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Computer graphic of a tree with the branches shaped like a face and flying leaves away from it arranged like a face representing the impact of dementia and Alzheimer's Disease

Do you feel the unknown inevitability of your future health is out of your control? Kenneth H. Cooper, MD, MPH, Founder and Chairman of Cooper Aerobics, explains how to take your health back into your own hands and shares key practices that can help prevent the onset of Alzheimer’s disease and dementia.

Alzheimer’s disease Prevention: Healthy Lifestyle Prescription

Brain health, in general, is something some people don’t pay attention to until it is too late. We can actually protect the brain just like we can protect the heart. What is good for the heart is also good for the brain. It is a whole lot easier and much more cost-effective to prevent cognitive decline before its onset than it is to try to find a cure for it. That is why America has spent more than $200 billion trying to find a cure for Alzheimer’s without success.

The Lancet Commission on Dementia Prevention, Intervention and Care concluded that modifying 12 risk factors might prevent or delay up to 40% of dementia. Modifiable risk factors, regardless of age, for dementia prevention include:

  1. Physical Activity – Exercise regularly for at least 30 minutes collectively or sustained most days per week.
  2. Manage Blood Pressure– Strive to maintain systolic blood pressure at 130 mm Hg or less in midlife (from around 40 years of age).
  3. Sleep – Get at least seven hours of sleep per night.
  4. Eat Well – Maintain a healthy diet by eating at least five servings of fruits and vegetables per day.
  5. Manage Weight – Maintain a healthy body weight with a BMI under 25.
  6. Challenge Your Brain – Challenge your brain with new activities such as crossword puzzles, memorization, learning a new language, or learning how to play a musical instrument.
  7. Protect Hearing – Protect ears from excessive noise exposure and use hearing aids for hearing loss.
  8. Manage Alcohol – Limit or minimize alcohol.
  9. Reduce – Exposure to second-hand smoke and air pollution.
  10. Do Not Smoke – Strive to quit smoking if you smoke.
  11. Prevent Head Injury – Wear a seat belt when in a motor vehicle, wear a helmet/headgear as recommended for various sports, and improve balance through strength and balance exercises.
  12. Supplement your diet with the appropriate vitamins and minerals needed for optimal cognitive function, such as folate and B vitamins, vitamin C, and vitamin D (at least 50 mcg (2,000 IU) daily).

In my 66 years of practicing medicine, one of the most common statements I hear is “if only.” “If only I had done what you told me to do 15-20 years ago, I would not be in the condition I am in today.” And I have also seen so many people who live five or six years after being diagnosed with Alzheimer’s or dementia before passing away, during which time they reach the state where they cannot even recognize family members.

I don’t want to go that way. My goal is to “square off the curve,” meaning I want to live a long, healthy and active life to the fullest and then die suddenly. What a wonderful way to go. On the contrary, the damaging psychological and physiological effects on a family of a loved one who dies after several years of suffering from Alzheimer’s is something we want to try and prevent.

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Alzheimer’s disease Prevention: What’s good for your heart is good for your head

The general recommendations to Get Cooperized™ are effective not only for protecting against cardiovascular disease but also for protection of your brain’s health. It is so simple. For example, exercise is important for brain health. I am aware of many examples of where that has occurred. In looking at the five categories of fitness and observing the size of an individual’s coronary arteries as determined by a CT scan, there is a direct correlation between the size of the coronary arteries and the level of cardiovascular fitness. As the level of fitness increases, the size of the arteries also increases. Recently, one of my patients, who was an outstanding former runner, came in with a very high coronary calcification score. We performed a CT angiogram to see if there were any signs of coronary artery obstruction or blockage with such a high calcification score. We found that due to his high fitness level, his coronary arteries were twice the size in diameter of anybody else of his age, and he did not have any blockage. This once again proves that, with high levels of fitness, you have some protection from having a heart attack and a higher survival rate.

Protection from the inside out

We also know the same thing happens to the brain. The blood circulation in the brain is entirely different in a person who is physically fit. I use a recent example of an older patient who had a stroke. When doing an MRI scan of the brain, their brain looked as if it was an insignificant stroke because the brain looked much younger than a man his age. The only way they could explain this phenomenon was either because of my patient’s long history of exercise or perhaps the vitamin supplementation he had been taking over the years. The vitamin recommendations for preventing Alzheimer’s, particularly vitamin D, along with regular exercise, which improves the circulation of the brain, both help reduce problems developing in the brain. These two preventive actions can certainly help improve the function of the brain for a long period of time and extend your life.

Alzheimer’s disease Prevention: Physical and Mental Connection With Others

If you start showing signs of dementia, you don’t want to isolate yourself from others. There is something about being gregarious and socializing with others that prolongs functional brain activity. The body also needs social interaction from a psychological standpoint. Depression can often be improved through socialization. The body needs contact with others for some type of stimulation.

But how long does it take to experience the benefits?

The question is, how long does it take to get the benefits that might protect the brain? The benefits don’t take place overnight, of course. Your brain’s health gradually improves, just like it does with the coronary arteries, over a period of years where you have some initial benefit, but it is a slow process. You can have an obstruction of the coronary artery that is very slow in blocking off significantly. The body even has an amazing ability to grow another vessel that can go around the obstruction, which is a physiological coronary bypass. We see that happen all the time in people who exercise. This can also happen to the brain, too—you can have a thrombotic stroke caused by blood clots, or you can have a hemorrhagic stroke when a weakened blood vessel ruptures. But if you have a blood clot and it is slowly progressing in the brain, then there is a possibility that the body would have a chance to develop collateral circulation around it, and you may never have any consequences.

Are there any new drugs for Alzheimer’s disease Prevention?

One drug, “Aduhelm,” approved by the FDA in 2021 as a means of slowing the progression of Alzheimer’s, has proven to be controversial under clinical trials, and it costs $28,200 per year. Whether it will be covered by Medicare has still not been decided, so I cannot recommend any new drug at this time. Remember, too, we have shown in one of our major Cooper Institute studies that people in the highest fitness category, at age 50, had 36% less Alzheimer’s and dementia than those in the bottom categories of fitness 25 years later. The only risk factor that we studied was their fitness level as determined by their treadmill stress test performance. As I have said many times in the past, “It is cheaper and more effective to prevent disease than it is to find a cure.”

The fact is people who exercise, socialize and follow these recommendations have some protection against Alzheimer’s disease. Your health is your responsibility. Regardless of your age, even making just a few small changes to your routine and lifestyle is investing tremendously in the health and well-being of your future. You will be amazed at how your body will take care of you later down the road if you take proper care of it in the here and now.

I have never said that exercising regularly can prevent a heart attack or stroke. But I can assure you, the survivability is much better if you’ve been exercising regularly. There is no drug that can replicate the benefits of an active lifestyle. Our lifestyle is the most unappreciated risk factor in the world today. So what you eat, what you drink, how much you exercise and how you supplement your diet may help you live a long, healthy and active life to the fullest—just as I am doing in my 91st year.

This article on dementia and Alzheimer’s disease prevention is provided by Cooper Aerobics Founder and Chairman Kenneth H. Cooper, MD, MPH.

(Bonus: Learn about Dr. Cooper’s daily supplement regimen.)

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