Young Brains, Beware
Did you ever think that wearing a bicycle helmet or seat belt is a protection against Alzheimer's? Prior brain injury is a well-established risk. And low-level brain inflammation, which can injure brain cells, appears to be as well. Indeed, for years scientists observed a curious decrease in old-age senility among those taking anti-inflammatory drugs for, say, arthritis. Though studies are mixed, using them as preventives is promising. If we can ever figure out the right formula, that is. The COX-2 drugs like Celebrex specifically target the kind of inflammation we want to avoid and, despite the negative press, are still a good possibility.
Women are a great puzzlement. They bear a higher risk for Alzheimer's than men, thanks to their longer life span. But age for age, men have less disease, and when they do, the same level of brain destruction exhibits fewer symptoms and less dementia. Is it nurture or nature? Surely, the present Alzheimer's generation of women was not as well educated as men or as women are today. That would mean baby-boomer women should make Alzheimer's more of an equal-opportunity problem. But there's also the unsettled matter of nature. Estrogen protects the healthy brain. And women go cold turkey at menopause, as men bask in the estrogen their own brains manufacture from testosterone. Some studies suggest estrogen replacement is brain protective but only if taken from the moment of menopause. In fact, estrogen in women over 65 in some instances can make Alzheimer's worse. It's a dilemma still unresolved, but estrogen replacement is a plausible consideration if initiated at the time of ovarian failure.
Increasingly, scientists are looking for critical windows to intervene with therapies before Alzheimer's does irreversible damage. Meanwhile, a public-health campaign for healthy brains would be a winner even if the best it does is delay Alzheimer's onset by five or 10 years. Not a bad fantasy: a thinner and more educated people, doing more mental and physical exercises, sporting better blood pressures and cholesterol levels, and eating their fruits and veggies. Perhaps even popping a preventive pill or two as they sip an occasional glass of wine. Speaking of wine, this effort would add a medical twist to the Robert Browning poem often used as a wedding toast: "Grow old along with me! / The best is yet to be, / The last of life, for which the first was made." Make that toast really sing. Ward off Alzheimer's in the first of life so you can celebrate the joys of those later years.