Today, I’m the director of the Alzheimer’s Prevention Clinic, and I oversee more than 30 people who build tech applications, assist with the myriad aspects of our research programs, and develop new methods of cognitive testing. We’re taking a different approach to managing Alzheimer’s prevention because we’ve learned that the disease builds up over 20 or 30 years before the first symptoms appear. We’ve created a free online course for the public on Alzheimer’s prevention and treatment, and done prospective studies that preliminarily show that changes in lifestyle — exercising more and eating a healthy diet — can maintain or improve cognition, and reduce a person’s calculated risk. Just because most people are diagnosed in their 70s and 80s doesn’t mean that you shouldn’t be treating them 20 to 30 years before. Since Alzheimer’s prevention is in its infancy and our patients are in their 30s and 40s, our next steps are to incorporate biomarker tests to more definitively assess the effectiveness of our clinical precision-medicine interventions. Before receiving our recent National Institutes of Health funding, the cost of biomarker testing was prohibitive, but now, with sufficient funds, we are on our way to determining the long-term impact.
Essentially, everything I tell my patients to do, in terms of making the right lifestyle choices, I do myself. Quite honestly, I firmly believe that the totality of evidence is overwhelming that these changes can reduce my own personal risk, as well as my patients’ risk, while also benefiting overall health.
I exercise a solid three days a week, at least twice with high-intensity interval training (like spinning classes), and once a week I do resistance training. I don’t eat more than 1,800 to 1,900 calories a day. I got my body fat measured, and I’m at 17 percent. I should probably get down to 16 percent, but I’m a firm believer in staying balanced and making your brain and belly happy, so I occasionally have chocolate ice cream and add some agave or brown sugar to my coffee and iced tea.
Using the words “Alzheimer’s” and “prevention” in the same sentence, oh, gosh. I used to get tomatoes thrown at me. Like, can you really prevent a heart attack? No, you can reduce a person’s risk. Same thing with Alzheimer’s. If we don’t use the word “prevention,” though, people think there’s nothing you can do, so they go on living their usual lifestyles, and guess what? One out of three cases of Alzheimer’s disease may be preventable based on lifestyle changes. A landmark study indicated that exercise, diet changes and cognitive training had a positive impact on cognitive function over time. And guess what again? These interventions are even more effective in those people who have the most common gene for late-onset Alzheimer’s disease. So, not only do we have some control over our destiny, it may even be possible to win the tug-of-war against your genes.
Dr. Richard Isaacson, M.D., specializes in neurology at NewYork-Presbyterian/Weill Cornell Medical Center. He is the founder of the Alzheimer’s Prevention Clinic (APC), Weill Cornell Memory Disorders Program, and a trustee of the McKnight Brain Research Foundation. He is also the author of two best-selling books, The Alzheimer’s Prevention & Treatment Diet and Alzheimer’s Treatment Alzheimer’s Prevention: A Patient & Family Guide.