Dementia is described as an anatomically caused, progressive degeneration of memory and intelligence that causes problems in family life or at work. Fifty percent of all cases of dementia are classified as Alzheimer’s Disease. Alzheimer’s is described as a degeneration with loss of brain cells in the cerebral cortex and frontal lobe. Dementia can be caused by severe or repetitive trauma to the brain, brain tumors, and other diseases. Alzheimer’s affects about fifteen percent of the population over sixty-five, with five percent being severe. The incidence of Alzheimer’s seems to be on the rise. Alzheimer’s is expected to increase due to the aging of our population. As well, a high percent of AIDS patients in late stages develop Alzheimer’s dementia. In Alzheimer’s, there is an entanglement of the nerves with a shrinkage of the brain and a decrease in the production of Acetylcholine. Acetylcholine is one of the neurotransmitters, which are chemicals in the brain that communicate from one nerve cell to another. This is the basis for the loss of memory, which is the first symptom to appear in Alzheimer’s Disease. Recent memory fades first, then long-term memory. Forgetfulness and apathy also occur. Alzheimer’s Disease progresses over five-to-ten years to become totally incapacitating. Normal personality traits are lost or changed. Paranoia, anxiety and depression are common. Patients with Alzheimer’s have difficulty acquiring new skills.
The diagnosis of Alzheimer’s Disease is made on the basis of history, physical exam, and diagnostic studies. A history from the patient’s family is very important in establishing a diagnosis, and can be very helpful in the early stages. Physical examination, as well as tests of memory and cognitive function, assist in making a diagnosis. Blood tests are used to rule out reversible causes of dementia such as B-12 deficiency, hypothyroidism, and syphylis. These reversible causes of Dementia are referred to as pseudo-dementia. EEG’s and Imaging studies are also used.
Other causes of Dementia are common in the elderly, such as overmedicating with over the counter or prescription drugs and nutritional deficiencies.. Depression, which is common in the elderly, can mimic Alzheimer’s, and a psychiatric evaluation will sometimes be necessary.
The exact cause of Alzheimer’s Disease is unknown, but several theories have been put forth:
- A Viral etiology
- An Auto-immune etiology.
- An abnormality in the utilization of aluminum.
- A Genetic etiology.
A sudden emotional or stressful event, such as the loss of a spouse or pet, can cause an exacerbation of this Alzheimer’s.
Some studies point to oxidative damage playing a factor in Alzheimer’s. Studies also show a slowing of the progression of Alzheimer’s with the use of antioxidants, in a fashion similar to other degenerative conditions, cardiovascular disease, and some cancers. On the basis of this information, we recommend for patients with Alzheimer’s Disease supplementation with antioxidants such as Vitamin C, Vitamin E, selenium, grape seed extract, isoflavones, and green tea extract. Vitamin B-1, or thiamine, and Vitamin B-12, or cyanocobalamin, have been found to play a role in Alzheimer’s disease and dementia. Deficiencies of these two B Vitamins are common, and blood levels can be measured. A B-12 deficiency can cause depression, which can mimick Alzheimer’s, and studies have shown that supplementation with B-12 has been shown to improve the symptoms of Alzheimer’s, more so in early stage disease. On this basis, we recommend for patients with Alzheimer’s Disease supplementation with B-12, B-1, and folic acid. Because of the need for zinc in the utilization of these B vitamins, and because a zinc deficiency is common in the elderly, supplementation with zinc is also recommended.
There are several other chemicals that have been found to be of benefit in the treatment of depression and cognitive dysfunction.
S-Adenosylmethionine, or SAM, is used in the formation of neurotransmitters in the brain, and a deficiency of SAM can result in an imbalance of neurotransmitters, which ultimately govern brain function Supplementation with SAM has been shown to benefit patients with depression and cognitive dysfunction.
L-Acetylcarnitine is a chemical that acts in the brain as an antioxidant, stabilizes cell membranes, and improves energy production. Studies have shown that supplementation with L-Acetylcarnitine delays the progression of Alzheimer’s disease and improves memory and cognitive function. It is also helpful in elderly patients with non-Alzheimers’s memory impairment .
DHEA (dehydroepiandrosterone) is a chemical present in high amounts in our body, and it serves as a precursor to all steroid hormones. As such, its function seems to be to be to supply the building blocks to maintain optimal levels of hormones that regulate all bodily functions, including the functions of the brain. Levels of DHEA have been found to drop with age, and such a drop has been linked to a variety of age-related conditions, including declining memory and thinking. Studies have shown that supplementation with DHEA can retard or reverse these declines in mental function.
Ginkgo biloba, and herb, has been extensively studied in the treatment od Alzheimer’s Disease. Multiple studies, including some published in the JAMA, demonstrate improvement in the functional capacity of the brain, and to slow the mental deterioration seen in the disease. It seems to be effective only for patients in the early stages of decline, however. In addition to Alzheimer’s Disease, Ginkgo has also demonstrated effectiveness in the mental deficit seen in vascular insufficiency and depression.
Huperzine-A, an herb used in China, in known to inhibit acetylcholinesterase, the enzyme that breaks down the neurotransmitter acetylcholine. Studies of patients with dementia show its use to be associated with improvement in measures of cognitive function, memory, and behavior.