The Most Popular Treatments for Alzheimers Disease
Why the best hope for avoiding dementia is still prevention!
Research Shows That Both Drugs And Supplements Can Do A Lot More Harm Than Good!
By Joel Fuhrman, M.D. www.drfuhrman.com
In 2005 alone, 2,376 randomized, controlled clinical trials were published on dementia treatments. Obviously, drug companies (who fund most of the studies) are expecting to reap huge profits from dementia treatments.
With such an enormous investment in research, it is no surprise that even when the efficacy of a drug is inconclusive; the results are often presented in a way to create a false perception of effectiveness. Cholinesterase inhibitors such as Aricept and Exelon are currently the drugs of choice for treating patients with Alzheimer’s disease. However, a recent systematic review of the studies on this class of medications shows that these medications only have a very slight clinical benefit.1 A few patients in a small subgroup received slight benefits, but 90 percent of patients showed no benefit at all.2 In addition, these medications cause many adverse effects, including increased cardiovascular- related deaths!3
Huperzine A is a potent cholinesterase inhibitor isolated from Chinese club moss. It really should be regulated as a drug, but it is sold over the counter as a dietary supplement for memory loss and treatment for Alzheimer’s disease and related conditions. Human trials have produced mixed results, and all studies have been done in China.4 I cannot recommend its use.
Since oxidative stress could play a role in the degenerative nerve cell changes in Alzheimer’s, it has been suggested that antioxidants may counteract the nerve damage by stopping damaging free radical reactions. A plant-based, antioxidant- rich diet has been shown to help prevent this disease, so people thought they could prevent and treat dementia with antioxidant vitamins such as vitamins C and E. It doesn’t work. In addition, these supplements taken in isolation actually may do more harm than good. A recent analysis of 19 trials involving more than 135,000 participants reported that high dose vitamin E supplementation increased all-cause mortality.5
Ginkgo biloba is the oldest surviving species of tree, dating back 300 million years. Ginkgo has long been used in traditional Chinese medicine and may provide some relief from symptoms of early stage Alzheimer’s. It is the most widely sold phytomedicine in Europe and is one of the 10 best-selling herbal medications in the United States. This herbal remedy is thought to work by increasing blood supply by dilating blood vessels and reducing blood viscosity.
Some studies have shown ginkgo to have a modest effect on improving the symptoms of dementia. A review of a number of studies of at least six months in duration demonstrated that ginkgo extract and traditional drug therapy were equally effective (meaning not very effective) in treating mild Alzheimer’s dementia.6
Other research, however, has indicated that ginkgo does not have a clinically significant benefit for people with dementia or cognitive impairment.7 So it may be that the very modest benefits occur only in the early stages of the disease.
The National Institutes of Health and the National Center for Complementary and Alternative Medicine have sponsored a six-year study with 2,000 subjects that are now ongoing. The safety and efficacy of ginkgo in preventing dementia and age-related cognitive decline will be further evaluated. The bottom line is that ginkgo is a mild intervention that is safe, but is only of slight benefit to a subset of mildly effected patients.
Phosphatidylserine is a phospholipid that is critical to the structure and maintenance of cell membranes. The cell membrane keeps cells intact and plays a role in moving nutrients into the cell and pumping waste products out. Your body makes all of the phosphatidylserine it needs, and the only way to get a therapeutic dosage is to take a supplement. It was originally manufactured from the brains of cows, but because animal brain cells can harbor viruses, that form is no longer available. Most phosphatidylserine now is made from soybeans or other plant sources. Unfortunately, well-designed studies are not available for the plant-based supplement. In preliminary trials, soy- and cabbage-based phosphatidylserine supplements have not proven beneficial.
Carnitine is an amino acid that the body manufactures to turn fat into energy. Acetyl-L-carnitine is a form of carnitine that is structurally similar to acetylcholine. Early studies indicated that it might be helpful in treating Alzheimer’s disease, but larger, more recent studies found no benefit.
Hormone levels change with aging, and significant differences have been found in women with Alzheimer’s. This created interest in the possible protective effect of estrogens on the risk of dementia. Phytoestrogens, plant-derived nonsteroidal estrogens found in abundance in most soy food products, have been evaluated for potential beneficial effects, but none have been found. Recent large scale studies, however, have indicated that estrogen therapy does not show any significant benefits among postmenopausal women diagnosed with mild to moderate Alzheimer’s. The largest and very definitive study, the Women’s Health Initiative Memory Study, was recently published. It showed that the incidence of dementia was actually increased in women receiving hormone therapy.8
Expecting medicines, herbs, vitamins, and other treatments to effectively deal with dementia is a pipe dream. Brain cells can live for 150 years, but once they are destroyed, they don’t come back. You must protect the brain cells you have now. Living longer is of no value unless you continue to enjoy a high quality of life, and a high quality of life cannot be achieved in your later years unless you take the proper steps when you are younger. The best nutritional steps to take to avoid dementia are:1) eat a diet rich in green vegetables, raw seeds, and berries; and 2) avoid the trans fats and fatty animal products that most Americans vastly over consume.
Green vegetables and berries are the two food categories with the highest amount of micronutrients per calorie. They are our super-foods. Vitamin D and DHA adequacy as well as regular exercise are also important, often overlooked factors. Can you imagine if everyone in America knew that they could avoid dementia as they age? Maybe that would motivate them to change their disease-causing diets.
1. Kaduszkiewicz H, Zimmermann T, Beck- Bornholdt HP, van den Bussche H. “Cholinesterase inhibitors for patients with Alzheimer’s disease: systematic review of randomized clinical trials.” BMJ 2005;331:321-327.
2. Doody RS, Stevens JC, Beck C, Dubinsky RM, Kaye JA, et al. “Practice parameter: Management of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology.” Neurology 2001;56:1154-1166.
3. “Alzheimer’s disease: beware of interactions with cholinesterase inhibitors.” Prescrire Int 2006; 15(83):103-6.
4. EBSCO Publishing; iHerb.Com; “Herbs & Supplements: Huperzine A.: date accessed: January 7, 2008.
5. Miller ER, Pator-Barriuso R, Dalad D, et al. “Meta-analysis: high dosage vitamin E supplementation may increase all-cause mortality.” Ann Intern Med 2005;142:37-46.
6. Sierpina V, Wollschlaeger B, Blumenthal M. “Ginkgo biloba.” Am Fam Physician 2003;68: 923-926.
7. Birks J. “Ginkgo biloba for cognitive impairment and dementia.” 2007; Cochrane Review Abstracts; The Cochrane Collaboration.
8. Writing Group for the Women’s Health Initiative Investigators. “Risks and benefits of estrogen plus progestin in healthy postmenopausal women; principal results from the women’s health initiative randomized controlled trial.” JAMA 2002;288:321-333.