Alzheimer's Disease

Alzheimer's Disease Overview:

Alzheimer's Disease (AD) is the primary form of dementia (accounts for up to 70% of cases). It has a strongly age-related prevelance, with less than 1% of those affected under the age of 65 and a 30% prevelance in those over the age of 85.

Alzheimer's disease is gradual, producing progressive symptoms over the course of 5-15 years after diagnosis. Despite its slow progression, it accounts for nearly 7% of deaths in Western countries.

 

Aetiology:

Alzheimer's involves a widespread loss of grey matter in the brain, and shrinkage in size. Most of the activity involved with this condition affects the hippocampus, limbic system, and frontal cortex. This condition will gradually progress for 15-25 years towards complete immobility and dependence on external support.

+ Causitive Factors

There are a number of causative factors associated with Alzheimer's & Dementia in general:

  • Old age (>65)
  • Cardiovascular disease
  • Stroke
  • Hypertension
  • Hypercholesterolemia
  • Low folate intake
  • Down's Syndrome
  • Diabetes
  • ApoE Variations
  • Obesity
  • Depression
  • High caloric intake
  • Poor excercise
  • Social isolation
  • Heavy metal exposure
  • Medications (such as benzodiazepines)
  • Aspartame intake

The definitive cause for Alzheimer's is still under scrutiny and is heavily debated within the medical community, however, there are some predominant theories that have been backed up by a lot of high quality studies in recent years. The result of this research has highlighted that the cause for Alzheimer's disease is not a single pathological process, rather a series of pathogenic alterations in nervous system function that includes both the peripheral autonomic network and the limbic system.

+ Misfolding/Aggregation of Proteins

Includes both beta-amyloid plaquing and tau-protein neurofibrillary tangles

+ Metabolic and Mitochondrial Dysfunction

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+ Calcium-handling Impairment

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+ Glial Cell Dysfunction

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+ Neuroinflammation

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+ Oxidative damage

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+ Excitotoxicity

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+ End Stage Alzheimer's Disease

End stage Alzheimer's disease patients are unable to ambulate, dress, bathe, use the bathroom, or generally care for themselves without assistance. Meaningful conversation is no longer achievable, and in many cases they will be unable to speak intelligable words at all.

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Symptoms:

Decrease in executive function

Impaired memory

Altered social & behavioural patterns

Irritability

Anxiety

Mood irregularities

Decreased ability to use or interpret language

Loss in the ability to recognize objects or faces

 

Diagnostic Considerations:

The presence of an acquired impairment in memory, associated with impairment in one or more cognitive domains, including:

  • Executive function (e.g., abstract thinking, reasoning, judgment)
  • Language (expressive or receptive)
  • Praxis (learned motor sequences)
  • Gnosis (ability to recognize objects, faces or other sensory information)

Impairments in cognition must be severe enough to  interfere with work, usual social activities or relationships with others. There are a number of standardised tests used for this diagnosis, including the Mini Mental Status Exam (MMSE). 

 

Other tests include:

  • Scans: CT or MRI to assess neuronal loss
  • Blood tests
    • Full blood count
    • ESR
    • Urea
    • Electrolytes
    • Blood glucose
    • Calcium
  • Liver function tests
  • Thyroid function tests
  • Vitamin B12
  • Syphilis culture
  • ANA
  • HIV serology
  • EEG
 

Therapeutic Aims:

1. Prevent or Treat Cardiovascular Risk Factors

Such as hypertension, hypercholesterolemia, or high homocysteine levels.

  • Hypotensives ()
  • Hypocholesterolemics ()
  • Cardiotonics ()

2. Improve Cognition

...

  • Nootropics (Bacopa, L-Theanine, Ginkgo biloba, Centella asiatica, Rosmarinus officinalis, Vinca major, Schisandra chinensis, Camellia sinensis)
  • Cerebrovasodilators (Ginkgo biloba, Vinpocetine)
  • Adaptogens (Eleutherococcus senticosus, Panax quinquefolius, Rhodiola rosea)
  • Nutrition (Essential fatty acids, Phosphatidylcholine, Phosphatidylserine, B Vitamins, Zinc, L-Acetyl-Carnitine, CoQ10)
  • Nervine Trophorestoratives (Avena sativa, Ginkgo biloba)

3. Reduce Oxidation In The Brain & Improve Cerebral Blood Flow

...

  • Cerebrovasodilators (ginkgo, periwinkle)
  • Antioxidants (Curcuma longa, Ilex paraguariensis, Rosmarinus officinalis, Camellia sinensis, Vaccinum myrtillus, Vitis vinifera, Allium sativum, Schisandra chinensis, Camellia sinensis)
  • Circulatory Stimulants (Rosmarinus, gingko)

4. prevent Dehydration

Ensure adequate water consumption.

5. Address Potential Risk Factors

Such as depression, heavy metal or solvent exposure ad head trauma.

  • Thymoleptics ()
  • Hypoglycemics (Panax ginseng, Gymnema sylvestris)
 

Differential Diagnosis:

  • Stroke
  • Cardiovascular disease
  • Diabetic dementia
 

Comorbidities:

  • Type II Diabetes
  • Stroke
  • Cardiovascular disease
  • Depression
 

Cautions:

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Herbs For Alzheimer's Disease:

  • Lions mane
  • Coffee
  • Panax ginseng
  • ginkgo
  • curcuma longa
  • bacopa
  • centella asiatica
  • Zingiber officinalis
  • rosmarinus
 

Nutritional Considerations:

  • B Complex
  • Antioxidants
  • Phosphatidylcholine
  • Vitamins A, C, & E
  • Zinc
 

Author:

Justin Cooke

The Sunlight Experiment

Updated: November 2017


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