Cause and Effect

New Research Is Exploring the Connection Between Alzheimer's and Inflammation

Local experts offer tips for people to prepare their future by creating good habits now.

By Elizabeth Djinis November 13, 2022 Published in the November-December 2022 issue of Sarasota Magazine

For years, scientists have struggled to pinpoint a clear cause for Alzheimer’s disease, the devastating neurological disorder that robs patients of their memory and their ability to interact with others to such a degree that patients typically only live four to eight years after being diagnosed. But multiple new studies have discovered a possible connection between the disease and inflammation in the brain.

Despite what its name suggests, inflammation is not a wholly negative phenomenon: It is a physical immune response meant to protect the brain from infections and pathogens. But problems occur when inflammation goes into overdrive.

“Inflammation is a normal reaction of the body, but there is a tipping point where too much or prolonged inflammation is bad and can cause a downward spiral process, which in this case promotes more neurodegeneration,” says Mauricio Concha, a neurologist with Sarasota’s Intercoastal Medical Group.

While inflammation has earned notice in recent years for its links to diabetes, cardiovascular disease and cancer, the new understanding of a potential connection between neuroinflammation and Alzheimer’s is particularly important because of what it rules out. In the past, scientists thought the presence of amyloid plaques—proteins that can collect between neurons—was one of the factors that distinguished those who would eventually get Alzheimer’s from those who wouldn’t. But after discovering signs of protein buildup in the brains of healthy people who died in their 90s, the connection lacked certainty. So, scientists wondered, what's the real cause?

The answer appears to be, in part, inflammation.

Part of this is old news, says Stephanie Peabody, a neuropsychologist and the executive director of Lakewood Ranch’s Brain Health Initiative. Scientists already understood inflammation was a key component to the puzzle, “a risk factor to brain health,” as Peabody puts it. Now they just have to figure out what can be done to offset it before neurological deterioration begins.

This comes with its own challenges. Doctors can’t exactly screen patients for Alzheimer’s based on their current neuroinflammation levels, says Concha. Blood tests, meanwhile, don’t offer sufficient information for neuroinflammation, and while examining spinal fluid might work, it is “investigational and not commercially available,” says Concha. The problem lies in part in the fact that there’s no real treatment for Alzheimer’s, so there’s little use for preliminary screening at the moment.

But for those who want to train their brain the way they might their muscles and joints in order to limit their risk of Alzheimer’s, it is possible to do so. That’s a large part of the work that the Brain Health Initiative wants to do in Sarasota: prepare people for their future by helping them create good habits now.

“We knew we had to do something about individuals’ diets, sleep patterns, sedentary lifestyles, stress and personal engagement,” says Peabody. “All of these risk factors have a common thread—they lead in part to chronic inflammation.”

There is a lesson buried in here: What we’ve done to ourselves can often be undone. Our bodies are changeable, and damage isn’t necessarily permanent.

But what changes do you need to make? Like with many healthy lifestyle habits, the adjustments may seem incremental, but can have big impacts. First, start by eating what Peabody calls a “brain-healthy anti-inflammatory diet.” These foods include what you might instinctively imagine: vegetables, especially green, leafy ones like broccoli, kale and spinach; fruits, particularly berries; nuts; seeds; and fatty fish, like mackerel, anchovies and salmon, rightly named as one of the best foods to eat before taking a test.
What you drink matters almost as much as what you eat. Peabody recommends green tea and, surprisingly, coffee, as long as it’s not filled with sugar or cream.

Along with healthy eating comes leading an active lifestyle. Spending most of the day seated has been associated with neuroinflammation, but even 20 minutes of moderate aerobic exercise on a regular basis can make a big difference.

Also: Get some sleep. Roughly 70 million Americans have chronic sleep problems, according to the U.S. Centers for Disease Control and Prevention. The goal is to hit somewhere in the middle of the ideal time: seven to nine hours per night.

The next two tips might seem obvious, but it’s time to quit smoking and limit your alcohol consumption. Even those who have smoked for most of their lives can see their inflammation vastly improve after just a few years of going without, according to Peabody. Reducing your alcohol intake is less clear-cut. The guidance isn’t to stop altogether. In fact, drinking a daily glass of wine can actually lower inflammation. Just don’t drink to excess.

The hardest advice to follow may be to limit chronic stress. Much like inflammation, stress in and of itself is not a bad thing; the problem occurs when there’s too much of it. A body that becomes desensitized to the release of cortisol is a dangerous thing. The key to limiting stress comes from many of the above tips: eating well, exercising and getting a good night’s sleep.

Adjusting those everyday habits to reduce inflammation can actually lower the risk of dementia and other brain illnesses by at least 40 percent, according to Peabody. And for those of you who might wonder whether being 70, 80 or even 90 years old puts you past the point of no return, the answer is no.

“The earlier you can start, the better, but it’s never too early and it’s never too late,” says Peabody. “You can start engaging in a brain-healthy lifestyle whether you’re 90, 9 or nine months. You will see improvements in your energy, in pain, in your clarity of thinking and your ability to increase your memory, cognitive functions and emotional function.”

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