Alzheimer's disease (pre-senile dementia, Lewy body disease)
This is a terribly sad disease, where a person’s mind slowly fades into oblivion, has become increasingly common and the incidence continues to rise. We do not know the cause - for some it is due to recurrent small strokes, is it a virus (perhaps a slow growing one), a pale amyloid tissue and tangles of nerve cells are often seen in the brains, and perhaps oxidative stress... Currently we have no real idea why it happens to some people. It does not appear to be inherited. But there is quite a lot we can do to help.
What your doctor can do
A number of groups of drugs have been tried to reduce the symptoms and progression, but mostly they are disappointing.
- Anticholinesterase inhibitors (donepezil) may improve mental functioning in some people with few side effects but does not affect the course of the disease.
- Memantine works differently and is believed to protect the brain nerve endings from toxic neuroexcitation. It has some modest improvements in some patients , mainly in those with moderate to severe disease, but we do not yet know if it has any lasting benefit or if it affects the progress of the disease.
- Other drugs NSAIDs, oestrogen and testosterone replacement. and Selegline have similarly been shown not to help.
The American Heart Assn recommends that persistent high blood pressure can worsen mental function, so maintaining optimal blood pressure (but not too low) does seem sensible.
What you can do
Stop some drugs - this is very important in older people who tend to be prescribed multiple drugs for multiple conditions.
- Make sure you are not taking any drugs which can blunt mental function – antidepressants (stop unless essential), other mind altering drugs (sedatives, sleeping pills, tranquilisers), beta blocking drugs (discuss with your doctor before stopping)
- Stop STATIN Drugs which have been shown to cause mental deterioration and give Alzheimer's like symptoms or can aggravate the disease. They should not be used in older people unless there is a very strong (severe coronary artery disease or stroke). (You can try a 2 month statin free trial period if your doctor insists that you continue to take them, and then use water soluble statins ( pravastatin and cerivastatin) which do not enter the brain tissue.
Lifestyle & diet
STOP PRESS - There are increasing reports that the ketogenic diet may possibly make a huge impact in Alzheimer's. Ketones are medium chain fatty acids which can cross the blood brain barrier, and the brain can use them for energy - it is believed that Alzheimer's people's brains cannot use sugars normally (some even call it a type 3 diabetes).
Because amyloid tissue seems to build up in the brain cells of people with Alzheimer's - clogging the cells, a process called AUTOPHAGY or cell spring cleaning may be able to get rid of some of the amyloid. Autophagy is started by fasting, and intermittent fasts (for one or two days - but drink plenty of water and still take supplements) are worth trying.
There is a page on this site (click here) which covers this, and I am writing a book which gives much more detail. I will put a link to this book when it is available).
Keep the mind active - While it has not yet been proven to slow the progression of the disease, keeping the mind active with enjoyable tasks may give positive benefit. Card games that require memory, suduko, scrabble, jigsaws, chess, crosswords and many video games keep the brain cells active.
Regular exercise is very valuable. Just getting off the couch, walking, gardening or any physical activity has been shown to improve mental ability and focusing (click here) and in one study did show some slowing in deterioration. Dancing is almost a forgotten art, but oldies remember and it provides both physical activity, companionship and mental stimulation. For those with physical problems, swimming and pool activity can be extremely beneficial.
Get out and enjoy life as much as possible - go to events, concerts and other activities. Make friends and do group activities like line dancing, tai chi etc.
Avoid toxins such as aluminium (in cooking ware and also deodorants), mercury is a real problem as often removal of mercury from teeth can hugely increase exposure - but certainly avoid more mercury fillings. Perhaps the flu vaccines (which contain both aluminium and mercury) should be only used in those people with severe lung or heart diseases.
A good healthy diet with plenty of fruit and vegetables is good for the brain as are fish (see omega 3 fish oils below). As a general rule, the Mediterranean diet (click here) is probably the most beneficial (perhaps hold back a little on the red wine).
Grapes in diet may help. In a study of elderly people with early memory decline, they compared a group those taking 2 1/4 cups of grapes per day with no grapes, and it improved mental function memory and also metabolic changes seen in the brain on PET scan. This seems a very simple and pleasurable way to possibly help.
Coconut oil - there is great interest in this oil as a treatment for Alzheimer's. [The brain can only use sugars as energy fuel, and some believe that Alzheimer's may be a type of 'diabetes of the brain [type 3 diabetes]' where the sugar cannot be properly used. Coconut oil provides short chain fatty acids which the brain can also use for energy.] By adding 8 - 10 teaspoons of coconut oil spread throughout the day may possibly help some patients. (The oil can be used to cook with, rubbed on the skin, added to foods and also sipped off a spoon.)(click here for an article and video on this)
Good nutrition is essential for the mind to stay healthy. There are also a number of herbs and supplements which have been shown to help with this condition, and might be worth trying. Note it can often take at least a month for any benefit to be seen, so persist if there is no immediate response.
- A good multivitamin / multimineral: to ensure that brain tissues have all the nutrients and minerals required to function perfectly. Studies show that some B vitamins can make a difference (B6 and B12 in high doses) – make sure your multi is complete and comprehensive.
- Omega 3 fish oils, 1–2 grams daily are very important for good brain function. In Alzheimer’s disease a high omega 3 intake can be very beneficial although not all trials have shown benefit. (NB make sure the fish oils are pure and contain no mercury - which could make Alzheimer's worse)
- Calcium and magnesium, 800-1,000mg/day, especially the magnesium, has a very calming effect, helps with sleep and enables people to cope better
- Vitamin D is a nutrient we are only just beginning to appreciate. People with Alzheimer's often have low vitamin D levels and there has been some suggestion that high dose vitamin D may help the symptoms (and perhaps the underlying disease) Take 5 - 8,000 iu of a good vitamin D preparation daily. (Vitamin D seems to have many beneficial actions, including turning the genes on and off when required. Low D levels are present in many diseases and it does seem important to have adequate levels all year round)
- Tumeric (curcumin) - this cooking spice acts on the cell membranes and may slow the entry of damaging amyloid tissue into the nerve cells. Either as a supplement or added to the cooking 2 or 3 times per week, it can do no harm and may well help. As a supplement take 500 mg twice daily.
- Ginkgo Biloba: this ancient Chinese herb has for centuries been used to help mental function in people all over the world, it is the 3rd most popular supplement used in the USA. It has a number of actions which can help brain function ( including protecting brain cells in animal tests, improves nerve transmission in the brain, and opens up arteries in the brain). A number of human studies in patients with Alzheimer's have shown benefit in depression, some studies suggest benefit in memory and function while others have not. In an area where little positive benefit is offered, a trial of ginkgo especially if combined with phosphatydil serine (which improves communication between brain cells) would be worth while (click here).
- Bacopa - (water hyssop), has been used for centuries as part of traditional Ayurvedic medicine in India. It has a strong antioxidant action in the brain but also seems to reduce brain excitotoxicity caused by heavy metals, pesticides and activated microglial cells making dementia and Alzheimer's worse. A review of studies (click here) showed that it improves cognition and decreased reaction time. It is very a very safe therapy.
- Antioxidant vitamins: because free radical damage is believed to be a cause of Alzheimer’s, high doses of the antioxidant vitamins should help. All authors believe that vitamin C and e deficiency increases the risk of Alzheimer's, but there is debate on high doses as supplements. However some studies are extremely positive - one (click here) from the John Hopkins University showed a 78% reduction in those elderly people taking both vitamin C and E. Animal studied also show benefits. So lots of vitamin C (at least 2 grams daily), vitamin E 100iu and vitamin D ( 2-5,000iu daily) is what we recommend.
- Hormones - while oestrogen has not been shown to help in women, no studies using bio-identical female hormones (oestrogens and progesterone) have been done. In men, Alzheimer's is more common in men with low testosterone levels, and it has been suggested that testosterone replacement ( cream or implants) may be helpful. These treatments seem logical, especially when low levels seem to be present with Alzheimer's and I would suggest that you discuss with your doctor about taking either testosterone or natural female hormones.
- Gut health - the importance of the gut in many diseases is only just being realised. Leaky gut allowing large molecules into their bloodstream, immune problems, changes in the gut bacteria, poor absorption and other problems are frequent in many people especially in the elderly. A regular course of probiotics, a healthy diet, plenty of fibre or fibre drinks and omega 3 oil can help keep the gut and bowel working normally.
- Other supplements which could be considered - Coenzyme Q10 (to provide more energy), Liver support supplements to aid detoxification.
Most people appreciate that a person with a positive outlook and happy disposition is much more likely to overcome a disease than those who turn their faces to the wall. When we consider that the atoms that make up our bodies are actually spinning energy particles (electrons, quarks, leptons, bosons, neutrinos….), then it is obvious that energy can affect our bodies.
Some therapies (Acupuncture, Reiki, Healing Touch…) address these directly, and there are many simple, safe and beneficial ways of improving the energy round out bodies. These include looking positively, forgiving events of the past, loving, hugging, meditation, listening to good uplifting music or TV programmes, Tai chi, hypnosis, massage, aroma therapy.
Accept the support and love of others.
Studies have shown that positive thoughts, prayers, love and concern can travel around the world and lead to beneficial outcomes. We don’t understand it, but then there are many things we don’t
understand. Just accept it as another implement in your recovery – possibly the most powerful tool.
The Nutritional supplements I use and recommend to my patients
For Alzheimer's patients - USANA - Cellsentials*, Biomega, Active Calcium plus, Ginkgo, Proflavanol C and vitamin D -
Curcumin (tumeric) - Curcugel or other quality products. Obtain in NZ from John Appleton (click here)
Coconut Oil - a good quality organic product.
Bacopa - drink tea made from dried water hyssop, or some herb shops sell bacopa monnieri supplements. Dose is between 300-600mg per day