The Myth of Alzheimers

The Myth of Alzheimers: What You Aren't Being Told About Today's Most Dreaded Diagnosis
Peter J. Whitehouse, M.D., Ph.D, with Daniel George, M.Sc.
St. Martin's Griffin, New York, 2008

Peter J. Whitehouse is a respected neurologist with over 30 years experience in the relevant field.

The Website for the book. 

Amazon Link.

This text takes a courageous stand. I appreciate the central thrust of their argument but also believe they have somewhat overstated their case. Nonetheless this text offers some valuable insights into what is wrong with so much media reporting about dementia and helps us understand why the concept of a cure of alzheimer's is predicated upon faulty assumptions concerning the causes and nature of the condition.

It is pleasing to note that the authors are quite upfront and acknowledge that loss of cognitive function is inevitable with age. There is far too much nonsense out there which purports to provide strategies so that we can have a timeless mind that does not age. Such claims are errant nonsense peddled by the either the naive or dishonest who are more interested in selling books than being honest to the truth about aging. My typical response to people who make such claims is this:

You say you can halt brain aging. Tell me, could you run as fast as when you were 20 years old? Can you recover from sleep deprivation or a night out partying as quickly as when you were 20 years old? The brain is the most vulnerable organ in our bodies yet you expect me to believe that  with your greying and receding hair, your reading glasses, your creaking joints and liver spots, your spider veins and botox manipulated forehead, you have managed to protect your brain from the effects of aging. I suggest that to entertain such a fallacy is evidence to the contrary.

Alzheimers - Prevention is Better than Cure

This news article highlights the problem of treating dementias. The relevant article from Nature can be found here.

Prevention is always better than cure. In relation to dementias it is now clear that years, if not decades, before symptoms arise a neurodegenerative process has been in play. As noted at the top of the news release, once alzheimers is established there probably is never going to be a cure. We may be able to forestall progression of pathology but that is all we will be able to do.

While it is tempting to think that alzheimers is all about the brain we must remember that the brain functions within a body. Our overall health is fundamental to cerebral health. Due to my lack of reading lately I can't be sure about all the relevant factors but the below list will serve as a useful guide:

• There has been a longstanding relationship between cardiovascular health and cerebral health. Maintaining good cardiovascular health is absolutely essential in addressing dementia. This appears to be particularly true for cholesterol and triglyceride levels. Keep check of these levels. Note however that for people over 60 there is evidence to suggest that slightly higher cholesterol levels are protective for the brain. Only slightly higher, the safer bet probably being higher but still within normal ranges.
• Immunological status is very important. Preventing excessive inflammation is very important for protecting the brain because systemic inflammations plays a cardinal role in promoting dementias. Diet is very important here, as is adequate vitamin D intake. Because many people lose the ability to manufacture vitamin D with age, and because dietary sources are usually of low quantities, supplementation is often a good idea. Before going down that road though have your vitamin D status checked. If it is low start taking supplements.
• Do not let low level infections linger. These promote systemic inflammation.
• Maintain oral health. Poor oral health is not only a risk factor for dementias but also heart disease. Again, systemic inflammation can arise from poor oral health.
• Maintain a appropriate fat intake. Keep the balance right. Avoid trans fats at all costs. Eat fish on a regular basis, watch your omega 3 - omega 6 balance because the modern diet tends to have too much omega 6 and too little omega 3, this promotes inflammatory mediators because omega 6 fats promote the generation of inflammatory prostaglandins while omega 3's promote anti-inflammatory prostaglandins. It is very important to cook fish the right way - baked or broiled, grilled and fried fish may actually promote dementias and heart disease because the high temperatures oxidize the fats.
• Be very careful about sugar rich foods. Sugar in strict moderation is fine but many processed foods are loaded with too much sugar. Popular carbonated drinks are sugar laden and should not be consumed as a habit.

Marijuana and Dementia

Over the years there have been multiple studies indicating the potential of cannabinoids across a wide range of conditions. This latest study provides further weight as to the therapeutic potential of cannabinoids. It is high time that the public was made aware of the considerable therapeutic potential of these compounds. As for the psychosis\schizophrenia risk, that has been too much overblown and the risk is virtually negligible post 21 years of age. The reasons for this therapeutic potential are:

• The two principal cannabinoids, THC and cannabidiol, have very strong antioxidant capacity.
• These two compounds are lipophilic, that is lipid soluble, hence will remain in the body for extended periods. For pot smokers, typical wash out periods are 90% after one week, though this can greatly vary.
• Both of these compounds target specific receptors. THC will target CB1 and to a lesser extent CB2(controversial), while cannabidiol is very specific for CB2 and hence is non-psychoactive.
• Both compounds will bind to the anion site of ACHe, an enzyme that breaks down acetylcholine. This neurotransmitter is markedly reduced in some dementias, particularly Alzheimers.
• ACHe is also strongly implicated in amyloid production, both cannabinoids reduce the production of amyloid, an early step in Alzheimers because this production seems contingent on the anion site.
• Activation of the CB2 receptor limits the expression of pro-inflammatory cytokines, excess production of these cytokines being implicated in everything from atherosclerosis to cancer to dementia.