17 Aug 1. Alzheimer’s Disease (AD) began to be known in the early 1

1. Alzheimer’s Disease (AD) began to be known in the early 1900’s, but with the baby boomer population aging into the elderly classification, the numbers of those diagnosed with AD is expected to climb (Edwards Iii, G. A., Gamez, N., Escobedo, G., Jr, Calderon, O., & Moreno-Gonzalez, I. 2019). Finding ways that humans Can reduce their risk of developing AD is important as the disease is disabling and fatal as there currently is no cure for the disease.  Risk factors for AD include stroke, hypertension, diabetes, atrial fibrillation, hypercholesterolemia, and cerebrovascular disease (Edwards Iii, G. A., Gamez, N., Escobedo, G., Jr, Calderon, O., & Moreno-Gonzalez, I. 2019).  Recently there have been studies looking at how thyroid hormone levels are linked to cognitive impairment and AD but nothing has been finalized as concrete data (Nomoto S, Kinno R, Ochiai H, Kubota S,Mori Y, Futamura A, et al. 2019).  I would educate patients on lifestyle modifications for any of these risk factors.  Not just because of AD, but because of the potential for those diseases to worse and become life altering or life ending.  One of the biggest lifestyle changes that affects almost every system in the body is exercise.  Increased activity lowers blood pressure, lowers blood sugars, improves lung function and has been linked to decreased biomarkers for AD (Morris JK, Vidoni ED, Johnson DK, Van Sciver A, Mahnken JD, Honea RA, et al. 2017).  Following a healthy diet that has shown improvement in high blood pressure is the Mediterranean Diet.  One specifically developed for cognitive issue prevention is the MIND diet: Mediterranean Intervention for Neurodegenerative Delay. This diet also can be modified for diabetics.  Patients need education on the importance of medication compliance to keep blood pressure controlled and to prevent further heart disease from occurring.  Keeping routine appointments with their primary provider is important as subtle changes in blood pressure and/or labs can be found during these visits.  Patients with mild cognitive impairment need to have family members accompany them to appointments so that medications can be discussed, results of labs, and any changes that are made can be discussed and questions answered so that the patient’s family can help with the patient’s treatment plan at home.  Edwards Iii, G. A., Gamez, N., Escobedo, G., Jr, Calderon, O., & Moreno-Gonzalez, I. (2019). Modifiable Risk Factors for Alzheimer’s Disease. Frontiers in aging neuroscience, 11, 146. https://doi.org/10.3389/fnagi.2019.00146Morris JK, Vidoni ED, Johnson DK, Van Sciver A, Mahnken JD, Honea RA, et al. (2017). Aerobic exercise for Alzheimer’s disease: A randomized controlled pilot trial. PLoS ONE 12(2): e0170547. doi:10.1371/journal.pone.0170547.Nomoto S, Kinno R, Ochiai H, Kubota S, Mori Y, Futamura A, et al. (2019). The relationship between thyroid function and cerebral blood flow inmild cognitive impairment and Alzheimer’s disease. PLoS ONE 14(4): e0214676. https://doi.org/10.1371/journal.pone.0214676