My grandmother's remedy for anything and everything was castor oil. It tasted so terrible that the thought of it cured a lot of ailments. Faced with a choice of castor oil or feeling well enough to go to school, we went to school.
Dr. Howard Fillit, the Executive Director of The Alzheimer's Drug Discovery Foundation (ADDF) has written a booklet [available online at their website] called "A Practical Guide to Achieving and Maintaining Cognitive Vitality With Aging." Although there is no guarantee that following the guidelines in this booklet will prevent Alzheimer's, they are not castor oil. Far from tasting bad, they will improve your life as you are living it. If they also turn out to prevent AD, that's a bonus. He tells us that "cognitive impairment with aging is preventable" and that "through lifestyle interventions and effective management of chronic medical conditions, attaining and maintaining cognitive health is possible."
When Dr. Fillit talks or writes, I listen. He is one of my Alzheimer heroes. A geriatrician, neuroscientist, and leading expert in Alzheimer's (AD), Dr. Fillit has a distinguished academic career at the Rockefeller University, and the Mount Sinai School of Medicine, (NY) where he is a clinical professor. The author or co-author of more than 300 scientific and clinical publications he is the senior editor of Textbook of Geriatric Medicine and Gerontology. To all that scientific background, he brings the personal knowledge gained in his private practice. He is one of the rare doctors who combine scientific knowledge with real experience with patients. And he understands the caregiver's burden: His own father recently died from AD.
Dr. Fillit points out that some medical illnesses -- among them, hypertension, high cholesterol, obesity, thyroid, diabetes and, in men, low testosterone -- are associated with diminished cognitive function, so the first of his recommended eight actions is to control those health issues.
The second is to follow a balanced, low-fat, low-calorie diet. He recommends a multi-vitamin every day as well as the clinically-tested DHA, a component of omega-3, which is available online. He adds, "Vitamin D deficiency, very common in older people, is not only bad for the bones, but also the brain. Older people should get their Vitamin D levels checked and, if low, should take supplements."
A B12 deficiency is also common among the elderly and when that is the case, Dr. Fillit recommends supplements, usually in the form of monthly injections. He suggests that alcohol be kept to a maximum of two drinks a day and, if you have already been diagnosed with mild cognitive decline (MCI), that you cut out alcohol completely.
Sleep is a component of his eight-point strategy. He offers some tips on getting a good night's sleep, one of which is to avoid sleeping pills. He recommends instead, a glass of warm milk, and avoiding eating and/or exercising three hours before bedtime. Pointing out that depression may cause memory loss and difficulty paying attention, Dr. Fillit urges family members or friends to encourage those who are depressed, anxious, grieving or lonely to seek help. He suggests that seniors plan a post-retirement life that keeps them involved socially, connected to their community as well as their family.
Dr. Fillit recommends exercise -- for the body, and the brain. He suggests moderate intensity aerobic exercise for at least 30 minutes, three to five days per week. As to the brain, he advises continued use through adult education, particularly learning something new. He writes, "Learning to play a musical instrument, reading books or a new language will all promote cognitive health". He lists mind games as a possible way to promote that, but adds, "they have not been proven to have generalized benefits on daily function".
Dr. Fillit also discusses the effect of stress on the body -- muscle tension, elevated heart rate, higher blood pressure, and the secretion of stress hormones. The result can be fatigue, disturbed sleep, poor concentration and memory lapses. He writes, "Chronically high levels of stress hormones suppress the immune system and kill brain cells. Older adults with a high level of psychological distress have twice the risk of cognitive impairment."
He lists eight ways to cope with stress, one of which is meditation. In an earlier blog, I reported that I have practised Transcendental Meditation (TM) for 35 years. I then recommended deep breathing and following the breath as a method of meditation. If I left the impression that the two are the same, I apologize. They are not. But, knowing that caregivers have difficulty carving out time for taking on something new, I offered, as Dr. Fillit does, a simple way to begin to meditate.
A reader suggests that those who practise TM don't -- possibly won't -- get AD. Amassing the evidence to prove that would be difficult. One would have to have the results of a large study of autopsies, and know whether those people had practised TM, for the same length of time. Or, take a group practising TM now, and follow that through until their death. But there is certainly plenty of evidence that meditation, of any kind, is a good thing to do.
One recent study approved by the University of Virginia Review Board, linked meditation and AD. Results of the study, by K.E. Innes, T.k. Selfe, C.J. Brown, K.M. Rose and A. Thompson Heisterman were published in Evidence-Based Complementary and Alternative Medicine, volume 2012. This study was among the first to investigate the effects of meditation in caregivers or AD patients. "Community dwelling adults with a diagnosis of mild cognitive impairment (MCI) or early-stage AD, together with their caregivers were enrolled in the study." They were asked to meditate for 11 minutes twice daily for 8 weeks. The participants "demonstrated improvement in all major outcomes including perceived stress, mood, depression, sleep, retrospective memory function, and blood pressure."
Definitely not castor oil. Definitely worth a try.