The Dreaded AD

Alzheimer’s Disease is not a happy subject, nor one that is specifically Cape Ann focused, but is one that has, is now, or may one day effect many GMG contributors and readers, personally or through a loved one.

My mother, who is a very young, healthy and still beautiful 82 year old, has been suffering from increasing memory loss for a couple of years, and has been on Donepezil for almost a year, with little noticeable affect.  Recently she took a sudden, severe and alarming cognitive nosedive which has resulted in my spending more time at her house attempting to get her back on a even keel and doing damage control on the chaos of paperwork, bills not paid, and other alarming developments that occurred very rapidly.  While going through and organizing papers and her surroundings, I have been coming across a lot of the old photos and history that you have been seeing me share on the blog recently.

Over the past year, I have been researching Alzheimer’s, memory and brain health in general.  I wanted to share some of what I have learned in case it might be beneficial to someone else in a similar situation, now or in the future.  Also, if anyone has other helpful information to share from their own experiences, it would be most welcome.   

For those who don’t know, Dementia is a loss of brain function that occurs with certain diseases.  It is not a normal symptom of aging, as I had long thought.  Alzheimer’s disease (AD) is one form of dementia that gradually gets worse over time and affects memory, thinking, and behavior.  While AD is the 6^th leading cause of death in the US, living with the disease is the more devastating aspect of it, both for the sufferers and their families and loved ones.

Dementia symptoms usually first appear as forgetfulness, and include difficulty with many areas of mental function, including: Emotional behavior or personality, Language, Memory, Perception, Thinking and judgment (cognitive skills).

Mild cognitive impairment (“MCI”) is the stage between normal forgetfulness due to aging, and the development of AD. People with MCI have mild problems with thinking and memory that do not interfere with everyday activities. They are often aware of their forgetfulness, and not everyone with MCI develops AD.  Symptoms of MCI include:  Difficulty performing more than one task at a time, difficulty solving problems, forgetting recent events or conversations, and taking longer to perform more difficult activities.

The early symptoms of AD can include:

• Difficulty performing tasks that take some thought, but used to come easily, such as balancing a checkbook, playing complex games (such as bridge), and learning new information or routines
• Getting lost on familiar routes
• Language problems, such as trouble finding the name of familiar objects
• Losing interest in things previously enjoyed
• Misplacing items
• Personality changes and loss of social skills

Although there is no proven way to prevent AD, there are some practices that may be worth incorporating into your daily routine, particularly if you have a family history of dementia. Talk to your doctor about any of these approaches, especially those that involve taking a medication or supplements.

• Consume a low-fat diet.
• Eat cold-water fish (like tuna, salmon, and mackerel) rich in omega-3 fatty acids, at least 2 to 3 times per week.
• Reduce your intake of linoleic acid found in margarine, butter, and dairy products.
• Increase antioxidants like carotenoids, vitamin E, and vitamin C by eating plenty of dark colored fruits and vegetables.
• Maintain a normal blood pressure.
• Stay mentally and socially active throughout your life.
• Consider taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin), sulindac (Clinoril), orindomethacin (Indocin). Statin drugs, a class of medications normally used for high cholesterol, may help lower your risk of AD. Talk to your doctor about the pros and cons of using these medications for prevention.

Nutritional Therapy for Alzheimer’s Disease

Nutritional therapists use diet to deter Alzheimer’s disease in susceptible people. Many practitioners now believe that certain nutritional deficiencies or excesses may actually trigger the disease. For example, free radicals, compounds in the body that can damage tissues and quicken the aging process, have been linked to the progression of the disease. Antioxidants have the ability to neutralize free radicals and are, therefore, typically recommended as preventive measures. Nutrients that are antioxidants or help in the antioxidant process include Beta-carotene, Vitamins C and E and Selenium.

Good food sources of beta-carotene include apricots, carrots, spinach and sweet potatoes. Vitamin C is found in broccoli, grapefruits, oranges and strawberries, and vitamin E is available from nuts and vegetable oils (coconut oil is especially good, as well as virgin olive oil as they are low in pro inflammatory Omega 6 – avoid sunflower, soy, cottonseed and corn oils which are the highest Omega 6 oils). Selenium is found in brewer’s yeast, cabbage, fish, liver and whole-grain cereals (although watch out for gluten). Supplements may also be prescribed to supply antioxidants, especially in the case of vitamin E, which has high-fat food sources.

Some supplements may actually be useful for slowing the progression of the disease. Phosphatidyl choline (also contained in eggs, soybeans, mustard, sunflower, and other foods) enhances the production of the neurotransmitter acetylcholine which is important for memory and other bodily functions. Acetylcholine-transmitting neurons and their target nerve cells are the most frequently affected part of the brain in Alzheimer’s disease. N-Acetyl-l-carnitine also appears to protect neurons in a similar manner. Phosphatidyl serine can enhance neural functioning significantly by normalizing cell membrane fluidity.

People with Alzheimer’s disease are frequently deficient in vitamin B12, vitamin B6, and folate. Adding these can also be preventive measures. Vitamin B12 deficiency is often associated with depression, confusion, neurologic problems and memory loss. Folate deficiency can also cause these symptoms, and deficiency of vitamin B6 is associated with a decline in the number of receptors in the brain for the neurotransmitter dopamine. All of these symptoms of deficiency seem to parallel the major symptoms of Alzheimer’s-related brain dysfunction.  Other helpful supplements include Zinc, Niacin and Coenzyme Q10.

I recently caught Dr. David Perlmutter’s show “Brainchange” on PBS and was interested in his findings and the treatments he is using with his Alzheimer’s, ADHD and Parkinson’s patients which involves removing gluten and sugar from their diets.  To learn more about the dangers of gluten to your brain, visit http://www.drperlmutter.com/eat/list-of-gluten-free-foods/ or if you have a chance, watch him and the show “Brainchange” on PBS.  This is not just for people with AD, but for all of us who want to do whatever we can now to prevent it and other neurological disorders in ourselves down the road.  I was alarmed to find out that AD can begin developing in our brains 20 or more years before symptoms appear – a good reason for people of all ages to follow a brain healthy diet and lifestyle.

In addition to a brain healthy diet, regular physical exercise is critical, as is an active social life.  As with other parts of our bodies, the adage “use it or lose it” applies equally to our brains, so learning new things and challenging your mind are important.  Contrary to popular belief, recent studies have determined that crossword puzzles do not improve cognitive function.  Of course, keep doing them if you enjoy them, as they may help with a brain function called fluency, or word finding, if you do ones that are challenging.

I am in the process of organizing my mother’s home (creating files and folders for the mounds of papers and photos, getting clothes hung and put away – color coordinated to make it easier for her to find things that go together, and throwing out things that are broken and of no value to anyone); have started preparing and bringing her brain healthy foods (and eating them myself) and getting rid of nutritionally bad things in her refrigerator and pantry.  I have gotten her to start keeping a memory journal to write down the flood of incredibly detailed old memories that seem to be crowding out what she did this morning or yesterday; and taken her kicking and screaming (slight exaggeration) to the Senior Center where they have great exercise and other classes, nice people and functions to get her more socially active (yes, mom, with all those “Old People”).  In a couple of weeks we go to her Neurologist to update him on what has happened and see about getting a brain scan and other tests done, in case there is something else going on that is causing her rapid decline.

Other than that, I don’t know what to do, except pray, listen and watch, keep researching and enjoy the time I am able to spend with her, hearing old stories and learning her history and the history of our family that I never paid much attention to when I was younger.  I realize I am blessed to be able to have this time with her.  Not everyone gets that opportunity.

E.J. Lefavour