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.
Image 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 Confused, unresponsive, withdrawn?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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More recently, the Hunza Valley in Pakistan looked like a modern Shangri-La. It’s a place high up in the Himalayas where people live long and healthy lives, many reaching one hundred years or more in good health. Then some researcher came along and found that their math was suspect because the Hunzas often celebrated 2 birthdays a year. So the story goes.