Brooks Kenny, executive director at WomenAgainstAlzheimer’s and director of the Be Brain Powerful™ campaign

“Alzheimer’s disease is not an inevitable consequence of aging,” says Brooks Kenny, executive director at WomenAgainstAlzheimer’s and director of the Be Brain Powerful™ campaign. “Science is catching up, and there are things we can do to take care of our brain health and reduce our risks.”

As neuroscientists unravel the complex nature of the structural, physiological, and metabolic changes in the brains of Alzheimer’s patients as they progress along the continuum of disease, and as potential treatments make their way through the research pipeline, we are learning more about how to help optimize brain health and why it is important to intervene earlier before cognitive function declines dramatically.

While an estimated 5.8 million Americans are living with Alzheimer’s disease in 2020 (or one in 10 of those over age 65), the percentage of people with Alzheimer’s dementia is only 3% for those between ages 65 – 74, 17% for those between ages 75 – 84, and 32% for those over 85. Still, Kenny observes, “there is a stigma that prevails—people think of dementia as something that happens to everyone as they get older.” They don’t realize that subtle changes often happen in our cognitive behaviors and brain function years before a diagnosis of Alzheimer’s or other forms of dementia.

In the early stage of disease progression, mild cognitive impairment (MCI), effects on memory and thinking may only be noticed by family and friends, but underlying changes in the brain (caused by amyloid plaque build-up) have already been present for years and lead to damage that will continue to progress. “By the time a person comes to clinical attention, the horse is already out of the barn,” says Dr. Brent P. Forester, chief of the Center of Excellence in Geriatric Psychiatry at McLean Hospital and medical director of behavioral health integration, quality, and patient experience at Mass General Brigham. By educating people about brain health and the importance of early detection, diagnosis, and intervention, the Be Brain Powerful campaign of USAgainstAlzheimer’s encourages people to understand their brain health, to help to protect it throughout their lifetimes—and to seek help as soon as the signs and symptoms of MCI appear.

Amyloid plaques in an Alzheimer’s disease brain, as observed during neuropathological examination

Why should we be concerned about brain health and the risk of Alzheimer’s disease?

Although age, genetics, and family history are the greatest risk factors for developing Alzheimer’s, according to the Lancet Commission on Dementia Prevention, Intervention, and Care, a range of modifiable risk factors exists that, if addressed together effectively, could prevent or delay up to 40% of dementias.

The Lancet Commission, building on earlier work by the World Health Organization, identifies 12 major modifiable risk factors for Alzheimer’s disease and other forms of dementia: (throughout one’s lifetime) level of education; (during midlife) hearing impairment, traumatic head injury, hypertension, excessive alcohol consumption, obesity; (in later life) smoking, depression, social isolation, physical inactivity, air pollution, and diabetes. The good news, according to the Lancet Commission, is that “it is never too early and never too late in the life course for dementia prevention.”

Be Brain Powerful™ campaign encourages people to understand their brain health, to help to protect it throughout their lifetimes—and to seek help as soon as the signs and symptoms of MCI appear

Because Alzheimer’s disease is a topic that carries stigma with it, people often won’t discuss concerns about the condition—attributing it to “senior moments” or normal consequences of aging—until the time for early diagnosis and intervention has passed. To counter this tendency, the Be Brain Powerful Campaign launched a 30-day Brain Health Challenge to help people understand their brain health, to learn how to improve their brain performance and reduce risks of dementia, and to talk to doctors, loved ones, and friends about brain health.

With daily challenges connected to the pillars of brain health—physical exercise, food and nutrition, medical health, sleep and relaxation, mental fitness, and social interaction—this campaign is helping people to think about their brains and to realize that there are things they can do to lower their risk of cognitive impairment and dementia. Kenny also notes that the Brain Health Challenge is now being disseminated together with training workshops to corporations and other organizations concerned about employee health and wellness, particularly in this time of coronavirus and social distancing. Early results suggest that the campaign is catching on: Participants surveyed report that they’ve learned more about brain health, that they’ve changed their behaviors, and that they’re more confident in talking to their health care practitioners about concerns.

What can you do to optimize your brain health and where can you get more information on the importance to early detection and diagnosis to reduce your risk of Alzheimer’s disease?

The basics of brain health include these healthy steps: Exercise, eat a healthy diet, maintain good overall health, get enough sleep, relax and avoid stress, stay connected with others, and use your brain.

For more information, go to www.bebrainpowerful.org, https://www.usagainstalzheimers.org/, www.aarp.org/health/brain-health, and www.alz.org.