Science and Research Questions

While science is still trying to figure out the exact cause (or causes) of Alzheimer's disease, researchers agree that the disease is likely due to both environmental and genetic factors. Diet, for example, can definitely affect your risk of developing the disease, but it has not been found to directly cause AD. For example, several independent research studies have reported an association between high cholesterol serum levels and Alzheimer’s disease. Consistent with these reports, other research findings also suggest that the best way to lower your risk of developing Alzheimer’s disease involves a combination of measures normally thought of as good for maintaining a healthy heart, such as eating a healthy diet low in saturated and trans-fats, exercising regularly, reducing stress, and of course, lowering serum cholesterol levels. Environmental factors such as exposure to toxins and metals (such as zinc and aluminum), and exposure to viruses and food-bourne pathogens have all been investigated as potential contributors to the development of AD. Unfortunately, the jury is still out for most of these. Still, the majority of researchers believe that is the culmination of a number of these environmental and genetic factors that determines a person’s likelihood of getting Alzheimer's disease. So in the meantime, the best you can do is to try to eat healthy and keep mentally and physically fit.

Axona is designated as a medical food that is only available by prescription from a doctor, and is indicated for the dietary management of the metabolic processes associated with mild to moderate Alzheimer's disease (AD). So what do metabolic processes have to do with Alzheimer's disease you ask? They determine how our bodies process energy for brain cells. Normally, the brain uses glucose as a primary source of fuel, but researchers believe that brain cells (neurons) altered by neurodegenerative diseases, such as AD, are not able to adequately utilize glucose and therefore neuronal performance is reduced. Axona contains a special formulation of medium chain triglycerides (MCTs). MCTs are converted to ketones by the liver, and these ketones serve as an alternative fuel source for neurons, allowing them to function better.

In addition to positive results in at least two clinical studies for Axona demonstrating improvements in cognition and memory for patients having probable AD or mild cognitive impairment (MCI), the “ketogenic diet” approach has already been investigated as a therapy for a number of other neurological and metabolic disorders, such as intractable epilepsy and phosphofructokinase deficiency, with positive results. Researchers believe that the ketogenic diet may actually be neuroprotective, and may therefore be beneficial for the treatment of neurodegenerative diseases as well as in instances of stroke and brain injury.

In addition, one study in animals found that ketones can reduce brain beta-amyloid levels, which if true in humans, may also be very beneficial in the treatment of AD. Under the supervision of a physician, the use of Axona has been demonstrated to be safe and effective. The reported side effects of Axona are generally mild and are mainly related to gastrointestinal issues such as diarrhea, flatulence, and upset stomach.

Alzheimer's disease is in fact far more common in people with Down syndrome than in the general population. Because Down syndrome causes premature aging, the symptoms of Alzheimer's disease often appear much earlier. Therefore a Down syndrome adult may experience symptoms of Alzheimer’s in their mid- to late-40s or early 50s, whereas in the general population symptoms of the disease are usually identified in people in their mid- to late-60s. Scientists are not entirely sure why this occurs, but believe that the extra genetic material on chromosome 21 of Down syndrome may play a role in the development of Alzheimer's disease. The brains of Down syndrome adults develop senile plaques caused by the abnormally high accumulation of beta-amyloid protein, much the same as what is seen in Alzheimer's disease. This buildup of amyloid in Down syndrome is caused by increased production of beta-amyloid, which is believed to be due to the extra copy of chromosome 21.

The connection between Down syndrome and Alzheimer's disease is fairly well established in the medical community, so it is unclear why this information has not been more widely publicized, particularly amongst non-medical persons. Because of the known link, medical treatments aimed at reducing amyloid plaques in the brains of Alzheimer's disease patients are also being investigated for use in treating such plaques in Down syndrome patients.

Sensitivity to loud noises is not a "diagnostic" feature of Alzheimer's disease. However, the alterations in inhibitory circuits in the brain caused by the disease can lead to increased sensitivity to various sensory inputs, including sound.

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.

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.

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.