researchers, for instance, found that a type of yoga that emphasizes breathing, meditation and visualization improved connectivity in an area of the brain associated with stress and memory loss.

Hearing loss is a factor in social isolation, and researchers have found hearing aids can slow cognitive decline. Based on a study of 1,000 older adults at high risk of dementia, Johns Hopkins researchers say hearing aids reduced the rate of cognitive decline by almost 50% over a three-year period.

In the nutritional arena, the Mediterranean diet — which emphasizes healthy oils, whole grains, vegetables, seafood and beans — is associated with a lower risk of dementia. A Harvard researcher said that replacing unhealthy fats, like butter and margarine, with olive oil “not only supports heart health but potentially brain health, as well.”

Emerging treatments

Currently, researchers focus on diagnosing and mitigating rather than curing or preventing Alzheimer's and dementia. In 2022, the FDA approved a blood test to detect the presence of beta-amyloid, the brain plaque that hampers cognitive function. Doctors consider drugs that increase levels of acetylcholine — an important neurotransmitter — as the first line of treatment.

Other drugs work to attack the buildup of beta-amyloid. Aducanumab was the first therapy to show that removing the plaque improved cognitive function in people with early Alzheimer's. Three newer immunotherapies take the same route. In January, the U.S. Food and Drug Administration approved Leqembi for people with mild cognitive decline after it was shown to reduce plaque by a statistically significant amount. Two other promising immunotherapies are Donanemab and Remternetug.

Three potential treatments caught my eye.

It's well known that dementia disrupts our circadian rhythm — the sleep/wake cycle — which can worsen the effects of cognitive decline. An experiment found that time-restricted feeding of mice reduced the beta-amyloid in their brains. If this can be translated to humans, it would give us a cost-effective treatment accessible to just about everyone.

There are also vaccines on the horizon. One has shown to be effective in reducing plaque in the brain and is awaiting further clinical trials. The other targets a protein found in aging brain cells and blood vessels and, in mice at least, improves cognitive behavior.

As a nurse and patient advocate, I've had a front-row seat for our evolving understanding of cognitive decline and the development of new therapies. Alzheimer's or any form of dementia is still a devastating diagnosis, but I'm encouraged not only by the ongoing research but also the different ways we can improve our chances of avoiding it.

• Teri Dreher is a board-certified patient advocate. A critical care nurse for 30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com). Her new book, “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” is now available on Amazon. She is offering a free phone consultation to Daily Herald readers; call her at (847) 612-6684.