A Patient Guide to Outsmarting Alzheimer’s Disease

By Terri Chrisman M.Nutr, Dip.ACLM from the PAN Academy – our online learning platform where you can learn all about nutrition and health.

Purpose

The purpose of this article is to equip you with knowledge about the causes of Alzheimer’s dementia. We will give you actionable strategies to help you or a loved one slow its growth and reduce its crippling effects.
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Alzheimer’s disease accounts for 70% of all cases of dementia, which makes daily living and functioning harder. Genes do play a part in Alzheimer’s disease, but they do not paint the whole picture. Lifestyle choices and healthy dietary habits can reduce the risk of dementia and even slow down its progression to Alzheimer’s.

What is Alzheimer’s disease, what is dementia?

Although often used interchangeably, Alzheimer’s disease and dementia are not the same. Dementia is an umbrella term for symptoms like memory loss, confusion, and difficulty with daily tasks. In contrast, Alzheimer’s disease is a specific cause of brain damage, particularly in the elderly. It’s the leading cause of dementia, accounting for 60-80% of cases. Yet, it’s just one type among several, each characterised by unique brain changes (1).

Image: Dementia – An umbrella term for symptoms affecting cognitive functions and daily activities. Dementia stems from various brain-damaging causes that often coexist.

Alzheimer’s disease is a debilitating degenerative disease where the brain slowly dies. Symptoms of Alzheimer’s disease may start with short-term memory loss. As the condition worsens, this short-term memory loss can progress to an inability to cope with the daily activities of living. There is no cure for Alzheimer’s disease but we can take steps to avoid it or slow down its progression.

What are the types of Alzheimer’s disease?

Alzheimer’s disease has 2 types: early-onset (familial) and late-onset (sporadic).
Generally, with early-onset Alzheimer’s, people develop cognitive decline before the age of 60. This type accounts for less than 10% of all Alzheimer’s cases and is genetic (2,3).

Late-onset Alzheimer’s can involve some genes but is largely lifestyle-based. It usually occurs in people over the age of 65 (4). By age 85, about half the population suffer from this debilitating condition. Sadly, more and more young people in their 30s and 40s are developing Alzheimer’s disease. This type of late-onset disease in the young is largely preventable.

What are the signs and symptoms of Alzheimer’s disease?

Alzheimer’s can take years or even decades to become obvious. Whilst damage may be happening to the brain, it may not be obvious to you or your family. In the early stages of Alzheimer’s disease, you may experience short-term memory loss, or have difficulty planning and solving problems. You might put it down to just getting older.

As the disease progresses, these changes may cause you and your family concern. At this stage, anxiety, confusion and depression are common. Advancing symptoms include the inability to remember major events, getting lost in familiar places and forgetting the use of common objects. When people lose the ability to live independently, they usually require around-the-clock professional care (5,6).

Image: Stages of Alzheimer’s disease and some of the symptoms during each stage.

What promotes the progression of Alzheimer’s disease?

The link between diabetes and Alzheimer’s disease is so strong that it is often called type 3 diabetes, or diabetes of the brain. Up to 80% of people with Alzheimer’s also have diabetes (7). The brain is the body’s largest user of glucose (8). When the body is suffering from insulin resistance or glucose control issues, the brain suffers too.

Being overweight or obese can contribute to Alzheimer’s disease the same way it contributes to diabetes, via inflammation. The biological hallmarks of Alzheimer’s disease, the build-up of protein plaques and tangles in the brain, thrive in this inflammatory environment (9). In addition, excess body fat promotes DNA ageing that contributes to accelerated brain ageing, particularly in young people (10).

Saturated fat intake contributes to obesity, high cholesterol and diabetes. Saturated fat comes from animal products, such as meat and dairy products (especially cheese) and ultra-processed foods like cookies, crackers and ready meals. People who eat the most saturated fat are 2.2 times more likely to develop Alzheimer’s disease than those who eat the least saturated fat (11).

How can I slow the progression of Alzheimer’s disease with nutrition?

Although just one of many healthy actions to take, nutrition has the biggest impact.
One of the precursors to Alzheimer’s disease is inflammation. In the brain, inflammation can damage brain cells and promote an environment favourable to the growth of Alzheimer’s disease.
A whole food plant-based diet can reduce inflammation.
Plants, including vegetables, whole grains, legumes and fruit contain antioxidant and anti-inflammatory compounds called phytonutrients. These healthful plant compounds can prevent or delay cognitive decline during ageing (12). Consuming green leafy vegetables, soy, mushrooms and green tea is linked to a lower chance of brain damage, slower cognitive decline and better memory (12). Consuming whole grains such as brown rice, millet, black rice and barley also reduces the risk of cognitive impairment. Berries contain nutrients called flavonoids that protect brain cells from quicker ageing (13, 14).

What about fat?

Omega-3 fats are great brain fats. Over a third of brain fat is from omega-3s. Omega-3s play a crucial role at both ends of our lives. They are essential for foetal brain growth and also for preserving the ageing brain. Omega-3 supplementation can increase learning, memory, well-being, and blood flow to the brain. The omega-3 eicosapentaenoic acid (EPA) increases thinking and task performance and the omega-3 docosahexaenoic acid (DHA) can protect against early cognitive impairment (15). An added benefit is that omega-3 fats can lower the risk of heart disease, arthritis and some cancers (16). Food sources of omega-3 fats include walnuts, chia seeds and flaxseeds. Supplements of EPA and DHA sourced from algae are a healthy choice. Eating a diet high in unsaturated fats can offer an 80% risk reduction in developing Alzheimer’s disease (11). Whole plant foods that contain such unsaturated fats include nuts, seeds, avocados, and olives.

How do I get started?

The best time to get started is today. It doesn’t matter if you are young, with no symptoms, or if you have already been diagnosed with Alzheimer’s disease. Adding more plants to your diet will improve your chances of slowing cognitive decline as you age.
Don’t be worried about being perfect. Just take each meal at a time and add healthy plant foods. As you become more comfortable eating a plant-predominant diet, you will be crowding out the unhealthy food. Plus you’ll be adding more nutrition to every bite. Eating a whole food, plant-based diet will protect your brain now and into the future.

What else can I do to prevent Alzheimer’s disease?

There are many other risk factors for Alzheimer’s disease that are within your control. Here are some tips for addressing some of the other risk factors:
  • Less education: make the love of learning a lifetime pursuit
  • Loss of hearing: protect your ears or seek medical attention to restore hearing, if possible
  • Abuse of alcohol: seek assistance if alcohol use becomes problematic
  • Smoking: seek help to quit
  • Traumatic brain injury: wear a helmet for all dangerous activities
  • Low social contact: join a community group of people who share your interests
  • High blood pressure: measure your blood pressure regularly and seek medical attention if it is high
  • Depression: seek help from your doctor or community programs
  • Exposure to air pollution: stay indoors if the air quality is low
  • Lack of exercise (17): partake in at least 30 minutes of moderate exercise every day
  • High cholesterol (18): reduce your saturated fat intake and seek advice from your physician
  • Chronically disturbed sleep (19): maintain a daily sleep hygiene
  • Chronic stress (20): learn resilience and coping strategies to effectively deal with stressful situations

Practical tips for you

Recognise the early signs of cognitive decline and take action to improve your brain health:
  1. Eat a whole food, plant-based diet of vegetables, beans/legumes, whole grains, fruit, nuts/seeds and herbs/spices.
  2. Reduce saturated fat intake from animal products such as meat and dairy and ultra-processed foods.
  3. Increase omega-3 intake from plants such as walnuts, chia seeds and flax seeds.
  4. Reduce your risk for Alzheimer’s disease by addressing the lifestyle factors listed above.

Conclusion

Dementia doesn’t magically appear when you turn 65. Many factors contribute to the likelihood of developing Alzheimer’s disease. All your lifestyle choices, especially your diet, determine how rapidly your brain will decline as you age. Cognitive decline takes decades to become obvious so it’s important to take our brain health seriously when we are young. Stave off or slow down cognitive decline with whole food, plant-based nutrition and enjoy your old age in good health. How you live your life at age 30 or 40 determines the health of your brain at age 70 or 80.

Quiz questions

Want to check if you remember the essentials of this article? Then test how much information you retained with this quick quiz!

Good luck!

Further information

For more information on this topic, download the Alzheimer’s Patient Factsheet.

For the definitions of important terms, go to the PAN Glossary.

 

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Making better physicians

Ready to improve your nutrition knowledge?

Sign up to the PAN Academy and take our free online courses on nutrition science.

Mini Modules on Diet-Related Diseases

This series of short modules addresses common diet-related diseases such as heart disease, hypertension and type 2 diabetes. Learn the causes and which patients are at risk, and find out practical solutions to managing these diseases through whole food, plant-based eating.

 

References List:

  1. WHO, 2023. Dementia. Available from: https://www.who.int/news-room/fact-sheets/detail/dementia Accessed 8 Nov 2023
  2. Potter et al., 2016. Population prevalence of autosomal dominant Alzheimer’s disease: A systematic review. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/alz.037129
  3. Robinson et al., 2018. Recent progress in Alzheimer’s disease research, part 2: genetics and epidemiology. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/pmc6705191/
  4. Baranowski et al., 2020. Healthy brain, healthy life: a review of diet and exercise interventions to promote brain health and reduce Alzheimer’s disease risk. Available from: https://cdnsciencepub.com/doi/10.1139/apnm-2019-0910
  5. Alzheimer’s Society, 2021. The progression, signs and stages of dementia. Available from: https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/how-dementia-progresses/progression-stages-dementia Accessed 29 Jan 2024
  6. Reisberg & Franssen. Clinical stages of Alzheimer’s. Available from: https://www.alzinfo.org/understand-alzheimers/clinical-stages-of-alzheimers. Accessed 21 Dec 2023
  7. Janson et al., 2004. Increased risk of type 2 diabetes in Alzheimer disease. Available from: https://doi.org/10.2337/diabetes.53.2.474
  8. Ardanaz et al., 2022. Brain metabolic alterations in Alzheimer’s disease. Available from: https://www.mdpi.com/1422-0067/23/7/3785
  9. Ferrari & Sorbi, 2021. The complexity of Alzheimer’s disease: an evolving puzzle. Available from: https://journals.physiology.org/doi/full/10.1152/physrev.00015.2020
  10. Gielen et al., 2018. Body mass index is negatively associated with telomere length: a collaborative cross-sectional meta-analysis of 87 observational studies. Available from: https://ajcn.nutrition.org/article/S0002-9165(22)02948-3/fulltext
  11. Morris et al., 2003. Dietary fats and the risk of incident Alzheimer disease. Available from: https://doi.org/10.1001/archneur.60.2.194
  12. Rajaram et al., 2019. Plant-based dietary patterns, plant foods, and age-related cognitive decline. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/pmc6855948/
  13. Devore et al., 2012. Dietary intakes of berries and flavonoids in relation to cognitive decline. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/pmc3582325/
  14. Agarwal et al., 2019. Association of strawberries and anthocyanidin intake with Alzheimer’s dementia risk. Available from: https://www.mdpi.com/2072-6643/11/12/3060
  15. Dighriri et al., 2022. Effects of omega-3 polyunsaturated fatty acids on brain functions: a systematic review. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9641984/
  16. National Institutes of Health. Omega-3 fatty acids. Available from: https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/Accessed 22 Dec 2023
  17. Livingston et al., 2020. Dementia prevention, intervention, and care: 2020 report of the Lancet commission. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30367-6/fulltext
  18. Moser et al., 2023. Association between fluctuations in blood lipid levels over time with incident Alzheimer disease and Alzheimer disease–related dementias. Available from: https://n.neurology.org/content/101/11/e1127
  19. Bishir et al., 2020. Sleep deprivation and neurological disorders. Available from: https://www.hindawi.com/journals/bmri/2020/5764017/
  20. Justice, 2018. The relationship between stress and Alzheimer’s disease. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991350/

 

Additional references from the patient factsheet:

21. Dhana et al., 2020. Healthy lifestyle and the risk of Alzheimer dementia. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455318/
22. Morris et al., 2015. MIND diet associated with reduced incidence of Alzheimer’s disease. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/pmc4532650/
23. Morris et al., 2015. MIND diet slows cognitive decline with aging. Available from: https://www.sciencedirect.com/science/article/pii/S1552526015001946

Kid with Raspberries

Author

Terri Chrisman M.Nutr, Dip.ACLM

Terri Chrisman M.Nutr, Dip.ACLM is a Medical Content Creator at PAN and part of the online education team responsible for the PAN Academy. She is an Australian citizen living in the USA who has travelled and lived all around the world. She is a qualified nutritionist and certified in lifestyle medicine, and is vastly experienced in creating educational content on the topics of nutrition, health and sports.

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