There is no doubt that one of the most significant health care challenges in today’s society is the explosive growth of the incidence of dementia and Alzheimer’s.
And no doubt most of you have been impacted directly by this, either in terms of family members, friends or colleagues – and probably directly with patients.
And one of the challenges in managing this condition in the elderly population is their relationship with the conventional allopathic medical community: their relationship is distinctly different from younger generations in that they typically will follow their Doctor’s orders exactly as indicated, and are very reluctant – and nervous to do otherwise.
There are many challenges in managing this condition in the elderly, however thanks to continued education which enhances physician’s “scope of practice”, (Orthomolecular Conferences; ISOM, Toronto Royal York April 24-26, orthomed.org) many are trending towards more natural approaches to brain health utilizing diet, nutrition and nutriceutical therapies.
Alzheimer’s: Overcoming the Challenges
From the Alzheimer’s Association website, here are the (U.S.) numbers:
An estimated 5.3 million Americans of all ages have Alzheimer’s disease in 2015.
- Of the 5.3 million Americans with Alzheimer’s, an estimated 5.1 million people are age 65 and older, and approximately 200,000 individuals are under age 65 (younger-onset Alzheimer’s).
- Almost two-thirds of Americans with Alzheimer’s are women. Of the 5.1 million people age 65 and older with Alzheimer’s in the United States, 3.2 million are women and 1.9 million are men.
- Although there are more non-Hispanic whites living with Alzheimer’s and other dementias than people of any other racial or ethnic group in the United States, older African-Americans and Hispanics are more likely than older whites to have Alzheimer’s disease and other dementias.
- There are many challenges in managing this condition in the elderly, however thanks to continued education which enhances physician’s “scope of practice”, (Orthomolecular Conferences; ISOM, Toronto Royal York April 24-26, org) many are trending towards more natural approaches to brain health utilizing diet, nutrition and nutriceutical therapies.
The number of Americans with Alzheimer’s disease and other dementias will grow each year as the size and proportion of the U.S. population age 65 and older continue to increase. By 2025, the number of people age 65 and older with Alzheimer’s disease is estimated to reach 7.1 million — a 40 percent increase from the 5.1 million age 65 and older affected in 2015. By 2050, the number of people age 65 and older with Alzheimer’s disease may nearly triple, from 5.1 million to a projected 13.8 million, barring the development of medical breakthroughs to prevent or cure the disease.
Interestingly missing from the dialogue about Alzheimer’s is why has this disease process started to develop prevalence during the last one hundred years, and of course is increasing in incidence in the general population as time goes on and as larger segments of the population enter older age.
There is no doubt that longer lifespans are a major contributing factor: evolutionarily, humans typically reproduced at a young age and lived short lives: genetic adaptation to this lifestyle and immunological response to trauma and infection (including parasites) does not translate as well into a longer lifespan.
And one cannot deny that environmental factors such as toxic metals load, artificial light, poor quality food, sedentary lifestyles, stress, sleep deprivation, radiation exposure and numerous other contributing factors play a significant part in the etiology of this disease process.
What Can Be Done
One of the best approaches to dealing with Alzheimer’s is to prevent it: lifestyle choices of course play a major role in whether an individual will develop this devastating disease.
One of the key issues this brings up is the fact that most of the general population has a lack of knowledge to be able to lead an optimal healthy lifestyle, and it is challenging for individuals to consider that their lifestyle choices will affect their quality of life decades from now (a good example being autoimmune conditions: on average, autoimmune conditions develop thirty five years prior to symptomolgy).
Here are a range of approaches that have been published to have significant impact on the progression of Alzheimer’s, and in many cases to stop progress and actually show signs or reversal of associated cognitive decline:
A4M Dementia Protocol
At a recent A4M meeting which (in a small cohort study) achieved dramatic results for cognitive decline: 9 out of 10 patients enrolled, many of whom were dealing with Alzheimer’s conditions achieved remarkable recoveries, even to the extent that they were able to return to work.
Dale E. Bredesen1, 2
1 Mary S. Easton Center for Alzheimer’s Disease Research, Department of Neurology, University of California, Los Angeles, CA 90095;
2 Buck Institute for Research on Aging, Novato, CA 94945.
The key takeaway from this paper is that these neurodegenerative conditions require comprehensive strategies to address all aspects of health and lifestyle to be effective (such as sleep, stress, diet, exercise, hormonal modulation, cardiovascular health, blood sugar/insulin, inflammation, gut health, neurotransmitters, heavy metals and POC loads etc.) – and not unlike a workup we would do with any patient, and by utilizing modalities and targeted supplements that would immediately come to mind for conditions like this (such as Bacopa, CoQ10, ALA – alpha-lipoic acid, coconut oil, curcumin, resveratrol, EPA/DHA, NAC, B12, progesterone etc. – more on supplement options later in the article).
Following is a (partial) list of issues which may contribute to cognitive decline and Alzheimer’s
There are some SNP’s (single nucleotide polymorphisms) which can make an individual predisposed to developing Alzheimers: but of course as we know from epigenetic expression considerations, inheriting these SNP’s does not mean that an individual will have to deal with the negative consequences of their expression.
SNPedia is always a good source for information of this type:
For early-onset Alzheimer’s, more than 150 mutations of the presenilin 1 PS1, presenilin 2 PS2, and amyloid precursor protein APP genes have been associated with autosomally dominant inheritance (of early-onset ALZ).
And there are some variants on the APOE4 gene (also known for a predisposition to cardiovascular conditions) that can impact on Alzheimer’s development:
Viral Infection Genes
Some specific genes which deal with viral infections also can be impactful in the development of Alzheimer’s:
One hypothesis is that genes relevant to viral infection, and in particular herpes simplex virus (HSV-1) infection, may increase the risk for Alzheimer’s, especially in individuals already predisposed to Alzheimer’s, such as those carrying ApoE4 alleles. PMID 16406033 In connection to this hypothesis, rs2254958, a SNP in a gene influencing HSV-1 infection, has been found in higher frequency in certain AD patients. PMID 17420072
Herpes simplex virus type 1 DNA is located within Alzheimer’s disease amyloid plaques†
MA Wozniak1, AP Mee2,‡ and RF Itzhaki1,*
Article first published online: 18 SEP 2008
Iron Accumulation and Free Radicals
Iron accumulation has historically been considered a major contributor to age related degenerative conditions, both within the mitochondria but also impacting on many other metabolic processes – and also the brain:
A report published online on March 9, 2012 in the Journal of Alzheimer’s Disease describes research conducted by Othman Ghribi, PHD of the University of North Dakota and his associates which suggests that lowering iron levels and supplementing with antioxidants could help protect the brain from some of the changes related to the development of Alzheimer’s disease.
“Alzheimer’s disease appears to be the consequence of several convergent factors including oxidative stress, inflammation, mitochondrial dysfunction, and accumulation of toxic protein aggregates in and around neurons (Luan 2012; Teng 2012; Rosales-Corral 2012; Wang 2007; Fonte 2011; Ittner 2011). Emerging, intriguing research implicates chronic infection with several pathogenic organisms in the development and progression of Alzheimer’s disease as well (Miklossy 2011). Moreover, age-related changes such as declining hormone levels and vascular dysfunction are thought to contribute to some aspects of Alzheimer’s disease (Vest 2012; Barron 2012; Baloyannis 2012)”.
Here is a list of suggested causative factors:
- Pineal Gland calcification
- Oxidative stress
- Glyphosate (and other pesticides and herbicides) exposure
- Mitochondrial dysfunction
- Elevated Homocysteine levels
- High consumption of hydrogenated fats
- Lead exposure
- Folate deficiency
- Loss of sex hormones
- Cardiovascular disease
- Metabolic Syndrome / Diabetes
- Chronic consumption of proton pump inhibitors (PPI’s)
- B12 and D3 deficiencies
- Copper deficiency
- SOD/Catalase deficiency (especially some specific SNP’s)
An intriguing theory that remains largely unappreciated by the community is that chronic infection with a variety of pathogenic bacteria and/ or viruses may contribute to the development of Alzheimer’s disease. Research indicates that some common pathogens are consistently detected in the brains of Alzheimer’s patients. For example, a comprehensive analysis of studies found that Spirochetes, a family of bacteria, was detected in about 90% of Alzheimer’s patients and was virtually absent in healthy age-matched controls. Further statistical evaluation revealed a high probability of a causal relationship between Spirochetes infection and Alzheimer’s disease (Miklossy 2011).
Spirochetes and other bacteria can linger in the brain and drive inflammation and the formation of amyloid beta and neurofibrillary tangles, all of which are hallmarks of Alzheimer’s disease (Miklossy 2011). Moreover, laboratory studies indicate that amyloid beta is an antimicrobial peptide, suggesting its formation could be an adaptive response to infectious organisms (Soscia 2010). These and other findings have led some researchers to hypothesize that “…early intervention against infection may delay or even prevent the future development of [Alzheimer’s disease]” (Honjo 2009).
Carotid Plaque can be a predictor of Alzheimer’s development:
Laure Carcaillon1 Matthieu Plichart Mahmoud Zureik Olivier Rouaud Bilal Majed
Karen Ritchie Christophe Tzourio Jean-François Dartigues Jean-Philippe Empana
1Laure Carcaillon and Matthieu Plichart contributed equally to this article.
Published Online: December 12, 2014
Risk Factors for Alzheimer’s Disease
Several factors influence the risk of Alzheimer’s disease such as obesity, carrying the ApoE4 gene and nutrient deficiencies. Below is a partial list of factors known to be associated with an increased risk of Alzheimer’s disease (Yilmaz 2012; Daviglus 2011; Harrison 2012; Hinterberger 2012; Luchsinger 2012; van Himbergen 2012; Stern 2008; Blum 2012; Miklossy 2011).
- Advancing age
- Family history of Alzheimer’s disease
- Carrying the ApoE4 genetic variant
- Certain bacterial infections
- Vascular risk factors (e.g., diabetes, atherosclerosis, high blood pressure, high cholesterol) appear to encourage the development of phenomena associated with Alzheimer’s disease such as accumulation of amyloid beta (Kalaria 2012).
- History of head trauma
- High homocysteine levels
- Nutrient deficiencies
- Silent strokes
- Central obesity (i.e., high waist-to-hip ratio)
Nutrients/dietary protocols with strong evidence from epidemiological studies which have been shown to be of benefit for Alzheimer’s:
- Mediterranean and Ketogenic diets
- Metformin / AMPK Activation Compounds
- Various stilbenes (such as Pterostilbene)
- Methylene Blue
- Coconut and MCT oils
- Lemon balm
- Sea Cucumber
- Alpha lipoic acid
- Kava Kava
- Amla (Indian Gooseberry)
- Goji berries
- CoQ10 and PQQ
- Cocoa procyanidins
- Grape Seed Extract
- Green Tea
- Nutrient Combinations
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- Brain-Derived Neurotrophic Factor (BDNF)
- Selective Estrogen Receptor Modulators (SERMs)
- Piracetam ( a nootropic compound)
- Hormone Replacement Therapy
- Dehydroepiandrosterone (DHEA)
- Red Yeast Rice
- Chinese Skullcap
- Huperzine A
- Lipoic Acid
- Panax ginseng
- Vitamins C, D and E
- Ginkgo biloba
- Docosahexaenoic acid (DHA)
- Pyrroloquinoline quinone (PQQ)
- Glycerophosphocholine Glycerophosphocholine (GPC)
- Coffee and Caffeine
- Chlorogenic acid
- Green Tea
- Grape Seed Extract
- Ginkgo biloba
- B Vitamins
- Coenzyme Q10
- Blueberry Extract
- Fisetin (an extract primarily from strawberries)
Nutritional Interventions Studied in Alzheimer’s
- Huperzine A: 200 – 800 mcg daily (Biotics NeuPrizine)
- R- Lipoic Acid: 240 – 480 mg daily (Biotics Lipoic Acid Plus)
- Acetyl-L-Carnitine: 1000 – 3000 mg daily (Biotics Acetyl-L-Carnitine)
- Panax Ginseng: 400 – 1000 mg daily
- Vitamin C: 1000 – 2000 mg daily (Biotics Mixed Ascorbate Powder)
- Vitamin E: 400 IU daily with at least 200 mg gamma tocopherol (Biotics Bio-E-Mulsion Forte)
- Ginkgo biloba (standardized extract): 120 mg daily
- Curcumin (as highly absorbed BCM-95®): 400 – 800 mg daily (Biotics KappArest)
Nutritional Interventions Studied in Cognitive Decline
- Fish oil (with olive polyphenols): providing 1400 mg EPA and 1000 mg DHA daily (Biotics Optimal EFA’s, Biomega 3 liquid)
- Vinpocetine: 10 – 30 mg daily
- Pyrroloquinoline quinone (PQQ): 10 – 20 mg daily
- Phosphatidylserine: 100 mg daily (Biotics Phosphatidylserine)
- Pregnenolone: 50 – 100 mg daily (depending on blood test results)
- DHEA: 15 – 25 mg daily for women; 25 – 75 mg daily for men (depending on blood test results)
- Melatonin: 0.3 – 5 mg before bed (sometimes up to 10 mg) (coming soon)
- Testosterone replacement in men to boost free testosterone levels to between 20 – 25 pg/mL
- Estrogen and progesterone replacement in women to increase blood levels to youthful ranges
- Green Coffee extract (standardized to 50% chlorogenic acid): 400 – 1000 mg daily
- Green tea extract (standardized to 98% polyphenols): 725 – 1450 mg daily (Biotics KappArest, Lipid-Sirt, Vasculo-Sirt)
- Resveratrol 250 mg daily (Biotics ResveraSirt HP)
- Whole Grape Extract: 150 mg daily
- Magnesium: 140 mg daily as magnesium-L-threonate and at least 100 mg daily as magnesium citrate (Biotics Mg-zyme, Mg-orotate)
- Vitamin B12: 1000 – 5000 mcg daily (Biotics B12 Lozenges)
- Vitamin B6: 250 mg daily B6 Phosphate (Biotics Bio-B-100, Bio-B-Complex)
- Folate (preferably as L-methylfolate): 400 – 1000 mcg daily (Biotics Methylfolate Plus)
- Niacin: 50 – 600 mg daily (Biotics Niacin 100)
- Vitamin D: 5000 – 8000 IU daily; optimal blood levels of 25-OH-vitamin D are between 50-80 ng/mL (Biotics Bio-D- Mulsion 1000 IU’s)
- Coenzyme Q10 (as ubiquinol): 100 – 300 mg daily (Biotics CoQ-Zyme 30)
- N-acetyl-cysteine (NAC): 600 – 1800 mg daily (Biotics N-Acetyl-L-Cysteine)
- Ashwagandha extract: 250 mg daily
- Blueberry extract: 375 – 750 mg daily
- Luteolin: 8 mg daily
- S-adenosylmethionine (SAMe): 200 – 1200 mg daily in divided doses
Here are a few key Biotics products that are of benefit as part of a comprehensive Alzheimer’s Protocol:
- Chela-Zyme (Oral Heavy Metals Chelation)
- CoQ-Zyme 100 Plus (Emulsified CoQ10 – activates AMPK)
- Dismuzyme Plus 5000 (High Potency SOD/Catalase)
- Intenzyme Forte (Proteolytic Enzymes)
- KappArrest (NF-kappa B – Activates AMPK)
- Berberine HCl (Activates AMPK)
- Lipoic Acid Plus (Alpha Lipoic Acid – Activates AMPK)
- Nutri-Clear (Phase 1 & ll detox, activates AMPK)
- Mixed EFA’s
- Lipid-Sirt (Dyslipidemia – Activates AMPK)
- MCS Canada (Metabolic Clearing – phase II detoxification pathways and for hepatic, renal, lymphatic, spleen and immune dysfunction)
The old adage: “Prevention is the best cure” certainly applies to Alzheimer’s.
Treatment modalities which include lifestyle modification, diet exercise and specific targeted supplements when incorporated as part of a comprehensive treatment strategy, have been shown to slow or reverse the development of Alzheimer’s.
Robert Lamberton Consulting
Functional Medicine Consultant – Biotics Canada Products
Author of the Biotics Newsletter Articles
Certified Light/Darfield Microscopy Nutritionist
Formulator of Professional Nutraceutical Products
Copyright © 2015 R. V. Lamberton & Associates, All rights reserved.