Alzheimer’s Disease & Dementia

1. Alzheimer’s Disease & Dementia Kelsey Conrow Shelby Lubbers Micca Henry Rachel Turley

2. Dementia vs Alzheimer’s Disease • Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. • Alzheimer’s Disease is a type of dementia that causes problems with memory, thinking, and behavior.

3. Alzheimer’s Disease • The most common form of dementia: 50-80% of dementia cases • Progressive disease where the symptoms worsen over time • Symptoms become severe enough to interfere with daily life

4. Who gets it? • Greatest risk factor is age. • Majority of people are >65 years • 5% people have early onset Alzheimer’s in their 40’s • Other risk factors: Family history & Genetics

5. Causes of Dementia • Diseases that affect blood vessels • Nutritional deficiencies • Infections that affect the brain and spinal cord • Diseases that cause degeneration or loss of nerve cells in the brain- Alzheimer’s Disease

6. Early Stages of AD • Before symptoms, plaques begin to form in brain areas involved in: • Learning & memory • Thinking & planning • May begin 20 years or more before diagnosis

7. Mild to Moderate AD • Plaques spread to areas involved in: • Speaking & understanding speech • Your sense of where your body is in relation to objects around you • Generally last from 2 to 10 years

8. Severe AD • Most of the cortex is severely damaged • Brain shrinks dramatically due to cell death • Lose ability to communicate, recognize family, and care for themselves • May last 1-5 years

9. Cortex shrivels upVentricles grow larger (fluid filled spaces)

10. http://www.youtube.com/watch?v=Eq_Er-tqPsA

11. So what is the proposed underlying metabolic cause of Dementia and Alzheimer’s Disease?

12. Metabolic • Aging is the most common risk factor for the development of neurodegenerative disease. • Oxidative stress may also contribute to the pathophysiology of neurodegenerative disorders. • Oxidative stress may lead to mitochondrial failure and problems with the ETC.

14. Proposed protective mechanism

15. Conventional Medicines • Cholinesterase inhibitors • Prevent breakdown of acetylcholine a key chemical messenger for nerve cells • Memantine • Regulates the activity of glutamate • All these drugs come with side effects such as headaches, constipation, confusion and dizziness

16. Can we stop or delay this terrible disease with nutrition? Micronutrients?

17. Micronutrients of Interest • Vitamin D • Ginkgo biloba

18. Vitamin D • Fat soluble vitamin • Key micronutrient in calcium absorption and mineral homeostasis • Vitamin D receptor (VDR) interaction also involved in modulation of transcription • Growing evidence of VDR activity

19. Vitamin D • Provides an antioxidant like protection via up regulation of glutathione • May protect the structure and integrity of neurons via detoxification and neurotrophin synthesis

20. Ginkgo biloba • One of the oldest living tree species • Dried leaves used to make plant extract • Antioxidant and anti-inflammatory properties • Protect cell membranes & regulate neurotransmitter function

21. Ginkgo biloba • Amyloid beta triggers mitochondrial dysfunction through elevation of ROS • Increased ROS can inhibit protein import & damage cellular structures • EGb761 has antioxidant effects and targets amyloid beta, thereby reducing ROS and preventing mitochondrial dysfunction • Amyloid beta is the main component of amyloid plaques found in AD

22. Conclusion • What is the moral of the Alzheimer’s Disease/Dementia Story? • Age and Genetics are primary contributing factors and largely unalterable • Key prevention seems to be a well rounded diet, plenty of key micronutrients and antioxidants • USE YOUR BRAIN!! Learning and staying sharp provide some of the greatest protective action.

23. References • (1) Alzheimer’s Association. Accessed on Jan 20, 2013. www.Alz.org • (2) Annweiler, C, Y Rolland, AM Schott, H Blain, B Vellas, FR Herrmann, and O Beauchet. Higher vitamin D dietary intake is associated with lower risk of Alzheimer’s disease: a 7-year follow-up. J Gerontol67(11):1205-1211, 2012. • (3) Bowden, J. The 150 Healthiest Foods on Earth. Fair Winds Press: Singapore, 2007. pp. 267-287. • (4) Buell, JS and B Dawson-Hughes. Vitamin D and neurocognitive dysfunction: preventing “D”ecline? Mol Aspects Med 29(6):415-422, 2008. • (5) Chun, S, J Liu, F Wu, DT Yew. Ginkgo biloba extract in Alzheimer’s disease: from action mechanism to medical practice. J MolSci 11(1): 107-123, 2010. • (6) Mazza, M, A Capuano, P Bria, and S Mazza. Ginkgo biloba and donepezil: a comparison in the treatment of Alzheimer’s dementia in a randomized placebo-controlled double-blind study. J Neurology 13:981-985, 2006. • (7) Murray, M and J Pizzorno. Encyclopedia of Natural Medicine. Three Rivers Press: New York, NY, 1998. pp. 221-232. • (8) Schaffer, S, H Asseburg, S Kuntz, WE Muller, and GP Eckert. Effects of polyphenols on brain ageing and Alzheimer’s disease: focus on mitochondria. MolNeurobiol 46:161-178, 2012. • (9) van Arnim, CAF, U Gola, and HK Biesalski. More than the sum of its parts? Nutrition in Alzheimer’s disease. Nutrition 26:694-700, 2010.