Heart Talk: October 2024: Strategies for Alzheimer’s Prevention

Strategies for Alzheimer’s Prevention: What We Have Been Doing All Along 

The Bale Doneen Method emphasizes the treatment and prevention of inflammation and oxidative stress as a means for controlling cardiovascular disease and risk. Recent studies that focused on the many aspects of health affecting Alzheimer’s risk unsurprisingly report significant overlap with the medications and supplements we routinely recommend in our practice. Because Alzheimer’s Disease, at its core, is a multifactorial disease, its treatment requires our multifactorial and personalized approach.

Vitamin B12 deficiency has been linked to an in creased risk of dementia or worsened cognitive perfor mance. This is logical, as there are multiple biochemical pathways involved in Alzheimer’s Disease affected by B12 deficiency. Studies showed that patients suffering from Alzheimer’s had lower plasma B12 levels than healthy controls, and supplementation of B vitamins was reported to improve cognitive function. 

Reference: Lauer AA, Grimm HS, Apel B, Golobrodska N, Kruse L, Ratanski E, Schulten N, Schwarze L, Slawik T, Sperlich S, Vohla A, Grimm MOW. Mechanistic Link between Vitamin B12 and Alzheimer’s Disease. Biomolecules. 2022 Jan 14;12(1):129. 

CoQ10 (Ubiquinol) is implicated in numerous neurodegenerative diseases, including Alzheimer’s Disease. In a recent study of CoQ10, supplementation protected the brain from inflammation and reduced beta-amyloid (the plaque found in the brains of Alzheimer’s patients) production while suppressing oxidative stress. CoQ10 is also known to protect the brain by decreasing brain atrophy (shrinkage). 

Reference: Ebrahimi A, Kamyab A, Hosseini S, Ebrahimi S, Ashkani-Esfahani S. Involvement of Coenzyme Q10 in Various Neurodegenerative and Psychiatric Diseases. Biochem Res Int. 2023 Nov 1;2023:5510874. 

Statin medications, used frequently for their anti-inflammatory and oxidative stress lowering effects, have also been found to significantly impact the progression of mild to moderate Alzheimer’s Disease. In short, statins protect the brain. Statins play a neuroprotective role by lowering the dangerous cholesterol levels, while also reducing amyloid beta peptides and tau proteins (p-tau) in the brain (inflammatory proteins found in the brain of Alzheimer’s patients). 

Reference: Liu L, Dai WZ, Zhu XC, Ma T. A review of autophagy mechanism of statins in the potential therapy of Alzheimer’s disease. J Integr Neurosci. 2022 Mar 18;21(2):46. 

Pioglitazone, used primarily in the treatment of Type 2 Diabetes and insulin resistance, has recently garnered attention for its role in Alzheimer’s Disease prevention. Insulin Resistance is so heavily implicated in the pathogenesis of Alzheimer’s that it is often referred to as “Type 3 Diabetes” or “Diabetes of the brain.” Pioglitazone is a powerhouse when it comes to Alzheimer’s Disease prevention, due to its ability to increase insulin sensitivity of the brain and impr ove glucose (sugar) utilization, reduce inflammation and reduce brain atrophy (shrinkage). Pioglitazone has been shown to improve learning and memory, and studies suggest that su perior effects are seen when treatment is started prior to the onset of symptoms. 

References: Saunders AM, Burns DK, Gottschalk WK. Reassessment of Pioglitazone for Alzheimer’s Disease. Front Neurosci. 2021 Jun 16;15:666958. doi: 10.3389/fnins.2021.666958. 

Nowell J, Blunt E, Gupta D, Edison P. Antidiabetic agents as a novel treatment for Alzheimer’s and Parkinson’s disease. Ageing Res Rev. 2023 Aug;89:101979. doi: 10.1016/j.arr.2023.101979. Epub 2023 Jun 14. 

ACE inhibitors (i.e.: Ramipril) and ARBs (i.e.: Losartan), used frequently for blood pressure control and arterial wall protection, may also affect Alzheimer’s risk and symptomatology. As the Renin Angiotensin System (RAS) is involved in regulating activities such as lear ning, memory, cognition and emotional stress, brain RAS has been shown to be associated with Alzheimer’s Disease. Inhibiting the RAS system with this class of medication presents another opportunity for overlapping cardiovascular and neuroprotective therapy. 

Reference: Gebre AK, Altaye BM, Atey TM, Tuem KB, Berhe DF. Targeting Renin-Angiotensin System Against Alzheimer’s Disease. Front Pharmacol. 2018 Apr 30;9:440. 

A power player in multiple areas of cardiovascular care, vitamin B3 also holds promise in the neurological world. Niacin protects the brain through lipid pathways and by inducing the breakdown of problematic amyloid-beta plaques. In fact, supplementation aside, research has established that increased dietary intake of niacin is associated with impr oved cognition and reduced risk of AD later in life. 

Reference: Wuerch E, Urgoiti GR, Yong VW. The Promise of Niacin in Neurology. Neurotherapeutics. 2023 Jul;20(4):1037-1054. Qin, B., et al. CARDIA. Am J Clin Nutr. 2017; 106(4):1032-40. 

Morris, MC, et al. J. Neurol Neurosurgery Psychiatry. 2004;75(8):1093-9 

While we have always believed wholeheartedly in our mantra “Healthy Heart, Healthy Brain,” Alzheimer’s Disease researchers are now coming to the same conclusions. When we protect arterial health in the heart and elsewhere, we are also keeping the brain healthy and sharp for life.