The first description of Alzheimer’s disease (AD) was given by Alois Alzheimer in 1906. The disease affects the brain activity in a way that people find it hard to remember things. Alzheimer described this disease at the time when the life expectancy in the US was on average 50 years. It was not as common, because the risk group is people over 65 years old. As the population ages globally, Alzheimer’s dementia (AD) research has increased as the disease forms a threat to the public health which is of substantial concern now. According to the Alzheimer’s Association, the AD is America’s sixth leading cause of death. This is because as the brain becomes progressively dysfunctional, it becomes difficult for the vital body processes to be sustained (Breitner et al.).
Due to the above reasons, there has been no viable research on this disease until recently. Alzheimer disease (AD) is now one of the several main causes of mortality without an effective treatment. This is an incurable disease; thus, early prevention is currently the focus of the medical community. The population keeps aging, yet the number of clinical research disappointments grows. Both humanity and scientists are recognizing the critical need to discover a treatment. Researchers in the subject are worried that unsuccessful clinical trials are due to testing of potential treatment strategies too late in the pathological and physiological course of the AD. Thus, a possible strategy to achieve success is earlier intervention, and better still, prevention (Sperling, Karlawish, and Johnson).
Prevention of Alzheimer’s Disease
Taking into consideration that treatment and cure research is still in the development phase, the next question that arises is whether Alzheimer’s disease can be prevented. This question helped to create a new area for research, intrigue scientists and provide the fuel for new investigations. Although there is no clear answer as yet, to some degree because there is a need for a large-scale research, this is a promising area for the global population instigation to stay healthy and enjoy a quality lifestyle at the older age. The Alzheimer’s Association is distributing funds for the research in relation to physical and mental fitness, environment and diet on the possible prevention of this form of dementia. The worrying fact that the number of people affected by Alzheimer’s disease continues to grow increases the efforts of scientists to determine and implement effective prevention strategies.
It makes sense to look at Alzheimer’s disease as a common chronic condition; like many other such conditions, AD develops as the result of the interaction between different factors and is possibly triggered by some of them more than the others. These factors include age, genetic predisposition, lifestyle and environment, as well as pre-existing medical conditions. While some of the factors cannot be changed, for example, age or genetics, determining risk factors can help in planning an early proactive preventative treatment. At the moment, there is no active large-scale testing being conducted from the genetic perspective, since no preventative treatment is available.
Alzheimer’s disease can be classified as vascular dementia, so the risk of having such disease increases for people with heart or blood vessels conditions. For instance, heart disease, high blood pressure, diabetes, stroke and high cholesterol are some of such risk factors. Some studies of the autopsies show that approximately 80 percent of people with Alzheimer’s disease had some form of cardiovascular disease (Alzheimer Association). Some specialists believe that at the current stage of research, controlling cardiovascular diseases is one of the most cost-effective prevention strategies. However, autopsies also showed that people contracted plaques and tangles associated with Alzheimer’s disease, with no cognitive decline of the brain, unless there was a vascular disease of the brain as well.
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Diet and Physical Exercise
As regular physical exercise is a beneficial strategy to lower the risk of vascular disease and benefit cardio-vascular system, it is logical to predict that it will help in preventing Alzheimer’s disease. Blood and oxygen flow can benefit the brain cells directly. A balanced diet has a similar effect on the cardiovascular system as a carefully chosen exercise program. As stated above, head-heart connection is a crucial research direction in the prevention of Alzheimer’s disease. Therefore, general wellbeing and prevention of heart disease is also part of the effective prevention of AD. In this context, whole grains, fruits and vegetables, fish and sea products, nuts, olive oil and other healthy fats are proven ingredients of such a healthy diet. The Alzheimer’s Association is funding the research into cardiovascular diseases prevention as part of Alzheimer’s disease prevention due to the connection of head-heart for over 20 years (Alzheimer Association).
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Social and Intellectual Activity
Another direction of research is concentrated on maintaining a cognitive brain function well into the later years of a person’s life. Social connections, mental activity, even studying in the later period of one’s life may lower the risk of cognitive function decline and, thus, reduce the risk of the AD. In terms of the research in this direction, there is still a need to determine the connection between keeping active and the risk of developing Alzheimer’s disease. An obstacle in this field of research is complicated by unclear early diagnostics of the symptoms of this disease, which on its early stages can cause apathy and impact one’s social and intellectual activity.
Finally, there is some research that shows the connection of Alzheimer’s disease to the head trauma, particularly with the associated loss of consciousness. Health and safety precautions at work, home and during social and sports activities are obvious for one’s safety and can prevent the risk of developing the early Alzheimer’s disease. Safe driving and wearing seat belts, the reasonable arrangement of one’s home and other obvious measures should not be underestimated.
A Glimpse into AD Prevention Research
Much of the prevention strategies described above are still investigated. Moreover, much of the current knowledge about Alzheimer’s disease comes from the research, particularly in the recent decades. Several points to note in relation to current directions in terms of studying in the AD prevention field are as follows.
It is important to understand that any conclusions or even assumptions of the AD prevention research of the risk factors are based on the study of the large groups of populations and do not take into consideration individual factors of risk. Studies can show the relation of the risk factor X to the outcome Y only as the probability, but cannot give any guarantees of this outcome. Unfortunately, following all the directions of a healthy lifestyle can prevent Alzheimer’s disease, but cannot be a full guarantee. As opposed to this, people, who have the underlying risk factors, may never have the AD (Anderson, McCaul, and Langley).
Most of the evidence from research come from studies of big groups and while exploring previous behaviors of patients with Alzheimer’s disease and making conclusions based on statistical methods of research, there is no direct scientific proof of their relation, Rather this stage of studies is an assumption-based phase. Thus, the research has still to develop as there are many grey areas in the AD prevention. Reisa Sperling from Harward Medical School in collaboration with the group of researchers has summarized findings of the recent studies on the biometric and cognitive research methods in the article “Preclinical Alzheimer Disease – The Challenges Ahead” for the Center for Alzheimer Research and Treatment, Massachusetts General Hospital. In particular, she states that one of the challenges is the silent stage of AD – when the disease has started in the brain, but no symptoms are clinically evident yet. This stage is referred to as “preclinical AD”. Scientists believe that the intervention at this early stage may result in delay or possibly even prevent the cognitive decline and, hence, dementia (Sperling, Karlawish, and Johnson).
The authors raise highly relevant ethical issues of research, especially in relation to genetic testing; they may impede the progress of scientific studies. Issues such as privacy and confidentiality of the medical information will require changing the policies and protect the individuals potentially determined with the risk of the AD at an older age:
If successful, trials can identify treatments that may delay or prevent cognitive decline, but disseminating these findings into clinical practice can bring ethical and policy challenges. Patients treated for preclinical Alzheimer’s disease, with the diagnosis and prescription recorded on their files, can raise stigma and a possible discrimination at the workplace, and problems with obtaining insurance. (Sperling, Karlawish, and Johnson)
A group of scientists from Columbia University, American Medical Association, in their article “Leisure Activity and Cognitive Decline in Incident Alzheimer Disease” (2004), used a statistical analysis method to investigate the dependence of the reduced rates of the AD and high levels of leisure activities in individuals. They claim that along with IQ, educational level and occupational qualification, high level of activity in the social and intellectual area can help to build a cognitive reserve. Individuals with the high level of cognitive reserve can tolerate a greater burden of pathological effects associated with the AD before the disease expresses itself on a clinical symptomatic level. They expanded on the Washington Heights-Inwood Columbia Aging Project community-based study, which was started in 1989, by finding that heightened levels of reading and other leisure activities were associated with the reduced risks of the AD (Scarmeas and Stern).
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Other researches in the area include but are not limited to the results highlighted in “Extended Results of the Alzheimer’s Disease Anti-Inflammatory Prevention Trial.” The authors describe the findings of both genetics and cognitive reserve analysis in AD prevention (Breitner et al.). A further research into the connection of the use of some medicine drugs and supplements, such as Vitamin B12, has provided some glimpses into the prevention of AD, but no major insights. Canadian scientists led by Christopher Patterson have reviewed and analyzed the recent research in the AD area, starting from 1996, and summed up their findings in the article “Diagnosis and Treatment of Dementia: Risk Assessment and Primary Prevention of Alzheimer’s Disease.” In particular, they stated that in addition to non-changeable genetic risk factors, potentially adjustable factors, such as environmental exposures, hyperlipidemias and hypertension, are recognized as risk factors for the AD. They provided physicians with a useful guide on risk assessment and prevention of AD (Patterson et al.).
Prevention is better than cure. This is a common belief, which is particularly relevant to Alzheimer’s disease as it is not only incurable at the moment but also proves to be difficult to diagnose at an early stage of its development. With over 5 million people in the US suffering from the AD, it is important to understand that it has a considerable impact upon not only individuals but families and society as well. This implies that there has to be a full consideration of the new condition in the family. Alzheimer’s disease is among those that may haunt the mankind for a long time. However, there is a hope. It has been understood to a greater extent, and scientists have developed more interest in it over time. Based on the information that has already been gathered, it is advisable to maintain a healthy lifestyle and keep one’s brain stimulated through the social and intellectual participation in order to lower the risk of contracting AD.
What can be done now to raise the awareness and ensure the prevention of AD, taking into consideration that the research into the area is still developing? The Alzheimer Association is a coordinating body for researches, grants, conferences, trials and information for scientists and the wide community. Centers for Disease Control and Prevention convene a multidisciplinary steering committee and a panel of invited experts to establish a plan to make brain health a part of the national wellness agenda (Alzheimer Association). The Healthy Brain Initiative was developed as a national public health road map to maintaining public cognitive health; it was recently started under the umbrella of the Alzheimer’s Association. Lynda Anderson, Ph.D. of Healthy Aging Program, Centers for Disease Control and Prevention, said that scientists are starting to take the next steps, based on the studies coming out of the National Institute of Health and developed by other researchers. This is where the science can make a difference in the everyday life of the Americans. In addition, there is a hope and, thus, a need to co-operate globally in order to improve the quality of life in all the countries and share the findings of researches in order to take the next steps into the future (Alzheimer Association).