Lifestyle choices to help you dodge Alzheimer's; no pain, no gain

Q: My 82-year-old mother has been diagnosed with Alzheimer's disease. I'm terrified that I will develop it. What can I do to reduce my risk? -- Geena F., Baltimore

A: It's true that researchers recently found 42 new genes that appear to be associated with the development of Alzheimer's. But according to the Alzheimer's Association, less than 1% of Alzheimer's cases are caused by "deterministic genes," meaning that when they exist, the disease develops. Instead, cases may arise because of genes that increase your risk -- but not the inevitability -- and those genes' inclinations often can be overruled by life choices.

That is confirmed by a new study published in JAMA Neurology that found that almost 37% of cases of Alzheimer's and related dementia cases were tied to eight lifestyle risk factors -- all of which you can modify or vanquish. They are midlife obesity, midlife high blood pressure, physical inactivity, depression, smoking, low education, diabetes and hearing loss.

My eight steps to combat the eight risk factors for Alzheimer's are:

1. Enjoy plant-based nutrition with no red or processed meats, and each day have seven servings of fruits and vegetables, two servings of whole grains, healthy oils from olive oil and fatty fish like salmon, and no added sugars or syrups in any food.

2. Make sure to get 10,000 steps a day or the equivalent and two to three strength-building sessions weekly.

3. Aim for seven to eight hours of sleep nightly.

4. Interact with friends and family and extend your generosity through volunteering.

5. See your doctor(s) regularly for check-ups and keep vaccinations up to date.

6. Seek help to quit smoking and for depression management, if needed.

7. Have hearing and vision checked and take steps to keep both sharp.

8. Take classes, go to lectures, play speed of processing games -- keep your brain awake. And read books: "What to Eat When" and my upcoming book "The Great Age Reboot" will guide your journey.

Q: I have developed lower back pain, and my doctor said he didn't think I should get a steroid shot or take NSAIDs like ibuprofen or naproxen. Instead, he says to stick with acetaminophen, cold and hot compresses and physical therapy. Is he just cruel? I've heard that NSAIDs and steroids work so well! -- Greg T., Memphis, Tennessee

A: Your doctor is looking at the very latest research into acute pain management, and he may be sparing you a lot of trouble down the road. New insights reveal that easing acute back pain with steroids or NSAIDs as the body reacts to injury or trauma may backfire. It appears that NSAIDs and steroids like dexamethasone and diclofenac do ease discomfort today, but may lead to chronic pain tomorrow.

In a study published in Science Translational Medicine, researchers looked at how pain is triggered and resolved in both humans with lower back pain and in mice. They found a type of white blood cell (neutrophils) is summoned by inflammation to an injury and those neutrophils help resolve pain. But if you block that action in the early stages with NSAIDs and steroids, you interfere with the repair of tissue damage and set the stage for chronic pain.

The researchers discovered that, in mice, blocking neutrophils with anti-inflammatory drugs and steroids like dexamethasone and diclofenac prolongs pain up to 10 times the normal duration, although the drugs were effective in quieting pain early on.

A separate look at 500,000 people in the U.K. shows that folks taking anti-inflammatory drugs to treat their lower back pain are more likely to have pain two to 10 years later, an effect not seen in people taking acetaminophen or antidepressants for the initial discomfort.

So, follow your doctor's advice. You should get relief from acetaminophen and hot and cold compresses. Physical therapy will help restore strength and mobility. And a few years from now, you likely won't have to deal with enduring aches and pains.

Health pioneer Michael Roizen, M.D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers. His next book is "The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow." Do you have a topic Dr. Mike should cover in a future column? If so, please email [email protected].

King Features Syndicate

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