Alzheimer’s Disease & Lifestyle Intervention

SciWorks Radio is a production of 88.5 WFDD and SciWorks, the Science Center and Environmental Park of Forsyth County, located in Winston-Salem.

Dementia is a brain condition that causes problems with thinking and memory. There are many different types, but the most prevalent is Alzheimer's Disease. According to the Alzheimer's Foundation of America, over 5 million Americans may be suffering from this incurable disease. To learn more about it and some possible preventable measures, I spoke with Dr. Laura Baker, Associate Professor of Gerontology and Geriatric Medicine at Wake Forest Baptist Medical Center.

Alzheimers Disease is a progressive loss of brain capacity that affects a person's ability to remember, think, problem solve and organize. And the hallmark cognitive symptom is the inability to remember events in the recent past.

An Alzheimer's patient might not remember what they had for lunch, but can clearly describe moments in the distant past. This is because the the disease affects the part of the brain called the hippocampus, which forms new memories. Meanwhile old memories have been stored elsewhere throughout the brain, making them difficult to erase. So, here's how Alzheimer's works:

There's a gradual transition that can take place up to 20 or even up to 30 years before it comes to the doctor's notice, affecting the way that the brain cells communicate with one another. We would see a shrinkage of the brain. We call that atrophy. There are some very specific cell types that develop as the disease progresses. These are called the hallmark Alzheimer plaques and tangles. You can think about these as trash in the highway. If you have large amounts of trash you are obstructed from passing from point A to point B. These plaques have the same kind of purpose in terms of brain signals from being able to communicate. The other type of cell abnormality is called a tangle. The deteriorating protein within the cell that interferes with information. The cell is not able to communicate from one end of the cell to the other.

There is no cure for Alzheimer's, but there some known factors that put people at risk for the disease.

How do we slow this down? If we were to identify people at high risk then we can identify the people who might benefit from early interventions. Age is the number one risk factor. There is no other risk factor that is more potent than age. The second highest risk factor that's been identified—if you have type 2 diabetes, your risk of developing Alzheimer's disease is 65% greater than someone who does not have type 2 diabetes. People with pre-diabetes are on the road to type 2 diabetes. They are at high risk because they have this metabolic disease that may perpetuate the progression of Alzheimers disease.

What is it about type 2 diabetes that puts a person at risk?

In our research program we're trying to understand why. We're learning that insulin, and those plaques I told you about a minute ago are related. Insulin plays a role in breaking down those plaques. And so if we have an insulin abnormality, that normal process cannot happen.

The idea of developing this disease is terrifying, but you can take steps to lower your risk, and possibly slow its progression in a loved one.

What can we do about it? The reason we're so excited in our research program at Wake Forest Baptist Health about studying this particular link: the link between type 2 diabetes and Alzheimer's disease is because you can do something. You can change the metabolic status of the body through lifestyle intervention, which could significantly impact the progression and maybe even the onset of Alzheimer's disease down the road. Now, there's not too many chronic diseases that end in death that you can say that about. Lifestyle intervention is a strategy we're exploring in terms of what is the right dose? What kinds of things in your diet are critical to change? What kinds of physical activity are important? How little can I get away with? How much do I have to do? And when should I expect a change? These are the parameters of those two interventions that we're exploring.

This Time Round, the theme music for SciWorks Radio, appears as a generous contribution by the band Storyman and courtesy of UFOmusic.com.