How to Protect against Alzheimer’s Disease

“Every 66 seconds, someone in the United States develops Alzheimer’s disease. Currently, more than 5 million Americans live with the memory-robbing ailment and by 2050 that number could rise as high as 16 million, according to new figures from the Alzheimer’s Association.

“Scientists are working to find ways to not only treat Alzheimer’s but prevent it from developing in the first place. In one key step in the process, researchers are gaining a better understanding of the role of amyloid proteins in the development of the disease.

“‘The amyloid plaques build up outside of the nerve cells [in the brain] and now we know that when the nerve cells interact with the plaque, it causes the nerve cell to make a tangle inside,’ explains Rudy Tanzi, Ph.D., director of the Alzheimer’s Genome Project and a leading researcher in the field at Massachusetts General Hospital and Harvard Medical School. ‘And that tangle then chokes the nerve cell from within and kills it. So the killing process begins with the amyloid – that’s kind of the gun – but the tangle’s the bullet, so to speak.’

“Experts now believe these amyloid plaques and the tangles they form start occurring in people’s brains 10 to 15 years before any symptoms like memory loss begin to show.

“The latest drug development efforts are focused on intervening much earlier on, before the disease takes an irreversible toll on memory and cognitive function. Tanzi likened it to taking statins to manage cholesterol to prevent a future heart attack.

“Another increasingly important focus of medical research is neuro-inflammation in the brain — why it happens, and how to stop it. For patients with Alzheimer’s, Tanzi explained, ‘What’s killing most of your nerve cells is neuro-inflammation, where the brain has reacted against all these plaques and tangles and cell death with an inflammatory response. And only over the last 5 years, we’ve discovered the genes that control neuro-inflammation in Alzheimer’s and we’re doing drug discovery based on those as well.’

“Yet, while such drugs can take years to develop, Tanzi says there are things people can do right now to help protect their brain. He spoke with CBS News chief medical correspondent Dr. Jon LaPook about these strategies:

Q: Aside from choosing the right parents, what can somebody do to prevent Alzheimer’s – or try to help prevent Alzheimer’s?

A: The four big categories are diet, exercise, sleep and stress reduction. I wrote about this in detail in my last book, ‘Super Genes’ – six chapters, more than you wanted to know about how to adapt your diet to minimize inflammation and plaques. Meaning Mediterranean diet, probiotics – take care of your gut bacteria.

Q: Which probiotics?

A: Yogurt, a yogurt drink like kefir, or a probiotic pill with live bacteria.

Q: But there’s so many different ones ... which ones? Do we know yet? We don’t know yet.

A: It’s a hot area right now. There are companies that are looking at what are the best bacteria to put in a probiotic.

Q: Why would what’s going on in your gut affect what’s going on in your brain?

A: So it turns out there’s what’s called a gut-brain axis, where the bacteria in your gut are creating chemicals that interact with your brain that do everything from determine your mood to control how much inflammation there is in your brain.

Q: And even obesity, right? It’s amazing what we’re learning about these trillions of bacteria that people were saying, ‘Oh, wash them out … I’m going to get cleansed. They’re icky! Let’s get them out of us!’ It turns out, of course, millions of years of evolution – they’re there for a reason.

A: And you want to take care of them. They’re there to help you. A Mediterranean diet, more fiber, more fruit, what are called prebiotics, probiotics – meaning, if you don’t know exactly what probiotic pill to take, at least live-culture yogurt. I drink kefir every morning. And then after diet – exercise. You know at least an hour-long brisk walk, or try to get 8,000 to 10,000 steps if you’re using a device. And sleep. Eight hours. After 40 years old, you have to get seven to eight hours of sleep, and try your best to do it because as you cycle in and out of REM sleep, this is when you clean amyloid plaque out of your brain.

Q: That was one of the most amazing discoveries, when I first read about that – you’re actually ‘garbage collecting’ at night when you’re asleep. The toxins get carried out of your brain.

A: The brain – first of all, the cells that can cause inflammation, when they’re behaving are clearing the plaque. So you want to keep these certain cells clearing the plaque away and not causing inflammation. During the deep sleep, those cells eat all the plaque. And then the brain literally, physically constricts itself and releases the plaque debris – the proteins from the plaque – into the spinal fluid and out of the brain to wash away. 

You can actually see the brain physically constricting after the material’s been broken down by the resident cells. And this only happens during delta – slow-wave – the deepest sleep that comes in after REM. So you want to be able to cycle in and out of REM several times per night. Kind of like a dishwasher on multiple cycles, you want to go in and out to clean the brain as much as you can every night with sleep.

Q: So it’s coming down to what our parents told us, right? Eat your fruits and vegetables, get a lot of exercise, get plenty of sleep. And then the last thing you said was stress reduction.

A: Managing stress. It turns out, we just published a study on meditation, a new trial on how does meditation affect your gene activity – your gene expression, as we call it. We did it with folks at Mount Sinai [Hospital] in New York. And what we found was that with a meditation practice, there are changes in your gene expression that work against inflammation and that actually create a healthier state. We also see changes in genes that affect the amount of amyloid in your brain during a full one-week intensive meditation course. 

So we have meditation instructors, we have novice meditators who are learning, and our control group of people at the same resort who were just hanging out and having fun but not learning how to meditate. And there were significant differences in terms of very beneficial gene expression changes in those who were meditating.

Q: One of the biggest fears my patients have is that they might be developing dementia. So how do you distinguish between a ‘senior moment’ and dementia? I mean, people would kind of flippantly say, if you can’t find your car keys that’s one thing, if you find them and don’t know what they do, that’s another thing. But I always found that a very flip answer. What do you really say to a patient in that situation?

A: Well the fact is, as we get older, we don’t recall names as well, we can see the face of an actor we know but can’t recall the name as fast. There are changes that happen in the brain just as there are changes in the muscles. Our joints, our muscles get a bit weaker. So that’s why it’s so important to work out physically and mentally. You know, stay engaged in learning new things.

Q: Crossword puzzles? Learning a new language?

A: I like to say – if crossword puzzles help you, if it’s the New York Times it would help you between Friday and Sunday, because you’d probably have to look something up and learn something new. But it’s really learning new things. When you learn something new, you make new synapses – connections between nerve cells [in the brain]. And all learning is based on what you already knew, you learn by association to what you already knew. So not only do you make new synapses, but you strengthen the ones you already have.”

Top Alzheimer's researcher explains how you can help protect your brain by Ashley Welch, CBS News

The Governor's Veto Threatens School Funding Statewide (from the Center for Tax and Budget Accountability)

August 7, 2017 CTBA analysis shows that school districts around the state would see their funding threatened by Governor Bruce Rauner's amendatory veto of Senate Bill 1, the Evidence Based Model for School Funding Reform. Part of the veto would require that property wealth in Tax Increment Financing (TIF) districts be included in a school district's total local resources-even though school districts cannot access tax revenue from TIFs.  As a result, including the TIF value makes it appear as if school districts have more property wealth than is actually the case and reduce the amount of state funding it receives. In total, of the $313 billion in equalized assessed value (EAV) of property wealth in Illinois, $12.4 billion is in a TIF district, as of 2015. If this amendatory veto were approved by the legislature, it would lead to less money going to school districts all over Illinois that desperately need all the state support they can get.  Download CTBA's Fact Sheet here. For more information, contact CTBA's Budget Director, Bobby Otter, at (312) 332-2151 or by email at botter@ctbaonline.org, or Senior Policy Analyst Daniel Hertz, at (312) 332-1481, or dhertz@ctbaonline.org.

Reducing the Risks of Dementia/Alzheimer's

“One-third of cases of dementia worldwide could potentially be prevented through better management of lifestyle factors such as smoking, hypertension, depression, and hearing loss over the course of a lifetime, according to a new report.

“Across the globe, about 47 million people were living with Alzheimer's and other forms of dementia in 2015. That number is projected to triple by the year 2050 as the population ages. Health care costs associated with dementia are enormous, with an estimated $818 billion price tag in 2015.

“The new study, published in The Lancet and conducted by the first Lancet Commission on Dementia Prevention and Care, brought together 24 international experts to review existing dementia research and provide recommendations for treating and preventing the devastating condition.

“‘Dementia is the greatest global challenge for health and social care in the 21st century,’ lead study author Professor Gill Livingston, of University College London, told CBS News. ‘The purpose of the commission was therefore to address it by consolidating the huge strides and emerging knowledge as to what we should do to prevent dementia and intervene and care for people with dementia.’

“There is currently no drug treatment to prevent or cure dementia. But the report highlights the impact of non-drug interventions and identifies nine modifiable risk factors through various stages of life — beginning in childhood — that affect the likelihood of developing dementia.

“To reduce the risk, factors that make a difference include getting an education (staying in school until over the age of 15); reducing high blood pressure, obesity and diabetes; avoiding or treating hearing loss in mid-life; not smoking; getting physical exercise; and reducing depression and social isolation later in life. About 35 percent of dementia cases are attributable to these factors, the analysis found. Removing them could then theoretically prevent 1 in 3 cases.

“In contrast, finding a way to target the major genetic risk factor, a gene called the apolipoprotein E (ApoE) ε4 allele, would prevent less than 1 in 10 cases – or about 7 percent.

“‘There's been a great deal of focus on developing medicines to prevent dementia, including Alzheimer's disease,’ commission member Lon Schneider, M.D., a professor of psychiatry and the behavioral sciences at the Keck School of Medicine of USC, said in a statement. ‘But we can't lose sight of the real major advances we've already made in treating dementia, including preventive approaches.’ Schneider presented the findings at the Alzheimer's Association International Conference (AAIC) 2017.

“Of the nine risk factors, the researchers identified the three most common ones that could be targeted for dementia prevention. The first is increasing education in early life, which the report estimated could reduce the total number of dementia cases by 8 percent if all people worldwide continued their education until over the age of 15.

“The researchers note that not completing secondary education could raise dementia risk by reducing what's referred to as ‘cognitive reserve.’ It's believed that education and other mentally stimulating tasks help the brain strengthen its networks so it can continue to function at a higher level even if it starts to decline later in life.

“For the first time, the researchers also identified hearing loss as a major modifiable risk factor for dementia. They estimated that reducing hearing loss in mid-life could also reduce the number of dementia cases by 9 percent if all people were treated.

“Livingston notes that research surrounding hearing loss and dementia is still in early stages and the link likely has something to do with the social isolation that can come with losing the ability to hear. ‘They may work in similar ways as they reduce the chance of interactions and conversations, which are like exercise for the brain and enrich it and predispose to depression,’ she said. It's not clear from medical research yet whether using hearing aids can counteract this risk.

“Additionally, the researchers found the number of dementia cases worldwide could be reduced by 5 percent if all people stopped smoking. It's particularly important to stop smoking later in life, they say, to reduce neurotoxins and improve heart health, which in turn improves brain health.

“Other interventions likely to reduce dementia rates include increased physical activity and treating high blood pressure and diabetes.

“The study authors say the report can offer guidance on ways to reduce the risk of dementia throughout life and improve the care for those living with the disease. ‘This includes providing safe and effective social and health care interventions in order to integrate people with dementia within their communities,’ Schneider said. ‘Hopefully this will also ensure that people with dementia, their families and caregivers, encounter a society that accepts and supports them.’

“It's important to note that lifestyle interventions will not delay or prevent all dementia cases. But the researchers say they are hopeful that the report will help shift more focus to concrete steps that can be taken to help avoid the disease.

“‘We hope that this report will feed into individual nations' dementia policies and public health strategies, be used by individual clinicians to inform and improve their practice, and through media publicity inform the general public of what they can do to help avoid dementia, which is the most feared illness in old age.’”

One-Third of Dementia Cases Could Be Prevented, Report Says by Ashley Welch

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