The world's population is graying, and as a result, nations around the globe are staring down a rising tide of people who will grapple with the ravages of Alzheimer's disease and other dementias. According to a new report from Alzheimer's Disease International, some 35.6 million people worldwide will have a form of dementia in 2010. That number is expected to nearly double every 20 years, reaching an estimated 65.7 million in 2030 and 115.4 million by 2050.

Undoubtedly, adult children navigating the emotional and logistical maze of caring for a parent with dementia wonder, "Will this be my fate, too?" Even those without familial ties to a person with the disease fear its hallmark memory loss, confusion, and relinquishing of independence. "What every survey points to [as] the biggest fear of people as they age is becoming dependent on others or becoming a burden," says William Thies, chief medical and scientific officer of the Alzheimer's Association.

But Mother Nature has counterbalanced the power of our hard-wired genes by allowing multiple lifestyle choices to greatly influence our aging. Read: Your destiny is not fated; you do have some control. While genes influence your risk of developing Alzheimer's or another form of dementia, they "are not even the dominant factor" for the vast majority of people, says Paul Thompson, professor of neurology at the University of California Los Angeles School of Medicine. There is a rare genetic scenario that appears to guarantee dementia, he says. But for everyone else, Thompson explains, science knows several factors that help your brain stay healthy and build up reserves that will help as certain areas become diminished through normal aging.

Granted, there isn't a proven prescription for prevention. The challenge researchers face is how to pluck out the meaningful behaviors of people who maintain cognitive function into old age, then put them to the test in rigorous clinical trials. For example, ginkgo biloba, which in the lab had been shown to diminish the fatty plaques that wipe out nerve cells in the brains of people with Alzheimer's, was shown not to prevent Alzheimer's in healthy older subjects in a major trial last year. Another recent trial testing the inflammation-dampening potential of two nonsteroidal anti-inflammatory drugs--naproxen, also known as Aleve, and celecoxib, also known as Celebrex--in older people at high risk of developing Alzheimer's was stopped early because of concerns about celecoxib. Research interest in nonsteroidal anti-inflammatories is still high, notes Thompson, who knows several neurologists who pop an aspirin daily for its suspected defense against brain decline. (Caution: It's not safe for everyone to take an aspirin a day, so you should check with a doctor before doing so.)

But previous studies tell us that certain behaviors and lifestyle choices play an important role in influencing the trajectory of dementia, and there are all kinds of health benefits to be gained in mimicking early on the behaviors of people who have aged healthfully and with mental function intact. "A whole body of research shows that your condition at midlife determines what you see in later years," says Thies.






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