August 2022 Newsletter | The Game of Clue and Alzheimer’s Disease
My mission is to be the first woman in 4 generations to not develop Alzheimer’s Disease (AD). On my journey of discovering ways to mitigate my risk, I pass this information on to you in this Brain-Body-Health (BBH) Newsletter.
“Come to the jacaranda tree at seven o'clock and you will hear something to your advantage. Destroy this note.
No signature, no clue to the identity”
—Kerry Greenwood from “Death Before Wicket”
Sometimes, when I’m reading the news and studies about Alzheimer’s Disease (AD), I feel like I’m in the middle of a detective novel or playing the family board game ‘Clue’. If only we could solve the mystery and find a cure. Or better yet if we could prevent the crime or stop AD, dead in its tracks from fast becoming the crime of this century. If you ever have played ‘Clue’, join me in the 3 questions as we explore this complicated and perplexing mystery of AD as we wait for Sherlock Holmes to be reincarnated.
WHO DONE IT: Does Amyloid Cause Alzheimer’s Disease?
This past month one of the biggest stories has been the question of fraud in the scientific community. The incident involves the possible altering of experimental data around amyloid, the hallmark pathology of AD. Read all about this mystery here. This crime of fraud may or may not be real, however when news takes on a form of sensationalism it can steer us towards unfounded conclusions or the more hopeful alternative of weighing the scientific data more accurately in the future.
This isn’t the first time the amyloid cascade hypothesis has been called into question. There are currently other theories for the root cause of Alzheimer’s, including, bacteria, viruses, diabetes, and environmental toxins, though funding and pharmaceutical research is still concentrated on amyloid studies. It has been hypothesized that amyloid is not necessarily the bad guy we’ve been led to believe. Maybe it has immune properties that protected brains and helped us along our evolutionary trajectory to respond quicker to insults. An example of this is the Amazonian Tsimane tribe. Researchers found tribal members who tested positive for parasites were more likely to maintain their mental fitness if they carried one or two copies of the ApoE4 gene; for them, the “Alzheimer’s gene” provided an advantage. For the minority who’d managed to elude parasitic infection, however, the opposite was true, and the ApoE4 gene was connected with cognitive decline, just as it is for people in industrialized countries. So the Tsimane may hold secrets about what scientists call the “Weird”- Western, educated, industrialized, rich, and democratic — human brain/bodies that might be better designed for the not-Weird environment in which our species evolved.
If you haven’t read, Dr. Dale Bredesen’s, book, "The End Of Alzheimer’s Disease," he was one of the first to publicly announce the possibility of lifestyle choices as central to the cause and development of AD.
To thicken the plot, consider the book by Donna Jackson Nakazawa, “The Angel and the Assassin: The Tiny Brain Cell That Changed Medicine”. This is a thrilling scientific detective read illuminating the role of the brain’s microglia cells and the important role they play. These cells are another clue into the complexity of the AD crime for which we continue the search for usual and unusual suspects. This article further builds a case for microglia as the central suspect in the AD mystery.
WHAT’S THE WEAPON?
In brain health circles the saying goes like this - “genetics is the weapon and epigenetics pulls the trigger.” Learning about genetics and epigenetics risks are clues for you to build your strategy against AD. When I first started Brain-Body-Health in 2016, the worldwide population of AD was estimated at 5.4 million. As of 2022, it has jumped to 6.5 million, 4 million women, and 2.5 million men. The criminal AD is increasing its territory while plotting more memory heists 10-20 years before they happen. To counter this attack, we need to employ our SLEDSS our acronym for taking actionable steps to reduce AD — Sleep, Learning, Exercise, Diet, Stress reduction, and Socialization. All are important but in the game against our worthy opponent AD, we will need to learn skills to hone our attention and search into our habits and patterns that weaken us and pull the triggers. With AD, each of us can become our own best detective. Here’s a recent article in Neurology about HOW processed foods can be a potential weapon for AD. This is an association study which does not necessarily mean causation, however, it can mean potential risk, especially considering the large number of people in the study, (76,000).
WHAT ROOM WAS THE CRIME COMMITTED IN - WHERE IS ALZHEIMER'S HAPPENING?
Here are the ‘rooms’ that put you at greater risk of getting AD and or dementia. All are modifiable or able to be mitigated.
Obesity (mid-life)
Physical inactivity (aka- couch potato)
Low education
Low socialization
Depression
Genetics: APOE 4 gene
Family history - of heart attack, stroke, and AD
Hypertension
Diabetes or Pre-diabetes
Hearing loss
Excessive alcohol intake
Smoking
Traumatic Brain Injury
Interestingly this study in JAMA (May 2022) shows these risky rooms have changed from 10 years ago when the top 3 risks were physical inactivity, depression, and smoking. Today midlife obesity, physical inactivity, and low education prove to be the greatest risks of developing AD. Finally, midlife obesity has overtaken physical inactivity as the top-ranked modifiable dementia risk factor in the United States.
LESSONS FROM COACHING
Another crime maybe taking place: A friend stopped me at the health club the other day asking about why he was feeling so tired after lunch. This is a minor crime that can potentially turn into a major heist putting us at risk for AD. Feeling tired after a meal is an important clue indicating you have eaten too many simple carbohydrates and/or protein or just too much food. Fatigue happens because your blood sugar is peaking, followed by an insulin peak. Both then will sharply drop and leave you fatigued and longing for that dangerous nap. The crime is more insidious when you start to lose your insulin stores which put you at risk for diabetes and AD. We want your blood sugar to slowly go down and your insulin to slowly rise. This is facilitated if you stay active after you eat, avoid alcohol, eat fewer carbs, lower glycemic (sugar) foods and add fiber (which slows the metabolism of foods). Do yourself and your brain a favor, instead of a nap take a walk or stay active for 5-10minutes after you eat.
This week a reader had a question about brain stimulation. What program would I recommend? Answer: Brain HQ Posit Science (LINK to Brain HQ website) has the most research supporting its improvement in cognitive health and reversal of MCI (mild cognitive impairment). It was also used in the recent study I mentioned in the BBH July newsletter under reversing MCI and dementia. My colleague and physician, Ann Hathaway, MD was one of the co-authors of the study.
Two readers contacted me about wanting information on HRT (Hormone Replacement Therapy) . One had symptoms that were similar to mine, perimenopausal anxiety, depression, and sleeplessness. Since I am no longer prescribing, I referred her to her family nurse practitioner who placed her on HRT and she improved within one month. September’s newsletter will be all about HRT and Women’s Health. The other client was concerned that her practitioner would not be open to discussing HRT.
This challenge of conversing with your practitioner has been reported before. I referred this second client to Naturopathic Integrated Medicine Center, and International Functional Medicine IFM.org. Peter Attia describes 4 qualities as necessary in your search for a good primary care doctor.
To our optimized health!
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“If you want to go FAST, go alone. If you want to go FAR, go together."
- African proverb