They argue that prevention of Alzheimer’s disease hasn’t worked because, as they point out, Ronald Regan got Alzheimer’s even though he was both mentally and physically active. They also argue what we really need is a massive increase in research funding to find drug treatments for Alzheimer’s disease. Click here to see the opinion piece.

Is it possible to agree with someone’s conclusion but think that their reasoning is wrong? I think the answer for me has to be yes.

Their argument reflects a basic misconception about prevention. It’s as though we were saying because Jim Fixx (a famous runner) died of a heart attack we should give up on exercise and only focus on drug and surgical treatments for heart disease. It as thought we are saying, Let’s give up being healthy, because even people who exercise and eat right still get heart disease.

O’Connor and her colleagues argue that a major increase in funding for Alzheimer disease drug development might lead more rapidly to effective treatments, and cite the effort made in the 1980s to develop treatment for HIV infection. A similar effort, they argue, would lead to similar progress in Alzheimer’s.

We don’t know that, but there’s only one way to find out. Even though there have been important advances in understanding the basic pathology of Alzheimer’s, it’s still not clear how well treatments based on those advances will work. Recent drug trials have not panned out. A major advance could happen tomorrow, or not for many years.

An alternative model for understanding potential advances in treating Alzheimer’s might be efforts to treat cancer. While major advances in treatment have occurred since the time of the Nixon administration, reductions in cancer rates for things such as lung cancer are also heavily influenced by public health efforts to reduce smoking.

Maybe what we really need is a targeted effort to evaluate both preventive as well as drug treatment strategies in Alzheimer’s. The op-ed piece neglects promising developments such as Carl Cotman’s work on reducing amyloid load in animals that I wrote about several weeks ago. He showed that diet and exercise actually reduced amyloid (a substance believed to be central in Alzheimer’s disease) in aging dogs. That work can lead to preventive efforts but may also lead to drug therapies for cognitive decline and perhaps Alzheimer’s. (See my earlier post here.)

So give up on brain health? I think that’s a really bad idea. We know that people who are healthy as well as physically, socially, and mentally active are less likely to have cognitive decline. Will brain health prevent all Alzheimer’s? Probably not. But should we give up and throw all of our efforts into drug development? Until we have better treatments for cognitive decline, a brain healthy lifestyle is probably the best strategy for staying mentally sharp.

1. Very little research shows that any supplement has a positive effect on brain fitness, and
2. Many supplements are costly, and some may have negative side effects such as interactions with prescription medications.

The first fact means that it’s very hard to know whether any supplement measures up to the claims that some people at least make for it. The second means that you may have to make a substantial investment in something that may or may not help you, and that the makers of the supplements may have a lot of money to promote them.

Having said that, some dietary supplements have limited evidence to support their inclusion in a brain fitness program. Probably the best-supported supplement for heart health, omega-3 fish oils, is a likely candidate for brain health. The American Heart Association recommends that everyone get some omega-3 fish oils from their diet, and from supplements if they to lower their triglycerides.

Another supplement that has been touted as possibly effective in reducing your risk of getting Alzheimer’s disease is curcumin. It’s a substance that occurs in turmeric, a common spice. Consumption of turmeric in some parts of India, some researchers have suggested, may account for low rates of Alzheimer’s disease in those areas. In one study with mice, those fed curcumin seemed to have a reversal of amyloid plaque formation in their (those are one of the key things that happen in the brain in Alzheimer’s).

Large scale studies have shown that people who get more antioxidants in their diet, and possibly those who take supplements of antioxidants like vitamins C and E, may have lower risk for developing Alzheimer’s disease. A group of researchers in New York have shown that people who follow the antioxidant-rich Mediterranean diet more closely have a lower risk for Alzheimer’s disease.

At the moment, these are our best guesses for supplements that may help maintain brain fitness. As interest increases in brain fitness, we may know more about these and other supplements.

First, I warn everyone that supplements aren’t as well researched as regular drugs. This may mean that some supplements work better than we know. It may also mean that they have side effects that we don’t know about, or that may interact with other supplements or regular prescription drugs. So if you intend to take any supplement, be aware of the risks.

Of all the supplements for brain fitness, one of the most promising is already recommended by the American Heart Association. Omega-3 fish oils have been shown to have benefits for the cardiovascular system. Although it may be possible to get enough fish oil from eating fish several times a week, many people can’t eat fish so regularly or are worried about how much mercury they might get from the fish. Fish oil are readily available as capsules. Depending on your condition, you may want to take from 1 to 4 grams of fish oil every day. You can read the AHA’s recommendations here.

As I mentioned, there is little information about any supplement and brain fitness. In one study, a small group of people with very mild cognitive problems appeared to benefit from fish oil supplements. More and more, it’s becoming apparent that there is a close link between cardiovascular risk factors and brain fitness. This means, I believe, that most of the things we can do to improve cardiovascular health are probably good for the brain. The same blood vessels that are critical to keep blood flowing to the heart and the rest of the body are present in the brain. In fact, the most metabolically active organ in the body is the brain. So anything you can do to improve vascular health is likely to help your brain.