1. 10 tips to avoid Alzheimers Disease Dr. Michael Mullan President of Roskamp Institute 2012 Sarasota, FL

2. Our risk for Alzheimers Disease Demographically the world population is aging - particularly quickly in advanced societies Risk for the disease is impacted by genetics but also by many lifestyle choices Despite genetic predisposition risk for the disease can be altered by modifying lifestyle

3. 1. Stay physically active Direct relationship between physical activity and protection against Alzheimers disease Open questions: – How much activity is required? – How long ? – What type of activity?

4. 2. Eat well Diets which resemble the Mediterranean Diet lower the risk for Alzheimers disease Mediterranean diet consists of : – high amounts of vegetables, fruits, legumes and cereals – low intake of saturated fats and relatively high intake of olive oil – moderate fish intake – low to moderate intake of dairy products – low consumption of meat – low to moderate consumption of wine This diet is also associated with other health benefits such as cardiovascular health

5. 3. Mental Exercise - Use it or Lose it Educational status protects against onset of Alzheimers disease – Cognitive stimulation in mouse models of Alzheimers reduces Alzheimer pathology How much should we do? What should we do? – Games vs. hard learning – Integration of different brain areas and different skills

6. 4. Manage medical risk factors aggressively Common disorders increase our risk for Alzheimers disease – Diabetes, heart disease, hypertension This risk is independent of risk for cerebrovascular dementia What can we do? – Tight monitoring of blood sugar levels in diabetics, blood pressure in hypertensives, arrhythmia in those with rhythm abnormalities and maintain a healthy weight

7. 5. Sleep well Sleep deprivation is associated with errors of judgment, inattention and memory problems Brain organizes information overnight and consolidates memories – Poor sleep patterns stop consolidation and increase inattention

8. 6. Drink well J-shaped relationship between alcohol risk for dementia Abstainers at higher risk than drinkers Excess drinking increases risk Modest consumption is protective Red wine better than other alcohol ? Polyphenols

9. 7. Supplements and Vitamins Vitamin B 12 and Folate deficiency is associated with memory loss and risk for Alzheimers disease Other vitamins not shown to reduce risk when supplemented Take away message – Dont be deficient by excess vitamins > not preventative Omega-3 fatty acid supplementation – Still being tested > ratio of Omega-3 to omega-6 fatty acids importance – Most diets deficient in Omega-3 Other supplements seem protective (Curcumin) But others dont (Ginkgo Biloba)

10. 8. Dont smoke Data is contradictory, but overall smoking increases the risk for Alzheimers disease and other dementias Nicotine itself might be helpful when not taken by cigarette Cerebrovascular disease caused by smoking interacts extremely negative with Alzheimer pathology

11. 9. Dont hit your head Traumatic brain injury increases risk for Alzheimers disease Multiple repeat injuries worse than single large blows in general Wear protective head gear Increase balance and strength in the elderly Head injuries due to falls major cause of increased risk

12. 10. Putting it all together Not one activity but many Small changes in several aspects of lifestyle probably better than huge changes in one area Sustainable lifestyle better than short-lived enthusiasm Enjoy the new regimen!

13. Contact: mmullan@roskampinstitute.net