Alzheimer’s disease (AD) begins developing in the brain 20-30 years before symptoms start to present in patients. Recent evidence suggests that up to 40% of AD cases could potentially be prevented by addressing modifiable risk factors such as insufficient education, hearing loss, hypertension, obesity, smoking, depression, social isolation, physical inactivity, diabetes, excessive alcohol consumption, air pollution, and traumatic brain injury. 

Dr. Christina Shenvi is joined once again by Dr. Richard Isaacson, M.D., a Harvard-trained preventive neurologist and world-renowned researcher at the Institute for Neurodegenerative Diseases in Florida. In 2013, he founded the Alzheimer’s Prevention Clinic at Weill Cornell Medicine and New York-Presbyterian, the first of its kind in the United States. In this episode of GEMCast they focus on the importance of individualized intervention and prevention as the future of AD treatment. 

• The exact pathology of AD is unclear and there is likely a combination of mechanisms behind the disease. Current theories involve amyloid-ß deposits, tau neurofibrillary tangles, neurodegeneration and neuroinflammation, glucose hypometabolism, mitochondrial dysfunction and oxidative stress. 

• First and foremost, reduce vascular disease by exercising regularly and managing risks such as hypertension, diabetes, tobacco exposure.

• • Prioritizing educational attainment early on creates cognitive reserve which protects the brain from decline in later life. 

• • Hearing loss, which accounts for 8% of AD cases, can be prevented through assessment and treatment.  

• • Optimizing other factors such as sleep, social engagement, and mental activity.

• Blood biomarkers, such as amyloid-ß and tau, provide quantitative insight into brain risk and progression of neurodegenerative disease.  

• 2/3 of brains affected by AD are women, who are particularly vulnerable at the perimenopausal transition.

• 25% of the population carries at least 1 copy of the variant of the APOE4 gene, a known risk factor for development. 

• Diabetes doubles the risk of dementia.