Science and Research Questions

There are no studies in the scientific literature or in medical reports indicating that hearing loss contributes to the development of Alzheimer's disease. In fact, in a recent study conducted in China comparing the hearing capabilities of Alzheimer's disease patients and age-matched control subjects, no correlation was found between hearing ability and mental status. It is not uncommon to find both conditions together, however, as both are more common in aged individuals. Nevertheless, hearing loss is not routinely associated with early symptoms of Alzheimer’s disease.

Oleocanthal is a compound found naturally in extra-virgin olive oil. Researchers at Northwestern University recently discovered that oleocanthal can change the structure of the toxic proteins (known as ADDLs) that are found in the amyloid deposits in the brains of Alzheimer's disease patients. Olecanthal was also found to inhibit the ability of ADDLs to bind to nerve synapses (the junctions between nerve cells) and disrupt neuronal functioning. Additionally, the researchers unexpected discovered that olecanthal can enhance the ability of antibodies to bind to ADDLs, which could lead to the development of a better immunotherapeutic approach against Alzheimer's disease. It is important to note, however, that all of these studies were performed in cell cultures, and additional research is therefore necessary to determine if these laboratory findings can translate into effective clinical therapeutic results in humans.

Based upon very loose estimates, it does not appear that the incidence of Alzheimer's disease in Italy is much different from that of other western European countries (or of the US or Canada).

Italy, Greece, Spain and other Mediterranean cultures are all known to predominantly use olive oil in their cuisines. One early study reported that a Mediterranean-style diet (in which olive oil figures largely) was linked to a lower incidence of dementia and cognitive decline, but subsequent studies have failed to replicate this positive correlation. Regardless, a Mediterranean diet that is rich in fruits, vegetables, nuts, whole grains, legumes and fish and low in saturated fats (such as from red meat and processed foods) has been associated with a lowered incidence of cardiovascular disease and diabetes. Coincidentally, vascular disease is associated with Alzheimer's disease and dementia. Some researchers therefore believe that lowering your risk of cardiovascular disease may also help to lower your associated risk of dementia. So olive oil, when used in moderation in a healthy diet, may someday be found to be beneficial on more than one level.

Although it can be disconcerting, we have all had what are sometimes called “senior moments” where we completely forget what it is that we are doing or saying. Ask anyone if they’ve ever walked into another room and, once having arrived at their destination, completely forgetting why it is that they were going there or for what purpose. I would bet that most people will say this has happened to them more than once (myself included).

Daily stress can often interfere with memory. As a mother, you probably have to remember many things throughout the day (shopping lists, items for your child’s school or daycare, errands to run, household agendas, work agendas, etc.) It can be very overwhelming sometimes! Dietary and hormonal imbalances, depression, stress, as well as some viral infections can all cause memory disturbances and disorientation. In other words, there are a number of conditions besides Alzheimer's disease that could have caused the confusion you experienced, most of which are treatable.

So talk to your doctor and explain your concerns. If you haven’t had a routine physical in a while, you may want to consider scheduling one with your primary care physician. Your doctor may, for example, want to check for vitamin B12 levels and thyroid hormone levels in your blood; insufficient amounts of either of these can sometimes cause confusion and memory problems. Fortunately, imbalances such as these are treatable, as are a number of other conditions that can cause memory disturbances.

There have been several studies that have looked at the average survival time following a diagnosis of Alzheimer’s disease. All of the studies basically come to the same conclusion: the median survival time following diagnosis is largely dependent upon the age at which the person was diagnosed and/or disease severity at time of diagnosis. For example, persons diagnosed as having mild AD at age 55-65 had a average survival time of 6-10 year, whereas patients diagnosed in their 70s, 80s or 90s, or patients with more severe dementia symptoms at the time of diagnosis, had a much lower average survival time, sometimes as low as 3 years. Of course, the overall health of the patient at the time of diagnosis and whether or not they have any other disease conditions (heart disease, diabetes, gait disturbances, etc.) also greatly affects survival time following diagnosis. Some studies on this topic include the following articles, which are available through PubMed or through your local medical or research library:

Brookmeyer R, Corrada MM, Curriero FC, Kawas C. Survival following a diagnosis of Alzheimer disease. Archives of Neurology, 2002 Nov; Vol. 59, No. 11, pages 1764-1767.

Larson EB, Shadlen MF, Wang L, McCormick WC, Bowen JD, Teri L, Kukull WA. Survival after initial diagnosis of Alzheimer disease. Annals of Internal Medicine, 2004 Apr; Vol. 140, No. 7, pages 501-509.

Zanetti O, Solerte SB, Cantoni F. Life expectancy in Alzheimer disease (AD). Archives of Gerontology and Geriatrics, 2009; Vol. 49, Suppl. 1, pages 237-243.

There is a considerable body of literature suggesting that modest memory impair can occur in the normal person or animal after general anesthesia. This usually is not debilitating and diminishes in severity over a period of months. Your wife's case is an unusual one in the fact that the decline in her function was so profound. The brain of a demented person has much less "reserve" than that of a normal person of the same age. A drop in blood flow under anesthesia or other effects of the anesthetic on structural proteins of the nerve cell could underlie these changes. The anesthetic does not remain in the system for a prolonged period after surgery so it is unlikely that its effect can be reversed. Without examining your wife, it is extremely difficult to be specific about what has happened and what might be done. I would suggest that she be thoroughly evaluated by a neurologist or other physicians with experience in dementia.

Lipogen PS is composed primarily phosphatidylserine, a constituent of biological membranes. Lipogen PS is soy derived but there is no evidence that it is more effective than phosphatidylserine from other sources. These agents have been reported to give modest and temporary improvement to patients with early symptoms of dementia.

There are no recommended and effective dietary treatments for patients with Alzheimer's disease; however, there is good evidence that a balanced diet that contains monosaturated fats (found in the Mediterranean diet) reduces risk of developing this neurodegenerative disease.

While some studies have suggested that tobacco use (and in particular cigarette smoking) may actually reduce the risk of developing Alzheimer’s disease (AD), more recent studies have found this to be incorrect. Earlier research may have been biased on some factors (for example, the authors conducting the research were affiliated with the tobacco industry). Also, because non-smokers generally live longer than smokers, the occurrence of age-related diseases such as Alzheimer’s disease may be biased to reflect more non-smokers having AD. When these and other factors are taken into account, the most recent evidence indicates that cigarette smoking is indeed a risk factor for AD. Unfortunately, however, these studies were mainly focused on cigarette smoking. None of the research so far has looked into snuff use as a risk factor for Alzheimer’s disease.

Interestingly, nicotine - one of the main chemicals found in tobacco - is known to improve concentration, coordination and short-term memory. Researchers therefore became interested in using nicotine therapeutically, such as for the treatment of neurodegenerative disease. These results are also mixed. Some studies have found that Alzheimer’s patients (or transgenic mouse models of AD) show improvements with chronic nicotine treatment, while other studies have found no beneficial effect. Therefore, more research is clearly needed to determine if nicotine can impact the course or progression of AD.

That being said, could snuff use have influenced your husband’s disease onset or progression? It is quite possible that it did, however, without more research on the effects of smokeless tobacco on neurodegenerative diseases, it is impossible to say just how (positively or negatively) snuff use affected your husband’s disease.

Researchers at Columbia University in New York recently reported that a drug belonging to a class of agents used for treating cancer can improve the memory of transgenic mice that are a model of Alzheimer’s disease (AD).

The drug is a histone deacetylase (HDAC) inhibitor. The researchers noted that transgenic AD mice had lower levels of acetylated histone 4 (called H4) in their brains than wild-type (non-transgenic) mice. Acetylated histone is required for the synthesis (production) of new proteins by brain cells. The researchers believed that the memory impairments observed in AD patients (and in the transgenic AD mice) is due to a defect in the ability of their brain neurons to synthesize new proteins, which is critical for the process of making and retaining memories. The researchers tested their hypothesis by giving an HDAC inhibitor (which blocks the breakdown of acetylated histone, thereby allowing more of it to be available in the brain for protein synthesis) to the AD mice and then testing their memory. The AD mice administered the HDAC inhibitor scored as well as the wild-type (non-diseased) control mice on the memory tests, thus indicating that HDAC inhibitors can improve memory functioning in individuals the animals with impaired memory.

Clearly, the findings of this study have implications for Alzheimer’s disease patients in terms of a potential new therapeutic approach. But it also clear that additional research will have to be performed to validate these results in other animal models and then in humans. One good thing, the drug used in the study has already been approved as safe for human use for the treatment of certain forms of cancer, so that that puts it one step closer to its potential use as a treatment for Alzheimer’s disease.