There are now three medications that have been shown in studies to clear the brain of amyloid, a protein whose accumulation is one of the critical steps to developing Alzheimer’s Disease. They are available in the US and may arrive in Australia as soon as mid-2024.
Though I certainly welcome these developments, the medications are only modestly beneficial when it comes to improving day to day cognition.
This may be, in part, because they are being used too late in the disease process, and research is underway to see if they are more helpful if used earlier.
They also, like any drug, have the potential for side effects and the risks and benefits of use will need to be weighed up on an individual basis.
Meanwhile, I still think the best bet is to try and reduce the risk of Alzheimer’s dementia developing in the first place, or at least to push it back by a number of years.
One of the most optimistic areas of research in this regard focuses on those with so-called mild cognitive impairment (MCI). This is a condition where someone has reduced cognitive function (usually, but not always, memory difficulties) measurable on formal tests, but they are functioning well in their daily lives.
This contrasts to dementia where the functioning is compromised. The exact number of people with MCI is unknown but it is considerably more than those with dementia. Those with MCI have an increased risk (10 to 15 per cent a year) of going on to develop dementia.
Researchers have been fervently studying what can be done to reduce the risk of “converting” from MCI to dementia and have already come up with some useful and practical findings.
Perhaps unsurprisingly, many of the things that help are those we recommend to keep your brain healthy in the first place. These include regular physical activity, which in my opinion is the king of all interventions.
Both moderate aerobic exercise and weight training seems to help, and high intensity exercise may confer greater benefits. Following a Mediterranean diet has also been shown to reduce the risk of dementia development.
Another approach is to reduce inflammation, and a bioavailable form of curcumin known as Theracumin, available as a supplement, has shown some promise. Taking 50ml of high-phenol content olive oil (the more flavoursome stuff) has also been associated with similar benefits.
A milky drink called Souvenaid, available over the counter at pharmacies, also seems to help, primarily through supplying the brain with appropriate nutrients.
Omega 3 fatty acids are also critical for the brain. These are primarily derived from oily fish (search the acronym SMASH fish for example), though can be obtained by supplementing with fish oil or krill oil.
Certain B vitamins, chiefly B6, B12 and folate, are also very important and their use has been associated with improved brain structure and function.
Persistent psychological symptoms such as anxiety and depression are also associated with increased dementia risk, and one study has shown that long-term treatment with SSRIs, the most common form of antidepressant, in those with MCI and a history of depression, seems to reduce the risk of going on to develop dementia.
This is by no means an exhaustive account of what might help, and I suspect with time more helpful interventions will be discovered, but it is heartening to know that there are things you can do that may optimise your brain, even if you have started noticing cognitive problems.
Kailas Roberts is a psychogeriatrician and author of Mind your brain The Essential Australian Guide to Dementia now available at all good bookstores and online. Visit yourbraininmind.com or