Your Attitude Toward Aging Might Influence Your Risk Of Alzheimer’s Disease

How do you feel about aging? The answer to that question really depends on who it’s being asked of, right? If you’re under 40, this question probably seldom enters your mind. Like relationships, raising kids, and paying bills.

However, for those of you over 40 who know your body is starting to betray you, it might be a question that’s been entering your mind more often these days.

So, how do you feel about aging? Do you embrace the fact that you’re going to be a senior one day or do you despise it?

Your answer to the question really matters because it can profoundly affect how well you age.

A study conducted last year by the Yale School of Public Health showed that how you feel about your own aging can have a profound impact on your risk of developing dementia and even Alzheimer’s disease.

Dementia and Alzheimer’s Disease – The Dreaded Diseases of Our Time

Currently, about 10% of Americans over the age of 65 have Alzheimer’s disease (AD). However, AD accounts for only about 60% – 70% of dementia cases. Comedian Robin Williams was suffering from dementia at the time of his death. But it was Lewy body dementia, not AD.

Nonetheless, if you make it to age 65, your chances of developing some kind of dementia are greater than 1 in 10. Those odds, however, will increase after the age of 65.

If you’ve ever had a loved one suffer from AD, you know the devastation caused by this disease. Barbara and I watched in horror as Alzheimer’s eventually left her mom without a memory or even the ability to perform simple tasks. All the while, we were powerless to do anything to reverse its course.

It appears now that many Americans are also becoming aware of how devastating this disease is. And they’re scared of it. Americans fear losing their mental capabilities twice as much as they fear losing their physical abilities.

While there are several interventions that you can take to lessen your risk of getting dementia or AD (see here and here), the Yale study highlighted how your view on growing older can actually help you in your fight against dementia.

Let’s take a look.

Positive Beliefs on Aging Protect Against Dementia

There has been considerable research performed showing that amongst seniors positive beliefs about aging predict better cognitive performance; whereas, negative age beliefs correlate with worse cognitive performance. See here, here, and here.

One meta-analysis even showed that negative views on aging have a worse effect on cognitive health than the promoting effect of positive views.

More recently, research has shown that there is even the possibility of a link between aging beliefs and the risk of developing AD.

Beliefs About Aging Might Be Predictive of Alzheimer’s Disease

In 2016, Becca Levy, Professor of Epidemiology at Yale School of Public Health, and her associates published a fascinating study on age stereotypes and AD.

They recorded aging stereotypes from dementia-free patients decades before yearly magnetic resonance images and brain autopsies were performed.

The study found that,

Those holding more-negative age stereotypes earlier in life had significantly steeper hippocampal-volume loss and significantly greater accumulation of neurofibrillary tangles and amyloid plaques, adjusting for relevant covariates.

Okay, I’ll translate that. The individuals who had negative aging beliefs had greater signs of the markers for AD.

Levy’s next study, however, showed an even greater correlation between negative aging stereotypes and dementia, including AD.

Levy’s 2018 Yale Study

In 2018, Levy and her associates published another study on the relationship between negative aging beliefs and cognitive decline. This study included 4,765 Health and Retirement Study participants who were at least 60 years old and dementia-free at the beginning of the study.

The participants were also assessed as to whether or not they possessed the APOE 4 gene. This gene variant is highly associated with an increased risk of AD. Among the participants, 1,250 had at least one form of the gene (more on that later).

In order to assess age beliefs, the researchers used the five-item Attitude toward Aging (ATA) subscale of the Philadelphia Geriatric Center Morale Scale. This survey asked participants to rate on a scale from strongly disagree to strongly agree on questions such as, “Do you feel that as you get older you are less useful?” or “Do things keep getting worse as you get older?”

The individuals were followed for 4 years and were on average 72 years old at the end of the study.

The Results Concerning Aging Beliefs And Cognitive Health Were As Predicted

The first conclusion of the study came as no surprise to the researchers. They stated,

The impact of positive age beliefs as a protective factor against developing dementia was suggested by our finding that in the total sample participants holding these beliefs at baseline had a 43.6% lower risk of developing dementia over the course of 4 years, compared to those holding negative age beliefs at baseline.

Okay, this study confirmed what others had found. If you feel good about your aging process, you are a lot less likely to develop dementia.

However, where the study really shines is in its discovery about aging beliefs and AD.

Aging Beliefs And Alzheimer’s Disease

Levy and her associates found that “Among those with APOE 4, those with positive age beliefs were 49.8% less likely to develop dementia than those with negative age beliefs.”

Remember that the APOE 4 variant is highly associated with an increased risk of Alzheimer’s disease.

They also found that of the 1250 carriers APOE 4 that had positive views on aging, there was a 3% risk of dementia. Those carriers of the gene who had a negative view had a 6% risk of dementia. That means those who had negative attitudes on their aging had twice the risk of getting dementia over the four-year duration of the study.

So, the study seems to suggest that positive age beliefs among those with APOE 4 could be capable of helping them offset the influence of this genetic risk factor.

The study concluded that “APOE 4 carriers with positive age beliefs had a risk of developing dementia that is similar to the risk of their same-aged peers without APOE 4, regardless of age beliefs.”

This study is encouraging news. It confirmed for us that,

1. Positive views on aging decreased the risk of getting dementia
2. Positive views on aging also reduced the risk of developing AD in the largest at-risk population

While researchers believe that more work has to be done in this area, the study once again shows that some of what we believe may be inevitable age-related diseases can be mitigated, even for those who are at a genetically high risk.

In order to get a fuller picture of the study, it’s important to understand a few things about the APOE 4 gene in the context of this study.

The APOE 4 Gene and Alzheimer’s Disease.

APOE (Apolipoprotein E) is a class of proteins that are responsible for transporting lipids (fats) around your bloodstream. The APOE gene provides instructions for making this protein.

The APOE gene, however, can exist in different forms (alleles). The major alleles are termed E2, E3, and E4. About 7% of the population has the E2 gene, 79% has E3, and about 14% have the E4 allele.

Remember that since we get one copy of a gene from each parent these genes can exist in a number of different combinations, eg. APOE 4,4, 4,3 or 3,2 etc.

Now here is the significance of this for the general population.

1. APOE 4 is the strongest known genetic risk factor for AD.
2. 40–65% of AD patients have at least one copy of the E4 allele.
3. Not everyone who develops AD has the APOE 4 gene (this suggests that there are other risk factors involved).
4. Not everyone who has the APOE 4 gene develops AD (this also suggests that there are other risk factors involved).
5. People who have two copies of the APOE 3 gene have about a 9% genetic risk of getting AD (Dale Bredesen MD, The End of Alzheimer’s, p. 100).
6. Individuals with a single copy of APOE 4 (eg. APOE 4,3) have a 30% increased risk of developing AD (Bredesen).
7. Individuals with two copies (APOE 4,4) have a 50% or greater risk of developing AD (Bredesen).
8. Individuals with two copies (APOE 4,4) have an increased risk of developing AD by 12-fold, as compared to the most common version of the gene, APOE 3.

While researchers are not sure of the exact role of APOE 4 in AD, the predominant theory is that it prevents the clearance of amyloid beta plaques from the brain. Dr. Bredesen and others believe it also promotes inflammation within the brain (Bredesen, p.100).

Now, what does this have to do with the above study?

The Yale Study Revisited

In Levy’s study, the 1250 individuals with the APOE 4 gene had the following variants: 85% E4/E3, 8% E4/E2, and 7% E4/E4.  

Since there was no data reported for the different alleles, we don’t know if the results were positive for the people who had the high risk ApoE 4 allele.

What we can say is that positive attitudes toward aging significantly helped the individuals with the E 4,3 variant to decrease their risk of AD.

Why Do Negative Views on Aging Increase Our Risk Of Dementia?

Researchers are not exactly sure why a negative view on aging adversely affects dementia, but they theorize that it may have something to do with stress.

There is abundant evidence to support this view. Poor aging beliefs have been shown to cause cardiovascular stress on our bodies. See here and here. These two studies both show that stress is connected to dementia. See here and here.

The causal connection between stress and dementia may be tied to the hormone cortisol.

Chronic Stress, The HPA Axis, and Dementia

The HPA axis is a subsystem in your body that includes the hypothalamus, the pituitary gland, and the adrenal glands. This system controls a major part of your physiologic response to stress.

When you face a stressor, be it physical or psychological, your HPA axis will act to produce among other things the steroid cortisol. Cortisol allows your body to deal with the stressor. When the stressor leaves or you have dealt with it successfully, the HPA axis returns to its normal homeostatic state and cortisol levels return to normal.

However, when you are chronically stressed, the release of cortisol from your adrenal glands may become excessive and eventually become detrimental to your body, especially your brain.

The Association Between Cortisol And Dementia

Excess glucocorticoids (cortisol) in the brain have been linked to dementia and AD. See here and here.

Individuals with significantly prolonged cortisol elevations showed reduced hippocampal volume. The hippocampus is the part of your brain that is responsible for forming memories.

Researchers believe that cortisol may in some ways damage neurons in the brain though they are not sure exactly how. See here.

And, finally, seniors who had negative age beliefs had cortisol levels that were elevated as compared to those who had positive beliefs.

Even though most of the studies I presented are correlation studies and don’t provide exact causation, I think the connection is clear. If you have a negative attitude toward your aging process, you will be under constant stress. And that stress will increase your risk of dementia.

It’s almost as if it’s a self-fulfilling prophecy. If you think badly about aging, you’ll increase your risk of aging badly.

The Role Of Conscientiousness In Dementia And Longevity

Interestingly, there is one personality trait that has broad scientific support of a positive influence on cognitive health and longevity.

This study released in 2013 from Wayne State University argues that after 20 years of study by numerous researchers, the psychological attribute of conscientiousness has been shown to have a significant positive effect on health and longevity.

The authors of the study define conscientiousness this way:

…the relatively stable pattern of individual differences in the tendencies to follow socially prescribed norms for impulse control, to be goal-directed, planful, to delay gratification, and to follow norms and rules.

Sounds like the personality trait we’d all love our children to have.

But you get the picture. According to the numerous studies and meta-analyses presented in this paper, conscientiousness will improve your longevity and lower your risk of getting dementia, including AD.

The reason for this seems pretty obvious. Conscientious people will probably be more diligent in taking care of themselves, particularly in the area of diet and exercise.

How Can You Have A Better View Of Aging?

Your views on aging might have been developed since your childhood or they could have developed as your years mounted. What I know from experience is that there are a number of factors that can increase your negative attitude toward aging.

If you can correct these factors, it may do a lot to help improve your attitude. Let’s briefly take a look at these.

Feeling Unhealthy

If you feel unhealthy all the time, it’s hard to feel positive about aging. After all, you’re going to get older and weaker, right? I suffered from severe CFS until I was 58 years old. I was frightened of what this would mean for me at 65.

Not only did I have poor energy levels, but also because of inactivity, my muscle mass had decreased significantly. I was facing the likelihood of becoming more and more debilitated as the years continued. That didn’t make me a happy camper when it came to my aging process.

Some of you out there are suffering from chronic lifestyle diseases like diabetes, CVD, metabolic syndrome, or obesity. (These are all risk factors for AD by the way).

My friends and family members who have these diseases tell me that they generally feel unwell and are not looking forward to living out their seniors years with them.

However, there are things you can do to improve your health. I’ll stick with the main ones for now.

Diet

Doctors are having great success with low-carb and ketogenic diets in improving weight loss and reversing the above diseases. See here and here.

These diets promote better insulin sensitivity which is important for good health.  They also generally avoid gluten (important for healing gut permeability) and industrial seed oils (important for correcting a poor Omega6/Omega3 ratio).

Hey, if you can reverse your poor health and feel better at 60 than you did at 45, then you’ll feel a lot better about your future aging. I know I did.

Exercise

We all know that exercise improves fitness and makes you feel better about yourself. However, did you know that it’s a proven fact that poor muscle strength is another risk factor for poor cognitive health decline? See here and here.

I like what strength coach Mark Rippetoe had to say, “A weak man is not as happy as that same man would be if he were strong.”

Some kind of resstrength training is must for anyone wanting to improve their risk of avoiding dementia. See my post here. 

Read here about how walking can improve your health and cognitive function.

Eliminate Toxins

Eliminate or reduce as many toxins as possible. You know what the big ones are: smoking and alcohol. Mold is another common toxin and has been linked to AD.

Get Good Sleep

It’s difficult to recover from the stresses of life if you don’t sleep well or you don’t get enough sleep. Lack of sleep will also increase inflammation in your body and inflammation is closely linked to dementia and AD. See my post on sleep here.

Dealing With Stress

The above interventions will help lessen stress on your body. However, dealing with life stress is a different subject.

Guided diaphragmatic breathing is one thing I practice to help me deal with the negative effect of life stress and a dysfunctional autonomic nervous system associated with CFS. If your autonomic nervous system (ANS) is dysfunctional, your stress response will be dysfunctional, and you’ll be pumping out excess cortisol. It’s guaranteed that you’ll not feel well.

Guided breathing (this is not meditation) at least 10 minutes a day is one method that will help bring your ANS back into balance.

Loneliness

For those of us who have lost a parent, we know the toll it takes on the surviving parent. It’s hard to have joy in old age when your partner is gone. While I can’t offer a solution to this, there is a way to limit the risk of losing your partner.

The key here is to keep your spouse as healthy as you are. Studies have shown that you’ll increase your own lifespan as well.

Spiritual Awareness

Researchers have found that religious belief is a positive factor for how well individuals age. Faith brings comfort, strength, and hope when times become difficult. As we get older, we’ll lose family members and friends. Faith helps us make sense of that.

Religious belief also provides a community to mitigate against loneliness and a sense of abandonment.

Let’s be honest. As you get older, your number of years on this earth are declining. One day you will have to face the inevitable thought of where will you spend eternity. Some people shrink in terror at this thought. Especially as that day grows nearer and nearer. It’s hard to have joy in your senior years when you don’t know where you’re going.

Now I’ll preach a little and end with this verse,

For God so loved the world, that he gave his only begotten Son, that whosoever believeth in him shall not perish, but have everlasting life (John 3:16).

That’s it for this post. I encourage everyone to read Dr. Bredesen’s book, The End of Alzheimer’s. AD might not be as uncurable as most people believe.

God bless and have a great week. Let’s us know if you have any comments. We would love to hear from you.