Thursday, February 10, 2011

When Your Brain Has Left the Building

We Americans seem to have an abundance of things to worry about.There is the threat of another attack from crazed, fanatical terrorists looming in our collective psyches, as is the current downward trend in the economy.But there is another threat even more imminent that is facing many of those in the baby boomer generation.That threat is Alzheimer’s disease (AD). The incidence of AD is expected to rise in the coming years as baby boomers get older and approach age 65, when the incidence of AD commonly begins. Some studies suggest that one out of 85 people will have AD in 2050. Clearly, this is an alarming statistic that calls for some action to be taken now. This serious threat has not escaped the notice of researchers around the world, who are working overtime to come up with solutions to the impending threat of epidemic AD. Just two days ago, a consensus report was issued by a blue ribbon gathering of scientists who convened at the National Institute of Health for two days. The report examined all methods suggested to prevent the onset of AD, but before I discuss what they found, it’s probably a good idea to discuss what AD is.

AD was first described by German physician, Alois Alzhemier in 1906, based on his post-mortem examination of a female patient who had been showing various mental symptoms, including memory loss, language problems, and unpredictable behavior. His autopsy examination of her brain revealed abnormal protein clumps, later called beta amyloid plaques, along with tangles of another brain protein, later called tau. These two abnormalities became the basis of AD.The incidence of AD has risen over the years, to the extent that it now constitutes 60 to 80 percent of all dementia cases. It’s estimated that 5.3 million Americans suffer from AD,  and it’s  the sixth leading cause of death in the U.S, and the fifth leading cause of death in people over age 65. The greatest risk  factor for AD is age, with the majority of cases showing up after age 65, although there is a version that strikes younger people, which is far more rare.

The blue ribbon science panel looked at randomized, controlled trials of various factors thought to be related to AD prevention. They noted that having the apolipoprotein A4 gene increases your likelihood of acquiring AD, although it doesn’t mean that the disease is inevitable. Not mentioned in the report is the fact that undergoing head trauma, as occurs in various sports, such as boxing and mixed marital arts, is especially dangerous for those with the APOA4 genes in relation to the development of AD. Other health factors related to AD onset include long-term high blood pressure, diabetes (or more specifically, high resting insulin levels) , and having elevated blood cholesterol readings in middle age.While various nutrients have been suggested as protective against AD onset, according to the report, ingesting many of these suggested protective nutrients, including fish oil, and B-complex vitamins including folic acid, shows limited evidence of efficacy because some studies show beneficial effects, while others do not. There is also limited evidence for a diet that is low in saturated fat and rich in vegetable intake. They do suggest that preliminary evidence points to exercise as being protective in the preservation of cognitive (thinking) ability.

So what they are saying in essence is that there in no definitive evidence that any of the suggested methods to prevent AD will help prevent the disease. But nearly all the studies they base this assertion on lasted no longer than two years, and AD is a process that likely takes many years before it becomes evident. Thus, studying preventive techniques for only two years or less will not yield any definitive results. But there is abundant evidence that AD has a large inflammatory component, and  may even be the underlying basis of the disease. As such, techniques that lower brain inflammation should offer preventive effects against AD onset. One way to do this is to avoid obesity, especially beginning at about age 40. Exercise lowers inflammation, as does consuming diets rich in such protective factors as antioxidants. One study found that eating a Mediterranean-style diet that is low in saturated fat, but rich in antioxidants, leads to a 40% decreased risk of AD. Preliminary evidence shows that DHA, one of the omega-3 fatty acids, prevents the accumulation of beta amyloid protein in the brain that is the hallmark of AD. Curcumin from turmeric has been shown to not only prevent beta amyloid accumulation in the brain, but also seems to help remove it through activating certain immune system components. Even drinking 5-6 cups of coffee daily significantly lowers AD risk because of the antioxidant effect of compounds found in coffee. The same holds true for green tea, and one study showed that the antioxidants in green tea can reduce AD risk by 78%. One of the most important things you can do to prevent AD is to maintain cardiovascular health, since this is related to the activity of the APO-A4 genes found to be a risk factor for AD development. Exercise and maintaining healthy blood pressure levels will also prevent the other type of primary dementia, vascular dementia, which looks a lot like AD. Nicotinamide, a B-complex vitamin, can significantly lower levels of the Tau protein that forms the basis of the nerve tangles of AD, as can an increase in heat shock protein 70, which is increased by exercise. Exercise also increases levels of brain-derived neurotropic factor, which can repair damaged neurons in the brain.

So although the consensus report issued by the NIH panel offers a rather bleak perspective on AD prevention, the thing to remember is that these conclusions are based on the “scientific method.” In short, this means that nothing is accepted in science until results have been replicated numerous times by different scientists or researchers. This could take decades before it’s completely accepted as scientific gospel. In the meantime, I suggest it would be prudent not to wait for definitive scientific consensus, but rather adapt some of the preliminary preventive techniques mentioned above,since at least they will improve total health, and you can’t go wrong with that.

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