Is Alzheimer's Disease preventable?
Updated: Apr 15, 2020
I am very proud of one of my former students Richard Isaacson. As a neurologist with a strong history of Alzheimer’s Disease in his family, he decided to dedicate his career to the prevention of Alzheimer’s Disease. He was the first doctor in the US to start an Alzheimer’s prevention program in an academic medical center - Weill-Cornell Medical Center in NYC.
Recently, he was a guest on the popular longevity medicine podcast - The Peter Attia Drive. Dr. Isaacson and Dr. Attia take a deep dive into the topic of Alzheimer’s disease and its causes. Alzheimer’s Disease, like heart disease, seems to be a tug-of-war between environment and genetics. Environment includes diet, obesity, exercise, how you use your brain, sleep etc. Genetics include the apoE gene. However, he explains the limitations of apoE gene testing and how Alzheimers inheritance is polygenic. There are likely many other contributing genes we are yet to discover.
They also discuss the difficulty in diagnosing Alzheimer’s and determining its prevalence. This, in part, is the reason why so many trials of drugs used to treat Alzheimer’s have failed. A lot of patients in these trials don’t actually have Alzheimer’s - they have other memory problems. In fact, drug companies have spent over $600 billion dollars since 1996 to no avail - all 150 drugs have failed clinical trials.
Consequently, Dr. Isaacson believes that a prevention approach, instead of treatment approach, is more realistic at present, and more likely to produce results. Treat the risk factors instead of the disease. He has observed the delaying of onset of the disease in his clinic patients. Mind you, these are highly motivated patients, that completely change their lifestyle. Despite these successes, he has had considerable push-back for his use of the word “prevention”. The academics require hard proof from long term controlled trials that Alzheimer’s is truly preventable before the word “prevention” can be used together with Alzheimers.
The general message is: keep thin, exercise, keep blood pressure down, use your brain, sleep, don’t stress. If, however, you have a very strong family history of Alzheimer’s disease and are willing to make major sacrifices to adopt a healthier lifestyle, you may want to consider visiting Richard in NYC. Dr. Isaacson takes a much deeper dive and a personalized approach.
Here is the link to the podcast
(You can skip the first 30 minutes of the interview unless you want to hear pleasant small talk and about Richard’s career.)