JANUARY BLOG

ALZHEIMER’S AWARENESS

Alzheimer's is a progressive disease that destroys memory and other important mental functions. In the beginning, people suffering from the disease may find they are experiencing problems with memory, judgment, thinking, even forgetting important people in their lives and may experience dramatic personality changes.  Memory loss and dementia will progress as the stages of Alzheimer's advance.  Symptoms can be treated with medication, but there is no cure.

Alzheimer's disease is the most common cause of dementia — a group of brain disorders that cause the loss of intellectual and social skills.  In Alzheimer's, brain cells degenerate and die, causing a steady decline in memory and mental function.

Current medications and management strategies for Alzheimer’s may improve symptoms temporarily.  These strategies can help those suffering from the disease by maximizing function and maintaining independence a little while longer!  Because there's no cure for Alzheimer's, it's important to seek supportive services and establish a support network as early as possible. 

Investigators have found that healthy living is a person's best defense against dementia.   Eating right, exercise, early recognition and treatment of health problems such as high blood pressure and remaining socially active have aided in slowing the progression of the disease. 

Symptoms

I had first-hand knowledge of Alzheimer’s through a friend and neighbor.  At first we laughed and ignored the incidents where he “took a wrong turn,” to “I’m lost and don’t know where I am!”  Usually, the frequency of forgetfulness and mild confusion may be the only symptoms of Alzheimer's that you notice.  Or you may not recognize that anything is wrong, though changes are noticeable to family, close friends or co-workers.

But over time, the disease erases more memory, especially recent memories.  The rate at which symptoms worsen varies from person to person.  I saw my friend go from happy to see me, to only remembering my cookies, to no recognition over a 10 year period.   Brain changes associated with Alzheimer's disease lead to growing trouble with:

• Memory - Everyone has occasional memory lapses - lose track of your keys or forget someone’s name.  But with Alzheimer's, the memory persists and worsens, affecting your ability to function at work and at home.  People with Alzheimer's may:

1. Repeat statements and questions over and over, not realizing that they've asked the question before
2. Forget conversations, appointments or events, and not remember them later
3. Routinely misplace possessions, often putting them in illogical locations
4. Get lost in familiar places
5. Eventually forget the names of family members and everyday objects
6. Have trouble finding the right words to identify objects, express thoughts or take part in conversations

• Changes in personality and behavior - Brain changes that occur in Alzheimer's can affect the way you act and how you feel. People with Alzheimer's may experience:

1. Depression
2. Apathy
3. Social withdrawal
4. Mood swings
5. Distrust in others
6. Irritability and aggressiveness
7. Changes in sleeping habits
8. Wandering
9. Loss of inhibitions

10.Delusions, such as believing something has been stolen

• A person with Alzheimer's may not be able to:

1. Communicate that he or she is experiencing pain — for example, from a dental problem
2. Report symptoms of another illness
3. Follow a prescribed treatment plan
4. Notice or describe medication side effects

Many important skills are not lost until very late in the disease, which include the ability to read, dance and sing, enjoy old music, engage in crafts and hobbies, tell stories, and reminisce.  This is because information, skills and habits learned early in life are among the last abilities to be lost as the disease progresses; the part of the brain that stores this information tends to be affected in later stages. 

As Alzheimer's disease progresses to its last stages, brain changes begin to affect physical functions, such as swallowing, balance, and bowel and bladder control. These effects can increase vulnerability to additional health problems such as:

• Inhaling food or liquid into the lungs (aspiration)
• Pneumonia and other infections
• Falls
• Fractures
• Bedsores
• Malnutrition or dehydration

Causes

Scientists believe that for most people, Alzheimer's disease is caused by a combination of genetic, lifestyle and environmental factors affecting the brain over time.  Alzheimer's is caused by specific genetic changes that virtually guarantee a person will develop the disease less than 5 percent of the time.  Although Alzheimer's isn’t fully understood, its effect on the brain is clear. Alzheimer's damages and kills brain cells - fewer cells and fewer connections among surviving cells leads to significant brain shrinkage.

Under the microscope, there are two types of abnormalities: that are considered hallmarks of the disease:

• Plaques - Clumps of a protein or beta-amyloid on the outside of brain cells may damage and destroy these cells by interfering with cell-to-cell communication.   

• Tangles - In Alzheimer's, threads of the tau protein twist into tangles inside brain cells. The “tangles” lead to failure of the transport system to carry nutrients and other essential materials throughout.  This failure is also strongly implicated in the decline and death of brain cells.

Risk factors

• Age - Alzheimer's is not a part of normal aging, but your risk increases greatly after you reach age 65.  The rate of dementia doubles every decade after age 60.  Those with rare genetic links begin experiencing symptoms as early as their 30s.
• Family history and genetics - The risk of developing Alzheimer's appears somewhat higher if a parent or sibling has the disease.  Most genetic mechanisms of Alzheimer's among families remain largely unexplained.
• Down syndrome - Signs and symptoms tend to appear 10 to 20 years earlier in people with Down syndrome.  A gene in the extra chromosome that causes Down syndrome significantly increases the risk of Alzheimer's.
• Sex - Women seem to be more likely than are men to develop the disease, in part because they live longer.
• Past head trauma - People who've had a severe head trauma have a greater risk of Alzheimer's.   

Prevention, Lifestyle and Heart Health - Right now, there's no proven way to prevent Alzheimer's.  Some evidence suggests that the same factors that put you at risk of heart disease also may increase the chance that you'll develop Alzheimer's and vascular dementia. Examples include:

• Lack of exercise
• Obesity
• Smoking or exposure to secondhand smoke
• High blood pressure
• High blood cholesterol
• Poorly controlled type 2 diabetes

Nutrition

The Mediterranean diet — a way of eating that emphasizes fresh produce, healthy oils and foods low in saturated fat — can lower the risk of death from cardiovascular disease and stroke. This diet has also been associated with a reduced risk of Alzheimer's disease.  Keeping active — physically, mentally and socially — may make your life more enjoyable and may also help reduce the risk of Alzheimer's.

People with Alzheimer's may forget to eat, lose interest in preparing meals or not eat a healthy combination of foods. They may also forget to drink enough, leading to dehydration and constipation.

Alternatives????

• High-calorie, healthy shakes and smoothies.  You can supplement milkshakes with protein powders or use your blender to make smoothies featuring your favorite ingredients.
• Water, juice and other healthy beverages.  Try to ensure that a person with Alzheimer's drinks at least several full glasses of liquids every day.  Avoid caffeine, which can increase restlessness, interfere with sleep and trigger a frequent need to urinate.

Certain nutritional supplements are marketed as "medical foods" specifically to treat Alzheimer's disease.  The Food and Drug Administration (FDA) does not approve products marketed as medical foods.  

Treatment

• Drugs - Current medications for Alzheimer's help for a time with memory symptoms and other cognitive changes.  Two types of drugs are currently used to treat cognitive symptoms:

1. Cholinesterase inhibitors. These drugs work by boosting levels of a cell-to-cell communication, providing a neurotransmitter or acetylcholine, which has been depleted in the brain by Alzheimer's.  The improvement is modest but can also improve symptoms of agitation or depression.  Commonly prescribed cholinesterase inhibitors:  

• donepezil (Aricept),
• alantamine (Razadyne)
• rivastigmine (Exelon).

Side effects include: diarrhea, nausea, loss of appetite and sleep disturbances. In people with cardiac conduction disorders, serious side effects may include a slow heart rate and heart block.

2.  Memantine or Namenda.  Works in an alternate brain cell communication network and slows the progression of symptoms with moderate to severe cases of Alzheimer's.  It's sometimes used in combination with a cholinesterase inhibitor.

Side effects include constipation, dizziness and headache.

3.  Sometimes antidepressants are used to help control the behavioral symptoms.   Anti-anxiety medications — clonazepam (Klonopin) and lorazepam (Ativan) — increase the risk of falls, confusion and dizziness.

Natural Remedies to Promote Brain Health

Healthy Fats

Believe it or not, your brain’s fat content is as much as 60%!  The brain needs quality fats to work well.  Omega 3’s appear to be helpful in preventing Alzheimer’s disease.⁸  Diets low in fat or high in saturated fats are not providing the essential fatty acids needed for proper brain function and maintenance.  Some good fats and good fat sources include:

• Coconut Oil
• Olive Oil
• Chia Seeds
• Fish
• Nuts
• Eggs

You have to “nourishing your body - all of you.”  Eat a variety of whole foods from a variety of food groups.  Try to limit processed foods, white flour and sugar – which do not provide nutrition to your body.

• Vitamin C - is critical for countless processes in the body.  It is difficult to get adequate vitamin C from food sources.  The body will often utilize much larger amounts of vitamin C when sick or stressed.  As part of your routine, vitamin C will also support your immune health and joint function.
• Cayenne - pepper increases blood circulation, allowing more oxygen and nutrients to get to the brain and other areas of the body.  Cayenne helps to regulate blood glucose and also be an important element in cognitive function.¹⁰
• Niacin - Niacin, B3, is a necessary water soluble vitamin that supports the health of the nervous system.  B3 deficiency can cause pellagra, which dementia is a symptom of!   Dietary sources of niacin include liver, chicken, turkey, tuna, cottage cheese, peanuts, almonds, lentils, and sunflower seeds.
• Exercise - Even light exercise has a positive effect on the brain.  First, it is good for your mood and attitude.  Secondly, it increases blood flow and oxygen levels to the entire body, especially the brain.

Herbs for improving brain health

Traditional medicine from many cultures incorporates herbs for all kinds of ailments, including memory and learning troubles. These natural brain power builders and memory boosting supplements are worth trying, so why depend solely on prescription medications or over-the-counter pills and capsules if natural herbs can provide better results or are less invasive!

Herbs for boosting brain power and stopping memory loss

• Sage - is a member of the mint family and a known memory enhancer. It has been suggested that it works by protecting acetylcholine, a chemical messenger in the brain critical to memory.  Sage is also delicious in your diet - try it on roast chicken, pork, in tomato sauce, squash, and scrambled eggs.  Or a therapeutic “cuppa” tea - steeping two teaspoons of dried sage in a cup of boiled water. Strong and powerful!
• Wasabi - the hot, green condiment served alongside your favorite sushi.  This tasty member of the mustard family that temporarily clears the sinuses!  It’s an excellent source of a compound that aids nerve cells grow healthy extensions or dendrites and axons – helping cells communicate and boosting brain connections, empowering memory and other functions.
• Garlic - a healing-herb that is great for circulation and cholesterol.  This herb from the onion family is one of the main herbs for improving brain health. Get the most benefit from your garlic by peeling and exposing it to open air for about 15 minutes, to release the healing compounds.
• Turmeric - In India, the risk of memory loss common in seniors is 25 percent lower than the risk to seniors in the United States.   Turmeric is an antioxidant and a powerful anti-inflammatory.

Knowing how to boost your brain power just got a lot simpler - a sharper, healthier mind is as close as your spice rack and herb garden.  Fresh, dried, raw, sautéed or steeped, herbs are nature’s medicine cabinet.  Combine these tops herbs with other healthy foods for brain health, like fish, nuts and fresh fruits and vegetables, and you’ll be able to list all 50 states in America and their capitals!

Diagnosis

There's no specific test today that confirms you have Alzheimer's.  Doctors can almost determine whether you have dementia or if dementia is due to Alzheimer's.  Alzheimer's can be diagnosed with accuracy only after death, when microscopic examination of the brain reveals the characteristic plaques and tangles. 

To help distinguish Alzheimer's disease from other causes of memory loss, doctors now typically rely on the following types of tests.

• Physical and neurological exam - Your doctor will perform a physical exam to check your overall neurological health by testing your:

1.  Reflexes
2.  Muscle tone and strength
3. Ability to get up from a chair and walk across the room

4.  Sense of sight and hearing

5.  Coordination

6.  Balance

• Lab tests - help rule out other potential causes of memory loss and confusion, such as thyroid disorders or vitamin deficiencies.
• Brain imaging - are now used chiefly to pinpoint visible abnormalities related to conditions other than Alzheimer's such as strokes, trauma or tumors — that may cause cognitive change. New imaging applications used primarily in major medical centers or in clinical trials, enable doctors to detect specific brain changes caused by Alzheimer's.

Brain-imaging technologies include:

1. Magnetic resonance imaging (MRI). An MRI uses radio waves and a strong magnetic field to produce detailed images of your brain. MRIs are used to rule out other conditions that may account for or be adding to cognitive symptoms or to assess shrinkage in the brain.   
2. Computerized tomography (CT). A CT scan produces cross-sectional images used chiefly to rule out tumors, strokes and head injuries.
3. Positron emission tomography (PET). During a PET scan, you'll be injected in a vein with a low-level radioactive tracer. The tracer shows overall activity in various brain regions and also show which parts of the brain aren't functioning well.   
4. Cerebrospinal fluid. In special circumstances such as rapidly progressive dementia or very young onset dementia, a cerebrospinal fluid examination may be performed. The spinal fluid can be tested for biomarkers that indicate the likelihood of Alzheimer's.   

Future diagnostic tests

Researchers are working with doctors to develop new diagnostic tools to help definitively diagnose Alzheimer's.  Another goal is to detect the disease before it causes the symptoms.  New tools under investigation include:

• Additional approaches to brain imaging
• More-sensitive tests of mental abilities
• Measurement of key proteins or protein patterns in blood or spinal fluid (biomarkers)

Genetic testing generally isn't recommended for a routine Alzheimer's disease evaluation. The exception is people who have a history of early-onset Alzheimer's disease.  However, anyone with a family history of early Alzheimer's should consult with a genetic counselor to discuss the risks and benefits of genetic testing.

Creating a safe and supportive environment

Adapting to the needs of a person with Alzheimer's is an important part of any treatment plan. For someone with Alzheimer's, establishing and strengthening routine habits and minimizing memory-demanding tasks can make life much easier.

You can take these steps to support a person's sense of well-being and continued ability to function:

• Always keep keys, wallets, mobile phones and other valuables in the same place at home, so they don't become lost.
• Simplify your medication regimen to once-daily dosing with the help of your medical professional. 
• Arrange for your finances to be on automatic payment and automatic deposit.
• Develop the habit of carrying a cell phone with GPS capabilities which aid if calling in case you become lost or confused and your location can be tacked
• Program medications, doctor’s info, important contacts and phone numbers into your phone, so you don't have to try to recall them.
• Make sure regular appointments are on the same day at the same time as much as possible.
• Use a calendar or whiteboard in the home to track daily schedules. Get into the habit of checking off completed items as they are completed.
• Keep photographs and other meaningful objects around the house.
• Remove excess furniture, clutter and throw rugs.
• Install sturdy handrails on stairways and in bathrooms.
• Ensure that shoes and slippers are comfortable and provide good traction

Always check with your doctor before taking any new medications.

• https://www.webmd.com/alzheimers/news/20171218/theres-still-no-proven-way-to-prevent-alzheimers
• https://www.webmd.com/alzheimers/guide/early-warning-signs-when-to-call-the-doctor-about-alzheimers#1
• https://www.webmd.com/alzheimers/guide/alzheimers-maintaining-normal-life#1
• https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447
• https://www.earthclinic.com/cures/alzheimers-disease-dementia-treatment3.html#ves
• https://www.belmarrahealth.com