Understanding Neurodegenerative Disorders

Neurodegenerative disorders, such as Alzheimer's and Parkinson's are on the rise in the UK and worldwide, partly due to ageing populations but lifestyle and environmental factors are also known to play a role [1].

This post will be part one of a series of blogs that will look at how neurodegenerative disorders affect people, what we can do to prevent them and what steps can be taken to slow down their progression if you have been diagnosed.

What are Neurodegenerative Disorders?

Neurodegenerative disorders are a group of health conditions, characterised by the progressive deterioration of nerve cells, particularly neurons, which are essential for brain function, communication, and control of bodily functions. The conditions are described as 'progressive' because the symptoms continue to worsen as more and more neurons die off. As symptoms worsen, quality of life can degrade considerably to the point of severe disability and people can become susceptible to other, life-threatening, conditions.

There are currently over six hundred identified neurodegenerative disorders. Some of the most commonly diagnosed include:

• Alzheimer's - Characterised by cognitive decline and memory loss, Alzheimer's disease is the most common type of dementia. It is caused by a build-up of plaques in the brain that clump together and disrupt communication between neurons.

• Parkinson's Disease - Known for its effect on movement, resulting in symptoms like tremor, stiffness, and bradykinesia It can also have non-motor symptoms, including personality changes. Parkinson's disease is linked to the breakdown in production of an important neurochemical called dopamine, which plays a vital role in controlling movement, as well as many other functions.

• Huntington's - An inherited condition that causes the progressive breakdown of nerve cells in the brain, affecting movement, cognition, and emotions.

• Multiple Sclerosis (MS) - Involves an immune-mediated process in which an abnormal response of the body’s immune system is directed against the central nervous system. This can lead to symptoms including chronic pain, vision problems, loss of coordination and even paralysis.

• Amyotrophic Lateral Sclerosis (ALS) - This debilitating condition involves a similar process to MS, but is directed at the motor neurons of the brain and spine. ALS can result in muscle weakness, atrophy, and eventually paralysis.

• Frontotemporal Dementia (FTD) - FTD is an umbrella term for a group of brain disorders that primarily affect the frontal and temporal lobes of the brain, associated with changes to personality, behavior, and language ability.

• Spinocerebellar Ataxia (SCA) - A progressive, degenerative, genetic disease with multiple types, affecting the cerebellum, the part of the brain that controls coordination and balance.

Causes of Neurodegenerative Disorders

Pinpointing the exact cause of a neurodegenerative disorder can be difficult, due to the complex interweaving of factors that can be involved. A single condition, such as Alzheimer's, may be brought on through genetic, lifestyle or environmental factors, or even a mix of the three [2]. Some combination of the following factors are believed to contribute to most neurodegenerative disorders:

• Genetics - Genes are what give us family heredity, such as facial characteristics, height etc. Unfortunately, our genes can sometimes be responsible for chronic health conditions, either because one or both of your parents had the condition, or because the genetic code has become mutated. Specific gene mutations have been identified as likely contributors to many neurodegenerative conditions, including forms of dementia [3].

• Ageing - As we get older, the risk of being diagnosed with a neurodegenerative disorder increases dramatically. In fact, age is considered to be the primary risk factor for conditions such as Parkinson's and Alzheimer's [4]. As we age, the processes that protect our cells from damage become less efficient, while other cells naturally die off without being replaced (necrosis).

• Environmental Factors - A growing body of evidence suggests that environmental pollutants, such as lead, mercury, aluminum, cadmium and arsenic, as well as some pesticides and metal-based nanoparticles, can play a role in the development of neurodevelopmental disorders [5]. It has even been suggested that pre-natal exposures could predispose one to conditions such as Alzheimer's and Parkinson's in later life.

• Sex - Different neurodegenerative disorders pose different risk levels, depending according to gender. For example, two-thirds of people with Alzheimer's are women, as are over seventy percent of those with multiple sclerosis. Conversely, two-thirds of people with Parkinson's disease are men [6].

• Vascular Factors - Poor blood flow to the brain can damage nerve cells and potentially open the door to neurodegenerative disorders. Dyslipidemia refers to an imbalance in LDL cholesterol levels or other lipids, often caused by poor diet and lifestyle, but also with a genetic component. The condition is associated with a higher instance of Alzheimer's disease and research suggests that bringing the condition under control, may prevent damage to brain tissue [7]. To learn more about maintaining a healthy cholesterol level, please read this in-depth article.

Preventing Neurodegenerative Disorders

I think we can all agree that 'prevention is better than cure'. This is especially true in the case of neurodegeneration as the condition is often developing decades before any symptoms begin to appear, meaning that by the time a diagnosis is reached, the condition is already in a very late stage. While the exact causes of many neurodegenerative disorders remain unclear, and genetic factors play a critical role, lifestyle changes have been shown to influence the risk of developing one of these diseases. Here are some interventions that you can make that may help to prevent or delay the onset of neurodegenerative disorders, and happily they correlate pretty well with changes you can make for overall health and wellbeing:

• Diet - A healthy diet plays a crucial role in brain health and can reduce the risk of neurodegenerative diseases. We discussed earlier the link between heart health and brain health, so it is probably unsurprising that diets that help to promote vascular health have the effect of reducing neurodegenerative risk. Diets rich in antioxidants, vitamins, and omega-3 fatty acids, such as the Mediterranean diet, have been associated with a lower risk of Alzheimer's disease and other cognitive declines [8]. This diet emphasises fruits, vegetables, whole grains, olive oil, fish, and moderate wine consumption. I describe the Mediterranean diet in greater detail in this article.

• Exercise - Regular physical exercise is one of the most effective lifestyle changes for preventing neurodegenerative disorders [9]. Exercise increases blood flow to the brain, improves the efficiency of brain cells, and encourages the growth of new brain cells. It can also reduce inflammation and stress, which are linked to cognitive decline. Both aerobic exercises, like walking or cycling, and strength training are beneficial.

• Sleep - Good sleep hygiene is essential for brain health. Poor sleep patterns, disruption of circadian cycles and disorders like sleep apnoea are linked to an increased risk of neurodegenerative diseases [10]. Quality sleep supports the clearance of brain toxins, including beta-amyloid, which is implicated in Alzheimer's disease. Practising good sleep habits can enhance memory and cognitive function.

• Stress Management - Chronic stress is associated with harmful effects on the brain, including increased risk of neurodegenerative diseases, such as Alzheimer's. This is further compounded by the stressful effects of Alzheimer's, creating a vicious cycle of stress and disease [11]. Stress management techniques such as mindfulness, meditation, yoga, and deep-breathing exercises can reduce stress and its negative impact on brain health, as well as helping with heart health and many other health conditions. I take a closer look at stress management in this article.

• Socialising - Social isolation is known to have a detrimental effect on brain health [12], so it is important to foster meaningful relationships and find ways of regularly interacting with others. Isolation can often become an issue in older age, when mobility is often impaired. Getting in touch with a local charity, such as Age UK can be a good way of finding support and fostering new social connections.

• Avoiding Toxins - As detailed above, there is growing evidence to support the theory that environmental pathogens are contributing to rising levels of neurodegenerative disorders. Start thinking about lifestyle choices you can make that reduce your exposure to these toxins. Top of the list is quitting smoking and excessive alcohol consumption, but you can also think about air quality, water filters and organic foods, to name a few.

• Get Regular Checkups - While a checkup may not be able to actually prevent a neurodegenerative disorder, early diagnosis can make a big difference to the effectiveness of treatment, so make sure you regularly advise your GP of any changes you have noticed in your cognitive abilities.

This blog post has outlined some of the most common types of neurodegenerative disorders and what you can do to minimise your risk of developing them. In the next post in this series, we will be looking at the Functional Medicine approach to treating neurodegenerative disorders for anyone who has already been diagnosed.