Is Prevention the Only Answer to the Alzheimer's Epidemic?

Medical science is working miracles lately. At times it seems like science fiction. We are transplanting faces onto injured individuals. Patients swallow cameras that videotape their travels through the gastrointestinal tract to find growths that would otherwise remain undiscovered. Computer interfaces with the nervous system are restoring movement to those who have been paralyzed by accidents or war injuries. Great strides are also being made in research into the causes and cures of Alzheimer's disease and other forms of dementia. Unfortunately, all of these magnificent new medical technologies are extremely expensive. We might not be able to afford them.

Advances are being made in the methods to diagnose Alzheimer's disease. However, the brain-scanning techniques being developed to visualize the amyloid plaques that characterize Alzheimer's disease will cost thousands of dollars for each patient. The new, technically-advanced tests of blood and cerebrospinal fluid to find markers of Alzheimer's disease will cost hundreds, if not thousands, of dollars.

After Alzheimer's disease has been diagnosed, the medications to treat the illness are also expensive. Today, such medication can cost up to $2,000 per person a year. The next generation of medications to treat Alzheimer's disease are likely to be even more expensive. Unfortunately, the changes that Alzheimer's disease causes in the brain usually begin 15 years or more before any changes in memory and behavior are noted. Thus, by the time Alzheimer's disease is diagnosed, the damage is done and the expensive treatments do little more than slow the pathological processes down a little. Although methods are being developed to diagnose the illness at the earliest possible time, there are few indications that an accurate, simple and inexpensive method will arrive anytime soon.

We are currently experiencing an epidemic of Alzheimer's disease. We are also in the throes of a severe economic downturn. The country is deeply in debt, and government expenditures, including those for health care, must be trimmed back. With millions of new cases of dementia expected to develop over the next few years, medication alone will amount to billions of dollars. Nursing home care can easily cost $50,000 a year, with prices going up annually. In the next few years, the cost of treating Alzheimer's disease is expected to skyrocket. In 2005, Medicare spent $91 billion on the care and treatment of Alzheimer's patients. By 2015, the expenditures are expected to be close to $200 billion. With the government going broke, and austere measures being implemented, it is clear that we simply cannot afford the current approach to the diagnosis and treatment of Alzheimer's disease in the midst of a growing epidemic of the illness.

I believe the most reasonable stance to take is not to develop evermore technically advanced and expensive means to diagnose and treat Alzheimer's disease, but rather to assume that we are all at risk for developing Alzheimer's disease, and that we must do what we can right now to minimize our risks for developing it. Thankfully, there is a substantial and growing body of evidence that for many if not most people, the prevention -- or at least the postponement -- of Alzheimer's disease can be accomplished with simple, inexpensive changes in lifestyle.

Much to its credit, the National Institute of Health financed a study to determine whether or not there is anything a person can do to reduce their risk of developing Alzheimer's disease. Last year, the findings of that study were published with the title: "Preventing Alzheimer's Disease and Cognitive Decline." The panel discovered that several factors in lifestyle and health maintenance can be improved to reduce the risk of Alzheimer's. It was found, for example, that combating diabetes, stopping smoking, treating major depression, exercising regularly and staying intellectually active can help to reduce the risk of developing Alzheimer's disease.

The NIH panel was reluctant to endorse other measures that have been shown in scientific studies to reduce the risk the risk of Alzheimer's disease. They recognized the existence of such studies but felt the evidence was not strong enough for them to lend their support. However, most of these measures are inexpensive, common sense steps that not only can reduce the risk of Alzheimer's disease but improve one's general health at the same time. Indeed, many of these measures are recommended without reservations by doctors for the good health and happiness of their patients. These other means to reduce the risk of Alzheimer's disease include: reaching and maintaining your ideal weight, controlling high blood pressure, maintaining healthy cholesterol and triglyceride levels, reducing stress, getting a good night's sleep, treating sleep apnea, seeing a dentist regularly, maintaining healthy blood levels of vitamins, such as folic acid, vitamin B12, vitamin C, vitamin E and vitamin D, increasing intake of antioxidants, such as those found in richly-colored fruits and vegetables, maintaining friendships and pursuing a rewarding spiritual life.

There is no need to completely stop our search for the "magic bullet" to cure Alzheimer's disease. We may yet come upon a way to stop Alzheimer's in its tracks. Moreover, research itself is valuable. Our studies of the brain could bring us entirely new and unexpected insights with applications for the treatment of other human ailments. However, with the government finances in shambles, the rates of Alzheimer's disease climbing, and the costs of medical care skyrocketing, it is irresponsible not to emphasize the prevention of this terrible disease through safe, inexpensive methods we already know.

 

Comments

[MarieCoyle]

06:29 PM on 10/10/2011

My heart goes out to everyone who cares for someone with Alzheimer's, as I know how difficult it is. As a family caregiver I was always hesitant to leave my mother, who has Alzheimer'­s disease, with a homecare agency. However, I recently found a local provider that offers ClearCare care management software - something I highly recommend. . Now I'm able to leave my mom with our homecare provider, and still see everything that's going on, as caregivers are required to check in with every task. It's one of the only things about my mom's situation that I'm actually happy with.

[Lane Simonian]

08:26 PM on 09/20/2011

Here is a short list of the factors that may contribute to Alzheimer's disease: high glucose levels, high blood pressure, late estrogen replacement therapy, bisphosphonate osteoporosis drugs (such as Fosamax and Boniva), mercury, aluminum fluoride, stress, the APOE4 gene, and presenilin gene mutations. One can live a healthy lifestyle and still get the disease for genetic reasons, environmental exposures, and/or drugs.

These risk factors lead to the formation of peroxynitrites--the primary cause of short-term memory in Alzheimer's dsiease. Peroxynitrites oxidate choline transport systems, muscarinic receptors (involved in the uptake of choline), and choline acetyltransferases--thus acetylcholine a compound critical for short-term memory is scarce.

Alzheimer's disease can be delayed, treated, and partially reversed using phenolic compounds. For instance, aromatherapy using clove, rosemary, sage, thyme, oregano and cinnamon leaf essential oils (among others) helps to treat the disease: these essential oils are high in methoxyphenols--peroxynitrite scavengers that can be inhaled directly into the brain (see the clinical trial by Jimbo et al.) To quote an anonymous blogger: "Excellent results have been obtained with peroxynitrite scavengers, with reversals of Alzheimer's disease in human clinical trials being repeatedly demontrated." So before we come to the conclusion that there will not be a treatment for Alzheimer's disease for years and that we should focus on prevention, examine what has already been proven successful multiple times in animal models, clincal trials, and case studies of Alzheimer's disease.

[Amalie Everett]

09:59 AM on 09/20/2011

Until the magic bullet is discovered - lifestyle seems to be the best approach for addressing Memory Loss and Mild Cognitive Impairment which can sometime result in AD. Exercise regularly and incorporate a diet rich in folate, moreso - L-Methylfolate - the most available form of folate for the brain to use. Ask your doctor about CerefolinNAC - I take it since I have a family history and learned about the benefits of slowing the progression while working with this company. There are options to slow the progression of MCI.

[EddieNM]

05:28 PM on 09/19/2011

I think there are a couple important directions those of us who must prevent Alzheimer's, must go.

1) The new theory of "toxic gut syndrome" as a cause of Autism, I suspect is applicable here too. Each of us must get rid of those foods that are dragging us down (e.g. gluten), and be extra careful to avoid toxic "foods" like aspartame, high-fructose corn syrup, GMOs, etc. This also involves supplementation of important substances, esp. probiotics to optimize gut bacteria.
2) We must optimize our hormones, esp. those hormones known to have a brain-protective effect (pregnenolone, progesterone, active thyroid hormone [T3], DHEA). Of these hormones, T3 is especially important because the gut cannot work properly without enough of it.

[Donna Augustine Hoskins]

10:40 AM on 09/19/2011

I find this article insulting as well as misleading. It implies that people suffering from Alzheimer's are fat, lazy, intelectually dull and in poor physical condition. This is simply not the case. While there is certainly no harm (and all good) in leading a healthy, mentally active lifestyle, there is no proof that doing so will help you avoid Alzheimer's, especially the early-onset variety which is thought to be genetic. I've seen more than one active and mentally alert person obliterated by this horrible disease. My own mother had LOW blood pressure, walked every day, was at a healthy weight, was one of the most well read people I've ever known, did daily crossword puzzles and yet Alzheimer's still ravaged her mind over 15 years until her death. More funding for a real treatment and possibly a cure is the answer. Attempting to shift the blame to the victims of this horrible disease to account for medical science's shortcomings is insulting.

[Scott Mendelson, M.D.]

11:01 AM on 09/19/2011

Dear Donna, It is painful to me that you have interpretted my article in this manner. This was absolutely not my belief or intention. It is impossible to convey the full complexity of something like Alzheimer's Dementia in a brief article such as mine. In fact, there are forms of Azlheiemr's that are genetically driven, early in onset, and quite likely unavoidable by any means. The only hope for the sufferers is indeed advances in medical science. Nonetheless, the fact remains that for most people, a variety of lifestyle changes, good medical advice and care to maintain overall good health, and healthy lifestyle changes will certainly prevent or at least postpone the development of so-called sporadic Alzheimer's and other forms of dementia. Best wishes,
Scott D. Mendelson, M.D., Ph.D.

[mosttruthful]

10:11 AM on 09/19/2011

If you could do all these things you would most likely live a healthy life to the age of 100.

[LadyXoc]

02:54 AM on 09/19/2011

I have watched the progress of dementia in more than one person.These were once intelligent and active people with many interests One day, they forgot - sometimes quite suddenly - how to play the piano or, how to use a telephone. Eventually, they could not even walk. Nothing could be done. Perhaps these measures, not smoking, exercise and so forth may slow the disease a little,and there is no question they add to quality of life - but prevent dementia? - only in the sense that the sufferer dies of something else before the disease takes his/her mind completely. In the total helplessness in the face of our loved ones' disintegration is the true horror.

[Allen Golden]

01:54 AM on 09/19/2011

As we look at the treatment options for Alzheimer's Disease let us keep an open mind as to all options available. There is not a known cure for Alzheimer's as yet. We hope to see this sometime, hopefully not far down the road. In the meantime the use of pharmaceutical medications have at least helped Alzheimer's patients to have some success. There are also natural supplements which-with the use of the pharmaceuticals-may take things a step further. Many people who have participated in medical research have seen significant changes. In as little as 24 months people have been able to go back to some form of occupations. So many of us are not aware of this because unless someone pays to have this heard it is kept under a rock. God Bless those who take that extra step to look a little deeper. Most of us are too devastated to do so and need help from those who keep an open mind. http://bit.ly/pcveaR

[andromadextra]

01:13 AM on 09/19/2011

I am not a medical doctor or medical researcher; however, it does seem to me that much of the problem in combating Alzheimer's and other diseases that have reached epidemic proportions has to do with what people are eating. First of all, very little control is exercised by the FDA to actually protect the health of Americans because they are too busy protecting the bottom line of big business, the medical industry, and pharmaceutical companies. Moreover, the insurance business has become grotesquely bloated by making it impossible to have medical care, home or car insurance, or any number of other expensive legally mandated expenses controlled by the insurance industry. You are out of luck if you're poor. So what are people eating? Genetically modified food--food that has built-in pesticides so that pests won't eat the food. But guess what, you do. All of the poisons, hormones, additives of various sorts in the food are a good starting place for the cause of endemic diseases such as Alzheimer's, obesity, etc. Don't believe the so-called "scientific" studies that say that what you're eating, where you are living, is safe. Because it's not. Most of the contemporary modern plagues began with the additives, poisons, and genetic modification of foods. Check out the dates for your self--it becomes quite evident. And who is allowing all of this? Just listen to political news; it's very easy to figure out.

[Welshish]

08:50 AM on 09/19/2011

I believe that pesticides are what is lurking behind the epidemics of Alzheimer's and the autism-spectrum. After all, they are neurotoxics and kill pests by attacking their nervous system.

[drvittoriarepetto]

03:29 PM on 09/19/2011

I agree that what we take into our bodies as well as what we don't put into our bodies has an effect in getting dementia.
GMO, artificial sweeteners, HFSP, heavy metals, pesticides as well as the drugs we are prescribed can inch us closer to dementia (check out table #3 common drugs affecting cognition http://tinyurl.com/3qdt9hl )
I also suspect that the low fat/non fat advice affects the development of dementia; we need fat...60-70% of our brains are made of fat. Italian senior citizens who consumed extra-virgin olive oil as main dietary fat less likely to experience age-related cognitive decline,
And we need to eat fat in order to absorb oil soluble vitamins like Vitamin D, A, E & K, http://tinyurl.com/36krj6w

[youngblood360]

04:44 PM on 09/18/2011

Excellent article. Alzheimer's have taken people out on both sides of my family - both grandmothers and my mother all suffered from the disease. It has both me and my siblings constantly checking ourselves for any sign of memory issues; we are also constantly reading about new breakthroughs as well as prevention. It is absolutely true what Dr. Mendelson talks about. The breakthrough tests and procedures will cost thousands and most likely will not be covered by health insurers; they will certainly turn down all claims for these tests because none of the insurance companies will cover what they see as "experimental treatments". This of course is a whole other conversation; but suffice to say Mendelson is spot on in his assessments.