Every 68 seconds, another American develops Alzheimer's disease, the fatal brain disease that steals memory and personality. It's the fifth-leading cause of death among people age 65 and older.

You can lower your likelihood of getting Alzheimer's disease by reducing controllable and well-known risk factors (see box below). Here Marwan Sabbagb, MD, shares new scientific research that reveals additional little-known "secret" risk factors that you can address…

Check Your Tap Water

A scientific paper published in Journal of Trace Elements in Medicine and Biology theorizes that inorganic copper found in nutritional supplements and in drinking water is an important factor in today's Alzheimer's epidemic.

Science has established that amyloid-beta plaques-inflammation-causing cellular debris found in the brains of people with Alzheimer's - contain high levels of copper Animal research shows that small amounts of inorganic copper in drinking water worsen Alzheimer's. Studies on people have linked the combination of copper and a high-fat diet to memory loss and mental decline. It may be that copper sparks amyloid-beta plaques to generate more oxidation and inflammation, further injuring brain cells.

What to do: There is plenty of copper in our diets-no one needs additional copper from a multivitamin/mineral supplement. Look for a supplement with no copper or a minimal amount (500 micrograms).

I also recommend filtering water. Water-filter pitchers, such as ones by Brita, can reduce the presence of copper. I installed a reverse-osmosis water filter in my home a few years ago when the evidence for the role of copper in Alzheimer's became compelling

Increase Vitamin D Intake

Mounting evidence shows that a low blood level of vitamin D may increase Alzheimer's risk.

A 2013 study in Journal of Alzheimer's Disease analyzed 10 studies exploring the link between vitamin D and Alzheimer's. Researchers found that low blood levels of vitamin D were linked to a 40% increased risk for Alzheimer's.

The researchers from UCLA, also writing in Journal of Alzheimer's Disease, theorize that vitamin D may protect the brain by reducing amyloid-beta and inflammation.

What to do: The best way to make sure that your blood level of vitamin D is protective is to ask your doctor to test it-and then, if needed, to help you correct your level to greater than 60 nanograms per milliliter (ng/mL.). That correction may require 1,000 IU to 2,000 IU of vitamin D daily...or another individualized supplementation strategy.

Important: When your level is tested, make sure that it is the 25-hydroxyvitamin D, or 25(OHD, test and not the 1.25-dihydroxyvitamin D test. The latter test does not accurately measure blood levels of vitamin D but is sometimes incorrectly ordered. Also, ask for your exact numerical results. Levels above 30 ng/mL are considered "normal," but in my view, the 60 ng/mL level is the minimum that is protective.

Reconsider HRT

Research shows that starting hormone-replacement therapy (HRT) within five years of entering menopause and using hormones for 10 or more years reduces the risk for Alzheimer's by 30%. But a recent 11-year study of 1,768 women, published in Neurology, shows that those who started a combination of estrogenprogestin therapy five years or more after the onset of menopause had a 93% higher risk for Alzheimer's.

What to do: If you are thinking about initiating hormone replacement therapy five years or more after the onset of menopause, talk to your doctor about the possible benefits and risks.

Fall-Proof Your Home (And Life!)

A study published in Neurology in 2012 showed that NFL football players had nearly four times higher risk for Alzheimer's than the general population-no doubt from repeated brain injuries incurred while playing football.

What most people don't realize: Your risk of developing Alzheimer's is doubled if you've ever had a serious concussion that resulted in loss of consciousness—this newer evidence shows that it is crucially important to prevent head injuries of any kind throughout your life.

What to do: Fall-proof your home, with commonsense measures such as adequate lighting, eliminating or securing throw rugs and keeping stairways clear. Wear shoes with firm soles and low heels, which also helps prevent falls.

If you've ever had a concussion, it's important to implement the full range of Alzheimer's-prevention strategies in this article.

Have A Purpose In Life

In a seven-year study published in Archives of General Psychiatry, researchers at the Rush Alzheimer's Disease Center in Chicago found that people who had a "purpose in life" were 2.4 times less likely to develop Alzheimer's.

What to do: The researchers found that the people who agreed with the following statements were less likely to develop Alzheimer's and mild cognitive impairment-"I feel good when I think of what I have done in the past and what I hope to do in the future" and "I have a sense of direction and purpose in life."

Help for Alzheimer's Patients and Their Families

Best Web sites include Alzheimer's Association (www.alz.org), which lists warning signs, disease stages, treatments, care options and financial planning advice. It has message boards for patients and caregivers. Alzheimer's Disease Education and Referral Center (www.nihseniorhealth.gov), from the National Institute on Aging, has information on the latest studies about the disease's causes and possible cures. PBS offers a 90-minute documentary on Alzheimer's patients and their families (www.pbs.org/theforgetting). This Caring Home (www.this caringhome.org), from Weill Cornell Medical College, gives room-by-room safety recommendations and solutions to problems.

If you cannot genuinely agree with the above statements, there are things you can do to change that-in fact, you even can change the way you feel about your past. It takes a bit of resolve...some action...and perhaps help from a qualified mental health counselor.

One way to start: Think about and make a list of some activities that would make your life more meaningful. Ask yourself, Am I doing these and then write down small, realistic goals that will involve you more in those activities, such as volunteering one hour every week at a local hospital or signing up for a class at your community college next semester.

Crucial Steps to Fight Alzheimer's

Lose weight if you're overweight.

Control high blood pressure.

Exercise regularly.

Engage in activities that challenge your mind.

Eat a diet rich in colorful fruits and vegetables and low in saturated fat, such as the Mediterranean diet.

Take a daily supplement containing 2,000 milligrams of omega-3 fatty acids.

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