Age, family history, heredity.

While there are certain risk factors for Alzheimer's disease that can't be controlled, research is beginning to offer more clues about the risk factors that can be.

But it's nothing too different from what you learned in elementary school.

“It's all the things we've heard about,” said Tonya Cox, vice president of education and programs for the Lexington Regional Office of the Alzheimer's Association, the world leader in Alzheimer research and support.

Eat your fruits and vegetables, get plenty of sleep and exercise, engage in social activities, challenge your mind.

Research suggests that all may help postpone or even prevent Alzheimer's by keeping the brain young. Increasing age is the greatest risk factor for the degenerative brain disorder that an estimated 4.5 million Americans are living with.

While the information is nothing too new, it is considered to be powerful knowledge regarding a disease that still has no identifiable cause, even though it was first described a century ago.

Knowing that a healthy lifestyle may prolong or prevent a disease that has reportedly more than doubled in Americans since 1980 should bring new meaning to the food guide pyramid or the great outdoors.

But it doesn't always work that logically.

Jeanne Barnes, director of dietary services at Harlan ARH Hospital, said it's “hard to say” why some individuals choose not to maintain a healthy diet when research has shown that even the smallest changes in lifestyle may delay or perhaps prevent Alzheimer's.

“I think it's everywhere. People have a hard time with (change). They won't change until something makes them change. Some people wait until it's too late,” Barnes said.

But living a healthier lifestyle doesn't mean making drastic changes. It's about small adjustments that often see huge responses from your body, Barnes said.

One mistake Barnes said she sees too often when individuals try to eat healthier is they attempt to cut certain food groups from their diet.

“Don't attempt any diet that eliminates anything,” she said, adding that by doing so the diet will be easier to maintain. “It's about portion control.”

According to the state Department for Public Health, heart disease and cancer are the primary causes of death across the state. The two diseases have also been associated with poor diet, psychological stress and a lack of physical activity, indicating a widespread trend of unhealthy lifestyles.

Still, because research is beginning to offer more clues about risk factors associated with Alzheimer's disease, scientists and health professionals are stressing that individuals take control of the factors that can be influenced.

“Research has given us a lot of reason to hope,” Cox said. “We can't control our age or our family history. But we know that a heart-healthy diet is a brain-healthy diet.”

And while the jury is still out on what contributing factor the environment might have in developing the disease, Cox said the environment likely plays some kind of a role.

“That's part of the research. To date, there is nothing significant in regards to the environment,” she said.

There are an estimated 74,000 Kentuckians and approximately 4,000 Cumberland Valley residents suffering from Alzheimer's, Cox said. The state's estimate is expected to jump by 30 percent over the next 20 years, and no one area in the state appears to be more affected by the disease, she said.

The disease does, however, differ among states because some, including Florida, have more of an aging population, Cox said. Alzheimer's has also moved into younger populations, prompting more and more federal funding requests for continued research into possible treatments and, ultimately, a cure.

The Alzheimer's Association predicts that, by 2050, the number of individuals with the disease could range from 11.3 million to 16 million.

For those who are concerned about the risks associated with Alzheimer's, especially those who have a family history of the disease, Cox suggests considering what research has indicated.

“If you have a family history, look at the steps to take (to prevent the disease). You can't change your family history, but you can change your lifestyle,” she said.

According to the Alzheimer's Association, a brain-healthy diet is one that aims to reduce the risks of heart disease and diabetes, encourages good blood flow to the brain and is low in fat and cholesterol.

The association recommends that health-conscious eaters strive for foods rich in HDL, or “good,” cholesterol, which may help protect brain cells. Other foods that appear to protect brain cells include dark-skinned fruits and vegetables, which have the highest levels of naturally occurring antioxidants; cold water fish (salmon, trout and tuna), which contain the beneficial omega-3 fatty acids; and some nuts (pecans, almonds and walnuts), which are rich in vitamin E.

Daily vitamins and mental activities - such as reading, writing or working a crossword puzzle - are also encouraged.

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(November is National Alzheimer's Disease Awareness Month. This is part two of a three-part series on the mystery of Alzheimer's, how the disease is changing and what health professionals are predicting for the future)