Fortanasce & Associates Neurology Center

Fortanasce – Purino Neurology Center

The fact that you are reading this suggests you are concerned about Alzheimer’s Disease and other causes of cognitive decline. You’re not alone, if you’re one of the 78 million baby boomers approaching retirement years or the 40 million people in the United States 62 years of age and older. Most Americans reaching 65 today have an average life expectancy of another two to three decades. By the year 2050, and estimated 40% of 65 year olds are likely to reach 90. The problem is, modern medicine has helped us to live longer, however there has been no medical breakthroughs to help stop the brain from aging. This happens in Alzheimer’s Disease and normal cognitive decline. In the U.S.,one-third of the adults over 80 have dementia and 50% by the time they reach 85 years old.


Recent studies have indicated there is no medical treatment that prevents Alzheimer’s Disease. The AD 2000 study which compared the effects of the three leading drugs used for Alzheimer’s and placebo, concluded that these drugs (costing an average of $120/month) did not effect the progression of the disease in any significant fashion.
That is those on the medication and those on placebo were admitted to nursing homes in a similar period of time.

The medical intelligencia which rarely agrees on anything, agree unanimously that preventative measures are the only way to starve off Alzheimer’s. Further more, we now know there are predictors of memory loss and cognitive decline. Not unlike the warning of chest pain, abdominal distress that rings an alarm to watch what you eat, to care for your heart and stomach. The same is true for the brain. There are clinical predictors that can greatly increase your likelihood of getting Alzheimer’s or decreasing your likelihood.


  1. Age
  2. Genetics
  3. History of previous heart attack
  4. Education

Age is the number one predictor of Alzheimer’s Disease. At 60 approximately 1% of that population will have Alzheimer’s. This doubles, according to what epidemiological study you review, every 3-5 years every 5 years until one hits 75 years old, then it triples.

Genetics: approximately 5% of the populous have genetic predisposition for Alzheimer’s. If one has both parents with the disease, there is a 50% chance of developing it early. People with the APOE4 allele also have an increase risk of developing Alzheimer’s. Unfortunately Alzheimer’s Disease is also twice as frequent in women as men. Part of this may be due to their increased longevity. Those women reaching 65 today have a 40% chance of turning 90.

Those with a history of previous heart attack have more than twice the likelihood of developing dementia. Remember that not all dementias are Alzheimer’s, some 20% are vascular in origin, and some a combination of both Alzheimer’s and vascular. This is the reason that those patients with increased risks for cardiovascular disease also have an increased risk for Alzheimer’s. The old adage, “as goes the body, goes the mind.”

Education is seen as a protector from Alzheimer’s due to increased brain reserve. The opposite is also true; those who have not developed cerebrally and have less reserve have an increase in Alzheimer’s risk.


There are at least 12 clinical predictors that we can control. There are those that are obvious such as obesity (BMI over 30), insulin resistant diabetes, diabetes, high blood pressure, high cholesterol, and stress. There are those that are not obvious, but testable such as our C-reactive protein, homocystiene, and a number of vitamin deficiencies. All of these are extremely important to be aware of. An assessment of your own likelihood of these risk factors and others can predict an increase or decrease possibility of developing Alzheimer’s, whether you are genetically predisposed or not.

One of the predispositions is obesity. Obesity in women may give a 300% increase in the likelihood of Alzheimer’s, meaning if at 60 years of age, you have a 1% chance of Alzheimer’s, this may increase your risk to 3%. Men show a 30% increase Alzheimer’s with a Body Mass Index over 30, or waist size of 40 or more.

Insulin resistant diabetes is running rampant in our society. The estimate is that one in four adults have it. This may increase the likelihood of Alzheimer’s by two to four-fold according to some estimates. An important enzyme in the brain that decreases the brain’s insulin is also used to decrease amyloid (the substance that is pathognomonic for Alzheimer’s) so therefore if there is too much insulin, the brain removes the insulin, but does not remove the amyloid, resulting in amyloid destroying brain cells and brain connections.

Chronic stress is becoming a major predictor in Alzheimer’s. We all have stress and some stress is good as it provokes us to get things done, and in the long run decrease our overall stress. However stress that is defined by a frustration and inability to succeed or help ones-self can cause an elevation in cortisol. Cortisol is regarded as one of the bad hormones that increases salt retention and therefore blood pressure. That directly can affect an increase in insulin and all its negative effects plus many other effects that cause the so-called “brain freeze” that we all experience at one time or another. This “brain-freeze” is an actual anatomical effect that prevents brain transmission. Chronic stress also provokes a decrease in a number of neurotransmitters such as dopamine, and serotonin which are nick-named the “happy and relaxing transmitters” and eventually provoke depression.

Further information can be sought through the Alzheimer’s Association and further articles at Anti-Alzheimer’