Take Steps Now to Avoid Alzheimer’s in the Future

The cardiologist who recruited me to Kansas City in 1988, Ben McCallister, MD, was a brilliant visionary and a lovable character. He founded Saint Luke’s Mid America Heart Institute in 1975 as the first hospital in America developed and designed specifically for cardiovascular care. Each year, the U.S. News & World Report ranks patient outcome data and other key details from the largest 800 hospitals in the U.S. In 2022, Saint Luke’s Mid America Heart Institute was ranked #22 in the nation. No other hospital in Missouri or Kansas was in the top 25 for cardiology. The next closest was Barnes Jewish Hospital in St. Louis, Missouri, at #39. The Mid America Heart Institute would have never come into existence without Ben’s vision, hard work, and dedication to making it a reality.

Dr. McCallister was one of my all-time favorite people. He was always genuinely concerned about his family, patients, and colleagues, as well as the nurses, techs, and maintenance staff at the hospital. A happy and optimistic soul with a great sense of humor, he was a genius at program development. He devoted virtually all his boundless energy to the people in his life, his profession, Saint Luke’s hospital, and the Kansas City community.

In his late 70s, Ben began to have memory problems and became increasingly confused. Tragically, he was diagnosed with Alzheimer’s disease, which progressed rapidly. About 18 months after he was diagnosed, his son told him that they were looking at admitting him to a skilled nursing unit. Upon hearing this, Ben never uttered another word and immediately stopped eating or drinking anything. It was like a deep part of his personality that was still intact decided a hunger strike was his last, best option. He slowly drifted into a coma and died just one week later.

It broke my heart to see this happen to Ben. He was an iconic leader in American cardiology and gave so much to the world, yet in the end had to endure such a tragic fate. Still, if he could see Saint Luke’s Cardiovascular Constultants today, it would make him smile to recognize that his legacy remains the foundation of our group: cutting-edge excellence in a diverse and collegial healthcare team that follows his dictum, “The best interests of the patient are the only interests to be considered.”

Alzheimer’s is perhaps the worst disease of all as it robs us of our personality and leaves us unable to care for ourselves so that we become a burden on our loved ones. With the improved life expectancy over recent decades, more and more of us are vulnerable to this increasingly prevalent scourge. Today, we have no cures or effective therapies for this type of dementia so it is essential to get out in front of it and prevent it from someday destroying our brains.

Thankfully, we are increasingly able to prevent Alzheimer’s, and the beauty of this evolving strategy is that it’s also a sure-fire recipe for keeping you fit, happy, and healthy with a good heart. If you make it a priority to try to follow the steps outlined below, you can almost certainly avoid ever having to deal with the dreadful consequences of Alzheimer’s, even if you have a family history of dementia or genes like Apo E4 that predispose to it.

Good for the heart, good for the brain.

Most of the risk factors that cause atherosclerosis, heart attacks, and strokes also increase the risk for Alzheimer’s. These troublemakers include high blood pressure, high LDL cholesterol, obesity, inactivity, depression, bad diet, sugar, junk food or ultra-processed foods, and smoking. Vascular dementia can be prevented by making sure these risk factors are controlled. We recently completed a notable study that showed having blood levels of omega-3 in the top quintile reduced the risk of stroke by 17%.

We know for sure how to prevent strokes and heart attacks by stopping smoking, and minimizing the use of alcohol to not more than seven drinks per week for women or up to 10 drinks per week for men. It is also essential that you are conscientious about following a healthy diet high in fiber from vegetables (especially leafy greens and cruciferous veggies like broccoli, kale, and cauliflower), fruit (particularly berries), nuts, and fish or seafood. It’s equally important to avoid the dietary villains, including anything with added sugar, white flour, and other highly processed foods. Additionally, you need at least 150 minutes per week of exercise— moderate activity is ideal, and more is better. Make sure your blood pressure is low-normal and keep your blood sugar level under 100 as much as possible.

Lifestyle affects Alzheimer’s risk.

Emerging research indicates that other factors are linked to dementia. By modifying these risk factors, we can lower the risk of dementia including Alzheimer’s disease.

• Social isolation and loneliness. Take a class, join a group, or attend religious services regularly. Connect with your family, neighbors, and friends every chance you get. Humans are among the most social creatures on Earth - we are happier and healthier when we bond with other people, animals, and plants. Dr. O.E. Wilson, a famous Harvard biologist, dubbed this “biophilia,” or love of living things. This is the notion that we Homo sapiens possess an innate tendency to seek connections with other forms of life. An instinctive need to connect with natural creatures, including other humans, is deeply ingrained in our DNA.

• Physically inactive lifestyle. Make it a priority to be more active. It’s one of the best ways to reduce the risk of dementia. Exercise is extremely beneficial, particularly if it’s done outdoors, with a friend or a dog, or by playing interactive sports. Shoot for 8,000 to 10,000 steps per day. Get an activity tracker or just use your phone. Pro-tip: You will get credit for more steps per day if you are wearing a tracker on your wrist rather than using your phone to count your steps.

• Hearing loss. Protect your ears when around loud noises. If you have hearing loss that’s making it hard to communicate with others, get hearing aids. They get better and more affordable all the time. Now hearing aids are available without a prescription, which makes them much less expensive.

A Therapy that shows promise.

• Statins. A recent definitive meta-analysis of 46 observational studies that included almost six million participants focused on the effects of long-term statin use on the risk of Alzheimer’s disease. Surprisingly, this study found that statins were associated with a highly significant 32% reduction in the risk of Alzheimer’s. Rarely, do people complain of temporary brain fog on a statin, and there is an urban myth in America that statins cause brain problems. This authoritative study indicates that the opposite may be true—statins help to protect your brain and prevent Alzheimer’s in the long run. If you have high cholesterol but can’t or won’t take statins, talk to your doctor about ezetimibe or Repatha—drugs that have minimal side effects yet lower cholesterol and reduce the risk of heart attack, stroke, and CV death.

• Keep your blood pressure normal, ideally under 120/80 most of the time. A healthy lifestyle and diet help to keep blood pressure down but take prescription BP meds if needed.

• Flu vaccine. A recent study of 2 million Americans found that those who routinely got an annual flu vaccine were 40% less likely to get Alzheimer’s. One more reason to get your flu shot each fall.

Practical steps to slash the risk of Alzheimer’s and dementia:

• Be an avid reader and listen to audiobooks.

• Study a foreign language.

• Learn to play a musical instrument.

• Volunteer in your community. Here at Saint Luke’s, the volunteers are a force for good that help make our patients feel truly cared for.

• Play group sports, such as pickleball, tennis, soccer, golf, bowling, softball, or frisbee.

• Explore new activities or hobbies.

• Cultivate an active social life.

• Prioritize getting at least seven to eight hours of restful and restorative sleep.

• Garden and care for plants.

• Adopt a dog into your home.

• Protect your head with a helmet when bicycling, etc. Don’t dive into water.

In Good Health,
James O'Keefe, MD