September 21st has been designated by the World Health Organization (WHO) as World Alzheimer’s Day, the most common form of dementia. In our country, it is estimated that there are over 150,000 people with some form of dementia. The incidence of the disease is increasing and it is estimated that in 2030 and 2050 approximately 276,000 and 365,000 people will have the disease, respectively.
What is Alzheimer’s
Alzheimer’s disease is a chronic neurodegenerative disease of the Central Nervous System. It is characterized by the deposition of two pathological proteins in the brain, β-amyloid and t-protein, resulting in the degeneration of its neurons. Premature and gradual destruction of brain cells is observed, which leads to the weakening of individuals’ memory over time and to changes in their behavior.
Stages of the disease
The stages of the disease are the following three:
- 1o: Early or pre-symptomatic stage in which individuals have difficulty retrieving things that happened in their recent past, but this loss is not significant.
- 2o: Intermediate stage in which memory loss is more pronounced and is accompanied by disorientation, disorganized thinking and moodiness
- 3o: Final stage in which individuals have difficulty remembering even their most familiar faces and also have difficulty speaking. At this stage, individuals forget to perform even basic biological functions, such as swallowing and urinating.
Causes
The exact causes of the disease remain unknown. However, there are genetic and environmental factors that predispose to the onset of the disease and influence the intensity of symptoms. The most important risk factors are summarized below:
- Age: The disease rarely occurs in people under 65 years of age, and after this age the risk doubles every five years.
- Family history:People with the disease usually have at least one first-degree relative who has the same disease compared to older people who do not suffer from it.
- Genetic factors: Mutations in genes and variations of the same genes are responsible for the development of familial Alzheimer’s disease, which rarely occurs. Most of the genes responsible for the development of the disease remain unknown.
- Nutrition: Diet significantly affects brain function. Recent research suggests that increased consumption of foods rich in calories and fat leads to faster cell destruction, resulting in faster progression of the disease.
- Medications: Large doses of medications and the combination of different medications, known as polypharmacy, in vulnerable groups such as the elderly can lead to memory disorders. In addition, some groups of medications such as benzodiazepines, antidepressants and classic antipsychotics used to manage severe stress, insomnia and mental illnesses respectively accelerate cognitive decline.
Additional risk factors that may be responsible for Alzheimer’s disease and for which more research is needed:
- Cerebral Vascular Attack (CVA)
- Smoking
- Traumatic Brain Injury
- Depression
Diet and Prevention
A person’s diet may significantly affect both the development and progression of Alzheimer’s disease, as it can modify risk factors. In fact, this effect is greater in people with nutritional deficiencies and in people with a genetic predisposition.
Food ingredients that slow down cell destruction and therefore the development of the disease are the following:
- Antioxidants: A diet that includes foods high in antioxidants, such as fruits and vegetables, helps reduce the oxidative stress that is observed either in the presence or absence of Alzheimer’s disease.
- Omega-3 fatty acids: Fatty acids are a component of cell membranes and contribute to their stability. In the presence of the disease, an increased rate of oxidation of fatty acids in cell membranes is observed, resulting in early cell destruction. Therefore, increased consumption of fish rich in omega-3 fatty acids will reduce cell destruction and therefore the progression of the disease.
- B complex vitamins: Many B complex vitamins such as B12, B6 and B1 contribute to maintaining the structure and functionality of nerve cells, with the result that their deficiency is associated with the development of various neurological disorders. Therefore, increased consumption of fruits and vegetables rich in vitamins is recommended, while additional supplementation of these vitamins does not seem to further reduce the risk of developing the disease.
Adopting the Mediterranean diet ensures the intake of all the above food components and therefore constitutes the best dietary pattern for preventing the onset of the disease as well as reducing the progression of the disease.
Nutrition during the disease
Very often, Alzheimer’s patients lose weight, both due to memory loss and reduced appetite. The reduction in weight of individuals, in addition to leading to an increased risk of developing other diseases, is also responsible for the worsening of the disease itself. Therefore, patients must maintain a good nutritional status.
In some cases where patients are unable to feed themselves adequately, care from a third person is necessary. To ensure adequate food intake, the caregiver can:
- Cut the food into smaller pieces or modify the texture to make it easier for the patient to chew
- Provide small and frequent meals throughout the day
- Encourage the patient to eat their food, without exerting pressure
- Provide information about the foods to be consumed, in case the patient is unable to recognize them and therefore refuses to eat them
- In case feeding is not possible, for example in terminally ill patients, it is recommended to take foods or drinks with increased calories, such as smoothies, alternatively, appropriate supplements are required in consultation of course with the attending physician and dietitian.
In summary
Alzheimer’s disease affects many elderly people, affecting their functionality and behavior, ultimately reducing their quality of life. Adopting a balanced diet based on the Mediterranean model, quitting smoking, maintaining a normal weight and indicators such as cholesterol, glucose and blood pressure can ultimately reduce the risk of developing the disease. In recent years, a great research effort has been carried out with the aim of finding more effective treatments and there is great optimism in the scientific field. Until then, increased awareness of society, prevention and maintaining a good nutritional status are extremely important in order to reduce the complications of the disease.
SOURCES
Breijyeh Z, Karaman R. Comprehensive Review on Alzheimer’s Disease: Causes and Treatment. Molecules. 2020 Dec 8;25(24):5789. doi: 10.3390/molecules25245789. PMID: 33302541; PMCID: PMC7764106.
Kumar A, Sidhu J, Goyal A, Tsao JW. Alzheimer Disease. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2022. PMID: 29763097.