Ep 4: Treatment for Alzheimer’s Disease (Part 1): Diet, Exercise and Lifestyle Changes

Transcript

[00:00:00] Micaela: So far, there is no cure for Alzheimer’s disease.

[00:00:06] Dr. Dan Gibbs: And I think there’s been perhaps a mistake in putting all our eggs in the “cure” basket.

[00:00:14] Micaela: But there are ways to manage and treat the disease and reduce the risk of getting it in the first place.

[00:00:19] Dr. Dan Gibbs: There already is a huge amount of data that lifestyle modifications are effective if started early.

[00:00:26] Sandra Robinson: If we do meet somebody soon enough, we can help them maintain cognitive and functional skills for as long as possible.

[00:00:35] Micaela: In these next two episodes of the Alzheimer’s disease podcast, we’ll talk about healthy lifestyle habits, therapy, and medication, including the things we know so far and the questions we still have.

[00:00:47] Dr. Andrew Budson: The standard medications which are used to treat the memory loss associated with Alzheimer’s have the ability to turn the clock back on the disease by six to 12 months.

[00:01:04] Micaela: So welcome back. And thanks for listening. I’m your host Micaela Arneson.

This show was created for educational purposes only. It is not a substitute for formal medical advice, diagnosis, or treatment. So if you have questions about a medical condition, talk to your qualified healthcare provider.

[00:01:23] Dr. Philip Sloane: Imagine if you live in a house that’s just all disheveled and there’s bugs running around and it’s dirty. Imagine what that might do to your health.

[00:01:32] Micaela: This is physician Dr. Philip Sloane.

[00:01:35] Dr. Philip Sloane: The environment that the brain lives in is the body. And so if you take care of the body, it’s just like taking care of the house.

[00:01:43] Micaela: Healthy lifestyle habits not only reduce the risk of disease, but they help people with Alzheimer’s disease live well. One important lifestyle habit is diet.

[00:01:54] Dr. Andrew Budson: There have been many studies, over 100 studies, showing that a Mediterranean menu of foods really can make a difference in terms of individuals who may be at risk for developing Alzheimer’s disease.

[00:02:13] Micaela: More specifically, neurologist Dr. Andrew Budson said these studies show a Mediterranean diet can reduce or prevent the buildup of amyloid and tau, proteins that can cause cells in the brain to die and are thought to be responsible for Alzheimer’s disease.

[00:02:28] Dr. Dan Gibbs: I really went full bore on what’s called the MIND diet.

[00:02:33] Micaela: MIND stands for Mediterranean-DASH Intervention for Neurodegenerative Delay. It’s a combination of the Mediterranean diet and the DASH diet, which is aimed to reduce hypertension and promote heart health.

[00:02:45] Dr. Andrew Budson: The Mediterranean menu of foods that has been looked at includes fish, olive oil, avocados, fruits and vegetables, nuts and beans, whole grains and chicken.

[00:03:01] Dr. Dan Gibbs: A lot of the things that people turn their noses up, the bitter green vegetables, kale and arugula, but that’s easy for me because I have no sense of smell and my taste is affected as well. So actually kale tastes pretty good to me because I can actually taste it, the bitter flavor, so it stands out.

[00:03:19] Micaela: It probably won’t surprise you that processed and fatty foods are not on the menu.

[00:03:25] Dr. Andrew Budson: Red meats, fried foods, fatty foods, most pastries and sweets, white bread, sugar, white flour, white rice, sugar sodas and sugar juices, diet sodas and diet juices. All of those things would be “once in a while” foods, not “every day” foods.

[00:03:46] Micaela: Of course, this doesn’t mean you can’t ever have anything sugary.

[00:03:50] Dr. Andrew Budson: Before everyone gets all depressed, I did want to remind your listeners that chocolate in small amounts has been shown to benefit thinking and memory and mood. We all just have to remember that it’s the dark chocolate that’s the healthy part, not so much the sugar and the butter and the milk that they put in it to make it sweet and creamy.

[00:04:15] Micaela: Thank goodness.

[00:04:17] Dr. Andrew Budson: The other lifestyle factor that is so important, probably even more important than the foods we eat is aerobic exercise. In other words, gets your heart beating quickly, gets your breathing heavy.

[00:04:32] Micaela: Exercise was a big part of Anthony Copeland-Parker and his partner Catherine’s life, even before she was diagnosed with Alzheimer’s.

[00:04:40] Anthony Copeland Parker: Catherine lost her husband after only being married a year in her mid-thirties. So her older brother decided that it would be a good idea to have her concentrate on something outside of the loss of her husband. And he decided to train her to run her first marathon.

[00:05:00] Micaela: Running is actually how Anthony and Catherine met.

[00:05:03] Anthony Copeland Parker: I was doing a small race and I overheard her talking about wanting to run a marathon in all 50 states. I’d always thought that maybe one day I would run a marathon. So I started asking her questions and was able to get her to agree to train me to run my first marathon in 2000. I’ve done 68 marathons and she’s done 83.

[00:05:28] Micaela: After Catherine’s diagnosis, she and Anthony made the unconventional decision to sell their house and lead a nomadic lifestyle. Traveling around the world to participate in marathons. Catherine’s condition has since declined. So while they no longer do marathons, they still run races.

[00:05:45] Anthony Copeland Parker: I try to have us concentrate on things outside of disease. So setting goals and having someplace new and exciting as a destination on a horizon I found to be very helpful for her. I think it’s very important for the caregiver to do something that they enjoy doing also. So the fact that I love to travel and I have someone by my side that loves to travel as much as me and loves to run. So we have the love for each other, our love and passion for traveling, and running. And so that makes a very good combination for us.

[00:06:24] Micaela: Of course, you don’t have to be an ultramarathoner to get the benefit of aerobic exercise.

[00:06:29] Dr. Andrew Budson: Brisk walking, bike riding or running or swimming or moving in a pool or taking an aerobics class, anything like that.

[00:06:40] Dr. Dan Gibbs: I’m just not a runner, but walking I really enjoy. I have a fitness tracker and I religiously try to get my 10,000 steps a day.

[00:06:49] Dr. Andrew Budson: The thing that’s wonderful about exercise is it actually can release growth factors in the brain that can help one to grow new brain cells. And the growth in the brain cells is so large that it can actually be observed on an MRI scan of the brain and the part of the brain that shows the greatest enlargement is actually the memory centers in the brain.

[00:07:22] Micaela: Another important lifestyle habit is sleep. To extend Dr. Sloane’s earlier metaphor:

[00:07:28] Dr. Philip Sloane: The brain takes out the trash during sleep. So all these little nasty chemicals that accumulate in the brain when we’re thinking, when it’s quiet, the brain cleans it out. So that’s why we need sleep.

[00:07:40] Micaela: The question is how much should you get?

[00:07:43] Dr. Andrew Budson: That’s approximately eight hours for the average person.

[00:07:49] Micaela: You’ve probably heard this before, but you’ve also probably heard of people who function just fine on way less, like four hours. For the average person, though, there does appear to be a cutoff.

[00:08:00] Dr. Andrew Budson: This sleep has been studied. The really damaging effects are people who get less than six hours of sleep a night. Now people often ask me like, how do I know what’s the right amount of sleep for me? And one way you know you’ve had enough sleep, is that when you wake up, you don’t feel tired and you don’t find yourself falling asleep. And the last thing I did want to mention is most of the over-the-counter and prescription sleeping pills are not good for your memory. They can actually interfere with your memory.

[00:08:39] Micaela: So if you struggle to sleep well, you should talk to your qualified healthcare provider. Sleep is important for caregivers too, and people with Alzheimer’s can sometimes have disturbances that can make it especially difficult for partners to make it all the way through the night.

[00:08:53] Anthony Copeland Parker: I just had one that just cropped up, which was because of her incontinence during the night, she has a tendency to get up. Sometimes she has to get up because she has to go to the bathroom or get up because she went to the bathroom. We’ll go through that, then trying to get her to go back to sleep. She’ll go back to sleep, I’ll go back to sleep, and then she’ll get up again. And I used to worry about that. Now I’m up watching her.

[00:09:19] Micaela: Anthony turned to a couple Facebook groups of other carers for advice.

[00:09:23] Anthony Copeland Parker: It said just make the surroundings as safe as possible and go back to sleep. If she gets up at, you know, six o’clock and wants to walk around, let her get up and walk around. And now I do. I get another hour of sleep and she’s probably gotten her eight hours because she went to sleep an hour before me, so it all works out.

[00:09:41] Micaela: Finally…

[00:09:43] Dr. Andrew Budson: It’s important to participate in social activities, to do novel cognitive activities and to have a positive mental attitude about aging and life in general.

[00:10:00] Anthony Copeland Parker: The tendency is for the person afflicted with the disease to want to withdraw.

[00:10:06] Micaela: Anthony has found that his and Catherine’s nomadic lifestyle has really helped her stay cognitively engaged and stimulated. They meet lots of people on running tours.

[00:10:15] Anthony Copeland Parker: So you’re on buses and you’re sitting around the table with people that you don’t know, and you’re having opportunities to socialize.

[00:10:23] Micaela: And the changes in their schedule give her something to look forward to.

[00:10:27] Anthony Copeland Parker: So far, we have found that not having a routine is something that keeps it a little bit more interesting to her. As an example, we were in Atlanta yesterday and I start talking about, oh, we’re going to Connecticut, we’re gonna visit with my sister and sister-in-law. She has some remembrance of who they are, but the mere fact that we’re getting ready to go someplace new, I can see a change in her behavior. She seems to like that, because travel is something that she enjoys doing.

[00:10:56] Micaela: But again, you don’t have to plan lots of travel. And for some people with Alzheimer’s disease, travel may no longer be realistic. Cognitive stimulation and social interaction can come in many forms. Lori La Bey’s mom was always a social butterfly, and Lori also made sure that the family spent time together.

[00:11:13] Lori La Bey: I think why she lived as long as she did is because she was socially engaged. And I’m glad to see that there are finally discussions about that. I would love to see doctors be able to write a prescription for music or dance or art or a lot of those types of things versus a medication.

[00:12:32] Micaela: We’ll talk about medication in the next episode as well as occupational and physical therapy.

If you’d like to learn more about lifestyle habits, Healthline and The Alzheimer’s Society are great resources. Links to these, a directory of memory cafes across the US and other resources are on our website, hupstaging.wpengine.com

This is the Alzheimer’s Disease podcast. This show is part of the Health Unmuted audio library by Mission Based Media. To listen and learn more, visit hupstaging.wpengine.com and follow our show on your favorite podcast player. The Alzheimer’s disease podcast is written, hosted and produced by me, Micaela Arenson. Many thanks to Dr. Daniel Gibbs, Anthony Copeland-Parker, Paul Hornback, and Lori La Bey for sharing their personal experiences, and to Dr. Gibbs, Dr. Philip Sloane and Dr. Andrew Budson, for sharing their medical expertise.