19 - Alzheimer's Disease

Question 1

What are the 4 main types of dementia? What can be found in testing and what are the associated symptoms?

Answer 1

• Frontotemporal dementia: Atrophy of frontal and temporal lobes. causing behavioral, language and movement difficulties.
• Vascular dementia: Impaired blood flow to the brain leading to cognitive decline, often associated with cardiovascular disease.
• Lewy body dementia: Abnormal clumps of protein cause alterations in thoughts, perceptions and movement.
• Alzheimer’s disease: Elevated amyloid beta and tau proteins (symptom, not cause). Progressive loss of memory, language and reasoning.

Question 2

What drives elevated amyloid beta proteins? (3)

Answer 2

• Infection
• Inflammation
• Oxidative stress

Question 3

What brain scans are used in diagnosis?

Answer 3

CT, MRI, PET

Question 4

How does Dr Dale Bredesen categorise dementia? Give main causes (3)

Answer 4

• Inflammation or ‘hot’: High inflammation
• Atrophic or ‘cold’: Low BDNF
• Cortical or ‘toxic’: Environmental toxins

Question 5

What are the immune cells of the brain called? What sub-types exist and which transcription factors promote which type?

Answer 5

Microglia
- M1 = Inflammatory > neurodegeneration > promoted by NF-kb
- M2 = Anti-inflammatory > neuroprotective > promoted by Nrf2

Question 6

How does gut dysbiosis impact the brain and via what communication mechanism?

Answer 6

Pro-inflammatory communication to toll like receptors on brain microglia via the microbiota-gut-brain axis.

Question 7

How do enriched social interactions help to reduce brain inflammation?

Answer 7

Oxytocin can act via the vagus nerve to reduce inflammation.

Question 8

What is neurogenesis? In which brain region is neurogenesis reduced during Alzheimer’s?

Answer 8

Growing of new neurons.
Hippocampus.

Question 9

What does BDNF stand for?

Answer 9

Brain-Derived Neurotrophic Factor

Question 10

What physiological processes does BDNF support (3).

What abilities does it support (2)

Answer 10

• Survival of cholinergic neurons
• Neurogenesis
• Synapse function
• Cognitive ability
• Memory

Question 11

What supports BDNF?

Answer 11

Anything to reduce stress and inflammation (all the usual stuff - e.g. walking in nature, yoga, diaphragmatic breathing, exercise, turmeric, Omega-3)

Question 12

What Alzheimer’s drug is commonly used? How does it work?

Answer 12

Donepezil - raise levels of acetylcholine by inhibiting acetylcholinesterase

Question 13

What is Acetylcholine essential for? (3)

What is it made from? (2)

Answer 13

Mood, memory and learning.

Made from mitochondrial acetyl-CoA and dietary choline

Question 14

What supports Acetylcholine production (2) and via which signaling pathway?

Answer 14

Healthy diet & lifestyle via vagus nerve stimulation.

Question 15

How does aluminum contribute to Alzheimer’s Disease?

Answer 15

It complexes with cellular components, depleting neurons of ATP

Question 16

How does obesity contribute to Alzheimer’s disease? (2)

Answer 16

• Insulin resistance causes inflammation & neuro-inflammation
• Over-activates the sympathetic nervous system, suppressing acetylcholine activity

Question 17

What do all Alzheimer’s diets have in common? (6)

Answer 17

• Whole unprocessed foods.
• Green leafy vegetables / brassicas
• Berries
• Healthy fats from olive oil, avocado, nuts and seeds.
• Oily fish
• Drink plenty of water

Question 18

What eating pattern does Dr Dale Bredesen advise for Alzheimer’s prevention / treatment.

Answer 18

Mild ketogenic diet:
- 12 hour overnight fast.
- 3 hours between dinner & bed.
- Avoid simple carbohydrates

Question 19

How does coconut oil support Alzheimer’s patients? How much?

Why does this work?

Answer 19

20g daily of coconut oil raises ketones due to the MCTs.

Brain glucose metabolism is compromised, but ketone metabolism remains intact.

Question 20

What are the components of the MEND protocol for Alzheimer’s Disease? (14)

Answer 20

• Optimise diet
• Exercise
• Reduce stress
• Optimise sleep
• Brain stimulation
• Test B6, 9, 12 - for methylation
• Gut repair protocol and probiotics
• Optimise fasting glucose & insulin
• Optimise Vit D status (50 - 100 nmol/L)
• Provide synaptic componenets (Citicholine & DHA)
• Optimise antioxidants (e.g. berries, fruit, veg)
• Support mitochondria (CoQ10, B vits)
• Heavy metal testing
• MCT / coconut oil

Question 21

Supplements to support a patient with Alzheimers Disease (12)

Answer 21

• B complex
• Vitamin C (1 - 5g)
• Vitamin D (optimise levels / 2,000 iu)
• Vitamin E (1,000 iu)
• Probiotics
• ALA (300mg)
• CoQ10 (600mg)
• Citicoline (250mg)
• Taurine (1g)
• Turmeric (1g)
• Omega-3 (>1g EPA)
• Resveratrol (100mg)

Question 22

How does Resveratrol support Alzheimer’s Patients?

Answer 22

Protects against misfolded amyloid and tau proteins

Question 23

How does Citicoline support Alzheimer’s patients?

Answer 23

Promote synapse formation and support mitochondria