What if Everything they told us about Alzheimer’s was Wrong?

Two decades of research have failed to shine any light on the darkness that is Alzheimer’s Disease, yet the answer is staring us in the face

Alzheimer’s Disease accounts for two thirds of dementia cases. AD is not reversible, and its progress is unrelenting; it’s a long, lonesome road with a dead end. We don’t know what causes it, we don’t know how to fight it, and there’s no cure. Alzheimer’s Disease is always fatal, so the experts tell us. The good news is that they’re wrong.

dementia_vs_mental_illnessImage Source: Symphony Senior Living

Do you have a mum or dad who suffers from dementia? A husband or wife, a brother or sister? It’s soul-destroying, is it not, watching a loved one who was so full of love and life yesterday become a different person? Confused, unresponsive, withdrawn?

My mother-in-law has been sliding away from us, and all we can do is show her photos we took in the good times, play her favourite CDs and the movies she once loved. How much of this she registers we don’t know. My brother-in law has Parkinson’s Dementia, is fed by a tube and wears diapers. He’s nearing the end of his life. My sister is at the end of her wits.

Sentenced without Trial

Dementia strikes more fear into our baby boomer hearts than any other threat. It starts in such innocent ways: forgetting a name or word, taking longer to do a routine task, struggling to make a connection. It gets worse as the months go by so we see a doctor who arranges some tests.

Dementia is the most heartless of diseases. They call it the memory thief, a label that’s designed not to frighten the children. Let’s be clear: Dementia is a ruthless killer who grabs your heart and never lets go, a sadist who torments you for years before death sets you free. When it’s first diagnosed, you’re at stage 2 or 3; by the time you get to stage 6, you’ve become a burden for a loved one who has to feed you, toilet you and dress you. There are 7 stages on this abhorrent journey, which can last 5 to 20 years.

It takes a while for the brutal truth to sink in: You’ve committed no crime but you’ve been given a death sentence. Not by a judge and jury, but by a lottery you didn’t buy a ticket in. There’s no court of appeal, there’s no going back, no choice. Medicine works miracles every day, but it has nothing to offer you. It can’t even tell you how you got here.

Dead End

Dementia is an out-of-control bushfire. Over 1 in 6 women aged 65 suffers from dementia, and 1 in 10 men. After 65, our risk doubles every 5 years. By the time we reach 85, 1 in 3 of us will be affected. Dementia has become the leading cause of death for Australian women. Dementia kills more British citizens than heart disease. In the USA, deaths from Alzheimer’s Disease grew by 70% from 2000 to 2010. AD killed 100,000 Americans last year.

Researchers have been mesmerized by the amyloid plaques and tau protein tangles that are said to cause AD, in a race to find agents that block their formation. After 20 years of heroic effort, they’ve come up empty-handed. Over 100 drug candidates have seen a near 100% failure rate in that time. The only drugs on offer are anticholergenics, which improve some symptoms for a short time but don’t stop the decline.

How do we explain this resounding failure? The answer is that they’ve been looking in the wrong place. There’s plenty of evidence that AD is a lifestyle disorder, and not caused by abnormal protein formation in our brains. Some researchers call it type 3 diabetes because diabetics are at 4 times greater risk of cognitive dysfunction than the rest of us.

Yet dementia research continues along the same track, unable to see the wood for the trees: some people diagnosed with AD do not have amyloid plaques or tau tangles in their brains. Conversely, these classic ‘AD pathologies’ are also found in people with no signs of dementia.

Running on Empty

Diabetes is caused by a defective glucose metabolism, which is one of the early signs of impending trouble: in AD, the brain’s glucose uptake is reduced by around 20%. Our brains need a lot of energy to function and burn up a fifth of our daily calorie intake. The usual brain fuel is glucose, and when that supply line is malfunctioning, brain cells literally starve.

A healthy brain would switch to using ketone bodies for fuel — produced by the liver when we burn fat — but the AD affected brain can’t seem to find the switch. The result is that neurons stop functioning, lose connections with other neurons, and die. In addition, the normal process of brain cell renewal (neurogenesis) is disrupted.

Another feature of AD is that the brain doesn’t get enough oxygen. This leads to inflammation and degeneration of blood vessels in the brain, causing more cell death and leading to the formation of protein clusters and tangles.

The Good News

Some researchers are seeing astonishing results with dementia patients on programs of regular weight training or aerobic exercise. How can physical activity possibly improve brain function? Because exercise pumps more blood and oxygen through the brain and improves glucose metabolism.

‘… we saw aerobic exercise lead to a remarkable change in the brain,’ said Dr Laura Baker who led a study at the Wake Forest School of Medicine in Winston-Salem. ‘No currently approved medication can rival these effects.’

The SMART study run by the University of Sydney showed similar results with weight training. Study leader Dr Yorgi Mavros said: ‘The stronger people became, the greater the benefit for their brain.’ Regular strength training improved cognitive function in participants with Mild Cognitive Impairment (MCI), an early stage of Alzheimer’s. ‘The more we can get people doing resistance training like weight lifting,’ said Dr Mavros, ‘the more likely we are to have a healthier ageing population.’

More Good News

Researchers from the Rush University Medical Centre in Chicago ran multiple trials with the MIND diet on some 900 participants. The results showed that this plant-based, Mediterranean-style diet can postpone cognitive decline by nearly 8 years (compared to the average population), while cutting the risk of Alzheimer’s Disease.

The University of Kansas ran a small study on AD patients with a ketogenic diet (low-carb, high fat), and raised their ADAS-cog score by 4 points in 3 months. Study leader Dr Russell Swerdlow called it the most robust improvement he’d ever seen. He said. ‘In some studies, patients decline 5 points in 12 months, so an improvement of 4 points is quite something.’

Still More Good News

A few researchers are using both physical and diet strategies and seeing remarkable results, including people going back to work. Neurologist Dale Bredeson ran a small trial with 10 patients who suffered from cognitive impairment and AD. Within 3 to 6 months, 9 of the 10 patients showed measurable improvements in memory and cognition.

Bredeson’s protocol included diet, exercise and stress reduction. Before the study, six of the patients had been forced to discontinue work or were struggling with their jobs. After the study, all six returned to work or continued working effectively.

Alzheimer’s is not Old-Timer’s

‘Alzheimer’s disease starts in the brain more than twenty years before the first symptom,’ says Richard Isaacson, director of the first Alzheimer’s Prevention Clinic in the USA. ‘Alzheimer’s disease is not an older person’s disease. It’s a disease of younger and middle-aged people. And that’s how we have to shift the paradigm.’

Exercise and nutrition are the mainstays of the clinic’s prevention program, along with good sleep, stress management, cognitive activities and social engagement. Weight management is another factor, especially a reduction of visceral fat. ’As the belly size increases,’ says Isaacson, ‘the memory centre in the brain gets smaller.’

Catch it While You Can

Messages don’t come much clearer than that, do they? Dementia is not a normal part of aging, and you can prevent it by staying fit, eating real food instead of junk food, and learning to deal with stress. It’s also clear from the evidence we’ve touched on that dementia is reversible in the early stages. Watch your loved ones and take remedial action as soon as they’re showing signs of mild cognitive impairment.

So why aren’t doctors shouting the good news from the rooftops, instead of sending people down a torturous road that leads to an agonising death? Why aren’t more scientists setting up more trials along the lines of those we’ve covered, run by universities with meagre budgets? Modern research is obsessed with finding genes and molecules that make good drug targets. Lifestyle research is really messy, and seniors with dementia present added challenges.

The husband and wife team of Dean and Ayesha Sherzai run the Alzheimer’s Prevention Program at Loma Linda University Medical Center, focusing on nutrition and exercise. The Sherzais are neurologists who saw that dementia is a lifestyle disease. They observe that, ‘while scientists and physicians are working furiously to find a cure for dementia and Parkinson’s, and in this frantic race against time, the big picture is lost among the molecules and chemicals …’

As the next quote shows, the official outlook is completely at odds with the Sherzais’ observation:

‘Researchers believe successful treatment will eventually involve a ‘cocktail’ of medications aimed at several targets, similar to current state-of-the-art treatments for many cancers and AIDS.’ Heather Snyder, Director of Medical and Scientific Operations at the US Alzheimer’s Association.

Additional Reading

What if we have got it wrong on Alzheimer’s? – Liam Mannix, Sydney Morning Herals

Mild Cognitive Impairment (MCI) Symptoms — List from the Mayo Clinic

11 warning signs your loved one has Alzheimer’s — not to be confused with the 5 signs of normal aging

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Red Wine – Fountain of Youth?

If you Love Wine, this is the Best News in Years

We are all mortal until the first kiss and the second glass of wine. Eduardo Galeano

Plastic Surgeon Richard Baxter’s book ‘Age is Better with Wine’ tells the story of Jeanne Calment who died in her sleep in Arles in the south of France in 1997, at close to 123 years of age.

‘Her birth predated the telephone,’ writes Baxter, ‘and her death was announced via the internet.’ As a young woman she sold art supplies to van Gogh and other impressionists who came to the Provence to catch the light. When she reached the age of 90, she made an agreement with her lawyer to subsidise her stay in her apartment until her death when it would pass to him. He died years before her, and his heirs had to continue paying the rent.

Apparently Calment followed a Mediterranean diet, loved rich foods, chocolate and red wine (not at the same time perhaps). A few years after her death, researchers discovered resveratrol, a compound that Baxter calls the most potent antioxidant of all. The best source, as luck would have it, is red wine because the process of making it extracts large amounts of resveratrol from the grape skins.

David Sinclair and colleagues discovered this miraculous antioxidant, and in 2006 ran some experiments with mice. ‘These were mice that were fed a Western diet,’ Sinclair tells NPR. ‘They were chubby, and they were developing the usual signs of disease that we see in elderly obese people. The mice that had the resveratrol in their diet were still obese, but they were seemingly or relatively immune to the effects of the obesity. So their arteries were clear, their livers were nice and thin. Their bones were stronger. They could run further.’

A Lucky Strike

In an interview with WebMD, Baxter said this about red wine: ‘You will look better, your skin will glow, and you will live five years longer than a teetotaller. There are also good studies that show people who drink red wine on a regular basis have fewer actinic keratoses [precancerous skin lesions]. You will have a significantly lower risk of Alzheimer’s disease, cancer, diabetes, and all of the things that go along with aging. People assume that drinking would decrease brainpower as you get old, but the most amazing thing is that regular wine drinkers have an 80% lower risk of developing Alzheimer’s disease.’

Baxter makes the point that you don’t get the same benefit from white wine or grape juice, so a glass of red or two is clearly the best news for your health. This is not exactly news since red wine has been used as medicine since the pharaohs ruled Egypt. Hippocrates promoted wine as a part of a healthy diet, and advised disinfecting wounds with it.

Alcohol is good for these things as well, of course, and many of us like the relaxing effect it has on us. Alcohol and heart health have been fertile ground for heated debate and censorship, because in Anglo-Saxon countries it’s politically incorrect to say anything positive about drinking.

The Thought Police

Just google alcohol and health and check a few of the health & medical websites that come up, and you’ll see what I mean when you read the tortured prose. The authors simply can’t bring themselves to state in plain language that drinking alcohol in moderation is good for us, that drinking wine is better, and that drinking red wine is better still.

In his book, Richard Baxter tells the story of the famous Framingham study, which has followed some 5000 citizens of that Boston suburb since the late fifties. By the 1980s it was clear that those citizens who drank alcohol on a regular basis were in better health and lived longer than non-drinkers.

When the researchers reported this, the US National Institutes of Health (NIH, the sponsor of the study) told them to remove all references to the fact that drinking alcohol had benefits. It couldn’t be said then, and it still can’t be said today without qualification.

Malcolm Kendrick is a Scottish physician, author and speaker who has made it his life’s work to understand the real causes of heart disease. In a recent post, Kendrick summed up the results of a British Medical Journal study this way:

Increased risk of fatal CVD, and moderate drinking

  • Non-drinker = 1.32 (32% increased risk)
  • Former drinker = 1.44 (44% increased risk)

Increased risk of all-cause mortality vs. moderate drinking

  • Non-drinker = 1.24 (24% increased risk)
  • Former drinker = 1.38 (38% increased risk)

Kendrick’s conclusion? ‘I recommended that, from a cardiovascular health point of view, those who do not drink alcohol should start.’

The Gods Must be Crazy

Baxter’s book is a long eulogy to the God Bacchus, and the stylecraze.com website comes up with no less than 24 benefits of red wine consumption. Here’s the list of the magic that red wine apparently weaves:

  1. Boosts Heart Health (obviously)
  2. Lowers Cholesterol Levels (you know my view on that subject by now)
  3. Helps Fight Diabetes (not quite sure how but I’ll find out)
  4. Fights Cancer (nice idea)
  5. Prevents Obesity (doubtful)
  6. Prevents High Blood Pressure And Stroke (so we can stop exercising?)
  7. Promotes Longevity (by as much as 60%, would you believe?)
  8. Reduces Stress (For sure)
  9. Improves Bone Strength (I suspect we’re heading toward the ragged edge)
  10. Reduces The Risk Of Cataracts
  11. Promotes Liver Health (in mice anyway)
  12. May Help Prevent Alzheimer’s (more here and here)
  13. Boosts Brain Health (more of the same)
  14. Fights Depression
  15. Improves Sleep
  16. Enhances Lung Function
  17. Prevents Tooth Decay (not in my experience)
  18. Boosts Levels of Omega-3 Fatty Acids
  19. Strengthens the Immune System
  20. Helps Fight Parkinson’s Disease
  21. Slows Down Aging And Makes Skin Glow
  22. Fights ACNE
  23. Treats Sunburn
  24. Promotes Thick Hair (It did in my case)

That’s quite a list, right? You kind of expect to find that red wine, if consumed from ancient goblets during a Pagan feast under a full moon, would restore the Great Barrier Reef to its former glory, don’t you? Or at least make the moon shine more brightly. Still, even if only a fraction of these claims are valid, red wine is a medicine that won’t need much help going down from anyone.

Drinking is Believing

The positive effect of red wine on brain function was seen in French and Italian  studies decades ago, with 25% to 80% reductions in risk of dementia or Alzheimer’s disease for moderate consumption of red wine, compared to people who didn’t drink alcohol. In the 1997 Bordeaux study, ‘moderate’ was defined as 3-4 glasses a day. More Here and Here.

However, a recent UK study showed that even half a glass of wine a day can damage our brains. The researchers said that ‘adults who drink more than this amount are putting themselves at ‘significant risk’ of dementia.’ A huge meta-analysispublished in The Lancet just now produced this verdict from the researchers: ‘There is no safe level of alcohol consumption.’

At the same time, Science Daily wrote: ‘While a couple of glasses of wine can help clear the mind after a busy day, new research shows that it may actually help clean the mind as well. The new study, which appears in the journal Scientific Reports, shows that low levels of alcohol consumption tamp down inflammation and help the brain clear away toxins, including those associated with Alzheimer’s disease.’

It’s a minefield, and it’s not easy to explain the dramatic variations in the results of different studies. The European studies were observational, whereas the UK study tested the brain function of subjects 5 years apart. Observational studies can’t tease out the other things going on in people’s lives; their environments, their physical fitness and their diets will have played a crucial part in the outcome.

That doesn’t make the results any less valid; it merely supports what we’ve been saying all along: physical and mental health is the result of many factors, and can’t be reduced to a single molecule or a single polyphenol. Sadly the constant media hype about single molecules that cause diseases and magic bullet drugs that cure them has muddled our thinking.

The Best Kinds of Red

That’s the obvious next question, if you believe in the benefits of red wine. Which variety delivers the most resveratrol? Richard Baxter confesses to a fondness for Aussie Shiraz, while others point to different varieties. ‘Malbec grapes have the thickest skin,’ says Dr Liji Thomas, ‘and therefore the highest content of resveratrol.’

Livestrong, the charity set up by cycling legend Lance Armstrong refers to ‘a study published in 1995 which found that Pinot Noir wines had the highest content of resveratrol regardless of country of origin.’ This is a strange claim, given that Pinot Noir is a soft, light red with less colour and tannin extract than most reds.

It comes down to thick skins, and the thickest skins are found in Syrah, Petite Syrah, Shiraz, Mourvedre and Malbec. The way wine is made is more important though: Traditional slow fermentation in open vats with lots of plunging the cap of grape skins under the bubbling liquid for a number of days produces the strongest extract and concentration of resveratrol.

And if you don’t Drink?

According to Livestrong, MayoClinic.com stated that ‘the daily amount of resveratrol necessary for humans to see a health benefit, based on animal studies, can be found in 100 to 1,000 bottles of red wine, so drinking wine is an impractical way of getting resveratrol’s benefits — if any.’

‘The polyphenol content of red wines is in the range of 1500 to 3500 mg/liter,’ says nutrition researcher David Mark. ‘Of this, resveratrol makes up 1 to 5 mg/litre, or less than 1%.’

Another minefield? Clearly some researchers think resveratrol gets more credit than it deserves. Mark says flavonoid polyphenols known as proanthocyanidins (PACs) are most likely the compounds that provide the real benefit, and red grape skins are just one source of these. Other sources are blueberries and cranberries, apples, beans, dark chocolate, hazelnuts, pecans, pistachios and green tea.

You can also take supplements containing PACs, extracted from pine bark or grape seeds; both are rich sources. The story goes that American Indians on the east coast used pine bark to boost their immunity during the harsh winter month. More recently. Atlantic pine bark extract was patented by a French scientist under the name pycnogenol.

Alternative practitioners attribute many benefits to PACs, some even claim they can cure advanced cancer. The problem with these claims, apart from lack of solid evidence, lies in the poor bioavailability of PACs. As always, my advice is to get most of your share from real foods like blueberries, apples and nuts. That way, you’ll get the vital compounds and the enzymes that make them easier to absorb.

Blue Zones — Living to 100 in Good Health

From Okinawa to Loma Linda — what’s their secret?

‘Health is the state about which medicine has nothing to say.’ W. H. Auden

Shangri La

The literature is full of adventurers who searched for places on this earth where time stood still. In the 1933 novel Lost Horizon, British author James Hilton describes a place called Shangri-La in a mystical valley enclosed in the western end of the Kunlun Mountains between China and Tibet. Shangri-La soon became a byword for a secluded, idyllic place where people lived far beyond the average human lifespan.

Modern civilisation has brought us many fancy things and astounding advances in medicine, yet it’s brought us much misery too. So the dream of a mythical place where people live to 100 years or more in good health is more than appealing to those of us who want to avoid the chronic ills of civilisation.

The Secret to a Long Life

Wind the tape forward to the new millennium, and we find American journalist Dan Buettner and a couple of European demographers looking for places in the world that come close to the dream of Shangri-La. They found 5 places where people live longer, healthier and happier lives than people elsewhere:

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