Category: Health Equity

Treat these three conditions to avoid Alzheimer’s Disease.

Consult your medical provider for a comprehensive evaluation to identify which of the following conditions you have. Research recommends that early screening and treating any three of the conditions could prevent Alzheimer’s disease.

Consult your medical provider for a comprehensive evaluation to identify which of the following conditions you have. Research recommends that early screening and treating any three of the conditions could prevent or cure Alzheimer’s disease.

  1. Depression
    • Screen for depression using clinical assessments.
    • Treatment: Avoid selective serotonin reuptake inhibitors (SSRIs) due to their association with increased dementia risk. If needed, fluoxetine may be preferred as it increases TGF-β, which benefits neuroprotection.
  2. Diabetes and Insulin Resistance
    • Check fasting blood glucose and HbA1c levels.
    • Treatment: Optimize diabetes management with insulin or glucose-lowering medications. Consider intranasal insulin therapy to improve cerebral glucose metabolism.
  3. Dyslipidemia
    • Measure cholesterol and triglyceride levels.
    • Treatment: Use statins (lipophilic or hydrophilic) to reduce dementia risk.
  4. Hypertension
    • Monitor blood pressure regularly.
    • Treatment: Beta-blockers and diuretics are most effective in reducing dementia risk.
  5. Inflammation
    • Measure C-reactive protein (CRP) to detect systemic inflammation.
    • Treatment: NSAIDs (e.g., ibuprofen) may lower AD risk. Gut microbiome modulation (probiotics or antibiotics) can reduce neuroinflammation.
  6. Vascular Abnormalities
    • Screen for cerebrovascular disease (stroke history, carotid ultrasound, or MRI).
    • Treatment: Manage vascular health through antiplatelet therapy, lifestyle interventions, and hypertension control.
  7. Nutritional Deficiencies
    • Test for Vitamin D, folate, and niacin levels.
    • Treatment: Supplement with Vitamin D, folate, and a Mediterranean diet to slow cognitive decline.
  8. Mitochondrial Dysfunction
    • Assess for chronic fatigue and metabolic indicators.
    • Treatment: Lithium therapy can restore mitochondrial function. Valproate may enhance mitochondrial energy production.
  9. Transforming Growth Factor Beta (TGF-β) Deficiency
    • Measure TGF-β levels in plasma.
    • Treatment: Fluoxetine increases TGF-β and may aid in neuronal repair.
  10. Wnt/β-Catenin Deficiency
    • Screen for cognitive decline progression.
    • Treatment: Doxycycline therapy has been shown to increase Wnt signaling and enhance neuroprotection.
  11. Metabolic Syndrome
    • Identify obesity, insulin resistance, and hypertension.
    • Treatment: Address hypertriglyceridemia, high waist circumference, and hypertension.
  12. Circadian Rhythm Disturbances
    • Assess sleep patterns and actigraphy data.
    • Treatment: Melatonin therapy, bright light exposure, and photobiomodulation therapy (near-infrared light therapy) can improve circadian function and cognitive health.
  13. Underweight and Malnutrition
    • Monitor BMI and dietary intake.
    • Treatment: Increase caloric intake, protein-rich diets, and short-chain fatty acid (SCFA) supplementation to promote neuroprotection.

Sources of research evidence:

  1. Fessel J. Formulating Treatment to Cure Alzheimer’s Dementia: Approach . Int J Mol Sci. 2024;25(6):3524. doi:10.3390/ijms25063524.
  1. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413-446. doi:10.1016/S0140-6736(20)30367-6.
    • Supports multimodal interventions, including vascular risk factor management, lifestyle modifications, and cognitive training in preventing and reversing cognitive decline.
  2. Cummings J, Lee G, Nahed P, et al. Alzheimer’s disease drug development pipeline: 2022. Alzheimers Dement (N Y). 2022;8(1):e12295. doi:10.1002/trc2.12295.
    • Discusses the failure of single-drug approaches in AD treatment and the need for personalized medicine, aligning with Fessel’s multimodal approach.
  3. Jack CR Jr, Bennett DA, Blennow K, et al. NIA-AA research framework: Toward a biological definition of Alzheimer’s disease. Alzheimers Dement. 2018;14(4):535-562. doi:10.1016/j.jalz.2018.02.018.
    • Provides evidence that Alzheimer’s pathology is driven by multiple interacting factors, necessitating individualized treatment strategies.
  4. Espeland MA, Rapp SR, Manson JE, et al. Long-term effects of lifestyle interventions to prevent diabetes on cognitive function: Action for Health in Diabetes study. J Am Geriatr Soc. 2021;69(3):698-708. doi:10.1111/jgs.16948.
    • Demonstrates that aggressive diabetes management improves cognitive function, supporting the inclusion of diabetes treatment in AD intervention strategies.
  5. Walker KA, Gottesman RF, Wu A, et al. Systemic inflammation during midlife and cognitive change over 20 years: The ARIC Study. Neurology. 2019;92(11):e1256-e1267. doi:10.1212/WNL.0000000000007094.
    • Confirms the role of inflammation in cognitive decline and supports the recommendation to target systemic inflammation as part of a curative strategy for AD.
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Patient Care and Implicit Biases

Suppose you have ever attempted the Harvard Implicit Association Test (IAT). In that case, you will realize it shows implicit biases or an unexpected inclination towards a particular category of interest that may often contradict your beliefs or expectations. Nevertheless, the IAT emerged as a valuable instrument for unearthing unconscious biases that may not align with our convictions.

Navigating through professional responsibilities laden with ethical considerations, I have always been vigilant about addressing both conscious and unconscious biases. However, the IAT underscored the intricate nature of these biases, penetrating even the subconscious layers of our attitudes. Implicit attitudes towards race/ethnicity, disability, gender, age, sexual orientation, national origin, veteran status, obesity, addiction, and homelessness can significantly influence clinical judgment. The intricacies and limitations in understanding these multifaceted factors often contribute to these biases, highlighting the need for continued introspection.

In healthcare, where the stakes are high, and patient well-being is paramount, acknowledging the influence of implicit biases becomes a critical aspect of delivering equitable and patient-centered care. Understanding that these biases impact clinical judgment necessitates a nuanced approach to patient interactions. It calls for recognizing patients’ diverse backgrounds, experiences, and identities in healthcare.


The path forward lies in fostering a healthcare environment where patients are treated as care recipients and active contributors to their well-being. Contextualizing care, active listening, and involving patients in decision-making become indispensable practices in mitigating the impact of implicit biases. Education emerges as a key catalyst for change, equipping healthcare professionals with the knowledge and awareness needed to navigate the complex landscape of human diversity.

As we strive for positive health outcomes, we must view patient care as a collaborative effort, transcending the boundaries of bias. The journey toward unbiased healthcare is ongoing, requiring commitment, self-reflection, and a collective dedication to dismantling ingrained prejudices. By embracing this ethos, we can pave the way for a healthcare system that not only recognizes the existence of implicit biases but actively works towards mitigating their impact to improve patient well-being.

You can take the Harvard Implicit Association Test here.

Nurturing Equality in the Face of Forgetfulness: Health Equity and Alzheimer’s Disease

Health Inequalities arise when barriers hinder individuals and communities from accessing optimal conditions for reaching their full potential. It distinguishes inequities from health disparities, which are differences in health status linked to social or demographic factors. Health Equity involves valuing everyone equally, optimizing conditions across various life stages, and collaborating with different sectors to address factors influencing health, such as employment, housing, education, healthcare, public safety, and food access. Notably, the passage acknowledges racism as a factor influencing the distribution of these social determinants.

According to the Centers for Disease Control and Prevention (CDC), addressing disparities necessitates national leadership to involve diverse stakeholders, coordinate federal entities and nonfederal partners, advocate for effective policies, and ensure accountability. The CDC and its collaborators can utilize the report’s findings to heighten awareness of vulnerable groups. Additionally, the insights can motivate increased interventions at state, tribal, and local levels to tackle health disparities and inequalities effectively.

Also, Healthy People 2030 offers diverse strategies for attaining health equity. A pivotal aspect in realizing the overarching vision of enhancing the health and well-being of all is the targeted addressing of health disparities. Consequently, disparity ratios are being formulated to evaluate data on disparities for population-based core objectives, utilizing demographic group data available at a specific time point.

In Alzheimer’s disease, achieving health equity gains significant importance. Factors such as income, education, and access to health care can create disparities in diagnosis, treatment, and support services. We address all disparities so that patients and caregivers have equal opportunities for early detection, quality care, and support services regardless of their background. This approach is crucial for creating an inclusive society where everyone can age with dignity and receive the necessary assistance in managing the challenges posed by Alzheimer’s disease.

https://www.apha.org/Topics-and-Issues/Health-Equity
https://www.cdc.gov/minorityhealth/CHDIReport.html
https://health.gov/healthypeople/objectives-and-data/about-disparities-data
https://www.nimhd.nih.gov/resources/understanding-health-disparities/health-equity.html