ALZHEIMER’S DISEASE
Alzheimer’s disease is a chronic, degenerative disease of the brain that impairs thinking, memory, and cognitive function. It is the most common form of dementia. It is estimated that 280,600 Canadians over 65 and 50 percent of people over age 85 have Alzheimer’s disease. These numbers are expected to rise substantially over the next few decades due to our aging population.
Alzheimer’s is not a normal part of aging, but it is more common in people as they age. The actual cause is not known, but its effect on brain tissue is clear. The disease causes damage and death to brain cells.
In a healthy brain, there are billions of neurons (nerve cells) that generate electrical and chemical signals, which help us think, remember, and feel. In those with Alzheimer’s the neurons begin to die, affecting the normal signalling in the brain. A key feature of this disease is the development of plaques and tangles in the brain. The plaques consist of normally harmless proteins called beta-amyloid. It is thought that a genetic defect in these proteins may be involved in the development of the disease. Tangles refer to a twisting of internal support structures of the brain, which causes damage and death of the neurons.
Research has shown that Alzheimer’s disease involves oxidative and inflammatory processes, although it is not known whether these processes are a cause or effect of the disease or both. The ultimate result, however, is disruption of neuronal cell functioning and signalling, leading to neuronal cell death, which impairs memory and other mental abilities. There also are lower levels of some neurotransmitters, chemicals in the brain that carry messages back and forth between nerve cells. This also results in impaired thinking and memory.
Although there’s no cure for Alzheimer’s disease, a number of medical advances in recent years and the use of natural supplements can delay the progression of the disease and improve symptoms and quality of life.
Alzheimer’s was first identified by Dr. Alois Alzheimer in 1906. He described the two hallmark features of the disease—plaques (tiny dense deposits scattered throughout the brain) and tangles (structures of the brain that are twisted)—which interfere with normal brain processes and cause death of brain cells.
SIGNS & SYMPTOMS
Confusion and disorientation
Depression
Difficulty performing familiar tasks (cooking, tying your shoes)
Difficulty with abstract thinking (for example, dealing with numbers)
Gradual memory loss
Increasing forgetfulness
Loss of judgment (difficulty solving everyday problems)
Paranoia
Personality changes (mood swings)
Symptoms and the progression of the disease vary among individuals. As the disease progresses, there is a decline in language skills and the ability to perform tasks. The average length of time from diagnosis of Alzheimer’s to death is about eight years, but some people live beyond 10 years.
RISK FACTORS
Age: It is most common in those over 65, but can rarely affect those younger than age 40.
Environmental toxicity: Pollution and smoking generate excess free radicals. Some research has connected aluminum and mercury exposure to the disease.
Family history: Having a parent or sibling with the disease increases your risk as there are genetic mutations that may be inherited.
Gender: Women are at greater risk.
Head injury: Some studies show that trauma to the head increases risk of Alzheimer’s.
Hormone replacement therapy: Results from one large-scale study suggested that women taking estrogen after age 65 are at increased risk of Alzheimer’s (JAMA, 2004: 291; 1701-1712).
Lifestyle: Inactivity, obesity, poor diet, and smoking increase risk.
Poorly controlled diabetes increases risk.
DOCTOR’S ORDERS
There are a variety of drugs that can help reduce symptoms of insomnia, anxiety, and agitation.
There are no drugs that can reverse the disease, but there are a few that can help improve cognitive function and slow the cognitive decline associated with Alzheimer’s, such as Aricept, Reminyl, and Exelon. These drugs improve the levels of neurotransmitters (chemical messengers such as serotonin and acetylcholine) in the brain and can delay the onset of Alzheimer’s in those with mild cognitive impairment. Not everyone responds positively to these drugs; some people have to stop because of side effects such as nausea, vomiting, and diarrhea.
Dietary Recommendations
Foods to include:
• Fish (wild, organic salmon, halibut, sole, and cod) provide good sources of omega-3 fatty acids, a polyunsaturated fat that has been found to reduce Alzheimer’s risk by reducing inflammation and protecting the nerve cell membranes.
• Olive oil is a monounsaturated fat that is also helpful.
• Vitamin E-rich foods such as whole grains, vegetable oils, nuts, seeds, and egg yolks are good. Two studies have found a lower risk of Alzheimer’s disease with a higher food intake of vitamin E.
• Zinc may be deficient in those with Alzheimer’s. Boost your intake by eating pumpkin seeds, black-eyed peas, wheat germ, tofu, and seafood.
FISH AND YOUR BRAIN
Two prominent clinical studies have demonstrated that eating one fish meal a week was associated with a 60 percent reduction in the risk of developing Alzheimer’s disease (JAMA, 2002: 288; 2266-2268 and Archives of Neurology, 2003: 60; 940-946).
Foods to avoid:
• Aluminum has been associated with an increased risk, although the evidence is not conclusive. However, it may be wise to avoid aluminum food additives, which are found in some baked goods, processed foods, and beverages.
• Saturated and trans fats raise blood cholesterol levels, and are associated with an increased risk of Alzheimer’s. Avoid fast foods, deep-fried foods, and baked goods and margarine containing hydrogenated oils; minimize saturated fat (red meat and high-fat dairy).
Lifestyle Suggestions
• Maintain a healthy body weight. Being obese and its consequences of high blood pressure and cholesterol are risk factors for Alzheimer’s.
• Exercising regularly helps with weight management, and also increases blood flow to the brain. According to one study, regular exercises (walking 15 minutes three times per week) reduced the risk of Alzheimer’s and dementia by 40 percent in individuals over age 65.
• Mental exercises: Some studies have shown that keeping your brain active, especially in later years, reduces the risk of Alzheimer’s. The theory is the more you use your brain, the more synapses you create, which provide a greater reserve as you age. Read, do cross word puzzles, and play memory games.
• Minimize aluminum exposure—do not cook foods in aluminum pots, and minimize foods that come into direct contact with aluminum foil and beverages stored in aluminum cans.
• Eliminate risky situations at home that may cause injury or falls, such as clutter and floor mats. Grip rails in the bathroom can be helpful.
• Interact with others as much as possible to enhance communication and get necessary assistance from support groups and health care aides.
Top Recommended Supplements
Acetyl-L-carnitine: An amino acid derivative that crosses into the brain and increases the levels of acetycholine, a brain neurotransmitter that is depleted in those with Alzheimer’s. Several studies have shown that it can delay the progression of the disease. Dosage: 1 g three times daily.
Bacopa monnieri: An herb that has been shown to enhance several aspects of mental function. It increases availability of acetylcholine in the brain, which improves memory and cognition. Antioxidant properties help protect brain cells. Dosage: 200-450 mg daily, standardized to contain bacosides.
Ginkgo biloba: An herb that improves memory and cognitive function and slows the progression of Alzheimer’s. Four studies have found it helpful in those with early stages of the disease. Dosage: 1 20-240 mg daily, standardized to 6 percent terpene lactones and 24 percent flavone glycosides. It may take six weeks to notice benefit.
Phosphatidylserine: A nutrient that is related to lecithin, which is naturally occurring in the brain. It helps support the structure and health of cell membranes. Several studies involving more than 1,000 people suggest that phosphatidylserine is an effective treatment for Alzheimer’s disease and other forms of dementia. It improves both behaviour and mental function and reduces symptoms of depression. The form used in these studies was from a bovine source. Dosage: 300 mg daily.
Complementary Supplements
B-vitamins: Support neurotransmitter function. Vitamin B1 is involved in nerve transmission and may be deficient in those with Alzheimer’s. Two small studies found benefits in mental function with B1 supplements. Dosage: Take 40-100 mg as part of a B-complex as they work together.
Fish oils: Reduce inflammation and protect the nerve cell membranes. Regular consumption of fish reduces Alzheimer’s risk and is important for brain function. Those who do not eat fish should consider supplements. Dosage: 1-3 g daily.
Vitamin E: A potent antioxidant that protects the brain from damage due to oxidative stress and inflammation. Higher blood levels of vitamin E are associated with better brain function in older adults and some research has shown that supplements can lower the risk of Alzheimer’s. Higher dosages have been found to slow cognitive decline. Dosage: 1,000-2,000 IU daily.
FINAL THOUGHTS
To improve cognitive function and delay the progression of Alzheimer’s, consider the following:
1. Eat more fish, whole grains, vegetables, nuts, seeds, and olive oil.
2. Avoid saturated, trans fats, and aluminum-containing food ingredients.
3. Get regular exercise such as walking.
4. Keep your brain active with games, puzzles, and exercises.
5. Consider supplements of acetyl-L-carnitine, bacopa, ginkgo, phosphatidylserine, and fish oils.
