Guest article from MINES’ Trainer and Alzheimer’s/Dementia Expert JJ Jordan

It is hard to believe it is November already. This year has gone fast in some ways and yet has moved slowly for many of us who are anxious to fully emerge from pandemic concerns. The good news is that each November brings National Alzheimer’s Awareness Month, and this year is one for the history books in terms of research advances and hope! Our goal of a world without Alzheimer’s and other dementia is closer than ever. I am told my optimism about this topic is contagious so I hope this post will cause you to “catch” my enthusiasm as we head into the holiday season.

As a quick reminder, three of our four parents in my immediate family were diagnosed with Alzheimer’s and they lived for 16, 14, and 11 years with the disease. I vividly remember being caught off guard by the first of the three diagnoses, which all happened within an 18-month period. Of course, we had noticed some forgetfulness, but we had no idea of the journey our family would embark upon once we fully understood the ramifications of caring for three parents with this memory-robbing disease. When the third diagnosis was delivered, I knew that I needed to educate myself thoroughly on the topic. Who knew it would steer me toward a complete change of occupation where everything I do both professionally and philanthropically revolves around dementia.

As I fill you in on this year’s news, let me say once again that I have never been more optimistic than I am as I write this blog that the breakthrough is on the horizon. While covid slowed our progress by about a year due to pauses in some hands-on clinical trials, the big-brained women, and men in the fields of neurology and neuroscience were diligently working behind the scenes to continue the quest for treatments and risk-reduction tactics. And I would be remiss if I didn’t remind you right off the bat that when the breakthrough occurs, I will be throwing a party for the entire world so you will all be invited. Watch for your invitation!

Ready for this year’s amazing developments? (And of course, I will include my yearly disclaimer that I am not a physician, nor do I play one on TV, so without dispensing medical advice, I will impart knowledge that I have gained by attending multiple seminars each week and through my teaching and lectures. Here you go…

• In the wake of last year’s accelerated approval by the FDA of aducanumab and the controversy regarding cost, efficacy, and side effects, September 2022 yielded the preliminary “reveal” of a very promising drug, lecanemab. I am excited. In fact, I just sat in on a discussion featuring eight of the nation’s top experts and the overwhelming takeaway is that this drug is proving to be better than aducanumab. The recent “tease” results show a 27% “slowing of cognitive worsening” for Alzheimer’s among the test groups of Mild Cognitive Impairment and early-stage patients. The side effects are less than with last year’s drug and while costs are yet to be determined, I am optimistic that the federal government will be impressed by the efficacy of this new drug and hopefully FDA approval and Medicare and Medicaid coverage will occur as early as the new year. Fingers crossed. The drug is an infusion treatment administered in a clinical setting. Full results of Phase III clinical trials will be revealed on November 29, so stay tuned!
• This year could not have been more exciting in the gene arena. In February, 33 more genes were discovered that are connected to dementia, accounting for a total of 75. Think of it this way…I know you are all familiar with jigsaw puzzles after 2.5 years of Covid. (If someone had told me I would be home doing a jigsaw puzzle on a Saturday night in 2020, I wouldn’t have believed them!) Anyway, you can’t solve the puzzle without the edges being in place first and this recent discovery completes the edges of the Alzheimer’s/dementia puzzle. While we can’t clearly see the picture in the middle just yet, this breakthrough is significant.
• Speaking of genes, another massive development this year was the August news regarding the discovery of the MGMT gene. That stands for 06-methylguanine DNA methyltransferase, (I expect applause when I rattle that one off in my dementia talks,) and it may very well be the explanation we have been looking for regarding why women are more susceptible to Alzheimer’s than men. Of course, with age as the number 1 risk factor, the fact that females live longer can explain some of our increased risk, but we have always known there was more to it than that. Women are more affected by the risk gene APOE4, but women get Alzheimer’s who do not carry the risk gene, so the MGMT gene discovery is big news. Work is underway on what this means in terms of prevention and treatment.
• This year has shown an abundance of new approaches to figuring this out. Aside from drugs that target reducing amyloid beta and tau in the brain (brain proteins we all need to live, but that normally dissolve during sound natural sleep when toxic buildups occur), there are several innovative studies going on that are fascinating and ensure that we are not putting all our research “eggs” in one basket. A study around a procedure called TACS, “transcranial alternating current stimulation” is being conducted by an Alzheimer’s researcher who is exploring the effect of mild current stimulation to the brain which appears to improve memory for about a three-month period. I know this sounds a bit sci-fi but stay tuned on this one for sure. In addition, trials are continuing around intranasal insulin and the gut microbiome. Along with DNA research, it is a constantly expanding realm of investigation, further adding to my optimism that we will figure this out sooner than many of you might think.
• Studies are now confirming that environmental factors like air pollution can contribute to the risk for cognitive decline, so long after Covid is in the rear-view mirror, I plan to hang onto some of my masks. I will always wear them when in Los Angeles and during fire season when there is ash and particulate in the air.
• Watch for news in 2023 about blood tests for Alzheimer’s. They are already in use by a reputable lab in St. Louis and I am hopeful that FDA approval will make them a mainstream diagnostic tool, allowing us to adjust our lifestyle habits and seek treatment earlier than ever before.
• We now know that 40% of our risk for Alzheimer’s/dementia is due to modifiable factors! This is the best news ever in that we have control over our lifestyle choices. 60% of our risk is due to non-modifiable factors like gender, age, and race, but knowing we can improve our odds of not getting dementia by making smart choices day in and day out is awesome news.

And I would be remiss if I didn’t share with you what I call “The Dementia Tens”. These are three lists of ten things everyone on the planet should know regarding Alzheimer’s and other dementias.

The Ten Warning Signs

1. Memory loss that interferes with daily life
2. Challenges with planning or problem solving
3. Difficulties performing familiar tasks
4. Confusion with time or place
5. Visual and spatial issues
6. Problems with words
7. Misplacing things
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood or personality

The Ten Risk Factors

1. Age
2. Health Factors (cholesterol, blood pressure, diabetes, inflammation)
3. Lifestyle Factors (inactivity, poor diet, poor sleep, obesity, smoking, alcohol, stress)
4. Family History
5. Genetics
6. Gender (2/3 of Alzheimer’s patients are women)
7. Race/Ethnicity (African Americans are 2x more like to develop Alzheimer’s – Latinos 1.5 x
8. Social Isolation
9. Life Course Factors (childhood nutrition, rural vs urban healthcare, education, poverty
10. Traumatic Brain Injury

The Ten Risk Reducers

1. Exercise – Regular cardiovascular exercise is the closest thing we have to a silver bullet while we await a cure. Be sure to check with your doctor to make sure it is safe for your overall health.
2. Diet – Adopt a Mediterranean-type diet high in vegetables, fruits, and lean proteins. Avoid salty, sugary, fatty, and fried foods, and limit red meat consumption. Blueberries are awesome for your brain!
3. Sleep – Good sound, natural sleep is critical in allowing your brain to rid itself of toxins. Put your devices in another room, make it cool and dark, and discuss sleep issues with your doctor before taking sleep aids. If you are older, ask your doctor about avoiding a class of drugs called anticholinergics that may increase the risk for dementia.
4. Heart and Inflammation Health – There is a correlation between dementia and cardiovascular disease, high blood pressure, diabetes, and obesity. If it is good for your heart, it’s good for your brain! Air pollution affects your cardiovascular system so mask up as appropriate. Studies also show a correlation between cognitive issues and brain inflammation. Choose salmon, broccoli, walnuts, avocado, berries, and other anti-inflammatory foods in your diet. Discuss inoculations with your doctor to avoid viral illnesses which can increase neuroinflammation. Simply by getting your annual flu shots, studies show you may decrease your risk for dementia by up to 40%!
5. Smoking/Alcohol – There is a direct correlation between Alzheimer’s disease and smoking. Enough said! If you drink alcohol, always practice moderation.
6. Mental Health – Depression, stress, and other emotional conditions can negatively affect cognition. Discuss these with your doctor for treatment. Manage your stress through safe exercise, yoga, meditation, or music.
7. Hearing/Sight Decline – There is an increase in Alzheimer’s/dementia among those with untreated hearing loss in middle to older age. Discuss hearing loss with your doctor. There should be no stigma regarding hearing devices! Treat cataracts and maintain good vision as you age. Your brain cannot process what you never heard or saw to begin with.
8. Social Interaction – Involvement with others is critical for brain health. Socialize, (safely of course), by volunteering, taking dance lessons, and enjoying activities with family and friends.
9. Continual Learning/Brain Engagement – Learn a new language, instrument, or hobby or take online classes. While not every brain game may have science behind it, (some do, some don’t – I do them all), exercise your brain through games, puzzles, and new challenges. Games of strategy and those that challenge your peripheral vision are best.
10. Helmets/Seatbelts – Always use your seatbelt and wear helmets when skiing, snowboarding, during contact sports, and while biking or riding a scooter. Protect your most precious and important asset, your brain!

As the year comes to a close, these past twelve months have been especially busy for me. I am in my seventh year as volunteer Community Chair for Dementia Friendly Denver, which is affiliated with Dementia Friendly America, a 2015 White House Conference on Aging program. We present a free one-hour virtual or in-person program for organizations and community groups called Dementia 101 + Reducing Your Risk, so to schedule those, you can contact me at dementiafriendlycolorado@gmail.com. I continue to volunteer with the Alzheimer’s Association, having completed a six-year term on their Board of Directors, and currently serve as their public policy ambassador to Capitol Hill, where I speak with congress about dementia research funding and legislation. Btw, you can access the Alzheimer’s Association 24/7 helpline at 800.272./3900 or refer to their website at alz.org to get connected to community resources and stay up on the latest news.

I am now teaching dementia curriculums at CU, DU, and AARP, and conduct “Brain Camp” in the summer through the Denver Public Library. I have also been a member of the Colorado Department of Health and Environment’s Dementia Advisory Committee for the past 18 months, where we have recently completed the creation of the State Alzheimer’s Plan and are now entering the implementation stage, so my days are full of purposeful dementia pursuits.

And I recently celebrated my eighth year on the Mines and Associates team providing Employee Assistance Plan Alzheimer’s/dementia coaching and corporate client group dementia training, so please reach out to me through Mines and Associates (800.873.7138) for help creating a family dementia plan, increasing your dementia knowledge, or honing your communication, interaction, and behavior caregiving skills. I stand ready to help you should your family be dealing with dementia issues.

Finally, in observance of National Alzheimer’s Awareness Month in November, let’s all pledge to take care of each other and of course, our brains. This Thanksgiving let’s be especially grateful for good health. In a highly charged political season and with plenty of things to worry about, one thing we can all agree upon is the goal of a world without Alzheimer’s. Please don’t forget to relax and enjoy your family and friends this holiday season and rest assured, the future in the field of Alzheimer’s/dementia has never been brighter.

To Your Wellbeing,

JJ Jordan – The MINES Team