This page is dedicated to my Grandma. She suffered from Senile Dementia.

DESCRIPTION

Besides senile dementia, other terms often used to describe dementia include senility and organic brain syndrome. Senility and senile dementia are outdated terms that reflect the formerly widespread belief that dementia was a normal part of aging. Organic brain syndrome is a general term that refers to physical disorders (not psychiatric in origin) that impair mental functions.

It was once thought that senile dementia was an inevitable consequence of aging. However, we now know that it is a physically based disease resulting from a loss of brain cells. Brain function, or certain aspects of brain function, decline to the point that mental disability results. Progressive loss of memory, mental abilities and noticeable personality changes occurs with senile dementia. Dementia is not a specific disease but a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. Alzheimer's disease (AD) is one form of dementia and is the most common form.

People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems such as agitation, delusions, and hallucinations. While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia. Health care providers diagnose dementia only if two or more brain functions - such as memory, language skills, perception, or cognitive skills including reasoning and judgment - are significantly impaired without loss of consciousness.

There are many disorders that can cause dementia. Some, such as AD, lead to a progressive loss of mental functions. But other types of dementia can be halted or reversed with appropriate treatment.

With AD and many other types of dementia, disease processes cause many nerve cells to stop functioning, lose connections with other neurons, and die. In contrast, normal aging does not result in the loss of large numbers of neurons in the brain.

CONDITIONS THAT ARE NOT DEMENTIA

Age-Related Cognitive Decline: As people age, they usually experience slower information processing and mild memory impairment. In addition, their brains frequently decrease in volume and some nerve cells, or neurons, are lost. These changes, called age-related cognitive decline, are normal and are not considered signs of dementia.

Mild Cognitive Impairment: Some people develop cognitive and memory problems that are not severe enough to be diagnosed as dementia but are more pronounced than the cognitive changes associated with normal aging. This condition is called mild cognitive impairment. Although many patients with this condition later develop dementia, some do not. Many researchers are studying mild cognitive impairment to find ways to treat it or prevent it from progressing to dementia.

Depression: People with depression are frequently passive or unresponsive, and they may appear slow, confused, or forgetful. Other emotional problems can also cause symptoms that sometimes mimic dementia.

Delirium: Delirium is characterized by confusion and rapidly altering mental states. The person may also be disoriented, drowsy, or incoherent, and may exhibit personality changes. Delirium is usually caused by a treatable physical or psychiatric illness, such as poisoning or infections. Patients with delirium often, though not always, make a full recovery after their underlying illness is treated.

It is extremely important to obtain an accurate diagnosis before trying to find a cure. Many diseases and conditions share common symptoms: if you treat yourself for the wrong illness or a specific symptom of a complex disease, you may delay legitimate treatment of a serious underlying problem.

Research in the last 30 years has led to a greatly improved understanding of what dementia is, who gets it, and how it develops and affects the brain. This work is beginning to pay off with better diagnostic techniques, improved treatments, and even potential ways of preventing these diseases.

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FREQUENT SIGNS & SYMPTOMS

Symptoms at the early stage often include the following:

• Recent memory loss. Forgetting recent events (distant memories also fade as the disease progresses). An ability to remember things that happened years ago, but not things that took place a few minutes ago, is typical. Everyone forgets things for awhile, but remembers them later. Dementia patients often forget things, and never remember them. They might ask the same question repeatedly, each time forgetting that you already answered it. They do not even remember they already asked the question.



• Problems with language. Dementia patients may forget simple words or use the wrong words, making it hard to understand what they want, causing an outburst of anger directed at the person they are talking to.



• Changes in mood. Everyone is moody occasionally, but patients may have fast mood swings, going from calm to tears to anger in just minutes.



• Problems with abstract thinking and experiencing difficulty in reasoning, calculation, and accepting new things. Anyone might have trouble balancing a checkbook from time to time; dementia patients can forget what numbers are and how to use them.



• Misplacing things. Patients may put things in the wrong places such as an iron in the freezer or a wristwatch in the sugar bowl. Then they cannot find them later.



• Hoarding of food and/or non-food items, such as newspapers, grocery bags, books, clothes. Hoarding of too many pets (cats, dogs, and birds are common pets). My grandmother had over 100 cats in a 2 bedroom apartment. Living conditions may be cluttered, unsafe, unsanitary, smelly and messy. If pets are involved, they are often undernourished, sick and improperly cared for.



• Time and place disorientation. Becoming confused over time, place and direction. Patients may get lost on their own street, forgetting how they got to a certain place and how to get back home. No longer having any concept of time or lacking a sense of time.



• Impaired judgment and/or poor judgment. Anyone might get distracted and forget to watch a child closely for a short time. Dementia patients might forget about the child and just leave the house for the day.



• Personality changes. Patients may have drastic changes in personality, often becoming irritable, suspicious, jealous, or fearful. Paranoia, frustration, anger, and insensitivity towards the feelings of others.



• Becoming passive and losing initiative. Patients may not want to go places or see other people.

Symptoms at the middle stage include the following:

• Losing cognitive ability, such as the ability to learn, judge, and reason.



• Becoming emotionally unstable, and easily losing temper or becoming agitated. Loss of normal emotional responses.



• Needing help to simply live from day to day. Difficulty performing familiar tasks. Patients might cook a meal but forget to serve it. They might even forget cooking it.



• Confusing night and day; disturbing others' normal sleeping time.

Symptoms at the later stage include the following:

• Losing all cognitive ability. Unable to recognize people.



• Becoming entirely incapable of self-care, including eating, bathing, and so on.



• Neglecting personal hygiene, self-neglect. Increased risk of infections.



• Incontinence. Chronic constipation.



• Losing weight gradually. Inadequate nutrition or inappropriate diet. My grandmother enjoyed eating moist cat food sandwiches only. She ate very little of anything else.



• Walking unsteadily and becoming confined to bed.

Injuries and falling can become a problem. Older adults who develop gait abnormalities seem to be more prone to getting vascular or other non-Alzheimer's type dementia, according to a 2002 study. This is a valid early warning signal because such individuals are more than 3.5 times more likely to develop dementia as compared with those who have the same basic risk factors but who do not have the gait problem.

Important Note: Even if your loved one has some of these problems, they may not have senile dementia or Alzheimer's disease. Many people diagnosed as senile dementia actually suffer from pseudodementia - symptoms that mimic dementia but that are actually caused by other health conditions. Many treatable health conditions have the same signs. Among them are:

• Prescription drugs interactions and side effects. Drug abuse.
• The combined effect of weight loss/gain and medications.
• Kidney or liver problems.
• Brain tumors.
• Depression.
• Deafness.
• Hypothyroidism and thyroid problems.
• Multiple strokes.
• Atherosclerosis.
• Multiple sclerosis (MS).
• AIDS.
• Diabetes and blood sugar problems.
• Dehydration.
• Nutritional deficiencies of vitamin B-1 (thiamine), B-3 (Niacin), B-6 (pyridoxine) and/or Vitamin B-12.
• Falls and concussions.
• Alcohol use. Alcoholism.

A thorough medical and psychological examination by a qualified professional, preferably a specialist in the field, is necessary for an accurate diagnosis.

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CAUSES

Dementia is always caused by an underlying disease or condition. Brain tissue is damaged, and functioning is diminished. All forms of dementia result from the death of nerve cells and/or the loss of communication among these cells. The human brain is a very complex and intricate machine and many factors can interfere with its functioning.

The most common cause of dementia is Alzheimer's disease. Health care providers have identified many other conditions that can cause dementia or dementia-like symptoms. Many of these conditions are reversible with appropriate treatment. Others result in permanent, irreversible damage.

NERVE DEGENERATIVE DISEASES

Many types of dementia, including AD, Lewy body dementia, Parkinson's dementia, and Pick's disease, are characterized by abnormal structures called inclusions in the brain. Because these inclusions, which contain abnormal proteins, are so common in people with dementia, researchers suspect that they play a role in the development of symptoms. However, that role is unknown, and in some cases the inclusions may simply be a side effect of the disease process that leads to the dementia.

Creutzfeld-Jakob disease, a rapidly progressing degenerative disorder of the nervous system causing problems with walking, talking, and the senses.

Huntington disease, a progressive degenerative disease that causes dance-like movements and mental deterioration.

Lewy body disease, a degenerative disease of the nervous system.

Multiple sclerosis, a disorder of the sheath that lines the brain and spinal cord.

Parkinson's disease, a degenerative disorder of part of the nervous system.

Pick's disease, a disorder of the brain that causes slowly progressing dementia.

Progressive supranuclear palsy, also known as Steele-Richardson-Olszewski syndrome, a rare disorder of late middle age that causes widespread neurological problems.

For other dementias, such as corticobasal degeneration and most types of frontotemporal dementia, the underlying causes have not yet been identified.

INFECTIVE DISEASES

Infections. Many infections can cause neurological symptoms, including confusion or delirium, due to fever or other side effects of the body's fight to overcome the infection.

In rare cases, Lyme disease can cause memory or thinking difficulties.

HIV, the immunodeficiency disorder that leads to AIDS. People in the advanced stages of AIDS also may develop a form of dementia (see HIV-associated dementia). People with compromised immune systems, such as those with leukemia and AIDS, may also develop an infection called progressive multifocal leukoencephalopathy (PML). PML is caused by a common human polyomavirus, JC virus, and leads to damage or destruction of the myelin sheath that covers nerve cells. PML can lead to confusion, difficulty with thinking or speaking, and other mental problems.

Viral or bacterial encephalitis, an inflammation of the brain. Meningitis and encephalitis, which are infections of the brain or the membrane that covers it, can cause confusion, sudden severe dementia, withdrawal from social interaction, impaired judgment, or memory loss.

Neurosyphilis, an infection of the nervous system by the syphilis bacteria, which causes weakness and mental deterioration. Untreated syphilis also can damage the nervous system and cause dementia.

BRAIN INJURY OR DISORDER

Post-traumatic dementia is directly related to brain cell death after injury.

Normal pressure hydrocephalus, or increased cerebrospinal fluid in the brain.

Chronic subdural hematoma, or bleeding between the brain lining and brain tissue. Subdural hematomas. Subdural hematomas, or bleeding between the brain's surface and its outer covering (the dura), can cause dementia-like symptoms and changes in mental function.

Brain tumor. In rare cases, people with brain tumors may develop dementia because of damage to their brains. Symptoms may include changes in personality, psychotic episodes, or problems with speech, language, thinking, and memory.

HEART, CIRCULATORY & PULMONARY DISORDERS

Vascular dementia can be caused by cerebrovascular disease or any other condition that prevents normal blood flow to the brain. Without a normal supply of blood, brain cells cannot obtain the oxygen they need to work correctly, and they often become so deprived that they die.

Heart and lung problems. The brain requires a high level of oxygen in order to carry out its normal functions. Therefore, problems such as chronic lung disease or heart problems that prevent the brain from receiving adequate oxygen can starve brain cells and lead to the symptoms of dementia.

Atherosclerosis, or hardening of the arteries.

Wilson disease, a rare disease causing an accumulation of copper in the liver, brain, kidneys, and corneas.

METABOLIC & ENDOCRINE DISORDERS

Metabolic problems and endocrine abnormalities. Tests can determine if any of these problems are present.

Certain abnormalities of a person's metabolism or hormones that may also be responsible for the development of dementia, include the following:

Thyroid problems can lead to apathy, depression, or dementia.

• Hypothyroidism, which means the thyroid gland is underactive.



• Hyperthyroidism, which means the thyroid gland is overactive.

Hypoglycemia, a condition in which there is not enough sugar in the bloodstream, can cause confusion or personality changes.

Dehydration can also cause mental impairment that can resemble dementia. Electrolyte imbalances such as too little or too much sodium or calcium can also trigger mental changes. Dehydration also causes problems with the brain, kidneys, and cardiac systems.

NUTRITIONAL DEFICIENCIES

In some of these cases, dementia can be reversed by removing the toxic agent or bringing vitamin levels back to normal.

Deficiency, or low body levels, of Vitamin B-12. Some people have an impaired ability to absorb vitamin B-12, which creates a condition called pernicious anemia that can cause personality changes, irritability, or depression. Deficiencies of vitamin B-12 also have been linked to dementia in some cases.

Vitamin B-1 (Thiamine) deficiency. Deficiencies of thiamine (vitamin B-1) frequently result from chronic alcoholism and can seriously impair mental abilities, in particular memories of recent events.

Deficiency of niacin (Vitamin B-3).

Deficiency of Vitamin B-6 (Pyridoxine). Severe deficiency of vitamin B-6 can cause a neurological illness called pellagra that may include dementia.

ENVIRONMENTAL EXPOSURE & TOXICITY

Poisoning. Exposure to lead, other heavy metals, or other poisonous substances can lead to symptoms of dementia. These symptoms may or may not resolve after treatment, depending on how badly the brain is damaged. Chronic exposure to metals, such as lead or mercury, and to dyes, such as aniline.

Chronic alcohol abuse ( Alcoholism) often results in nutritional deficiencies as well as damage to the brain, liver and other systems of the body. People who have abused substances such as alcohol and recreational drugs sometimes display signs of dementia even after the substance abuse has ended. This condition is known as substance-induced persisting dementia.

Anoxia. Anoxia and a related term, hypoxia, are often used interchangeably to describe a state in which there is a diminished supply of oxygen to an organ's tissues. Anoxia may be caused by many different problems, including heart attack, heart surgery, severe asthma, smoke or carbon monoxide inhalation, high-altitude exposure, strangulation, or an overdose of anesthesia. In severe cases of anoxia the patient may be in a stupor or a coma for periods ranging from hours to days, weeks, or months. Recovery depends on the severity of the oxygen deprivation. As recovery proceeds, a variety of psychological and neurological abnormalities, such as dementia or psychosis, may occur. The person also may experience confusion, personality changes, hallucinations, or memory loss.

MEDICATIONS & DRUG USE

Reactions to medications. Medication side-effects or drug interactions. Drug abuse. Medications can sometimes lead to reactions or side effects that mimic dementia. These dementia-like effects can occur in reaction to just one drug or they can result from drug interactions. They may have a rapid onset or they may develop slowly over time.

High-dose steroid abuse.

GENETIC FACTORS

Genes clearly play a role in the development of some kinds of dementia. However, in AD and many other disorders, the dementia usually cannot be tied to a single abnormal gene. Instead, these forms of dementia appear to result from a complex interaction of genes, lifestyle factors, and other environmental influences. Researchers have identified several genes that influence susceptibility to AD. Mutations in three of the known genes for AD - genes that control the production of proteins such as amyloid precursor protein (APP), presenilin 1, and presenilin 2 - are linked to early-onset forms of the disease.

Variations in another gene, called apolipoprotein E (apoE), have been linked to an increased risk of late-onset AD. The apoE gene does not cause the disease by itself, but one version of the gene, called apoE epsilon4 (apoE E4), appears to increase the risk of AD. People with two copies of the apoE E4 gene have about ten times the risk of developing AD compared to people without apoE E4. This gene variant seems to encourage amyloid deposition in the brain. One study also found that this gene is associated with shorter survival in men with AD. In contrast, another version of the apoE gene, called apoE E2, appears to protect against AD.

Studies have suggested that mutations in another gene, called CYP46, may contribute to an increased risk of developing late-onset sporadic AD. This gene normally produces a protein that helps the brain metabolize cholesterol.

Scientists are trying to determine how beta amyloid influences the development of AD. A number of studies indicate that the buildup of this protein initiates a complex chain of events that culminates in dementia. One study found that beta amyloid buildup in the brain triggers cells called microglia, which act like janitors that mop up potentially harmful substances in the brain, to release a potent neurotoxin called peroxynitrite. This may contribute to nerve cell death in AD. Another study found that beta amyloid causes a protein called p35 to be split into two proteins. One of the resulting proteins triggers changes in the tau protein that lead to formation of neurofibrillary tangles. A third study found that beta amyloid activates cell-death enzymes called caspases that alter the tau protein in a way that causes it to form tangles. Researchers believe these tangles may contribute to the neuron death in AD.

The causes of other types of dementias vary. Some, such as CJD and GSS, have been tied to abnormal forms of specific proteins. Others, including Huntington's disease and FTDP-17, have been linked to defects in a single gene.

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TYPES OF DEMENTIA

Dementing disorders can be classified many different ways. These classification schemes attempt to group disorders that have particular features in common, such as whether they are progressive or what parts of the brain are affected. Some frequently used classifications include the following:

CORTICAL DEMENTIA

Dementia where the brain damage primarily affects the brain's cortex, or outer layer. Cortical dementias tend to cause problems with memory, language, thinking, and social behavior.

SUBCORTICAL DEMENTIA

Dementia that affects parts of the brain below the cortex. Subcortical dementia tends to cause changes in emotions and movement in addition to problems with memory.

PROGRESSIVE DEMENTIA

Dementia that gets worse over time, gradually interfering with more and more cognitive abilities.

PRIMARY DEMENTIA

Dementia such as AD that does not result from any other disease.

SECONDARY DEMENTIA

Dementia that occurs as a result of a physical disease or injury.

Some types of dementia fit into more than one of these classifications. For example, AD is considered both a progressive and a cortical dementia.

ALZHEIMER'S DISEASE

Alzheimer's disease is the most common cause of dementia in people aged 65 and older. Experts believe that up to 4 million people in the United States are currently living with the disease: one in ten people over the age of 65 and nearly half of those over 85 have AD. At least 360,000 Americans are diagnosed with AD each year and about 50,000 are reported to die from it. In most people, symptoms of AD appear after age 60. However, there are some early-onset forms of the disease, usually linked to a specific gene defect, which may appear as early as age 30. AD usually causes a gradual decline in cognitive abilities, usually during a span of 7 to 10 years. Nearly all brain functions, including memory, movement, language, judgment, behavior, and abstract thinking, are eventually affected.

AD is characterized by two abnormalities in the brain: amyloid plaques and neurofibrillary tangles. Amyloid plaques, which are found in the tissue between the nerve cells, are unusual clumps of a protein called beta amyloid along with degenerating bits of neurons and other cells. Neurofibrillary tangles are bundles of twisted filaments found within neurons. These tangles are largely made up of a protein called tau. In healthy neurons, the tau protein helps the functioning of microtubules, which are part of the cell's structural support and deliver substances throughout the nerve cell. However, in AD, tau is changed in a way that causes it to twist into pairs of helical filaments that collect into tangles. When this happens, the microtubules cannot function correctly and they disintegrate. This collapse of the neuron's transport system may impair communication between nerve cells and cause them to die. Researchers do not know if amyloid plaques and neurofibrillary tangles are harmful or if they are merely side effects of the disease process that damages neurons and leads to the symptoms of AD. They do know that plaques and tangles usually increase in the brain as AD progresses.

In the early stages of AD, patients may experience memory impairment, lapses of judgment, and subtle changes in personality. As the disorder progresses, memory and language problems worsen and patients begin to have difficulty performing activities of daily living, such as balancing a checkbook or remembering to take medications. They also may have visuospatial problems, such as difficulty navigating an unfamiliar route. They may become disoriented about places and times, may suffer delusions (such as the idea that someone is stealing from them or that their spouse is being unfaithful), and may become short-tempered and hostile. During the late stages of the disease, patients begin to lose the ability to control motor functions. They may have difficulty swallowing and lose bowel and bladder control. They eventually lose the ability to recognize family members and to speak. As AD progresses, it begins to affect the person's emotions and behavior. Most people with AD eventually develop symptoms such as aggression, agitation, depression, sleeplessness, or delusions.

On average, patients with AD live for 8 to 10 years after they are diagnosed. However, some people live as long as 20 years. Patients with AD often die of aspiration pneumonia because they lose the ability to swallow late in the course of the disease.

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VASCULAR DEMENTIA

Vascular dementia is the second most common cause of dementia, after AD. It accounts for up to 20 percent of all dementias and is caused by brain damage from cerebrovascular or cardiovascular problems - usually strokes. It also may result from genetic diseases, endocarditis (infection of a heart valve), or amyloid angiopathy (a process in which amyloid protein builds up in the brain's blood vessels, sometimes causing hemorrhagic or "bleeding" strokes). In many cases, it may coexist with AD. The incidence of vascular dementia increases with advancing age and is similar in men and women.

Symptoms of vascular dementia often begin suddenly, frequently after a stroke. Patients may have a history of high blood pressure, vascular disease, or previous strokes or heart attacks. Vascular dementia may or may not get worse with time, depending on whether the person has additional strokes. In some cases, symptoms may get better with time. When the disease does get worse, it often progresses in a stepwise manner, with sudden changes in ability. Vascular dementia with brain damage to the mid-brain regions, however, may cause a gradual, progressive cognitive impairment that may look much like AD. Unlike people with AD, people with vascular dementia often maintain their personality and normal levels of emotional responsiveness until the later stages of the disease. People with vascular dementia frequently wander at night and often have other problems commonly found in people who have had a stroke, including depression and incontinence.

There are several types of vascular dementia, which vary slightly in their causes and symptoms. One type, called multi-infarct dementia (MID), is caused by numerous small strokes in the brain. MID typically includes multiple damaged areas, called infarcts, along with extensive lesions in the white matter, or nerve fibers, of the brain. Because the infarcts in MID affect isolated areas of the brain, the symptoms are often limited to one side of the body or they may affect just one or a few specific functions, such as language. Neurologists call these "local" or "focal" symptoms, as opposed to the "global" symptoms seen in AD, which affect many functions and are not restricted to one side of the body.

Although not all strokes cause dementia, in some cases a single stroke can damage the brain enough to cause dementia. This condition is called single-infarct dementia. Dementia is more common when the stroke takes place on the left side (hemisphere) of the brain and/or when it involves the hippocampus, a brain structure important for memory.

Another type of vascular dementia is called Binswanger's disease. This rare form of dementia is characterized by damage to small blood vessels in the white matter of the brain (white matter is found in the inner layers of the brain and contains many nerve fibers coated with a whitish, fatty substance called myelin). Binswanger's disease leads to brain lesions, loss of memory, disordered cognition, and mood changes. Patients with this disease often show signs of abnormal blood pressure, stroke, blood abnormalities, disease of the large blood vessels in the neck, and/or disease of the heart valves. Other prominent features include urinary incontinence, difficulty walking, clumsiness, slowness, lack of facial expression, and speech difficulty. These symptoms, which usually begin after the age of 60, are not always present in all patients and may sometimes appear only temporarily. Treatment of Binswanger's disease is symptomatic, and may include the use of medications to control high blood pressure, depression, heart arrhythmias, and low blood pressure. The disorder often includes episodes of partial recovery.

Another type of vascular dementia is linked to a rare hereditary disorder called CADASIL, which stands for cerebral autosomal dominant arteriopathy with subcortical infarct and leukoencephalopathy. CADASIL is linked to abnormalities of a specific gene, Notch3, which is located on chromosome 19. This condition causes multi-infarct dementia as well as stroke, migraine with aura, and mood disorders. The first symptoms usually appear in people who are in their twenties, thirties, or forties and affected individuals often die by age 65. Researchers believe most people with CADASIL go undiagnosed, and the actual prevalence of the disease is not yet known.

Other causes of vascular dementia include vasculitis, an inflammation of the blood vessel system; profound hypotension (low blood pressure); and lesions caused by brain hemorrhage. The autoimmune disease lupus erythematosus and the inflammatory disease temporal arteritis can also damage blood vessels in a way that leads to vascular dementia.

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LEWY BODY DEMENTIA (LBD)

Lewy body dementia (LBD) is one of the most common types of progressive dementia. LBD usually occurs sporadically, in people with no known family history of the disease. However, rare familial cases have occasionally been reported. In LBD, cells die in the brain's cortex, or outer layer, and in a part of the mid-brain called the substantia nigra. Many of the remaining nerve cells in the substantia nigra contain abnormal structures called Lewy bodies that are the hallmark of the disease. Lewy bodies may also appear in the brain's cortex, or outer layer. Lewy bodies contain a protein called alpha-synuclein that has been linked to Parkinson's disease and several other disorders. Researchers, who sometimes refer to these disorders collectively as "synucleinopathies," do not yet know why this protein accumulates inside nerve cells in LBD.

The symptoms of LBD overlap with AD in many ways, and may include memory impairment, poor judgment, and confusion. However, LBD typically also includes visual hallucinations, parkinsonian symptoms such as a shuffling gait and flexed posture, and day-to-day fluctuations in the severity of symptoms. Patients with LBD live an average of 7 years after symptoms begin.

There is no cure for LBD, and treatments are aimed at controlling the parkinsonian and psychiatric symptoms of the disorder. Patients sometimes respond dramatically to treatment with anti-parkinsonian drugs and/or cholinesterase inhibitors, such as those used for AD. Some studies indicate that neuroleptic drugs, such as clozapine and olanzapine, also can reduce the psychiatric symptoms of this disease. But neuroleptic drugs may cause severe adverse reactions, so other therapies should be tried first and patients using these drugs should be closely monitored. Lewy bodies are often found in the brains of people with Parkinson's and AD. These findings suggest that either LBD is related to these other causes of dementia or that the diseases sometimes coexist in the same person.

FRONTOTEMPROAL DEMENTIA (FTD)

Frontotemporal dementia (FTD), sometimes called frontal lobe dementia, describes a group of diseases characterized by degeneration of nerve cells - especially those in the frontal and temporal lobes of the brain. Unlike AD, FTD usually does not include formation of amyloid plaques. In many people with FTD, there is an abnormal form of tau protein in the brain, which accumulates into neurofibrillary tangles. This disrupts normal cell activities and may cause the cells to die. Experts believe FTD accounts for 2 to 10 percent of all cases of dementia. Symptoms of FTD usually appear between the ages of 40 and 65. In many cases, people with FTD have a family history of dementia, suggesting that there is a strong genetic factor in the disease. The duration of FTD varies, with some patients declining rapidly over 2 to 3 years and others showing only minimal changes for many years. People with FTD live with the disease for an average of 5 to 10 years after diagnosis. Because structures found in the frontal and temporal lobes of the brain control judgment and social behavior, people with FTD often have problems maintaining normal interactions and following social conventions. They may steal or exhibit impolite and socially inappropriate behavior, and they may neglect their normal responsibilities. Other common symptoms include loss of speech and language, compulsive or repetitive behavior, increased appetite, and motor problems such as stiffness and balance problems. Memory loss also may occur, although it typically appears late in the disease.

In one type of FTD called Pick's disease, certain nerve cells become abnormal and swollen before they die. These swollen, or ballooned, neurons are one hallmark of the disease. The brains of people with Pick's disease also have abnormal structures called Pick bodies, composed largely of the protein tau, inside the neurons. The cause of Pick's disease is unknown, but it runs in some families and thus it is probably due at least in part to a faulty gene or genes. The disease usually begins after age 50 and causes changes in personality and behavior that gradually worsen over time. The symptoms of Pick's disease are very similar to those of AD, and may include inappropriate social behavior, loss of mental flexibility, language problems, and difficulty with thinking and concentration. There is currently no way to slow the progressive degeneration found in Pick's disease. However, medication may be helpful in reducing aggression and other behavioral problems, and in treating depression.

In some cases, familial FTD is linked to a mutation in the tau gene. This disorder, called frontotemporal dementia with parkinsonism linked to chromosome 17 (FTDP-17), is much like other types of FTD but often includes psychiatric symptoms such as delusions and hallucinations.

Primary progressive aphasia (PPA) is a type of FTD that may begin in people as early as their forties. "Aphasia" is a general term used to refer to deficits in language functions, such as speaking, understanding what others are saying, and naming common objects. In PPA one or more of these functions can become impaired. Symptoms often begin gradually and progress slowly over a period of years. As the disease progresses, memory and attention may also be impaired and patients may show personality and behavior changes. Many, but not all, people with PPA eventually develop symptoms of dementia.

HIV-ASSOCIATED DEMENTIA (HAD)

HIV-associated dementia (HAD) results from infection with the human immunodeficiency virus (HIV) that causes AIDS. HAD can cause widespread destruction of the brain's white matter. This leads to a type of dementia that generally includes impaired memory, apathy, social withdrawal, and difficulty concentrating. People with HAD often develop movement problems as well. There is no specific treatment for HAD, but AIDS drugs can delay onset of the disease and may help to reduce symptoms.

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HUNTINGTON'S DISEASE (HD)

Huntington's disease (HD) is a hereditary disorder caused by a faulty gene for a protein called huntingtin. The children of people with the disorder have a 50 percent chance of inheriting it. The disease causes degeneration in many regions of the brain and spinal cord. Symptoms of HD usually begin when patients are in their thirties or forties, and the average life expectancy after diagnosis is about 15 years. Cognitive symptoms of HD typically begin with mild personality changes, such as irritability, anxiety, and depression, and progress to severe dementia. Many patients also show psychotic behavior. HD causes chorea - involuntary jerky, arrhythmic movements of the body - as well as muscle weakness, clumsiness, and gait disturbances.

DEMENTIA PUGILISTICA

Dementia pugilistica, also called chronic traumatic encephalopathy or Boxer's syndrome, is caused by head trauma, such as that experienced by people who have been punched many times in the head during boxing. The most common symptoms of the condition are dementia and parkinsonism, which can appear many years after the trauma ends. Affected individuals may also develop poor coordination and slurred speech. A single traumatic brain injury may also lead to a disorder called post-traumatic dementia (PTD). PTD is much like dementia pugilistica but usually also includes long-term memory problems. Other symptoms vary depending on which part of the brain was damaged by the injury.

CORTICOBASAL DEGENERATION (CBD)

Corticobasal degeneration (CBD) is a progressive disorder characterized by nerve cell loss and atrophy of multiple areas of the brain. Brain cells from people with CBD often have abnormal accumulations of the protein tau. CBD usually progresses gradually over the course of 6 to 8 years. Initial symptoms, which typically begin at or around age 60, may first appear on one side of the body but eventually will affect both sides. Some of the symptoms, such as poor coordination and rigidity, are similar to those found in Parkinson's disease. Other symptoms may include memory loss, dementia, visual-spatial problems, apraxia (loss of the ability to make familiar, purposeful movements), hesitant and halting speech, myoclonus (involuntary muscular jerks), and dysphagia (difficulty swallowing). Death is often caused by pneumonia or other secondary problems such as sepsis (severe infection of the blood) or pulmonary embolism (a blood clot in the lungs). There are no specific treatments available for CBD. Drugs such as clonazepam may help with myoclonus, however, and occupational, physical, and speech therapy can help in managing the disabilities associated with this disease. The symptoms of the disease often do not respond to Parkinson's medications or other drugs.

CREUTZFELDT-JAKOB DISEASE (CJD)

Creutzfeldt-Jakob disease (CJD) is a rare, degenerative, fatal brain disorder that affects about one in every million people per year worldwide. Symptoms usually begin after age 60 and most patients die within 1 year. Many researchers believe CJD results from an abnormal form of a protein called a prion. Most cases of CJD occur sporadically - that is, in people who have no known risk factors for the disease. However, about 5 to 10 percent of cases of CJD in the United States are hereditary, caused by a mutation in the gene for the prion protein. In rare cases, CJD can also be acquired through exposure to diseased brain or nervous system tissue, usually through certain medical procedures. There is no evidence that CJD is contagious through the air or through casual contact with a CJD patient. Patients with CJD may initially experience problems with muscular coordination; personality changes, including impaired memory, judgment, and thinking; and impaired vision. Other symptoms may include insomnia and depression. As the illness progresses, mental impairment becomes severe. Patients often develop myoclonus and they may go blind. They eventually lose the ability to move and speak, and go into a coma. Pneumonia and other infections often occur in these patients and can lead to death. CJD belongs to a family of human and animal diseases known as the transmissible spongiform encephalopathies (TSEs). Spongiform refers to the characteristic appearance of infected brains, which become filled with holes until they resemble sponges when viewed under a microscope. CJD is the most common of the known human TSEs. Others include fatal familial insomnia and Gerstmann-Straussler-Scheinker disease (see below). In recent years, a new type of CJD, called variant CJD (vCJD), has been found in Great Britain and several other European countries. The initial symptoms of vCJD are different from those of classic CJD and the disorder typically occurs in younger patients. Research suggests that vCJD may have resulted from human consumption of beef from cattle with a TSE disease called bovine spongiform encephalopathy (BSE), also known as "mad cow disease."

OTHER RARE HEREDITARY DEMENTIAS

Other rare hereditary dementias include Gerstmann-Straussler-Scheinker (GSS) disease, fatal familial insomnia, familial British dementia, and familial Danish dementia. Symptoms of GSS typically include ataxia and progressive dementia that begins when people are between 50 and 60 years old. The disease may last for several years before patients eventually die. Fatal familial insomnia causes degeneration of a brain region called the thalamus, which is partially responsible for controlling sleep. It causes a progressive insomnia that eventually leads to a complete inability to sleep. Other symptoms may include poor reflexes, dementia, hallucinations, and eventually coma. It can be fatal within 7 to 13 months after symptoms begin but may last longer. Familial British dementia and familial Danish dementia have been linked to two different defects in a gene found on chromosome 13. The symptoms of both diseases include progressive dementia, paralysis, and loss of balance.

SECONDARY DEMENTIAS

Dementia may occur in patients who have other disorders that primarily affect movement or other functions. These cases are often referred to as secondary dementias. The relationship between these disorders and the primary dementias is not always clear. For instance, people with advanced Parkinson's disease, which is primarily a movement disorder, sometimes develop symptoms of dementia. Many Parkinson's patients also have amyloid plaques and neurofibrillary tangles like those found in AD. The two diseases may be linked in a yet-unknown way, or they may simply coexist in some people. People with Parkinson's and associated dementia sometimes show signs of Lewy body dementia or progressive supranuclear palsy at autopsy, suggesting that these diseases may also overlap with Parkinson's or that Parkinson's is sometimes misdiagnosed.

Other disorders that may include symptoms of dementia include multiple sclerosis; presenile dementia with motor neuron disease, also called ALS dementia; olivopontocerebellar atrophy (OPCA); Wilson's disease; and normal pressure hydrocephalus (NPH).

DEMENTIAS IN CHILDREN

While it is usually found in adults, dementia can also occur in children. For example, infections and poisoning can lead to dementia in people of any age. In addition, some disorders unique to children can cause dementia.

• Niemann-Pick disease is a group of inherited disorders that affect metabolism and are caused by specific genetic mutations. Patients with Niemann-Pick disease cannot properly metabolize cholesterol and other lipids. Consequently, excessive amounts of cholesterol accumulate in the liver and spleen and excessive amounts of other lipids accumulate in the brain. Symptoms may include dementia, confusion, and problems with learning and memory. These diseases usually begin in young school-age children but may also appear during the teen years or early adulthood.



• Batten disease is a fatal, hereditary disorder of the nervous system that begins in childhood. Symptoms are linked to a buildup of substances called lipopigments in the body's tissues. The early symptoms include personality and behavior changes, slow learning, clumsiness, or stumbling. Over time, affected children suffer mental impairment, seizures, and progressive loss of sight and motor skills. Eventually, children with Batten disease develop dementia and become blind and bedridden. The disease is often fatal by the late teens or twenties.



• Lafora body disease is a rare genetic disease that causes seizures, rapidly progressive dementia, and movement problems. These problems usually begin in late childhood or the early teens. Children with Lafora body disease have microscopic structures called Lafora bodies in the brain, skin, liver, and muscles. Most affected children die within 2 to 10 years after the onset of symptoms.

A number of other childhood-onset disorders can include symptoms of dementia. Among these are mitochondrial myopathies, Rasmussen's encephalitis, mucopolysaccharidosis III (Sanfilippo syndrome), neurodegeneration with brain iron accumulation, and leukodystrophies such as Alexander disease, Schilder's disease, and metachromatic leukodystrophy.

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RISK FACTORS FOR DEMENTIA

Researchers have identified several risk factors that affect the likelihood of developing one or more kinds of dementia. Some of these factors are modifiable, while others are not.

AGE: The risk of AD, vascular dementia, and several other dementias goes up significantly with advancing age.

GENETICS & FAMILY HISTORY: Researchers have discovered a number of genes that increase the risk of developing AD. Although people with a family history of AD are generally considered to be at heightened risk of developing the disease themselves, many people with a family history never develop the disease, and many without a family history of the disease do get it. In most cases, it is still impossible to predict a specific person's risk of the disorder based on family history alone. Some families with CJD, GSS, or fatal familial insomnia have mutations in the prion protein gene, although these disorders can also occur in people without the gene mutation. Individuals with these mutations are at significantly higher risk of developing these forms of dementia. Abnormal genes are also clearly implicated as risk factors in Huntington's disease, FTDP-17, and several other kinds of dementia.

SMOKING & ALCOHOL USE: Several recent studies have found that smoking significantly increases the risk of mental decline and dementia. People who smoke have a higher risk of atherosclerosis and other types of vascular disease, which may be the underlying causes for the increased dementia risk. Studies also have found that drinking large amounts of alcohol appears to increase the risk of dementia. However, other studies have suggested that people who drink moderately have a lower risk of dementia than either those who drink heavily or those who completely abstain from drinking.

ATHEROSCLEROSIS: Atherosclerosis is the buildup of plaque - deposits of fatty substances, cholesterol, and other matter - in the inner lining of an artery. Atherosclerosis is a significant risk factor for vascular dementia, because it interferes with the delivery of blood to the brain and can lead to stroke. Studies have also found a possible link between atherosclerosis and AD.

CHOLESTEROL: High levels of low-density lipoprotein (LDL), the so-called bad form of cholesterol, appear to significantly increase a person's risk of developing vascular dementia. Some research has also linked high cholesterol to an increased risk of AD.

PLASMA HOMOCYSTEINE: Research has shown that a higher-than-average blood level of homocysteine - a type of amino acid - is a strong risk factor for the development of AD and vascular dementia.

DIABETES: Diabetes is a risk factor for both AD and vascular dementia. It is also a known risk factor for atherosclerosis and stroke, both of which contribute to vascular dementia.

MILD COGNITIVE IMPAIRMENT: While not all people with mild cognitive impairment develop dementia, people with this condition do have a significantly increased risk of dementia compared to the rest of the population. One study found that approximately 40 percent of people over age 65 who were diagnosed with mild cognitive impairment developed dementia within 3 years.

DOWN SYNDROME: Studies have found that most people with Down syndrome develop characteristic AD plaques and neurofibrillary tangles by the time they reach middle age. Many, but not all, of these individuals also develop symptoms of dementia.

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DEMENTIA PREVENTION

There is up till now no effective way to prevent Alzheimer's disease. However, multi-infarct dementia is caused by damaged blood vessels, and can be prevented through healthy living habits.

Research has revealed a number of factors that may be able to prevent or delay the onset of dementia in some people. For example, studies have shown that people who maintain tight control over their glucose levels tend to score better on tests of cognitive function than those with poorly controlled diabetes. Several studies also have suggested that people who engage in intellectually stimulating activities, such as social interactions, chess, crossword puzzles, and playing a musical instrument, significantly lower their risk of developing AD and other forms of dementia. Scientists believe mental activities may stimulate the brain in a way that increases the person's "cognitive reserve" - the ability to cope with or compensate for the pathologic changes associated with dementia.

Researchers are studying other steps people can take that may help prevent AD in some cases. So far, none of these factors has been definitively proven to make a difference in the risk of developing the disease. Moreover, most of the studies addressed only AD, and the results may or may not apply to other forms of dementia. Nevertheless, scientists are encouraged by the results of these early studies and many believe it will eventually become possible to prevent some forms of dementia. Possible preventive actions include:

• Lowering homocysteine. In one study, elevated blood levels of the amino acid homocysteine were associated with a 2.9 times greater risk of AD and a 4.9 times greater risk of vascular dementia. A preliminary study has shown that high doses of three B vitamins that help lower homocysteine levels - folic acid, B-12, and B-6 - appear to slow the progression of AD. Researchers are conducting a multi-center clinical trial to test this effect in a larger group of patients.



• Lowering cholesterol levels. Research has suggested that people with high cholesterol levels have an increased risk of developing AD. Cholesterol is involved in formation of amyloid plaques in the brain. Mutations in a gene called CYP46 and the apoE E4 gene variant, both of which have been linked to an increased risk of AD, are also involved in cholesterol metabolism. Several studies have also found that the use of drugs called statins, which lower cholesterol levels, is associated with a lower likelihood of cognitive impairment.



• Lowering blood pressure. Several studies have shown that anti-hypertensive medicine reduces the odds of cognitive impairment in elderly people with high blood pressure. One large European study found a 55 percent lower risk of dementia in people over 60 who received drug treatment for hypertension. These people had a reduced risk of both AD and vascular dementia.



• Exercise. Regular exercise stimulates production of chemicals called growth factors that help neurons survive and adapt to new situations. These gains may help to delay the onset of dementia symptoms. Exercise also may reduce the risk of brain damage from atherosclerosis.



• Education. Researchers have found evidence that formal education may help protect people against the effects of AD. In one study, researchers found that people with more years of formal education had relatively less mental decline than people with less schooling, regardless of the number of amyloid plaques and neurofibrillary tangles each person had in his or her brain. The researchers think education may cause the brain to develop robust nerve cell networks that can help compensate for the cell damage caused by AD.



• Controlling inflammation. Many studies have suggested that inflammation may contribute to AD. Moreover, autopsies of people who died with AD have shown widespread inflammation in the brain that appeared to be caused by the accumulation of beta amyloid. Another study found that men with high levels of C-reactive protein, a general marker of inflammation, had a significantly increased risk of AD and other kinds of dementia.



• Non-steroidal anti-inflammatory drugs (NSAIDs). Research indicates that long-term use of NSAIDs - ibuprofen, naproxen, and similar drugs - may prevent or delay the onset of AD. Researchers are not sure how these drugs may protect against the disease, but some or all of the effect may be due to reduced inflammation. A 2003 study showed that these drugs also bind to amyloid plaques and may help to dissolve them and prevent formation of new plaques.

The risk of vascular dementia is strongly correlated with risk factors for stroke, including high blood pressure, diabetes, elevated cholesterol levels, and smoking. This type of dementia may be prevented in many cases by changing lifestyle factors, such as excessive weight and high blood pressure, which are associated with an increased risk of cerebrovascular disease. One European study found that treating isolated systolic hypertension (high blood pressure in which only the systolic or top number is high) in people age 60 and older reduced the risk of dementia by 50 percent. These studies strongly suggest that effective use of current treatments can prevent many future cases of vascular dementia.

A study published in 2005 found that people with mild cognitive impairment who took 10 mg/day of the drug donepezil had a significantly reduced risk of developing AD during the first two years of treatment, compared to people who received vitamin E or a placebo. By the end of the third year, however, the rate of AD was just as high in the people treated with donepezil as it was in the other two groups.



DIAGNOSIS & TREATMENT

Senile dementia that is caused by depression, poor nutrition, thyroid dysfunction, drug poisoning, alcoholism, and so on, can often be corrected by treating the underlying problem.

Alzheimer's disease and multi-infarct dementia are degenerative diseases, and up to now there is no effective treatment. It is best to recognize the symptoms early and be diagnosed and assessed by a health care provider specializing in the treatment of dementia and degenerative diseases. There are currently some medications available to slow the progress of Alzheimer's disease.

Because the symptoms are almost identical, many health problems are often mistaken for Alzheimer's and other age related dementia. But, the problems causing the symptoms are usually treatable if detected early enough. Prescription drugs interactions and side effects, vitamin B-12 deficiency and dehydration most commonly produce false symptoms of dementia. (According to Consumer Reports on Health, "Any new health problem in an older person should be considered drug induced until proven otherwise.") Improving early diagnosis of AD and other types of dementia is important not only for patients and families, but also for researchers who seek to better understand the causes of dementing diseases and find ways to reverse or halt them at early stages. Improved diagnosis can also reduce the risk that people will receive inappropriate treatments.

Symptoms that some people, including many health care providers, often dismiss as a "normal part of aging" - really are not. If these symptoms are left untreated, a person could face a life of despair in a nursing home. But, if the symptoms are treated early enough, a person can very often regain a full and normal life. Early, accurate diagnosis of dementia is important for patients and their families because it allows early treatment of symptoms. For people with AD or other progressive dementias, early diagnosis may allow them to plan for the future while they can still help to make decisions. These people also may benefit from drug treatment. If a person has one or more of the symptoms described above, take him or her to a health care provider as soon as possible. Determining the cause usually involves a team of medical specialists under the guidance of a patient's primary care practitioner. For patients who are 65 or older, the tests and health care provider costs are usually covered by Medicare.

Important Note: Even if a health care provider has a lot of older patients, that does not make the practitioner an expert in the special problems of the elderly (geriatrics). If a health care provider dismisses a person's memory problems as "just a part of growing older" or decides that he or she has Alzheimer's or senility without testing for other possible problems, it is highly recommended that a second opinion is obtained from another practitioner.

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DIAGNOSTIC TESTS

The "gold standard" for diagnosing dementia, autopsy, does not help the patient or caregivers. Therefore, health care providers have devised a number of techniques to help identify dementia with reasonable accuracy while the patient is still alive.

Health care providers employ a number of strategies to diagnose dementia. It is important that they rule out any treatable conditions, such as depression, normal pressure hydrocephalus, or vitamin B-12 deficiency, which can cause similar symptoms. The tests may involve some or all of the following, many of which are designed to rule out other possible causes for a person's problems:

Patient history. Health care providers often begin their examination of a patient suspected of having dementia by asking questions about the patient's history. For example, they may ask how and when symptoms developed and about the patient's overall medical condition. They also may try to evaluate the patient's emotional state, although patients with dementia often may be unaware of or in denial about how their disease is affecting them. Family members also may deny the existence of the disease because they do not want to accept the diagnosis and because, at least in the beginning, AD and other forms of dementia can resemble normal aging. Therefore additional steps are necessary to confirm or rule out a diagnosis of dementia.

Cognitive and neuropsychological tests are an evaluation of memory and mental skills. Health care providers use tests that measure memory, language skills, math skills, and other abilities related to mental functioning to help them diagnose a patient's condition accurately. For example, people with AD often show changes in so-called executive functions (such as problem-solving), memory, and the ability to perform once-automatic tasks. Health care providers often use a test called the Mini-Mental State Examination (MMSE) to assess cognitive skills in people with suspected dementia. This test examines orientation, memory, and attention, as well as the ability to name objects, follow verbal and written commands, write a sentence spontaneously, and copy a complex shape. Health care providers also use a variety of other tests and rating scales to identify specific types of cognitive problems and abilities.

A physical examination, including a review of family medical history, to detect other medical problems, including possible interactions between prescription drugs, over-the-counter medications, herbal supplements, vitamins and/or mineral supplements. Many foods can also cause unexpected interactions with prescription medications. A physical examination can help rule out treatable causes of dementia and identify signs of stroke or other disorders that can contribute to dementia. It can also identify signs of other illnesses, such as heart disease or kidney failure, that can overlap with dementia. If a patient is taking medications that may be causing or contributing to his or her symptoms, the health care provider may suggest stopping or replacing some medications to see if the symptoms go away.

A nutritional evaluation to determine if dietary problems or improper eating habits may be causing the problem.

Blood tests, including nutritional blood tests for vitamin B-12 and folic acid deficiencies. Health care providers may use a variety of laboratory tests to help diagnose dementia and/or rule out other conditions, such as kidney failure, that can contribute to symptoms. A partial list of these tests includes a complete blood count, to check for anemia and infections, blood glucose test, urinalysis, drug and alcohol tests (toxicology screen), cerebrospinal fluid analysis (to rule out specific infections that can affect the brain), and analysis of thyroid and thyroid-stimulating hormone (TSH) levels. A health care provider will order only the tests that he or she feels are necessary and/or likely to improve the accuracy of a diagnosis.

EEG (electroencephalogram) to check brain function. Health care providers also may use electroencephalograms (EEGs) in people with suspected dementia. In an EEG, electrodes are placed on the scalp over several parts of the brain in order to detect and record patterns of electrical activity and check for abnormalities. This electrical activity can indicate cognitive dysfunction in part or all of the brain. Many patients with moderately severe to severe AD have abnormal EEGs. An EEG may also be used to detect seizures, which occur in about 10 percent of AD patients as well as in many other disorders. EEGs also can help diagnose CJD.

A neurological examination and evaluation to rule out other disorders of the brain such as Parkinson's disease, hydrocephalus (fluid accumulation in the brain), prior strokes and mini-strokes, brain tumors, etc. Health care providers will be looking at balance, sensory function, reflexes, and other functions, to identify signs of conditions - for example movement disorders or stroke - that may affect the patient's diagnosis or are treatable with drugs.

Brain Scan (CT or MRI). Health care providers may use brain scans to identify strokes, tumors, or other problems that can cause dementia. Also, cortical atrophy -degeneration of the brain's cortex (outer layer) - is common in many forms of dementia and may be visible on a brain scan. The brain's cortex normally appears very wrinkled, with ridges of tissue (called gyri) separated by "valleys" called sulci. In individuals with cortical atrophy, the progressive loss of neurons causes the ridges to become thinner and the sulci to grow wider. As brain cells die, the ventricles (or fluid-filled cavities in the middle of the brain) expand to fill the available space, becoming much larger than normal. Brain scans also can identify changes in the brain's structure and function that suggest AD. Some researchers are investigating whether three-dimensional computer models of PET and MRI images can identify brain changes typical of early AD, before any symptoms appear. This research may lead to ways of preventing the symptoms of the disease.

The most common types of brain scans are computed tomographic (CT) scans and magnetic resonance imaging (MRI). Health care providers frequently request a CT scan of the brain when they are examining a patient with suspected dementia. These scans, which use X-rays to detect brain structures, can show evidence of brain atrophy, strokes and transient ischemic attacks (TIAs), changes to the blood vessels, and other problems such as hydrocephalus and subdural hematomas. MRI scans use magnetic fields and focused radio waves to detect hydrogen atoms in tissues within the body. They can detect the same problems as CT scans but they are better for identifying certain conditions, such as brain atrophy and damage from small TIAs.

Several other types of brain scans allow researchers to watch the brain as it functions. These scans, called functional brain imaging, are not often used as diagnostic tools, but they are important in research and they may ultimately help identify people with dementia earlier than is currently possible. Functional brain scans include functional MRI (fMRI), single photon-emission computed tomography (SPECT), positron emission tomography (PET), and magnetoencephalography (MEG). fMRI uses radio waves and a strong magnetic field to measure the metabolic changes that take place in active parts of the brain. SPECT shows the distribution of blood in the brain, which generally increases with brain activity. PET scans can detect changes in glucose metabolism, oxygen metabolism, and blood flow, all of which can reveal abnormalities of brain function. MEG shows the electromagnetic fields produced by the brain's neuronal activity.

Spinal fluid beta amyloid test. One study found that levels of beta amyloid and tau in spinal fluid can be used to diagnose AD with a sensitivity of 92 percent. If other studies confirm the validity of this test, it may allow health care providers to identify people who are beginning to develop the disorder before they start to show symptoms. This would allow treatment at very early stages of the disorder, and may help in testing new treatments to prevent or delay symptoms of the disease. Other researchers have identified factors in the skin and blood of AD patients that are different from those in healthy people. They are trying to determine if these factors can be used to diagnose the disease.

Psychiatric evaluation. A psychiatric evaluation may be obtained to determine if depression or another psychiatric disorder may be causing or contributing to a person's symptoms.

Presymptomatic testing. Testing people before symptoms begin to determine if they will develop dementia is not possible in most cases. However, in disorders such as Huntington's where a known gene defect is clearly linked to the risk of the disease, a genetic test can help identify people who are likely to develop the disease. Since this type of genetic information can be devastating, people should carefully consider whether they want to undergo such testing.

Researchers are examining whether a series of simple cognitive tests, such as matching words with pictures, can predict who will develop dementia. One study suggested that a combination of a verbal learning test and an odor-identification test can help identify AD before symptoms become obvious. Other studies are looking at whether memory tests and brain scans can be useful indicators of future dementia.

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CONVENTIONAL MEDICAL TREATMENTS FOR DEMENTIA

While treatments to reverse or halt disease progression are not available for most of the dementias, patients can benefit to some extent from treatment with available medications and other measures, such as cognitive training. Drugs to specifically treat AD and some other progressive dementias are now available and are prescribed for many patients. Although these drugs do not halt the disease or reverse existing brain damage, they can improve symptoms and slow the progression of the disease. This may improve the patient's quality of life, ease the burden on caregivers, and/or delay admission to a nursing home. Many researchers are also examining whether these drugs may be useful for treating other types of dementia.

MEMORY & COGNITIVE FUNCTION EXERCISES

Many people with dementia, particularly those in the early stages, may benefit from practicing tasks designed to improve performance in specific aspects of cognitive functioning. For example, people can sometimes be taught to use memory aids, such as mnemonics, computerized recall devices, or note taking.

BEHAVIOR MODIFICATION

Behavior modification - rewarding appropriate or positive behavior and ignoring inappropriate behavior - also may help control unacceptable or dangerous behaviors.

DRUG THERAPY

Most of the drugs currently approved by the U. S. Food and Drug Administration (FDA) for AD fall into a category called cholinesterase inhibitors. These drugs slow the breakdown of the neurotransmitter acetylcholine, which is reduced in the brains of people with AD. Acetylcholine is important for the formation of memories and it is used in the hippocampus and the cerebral cortex, two brain regions that are affected by AD. There are currently four cholinesterase inhibitors approved for use in the United States:

• Tacrine (Cognex).
• Donepezil (Aricept).
• Rivastigmine (Exelon).
• Galantamine (Reminyl).

These drugs temporarily improve or stabilize memory and thinking skills in some individuals. Many studies have shown that cholinesterase inhibitors help to slow the decline in mental functions associated with AD, and that they can help reduce behavioral problems and improve the ability to perform everyday tasks. However, none of these drugs can stop or reverse the course of AD.

A fifth drug, memantine (Namenda), is also approved for use in the United States. Unlike other drugs for AD, which affect acetylcholine levels, memantine works by regulating the activity of a neurotransmitter called glutamate that plays a role in learning and memory. Glutamate activity is often disrupted in AD. Because this drug works differently from cholinesterase inhibitors, combining memantine with other AD drugs may be more effective than any single therapy. One controlled clinical trial found that patients receiving donepezil plus memantine had better cognition and other functions than patients receiving donepezil alone.

Health care providers may also prescribe other drugs, such as anticonvulsants, sedatives, and antidepressants, to treat seizures, depression, agitation, sleep disorders, and other specific problems that can be associated with dementia. In 2005, research showed that use of "atypical" anti-psychotic drugs such as olanzapine and risperidone to treat behavioral problems in elderly people with dementia was associated with an elevated risk of death in these patients. Most of the deaths were caused by heart problems or infections. The FDA has issued a public health advisory to alert patients and their caregivers to this safety issue.

VASCULAR DEMENTIA TREATMENT - DRUG THERAPY & SURGERY

There is no standard drug treatment for vascular dementia, although some of the symptoms, such as depression, can be treated. Most other treatments aim to reduce the risk factors for further brain damage. However, some studies have found that cholinesterase inhibitors, such as galantamine and other AD drugs, can improve cognitive function and behavioral symptoms in patients with early vascular dementia. The progression of vascular dementia can often be slowed significantly or halted if the underlying vascular risk factors for the disease are treated. To prevent strokes and TIAs (transient ischemic attack), health care providers may prescribe medicines to control high blood pressure, high cholesterol, heart disease, and diabetes. Health care providers also sometimes prescribe aspirin, warfarin, or other drugs to prevent clots from forming in small blood vessels. When patients have blockages in blood vessels, health care providers may recommend surgical procedures, such as carotid endarterectomy, stenting, or angioplasty, to restore the normal blood supply. Medications to relieve restlessness or depression or to help patients sleep better may also be prescribed.

DRUG THERAPY & OTHER TYPES OF DEMENTIAS

Some studies have suggested that cholinesterase inhibitors, such as donepezil (Aricept), can reduce behavioral symptoms in some patients with Parkinson's dementia.

At present, no medications are approved specifically to treat or prevent FTD and most other types of progressive dementia. However, sedatives, antidepressants, and other medications may be useful in treating specific symptoms and behavioral problems associated with these diseases.

Scientists continue to search for specific treatments to help people with Lewy body dementia. Current treatment is symptomatic, often involving the use of medication to control the parkinsonian and psychiatric symptoms. Although anti-parkinsonian medication may help reduce tremor and loss of muscle movement, it may worsen symptoms such as hallucinations and delusions. Also, drugs prescribed for psychiatric symptoms may make the movement problems worse. Several studies have suggested that cholinesterase inhibitors may be able to improve cognitive function and behavioral symptoms in patients with Lewy body disease.

There is no known treatment that can cure or control CJD. Current treatment is aimed at alleviating symptoms and making the patient as comfortable as possible. Opiate drugs can help relieve pain, and the drugs clonazepam and sodium valproate may help relieve myoclonus. During later stages of the disease, treatment focuses on supportive care, such as administering intravenous fluids and changing the person's position frequently to prevent bedsores.

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REQUIRED CARE FOR DEMENTIA PATIENTS

People with moderate and advanced dementia typically need round-the-clock care and supervision to prevent them from harming themselves or others. They also may need assistance with daily activities such as eating, bathing, and dressing. Meeting these needs takes patience, understanding, and careful thought by the person's caregivers.

A typical home environment can present many dangers and obstacles to a person with dementia, but simple changes can overcome many of these problems. For example, sharp knives, dangerous chemicals, tools, and other hazards should be removed or locked away. Other safety measures include installing bed and bathroom safety rails, removing locks from bedroom and bathroom doors, and lowering the hot water temperature to 120°F (48.9°C) or less to reduce the risk of accidental scalding. People with dementia also should wear some form of identification at all times in case they wander away or become lost. Caregivers can help prevent unsupervised wandering by adding locks or alarms to outside doors.

People with dementia often develop behavior problems because of frustration with specific situations. Understanding and modifying or preventing the situations that trigger these behaviors may help to make life more pleasant for the person with dementia as well as his or her caregivers. For instance, the person may be confused or frustrated by the level of activity or noise in the surrounding environment. Reducing unnecessary activity and noise (such as limiting the number of visitors and turning off the television when it is not in use) may make it easier for the person to understand requests and perform simple tasks. Confusion also may be reduced by simplifying home decorations, removing clutter, keeping familiar objects nearby, and following a predictable routine throughout the day. Calendars and clocks also may help patients orient themselves.

People with dementia should be encouraged to continue their normal leisure activities as long as they are safe and do not cause frustration. Activities such as crafts, games, and music can provide important mental stimulation and improve mood. Some studies have suggested that participating in exercise and intellectually stimulating activities may slow the decline of cognitive function in some people.

Many studies have found that driving is unsafe for people with dementia. They often get lost and they may have problems remembering or following rules of the road. They also may have difficulty processing information quickly and dealing with unexpected circumstances. Even a second of confusion while driving can lead to an accident. Driving with impaired cognitive functions can also endanger others. Some experts have suggested that regular screening for changes in cognition might help to reduce the number of driving accidents among elderly people, and some states now require that health care providers report people with AD to their state motor vehicle department. However, in many cases, it is up to the person's family and friends to ensure that the person does not drive.

The emotional and physical burden of caring for someone with dementia can be overwhelming. Support groups can often help caregivers deal with these demands and they can also offer helpful information about the disease and its treatment. It is important that caregivers occasionally have time off from round-the-clock nursing demands. Some communities provide respite facilities or adult day care centers that will care for dementia patients for a period of time, giving the primary caregivers a break. Eventually, many patients with dementia require the services of a full-time nursing home.

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DEMENTIA DISORDER RESEARCH

Current research focuses on many different aspects of dementia. This research promises to improve the lives of people affected by the dementias and may eventually lead to ways of preventing or curing these disorders.

RESEARCH FOR CAUSES & PREVENTION

Research on the causes of AD and other dementias includes studies of genetic factors, neurotransmitters, inflammation, factors that influence programmed cell death in the brain, and the roles of tau, beta amyloid, and the associated neurofibrillary tangles and plaques in AD. Some other researchers are trying to determine the possible roles of cholesterol metabolism, oxidative stress (chemical reactions that can damage proteins, DNA, and lipids inside cells), and microglia in the development of AD. Scientists also are investigating the role of aging-related proteins such as the enzyme telomerase.

Since many dementias and other neurodegenerative diseases have been linked to abnormal clumps of proteins in cells, researchers are trying to learn how these clumps develop, how they affect cells, and how the clumping can be prevented.

Some studies are examining whether changes in white matter - nerve fibers lined with myelin - may play a role in the onset of AD. Myelin may erode in AD patients before other changes occur. This may be due to a problem with oligodendrocytes, the cells that produce myelin.

Researchers are searching for additional genes that may contribute to AD, and they have identified a number of gene regions that may be involved. Some researchers suggest that people will eventually be screened for a number of genes that contribute to AD and that they will be able to receive treatments that specifically address their individual genetic risks. However, such individualized screening and treatment is still years away.

Insulin resistance is common in people with AD, but it is not clear whether the insulin resistance contributes to the development of the disease or if it is merely a side effect.

Several studies have found a reduced risk of dementia in people who take cholesterol-lowering drugs called statins. However, it is not yet clear if the apparent effect is due to the drugs or to other factors.

Early studies of estrogen suggested that it might help prevent AD in older women. However, a clinical study of several thousand post-menopausal women aged 65 or older found that combination therapy with estrogen and progestin substantially increased the risk of AD. Estrogen alone also appeared to slightly increase the risk of dementia in this study.

A 2003 study found that people with HIV-associated dementia have different levels of activity for more than 30 different proteins, compared to people who have HIV but no signs of dementia. The study suggests a possible way to screen HIV patients for the first signs of cognitive impairment, and it may lead to ways of intervening to prevent this form of dementia.

RESEARCH FOR TREATMENT OF DEMENTIA

Researchers are continually working to develop new drugs for AD and other types of dementia. Many researchers believe a vaccine that reduces the number of amyloid plaques in the brain might ultimately prove to be the most effective treatment for AD. In 2001, researchers began one clinical trial of a vaccine called AN-1792. The study was halted after a number of people developed inflammation of the brain and spinal cord. Despite these problems, one patient appeared to have reduced numbers of amyloid plaques in the brain. Other patients showed little or no cognitive decline during the course of the study, suggesting that the vaccine may slow or halt the disease. Researchers are now trying to find safer and more effective vaccines for AD.

Researchers are also investigating possible methods of gene therapy for AD. In one case, researchers used cells genetically engineered to produce nerve growth factor and transplanted them into monkeys' forebrains. The transplanted cells boosted the amount of nerve growth factors in the brain and seemed to prevent degeneration of acetylcholine-producing neurons in the animals. This suggests that gene therapy might help to reduce or delay symptoms of the disease. Researchers are now testing a similar therapy in a small number of patients. Other researchers have experimented with gene therapy that adds a gene called neprilysin in a mouse model that produces human beta amyloid. They found that increasing the level of neprilysin greatly reduced the amount of beta amyloid in the mice and halted the amyloid-related brain degeneration. They are now trying to determine whether neprilysin gene therapy can improve cognition in mice.

A clinical trial called the Vitamins to Slow Alzheimer's Disease (VITAL) study is testing whether high doses of three common B vitamins - folic acid, B-12, and B-6 - can reduce homocysteine levels and slow the rate of cognitive decline in AD.

Since many studies have found evidence of brain inflammation in AD, some researchers have proposed that drugs that control inflammation, such as NSAIDs, might prevent the disease or slow its progression. Studies in mice have suggested that these drugs can limit production of amyloid plaques in the brain. Early studies of these drugs in humans have shown promising results. However, a large NIH-funded clinical trial of two NSAIDS (naproxen and celecoxib) to prevent AD was stopped in late 2004 because of an increase in stroke and heart attack in people taking naproxen, and an unrelated study that linked celecoxib to an increased risk of heart attack.

Some studies have suggested that two drugs, pentoxifylline and propentofylline, may be useful in treating vascular dementia. Pentoxifylline improves blood flow, while propentofylline appears to interfere with some of the processes that cause cell death in the brain.

One study is testing the safety and effectiveness of donepezil (Aricept) for treating mild dementia in patients with Parkinson's dementia, while another is investigating whether skin patches with the drug selegiline can improve mental function in patients with cognitive problems related to HIV.

PATIENT PARTICIPATION IN CLINICAL STUDIES

People with dementia and others who wish to help research on dementing disorders may be able to do so by participating in clinical studies designed to learn more about the disorders or to test potential new therapies. Information about many such studies is available free of charge from the Federal government's database of clinical trials, http://clinicaltrials.gov.

Information about clinical trials specific to AD is available from the Alzheimer's Disease Clinical Trials Database, a joint project of the U. S. Food and Drug Administration and the National Institute on Aging (NIA) that is maintained by the NIA's Alzheimer's Disease Education and Referral Center.

For clinical trials taking place at the National Institutes of Health, additional information is available from the following office:

Patient Recruitment and Public Liaison Office
Clinical Center
National Institutes of Health
Building 61, 10 Cloister Court
Bethesda, Maryland 20892-4754
800-411-1222
TTY: 301-594-9774 (local), 866-411-1010 (toll free)
www.cc.nih.gov/ccc/prpl/

Voluntary health organizations may be able to provide information about additional clinical studies.

Another important way that people can help dementia research is by arranging to donate their brains to brain and tissue banks after they die. Tissue from these banks is made available to qualified researchers so that they can continue their studies of how these diseases develop and how they affect the brain. Brain banks accepting donations include the following:

National Disease Research Interchange
1628 JFK Blvd.
8 Penn Cntr. 8th floor
Philadelphia, PA 19103
Tel: 215-557-7361, 800-222-NDRI (6374)
Fax: 215-557-7154
E-Mail: info@ndriresource.org
Web Site: www.ndriresource.org

Human Brain and Spinal Fluid Resource Center
Neurology Research (127A) W. Los Angeles Healthcare Center
11301 Wilshire Blvd. Bldg. 212
Los Angeles, CA 90073
Tel: 310-268-3536, Page: 310-636-5199
Fax: 310-268-4768
E-Mail: RMNbbank@ucla.edu
Web Site: www.loni.ucla.edu/~nnrsb/NNRSB

UM/NPF Brain Endowment Bank
University of Miami Dept. of Neurology
1501 N.W. 9th Ave., Rm. 4013 (D 4-5)
Miami, FL 33136
Tel: 305-243-6219, 800-UM-BRAIN (862-7246)
Fax: 305-243-3649

Harvard Brain Tissue Resource Center
McLean Hospital
115 Mill Street
Belmont, MA 02478
Tel: 800-BRAIN BANK (272-4622), 617-855-2400
Fax: 617-855-3199
E-Mail: btrc@mclean.harvard.org
Web Site: www.brainbank.mclean.org

People who have more than one family member affected by AD also may be able to help research by contributing blood samples to a gene bank. A large initiative to collect such samples was announced in 2003. This large gene bank should accelerate research efforts to identify genes that play a role in AD. People interested in participating in this gene bank can learn more about it at the address and telephone numbers below:

Alzheimer's Disease Genetics Initiative
National Cell Repository for Alzheimer's Disease (NCRAD)
Indiana University
Indianapolis, Indiana 46202-5251
800-526-2839, 317-274-7360
E-Mail: alzstudy@iupui.edu
Web Site: http://ncrad.iu.edu

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HOLISTIC & NUTRITIONAL RECOMMENDATIONS

DIETARY RECOMMENDATIONS FOR DEMENTIA

Eat a well-balanced diet of natural foods consisting of 50 to 75 percent raw foods, along with seeds, whole-grain cereals, and breads, raw nuts, and low-fat yogurt and soured products. Eat Swiss cheese, brown rice, and plenty of fiber daily. Follow with the supplementation program recommended in "NUTRIENTS" below.

Consume plenty of steam-distilled (preferred) or at quality bottled water only. Do not drink tap water, as it may contain aluminum. Drink at least 8 glasses a day. Water keeps the body (and brain) hydrated and helps to remove toxins from the body. Drink plenty of liquids, even if you are not thirsty. As we grow older, our "thirst system" does not work as well and dehydration becomes a common chronic problem.

Include plenty of fiber in your diet. Move your bowels daily. It is important to try oat bran, rice bran and follow a high-fiber diet. Use of a colon cleanser, such as Aerobic Bulk Cleanse (ABC), can be very helpful. Enemas may be needed.

MoonDragon's Health Therapy: Colon Cleanse

MoonDragon's Health Therapy: Enemas

MoonDragon's Nutrition Information: Fiber Diet

LIFESTYLE RECOMMENDATIONS

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.

Keep physically active. Moderate exercise and fresh air as well as pursuing things you enjoy, such as a hobby is very beneficial and are important. Regular exercise throughout adulthood can reduce the changes of developing dementia. Activities associated with reduced risk include biking, walking, swimming and golf.

Seek out companionship and new experiences. Some people withdraw and keep to themselves as they get older because it seems easier and/or safer, but this can lead to loneliness and depression. If getting out and about is a problem, consider investing in and learning to use a computer. There are a number of online services geared to seniors that can serve as a source of companionship as well as information.

Be sure to maintain a safe environment at home.

Protect against head injury by wearing your seat belt and by wearing protective head gear when participating in activities such as bicycle riding.

Avoid alcohol, cigarette smoke, processed foods, and environmental toxins, especially metals such as lead, aluminum, and mercury. Smoking more that 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 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 lead, aluminum, and mercury.

MoonDragon's Health & Wellness: Aluminum Toxicity

MoonDragon's Health & Wellness: Mercury Toxicity

MoonDragon's Health & Wellness: Lead 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

Have a complete physical examination to rule out the possibility of underlying illness as a cause of symptoms.

A NOTE FOR CAREGIVERS OF SOMEONE WITH DEMENTIA

If you are involved in caring for someone with Senile dementia, Alzheimer's disease or another form of dementia, 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 dementia 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.

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RECOMMENDATIONS FOR ALZHEIMER'S DISEASE

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" for an adequate supply of all nutrients.

Consume steam-distilled (preferred) or at least quality bottled water only. Do not drink tap water, as it may contain aluminum. 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 for the helpful elimination of toxins. Try oat bran or rice bran.

Avoid alcohol, cigarette smoke, processed foods, and environmental toxins, especially metals such as aluminum and mercury. Smoking more that 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 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. Avoid exposure to aluminum by not using aluminum cookware and by buying bottled, not canned beverages. Also read labels carefully when shopping. Aluminum is used in some processed foods, such as processed cheeses, pickles, cake mixes, and baking soda, and in some antacids, buffered aspirins, anti-diarrhea preparations, douches, deodorants, and shampoos. It is also found in tap water in many localities.

Avoid the artificial sweetener aspartame (Equal, NutraSweet). Physician and author H.J. Roberts, M.D., who has been researching Alzheimer's disease for 30 years, states that two amino acids in aspartame - phenylalanine and aspartic acid - can be neurotoxic when consumed in this form. He maintains that these substances can get past the blood-brain barrier and cause deteriorations of the nerve cells in the brain.

Have a hair analysis to rule out the possibility of heavy metal toxins, especially metals such as aluminum and mercury.

MoonDragon's Health & Wellness: Aluminum 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

Take a good combination antioxidant supplement daily, as recommended on the label. Although a direct link between increasing dietary antioxidants and controlling Alzheimer's disease has not been proven, it is likely that antioxidants may slow the progress of the condition. They also have many other benefits.

Use essential oil of rosemary in aromatherapy, or add 1 tablespoon (10-12 mL) of the oil to shampoo. The essential oil releases compounds that can be inhaled and that prevent the breakdown of acetylcholine.

Mountain Rose Herbs: Rosemary Essential Oil, Aromatherapy Oils


MoonDragon's Aromatherapy Information Index

Take 300 mg of docosahexaenoic acid (DHA) daily with a meal. In people with Alzheimer's disease, calcium enters brain cells and starts a series of chemical reactions that result in the formation of beta-amyloid, the toxic protein that forms plaques in the brain. DHA keeps calcium from entering the cells and also stabilizes brain-cell membranes. In addition to taking DHA as a supplement, eat two or three servings of cold-water fish, such as salmon, sardines, or tuna, every week. Cold-water fish provides not only DHA, but also other essential fatty acids.

Take 2 grams of acetyl-L-carnitine (ALC) daily, between meals. ALC is a natural substance derived from the amino acid L-carnitine. It works with L-carnitine to help essential fatty acids cross into the cells of the brain. These fatty acids provide a fuel for brain cells that allows them to survive oxygen deprivation. Some studies have shown that ALC can slow the progression of dementia, especially in people who have mild to moderate Alzheimer's disease.

Take 1,000 mg of cytidine diphosphate choline (CDP) daily. In late-stage Alzheimer's disease, this nutrient enables the brain to produce more acetylcholine, the building block of healthy brain tissue. In early-stage Alzheimer's disease, it stops the immune system from producing interleukin-1B, a chemical that destroys brain tissue. If CDP is not available, take 4 grams of choline daily, with food.

Since soy lecithin provides nutrients that the prescription drug tacrine (Cognex) preserves, the two treatments are complementary. Lecithin may help mild to moderate cases. If there is no noticeable improvement within two weeks, this supplement should be stopped, since large doses of soy lecithin are expensive and may cause mild diarrhea. If diarrhea occurs, use food sources of lecithin, which include Brazil nuts, cowpeas (black-eyed peas), dandelion flowers, fava beans, lentils, mung beans, sesame seeds, and the Indian vegetable alu methi (fenugreek leaves).

Practitioners of ayurvedic medicine recommend a diet rich in cumin, coriander, fennel, ginger, and turmeric for people with Alzheimer's disease. These spices contain natural antioxidants that may slow the progression of the disease.

Vitamin B-12 (Cobalamin) deficiency can cause symptoms similar to those of Alzheimer's disease. The deficiency is correctable if detected early, but if symptoms are allowed to become severe, they can be permanent. Unfortunately, many times test results show vitamin B levels that would not automatically lead a health care provider to suspect a deficiency. There may be adequate levels of vitamin B-12 in the bloodstream but inadequate levels in brain tissue. Blood tests for amino acid homocysteine are the most sensitive measures of vitamin B-12 deficiency. High levels of homocysteine indicate inadequate levels of the vitamin.

PROVIDING CARE FOR A PERSON WITH ALZHEIMER'S DISEASE

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.

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CONSIDERATIONS

SENILE DEMENTIA

To make an accurate diagnosis of senile dementia, a health care provider needs to be thoroughly informed about symptoms - exactly what they are, how often they occur and under what circumstances, and any factors that have been noted to improve or worsen them. He or she will also need to know about any medications (prescription and OTC) and supplements the patient is taking, as these can have an effect on memory. To rule out other conditions, the health care provider may perform a number of tests (see above under Diagnosis), including blood tests, memory testing, an electrocardiogram (EKG) to measure heart activity, an electroencephalogram (EEG) to measure brain waves, brain scans, and/or a spinal tap.

There is no cure for most types of dementia. Often treatment is aimed at controlling anger, depression, delusions, and other symptoms that are present as a result of the condition. Anti-depressants and tranquilizers are some of the types of medications that may be recommended.

Evidence suggests that many cases of dementia may be prevented by "stroke reduction" measures - not smoking, controlling high blood pressure, pursuing chelation therapy to remove toxic metals from the body, adhering to a proper diet, and taking appropriate nutritional supplements.

Ultimately, a person with long-term dementia is unable to live independently, and often requires nursing care.

Feelings of isolation, loneliness, frustration, anger, fatigue, and loss of a social life often accompany this condition - and this can be overwhelming. Frequent time spent with family members and friends, along with psychological care, can help to alleviate these feelings.

Smoking may increase the chance of getting dementia.

People who have atherosclerosis and high blood pressure have a higher risk of developing senility.

Food allergies can cause mental as well as physical symptoms.

Toxic metals in the body can produce symptoms similar to those of senility. A hair analysis can reveal whether the body is incurring damage due to the presence of toxic levels of metals like aluminum and lead.

MoonDragon's Health & Wellness: Alzheimer's

MoonDragon's Health & Wellness: Alzheimer's - Holistic, Nutrition & Herbal Therapy

MoonDragon's Health & Wellness: Alzheimer & Aluminum

MoonDragon's Health & Wellness: Parkinson's Disease

MoonDragon's Health & Wellness: Rare Disorders - Binswanger's Disease & Pick's Disease

ALZHEIMER'S DISEASE

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 balm and sage are being researched for possible beneficial effects on brain chemistry. Balm appears to simulate the neurological receptors that bind acetylcholine. 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 omega03 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.

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 the:

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
- by Tom Warren

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MoonDragon's Health & Wellness: Alzheimer's - Holistic, Nutrition & Herbal Therapy

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

MoonDragon's Health & Wellness: Aluminum Toxicity

MoonDragon's Health & Wellness: Mercury Toxicity

MoonDragon's ObGyn Information: Alcoholism

Preventing Alzheimer's: Guide to Prevention of Senility Dementia & Alzheimer's

Dementia & Alzheimer's: Caregiver & Professional Information Resource

Alzheimer's or NPH?: Similar Symptoms to Normal Pressure Hydrocephalus

Alzheimer's Disease Education & Referral (ADEAR Center)

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HERBAL RECOMMENDATIONS FOR SENILE DEMENTIA

Anise, Blessed Thistle, and Blue Cohosh appear to sharpen brain power.

Mountain Rose Herbs: Anise, Organic & Wild Harvested Bulk Herbs

Herbal Remedies: Anise Essential Oil (Pimpinella Ansium), 100% Pure, NOW Foods, 1 fl. oz.
Use 1-2 drops of anise essential oil in tea or hot water will soothe an upset stomach.

Mountain Rose Herbs: Blessed Thistle, Organic & Wild Harvested Bulk Herbs

Herbal Remedies: Blessed Thistle Herb, Nature's Way, 390 mg, 100 Caps

Mountain Rose Herbs: Blue Cohosh, Organic & Wild Harvested Bulk Herbs

Herbal Remedies: Blue Cohosh Tincture (Caulophyllum Thalictroides), 100% Organic, 2 fl. oz.

Herbal Remedies: Blue Cohosh Powder (Caulophyllum Thalictroides), 4 oz. Bulk

Herbal Remedies: High Blood Pressure Tincture, 2 fl. oz.

Ginkgo Biloba improves cerebral circulation, enhances brain function and memory, and destroys free radicals to protect brain cells. It should be take 3 times a day, placing 1/2 dropperful of alcohol-free liquid extract under your tongue and hold it there for a few minutes before swallowing. Or take 400 mg in capsule form 3 times daily.

Mountain Rose Herbs: Ginkgo Biloba, Organic & Wild Harvested Bulk Herbs

Herbal Remedies: Ginkgo Leaf Powder (Ginkgo Biloba), 4 oz. Bulk

Herbal Remedies: Irwin Naturals Advanced Ginkgo Smart, 90 GelCaps

Herbal Remedies: Ginkgo Biloba Extract, Standardized, Nature's Way, 60 mg, 120 VCaps

Herbal Remedies: Ginkgold MAX, Ginkgo Biloba Extract, Vegetarian, Nature's Way, 120 mg, 60 Tabs

Herbal Remedies: Ginkgold, Ginkgo Biloba Extract, Nature's Way, Vegetarian, Standardized, 60 mg, 150 Tabs

Herbal Remedies: Ginkgo IQ, Brain Function Support Tea, Yogi Tea, 16 Tea Bags

Herbal Remedies: Ginkgo Leaf Powder (Ginkgo Biloba), 4 oz. Bulk

Herbal Remedies: Brain Elevate Formula With Huperzine A, Ginkgo, Phosphatidyleserine & RoseOx, NOW Foods, 60 VCaps

Herbal Remedies: BrainAid, Allergy Research Group / Nutricology, 60 Tabs

Herbal Remedies: Lucid Head, PCK Technologies / MagiHerbs, 500 mg, 60 Caps

Gotu Kola, Ginseng, and Mullein Oil all aid with memory function.

In the 1970s, Italian and other European researchers found evidence that Gotu Kola significantly improved the symptoms of varicose veins such as the overall discomfort, tiredness, and swelling; however, it is not thought to do much for the appearance of veins that are badly damaged. It has been suggested that hemorrhoid sufferers could use Gotu Kola for the treatment of their symptoms since hemorrhoids are a type of varicose vein. Gotu Kola is also used to improve memory and can be beneficial to Alzheimer's patients. It is also still used to heal wounds and alleviate the symptoms of scleroderma. This plant has also been used to help treat high blood pressure, abscesses, rheumatism, fever, ulcers, leprosy, skin eruptions nervous disorders and jaundice. The fresh leaves can be given to children for dysentery. An extract of the oil is used to promote hair growth. Gotu Kola is known to thin the blood, and, in large dosages, can help lower blood sugar levels. Gotu Kola comes in various forms and is an ingredient in many products. For making a tea take 1-2 teaspoons of dried leaf to 150 ml of boiling water. Let it steep for 10 to 15 minutes. Drink 3 cups per day. In tincture form, take 10-20 ml 3 times per day. Extracts that contain 100% total triterpenoids are usually taken as 60 mg once or twice per day. For other formulations, read and follow product label directions. Gotu Kola appears to be safe when taken in the recommended doses. Side effects are rare and include the occasional allergic skin rash; however, there are some concerns that Gotu Kola may be carcinogenic if applied directly to the skin. Do not take while pregnant or nursing. Safety in those with severe liver or kidney disease is not known. If you are taking any medications (prescription or over-the-counter), it is best to consult with your health care provider before using this herb for the treatment of your condition.

In addition to Ginseng's ability to help the body adapt to stress, studies have confirmed it's effectiveness in boosting the immune system, helping control diabetes, stimulating the mind, and improving physical performance (for athletes). This herb is also said to help prevent cancer, fight chemical dependency and improve sexual performance; however, there is no evidence to support those claims. The standard dosage of Panax Ginseng is 1 to 2 grams of raw herb, or 200 mg per day of an extract standardized to contain 4 to 7 percent ginsenosides. For Eleutherococcus, take 2 to 3 grams whole herb or 300 to 400 mg of extract per day. In most cases, a 2 to 3 week period of using Ginseng is recommended, with a 1 to 2 week "rest" period. Panax Ginseng is very expensive so many products contain very little of the herb, but instead is combined with other herbs and even caffeine in some cases. It is important to read product label directions. Ginseng appears to be non-toxic and side effects are rare. Some reports suggest that exceeding the recommended doses causes increased blood pressure and heart rate, over-stimulation, and insomnia; however, it is not clear if the effects are from the combination of caffeine with Ginseng. There is some evidence that Ginseng interferes with drugs processed by an enzyme called "CYP 34A", MAO inhibitors, digitalis, and Coumadin (warfarin). If you are taking medications of any kind, it is best to consult with your health care provider before adding a Ginseng supplement to your regimen. Safety in young children, pregnant or nursing women, or those with severe liver or kidney disease is not known.

Mountain Rose Herbs: Gotu Kola, Organic & Wild Harvested Bulk Herbs

Herbal Remedies: Gotu Kola Powder, 4 oz. Bulk

Herbal Remedies: Gotu Kola Tincture, 100% Organic, 2 fl. oz.

Herbal Remedies: Gotu Kola, Nature's Way, 475 mg, 180 Caps

Mountain Rose Herbs: Ginseng, Organic & Wild Harvested Bulk Herbs

Herbal Remedies: Ginseng Information, Products & Supplements

Mountain Rose Herbs: Mullein, Organic & Wild Harvested Bulk Herbs

Herbal Remedies: Mullein Leaf Powder (Verbascum Thapsus), 4 oz. Bulk

Herbal Remedies: Mullein Oil, 2 fl. oz.

Herbal Remedies: Mullein Supplement Tincture, 2 fl. oz.

Kava Kava and St. John's Wort help to calm people who anger easily.

The German Commission E recommends Kava for treating nervous anxiety, tension, and agitation. It is also used to relieve stress and reduce insomnia, tension headaches, and alcohol withdrawal. Kava is sometimes used as a local anesthetic. When combined with pumpkin seed, it is used in treating irritable bladder syndrome. Kava is used in Hawaii to reduce anxiety and fatigue, induce sleep, but is also used to treat asthma, arthritis pains, and urinary difficulties. Medical tests suggest it may be helpful in treating psychosomatic symptoms in menopause. In the South Sea Islands, Kava Kava is used as a calming and stimulating intoxicant. Taken in large quantities this herb produces a euphoric state. There are many forms of Kava and the quality varies with each manufacturer. Due to the nature of this herb, it is best to consult with a health care provider or herbalist before using this herb for the treatment of your condition. Kava Kava is not intended for use by persons under the age of 18. If pregnant, nursing or taking a prescription drug, consult a health care practitioner prior to using Kava Kava. Do not exceed the recommended dose. Excessive consumption may impair ability to drive or operate heavy equipment. It is possible to experience side effects such as temporary yellowing of the skin, hair and nails. Persons who have liver disease or liver problems, or persons who are taking drug products that can affect the liver, should consult a health care provider before using Kava-containing supplements. Consumers who use a Kava-containing dietary supplement and who experience signs of illness associated with liver disease should also consult their health care provider.

St. John's Wort is mainly used for the treatment of mild to moderate depression. It can also be used for chronic insomnia and anxiety related to depression. St. John's Wort may also be effective in relieving seasonal affective disorder (SAD). St. John's Wort extract is usually standardized to the substance hypercin. The recommended dose of St. John's Wort is 300 mg 3 times a day of an extract standardized to contain 0.3 percent hypericin; however, a few new products on the market are standardized to hyperforin content of 2 to 3 percent, instead of hypercin, and should be taken at the same dosage. If the herb bothers you, take it with food. It can take four weeks of usage to receive the full benefits of St. John's Wort. If you are taking antidepressant drugs, MAO inhibitors, SSRIs, and tricylics, or the drugs Tramadol or Imitrex, do not use St. John's Wort at the same time. Let your system completely flush those drugs out of your system before starting with the herb. If you are using Digoxin, cyclosporine, protease, inhibitors, oral contraceptives, amitriptyline, Coumadin (warfarin), theophylline, chemotherapy drugs, olanzapine or closapine, or any critical medication, St. John's Wort may cause the drugs to be less effective. St. John's Wort may have an additive effect if you are taking medications that cause sun sensitivity such as sulfa drugs, and the anti-inflammatory medication Feldene (piroxicam), as well as Prilosec or Prevacid.

Mountain Rose Herbs: Kava Kava, Organic & Wild Harvested Bulk Herbs

Herbal Remedies: Kava Kava Products & Supplements

Mountain Rose Herbs: St. John's Wort, Organic & Wild Harvested Bulk Herbs

Herbal Remedies: St. John's Wort Information, Products & Supplements

The Chinese herb Qian Ceng Ta (Huperzia Serrata), increases memory retention. It is the source of the compound Huperzine A. Pure standardized extracts of this compound have been shown to increase mental sharpness, language ability, and memory in a significant percentage of people with Alzheimer's disease. It is a potent blocker of actylcholinesterase, an enzyme that regulates the activity of acetylcholine, which is an important brain chemical involved in maintaining healthy learning and memory functions.

Herbal Remedies: Brain Elevate Formula With Huperzine A, Ginkgo, Phosphatidyleserine & RoseOx, NOW Foods, 60 VCaps

Herbal Remedies: Irwin Naturals Advanced Ginkgo Smart, 90 GelCaps

Valerian Root promotes better sleep patterns when taken at bedtime. Valerian has been used for hundreds of years for treating panic attacks or nervous tension, and in fact, was named the "Valium of the 19th century." In Europe, Valerian is a leading over-the-counter tranquilizer. This herb is not addictive like the prescription drugs Valium and Xanax. Teas, tinctures, and/or extracts of this plant affect the central nervous system (CNS), and have antispasmodic, sedative, stimulant, antibacterial, and anti-diuretic properties. In the 1970s, scientific human studies were performed on Valerian which lead the German Commission E to approve its use a sleep aid in 1985. This herb works well in treating depression, panic attacks, emotional stress, PMS, menstrual cramps, and despondency. It is also used for hypochondria, nervous headaches, migraine headaches, irritability, hysteria, and mild spasmodic affections. Valerian has been used to treat diarrhea, epilepsy, croup, convulsions, vertigo, nervous cough, delirium, neuralgia, muscle cramps, gas pains, stomach cramps, spasms, palpitations, gas, and colic. For treating insomnia, the recommended dosage of Valerian Root is 2 to 3 grams of dried herb, 270 to 450 mg of an aqueous valerian extract, or 600 mg of an ethanol extract, taken 30 to 60 minutes before bedtime. For the best results, take this herb over an extended period of time. Try the same dosages for treating anxiety, or reduce the dose and take twice daily. Note: These dosages are meant to be used as guidelines. Always read product label directions before use.

Mountain Rose Herbs: Valerian, Organic & Wild Harvested Bulk Herbs

Herbal Remedies: Valerian Root Products & Supplements

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HERBAL RECOMMENDATIONS FOR ALZHEIMER'S DISEASE

Butcher's broom promotes healthy circulation.

Mountain Rose Herbs: Butcher's Broom, Bulk Herb

Herbal Remedies: Butcher's Broom Tincture, 100% Organic, 2 fl. oz.

Herbal Remedies: Butcher's Broom Root, Nature's Way, 470 mg, 100 Caps

Ginkgo biloba extract, taken in liquid of capsule form, acts as an antioxidant and increases blood flow to the brain. Studies have shown that it can improve brain function. According to a report published in the October 22, 1977, edition of the Journal of American Medical Association (JAMA) ginkgo biloba extract can stabilize and, in some cases, improve the mental functioning and social behavior of people with Alzheimer's disease. This was confirmed in a 1997 study. Take 100 to 200 mg of ginkgo biloba extract three times daily.

Herbal Remedies: Ginkgo Biloba Extract, Standardized, Nature's Way, 60 mg, 120 VCaps

Herbal Remedies: Ginkgold MAX, Ginkgo Biloba Extract, Vegetarian, Nature's Way, 120 mg, 60 Tabs

Kava Kava and St. John's Wort help calm people who anger easily.

Mountain Rose Herbs: Kava Kava, Bulk Herb

Herbal Remedies: Kava Kava Root, Maximum Strength, Standardized to 90% Kavalactones, 175 mg, 60 Caps

Mountain Rose Herbs: St. John's Wort, Bulk Herb

Herbal Remedies: St. John's Wort, 350 mg, 180 Caps

Herbal Remedies: St. John's Wort, Herb Tincture, 100% Organic, 2 fl. oz.

Herbal Remedies: St. John's Wort Tincture, Alcohol Free, 1 fl. oz.

Recent studies from Japan suggest that curcumin (a compound in turmeric) and rosmarinic acid inhibit the formation and extension of beta-amyloid fibrils, and destabilize existing beta-amyloid plaques. The recommended dosage for curcumin is 600 mg daily. Rosmarinic acid is a plant phenolic that is present in significant quantities in oregano, sanicle, gypsywort, rosemary, marjoram, the mints, and sage. Capsules commonly contain 35 mg of rosmarinic acid, 4 to 6 capsules (140 to 210 mg) a day is a normal dosage.

Herbal Remedies: Curcumin, NOW Foods, 665 mg, 60 VCaps

Herbal Remedies: Turmeric Tincture, 100% Organic, 2 fl. oz.

The Chinese herb qian ceng ta (Huperzia serata) increases memory retention. This is the same herb that is the source of huperzine A, and it is also known as club moss. Pure and standardized extracts of this herb have been shown to increase mental acuity, language ability, and memory in a significant percentage of subjects with Alzheimer's disease. It is a potent blocker of acetylcholinesterase, an enzyme that regulates the activity of acetylcholine, which is an important chemical of the brain that maintains healthy learning and memory functions.

Mountain Rose Herbs: Club Moss, Bulk Herb

Herbal Remedies: Brain Elevate Formula W/ Huperzine A, Ginkgo, Phosphatidylserine & Rose Ox, NOW Foods, 60 VCaps

Herbal Remedies: Irwin Naturals Advanced Ginkgo Smart, 90 Gelcaps - Irwin Naturals is Bioperine Enhanced with Huperzine, Choline, TMG, Plus Six Powerful Brain Boosters. Medical Doctor Formulated. This Bioperine enhanced brain complex is perhaps the most sophisticated cognitive formula on the market. It combines a delicate balance of brain circulation agents and neurotransmitter precursors with powerful natural brain chemicals that support: Memory, Mental Clarity, Concentration, Alertness & Focus.

Valerian root improves sleep patterns when taken at bedtime.

Mountain Rose Herbs: Valerian, Bulk Herb

Herbal Remedies: Valerian Root, 530 mg, 100 VCaps

Herbal Remedies: Valerian Root Extract (Standardized), 510 mg, 90 Caps

Herbal Remedies: Valerian Root (Valeriana officinalis), Alcohol-Free With Glycerin Tincture, 100% Organic, 1 fl. oz.

GINKGO: THE MEMORY HERB & ALZHEIMER'S DISEASE Ginkgo biloba extract can help people with many diseases of senility, including Alzheimer's disease. This extract increases the functional capacity of the brain through its effects on acetylcholine, a chemical that allows the nerve cells responsible for memory and reasoning to communicate with each other. Ginkgo makes the hippocampus, the part of the brain most affected by Alzheimer's disease, more receptive to acetylcholine. It also increases the ability of acetylcholine to transmit nerve messages. The benefits of ginkgo in treating early stages of Alzheimer's disease have been demonstrated in two carefully controlled, double-blind studies. In the first study, 216 people with either Alzheimer's disease or loss of mental function caused by "mini-strokes" were given 240 mg of ginkgo extract or a placebo daily for 24 weeks. The data from the 136 people who completed the study show that ginkgo was very useful in treating both kinds of dementia. A second study, published in the Journal of the American Medical Association (JAMA), was the first clinical study of ginkgo extract conducted in the United States. In this study, 202 people with Alzheimer's disease, at six research centers supervised by Harvard Medical School and the New York Institute for Medical Research, were given either 120 mg of ginkgo extract or a placebo daily for a year. Ginkgo treatment improved symptoms in 64 percent of those who received it, and there were no reports of side effects. The authors of the study reported in JAMA did not find ginkgo to be a miracle cure, but they did find that its use was worthwhile. One of the scientists who conducted the study noted, "While the effect was modest, Egb 761 [ginkgo] reduced patient' cognitive decline and manifestations of dementia rated by the caregiver as compared with placebo, particularly for patients with a diagnosis of AD [Alzheimer's disease]. The mechanism of action is unclear but it is postulated to be related to the agent's [ginkgo's] antioxidant properties. Only a single dose was studied, drop-out rates were high, and longer-term follow-up will be important; but this agent is an intriguing addition to the drugs thought to be helpful for patients with AD." In addition to treating Alzheimer's disease, gingko is useful if similar symptoms are caused by insufficient blood blow or depression misdiagnosed as Alzheimer's disease. Discuss the use of ginkgo with your health care provider before any type of surgical procedure. HealthyNet: Ginkgo & Alzheimer's Disease University of Maryland Medical Center: Ginkgo Biloba Alzheimers.about.com: Ginkgo Biloba For Alzheimer's Disease Menopause.com: Alzheimer's Page MedlinePlus: Alzheimer's Disease American Family Physician: Ginkgo Biloba

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NUTRITIONAL SUPPLEMENTS

Dementia is considered incurable. However, because generally declining health contributes to the problem, proper diet and nutritional supplements can help. The following supplements are helpful for improving brain function. When choosing supplements, avoid heavily coated or sustained release products. These are difficult to break down. Instead, choose liquids, powders, or sublingual form. The doses recommended below are for adults.

NUTRIENTS FOR SENILE DEMENTIA
Supplement	Suggested Dosage	Comments
Essential
Dimethylglycine (DMG)	As directed on label.	Helps to maintain mental acuity and enhances immune function. Improves tissue oxygenation and enhances oxygen utilization by affected tissue. DMG Supplement N,N Dimethyl Glycine, NOW Foods, 125 mg, 100 Caps
Essential Fatty Acids (Flaxseed Oil & Primrose Oil are a good sources)	As directed on label.	Supplies needed essential fatty acids. Promotes brain and nerve function as well as a healthy immune system. Barlean's Flax Oil, 100% Highest Lignan Content, Organic, Pesticide & Herbicide Free, 16 fl. oz., Evening Primrose Oil With Gamma-Linolenic Acid (GLA), Barlean's, 1300 mg, 120 Softgels, Ultimate Oil, Essential Fatty Acids Supplement, Nature's Secret, 90 Softgels
Free-Form Amino Acid Complex	As directed on label.	To supply protein, needed for improved brain function. Protein deficiency is common among older adults. Amino 1000 Complete, NOW Foods, 120 Caps, Branched Chain Amino Acid Powder, NOW Foods, 12 oz., Amino 1500, Chewable Blend of 20 Amino Acids, Predigested, NOW Foods, 150 Tabs, Branched Chain Amino Acids, Free Form, 120 Caps
Gamma-Amino-Butyric Acid (GABA)	As directed on label, on an empty stomach. Take with water or juice. Do not take with milk. Take with 50 mg Vitamin B-6 and 100 mg Vitamin C for better absorption.	Essential for brain function and metabolism. Has a calming effect. See Amino Acids for more information. GABA Supplement, NOW Foods, 500 mg, Plus B-6, 2 mg, 100 Caps, GABA Powder, 100% Pure, Vegetarian, NOW Foods, 500 mg, 6 oz., GABA Calm, Source Naturals, Sublingual, Orange Flavor, 30 Tabs
Garlic (Kyolic)	As directed on label.	Enhances brain function, helps to reduce stress and anxiety. Garlic Oil Tincture, Alcohol Free, Nature's Way, 1 fl. oz., Garlic Bulb Cloves, Garlic Supplement, Nature's Way, 580 mg, 100 Caps, Odorless Garlic Supplement, NOW Foods, 50 mg, 250 Softgels, Garlic Supplement, Kwai, Triple Concentrated, 180 Tabs, Every Day Garlic Supplement, Kwai, 30 Tabs, Garlic Tincture, 100% Organic, 2 fl. oz., Aged Garlic Extract, Cardiovascular Formula 100, Wakunaga Kyolic Supplements, 300 Caps, Kyolic Liquid Aged Garlic Extract, Cardiovascular, Vegetarian, Wakunaga Kyolic, 4 fl. oz., Kyolic Aged Garlic Extract, One-A-Day, Vegetarian, 1000 mg, Wakunaga Kyolic, 30 Caps, Aged Garlic Extract, Cholesterol Formula 104, Wakunaga Kyolic, 200 Caps
L-Asparagine	As directed on label, on an empty stomach.	To maintain balance in the brain and central nervous system.
L-Phenylalanine	As directed on label, on an empty stomach.	Promotes alertness, aids memory, and helps overcome depression. Caution: Do not take this supplement if you are taking an MAO inhibitor drug, or if you suffer from panic attacks, diabetes, high blood pressure, or PKU. L-Phenylalanine, Free Form, NOW Foods, 500 mg, 60 Caps
L-Tyrosine	As directed on label, on an empty stomach.	Promotes brain function and helps fight depression. Caution: Do not take tyrosine if you are taking a MAO inhibitor drug, commonly prescribed for depression. L-Tyrosine High Potency, NOW Foods, 750 mg, 90 Caps, L-Tyrosine, Pharmaceutical Grade, Free Form, NOW Foods, 500 mg, 120 Caps, L-Tyrosine Powder, Vegetarian, Free Form, NOW Foods, 4 oz., 5-HTP With L-Tyrosine, NOW Foods, 200 mg, 60 VCaps
Melatonin	2-3 mg daily, taken 2 hours or less before bedtime.	Aids sleep, helps maintain equilibrium, and strengthens the immune system. Melatonin Cream, Melatonin Supplement, Life-Flo, 2 oz., MetaRest With Melatonin, Natural Sleep Aid, 60 Caps, Deep Dreams Sleep Aid Formula, 30 Tabs, Melatonin, Sublingual Orange, Source Naturals, 2.5 mg, 60 Tabs, Melatonin, Sublingual Peppermint, Source Naturals, 2.5 mg, 60 Tabs, Melatonin Supplement, Time-Released, NOW Foods, 1 mg, 100 Tabs, Melatonin Supplement, Sublingual, Nature's Way, 2.5 mg, 100 Lozenges, Melatonin NutraSpray, Sublingual Orange Flavor, Source Naturals, 1.5 mg, 2 oz.
Nicotinamide Adenine Dinucleotide (NADH)	As directed on label.	A coenzyme form of niacin that is essential for production of energy and various neurotransmitters. ENADAlert, ENADA NADH Supplement, Source Naturals, 5.0 mg, 30 Tabs, NAD (Niacin), NOW Foods, 25 mg, 60 Lozenges,
Phosphatidyl Choline	As directed on label.	Aids in treating neurological disorders, memory loss, and depression. Is safe and effective. However, if you have manic-depressive disorder, you should not take large amounts. See Lecithin (below), a natural form of this supplement.
Phosphatidyl Serine	As directed on label.	Improves memory. Has been known to reverse depression and symptoms of Alzheimer's disease, and to enhance memory and learning abilities. The brain normally produces it, but production dwindles with age. Phosphatidyl Serine (PS), Nature's Way, 500 mg, 60 Softgels
Pregnenolone	As directed on label.	May treat symptoms of aging, increase brain function, and enhance mood, memory, and thinking. Pregnenolone Cream, Life-Flo, 2 oz.,
Vitamin B Complex	Injections: 1 cc once weekly or as prescribed by health care provider. Sublingual form: 100 mg 3 times daily. Amounts of individual vitamins in a complex will vary)	All B vitamins are necessary for brain and nerve function and health. Older adults often have deficiencies because the ability to absorb the B Vitamins declines with age. Aids in the digestion of food. Injections under a health care provider's supervision. If injections are not available, use a sublingual form. Ultimate B (Vitamin B Complex), Nature's Secret, 60 Tabs, Vitamin B-100 Complex, w/ Coenzyme B-2, Nature's Way, 631 mg, 100 Caps
Plus Extra Vitamin B-3 (Niacin)	100 mg daily. Do not exceed this amount of regular niacin. Take with 100 mg niacinamide to reduce flushing. Niacinamide is safer at higher doses than niacin.	Improves cerebral circulation and lowers cholesterol levels. Caution: Do not take niacin if you have a liver disorder, gout, or high blood pressure. Vitamin B-3 (Niacin), 100% Natural, Nature's Way, 100 mg, 100 Caps, Flush Free Niacin (Vitamin B-3), Double Strength, NOW Foods, 640 mg, 90 VCaps, Flush Free Niacin (Vitamin B-3), NOW Foods, 250 mg, 90 VCaps, Niacinamide Non-Flushing Niacin (Vitamin B-3), 100% Natural, Nature's Way, 500 mg, 100 Caps
Plus Pantothenic Acid (Vitamin B-5)	100 mg 3 times daily.	Plays a role in converting choline into acetylcholine, needed for memory. Vitamin B-5 (Pantothenic Acid), 100% Natural, Nature's Way, 250 mg, 100 Caps
Plus Extra Vitamin B-6 (Pyridoxine)	Injections: 1/2 cc once weekly or as prescribed by health care provider. Sublingual or lozenge form: 50 mg daily.	Vital for mental health and for maintaining proper electrolyte balance in the body. Deficiency can cause depression and mental difficulties. Vitamin B-6 (Pyridoxine), 100 mg, 100 Caps
And Vitamin B-12	Injections: As prescribed by health care provider. Sublingual or lozenge form: 2,000 mcg daily.	Important for brain function. Needed to prevent anemia. Prevents nerve damage and may assist memory and learning. Deficient in people with Alzheimer's disease. Use a lozenge or sublingual form if injections are unavailable. Injections (under a health care provider's supervision) are fast and give good results. Vitamin B-12 Complex Liquid, Now Foods, 2 fl. oz.
Very Important
SAM-e (S-Adenosylmethionine)	400 mg twice daily.	Lowers homocysteine levels. Aids in relieving stress and depression, eases pain, and produces antioxidant effects. Caution: Do not use if you have manic-depressive disorder or take prescription antidepressants. SAM-e, Enteric Coated, NOW Foods, 100 mg, 30 Tabs
TMG (Trimethylglycine)	500-1,000 mg daily, in the morning.	Assists the body in utilizing vitamin B-12, Folic Acid, and Vitamin B-6. It also helps to rid the body of toxic elements (such as homocysteine) and increases levels of the natural mood elevator S-adenosylmethionine. TMG (Trimethylglycine) Powder, NOW Foods, 3.5 oz., Extra Strength TMG (Trimethylglycine), NOW Foods, 1000 mg, 100 Tabs
Vitamin C With Bioflavonoids	3,000-10,000 mg daily in divided doses.	Enhances immune function and increases energy level; a powerful antioxidant. Reduces blood clotting tendency, improving cerebral circulation. Use a buffered form. Vitamin C Liquid w/ Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, Dynamic Health, 1000 mg, 16 fl. oz., Ester C With Bioflavonoids, Nature's Way, 1000 mg, 90 Tabs, Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 Vcaps, The Right C, Nature's Way, 1000 mg, 120 Tabs
Vitamin E	Start at 200 IU daily and increase slowly to 600 to 1,000 IU daily.	Improves cerebral circulation and boosts immunity, which declines with age. An antioxidant that helps transport oxygen to the brain cells and protects them from free radical damage. Use d-alpha-tocopherol form, if available. Caution: If you are taking blood-thinning medication, consult your health care provider before taking vitamin E. Vitamin E, D-Alpha-Tocopherol, Nature's Way, 400 IU, 100 Softgels, Vitamin E, Mixed Tocopherols, Unesterified, 400 IU NOW Foods, 250 Softgels, Vitamin E, DL-Alpha-Tocopherol, Hypoallergenic, Allergy Research Group, Nutricology, 400 IU, 120 Softgels
Important
GH3 (Gerovital)	As directed on label.	Helps to promote brain function. Consider injections, under a health care provider's supervision. The original Gerovital H3 (GH3) injectable has now advanced 600% to this Procaine Ultra GH9 Capsules. Anti-aging breakthrough. Procaine Ultra GH9 (Ultimate 9), Procaine HCl, 100 mg, 60 Caps
Helpful
Apple Pectin	2 tablespoon twice daily.	Aids in removing toxic metals such as mercury, and aluminum, which can contribute to dementia.
Coenzyme Q-10	100-200 mg daily.	Free radical scavenger and immunostimulant. Increases oxygenation of cells and is involved in the generation of cellular energy. CoQ10, NOW Foods, 400 mg, 60 Softgels, CoQ10, Hi-Tech Pharmaceuticals, 100 mg, 60 Tabs, Liquid CoQ10, NOW Foods, 4 oz.
Plus Coenzyme A Coenzyme A Technologies	As directed on label.	Supports the immune system's detoxification of many dangerous substances. Pantethine (Coenzyme A Precursor), Highly Active Form of Vitamin B-5, NOW Foods, 300 mg, 60 Softgels,
Kelp	As directed on label.	Reported to be very beneficial to brain tissue, the membranes surrounding the brain, the sensory nerves, and the spinal cord. Supplies needed minerals. Acts as a detoxifier of excess metals. Kelp Supplement, Nature's Way, Certified, 650 mg, 100 Caps, Kelp Seaweed Norwegian, NOW Foods, 100% Natural Acophyllum Nodosum, 550 mg, 250 Caps, Kelp Seaweed Norwegian Powder, 4 oz. Bulk, Kelp Seaweed Norwegian Tincture, 100% Organic, 2 fl. oz., Kelp Granules, Vegetarian, NOW Foods, 8 oz.
Lecithin granules or capsules	Granules: 1 tablespoon 3 times daily before meals. Capsules: 1,200 mg 3 times daily, before meals. Soy Lecithin: Take 10,000 to 25,000 mg (15-25 grams) daily.	Aids in healing of the brain and cell membranes. Needed for improved memory. Contains choline. Soy lecithin prevents brain tissue destruction under reduced oxygen conditions. Caution: Soy lecithin may cause mild diarrhea when first used. Lecithin Vegetarian Granules, NOW Foods, 97% Phosphatides, Pure & Fresh, 1 lb., Lecithin Vegetarian Granules, NOW Foods, 97% Phosphatides, Identity Preserved Non-GE, 1 lb., Lecithin Liquid, NOW Foods, Vegetarian, 16 fl. oz., Lecithin, Nature's Way, 1200 mg, 100 Softgels
L-Glutamine	As directed on label, on an empty stomach. Take with water or juice. Do not take with milk. Take with 50 mg Vitamin B-6 and 100 mg Vitamin C for better absorption.	Needed for normal brain function. See Amino Acids for more information. L-Glutamine Powder, 100% Pure Free Form Amino Acid & GH Releaser, Vegetarian, NOW Foods, 1 lb., L-Glutamine, Amino Acid Supplement, NOW Foods, 1000 mg, 120 Caps, L-Glutamine, Amino Acid Supplement, NOW Foods, 500 mg, 120 Caps, Whey Protein Powder, Premium, With L-Glutamine, Natural Vanilla Flavor, NOW Foods, 1 lb.,
Multi-Vitamin & Mineral Complex	As directed on label.	All nutrients are necessary in balance. Use a high-potency formula. Super Multi-Vitamin & Multi-Mineral, Pure Vital Earth, 32 fl. oz. (98% Bio-Available for Absorption), Damage Control Master Formula, High Potency, Multi-Vitamin & Mineral, 60 Packets (30 Day Supply)
Zinc	50-80 mg daily. Do not exceed a total of 100 mg daily from all supplements.	Aids in heavy metal detoxification and enhancing immunity. Helps stop amyloid plaque formation induced by zinc deficiency. Use zinc gluconate lozenges or OptiZinc for best absorption. Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz., Colloidal Silver & Zinc Lozenges, Silva Solution, 90 Lozenges, Zinc Lozenges W/ Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges, Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 Caps
BENEFICIAL HERBS
Herb	Form & Dosage	Comments
Ginkgo Biloba	Capsules or tablets. Take up to 500 mg once daily.	Has many beneficial effects on the brain and on circulation. Caution: Avoid ginkgo if you are taking any type of blood-thinning medication. Discuss its use with your health care provider before having any type of surgery. Ginkgo Biloba Extract, Standardized, Nature's Way, 60 mg, 120 VCaps, Ginkgold MAX, Ginkgo Biloba Extract, Vegetarian, Nature's Way, 120 mg, 60 Tabs
Gotu Kola Plus Hawthorn	Tincture. Take 15 drops of each herb in 1/4 cup water twice daily.	Reduces cholesterol plaques in blood vessels serving the brain. Normalizes the brain's use of oxygen. Gotu Kola Tincture, 100% Organic, 2 fl. oz., Hawthorn Berry Tincture (Heart Herb), 100% Organic, 2 fl. oz.
Hawthorn	Tablets. Take 100-250 mg 3 times daily.	Reduces cholesterol plaques in blood vessels serving the brain. Hawthorn Extract, Standardized, Nature's Way, 500 mg, 90 Caps, Heartcare Hawthorn Extract, Nature's Way, 80 mg, 120 Tabs
Rose Hips	Take 1,000 mg daily.	A traditional Japanese remedy for memory loss caused by aging. Vitamin C Liquid, With Rose Hips and Bioflavonoids, Kosher, Natural Citrus Flavor, 1000 mg, Dynamic Health, 16 fl. oz., Rose Hips Tincture, 100% Organic, 2 fl. oz., Vitamin C 1000 W/Rose Hips, 100% Natural, 1000 mg, 250 Caps
Soy Isoflavone	Tablets. Take 100 mg once daily, before a meal.	Has effects similar to those of estrogen. May slow progression of disease. Soy Isoflavone, Standardized Extract, Nature's Way, 100 mg, 60 Caps

NUTRIENTS FOR ALZHEIMER'S DISEASE
Supplement	Suggested Dosage	Comments
Essential
Acetylcholine	500 mg 3 times daily, on an empty stomach.	Deficiency has been implicated as possibly causing dementia. Phosphatidylcholine (From Soy), Allergy Research Group / Nutricology, 385 mg, 100 Softgels - Phosphatidylcholine, a primary component of lecithin, is converted in the brain into the neurotransmitter acetylcholine. Researchers have found acetylcholine to be a primary carrier of memory. Brain acetylcholine levels are thought to be crucial for maintaining memory function as we age. Memory is stored in neurons in the brain, and sufficient acetylcholine supports effective transport of memory across neurons, resulting in protection and enhancement of memory function.
Acetyl-L-Carnitine	500 mg twice daily.	Believed to enhance brain metabolism. Slows deterioration of memory. Acetyl L-Carnitine Powder, NOW Foods, Vegetarian Formula, 635 mg, 3 oz., Acetyl L-Carnitine, Pharmaceutical Grade, NOW Foods, 500 mg, 100 Caps
Boron	3 mg daily. Do not exceed this amount.	Improves brain function. Boron Ionic Mineral Supplement, Fully Absorbable, 20 +/- ppm, 16 fl. oz., Boron Chelate, Nature's Way, 3 mg, 100 Caps
Coenzyme A Coenzyme A Technologies	As directed on label.	Supports the immune system's detoxification of many dangerous substances. Pantethine (Coenzyme A Precursor), Highly Active Form of Vitamin B-5, NOW Foods, 300 mg, 60 Softgels,
Coenzyme Q-10	100-200 mg daily.	Increases oxygenation of cells and is involved in the generation of cellular energy. CoQ10, NOW Foods, 400 mg, 60 Softgels, CoQ10, Hi-Tech Pharmaceuticals, 100 mg, 60 Tabs, Liquid CoQ10, NOW Foods, 4 oz.
Folic Acid	As directed on label.	To aid in controlling homocysteine levels. Studies have shown high levels of homocysteine in this disorders. Folic Acid (Vitamin B-9), 100% Natural, Nature's Way, 800 mcg, 100 Caps
Iron	As directed by heath care provider.	A deficiency may be present. Caution; Do not take iron unless prescribed by health care provider. Iron Ionic Mineral Supplement, Fully Absorbable, 20 +/- ppm, 16 fl. oz., Ionic Iron Supplement With ConcenTrace, Trace Minerals, 2 oz., Iron Gluconate, Nature's Way, 18 mg, 100 Caps
Lecithin granules or capsules	Granules: 1 tablespoon 3 times daily before meals. Capsules: 1,200 mg 3 times daily, before meals. Soy Lecithin: Take 10,000 to 25,000 mg (15-25 grams) daily.	Aids in healing of the brain and cell membranes. Needed for improved memory. Contains choline. Soy lecithin prevents brain tissue destruction under reduced oxygen conditions. Caution: Soy lecithin may cause mild diarrhea when first used. Lecithin Vegetarian Granules, NOW Foods, 97% Phosphatides, Pure & Fresh, 1 lb., Lecithin Vegetarian Granules, NOW Foods, 97% Phosphatides, Identity Preserved Non-GE, 1 lb., Lecithin Liquid, NOW Foods, Vegetarian, 16 fl. oz., Lecithin, Nature's Way, 1200 mg, 100 Softgels
Ginkgo Biloba Extract	100-200 mg extract 3 times daily.	Acts as a antioxidant and increases blood flow to the brain. It can improve brain function. Ginkgo Biloba Extract, Standardized, Nature's Way, 60 mg, 120 VCaps, Ginkgold MAX, Ginkgo Biloba Extract, Vegetarian, Nature's Way, 120 mg, 60 Tabs
Multi-Vitamin & Mineral Complex	As directed on label.	All nutrients are necessary in balance. Use a high-potency formula. Super Multi-Vitamin & Multi-Mineral, Pure Vital Earth, 32 fl. oz. (98% Bio-Available for Absorption), Damage Control Master Formula, High Potency, Multi-Vitamin & Mineral, 60 Packets (30 Day Supply)
With Potassium	99 mg daily.	Needed for proper electrolyte balance. Potassium Ionic Mineral Supplement, Fully Absorbable, 340 +/- ppm, 16 fl. oz., Potassium, 100% Natural, Nature's Way, 99 mg, 100 Caps
Phosphatidyl Serine	300 mg 3 times daily.	Improves memory. Phosphatidyl Serine (PS), Nature's Way, 500 mg, 60 Softgels, Phosphatidyl Serine, Nature's Way, 500 mg, 30 Softgels
Pycnogenol Or Grape Seed Extract	60 mg 3 times daily. As directed on label.	Potent antioxidants that readily pass the blood-brain barrier to protect brain cells from free radical damage. Pycnogenol W/ Vitamin E, 100% Natural, Nature's Way, 50 mg, 30 Tabs, Grape Seed (Grapeseed) (Vitus vinifera), 100% Pure, NOW Foods, 16 fl. oz.
SAM-e (S-Adenosylmethionine)	400 mg twice daily.	Lowers homocysteine levels. Caution: Do not use if you have manic-depressive disorder or take prescription antidepressants. SAM-e, Enteric Coated, NOW Foods, 100 mg, 30 Tabs
Selenium	200 mcg daily.	Powerful antioxidant for brain cell protection. Selenium Supplement, Yeast Free, NOW Foods, 200 mcg, 180 Caps, Ionic Selenium, 300 mcg, 2 fl. oz., Trace Minerals, Selenium Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz.
TMG (Trimethylglycine)	500-1,000 mg daily, in the morning.	Assists the body in utilizing vitamin B-12, Folic Acid, and Vitamin B-6. It also helps to rid the body of toxic elements (such as homocysteine) and increases levels of the natural mood elevator S-adenosylmethionine. TMG (Trimethylglycine) Powder, NOW Foods, 3.5 oz., Extra Strength TMG (Trimethylglycine), NOW Foods, 1000 mg, 100 Tabs
Vitamin A	15,000 IU daily.	Deficiencies of antioxidants expose the brain to oxidative damage. Vitamin A, 10,000 IU, 100% Natural, Nature's Way, 100 Softgels
Natural Carotenoid Complex (with Beta-Carotene)	25,000 IU daily.	Deficiencies of antioxidants exposes the brain to oxidative damage. Beta Carotene (Natural Dunaliella Salina), Nature's Way, 100% Natural, 25,000 IU, 100 Softgels, Multi-Carotene Antioxidant, Nature's Way, 60 Softgels
Vitamin E	Start at 200 IU daily and increase slowly to 800 IU daily.	An antioxidant that helps transport oxygen to the brain cells and protects them from free radical damage. Use d-alpha-tocopherol form, if available. Caution: If you are taking blood-thinning medication, consult your health care provider before taking vitamin E. Vitamin E, D-Alpha-Tocopherol, Nature's Way, 400 IU, 100 Softgels, Vitamin E, Mixed Tocopherols, Unesterified, 400 IU NOW Foods, 250 Softgels, Vitamin E, DL-Alpha-Tocopherol, Hypoallergenic, Allergy Research Group, Nutricology, 400 IU, 120 Softgels
Vitamin B Complex	Injections: 2 cc 3 times weekly or as prescribed by health care provider. Sublingual form: 100 mg 3 times daily.	Needed for brain function; aids in the digestion of food. Ultimate B (Vitamin B Complex), Nature's Secret, 60 Tabs, Vitamin B-100 Complex, w/ Coenzyme B-2, Nature's Way, 631 mg, 100 Caps
Plus Extra Vitamin B-6 (Pyridoxine)	Injections: 1/2 cc once weekly or as prescribed by health care provider. Sublingual or lozenge form: 50 mg daily.	Deficiency can cause depression and mental difficulties. Vitamin B-6 (Pyridoxine), 100 mg, 100 Caps
And Vitamin B-12	Injections: 1 cc 3 times weekly or as prescribed by health care provider. Sublingual or lozenge form: 2,000 mcg daily.	Important for brain function. Deficient in people with Alzheimer's disease. Injections (under a health care provider's supervision) are fast and give good results. Vitamin B-12 Complex Liquid, Now Foods, 2 fl. oz.
Plus Pantothenic Acid (Vitamin B-5)	100 mg 3 times daily.	Plays a role in converting choline into acetylcholine, needed for memory. Vitamin B-5 (Pantothenic Acid), 100% Natural, Nature's Way, 250 mg, 100 Caps
Zinc	50-100 mg daily. Do not exceed this amount.	Helps stop amyloid plaque formation induced by zinc deficiency. Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz., Colloidal Silver & Zinc Lozenges, Silva Solution, 90 Lozenges, Zinc Lozenges W/ Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges, Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 Caps
Important
Apple Pectin	2 tablespoon twice daily.	Aids in removing toxic metals such as mercury, and aluminum, which can contribute to dementia.
Calcium	1,600 mg daily at bedtime.	Has a calming effect and works with magnesium. Calcium Ionic Mineral Supplement, Fully Absorbable, 700 +/- ppm, 16 fl. oz., Liquid Calcium W/ConcenTrace, Orange Vanilla, Trace Minerals, 1000 mg, 32 fl. oz., Cal-Mag Pre-Chelated Calcium & Magnesium, Vital Earth, 240 Gelcaps
And Magnesium	800 mg daily.	Acts as a natural calcium channel blocker. Magnesium Ionic Mineral Supplement, Fully Absorbable, 350 +/- ppm, 16 fl. oz., Just An Ounce Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz., Calcium & Magnesium Mineral Complex, 100% Natural, Nature's Way, 500 mg / 250 mg, 250 Caps
Free-Form Amino Acid Complex	1,000-2,500 mg daily, before meals. Take with 8 oz. of fluid.	Needed for improved brain function and tissue repair. Use free-form amino acids for best absorption. Amino 1000 Complete, NOW Foods, 120 Caps, Branched Chain Amino Acid Powder, NOW Foods, 12 oz., Amino 1500, Chewable Blend of 20 Amino Acids, Predigested, NOW Foods, 150 Tabs, Branched Chain Amino Acids, Free Form, 120 Caps
Huperzine A	100 mcg daily.	Improves cognitive functions and may improve short-term memory. Inhibits the breakdown of acetylcholine. Brain Elevate Formula W/ Huperzine A, Ginkgo, Phosphatidylserine & Rose Ox, NOW Foods, 60 VCaps
Kelp	1,000-1,500 mg daily.	Supplies needed minerals. Acts as a detoxifier of excess metals. Kelp Supplement, Nature's Way, Certified, 650 mg, 100 Caps, Kelp Seaweed Norwegian, NOW Foods, 100% Natural Acophyllum Nodosum, 550 mg, 250 Caps, Kelp Seaweed Norwegian Powder, 4 oz. Bulk, Kelp Seaweed Norwegian Tincture, 100% Organic, 2 fl. oz., Kelp Granules, Vegetarian, NOW Foods, 8 oz.
Melatonin	2-3 mg daily, taken 2 hours or less before bedtime.	Improves brain function and aids sleep. Reduces cell destruction in the brain and has antioxidant properties. Melatonin Supplement, Time-Released, NOW Foods, 1 mg, 100 Tabs, Sublingual Melatonin, Nature's Way, 2.5 mg, 100 Lozenges, Melatonin, Pharmaceutical Grade, NOW Foods, 3 mg, 60 Caps
RNA / DNA Supplement	As directed on label.	These are the brain's cellular building blocks. Use a formula containing 200 mg RNA and 100 mg DNA per tablet. Caution: Do not use supplement if you have gout. Cellfood DNA-RNA Liquid Intra Oral Spray, 1 fl. oz.,
Superoxide Dismutase (SOD)	As directed on label.	A potent antioxidant that improves utilization of oxygen. GliSODin Antioxidant Catalyst, NOW Foods, 100 mg, 90 Vcaps
Plus Copper	3 mg daily.	SOD needs copper to function properly as an antioxidant. Copper Ionic Mineral Supplement, Fully Absorbable, 50 +/- ppm, 16 fl. oz.
Vitamin C With Bioflavonoids	6,000-10,000 mg daily.	Enhances immune function and increases energy level; a powerful antioxidant. Use a buffered form. Vitamin C Liquid w/ Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, Dynamic Health, 1000 mg, 16 fl. oz., Ester C With Bioflavonoids, Nature's Way, 1000 mg, 90 Tabs, Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 Vcaps, The Right C, Nature's Way, 1000 mg, 120 Tabs
BENEFICIAL HERBS
Herb	Form & Dosage	Comments
Ashwaganda (Ashwagandha)	Gelcaps. Take as directed on the label.	Reduces the brain's reliance on its own cells as a source of choline. Ashwagandha Root (Withania Somnifera) Powder, 4 oz. Bulk
Brahmi Concentration	Bacoside tablets. Take 300 mg once daily.	Restores balance between brain proteins GABA and glutamate.
Butcher's Broom	Capsules or tablets. Take as directed on label.	Promotes healthy circulation. Butcher's Broom Root, Nature's Way, 470 mg, 100 Caps
Ginkgo Biloba	Capsules or tablets. Take up to 500 mg once daily.	Has many beneficial effects on the brain and on circulation. Caution: Avoid ginkgo if you are taking any type of blood-thinning medication. Discuss its use with your health care provider before having any type of surgery. Ginkgo Biloba Extract, Standardized, Nature's Way, 60 mg, 120 VCaps, Ginkgold MAX, Ginkgo Biloba Extract, Vegetarian, Nature's Way, 120 mg, 60 Tabs
Gotu Kola Plus Hawthorn	Tincture. Take 15 drops of each herb in 1/4 cup water twice daily.	Reduces cholesterol plaques in blood vessels serving the brain. Normalizes the brain's use of oxygen. Gotu Kola Tincture, 100% Organic, 2 fl. oz., Hawthorn Berry Tincture (Heart Herb), 100% Organic, 2 fl. oz.
Hawthorn	Tablets. Take 100-250 mg 3 times daily.	Reduces cholesterol plaques in blood vessels serving the brain. Hawthorn Extract, Standardized, Nature's Way, 500 mg, 90 Caps, Heartcare Hawthorn Extract, Nature's Way, 80 mg, 120 Tabs
Rose Hips	Take 1,000 mg daily.	A traditional Japanese remedy for memory loss caused by aging. Vitamin C Liquid, With Rose Hips and Bioflavonoids, Kosher, Natural Citrus Flavor, 1000 mg, Dynamic Health, 16 fl. oz., Rose Hips Tincture, 100% Organic, 2 fl. oz., Vitamin C 1000 W/Rose Hips, 100% Natural, 1000 mg, 250 Caps
Soy Isoflavone	Tablets. Take 100 mg once daily, before a meal.	Has effects similar to those of estrogen. May slow progression of disease. Soy Isoflavone, Standardized Extract, Nature's Way, 100 mg, 60 Caps

TCM (TRADITIONAL CHINESE MEDICINE) FORMULAS These formulas are usually only available through TCM Practitioners and may not be available from standard herbal suppliers. FORMULA COMMENTS Biota Seed Pill to Nourish The Heart Considered to be the most important TCM herbal formula for age-related memory loss. It aids short-term memory. Bai Zi Yang Xin Wan [Biota Nourishing the Heart Pill; Biota Seed Pill to Nourish the Heart] Class: Calm the Mind Source/Author: Ti Ren Hui Bian (Compilation of Materials of Benevolence for the Body) Recipe: Bai Zi Ren (Semen Biotae Orientalis) 26.00 % Gou Qi Zi (Fructus Lycii) 19.00 % Xuan Shen (Radix Scrophulariae Ningpoensis) 13.00 % Shu Di Huang (Radix Rehmanniae Glutinosae Praeparata) 13.00 % Mai Men Dong (Tuber Ophiopogonis Japonici) 6.50 % Dang Gui (Radix Angelicae Sinensis) 6.50 % Shi Chang Pu (Rhizoma Acori Graminei) 6.50 % Fu Shen (Sclerotium Poriae Cocos Paradicis) 6.50 % Gan Cao (Radix Glycyrrhizae Uralensis) 3.00 % Actions: Calms the Mind. Nourishes the Heart. Tonifies Kidney-Yin. Indications: Disharmony between the Heart and Kidneys (Yin Deficiency together with Empty-Heat). Symptoms: Anxiety; Continuous palpitations; Disturbing dreams; Insomnia; Memory loss; Mental confusion; Night sweating; Restless sleep; Severe palpitations; Dry mouth; Parched lips Preparation: PILLS: Grind the ingredients into powder and form into small pills with honey. Administration/Dosage schedule: PILLS: 3-5 g doses, 3 times daily, with warm water. Patent Formula Dosage: 2 grams, 3 times a day, depending on the patient's condition, the dosage may vary. Bupleurum Plus Dragon Bone and Oyster Shell Decoction A traditional Chinese formula that reduces agitated behavior. A free radical scavenger, it absorbs substances that would destroy nerve tissue. Caution: Do not use Bupleurum plus Dragon Root and Oyster Shell Decoction if you have a fever. Chai Hu Jia Long Gu Mu Li Tang [Bupleurum plus Dragon Bone and Oyster Shell Decoction; Bupleurum D Formula] Class: Calm the Mind Source/Author: Shang Han Lun (Discussion of Cold-induced Disorders) Recipe: Chai Hu (Radix Bupleuri) 17.00 % Ban Xia (Rhizoma Pinelliae Ternatae) 9.00 % Da Zao (Fructus Jujubae) 9.00 % Da Huang (Radix et Rhizoma Rhei) 9.00 % Mu Li (Concha Ostreae) 7.00 % Long Gu (Os Draconis) 7.00 % Huang Qin (Radix Scutellariae Baicalensis) 7.00 % Sheng Jiang (Rhizoma Zingiberis Officinalis Recens) 7.00 % Qian Dan (Minium) 7.00 % Ren Shen (Radix Ginseng) 7.00 % Gui Zhi (Ramulus Cinnamomi Cassiae) 7.00 % Fu Ling (Sclerotium Poriae Cocos) 7.00 % Actions: Calms the Mind. Sedative. Unblocks the three Yang stages. Indications: Problems in all three of the Yang-stages of diseases resulting from an improper use of purgatives which are used before the disease enters the Yang brightness stage. The externally- contracted pathogenic influence takes advantage of the weakness caused by the purgatives and invades the Interior. Symptoms: Atrioventricular block; Bouts of palpitations; Delirious speech; Epilepsy; Fullness of the chest; Hypertension; Hyperthyroidism; Hysteria; Irritability; Ménière's disease; Neurosis; Schizophrenia; Sensation of extreme heaviness in the body; Constipation; Dysuria; Gastritis; Inability to rotate the trunk; Menopausal disorders; Red tongue, slippery-yellow coating; Rapid-Wiry pulse (Shu Xian) Preparation: DECOCTION: 60 g/liter until 40 cl remain. Today Dai Zhe Shi or Sheng Tie Luo are usually substituted for the toxic Qian Dan. Administration/Dosage schedule: DECOCTION: Take while still warm 3-4 times daily. Patent Formula dosage: 2 grams, 3 times a day. Depending on the patient's condition, the dosage may vary. Coptis Decoction To Relieve Toxicity A traditional Chinese herbal formula that destroys harmful free radicals, preventing the damaging effects of both aluminum and D-aspartic acid from the artificial sweetener, aspartame. Huang Lian Jie Du Tang [Coptis Decoction to Relieve Toxicity; Coptis and Scute Decoction] Class: Clear Heat Subclass: Clear Heat and Relieve Toxicity Source/Author: Wai Tai Bi Yao (Arcane Essentials from the Imperial Library) Recipe: Huang Lian (Rhizoma Coptidis Recens) 20.00 % Chief Huang Qin (Radix Scutellariae Baicalensis) 30.00 % Deputy Huang Bai (Cortex Phellodendri) 30.00 % Assistant Zhi Zi (Fructus Gardeniae Jasminoidis) 20.00 % Assistant Actions: Clears Heat and relieves toxicity. Drains Fire from the Triple Burner. Indications: Severe obstruction of the Three Burners by Heat toxin which pervades both the Interior and Exterior. Symptoms: Bacillary dysentery; Dark urine; Delirium; Dry mouth; Dry throat; Dysuria; Encephalitis; Epistaxis; Furuncle; Hematemesis; High fever; Insomnia; Irritability; Jaundice; Pneumonia; Scanty urine; Septicemia; Skin infection; Urinary tract infection; Red tongue, yellow coating; Forceful-Slippery-Rapid-Overflowing pulse (Shu Hua You Li Hong); Forceful-Rapid-Overflowing pulse (You Li Shu Hong) Preparation: DECOCTION: 30 g/liter until 40 cl remain. Administration/Dosage schedule: DECOCTION: Take 3-4 cups daily (very bitter). Patent Formula Dosage: 2 grams, 3 times a day, depending on the patient's condition, the dosage may vary. Contraindications: Heat in the Blood level. Weak patients. Empty-Heat. Warning: Long-term use. Eight-Ingredient Pill With Rehmannia A traditional Chinese herbal formula that keeps blood-sugar levels constant. Particularly useful for people who have both Alzheimer's disease and diabetes. Ba Wei Di Huang Wan (1/2) [Eight-Ingredient Pill with Rehmannia; Rehmannia Eight Pill] Class: Tonify Subclass: Tonify the Yang Recipe: Shu Di Huang (Radix Rehmanniae Glutinosae Praeparata) 29.00 % Wu Zhu Yu (Fructus Evodiae Rutaecarpae) 15.00 % Shan Yao (Radix Dioscoreae Oppositae) 15.00 % Ze Xie (Rhizoma Alismatis Orientalis) 11.00 % Fu Ling (Sclerotium Poriae Cocos) 11.00 % Mu Dan Pi (Cortex Moutan Radicis) 11.00 % Fu Zi (Radix Aconiti Carmichaeli Praeparata) 4.00 % Rou Gui (Cortex Cinnamomi Cassiae) 4.00 % Actions: Tonifies Spleen-Yang and Kidney-Yang. Warms Lower and Middle Burners. Indications: Spleen and Kidney Yang Deficiency. Symptoms: Bloating; Chronic gastroenteritis; Chronic nephritis; Clear urine; Cold abdomen; Cold extremities; Digestive weakness due to internal cold; Distension of the abdomen; Frequent urination; Hypothyroidism; Oliguria; Pain in the lower back; Persistent diarrhea; Profuse urine; Undigested food particles in the stools; Weakness of lower back; Weakness of the knees; Chronic asthma; Cough; Diabetes; Hot flashes (avoid confusion with hot flashes due to Kidney-Yin Deficiency); Neurasthenia; Edema; Urinary incontinence; Pale, swollen, tooth-marked tongue, moisty-white coating; Slow-Deep-Faint-Empty pulse (Chi Chen Wei Xu) Preparation: PILLS: Grind the ingredients into powder and form into small pills with honey. Administration/Dosage schedule: PILLS: 6 gram doses, once or twice daily, with warm water. Contraindications: Yin Deficiency. Heat. Warning: Must be carefully monitored due to the presence of Fu Zi and Rou Gui. Gastrodia and Uncaria Decoction A traditional Chinese herbal formula that increases both circulation to the brain and production of the brain's own free-radical scavenger, superoxide dismutase (SOD). Tian Ma Gou Teng Yin [Gastrodia and Uncaria Decoction; Restore the Right Decoction] Class: Eliminate Wind Subclass: Calm Internal Wind Source/Author: Za Bing Zheng Zhi Xin Yi (New Significance of Patterns and Treatment in Miscellaneous Diseases) Recipe: Tian Ma (Rhizoma Gastrodiae Elatae) 5.00 % Chief Gou Teng (Ramulus cum uncis Uncariae) 9.00 % Chief Shi Jue Ming (Concha Haliotidis) 14.00 % Chief Zhi Zi (Fructus Gardeniae Jasminoidis) 5.00 % Deputy Huang Qin (Radix Scutellariae Baicalensis) 5.00 % Deputy Yi Mu Cao (Herba Leonuri Heterophylli) 7.00 % Assistant Chuan Niu Xi (Radix Cyathulae Officinalis) 7.00 % Assistant Du Zhong (Cortex Eucommiae Ulmoidis) 7.00 % Assistant Sang Ji Sheng (Ramulus Loranthi) 14.00 % Assistant Ye Jiao Teng (Caulis Polygoni Multiflori) 18.00 % Assistant Fu Shen (Sclerotium Poriae Cocos Paradicis) 9.00 % Assistant Actions: Calms Liver-Wind. Clears Heat. Moves Blood. Tonifies Liver and Kidneys. Indications: Ascendant Liver Yang with internal movement of Liver Wind. Symptoms: Cerebrovascular accident; Dizziness; Essential hypertension; Headache; Hemiplegia; Spasms of the extremities; Tic; Tinnitus; Aphasia; Blurred vision; Conflicting dreams; Epilepsy; Insomnia; Restless sleep; Sensation of heat in the head; Red tongue; Rapid-Wiry pulse (Shu Xian) Preparation: DECOCTION: 70-90 g/liter until 40 cl remain. Administration/Dosage schedule: DECOCTION: Take 3-4 times daily. Settle The Emotions Pill A traditional Chinese herbal formula that treats poor memory compounded by insomnia, dizziness, hot flashes, or dry mouth. Ding Zhi Wan (Formula 1/2) [Settle the Emotions Pill] Class: Calm the Mind Source/Author: Qian Jin Yao Fang (Thousand Ducat Formulas) Recipe Ren Shen (Radix Ginseng) 30.00 % Chief Fu Ling (Sclerotium Poriae Cocos) 30.00 % Chief Shi Chang Pu (Rhizoma Acori Graminei) 20.00 % Deputy Yuan Zhi (Radix Polygalae Tenuifoliae) 20.00 % Deputy Actions: Calms the Mind. Tonifies Heart-Qi. Indications: This presentation occurs in those with deficient Heart Qi who suffer a severe emotional shock or are badly frightened. Symptoms: Apprehension; Euphoria (incessant laughing); Fear; Mental fragility; Patient is easily frightened; Excess of one of the five emotions (anger, joy, worry, sadness, fear); Memory loss; Palpitations Preparation: PILLS: Grind the ingredients into powder and form into small pills with honey. DECOCTION: 30-35 gram in 50 cl. Cook very slowly until 25 cl remain. Shi Chang Pu is added near the end of the decoction. Administration/Dosage schedule: PILLS: 4-6 g doses, 3 times daily, with warm water. DECOCTION: Take 2-3 times daily. Patent Formula Dosage: 2 grams, 3 times a day. Depending on the patient's condition, the dosage may vary. Note: The name of this formula is literally "settle the will pill". Here the word ZHI refers to all the emotions which are upset due to a sudden fright. Ding Zhi Wan (Formula 2/2) [Settle the Emotions Pill] Class: Calm the Mind Source/Author: Za Bing Yuan Liu Xi Zhu (Wondrous Lantern of Peering into the Origin and Development of Miscellaneous Diseases) Recipe Ren Shen (Radix Ginseng) Fu Ling (Sclerotium Poriae Cocos) Shi Chang Pu (Rhizoma Acori Graminei) Yuan Zhi (Radix Polygalae Tenuifoliae) Fu Shen (Sclerotium Poriae Cocos Paradicis) Bai Zhu (Rhizoma Atractylodis Macrocephalae) Mai Men Dong (Tuber Ophiopogonis Japonici) Zhu Sha (Cinnabaris) Actions: Calms the Mind. Tonifies Heart-Qi. Indications: This presentation occurs in those with deficient Heart Qi who suffer a severe emotional shock or are badly frightened. Symptoms: Apprehension; Euphoria (incessant laughing); Fear; Mental fragility; Patient is easily frightened; Excess of one of the five emotions (anger, joy, worry, sadness, fear); Memory loss; Palpitations Formula Information From www.tcmassistant.com

SENILITY / DEMENTIA / ALZHEIMER'S DISEASE NUTRITIONAL SUPPLEMENTS

Information and help for senility and dementia, a disease that results in a loss of brain cells and Alzheimer's Disease, an irreversible, progressive brain disorder that occurs gradually and results in memory loss, unusual behavior, personality changes, and a decline in thinking abilities.

Alive! Whole Food Energizer Multi Vitamin with Mineral, 18 mg of Iron added, 90 Tabs Alive Whole Food Energizer Multi Vitamin with Mineral with Iron is absorbed into your blood stream 5 times faster than other leading brands.

Back To Youth, TCM Formula, Congrong Huanshao, 100% Natural, 60 Caps Back to Youth, TCM Formula is made of extracts from prepared rehmannia root, common yam, achyranthes, wolfberry, dogwood fruit, poria, salty eucommia bark, polygala prepared with licorice, roasted morinda, schizandra fruit, salty fennel, chinquapin seed, cistanche, acorus root and common jujube fruit, chinese herbs for aging.

Boron Ionic Mineral Supplement, Fully Absorbable, 20 +/- ppm, 16 fl. oz. WaterOz Ionic Boron is a pure liquid Boron supplement. WaterOz Ionic Boron is pure liquid Boron. Boron is essential to bone metabolism and calcification of bones, and helps prevent osteoporosis, arthritis, and tooth decay. Boron is necessary for cartilage formation and repair; it affects calcium, magnesium, and phosphorus levels. Memory and brain function can be improved with boron.

Brahmi Powder (Bacopa Monniera), 100% Organic, 8 oz. Bulk Nutritionally supports concentration, clarity and memory. Brahmi is traditionally used in Ayurveda as a brain and mind tonic.

Brain Elevate Formula w/ Huperzine A, Ginkgo, Phosphatidylserine & RoseOx, 60 Vcaps Brain Elevate Formula is scientifically formulated to provide maximum support and nourishment to cerebral functions.

Brain Tonic, 100% Natural, 375 mg, 60 Caps The Ayurvedic formula is used to help improve mental clarity and vision by helping to regenerate comprehensibility and self confidence.

Cerebral Cardiovascular Cleanser, 100% Natural, 500 mg, 60 Caps Cerebral Cardiovascular Cleanser, Fibrinolytic and Hemolytic, is made of extracts of astragalus root, Chinese angelica root, common peony root, lumbricus (earthworm), cnidium, safflower flower and peach seed.

Coral Calcium (Okinawa) Plus w/ Magnesium & Vitamin D, 100% Natural, 500 mg, 100 Vcaps Okinawa Coral Calcium Plus with Magnesium, Vitamin D and 70 other trace minerals provides essential minerals, restores body alkalinity, supports the immune system, and is bio available for better absorption.

DHA, 250 mg w/ 500 mg EPA & Omega 3 from Fish Oil, 120 Softgels Numerous published studies have provided strong evidence that the Omega-3 fatty acids found in fish oil may reduce the risk of coronary artery disease (CAD) and sudden death from cardiac causes.

DMAE Supplement (dimethylaminoethanol), Vegetarian, 250 mg, 100 Vcaps DMAE is a memory enhancing substance common to a number of drugs that are known to stabilize cell membranes. In Europe, the drug Centrophenoxine, which combines DMAE with a synergistic chemical called p-chlorophenoxyacetate, is prescribed to boost cognitive function in the aged. Used to assist with Anxiety, Alertness and Neuromotor Control, Behavior and Learning Problems,ADD and Hyperactivity.

DMG Supplement, N,N Dimethyl Glycine, NOW Foods, 125 mg, 100 Caps NOW Foods' DMG Supplement is a methylated amino acid found in all cells. DMG is an antioxidant and methyl donor that has a number of beneficial effects. It has shown to have potential in increasing immune response to the flu and salmonella.

GABA Powder (Gamma Aminobutyric Acid), 100% Pure, Vegetarian, NOW Foods, 500 mg, 6 oz. GABA is a non-essential amino acid found mainly in the human brain and eyes and it is considered an inhibitory neurotransmitter, which means it regulates brain and nerve cell activity by inhibiting the number of neurons firing in the brain - GABA is referred to as the brain's natural calming agent.

Garlicin HC, Healthy Circulation Formula With Odor Free Garlic Supplement, Nature's Way, 90 Enteric-Coated Tabs Garlicin HC garlic supplement supports cardiovascular health with the help of hawthorn, cayenne and vitamin E.

Ginkgo Biloba Extract Standardized, 60 mg, 120 Vcaps Supports circulation to the brain as well as the extremities. This is achieved by maintaining healthy blood vessel tone and reducing blood viscosity. Additionally, Ginkgo biloba is a proven free radical scavenger and antioxidant.

Ginkgold, Ginkgo Biloba, Vegetarian, Standardized Extract, 60 mg, 150 Tabs Ginkgold improves mental sharpness, concentration, memory and cognitive activity. It also supports healthy circulation to the brain as well as the extremities. And, it maintains healthy blood vessel tone and reduces blood viscosity.

Ginkgo Leaf Tincture, 2 fl. oz. Preliminary studies show that Gingko Leaf is helpful in ordinary age-related memory loss as well.

Gotu Kola, Nature's Way, 475 mg, 180 Caps Gotu Kola (Centella asiatica) is used in India similar to how the Chinese use Ginseng, for longevity and vitality. Although its name is similar to cola nut, Gotu Kola does not contain caffeine.

Gotu Kola Powder, 4 oz. Bulk This herb rebuilds the energy reserves, and is useful after a nervous breakdown and to help prevent nervous breakdown.

Heart RX, Heart Supplement, Hi-Tech, 120 Tabs Heart Rx Heart Supplement is the ultimate antioxidant and cardiovascular support formula. Heart Rx Heart Supplement contains Idebenone and other Essential Heart Co-Factors. Idebenone is a synthetic analog of CoQ10, the vital cell membrane antioxidant and essential constituent of th ATP-producing mitochondrial electron transport chain (ETC). Idebenone is a potent antioxidant, with the ability to operate under low oxygen tension situations. Because of its ability to inhibit lipid peroxidation, idebenone protects cell membranes and mitochondria from oxidative damage. Its antioxidant properties protect against cerebral ischemia and nerve damage in the central nervous system. This compound has also been shown to stimulate nerve growth factor, a characteristic that could be important in the treatment of Alzheimer's and other neurodegenerative diseases. Idebenone has been shown to increase Nerve Growth Factor and enhanced Cholinergic Activity, thereby showing it to have cognitive enhancement abilities. German studies showed that 90 mg of idebenone administered daily to Alzheimer patients, thereafter showed statistically significant improvement. As a result of the studies, idebenone is being used in the treatment of senile dementias, particularly Alzheimer's disease. Idebenone has been deemed safe and effective, in fact, for the treatment of Alzheimer's patients due to this recent landmark study. It's been shown that if you can catch and treat it early before it becomes a major problem, idebenone can retard the natural progression of the disease.

Lecithin concentrate, Nature's Way, 400 mg, 100 Softgels Nature's Way Lecithin Supplement is 100% natural from soy oil and it contains no artificial ingredients or preservatives.

L-Theanine, w/ Decaffeinated Green Tea Extract, 100 mg, 90 Vcaps L-Theanine is an amino acid found in green tea that produces tranquilizing effects in the brain and creates a feeling of relaxation without drowsiness. Helps reduce high blood pressure and relieve stress.

Manganese Ionic Mineral Supplement, Fully Absorbable, 30 +/- ppm, 16 fl. oz. WaterOz Ionic Manganese is a pure liquid Manganese supplement. Manganese, also called the "brain mineral," is important in the utilization of all mental facilities/functions.

Neuromins DHA (Docosahexaenoic Acid), 100 mg, 60 Softgels DHA is an essential fatty acid is the primary structural fatty acid in the gray matter of the brain and retina of the eye and is important for signal transmissions in the brain, eye and nervous system. DHA is taken by expecting mothers to support fetal development, and by mothers while lactating to enhance breast milk.

Phosphatidyl Serine (PS), 500 mg, 60 Softgels Phosphatidyl Serine complex aids brain cell function and reduces age-related mental decline. With age normal brain and nerve cell activity may decline due to diminished neurotransmitter and brain cell function.

Procaine Ultra GH9 (Ultimate 9), 100 mg, 60 Caps Procaine Ultra GH9 is the MOST TRUSTED Anti-Aging THERAPY - of choice of the RICH & FAMOUS in over 70 countries.

Rooibos, 100% Natural, 350 mg, 60 Caps Rooibos contains potent anti-oxidant and anti-ageing properties packed with selenium, vitamin A, C, E and magnesium.

St. John's Wort Supplement, 350 mg, 180 Caps St. John's Wort Supplement can be helpful in support of depression, menopause, cramps, and insomnia. Nature's Way St. John's Wort extract standardized to 0.3% Hypericin, then synergistically blended with the whole St. John's Wort herb in the perfect balance to ensure consistent hypericin content in each capsule.

Vitamin E (as d-alpha-Tocopheryl-Acetate), 100% Natural, 400 IU, 250 Softgels Vitamin E is a major antioxidant and the primary defense against lipid peroxidation. It is particularly important in protecting the body's cells from free radical/oxidative damage.

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Herbal Remedies: Senility / Dementia Information

Herbal Remedies: Senility / Dementia Supplements, Information & Products

Herbal Remedies: Alzheimer's Information

Herbal Remedies: Alzheimer's Supplements, Information & Products

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NOTIFY YOUR HEALTH CARE PROVIDER IF...

You recognize the symptoms of senile dementia in a family member, these steps should be taken:

• Consult your health care provider to confirm the diagnosis.



• Join a family support group for senile dementia patients. This will help to ease the pressure of looking after the patient through sharing of experience.



• Take advantage of social services such as day care centers for the elderly.



• Explain your family member's illness to your relatives and neighbors to gain their understanding and support.



• Make alterations in your home environment to prevent accidents.



• Establish a daily routine for the patient to reduce his or her feelings of confusion.



• Have the patient wear a wrist bracelet labeled with his name and telephone number. Always have a recent photo of the patient at home so that it will help to find him if he or she gets lost.

Symptoms are not relieved after treatment or if side effects of medication are experienced and are disruptive to daily life. Another therapy method or medication may needed.

FOR MORE INFORMATION

For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute's Brain Resources and Information Network (BRAIN) at:

BRAIN
P.O. Box 5801
Bethesda, MD 20824
(800) 352-9424
Web Site: http://www.ninds.nih.gov

Information also is available from the following organizations:

Alzheimer's Disease Education and Referral Center (ADEAR)
P.O. Box 8250
Silver Spring, MD 20907-8250
E-Mail: adear@nia.nih.gov
Web Site: http://www.alzheimers.nia.nih.gov
Tel: 301-495-3311, 800-438-4380
Fax: 301-495-3334

Alzheimer's Association
225 North Michigan Avenue
17th Floor
Chicago, IL 60601-7633
E-Mail: info@alz.org
Web Site: http://www.alz.org
Tel: 312-335-8700
TDD: 312-335-5886
Fax: 866.699.1246

National voluntary health organization committed to finding a cure for Alzheimer's and helping those affected by the disease.

Alzheimer's Foundation of America
322 Eighth Avenue
7th Floor
New York, NY 10001
E-Mail: info@alzfdn.org
Web Site: http://www.alzfdn.org
Tel: 866-AFA-8484 (232-8484)
Fax: 646-638-1546

Works to provide optimal care and services to individuals confronting dementia and to their caregivers and families through member organizations dedicated to improving quality of life.

John Douglas French Alzheimer's Foundation
11620 Wilshire Blvd.
Suite 270
Los Angeles, CA 90025
E-Mail: jdfaf@earthlink.net
Web Site: http://www.jdfaf.org
Tel: 310-445-4650, 800-477-2243
Fax: 310-479-0516

Generates funds for Alzheimer's research targeted at areas of research typically not supported by Federal agencies.

Association for Frontotemporal Dementias (AFTD)
100 North 17th Street
Suite 600
Philadelphia, PA 19103
E-Mail: info@FTD-Picks.org
Web Site: http://www.FTD-Picks.org
Tel: 267-514-7221, 866-507-7222

Non-profit organization that promotes and funds research into finding the cause and cure for frontotemporal dementias (FTD); provides information, education, and support to those affected by FTD and their caregivers; and sponsors professional health education programs related to FTD.

National Organization for Rare Disorders (NORD)
P.O. Box 1968
(55 Kenosia Avenue)
Danbury, CT 06813-1968
E-Mail: orphan@rarediseases.org
Web Site: http://www.rarediseases.org
Tel: 203-744-0100
Voice Mail 800-999-NORD (6673)
Fax: 203-798-2291

Federation of voluntary health organizations dedicated to helping people with rare "orphan" diseases and assisting the organizations that serve them. Committed to the identification, treatment, and cure of rare disorders through programs of education, advocacy, research, and service.

Family Caregiver Alliance/ National Center on Caregiving
180 Montgomery Street
Suite 1100
San Francisco, CA 94104
E-Mail: info@caregiver.org
Web Site: http://www.caregiver.org
Tel: 415-434-3388, 800-445-8106
Fax: 415-434-3508

Supports and assists families and caregivers of adults with debilitating health conditions. Offers programs and consultation on caregiving issues at local, state, and national levels. Offers free publications and support online, including a national directory of publicly funded caregiver support programs.

C-Mac Informational Services/Caregiver News [For Alzheimer's-Type Dementia Caregivers]
120 Clinton Lane
Cookeville, TN 38501-8946
E-Mail: caregiver_cmi@hotmail.com
Web Site: http://www.caregivernews.org

Non-profit, tax-exempt, charitable organization that offers information about care for patients with Alzheimer's-type dementia. Publishes and distributes a newsletter, cookbook, and the Caregiver's Information Pack.

National Institute of Mental Health (NIMH)
National Institutes of Health, DHHS
6001 Executive Blvd. Rm. 8184, MSC 9663
Bethesda, MD 20892-9663
E-Mail: nimhinfo@nih.gov
Web Site: http://www.nimh.nih.gov
Tel: 301-443-4513/866-615-NIMH (-6464), 301-443-8431 (TTY)
Fax: 301-443-4279

National Family Caregivers Association
10400 Connecticut Avenue
Suite 500
Kensington, MD 20895-3944
E-Mail: info@thefamilycaregiver.org
Web Site: http://www.thefamilycaregiver.org
Tel: 301-942-6430, 800-896-3650
Fax: 301-942-2302

Grassroots organization dedicated to supporting and improving the lives of America's family caregivers. Created to educate, support, empower, and advocate for the millions of Americans who care for their ill, aged, or disabled loved ones.

Lewy Body Dementia Association
P.O. Box 451429
Atlanta, GA 31145-9429
E-Mail: lbda@lbda.org
Web Site: http://www.lewybodydementia.org
Tel: 404-935-6444, 800-LEWYSOS (539-9767)
Fax: 480-422-5434

Supports those affected by Lewy body dementias and promotes research for a cure. Sponsors education and outreach programs.

Alzheimer's Drug Discovery Foundation (formerly, Institute for the Study of Aging)
1414 Avenue of the Americas
Suite 1502
New York, NY 10019
E-Mail: hfillit@alzdiscovery.org
Web Site: http://www.alzdiscovery.org
Tel: 212-935-2402
Fax: 212-935-2408

Public charity whose mission is to accelerate the discovery and development of drugs to prevent, treat, and cure Alzheimer's disease, related dementias, and cognitive aging.

Creutzfeldt-Jakob Disease (CJD) Foundation Inc.
P.O. Box 5312
Akron, OH 44334
E-Mail: help@cjdfoundation.org
Web Site: http://www.cjdfoundation.org
Tel: 800-659-1991
Fax: 330-668-2474

Non-profit, volunteer foundation that promotes research, education, and awareness of CJD and reaches out to people affected by CJD.

CJD Aware!
2527 South Carrollton Ave.
New Orleans, LA 70118-3013
E-Mail: cjdaware@iwon.com
E-Mail: info@cjdaware.com
Web Site: http://www.cjdaware.com
Tel: 504-861-4627

Non-profit organization established for support, information sharing, and advocacy.

Well Spouse Association
63 West Main Street
Suite H
Freehold, NJ 07728
E-Mail: info@wellspouse.org
Web Site: http://www.wellspouse.org
Tel: 800-838-0879, 732-577-8899
Fax: 732-577-8644

International non-profit organization whose mission is to provide emotional support to, raise consciousness about, and advocate for the spouses/partners and children of the chronically ill and/or disabled.

National Respite Network and Resource Center
800 Eastowne Drive
Suite 105
Chapel Hill, NC 27514
Web Site: http://www.archrespite.org
Tel: 919-490-5577 x222
Fax: 919-490-4905

Information and referral service that assists and promotes the development of quality respite and crisis care programs; helps families locate respite and crisis care services in their communities; and sponsors advocacy and awareness efforts concerning respite care.

American Health Assistance Foundation
22512 Gateway Center Drive
Clarksburg, MD 20871
E-Mail: info@ahaf.org
Web Site: http://www.ahaf.org
Tel: 301-948-3244, 800-437-AHAF (2423)
Fax: 301-258-9454

Non-profit charitable organization dedicated to funding research and educating the public on Alzheimer's disease, glaucoma, macular degeneration, heart disease, and stroke. Provides emergency financial assistance to Alzheimer's disease patients and their caregivers.

National Hospice and Palliative Care Organization /National Hospice Foundation
1700 Diagonal Road
Suite 625
Alexandria, VA 22314
E-Mail: nhpco_info@nhpco.org
Web Site: http://www.nhpco.org
Tel: 703-837-1500
Helpline: 800-658-8898
Fax: 703-837-1233


Non-profit membership organization representing hospice and palliative care programs and professionals. Provides free referrals to the public for hospice listings across the United States and internationally. Distributes free packets of general information describing hospice services and the Medicare Hospice Benefit.

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