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Thursday, Jan. 25, 2018 12:12 am

A program to prevent Alzheimer’s

The solution isn’t simple, and may require lifestyle changes. It’s far better than the usual prevention method – nothing.

Researchers have discovered there are 36 different factors that determine whether someone gets Alzheimer’s or whether the disease is prevented. Prevention advocates think of the problem as “36 holes in the roof.” Repairing just one “hole” doesn’t offer much chance of success, but neither do all of the “holes” have to be patched to prevent most potential damage from the leaky roof. Source: The End of Alzheimer’s, The First Program to Prevent and Reverse Cognitive Decline, by Dale E. Bredesen, M.D.
Dale E. Bredesen’s 2017 book, The End of Alzheimer’s, provides a new perspective on this debilitating and dreaded disease. Subtitled The First Program to Prevent and Reverse Cognitive Decline, the book includes stories of individuals with Alzheimer’s who have improved their cognitive function. The audience for this book includes those already suffering cognitive decline, individuals who carry the genetic marker for Alzheimer’s, and anyone over the age of 40.

In spite of the amount of money spent on research, no drug has been developed to prevent, cure or reverse Alzheimer’s. Bredesen is a research neurologist who has studied the disease for over 28 years. Through his extensive research, he has come to several conclusions:

• Alzheimer’s is not a single disease, but three subtypes.
• It can be prevented and cognitive decline reversed, especially when steps are taken early.
• There is no silver bullet, and multiple factors need to be considered and treated.

Bredesen says the three threats to cognitive decline are inflammation, shortage of brain-boosting nutrients and hormones, and toxic exposure. These reflect the three different types of Alzheimer’s, which is the result of the brain trying to respond. His premise is that multiple factors contribute to these threats, and there are substantial differences between the three different types of Alzheimer’s. Each needs to be addressed differently through a personalized plan.

Genetic testing is recommended to determine if you carry the gene variant ApoE4, which is the strongest known genetic factor for Alzheimer’s disease. Type 1, inflammatory Alzheimer’s, occurs more often in people who carry one or two ApoE4 alleles and runs in families. The number of ApoE4 alleles can also affect the age at which symptoms begin. People with two copies of ApoE4 have a risk factor over 50 percent; those with one copy of ApoE4 have a risk factor of 30 percent, and those with two copies of ApoE3 have a genetic risk of nine percent. Type 2, atrophic Alzheimer’s, occurs more frequently in people who carry the ApoE4 allele, but symptoms typically start later. Type 3, toxic Alzheimer’s, is more likely to occur in people with the common ApoE3 allele and does not run in families.

With no known prevention or treatment for Alzheimer’s, many people don’t want to know their ApoE status. However, Bredesen argues that there is now hope, and knowing your genetic status means that prevention strategies can be initiated long before symptoms develop, thus improving one’s prospects, reducing the risk and reversing cognitive decline

To date a major focus of Alzheimer’s research has been on amyloid plaque clogging spaces between brain neurons and potential medicines to target this. In contrast, Bredesen takes a more holistic approach. He says Alzheimer’s is “…caused by an imbalance between synapse-preserving and synapse-destroying processes.” He has identified 36 molecular factors that impact cognitive decline, which he compares to having “36 holes in the roof,” and attempting to fix just one will not solve the problem. Bredesen proposes measuring all of these at a level of detail that is typically not done. By measuring the many factors that affect cognition, the goal is to design a personalized plan to optimize all of these factors.

Just as individuals are advised to get a colonoscopy when they turn 50, he proposes taking a “cognoscopy.” Examples of what he proposes measuring include levels of homocysteine; vitamin B6, B12, C, D, E; insulin; hormones; metals; copper/zinc ratio; microbiomes; thiamine; sleep apnea; gastrointestinal permeability and inflammation. He explains how each of these factors contributes to decline in cognitive function. Furthermore, the analysis is focused on identifying the root cause of things like inflammation so that effective treatments can be defined.

High insulin and high glucose are two of the most important risk factors, so it is no surprise that diet is a critical part of the protocol. He calls sugar an “addictive poison,” noting that humans evolved to handle only a small amount of sugar in a daily diet. In contrast, the typical American diet is loaded with sugar, causing the body to produce insulin to lower the glucose level, ultimately leading to insulin resistance, which contributes to diabetes and also Alzheimer’s. The “anti-Alzheimer’s diet” is designed to switch metabolism from carbohydrate-burning and insulin resistance, which promotes Alzheimer’s disease, to fat-burning and insulin sensitive, which helps cognition. A low-carb diet, combined with moderate exercise and fasting for at least 12 hours between the last meal of the evening and first meal of the morning, is recommended.

Constant stress and lack of sleep are other risk factors, and the personalized treatment regime involves diet, exercise, sleep, stress reduction, nutrient and vitamin supplements, and other issues, all targeted at addressing the specific molecular factors that are not optimal. For example, by eliminating inflammation and reducing chronic infections and insulin resistance, threats are removed that otherwise would allow amyloid to accumulate.

“For the first time, hope and Alzheimer’s have come together,” says Bredesen. Anyone looking for a quick fix to address this insidious disease won’t find it in this book. If there were a quick fix, it would have been discovered by now. Instead, this book proposes a complex and individualized approach, based upon extensive measurements of 36 different factors affecting cognition. Effective treatment requires a personal commitment that involves lifestyle changes and ongoing monitoring, preferably before or early in the process of cognitive decline. “Drugs are the dessert, not the entrée,” says Bredesen. Although Alzheimer’s is considered the untreatable disease, over 200 patients are using Bredesen’s ReCODE (Reversal of Cognitive Decline) program with successful results.

Karen Ackerman Witter is a part-time freelance writer following her retirement from the State of Illinois. She was introduced to this book through a colleague in her Crossfit Instinct Longevity class, which is focused on healthy lifestyles through a combination of exercise and nutrition.

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