A couple of weeks ago, as part of my academic day job, I led a three-hour workshop on the care and treatment of patients with age-related cognitive disorders like Alzheimer’s Disease.
The US Centers for Disease Control and Prevention (CDC) currently ranks Alzheimer’s as the sixth leading cause of death in the United States. Nearly 100,000 Americans died of the disease in 2014, the most recent year for which we have complete data.
In reality, however, those figures are likely to be a gross underestimate of Alzheimer’s true physical toll. According to a study conducted at Rush Alzheimer’s Disease Center in Chicago, the number of deaths that are actually attributable to the disease may be 5 to 6 times higher. That would mean that over half-a-million Americans died of Alzheimer’s in 2014, making it the third leading cause of death in the US. Only heart disease and cancer took more lives.
Approximately 1 in 9 Americans aged 65 or older has Alzheimer’s. That proportion rises to nearly 1 in 3 for those aged 85 and older. Thus, about 5 million people in the United States currently have the disease, a number that is expected to quadruple over the next few decades with the demographic changes associated with the aging of the baby boom generation.
Alzheimer’s is already the most expensive disease in the US. We now spend over $200 billion dollars a year caring for those with Alzheimer’s, including $150 billion in Medicare and Medicaid. About half of all nursing home residents are people with Alzheimer’s disease or other neurodegenerative diseases, most of who rely upon Medicaid to pay for their long-term care.
That too is likely a gross underestimate of the financial toll of this disease, as it fails to take into account all of the unpaid care provided by family and friends. Nearly 20 billion hours (or $220 billion) of free care was provided in 2014. Most often than not, this care was provided by women who left the workforce in order to care for an ailing spouse, parent, or sibling.
These issues are particularly important to me. I have immediate family members who have been affected by Alzheimer’s disease, both as patients and as long-term caregivers. I also carry a genetic trait known as APOE-ε4 that makes me far more likely to develop the disease, and to do so at a younger age; according to current research data, people with my particular genetic makeup (those who have two copies of the APOE-ε4, so calledε4 homozygotes) have a 50-90% chance of being diagnosed with Alzheimer’s during their lifetime, about 15 times the rate of those who lack the APOE-ε4 allele.
As someone whose career and self-worth are tied to my ability to think and write creatively, the very thought that I could slowly lose everything that makes me who I am terrifies me. I also worry about the huge personal and financial impact that a diagnosis of Alzheimer’s could have on my family.
Given this, I plan to fight my genetic predisposition tooth and nail. For me, genotype does not necessarily equal phenotype. I plan to do anything I can to ensure that I do not develop this devastating disease.
As of yet, there is no known cure for Alzheimer’s. However, there are some promising studies that suggest that its onset can be delayed (or even prevented) and its progression slowed. For example, a recent study conducted by researchers at the UCLA Mary S. Easton Center for Alzheimer’s Disease Research and the Buck Institute for Research on Aging, found that memory loss in Alzheimer’s patients could be slowed or reversed using a program that involves changes in diet and nutritional supplementation, optimization of sleep, regular exercise, and reduction of stress.
Although the treatment protocol itself was rather complex, consisting of 36 different steps, the study suggested that those patients with the best clinical response (i.e. those that showed the greatest improvement in memory, mood, and the other cognitive, behavioral, and psychological symptoms of Alzheimer’s) did the following:
- They eliminated all simple carbohydrates from their diet;
- They also eliminated gluten and processed food from their diet;
- They increased their consumption of vegetables, fruits, and non-farmed fish;
- They reduced their stress through yoga and meditation;
- They exercised for a minimum of 30 minutes, 4-6 days per week;
- They incorporated resistance training into their weekly workout routine;
- They increased their sleep to 7-8 hours per night;
- They supplemented their diet with folic acid, vitamin D3, Omega 3-rich fish oil, and CoQ10; and
- They regularly engaged in intermittent fasting, usually for a minimum of 12 hours between dinner and breakfast, and for a minimum of three hours between dinner and bedtime.
These findings also dovetail nicely with the Alzheimer’s Association’s Six Pillars ofPrevention: regular exercise, social engagement, healthy diet, mental stimulation, quality sleep, and stress management.
What is particularly interesting about these findings is that many of these same recommendations are part and parcel of a paleo- or primal-aligned lifestyle.
As mentioned in a previous post, eating primally is about eating healthy proteins like organic meats and wild-caught fish, cooking with natural derived rather than industrially manufactured fats, and consuming plenty of leafy vegetables, nuts, seeds, and a variety of sprouted and fermented foods. This approach to nutrition not only involves eliminating simple carbohydrates, gluten, and processed foods from the diet, but also includes foods that are naturally high in the two key long chain omega 3 fatty acids (EPA and DHA) and in CoQ10, reducing the need to take these supplements.
Moreover, adopting a primal lifestyle includes a consideration of the other physical and social factors that influence health, including engaging in intermittent fasting, exercising regularly, improving the length and quality of sleep, reducing stress and anxiety through regular meditation or mindfulness sessions, avoiding the overuse of electronic media and devices, and improving our relationships with friends and family.
No research has yet looked at whether a paleo or primal lifestyle can prevent cognitive decline or dementia, although some studies indicate that a paleo diet can improve measures of metabolic health, including triglyceride levels, cholesterol levels, and blood pressure that are known risk factors for Alzheimer’s disease.
Similarly, a ketogenic diet (i.e. a diet that is high in healthy fat, low in carbohydrates, with moderate protein intake, popular with many who adhere to a paleo or primal lifestyle) seems to improve the symptoms of Alzheimer’s disease in animal models. Again, no large-scale study has yet has tested the effect of a ketogenic diet in Alzheimer’s patients but one small study suggested that elderly individuals with age-related memory decline performed better on memory-related tasks after six weeks on a low carbohydrate diet.
So, while going primal is necessarily a cure for Alzheimer’s, it may be an important step towards reducing the risk of developing this devastating disease.