Preventing Alzheimer’s Disease?

I’ve been asked to comment on this article: Astaxanthin: A Rising Star in Alzheimer’s Prevention. I am happy to do so.

Whenever I see an article like this one, that touts a new “cure”(or in this case, a new preventative) for Alzheimer’s disease, my first reaction is always distrust. There are entirely too many people out there trying to make a buck by preying on the hopes of those caring for a loved one with Alzheimer’s or on the fears of those desperate to avoid the disorder.

I cannot judge Dr. Mercola’s motivation, but I do note that his site sells the products he espouses.

My second reaction is to check the information out.

This particular article makes so many claims, it will take some time to go through them all, but I think it may be worthwhile to do so.

The first two paragraphs of the article are absolutely 100% accurate.

There is no reference cited for the projection in paragraph three that Alzheimer’s will increase in prevalence from the current one in eight persons age 65 and over, to a state where one in four Americans will be affected. It is unclear whether we are now talking about one in four Americans age 65 and over, or just one in four Americans.

But put aside for the moment the fact that we don’t know exactly to whom the “one in four” refers. Whatever group is meant, this is a major increase.

But you have to wonder… How much of the increase is due simply to the increase in elderly people in the population? We are, thanks to our current excellent health care system, living longer, healthier lives than ever before. It was not that long ago that few adults lived long enough for the neurodegenerative diseases associated with aging to show themselves. One reason the incidence of Alzheimer’s is going up is that we are doing a better job of not dying from other causes. Scary as this projection is, it is unsubstantiated (no reference) and may be misrepresented… or not (we can’t tell since the wording is imprecise). So one probably should not give it much weight.

The fourth paragraph is accurate, but fails to mention that there is no way to objectively determine whether any particular regimen prevents Alzheimer’s, since we don’t really know what causes it and we cannot predict who is going to get it.

There are a few families in which Alzheimer’s is hereditary and caused by specific gene defects. (Don’t worry. If you were in one of these families, you’d know it—researchers would be knocking at your door.) People from these families are not included in clinical trials, since they would skew the data. Familial Alzheimer’s, as it is called, accounts for approximately 10% of all cases.  The other 90% of Alzheimer’s cases are sporadic, meaning the disease occurs for no apparent reason.

The next two paragraphs continue to imply that there is a known regimen that will decrease your risk of getting Alzheimer’s. But there isn’t. We do, however, know a few things about brain health and some of the suggestions later in the article are based on that information.

So thus far, the article is reasonably accurate, but does make some implications that could be misleading. Next time we’ll begin analyzing the specific recommendations one by one.

Until then…

–Susan.

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3 thoughts on “Preventing Alzheimer’s Disease?

  1. Well I hope the next post is a little more constructive and helpful to people who come to this blog hoping to find some sensible evidence based suggestions that may enable them to delay the onset of Alzheimer’s or other dementias.

    Mercola has provided a link to his source of statistics and I while using the upper figures from the ranges provided isn’t distorting them unduly. Bear in mind Mercola has had several previous run ins with the FDA and doesn’t have many friends in consensus medical opinion so ALL his online statements HAVE to be checked by his legal team before he can write anything. Only AFTER they have been double checked to see if they would stand up to legal scrutiny is he permitted to post.

    I think the one in four people being affected by Alzheimer’s includes the relatives carer’s and other close family. I’m sure everyone with an Alzheimer’s relative is affected by that and the stress it imposes on the family and friends.

    I think your claim that we are living longer healthier lives is mistaken. Sure we may at the moment be living longer but surely not healthier lives. I don’t know how many people you know aged 70 but try asking how many medications they are taking and what side effects they are experiencing? Sure I know a lot of blokes my age with Prostate cancer and while they certainly are still alive it’s not the same quality of life that they experienced before treatment. Try asking how many are on statins and what the side effects of those are and any reasonable person would question if the trade off between the claimed risk reduction and the actual side effects they are experiencing is actually worth it is certainly debatable. Early detection of many conditions now doesn’t necessarily lead to any reduction in all cause mortality but certainly leads to increased medical costs, treatments and other iatrogenic consequences.

    While it is true that 10% of Alzheimer’s is attributed to genetic predisposition I think it would have been better if you had pointed out this is mainly through the maternal DNA so people whose fathers but not mothers had AD can ignore that potential risk factor. While it may be different in the USA, in the UK I’m not sure that most people appreciate that the genetic predisposition for AD is generally through the maternal side. While genes certainly load the gun it’s still environmental/dietary factors that pull the trigger, so even if your mother did get AD and you have had your DNA checked and found you carried the risk that still does not mean there is absolutely nothing you could try to prevent or delay onset of AD.

    You will have to apply a bit of common sense and have an element of luck but I think it’s simply untrue to state that 90% of Alzheimer’s cases are sporadic, meaning the disease occurs for no apparent reason.

    We know what the basic risk factors for AD are and we know roughly (though I accept not all the dots are as yet connected) how this impacts on disease initiation therefore I contend that most of the suggestions Mercola makes are sufficiently evidence based to be worthy of investing some time examining the evidence he uses and which are also supported by papers listed at Pubmed.

    We have to take Alzheimer’s incidence very seriously in the light of the explosion in obesity and diabetes. These conditions predispose people to increased risk of dementia so it shouldn’t be hard to work out that AD incidence will increase. Therefore to do everything possible to reduce hyperglycaemia and conditions that result from raised levels of inflammation is simply common sense. There was a recent report of a 68 yr old woman on being given an Alzheimer’s diagnosis walking in front of a train, irrespective of whether this was a result of knowing the diagnosis or just a consequence of the condition (obviously we’ll never know) we should not give people the impression that pharmaceutical drugs are the only or even the best way of managing the condition.
    We ought be talking about The Myth of Alzheimer’s, What You Aren’t Being Told About Today’s Most Dreaded Diagnosis Aging with Dignity; Aging with Hope
    http://www.themythofalzheimers.com/

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    • Thanks for your analysis!
      When I write a post, I am trying to walk a line between over-generalization and inundating people with scientific terminology.
      I was unaware of Dr. Mercola’s run ins with the FDA. Interesting.
      Although I agree with you that Alzheimer’s affects a whole cluster of people beyond the person diagnosed, usage of the term ‘affected’ in the context of Dr. Mercola’s original article is scientifically used to speak only of the actual incidence of the disease, and does ignore the numbers of collaterally affected friends, relatives and care-givers.
      The matter of 10% genetic versus 90% sporadic is an instance where my effort not to overdo the scientific terminology has apparently led to confusion. The 10% of Alzheimer’s that is genetic refers to those individuals who carry a single inherited gene mutation known to directly cause the development of the disorder. There are a number of specific single gene mutations that can do that. The maternal inheritance you spoke of is part of the 90% still classified as sporadic in the scientific community.
      As we learn more about Alzheimer’s new risk factors and tendencies become apparent. The maternal inheritance theory is such a risk factor. But it is not known that everyone who has Alzheimer’s on their mother’s side of the family is at increased risk. There are other parameters that must also be considered. Instead of saying sporadic meant “for no apparent reason” I should have said “due to an unidentified cause”. No matter how many risk factors you have, you may or may not develop Alzheimer’s. It is the element of uncertainty that makes it sporadic.
      I certainly agree that there are things we can do to enhance our chances of successful aging; my point is that there is no set regimen that will prevent Alzheimer’s with a high degree of certainty. And I do not believe that drugs are the only or the best option for dealing with an Alzheimer’s diagnosis. If I have given that impression, I apologize.
      But sadly, Alzheimer’s is no myth. It makes aging with dignity and hope quite difficult, but not impossible–thanks to the heroic efforts of many loving caregivers. Much of our most hopeful information comes from the study of successful aging. That avenue of study was pioneered by Dr. Carl Cotman at the University of California, Irvine many years ago. It has yielded information which empowers people to take simple steps to enhance their aging experience. Dr. Mercola’s article goes into some of these behaviors later, and so will my posts.

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