Focusing on Alzheimer’s & Dementia Integrative Care

By Sarah A LoBisco, ND

The Facts

According to the Alzheimer’s Association:

“Dementia” is an umbrella term describing a variety of diseases and conditions that develop when nerve cells in the brain die or no longer function normally. The death or malfunction of these nerve cells, called neurons, causes changes in one’s memory, behavior and ability to think clearly. In Alzheimer’s disease, these brain changes eventually impair an individual’s ability to carry out such basic bodily functions as walking and swallowing. Alzheimer’s disease is ultimately fatal.”

There are eight main types of dementia, with Alzheimer’s being the most common at a prevalence of 60-80%.

The following is an overview of these 8 categories of dementia:

1. Alzheimer’s  Disease –

Currently, the diagnosis of Alzheimer’s disease has updated criteria from the 1984 clinical guidelines, which was solely based on a physician’s clinical judgment. Formally, practitioners would base their conclusions through the integration of a comprehensive patient history, cognitive tests, and a general neurological assessment.

The new criterion now incorporates specific biomarkers which may occur up to 20 years prior to any symptoms of memory loss. The two pathological biomarkers are (1) beta-amyloid accumulation in the brain and (2) damage, degeneration, or injury to nerve cells.

Symptoms of Alzheimer’s include changes in memory and affect. These changes progress to changes in behavior, impaired judgment, disorientation, and difficulty speaking, swallowing, and/or walking.

Due to these recent changes in criterion,  Alzheimer’s disease progression has an updated staging  system based on three categories: (1) preclinical Alzheimer’s disease (which demonstrates changes in the structure of the brain prior to symptoms) (2) mild cognitive impairment (MCI) due to Alzheimer’s disease and (3) dementia due to Alzheimer’s disease.

2. Vascular Dementia-

Changes in brain function resulting from head injuries which create microscopic bleeding and blood vessel blockage to various portions of the brain.

3. Parkinson’s Disease-

Dementia caused from aggregates formed in the brain (alpha-synuclein) affecting dopamine production in the substantia nigra.  Movement disorders are the most common manifestations of this disease.

4. Dementia with Lewy bodies (DLB)-

Dementia as a result of Lewy bodies (protein aggregates of alpha-synuclein) accumulation in the brain. The aggregates appear in a pattern that is different from Parkinson’s Disease.

5. Mixed Dementia- A combination of Alzheimer’s with another form of Dementia.

6. Frontotemporal lobar degeneration (FTLD)-

FTLD is the result of damage to front and side regions of the brain with nerve damage resulting.  This classification includes behavioral variant FTLD, primary progressive aphasia, Pick’s disease, and progressive supranuclear palsy.

FTLD has similar characteristics of Alzheimer’s but symptoms occur at a younger age.

7. Creutzfeldt-Jakob disease–

This brain pathology is due to an infection in the folding of proteins as a result of ingestion of prion consumption in affected cattle

8. Normal pressure hydrocephalus –

Dementia resulting from abnormal buildup of fluid in brain

Conventionally, treatment centers on active management and is reported to be helpful for some patients.

It includes:

 (1)Appropriate use of available treatment options,

(2)Effective management of coexisting conditions,

(3)Coordination of care among physicians, other health care professionals and lay caregivers

(4)Participation in activities and adult day care programs and

(5)Taking part in support groups and supportive services such as counseling.

The Stats

A Growing Trend

An increase in the number of adult caretakers to their parents is on the rise due to the aging baby boomer population. As this booming population is forced to watch their loved ones’ memory and cognition fall, the concern for a healthy working memory and brain is a major area of focus in this majority population.

Unfortunately, anxiety of caretakers will not be alleviated by viewing the updated statistics of Alzheimer’s disease:

• One in eight older Americans has Alzheimer’s disease.
• Alzheimer’s disease is the sixth-leading cause of death in the United States.
• Over 15 million Americans provide unpaid care for a person with Alzheimer’s or other dementias.
• Payments for care are estimated to be $200 Billion in 2012.
• The different ways in which dementia eventually ends in death can create ambiguity about the underlying cause of death. Severe dementia frequently causes such complications as immobility, swallowing disorders and malnutrition.
• Regardless of the cause of death, 61 percent of people with Alzheimer’s at age 70 are expected to die before age 80 compared with 30 percent of people at age 70 without Alzheimer’s.(91)

Now, the Good News!

Let’s shift our focus from fear to solution now. Everyone, take a breath.

True, currently, there is no conventional effective treatment to treat dementia; however, note the timing of symptoms is believed to occur up to 20 years AFTER changes occur in the brain. This means preventative medicine can play a huge role in optimizing brain health! J

The Brain’s making a Come Back!

Many of my readers by now are familiar with Dr. Amen’s work from my previous postings.

Recently, Dr. Mercola interviewed this functional psychiatrist, providing many with a sigh of relief that hope and function to a damaged brain can be restored!

This article summarized Dr. Amen’s viewpoint on brain health and gave integrative solutions to support mental function.

The article reads:

• Research has negated the outdated view that once you lose brain function, you cannot retrieve it. Studies into brain plasticity shows that this is not true, and that your brain can indeed recover, repair, and regain functionality that was previously lost
• Brain SPECT imaging looks at how your brain works, and can be a tremendously important tool to help diagnose psychiatric problems and help determine the most appropriate treatment plan
• Most cases of depression and anxiety are really symptoms of underlying brain dysfunction. For example, depression can arise if brain activity is too low or too high in your frontal lobes. A traumatic brain injury or toxic exposure can also result in symptoms of depression
• Compulsive disorders are typically associated with over-firing in your brain due to a deficit in the neurotransmitter serotonin. You can boost your serotonin levels naturally, using 5-HTP, L-tryptophan, St. John’s Wort, saffron, and exercise
• Impulsive disorders are typically associated with low activity in the prefrontal cortex, indicating you have trouble inhibiting your behavior. Boosting serotonin levels will worsen this lack of impulse control. Instead, impulsive disorders are best treated with dopamine-boosting strategies. Natural alternatives include green tea, L-tyrosine, and Rhodiola

Treating the Cause

Dr. Amen’s approach is focused on the connection between a healthy brain and an optimal, full functioning body.  It is very much in resonance with my training as an integrative and holistic practitioner.

The neat thing about functional medicine is the approach to any disorder or disease, including the brain, is based on treating the cause and viewing the whole person in a matrix of interactions. I have integrated Dr. Amen’s work with all my established patients and have found that supporting brain balance can ease the stress or lack of motivation when implementing lifestyle changes!

Digging Deeper

Currently, much conventional research for dementia treatment is focused on drugs that attempt to modulate inflammatory pathways.  For example, one population study found a correlation with those who used Non-steroidal Anti-Inflammatory Drugs (NSAIDs) and lower levels of dementia than the comparison population.

However, don’t go running to the store! The problem with this approach is that downstream effects of suppressing inflammation, without finding the cause, can cause damage downstream.  One study proved this when researchers linked the use of NSAIDs with an increased risk of cardiovascular disease!

Therefore, we need a new way to treat and protect the body and mind!

An Integrative Approach to Mind Health

Dr. Hyman’s recent blog on demonstrated how the label of dementia is treated differently based on the cause of the degeneration in one person and their unique brain.

He explains in his blog (bold emphasis is mine):

There is no effective known treatment for dementia. But we do know a lot about what affects brain function and brain aging: our nutrition, inflammation, environmental toxins, stress, exercise, and deficiencies of hormones, vitamins, and omega-3 fats.

It is not just one gene, but the interaction between many genes and the environment that puts someone at risk for a chronic disease such as dementia. And we know that many things affect how our genes function — our diet, vitamins and minerals, toxins, allergens, stress, lack of sleep and exercise, and more.

Even though no long-term studies have been done to look at treating dementia based on genes, there are so many scientific threads that weave together a picture of how and why our brains age and what genes are involved. This leads me back to George …

For this man, whose mind and life were evaporating, I looked deeply into his genes and the biochemistry his genes controlled and found places where we could improve things.

He had a gene called apo E4, which is a high-risk gene for Alzheimer’s disease(ii) and also made it hard for him to lower his cholesterol and detoxify mercury from his brain.(iii) He also had a version of a gene for detoxification of metals and other toxins (glutathione-S-transferase, or GST)(iv) that was very inefficient, making him accumulate more toxins over his lifetime. Having the combination of a problem with GST and apo E4 puts people at even more risk for dementia.(v),(vi) In another study, people with an absent GST gene were likely to have much higher levels of mercury.(vii)

George had another gene called MTHFR(viii) that made him require very high doses of folate to lower his blood levels of homocysteine, which is a substance very toxic to the brain. Lastly, he had a gene called CETP that caused his cholesterol to be high, which contributes to dementia. Combine this gene with the apo E4 gene and your risk of dementia goes way up.(ix)

So, My Dear Readers, There is Hope!

As Dr. Hyman’s blog demonstrated, there are various functional tests and holistic approaches that are now available to assist in maintaining healthy brain function throughout one’s life span! These methods are now being utilized by Naturopathic, Functional, and Integrative practitioners worldwide.

The approach is different in this holistic model. It is about evaluating the whole person, not just suppressing the resultant symptom of the disease. For example, a good practitioner would be digging to the various causes of the resultant inflammation, such as toxic exposure, diet, blood sugar, hormonal imbalances, and removing the stimulus WHILE providing solutions to assist in alleviating it!

I go into more details of various holistic mind support at Saratoga.com.

So, on to empower yourself with fun brain-boosting facts!

(And remember; use your oxygenating Young Living Essential Oils!)

References:

Alzheimer’s Association, 2012 Alzheimer’s Disease Facts and Figures, Alzheimer’s & Dementia, Volume 8, Issue 2. http://www.alz.org/downloads/facts_figures_2012.pdf

Mercola, J. Why Psychiatry Needs to Add Brain SPECT Imaging, Especially in Complex Cases. Mercola.com. 10/28/12. http://articles.mercola.com/sites/articles/archive/2012/10/28/psychiatry-needs-spect-imaging.aspx?e_cid=20121028_SNL_Art_1

Hyman, M. 9 Steps to Reverse Dementia and Memory Loss as You Age. Drhyman.com. 6/14/2010. http://drhyman.com/blog/conditions/9-steps-to-reverse-dementia-and-memory-loss-as-you-age-2/?utm_source=WhatCounts+Publicaster+Edition&utm_medium=email&utm_campaign=drhyman+newsletter+issue+%2397&utm_content=+Read+more

Walter F. Stewart, Claudia Kawas, Maria Corrada, & E. Jeffrey Metter. Risk of Alzheimer’s disease and duration of NSAID use (abstract). Neurology. 1997;48: 626-632. http://www.neurology.org/content/48/3/626.short

Anthony A. Bavry, Asma Khaliq,Yan Gong, Eileen M. Handberg, Rhonda M. Cooper-DeHoff, & Carl J. Pepine. Harmful Effects of NSAIDs among Patients with Hypertension and Coronary Artery Disease (abstract). The American Journal of Medicine. July 2011.124 (7): 614-620. Published online on May 19, 2011. http://www.amjmed.com/article/S0002-9343%2811%2900264-6/abstract

News and Updates:

1. Check out the wonderful health support tool of Sharecare!

Dr. Oz has done a superb job on bringing together various experts in conventional and integrative medicine. The result of this collaboration is a wonderful comprehensive viewpoint on health issues from all sides.

This link provides my latest answers: http://www.sharecare.com/user/sarah-lobisco

2. Read more about brain health solutions at the Living Well Blog

3. Listen to Women’s Health Topics on Dr. Northrup’s Weekly Hayhouse Radio Show

 4. Please Like me as “Dr. Sarah LoBisco” on Facebook. This page is being updated, along with this site. Watch it evolve in the coming holiday season.

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