Alzheimer’s Disease (AD) Defined
As defined by the Alzheimer’s Society of Canada Alzheimer’s disease is the most common form of dementia. This progressive degenerative disease negatively impacts memory, reasoning, mood and behavior. This disease destroys brain cells and is ultimately fatal (1). Although this definition is bleak as
you will come to appreciate contrary to what this definition states it’s the authors belief that much can be done to prevent, slow and hopefully even stop the progression of this disease.
The signs of dementia are numerous and they include: short-term memory impairment (principal symptom of AD); impaired learning, anosmia (impairment of the sense of smell) and in the latter stages of this disease inappropriate aggressiveness (2).
The Alzheimer’s Society of Canada estimates that “500,000 Canadians have Alzheimer's disease or a related dementia. Over 70,000 of them are under 65 and approximately 50,000 are under the age of 60" (3). Three-quarters of Canadians with Alzheimer’s are women. It’s been estimated that Alzheimer’s disease will more than double within a generation here in Canada (4). In the US the numbers are even more dramatic. A study published this year in the prestigious journal Neurology estimates that AD will increase from its current 4.7 million to 13.8 million by 2050, that’s a staggering threefold increase (5). The World Health Organization estimates that a new case of dementia occurs once every four seconds in the world. As of 2010 there were 36 million people with dementia (once again AD is the most common form of dementia) (6). This number will double by 2030 and triple by 2050 (7). With such unimaginable numbers it’s absolutely critical we do everything we can to curtail the growth of AD.
Etiology (Causes) of Alzheimer’s
No clear cause of Alzheimer’s has been established however several mechanisms have been theorized: beta-amyloid plaque deposits in the brain; tau protein abnormalities; free-radical damage; inflammation; advanced glycation end products (AGEs); low levels of acetylcholine; aluminum toxicity; elevated homocysteine levels; poor nutrition; myelin breakdown in the brain; herpes simplex virus type 1 infection. Clearly with so many theories behind the cause of Alzheimer’s it’s likely that several play a role. For an elaboration on these causes visit www.keepwell.ca and look for the presentation on Alzheimer’s disease.
Predicting Alzheimer’s Disease
Although there are no absolute tests that have been proven to be completely predictive of AD one in particular is intriguing. This test involves fingerprint analysis. There are three types of fingerprint patterns that have been identified. They are loops, arches and whorls. Alzheimer's patients have significantly more loops on their fingertips and a reduced frequency of whorls and arches (to view what these patterns look like visit http://www.4yourtype.com/fingerprint.asp) (8). A study published in the Archives of Neurology showed that individuals with Alzheimer’s had a 72% greater likelihood of having 8 or more loops in both hands whereas this pattern was only found in 26% of controls (9).
Supplements That Offer Some Promise
Numerous supplements hold some exciting promise for those with AD or at risk of developing this disease. Elevating glutathione is believed to reduce the oxidative stress associated with AD. To bolster glutathione levels vitamin C, whey protein and NAC can be used. A combination of peptides (colostrinin) found in Colostrum may slow the progression of Alzheimer's disease by reducing beta amyloid levels (10). In fact a number of supplements have the potential to lower beta amyloid plaque levels and in some cases even help break them up. They include: green tea standardized to contain EGCG (reduced build-up of beta-amyloid by as much as 54 percent compared to controls)(11); resveratrol; EPA/DHA; curcumin. Interestingly India has one of the lowest rates of AD in the world and it has been speculated this may have to do with their consumption of curry which contains turmeric and its active constituent curcumin. Huperzine A is a substance isolated from Chinese club moss that has shown potential benefit (12,13). Levels of neurotransmitter GABA fall at the onset of Alzheimer's disease making supplemental GABA potentially beneficial (14). Caffeine was shown in a study to reverse memory loss and beta-amyloid levels in mice bred to develop Alzheimer’s disease (15). Vinpocetine is a man made chemical that resembles a substance found in the periwinkle plant. It’s been shown to improve brain function in AD patients (16).
A study published in the Journal of the American Medical Association suggested that Alzheimer’s risk was reduced by 35% with vitamin C, 42% with vitamin E, 46% with flavonoids and 51% with beta- carotene (17). Several studies have now demonstrated melatonin may also offer benefits (18,19,20). In fact psychologists from University of Kingston Psychiatric Hospital said back in 1996 that it was "the first effective treatment for Alzheimer's disease" (21). Broccoli, potatoes, oranges, apples and radishes all contain substances that act in the same way as drugs used to treat Alzheimer's. Compounds in these fruits & veggies inhibit acetylcholinesterase (enzyme responsible for breakdown of the neurotransmitter acetylcholine). Broccoli was found to have the most potent activity and glucosinolates (compounds found in cabbage family), were likely responsible (22).
Essential Oils and AD
There has been some promising research looking at essential oil inhalation and topical application and its benefits on those with AD. Cedarwood, geranium, lavender, mandarin, ylang ylang, patchouli, rosemary, peppermint, lavender, lemon balm, marjoram and vetiver have all shown some promise. They
can increase mental clarity, improve awareness, increase alertness, enhance contentment, improve sleep and reduce agitation, withdrawal and wandering (23,24,25).
Dietary Strategies for AD
Numerous dietary strategies hold some real potential in preventing AD. A low calorie diet (33% less calories than would be called for based on your height and age) were shown to enhance memory, reduces inflammation, improves mitochondrial function, generates ketones and improve insulin sensitivity (the last two will be covered later on in this article) (26). A Mediterranean diet rich in fruits, vegetables, olive oil, legumes, whole grains and fish may offer some protection as well (27). Alzheimer’s patient's brains have difficulty metabolizing glucose which your brain cells need for energy.
Ketones can be an alternative source of energy for brain cells. MCT’s (found in abundance in coconut oil) are converted in the liver into ketones and are an excellent source of fuel for those brain cells that can no longer metabolize glucose efficiently. Dr Newport, MD suggests using “4-6 tablespoons a day, depending on the size of the person, spread over 2-4 meals. Mixing MCT oil and coconut oil could provide higher levels and a steady level of ketones. One formula is to mix 16 ounces MCT oil plus 12 ounces coconut oil in a quart jar and increase slowly as tolerated, starting with 1 teaspoon.”She tried this formula on her husband who had AD and was amazed by the results she achieved. For more info on Dr Newport’s protocol visit http://www.coconutketones.com/dietguidelines.doc.
Factors that May Increase AD Risk
Obese individuals are at a higher risk for developing Alzheimer's (28). Hand in hand with obesity is overeating which also been shown to increase AD risk (29). Chemicals in our environment like aluminum and mercury have long been implicated in AD risk but no studies to date have been able to verify this connection.
Is Alzheimer’s Type III Diabetes?
Researchers from Brown Medical School were the first to coin AD as type 3 diabetes. Strong evidence suggests AD is a metabolic disease. Researchers have found that people with type 2 diabetes have a greater risk of developing AD, when compared to healthy individuals (30). Insulin produced in the brain of those with AD is lower than those that don’t have this condition (31). This evidence points to yet another reason why we should limit our sugar intake and follow a diet that has lower glycemic foods.
AD and Infection
Another intriguing piece of the puzzle is linking infections in the brain to AD risk. It was discovered that the “..herpes virus causes accumulation of two key AD proteins - β-amyloid (Aβ) and abnormally phosphorylated tau … both proteins are thought by many scientists to be involved in the development of the disease" (32). Aside from the herpes virus both Chlamydia and Candida have also been found in the brain and implicated in AD (33). An interesting twist to AD and beta amyloid connection has been recently proposed. Researchers from Massachusetts General Hospital have evidence suggesting that beta amyloid may be trying to protect the brain from these invading organisms (34). In essence beta amyloid may be acting as an “antibiotic” of sorts trying to keep these organisms in check.
Activities that May Offer Benefits to Those With AD
Studies have shown that patients with AD that spend time in green spaces and healing gardens in a health-care setting have experienced “measurable improvements in their well-being" (35). Participating regularly in social and leisure activities (traveling, knitting, gardening, etc.) was found to lower the risk of dementia (36). Regular exercise has been shown consistently to improve cognitive function, decrease cognitive decline and reduce the risk of AD or dementia (37,38,39).
Alzheimer’s Doesn’t Have to Be a Death Sentence
Collectively all of these strategies hold some exciting promise for those with AD and for those looking to reduce their risk of developing this disease. The Alzheimer’s Association has on its website the following grim quote: “At this time, there is no treatment to cure, delay or stop the progression of Alzheimer's disease. FDA-approved drugs temporarily slow worsening of symptoms for about 6 to 12 months, on average, for about half of the individuals who take them” (40). With such little in the way of hope being offered to those with AD why not try a holistic approach and use foods, lifestyle modification and supplements, that have shown to offer some promise? Holistic practitioners that have employed these strategies would tell you a very different story. One of hope and success were they’ve been able to dramatically slow and even reverse some cases of AD.