Escaping Alzheimer’s

Doug Whitney comes from a family whose members are almost certain to develop Alzheimer’s disease, a progressive brain disease that impairs memory, thinking skills, and the ability to manage daily living activities.

Whitney and his relatives have a gene called presenilin 2 (PSEN2), which is linked to an increased risk for early-onset familial Alzheimer’s disease (EOFAD) that occurs in people 65 and under. The Alzheimer’s Association reports that early-onset Alzheimer’s can occur in people under 65. People with younger-onset Alzheimer’s can be in the early, middle, or late stages of the disease.

Although the majority of people with the disease are 65 and older, Alzheimer’s is not a normal part of aging. Alzheimer’s is the most common form of dementia and accounts for 60 to 80 percent of dementia cases, according to the Alzheimer’s Association. There is no cure for the disease. On average, a person with Alzheimer’s lives four to eight years after diagnosis but can live as long as 20 years, depending on other factors.

Previous studies have found that genetics play a role in a person’s chances of developing Alzheimer’s, which worsens over time. Scientists believe there are at least 80 genetic regions involved in the progression of Alzheimer’s disease, including presenilin 2 (PSEN2) found on chromosome 1.

Although Whitney’s relatives typically showed signs of cognitive decline in their early 50s, he did not display signs of cognitive decline or Alzheimer’s disease. Because of this, Whitney volunteered to participate in the international Dominantly Inherited Alzheimer Network study, which was published in the journal Nature Medicine in February 2025.

Dr. Jorge J. Llibre-Guerra, assistant professor of neurology at Washington University in St. Louis and co-first author of the study, told Medical News Today that studying Dominantly Inherited Alzheimer’s Disease (DIAD) “not only improves our understanding of this specific form of Alzheimer’s but also enhances our knowledge of sporadic Alzheimer’s disease.”

When Whitney met the Washington University researchers, he was 75 years old. Initially, the scientists did not believe that Whitney had the PSEN2 gene because he showed no signs of cognitive decline, particularly after discovering that his relatives had symptoms in their early 50s.

However, brain scans revealed that Whitney not only had the gene but also had an accumulation of the amyloid-beta protein in the brain, which, along with increased risk for EOFAD, are considered indicators of Alzheimer’s disease. Although Whitney had an accumulation of amyloid protein, the scans showed only a localized concentration of tau protein. The buildup of tau in the brain is associated with the progression of Alzheimer’s disease.

The DIAN researchers designated Whitney as an “escapee” or “exceptional resilience mutation carrier” because something in his body prevented the PSEN2 mutation from taking effect.

“[Whitney’s] case provides a rare opportunity to investigate potential protective factors and mechanisms that could be influencing the non-typical progression of the disease, offering insights that could lead to new therapeutic strategies,” Dr. Llibre-Guerra told Medical News Today.

The research team is currently investigating what causes Whitney’s brain to resist Alzheimer’s in hopes of finding new therapies for the disease.

“Identifying how certain proteins and genetic variants contribute to this protective effect could open up new avenues for drug development aimed at mimicking these natural defenses in broader populations,” Dr. Llibre-Guerra told Medical News Today.

Healthy lifestyle choices may lower the risk of cognitive decline

Alzheimer’s disease is a puzzle that researchers are still trying to piece together. Although discoveries have been made about Alzheimer’s, scientists are not sure about other factors that can contribute to the disease and who will ultimately develop Alzheimer’s.

“For 1% of all cases, there are three genes that determine definitively whether or not you will have Alzheimer’s, and all three relate to amyloid-beta production, which in these cases is likely the cause of Alzheimer’s,” Dr. Gad Marshall, associate medical director of clinical trials at the Center for Alzheimer Research and Treatment at Harvard-affiliated Brigham and Women’s Hospital, told Harvard Health Publishing. “For the other 99%, amyloid and tau are closely associated with Alzheimer’s, but many things may contribute to the development of symptoms, such as inflammation in the brain, vascular risk factors, and lifestyle.”

While a search for answers about Alzheimer’s continues, there is strong evidence that suggests people can reduce their risk of cognitive decline by making strategic lifestyle changes. Three of the healthy habits to develop include the following:

1. Exercise. “The most convincing evidence is that physical exercise helps prevent the development of Alzheimer’s or slow the progression in people who have symptoms,” Dr. Marshall said.” The recommendation is 30 minutes of moderately vigorous aerobic exercise, three to four days per week.”

2. Eat a Mediterranean diet. “This has been shown to help thwart Alzheimer’s or slow its progression. A recent study showed that even partial adherence to such a diet is better than nothing, which is relevant to people who may find it difficult to fully adhere to a new diet,” Dr. Marshall said.

Medical and nutritional experts tout the Mediterranean diet as one of the best eating plans worldwide. The diet is based on people’s dietary habits in countries bordering the Mediterranean Sea, such as Greece, Italy, and Spain. The diet plan emphasizes plant-based foods, healthy fats, and moderate consumption of animal products. The Mediterranean diet includes:

Fresh vegetables and fruits
Whole grains
Olive oil
Nuts
Legumes
Fish
Moderate amounts of poultry, eggs, and dairy
Moderate amounts of red wine
Red meat, only sparingly

3. Get enough sleep. “Growing evidence suggests that improved sleep can help prevent Alzheimer’s and is linked to greater amyloid clearance from the brain,” Dr. Marshall. Aim for seven to eight hours of sleep per night.

Evidence is not as strong about whether the following lifestyle choices may help to prevent Alzheimer’s:

1. Learn new things. “We think that cognitively stimulating activities may be helpful in preventing Alzheimer’s, but the evidence for their benefit is often limited to improvement in a learned task, such as a thinking skills test, that does not generalize to overall improvement in thinking skills and activities of daily living,” Dr. Marshall said.

2. Connect socially. “We think that greater social contact helps prevent Alzheimer’s,” Dr. Marshall said, but so far, “there is only information from observational studies.”

3. Drink—but just a little. The link between moderate alcohol consumption and a lower Alzheimer’s risk is unclear due to conflicting evidence. “It is thought that wine in particular, and not other forms of alcohol, may be helpful, but this has not been proved,” Dr. Marshall said.

Although there isn’t enough evidence to conclude that all good lifestyle choices prevent Alzheimer’s, it is clear that they can prevent a number of other chronic conditions. For example, reducing alcohol consumption can reduce the risk of developing some types of cancer, such as breast cancer.

The best advice is to incorporate as many healthy lifestyle practices as you can into your life.

Source Links:

https://www.medicalnewstoday.com/articles/what-one-mans-escape-from-alzheimers-might-tell-us-about-the-disease
https://www.health.harvard.edu/alzheimers-disease/what-can-you-do-to-avoid-alzheimers-disease
https://www.alz.org/alzheimers-dementia/what-is-alzheimers