kris ulland

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Scientists do not fully understand what causes Alzheimer’s disease in most people.The causes probably include a combination of age-related changes in the brain, along with genetic, environmental, and lifestyle factors. The importance of any one of these factors increasing or decreasing the risk of Alzheimer’s disease may differ from person to person.

Changes due to Alzheimer’s Disease (AD) may occur many years before symptoms appear. Mild Cognitive Impairment (MCI) due to AD provides a window to detect and diagnose Alzheimer’s disease before significant neurodegeneration has begun.

Even so, Alzheimer’s disease remains underdiagnosed and underreported. In fact, the average diagnosis is delayed by an average of 2 to 3 years after symptom onset.

AD is the most common cause of MCI, accounting for an estimated 34% to 75% of all patients. Patients with suspected MCI should undergo a comprehensive history and physical examination to distinguish MCI from normal aging or dementia, and separate it from other causes. Alzheimer’s disease biomarkers may provide evidence of the underlying cause.

Amyloid beta proteins have been found to accumulate in clumps in the brains of Alzheimer’s patients. This plaque buildup damages key areas of the brain like the hippocampus, which is essential to memory and spatial navigation. These buildups disrupt normal brain cell communications, and also cause inflammation, oxidative damage and the development of tangles of tau proteins which behave in the same way as the amyloid beta proteins.

Older age does not cause Alzheimer’s, but it is the most important known risk factor for the disease. The number of people with Alzheimer’s disease doubles about every 5 years beyond age 65. About one-third of all people age 85 and older may have Alzheimer’s disease.

Scientists are learning how age-related changes in the brain may harm neurons and affect other types of brain cells to contribute to Alzheimer’s damage. These age-related changes include atrophy (shrinking) of certain parts of the brain, inflammation, vascular damage, production of unstable molecules called free radicals, and breakdown of energy production within cells. But, age is only one risk factor for Alzheimer’s disease. Many people live into their 90s and beyond without ever developing dementia.

Most of us have had “senior moments”, when you walk into a room and forget why you went there, or struggle to find the correct word for the situation.

Trying to discern what is normal age-related forgetfulness versus something more is not always black and white. Small lapses in memory are generally not a big deal. For example, not being able to recall a person’s name upon seeing them, then remembering that name sometime later is less likely to be of concern.  Dr. Teng, MD, is a neurologist at the Geffen School of Medicine at UCLA. Dr. Teng says that remembering later is likely normal age-related memory changes. “It’s the people who don’t remember that they have forgotten things. That’s when our suspicion goes up.”

Other instances that raise concern include:

  • Repetitive questioning within a short period of time
  • Getting lost on familiar routes
  • Memory loss that affects daily function
  • Falling for similar financial scams multiple times

If you or someone you care about experiences some of the above situations, the first step is to see a primary care doctor or a geriatric physician. That physician will typically do a short cognitive screening test before referring you to a specialist for more extensive memory testing.

A common test is called the Mini Cog. It includes comprehension and recall. The patient is asked to draw a circle for a clock and to place the hands to reflect a specific time. For recall, the doctor will ask the patient to remember three unrelated words, such as chair, pineapple, and dust. Then later during the exam, the doctor will ask for those words to be recalled.

The Mini-Mental State Exam, MMSE, is another commonly used assessment. it is a quick way to evaluate language function, attention, speed of processing, visual and visual-spatial contexts, and executive function. The test takes about 10 minutes and includes questions like what is the date and season. A patient might be asked to count backward from 100 by 7’s. A doctor might hold up a pencil and ask what it is.

Like the mini-Cog, the MMSE doesn’t diagnose a specific underlying disease, but it can indicate if there are cognitive problems to investigate.

Worldwide studies report that although Alzheimer’s can’t be completely prevented with lifestyle choices, it may be delayed. There’s a lot you can do personally to potentially lower your risk of getting AD. A report from China identifies 19 “life-course practices” that can reduce Alzheimer’s disease risk through behavioral change.

“Nearly two-thirds of these suggestions target vascular risk factors and lifestyle, strengthening the importance of keeping a good vascular condition, and maintaining a healthy lifestyle for preventing [Alzheimer’s],” according to the research review led by Dr. Jin-Tai Yu of Shanghai Medical College, Fudan University.

The review of nearly 400 studies identified higher risk factors such as:

  • high body mass index (BMI) in late life
  • hyperhomocysteinemia (high levels of the amino acid homocysteine in the blood – high levels might be due to poor diet, poor lifestyle especially smoking and high coffee and alcohol intake, some prescription drugs, diabetes, rheumatoid arthritis and poor thyroid function)
  • depression
  • stress
  • diabetes
  • head trauma
  • hypertension in midlife
  • orthostatic hypotension (dizziness when you stand up after sitting or lying down)

The brain shrinks with aging but studies show that aerobic exercise can increase its size. The Harvard Aging Brain Study followed older adults and documented their physical activity, risk for cardiovascular disease, brain volume, and levels of brain amyloid plaques (the toxic protein found in people with Alzheimer’s disease).

Studies are showing more and more that physical activity as well as nutrition and cognitive stimulation across a life course can potentially change the trajectory for developing cognitive impairment and dementia.

Researchers found that higher physical activity was linked to less cognitive decline and less brain volume loss, even in those with amyloid plaques.

A systematic review from the World Health Organization (WHO) found that studies point to aerobic training having a greater impact on brain health than resistance training.

“We have always known that untreated hearing loss can significantly limit a person’s quality of life since they will tend to withdraw from many of the familial, social, and occupational opportunities that have always meant a lot to them. But over the past decade, there has been a growing accumulation of scientific evidence that untreated hearing loss is also a factor in accelerating cognitive decline in the later years,” Donald Schum, PhD, vice president of audiology for Oticon, told Healthline. A major work published in The Lancet from 2018 identified hearing loss as the No.1 treatable cause of premature cognitive decline.

Adding blue-purple colored foods like eggplant, beets, red cabbage, and purple potatoes are healthy choices for brain health. The deep red of these foods are caused by anthocyanin. These antioxidants prevent blood clots, delay cell aging, and may slow the onset of Alzheimer’s.

People who lack omega-3s in their diets are at a greater risk of heart disease and chronic inflammation. These deficiencies have been linked to a higher prevalence of AD. Add chia and hemp seeds to your diet. Walnuts and flaxseeds also have a good amount of omega-3s.

Chia Seeds

Chia seeds appear on many lists of so-called “superfoods”  because they are high in omega-3 fatty acids, fiber, protein, and other nutrients.

Chia seeds are harvested from the flowering plant Salvia hispanica, a member of the mint family that grows wild in Central America, where the seeds were a major food source for centuries. Chia seeds are nutrient-dense kernels with a slightly nutty flavor; you can eat the easily digested seeds whole or ground, dry, or soaked in liquid. “Chia” translates from the Mayan language as strength, and they are popular with athletes to enhance energy and endurance.

Chia seeds are a  pseudo grain. That means they’re the carbohydrate-rich seeds of a nongrass plant. When chia seeds encounter liquid, they expand and form a thick gel.

Chia seeds were said to be a staple of Aztec and Mayan diets, but were later banned because of their ritualistic religious use. Over the last century or so, they’ve enjoyed a minor following, but recently made a comeback on the market as a potential superfood.

Top producers of chia seeds include Bolivia, Argentina and Ecuador, with Mexico and Australia.

Omega-3 represents  65% of chia’s total oil content. The seeds are small but rich in valuable amino acids, antioxidants and flavonoids, including chlorogenic acid, caffeic acid, myricetin, quercetin and kaempferol. Along with other benefits, a 2003 study from Biochemical Pharmacology shows quercetin and kaempferol have possible preventative effects against postmenopausal bone loss.

Two tablespoons of chia seeds have almost 10 grams of fiber. That’s around 40 percent of the recommended daily intake. Diets high in fiber have been linked to weight loss. According to research, eating 30 grams of fiber daily may help you lose as much weight as if you followed a more complicated diet. Fiber can help you feel full faster and may contribute to weight loss. Chia seeds may promote regular bowel movement and digestion by promoting the peristaltic movement of the intestine. Fiber also has the additional benefit of inhibiting the body to break down food into sugars, resulting in more stable blood glucose levels.

Chia seeds are also relatively high in calories and fat. Two tablespoons have 138 calories and 9 grams of fat.

Chia seeds are a low-cholesterol and low-sodium food and have high levels of potassium, calcium and phosphorus, which are important for nerve and bone health. Niacin, a B vitamin, is another nutrient that helps reduce LDL cholesterol levels in the blood, manage nervous system disorders and increase GABA activity inside the brain, which in turn helps reduce anxiety and even lessen the effects of Alzheimer’s. Chia seeds are particularly high in calcium, with a 1-ounce serving providing 13.8% of the recommended daily value.

Chia seeds may interact with blood pressure medications or blood thinners such as warfarin. If you take any of these drugs, don’t eat chia seeds. Because chia seeds are so high in fiber, it is recommended that daily intake be limited to 1 to 2 ounces. Higher doses may cause digestive upset. Always consult your doctor before adding chia seeds to your diet.

How to Buy

Health food stores and most grocery stores sell chia seeds. You can also order them from online grocery retailers. Look for a mix of the black and white ones; brown chia seeds are not yet fully mature and won’t contain the same high level of nutrients. They may also have a bitter flavor.

Because of their crunchy texture and nutty flavor, chia seeds are a common addition in commercially produced granola bars and cereals. They’re also frequently included in pancake and waffle mixes for extra fiber and nutrients.

How to Store

Whole chia seeds can last for years stored in a cool, dry location. Ground chia seeds also have a long shelf-life, but it’s best to keep the flour in a glass container in the refrigerator or freezer. Soaked chia seeds stay good in the refrigerator for about a week, while sprouted chia seeds should be eaten within a few days.

How to Cook

There are a number of ways you can include chia seeds in your diet. You can sprinkle them in your salads or ad them to nuts and seeds trail mix.

Try adding chia seeds to:

  • smoothies
  • oatmeal
  • salads
  • salad dressing
  • yogurt
  • soups or gravy
  • muffins
  • homemade bread
  • baked goods in place of eggs
  • chia pudding

When using chia seeds, remember the more seeds you use and the longer they sit, the thicker the final product. If you aren’t a fan of the texture of chia seeds, blend them to your preferred consistency.


Seedy Oat Crackers with Chia Seeds

Anna Jones

8 Servings


  • 1 cup gluten-free oats
  • ¾ cup raw, sprouted pumpkin seeds (pepitas)
  • ⅓ cup raw, sprouted sunflower seeds
  • ⅓cup sesame seeds
  • 3 tablespoons chia seeds
  • 3 tablespoons poppy seeds
  • 1 teaspoon kosher salt
  • 1 tablespoon plus 1 teaspoon vegetable oil
  • 1 tablespoon pure maple syrup


  • Preheat oven to 375°. Mix oats, pumpkin seeds, sunflower seeds, sesame seeds, chia seeds, poppy seeds, and salt in a large bowl. Stir oil, maple syrup, and ¾ cup room-temperature water in a medium bowl to combine. Pour liquid over oat mixture and toss until mixture is completely soaked. Let sit 10 minutes; mixture will absorb water and thicken.
  • Form oat mixture into a ball and transfer to a parchment-lined baking sheet. Press a second sheet of parchment paper directly on top and, using a rolling pin, flatten to ⅛” thick (the shape doesn’t matter). Remove top layer of parchment.
  • Bake cracker until golden brown around edges, 15–20 minutes. Remove from oven and carefully turn out, parchment side up. Place a fresh sheet of parchment on baking sheet. Remove parchment from cracker, carefully turn cracker over, and return to baking sheet. Bake until firm and golden brown around edges, 15–20 minutes. Let cool on baking sheet, then break into pieces with your hands.

Crackers can be made  and stored in an airtight container for a week at room temperature.

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