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MoonDragon's Health & Wellness
Disorders

ALZHEIMER'S DISEASE
"For Informational Use Only"
For more detailed information contact your health care provider
about options that may be available for your specific situation.





  • Alzheimer's Disease Description
  • Alzheimer's Signs & Symptoms
  • Alzheimer's Disease Causes
  • Alheimers Diagnosis & Treatment
  • Therapy Recommendation
  • Treatment Considerations
  • Alzheimer's Disease - Herbs, Nutrition & Recommendations
  • Alzheimer's Disease Supplements & Products




  • ALZHEIMER'S DISEASE DESCRIPTION

    A TYPE OF DEMENTIA

    Alzheimer's disease is a common type of dementia, or decline in intellectual function. This disorder was first identified in 1907 by a German neurologist named Alois Alzheimer. There are currently more than 4.5 million people in the United States who suffer from Alzheimer's disease. It afflicts 10 percent of Americans over the age of 65 and as many as 50 percent of those over 85 years of age. Dementia is the fourth leading cause of death in those over 60, while Alzheimer's alone kills 100,000 people per year in the United States. However, Alzheimer's disease does not affect elderly people only, but may strike when a person is in his or her 40's.

    Many people worry that their forgetfulness is a sign of Alzheimer's disease. Most of us forget where we have put our keys or other everyday objects at one time or another, but this is not an indication of Alzheimer's disease. A good example of the difference between forgetfulness and dementia is the following: If you do not remember where you put your glasses, that is forgetfulness; if you do not remember that you wear glasses, that may be sign of dementia.

    MoonDragon's Health & Wellness: Aluminum & Alzheimer's Connection





    ALZHEIMER'S FREQUENT SIGNS & SYMPTOMS

    A PROGRESSIVE MENTAL DETERIORIZATION

    This disorder is characterized by progressive mental deterioration, to such a degree that it interferes with the ability to function socially and at work:
    • Memory and abstract thought processes are impaired. Memory loss. As Alzheimer's disease progresses, there is severe memory loss, particularly in short term memory. The person may recall past events but be unable to remember a just-viewed television show. At this stage, disorientation usually begins as well.

    • Disoriented perceptions of space and time.

    • Depression.

    • An ability to concentrate or communicate. Dysphasia (the inability to find the right word) may occur.

    • Loss of bladder & bowel control.

    • Personality changes and severe mood swings. Moon swings can be unpredictable and sudden.

    • Health & functioning progressively deteriorate until individual becomes totally incapacitated. Alzheimer's disease is an irreversible, progressive disorder. Deteriorization in critical areas of the brain may precede symptoms by as much as 20 to 40 years. In the final stage, Alzheimer's disease creates severe confusion and disorientation, and possibly hallucinations or delusions. Some people become violent and angry, while others may be docile and passive. It is at this later stage that people with Alzheimer's disease may wander without purpose, experience incontinence, and neglect personal hygiene. Since the behavioral symptoms of Alzheimer's disease result from changes in the brain, the person neither intends to nor can control this behavior.

    • Death usually occurs within 5 to 10 years.

    Other disorders can cause symptoms similar to those of Alzheimer's disease. Dementia may result from arteriosclerosis (hardening of the arteries) that slowly cuts off the supply of blood to the brain. The death of brain tissue from a series of minor strokes, or from pressure exerted by an accumulation of fluid in the brain, may cause damage. The presence of small blood clots in vessels that supply the brain, a brain tumor, hypothyroidism, and advanced syphilis can all cause symptoms similar to those of Alzheimer's. In addition, the average person over the age of 65 is likely to be taking between 8 and 10 different prescription and over-the-counter drugs. Drug reactions, coupled with a nutrient-poor diet, often adversely affect people not only physically, but mentally as well.





    ALZHEIMER'S DISEASEA CAUSES

    A DEGENERATIVE DISORDER

    Alzheimer's was once considered a psychological phenomenon, but it is now known to be a degenerative disorder that is characterized by a specific set of physiological changes in the brain. The precise cause or causes of Alzheimer's disease are unknown, but research has revealed a number of interesting clues:

    TANGLED NERVE FIBERS

    Nerve fibers surrounding the hippocampus, the brain's memory center, become tangled, and information is no longer carried properly to or from the brain. New memories cannot be formed, and memories formed earlier cannot be retrieved.

    BETA-AMYLOID PLAQUES

    Characteristic plaques accumulate in the brain as well. These plaques are composed largely of a protein-containing substance called beta-amyloid. Researchers believe that this plaque accumulates in and damage the nerve cells.

    VITAMIN B & ZINC DEFICIENCIES

    Nutritional deficiencies contribute to the development of Alzheimer's disease. People with Alzheimer's tend to have low levels of Vitamin B-12, Vitamin B-3 and Zinc in their bodies. The B vitamins are important in cognitive functioning, and it is well known that the processed foods that make up so much of the modern diet have been stripped of these essential nutrients. The development of the neurofibrillary tangles and amyloid plaques in that brain that are characteristic of the disease have been associated with zinc deficiency.

    MALABSORPTION DISORDERS

    Malabsorption problems, which are common among elderly people, make them more prone than others to nutritional deficiencies, and alcohol and many medications further deplete crucial vitamins and minerals.

    ANTIOXIDANT & MINERAL DEFICIENCIES

    Levels of the antioxidant Vitamin A and Vitamin E and the Carotenoids (including Beta-Carotene) also are low in people with Alzheimer's disease. These nutrients act as free radical scavengers; deficiencies may expose the brain cells to increased oxidative damage. In addition, deficiencies of Boron, Potassium, and Selenium have been found in people with Alzheimer's disease.

    ALUMININUM & MERCURY METAL TOXICITY

    Research has also revealed a connection between Alzheimer's disease and high concentrations of Aluminum in the brain. Autopsies of people who have died of Alzheimer's disease reveal excessive amounts of aluminum in the hippocampus area and in the cerebral cortex, the external layer of gray matter responsible for higher brain functions. It may be that exposure to excessive amounts of aluminum, especially if combined with a lack of essential vitamins and minerals, may directly or indirectly predispose one to developing Alzheimer's disease.

    Aluminum is not the only metal that has been linked to Alzheimer's disease. The brains of people with Alzheimer's disease have been found to have higher than normal concentrations of the toxic metal mercury. For most people, the release of mercury from dental amalgams is the main means of mercury exposure, and a direct correlation has been demonstrated between the amount of inorganic mercury in the brain and the number of amalgam surfaces in the mouth. Mercury from dental amalgam passes into body tissues, and it accumulates in the body over time. Mercury exposure, especially from dental amalgams, cannot be excluded as a major contributor to Alzheimer's disease.

    MoonDragon's Health & Wellness: Aluminum Toxicity
    MoonDragon's Health & Wellness: Mercury Toxicity

    GENETIC LINK - HEREDITY & FAMILY HISTORY

    Many people who develop Alzheimer's disease have a family history of the disorder, suggesting that heredity may be involved. By age ninety, the risk is at least 50 percent for those with a first-degree relative (father, mother, brother, sister) who has (or had) Alzheimer's disease. The equivalent rate is about 50 percent for identical twins. As with other brain disorders, such as schizophrenia and manic-depressive disorder, the hereditary pattern is complicated. At least four gene variations are linked to Alzheimer's disease. All of them reduce the clearance, or increase the production of, beta-amyloid. A variation of a gene involved in the synthesis of beta-amyloid, located on chromosome 21, is associated with a rare type of Alzheimer's disease that typically begins between the ages of 40 and 50. Interestingly, people with Down syndrome, who carry an extra copy of chromosome 21, are prone to develop very early Alzheimer's disease, beginning in their 30's and 40's. No one knows for sure when the disease actually begins, and the onset of illness may predate clinical symptoms by years, or even decades.

    IMMUNE SYSTEM MALFUNCTION

    Another possible cause in the death of brain cells is the immune system. Many illnesses result from immune system malfunction causing it to attack the body's own tissues. Powerful immune system proteins called complement proteins have been found around the plaques and tangles in the brains of deceased Alzheimer's victims. In animals, brain injury is known to result in an alteration in the genetic "instructions" for two kinds of complement proteins. Some experts theorize that complement proteins normally clear away dead cells, but that in Alzheimer's disease, then begin to attack healthy cells as well, and the degeneration of the cells results in accumulations of amyloid. There is also evidence that the presence of amyloid may trigger the release of a cascade of complement proteins, perhaps sparking a vicious cycle of inflammation and further plaque deposits. However, an immune system attack on brain cells may be a result, or merely one element of Alzheimer's disease, rather than its cause.

    BRAIN INJURY & BRAIN CELL DEGENERATION

    In animals, brain injury is known to result in an alteration in the genetic "instructions" for two kinds of complement proteins. Some experts theorize that complement proteins normally help clear away dead cells as well. Cell degeneration results in accumulations of amyloid. Many researchers believe that beta-amyloid is a key player in this memory-destroying disease. This substance is not unique to the brain, but is produced in virtually every cell in the body as a result of the degeneration of tissue. Many of the dangerous effects of beta-amyloid seem to arise from oxidative damage. Amyloid itself is not highly toxic, but it is possible it may trigger dementia if a critical mass accumulates in the brain. Further evidence reveals that the presence of amyloid may trigger the release of a cascade of complement proteins, perhaps sparking a vicious cycle of inflammation and further plaque deposits. However, an immune system attack on brain cells may be a result, or may be merely one element, of Alzheimer's disease, rather than the cause.

    OTHER POTENTIAL RISK FACTORS

    Other potential risk factors being studied are head injury, very high blood pressure, and low education levels.





    DIAGNOSIS & TREATMENT

    MAKING THE DIAGNOSIS

    Although all the findings above offer hope that Alzheimer's disease may one day be more fully understood, and thereby prevented, science does not yet know what can be done to arrest the mental deterioration. Even diagnosis of the disease is not a precise science.

    Many people worry that their forgetfulness is a sign or Alzheimer's disease. Most of us forget where we have put out keys or other everyday objects at one time or another, but this is not an indication of Alzheimer's disease. A good example of the difference between forgetfulness and dementia is the following: If you do not remember where you put your glasses, that is forgetfulness. If you do not remember that you wear glasses, that may be a sign of dementia.

    Other disorders can cause symptoms similar to those of Alzheimer's disease. Dementia may result from arteriosclerosis (hardening of the arteries) that slowly cuts off the supply of blood to the brain. The death of brain tissue from a series of minor strokes, or from pressure exerted by an accumulation of fluid in the brain, may cause dementia.

    The signs of alcohol abuse and the symptoms of Alzheimer's disease can be very similar. For example, actress Rita Hayworth, who had Alzheimer's disease, was at first thought to be an alcoholic. An "alcoholic" misdiagnosis may be made by a health care provider when in fact the person may actually be afflicted with Alzheimer's.

    MoonDragon's Womens Health Information: Alcoholism

    The presence of small blood clots in vessels that supply the brain, a brain tumor, hypothyroidism, and advanced syphilis all can cause symptoms similar to those of Alzheimer's disease. In addition, the average person over the age of 65 is likely to be taking between 8 and 10 different prescription and over-the-counter drugs. Drug reactions, coupled with a nutrient-poor diet, often adversely effect people not only physically, but mentally as well.

    There are tests that can suggest a diagnosis of Alzheimer's and that can rule out other problems as the cause of symptoms, but there currently is no single laboratory procedures or biochemical marker that can definitively confirm the disorder in a living person. Because dementia can be a symptom of many disorders, a diagnosis of Alzheimer's disease is usually made when all other possibilities have been eliminated.

    A study conducted at the National Institute of Mental Health (NIMH) and reported in the Journal of the American Medical Association (JAMA) showed that testing spinal fluid for beta-amyloid and tau proteins (which make up the tangles) could help identify people at risk for the disease. It would first be necessary to establish a baseline measurement, then track the changes over time, but using these two biomarkers may signify some progress in the diagnosis of the disease. At present, health care providers make a probable diagnosis by performing a comprehensive evaluation including a complete health history and physical examination, a mental status assessment, neurological tests, blood tests, urinalysis, and electrocardiogram (EKG), and x-rays. Additional tests may be conducted, such as computerized tomography (CT) scan, electrocephalography (EEG, a recording of brainwave patterns), and formal psychiatric assessment. These tests are necessary to rule out other possible causes of dementia symptoms, such as pernicious anemia, hypothyroidism, or tumors. Documenting symptoms over time, in a diary-like fashion, helps health care providers to understand each individual case. Unfortunately, the diagnosis of Alzheimer's disease is often made long after the person has lost the ability to communicate and comprehend information. Milder signs of Alzheimer's disease may not be detected in the very old, and many people die before developing obvious symptoms. People with family members who have Alzheimer's disease are probably more able to detect the early signs than are health care providers.

    As more is learned about the contribution of genetic and other factors to Alzheimer's disease, the possibility of delaying the progression of disease may become more real.

    NUTRITIONAL DEFICIENCY & THERAPY

    Nutrients may have a beneficial effect, and one study has shown that vitamin E slowed the progress of some components of the disease by up to 7 months. Research also indicates that the herb ginkgo biloba, a natural remedy known for many years, may be helpful in treating some symptoms, although it should be used with caution as its use can sometimes lead to excessive bleeding, especially if it is used in conjunction with aspirin therapy.

    A study done at the Rush Institute for Healthy Aging in Chicago indicated that people with low levels of niacin (vitamin B-3) were 70 percent more likely to get Alzheimer's that those who had higher levels in their diet. Niacin is required for cell respiration, helps release energy, and assists in metabolizing carbohydrates, fats, and proteins. The excretion of bile, functioning of the nervous system, synthesis of sex hormones, and many other processes require this vitamin. The study showed the protective effect began at 17 milligrams (mg) per day, about what a healthy male normally requires (females require about 13 mg per day). Supplements are usually taken in 100 mg increments, so benefits certainly can be expected at this level.

    No one should accept a diagnosis of Alzheimer's disease without first undergoing a trial of intensive nutritional therapy, using zinc, Vitamin B-3, and vitamin B-12 injections (if available). Vitamin B-12 functions in numerous metabolic processes affecting nerve tissue, including the synthesis of neurotransmitters and the formation of the insulating sheath surrounding many nerves, and it may play a role in the fight against Alzheimer's disease. Strange prickly or tingling sensations, loss of coordination, and dementia can be caused by B-12 deficiency even if the person does not have pernicious anemia, the classic sign of that deficiency. If an individual responds to vitamin treatment, Alzheimer's disease can be ruled out.



    BRAIN HEALTHY FOODS

    The foods you choose to put on your plate affects more than just your stomach and energy levels. Foods can have a large impact on how well your body and your brain functions, today and tomorrow. The brain's cells, known as neurons, can become rigid as you age, which means they do not translate information between them as they should. You can help keep those brain cells communicating quickly and correctly, improving memory and lowring risk of dementia and Alzheimer's disease as you get older, is to add certain foods, regularly into your diet. This will help to boost your brain power, nutritionally.

    OLIVE OIL

    According to a study on mice in a 2012 issue of the Journal of Alzheimer' Disease, researchers showed that extra virgin olive oil may improve learning and memory. Olive oil is already considered a cornerstone to a heart healthy diet and is good for cardiovasular health and is known to help support brain health. Adding Olive oil to your diet is incredibly easy. You can use it in salad dressings, saute meats and vegetable in it and drizzle some on top of a variety of foods such as nutritious soup.

    SALMON

    Salmon is another recommended food that keep your brain sharp with omega-3 fatty acids. Your body does not create omega-3 fatty acids, so you have to consume them through your diet. One of the most popular ways to do that is to eat wild salmon, and other oily fish such as sardines and anchovies. These are also great sources of omega-3s. If you cannot splurge on fresh fish from your supermarket seafood department, canned salmon and sardines are just as healthy. Gently flake canned sardines or salmon over a salad and add a squeeze of lemon on top.

    BERRIES

    Dark fruits like blueberries and blackberries are loaded with antioxidants. Antioxidants are known free radical fighters and should be thought of as a broom that sweeps out dust from the garage. The dust particles in your body are known as free radicals, which can cause damage wherever they go, including in the brain. And just like omega-3 fatty acids, your body does not create antioxidants, so you have to eat foods that have them. Snack on fresh berries, use frozen ones in smoothies, or cook them down in a pot with a little water and a squeeze of lemon juice to make a compote perfect for spooning on top of yogurt. LENTILS

    A 2013 study in the Proceedings of the National Academy of Sciences showed that B vitamin supplementation in people with high homocysteine levels can slow the shrinking of the brain that is associated with Alzheimer's disease. Add these little legumes to your regular diet. Lentils are packed with some of those vitamins. They are easy to eat and lentil soup, whether homemade or canned low sodium variety, is delicious. You can boil lentils for 20 minutes with a cinnamon stick, a few garlic cloves, and some oregano sprigs. Drain and use the lentils as a brain-boosting salad topper.

    BEETS

    The nitrates in beets increase blood flow to the brain, which is directly linked to how well your brain operates. These vegetables also have folate (also known as Vitamin B-9), which may delay dementia as you age. You can roast them and put them on a salad with some goat cheese. Shredding raw beets and adding them to a cabbage and carrot slaw as a refreshing side dish is highly recommended.

    KALE

    Kale is a dark leafy green with a good reputation for bein a nutritional powerhouse. Kale contains 45 different kinds of flavonoids, which have anti-inflammatory and antioxidant properties that may clear the cobwebs out of your brain. Kale is also high in Vitamin K, which boosts memory. The moment you bring it home from the grocery store, clean it and rip the leaves off the tough-to-eat stem so that it is ready to go. It can be used by sauteing it up and adding it to a frittata, or using it in a salad instead of romaine. It is super hardy, so feel free to add your dressing to the salad in the morning as it will not wilt. Blending kale into your smoothie is also a great way to add a boost of antioxidants to breakfast, plus it makes the green more palatable for picky eaters.

    CAULIFLOWER

    Cauliflower is a cruciferous veggie is full of folate and the antioxidant vitamin C, both of which improve how well your brain functions. A research review in the Journal of Alzheimer's Disease showed that eating a healthy amount of vitamin C can help protect your brain against cognitive decline and Alzheimer's. And cauliflower is a versatile vegetable. You can roast it or mash it as a delicious substitute for potatoes. It can also stand in for rice if you steam it and pulse it in a food processor

    WALNUTS

    Walnuts, when you look at them, actually look like little brains, which is interesting because they are a great brain food. A study in the October 2014 issue of the Journal of Alzheimer's Disease showed that walnuts improve learning and memory in mice. Buy the nuts pre-roasted and unsalted, add them to salads or yogurt, or even snack on them straight. If you do not love the natural taste of walnuts, toss them with cinnamon and allspice, and toast them for eight minutes or so to give them a little more flavor.

    LAMB

    Pasture-raised lamb has a healthy share of omega-3 fatty acids (like salmon and sardines). Lamb also has B vitamins to help prevent cognitive decline. Lamb may sound intimidating to cook with, but buy it ground and use it instead of beef in sliders or meatballs. Just add some Middle Eastern spices like cumin, coriander, and cinnamon. You do not need a lot of met, four ounces will suffice and will go a long way toward boosting brain health.

    GREEN TEA

    Green Tea is included on the list as an antioxidant rich food and should be included in the diet as a healthy, nutritious beverage. Researchers from the University of Michigan have found that an element in green tea helps stop plaque growth in the brain that is connected to Alzheimer's disease. Drink it hot (a cinnamon stick and orange peel can boost the flavor) or make it iced and add a little papaya juice to sweeten it.





    THERAPY RECOMMENDATIONS

    EAT WELL, STAY ACTIVE, EXERCISE BRAIN

  • Keep your brain active and busy. Using and exercising your brain by remaining busy, writing, reading, and learning new things are important overall factors in staying sharp and preventing mental disorders. This helps slow down the progression of the disease. This means keeping active and intellectually involved, as well as getting plenty of moderate exercise and fresh air. Regular exercise throughout adulthood can reduce the changes of developing Alzheimer's disease. Activities associated with reduced risk include biking, walking, swimming and golf.

  • Eat a well-balanced diet of natural foods and follow with the supplementation program recommended in "Nutrients" section of this article.

  • Consume steam-distilled (preferred) or at least quality bottled water only. Do not drink tap water, as it may contain aluminum, lead, fluoride, and other chemicals that can cause brain-related problems. Drink at least 8 glasses a day. Water keeps the body (and brain) hydrated and helps to remove toxins from the body.

  • Include plenty of Fiber in your diet. Try Oat Bran or Rice Bran.

  • Avoid alcohol, cigarette smoke, processed foods, and environmental toxins and products containing toxic substances and metals, especially metals such as aluminum, lead and mercury. Smoking more than doubles the risk of developing dementia and Alzheimer's disease, according to a study published in the British Medical Journal Lancet. While recent studies have not fully substantiated a connection between Aluminum and Alzheimer's disease, it is still wise to avoid aluminum intake as much as possible. All metals in excess are toxic to the body.

  • Have a Hair Analysis to rule out the possibility of heavy metal toxins, especially metals such as aluminum, lead and mercury.

  • MoonDragon's Health & Wellness: Aluminum Toxicity
    MoonDragon's Health & Wellness: Led Toxicity
    MoonDragon's Health & Wellness: Mercury Toxicity

  • Have allergy testing performed to rule out environmental and/or food allergies. Evidence is cited that diet and chemical allergies may play an important role in Alzheimer's disease. Reactions to allergens can cause swelling in the brain. Recurring headaches are a common symptom of cerebral (brain-related) allergies.

  • MoonDragon's Health & Wellness: Allergies

    GETTING HELP FOR CARETAKERS

    If you are involved in caring for someone with Alzheimer's disease, seek counseling and support from the various agencies and groups, such as the Alzheimer's Association, that are trained to help. They can teach you how to handle such things as difficult behaviors. With aggressive behaviors, for example - whether name-calling, shouting, or physical aggression toward the caregiver - understanding why the behavior occurred is the key. Some tips from the Alzheimer's Association:
    • Think about what happened just before the reaction that may have "triggered" the behavior.
    • Look for the feelings behind the words.
    • Be positive, reassuring, and speak slowly, with a soft tone.
    • Use music, massage, and/or exercise to help soothe the person.

    Memory loss and confusion can cause a person with Alzheimer's disease to become suspicious of those around him or her. If this occurs, try not to take offense or argue, but rather offer a simple answer or try to divert the person's attention to another activity.



    BOOST YOUR BRAIN HEALTH
    By P. Murali Doraiswamy, M.D.
    From AARP Magazine, March & April 2010


    Worried you're losing it? Join the club. But with a few easy changes, you can stay at your sharpest. Science shows you how.

    Gary Small, M.D., remembers the patient well. An accomplished mathematician in his early 70s, the man consulted Small after struggling with calculations, and after his wife noticed he was getting cranky. Small, director of the ULCA Center on Aging, put the mathematician through a batter of tests - and the man got top scores on all of them, including 30 out of 30 on a memory test and a whopping 140 on his IQ test. So when Small saw the patient's brain scan, he was stunned: it had all the markings of full-blown Alzheimer's disease.

    "Usually, people with such profound brain changes can barely carry on a conversation," says Small. "This man was still doing high-level mathematics." Though the case is extreme, it is not unique. In fact, up to 20 percent of people autopsied who had no major memory problems are discovered to have had Alzheimer's, says Yaakov Stern, Ph.D., a neuropsychologist at Columbia University College of Physicians and Surgeons in New York City.

    How does the brain continue to function - sometimes quite efficiently - despite changes that should cause severe disability? An answer, many scientists believe, is "cognitive reserve": the combination of a person's innate abilities and the additional brainpower that comes from challenging the mind. Studies show that diverse, mentally stimulating tasks result in more brain cells, more robust connections among those cells, and a greater ability to bypass age- or disease-related trouble spots in the brain. The more you work your mind, the greater your cognitive reserve. And the greater your reserve, the greater your ability to withstand the inevitable challenges of aging.

    As a doctor specializing in memory problems, I have seen recent discoveries offer new hope and guidance to people who want to maintain peak brain performance. Although we don't know how to stop the devastation of dementia, we learn more each year about combating the small losses in brainpower that often come after 50 - even while you enjoy the brain benefits of getting older (and yes, you'll see below, those benefits do exist).

    YOUR BRAIN AT 50-Plus

    Despite what our youth-oriented culture tells us, mental decline after 50 is not a given. In fact, in some ways the healthy brain gets stronger with age. Studies confirm that accumulated knowledge and expert skills (a.k.a. wisdom) increase as you get older. In addition, emotional savvy, such as not dwelling on negative thoughts, also appears to grow with age, as demonstrated in a recent Duke University study. Researchers showed a set of photos to study participants. Some of the photos were of neutral items such as household objects; others were distressing shots of violent scenes. Tested later, participants in their 70s remembered about the same number of neutral images as did those in their 20s, but the older people remembered fewer of the unpleasant ones. Cell-signaling activities in the older group suggested their brains filtered out bad memories.

    Other brain functions may not improve with age, but they don't automatically wane either. One example is higher-order decision making such as choosing the best investments. Older people do as well as younger ones on tests that measure this function - as long as they are not rushed.

    And that's the catch. Some brain functions tend to decline with age, and speed is one of them. The likely reasons are loss of neural connections, blockages of blood supply, and decreases in nerve-signaling chemicals.

    Memory can also diminish with age, though only certain types. Learned skills such as driving are wired so firmly that they typically do not decline unless you have a disease such as Alzheimer's. Memory for events (called explicit memory) is a bit more vulnerable, although episodes that really made an impression, such as meeting your spouse, are generally secure.

    If your memory is suffering, it's most likely your short-term memory. This ability - which includes "working memory," where events are held before being filed for the long term - usually peaks by the early 30s. That's why memorizing complex new information, such as a foreign language, can get harder as you get older.

    NURTURING NEURONS

    So how do you keep your brain at its best? By growing new brain cells, for starters. Long though impossible, this turns out to be relatively routine in lab animals and, thus, maybe in humans. Scientists suspect that certain lifestyle habits can spark the cells' growth.

    In 1998, Fred Gage, Ph.D., and his colleagues at the Salk Institute for Biological Studies in La Jolla, California, showed that the memory centers of adult human brains can grow new cells. Since then, studies by Gage and others have suggested that the more physical and mental exercise you get, the more brain cells you grow, the longer they survive, and the better they connect with other nerve cells. Exercise, such as brisk walking for 40 minutes four times a week, increases blood flow to the regions of the brain shown able to grow new cells. "In our lab, when we discovered this, people started taking walks during their lunch hour," says Gage. Movement is so crucial to brain health that some of the cognitive changes blamed on aging may in fact be the result of inactivity, he adds.

    Another simple, brainpower-boosting habit: pay attention to what you're doing. As we age, we become more prone to distraction, thanks to some of the same brain changes that can hamper our thinking speed. But even a split-second loss of focus can prevent a memory from being properly stored. So when you put down your glasses, focus on where you put them; they may be a whole lot easier to find.

    Many memory problems stem from treatable conditions such as vitamin B deficiencies, depression, thyroid problems, or uncontrolled vascular disease. So if you notice changes, a visit to the doctor could set you straight.

    If you're worried about your response time, practice can help quite a bit, researchers have found. After a group of people 65 and up did exercises in which they searched for and matched images, 87 percent of them improved their speed, according to a multicenter study led by the University of Alabama. The older adults who regularly tutored elementary-school students saw improvements in their own cognitive function after six months, a 2009 Johns Hopkins study showed.

    Several of the activities that help you stay sharp are also good for your heart, your immune system, and your body's other machinery. In fact, a recently published study of 2,500 people ages 70 to 79 found that 30 percent of the group saw no decline in their mental performance or improved on cognitive tests over the course of 8 years. And that fortunate 30 percent were more likely than the others to have some or all of these healthy traits:
    • Exercised at least once a week.
    • Had at least a high-school education (or equivalent).
    • Did not smoke.
    • Worked or volunteered.
    • Lived with at least one other person.

    Note that most of the time, these behaviors are under our own control.

    HELPFUL HABITS

    Everyone can maximize his or her brain health. Living an active life - resisting the siren call of the couch and the remote control - is your best bet for staying sharp. Puzzles (like the ones seen below) are one way to keep those synapses firing properly (see bottom of this article for puzzle solutions).

    SAMPLE PUZZLES

    Puzzle 1: Tile Game


    Puzzle 2: Space Race


    Puzzle 3: The LineUp


    Puzzle 4: About Face


    Puzzle 5: Word Grid


    10 MORE BRAIN-BOOSTING ACTIVITIES

    1. Walk & Talk: Find a walking partner, study a topic, and discuss it on your walks. You'll get mental stimulation, physical exercise, and social connection - the key brain strengtheners.

    2. Vary Your Routine: Try a different grocer. Join a new club. Novelty stimulates new neural connections.

    3. Get Smart: Be a lifelong learner, and don't dabble. If you decide to study a language, sign up for as many classes as you can fit in your week.

    4. Play: Pick games with several levels of difficulty, to master one by one. For quicker thinking, try to beat the clock.

    5. De-Stress: Meditation, yoga, a walk in the woods - focus your mind and relax. This may build clearer memories.

    6. Sleep: Your brain is active when you are asleep - it is consolidating memories from your day. Skip the late show and give your brain time to work.

    7. Imagine: Include creativity in your day. Paint, write a diary or novel, visit new websites, or build your own.

    8. Party: Socialize and make new friends. Don't be a loner - it can lull your brain into slowdown mode.

    9. Eat Right: A diet rich in fruits and vegetables, whole grains, and fish will help keep oxygen flowing to the brain.

    10. Watch Your Numbers: Work with your health care provider to keep blood pressure, weight, blood sugar, and cholesterol in check.

    Most important, shun gimmicks. No product can build extra brainpower instantly or effortlessly. But with challenging new habits, you can make your mind steadily sharper and stronger - now and for the rest of your life.

    PUZZLE SOLUTIONS

    Puzzle Solutions


    PennyDell Puzzles: A variety of Puzzle Books to help stimulate the mind. Visit their website for more information about products available.


    P. Murali Doraiswamy, M.D., is chief of biological psychiatry at Duke University Medical Center and coauthor of the Alzheimer's Action Plan. A writer on that book, Maryland freelancer Tina Adler, contributed to this article.

    Puzzles adapted from "The Memory Prescription: Dr. Gary Small's 14 Day Plan To Keep Your Brain and Body Young" By Gary Small, M.D. (Hyperion, 2005).





    TREATMENT CONSIDERATIONS

    DIAGNOSTIC TESTS & RESEARCH

  • A test that measures electrical activity in the brain and stores the information on a computer disk for analysis can be used to help diagnose Alzheimer's disease. A skin test is also under development, and may allow for earlier and more rapid diagnosis.

  • A skin test using lasers is under development in Australia that may provide earlier and more rapid diagnosis. Developed at the National Aging Research Institute at the University of Melbourne, this test detects blood flow restrictions associated with Alzheimer's disease. The test involves the use of lasers along with a mild electrical current that activates a chemical useful in assessing blood flow. It is hoped that the test will become a public screening measure in the near future.

  • Carbamazepine (Tegretol), an anti-seizure medication, can ease Alzheimer's-related anger and hostility, according to a recent study. Aggression was markedly reduced in three out of four of the Alzheimer's patients in the study.

  • Hopes for the drug tacrine (Cognex) as a treatment for Alzheimer's disease have been deflated. Trials of tacrine yielded ambiguous results. It resulted in at best a modest decline in the progression of some cases of the disease, while at the same time raising concerns about liver damage.

  • Recent studies show that the progression of Alzheimer's disease can be slowed or even reversed by reducing free radical accumulation through the use of antioxidants. Tests conducted in Switzerland over a 22 year period produced evidence of significantly higher memory scores associated with antioxidant therapy.

  • The herbs Lemon Balm and Sage are being researched for possible beneficial effects on brain chemistry. Lemon Balm appears to simulate the neurological receptors that bind acetylcholine. It has been used to combat Alzheimer's disease by boosting memory and preventing plaque accumulation in arteries of the brain. Sage contains compounds that are cholinesterase inhibitors. Current drugs used to treat Alzheimer's are typically cholinesterase inhibitors.

  • Preliminary studies performed on rats at the University of Washington in Seattle indicate that Cat's Claw, when mixed with other herbal extracts (such as Ginkgo Biloba, Gotu Kola, and Rosemary, inhibits the buildup of plaques in the brain.

  • Some experts distinguish between a rapidly progressive form of Alzheimer's disease that begins earlier in life (usually between the ages of 36 and 45) and a more gradual form that develops in people around the age of 65 or 70. For more information, consult:

  • Guide to Symptoms, Illness and Surgery for People Over 50
    by H. Winter Griffith, M.D.

  • Research studies supported by the Alzheimer's Association and studies done at the Department of Research at Oakwood College in Huntsville, Alabama, found that Liquid aged garlic extract (Kyolic) might proved to be useful in the improvement of Alzheimer's disease symptoms. Kyolic protected the cells from toxic effects of beta-amyloid.

  • Beta-amyloid, the protein-containing substance that makes up the characteristic senile plaques in the brain, has also been found in the spinal fluid of people with Alzheimer's disease. This finding may lead to the development of methods for earlier diagnosis of the condition.

  • Homocysteine, an amino acid that forms as the result of the breakdown of another amino acid, Methionine, is a biomarker for the development of dementia and Alzheimer's disease. Some scientists speculate that Alzheimer's disease might be avoided if people reduced the levels of homocysteine levels in their blood, although it has not yet been determined whether homocysteine itself actually contributes to Alzheimer's disease. A more likely explanation is that elevated homocysteine levels are an indication of a severe disruption of methylation (a type of biochemical process essential for the repair and maintenance of genetic material and the productions of neurotransmitters, among other things) in the brains of people with Alzheimer's disease. Methylation deficiencies can result in severe damage to brain cells. Other researchers report that abnormal amino acid metabolism in Alzheimer's disease causes higher homocysteine levels. This may lead to the neurological damage that occurs as the disease advances.

  • A decline in the ability to smell often occurs as much as two years prior to the beginning of mental decline in people with Alzheimer's. People with this disorder need to be exposed to very strong concentrations of a substance before they can detect its odor, according to scientists at the University of California - San Diego Medical Center. The rate at which the ability to distinguish smells is lost is a useful predictor of how rapidly an individual will lose cognitive functioning. Smoking can damage cells involved in the sense of smell, however, making this less useful as an indicator of disease in smokers.

  • In a research study, care givers of 88 elderly people were questioned about the eating habits of the elderly people in their care, half of the elderly people in the study had either Alzheimer's or a related form of dementia. Half the people with Alzheimer's disease had such a strong desire for sweets that their access to these foods had to be restricted.

  • The hormone Dehydropiandrosterone (DHEA) may help to prevent Alzheimer's disease.

  • MoonDragon's Health & Wellness: DHEA Therapy

  • No treatment can stop or reverse Alzheimer's disease. However, for people in the early and middle stages of the disease, drug therapy using cholinesterase inhibitors such as tacrine (Cognex), donepezil (Aricept), rivastigmine (Exelon), or galantamine (Reminyl) may alleviate some symptoms for a limited period of time. A new class of drug, which is currently the only available neuroprotective therapy, is memantine (Namenda), which has been approved for treatment of moderate to severe cases. However, this drug does not appear to be the "silver bullet" everyone has been looking for, and indeed, might only offer some slight relief to those patients already in the last stages of the disease.

  • There is some evidence that inflammation in the brain may contribute to damage caused by the disease. As a result, studies were being conducted on the effect of non-steroidal anti-inflammatory drugs (NSAIDs) to see if they could slow its progression. But at this point, on study on rofecoxib (Vioxx) and naproxen sodium (Aleve) was inconclusive, and another on celecoxib (Celebrex) and Naproxen sodium was discontinued. Rofecoxib has since been withdrawn from the market.

  • Because the beta-amyloid plaques appear to be in large measure the culprits behind Alzheimer's damage, if a way could be developed to clear them out, or prevent their buildup altogether, the disease could be managed. Researchers at Lilly Research Laboratories and Elan Pharmaceuticals have discovered that certain monoclonal antibodies bind to beta-amyloid and clear it from the brain. In animal experiments, a treatment with monoclonal antibody M266 both cleared beta-amyloid from the brains of the subject and reversed some existing memory problems. Meanwhile, a study published in the Journal of Neuroscience in March 2003 showed that levels of neprilysin, a beta-amyloid-degrading enzyme, could be boosted by means of gene therapy. This caused a reduction in the plaque found in the brains of the animal subjects. Another study, published in Nature Medicine, was conducted that pointed to astrocytes, naturally occurring cells that protect neurons, as mechanisms that counter beta-amyloid. Researchers theorize that defects in the ability of astrocytes to clear beta-amyloid could be a contributing factor in plaque development.

  • A research study published in the Proceedings of the National Academy of Sciences has shown that mice modified to lack the enzyme insulysin (which degrades insulin) had levels of beta-amyloid 1.5 times greater in their brains than control mice. Because insulysin is so closely tied to insulin and glucose metabolism, and because there appears to be a link between diabetes and Alzheimer's disease, scientists hope that modifying insulysin activity or some other aspects of insulin metabolism may assist in management of the disease.

  • Research reported in the journal Biochemistry indicated possible therapeutic potential of anti-beta-amyloid proteolytic antibody light chain fragments. These fragments are able to zero in on the beta-amyloid and reduce its toxicity, and they can be introduced into the parts of the brain that carry heavy concentrations of the plaque by non-intrusive methods.

  • A promising new drug, called Alzhemed, is undergoing FDA Phase III trails. An orally administered, small organic molecule, this drug is designed to clear soluble beta-amyloid fibrils from the brain before they can cause plaques, to prevent and stop formation and deposition of amyloid fibrils, and to inhibit the inflammatory response associated with amyloid buildup. If ultimately successful, this drug would be the "silver bullet". The Phase II trial was very successful, reducing spinal fluid concentrations of beta-amyloid by as much as 70 percent.

  • Using a different approach, a Phase I safety trial has been run on humans with a proposed vaccine-like drug that showed a lot of promise in animal studies. As these trials showed no ill effects on the subjects, a Phase II trial was begun in 2001 with 360 participants. Unfortunately, the trial was halted due to some severe side effects, but the results even of the foreshortened trail showed great promise. The drug appears to have reduced the amount of beta-amyloid plaques on one patient, and a significant number of those treated did develop the antibodies. This study has encouraged researchers to try different approaches based on the underlying theory because there did appear to be a positive effect caused by the drug. This avenue, immune therapy, shows much promise and may be a path to be effective treatment in the future.

  • Preliminary trials suggest that nicotinamide adenine dinucleotide (NADH) may benefit those afflicted with Alzheimer's. In a study conducted by Austrian researcher and physician Dr. George Birkmayer and colleagues, 17 patients with Alzheimer-type dementia were treated with NADH for 8 to 12 weeks. The patient's cognitive function improved as measured by two standard tests, according to the Folstein Mini-Mental Status Examination and the global deterioration scale. The patients reportedly did not suffer any adverse side effects.

  • High doses of Lecithin may be helpful for people with Alzheimer's disease. However, a double blind controlled trial of high doses of Lecithin reported in the Journal of Neurology, Neurosurgery & Psychiatryfound that there may be a "therapeutic window" for the effects of Lecithin on people with Alzheimer's disease, and that this may be more evident in older people.

  • Women with Alzheimer's disease have been found to have lower estrogen levels than their healthy counterparts.

  • Researchers discovered that levels of choline and ethanolamine are significantly lower than normal in people suffering from Alzheimer's disease. Both choline and ethanolamine are used for the synthesis of phospholipids that are major components of the cell membranes of neurons in the brain.

  • Scientists at the University of Kentucky found that levels of glutamine synthelase, an enzyme that controls the production of ammonia and glutamate, were higher in a group of people with Alzheimer's disease than in a healthy control group. Glutamate is vital to the brain in small amounts, but can be poisonous in high concentrations. Abnormally high levels of glutamate have recently been associated with amyotropic lateral sclerosis (ALS, also known as Lou Gehrig's disease) and glaucoma as well.

  • An estimated 2 percent of Americans have two copies of a gene for the production of a substance called apolipo-protein E4, or APO-E4. APO-E4 transports cholesterol through the bloodstream and also changes the form of amyloid in the brain. Those with two copies of the gene have 50 percent chance of getting Alzheimer's before the age of 70. In contrast, for those with no copies of the gene, the risk of developing the disease does not rise to 50 percent until after the age of 90.

  • Researchers found that the brains of a group of individuals with Alzheimer's disease contained higher levels of mercury than the brains of a comparable control group, particularly in areas of the brain responsible for cognitive functioning, movement, and expression. The Alzheimer's group also had higher ratios of mercury to the trace minerals selenium and zinc, which help to protect the body against the toxic effects of mercury.

  • People who tend to experience psychological distress appear to be more likely to develop Alzheimer's disease than those who are less prone to experience distress. In a study reported in the journal Neurology people who most often experienced negative emotions such as depression and anxiety were twice as likely to develop the disease as those who were less prone to experience these negative emotions. However, more research is needed before across-the-board prescription of antidepressants is approved to prevent Alzheimer's disease.

  • The Omega-3 Fat DHA (Docosahexaenoic Acid), which is found in many cold-water fish (such as salmon, tuna, and mackerel), is known to have cardio-protective effects. Researchers at the University of California - Los Angeles School of Medicine found that genetically engineered mice fed a diet rich in DHA were found to have less brain cell damage than those fed a diet which substituted safflower oil, which is low in omega-3 fatty acids. The American Heart Association recommends at least 2 meals a week of fish rich in omega-3 fatty acids. While this is for good cardiovascular health, it is possible that this diet can also favorably affect people who have Alzheimer's disease or who have a high risk of developing the disease. This is surely a case of "it can't hurt, and it might help".

  • The calming effect of watching fish swimming peacefully in an aquarium is found to help people with Alzheimer's disease eat better by helping them to concentrate long enough to eat well, according to Nancy Edwards, PhD, a professor of nursing at Purdue University.

  • Experts say that it is in an individual's best interest to be told as soon as there is reason to suspect a diagnosis of Alzheimer's disease. Early warning cannot prevent the disease, but it gives people time to settle their affairs and make informed judgments about future care and other matters.

  • CARETAKERS

    Anyone who takes care of a person with Alzheimer's disease will eventually find the job overwhelming and need some help. For many, adult day care centers are an option and may be a blessing. A good day-care center should be clean, safe (without glass doors, uneven or slippery floors, furniture with sharp corners, and so forth), and have barriers at entrances and exits to protect wanderers without making them feel trapped. The food should be nutritious and appetizing. Staff members should be warm and friendly, and professionally trained to work with people with Alzheimer's. There should be psychologists or social workers on hand to help people work through the ordinary frustrations of daily life and to assist them in coping with anger and depression. A quiet room should be available where an agitated or ill person can be separated from others, since some people find an active, stimulating environment upsetting. The availability of other specific services, such as physical therapy, help with hygiene, family counseling, or support groups for care givers, as well as usual activities of the center, should be suited to particular needs of the individual and his or her family.

  • Further information about this disorder is available from these resources:

  • Alzheimer's Association
    919 North Michigan Avenue, Suite 1000
    Chicago, IL 60611
    800-272-3900
    312-335-8700
    www.alz.org

    Beating Alzheimer's: A Step Towards Unlocking the Mysteries of Brain Diseases
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