Dementia: Irreversible but not untreatable
Alzheimer’s disease is the most common form of dementia – a progressive condition for which no single causative factor has been established, although it is thought that a combination of advancing age, genetics and environmental factors are accountable. As the disease advances physical changes within the brain affects a person’s ability to manage their normal memory recall, understanding and reasoning capabilities, there is a decline in their communication skills, as well as difficulty performing their everyday activities. In New Zealand there are around 48,000 people with dementia, and between 50-70% of these people have Alzheimer’s.
This figure is predicted to double every twenty years. Furthermore a press release from Alzheimer’s New Zealand last year in response to the World Alzheimer Report 2011 states that around 26,000 New Zealanders may actually be living with undiagnosed Alzheimer’s. The concern here is that people don’t seek professional help because a degree of dementia is wrongly viewed as a normal feature of getting older and that there is no way of preventing it. The reality is that early detection and subsequent treatment can be beneficial for people with Alzheimer’s in terms of cognitive processes, maintaining some independence and an overall better quality of life. At present by the time a person is diagnosed with Alzheimer’s the damage to their brain is beyond repair and the best modern medicine can offer is to slow the progression of the disease somewhat.
Interesting research from earlier this year suggests that Alzheimer’s is a metabolic disease that affects how the brain utilises glucose (its primary fuel), and how it responds to insulin. The evidence also points to factors including impaired energy metabolism, oxidative stress, and inflammation as players in the development and progression of the disease. In much the same way that diabetes, another metabolic disease, is managed with a combination of medications and dietary and lifestyle modifications, there is evidence for treating Alzheimer’s in a similar manner.
The study advocates that:
a) exercise and calorie restriction (i.e. not overeating) and maintaining a healthy weight can improve mental processes and slow the development of neurodegeneration by improving the brains response to insulin and by slowing the aging process.
b) dietary supplements including Omega-3 essential fatty acids, the mineral chromium, and curcumin (from turmeric) can support nerve cell metabolism as well as neuronal plasticity – the alterations that occur within nerve pathways and synapses in response to changes in our behaviour and environment, neural processes or bodily injury. Omega-3 fatty acids can help repair synapses (neuronal junctions) in the brain that may be damaged by the formation of plaques and tangles, which occur in the brains of Alzheimer’s patients. Chromium and curcumin improve the body’s utilisation of glucose, and keep blood sugar levels healthy.
c) antioxidants including resveratrol, green tea and curcumin can reduce the incidence of damaging oxidative stress-causing species which can kill brain cells when present in excess. Antioxidants also decrease DNA damage and limit the activation of inflammatory processes.
d) daily consumption of the B-complex vitamins can have a neuroprotective effect on the brain, as well as supporting the entire nervous and cardiovascular systems.
Early indicators of cognitive decline that may be warning signals of Alzheimer’s:
• memory loss which affects job skills
• difficulty performing everyday chores
• problems with language and communication
• frequently losing belongings
• repeatedly misplacing things and/or putting them in inappropriate places
• mood changes • personality changes
• loss of initiative
de la Monte SM. Brain insulin resistance and deficiency as therapeutic targets in Alzheimer’s disease. Curr Alzheimer Res. 2012 Jan;9(1):35-66