Glen Campbell has it and is talking about it, my best friend’s father just died from it and my own grandfather has a variation of it. According to a Harvard School of Public Health survey 25% of us fear developing this disease more than any other. Alzheimer’s dementia – the progressive loss of mental and physical function that starts as an anxious worry, peaks as a plaintive whine, and years later ends in a quiet wimper.
Dementia, meaning “without mind” in Latin, is the loss of cognitive function and usually occurs in progressive stages associated with aging. It is a syndrome in which areas of memory, language, attention and problem solving are affected. It reduces the ability to learn new information, retain or recall past experience. There is also loss of ability to reason, patterns of thoughts, emotions, and ability to perform activities.
Alzheimer’s dementia was first described in 1906 by German psychiatrist and neuropathologist Alois Alzheimer. The exact cause of Alzheimer’s is uncertain but it is a disease of “plaques and tangles”. Intense research is pointing to the role of oxidation and inflammation as a causative factor. Thousands of studies seek a novel compound that will prevent or treat Alzheimer’s but as yet there is no cure.
In Alzheimer’s the intricate and delicate neuron pathways of the brain start to wither and die while sticky protein plaques call “beta-amyloid” begin to accumulate and further disturb the brain signals. Structural tubules call “tau proteins” within the neurons that normally help keep them aligned for nutrient transport become tangled and thrown into disarray. The result is an accumulation of plaques and tangles that turn the brain circuits into “muck”. Over time neurons die and the brain shrinks.
Alzheimer’s dementia is one type of dementia, estimated to represent about 60% of all cases of dementia. Other types of dementia include those related to poor circulation, aging, other diseases such as Parkinson’s, and some specific degenerative brain disorders. If the syndrome is reversible then it is known as delirium and is not a type of dementia. Delirium can be caused by head injuries, psychiatric conditions, and medical illnesses such as electrolyte disturbances, thyroid disorders or infections. Physicians should be careful to rule out treatable causes of delirium before making the diagnosis of dementia.
Is it Alzheimer’s Dementia?
Alzheimer’s progresses through fairly predictable stages and in the earliest phase it is hard to diagnose. The subtle mental changes are often noted only by close friends and family. What is the difference between early dementia and typical age-related changes? According to the Alzheimer’s Association there are 10 warning signs or stages of Alzheimer’s:
1) Memory loss that disrupts daily life, such as forgetting important dates, names of people one should know, or directions to a familiar place. A typical age related change is simply forgetting an appointment or name but remembering them later.
2) Challenges in planning or solving problems such as following a recipe or balancing a checkbook. Making a simple error in balancing the checkbook is normal.
3) Difficulty completing familiar tasks at home, at work or at leisure, such as driving to work or remembering rules to a favorite game. Needing help using the VCR is a typical age-related change.
4) Confusion with time or place, losing track of dates, seasons and the passage of time, or not realizing where they are or how they got there. Getting confused about the day of the week and figuring it out later is normal.
5) Trouble understanding visual images and spatial relationships, such as having difﬁculty reading, judging distance and determining color or contrast. They may not recognize their own reﬂection in a mirror. Typical age-related changes are vision changes related to cataracts.
6) New problems with words in speaking or writing, including trouble following or joining a conversation or stopping in the middle of a conversation and having no idea how to continue or they may repeat themselves. They may have trouble naming a familiar object. Occasionally having trouble finding just the right word is a normal variant.
7) Misplacing things and losing the ability to retrace steps. Putting things in unusual places and not being able to retrace their steps to find it. This may lead to accusations of stealing. Typical age-related changes include misplacing items such as glasses.
8) Decreased or poor judgment leading to changes in judgment or decision making. Using poor judgment with money or paying less attention to grooming. Having a favorite old worn out sweater that everyone else is tired of is normal.
9) Withdrawal from work or social activities and not participating in hobbies, social activities, work projects or sports. A typical age-related change is sometimes feeling weary of work, family and social obligations.
10) Changes in mood and personality can lead to confusion, suspicion, depression, fear or anxiety. Being easily upset especially when in unfamiliar locations is common. It is normal to develop very speciﬁc ways of doing things and becoming irritable when a routine is disrupted.
Alzheimer’s Prevention and Treatment
There is currently no cure for Alzheimer’s. There are two main types of drugs that are FDA approved for treatment of symptoms of Alzheimer’s in the moderate to severe stages yet they are only modestly effective in slowly the progression for 6-12 months. Intense research is trying to unlock a cure by disrupting the process of plaque and tangle formation. Inflammation is a key player but as yet it is not clear if it causes the disease or comes along as a byproduct.
There are proven ways to keep the brain healthy and stave off dementia. These include regular aerobic exercise, strength training, learning new skills, controlling stress and having an active social life. Eat a healthy anti-inflammatory diet such as the Mediterranean diet. Include herbs and spices that control oxidation such as curcumin, ginger, and many others. Check for vitamin deficiencies, especially B12. And getting control of other diseases such as diabetes or high blood pressure can delay dementia.
Functional Medicine Treatments
There are many natural supplements that have promise in prevention and treatment of Alzheimer’s. These are targeted to control oxidation and inflammation, support healthy nerve tissue and encourage cellular energy production. Examples include SAMe, alpha-lipoic acid, vitamins C and E, resveratrol, phosphatidylserine, CoEnzyme Q, activated B vitamins and more.
We are seeing some tremendous results in our clinic using high doses of glutathione, the body’s master anti-oxidant, given intravenously. Patients and family members report improved memory, mood and energy. This is an exciting area of promising research as well as rewarding clinical practice. Next week I’ll review glutathione in more detail. Maybe we’ll soon take Alzheimer’s off the most feared list but for now the struggle continues.
Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement for men and women, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call (970) 245-6911 for an appointment or more information.