Alzheimer's Disease Last updated: May 12, 2008

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Conditions that suggest it | Contributing risk factors | Other conditions that may be present | It could instead be... | Recommendations

 
 

Alzheimer's disease (AD) is a progressive, neurodegenerative disease characterized by memory loss, language deterioration, impaired visuospatial skills, poor judgment, indifferent attitude, but preserved motor function. AD usually begins after age 65, however, its onset may occur as early as age 40, appearing first as memory decline and, over several years, destroying cognition, personality, and ability to function. Confusion and restlessness may also occur. The type, severity, sequence, and progression of mental changes vary widely. The early symptoms of AD, which include forgetfulness and loss of concentration, can be missed easily because they resemble natural signs of aging. Similar symptoms can also result from fatigue, grief, depression, illness, vision or hearing loss, the use of alcohol or certain medications, or simply the burden of too many details to remember at once.

There is no cure for AD and no confirmed way to slow the progression of the disease. For some people in the early or middle stages of the disease, conventional medication may alleviate some cognitive symptoms. Some medications may help control behavioral symptoms such as sleeplessness, agitation, wandering, anxiety, and depression.
AD is a progressive disease and the course of the disease varies from person to person. Some people have the disease only for the last 5 years of life, while others may have it for as many as 20 years. The most common cause of death in AD patients is infection.

The Lancet Publishing Group (July 12, 2007) proposes that to meet the new criteria for probable AD, patients must show progressive memory loss over more than six months, plus at least one or more of the supportive biomarker criteria. These include: atrophy in a particular part of the brain shown by MRI, abnormal biomarker proteins in the cerebrospinal fluid, a specific pattern on PET of the brain, and a genetic mutation for AD within the immediate family. The authors say: "These new criteria are centred on a clinical core of early and significant episodic memory impairment…the timeliness of these criteria is highlighted by the many drugs in development that are directed at changing pathogenesis."

The researchers add that validation studies are required to advance the new criteria and optimise their sensitivity, specificity and accuracy. They conclude: "When effective disease-modifying medications are available, the argument for such biologically based studies will be even more compelling.

"These proposed criteria move away from the traditional two-step approach of first identifying dementia according to degree of functional disability, and then specifying its cause. Rather, they aim to define the clinical, biochemical, structural, and metabolic presence of AD." In an accompanying comment, Dr Norman Foster, Center for Alzheimer's Care, Department of Neurology, University of Utah, USA says: "We should seize this opportunity to reopen the discussion of Alzheimer's disease diagnosis. The time is right to use the advanced technology at our disposal to improve the early, accurate diagnosis of dementia and develop more effective treatments."

 
 

Conditions that suggest Alzheimer's Disease:
 
 
Aging  Parkinson's Disease / Risk
 About 30% of Parkinson's disease victims eventually develop Alzheimer's disease or other forms of dementia.
 
 

Risk factors for Alzheimer's Disease:
 
 
Lab Values - Chemistries  (Highly) elevated CRP level
 C-reactive protein may serve as a warning sign for the onset of certain dementias like Alzheimer’s disease. [Ital Heart J 2001 Nov;2(11): pp.804-6; Circulation 1998 Feb 10;97(5): pp.425-8; Am J Clin Pathol 2001 Dec;116 Suppl:S108-15]

Symptoms - Glandular

  Poorly controlled diabetes
  Reasonably controlled diabetes
 See the link between Diabetes / Risk and Alzheimer's disease.

Symptoms - Mind - General

  Possible Alzheimer's disease
 
 

Alzheimer's Disease suggests the following may be present:
 
 
Nutrients  Vitamin B1 Requirement
 Thiamin metabolism appears to be altered in Alzheimer's with lower levels of thiamin and enzymes which metabolize thiamin found in the brains of Alzheimer's disease patients. Clinical data suggest that high dose thiamin may have a mild beneficial effect in some patients with Alzheimer's disease but it does not appear to halt the progress of the disease. [J Geriatr Psychiatry Neurol, 1993 Oct-Dec, 6:4, pp.222-9]
 
 

Alzheimer's Disease could instead be:
 
 
Infections  Lyme Disease
 Spirochetes, such as those found in Lyme disease, may be one of the causes of Alzheimer's disease and may also be the source of beta amyloid deposited in the brains of such infected patients.
 
 

Recommendations for Alzheimer's Disease:
 
 
Amino Acid / Protein  L-Carnitine
 In 19 male and 14 female subjects (mean ages 73.9 and 76.2 years, respectively) with Alzheimer's disease who were non-responders to acetylcholinesterase inhibitor therapy, subjects were given in addition to their donepezil at 5mg/day or rivastigmine at 3mg, BID, acetyl-L-carnitine at 2gm/day, BID. There was an improvement in responders from 38% with drug therapy alone to 50% with the addition of acetyl-L-carnitine. [Curr Med Res Opin. 2003;19(4): pp.350-353]


Not recommended:
  Glutamine
 Glutamine accumulation has also been found in Alzheimer’s disease, Huntington’s disease and high levels of brain glutamine have been associated with a worse prognosis in Lou Gehrig’s disease. Likewise, recent studies have shown that high brain glutamine levels increase brain levels of free radicals and impair the ability of brain mitochondria to produce energy. When the brain produces low energy, excitotoxins, such as glutamate, become even more toxic. It has been shown that the reason for glutamine toxicity under these conditions is because it is converted to the excitotoxin - glutamate. Russell L. Blaylock, M.D.

Animal-based

  Fish Oils
 Scientists have discovered the mechanism by which the omega-3 fatty acids found in fish oils can help protect the brain against the cognitive decline associated with Alzheimer's disease.

Docosahexaenoic acid (DHA), preformed in fish oil, reduces the levels of a protein known to cause damage in the brains of Alzheimer's patients. They also discovered that a derivative of the fatty acid called neuroprotectin D1 (NPD1) is formed in the human brain, and is essential in protecting against brain cell death. [Journal of Clinical Investigation September 8, 2005]

A number of epidemiological studies have shown that eating fatty fish provides a certain degree of protection against Alzheimer's and other dementia diseases - an effect often thought attributable to the omega-3 fatty acids it contains. Some studies also suggest that omega-3 can have a therapeutic effect on some psychiatric conditions.

Researchers at Karolinska Institutet and Uppsala University have now examined whether omega-3 supplementation has any effect on the psychiatric symptoms associated with Alzheimer's disease. Just under 200 patients with mild Alzheimer's were divided into two groups, one of which received omega-3, and one a placebo. The study lasted for one year.

There was no observable difference in therapeutic effect between the patients receiving the omega-3 and the placebo group. However, when the researchers took into account which of the patients carried the susceptibility gene APOE ?4 and which did not, an appreciable difference appeared. Carriers of the gene who had received active treatment responded positively to the omega-3 as regards agitation symptoms, while non-bearers of the gene showed an improvement in depressive symptoms. [International Journal of Geriatric Psychiatry, doi 10.1002/gps.1857 Published online 21 June 2007]

[Scotsman.com News April 6, 2008] Eat your omega-3's if you want to avoid getting Alzheimer's. In part, that's the moral of the story out of new research from Aberdeen University which has found that patients whose diets are high in omega-3 oils do better in mental tests than those who do not have the oils in their diet.

Calling the discovery a "major breakthrough" in the fight against Alzheimer's, the article in The Scotsman explains how the study was conducted using 58,000 Scots who suffer from the condition.

Lead researcher, Lawrence Whalley, professor of mental health at Aberdeen University, said: "Ten years ago this would have been science fiction. What we are touching on here is how nutrients can interact with specific genes in the body."

The red herring (excuse the pun) appears to be a crucial gene some individuals possess called APOE e4 that prevents the omega oils from having a healing or preventive effect. Unfortunately, those individuals must pursue other avenues of treatment.

Whalley said: "What emerges from this research is that if you don't have this gene, omega-3s can make a difference. The next big thing will be to identify what factors can influence how these genes can be switched on and off, and also what to do if you have the gene."

Maureen Thom, information manager for Alzheimer Scotland, said: "It's a very welcome and interesting piece of research, very thorough. I would like to see it developed and have results analyzed for a larger number of people. We do advise that everyone should try to stick to a healthy lifestyle and consume omega-3 oils as part of a healthy diet."

Botanical

  Chlorella / Algae Products
 A study showed that among 50 people with Alzheimer’s, aged 70-90, taking 6gm daily of chlorella for 6 months, 68% experienced either a stabilization or improvement in cognitive functions.

  Pomegranate
 Researchers from Loma Linda University in California (2006) believe that Alzheimer's may be caused by the buildup of plaque from deposits associated with brain cell death due to oxidation, called beta-amyloid deposits. Pomegranate juice, which is high in antioxidant polyphenols, may offer protection against the oxidative stress that causes beta-amyloid deposits.

The researchers studied two groups of transgenic mice that had been genetically engineered to express a protein that eventually leads to Alzheimer's disease. The mice -- aged between six and 12.5 months -- were split into two groups: The first group's diet was supplemented with plain water, and the second group's diet was supplemented with diluted pomegranate juice concentrate. The concentrate was diluted to resemble the strength of commercially sold pomegranate juices.

The researchers then tested the two groups' cognitive function by subjecting the mice to a water maze, which required the animals to swim various distances to find a submerged platform. The group given pomegranate juice negotiated the maze 35 percent faster than the water group, and also swam a more direct path to find the submerged platform compared to the water group.

The researchers then examined the amount of beta-amyloid deposits in the brain cortex of the mice, and found that the group supplemented with pomegranate juice had 50 percent less of the deposits than the non-supplemented mice.

"This study is the first to show beneficial effects (both behavioral and neuropathological) of pomegranate juice in an animal model of (Alzheimer's disease)," wrote lead researcher Richard Hartman.

  Huperzia serrata
  Gingko Biloba
 A Ginkgo biloba extract (EGb 761) was tested in Alzheimer's patients for one year at a daily dose of 120mg. Improvement was experienced in patients with primarily visual impairment, delayed worsening occurred in patients with predominant verbal deficits, and there was a stabilization of symptoms in patients with both types of impairment. [Pharmacopsychiatry 2003;36(Suppl 1): pp.S50-5]

  Marijuana
 "Treatment with a synthetic compound similar to marijuana reduced inflammation in older rats in addition to making the animals "smarter," said Wenk, who is also a professor of neuroscience and molecular virology, immunology and medical genetics.

"The compound substantially improved the memories of the older rats," he said. "These animals were able to hold on to key details of a specific task. Untreated older rats, on the other hand, were not."

The colleagues treated young and old rats with WIN-55212-2 (WIN), a synthetic drug similar to marijuana. While the compound improved memory and helped to control inflammation, it is not a candidate for use in humans because it still contains substances that could trigger a high. [www.medicalnewstoday.com/]

Diet

  Artificial Sweetener Avoidance
 Aspartame use has been reported to trigger symptoms of Alzheimer's disease.

Drug

  Conventional Drugs / Information
 Researchers found that clioquinol can almost stop the progression of Alzheimer’s disease. They believed that by absorbing the copper and zinc atoms that concentrate in the brains of Alzheimer's sufferers, clioquinol could stop the onset of dementia before it starts.

The finding came from a study conducted on 26 Alzheimer’s sufferers; half were given clioquinol while the other 13 were given a placebo. Researchers studied all 26 patients over a nine-month period of time and found that patients given the clioquinol retained more mental capacity than those who received the placebo. Research also showed patients who were given clioquinol had a 1.4 percent decrease in their mental capacity, whereas patients who were given the placebo had an 8.9 percent decrease in their mental capacity.

The study suggests that before dementia sets in in the brains of Alzheimer’s sufferers, clioquinol could prevent zinc from building up on the surface of the brain by absorbing the mineral’s atoms. The results of the study show that clioquinol could treat patients with Alzheimer’s twice as well as the latest Alzheimer’s drugs that are available.

Clioquinol has been around for 100 years and is currently used to treat athlete’s foot, ear infections and indigestion. [Archives of Neurology December, 2003;60(12):pp.1685-91]

In October 2003, the FDA finally approved memantine for the treatment of moderate to severe Alzheimer’s disease. Memantine is marketed in the US by Forest Laboratories under the trade name Namenda.

Memantine is an N-methyl- D-aspartate (NMDA) receptor antagonist that is neuroprotective by blocking glutamate, which can cause overstimulation of the nerves and become toxic to the nervous system. Memantine may benefit individuals with Alzheimer’s disease by improving cognition and overall functioning.

Jan 10, 2008. Newsmax reports that an "extraordinary new scientific study, which for the first time documents marked improvement in Alzheimer's disease within minutes of administration of a therapeutic molecule, has just been published in the Journal of Neuroinflammation."

Known as anti-TNF therapeutics, the drug used in the study is called Etanercept (trade name Enbrel) which is given by an injection into the spine. Improvement was said to have come came within minutes of the injection.

Sue Griffin, Ph.D., director of research at the Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences (UAMS) in Little Rock and at the Geriatric Research and Clinical Center at the VA Hospital in Little Rock, said: "It is unprecedented that we can see cognitive and behavioral improvement in a patient with established dementia within minutes of therapeutic intervention."

To date other patients with mild to severe Alzheimer's have reportedly received the treatment and "all have shown sustained and marked improvement."

Mineral

  Lithium (low dose)
 There are many research findings that strongly suggest that lithium will protect against potential Alzheimer's disease and slow the progression of existing cases. Researchers have reported that lithium inhibits beta-amyloid secretion, and also prevents damage caused by beta-amyloid protein once it's been formed. Beta-amyloid peptide is a signature protein involved in Alzheimer's disease: the more beta-amyloid protein, the worse the Alzheimer's becomes. Overactivation of a brain cell protein called tau protein also contributes to neuronal degeneration in Alzheimer's disease, as does the formation of neurofibrillary tangles Lithium inhibits both of these nerve-cell damaging problems.

Nutrient

  Lecithin / Choline / GPC
 Study participants received 1200mg GPC daily for six months. On a variety of assessment scales for Alzheimer's disease (AD), GPC patients scored more favorably than patients from the control group, all of whom received placebo. The mental status of patients on GPC therapy improved, while those receiving the placebo worsened. These findings are comparable to the results obtained with the use of the prescription drugs Aricept (donepezil HCl) Exelon (rivastigmine tartrate) and Reminyl (galantamine hydrochloride) in the treatment of AD patients, and with fewer side effects. [Mech Ageing Dev 2001 Nov: 122(16): pp.2041-2055]

Oxygen / Oxidative Therapies

  Oxygen, Hyperbaric
 Senile patients, including those with Alzheimer's type, have shown measurable improvement after hyperbaric oxygen treatments. Some doctors claim that patients seem to respond better when chelation and hyperbaric oxygen are used together compared to either one alone. The use of hyperbaric oxygen for this condition is still experimental and needs further study.
 
 


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
May do some good
Likely to help
Highly recommended
May have adverse consequences

Take a look at America over a century ago (1904):
Only 14 percent of the homes in the U.S. had a bathtub.
Only 8 percent of the homes had a telephone.
A three-minute call from Denver to New York City cost only $11.
There were only 8,000 cars in the U.S. and only 144 miles of paved roads.
The maximum speed limit in most cities was 10 mph.





GLOSSARY

Alzheimer's Disease:  A progressive disease of the middle-aged and elderly, characterized by loss of function and death of nerve cells in several areas of the brain, leading to loss of mental functions such as memory and learning. Alzheimer's disease is the most common cause of dementia.

Anxiety:  Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.

Dementia:  An acquired progressive impairment of intellectual function. Marked compromise exists in at least three of the following mental activity spheres: memory, language, personality, visuospatial skills, and cognition (i.e., abstraction and calculation).

Diabetes Mellitus:  A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.

Enzymes:  Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.

Metabolism:  The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.

MRI:  Magnetic Resonance Imaging. A technique used in diagnosis that combines radio waves and magnetic forces to produce detailed images of the internal structures of the body.

Parkinson's Disease:  A chronic, slowly-progressing disease of the nervous system characterized clinically by the combination of tremor, rigidity, extreme slowness of movement, and stooped posture. It is characterized pathologically by loss of dopamine in the substantia nigra.

Protein:  Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.

Thiamine:  (Vitamin B-1): A B-complex vitamin that acts as a coenzyme necessary for the conversion of carbohydrates into glucose, which is burned in the body for energy. It is essential for the functioning of the nervous system.