On the evening of Monday 27 November 2023, Professor Michael Heneka, Director of the Luxembourg Centre for Systems Biomedicine at the University of Luxembourg, held a conference at the Abbaye de Neumünster in Luxembourg-Grund, discussing how Alzheimer’s disease can be prevented.
Alzheimer’s disease is the most common neurodegenerative disease of our time. Due to demographic changes in our society, a rapid increase in the number of cases is expected worldwide - from the current 44 million to around 150 million by 2050. This number of cognitively impaired patients will impact healthcare systems and living conditions in far-reaching ways. Alzheimer’s disease has a heavy impact on the caregivers and family members of those affected.
Preventive measures such as sufficient and regular physical exercise, maintaining normal body weight, regulating blood pressure and special dietary measures may prevent one-third of cases by 2050. Engaging in mental activities on a regular basis also guards against the onset and swift progression of Alzheimer's disease. Alongside exploring novel diagnostic options and pharmaceutical treatments, the lecture highlighted pre-emptive measures individuals can implement starting today.
Professor Michael Heneka highlighted the seriousness of dementia induced by Alzheimer’s disease – around 100,000,000 people worldwide currently live with the disease. It is deadlier than both breast and prostate cancer. In fact, between the years 2000 and 2019, deaths from stroke, heart disease and HIV decreased, while worldwide reported deaths from Alzheimer’s Disease increased by 145,2%.
Alzheimer’s disease is a brain disorder that gradually destroys memory and thinking skills and, ultimately, the ability to carry out even the simplest tasks. People living with Alzheimer’s also experience behaviour and personality-related changes.
The disease causes (and/or worsens) age-related changes in the brain, such as shrinking, inflammation, blood vessel damage and breakdown of energy within cells, which may harm neurons and affect other brain cells. Tau is the protein that helps stabilise the internal skeleton of nerve cells (neurons) in the brain. According to Professor Michael Heneka, cerebrospinal fluid levels of total tau protein reflect the intensity of neuronal damage in the levels of neurodegeneration of Alzheimer's disease. Up until last year, it was only possible to measure this via lumbar puncture, a painful and invasive procedure. Since this year, a new method has been used in research laboratories to measure the cerebrospinal fluid levels of total tau protein via a blood sample, although this is not yet widely available. Tau protein can also be determined by imaging the brain.
The attempt to find a cure for Alzheimer’s disease has been ongoing for the past 30 years, with very few promising results. One successful result was only achieved at the end of last year, with Clarity Lecanemab. Professor Michael Heneka called this new medicine a “game changer”, based on preliminary studies, despite a high side-effect rate of 12.5% brain inflammation and 17% brain haemorrhage. Notwithstanding these serious side effects, Lecanemab showed a successful slowing of the disease’s advancement of 27% over a period of eighteen months. This would translate to a six-to-nine-months of memory gained, but at an expense of €55,000 per patient per year. Additional research is needed to refine the medication, but the findings indicate a reduced number of nerve cells died in the participants involved in this study.
Professor Michael Heneka pointed out that, in the case of such a disease where treatment possibilities are very limited, prevention proves all the more crucial. He stressed the importance of lifestyle choices to protect the brain, such as nutrition (observing a Mediterranean diet rich in fish and plant-based foods ), managing high blood pressure, treating depression, paying particular attention to systemic infection and partaking in regular physical activity.
Multiple studies have shown the difference that physical activity can make in the efforts to prevent or delay Alzheimer’s disease onset. In one quoted study from Sweden, the fitness of women was measured and compared to the likelihood of them developing Alzheimer’s disease in older age. After the age of 44, only 5% of women who demonstrated high fitness developed symptoms of Alzheimer’s disease, while for medium fitness levels, the percentage was 25% and for low fitness levels the percentage was 32%. Surprisingly, even for patients already suffering from the disease in their older age, a mere two hours per week of exercise significantly helped slow down the disease’s advancement.
Furthermore, the professor stressed the critical importance of maintaining normal body weight, as the risk of developing Alzheimer’s disease later in life is fourfold increased if one is overweight in the midlife stage.
This lecture formed part of the series organised in collaboration with researchers from the University of Luxembourg, on the occasion of the university’s 20th anniversary.