22 May 2017

One-dozen-proven-things-you-can-do-to-prevent-Alzheimer's-Disease

Dementia, and its most common form, Alzheimer’s disease, is well recognised as another chronic degenerative disease. While most of us are pretty worried about developing dementia, and many families really struggle when it affects one of their members, the good news is that it is highly preventable.

This week, we investigate Alzheimer’s specifically and examine proven ways to prevent it. There is a crucial need to act. A 2007 study published in the Journal of the Alzheimer’s Association estimated that 26 million people throughout the world at that time were affected by Alzheimer’s (the most common form of dementia), and that by 2050, the prevalence will quadruple; by which time 1 in 85 persons worldwide will be afflicted with the disease. But first,



                  Thought for the day

               Beginning today, treat everyone you meet 
                As if they were going to be dead by midnight. 
                 Extend to them all the care, kindness, 
                  And understanding you can muster, 
                   And do it with no thought of any reward. 
                    Your life will never be the same again. 

                                   Og Mandino




HOW TO PREVENT ALZHEIMER'S DISEASE 
In the 2 previous posts on dementia (follow the links below), we examined what dementia is, and its causes. Clearly, there are many causal similarities between AD and other chronic degenerative diseases like heart disease, cancer and diabetes. Just as those conditions are all highly preventable, the good news is that AD is also highly preventable. Here is how…

1. Avoid smoking
Enough said.

2. Avoid excess alcohol
Safe limits are being constantly reduced by the authorities. Anything more than occasional social drinking is a risk factor for AD.

3. Plant based, wholefood diet 
This is a lot simpler and tastier than many might think. A diet rich in vegetables, fruits and other plant-based foods, with minimal or no animal protein and minimal or no processed and refined foods is anti-inflammatory and regenerative. It both prevents and reverses chronic degenerative disease. Research says this dietary approach prevents AD, we do not know yet what potential it may have for reversing it.

We do know this approach prevents obesity, insulin resistance and diabetes, and, as we have seen, the rise in these health issues has paralleled the rise in AD.


Eating lots of green vegetables provide plenty of folate (derived from the word foliage), and other phyto-micronutrients.

These are the foods with the most powerful degree of protection.

Berries, especially blueberries, contain a purple compound called anthocyanins, which have been shown to be particularly beneficial for the brain.

In fact, September is World Alzheimer’s Month, and purple is the colour theme, and this was not co-incidental.


Also important for proper brain function is to avoid known food allergens and foods you are sensitive to. Gluten is notorious for triggering not only physical symptoms, but also cognitive loss in those sensitive to it.  As is lactose, found in most dairy foods. These poorly digested molecules can cross into the blood leading to meta-inflammation (systemic, low level, chronic inflammation that is a recognised pre-cursor of all the chronic degenerative diseases) that also affects the brain.

4. The special case of the elderly
Many elderly people often eat very poor diets, even if cared for in specialised facilities. Tea, coffee, biscuits, sweets and cakes, meat and other animal protein eaten more than once a day, with only a few vegetables and very little fruit, are all common.

Combine all this with many drugs routinely given to the elderly, low vitamin D through little sun exposure, constricted life space and very little activity, and we have a recipe for metabolic dysfunction, including Alzheimer’s and cognitive deterioration.

The elderly often suffer unnecessarily through eating an appalling diet, not getting out of their constricted environment, no sun exposure, little exercise and profligate drug prescriptions.

We need to make sure we not only encourage ourselves to go more plant-based, but also the elderly. Their brains and minds depend on it!

5. Exercise
Regular exercise significantly reduces the risk of developing cognitive impairment and AD (17)

Combine aerobic activity with some anaerobic (lifting, pulling etc), as this provides a more complete health benefit. ). Aim to combine exercise with forms of activity you enjoy. Walking, running, cycling, rowing, tennis, golf, gardening, gym – whatever you enjoy and can sustain. Regularity and consistency is the key, more so than the intensity.

6. Avoid Copper, Iron and Aluminium
These heavy metals are implicated in the development of plaques and tangles in the brain, particularly when the diet is also high in cholesterol and saturated fat (op.cit ref.2). There seems to be an accelerated oxidative effect on cholesterol in the body when inorganic copper from sources previously mentioned is present. The organic copper found in trace amounts in natural foods is, however, essential.

7. Sleep
Make it a priority to get regular, adequate sleep. This is more easily achievable when alcohol and caffeine are minimised or avoided and when we get regular moderate exercise.

8. Use it or lose it

Evidence bears out what we all intuitively know.

The brain responds to what we do with it.

Neuroplasticity has confirmed the benefits of exercising the brain.

Crosswords, Scabble, good books, uplifting music, thought-provoking movies, meaningful discussion.

Show an interest in other people and the world around you.


Limit newspaper- reading and television time and be mindful of spending too much time on technology like mobile phones and computer games and screens. The long-term effect on the brain of all this technology remains to be seen, although it would appear to be undesirable.

As life moves on take a pride in developing new friends, hobbies and interests. Explore new things. Ask questions.

9. Mindfulness and meditation
Many people’s minds today are continually “psychobabbling”, never still. This drains the nervous system and is a real problem.

Lean to focus on one thing at a time. Learn to meditate or learn relaxation techniques. Think more positively and less negatively. This happens as a matter of course when you read less newspapers, watch less television and listen less often to radio talk- back, all of which seem to thrive on negativity.

10. Fasting
New evidence suggests fasting carries benefits not just for the body but also for the brain (18).

Dr Richard Isaacson stated: “ There is evidence that fasting (through ketosis) may have anti-ageing effects on the brain. The ketone bodies that are produced while fasting can actually be protective of the brain. You are doing something protective to slow ageing which can lower the risk of Alzheimer’s disease”(19).

Further, from another source: “ It is clear that fasting can change brain chemistry, mood and mental function to the point of reducing risk for neurodegenerative diseases”(20).

Fasting is the voluntary and complete abstinence of all food, except water, while nutritive reserves remain intact. It must be emphasised that fasting should be done under qualified supervision, especially if the person has a serious health issue or the fast is longer than a few days.


11. Avoid Drugs As Much as Possible

This includes over the counter drugs and recreational drugs.

Stay away from painkillers, anti-inflammatories and antibiotics as much as possible.

If in ICU do your best to minimise the intake of sedative drugs. Delirium is closely linked to sedatives. These drugs can scramble the brain and cause long-term physical and cognitive problems and need to be minimised wherever possible.


12. Special mention for turmeric and possible reversal
Turmeric has been used in India for over 5,000 years, which is related to India’s rural and urban populations having some of the lowest prevalence rates of Alzheimer’s disease (AD) in the world.

Incorporating small, high-quality culinary doses of turmeric into your daily diet may be enough; ‘adding to taste,’ in a way that is truly enjoyable, may be the ultimate standard for determining what a ‘healthy dose’ is for you for prevention. 

But reversal? A recent small study on patients with AD found that less than a gram of turmeric daily, taken daily for three months, resulted in ‘remarkable improvements’. Turmeric is attracting huge interest from the scientific community, and more trials are needed in this arena to be confident of how useful it may be.

For details of what type of turmeric to use therapeutically, and how much, link to the 2 posts below.

CONCLUSION
Dementia and AD, like most if not all diseases, are not “just bad luck”. Alzheimer’s Disease and cognitive decline is not an inevitable consequence of ageing.

We know a great deal about what causes these conditions and we know the biggest factor is how we live our lives – our lifestyle. This is good news as we can control how we live.

Make poor choices, get into tough habits, and old age could be very scary.

Make wise choices, get into healthy habits and not only today, but old age could be full on delightful – and free of chronic degenerative disease including dementia and AD

REFERENCES   (this is a complete list that includes references from the previous 2 posts)
1) Journal of Alzheimer’s Disease, Feb, 2005,7(1); 63-80;
2) Physicians Committee of Responsible Medicine Special Report: Dietary Guidelines for Alzheimer’s Prevention, July 2013;
3) Dr Lori Laffel, CNN.com, 15/04/2003 ;
4) National Review of Medicine, Dec 15, 2005, Vol 12, No 2;
5) Journal of Alzheimer’s Disease, Nov, 2005;
6) NEJM, Aug 8, 2013, 369: 540-548;
7) Neurology, 16/09/11;
8) Science Daily, November8, 2007: “Copper damages protein that defends against Alzheimer’s”;
9) Dr Fuhrman’s Healthy Times Newsletter, Jan, 2008 “ Dementia is Not a Natural Part of the Ageing Process”;
10) Archives of Neurology, 2003; 60: 194-200 “ Dietary Fats and the Risk of AD”;
11) Journal of Alzheimer’s Disease,  Aug, 2013;
12) NEJM, Oct 3, 2013;
13) American Journal of Geriatric Psychiatry, April, 2011;
14) op.cit reference 1;
15) British Medical Journal, May 20, 2010;
16) Archives of Neurology, 2006; 63: 1545-1550;
17) Journal of Alzheimer’s Disease, August, 2013;
18) Scientific American, January, 2013;
19) “The Alzheimer’s Diet” by Dr Richard Isaacson;
20) Mind The Science Gap.org, April 2013;
21) “ Prevent and Reverse Heart Disease” by Dr Caldwell Esselstyn, 2010
22) “ The Complete Program for Preventing and Reversing Heart Disease” by Dr Dean Ornish, 1990;
23) “ The Brain That Changes Itself”, by Dr Norman Doidge, 2007

Special thanks
Greg Fitzgerald - Health for Life Clinic & Seminars. www.healthforlife.com.au
email: info@healthforlife.com.au   Phone  02 9544 0445

RELATED BLOGS
Dementia and Alzheimer’s Disease easily explained? Can we prevent or cure them?

Alzheimer’s Disease, Type 3 Diabetes and its causes

What form of turmeric is best?

How much turmeric how much curcumin?


COMING SOON 
WINTER MEDITATION RETREATS AND TRAINING

June 5 – 9th Deepening Your Meditation

Our only 5 day meditation retreat, this program is all about taking time out, entering into a meditative environment and being supported to deepen your experience. Then, with this deeper experience, being able to take it with you so that your ongoing practice is more rewarding, more beneficial, more enjoyable.








July 1 -7th Mindfulness and Meditation in Daily Life

We have had many requests to present a meditation retreat in Queensland, so this is it. This retreat will focus on integrating mindfulness and meditation into daily life.

I know when I first started, meditation was something I did for a few minutes (or hours) every day; but at first, I then went back to my day as if nothing much had happened. The real benefit of these practices is in how they inform our daily life, so this retreat will be very practical.

We will practice mindfulness and meditation together formally, and then use the rest of our time to bring the qualities of the practice into our daily experience – in a way that we can take them home and maintain them. My sense is that for many this could well be life changing.

We are fortunate to be able to use the facilities of the Chenrezig Institute – a purpose built Retreat Centre in the hills back of the Sunshine Coast.

October 9 – 13th Meditation Teacher Training – Module 2

In this training we use a fully documented manual to learn how to teach 2 4 week programs one on guided imagery; the other contemplation. These training have been booking out, and like all our retreats, it is wise to register early.



15 May 2017

Alzheimer’s-Disease,-Type-3-Diabetes-and-its-causes



Grandpa stands at the kitchen sink, a glazed expression across his face.

He is wondering… What am I here for? Get a drink? Do the dishes? Make a cup of tea?

Is all this preventable? And if so, how much?

More radically, is it reversible? How might that be?



Increasingly, Alzheimer’s Disease (AD) is being called Type 3 Diabetes. It is known to be another of the major chronic, degenerative, lifestyle related diseases.


So this week we go Out on a Limb once more with the intention of explaining in simple terms (with many references!) the AH / diabetes connection, along with other causative factors, before investigating prevention and reversal, plus details of coming meditation retreats, but first


Thought for the day
Men come and they go and they trot and they dance, and never a word about death. All well and good. Yet when death does come—to them, their wives, their children, their friends—catching them unawares and unprepared, then what storms of passion overwhelm them, what cries, what fury, what despair! . . .

To begin depriving death of its greatest advantage over us, let us adopt a way clean contrary to that common one; let us deprive death of its strangeness, let us frequent it, let us get used to it; let us have nothing more often in mind than death.

We do not know where death awaits us: so let us wait for it everywhere.

To practice death is to practice freedom.

A man who has learned how to die has unlearned how to be a slave.

Montaigne

DEMENTIA and ALZHEIMER'S
In our last post, we examined the range of conditions collectively known as dementia. Alzheimer’s Disease (AD) is the most common of these making up 50% to 70% of cases.




As explained in the previous post, in AD the brain develops beta-amyloid plaque outside the brain cell, and tangles within the brain cell, literally killing the cells and causing the brain to shrink.

This shrinkage is particularly evident in the hippocampus, which is the brain’s memory centre.




It is often said that the seriousness of, and difference between, AD and other dementias, is seen in the response to the question: “Did you turn the computer off?”

Those with dementia respond: “I can’t remember”. Those with AD respond: “ What’s a computer?”.

ALZHEIMER’S FACTS 
- from The USA’s  Alzheimer’s Association 2013 Facts and Figures Report

# Death from AD increased 68% between 2000 and 2010

# One in three seniors dies with AD or other dementias

# AD is the sixth leading cause of death in the USA

# Within the next three decades, AD is expected to reach epidemic proportions and become the greatest health impairment in the population

# Diabetics have a 65% increased risk of developing AD

ALZHEIMER'S and the DIABETES CONNECTION 
The idea that AD might be Type 3 diabetes has been around since 2005 (Ref.1), while the connection between poor diet and AD is rapidly gaining scientific credence – see a cover story in New Scientist entitled Food for thought: Eat your way to dementia.

Insulin resistance is at the root of Type 2 Diabetes and insulin resistance also affects the brain.

Insulin is a hormone that is secreted by the pancreas and regulates our blood sugar, allowing the cells to take in glucose for energy.

Insulin is also produced by the brain itself. (ref.4).

Insulin resistance means the cells resist the actions of insulin (either because the quantity and/or quality of insulin is compromised or the cell has lost its receptor ability).

Dr Suzanne de la Monte, a Neuropathologist and Professor of Pathology in the States, found that not only insulin but its receptors, diminished up to 80% in the brain of AD patients. She states: “many of the features of AD, such as cell death (apoptosis) and tangles, appear to be linked to abnormal insulin signalling. This demonstrates that the disease is most likely a neuro-endocrine disorder, or another type of diabetes” (ref.5).

The New England Journal of Medicine stated: “ Our results suggest that higher glucose levels may be a risk factor for dementia, even among persons without diabetes” (6,7).

So not only do liver, fat and muscle cells get adversely affected by insulin resistance, but now we know the brain is also a target organ.

PREVENTION and REVERSAL
We know that diabetes and insulin resistance can be reversed by dietary and lifestyle changes, as evidenced by the wonderful work of people like Drs Neal Barnard, Joel Fuhrman and John McDougall who have been helping people reverse their diabetes without drugs for years. The diabetes connection provides increased hope that AD and dementia are not inevitable consequences of ageing.

However, all chronic diseases are multi-factorial – they have many causes.  AD is no different. So first we seek to understand the causes; then the path to prevention becomes more obvious.

OTHER RISK FACTORS
1) Heavy metals
i) Copper
Although involved in a number enzyme systems at trace levels, when taken in excess, copper (8), interferes with a special lipo-protein which helps clear the beta-amyloid plaque from the brain and also stimulates production of the plaque.

ii) Iron
Excess iron increases oxidation and free radical damage and therefore increases the risk of AD.

iii) Aluminium
Aluminium has long been suspected of a strong link to AD, but evidence is scant.

2) High saturated and trans fat levels
Researchers have reported people consuming the most saturated fat were up to 300% more likely to develop AD. Those who consumed the most trans fat were 500% more likely! (10). It should be kept in mind that saturated fats have the tendency to elevate cholesterol levels, and there have been some studies done showing that elevated cholesterol levels are also associated with greater AD risk.

3) Lack of exercise
Exercise has been shown to increase the size of the hippocampus, the part of the brain that is affected in AD, and this could be the reason why exercise has been shown to improve memory. (11)

4) Low Vitamin D
Links have been found between low vitamin D and AD. There are vitamin D receptor sites in our brains, spinal cord and central nervous systems. The medical profession has for decades discouraged people from sun exposure to avoid skin cancer and this has led to the unexpected consequence of widespread Vitamin D deficiency.

5) Intensive Care Units
Given ICU can be a great place to be when you really need to be there, recent research confirms what many have observed. One in four people had cognitive impairment a year after release from an ICU that was similar in severity to having mild AD, and 1-in-3 had cognitive impairment similar to that seen with moderate traumatic brain injury. This was seen across all age groups, not just the elderly! The mechanism for this is believed to be the experience of delirium, brought on by the aggressive and routine use of sedative drugs.

Delirium is a form of acute brain dysfunction where changes such as inattention, disorganised thinking, altered levels of consciousness and changes in mental status are observed. It is associated with inflammation and neuronal apoptosis (brain cell death).

6) Smoking and Alcohol
We examined the evidence for these two in the previous post.

7) Constricted Life-Space
Researchers have found that seniors who had a constricted life space were twice as likely to develop AD as seniors whose life space extended well beyond the home (13).

8) Nitrates and Nitrates
Nitrosamine (N/S) compounds cause the liver to produce toxic lipids that cross the blood/brain barrier and damage certain cells such that the brain develops insulin resistance (14).

These N/S compounds have been known for a long time to be carcinogenic.

They are found most often in preserved meats, hot dogs, ground beef, smoked meats and bacon.

9) Homocysteine
Increased homocysteine levels in the blood metabolically can be very damaging. This can be caused by excess animal protein, vitamin B12 deficiency or folate (B9) deficiency.

Recent research has shown that one popular anti- diabetic drug, called metformin (15), can significantly lower blood levels of vitamin B12 and folate, which then increases homocysteine levels.

10) Docosahexaenoic acid (DHA) deficiency
A number of studies have shown the relationship between DHA which is the chief omega 3 fatty acid in the brain, and neurological disease, including AD. The content of DHA in the brain decreases with ageing, and more so in patients with dementia. DHA stimulates growth of the branches that connect one cell to another.

Also, recent studies have shown that DHA increases production of the protein that is found in reduced levels in Alzheimer’s patients. This protein facilitates breakdown of the beta-amyloid plaque. Some studies have shown an inverse relationship betwee
n DHA levels and AD (16). DHA can be synthesized from alpha-linolenic acid in the diet or obtained directly from maternal milk (breast milk), fish oil, or algae oil.

11) Sleep problems
It has been shown that deep sleep facilitates removal of brain toxins through a network of drainage channels called the Glymphatic System, named after brain cells called glial cells.

Normally the lymphatic system does this job in other parts of the body, but the blood/brain barrier precludes lymph drainage in the brain.

Without regular and deep, uninterrupted sleep, toxic deposits do not get adequately cleared, leading to cognition problems.

SO HOW DO WE AVOID ALZHEIMER’S DISEASE?
It is apparent that there are many causal similarities between AD and other chronic diseases.

AD and cognitive decline is not an inevitable consequence of ageing, just as cancer, heart disease, diabetes, arthritis, osteoporosis and most other chronic diseases are not. Most if not all chronic degenerative diseases are both preventable and reversible by maintaining a therapeutic lifestyle. So next week, a thorough investigation of how this fits with Alzheimer’s.


References
1) Journal of Alzheimer’s Disease, Feb, 2005,7(1); 63-80;
2) Physicians Committee of Responsible Medicine Special Report: Dietary Guidelines for Alzheimer’s Prevention, July 2013;
3) Dr Lori Laffel, CNN.com, 15/04/2003 ;
4) National Review of Medicine, Dec 15, 2005, Vol 12, No 2;
5) Journal of Alzheimer’s Disease, Nov, 2005;
6) NEJM, Aug 8, 2013, 369: 540-548;
7) Neurology, 16/09/11;
8) Science Daily, November8, 2007: “Copper damages protein that defends against Alzheimer’s”;
9) Dr Fuhrman’s Healthy Times Newsletter, Jan, 2008 “ Dementia is Not a Natural Part of the Ageing Process”;
10) Archives of Neurology, 2003; 60: 194-200 “ Dietary Fats and the Risk of AD”;
11) Journal of Alzheimer’s Disease,  Aug, 2013;
12) NEJM, Oct 3, 2013;
13) American Journal of Geriatric Psychiatry, April, 2011;
14) op.cit reference 1;
15) British Medical Journal, May 20, 2010;
16) Archives of Neurology, 2006; 63: 1545-1550;

WITH ACKNOWLEDGEMENT AND GRATITUDE TO GREG FITZGERALD of
Greg Fitzgerald’s Health for Life Clinic & Seminars
www.healthforlife.com.au  email: info@healthforlife.com.au  02 9544 0445

RELATED BLOG
Dementia-and-Alzheimer’s-Disease-easily-explained?-Can-we-prevent-or-cure-them?

COMING SOON 
WINTER MEDITATION RETREATS AND TRAINING

June 5 – 9th Deepening Your Meditation

Our only 5 day meditation retreat, this program is all about taking time out, entering into a meditative environment and being supported to deepen your experience. Then, with this deeper experience, being able to take it with you so that your ongoing practice is more rewarding, more beneficial, more enjoyable.








July 1 -7th Mindfulness and Meditation in Daily Life

We have had many requests to present a meditation retreat in Queensland, so this is it. This retreat will focus on integrating mindfulness and meditation into daily life.

I know when I first started, meditation was something I did for a few minutes (or hours) every day; but at first, I then went back to my day as if nothing much had happened. The real benefit of these practices is in how they inform our daily life, so this retreat will be very practical.

We will practice mindfulness and meditation together formally, and then use the rest of our time to bring the qualities of the practice into our daily experience – in a way that we can take them home and maintain them. My sense is that for many this could well be life changing.

We are fortunate to be able to use the facilities of the Chenrezig Institute – a purpose built Retreat Centre in the hills back of the Sunshine Coast.

October 9 – 13th Meditation Teacher Training – Module 2

In this training we use a fully documented manual to learn how to teach 2 4 week programs one on guided imagery; the other contemplation. These training have been booking out, and like all our retreats, it is wise to register early.



02 May 2017

Dementia-and-Alzheimer’s-Disease-easily-explained-Can-we-prevent-or-cure-them?

Worried about dementia or Alzheimer’s? In a family currently affected by these potentially devastating diseases? Concerned for your own old age and your capacity to remember, to think and to emote?

Good news. They say that knowledge dispels fear. A growing body of evidence concludes these conditions are largely lifestyle related chronic degenerative diseases that may well be preventable through a range of measures.

However, often there is confusion around what even the names mean. So before we delve into the possibilities of prevention and cure; a summary of what we are talking about, plus details of the winter meditation retreats in Victoria and Queensland that are coming soon, but first




   Thought for the day

          Dr Denis Burkitt commenting on this
                  abbreviated version of Mark 4:26-27

     “A man scatters seed on the land
     —the seed sprouts and opens
     —how, he does not know,” 

     The farmer does not wait to find out. 
     Had the farmer postponed his sowing 
     Until he understood seed germination, 
     He would not have lasted very long. 




A SIMPLE GUIDE TO THE FACTS ABOUT DEMENTIA AND ALZHEIMER’S DISEASE
What follows is a compilation of information from sources such as dementia and Alzheimer’s websites, scientific references and Wikipedia. This information represents my understanding of these various conditions, has been compiled in good faith and is intended to be accurate, succinct and easy to understand. It is not a short read as dementia represents a range of conditions, each of which are explained in turn. Hope you find this helpful…

Dementia
Dementia, also known as senility, is a broad category of brain diseases that cause a long term and often gradual decrease in the ability to think and remember that is great enough to affect a person's daily functioning. Other common symptoms include problems with emotional expression, language, and a decrease in motivation.

The most common type of dementia is Alzheimer’s disease which makes up 50% to 70% of cases. Other common types include vascular dementia (25%), dementia associated with Lewy bodies (15%), alcohol related dementia (unclear), fronto-temporal dementia (rare) and mixed dementia (10%).

Alzheimer's disease 
First be clear, Alzheimer's disease is not a normal part of aging. Alzheimer's disease is an acquired, progressive, degenerative disorder that attacks the brain's nerve cells, or neurons, resulting in loss of memory, thinking and language skills, and behavioural changes.



Alzheimer's disease is associated with 2 types of abnormal lesions - plaques and tangles.

Plaques or to be more specific, Beta-amyloid plaques, are sticky clumps of protein fragments and cellular material that form outside and around neurons.

Tangles, or neurofibrillary tangles, are insoluble twisted fibers composed largely of the protein that builds up inside nerve cells.

Although these 2 lesions are hallmarks of the disease, scientists are unclear whether they cause it or a by-product of it.

The most common symptoms are short-term memory loss and word-finding difficulties. People with Alzheimer's disease also have trouble with visual-spatial areas (for example, they may begin to get lost often), reasoning, judgment, and insight. Insight refers to whether or not the person realizes they have memory problems.

Common early symptoms include repetition, getting lost, difficulties keeping track of bills, problems with cooking, forgetting to take medication, and word-finding problems.

The part of the brain most affected by Alzheimer's is the hippocampus. Other parts of the brain that show shrinking (atrophy) include the temporal and parietal lobes. However, the brain shrinkage in Alzheimer's disease is very variable, and a brain scan cannot actually make the diagnosis (but may eliminate other causes). The relationship between undergoing anaesthesia and Alzheimer's disease is unclear.

Vascular dementia
This type of dementia is caused by disease or injury affecting the blood supply to the brain, typically involving a series of minor strokes. Symptoms will depend upon where the strokes have occurred and whether the vessels involved are large or small. Multiple injuries can cause progressive dementia over time, while a single injury located in a critical area critical (i.e. hippocampus, thalamus) can lead to sudden cognitive decline.

On scans of the brain, a person with vascular dementia may show evidence of multiple strokes of different sizes in various locations.

     So what actually is a stroke?
A stroke happens when blood supply to the brain via an artery is interrupted.

This occurs most commonly when the artery is blocked (ischaemic stroke) or much less commonly bursts (haemorrhagic stroke).

The resulting area of brain damage is called a cerebral infarct, or more simply, just an infarct.

A major stroke occurs when the blood flow in a large vessel in the brain is suddenly and permanently cut off. Most often this happens when the vessel has become narrower and then is blocked by a clot. Much less often it is because the vessel bursts and bleeds into the brain.

Minor strokes are when the same processes occur on a smaller scale.

Types of vascular dementia
Vascular dementia can differ according to the cause of the damage, the type of stroke involved and the part of the brain that is affected. The different types of vascular dementia have some symptoms in common and some symptoms that differ. Their symptoms tend to progress in different ways.

a) Post-stroke dementia
After a major stroke, the sudden interruption in the blood supply starves the brain of oxygen and leads to the death of a large volume of brain tissue. However, not everyone who has a stroke will develop vascular dementia, but about 20% of people who have a stroke do develop post-stroke dementia within the following 6 months. A person who has one major stroke is then at increased risk of having further strokes. If this happens, the risk of developing dementia is higher.

b) Single-infarct dementia and Multi-infarct dementia
This type of vascular dementia is caused by smaller strokes that commonly cause damage to the cortex of the brain, the area associated with learning, memory and language.

These types of stroke may be so small that the person does not notice any symptoms when they occur. Alternatively, the symptoms may only be temporary - lasting perhaps a few minutes - because the blockage clears itself. If symptoms last for less than 24 hours, it is called a 'mini-stroke' or transient ischaemic attack (TIA). A TIA may mistakenly be dismissed as a 'funny turn'.

If such a stroke interrupts the blood supply for more than a few minutes, an infarct will result. Sometimes just one infarct forms in an important part of the brain and this causes dementia (known as single-infarct dementia). Much more often, a series of small strokes over a period of weeks or months lead to a number of infarcts spread around the brain. Dementia in this case (known as multi-infarct dementia) is caused by the total damage from all the infarcts together.

A person with Multi-infarct dementia is likely to have better insight in the early stages than people with Alzheimer's disease, and parts of their personality may remain relatively intact for longer. Symptoms may include severe depression, mood swings and epilepsy.

c) Subcortical dementia or Binswanger's disease 
This was thought to be rare, but is now being reassessed, and may in fact be relatively common. Once considered rare, is now thought to be the most common type of vascular dementia.

Subcortical vascular dementia is caused by diseases of the very small blood vessels that causes infarcts to tissue that lies deep in the brain - the “white matter”. These small vessels develop thick walls and become stiff and twisted, meaning that blood flow through them is reduced. It is caused by high blood pressure, thickening of the arteries and inadequate blood flow.

Small vessel disease often damages the bundles of nerve fibres that carry signals around the brain, known as white matter. It can also cause small infarcts near the base of the brain. Small vessel disease develops much deeper in the brain than the damage caused by many strokes. This means many of the symptoms of subcortical vascular dementia are different from those of stroke-related dementia.

Common symptoms include slowness and lethargy, difficulty walking, emotional ups and downs and lack of bladder control early in the course of the disease.

d) Lewy Body disease
Lewy body disease is caused by the degeneration and death of nerve cells in the brain.

The name comes from the presence of abnormal spherical structures, called Lewy bodies, which develop inside nerve cells. It is thought that these may contribute to the death of the brain cells.

Lewy body disease is similar to Alzheimer's disease in many ways, and in the past it has sometimes been difficult to distinguish the two. It has only recently been accepted as a disease in its own right. It can occur by itself or together with Alzheimer's disease and/or Vascular dementia. It may be hard to distinguish Lewy body disease from Parkinson's disease, and some people with Parkinson's disease develop a dementia that is similar to that seen in Lewy body disease.

The symptoms of dementia with Lewy body disease include difficulty with concentration and attention, extreme confusion and difficulties judging distances, often resulting in falls.

There are also three cardinal symptoms, two of which must be present in order to make the diagnosis:

Visual hallucinations
Parkinsonism (tremors and stiffness similar to that seen in Parkinson's disease)
Fluctuation in mental state so that the person may be lucid and clear at one time and confused, disoriented and bewildered at other times. Typically this fluctuation occurs over a period of hours or even minutes and is not due to any underlying acute physical illness.

Some people who have Lewy body disease may also experience delusions and/or depression.

e) Alcohol related dementia
Alcohol related dementia can affect men and women of any age. It is currently unclear as to whether alcohol has a direct toxic effect on the brain cells (neurotoxicity hypothesis), or whether the damage is due to lack of thiamine (or vitamin B1). Nutritional problems, which often accompany consistent or episodic heavy use of alcohol, are thought to be contributing factors.

Symptoms include
Impaired ability to learn things
Personality changes
Problems with memory
Difficulty with clear and logical thinking on tasks which require planning, organising, common sense judgement and social skills
Problems with balance
Decreased initiative and spontaneity.

Generally skills learned earlier in life and old habits such as language and gestures tend to be relatively unaffected.

     Who gets alcohol related dementia?

Anyone who drinks excessive amounts of alcohol over a period of years may get alcohol related dementia.

Males who drink more than six standard alcoholic drinks a day, and women who drink more than four, seem to be at increased risk of developing alcohol related dementia.

The risk clearly increases for people who drink high levels of alcohol on a regular basis.

The National Health & Medical Research Council of Australia recommends that for health reasons related to the prevention of brain and liver damage adult males should drink no more than four standard drinks per day and adult females should drink no more than two standard drinks per day. NOTE : For cancer, there is no really safe limit.

Some people who drink at high levels do not develop alcohol related dementia, but it is not currently possible to understand and predict who will and who will not develop alcohol related dementia.

Some people who develop alcohol related dementia might also show some degree of recovery over time if they reduce alcohol intake to safe levels or abstain from alcohol and maintain good health.

f) Fronto-temporal dementia or Pick’s disease
Fronto-temporal dementia (FTD) is one of the less common types of dementia. The term covers a wide range of different conditions. FTD occurs when nerve cells in the frontal and/or temporal lobes of the brain die, and the pathways that connect the lobes change. Some of the chemical messengers that transmit signals between nerve cells are also lost. Over time, as more and more nerve cells die, the brain tissue in the frontal and temporal lobes shrinks.

The frontal lobes of the brain, found behind the forehead, deal with behaviour, problem solving, planning, speech and the control of emotions.

Symptoms of FTD include changes in personality and behaviour, and difficulties with language. These symptoms are different from the memory loss often associated with more common types of dementia, such as Alzheimer’s disease. As FTD is a less common form of dementia, many people (including some health professionals) may not have heard of it.

Mixed dementia
At least 10 per cent of people with dementia are diagnosed with mixed dementia. This generally means that both Alzheimer's disease and vascular disease are thought to have caused the dementia. The symptoms of mixed dementia may be similar to those of either Alzheimer's disease or vascular dementia, or they may be a combination of the two.



Early signs 


The early signs of dementia are very subtle and vague and may not be immediately obvious.

Some common symptoms may include:

Progressive and frequent memory loss
Confusion
Personality change
Apathy and withdrawal
Loss of ability to perform everyday tasks.


Prevention and cure
Next post we look into what causes dementia and where the prospects for prevention and cure dwell; and a hint, dementia being a disease closely related to lifestyle, all the hope seems to rest with a healthy, therapeutic lifestyle.


COMING SOON 
WINTER MEDITATION RETREATS AND TRAINING

June 5 – 9th Deepening Your Meditation

Our only 5 day meditation retreat, this program is all about taking time out, entering into a meditative environment and being supported to deepen your experience. Then, with this deeper experience, being able to take it with you so that your ongoing practice is more rewarding, more beneficial, more enjoyable.








July 1 -7th Mindfulness and Meditation in Daily Life

We have had many requests to present a meditation retreat in Queensland, so this is it. This retreat will focus on integrating mindfulness and meditation into daily life.

I know when I first started, meditation was something I did for a few minutes (or hours) every day; but at first, I then went back to my day as if nothing much had happened. The real benefit of these practices is in how they inform our daily life, so this retreat will be very practical.

We will practice mindfulness and meditation together formally, and then use the rest of our time to bring the qualities of the practice into our daily experience – in a way that we can take them home and maintain them. My sense is that for many this could well be life changing.

We are fortunate to be able to use the facilities of the Chenrezig Institute – a purpose built Retreat Centre in the hills back of the Sunshine Coast.

October 9 – 13th Meditation Teacher Training – Module 2

In this training we use a fully documented manual to learn how to teach 2 4 week programs one on guided imagery; the other contemplation. These training have been booking out, and like all our retreats, it is wise to register early.