Back on the 8th April I wrote a blog on Alzheimer’s disease (AD).  Today we are starting a new series based to some extent on information provided by Peggy Sarlin and Lee Euler in a series entitled “Awakening from Alzheimer’s – Regain your brain” in which Peggy interviews a number of experts.  Other references are also used to fill out the details.

Depending upon which statistics you examine, Alzheimer’s disease is the 6th most common cause of death in the USA, preceded by cardiovascular disease and cancer.

It is a major contributor to morbidity (disease burden) and mortality.  It is also enormously expensive to treat when you consider the costs of care.

Much has changed in the last 10-15 years in the area of Alzheimer’s disease both in terms of understanding the pathophysiology (what is going on) and how to both prevent and even reverse the disease.

Dr. Dale Bredesen is internationally recognised as an expert in the mechanisms of neurodegenerative diseases such as Alzheimer’s disease.  He has developed a diagnostic protocol, and identified and described 3 types of the disease, with different causes.  This description also allows for individualised management.

In this blog we will just give the outline of the disease types and what causes them.  Next time we will deal with management.

One of the diagnostic criteria for AD is the presence of amyloid plaques in the brain.  Originally these were only found by the pathologist on post mortem examination, so the diagnosis was only confirmed after death.  But these days it is possible to identify amyloid plaques on a PET scan, as well as other more fancy diagnostics.

For years it was thought that the plaques were the cause of the disease, but recent research proves that the amyloid plaques are just the reaction to the underlying pathology – the body’s attempt to isolate the neurons from whatever is causing attack.  Numerous drugs have been developed over the years to try to eliminate amyloid plaques with varying degrees of success, but they have not been shown to do anything substantial for the AD.

Dr Bredesen describes it simply by this illustration.  At a crime scene you will have a whole bunch of police all milling around.  Their presence is not the problem  You are not going to solve the cause of the crime by removing the police.  The only way the crime scene will be cleaned up is when the police move away once the crime has been solved.  By trying to remove amyloid (the focus of current medicines and research) without dealing with the underlying cause may expose the neurons to increased risk of damage.

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AD Type 1 – Inflammation.  Two basic causes of inflammation occur.  One is through unhealthy diet and lifestyle – particularly trans fats (as found in baked foods, processed foods and hard margarines), saturated fats and excess sugar.  The second is infection.  These include such things as Herpes simplex (cold sores and genital herpes) and Lime disease (a tick born bacterial infection more common in the USA and Europe, not to be confused with Rickettsial Tick-bite fever common in South Africa).  Also specific fungi and moulds associated with living in damp houses or working in damp areas can be a cause.  Even recurrent infections from gingivitis due to an organism called P. gingivalis have been fingered. Thus, good dental care is important.

AD Type 2 – Withdrawal of Trophic Support.  The brain is dependent upon a whole array of factors to maintain function – good blood supply and oxygenation are obvious primary needs.  But also multiple nutritional and hormonal substances.  Some of the these that can easily become deficient including vitamin D, vitamin B12, brain derived neurotrophic factor, hormones such as estradiol, testosterone and thyroxine, etc.  Dr Bredesen’s illustration is like a company going through hard times, and the board decides to downsize.  The newest staff are the first to be laid off – keeping those who have all the institutional knowledge to keep things going.  Thus the brain maintains its past, but cuts out recent memory.  Patients may well remember the past pretty well, but forget what they had for breakfast this morning.

AD Type 3 – Toxin exposure.  This type results from either a) chemical toxins, such as mercury or copper, perhaps even aluminium, and other environmental toxins, like pesticides;  b) bioitoxins such as mycotoxins or mould toxins (like stachybotris, penicillium, aspergillis fungi moulds).  The body responds by making amyloid to seal off any of these toxins.

Type 1 and 2 AD start with recent memory loss. Most commonly in 60-80 year olds.  Type 3 starts with executive dysfunction – trouble with planning such as word finding, or calculation.  This type often starts in the early 50s.

It is possible to have combinations of all three types.  Because each person is different, Dr Bredesen and his trainees – and he has trained hundreds of people in his protocol – do a whole series of assessments and investigations to identify the factors involved, and then develop a specific management protocol for each person.

In our next blog, we will be looking at specific management of each type and more specific information as to how the different factors affect brain functioning.

If you want to go into this in greater depth, here is a good website: https://www.drbredesen.com/thebredesenprotocol.

This is such a fascinating subject – learning how lifestyle can impact even some of the most debilitating and feared diseases both in prevention as well as management.

To new insights and motivations for the week ahead,

Dave Glass.

Dr David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.

He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology.

An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.

He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.

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