Watch: Cognitive and Vascular Disease Progression

Understanding how diseases progress helps us see how the different lifestyle variables work on effecting and reversing disease processes. In this video, neurologists and co-directors of the Alzheimer’s Prevention Program at Loma Linda University Drs. Dean and Ayesha Sherzai map several major mechanisms of degenerative or vascular disease of aging. They also describe the five main lifestyle factors that can help manage these mechanisms: Nutrition, Exercise, Unwind or stress management, Restorative sleep, and Optimizing mental and social activity, represented by the acronym NEURO.

Key Points

A combination of the following four mechanisms often work together in the progression of diseases: lipid dysregulation, sugar dysregulation, inflammation, and oxidation.
Controlling these mechanisms early in the disease history can help stop them from manifesting or getting worse.

Shieh, JC, Huang, PT, Lin, YF. Alzheimer's Disease and Diabetes: Insulin Signaling as the Bridge Linking Two Pathologies. Mol Neurobiol. 2020;57(4):1966-77. http://dx.doi.org/doi:10.1007/s12035-019-01858-5 (Links to an external site.)
Solfrizzi, V, Panza, F, Frisardi, V, Seripa, D, Logroscino, G, Imbimbo, BP, Pilotto, A. Diet and Alzheimer's disease risk factors or prevention: the current evidence. Expert Rev Neurother. 2011;11(5):677-708. http://dx.doi.org/doi:10.1586/ern.11.56 (Links to an external site.)
Grant, WB. Using Multicountry Ecological and Observational Studies to Determine Dietary Risk Factors for Alzheimer's Disease. J Am Coll Nutr. 2016;35(5):476-89. http://dx.doi.org/doi:10.1080/07315724.2016.1161566 (Links to an external site.)
Hsu, TM, Kanoski, SE. Blood-brain barrier disruption: mechanistic links between Western diet consumption and dementia. Front Aging Neurosci. 2014;6:88. http://dx.doi.org/doi:10.3389/fnagi.2014.00088 (Links to an external site.)
Kanoski, SE, Davidson, TL. Western diet consumption and cognitive impairment: links to hippocampal dysfunction and obesity. Physiol Behav. 2011;103(1):59-68. http://dx.doi.org/doi:10.1016/j.physbeh.2010.12.003 (Links to an external site.)
Więckowska-Gacek, A, Mietelska-Porowska, A, Wydrych, M, Wojda, U. Western diet as a trigger of Alzheimer's disease: From metabolic syndrome and systemic inflammation to neuroinflammation and neurodegeneration. Ageing Res Rev. 2021;70:101397.
Brown, BM, Sohrabi, HR, Taddei, K, Gardener, SL, Rainey-Smith, SR, Peiffer, JJ, Xiong, C, Fagan, AM, Benzinger, T, Buckles, V, Erickson, KI, Clarnette, R, Shah, T, Masters, CL, Weiner, M, Cairns, N, Rossor, M, Graff-Radford, NR, Salloway, S, Voglein, J, Laske, C, Noble, J, Schofield, PR, Bateman, RJ, Morris, JC, Martins, RN. Dominatly Inherited Alzheimers Network. Habitual exercise levels are associated with cerebral amyloid load in presymptomatic autosomal dominant Alzheimer's disease. Alzheimers Dement. 2017;13(11):1197-206. http://dx.doi.org/doi:10.1016/j.jalz.2017.03.008 (Links to an external site.)
Erickson, KI, Voss, MW, Prakash, RS, Basak, C, Szabo, A, Chaddock, L, Kim, JS, Heo, S, Alves, H, White, SM, Wojcicki, TR, Mailey, E, Vieira, VJ, Martin, SA, Pence, BD, Woods, JA, McAuley, E, Kramer, AF. Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci U S A. 2011;108(7):3017-22. http://dx.doi.org/doi:10.1073/pnas.1015950108 (Links to an external site.)
Liang, KY, Mintun, MA, Fagan, AM, Goate, AM, Bugg, JM, Holtzman, DM, Morris, JC, Head, D. Exercise and Alzheimer's disease biomarkers in cognitively normal older adults. Ann Neurol. 2010;68(3):311-8. http://dx.doi.org/doi:10.1002/ana.22096 (Links to an external site.)
Morris, JK, Vidoni, ED, Johnson, DK, Van Sciver, A, Mahnken, JD, Honea, RA, Wilkins, HM, Brooks, WM, Billinger, SA, Swerdlow, RH, Burns, JM. Aerobic exercise for Alzheimer's disease: A randomized controlled pilot trial. PLoS One. 2017;12(2):e0170547. http://dx.doi.org/doi:10.1371/journal.pone.0170547 (Links to an external site.)
Rolland, Y, Abellan van Kan, G, Vellas, B. Physical activity and Alzheimer's disease: from prevention to therapeutic perspectives. J Am Med Dir Assoc. 2008;9(6):390-405. http://dx.doi.org/doi:10.1016/j.jamda.2008.02.007 (Links to an external site.)
Flockhart, M, Nilsson, LC, Tais, S, Ekblom, B, Apro, W, Larsen, FJ. Excessive exercise training causes mitochondrial functional impairment and decreases glucose tolerance in healthy volunteers. Cell Metab. 2021;33(5):957-70 e6. http://dx.doi.org/doi:10.1016/j.cmet.2021.02.017 (Links to an external site.)
Durmer, JS, Dinges, DF. Neurocognitive consequences of sleep deprivation. Semin Neurol. 2005;25(1):117-29. http://dx.doi.org/doi:10.1055/s-2005-867080 (Links to an external site.)
Bubu, OM, Andrade, AG, Umasabor-Bubu, OQ, Hogan, MM, Turner, AD, de Leon, MJ, Ogedegbe, G, Ayappa, I, Jean-Louis, GG, Jackson, ML, Varga, AW, Osorio, RS. Obstructive sleep apnea, cognition and Alzheimer's disease: A systematic review integrating three decades of multidisciplinary research. Sleep Med Rev. 2020;50:101250. http://dx.doi.org/doi:10.1016/j.smrv.2019.101250 (Links to an external site.)
Ballóková, AL, Fialová, D. Benzodiazepines, Age-Related Pharmacological Changes, and Risk of Falls in Older Adults. Academic Press. 2016:334-44.
Maust, DT, Solway, E, Clark, SJ, Kirch, M, Singer, DC, Malani, P. Prescription and Nonprescription Sleep Product Use Among Older Adults in the United States. Am J Geriatr Psychiatry. 2019;27(1):32-41. http://dx.doi.org/doi:10.1016/j.jagp.2018.09.004 (Links to an external site.)
Edinger, JD, Olsen, MK, Stechuchak, KM, Means, MK, Lineberger, MD, Kirby, A, Carney, CE. Cognitive behavioral therapy for patients with primary insomnia or insomnia associated predominantly with mixed psychiatric disorders: a randomized clinical trial. Sleep. 2009;32(4):499-510. http://dx.doi.org/doi:10.1093/sleep/32.4.499