Early Alzheimer’s, mild or subjective neurocognitive decline, “brain fog” Is it permanent? NO. Thanks to Functional Medicine / Dr. Bredesen’s approach

According to Alzheimer’s association 2017 fact and figures-
“-Alzheimer’s is the 6th leading cause of death in USA
-35% of caregivers for people with Alzheimer’s or other dementia report that their health has gotten worse due to care responsibilities compared to 19% of caregivers for older people without dementia
-1 in 3 seniors dies with Alzheimer or another dementia
-Since 2000, deaths from heart disease have decreased by 14%,while deaths from Alzheimer’s disease have increased by 89%.”

When older patients and their families report symptoms of “memory loss,” experienced clinicians know that these concerns refer to a range of cognitive abilities or to general cognitive decline, and not just memory. .

Cognitive decline is a major concern of the aging population, and Alzheimer’s disease is the major cause of age-related cognitive decline. Unlike several other chronic illnesses, Alzheimer’s disease prevalence is on the rise. Approximately 5.5 million suffer from this disease in America and 46 million globally.

Neurocognitive disorders, , have tremendous consequences for individuals, their families, the healthcare system, the economy. In the United States, Alzheimer’s disease (AD) is a leading cause of death, hospital admissions, skilled nursing facility admissions, and home health care (1). Family caregivers also experience increased emotional stress, depression, and health problems (2).

Some of the risk factors for neurocognitive decline

AGE –Increasing age is not only the strongest risk factor for dementia, but also the only risk factor consistently identified after the eighth decade of life. There are other causes for mild cognitive decline in younger populations.

GENES –While several genes have been identified as increasing susceptibility for Alzheimer’s disease, the best-established is the Apolipoprotein E (APOE) polymorphism on Chromosome 19. The APOE*4 allele, associated with higher risks of hypercholesterolemia and heart disease, is also associated with dementia due to Alzheimer’s and Parkinson’s diseases, Dementia with Lewy Bodies, vascular dementia, and frontotemporal dementia in men.

MEDICAL –The medical risk factors are, cardiovascular disease, hypertension, high cholesterol, high body mass index, diabetes etc.

INFLAMATION/INFECTIONS –Inflammation and inflammatory markers like interleukins, cytokines, CRP, has been reported in Alzheimer’s and vascular dementia. Inflammation because of any infection, heavy metal toxicity, high blood sugar, increased stress, mold ,Lyme dieses etc. (3) (4).

SLEEP–Sleep apnea is associated with hypertension, heart disease and increased risk of stroke, white matter changes in brain with increased risk of dementia (5).

DEPRESSION –Depression has a complex and likely bidirectional association with dementia. Recurrent major depression in earlier adulthood appears to increase risk of dementia in later life (6).

ANXIETY–Late-life anxiety is associated with cognitive impairment and decline Late-life anxiety and cognitive impairment: a review.

PTSD–Posttraumatic stress disorder has been reported to increase the risk of dementia and mild cognitive impairment. Posttraumatic stress disorder and risk of dementia among US veterans.

SENSE OF PURPOSE –Lifelong traits of harm avoidance and lesser sense of purpose have been reported as harbingers of AD. Harm avoidance and risk of Alzheimer’s disease.

HEAD TRAUMA –Head trauma is associated with increased risk of dementia, and the severity of injury appears to heighten this risk. Neurocognitive disorders can occur immediately after a traumatic brain injury or after the recovery of consciousness at any age. However, chronic traumatic encephalopathy is diagnosed years after repeated concussive or sub concussive blows to the head, with a clinical presentation similar to AD (Alzheimer Disease) or frontotemporal lobar degeneration. Mild traumatic brain injury.

TOXINS –Many environmental and occupational exposures have been associated with neurodegenerative disease. Neurodegenerative diseases: an overview of environmental risk factors. Smoking has been associated with an elevated risk of dementia. Smoking as a risk factor for dementia and cognitive decline. Heavy consumption of alcohol increases odds of developing dementia. Parkinson’s disease risk is associated with exposure to pesticides, for which a molecular mechanism has been established. Molecular mechanisms of pesticide-induced neurotoxicity.

Protective factors

Protective factors are those which reduce incidence rate or reduced odds of dementia. Cognitive reserve refers to its functional capacity, specifically the ability to utilize alternative neural networks and compensatory strategies. What is cognitive reserve?

EDUCATION–Where educational opportunities are universal, higher education may reflect innate reserve; the process of education may also promote the development of reserve through mechanisms such as increased dendritic branching. Regardless of mechanism, higher education is associated with lower prevalence of dementia. Education and dementia.

LANGUAGE–Bilingualism has been associated with delayed onset of dementia, independent of education, and may specifically protect against declines in attention and executive functioning. Delaying the onset of Alzheimer disease. Bilingualism delays age at onset of dementia.

COGNITIVE ACTIVITY–Cognitive activity: Lifelong occupations that do not require higher education or skilled vocational training appear to be associated with a higher risk of dementia. Education and occupation as risk factors for dementia Education, occupation, and dementia. Cognitively stimulating activities appear to have both protective and enhancing effects on cognition.

LEISURE ACTIVITIES–Several popularly usual activities such as reading, playing board games, playing musical instruments, and dancing are associated with a reduced risk of dementia. Leisure activities and the risk of dementia in the elderly.

LIFE STYLE FECTORS–As mentioned above Mediterranean diet, high physical activity, stress reduction, good nutrition, restful sleep, community involvement, and less exposure to toxins are protective factors. It is difficult to cover all protective methods here.

Simple “Brain fog” is a state of temporary cognitive impairment. Early Alzheimer’s disease and mild cognitive decline does not always have to progress to dementia. Keep in mind above risk and protective factors and start correcting them.

As Dr. Bredesen says “Neurodegenerative disease therapeutics has been, arguably, the field of greatest failure of biomedical therapeutics development. Patients with acute illnesses such as infectious diseases, or with other chronic illnesses, such as cardiovascular disease, osteoporosis, human immunodeficiency virus infection, and even cancer, have access to more effective therapeutic options than do patients with AD or other neurodegenerative diseases such as Lewy body dementia, frontotemporal lobar degeneration, and amyotrophic lateral sclerosis. In the case of Alzheimer’s disease, there is not a single therapeutic that exerts anything beyond a marginal, unsustained symptomatic effect, with little or no effect on disease progression. Furthermore, in the past decade alone, hundreds of clinical trials have been conducted for AD, at an aggregate cost of billions of dollars, without success. This has led some to question whether the approach taken to drug development for AD is an optimal one.”

Dr. Bredesen’s approach utilizes functional medicine approach. 21st-century medicine is completely different. Larger data sets are used to identify network changes that characterize chronic illnesses, revealing the “why” for each person. Addressing the cause of each condition in a comprehensive and personalized, programmatic way leads to improved outcomes.

Such an approach was used to bring about the first reversal of cognitive decline in patients with early Alzheimer’s disease or its precursors, MCI (mild cognitive impairment) and SCI (subjective cognitive impairment), published in 2014 (Bredesen, Aging 2014).


(1) https://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf
(2) https://www.alz.org/downloads/facts_figures_2013.pdf
(3) https://www.ncbi.nlm.nih.gov/pubmed/17011077/
(4) https://www.ncbi.nlm.nih.gov/pubmed/15474976/
(5) https://www.ncbi.nlm.nih.gov/pubmed/24205289/
(6) https://www.ncbi.nlm.nih.gov/pubmed/24205289/

Author: Rekha Shah

Dr Shah practices Functional & Integrative medicine. She is Board certified by American Board of Medical Specialists in Internal Medicine and Gastroenterology. She is also a Certified Functional Medicine Practitioner.

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