Seniors
Preventing Alzheimer’s
Disease BY DR. PAUL E. BENDHEIM
U ntil recently, we thought today’s grim facts
about Alzheimer’s disease could not be changed.

According to the Alzheimer’s Association “2022
Alzheimer’s Disease Facts and Figures”:
• One in three seniors dies from Alzheimer’s
disease or another form of dementia.

• More than 6 million Americans currently have
Alzheimer’s disease.

• Since 2000, heart disease deaths are down 7.3%,
but AD deaths are up 145%.

• Dementia will cost the US $362 billion in 2022,
projected at $1 trillion by 2050.

Years ago, when I was a fourth-year medical stu-
dent at the University of Arizona College of Medicine
in Tucson, I had the privilege to spend several months
at the Neurological Institute of Columbia University
in Manhattan. Dr. Houston Merritt, emeritus chair-
man and perhaps the most famous neurologist in the
history of American medicine, met with our group
of students every week. On one of those occasions,
he noted that the worst thing about getting old was
listening to his brain cells commit suicide.

That seemingly programmed, self-destructive behav-
ior of brain cells (neurons) was the central dogma of the
aging brain until the last 20 years. This old dogma stated
that the human brain — the most complex, creative and
remarkable object in the universe — started to unravel
at about the age of 40. If you were “lucky,” it unraveled
slowly and you maintained mental agility into your 60s,
70s and beyond. If you were “unlucky,” it unraveled
more rapidly and you became senile — or in modern
medical parlance, demented.

It is true that the normal wear and tear of the aging
brain causes some loss of gray matter brain cells and the
white matter connections between them and results in
an 80-year-old brain not being as nimble as a 40-year-
old brain. But if properly maintained, the brain, even
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The New Science
of the Aging Brain
“Nor, indeed, are we to give our attention solely to the
body; much greater care is due to the mind and soul
for they, too, like lamps, grow dim with time unless we
keep them supplied with oil ... intellectual activity gives
buoyancy to the mind.” Cicero, 44 BCE.

in those 90 or even 100 years of age, can maintain its
sharpness, agility and creativity. Alzheimer’s disease is
not an inevitable consequence of aging.

The new science of the aging brain
Charles Darwin predicted what modern neuroscience
has now proven: “If I had my life to live over again,
I would make it a rule to read some poetry, listen to
some music and see some painting or drawing at least
once a week, for perhaps the part of my brain now
atrophied would then have been kept alive through
life. The loss of these tastes is a loss of happiness.”
The new science of the aging brain is founded
on two fundamental principles. The first is neuro-
plasticity. Neuroplasticity is the brain’s ability to
rewire, improve and fortify itself. Neurologists have
known for many decades that a child’s brain can take
advantage of this inherent property to compensate
for injuries occurring in childhood. We have learned
over the past few decades that neuroplasticity can
be activated throughout the lifespan. New cells can
be generated — especially in the hippocampus, the
seahorse-shaped structure responsible for new mem-
ory formation — and new synapses (connections) can
be formed between brain cells.

The second fundamental principle is cognitive
reserve, also called brain reserve.

Cognitive reserve is like physical reserve. Physical
reserve results from regular physical exercise, a heart-
healthy diet and controlling medical risk factors such
as hypertension, diabetes, smoking, cholesterol and
obesity. Physical reserve significantly reduces the
risk of heart attack and stroke; it hastens your ability
to recover from the flu, COVID-19 or an operation.

Similarly, cognitive reserve is preserved, built and
strengthened by practicing brain-healthy lifestyle
behaviors and managing the same risk factors. There are
six evidence-based lifestyle components that contribute
to cognitive reserve and to happier, healthier aging:
• Brain workouts that engage, stimulate and for-
tify your inherent abilities to learn, think and
remember • Modest physical exercise on an almost daily basis
• An active social life
• Healthy nutritional habits
• Stress reduction
• Memory strengthening sleep
Cognitive reserve is an insurance policy. Building
and maintaining it will not guarantee that you will
not get Alzheimer’s disease but it greatly reduces your
risk and will enrich your life.

Preventing cognitive decline and
Alzheimer’s disease
In 2015, “The Finnish Geriatric Intervention Study
to Prevent Cognitive Impairment and Disability”
(FINGER Study) was published in The Lancet,
the leading British medical journal. This scientif-
ically rigorous clinical trial involved 1,200 aging
Scandinavians. It showed that it is possible to prevent



cognitive decline by employing a multi-compo-
nent lifestyle intervention in at-risk older peo-
ple. Individuals participating in the active arm
of the study received cognitive training, phys-
ical fitness, socialization, nutritional guidance
and monitoring and treatment of medical risk
factors. Participants in the control arm received
only general medical advice.

The results were so noteworthy that two
years later, they made the cover of Scientific
American (April 2017). “A Success in the Fight
Against Alzheimer’s: New Ways to Stop the Fog
of Dementia Before it Starts.” The authors, Miia
Kivipelto and Krister Håkansson, wrote “A
gold-standard clinical trial provides evidence
that diet, exercise and an active social life can
help prevent cognitive decline.”
Medical-science advances when experimen-
tal results are tested by other investigators
and findings are reproduced. The Alzheimer’s
Association recently launched the U.S. Study
to Protect Brain Health Through Lifestyle
Intervention to Reduce Risk (U.S. POINTER)
study. This two-year clinical trial evaluates
whether lifestyle interventions that simultane-
ously target many risk factors protect cognitive
function in older adults who are at increased
risk for cognitive decline.

Dementia has been declared a public health
priority by the World Health Organization.

The WHO 2021 report on dementia stated:
“Studies show that people can reduce their risk Dr. Paul E. Bendheim
of cognitive decline and dementia by being
physically active, not smoking, avoiding harm-
ful use of alcohol, controlling their weight,
eating a healthy diet and maintaining healthy
blood pressure, cholesterol and blood sugar lev-
els. Additional risk factors include depression,
social isolation, low educational attainment,
cognitive inactivity and air pollution.”
As of 2022, approximately 300 trials have
failed to conclusively identify a drug or bio-
logical intervention to prevent or modify the
relentless, progressive course of Alzheimer’s
disease. The only proven approach to slow the
growing epidemic of Alzheimer’s disease is the
management of risk factors, both medical and
lifestyle. This means a personal commitment to
a brain-healthy lifestyle. Each of us has to be our
own brain health quarterback.

One final note: There are numerous causes of
memory problems and dementia, some of which
are treatable and reversible. If you, a loved one,
or a friend are experiencing increasing memory
lapses, forgetfulness or have any concerns about
your brain health, I urge you to speak with a
health care provider. JE
Courtesy of Dr. Paul E. Bendheim
Dr. Paul E. Bendheim is a clinical professor of
neurology at the University of Arizona College
of Medicine – Phoenix and author of “The Brain
Training Revolution: A Proven Workout For
Healthy Brain Aging.” Bendheim is also the
founder, chairman and CEO of BrainSavers, Inc.

Live fully in a
vibrant community
The Quadrangle is an inspired and highly engaged community for older
adults. Here, you will join residents who are as creative, active, and
intellectual as you. Plus, you’ll get to know our in-house chef who crafts
fresh, seasonal dishes made with your tastes in mind.

Join us for lunch to meet our welcoming residents
and sample our cuisine for yourself.

Get in touch by calling 610-484-4328 or visiting TheQuadrangleCCRC.com/Exponent.

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