Alzheimer’s Disease: Prevention

To prevent Alzheimer’s disease, attention must be paid to reducing individual risk factors. Behavioral risk factors

  • Diet
    • Intake of saturated or trans-saturated fats (the fats are found in margarine, for example).
    • Low consumption of fruits, vegetables, fish and omega-3-rich oils leads to an increased risk of dementia and Alzheimer’s disease, especially in ApoE-ε4 non-carriers.
    • Micronutrient deficiency (vital substances) – see Prevention with micronutrients.
  • Consumption of stimulants
    • Alcohol – even low alcohol consumption – women < 20 g and men < 35 g per day – has a neurodegenerative effect!
    • Tobacco (smoking); increased risk due to smoking especially pronounced in ApoE-ε4 non-carriers.
  • Physical activity
    • Low or lack of physical activity (has the highest impact on Alzheimer’s prevalence at 21%).
  • Psycho-social situation
    • Psychosocial stressors leading to cognitive overload.
  • Overweight (BMI ≥ 25; obesity) (in middle age).

Environmental pollution – intoxications (poisonings).

  • Aluminum? ; contra
  • Air pollutants: particulate matter (PM2.5) – 13% increased risk of disease per 5 µg/m3 increase in particulate matter at residence (hazard ratio 1.13; 1.12 to 1.14); association was dose-dependent up to a PM2.5 concentration of 16 µg/m3.
  • Copper.
  • Manganese

Prevention factors (protective factors)

  • Genetic factors:
    • Genetic risk reduction depending on gene polymorphisms:
      • Genes/SNPs (single nucleotide polymorphism; English : single nucleotide polymorphism):
        • Gene: CLU, KL, PSEN1
        • SNP: rs11136000 in gene CLU
          • Allele constellation: AG (0.84-fold decreased risk of Alzheimer’s disease in European populations).
          • Allele constellation: AA (0.84-fold decreased risk of Alzheimer’s disease in European populations).
        • SNP: rs9536314 in the gene KL
          • Allele constellation: GT (0.75-fold decreased risk of AD (Alzheimer’s dementia) in APOE4 carriers who are at least 60 years of age; 0.64-fold decreased risk in APOE4 carriers of developing AD from mild cognitive impairment)
        • SNP: rs3025786 in the PSEN1 gene.
          • Allele constellation: CT (slightly decreases Alzheimer’s risk if ApoE4 is present).
          • Allele constellation: CC (slightly decreases Alzheimer’s risk when Apoe4 is present).
        • SNP: rs3851179 in an intergenic region.
          • Allele constellation: AG (0.85-fold).
          • Allele constellation: AA (0.85-fold)
  • Education: Highly educated subjects who were carriers of the ApoE4 risk gene had significantly fewer plaques on positron emission tomography (PET; FDG-PET) with the radiotracer fluorodeoxyglucose (FDG) when they remained mentally active during leisure time in middle age
  • People who carry the genetic risk factor for Alzheimer’s disease apolipoprotein E (ApoE-ε4) could reduce their increased risk for cognitive impairment with lower cholesterol levels.
  • Lifestyle: complete abstinence from tobacco smoking, > 150 minutes of exercise per week, restriction of alcohol consumption, healthy diet according to the criteria of the MIND diet (Mediterranean cuisine and low-salt diet combined), and increased cognitive activities. Results: Participants with 2 or 3 activities were 37% less likely to develop AD (pooled hazard ratio 0.63; 95% confidence interval 0.47 to 0.84); with 4 or 5 activities, the risk was as much as 60% lower (pooled hazard ratio 0.40; 0.28 to 0.56).
  • Diet
    • Regular fish meals were associated with lower beta-amyloid protein and tau protein concentrations; the protective effect was limited to carriers of the ApoE-ε4 risk gene. Secondary finding: participants who ate fish more frequently had increased brain mercury concentrations, as expected, but had fewer macro- and microinfarcts.
    • Seniors who frequently distorted foods with flavonols were less likely to develop Alzheimer’s dementia in a prospective observational study.Flavonols are found in, among others: Currants (black), cranberries; fennel, parsley; currant juice (black); apples, blackberries, cranberries; broccoli, kale, chives, onions.
  • Regular physical activity
    • National Runnerś and Walkerś Health study (153,536 participants) was able to show that exercise (depending on intensity: – 6 – – 40%, statins (- 61%) and fruit consumption (≥ 3 pieces of fruit: – 39.7%) were associated with a lower risk of Alzheimer’s disease
    • In people with monogenetic Alzheimer’s disease (autosomal dominant Alzheimer’s disease (ADAD)), at least 2.5 hours of physical activity per week positively affected Alzheimer’s disease markers in the brain (AD-like pathologies in cerebrospinal fluid/spinal fluid) and delayed cognitive decline.
  • Sauna sessions: men who went to the sauna 4-7 times a week reduced their risk of developing AD by 65 percent compared with those who saunas only once a week.
  • Gout in the general population is inversely associated with the risk of Alzheimer’s disease, suggesting a neuroprotective effect of uric acid.
  • Patients with cognitive impairment (MCI) taking Selective Serotonin Reuptake Inhibitors (SSRIs; drug class of antidepressants) showed a lower conversion rate from MCI to AD (about 20 percent in 1,000 days) than MCI patients with depression but without antidepressant therapy (about 40 percent in 1,000 days) in the first two to three years; in this case, SSRI treatment had to have lasted longer than four years