Alzheimer's: A Midlife Guide to Risk Reduction

Updated: Apr 5, 2019

Contrary to popular belief, Alzheimer’s and other forms of dementia are not necessarily inevitable.

Like other chronic, degenerative conditions, dementia is easier to prevent than it is to reverse. This article covers seven ways to reduce the risk of developing dementia later in life.

Know Your APOE Status

Genes are one of many risk factors for Alzheimer’s disease and other forms of dementia. Certain mutations are associated with early-onset Alzheimer’s or the more common, late-onset type.

Services such as 23andme or Life Extension provide cost-effective genetic testing. From the convenience of your own home, you can swab your cheeks or fill up a test tube with saliva and send it off.

We can’t change our genes (yet), but we can change how our genes express. Each cell in your body is able to respond to changes in its environment. They control which genes get transcribed and which transcripts get translated.

Having certain genes or biomarkers doesn’t mean you will experience symptoms of dementia. People with no genetic risk develop dementia. In fact, some people live symptom-free despite their brains showing Alzheimer’s disease progression!

Get Moving

Lifestyle is the most modifiable dementia risk domain. Physical activity is one aspect of lifestyle modifications that make the most difference. Studies show that higher physical activity levels correlate with the lowest risk of dementia.

The cognitive benefits of physical activity accumulate over the course of our lives. The more active we are when young, the better our cognitive health is in midlife. And the more active we are in midlife, the lower our risk for dementiain late life. Even in old age, increasing physical activity improves cognitive function and performance.

Eat As If Your Brain Depends On It

Different diets work for different people. Whether ketoflex 12/3, vegetarian, keto, paleo, Mediterranean, vegan or gluten-free the underlying principles of eating for our brains are simple. These principles are: see food as fuel, avoid chronic inflammation, and honor the gut-blood barrier.

When we see food as fuel, we respect that everything we put into our bodies impacts our quality of life today and in the future. Eating foods that we may not enjoy such as oily fish or raw vegetables — but that we know are good for us — is a responsibility to take seriously. Become an informed consumer of food. Nutrition is not a one-size-fits-all thing, so get curious and see which ways of “healthy” eating appeal to you.

Food is also a means to reduce and eliminate chronic inflammation, a key risk factor for Alzheimer’s and other forms of dementia. Our body’s inflammatory response is triggered when it senses an unwelcome invader such as a microbe or chemical. When this response is triggered all the time, it is known as chronic inflammation. Many foods and beverages have strong anti-inflammatory properties and are often much more effective than pharmaceuticals for reducing chronic inflammation.

The gut-blood barrier controls which molecules cross out of the digestive system and into the bloodstream. When this barrier is compromised, molecules that should stay inside the gut (like bacteria) can leach out into the bloodstream, causing infections and chronic inflammation. Sometimes these rogue molecules will end up in the brain. When compromised, this brain-gut axis contributes to a wide range of neurologic, psychiatric and gastrointestinal disorders.

Honor the Blood-Brain Barrier

The blood-brain barrier prevents toxins from crossing from the blood into the brain. Studies show high blood pressure in middle age increases the risk of dementia in late life. This may be due to the negative impact of chronic hypertension on the blood-brain barrier.

Systemic inflammation is another threat to the integrity of the blood-brain barrier (BBB). When the BBB functions properly, it balances conditions necessary for optimal brain function. Our central nervous system can be disrupted by acute infections and chronic conditions. This may cause temporary or permanent deterioration in the BBB.

Reducing inflammation helps maintain integrity in the blood-brain barrier. One way to reduce chronic inflammation is the stimulation of the vagus nerve. We can stimulate the vagus nerve by dramatically slowing down our breathing, as in deep meditative states. Typically, we take 10–14 breaths per minute. In deep meditative states, breathing can slow to 5–7 breaths per minute. This is a drug-free, cost-free method for daily stimulation of the vagus nerve.

Maintain a Healthy Weight

Midlife cardiometabolic health is a strong indicator of dementia risk in late life. Cardiometabolic encompasses both cardiovascular and metabolic diseases. This includes type 2 diabetes and metabolic syndrome.

Being obese in midlife doubles your risk of developing Alzheimer’s in late life. Studies show midlife impaired glucose tolerance and insulin resistanceincrease the risk of dementia. Being overweight or obese also causes high blood pressure, which increases stroke risk. Strokes are a known risk factor for Alzheimer’s.

Be Wary of Anticholinergics

Anticholinergics are drugs that block the neurotransmitter acetylcholine from binding to receptor cells. As we age, the number of cholinergic receptors decreases. Our blood-brain barrier may also degrade. This makes it easier for drugs to cause cognitive impairment.

Studies show that elderly patients taking anticholinergic drugs have significantly increased dementia risk. While research has not yet established a link between midlife use of these drugs and late-life dementia, studies are ongoing.

Anticholinergic drugs are extremely common. They treat many conditions including asthma, urinary incontinence, seasonal allergies, insomnia, and depression. For a list of anticholinergic drugs, both prescription and over-the-counter, click here.

Don’t Worry, Be Happy

When we are experiencing depression, our brains don’t perform at peak capacity. We may experience impaired cognitive function and performance. Depression and its symptoms, whether clinically diagnosed or not, increase dementia risk in late life.

Anxiety, likewise, has a tendency to increase blood pressure. This increases the risk of stroke and thus the risk of dementia. It also increases levels of stress hormone production in the body. Elevated stress hormones may lead to chronic inflammation. This may result in further degradation of the blood-brain barrier.

Positive social contact is one therapeutic intervention for chronic anxiety and chronic depression. There is evidence that social engagement even increases brain volume. Research also shows lower rates of late-life Alzheimer’s and dementia for highly-sociable people. It is not the number of social interactions that matters the most. Rather, it is the quality.

Alzheimer’s and other forms of dementia are not necessarily inevitable. In our middle years, the best thing we can do is recognize and respect the fact that we are growing older. How we treat our bodies in middle age impacts how our bodies function in late life. This includes our brains.

In Wellness,


Disclaimer. I am not a doctor, and as such cannot diagnose or treat any medical issues. The Content of this blog and website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog or the VitaV website!

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