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'The Alzheimer's Prevention Program': A Book Review

In this new book on Alzheimer's prevention, Dr. Gary Small and his co-author (and spouse) Gigi Vorgan clearly lay out a plan to prevent, delay and diminish the symptoms of AD for those who are at risk, which is most of us if we live long enough.
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Remember these eight words: bus, screwdriver, mango, playground, swallow, sun, couch and rectangle.

Wait a few minutes. How many can you recall?

How many words of three letters or more can you make from the following scrambled letters: A-E-L-S-K

How many did you create? There are 18.

How many times this past week did you struggle to remember a name? Or forget where you put something?

Just about everyone has some loss of memory as the decades collect. Don't confuse normal aging with Alzheimer's. But some people as they enter their 50s and 60s experience what is called "mild cognitive impairment" (MCI). They are often forgetful, can become a bit confused and display other symptoms suggestive of mild Alzheimer's -- but they can manage. However, MCI heralds a far greater likelihood of developing AD -- as great as 15 times more risk. Some regard MCI as a transition to AD.

Alzheimer's disease (AD) is the demon of older age. A small percentage of people (5 percent) will fall ill to its neurological destruction before the age of 65. But as we age into the 70s, 80s and beyond the numbers affected grow substantially. Today, every 70 seconds a person in the U.S. develops AD; estimates are that this rate will rise to every 30 seconds by 2050 as we all live longer. Not all dementia is due to Alzheimers: vascular dementia (due to blood vessel narrowing or stroke in the brain) accounts for perhaps 40 percent of severe memory problems (and other symptoms). But AD is the greatest threat to our memory -- and even more so to our very sense of identity as we grow old.

While there is a genetic risk to developing Alzheimer's (1 in 5 people carry the gene type APOE-4 that increases the risk of AD), having the risk does not mean you will get the disease. In fact, most experts do not recommend that patients get genetic testing to determine if they have this gene type. Instead, sound advice centers on what we can do to prevent, delay and reduce the impact of AD. In fact, what can be done is principally under our control: It is in how we lead our lives.

Feeling like you need to do something? Well, the prescription is quite clear, useful and even feasible. Enter Dr. Gary Small and his co-author (and spouse) Gigi Vorgan. Dr. Small is an internationally-renowned expert on aging and dementias; he is a professor and director of the UCLA Longevity Center at the Semel Institute for Neuroscience and Human Behavior. Ms. Vorgan is a professional writer and producer for film and television. Their collaborations have produced books as varied as "The Memory Bible" (a NYT bestseller) and a collection of short stories called "The Naked Lady Who Stood On Her Head."

In this new book on Alzheimer's prevention, they clearly lay out a plan to prevent, delay and diminish the symptoms of AD for those who are at risk, which is most of us if we live long enough. The writing is personable, funny and helpful. The book is full of puzzles, informational charts and exercises (body and mind). The actions you can take are entirely feasible:

Try reading a few sentences of this article upside down (except on an iPad, which will defy you).

Try their memory training regimen, which they call "look, snap and connect." I did -- it works.

Stand on one leg, close your eyes and count backward from 100 by 7s.

These are but a few types of brain exercises. There are many, from crosswords to learning a new language to trying to beat someone in Scrabble. You can discover how memory wizards recall the random order of a shuffled deck of 52 cards. You can complement brain training with walking more, socializing more, eating more fish, olive oil and nuts, managing your stress and reducing the body's inflammatory response, even have a glass of wine. You can use food supplements, meditation and perhaps medications.

You may be asking: Who has time for this? But self-care, self-management, is the secret to managing every form of chronic disease -- including cardiovascular disease, diabetes, depression and PTSD, asthma, emphysema and other lung conditions, Parkinson's disease, low back pain and a myriad of arthritic conditions, and cancers of all sorts. The question may not be who has time but rather who can escape self-care and expect to function well and have a good quality of life?

As a rule, I am not much for self-help books. But this one is more than self-help. It is more like having an expert coach teach you about aging, memory and neurological diseases and then instruct you about how to do what is in your control to maximize your brain functioning as you age. Each part of their plan is beneficial -- nutrition, exercise, stress reduction, brain training and having people in your life all make a difference. And each one complements the other. So, if you only do a few, you are better off with each element of their plan that you incorporate into your life. Not only that, as you build these healthy actions into your life you are going to help all the other things that ail you. Now that's worth doing.

Hmmm, now what were those eight words?

The Alzheimer's Prevention Program
Dr. Gary Small and Gigi Vorgan
Workman Publishing, NY, 20111

The opinions expressed here are solely mine as a psychiatrist and public health advocate. I receive no support from any pharmaceutical or device

Visit Dr. Sederer's website ( for questions you want answered, reviews, commentary and stories.

For more by Lloyd I. Sederer, M.D., click here.

For more on Alzheimer's disease, click here.

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