Advances in Alzheimer’s Disease

Volume 10

Handbook of Prevention and Alzheimer’s Disease

Cyrus A. Raji, MD, PhD

Washington University, St. Louis, MO, USA

Yue Leng, PhD

University of California, San Francisco, CA, USA

J. Wesson Ashford, MD, PhD

VA Palo Alto Health Care System, Palo Alto, CA, USA

Stanford University, Palo Alto, CA, USA

Dharma Singh Khalsa, MD

Alzheimer’s Research and Prevention Foundation, Tucson, AZ, USA

The Handbook of Prevention and Alzheimer’s Disease educates physicians, scientists, and members of industry into a subfield of Alzheimer’s disease (AD) research that has matured in the early 21st Century—the notion that AD can be prevented and modified through changeable factors and related interventions. The idea of AD prevention is not new with reference to strategies noted as early as the 1990s [1], with additional prescriptive approaches arising shortly thereafter [2]. Foundational highly cited work would then follow [3]. AD was first reported almost 120 years ago and remarkably even the article that gave rise to this field noted the presence of large vessel arteriosclerosis in the first identified person with Alzheimer’s, Auguste D [4]. Thus, the concept that modifiable risk factors may be part of AD is virtually part of the origin of this field and make the need for additional work in this area urgent.

The number of modifiable risk factors related to AD continues to increase from the initial seven identified in foundational work [3] to 12 modifiable risk factors [5] with a current projected contribution to 40% of worldwide dementias. Thus, an Alzheimer’s disease ‘preventome’ now exists and will continue to expand as understanding of newer factors and related biomarkers is refined. The outcome of optimizing the AD preventome is an improvement in overall brain health [6]. Such an outcome will reduce risk for AD and improve quality of life by enhancements in brain health. Newer supporting fields will also evolve around these principles such as preventive neuroradiology [7].

The growth of this field is reflected in the fact that we have two volumes: Volume 10 on Prevention and Volume 11 on Intervention. The Prevention volume goes into greater depth than an AD preventome by examining domains of prevention from vascular risk factors to social engagement, sleep health and spirituality. If the journey to end AD can be likened to a long and arduous challenge, understanding every possible part of the overall toolkit of approaches for disease prevention and intervention is essential.

References

[1] Khalsa DS (1998) Integrated medicine and the prevention and reversal of memory loss. Altern Ther Health Med 4, 38–43.

[2] Ashford JW (2002) The top ten treatments for preventing Alzheimer’s disease. LIAF Line: Newsletter of the Long Island Alzheimer’s Foundation.

[3] Barnes DE, Yaffe K (2011) The projected effect of risk factor reduction on Alzheimer’s disease prevalence. Lancet Neurol 10, 819–28.

[4] Alzheimer A (1907) Uber eine eigenartige Erkrankung der Hirnrinde. Allg Zeits f Psychiat 64, 146–148.

[5] Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, Costafreda SG, Dias A, Fox N, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Ogunniyi A, Orgeta V, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N (2020) Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 396, 413–446.

[6] Hachinski V, Avan A, Gilliland J, Oveisgharan S (2021) A new definition of brain health. Lancet Neurol 20, 335–336.

[7] Raji CA, Eyre H, Wei SH, Bredesen DE, Moylan S, Law M, Small G, Thompson PM, Friedlander RM, Silverman DH, Baune BT, Hoang TA, Salamon N, Toga AW, Vernooij MW (2015) Hot topics in research: preventive neuroradiology in brain aging and cognitive decline. Am J Neuroradiol 36, 1803–1809.