What is Alzheimer's disease?
Alzheimer's disease is a progressive disease in which healthy brain tissue degenerates, resulting in problems with memory, behavior, and other mental abilities. It is the most common cause of dementia (the loss of memory and other intellectual abilities serious enough to interfere with daily life) and the seventh-leading cause of death in the United States. Alzheimer's disease currently affects an estimated four million older Americans, a number that is expected to triple by the year 2050.
What are the symptoms?
The symptoms of Alzheimer's disease are more serious than the mild memory changes that typically accompany aging. Symptoms may start gradually but eventually become severe enough to interfere with activities of daily living. They include:
- Increasingly worse memory loss, especially forgetting recently learned information
- Difficulty performing familiar tasks, such as cooking or making a phone call
- Difficulty finding the right words
- Problems with abstract thinking, such as trouble balancing a checkbook
- Poor judgment, such as dressing inappropriately for the weather or overspending money
- Misplacing things or putting them in unusual places, like putting car keys in the freezer
- Disorientation, such as getting lost in familiar surroundings
- Loss of initiative
- Changes in mood, behavior, and personality.
Although the course of Alzheimer's disease is individual and highly variable, most people with the condition will survive about eight to ten years after being diagnosed.
What are the causes?
The exact cause of Alzheimer's disease isn't yet clear. However, scientists know that the brains of people with the condition contain abnormal clumps and knots of brain cells, called plaques and tangles. These plaques and tangles are made up of proteins that may be involved in the neuron (nerve cell) death that occurs in Alzheimer's disease. Researchers also believe that the inflammation observed in the brains of some people with the disease may play a central role.
Who is likely to develop Alzheimer's disease?
Alzheimer's appears be influenced by a combination of genetic, environmental, and other factors. Some major factors that appear to increase the risk of Alzheimer's disease include:
- Age. Alzheimer's disease is most common in people older than age 65.
- Family history. Having a parent or sibling with the disease slightly increases risk.
- Genetic mutations. Three genetic mutations are known to cause early-onset Alzheimer's, while a form of the APOE gene increases risk of late-onset disease.
- Gender. Women are more likely than men to develop Alzheimer's disease.
- Other conditions. The same factors that raise the risk of heart disease, such as high blood pressure, high cholesterol, and diabetes, also increase Alzheimer's risk.
- Education. Research shows a link between lower education levels and higher risk of Alzheimer's disease.
- Head injury. Some studies show a link between traumatic head injuries and Alzheimer's risk.
How is Alzheimer's disease diagnosed?
Alzheimer's disease is typically diagnosed after doctors rule out other conditions. There is no specific test used to diagnose or confirm the diagnosis of Alzheimer's disease. General tests that can help doctors determine whether a patient has Alzheimer's disease include:
- Physical exam
- Blood tests
- Mental and memory tests
- Brain scans
What is the conventional treatment?
Although there is no cure for Alzheimer's disease at this time, medications can help treat symptoms of the condition. Conventional doctors may recommend one of five prescription drugs currently approved to treat Alzheimer's, depending on the severity of the illness. These medications are:
- Razayne (galantamine)
- Exelon (rivastigmine)
- Aricept (donepezil)
- Cognex (tacrine)
- Namenda (memantine)
These drugs affect brain chemicals and may help improve symptoms of Alzheimer's and allow patients to perform daily activities longer than they otherwise would be able to.
What therapies does Dr. Weil recommend for preventing and slowing the progression of Alzheimer's disease?
Dietary changes: A 2002 study published in the New England Journal of Medicine indicated that people who have high blood levels of a toxic amino acid known as homocysteine have twice the usual risk of developing Alzheimer's disease. Homocysteine levels tend to be higher in people whose diets are high in animal protein; conversely, fruits and leafy green vegetables provide folic acid and other B vitamins to help the body reduce homocysteine levels. It's difficult to establish cause and effect, but reducing animal protein and eating more plant foods is a good idea for general health, and may help to prevent or alleviate symptoms of Alzheimer's.
An anti-inflammatory diet is generally protective against a wide range of diseases, and Alzheimer's disease is believed to have an inflammatory component.
One particularly promising spice is turmeric; one of its components, curcumin is strongly anti-inflammatory. Elderly villagers in India have one of the world's lowest rates of Alzheimer's; the reason may be the turmeric that they consume in their daily curries.
Exercise: Research indicates that regular physical exercise can lower the risk of developing Alzheimer's by up to 50 percent. A Japanese study found that among 265 people with both normal mental function and mild cognitive impairment due to Alzheimer's, after one year of moderate exercise intervention, 70 percent of participants showed significant improvement in memory function. And the more the participants exercised, the greater the improvement. Aim for at least 30 minutes of aerobic activity such as walking, cycling or swimming on most days of the week.
Mind/Body: People who participate in mentally stimulating activities such as reading and playing cards are at lower risk for developing Alzheimer's disease. Other research shows that the more years of formal education you have, the less likely you are to develop the condition. The theory is that challenging intellectual activity builds up rich neural connections that function as insurance against later brain-tissue losses, just as well-developed muscles maintain their integrity longer during periods of inactivity than atrophied muscles.
Traditional Chinese Medicine (TCM): In Chinese medicine, Alzheimer's disease is not yet recognized as a separate disease entity. Instead, it falls under the broader category of senile dementia. Practitioners of TCM often recommend herbal preparations for senile dementia, more research is needed to determine effectiveness.
Supplements: Some studies suggest that vitamins C and E, either in foods or supplements, are protective against Alzheimer's. In a January, 2004 study published in the Archives of Neurology, researchers reported that older people who took daily supplements containing at least 400 IU of vitamin E and 500 mg of vitamin C were 64 percent less likely to develop the condition.
In May of 2008, the journal Neurology published a study from Boston University School of Medicine showing that people who took ibuprofen for more than five years had a 44 percent lower than normal risk of developing Alzheimer's and that other NSAIDs reduced the risk by 25 percent. This study included more than 49,000 U.S. veterans aged 55 and older who developed Alzheimer's and nearly 200,000 who didn't. Ibuprofen is the active ingredient in Advil, Motrin and other pain medications. While this suggests that NSAIDs have a protective effect, it is not clear which ones work best or that people should start taking any of them to ward of Alzheimer's. First of all, taking NSAIDs long-term isn't risk-free. These drugs can cause serious gastrointestinal problems including stomach ulcers and bleeding, and even fatal GI bleeds, and it is not known yet know if the benefits outweigh these risks. More research is needed to look at that and to determine which NSAIDs are most effective. If one (or all) of the drugs prove to work as well as studies so far indicate, the next step will be to determine when to take them - and for how long - for maximum protection.
Ginkgo (Ginkgo biloba),a traditional herbal preparation made from the leaves of the ginkgo tree can increase blood flow to the brain. Some clinical evidence suggests that ginkgo can be useful in slowing the progression of early Alzheimer's disease and age-related dementia. If you want to try ginkgo for memory enhancement, take 40 mg of a standardized extract with a ratio of 24% ginkgo flavone glycosides and 6% terpene lactones three times a day with meals. Give it a two-month trial.
Also: Avoid smoking; smokers have twice the risk of developing Alzheimer's as nonsmokers.
Protect yourself from head trauma, which has also been linked to increased Alzheimer's risk, perhaps due to low-grade inflammation as the brain attempts to heal itself. Wear a helmet when on a motorcycle, bicycle, skates or skis, and high-traction footwear when surfaces are icy.
Maintain a normal weight; a study in Neurology online in March, 2008, revealed a potential link between excessive belly fat among people in their 40s and the onset of Alzheimer's about 35 years later. Of the 6,583 people studied, those in the highest 20 percent in terms of belly size were three times more likely to develop dementia than were those in the lowest 20 percent.