Lifelong Health: Studies: Dementia Comes Later for Higher-Educated

Dr. David Lipschitz

Alzheimer's disease is an overwhelming burden for thousands of Americans. Today more than 5 million Americans have Alzheimer's, an increase of 10 percent in the past five years. By 2050, this number is expected to exceed 16 million.

For the millions of baby boomers reaching 65, preventing this terrible illness is high on the priority list. From getting more exercise to eating more "brain food," studies show a variety of ways that may curb the onset of the disease. However, new information about the relationship between Alzheimer's and education levels is shedding interesting light on the situation.

In a recent study published in the journal Neurology, researchers from the Karolinska Institute in Sweden showed that the more years of formal education, the lower the risk of Alzheimer's. In the same journal, researchers from the Albert Einstein College of Medicine of Yeshiva University in New York showed that the more the education, the later the age at which Alzheimer's could be identified clinically. But when the disease did occur, it was far more aggressive, and declines in memory occurred extremely rapidly.

In the New York study, researchers reviewed data on 117 older adults who developed dementia during a 27-year study. Among the participants, there was a mix of educational levels, including high school graduates, college graduates and some with postgraduate education. All of the participants received regular medical checkups and exams. The typical patient, who had eight years of schooling, showed accelerated memory loss 5 1/2 years before a dementia diagnosis was made. However, in participants with 16 years of education or more, accelerated memory loss started later -- about four years before dementia diagnosis. But once the memory loss started, declines were 50 percent faster than their less-educated peers.

Researchers think more education may provide a cognitive reserve or greater compensatory mechanisms, allowing the brain to continue functioning despite damage. Because the pathology is more advanced by the time it becomes apparent, the rate of decline is more rapid.

This information does not mean that more education is associated with more aggressive Alzheimer's disease. What's more, the benefit of a late onset far outweighs the more rapid decline of memory.

While this research certainly sheds new light on how environmental and social factors can affect Alzheimer's disease, it is only one part of a greater research trend to understand the disease and develop a cure. Advances are being made in every area of science and medicine.

We now know that the disease is associated with the formation of an abnormal protein called beta-amyloid precursor protein. This leads to inflammation in the brain that in turn causes damage and loss of brain cells. At the moment, clinical trials are under way to examine the role of vaccines and novel medications to prevent the production of the abnormal protein. It is hoped that will arrest or even cure the disease.

For physicians and scientists, the big challenge lies in arresting the disease immediately after it begins to destroy brain cells. Alzheimer's is a slowly progressive disease, taking about 20 years for the disease to be recognized clinically. In other words, if the disease is diagnosed at age 80, the brain was abnormal at age 60. Developing an ability to identify individuals at increased risk at age 60 is an important goal. Waiting until much of the brain is affected is far too late.

But, while we wait for researchers to identify a cure, there is compelling evidence that living a heart-healthy lifestyle can effectively delay the onset of Alzheimer's disease -- eat right and exercise, treat elevated cholesterol and high blood pressure and take an aspirin tablet daily. If you have a family history of Alzheimer's disease, it is advised you keep your top (systolic) blood pressure less than 130 and your bad (LDL) cholesterol less than 70. In addition, a diet rich in omega-3 fatty acids has been linked to decreased risk of Alzheimer's disease.

We must focus all of our energies on identifying a cure for Alzheimer's. Everyone -- from physicians to patients to scientists -- must recognize that Alzheimer's disease is one of the greatest threats to our nation's health.

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Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.drdavidhealth.com.