elderly lady dementia

Dementia – The Missing Link

Dementia and alzheimer’s shocking statistics

There are at present approximately 850,000 cases of dementia in the UK and this looks set to rise to over a million by 2025. Nearly 40,000 of those suffering are under the age of 65 yrs old which by today’s standards is considered young. Additionally almost two thirds of the cost of dementia is paid for by the families and carers, saving the economy a whopping £11 billion per year. These statistics make for fairly depressing reading, leaving the patient and the carer fending for themselves, often powerless in the grip of these conditions. I’m pretty appalled that as a country we spend less on dementia than cancer and cardiovascular disease and at present there is no cure. As dementia is one of the main causes of disability in later life it is one of the top five concerns of my patients and clients. Many not only fear getting the disease, particularly if they have watched a family member suffer, but worry that they will be a burden to loved ones and family in the future. ” Physical disability is one thing, but I’m terrified of losing my mind. I suppose it’s the ultimate loss of control” said one client of mine. Recently I’ve popped in to see some wonderful centres and spoken to volunteers who are trying their very best to raise money and support where they can. In my local town these vital centres are being threatened by cuts. To be frank if we’re not mad about this we should be.



Despite the wonderful work going on, once dementia is diagnosed, the outcomes can be fairly bleak. To date all the drug research hasn’t yet come up with a magic formula. Aricept and Memantin go someway to help stall symptoms, but it’s not really what was hoped for and the side effects can be grim. Although we have had huge progress in HIV, cancer and heart disease, dementia is lagging behind in every avenue. It’s not just that it can be fatal but, sufferers can lose the very essence of themselves and the ability to lead independent lives. Some, no longer know their past, recognise loved ones which is not only highly distressing for the sufferer but for those around them. In all this darkness and gloom, is there any good news? Certainly looking at diet and lifestyle may go some way to help not only stopping symptoms in the first place but also preventing current symptoms getting worse. Looking at dementia as a multi factorial disease rather than a singular issue may be the key to lighting the way out of the darkness.

Where did I leave my specs?

Really, anyone over 40 yrs old needs to take note and look for early warning signs of cognitive decline. However, before you all panic at that day last week when you couldn’t find your specs, early alzheimer’s is rare. There are other conditions like the menopause and hypothyroidism that can make you forgetful and foggy in the head. As of course can something far more common like insomnia or any kind of sleep deprivation. However in these conditions, the symptoms will rectify themselves once the problem is identified and supported. The good news (if there is any) is that dementia takes years to develop so we can do much to prevent it worsening. If you feel that you are having too many ‘senior moments’ or forgetting names it’s all too easy to laugh it off as getting older. Such signs certainly don’t mean you have dementia but being in denial and battling symptoms can be detrimental. I often go into a room and go blank as to why I’ve gone in there but I know (to the best of my ability) that I don’t have dementia. More significant symptoms in the over 65’s can include: facial blindness, decreased interest in reading or having conversations, difficulty following a film with complicated plots, decreased vocabulary, struggling to find the right word, mixing words up, fuzzy thinking, anxiety about driving, getting overwhelmed, sleep disruption and forgotten learned languages. If you are over 65 yrs old and have any worries, please do see your GP, it’s most likely nothing to worry about but always best to check. Often it’s one of the most scary appointments to book, it seems people fear talking about cognitive decline more than other diseases of ageing. But early diagnosis can certainly give you some time to look at what you can do in order to change your outcome.

Different types of dementia

There are varying types of dementia, these are the most common:

  • Vascular – reduced blood flow to the brain, multiple small strokes. Overlaps with Alzheimer’s
  • Frontotemporal – less common than Alzheimer’s. Changes in behaviour, memory problems and difficulty speaking
  • Lewy Body – common, visual hallucinations, delusions, increased sleeping, flinging of limbs during sleep
  • Alzheimer’s- amyloid plaques and neurofibrillary tangles
  • Subjective cognitive impairment – patient passes tests but notices subtle changes in cognition.
  • Mild cognitive impairment – tests show memory, speaking etc are abnormal but patient can function

How important are our genes?

The most common gene associated with late onset Alzheimer’s (over 65 yrs old) is apolipoprotein APOE. This has three forms: Apoe E2, Apoe E3, and Apoe E4. Apoe E4 seems to increase the risk of Alzheimer’s. Apo E4 is the gene variant and the strongest known genetic risk for Alzheimer’s. Many people don’t even know they are carrying the gene until they are tested. Just to be clear people contract dementia whether they have the gene or not. So the gun is loaded if you carry the gene, but the trigger still needs to be pulled. Carrying the gene does not mean you automatically get dementia.Your genes are not your destiny and only 1% of the population develops Alzheimer’s due to a genetic mutation. The real risk for us is not then determined by our genes but by our lifestyles and is not inevitable.

Can diet and lifestyle changes help?

Without getting judgemental and finger pointy I am pretty peeved that most of the alzheimer’s and dementia information says very little about diet and lifestyle. If they do it’s fairly basic stuff and not much discussed. Your choices or so it seems are two fold; drugs or alternative therapies – one site mentioned coconut oil – talk about going from the sublime to the ridiculous. (For those that are wondering, no, coconut oil will not cure dementia) Looking at things from a slightly different angle, dementia has been called Type 3 Diabetes. When blood sugar is high, insulin is called up upon to bring it down. The body must degrade the insulin further to stop the blood sugar dropping too low. Its does so by an insulin degrading enzyme (IDE). Co-incidentally IDE degrades amyloid (present in Alzheimer’s) as well but can’t do both at the same time. So if IDE is breaking down insulin it can’t break down amyloid. Therefore one could conclude that that high levels of insulin may cause Alzheimer’s. If only it were that simple. Targeting the amyloid plaque found in alzheimer’s has not been the magic bullet we thought. Potentially going one step further and finding out what is triggering the plaque in the first place could be more relevant to finding solutions.

Rather than just sit and just wait for the inevitable, looking at diet and lifestyle may help not only prevent symptoms but reduce those already there. One of my patients who came with his son said to me how helpless he felt. At that point they had been given dire outcomes and had nothing to lose by looking at diet and lifestyle. Four years later, with no medication after a fairly poor prediction, the father has better cognition and symptoms have stabilised ie he has not worsened as predicted and has passed all his cognitive tests.

Two key components for reducing the likelihood of Alzheimer’s is dealing with inflammation and raised insulin. There is now weighty research on the role of insulin resistance and cognitive decline, how stress impacts cognition and how your diet can effect inflammation. Additionally with all patients I see with dementia their gut microbiome is remarkably altered (and not in a good way.) It is vital in my opinion to look at dementia, not as a singular issue of the brain but as a multi factorial issue. As it is with lifestyle medicine all patients are different but there are some similar patterns and changes of diet and environment that can go a long way to help better outcomes. As this is a complex medical issue I’ve devised a three month programme tailored to the needs of the patient/carer/family in order to work out a plan of action that best suits the sufferer. If you would like more details about this please call me for a free fifteen minute chat to see if the programme would be suitable and discuss reasonable outcomes and expectations.

If you would like further information please contact Kate on 01323 310532/737814 or email katenut@aol.com. For more information on Kate go to www.katearnoldnutrition.co.uk

Author

  • Kate Arnold

    Kate Arnold Nutrition is a nutrition consultancy specialising in gastrointestinal health and fatigue disorders. Kate is passionate about an evidence based, patient centred form of healthcare. She has a special interest in the pathophysiology of obesity and how alterations in the gut microbiome can lead to weight gain and other medical conditions. Kate is a vocal opponent of nutrition pseudoscience and works closely with GPs and consultants where possible. With over twenty years experience Kate has worked with a vast range of clients including charities, The Princes Trust, schools, local government, music and media personalities. Kate is the spokesperson for an award wining yearly campaign for Dulcolax, resident nutrition consultant for Wellbeing magazine and has a regular column in Gastro magazine. Kate is also a Map My Gut and SIBO certified practitioner.