Volunteers are needed for the dementia respite program to begin in November at St. Mark’s Church, Marco Island. Volunteers chosen will work with dementia participants in all of their activities from 10 AM to 3 PM on either Mondays or Wednesdays. Please contact Marna Barany, Manager of Volunteer Services at the Naples Senior Center for an interview at firstname.lastname@example.org or by calling 239-325-4444.
Last week I celebrated my birthday with dinner at a favorite restaurant and received calls, cards, and texts from family and friends, a good and special time. Later, I read the sobering statistics about the risk of getting Alzheimer’s as we age: the likelihood of developing Alzheimer’s disease doubles about every five years after 65 and after 85 the risk reaches nearly fifty percent, according to the Alzheimer’s Association, not good odds.
So when news of an online series featuring experts on brain health arrived in an email, I jumped on it. The “Awakening from Alzheimer’s” series consisted of fourteen daily interviews by Peggy Sarlin, journalist and author of the book by the same name, featuring neurologists, psychiatrists, and medical doctors sharing their findings on brain health. I’ve focused on three of the experts and listed the rest.
An authority on the prevention of chronic diseases, Dr. David Katz of New Haven, Connecticut is board certified in Internal Medicine and in Preventative Medicine Public Health. He spoke of Alzheimer’s dementia being a lot like coronary heart disease. The risk factors for it are similar: “Smoking, eating badly, not exercising, weight that’s out of control, diabetes, hypertension, high cholesterol… All the things that gum up the coronary arteries also adversely affect the arteries that provide the brain with its blood supply.”
Dr. Katz said when a person is prediabetic the body’s tissues are less sensitive to the actions of insulin. Insulin does many things, but, “one of them is to usher blood sugar into cells. If your tissues are less sensitive to insulin than they should be… insulin levels go up. High insulin levels are pro-inflammatory, they increase oxidative injury.” People who are vulnerable to Alzheimer’s disease have this poor ability to get sugar into cells. He stated that, “about 95 percent of the time insulin resistance is preventable by eating well, being active, and controlling weight.”
The empirical basis for evidence Dr. Katz cited is “The Blue Zones” by Dan Buettner, who is a National Geographic Fellow. His book chronicles the lifestyle practices of people around the world who routinely live the longest and have the least chronic disease. There are five documented Blue Zones including one in the United States: Loma Linda, California.
The Blue Zones are the places with the highest concentration of centenarians, Dr. Katz said. They not only live to 100, but very rarely get dementia or other chronic diseases: cancer, heart disease, diabetes, or have strokes. The answer, he said, is lifestyle. They live in cultures “where it’s normal to eat a wholesome diet, to avoid toxins like tobacco, to get routine physical activity, to get enough sleep, not be stressed out, and to have good, supportive, strong interactions with one another, a sense of community.” In Loma Linda, they’re vegetarian, and in this Seventh Day Adventist community, walking and meditating are encouraged.
The North Karelia Project in Finland is another example that lifestyle makes a difference. Dr. Katz said this is a decades long intervention study of people who had the highest rates of cardiovascular disease and its complications including dementia. Eliminating tobacco, excess salt, excess saturated fat, “the people involved shifted their diet to wholesome foods, mostly plants.” This was done in a cooperative way involving the citizens, political and business leaders. “They have reduced the rates of cardiovascular disease, metabolic disease, and dementia by approximately 80 percent. They have proven what’s possible.”
Dr. Pamela Wartian Smith also gave recommendations for living to a healthy old age. She directs the Center for Personalized Medicine in Grosse Pointe, Michigan. An authority on wellness and anti-aging, she’s the author of “What You Must Know About Memory Loss and How You Can Stop It.” Dr. Smith stated, “At 95 your brain should be just as sharp as at 24 and if it’s not, something’s wrong that you can fix.” The good news, is “even if you inherit a gene for Alzheimer’s disease, you don’t have to turn it on.”
Dr. Smith related the story of Sally, a 67-year-old woman scheduled for an 8 AM appointment, but who arrived at noon. She lived four blocks from the office and had been driving for four hours. One of the first signs of memory issues is getting lost, according to Dr. Smith. Sally’s husband had died recently so she had stress and was grieving. In addition, she was waking up four or five times a night, her thyroid was not optimal, her blood sugar was starting to decline, and her female hormones were not perfect. Her memory hormone pregnenolone, was unmeasurable.
A saliva test measured Sally’s estrogen, progesterone, testosterone, DHEA and cortisol which each affect cognition. Dr. Smith added that for women, estrogen has 400 functions in the body and that older men often need additional testosterone for wellbeing and memory. Dr. Smith emphasized it’s important to fix one thing at a time, get it balanced and then go on.
Dr. Smith optimized all Sally’s functions, and “in less than a year, Sally opened up a restaurant with her son, a chef, and it’s become a five-star restau- rant. Sally is now 80, is still working at the restaurant and thinking of opening another one.”
In addition to being seen by a good primary doctor, which the other experts emphasized, Dr. Smith recommends looking for a functional, metabolic, or anti-aging specialist and that, “in fifteen to twenty years every doctor will be doing this. “
Dr. Vincent Fortanasce, a California neurologist who wrote “The Anti-Alzheimer’s Prescription,” blames our bad sedentary lifestyle, stress, inadequate sleep, and a diet high in fructose and corn syrup for many ills including a high obesity rate. (It is about 40 percent for adults according to a recent study by Dr. Craig Hales of the U.S. Centers for Disease Control and Prevention.)
Dr. Fortanasce recommends an eight-week program, TEAM for those with mild cognitive impairment, which has the caregiver involved daily with the patient’s progress. Exercise, he says turns on genes and cells in the hippocampus where the first degeneration begins, where we lose our recent memories. He suggests six to ten minutes of isometric exercise to begin.
Giving the patient three things to smell that may bring back memories such as coffee or a wife’s perfume is also part of the TEAM program, which also includes tasting foods like your mother’s pasta sauce. Music is included with a person’s favorite songs not only listened to, but sung, and human touch is emphasized. Dr. Fortanasce stated older people may lose physical human contact sometimes by almost 100 percent. Touch can include a sexual life, hugs, holding teddy bears and other soft, gentle things. Tests given to TEAM participants after eight weeks showed improvement from getting a score of three out of ten in the beginning to seven and a half. The ultimate goal of the program is to provoke the emotions and stimulate the hippocampus.
At the University of South Florida, Dominic D’Agostino and Dr. Angela Poff, both holding Ph.D.’s, are researching ketogenic nutrition, looking at the body’s use of healthy fats for energy “which holds the promise of reversing and preventing neurodegenerative disease.” An early proponent of the benefits of incorporating coconut oil into one’s daily diet, Dr. Mary Newport, a physician from Spring Hill, Florida, spoke and Dr. Jacob Teitelbaum, internist from California outlined the MIND protocol to optimize metabolism, check for infections, offer nutritional support, and eliminate unnecessary drugs.
Others were Dr. Michael Breus, clinical psychiatrist from California, who suggested ways to optimize sleep and to test for sleep apnea, online at www.thesleepdoctor.com and Fred Pescatore, M.D., who practices integrative medicine in New York and focused on nutritional status, hormones, lifestyle, and how they relate to brain cognition. Dale Bredesen, M.D. from California, author of “The End of Alzheimer’s: The First Program to Prevent and Reverse Dementia” spoke of his ReCODE protocol that many acknowledge as the first effective treatment for reversing Alzheimer’s and dementia. (See my column in the September 29th issue of Coastal Breeze News.) Dr. David Perlmutter, neurologist of Naples, Florida and author of “Grain Brain and Brainmaker,” focused on inflammation in the body and how it affects the brain saying it starts with the gut, with one’s food choices. His online newsletter is at www.drperlmutter.com.
Many of the suggestions given in this online video series were for lifestyle changes that appear doable. Although there are skeptics who insist that no results are valid unless they’ve gone through clinically controlled trials, these experts have documented hundreds of case studies showing improvement in brain cognition. I expect to incorporate some of the findings into my routine with a new goal of being a healthy centenarian, and if my husband or mother were still living, I’d encourage them to make these changes too. Benefit Concert
Barbara and Mark Johnston, Naples folk singers, will give a benefit concert on Saturday, November 11 at 3:30 PM at St. Mark’s Church, Marco Island. Wine and cheese will be served and donations accepted for the new Marco Island dementia respite program and the Alzheimer Association’s research and education.
Shirley Woolaway has an M. Ed. in counseling and worked in journalism, in business, and as a therapist in Pennsylvania. She has 25 years personal experience with dementia as a caregiver for family members with Alzheimer’s disease, and nine years as the coordinator of an Alzheimer’s Association memory loss/ caregiver support group, earlier in Pennsylvania and now on Marco Island. We believe that Shirley’s insights will prove helpful to many of our readers.
For help on all aspects of Alzheimer’s disease and other dementias call the national Alzheimer’s Association confidential, 24/7 helpline at 800-272-3900 or the local Bonita Springs office at 239-405- 7008 for care consults and support group information. Also helpful with local educational programs, workshops, and support groups, is the Naples Alzheimer’s Support Network, 239-262-8388.