Types of Alzheimer's Disease
Different researchers classify Alzheimer's Disease using vastly different stages. Alzheimer's Disease has a genetic component that becomes active in some people and dormant in others. Alzheimer’s creates an environment that promotes brain changes in those affected. Lastly, amyloid plaque is the brain’s protective response to vastly different lifestyle insults.
Alzheimer’s Disease is an imbalance of multiple systems within the body.
People with Alzheimer’s disease usually have
more than one type and present multiple risk factors.
One of the things I like most about breaking
Alzheimer’s into types is once you know where you stand, it is easy to begin to
resolve. Dr. Bredesen’s books provide many examples from his
patients.
Also, please keep in mind that in the descriptions below, I am cutting and pasting most of the information. I do not want to risk misinterpreting any of Dr. Bredesen’s research and misinforming you.
Type 1
Type 1’s primary characteristic is inflammation. It tends to run in families as it is common in people who carry one or two ApoE4 alleles (ApoE in itself is considered an inflammatory gene). Individuals begin to lose the ability to store new information in the hippocampus – for individuals who carry two copies of ApoE4 this tends to start in the late fifties or early sixties. For those with no copies of ApoE4, symptoms present typically in the sixties or seventies. A reduced hippocampal volume – chronic inflammation encourages the brain to destroy synapses faster than it creates them.
Biochemical Markers of Type 1
Type 2
Type 2’s primary characteristic is low levels
of nutrients, hormone factors, and/or trophic factors. Type 2 also occurs
more frequently in those who carry one or two copies of the ApoE4 allele, but
the symptoms tend to initiate about a decade later than the inflammatory Type
1. Individuals begin to lose the ability to form new memories in the
hippocampus. However, there is little to no evidence of inflammation –
sometimes inflammatory markers may be lower than normal.
Biochemical Markers of Type 2
Levels of hormones such as thyroid, adrenal,
estrogen, progesterone, testosterone, and pregnenolone tend to be suboptimal.
The optimal hormone ranges are:
A decrease in serum Vitamin D levels. Normal
Vitamin D levels should be 50-80 ng/mL.
An increase in homocysteine levels can occur.
Normal homocysteine levels should be less than or equal to 7 μmol/ L
(homocysteine is also seen to increase in Type 1)
Insulin resistance can occur OR insulin levels
may be too low.
Type 1.5
Type 1.5’s primary characteristic is insulin
resistance (diabetes). Type 1 and Type 2 Alzheimer’s Disease can occur together
– often seen with neural inflammation in addition to the reduced support for
brain synapses. A commonly seen combination of type 1 and type 2 AD is known as
Type 1.5 or glycotoxic Alzheimer’s Disease.
Biochemical Markers of Type 1.5
Although characteristics are similar to those
found in Type 1 and Type 2 AD, blood glucose levels and hemoglobin A1c are
chronically high in Type 1.5 which results in inflammation.
High levels of insulin that are secreted in
response to this high blood glucose level lead to insulin resistance. This
results in a loss of trophic support. Trophic support
refers to a variety of chemical signals that neurons need to continue living.
Brain cells die and the brain shrinks when you experience a loss of trophic
support.
Neurons are energetically expensive cells. They
use a lot of oxygen and require a large expenditure of energy in the form of
ATP to do their normal functions. As part of homeostatic adjustment, the body
prefers to minimize extra energy usage. However, since neurons are critically
important for healthy functioning, they receive signals in the form of
chemicals that tell them to continue working. These chemicals are called
trophic factors.
Many of these trophic factors are synthesized
and released by glial cells of the nervous system, the non-neuronal cells that
interact closely with the neurons. Glial cells, particularly the astrocytes and
Schwann cells, are well-known producers of trophic support molecules.
One of the best-characterized trophic support
molecules is called brain-derived neurotrophic factor, or BDNF.
BDNF is a large protein. BDNF is normally synthesized and produced by cells of
the nervous system and is important for making changes in neurons or for the
growth of nerve cells. BDNF signals through the activity of several different
receptors, the most well-known being the TrkB receptor.
Other neurotrophic factors used by the nervous
system that are important as trophic support molecules include nerve growth
factor (NGF), neurotrophin-3, glial-derived neurotrophic factor (GDNF), and
ephrins. Trophic factors, such as NGF and BDNF, control the development and
survival of specific groups of neurons.
Type 1, Type 1.5 & Type 2 Alzheimer’s Disease lead to the imbalance between the production and destruction of neural synapses.
Type 3
Type 3’s primary characteristic is exposure to
toxins such as mercury, toluene, benzene (candles), or mycotoxins (mold). Type
3 tends to occur in those who have the ApoE3 allele rather than ApoE4 and does
not typically run in families.
Type 3 hits individuals at younger ages,
typically late forties to early sixties. Symptoms do not begin with memory loss
but rather with cognitive difficulties involving numbers, speech, or
organization. Individuals will start seeing difficulties with:
The brain ultimately loses recent and old
memories.
Patients with Type 3 are often diagnosed
initially with something other than Alzheimer’s Disease such as depression or
frontotemporal dementia.
Biochemical Markers of Type 3
Type 4
Type 4’s primary characteristic is low blood
flow to the brain. Type 4 or Vascular Alzheimer’s Disease, is caused by a
reduction of blood flow to the brain, which ultimately deprives the brain of
essential oxygen and nutrients. The brain is an extremely vascularized tissue,
meaning it requires large amounts of oxygen. A lack of oxygen to the brain
leads to hypoperfusion (low blood flow) and compromises the blood-brain barrier
which allows for harmful substances to leak in and damage neurons. Cerebral vasculature
is extremely important as it is one way the body clears the accumulation of
amyloid-beta.
Biochemical Markers of Type 4
“Leakiness” present in vascular tissues.
Individuals with cardiovascular disease have a
high risk for Type 4 Alzheimer’s.
These individuals do best when they prioritize
healing underlying insulin resistance.
Type 5
Type 5’s primary characteristic is brain
damage. Type 5 or trauma-induced Alzheimer’s, results from traumatic brain
injuries (TBI) which disrupt normal brain function, including learning and
thinking skills. Certain types of TBI’s may increase the risk of developing
Alzheimer’s disease years after the injury takes place.
One of the most impactful studies showed that
those with a history of moderate TBI had a 2.3 times greater risk of developing
Alzheimer’s than older adults with no history of a head injury and those with a
history of severe TBI had a 4.5 times greater risk.
Biochemical Markers of Type 5
There are no biochemical markers for Type 5 as it is triggered by injuries to the brain such as:
Now that we have broken down Alzheimer’s Disease into 6 different types and identified their characteristics and potential causes we can begin to address what you need to do to prevent and begin to heal the damaging insults to the brain. We will begin to work on that next week.
OR if you want to jump ahead, purchase Dr. Dale
Bredesen’s books. Here are the links to purchase them on Amazon.
The End of Alzheimer’s 2
Books Collection Set By Dale Bredesen Paperback – October 26, 2023
LINK: https://amzn.to/462LcY3
The End of Alzheimer's Program: The First Protocol to Enhance Cognition and Reverse Decline at Any Age Paperback – September 6, 2022
LINK: https://amzn.to/3xNcrct
Guardianship is a serious legal process that serves as a last resort for caring for an elderly parent who can no longer make sound decisions for themselves. It requires a court hearing and confirmation of incapacity by medical providers.What is Guardianship?Guardianship means an individual is appointed by the court to make medical decisions and manage daily care for an elderly parent. This typically occurs when an elderly parent:Is diagnosed with cognitive impairments like dementia or Alzheimer's diseaseHas suffered brain injuriesExperiences serious health conditions that impair decision-making abilitiesKey Considerations in GuardianshipEmotional ChallengesDeciding to pursue guardianship often involves mixed emotions. Adult children may feel uncomfortable, especially if family members disagree about the necessity of guardianship.Legal RequirementsTo establish guardianship, documentation must be submitted to the court that:Substantiates the degree of cognitive impairmentProvides evidence of poor decision-makingIncludes a medical assessment, potentially a neuropsychological evaluationTypes of GuardianshipGuardian ResponsibilitiesMake medical decisionsManage daily careAdvocate for the elderly parent's best interestsFollow the principle of substituted judgment (making decisions the parent would make)ConservatorshipIn most situations, a conservator is also appointed to manage money and property. This can be the same person as the guardian or a separate individual.Challenges of GuardianshipAdvocacy and Medical InteractionsGuardians must:Navigate complex healthcare systemsCommunicate with medical professionalsUnderstand and research medical conditionsMake thorough, prudent decisionsFamily DynamicsGuardianship can create:Potential conflicts between family membersDisagreements about care and spendingEmotional stress that may damage relationshipsState-Specific ConsiderationsGuardianship laws and terminology vary by state. Some states have:Different definitions of guardianshipVarying availability of professional guardiansUnique legal frameworks for elder careImportance of PreparationRecommended StepsHave early discussions about care preferencesDocument the elderly parent's wishesUnderstand the full scope of guardianship responsibilitiesSeek support and resources for caregiversAs the population ages and chronic diseases become more prevalent, understanding guardianship becomes increasingly important for families caring for elderly parents.
Check In on Your Loved One During the Holidays The holiday season is a time for family gatherings, traditions, and reconnecting with loved ones. Its a wonderful opportunity to catch up and celebrate, but its also the perfect chance to check in on elderly parents or relatives to ensure theyre doing well. Sometimes, these visits can provide insight into their health, well-being, and overall quality of life that you might not see from a distance.Here are some signs to look for during your visit: Changes in personal hygiene: Noticeable neglect of bathing, grooming, wearing clean clothes, or maintaining trimmed nails. Pay attention to mobility issues, recent falls, or unexplained bruising. Medication management: Look for missed doses, expired prescriptions, or general confusion about their medication routine. These are all signs they might need help managing their health. Living space upkeep: Take note of unkempt homes with piled laundry, misplaced items, spoiled food, or clutter that could pose a fall risk, like throw rugs or poorly placed cords. Emotional or cognitive changes: Watch for signs of depression, forgetfulness, confusion, loneliness, or isolation. These shifts can indicate underlying health issues. Financial management struggles: Keep an eye out for stacks of unopened mail, unpaid bills, or disorganized storage of important documents. Difficulty handling finances is a common red flag. Driving concerns: If theyre still driving, check their car for signs of accidents, such as scrapes or dents.What to Do if You Notice Changes If you spot signs of decline, here are steps you can take to address your concerns:1. Take notes: Write down your observations. Keeping a detailed list of your concerns will help when speaking with your loved one or their healthcare provider. 2. Start the conversation: Share your observations in a compassionate and nonjudgmental way. Use this as an opportunity to discuss their needs and explore support options, such as assistance with daily activities, companionship, or meal services. 3. Consult their doctor: Reach out to their primary care provider to share your concerns and learn about any recommendations. The doctor may already have insights into their health or suggest scheduling a physical or needs assessment. 4. Explore senior living options: If additional support seems necessary, consider visiting senior living communities to understand the available levels of care, such as independent living, assisted living, or memory care. Touring a community can help determine if its the right fit for your loved one.Tips for Having the Conversation Discussing a loved ones needs can be delicate. Here are some tips to make the conversation more effective and compassionate: Pick the right time: Choose a quiet, private moment to bring up your concerns. Avoid discussing sensitive topics during large family gatherings or high-stress situations. Be empathetic: Acknowledge their feelings and emphasize that you want to support them in maintaining their independence and quality of life. Involve them in decisions: Wherever possible, let them take an active role in deciding how to address their needs. This helps them feel respected and in control. Focus on solutions: Frame your concerns around finding practical ways to help, rather than simply pointing out problems.Why the Holidays Are a Perfect Time to Check In The holidays offer a rare opportunity to see your loved ones in person and observe any changes in their behavior, health, or environment. With everyone gathered together, its also easier to have collaborative conversations with other family members about how best to support them.By being proactive during your holiday visit, you can help ensure your loved one gets the care and support they need to stay happy and healthy. Whether that means arranging for extra assistance at home or exploring senior living options, taking action now can make a meaningful difference in their quality of life.
Im sorry to hear youre dealing with this difficult situation. When parents refuse care, especially if their health or well-being is at risk, it can be incredibly frustrating and stressful. There are a few things you can consider doing, depending on their specific situation, their reasoning for refusing care, and the legal options available to you:1. Understand Their ConcernsWhy are they refusing care? Sometimes, older adults resist help because they feel a loss of independence, fear of being a burden, or have concerns about the cost or quality of care.Have a conversation: Approach the subject with empathy. Ask them what specific concerns or fears they have about getting care and try to address them in a way that respects their autonomy.2. Discuss the Importance of Their HealthExplain how the care theyre refusing can improve their quality of life, maintain their independence longer, or prevent worsening conditions.Use specific examples of how delaying care can lead to complications (e.g., if they have a medical condition like diabetes, heart disease, or mobility issues).3. Offer AlternativesIf theyre against full-time care or a nursing home, offer other solutions, such as hiring a visiting nurse, a home aide, or setting up a family care schedule. This can make the care less intrusive.You might also want to suggest telehealth appointments if theyre hesitant to go to in-person appointments.4. Get Help from a ProfessionalTherapists or counselors: A neutral third party, such as a therapist or social worker, might be able to help mediate the conversation and address any fears or emotional resistance.Doctors advice: Sometimes, having their doctor explain why care is important can be more persuasive than anything you say. This might involve setting up a meeting where the doctor can directly discuss the necessity of care.5. Check for Cognitive ImpairmentIf their refusal of care seems irrational or if they are not understanding the risks, it could be a sign of cognitive decline (e.g., dementia, Alzheimers). If you suspect this, a doctor or specialist should assess their cognitive function.Legal options: If their cognitive state is compromised and they cannot make decisions in their own best interest, you might need to consider legal options like guardianship or power of attorney. However, this can be a delicate process and may require legal advice.6. Know Your Legal RightsPower of Attorney (POA): If your parents have given you power of attorney for healthcare or finances, you may be able to make decisions on their behalf, including arranging care.Guardianship: In extreme cases, if your parents are unable to care for themselves and are refusing help, you may need to pursue legal guardianship. This is a process that involves the court and can give you the authority to make decisions for them.7. Consider the Long-Term ImpactIf they continue refusing care and their health worsens, it might become a situation of crisis care, meaning emergency intervention could be needed. However, you should try to avoid this if possible since it can cause additional stress and trauma for both of you.8. Take Care of YourselfCaregiver burnout is a real concern. If youre feeling overwhelmed, its important to seek support from other family members, friends, or professional caregivers. Caregiving can be emotionally and physically exhausting, so make sure youre taking care of your own well-being too.If this is something youre dealing with, youre not alone. Many people face similar struggles with aging parents or loved ones. Taking small steps, seeking professional advice, and prioritizing communication can often make a big difference. Let me know if youd like specific advice or resources on any of the points.For more information, please contact: www.seniorhousingsolutions.net