New York, NY—In 1901, when Dr Alois Alzheimer started talking to his patient Mrs Auguste Deter, a 50-year-old patient, he immediately realised that there was something wrong with her. Her responses to his questions were not only repetitive and wrong, but she quickly seemed to forget them. Sadly, she seemed to be aware of her helplessness. He decided to place her in an isolated room, but she would later start showing clear symptoms of dementia: loss of memory, delusions, sleeping problems, and would even scream for hours in the middle of the night. He called her disease the "Disease of Forgetfulness." Alzheimer's is a progressive, degenerative disorder in which the cells in the brain become damaged, causing the symptoms described above. In 1902, Dr Alzheimer left the "Irrenschloss" (Castle of the Insane), as the institution was informally known, and moved from Frankfurt to Munich. However, he made frequent calls to Frankfurt to learn the health status of his former patient. On 9 April 1906, he was told that Mrs Auguste Deter had died. He requested that her medical records and brain be immediately sent to him. When he examined her brain, he found in it senile plaques and tangles that are the hallmark of Alzheimer's disease as we know it today. Later in 1906, he described these findings to the SouthWest German Society of Alienists. Also characteristic of the disease is the loss of brain mass and the degeneration of critical areas of the brain. Alzheimer's disease has no cure. However, certain measures related mainly to lifestyle can delay the onset of the disease in many patients. Delaying by a few years the onset of symptoms can greatly reduce the number of people suffering from this disease. Alzheimer's disease appears generally in people over 65. However, there is a variety called early-onset dementia (the one suffered by Mrs Auguste Deter) that can occur in people between 30 and 65. Alzheimer's, together with diabetes, heart disease, and arthritis, are complex diseases that can be caused by a variety of genetic, environmental and lifestyle factors. Although we cannot control all of them, we can control some risk factors for Alzheimer's disease. Age and genetic makeup cannot be changed. However, there are other risk factors—mainly associated with our lifestyle—for Alzheimer's that we can influence. Among the actions we can take is to keep our cholesterol, blood sugar level, and blood pressure under control, since it has been shown that when they are not between normal levels, it increases the risk of Alzheimer's. Although these strategies have proven to be helpful for many people, they will not necessarily stave off Alzheimer's, since they depend on each person's individual genetic makeup and lifestyle. A growing body of research has proven that changing long-standing lifestyle habits can significantly reduce the risks of developing Alzheimer's. Swedish and Finnish researchers studied more than a thousand people, whose ages were between 60 and 77, and found that those who changed their lifestyle were able to delay their dementia diagnosis by two years and reduce the prevalence of the disease by 25%. One of the key strategies is to get physically and mentally active. Several studies have shown that physical activity is one of the most effective measures for Alzheimer's protection. Also important are all the actions tending to exercise our brains. Learning new activities, languages, reading, and doing puzzles are useful ways to stimulate our brain. In a study with older adults, those who received as few as 10 sessions of mental stimulation significantly improved their cognitive functioning in daily activities and the effects lasted even 10 years later. Closely associated with this activity is maintaining an active social life and network of friends. Several studies have shown that the more socially connected we are, the better is our memory and our cognition skills. Among the basic strategies to combat Alzheimer's is also having a healthy diet with plenty of vegetables, beans, whole grains, fish, and olive oil, all elements present in the Mediterranean diet. In addition, we should eliminate smoking, drink moderate amounts of alcohol and, when possible, eat food without preservatives, dyes, antibiotics, and hormones. A healthy diet is the best way to having a healthy mind. We should also try to have a regular sleep schedule and eliminate stress in our lives. These measures will not necessarily prevent Alzheimer's, but will go a long way in delaying its pernicious effects. Dr César Chelala is an international public health consultant, and a winner of several journalism awards.
