Alzheimer's Prevention: The Latest Recommendations

  From the recent report of the National Academy of Sciences, Engineering and Medicine come general recommendations.
  Cognitive Training: there is currently no evidence to support a conclusion that cognitive training can prevent or delay mild cognitive impairment or Alzheimer's.
  Hypertension: manage blood pressure in those with hypertension (particularly in mid-life i.e.. 35-65) to prevent, delay or slow the progression of Alzheimer's.
  Physical activity: studies fail to demonstrate increasing physical activity prevents, delays or slows mild cognitive impairment or Alzheimer's. However, the report noted the other health benefits of increased physical activity such as lowering the risk of hypertension, stroke and obesity as well as symptoms of depression.
  Contrastly,to improve your life overall: consider the FINGER study out of Finland which found that targeting diet, exercise, vascular risk factors and brain training slowed cognitive decline in older adults.
Downloadable report: nationalacademies.org/Dementia

Vascular Risk Factors : Narrowing Arteries in the Head = Alzheimer's Risk Increase

  Researchers from the Atherosclerosis Risk in Communities (ARIC) Neurocognitive study demonstrated that hardening of the arteries in the head is associated with mild cognitive impairment and dementia.
  In MCI and dementia patients with posterior (back of the brain) cerebral watery plaque had 44% higher prevalence of MCI than without it. Dementia risk was increased threefold in those with anterior cerebral (front of the brain) artery plaque and twofold in those with narrowing > 70% or involvement of > vascular territories.
  Again, as per my last review, decreasing vascular risk factors (obesity, diabetes, hypertension and high cholesterol) decreases hardening if arteries inside the head and decreases cognitive impairment.
Neurology 2017 Apr 18;88:1156

Take Care in Mid-Life to Reduce the Risk of Alzheimer's

  Vascular risk factors are known to be associated with Alzheimer's i.e., obesity (BMI > 30), smoking, hypertension, diabetes and high cholesterol. In this study, researchers found that those with vascular risk factors in middle age (especially those that are APOE4 allele positive) had a greater amyloid (the protein found in excess in Alzheimer's brains) burden in their brains later in life. 
  However, late-life vascular risk factors were NOT associated with an increased risk later in life.
  Therefore, treatment of vascular risk factors in MIDLIFE while likely to be asymptomatic, may be critical in reducing the development of an underlying AD process.
JAMA 2017 April 11;317:1443