Alzheimer’s Disease and Carbohydrates (Transcript #1 of 4)

In today’s Carbohydrates Can Kill podcast show, I am going to discuss Alzheimer’s disease and Carbohydrates with you.

Alzheimer’s disease has been one of the diseases, which occur during one’s later life, such as cardiovascular diseases, diabetes mellitus, cancer, and more. From the pathophysiological perspective, these diseases have been considered as a result of aging process or degeneration.

As medicine seems having advanced so much in understanding diseases and offering their treatments, more people are living longer into the age beyond their 80’s or later. When I began practicing anesthesiology in the middle of 1970’s, most of my geriatric patients were 60’s of their age. Rarely, I had to attend patients who were in their 70 years and older.

As I continued practicing medicine, I had realized the age of my geriatric patients was growing older. By the time, when I retired from anesthesiology in August 1997, I had attended five patients who were older than 100 years. Thus, I should not be surprised when I saw an increasing number of older people who would suffer with the so-called degenerative diseases such as Alzheimer’s disease and cancer. However, I have always been puzzled with the fact that the prevalence of these diseases is generally growing faster than we have expected. Besides, the age of the patients when these diseases start is also becoming younger than we have anticipated. Aging process is no longer a perfect excuse for these diseases. Rather, there must be other factor or factors, which have promoted these degenerative diseases.

I had studied medicine during the second half of the 1960’s. When I learned about dementia, which included senile dementia and Alzheimer’s disease, I could appreciate the detrimental impacts of dementia on both the patient and his family or caregiver.

On one hand, the patient helplessly realizes he cannot remember things, which he has just learned.  He cannot remember the names and the use of things, which he has used in his daily life. He also finds himself in such a difficult situation that he cannot fully communicate with his family members or caregiver. He is so frustrated and depressed.

On the other hand, the patient’s family members and/or his caregiver helplessly watch him becoming much more confused and losing his ability of communication with the people in his surrounding. Because the patient loses his orientation and understanding of his surrounding, he may need a family member or caregiver to accompany him all the time, or he may have to commit himself to a special care facility for the rest of his life. Such care has become a large financial burden to his family and/or estate, and in some cases, to the society.

With the above introduction of dementia and/or Alzheimer’s disease, understanding their history, causes, pathological findings and updates, prognosis and available treatments, and prevention has become an urgent issue. For that, I am starting today with a special podcast series on Alzheimer’s disease. I am hoping that, with this series, I could help you learn more about this terrible disease. With the knowledge offered to you here from me and four of my featured guests of this podcast series, I hope you could help your loved one or friend who unfortunately has suffered with Alzheimer’s disease improve his symptoms and possibly recover from this disease. And, I also hope that, with the knowledge offered here, you would take whatever necessary measures to prevent you and your loved ones and friends from suffering with Alzheimer’s disease.

What is the history about dementia?

Before I specifically discuss with you about Alzheimer’s disease, let me briefly talk about dementia, which has been a longstanding neuro-psychiatric disease, or, rather, a syndrome. By definition, dementia means loss of mind or madness in Latin, which includes a global loss of cognitive functions including attention, learning, recalling or remembering the past experience, producing and understanding words or language, feelings, understanding logics and solving problems, and making decisions. Apparently, loss of any of the cognitive functions, an individual would not be able to normally conduct his daily activities and would behave unreasonably and erratically.

As mentioned, dementia is a syndrome or a group of diseases, which are characterized with loss of cognitive functions. In a broad sense, loss of cognitive functions is a result of injury or injuries to the neurons or nerve cells of the brain, which consequently fails to connect neurons or nerve cells to other neurons or nerve cells for coordinating physiological functions. The forms of dementia include vascular dementia, Pick’s disease (semantic dementia or frontotemporal dementia), dementia with Lewy bodies, and Alzheimer’s disease. Dementia can also be found in those with Huntington’s disease, multiple sclerosis, infections that affect the brain, Parkinson’s disease, progressive supranuclear palsy. Some causes of dementia, which might be preventable, are brain injury, brain tumors, chronic alcohol abuse, changes in blood sugar, sodium, and calcium levels, low Vitamin B12 levels, normal pressure hydrocephalus, and use of certain medications including cimetadine and some cholesterol-lowering drugs.

Vascular dementia is commonly observed in those who has had stroke with damages to the neurons for developing degenerative changes.

Progressive supranuclear palsy is a disease involving damages to the area of the brain where controls the eye movement. The disease progresses slowly and often affects the patient’s mood and behavior including depression, apathy, and progressive mild dementia.

Huntington’s disease is supposed to be a familial disorder and involves certain part of the brain with degenerative changes, which demonstrate behavioral disturbances, hallucinations, irritability, moodiness, restlessness or fidgeting, and psychosis. Huntington’s disease also causes abnormal movements such as grimaces, slow and/or uncontrolled movements, and unsteady gaits, as well as dementia.

Needless to say, infections that affect the brain can cause neurodegeneration and affect the individual’s mental state.

Multiple sclerosis affects more women than men, and occurs in younger age. It is thought an autoimmune disease affecting the myelin sheath of the neurons of the brain and spinal cord. Other than symptoms of the motor nerves, it also causes decreased attention span, poor judgment, and memory loss, as well as cognitive dysfunction.

Parkinson’s disease causes damages to the cells in the brain or nucleus nigra or substantia nigra, which produce dopamine for controlling movements. The cardinal symptom of this disease is tremor. In addition, this disease can cause anxiety, stress, tension, confusion, depression, hallucination, memory loss, and dementia.

Frequently, the elderly suffered with epilepsy and, at the same time, with dementia. It is not well known if dementia is a result of the untoward effects of the anti-epileptic medication. On the other hand, epilepsy may be a kind of neurodegenerative disease, which is shared by dementia.

Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease) had been considered a disease involving only the motor system of the brain. However, recent studies have found its relationship to Parkinson’s disease and dementia. Pathologically, it is also a neurodegenerative disease.

Pick’s disease is characterized with Pick bodies inside nerve cells in the damaged area of the brain. Pick bodies contain an abnormal amount and abnormal type or form of a protein called “tau.” “Tau” protein exists in normal neurons for stabilizing microtubules, which are important in maintaining cell structure. Pick’s disease causes slow shrinkage of the tissue in the temporal and frontal lobes of the brain. Pick’s disease also causes behavioral changes including compulsive and repetitive behavior, inability to function or interact in social or personal environments.

Lewy body disease, like Alzheimer’s disease, which will be discussed next, is one of the most common types of progressive dementia or loss of cognitive functions. The characteristic of this disease is the affected nerve cells containing Lewy body, which is an abnormal protein structure called alpha synuyclein. This disease involves motor disorder like those of Parkinson’s disease and dementia like Alzheimer’s disease.

We’ll be back in a moment.