The National Institute of Health arranged for a panel to determine whether or not there is anything a person can do to reduce their risk of developing Alzheimer's Dementia. This study was recently published with the title: "Preventing Alzheimer's Disease and Cognitive Decline." The conclusion of the this large, 727 page report was, "The current research on the list of putative risk or protective factors is largely inadequate to confidently assess their association with AD or cognitive decline. Further research that addresses the limitations of existing studies is needed prior to be able to make recommendations on interventions."
If this is taken to mean that we need to learn more about Alzheimer's Disease, then I completely agree. However, if this is taken to mean that we have no idea what causes Alzheimer's Disease and absolutely no idea what to do to reduce the risk of developing the illness, I must vehemently disagree.
Dr. Martha Daviglus of Northwestern University in Chicago, the physician who chaired the panel, went on to tell the media, "We wish we could tell people that taking a pill or doing a puzzle every day would prevent this terrible disease, but current evidence doesn't support this." In reply to Dr. Daviglus, I must state that neither I nor any other competent author on the subject believes that simply taking a pill or doing a puzzle every day will significantly reduce the risk of developing Alzheimer's Disease. As I think Dr. Daviglus would agree, the story is more complicated than that.
It is important to state that we know a lot about the risk factors for Alzheimer's Disease. Some forms of Alzheimer's Disease are very strongly related to genetics, appear early in life, and may not be avoidable. On the other hand, we know that choices we make in life influence the risk of developing the most common forms of Alzheimer's Disease. We know, for example, that when individuals leave simpler healthier lifestyles from other cultures and take up the lifestyles of modern America, the likelihood of dementia goes up. What are those things we do that expose us to risk of Alzheimer's? The answer is not simple. The difficulty is that the risks factors for Alzheimer's Disease are multiple, interactive and complicated. No one factor is responsible for this illness, and no one simple measure will stop it.
Let's begin with what the panel admits to be avenues for reducing the risk of Alzheimer's Disease. In their summary of results, the panel stated that "factors associated with increased risk of AD and cognitive decline were: diabetes, epsilon four allele of the apolipoprotein E gene [This is a genetic factor you cannot change], smoking, and depression." In addition, the panel stated that, " Factors showing a fairly consistent association with decreased risk of AD and cognitive decline were: cognitive engagement and physical activities." They went on to say that the benefits from addressing any one of those factors was small to moderate in terms of reducing the development of Alzheimer's or preventing cognitive decline. What they did not address was if a healthy lifestyle that imporved all of those factors in a comprehensive fashion might provide more than mere small to moderate benefit. No cardiologist would suggest that merely taking a blood pressure pill and walking around the block several times a week can eliminate a person's risk of heart disease. It is similarly nonsensical to suggest, as per Dr. Daviglus' statement, that a pill and a puzzle is the means to avoid the ever so complicated Alzheimer's Disease. Thus, even if we agree to ignore the considerable amount of data showing benefits of stress reduction, improved sleep, dietary changes, and other such measures, we must ask what benefits might result from combining the avoidance of diabetes, smoking, and depression with an increase in exercise and intellectual activity.
It is also important to realize that the method the panel used to discern what may or may not be useful to reduce the risk of Alzheimer's required them to eliminate the results of thousands of studies on the subject. They admitted that, "Some of the factors that did not show an association with AD or cognitive decline in this review may still play an influential role in late-life cognition, but there was not sufficient evidence to draw this conclusion." Certainly, the panel cannot be faulted for being stringent in their criteria for accepting scientific studies for inclusion in their review of the evidence for reducing the risk of Alzheimer's. Such stringency is what we expect of good scientific research. However, when lacking firm evidence, we physicians must rely on indications and known relationships. As only one example, the panel stated that Metabolic Syndrome could not be shown to increase the risk of Alzheimer's Disease. Metabolic syndrome is the combination of elevated blood sugar, high blood pressure, abdominal obesity, high triglycerides, and low good HDL cholesterol. The puzzling and unfortunate fact is that almost all cases of adult onset diabetes, which the panel recognized as a risk factor for Alzheimer's Disease, begin as Metabolic Syndrome. Thus, for the panel to fail to recommend that Metabolic Syndrome be diagnosed and treated as a means to reduce the risk of Alzheimer's Disease must be seen as contrary to common sense.
As another example, the panel noted that " high adherence to a Mediterranean diet is associated with lower risk of AD". However, because of one weak study to the contrary, they felt that the data was not yet strong enough to recommend it as a genuine preventative measure. If one takes into account that Mediterranean diet helps prevent diabetes, which the panel agrees is a risk factor for Alzheimer's, then the recommendation of this diet is not unreasonable.
I believe it can be said that in trying to be conservative, the panel has grossly understated our ability to avoid Alzheimer's and other forms of dementia through healthy diet, exercise, stress reduction, improvement of emotional well being, intellectual activity, good sleep, supplements, good medical care, and other comprehensive steps to improve overall health. To their credit, the panel did admit that, " Many of the exposures reviewed in this report likely do not work in isolation in their effect on risk of AD or cognitive decline. Instead, they work in combination with other factors." I myself believe that this is not a mere caveat, but rather the essence of the approach that must be taken. Dr. Daviglus is absolutely correct in saying that no mere pill or puzzle can prevent Alzheimer's Disease. However, the panel is simply wrong in stating that we have no means currently at our disposal to decrease our risk for avoiding this dreadful illness.
Lynn Casteel Harper: The Spiritual Implications of Dementia
Barry Petersen: Can a Marriage Die Even When the Loved One Doesn't?
Stanton Peele: Drinking Lowers the Risk of Dementia About One-Fourth
Just sayin'.
I have a couple of questions you might be able to answer:
1) Do the risk factors for Altheimers dementia significantly differ from other types of dementia?
2) Does history of concussions have any statistical correlation as a risk factor.
Thanks.
I'm going to explain why the good doctor M has reacted with such ire and rudeness to the intrusion of the vaccine question into his little blog on Alzheimer's.
Dr. M is questioning authority on Alzheimer's. He is sticking his neck out just a little bit. Not a lot, just a little.
But he knows damn well that if he sticks his neck out a lot, he'll get his head chopped off.
So he isn't going to question the efficacy or safety of influenza vaccines, including the influenza vaccines that contain mercury and that are recommended every year for the population which is most likely to get Alzheimer's. That would be going too far.
I agree with Hellbilly, that he could have effectively closed off the conversation without being rude, and that being rude made him look unprofessional.
Vaccines concerns are very scary. Questioning vaccines is professional suicide. So why do it?
Questioning vaccines is to professional suicide as administration of vaccines is to ______ .
"According to a 2009 study published in the Journal of Alzheimer's Disease, widespread exposure to nitrosamines, nitrates and nitrites in processed food and the environment are all linked to degenerative diseases like Alzheimer's. These chemicals are commonly used in food factories and large-scale farming operations."
"Five ways to protect yourself from Alzheimer's
#1) Avoid processed foods
#2) Install a home water filter
#3) Detoxify on a regular basis
#4) Exercise regularly (physical and mental)
#5) Eat plenty of superfoods and nutritional supplements"
http://www.naturalnews.com/028741_Alzheimers_disease_prevention.html
My grandparents bother suffered/ suffer from alzheimers or some other form of dementia. I was very interested by the new study out (I think it was a British study) that suggests spouse caregivers of alzheimers victims are more likely to develop the disease. It is unknown whether the correlation (if any) is environmental or the increase in likelihood of developing alzheimers is due to increased stress of caring for a loved one with the disease. I'm curious if Dr. Mendelson or others have thoughts on that study.
On the environmental side, I don't know much about the science but always questioned toxins my grandparents would have been exposed to in a rural area. They used some powder called 7 (not even sure what it is) around the property frequently -- I think it was meant to kill fleas? They also used well-water and I'm curious if it contained a toxin that could be a possible link.
Recent studies have correlated increased asthma and autism rates with such early vaccinations and have been ignored. The CDC funded several "Danish" studies on vaccines and autism on children less exposed to mercury and not exposed as early as American children. However, they yet to fund a significant epidemiological study done by Americans on American children and have also refused to fund any study that looks at the autism rate of non-vaccinated American populations.
The "Danish" studies were done by employees of a vaccine manufacturer and indicated that the removal of thimerosal from vaccines lead to about a 20-fold increase in autism!!! Ridiculous, and if true why haven't the Danish put the thimerosal back in their vaccines? The studies you likely are alluding to showing mercury exposure not affecting cognitive function are likely of questionable design like the Danish studies, its called manufacturing uncertainty. FOIA info indicates such malfeasance.
Jo
See my http://vaccineswork.blogspot.com/2010/03/thimerosal-guide-for-kids-0-to-6-years.html for details.
http://www.youtube.com/watch?v=foSYnrRYQew&feature=related
It would be unreasonable to deny the possibility that the enormous profits of the pharmaceutical industry could lead to corruption of the study/trial/approval process. The germane question is perhaps, how pervasive might be such corruption, and it is to this question that Dr. Golomb speaks.
"Don't Fear a Smallpox Outbreak"
http://chetday.com/smallpoxepidemic.htm
Yes doctor, we must beat this topic like the dead horse it is because our children & their well being is what's urgently important. I'm very sorry for you, you can't see that.
"Because the vaccine obviously acts in the body for a long period of time after it is given. A reaction can be gradual. Deterioration can be gradual. Neurological problems can develop over time. They do in various conditions, even according to a conventional analysis. So why couldn't that be the case with vaccines? If chemical poisoning can occur gradually, why couldn't that be the case with a vaccine which contains mercury?"
"You are dealing with correlations, most of the time.Correlations are not perfect. But if you get 500 parents whose children have suffered neurological damage during a one-year period after having a vaccine, this should be sufficient to spark off an intense investigation."
http://drbenkim.com/articles-vaccine-risks.htm
It's rare to see someone get as emotional as you have - simply because we disagree.
While I've enjoyed a good laugh over the name calling, it isn't a becoming approach to hurl insults at your readers...especially, when they aren't attacking you. I wonder how you must speak to your patients - when they ask questions or express concerns regarding the advice you offer. Hopefully the bedside manner you display is much more patient and empathetic. Good day doctor.
http://www.flcv.com/alzhg.html
Are you saying that some people are genetically iclined to detoxify metals and toxins from their environment more slowly than others? Or, something else?
If the doctor decides not to answer this question, could anyone else, please?
http://www.flcv.com/alzhg.html
You keep going back to cans of tuna. The last time you did I posted the following, to no reply. Perhaps you missed it that time?
"Doctor Mendelson,
Brief research shows that a 7lb. male can eat 0.2 oz of Albacore tuna or 0.6 oz of light tuna per -week- before being exposed to unsafe levels of mercury.
Given that your comments referenced an entire can of tuna consumption I'd say you're correct in your statement but entirely incorrect in your conclusion.
So, further questions.
How much mercury -is- in a can of Albacore or light (skipjack) tuna?
How much mercury -is- in a (mercury containing) vaccine?
Comparision between those two will show if your conclusions are flawed or not.
For the calculations I used 7 lbs because that seemed like a reasonable birth average. I used males since males are much more likely to present ASD symptoms."
"An incidental finding of oral mercury ingestion was followed clinically and did not result in complications....Subcutaneous mercury injection should be managed with local wound debridement, whereas ingestions are rarely of clinical significance."
http://www.jem-journal.com/article/S0736-4679(00)00283-3/abstract
"The oral route of metallic mercury use does not cause poisoning symptoms, but its use in infants and children could cause subclinical developmental problems. Concentrations in blood and urine after ingestion of mercury remain low because very little is absorbed. However, mercury injected subcutaneously causes sterile, inflammatory, and necrotic reactions resulting in abscesses and granulomas....When mercury is injected intravenously, it goes mainly to the lungs and can cross over to systemic circulation...Neurologic and renal complications can result from high systemic levels of mercury, and subcutaneous injection usually results in sterile abscesses."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1247524/
"Not surprisingly, neurofibrillary tangles similar to those found in the brains of Alzheimer’s victims have also been reported in the brain of an autistic person at autopsy."
http://www.greatplainslaboratory.com/home/eng/candida.asp
"Healthy people develop moderate numbers of tangles, with the most severe cases linked to Alzheimer's disease. But now we have evidence that some individuals are immune to tangle formation. The evidence also supports the notion that the presence of tangles may influence cognitive performance."
"The next step, researchers say, is to determine the role environment, lifestyle and genetics play in the immunity to tangle formation and subsequent memory loss."
Source: Presented at the 239th National Meeting of the American Chemical Society, March 23, 2010; San Franciso
The report dismissed much of the existing research because it did not rise to their standard. In my opinion a standard that is not likely to be reached anytime soon due to funding, and or lack of funding.
You did a good job in your article raising issues about the report.
Bob DeMarco
Alzheimer's Reading Room
http://www.alzheimersreadingroom.com