She's best known for her role as Wonder Woman on the hit 1970s TV show, but Lynda Carter's accomplishments go well beyond that iconic persona. She has raised two children and been an activist on issues such as breast cancer and LGBTQ rights. She's also written songs and made many other television appearances, including hosting Street Life, the 1982 Emmy-nominated TV special that featured castanets and flamenco dance in a nod to Carter's Hispanic heritage. Music is Carter's first love, and she has performed at Lincoln Center in New York, the Kennedy Center in Washington, DC, and the Eisemann Center for Performing Arts in Dallas.

But for more than 16 years—ever since her late mother, Juanita Cordova Carter, was diagnosed with Alzheimer's disease in 2003 at age 79—Carter has played her most important role: advocating for more awareness and research funding for the disease. She recently began lending her name and support to Maria Shriver's Women's Alzheimer's Movement. She also serves on an executive committee for the Alzheimer's Drug Discovery Foundation, a nonprofit organization founded in 1998 by the Lauder family to support Alzheimer's disease research worldwide.

At the time of her diagnosis, Carter's mother, who was known as Jean and whose family came from Mexico, was living alone in the Phoenix area, where Carter and her two siblings were raised. Carter, who lives outside Washington, DC, would fly to Arizona to see Jean every couple of months. Over time, she began to notice changes in her mother's behavior and signs of cognitive decline. "She would get angry if she had to drive at night," Carter recalls. Her mother, who had been independent and social and drove everywhere, was suddenly reluctant to drive. When Carter came to town and stayed at her brother's house, it would upset Jean if Carter asked her to come over in the afternoon. "She'd want to leave before dark because she couldn't remember the street numbers and would get lost," Carter says.

Jean's health became a problem her children couldn't ignore when she fell in her home. Carter's brother found her and took her to the doctor, who discovered that her toenails had grown so long they interfered with walking. The doctor told the family it wasn't safe for Jean to live on her own anymore, so she moved to a facility that included a secure indoor space, a backyard with a walking path, and plenty of medical oversight.

Given Jean's history—her two siblings and her mother had developed dementia in their mid-seventies—the diagnosis wasn't that surprising, says Carter. And it wasn't as distressing as it could have been once Jean moved to the senior facility. "My mom became a much happier person," Carter says. "She had people taking care of her all the time, she wasn't alone anymore, and the doctor put her on antidepressants." She also took two different medications to try to slow the progression of Alzheimer's, but the antidepressant made the biggest difference, Carter says. "It really improved her quality of life."

Throughout her mother's illness, Carter did what she could to preserve her mother's dignity. "I never played the don't-you-remember game with her," she says. Carter would call or visit her and joke, "Hi, Mom, it's Lynda—your favorite child!" Or, if her mother struggled to remember something, she'd say, "That's all right, Mom. You don't have to remember that; I can remember it for you."

Jean always recognized her daughter, "but if I walked out of the room and came back, she'd say, 'When did you get here?' She'd remember that it was me but not that I'd already been there," Carter says. She also never forgot Carter's father, who remarried twice after they divorced when Carter was a child. When he came to see her at one point, Jean, who never remarried, told him he was the only person she ever loved. "She remembered enough to know it was him and how much she loved him," Carter says. "She told him how handsome she thought he was. She didn't seem to hold any bitterness. It's a beautiful story, instead of the usual doom and gloom associated with Alzheimer's." Jean died at age 89 in 2013. (Carter's father is now 97.)

In the course of researching Alzheimer's disease, Carter learned about the Translational Genomics Research Institute (TGen), a nonprofit organization in Phoenix founded by her childhood friend Jeffrey Trent, PhD, who had been scientific director of the National Human Genome Research Institute at the National Institutes of Health in Bethesda, MD.

Among other projects, researchers at the institute conducted a study in collaboration with the Arizona Alzheimer's Consortium, the University of Miami, the Norwegian University of Science and Technology, and the Alzheimer's Prevention Initiative to determine if a family history of dementia affects cognition over time. They tested 59,571 participants between the ages of 18 and 85 using MindCrowd, a web-based program they developed. Their results, which were published in the open-access science journal eLife in June 2019, showed that family history of dementia was associated with lower scores on the memory test among people younger than 65. The researchers also identified factors that mitigated or exacerbated this effect, such as age, sex, education, and diabetes.

During the recruitment phase of the study, Carter and other celebrities, including Ashton Kutcher and Valerie Bertinelli, were instrumental in raising awareness and encouraging participation. "In spreading the word about our study, Lynda has helped move the research forward," Dr. Trent says.

Carter herself participated in the project and was tested to see if she carried the APOE4 gene, a possible marker for Alzheimer's. Although her test came back negative, she knows from her experience with TGen that genes aren't the whole picture.

Certain factors can help reduce the risk for Alzheimer's disease, experts say. "Treating high blood pressure, high cholesterol, and diabetes can lower your risk of dementia," says Thomas Bird, MD, FAAN, professor emeritus of neurology and medical genetics at the University of Washington and a consultant at the Geriatric Research Education Center at the Seattle VA Medical Center. "And you need to follow a healthy diet like the Mediterranean diet, get regular physical exercise, and stay socially and mentally active."

That's exactly what Carter, now 68, is doing. She eats mostly fresh, unprocessed foods and walks, swims, plays tennis, hikes, and skis, and recently took up rowing. When she exercises indoors, she rides her stationary bike, walks on a treadmill on an incline, and does high-intensity cardio workouts (with step-ups, lunges, and jump squats). She also works with a trainer two to three times a week to build strength, flexibility, and balance.

Carter also reads, does lots of puzzles (including jigsaws), stays socially active, and writes and learns new songs. She has created a butterfly garden in her backyard and can detail how to make one with the optimal plants and seeds for supporting the life cycle of monarch butterflies.

These habits reflect Carter's commitment to protecting her brain health and honoring her mother's memory. "My mother was a force to be reckoned with," she says. "She was beautiful, fiery, musical, full of life, and very smart." The same might be said of Carter.

Hispanics and Alzheimer's

People of Hispanic descent, like Lynda Carter and her mother, Juanita Cordova Carter, appear to be more vulnerable to Alzheimer's disease than some other races and ethnicities. According to a study of Medicare beneficiaries in the January 2019 issue of Alzheimer's & Dementia, the rate of Alzheimer's among the Hispanic population was 12.9 percent versus 10.3 percent for whites and 10.1 percent for Asians. (African Americans had the highest rate at 14.7 percent.)

Occurrence of Alzheimer's in Hispanics varies by region, according to a 2017 study in Alzheimer's & Dementia. Those in the Caribbean, for instance, have higher rates of dementia than Mexican Americans.

Caribbean Hispanics may have considerably higher rates because they have more cerebrovascular disease, says Jennifer J. Manly, PhD, professor of neurology at Columbia University. In a study of autopsies of people with dementia, published in the Journal of Alzheimer's Disease in 2019, researchers found that mixed dementia diagnoses and cerebrovascular disease are more common in Hispanics than in whites.

Certain factors—including lower socioeconomic status and education levels and higher prevalence of conditions such as cardiovascular disease, diabetes, high blood pressure, obesity, and depression—put Hispanics at increased risk for dementia, according to the Hispanic Community Health Study/Study of Latinos, which is sponsored by the National Institute on Aging (NIA).

"Hispanics may have a more metabolically driven pathology due to the increased incidence of diabetes and psychological issues like depression," explains neuropsychologist Sid O'Bryant, PhD, executive director of the Institute for Translational Research at the University of North Texas Health Science Center in Fort Worth. "These coexisting conditions are strongly related to the start and progression of Alzheimer's."

Hector M. Gonzalez, PhD, associate professor of neurosciences at the Shiley-Marcos Alzheimer's Disease Research Center at the University of California San Diego, adds: "The impact of diabetes on cognitive impairment appears to be much higher in Hispanics than in other populations. This is because diabetes, heart disease, and stroke are common and often undiagnosed and untreated in some Hispanic groups."

In addition, this population may experience more stress due to social and financial inequalities, which is probably bad for the brain, says Dr. Manly. Latinos also have a longer life expectancy than other racial and ethnic groups, and age is a major risk factor for Alzheimer's disease, notes Dr. Gonzalez.

In a study published in Alzheimer's & Dementia in 2019, researchers examined more than 1,600 brain tissue samples from autopsies to compare the progression of dementia among different ethnic groups. They found that Hispanic Americans lived an average of 12 years after developing symptoms, compared with nine years for whites and eight for African Americans.

Two theories might explain this discrepancy, says study co-author Melissa Murray, PhD, assistant professor of neuroscience at Mayo Clinic in Jacksonville, FL: One is that the brains of Hispanic Americans may be more resilient; the other is that the strong and consistent social support among Hispanic families may be neuroprotective, she says.

Despite the higher Alzheimer's rate, Hispanics continue to be underrepresented in clinical trials, an imbalance the NIA is trying to change. The Alzheimer's Disease Research Centers program has 30 centers around the country, and "some of them have a Latino focus," says Nina Silverberg, PhD, director of the centers. "We aim to get feedback on what's needed for this population."

In an ongoing NIA project called the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA), the researchers, including Dr. Gonzalez, have reported that mild cognitive impairment, a common precursor of Alzheimer's disease, was strongly related to cardiovascular disease risk factors in more than 6,000 middle-aged and older Latinos of diverse heritages.

In one of the largest studies on cognitive decline among Hispanics in the United States, published in Alzheimer's & Dementia in 2019, researchers found an association between getting more than nine hours of sleep per night and cognitive decline over seven years. It could be because too much sleep is associated with cerebrovascular disease, a known contributor to neurocognitive impairment. Alternatively, longer sleep may be a sign of poor sleep quality or disrupted circadian rhythms, either of which may contribute to neurocognitive decline and impairment.

Dr. O'Bryant and colleagues have developed a blood test to try to measure altered biological mechanisms of Alzheimer's that may be expressed differently among Mexican Americans than among other Hispanic groups. "By looking at different potential causes related to memory loss, we may be able to target the right pathway at the right time with the right intervention," Dr. O'Bryant explains. For example, he says, having the APOE4 genetic marker for Alzheimer's disease varies by national background for Hispanics, and it doesn't seem to be associated with a greater risk for dementia.

Dr. Gonzalez hopes the SOL-INCA findings will translate into more effective ways to reduce heart disease and stroke risk, with the aim of reducing cognitive impairment and Alzheimer's disease among all ethnic groups.

Smart Ways to Guard Against Dementia

Treat your heart right. The same habits that are good for your heart are also good for your brain, says David S. Knopman, MD, FAAN, professor of neurology at Mayo Clinic in Rochester, MN, and a specialist in studying and treating dementia. That means exercising regularly and eating a balanced diet, he says. Although exercise and a healthy diet won't prevent your brain from growing the neurofibrillary plaques and tangles characteristic of Alzheimer's disease, if you do get them, your brain will tolerate them better and you'll develop symptoms later, Dr. Knopman says. The effects are also cumulative, so a lifetime of exercise and healthy eating is key, he adds.

Learn another language. "If you're bilingual, keep using both languages," urges neuropsychologist Sid O'Bryant, PhD, executive director of the Institute for Translational Research at the University of North Texas Health Science Center in Fort Worth. Among people with dementia, those who are bilingual develop symptoms four and a half years later than those who speak only one language, according to a 2017 meta-analysis of studies about bilingualism in the Journal of Alzheimer's Disease. Moreover, middle-aged and older adults who are bilingual performed better on cognitive tests, particularly those involving visual-spatial functions, and had fewer Alzheimer's disease biomarkers in their cerebrospinal fluid than those who spoke just one language, according to a 2017 study in Neurobiology of Aging.

Engage your mind. Intellectual stimulation is another brain-healthy habit that is cumulative, says Dr. Knopman, who recommends mental activities that are also socially engaging. "Participate in a musical, join a book group or a bible study class, volunteer, or do homework with your kids or grandkids," he says.

Stay socially active. "You don't need to have a big social network, but if you maintain social support and you're happy with the social support you're getting, you're likely to fare better cognitively," says neuropsychologist Jennifer J. Manly, PhD, professor of neurology at Columbia University in New York.

Manage chronic health conditions. If you have diabetes, high blood pressure, or high cholesterol, have them consistently monitored and controlled, Dr. O'Bryant advises. Dr. Knopman adds sleep apnea to that list. Talk to your doctor about whether you need to be tested for sleep apnea. If you have it, treat and control it, he says. The same goes for depression, says Dr. O'Bryant. "Depression is not a weakness; it's something that needs to be dealt with."