LTC Bullet: The End of Alzheimer’s
Friday, April 20, 2018
LTC Comment: Is there hope for delaying, mitigating, even ending Alzheimer’s? We report, you decide, after the ***news.***
*** LTC CLIPPINGS: Three LTC Clippings sent this week to Center premium members follow. To inquire about premium membership including a subscription to LTC Clippings, contact Damon at 206-283-7036 or firstname.lastname@example.org.
4/19/2018, “New Census Bureau data show steady increase in prospective residents,” by Lois A. Bowers, McKnight's Senior Living
Quote: “Most U.S. older adults who make the move to a senior living community do so between ages 75 and 84, according to the American Seniors Housing Association's Where You Live Matters consumer education campaign. Data released by the Census Bureau on Thursday show a steady increase in the number of 75-year-olds from the years 2010 to 2017.”
LTC Comment: OK, but you ain’t seen nothin’ yet. Baby boomers don’t start turning 75 until 2021. After that, look out!
4/17/2018, “This state won’t extend Medicaid benefits to elderly nuns,” Associated Press
Quote: “A vow of poverty by more than 20 elderly nuns isn’t enough to qualify for Medicaid in Nebraska. The state cut Medicaid benefits earlier this year for the Sisters of Mercy, one of the oldest Roman Catholic religious orders in Nebraska, the Omaha World-Herald reported. … The state fears that expanding Medicaid to cover the Sisters of Mercy could prove costly if other people also qualify. Ignoring the sisters’ patrimony requires accounting for tithing in income qualification reviews of Medicaid recipients of all faiths, state officials said. Doing so could cost Nebraska $3 million annually by adding more than 300 Medicaid recipients by 2020.”
LTC Comment: How ironic. When I did the following study back in 2003, Nebraska routinely granted Medicaid LTC benefits to middle class and even savvy affluent people: The Heartland Model for Long-Term Care Reform. Not much has changed because many of the same mandatory eligibility loopholes still exist in federal law and regulation.
4/15/2018, “65% of Baby Boomers Are Making a Huge Financial Mistake That Could Leave Them Broke,” by Christy Bieber, Motley Fool
Quote: “Many pre-retirees think they don't need to worry about healthcare because they anticipate care costs will be covered by Medicare. But the reality is that Medicare makes seniors responsible for picking up a significant percentage of their cost of care. Seniors may face high deductibles, coinsurance costs, premiums, and coverage limitations. … There are also many services Medicare doesn't cover, including hearing aids, long-term care, and dental care. … Qualifying for Medicaid could also help you afford care costs by subsidizing Medicare premiums and paying for some services not covered by Medicare, such as routine nursing home care. While there are strict asset limits to obtain Medicaid, an attorney can help you to develop a plan that protects your wealth and still allows you to obtain coverage.” (Emphasis added.)
LTC Comment: There’s the essence of the problem in a nutshell. People are in denial about the long-term care risk, but not irrationally so because “an attorney can help you” protect your wealth and get the government to pay if you ever need LTC. The truly irresponsible parties in this public policy fiasco are the academics, politicians and policy-makers who refuse to take this simple, obvious reality into account. For details see How to Fix Long-Term Care Financing. ***
LTC BULLET: THE END OF ALZHEIMER’S
LTC Comment: Everything about Alzheimer’s disease jades me with pessimism, hopelessness and worry. Research goes nowhere. Incidence increases. Costs rise. Funding languishes. Patients and families suffer. Analysts and policymakers dither. You want to throw up your hands and cry “What’s the use?”
So, when a serious, well-credentialed, highly experienced research neurologist says cognitive decline is not inevitable, is actually reversible, and claims he has the evidence to prove it, we should at least listen. Today’s LTC Bullet introduces you to Dr. Dale Bredesen’s book The End of Alzheimer’s: The First Programme to Prevent and Reverse the Cognitive Decline of Dementia.
I’ve compiled a few pages of quotes from the volume to give you a sense of its content and argument. But first, here’s my takeaway in a nutshell. Alzheimer’s disease is not a single malady like cancer. So targeting a single cure, such as removing amyloid plaques, doesn’t work. Rather, cognitive decline leading to Alzheimer’s comes from a variety of sources, especially poor diet, lack of exercise, deficient sleep, and excessive stress. Eliminate those causes and, Bredesen’s research and clinical results show, cognitive decline can be avoided, stopped, reversed and Alzheimer’s evaded even in people who carry genes that predispose them toward the disease.
The following quotes from the book give you only a conceptual framework to consider. I haven’t attempted to summarize the extensive research, findings, case studies, or specific recommendations you’d need to consider to judge conclusively. I recommend that you get the book and see for yourselves.
“It is impossible to escape the drumbeat of grim news about Alzheimer’s disease: that it is incurable and largely untreatable, that there is no reliable way to prevent it, and that the disease has for decades beaten the world’s best neuroscientists.” (p. 3)
“[S]eemingly rock-sold evidence from lab rodents suggested that Alzheimer’s disease is caused by the accumulation in the brain of sticky synapse-destroying plaques made of a piece of a protein called amyloid-beta. (p. 6)
“But here’s the thing: when drug companies tested compounds that are based on any piece of the amyloid hypothesis, the results have ranged from frustrating to bewildering. … the experimental compounds did precisely what their inventors intended, following the amyloid rule book, but patients either got no better or, incredibly, got worse. … Targeting amyloid was supposed to be the golden ticket to curing Alzheimer’s. It wasn’t.” (p. 7)
“Just as tragic as the blinkered adherence to the amyloid hypothesis is mainstream medicine’s assumption that Alzheimers is a single disease.” (p. 7)
“Alzheimer’s is not a single disease. … [T]here are three main subtypes of Alzheimer’s. … Each one requires a different treatment. … Type 1 is inflammatory (hot). … Type 2 is atrophic (cold). … Type 3 is toxic (vile).” (pps. 9, 98, 102, 104)
“Alzheimer’s ‘disease’ is not the result of the brain doing something it isn’t supposed to do, the way cancer is the result of cells proliferating out of control or heart disease is the result of blood vessels getting clogged with atherosclerotic plaque. Alzheimer’s arises from an intrinsic and healthy downsizing program for your brain’s extensive synaptic network. … In Alzheimer’s, an otherwise normal brain-housekeeping process has gone haywire.” (pps. 12-13)
The right track:
“Contrary to the current dogma, therefore, what is referred to as Alzheimer’s disease is actually a protective response to, specifically, three different processes: inflammation, suboptimal levels of nutrients and other synapse-supporting molecules, and toxic exposures.” (p. 16)
“Let me say this as clearly as I can: Alzheimer’s disease can be prevented, and in many cases its associated cognitive decline can be reversed.” (p. 10)
“These are bold claims deserving of healthy skepticism. I expect you to exercise that skepticism as you read about the three decades of research in my lab, which culminated in the first reversals of cognitive decline in early Alzheimer’s disease and its precursors, MCI (mild cognitive impairment) and SCI (subjective cognitive impairment).” (p. 10)
“By following the protocol I describe, those with cognitive impairment that is not yet Alzheimer’s disease, as well as those who are already in the grip of Alzheimer’s, can not only halt but often actually reverse the cognitive decline they have already suffered.” (pps. 10-11)
“Called ReCODE, for reversal of cognitive decline, the protocol not only achieved the reversal of cognitive decline in Alzheimer’s disease and pre-Alzheimer’s that no one thought possible; it also allowed patients to sustain that improvement.” (p. 13)
“Because Alzheimer’s disease strikes an estimated one in nine Americans 65 and older, or 5.2 million people as I write this, the aging of the baby boom generation threatens to bring a tsunami of Alzheimer’s immense enough to bankrupt medicare and Medicaid and overwhelm the nation’s long-term care facilities—to say nothing of the toll it will take on tens of millions of families whose love ones are swallowed by this merciless disease.” (p. 15)
“[I]f enough people adopt ReCODE, the consequences would ripple across the nation and the world, cutting medical costs by many billions of dollars a year, preventing Medicare’s bankruptcy, reducing the global burden of dementia, and enhancing longevity. All of these are feasible.” (p. 15)
“The solution is a very effective combination of DESS (diet, exercise, sleep, and stress reduction)—which is so important for your cognitive health that you might call them your ‘desstiny’—along with some simple supplements and, as a last resort, medication.” (p. 177)
Diet: “This is a largely plant-based diet with an emphasis on vegetables, especially nonstarchy ones. It is best to include both uncooked vegetables, such as those in salads, and cooked ones, and to include as many colors as possible, from deep green to bright yellow and orange. Some fish, poultry, and meat are fine, but remember that meat is a condiment, not a main course.” (p. 180)
Exercise: “Sitting is the new smoking! … We are sitting ourselves to death! Research has shown not only that exercise is beneficial, but that sitting is detrimental to cognitive and physical (especially cardiovascular) health. … What is the optimal exercise for cognition? You want to combine aerobic exercise, such as jogging or walking or spinning or dancing, with weight training, preferably at least four or five days per week, for 45 to 60 minutes in total each day.” (p. 191)
Sleep: “When I asked whether [an expert in Alzheimer’s disease evaluation and clinical research] saw any differences between those who continued to decline [from mild cognitive impairment] and those who improved [avoiding Alzheimer’s] she thought about it for a few moments. ‘Yes,’ she said, ‘the ones who get good sleep are the ones who tend to improve.” (p.192) Then follows “how to optimize your sleep, thus improving brain function.”
Stress: “Stress is a factor in most cases of cognitive decline, but an especially strong one in type 3 (toxic) Alzheimer’s disease, MCI, or SCI. For those individuals, stress worsens cognition especially rapidly. The onset of cognitive decline in such patients often coincides with a period of great stress.” (p. 197)
“If someone had told me a few decades ago that, as a research neurologist, I would be recommending protocols that involve medication, yoga, laughter, music, joy, fasting, exercise, herbs, nutrition, and sleep, I would have laughed. But I cannot argue with results, or with the conclusions of years of research.” (p. 247)
“Cognitive decline, including dementia, is a hugely complicated process, affected by dozens of factors. Targeting all of the factors that are relevant to your case in order to change the course of illness has yielded the greatest success to date. The fact that no one of these alone is curative does not mean that a combination may not be helpful.” (p. 265)