Recovery from Dementia - the Truth Behind This Ageing Epidemic
Yesterday, it seemed like Dementia was everywhere in my life. I am in the middle of compiling a series of talks to do in the New Year in my local area (beginning with an Introduction to Functional Medicine in January) - one of which is on the subject of dementia, specifically Alzheimer's, and yesterday I was putting the finishing touches to it.
I had the news playing in the background, and at the top of every bulletin they were announcing the headlines that Dementia was now the "leading cause of death" in the UK.
This was deeply upsetting to me, because the talk that I was writing was all about the remission of, and recovery from, dementia.
Now, I recognise that this is controversial and perhaps a step too far for the modern media to accept. But in amongst the headlines, everywhere there was comment on this story, the popular message went along the lines of, "isn't it a shame we don't have any effective treatments for dementia" and "isn't a shame more funding isn't directed towards dementia vs. cancer or heart disease" etc. There seemed to be a general consensus that dementia was now our biggest killer because of lack of attention and medication, rather than an understanding that dementia is poorly treated and dealt with basically because it is so poorly understood.
It is days like yesterday which remind me why I am in Functional Medicine, and why I love that my training in this area has allowed me to think the way I do. Rather than focus on attacking the deterioration symptoms of mental and memory decline that are characteristic of dementia, I deal with dementia by questioning the 'why' behind the symptoms.
Classic Symptoms of Dementia
It's not easy to relate the classic symptoms of dementia, because in reality there are many forms. We are now beginning to understand that there are even several subtypes within Alzheimer's alone. We recognise that these are all forms of mental deterioration, however - and these classically manifest with the following symptoms:
problems with memory
impaired language skills
difficulty with information processing
decreased mental agility
lacks of understanding
impaired judgement.
The Causes of Dementia
My issue with all of this is that the world (and yesterday's media) seemed to account for increased dementia incidence simply as a result of an increasingly ageing population, as if dementia was a natural consequence of getting old. **UPDATED below after news media on 17 November, just a day after this blog was first posted**
The reality is that dementia is not a consequence of getting old, at all. However, it is a consequence of longevity.
i.e. Dementia is a consequence of living for a long time, and during that time being exposed to sources of inflammation, toxicity and nutritional deficiencies for many, cumulative years.
Focus on Alzheimer's
Far from being a result of ageing, dementia - in particular Alzheimer's - is a result of the formation of amyloid plaques. That's a sort of gummy substance which accumulates together in the brain and 'interferes' with communication between the neurons of the brain. But I am not interested in fighting amyloid plaques, I'm interested in understanding why on earth they develop in the first place.
It turns out that amyloid is a protective substance, in the right context. As with substances that are both anti- and pro- oxidant, what matters in the body is always context.
For amyloid the formation occurs as a form of protection against three situations: all of which are a threat to the brain and the neurological function. The first is called "trophic loss", which is essentially a rapid and drastic loss of a single nutrient, or many single nutrients, in the brain. The second is toxicity, wherein there is a toxic exposure in the body and the amyloid is formed to bind those toxins to prevent neuronal damage. The third is a Functional Medicine practitioner's favourite topic: inflammation.
Type III Diabetes
There are now thought to be over 54 contributing factors to the formation of amyloid, and the division of amyloid in a way that forms specific peptides which cause the typical loss of synapses, reorganisation of neuronal pathways and programmed cell death seen in the brains of Alzheimer's patients.
Key amongst these is actually what happens in the brain of those patients: a struggle with insulin resistance due to prolonged ingestion of a diet rich in carbohydrates, processed foods, sugars and refined products. The topic of insulin resistance is a huge one (and Diabetes and Insulin Resistance will form the basis of another talk I will be giving next year). But the behaviour of the brain when insulin resistance is present is fascinating.
The brain requires glucose to function, and whilst arguments can be made for ketones being an alternative fuel source, this only works in people obtaining and effectively utilising these ketones through high fat dieting. In reality, the bulk of the population will be using glucose for their brain's fuel.
Insulin is released when there is glucose in the bloodstream - and it is a master storage hormone, telling the cells that there is energy available for use. A state of insulin resistance occurs when there is continual consumption of the foods which cause insulin to be released: sugars, carbohydrates and refined foods. Prolonged intake of carbohydrates leads to prolonged exposure to high levels of insulin in the bloodstream. This cause a decrease in sensitivity of insulin receptors on cells. The cells may have a need for the glucose floating in the bloodstream but they become 'deaf' to the signal that there's energy there for use, because they're so accustomed to it just being there.
In the brain, this can be disastrous. The excess glucose in the blood stream leads to the glycation of proteins (again, too long to explain - but a damaging, non-beneficial process) which essentially equals inflammation. Additionally, the resistance of the cells to insulin equals a lack of glucose uptake in brain's cells. Glucose is a nutrient that the cells need - and this lack of uptake forms one example of "trophic loss" (see above). All of this leads to a brain both inflamed and without a vital nutrient.
The result? The formation of amyloid in the context of inflammation and nutrient deficiency and therefore the formation of plaques. Impaired neuronal signalling, impaired memory and compromised brain function are the only possible end result.
So What Can I Do?
This is why I become so upset when listening to the media's rendition of any health headline. Because they are so pessimistic and desperate to outsource the viability of health to a prescription medication and a pharmaceutical intervention.
In reality, however, I am someone (like a lot of the functional medicine community) passionate about restoring people's ability to marshal and master their own wellbeing.
If inflammation, insulin resistance and toxicity are big contributors to Alzheimer's and dementia, it would seem natural to conclude that a reduction in inflammation, increased insulin sensitivity and the removal of toxins are the logical first steps. Long before we reach for drugs, we recommend stepping away from the so-called "natural" substances (sugar, refined carbohydrates, processed food and seed oils, household toxicity, plastics, moulds etc.) which the body is having to battle and are not at all supportive or nourishing.
There are many things to consider, but these basic recommendations can actually change lives when it comes to dementia. Now there are many factors involved, so this may not hit all of them, but to do the most simple of steps is to safeguard, and potentially reverse, the process of neuroinflammation which is the first step to cognitive decline. It is stacking the odds very much in our favour.
A diet based on fats, high in nutrient density and low in refined or processed foods is the first prescription our ageing population require. Removal of sugars and additions of supplemental nutrients that are more than likely missing from our food supplies are stage one in recovery.
Yes - I said recovery.
Because the wonder of the brain is in its neuroplasticity. This flexible neuronal formation is why we often don't notice the symptoms of dementia until it is too late: because the brain finds workarounds and adaptations so it can 'think straight' for as long as possible.
But this neuroplasticity and ability to regenerate is precisely why the brain, and our bodies as a whole, are miraculous. Given the right fuel, the right support and removing the wrong foods and the substances which undermine wellbeing, can not only allow for the brain to begin to function properly. It can allow for the reduction in neuroinflammation and for normal glucose-using service to be resumed in the important parietal and temporal regions of the brain.
It can allow for dementia to disappear.
Don't believe me? Then please find the resources at the following links where you will see that research into this area is, in no way, in its infancy. Poor funding is not affecting us finding real cures. And they're not expensive, they're not far-fetched and they won't make Big Pharma a lot of money (possibly a reason behind the poor funding, but that's a separate conversation):
This blog post is not designed to be a complete insight into dementia or Alzheimer's. Like I said - over 54 different potential contributors to these conditions. However, of you would like to speak to me about your concerns or enquiries about dementia for you and your family or loved ones, the involvement of genetics in dementia (ApoE on your 23andme etc.) then please do get in touch.
***The update comes one day after this post was made: where the headlines today were that dementia is definitely a "lifelong decline" phenomenon - i.e. it gets worse with age. I wonder why the scientists aren't questioning this decline - and seeing it as a symptom of something, rather than a simple fact. Ageing is a process of damage and toxin accumulation and our brains aren't absolved of that process. To focus on the ways we can minimise these exposures and stack the odds in our favour is a much healthier attitude to all health concerns: dementia included. To surrender to the natural progression of cognitive decline is to fail to realise that our bodies are miraculous, and given the right stimulus/nutrition/support they will look after themselves and still be vital and functioning even into our old age.