Monday, May 9, 2011

Alzheimer’s Disease -- It's Preventable

This post comes from our friend and AK colleague Phil Maffetone.

"Alzheimer’s is defined as a progressive deterioration within the brain that can occur in middle or old age. The name itself refers to the German psychiatrist and pathologist Dr. Aloysius Alzheimer, who in 1901, observed that one of his patients at the Frankfurt Asylum, and only 51 years old, exhibited unusual behavioral symptoms, including short-term memory loss. After his patient’s death, Alzheimer, along with other research specialists, dissected his brain and discovered amyloid plaques and neurofibrillary tangles. In a healthy brain, neurons connect and communicate with one another at locations called synapses. But these invasive plaques and tangles interfere with this process, causing permanent damage to the brain's communication network. In other words, healthy brain cells die off. By 1911, Alzheimer’s description of the disease was being used by European physicians to diagnose patients.

Alzheimer’s disease is the most common type of dementia, which is not merely a problem of memory loss but also refers to the inability to learn, reason, or have certain feelings. Other types of dementia include mild cognitive impairment, Parkinson’s disease, Creutzfeldt-Jakob disease, and dementia pugilistica, which is caused by repetitive head trauma and is often seen in boxers and professional football players.

The changes that occur in someone with Alzheimer’s adversely affect the parts of the brain that control thinking, decision-making, moods, and memory. Once the classic behavioral symptoms develop, there’s really no cure for the victim.

While Alzheimer’s disease is consider the sixth leading cause of death in the U.S., it’s not fatal, but rather, the problem is often associated with other unhealthy conditions that can directly be a cause of death, especially pneumonia and other infectious diseases, dehydration and malnutrition. This makes it difficult to determine whether or not Alzheimer’s actually plays a direct role in the death. But the disease definitely affects quality of life.

Because Alzheimer's is a progressive condition, the dementia gradually worsens over the years. Those with Alzheimer's live an average of eight years after their symptoms become noticeable to oneself and others. Late-stage sufferers often require around-the-clock care and attention. They are as unprotected and defenseless as infants, placing a terrible strain on family members and finances. But given its aging baby-boomer population, America is seeing a steady increase in those suffering from Alzheimer’s. The disease currently affects five million Americans. The number is much higher for those with early onset or barely recognizable signs.

As Alzheimer’s progresses, the brain produces less acetylcholine, an important neurotransmitter important for many brain functions including memory. Acetylcholine is made in the body from the nutrient choline, found in the diet (it’s especially high egg yolks and in dietary supplement form). Phosphorus is another important neuro-nutrient (the Alzheimer’s brain contains much less phosphatides, whose main component is phosphorus). This compound is important for the healthy function of synapses. Uridine monophosphate is one form found in foods that, in animal studies, has shown improvement in cognitive function. Broccoli, tomatoes and organ meats are high sources in the diet. For many years, omega-3 fats have been shown to improve brain function, including learning and memory, and have a neuroprotective effect.

Alzheimer's disease is usually accompanied by oxidative stress as one of the primary mechanisms contributing to neurodegeneration and cognitive decline. Dietary antioxidants and phytonutrients are our main control of oxidative stress and chronic inflammation, and they play a role in prevention of Alzheimer’s and offer possibly early treatment.

Unfortunately, research on nutrition and the brain is quite limited compared to funding for studies on gene and drug therapy. It’s an issue of money—and corporate profits. There is no real financial return for companies and institutions to invest in researching various nutrients in a healthy diet, such as choline, omega-3 fats and antioxidant vitamins, minerals and phytonutrients, that can help successfully prevent or treat Alzheimer’s disease. Whereas investing millions to develop pharmaceuticals, which sometimes perform a very similar task, could bring billions in profits. Of course, the cost of these drugs to consumers will be high, adding to the existing healthcare burden, as will the potential of side effects. As big-pharma matters now stand, current FDA-approved Alzheimer drugs have been shown to slow down the process of deterioration but only up to 12 months.

According to the Mayo Clinic, scientists believe that for most people, Alzheimer's disease results from a combination of genetic, lifestyle and environmental factors that affect the brain. Less than five percent of the time, Alzheimer's is caused by specific genetic changes that will most likely guarantee a person will develop the disease.

Like virtually all other chronic illnesses, the condition starts long before the appearance of obvious symptoms. This “delay” provides the window of opportunity for prevention, when changes in lifestyles can influence the brain’s physical and functional state. Unfortunately, most people wait for long after the arrival of symptoms before seeking help or asking, “Why am I always forgetting things?”

The early abnormal changes that take place in the brain, which includes damage to certain neurons in particular areas, can sometimes be detected with positron emission tomography (PET) scans and cerebrospinal fluid analysis. These initial abnormalities are now considered the preclinical stage of Alzheimer’s. This first stage is only a category used for research purposes, as medicine has no preventative treatment. For patients who begin developing symptoms of memory loss, difficulty with new learning and finding words, this is the second stage of the disease, called mild cognitive impairment. Technically, it’s not until the third stage, when symptoms worsen, that the term Alzheimer’s disease is most often used.

However, categorizing Alzheimer’s into distinct stages is quite irrelevant for the patient and those family members and friends affected by his or her condition. Moreover, changes in the brain observed in the first stage don’t just appear overnight. There is a period before this occurs when the brain knows that it is being harmed—so there really are four stages—the earliest being the most important and relevant since this is when individuals can protect their brains by being healthy and fit. This marks the time of true prevention.

Alzheimer’s can strike even those in their 40s and 50s, though the problem is more common in older individuals. The disease usually begins after age 60 and risk goes up with age. About five percent of men and women between ages 65 and 74 have Alzheimer's disease. This rate increases in the following years.

As mentioned earlier, genetics is not the sole cause of Alzheimer’s disease. This condition appears clustered among family members or generations because individuals tend to adopt similar unhealthy lifestyles as their parents, siblings, and relatives, such as poor eating habits, obesity, and inactivity.

There are a variety of risk factors—more obvious indications of poor health—associated with Alzheimer’s disease, and most of these are preventable too. For example, it’s well known that diabetes and hypertension are major risks. Likewise, cardiovascular disease, heart attack and stroke, are associated with the onset of Alzheimer’s disease. But if you step back and look at the big picture, it’s clear that carbohydrate intolerance and chronic inflammation may both be a primary cause of the factors contributing to Alzheimer’s disease.

Carbohydrate intolerance can also directly increase the risk of Alzheimer’s disease. This occurs from the effects of chronically high levels of insulin in the blood that continually enter the brain. In addition, harmful chemicals called “advanced glycosylation end products” (AGEs) that result from carbohydrate intolerance accumulate in the brain and are also associated with the onset of Alzheimer’s disease.

Chronic inflammation can negatively affect the brain, further increasing the chance of Alzheimer’s. The neuroinflammatory process—inflammation in the brain—is related to various brain disorders, including stroke, a risk factor for dementia, and traumatic brain injury.

Increased physical activity is associated with a reduced probability of Alzheimer’s disease. The best workouts may be easy aerobic activities, such as walking or other lower heart rate training. These activities directly and indirectly help the brain through improvements in circulation, immune function, and blood-sugar control, and reduction in inflammation.

More than memory loss

Memory loss is not necessarily the only symptom of Alzheimer's disease. According to the National Institute on Aging, someone with Alzheimer's disease may experience one or more of the following signs:

Has difficulty with new learning and making new memories.
• Has trouble finding words—may substitute or make up words that sound like or mean something like the forgotten word.
• Loses spark or zest for life—does not start new projects.
• Loses recent memory without a change in appearance or casual conversation.
• Loses judgment about money.
• Has shorter attention span and less motivation to stay with an activity.
• Easily loses way going to familiar places.
• Resists change or new things.
• Has trouble organizing and thinking logically.
• Asks repetitive questions.
• Withdraws, loses interest, sudden mood changes, and uncharacteristically angry when frustrated or tired.
• Takes longer to do routine chores and becomes upset if rushed or if something unexpected happens.

Patients in the early stages of dementia, and especially family members and close friends seeking to help the patient find answers and treatment, often become frustrated and disillusioned because even the most respected specialists in this field have few answers and no overall cure. Like other modern diseases, the most potent remedy is prevention, and the time to start is the present. It only takes one short, easy walk, or one healthy meal to start improving brain function."

Thank you Dr. Phil Maffetone!