Friday, 30 January 2015

The Aging Brain: Focusing on Prevention

Your brain is your most critical organ – it is literally the control centre of your body. Without the ability to make judgments, process information and communicate, we would be rendered dysfunctional. 

We have all heard reports of a court of law declaring someone “incompetent” in the event that a person is unable to make basic life decisions. 

Think about it. 

You can lose many of your physical abilities, but as long as your brain is active and functioning, you are still in the game.

Several articles have been published on the topic of Dementia - discussing the problem and presenting statistics. The articles note the promise of research in this area, however, none of them report success with current treatments. Recently, The Globe and Mail published a story on a novel blood test with potential predictive value of developing Alzheimer’s-type dementia by measuring lipid levels. Again, no firm conclusions were communicated.

So let’s look at the problem. 

The World Health Organization (WHO) defines Dementia as a syndrome, chronic and progressive in nature, with deterioration in cognitive function beyond that from normal aging. Thinking and social abilities are affected severely enough to interfere with daily functioning such as paying bills or becoming lost driving. Alzheimer’s disease is the most common type of progressive dementia (The Mayo Clinic).

Neurophysiologically, in dementia, there is a rapid and intense degeneration of the brain. Imaging studies and post-mortem cross sections reveal substantial shrinking of the brain. Specific to Alzheimer’s disease, clusters of proteins deposit around neurons, interfering with proper cell function. Acetylcholine levels are reduced drastically and interneuron messaging is impeded (Merck Manual).

Current medical practice has little to offer other than prescription drugs such as acetylcholinesterase inhibitors, antidepressants and antipsychotics.  These drugs may reduce some symptoms but do not slow the progression of the disease.  

Let’s look at the statistics of the problem. 

The Canadian Institutes of Health Research (CIHR) reported 747, 000 Canadians were living with Alzheimer’s or related dementias in 2011. That number is expected to increase to 1.4 million by 2031 with an estimated $293 billion in economic cost. The Alzheimer’s Society Canada states that adding to the problem, primary caregivers are at greater risk of caregiver stress – which ultimately results in additional physical, emotional and financial strain.

At present, when it comes to Alzheimer’s disease and other dementias, we are faced with many more questions than answers. We know that a mixture of genetics and the environment play a role in susceptibility to the disease. Unfortunately, tackling these factors once illness has developed is often futile.

With a medical paradigm based on disease prevention and health promotion, consider the approach taken in naturopathic medicine when evaluating solutions to neurodegenerative diseases. Substantial evidence suggests that neurons exposed to free radicals are subject to oxidative stress- stress that can weaken and ultimately kill those cells (Bayani et al, Current Neuropharmacology, 2009).  In contrast, antioxidants are viewed as having paramount importance in scavenging the free radicals which are implicated as part of the problem in dementia-type illnesses.
Foods like red and green vegetables, nuts and a variety of berries are high in antioxidants (including Vitamin E and C) and should be included in a healthy diet but extensive research shows that supplementing with high doses of antioxidants is one strategy in preventing neurodegeneration.

Brain cells are surrounded by a phospholipid bilayer, which protects, and maintains the integrity of the cell membranes (Textbook of Natural Medicine, Pizzorno & Murray 1999). Fatty acid loss with the natural process of aging, through medication or low fat diets, causes cell membranes to become weaker exposing the vulnerable brain cell to assault. In 2008, The Canadian Medical Association Journal (CMAJ) produced an extensive review on the role of Omega-3 fatty acids. These polyunsaturated fats found in fish oils help support the lipid bilayer surrounding brain cells.  Studies have focused mostly on Age-Associated Memory Impairment (AAMI) and Mild Cognitive Impairment (MCI) with fatty acids as one successful treatment strategy.

The clinical significance of antioxidants and omega-3 fatty acids are the main components of the Mediterranean Diet which focuses on increasing antioxidant rich fruits, vegetables and nuts and healthy fats such as fish and seafood- while eliminating inflammatory foods such as alcohol, sweets and non-pastured red meat.  Fifty years of research has shown that a simple local, seasonal plant rich diet has innumerable health benefits. Both The Mayo Clinic and The Heart and Stroke Association recommend the Mediterranean Diet as a key component in lowering the risk of cardiovascular disease, Parkinson’s and Alzheimer’s disease.

When it comes to neurodegenerative diseases of the aging brain, naturopathic doctors aim at preserving brain integrity and maximizing conditions for optimal brain function- with the use of high dose, high quality evidence based natural medicines.  When dosed appropriate to the patient and condition, certain phospholipids, amino acids and botanical medicines, increase neurotransmitter function, act as cell membrane support and synthesis.  These in turn have a significant effect on cognitive function. The implications are clear that preventing dementia and Alzheimer’s is more effective than treating it once it has developed.

About the author

Dr Jilla Kahrobaei, Naturopathic Doctor, is passionate about her work. She focuses on stress, fatigue, digestive issues and hormone health, and believes that one of the most important roles of a naturopath is to identify and resolve issues before they create health problems.


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