What you can do

In Alzheimer’s, changes in the structure of the brain occur before symptoms of the disease become noticeable. The earliest recognizable signs of Alzheimer's are memory lapses, such as forgetting familiar words and names or the locations of everyday objects. It's normal to forget names or appointments occasionally, but forgetting recently learned information and forgetting more often may be early signs of the illness. Such problems may not be obvious or detectable during a medical exam.
Alzheimer’s disease is thought to develop in several phases, including an early, symptomless phase; a moderate stage, in which mild symptoms appear (also known as mild cognitive impairment, or MCI); and a later stage, which is the onset of dementia. At the earliest point in which the illness may be formally diagnosed, friends and family may notice that a person is having changes in mood or personality, exhibiting poor judgment, or having difficulty with:

• remembering words and names.
• performing familiar tasks at work or in social settings.
• remembering the location of a valuable object.   

A diminished sense of smell can also be an early warning sign, though this can be caused by other conditions such as allergies or sinus problems. It’s also important to note that not everyone who develops MCI will go on to develop Alzheimer’s, and that not all dementia is caused by Alzheimer’s.

If you are at increased risk for Alzheimer’s or suspect you have early symptoms, you may want to consider testing that can provide a baseline assessment of your cognitive function. These tests can help you and your physician be alert to any changes that may signal mild cognitive impairment. It’s important to know when such changes begin, because medications are available that, in some people, can slow their progression. (See drug treatment section below for more information.) Some tests are simple cognitive exams that your primary care physician can give you; others require you to have advanced screening or laboratory tests.  Deciding to undergo this testing isn’t an easy decision. You may want to discuss your options with your doctor or Navigenics Genetic Counselor. They can help you think through what’s best for you, and, if need be, direct you to Alzheimer’s experts in your area.

At present,there is no known cure for Alzheimer's, However, the FDA has approved certain drugs that can help to treat the symptoms of Alzheimer’s. These drugs, such as donepezil (Aricept) and galantamine (Razadyne), may temporarily improve memory problems. On average, about half the people who take these drugs see short-term reduction in cognitive decline for six to 12 months. In one study, donepezil plus vitamin E slowed the progression from mild cognitive impairment to dementia among patients who had one or more copies of the genetic marker that Navigenics tests for (APOE-4). To learn more about these drugs and those which may be available in the future, click here.

So far there are no clinically proven strategies for preventing Alzheimer's disease. But good evidence is emerging that healthy lifestyle measures like challenging your brain, exercising, and staying away from cigarettes can make a difference.

Challenge your brain. It's thought that maintaining an active mental life increases the connections between nerve cells and may compensate for the brain's degeneration over time. Engage in activities that involve a lot of information processing: doing puzzles, studying a language, learning to play a musical instrument. The more activities you do and the more often you do them, the more you'll benefit.

Exercise your body. Multiple studies have shown that regular aerobic exercise—the kind you get from brisk walking, bike riding or running—improves mental function, and can reduce the risk of Alzheimer’s. Exercise also lowers cholesterol, blood pressure and blood sugar levels—all of which are risk factors that have been associated with Alzheimer's. Engage in heart-pumping activity for at least 30 minutes five times a week. To see a short video on how diet and exercise can affect the risk for Alzheimer’s disease, click here.

Be social. People who have a strong network of friends and a lively social life are less likely to suffer cognitive decline. Social activities that are both mental and physical are the best. Take a learning vacation with friends, join a book group, or form a walking club.

Stop Smoking. Smoking significantly increases the risk for Alzheimer’s disease. Studies show that mid-life heavy smokers (2 packs per day) are two times more likely to develop Alzheimer's disease, as well as other forms of dementia. In addition, individuals who have the gene variant that Navigenics tests for (APOE-4) have been shown to be at even greater risk of Alzheimer’s from smoking. There has been less research done on Alzheimer’s risk in people who smoke only the occasional cigarette, but smoking at any level could be risky.

Trim your waistline. Being overweight not only raises your risk for high blood pressure, heart disease and cancer, but one study found that being overweight in midlife increased the risk of dementia later in life. Fat around the belly may be particularly worrisome. Women should aim for a waist circumference of no more than 35 inches; men for no more than 40 inches. People of Asian origin may be at risk at even lower waist circumferences. Asian women should aim for a waist circumference of no more than 31 inches; men for no more than 35 inches.

Control cholesterol and blood pressure. Many scientists suspect that cardiovascular risk factors, such as elevated cholesterol and blood pressure, increase the risk for Alzheimer's disease. If your HDL cholesterol (the "good" kind) is less than 35 milligrams/deciliter, your triglycerides are above 250 milligrams/deciliter, or your blood pressure is 140/90 or higher, talk with your doctor about how you can improve those numbers through diet, exercise or medication.

Consider statins. Statin drugs, commonly prescribed for high cholesterol, may also lower the risk of developing Alzheimer's or slow its progress. Some researchers suspect statins affect cholesterol formation in the brain, and may block the formation of the protein plaques that are a hallmark of the illness. This information is still preliminary, so talk to your doctor about deciding to take a statin. Like any medication, statins can cause side effects, so you and your doctor must weigh the risks and benefits.

Get your thyroid checked.  Studies have shown that women with either very low or very high thyroid hormone levels are twice as likely to develop Alzheimer’s disease than women with normal thyroid function. This finding has not, however, been seen in men.

Check your Navigenics hemochromatosis results. Increased iron levels in the brain have long been suspected to elevate the risk for Alzheimer’s disease and may lower the age of disease onset. It is normal for iron levels in the brain to rise with age; however, certain medical conditions such as hemochromatosis can accelerate that rise. Check your Navigenics results for hemochromatosis to determine if you are at risk for elevated iron levels in your body.

Go Mediterranean. Several studies have found that the more closely patients followed a Mediterranean diet, the less likely they were to develop Alzheimer's or to die if they did get the disease. A Mediterranean diet includes lots of fruits, vegetables, legumes and cereals; plenty of unsaturated fats, chiefly olive oil; few dairy products and little meat and poultry; a "moderately high" intake of fish; and wine with meals.

Get your vitamins. Antioxidant vitamins such as B and E have been extensively studied in the prevention of Alzheimer’s disease, but with conflicting results. There is some controversy about the safety of these supplements, so getting the vitamins from your diet may be more effective than taking them in pill form. You should always consult your physician before taking any new supplement or drug.

Manage stress. One study found that "chronic psychological distress" is linked to the development of mild cognitive impairment, which can be a precursor to Alzheimer's disease.

Eat your omega-3's. Several studies have found that eating omega-3 fatty acids, found in certain fish such as salmon, trout, herring, sardines, tuna and mackerel, may decrease the risk of dementia. These fish are high in "good" fats, such as omega-3 fatty acids. (You will need to be aware of the mercury content of some of these fish, especially if you are pregnant or planning to get pregnant. Check our chart for help selecting fish high in omega-3s but low in mercury.) If you don't eat much fish, ask your doctor whether you should take a dietary fish oil supplement of about 1,000 to 1,200 mg omega-3s. These supplements may cause excessive bleeding, as well as belching, flatulence, and stomach upset.

If you drink, choose wine. Some studies suggest that wine, in moderation (one drink a day for women, two for men), may help protect against dementia, particularly for women.

Have some curry. There is some evidence that curcumin, also known as turmeric, the spice that gives curry its yellow color, may help prevent Alzheimer's disease. India, where people eat a lot of curry, has one of the lowest rates of the disease in the world. Curcumin seems to have antioxidant and anti-inflammatory properties and inhibits the formation of amyloids, which make up the brain plaques characteristic of Alzheimer's disease. Studies are under way to see whether curcumin has an effect.

• Do you have a family history of Alzheimer's?
• Do your Navigenics test results show that you have an elevated risk for Alzheimer’s disease (meaning that you carry one or more copies of the APOE-4 gene variant)?
• Have you noticed any changes in how sharp your mind seems? Are you increasingly forgetful, especially of recent events, while your past memory seems fine? Do you lose things more often or get lost more often? Do you have trouble naming things?
• Ask those around you if they have noticed any changes in your memory, as they are often more objective.
• Try challenging your memory to see how you do compared to your expectations. Do a puzzle for several days in a row and see if you improve.
• Could anything else be causing memory problems? Some examples are stress, anxiety, depression, sleep deprivation, medications, alcohol or other medical problems.
• Have you noticed your sense of smell becoming less acute?

• Order blood tests looking for other medical conditions that can cause or mimic dementia.
• Perform screening tests such as cognitive exams, MRI or PET scans of your brain, or testing of your spinal fluid.
• Refer you to a neurologist or geriatric psychiatrist for consultation or testing.