Alzheimer’s Disease – Latest Research And Functional Medicine Approach
Alzheimer’s Disease is devastating, for both the patient and their family.
Numbers of diagnoses are only continuing to rise.
With the release of the first new Alzheimer’s medication in nearly two decades, the time is fitting to revisit this condition from a Functional Medicine perspective.
Recent research suggests that some of the plaque in the brain, that is a hallmark of Alzheimer’s, may actually be helpful, instead of harmful.
We’ll dive into this research in this article, where we cover:
- What Alzheimer’s Disease
- How the Functional Medicine approach differs
- The details of the new findings on Alzheimer’s plaques
- Action steps you can take
What Is Alzheimer’s Disease
Alzheimer’s Disease is the most common type of dementia and considered a chronic disease.
It is a progressive disease that starts with mild changes in memory or cognition and may progress into a severe cognitive disorder where patients require complete care for daily function.
Brain imaging of people with Alzheimer’s Disease reveals plaque buildup in the brain and these plaques are considered the hallmark of the disease.
Amyloid-beta is a protein found in such plaques that may progress the disease, but the amount of plaque doesn’t always correlate with the degree of dementia experienced.
Typically, symptoms of Alzheimer’s Disease begin to appear after age 60 and risk increases along with age, although younger people are also affected.
Alzheimer’s disease is the sixth leading cause of death among all adults and the fifth leading cause of death for those over age 65.
Symptoms of Alzheimer’s Disease include:
- Memory loss
- Impairment of thinking
- Changes in language and communication
- Behavior changes
- Changes in judgement
- Withdrawal from social activities
- Changes in personality
- Neuropsychiatric symptoms including delusions, hallucinations, aggression, apathy
- Changes in circadian rhythm
Per the Centers for Disease Control (CDC), in 2020 5.8 million Americans were living with Alzheimer’s disease.
This number is expected to nearly triple by 2060 due to an increased aging population, health factors and lack of tools for prevention.
The Conventional Vs. Functional Medicine Approach
The conventional approach to Alzheimer’s disease starts with diagnosis. In some cases mild cognitive impairment will be diagnosed and then progression is seen to Alzheimer’s disease.
For patients with Alzheimer’s disease the goal of treatment is to delay progression and manage symptoms.
There are a variety of medications used in the treatment of Alzheimer’s. The most recent medication to hit the market, Aduhelm, targets the Amyloid-plaques in the brain.
Functional Medicine takes this framework and goes deeper. By understanding the root causes of Alzheimer’s disease, which may have commonalities with other chronic diseases and be simmering under the surface for decades, we not only manage the disease, but prevention and disease reversal are also possible.
While there may be some commonalities between everyone with Alzheimer’s disease, Functional Medicine treats each person as a unique individual. Dr. Dale Bredesen is a pioneer in the field of Functional Medicine for Alzheimer’s and uses this approach.
He also trains other practitioners to treat Alzheimer’s from this lens. Remarkably, Dr. Bredesen has published research showing the reversal of cognitive decline in Alzheimer’s using his framework that simultaneously treats all root causes.
Since each person has many root causes, many approaches are required. A single intervention, or medication, doesn’t address all of the contributing factors.
Age and family history are the top risk factors discussed in allopathic medicine, but Functional Medicine considers additional risk factors or root causes to be:
- Glycemic dysregulation and insulin resistance. Interestingly, Alzheimer’s is sometimes referred to as Type 3 Diabetes.
- ApoE4 genotype. This genetic marker is related to Alzheimer’s disease risk and also provides clues about personalizing a diet strategy for prevention.
- Nutrient deficiencies. Deficiencies to essential nutrients including vitamin B1, vitamin B6, vitamin B12, folate, omega-3 fats and others have been linked to dementia.
- Poor methylation. Methylation is important for brain health and gene expression. Poor methylation is often related to deficiencies in key nutrients needed for preventing Alzheimer’s including vitamin B12 and folate.
- Inflammation. Underlying chronic inflammation may cause inflammation in the brain.
- Oxidative stress. When you are in a state of high free radicals and low antioxidants, damage is done to the cells, including brain cells.
- Toxin exposures or poor detoxification. Exposure to toxins, such as mold, heavy metals and pesticides, creates oxidative stress and a burden on the detoxification systems.
- Mitochondrial dysfunction. Brain cells are highly concentrated with mitochondria and require the efficient production of a high amount of energy in order to maintain function.
- Microbiome imbalances. The gut-brain axis plays a key role here. Restoring gut health helps to restore brain health.
- Pathogens. Consider underlying gut infections such as candida, parasites or bacterial overgrowth in addition to stealth viral infections including Epstein Barr or even long-COVID may also contribute as a root cause piece.
When we take a Functional Medicine view and understand that all pieces of health are connected, we have a lot to work with in order to help heal and restore balance to the body.
While this deep, more nuanced approach is foundational, we can also learn more about how to address the specific concerns, such as plaques, characteristic of Alzheimer’s.
Let’s review some of the latest research there.
New Thinking On Plaques
A 2021 publication in Nature Immunology used animal models to broaden our understanding of the brain plaques characteristic in Alzheimer’s disease. The research suggests that some Alzheimer’s plaques might actually be protective.
There are two kinds of plaques that were studied, diffuse plaque and dense-core plaque. The diffuse plaques aren’t as organized and are less dense, whereas the dense-core have a more dense center.
We used to think that both types of plaques produced the precursor to amyloid-beta called APP, but the study demonstrated that these are only found in the diffuse plaques. The dense-core plaques are created in an immune process where the body tries to clean up the diffuse plaques.
Here’s how it works. A receptor associated with the diffuse plaques, called TAM receptors, signal for microglial cells (a type of immune cell in the brain) to “eat” them. The TAM receptor is kind of like a flag that alerts the microglial to pay attention.
The same type of signaling happens on dead cells to allow for the breakdown and removal or recycling of that cell. When the signaling happens at the plaques, the problematic plaques break down, and thus reduce the amyloid beta.
It’s this process that forms the dense-core plaques.
These dense-core plaques may be more protective and beneficial than damaging. It’s a sign that the body is working to restore balance.
The idea that not all plaques are bad helps to explain why Alzheimer’s medications that target plaques have largely been unsuccessful.
They break up the good plaques along with the bad amyloid-beta plaques.
This discovery might give rise to new treatments that focus on targeting the amyloid-beta proteins themselves and transporting them out of the body.
It’s also a good case for the Functional Medicine approach that sees the connection between body systems and the importance of immune health for brain health.
While working with a Functional Medicine provider is always recommended for personalized guidance, here are some lifestyle pieces to explore for both prevention of Alzheimer’s and optimizing brain health.
1. Diet is foundational. A nutrient-dense diet that meets daily nutritional needs, provides polyphenols from colorful produce and anti-inflammatory omega-3 fats is a must. The Every Life Well Paleo Protocol is an easy and delicious way to begin your journey. To learn more about diet details for brain health, see the blog Foods That Reduce Dementia. In addition, balancing blood sugar and improving insulin sensitivity is another key dietary aspect for prevention. To learn more, see the blog Glycemic Control.
2. Check homocysteine levels. Homocysteine, often associated with heart disease, is a marker of methylation status. High levels of homocysteine have been linked to both dementia and Alzheimer’s disease. Bringing homocysteine down with diet and lifestyle support as well as supplementation of B vitamins may be helpful. Every Life Well Methylation Support is a comprehensive option.
3. Optimize gut health. The microbiome and digestive function impacts brain health via the gut-brain axis. Imbalances in the gut lead to imbalances in the brain. Exploring the microbiome may start with a functional stool test, such as GI MAP and then following a personalized gut healing protocol that includes diet change, lifestyle support and supplements.
4. Lifestyle change. Many of the lifestyle habits that prevent other chronic diseases, may play a role in Alzheimer’s prevention as well. During sleep is the time that the immune system works to clear the plaques that contain amyloid-beta, so prioritizing sleep quality and quantity is essential. In addition, move more, stress less and mitigate exposures to toxins. You’ll find many blogs on specific toxins and strategies for reducing or avoiding them on this blog.
5. Consider brain supportive supplements including:
- Acetyl-l-carnitine (ALC)
- N-acetyl-cysteine (NAC)
- Liposomal glutathione
- Alpha lipoic acid
- Coenzyme Q10
When we take a wider view of health, see the connections and peel back the layers with each individual, it’s easier to see that there isn’t a magic bullet or why a single pill doesn’t offer a miracle cure. Instead, Functional Medicine offers the framework to address each individual’s unique needs.
From this vantage point, we can work to prevent Alzheimer’s and other chronic diseases and even reverse disease progression that has already begun.
Functional Medicine truly is the future of medicine!