Scarborough Memory Program’s Alzheimer Prevention Clinic

Firstly, forgetfulness does not occur as a result of ageing and decline should never be excused as “just getting older”.  Secondly, stress, anxiety, depression and drugs can cause memory impairment but memory change due to these things will not get progressively worse over time.

The changes in the brain that produce Alzheimer’s symptoms begin 20 to 30 years beforehand. There is opportunity beginning within this timeframe to prevent the silent damage to the brain. The earliest symptoms of Alzheimer’s are collectively called Minimal Behavioral Impairment (MBI) and include increased irritability, mild anxiety, mild apathy, decreased mood and other mild psychological changes. Next comes the Mild Cognitive Impairment (MCI) stage with difficulties in attention and concentration, problems with short term memory, difficulty finding words or names of people or places, and perhaps, even getting lost. The MCI correlates with the damage seen to the very small arteries bringing the blood flow to brain cells particularly in the frontal lobe. Eighty percent of people with MCI will progress within six years to the clinical Alzheimer’s dementia stage. That is to say, when the degree of cognitive impairment is sufficient  to negatively effect one or more tasks in day-to-day functioning.

According to Statistics Canada, people age 65, have a life expectancy greater than 85. Of those, one in three can expect to have a dementia, seventy percent of who will suffer from Alzheimer’s dementia. Fortunately, scientific studies have shown that there are a number of things you can do to reduce the risk of this happening.

Increased risk occurs in people who have a family history of a close relative with Alzheimer’s, those who have a “pot belly”, are not physically active, have high blood pressure (greater than 120 systolic) or high cholesterol or borderline blood sugar, who have high inflammatory blood markers, or who are known to have fatty liver, or who have had a heart attack or mini-stroke. People are also at high risk if they are smokers, have low education level, or have had a concussion. Those who snore and do not feel rested after a night’s sleep are likely to have obstructive sleep apnea and are at greater risk of memory impairment and earlier onset of Alzheimer’s. By far the biggest risk of all is age. Just as “diabetes of the old” now occurs in nine year olds who are having their heart attacks in adolescence, Sporadic Alzheimer’s is now more commonly seen and referred to as “younger onset Alzheimer’s”. I have several patients with Alzheimer’s in their late thirties.

Alzheimer’s disease is recognized as a disease of metabolism (the chemical processes that occur within a living organism in order to maintain life.) Metabolic diseases can either be worsened by lifestyle or alternatively, their risk of occurrence can be reduced through lifestyle changes such as weight reduction, physical exercise, intellectual stimulation, stress reduction, and social stimulation. Medication can also modify your metabolism with the treatment of high blood pressure, diabetes and high cholesterol.

In fact, sufficient evidence exists to support the proposed name change in 2003 from Sporadic Alzheimer’s  to “Type 3 Diabetes” or diabetes of the brain. In my opinion, the most exciting advance in the fight to prevent Alzheimer’s is the recognition that far from being an untreatable, relentlessly deteriorating, ultimately fatal disease of the brain, Sporadic Alzheimer’s (aka Type 3 Diabetes) can be prevented after identifying those at risk, and then treating those risks, using a multi-pronged approach, individualized for each patient.

Dr. J E Lessard, BSc.,BMedSc.,MD.,FRCPC,

Memory clinic