Prevent Alzheimer's With Healthy Living

Sept. 12, 2003 (Philadelphia) -- New discoveries suggest that the war against Alzheimer's disease may be better fought on a different front -- by launching an offensive attack in trying to prevent the disease decades before symptoms appear, often with the same strategy used to fight heart disease and stroke.

The same risk factors linked to heart disease and stroke -- high blood pressure, high cholesterol, sedentary lifestyle, smoking, and diabetes -- also increase the risk of Alzheimer's disease, which currently affects about 4 1/2 million Americans, including half of those over age 85, and is expected to triple by 2050.

In fact, within only three months of having a stroke, about one in four patients develop memory and other thought impairments, and two in three eventually develop Alzheimer's disease, says Vladimir Hachinski, MD, professor of neurology at the University of Western Ontario in Canada and editor-in-chief of the medical journal Stroke.

"The key is prevention," he tells WebMD. "And the time to do it is middle age. By taking measures to reduce your risk of stroke and heart disease, you can also reduce the risk of Alzheimer's."

At the American Medical Association's annual Science Reporters Conference, Hachinski and another neurologist, Samuel Gandy, MD, of Thomas Jefferson University, reviewed some recent discoveries that indicate a connection between the three conditions and are leading to more emphasis on preventing, rather than treating, Alzheimer's disease, just as is done with heart disease and stroke.

Currently, many Alzheimer's disease patients are now treated with drugs such as Aricept, Reminyl, and Cognex. The so-called "cholinesterase inhibitors" increase the level of a chemical acetylcholine, which helps nerve cells in the brain communicate with each other. People with Alzheimer's disease and related conditions have decreased brain levels of this chemical.

"But the drugs we use today are only modestly effective," says Alzheimer's disease specialist Samuel E. Gandy, MD, PhD, director of the Farber Institute for Neurosciences at Thomas Jefferson University. They slow progression of the disease but do not stop it.

Several studies have suggested that statins, the same drugs used to lower high cholesterol in an effort to reduce risk of heart disease and stroke, offer promise. That's because statins, and in particular, Lipitor, help destroy the other telltale sign of Alzheimer's disease -- increased levels of amyloid, a sticky substance not unlike cholesterol that forms plaques in the brain.

Some of these studies indicate that people who currently take statins are less likely to develop Alzheimer's disease, and one suggested the popular cholesterol-lowering drugs, by themselves, might reduce the risk of developing Alzheimer's disease by as much as 39%.

But Gandy says that an experimental drug, known as PI3KI, may double the positive effects of statins. However, that drug is still being studied, and Gandy doesn't advocate people take statins specifically to lower their risk of Alzheimer's disease.