If this information had been available at the time our Constitution was forged, we would have a maximum acceptable age for President, instead of a minimum acceptable age.
48
Let's make sure the whole population has as many lucratively treatable ailments as possible as long as possible. Getting there boosts the GDP and being there boosts the GDP. Simplistic measurements of activity are where it's at.
5
My husband smoked 3packs of cigarettes a day for many years. He was becoming very forgetful. He often would not remember me telling him of some event. But that was it as far as dementia went. He had heart desease and took many meds for it. He finally had a heart attack when he was 75, had quad bypass heart surgery. While in the hospital he started having paranoid delusions while in hospital and they put him on anti-phocotic medication. I noticed that this made him a lot worse. I ask them to take him off and they would but then would put him on another one.
We finally took him home without those anti-phocotic meds. He did a little better but it seems to slowly go into something else. I noticed he would have long periods of lucid thinking and conversations but then would have these hallucinations. He was an artist and the hallucinations were usually people coming in the house and moving his art around. I finally got on the internet and found Lewy bodies dementia and one of the signs is they can't take anti-phocotic medications. He was at home on hospice at the time and I showed the nurse the information and she talked to the Dr. and they said they also though he had Lewy Bodies dementia.
I was 14 years younger than he when we married. So He passed on a few years ago.
46
@Priscilla Branham I wanted to add that I am now 79. I was 14 years younger than my husband. I have an auto Immune desease called Wegeners Granulomotosis which is also Vasculitis I have been told. I have had this for 8 years now. I have notice the last 2 years i have trouble remembering words. I often substitute a word when I can't think of the one I want. Because i have to take meds to suppress my immune system, I often get lung deseases that most people would not get becausse of the meds. This really causes me the most problem because I can't execersise or even walk very far because I just don't have the breath. I think all these things are related. I think at this point I have the onset of "old age" desease or senility. I am trying to watch myself and be aware of the progression. I don't know if that is possible or not.
35
Anyone concerned about dementia should buy a home blood pressure cuff and closely monitor your levels. As mentioned in the article and a few of the comments, keeping your systolic pressure below 140 is the most effective thing you can do. Statin drugs can also help.
19
My mother, her brother, and sister all died of complications of dementia. All three were extremely well educated and continued their education into their seventies to stay engaged. My uncle was a very successful man and a competitive athlete into his seventies as well. I wish people would lay off all the blame on the sufferers. So many comments about taking care of your brain and staying active and fit. I think with dementia it’s genetic. My siblings and I are all very concerned about our own well being and discuss the topic regularly. Scary stuff.
127
@Dementia Candidate
I agree with your comment. I do believe that there's a genetic mutation that causes many to have a propensity to develop the disease. Especially, those patients who show signs of the disease at a relatively young age. Researchers are starting to face the truth they'll have to address more than one health issue to control and eventually cure the disease. I think that they're on the right track at this time. Unfortunately, they'll have to keep peeling the layers of the onion back to uncover the priority of which issues to address first, though the genetic mutation would seem the most likely. High blood pressure and reduced blood flow seem to be strong candidates along with any other health issue(s) that reduce blood flow to the brain. I'm certain that doctors and researchers have seen many patients who were physically active yet developed the disease. I've seen the outcome in several relatives and friends. It's a real heartbreak.
23
@Dementia Candidate I agree. Dementia, both Alzheimer's and Lewy Body have been in my family for a few generations. My father has Alzheimer's right now and never smoked, ran into his 60s and then walked an hour a day until he ended up in the hospital after a fall. He read books all the time until the words started to make no sense and was only a little overweight as he got older. I think the only thing that staying fit has helped him is the delay of it coming on. His mother and brother showed signs in their 60s, where as he didn't until his mid to late 70s. Because he was so physically fit, though that is changing obviously, he may live with this horrid disease for a few more years, a downside in my opinion.
Because of the many cases in our family, I am obviously concerned I too will get it. At my age there will be no cure found to assist me, this I am convinced, so instead I discuss my wants with my husband and children as to my care, when and if it is needed. That is a sad state of affair but far more realistic.
16
Just as a matter of interest because it wasn't mentioned in the article, Australia has two clinical trials running for dementia medication at the moment. Fingers crossed:
https://www.abc.net.au/7.30/australian-scientists-trial-radical-alzheimers-drug/10304508
AND
https://www.news.com.au/lifestyle/health/health-problems/aussie-pill-could-hold-cure-for-alzheimers/news-story/5092f265dd51a55ebddcd145ae40b991
But gee it seems like an intractable problem to this layman...
11
Look up Dr. Dale Bredeson's seminal work on dementia called Recode. It is a multidimensional approach that has some good research.
24
What if brains become insulin resistant like the bodies of our hundreds of millions of people with diabetes, high blood pressure and non-alchoholic fatty liver disease? Would the brain cells get sick like our coronary arteries and die from lack of nutrition? Ketone bodies might be able to make up for that deficit.
18
My mom was recently diagnosed with mild Vascular and Alzheimer's Dementia and the treatment prescribed was Namenda and Galantamine. I've seen side effects of these in many patients so I looked for a second opinion. I follow Dr. Mark Hyman from the Institute of Functional Medicine at Cleveland Clinic, and I also follow other folks like Max Lugavare. In a closed Facebook group for brain health, I posted a question about my mom's situation and someone recommended Dr. Bredesen and the ReCode protocol. Bought the book and found a Neuropsychiatrist certified on ReCode. He says he thinks my mom has a very good chance at reversal. About my mom: 70 yrs old, history of severe hypertension since the 90's, one-pack a day smoker for 25 yrs until the 90's, mild alcohol drinker in youth, skinny. Hypertension caused end-stage renal disease, renal transplant for 18.5 yrs, now on hemodialysis. MoCA score of 25. According to MRI, the calcifications are so extensive she should be in much worse shape but they think the fact she has a Master's in Literature, decades as a professor and avid reading habits have protected brain function. The bredesen protocol is very individualized (because no two people are the same), tons of blood tests and gives us some hope. Good luck to all of us and our loved ones ❤️
50
@RN I'm happy to see someone do research! Right now ReCode seems to be the best treatment program out there. Inflammation is the root cause of most disease so a carefully chosen diet is of great importance. Oxidized and/or transfats are a major problem in the modern diet. Since more people are becoming aware of this it may be why there appears to be a decline in new cases. We also must realize that sugar is the major contributor to inflammation and perhaps the population is aware of this and has reduced intake levels. Soft drinks in particular.
8
I believe that Alzheimer's, etc. starts in the womb. I think that both the roaring 20's (consumption of alcohol went up during prohibition, and much of it was "poison") as well as the Depression (poor nutrition) are having an effect on our current generation of Dementia patients.
Alcohol depletes choline, and choline offers a baby neuroprotective effects in the brain that last into adulthood. Whether through poor nutrition or alcohol exposure in vitro, a lack of choline could leave many adults vulnerable to dementia. that's just my silly theory. I think the same vulnerable people also took choline (eggs liver beef in an effort to lower cholesterol) out of their diets (double whammy) in adulthood.
Choline is an important nutrient that is only recently being added to prenatal vitamins. I don't think there is a cure for Alzheimers, I think we will just have to wait.
12
@kr You may have a point since epigenetics have been show to be influenced by the grandparents diet. But it's nurture vs nature and I think we can overcome most of these epigenetic changes with diet and exercise.
4
My friend's mother was functioning well at age 87- working part time, driving, etc. She needed her pacemaker battery replaced, and the week before she went in for surgery, her apartment had a plumbing leak and flooded. We helped by getting out a soaked rug and anything else we could, but it already smelled very bad, and the next day I was very ill from it. She had the surgery and her children let her go back to her moldy apartment, and she was never the same. She started calling with paranoid delusions involving flashing lights. I researched side effects of her medications, and it was right there- this drug was not prescribed to elderly patients elsewhere because it was not effective for them, and also caused flashing light delusions in some. One doctor suggested changing her meds but was overruled by a doctor who just happened to be the staff doctor at the local nursing home. She was diagnosed as having Alzheimer's and put in the nursing home soon after. So, in the space of a few months, she went from fully functioning to completely delusional, paranoid and angry, and that was attributed to Alzheimer's! In reality, it was more probably mold poisoning combined with the troublesome medication and the stress of surgery. I could not get her children to do anything about it because they had this fantasy that all doctors are good and know everything. It was very sad. She died 3.5 years later, and then the nursing home sued her kids for money. Big business at work.
71
My dad, 8 months gone. On autopsy was confirmed what we already knew: LBD. He was active his whole life, many friends, loving father and grandfather. But ate too much junk food and loved Family Feud. Was that it? Potato chips and TV? I had the honor of caring for him for 5 years, through falls and scary hallucinations and terrible care facilities. We can figure this out. I know we can. Donate tissue. I know it’s weird. Do it for Dave Winger and his grandson’s first baseball season without his biggest fan.
44
If I can't eat/drink by myself, and if I can't ask for help eating/drinking, my Durable Medical Power of Attorney (husband and son) is instructed to deny any artificial hydration or nourishment. No feeding tubes, no peg tubes, no IV fluids.
If I can't toilet myself or ask for help: no urinary catheters, just comfort measures.
If I can't breathe on my own, or ask for help in breathing, no artificial breathing or oxygen.
In other words If I can't do it or ask for help to do it, I'm done. Let me go. Dehydration takes about 5 days and it's not a bad way to go. I can have control by refusing care in advance.
My husband and my son have pledged to respect my wishes.
I'm a retired doc, so I know what I'm doing.
Comfort measures include mucosal morphine.
221
Don't forget diseases like Corticobasal Syndrome or Corticobasal Gangilionic Degeneration. Diseases like this can be devastating, but they're just rare enough that the local doctors--even the local neurologists! don't recognize them. There are online sites like HealthUnlocked that have more expertise and practical than the neurologists we've seen.
10
When I spend time with my 85-year-old mother, diagnosed with Alzheimer's, we look at art books, and she engages as she wishes. She looks at the paintings and makes some of the most incredible observations. She accompanies my father to the symphony, as she has for years, and I often attend as well. As the music begins, she comes alive in a new way. Over the holidays my father brought her to my house to help me bake holiday cookies. I played Ella Fitzgerald and old jazz standards, and we sang and sang. She brought a book of poems to me, and together we read. I read out loud and pointed out the words, just as she'd done with me years ago. Sometimes she could recognize a word and would say it. I don't know what is going on in her brain, but we do share in powerful ways, different than in the past, but so precious.
162
Dementia is a syndrome caused by a multitude of factors, like crime in a bad neighborhood. The Beta amyloid plaques and tangles are symptomatic, think of that like tough cops. The reason the comments are so branching, is that there are at least 15 root causes to be addressed that can lead to dementia.
There are two things in America that seem sacrosanct these days that used not to be. There is no scientific controversy these will dramatically help with your brain and heart health:
1) Exercise a significant amount: remember the presidential fitness test during the Kenedy era? Who could pass it now? This would go a long way towards addressing vascular dementia.
2) Get natural sources that boost glutathione (soy-but our soy supply is riddled with toxins) and organ meats like kidneys and brains (but we can't eat brain anymore- same toxic food supply reason) but people used to be able to and the brain health effects are superlative
3) Forgo all sugar and alcohol. No excuses. We have been made into a nation of sugar addicts-- just look at the adversing. No amount of "flavonoid" pills can stem the tide of sugar attacking your brain and your insulin regulation. Alcohol is more insidious because it opens the capillaries and all your bloodstream's toxins directly into the brain, and it's sugar.
4) Meditate- every day
I am basing this on years of health coaching and experience working with people with dementia as a caregiver.
There is good news and people willing to help. ALZ.org
30
@Carolina Madeleine Reid
The differential diagnosis of every patient with dementia must include an infection with Borrelia.
Proper testing (not CDC) is critical.
In the NEJM,Jan., 2013, case report, an 80 y/o female with a 4 month history of progressive dementia was diagnosed with Alzheimer's Disease.
Because of a past history of Lymphoma an examination of her spinal fluid was performed to rule out recurrence of the Lymphoma in her brain.
The spinal fluid revealed spirochetes, Borrelia Myamotoi.
The patient was treated with antibiotics and the demential disappeared.
35
@Carolina Madeleine Reid I agree with a lot of what you say, but I also agree with a lot of what is in the Blue Zone books. Those people are all daily alcohol drinkers (in one Blue Zone they have their first small glass of wine at 10:30 AM!) and they live long healthy lives with low rates of dementia. There are no guarantees.
16
There is a very successful trial being run in Perth Western Australia that appears to be reversing many aspects of Alzheimers, so there are lost of people working to find a cure.
My stepmother died of Alzheimers and my Dad of Parkinsons, both awful diseases.
12
@Sharon Phillips
Both Alzheimer's and Parkinson's are caused by Borrelia Burgdorferi infection (Lyme Disease).
This spirochete infection may be transmitted sexually.
The occurrence in spouses is predictable.
16
This article really grabbed my attention, because unlike all other disabilities, cognition is essential to maintaining a quality of life we all understand. If one out of two persons reaching 90 has (serious) dementia, this problem is hugely important and needs effective treatment. Just as an infant can't yet properly communicate its needs and wants to parents, the neurologically impaired patient also presents a complex array of problems. I saw this in my own family and it drove us crazy with worry and concern. Medical advancements are great as drug companies will constantly remind us, but TV ads ignore the many conditions that defy our efforts to solve. They should be reminding us of these problems as well, and why research is urgently needed. Cancer specialty hospitals are but one way of helping patients with serious conditions, but this should be just as important in the minds of the public. "No one wants to get old, or feel old". Could this be one of the reasons in the back of our minds as we apply more wrinkle cream to our faces? I keep thinking about Steven Hawkins, who didn't have a great life with ALS taking away so much of his failing body, but his mind was still intact and he was able to fight back and overcome a hundred challenges that were devastating, overwhelming. I would hope we do all we can to protect this irreplaceable capability even as the years pass away
and we eventually see ourselves turn into our grandparents.
10
The dementia of Syphilis (a spirochete infection) is indistinguishable from the dementia of Alzheimers. Another spirochete disease, Neuroborreliosis (Lyme Disease) caused by Borrelia Burgdorferi also produces dementia indistinguishable from Alzheimer's.
The pathological findings in this patient's brain, including Lewey's bodies are also seen in infections caused by Borrelia Burgdorferi.
Every patient with a Neurodegenerative Disease including Alzheimer's MUST be PROPERLY tested (not CDC) for an infection with Borrelia.
The treatment is with appropriate antibiotics to eradicate the infection.
Neurodegenerative Diseases can be effectively treated and do not have to be fatal.
30
My father had malaria, which he contracted on a trip to Africa when he was 65. His cognitive function declined after that, and though he was never diagnosed with dementia, he was significantly impaired and those close to him could see it. He has now been gone 10 months. He died from lymphoma, but this was not discovered until an autopsy was performed. His brain was found to be completely normal. I wonder if malaria and/or lymphoma can cause dementia like symptoms? By the way, he was a runner and lived a very healthy and active life.
10
@Alfred Miller,M.D.
Excellent suggestion regarding the possibility of brain infection with spirochetes. Please consider also the oral spirochetes as possible causal agents, based on the following article by the Swiss neurologist J Miklossy, who finds ca. 25% of autopsied Alzheimer's patient brains to be infected with B. burgdorferi and 90% to be infected with oral spirochetes, originating in the human mouth (see bar charts):
https://www.ncbi.nlm.nih.gov/pubmed/21816039
9
Have there been any studies which compare the brains of strictly vegetarians versus people with other diets? What are the results? I'm betting the no meat eaters have very few, if any, decreased blood flow to the brain or Alzheimer.
6
@Jimmy
Thank you for your question. I was going to ask the same thing. Actually we as a society are not protein deprived but fiber deprived. Is anyone addressing the elephant in the room. What are people eating?
12
@Georges
I think you will find more and more people are getting the message about the need to eat more fruit and vegetables.
As a child I always pushed the meat around on the plate and ate the vegetables. My fruit and vegetable habit continues today.
6
@Jimmy
my understanding: Parkinson Disease higher in vegetarians my experience: studying in South India Siddha Vaidya medicine-Found that Hindus-the largest religious vegetarian population call fish SEA VEGETABLES.
3
Dementia is not too bad, and even has its benefits. The patient can enjoy sports on tv or soap operas, and like many animals, he has no concept of death. He is immortal. He certainly doesn't worry about Donald Trump.
13
@Diogenes
If spectator sports and soap operas are a measure of the quality of life, well... I will flunk when I get that old. I believe neurologists suggest crossword puzzles and Scrabble to (help) ward of dementia. Couch potatoes with remote controls are not the model to aspire to.
13
@Diogenes, That's a crock of rancid something or other. There are NO benefits in dementia. My late husband could not watch TV because he couldn't follow a game, couldn't follow a plot, lost sense of time and place, lost the sense of who he was, and spent hours searching for something he couldn't name.
He suffered terribly, but just couldn't tell anyone about it because he no longer had speech. His facial expressions and body language said a lot; the last six months of his life were tormented, and a torture for me to watch.
40
@Diogenes
A silver lining indeed!!
1
My mother died at 65 from a rapidly-progressive dementia, and three different neurologists kept telling me it was Alzheimers. Even after she had a post-mortem brain autopsy, and the report said it was vasculitis, not Alzheimers, that had caused her strange symptoms and death, the neurologist (from a top academic institution) STILL insisted it was Alzheimers because of the presence of amyloid. Her brain was a puddle of blood per the autopsy report. We need more clarity on the many CNS pathologies that manifest as dementia.
43
Wondering whether any research has shown an association between carotid artery disease and Alzheimer’s. Since there is documentation of decreased blood flow to the cerebrum in Alzheimer’s according to this article, a greater likelihood of Alzheimer’s for those with a narrowing or blockage in the Carotid, the artery that supplies blood to the brain, would seem an obvious question to explore.
7
@Eugene Shear This is hardly scientific, but my mother died of alzheimer's complications, and did not experience any carotid blockages. My dad died at 90 after a heart attack at 62 that reduced his heart's efficiency to ~30%, and operations on both carotid arteries in his 80's. He never suffered any Alzheimer's or dementia symptoms.
12
Article: “Dr. Hofman is convinced that the precipitating factor is diminished blood flow to the brain. “Alzheimer’s disease is a vascular disease,” he said. …[and]
Dr. Seth Love, professor of pathology at the University of Bristol in England, noted that a core feature of Alzheimer’s is a reduction in blood flow through the cerebrum of the brain.”
So how to get more blood flow to the brain?
Easy. Just as the cocoa flavanols in dark chocolate provide better arterial dilation in the body (https://vimeo.com/138675927 and scores of medical literature cites), they also provide better blood flow, oxygenation, and endothelial health in the brain.
See, in particular, PMID 25344629, 16794461, 18728792, 26047963, 27088635 & 30413065. (Also PMID 30513729 & 30060538.)
So we should expect better memory and cognitive outcomes in the aged with more cocoa flavanols and dark chocolate, right? Surprise—we do.
See PMID 22892813, 25733639, and 27163823.
Seems to me that the answer is obvious. Instead of taking daily vitamin pills (which have been shown to be useless), everyone of a certain age should be taking daily flavanol pills.
The development and testing of such pills should be a top medical priority—a dementia moonshot effort.
(Besides preventing dementia, the cardiovascular disease prevention co-benefits will be staggering. That is simply what all the data that we have say.)
10
@SRP
The beneficial ingredient in dark cocoa you refer to is called choline. It is in other foods as well, including many nuts. Another way to boost choline besides diet is to cut down on OTC supplements that are known to have anticholinergic properties. But don't take my word alone on all this. Start with google and wikipedia. And then hope for a steep learning curve.
5
@SRP THANK GOD!! I just knew chocolate was the answer.
26
@Anon (another woman) I did google this because I was pretty sure that choline and flavanols are different things. Eggs, liver, and seafood are the best sources of choline, but cocoa and chocolate do contain some. Flavanols are found only in plant sources. The processing of cocoa and chocolate may destroy most of the beneficial flavanols, however.
6
Rest, relax,
sleep enough,
sleep deep,
be in nature,
be inspired by its animals.
its flowers and its trees,
be with people who laugh and speak
their minds,
if you can afford spend time
in other countries,
be with the graceful and old for peace,
be with the young and brash for excitement,
be with the spiritual for exercise and meditation,
above all be by yourself to write and read,
to exercise and to breathe free
the oxygen there is to breathe,
in your house with plants go green,
eat clean, chew well and enjoy what you eat,
love yourself and know
that if you don't nobody else will,
slow down, do nothing and be still.
I know people in their nineties who are not demented. Alzheimers is not high in India. We use turmeric and cumin and all sorts of spices liberally. They add zing to your recipes, they enhance the flavors of everything you eat, they speed up your metabolism and clean out your arteries. Beets and Amla-- Indian gooseberry--hot peppers and greens of all sorts, eat aplenty. Food and sleep and relaxation, love and human contact are the medicines we all need.
76
@Usha Srinivasan One cannot generalize these without good data. My two sisters and a sister-in-law, all pure vegetarians have Alzheimers. another one died of the rapidly progressive Crutzfelt-Jacob disease. They may be generally healthy otherwise except for dementia which is often masked in joint families and a set routine of a simple life.
14
@Raghu Ballal
This, then, might be germain to the spirochette phenomenon noted elsewhere.
4
@Raghu Ballal
My experience in South India studying Siddha Vaidya medicine: Hindu population-largest 'vegetarians group-call fish SEA VEGETABLES.
2
Yes many factors and one thing will not be the answer. A very good research paper has discovered a "prescription" of various things we all can do that definitely reduces the dementia changes. Its based on very good science and has valid proof. Its cheap and means changing your habits.
See letswakeupfolks.blogspot.com- Mental decline and what we can do for a important addition to your life styles.
3
@RichardHead Thanks for this information; the blog "letswakeupfolks" is fascinating. Thanks a million Richard.
1
We've detailed how neurodegenerative diseases are predominantly protein level, non-genomic diseases involving matrix breakdown (Maguire, 2018,Neural Regen Res. 13(7):1185-1186) with resulting protein misfolding and prion-like spreading of the malformed proteins (Maguire, 2017, World J Stem Cells. 9(11):187-2020). We've discussed how the exposome underlies the initiation and maintenance of these disease state, and how diet is critical to preventing and remediating these proteinopathies (Maguire and Maguire, 2019, Rev. Neurosci, 30(2):179-201). We also have a new paper (Maguire et al, 2019, Physiological Reports, DOI: 10.14814/phy2.14072) showing how a "physiological renormalization strategy" can rescue neurons by acting at misfolded proteins. In principle, the strategy is similar to what Nobel Laureate James Allison , Ph.D. developed to renormalize immune cell physiology in his "checkpoint inhibitor" work. In other words, we renormalize the physiology in the nervous system so that protein misfolding is quelled, whereas Dr. Allison renormalized the physiology of T cells so that they could once again attack cancer cells. These are new strategies in therapeutic development.
16
This is from the Institute for Dementia Research and Prevention at the Pennington Biomedical Research Center in Baton Rouge, Louisiana:
“... Some of the more common forms of dementia in the elderly include Alzheimer’s disease, Vascular dementia, Frontotemporal dementia, Dementia with Lewy bodies, normal pressure hydrocephalous, and Parkinson’s disease with dementia. While there is some overlap between each of these disorders there are important clinical and pathological differences between each of these disorders. Additionally it is important to point out that there can be cases of mixed dementia, in which multiple forms of dementia are present in the same individual. The Institute is working to understand the basis by which aging promotes each of these disorders in order to develop better ways of detecting the disease and developing interventions which prevent dementia in the elderly...”
As for what causes dementia, here’s what the IDRP has to say:
“...the vast majority of cases of dementia in the elderly cannot be explained on the basis of genetics alone. Aging is the single biggest risk factor for the development of dementia. Additionally, studies at the PBRC and other institutions are finding that a number of dietary and lifestyle choices can modulate the development and progression of dementia and brain pathology. Similarly, obesity and diabetes may be potent modulators of dementia...”
Note that AGING IS THE SINGLE BIGGEST RISK FACTOR.
14
@Ann Yes true but how we choose to age is Key. We have choices and some can definitely reduce your chances for dementia. See letswakeupfolks.blogspot.com-mental decline and what to do
@RichardHead Where are the references in your blog to the various studies cited?
2
After many years of suffering my wife succumbed to Alzheimer recently. The only way to revive her brain was music, especially the music she listened to in her youth.
36
I find daily work with younger people, with intense memory effort, has worked well. Perhaps the brain is more of a muscle.
6
Science seems to be so focused on causation which is hard to prove and usually multi-factorial. How about a meta epidemiological study of 80+ year olds who thrive and showing us what their common habits and traits are? I would guess that preventing or limiting dementia is likely determined by lifestyle habits formed in our much earlier years that have cumulative protective effect.
38
@elotrolado
The University of California at Irvine is conducting such a study amongst people over 90. It started in the 1980's. I saw it on 60 Minutes some years ago, and know some folks in it.
6
@elotrolado What good will this do if the factors involved mostly aren’t lifestyle?
2
My stepdad died of Alzheimer’s. He was a health nut, daily jog, regular tennis game, and nonsmoker.
The disease does not have a single source. It’s gradual onset requires a loved one to be alert to the earliest signs of memory loss.
I am in my early 50s and already feel more forgetful than 30 years ago, less “quick” generally. Is this “normal” or the more ominous??
I think there’s likely not an effective wAy to halt aging’s effects on the brain... period. A healthier approach is to maintain the awareness and presence of mind to spot the tiniest signs and take a daily habit of being mindful.... do something to be proactive with regular activity and exercise
41
Off in the future. when all the killer diseases have been prevented or cured and our life span goes way beyond the limits of repetition and boredom, what will be the cure?
10
@RonRich
We already have 8 billion or so people on the planet, and many questions about the ability to feed them all (us all). Limits of repetition and boredom? Really? I'm nearing my middle sixties and my current projects will take 20 years to complete, and every couple of years I add another. Boredom might be a lifestyle, but it should not be a symptom of old age. To help avoid dementia neurologists recommend keeping your brain active. Never to late to start that!
6
The real problem is that for years Alzheimer’s was the label placed on many patients who had either mixed or other causes for their dementia. Thus many people were enrolled in trials with no chance of benefit from the experimental meds. Pure vascular causes, either mini strokes or decreased circulation from occlusive diseases are probably much more common in the elderly.
23
May I suggest we stand on our heads. Bend over, stretch,
shake your head. Get your blood flowing and your synapsis snapping! Meditate, breathe deep and send oxygen to your brain with love and care and the intention of cleaning all nasty debris away. Love your brain, love your body. It's your life time vehicle. Take care of it!
45
@Kathryn Graves
Inversion equipment is now available at ~$125. It only takes 5-10 min a day. I feel an improved level of alertness afterward.
But first, discuss this with your doctor.
7
I spent a good chunk of my life studying adult cognition, memory disorders, and pharmacological treatments for dementia and other memory disorders.
Human cognition is not a machine that one can simply replace broken parts for. The physical state of our neuropsychological apparatus provides a context (and limits) for how we *might* think. Things like our education, culture, work, experience, and daily habits, provide a given impetus for how we use that neuropsychological apparatus. Over our lives, the cognitive strategies we deploy become automatic and largely invisible to us. All too often, by the time sufficient symptoms have brought a possible diagnosis of dementia to clinical attention, the individual has lapsed, steadily and inexorably, into a set of hard-to-break "cognitive habits", based on how effortful it is to think otherwise. Buying a book of sudoku or word-search at age 70 is unlikely to fix that, and neither will any drug instantly create useful and automatically-deployed encoding strategies for the older rememberer.
None of that means it's hopeless. But it does mean that we need to be more realistic in our expectations of treatment, and that we (and clinicians and researchers, especially) need to think more about the evolving connection between health and cognition across the lifespan.
49
@Mark Hammer
I might suggest to all that learning technical neurocognitive skills in college like "academic discernment," might go a long way toward keeping the habit of asking questions one's whole life, and keep the curiosity freely flowing. One can build a foundation, perhaps, in K-12, but then skills like the one I mention can supply you with a lifetime of "connecting dots" from the foundation to the new data we input all our lives. Post-modernists say that language and concepts are highly connected, so the greater your language, the better are your odds of learning new concepts, which then, even if you get alzheimer's (like my mother did), then your brain can re-wire around the neural networks to your advantage for at least a couple of years, giving those years more quality and helping you communicate even after signs that it is starting to fail.
5
"Anti-aging" endeavors - drugs, diet, exercise, genetic/epigenetic manipulation - are bound to contribute knowledge to the dementia puzzle. New discoveries about the damage senescent (still alive but non-functional) cells do by hanging around past their use-by dates is leading to development of "senolytic" drugs that might extend the mileage of one's brain. In the last few years of my mom's 101 year run, she was diagnosed as having "vascular" dementia which never seemed as bad as those around her with diagnosed Alzheimers, and she never completely lost it like they did. I have the strong feeling we are on the cusp of curing this curse of old age. Otherwise, when I get there, please give me the red pill.
https://seniorjunior.blogspot.com/2018/06/can-you-buy-some-extra-years.html
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"The Many Benefits of Hydrogen Peroxide", by David G. Williams. The big pharma's DO NOT want you to have this information. It's not crazy, I do this therapy, a/k/a oxygen for the brain.
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Alzheimer's cure? There is only one proven strategy for reversing cardiovascular disease and thereby improving blood flow to your heart and brain. That is a switch to a whole plant food diet. If you are concerned about this issue affecting you or your loved ones. This is the only path that can help you. This is the diet of all of the communities in the world where there is no heart disease, diabetes, and Alzheimer's. There are no expensive supplements to buy. No gimmicks here nothing to buy. Just eat no processed foods, meats, fish or dairy and watch the pounds melt away, brain fog lifted and your general health dramatically improve. Google Dr. Neal Barnard or Dr. Michael Greger and your life and the life of everyone you touch will change forever.
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You have a profound lack of understanding of the disease and are simply using it as an opportunity to push your own personal agenda, which isn’t backed up by science. Eating more vegetables is certainly a wise decision, but a purely vegetarian diet isn’t the healthiest. Ask any dietician and they will recommend something like the Mediterranean diet, which includes abundant vegetables, but also moderate amounts of high quality protein. Communities with exceptionally long life spans, such as the Okinawans, include some protein in their diets. The key seems to be moderation and choosing healthier forms of protein, such as fish. I have considered being a vegetarian, but for ethical reasons, not health reasons. Anyway I knew a friend of my parents - a renowned surfer who lived in Hawaii and had books published on the subject. He was an ardent vegetarian and a health nut who surfed every day up until his 70’s. He was also highly educated, had a wide circle of close friends and ran his own small printing press to self-publish a local newspaper. All in all, the picture of health, with none of the risk factors associated with Alzheimer’s and no history of any major illness. Unfortunately Alzheimer’s chose him as a victim despite everything. I wish people would stop victim-blaming.
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@Stephen
my experience of studying Siddha Vaidya medicine in South India: Hindus-the largest population of 'vegetarians' call Fish SEA VEGETABLES.
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The latter section on vascular health highlights the health benefits of sauna bathing. There is recent data that shows the inverse correlation in Finnish men between Sauna bathing and dementia onset. This link also holds true for cardiovascular benefits. The benefit of sauna bathing for the vascular system is related to the production of heat shock proteins which promotes vascular health and pliability. 20 minutes a day keeps Alzheimer’s at bay should be the new slogan. Google “Sauna and Dementia” to find the 2017 Finnish studies
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@JmP, MD
My hot flashes ought to have me set for life.
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@JmP, MD I don't have access to a sauna, but from what I understand, taking a hot bath also creates heat shock proteins, so that's the method I use, with epsom salts to get magnesium. https://www.bbc.co.uk/programmes/articles/5yV29Kvy5VjxL385H0XstKW/could-having-a-hot-bath-give-some-of-the-benefits-of-exercise
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@JmP, MD
I studied Siddha Vaidya medicine in South India. We make heat shock protein during a process called KAYA HOT OIL.
The ancient practice KAYA HOT OIL addresses disorders of movement or motion-not virus, bacteria, fungus, parasites- but Old Age, diabetes, neurological disorders or mechanical difficulties.
I have had good results with clients suffering from ALS -slowing progression of ALS to one tenth normal speed & Parkinson-addressing cramping & fasciculation.
Thanks, excellent article! The problem with conditions like Alzheimer's disease is that the illness is diagnosed by symptoms and pathology, neither of which give us the full story of what cause had which effects.
To me, the key take home is that overall health, especially cardiovascular health, is an important factor for most of us who are at risk for non-familial Alzheimer's.
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It amazes me that all of these researchers can't properly explains what is happening with causation to Alzheimers and dementia, but at least this article scratches the surface when it brings up vascular issues. Finally!
Alzheimers and dementia are CAUSED by the western diet of high cholesterol consumption, which over time clogs the arteries in your brain. It's simple, but unreported due to the dairy industry's grip on food research. Change your diet and you will suffer NONE of these abnormalities.
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@Dallas Read, It amazes me that you are so sure you have found THE cause. And can promise no abnormalities!
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@Dallas Read... incredibly simplistic and generalized. If only dementia and the answers were truly as easy as you seem to think.
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@joan
This Comments section is full of personal views and beliefs on what causes mental decline. I for one would like to see how these people are doing 30 years from now. My own guess is that 50% of them will be in dementia if they survive to their 90s. In other words, no difference will be found in long-term clinical studies.
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The problem of dementia is as complex as the brain itself. I hope people don't start relying on blueberries and exercise to prevent brain disease.
My FIL was a lawyer, star athlete and very active in the community. He died at age 62 from a 10-year battle with Alzheimer's.
My husband left work at age 48 because of cognition problems. Strangely, PET scans show frontotemporal decline and he doesn't have symptoms of Alzheimer's. Tests on his spinal fluid indicate he doesn't have the genes for familial Alzheimer's. Again, he was fit, athletic and very engaged socially.
According to our neurologist, young onset dementia (under age 65) isn't rare - it accounts for up to 10% of the total population that has dementia.
Brain disease is a brutal blow to families. We take each day as it comes and support other younger people with dementia with a wellness day program called YouQuest to improve their - as well as their care partners' - quality of life.
#YouQuestCalgary #Youngonsetdementia
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Just saying --- that new recommendations telling seniors to avoid 81mg of ASA (aspirin) might be truly idiotic in a vascular disease analysis and (aging) pathophysiology considerations.
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@terry brady Aspirin and other blood thinners do nothing to promote vascular flow of oxygen-rich blood, which is what the brain needs and what all pathogens (spirochetes and cancers included) despise. I was advised years ago by the owner of several memory-care institutions and by the MD-in-charge at a large public 'old age home,' that we don't know why (or didn't at the time), but most Rx drugs have the effect of reducing oxygen flow, regardless of how effective they are at treating the prescribed-for condition. Their recommendations? As a preventative, AVOID Rx drugs at all costs in the first place. (Rx drugs are a significant, relatively new addition to the American 'lifestyle'. Has anyone investigated whether the rise in the use of Rx drugs tracks the rise in incidents of dementia?) Alternatively, AT MOST take no more than FOUR Rx drugs. (They advised that studies show that beyond 4, the interactions become synergistic, unpredictable, and clinically problematic in and of themselves.)
Effective methods of oxygenating blood (and thereby brain)? Aerobic activity (it's in its name!--STAY physically active); acupuncture (my vascular-dementia-affected mother lost all signs of aphasia when she was on the acupuncture table); hyperbaric oxygen treatment (shown to be effective in recovery from Lyme, treatment of Traumatic Brain Injury, among a long list of other conditions); saunas.
AND follow Dr Bredesen's protocols (it's what neurologists are doing for themselves!).
2
A cofactor discovered in autopsied brains of those suffering from a wide range of neurological dysfunctions is aluminium, a well established neurotoxin not revealed by micrographic analysis.
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The epidemic of dementia-related diseases is not going away, it is only compounding. What this country needs to do is finally embrace the right-to-die across all states to allow those afflicted or who will be afflicted by terminally-ill diseases to end their life in a dignified manner. My brother and I have spent the last 4 years watching our mother decline further and further. She can no longer speak in an audible coherent manner, she is on a purèed diet and confined to a wheelchair, and as a result her muscles have become constricted and causing her a fair amount of discomfort daily. She is under hospice care, but even that is no way to live. We see our father experiencing the beginning stages of 'senior moments' now as well. I wish we would have had been more proactive in speaking to my mom about the inevitable instead of passing it off as nothing. If this country cannot find its way to allowing people to die with dignity, then at the very least, our nursing homes and memory-care facilities need to be regulated in order to ensure better care, more dignified care. Fortunately, our mom is in the best (and most expensive) facility in town - and it it still lacks the qualified care that residents deserve. Whether you end up in a private pay facility and paying $10,000/mo or a subsidized facility, you deserve better.
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@William. Yep. I see your point -- and empathize. I'm 78 and have Alzheimer's or CTE, or some other type(s) of dementia, and the last thing I want is to punish my kids with expensive, frustrating, and emotionally debilitating constant personal care for years. Yet, the question remains: how do you deal with it? I dunno. It's possible that a law permitting assisted suicide might help. It might at least mitigate guilt and take the responsibility off the heads of our kids. I'm not sure, though, how to decide when the right moment has arrived. Surely, one doesn't want to miss the last few days of recognizing and appreciating his/her grandkids, but when does the moment arrive that it's too late to make the decision. A little help from people who deal with the issue regularly and objectively might be useful.
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@William
I agree with you 100%. I watched my mother go through the same, sad end.
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@William
I watched my mother, father, and 72 year old sister all die from complications of dementia. They each had two forms of dementia. You can imagine my concern. I WILL NOT allow my loved ones to suffer as I did watching them deteriorate. If your family is supportive, I would write a living will that lays out what needs to occur for you to terminate your life then go to a state that allows it. I presently have no symptoms but have already taken that course. When I reach the benchmark I have set, my family is supportive of me terminating a life that is not worth living for me.
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My guess is that moderate weight lifting twice a week for twenty minutes, avoiding sugar, walking 30 minutes a day and eating more fresh fruit and veggies would be better than most medical approaches. Of course keeping weight down and not smoking are desirable. Also a happy mind, a meaningful job, a loving relationship and a pet are good to have. A nice house, in a safe neighborhood, frequent vacations and self esteem are also desirable. The mind and body work together.
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@Michael, 78 years old, single w/o children, retired diplomat, living in independent apt in con care community. Please send me ASAP a meaningful job, nice house, cleaning staff and driver. means for frequent vacations, a lover, a pet, not allowed here so an overnight pet care person; I'll take care of eating the fruit.
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@Michael, my FIL did all of those things you mention and he died at age 78 of Lewy Body Disease, a Parkisonism whose hallmark is dementia. My mother did the exact opposite of what you recommend, was overweight, sedentary, had high blood pressure and smoked for 50 years. She died at age 89 with a mind as sharp as a tack. Severe COPD got her in the end, but definitely not dementia.
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@Michael
This is often heard yet still good advice. At the beginning anyway. I have a terrific pet, a nice enough house and live in a safe as can be these days country neighborhood. To me it is an absolute truth that mind and body are inextricably linked. Self esteem, happy mind and frequent vacations? Nice if that's the world you live in. Saying that, I'd be pleased to donate my brain to science today in honor of Suicide Prevention Day which just happens to be... April 10th!!! Not to worry, I have no plans to check out. But some were never blessed with a happy mind and consequently never picked a healthy loving healthy relationship, both being vital to any prescription for long term health. So I'm glad to live in a state that respects the right to die. I'm too old to wait for a medical breakthrough but happy to donate my brain if others can benefit from its dissection and inspection since I'm pretty sure it's an anomaly. Or at least on the odd side.
8
I for one am glad that doctors and researchers are still trying to find the cause and a treatment. My husband's parents both had Alzheimer's by their eighties - luckily if vascular health is a predictor he is in excellent shape to stave it off, but may not be able to completely avoid it before his late eighties. People who complain about the high cost of drugs should remember that R&D is funded by the profits. I want a better balance between price and value, but I also want to see the big trials continue - and they are very very costly
6
About the title, Alzheimer,s can only be diagnosed post Morten and there is no treatment, But several points have a commonality, blood flow to the brain. Diabete effects small vessels Multi infarct dementia could possibly be prevented by controlling hypertension.
I personally like the theory that placques and tangles are remnants of dead neurons.
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@F Varricchio
You're right and you're right. Once upon a time, the diagnosis was either "dementia, Alzheimer's type" or "organic brain syndrome." Now I see the Alzheimer diagnosis thrown out right and left, often without corresponding evidence, whatever that might be.
We stuff these unfortunate individuals with various and sundry medications which, in my experience, have little to no effect.
My lovely, vibrant mother developed dementia. I watched her decay. My only comfort was when she would say that her sister and my sister (both had been dead for years) visited her. She seemed to enjoy those.
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My husband was diagnosed w/ Alzheimer’s, Parkinsonism and Lewy Bidy dementia, variously. No one really knows without a brain biopsy/autopsy. Whatever it’s called, it’s devastating.
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@Samantha Kelly, my FIL died of Lewy Body disease, with the dementia that accompanies it. Lewy Body disease is a Parkinsonism highlighted by dementia. It presents initially as Parkinson’s but the trajectory is very rapid. For my FIL, the time from the first symptoms to death was 15 months, the last 8 of which entailed severe dementia. A consulting physician made the Lewy Body diagnosis only a few weeks before he died. His treating physician kept saying it was Parkinsons, but couldn’t account for the rapid progression and the dementia. And yes, it was devastating for his wife and his family to watch the disease play itself out.
Real Parkinsons progresses much much slower. Ironically (or not) my SIL (FIL’s daughter) has Parkinsons and she is 10 years out from her diagnosis. No sign of any cognition problems. There may be some connection between the father and the daughter getting somewhat similar diseases, but to date we don’t know of any. Neither one of them has a “cure”.
15
Yet another failure of the scientific method that tries to "test" one factor to the exclusion of other factors. The main thing that needs fixing here is how scientific studies are performed. When the scientists don't know what the factors are, it is simply guess work when deciding what factors to include and exclude.
And, in the meantime, walk 30 minutes almost every day and eat an apple or other fruit is still the best advice.
5
This article ignores the work of the UCLA neuroscientist Dr. Dale Bredesen, who has found many factors contributing to the disease, including diabetes, and has worked out a protocol with testing to find out the underlying cause, and then treatment which halts the progress of Alzheimer's and can reverse. Recently a published study of 100 people demonstrates this. See Dr. Dale Bredesen and Recode.
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@Sandra
I am a firm believer that like many human malady's that come with age.. there is no single root cause, but rather a cocktail of lifestyle, diet, and genetics. Which I think is one reason cause/treatment cycles for dementia are so difficult.
In my view, the post mortem analysis of the presence of plaques and lewy bodies in the brain are not the cause, but rather symptoms. Hence treating the symptoms being a trap so many medical researchers fall into.. this is a dead end.
Healthy blood and healthy blood flow are likely the biggest mitigation of dementia illnesses. And of course blood health and healthy blood flow are actually easy to test for and are known factors in age related decline in health in a wide range of different systems in our bodies. So to me.. the dominant question here for medical researchers is: what can be done to improve overall health of one's blood and vascular system... and not just once dementia signs appear.. but beginning in early middle age when our bodies begin to show the signs of early breakdown in ideal health profiles.
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@Sandra
Most of Dr. Bredesen's claims are not supported by research findings, which does not mean they are not helpful, just that they are not proven. No one knows the "underlying cause" of dementia, as this piece points out.
One clue to determine the legitimacy of health claims is to ask, are they selling stuff and making a lot of money? Brednesen is.
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@Chuck
Try swimming. Easier on the joints than walking or running.
5
There is so much conflicting information on Alzheimers out there that it is hard to determine if this argument is valid or not.
Everything from Alzheimers being another form of diabetes to blaming environmental exposures and genetic predispositions.
It is an expensive disease to have in terms of medical care and dementia based housing.
I'm glad these scientists are starting to rethink their approach to this devastating disease. It is far past time to try to think outside the box in terms of possible treatments or perhaps a vaccine to prevent the problems to start with.
I wish them much success and soon as I have a close family member with the disease which increases the chance for all the relatives to wind up with this too.
11
This exposes an all too understandable intellectual mistake made by all of us: we believe that one phenomenon has one cause. As a physician working for 20 years, I have seen and made this error time after time. Human beings are vastly complex systems that typically cannot be reduced down to univariate analysis. Illness is usually the result of a combination of factors, not one in isolation.
This makes science, and medicine, very difficult at times as problems have multiple slices, much like a pie. Figuring out which slice is most important is challenging. A heart attack isn't just due to cholesterol - there are contributors from genetics, hypertension, lifestyle, inflammation, plaque stability, and multiple other reasons too numerous to list.
Yet we persist in our search for the "one reason", as in this case with plaques / tangles. Clearly there are many other factors involved, and I am willing to bet that a rational approach to preventing dementia (I seriously doubt there will ever be a cure) will involve a multimodal approach involving lifestyle choices (avoiding tobacco, exercising, limiting calories), and judicious use of medications to control blood pressure during early to middle age as well as new therapies that may end up addressing undiscovered risks.
It won't be one pill. Many successful therapies, such as those for HIV / cancer involve combinations of approaches. So will it likely be for this multi-headed disease that is the sum of decades of aging.
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@Nicholas Browning
Excellent analysis, doc. I’m not a doctor, but I wonder about the effects of inflammation and infection on dementia.
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@Nicholas Browning
The same sort of approach can, and should, be applied to autism. Both dementia and autism are first and foremost *social* categories. I don't say this to suggest they are ephemeral or made up. Far from it. Both are profound problems for the individual and those close to them, with a neuropsychological basis. However, they come to our attention, as onlookers, by virtue of a constellation of symptoms we perceive as "a problem with X"; a social judgment about the person. The great diversity of characteristics *within* the category can be overlooked, leading us to mistakenly think that it is a monolithic problem with a singular cause.
Both autism and dementia are broad categorical *outcomes*, each arrived at in many different ways, with different symptomatologies, trajectories and different aetiologies. We have long since learned to think of cancer as having different types with various combinations of causes and treatments, as opposed to grouping it all as "consumption", the way we did generations back. It's time to start thinking of both dementia and autism in the same way as we've learned to think of cancer.
9
I'm not specifically trained in medicine, so anything I say here is just as much a question as it is an opinion.
Reading here about the difficulties in doing research on dementia in general and Alzheimer's in particular, I kept thinking about the history of research on the effect of cholesterol. Cardiovascular disease is as major a health problem as dementia. From the beginning, it was noticed that cholesterol level was correlated with vascular health. There was even an obvious possible mechanism, since plaques were often filled with cholesterol.
Forty or more years of intensive research have gone by since then. We obviously know a lot more about vascular health and the role of cholesterol in it. The dramatic drop in vascular disease in recent years certainly makes that obvious.
However, our understanding of the role of cholesterol in all this has become more nuanced. I personally remember when doctors began to test for the ratio of good to bad cholesterol. My overall cholesterol level was OK, but my ratio was bad. Other members of my bloodline found they had the same problem. Some of us, especially me, started taking niacin. Meanwhile there were promising tests of a new drug to raise the good/bad ratio. I was asking my doctor about when I could try that. As it turned out (or as I remember), changing the ratio in that way didn't help the problem. It just skewed the use of this ratio as a diagnostic tool. Are tangles part of a causal chain or just a diagnostic?
23
Blood flow seems a much more lucrative target than plaques. Some localities, working with local nonprofits and hospitals, are offering programs that integrate exercise and nutritional instruction to help reduce the likelihood of dementia. These programs focus on developing doable, incremental, long term habits to promote brain health.
Prevention isn't as sexy as a "cure-it-all" no doubt prohibitively expensive pill, but it always costs less in the long run and the community ROI is always far higher. Outreach, self discipline, and education are still our best medicine.
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@Julie
I very much agree with your assessment.
2
@Julie
While they rarely show success in *all* recipients, many clinical trials of putative "memory-enhancing drugs" often have beneficial effects on cerebrovascular circulation.
1
The point about blood flow is supported by protective effects of exercise . Getting that message out will save lives.
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@Nicola wolfe Add alcohol and head trauma to the mix.
4