1. Healthy Brain Aging: Exercise, Nutrition, and Preventing AD
Focus on Diabetes, Blood Pressure, Diet and Exercise
Henry Edmonds, MEd, Program Coordinator
Joseph & Kathleen Bryan Alzheimer’s Disease Research Center
Duke University Medical Center
https://adrc.mc.duke.edu/

2. Healthy Brain Aging: Exercise, Nutrition, and
Prevention of AD
Joseph & Kathleen Bryan Alzheimer’s Disease Research Center
 Some Facts about Alzheimer's Disease
Dementia and Alzheimer’s Disease
What Happens to the Brain
Diagnosis of AD
Reduce The Risk For Alzheimer’s Disease
Factors that Contribute to Cognitive Decline!
Ways to Exercise your Brain!
Eating Well!
Alzheimer’s Disease Prevention Registry (ADPR)
Brain Health Quiz

3. The Bryan ADRC
• Alzheimer’s Disease Research Center (ADRC)
began in 1984
• One of the oldest ADRCs in the US
https://adrc.mc.duke.edu

4. The Bryan ADRC: What we do?
Research on AD
• AD Braine Bank
• Alzheimer’s Disease
Prevention Registry
Memory Disorders Clinic
• Diagnosis and treatment
Help for Caregivers
• Duke Family Support Program
Educational Programs
• Lectures
African American Community Outreach Program (AACOP)

5. ALZHEIMER’S IS AN EPIDEMIC!
We need your
help with
prevention
studies.
The memories
you save could
be your own…
Alzheimer’s is an epidemic: it affects 1 in 9 Americans over 65, with a new diagnosis
every 68 seconds. By 2050, 16 million Americans may battle the disease, with the cost
of care jumping six-fold to $1.2 trillion.* We must accelerate Alzheimer's prevention
research NOW! But 80% of studies fail because too few people sign up. Will you help
change that?
Alzheimer’s Association, 2014 Alzheimer’s Disease Facts and Figures

6. African Americans And Alzheimer's
African-Americans may have a 60% higher risk
of type 2 diabetes, which is a risk factor for
Alzheimer's and vascular dementia.
Data from a large-scale longitudinal study
indicate that persons with a history of either high
blood pressure or high cholesterol levels are twice
as likely to get Alzheimer’s disease. Those with
both risk factors are four times as likely to
become demented.
The cumulative risk of dementia among first-degree
relatives of African-Americans who have
Alzheimer’s disease is 43.7%.
There is a critical need for African-American clinical trial participants. Join a study
today and help move research forward so your grandchildren when they are old,
will never hear the words, “You have Alzheimer’s.”
Data from, “Alzheimer's Silent Epidemic hits Black Americans,” Report prepared by the Alzheimer’s Association and released by the Congressional Black Caucus.

7. WHAT IS DEMENTIA AND ALZHEIMER’S DISEASE?
Dementia
 Dementia is memory loss that is severe enough to interfere with everyday
life and ability to function, and is not part of the normal aging process.
 Dementia is defined as a loss of mental function in two or more areas such
as language, visual and spatial abilities, memory, thinking and reasoning
skills, or judgment.
Alzheimer’s Disease
 Alzheimer’s Disease (AD) is the most common cause of dementia.
 AD is a degenerative disease that attacks the brain, begins gradually, and
progresses at a variable rate.
 AD results in impaired memory, thinking, and behavior and can last from 3
to 20 years from the time of onset of symptoms.
1Alzheimer’s Association. (2012). Alzheimer’s Disease Facts and Figures, Alzheimer’s & Dementia, Volume 8: 131-168.
2Brookmeyer, R., Johnson, E., Ziegler-Graham, K., & Arrighi, H. M. (2007). Forecasting the global burden of Alzheimer’s disease. Alzheimer’s & Dementia, 3, 186-191.

9. The Alzheimer’s Brain

11. Stages of Alzheimer’s Disease
Time
Initial Symptoms
Function
Dependence
Total Dependence
Final Stages
Diagnosis

12. Diagnosis of
Alzheimer’s Disease
Probable Alzheimer’s
 dementia established by exam & mental status
testing
 confirmation by neuropsychological exam
 deficits in two or more areas of cognition, one of
which is memory
 progressive worsening of symptoms
 onset between ages 40-90
 absence of other causes for dementia

13. HOW TO REDUCE THE RISK FOR
ALZHEIMER’S DISEASE
The relationship between hypertension,
cholesterol levels and dementia is
particularly relevant for elderly African-
American patients because they are more
likely than whites to have hypertension
and/or diabetes.
Every heartbeat pumps one-fifth of our blood
to our brain. Billions of brain cells need the
food and oxygen carried by our blood to
think, solve problems and remember.
Conditions that damage our heart and blood
vessels can threaten brain health also. When
we take steps to reduce our risk of heart
disease, diabetes and stroke, we may also
reduce our risk for Alzheimer's.

14. Factors that Contribute to
Cognitive Decline!
• Effects of hypertension and heart disease
• Effects of diabetes
• Sedentary lifestyle
• Lack of stimulation
• Stress/depression
• Neurodegenerative disease

15. Exercise your Brain!
Rationale: Use it or lose it!
You must exercise your brain in order to
maintain function.
Cognitive reserve: The development of
cognitive reserve may protect against
cognitive decline. This may be innate or
acquired earlier in life.

16. Ways to Exercise your Brain!
•Mental stimulation
Reading
Puzzles
Challenging games
•Social engagement
•Physical exercise

17. Eating Well!
Rationale:
•Healthy diet offers
protection from CVD and
obesity which are
associated with
increased risk of AD
•Antioxidant intake from
fruits and vegetables
may protect against
oxidative stress

18. 7 Super Foods That Prolong Life
1. Salmon
2. Walnuts, almonds or other nuts
3. A Carrot a day for vitamin A
4. Eggs – including the yoke
5. Flax Seeds
6. Blueberries
7. Dark Chocolate or Hot Cocoa

19. Concluding Suggestions
Maintain your brain through:
1. Exercise
2. Cognitive stimulation
3. Healthy Diet
4. Control blood pressure, cholesterol,
weight, and blood glucose levels
5. Work to improve your memory

20. Alzheimer’s Disease Prevention Registry
(ADPR)
Entry Criteria:
•55 years old or older
• Absence of dementia or life-threatening illness
• An interest in AD prevention
Enrollment signals nothing more than your willingness to be contacted
about potential primary or secondary AD prevention efforts conducted in
partnership with the Bryan ADRC
To enroll contact Michelle McCart (Registry Coordinator)
Toll-free 1-866-444-2372 or 919-668-1605
Or enroll securely online at
https://adrc.mc.duke.edu/index.php/research

21. Brain Health Quiz

22. Brain Health Quiz
Average Daily Blood Pressure
1) Normal or low blood pressure (below or
around 120/80)
2) Mildly elevated high blood pressure (around
130/85)
3) High blood pressure (around 140/90)
4) Very high blood pressure (above 160/100)

23. Brain Health Quiz
Diabetes
1) No diabetes
2) Diet-controlled diabetes
3) Mild-to-moderate diabetes, on medications
4) Severe diabetes for more than 10 years,
poorly controlled

24. Brain Health Quiz
Diet
1) Eat fruits and vegetables 5x/day, with a balanced
diet of meats, carbohydrates, bread and fish (2-3
servings a week)
2) Eat fruits and vegetables once or twice a day, with
a fairly good, balanced diet
3) Occasional fruits and vegetables, no particular
attention to diet
4) No fruits and vegetables, fast-food hamburgers
more than 2-3 times a week

25. Brain Health Quiz
Brain Stimulation
1) Interested in solving problems, crossword puzzles
and Sudoku puzzles, playing card games, fixing
things around the house, other brain-teasing
activities
2) Occasional brain-stimulating activities
3) Do not enjoy solving problems or puzzles of any
kind
4) Avoid active thinking as much as possible, let other
people figure things out

26. Brain Health Quiz
Stress and Anxiety
1) No stress, feeling happy and in control of life, have
a positive attitude
2) Occasional stressful situations, such as dealing with
deadlines weekly
3) Frequent stress and anxiety most days of the week,
rarely relax
4) Running around all the time, always feeling behind,
constantly feel worried, stressed and anxious

27. Brain Health Quiz
Cholesterol
1) Normal cholesterol profile (LDL <100, HDL>40),
controlled with diet and exercise
2) Mildly elevated cholesterol, on medications
3) High cholesterol (total cholesterol > 200), on
medications, but not under good control yet
4) High cholesterol, not on medications

28. Brain Health Quiz
Weight
1) Thin to normal
2) Mildly overweight
3) Overweight (with abdominal size of >40
inches for men, and >35 for women)
4) Obese

29. Brain Health Quiz
Smoking
1) Never smoked, or quit more than 10 years ago
2) Quit, with occasional smoking in bars or
restaurants
3) Smoke up to one pack per week
4) Smoke one pack per day or more

30. Brain Health Quiz
Leisure Activities
1) Enjoy hobbies (gardening, dancing, movies, day
trips, fishing, crochet, etc.), keep busy with them
once a week
2) Occasional hobbies, about once or twice per
month
3) No regular leisure activities, may travel once or
twice a year
4) No hobbies, no leisure activities, watch non-educational
programs on TV more than 3-4 hours a
day (reality shows?)

31. Brain Health Quiz
Exercise
1) Walk or engage in some form of exercise once or
twice a week, for more than 30-45 minutes, at
least four days a week
2) Walk or engage in some forms of exercise once or
twice a week, for at least 30 minutes each time
3) Do not participate in any regular exercise program,
may take a long walk occasionally
4) No exercise ever, sedentary (couch-potato) lifestyle

32. YOUR SCORES!
≤15: Green zone - keep up the good
work!
16-30: Yellow zone – need
improvement
31-40: Red zone - need major
improvements, see your doctor soon

33. In a Nutshell!
• Work to improve your memory
• Healthy diet: Dietary sources of
nutrients are preferred over
supplements
• Control chronic conditions: watch your
numbers!
• Regular physical exercise
Joseph and Kathleen Bryan Alzheimer’s
Disease Research Center

34. Thank You
Joseph and Kathleen Bryan Alzheimer’s Disease Research Center
https://adrc.mc.duke.edu/