What Causes Alzheimer's Disease - Types 3, 4, & 5

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Jul 22, 2024

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National , Texas - Dallas, Collin, SE Denton & Rockwall Counties

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In the past we have talked about and broken Alzheimer's down into multiple types.  They are:

Type 1

Type 1’s primary characteristic is inflammation. 

Type 2

Type 2’s primary characteristics are low levels of nutrients, hormone factors, and/or trophic factors. 

Type 1.5

Type 1.5’s primary characteristic is insulin resistance (DIABETES)

Here is the link if you would like to go back and read that:  https://alzheimerssurvivor.com/blogs/what-is-an-alzheimers-survivor/what-causes-alzheimers-disease

As we begin this week’s discussion, I want to remind you that Alzheimer’s Disease is not a single symptom.  Years of research show that you cannot point to one single trait as the single cause of Alzheimer’s Disease.  According to Dr. Dale Bredesen, people with Alzheimer’s Disease suffer from multiple “insults” for 20 - 30 years before developing Alzheimer’s. However, when you research what causes Alzheimer’s disease, most will tell you Alzheimer’s is a disease triggered by old age. Explaining that only people over 65 have Alzheimer’s Disease.   

When in reality, the most common person diagnosed with
Alzheimer’s Disease in 2024 is a 52-YEAR-OLD FEMALE!

Most people slowly develop Alzheimer’s Disease over 20 – 30 years. While symptoms will become apparent in a person in their 40s & 50s, the disease began when they were 22 – 32. What triggers Alzheimer’s Disease to start to develop at this age? Usually, an unhealthy lifestyle!  Such as eating too much junk food, eating fast food, not managing their weight, & developing insulin resistance. 

Recently, we broke Alzheimer’s Disease down into 5 different categories.  As I said then, I find it easier to differentiate the types and symptoms to address what caused it.  Here is a brief recap:

Type 1

Type 1’s primary characteristic is inflammation. 

Type 2

Type 2’s primary characteristics are low levels of nutrients, hormone factors, and/or trophic factors. 

Type 1.5

Type 1.5’s primary characteristic is insulin resistance (diabetes

Type 3

Type 3’s primary characteristic is exposure to toxins.

Type 4

Type 4’s primary characteristic is low blood flow to the brain.

Type 5

Type 5’s primary characteristic is brain damage.

This week we will review what causes Alzheimer’s Disease in Type 3, Type 4 & Type 5 Alzheimer’s Disease.

_______________________

TYPE 3

Type 3’s primary characteristic is exposure to toxins. 

What causes toxic Alzheimer’s?

Today toxins are everywhere. There are heavy metals in our food, mold in our houses, toxic substances in our plastic, and pollutants in the air. If you live in the US, toxin exposure is a fact of life. While these toxins certainly are not good for us, our bodies are capable of removing these substances. This is known as detoxification. It becomes a problem when more toxins are entering our bodies than we can remove, or when our body’s detoxification system is unequipped to detoxify a given substance. When this occurs for some people, they begin to develop a subtype of Alzheimer’s disease known as toxic Alzheimer’s. The most common contributors to toxic Alzheimer’s are as follows: 

Mycotoxins

Mycotoxins are a class of toxic chemicals secreted from certain types of molds. Some of the most well-documented mycotoxins include aflatoxin, ochratoxin, fumonisin, gliotoxins, and trichothecenes. These toxins are capable of disrupting neurotransmitter synthesis, depleting the body’s antioxidant reserve, impairing the blood brain barrier integrity, and even killing brain cells. Altogether, a heavy burden of mycotoxins can contribute to the onset of toxic Alzheimer's disease. 

Heavy Metals

Heavy metals are another source of chemical toxicants that can contribute to Alzheimer’s. The most common neurotoxic chemicals are lead, mercury, and arsenic. While we are still waiting on further research to clarify the role of heavy metals in Alzheimer’s Disease, this is what we know:

  • Lead - Lead is a heavy metal that readily passes through the blood brain barrier to cause direct damage to the brain. The result of lead toxicity is neuroinflammation, oxidative stress, and neurodegeneration. 
  • Mercury - Mercury disrupts the body’s natural antioxidant system and causes an accumulation of reactive oxygen species. These are destructive molecules that damage the DNA and cause all sorts of issues. In the case of Alzheimer's, mercury builds up in the brain and contributes to memory loss and personality changes.
  • Arsenic - Arsenic is a heavy metal found in the soil, air, and contaminated water. Arsenic travels through the blood and enters into various organ tissues where it stays. In the brain, arsenic disrupts the metabolism of brain cells called astrocytes. This metabolic disruption causes impairment to the central nervous system.

Other Toxins

There are many other toxins that we are exposed to in our modern world. Many of these are found in plastic products, such as bisphenol-A (BPA). Other sources include herbicides and pesticides used in agriculture. 

What are the signs and symptoms of toxic Alzheimer’s?

Toxic Alzheimer’s can be one of the hardest subtypes to diagnose. This is because different toxins affect the brain in different ways. For this reason, it is important to understand all signs and symptoms that may lead to a diagnosis. The following signs and symptoms are as outlined by Dr. Dale Bredesen as a part of the Bredesen Protocol in the book “The End of Alzheimer’s”.

  • Symptoms begin before age 65
  • Usually ApoE4 negative
  • No family history, or family history with symptoms beginning only at ages much older than the patient’s
  • Symptoms often occur around the time of menopause or andropause.
  • Depression precedes or accompanies cognitive decline
  • Headache is an early symptom, and sometimes the first.
  • Typical symptoms include executive function deficits (planning, problem solving, organizing, focusing), inability to manipulate numbers/perform calculations, trouble speaking or loss of speech, problems with visual perception, or problems with learned programs such as dressing.
  • Increased stress (e.g., loss of employment, divorce, family change) and sleep loss.
  • Exposure to mycotoxins or metals (e.g., inorganic mercury via amalgams, or organic mercury via fish) or both
  • Diagnosis of CIRS (chronic inflammatory response syndrome) with cognitive decline
  • Imaging suggests brain changes not seen in most cases of Alzheimer’s

TYPE 4

Type 4’s primary characteristic is low blood flow to the brain.

Type 4 or Vascular AD, 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.

CHARACTERISTICS & 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.

CARDIOVASCULAR HEALTH

Most people think of cardiovascular health, they only think about the heart.  However cardiovascular health extends to the entire body, including the brain. Vascular disease typically manifests in the brain as inflammation of the blood vessel lining. This inflammation has a series of negative effects such as activating the immune cells of the brain and reducing overall blood flow. Both of these are known contributors to the progression of Alzheimer’s and can increase the amount of amyloid plaque in the brain.  For this reason, there is a large crossover between the presence of cardiovascular disease and vascular Alzheimer’s. 

BLOOD BRAIN BARRIER INTEGRITY

The blood brain barrier often breaks down in those with Alzheimer’s disease. The blood brain barrier is the lining of the blood vessels around the brain that gives the brain an extra level of protection from bloodborne pathogens, & toxins. Since the blood brain barrier is so selective with what is and is not allowed to pass through, it can be a big deal when the structural integrity begins to degrade. Things that are not supposed to get into the brain begin to leak in. Nutrients that require an intact blood brain barrier to enter can no longer get in. This is why nutrients like omega-3 tend to be lower in those with blood brain barrier integrity issues. Cardiovascular health appears to play a large role in blood brain barrier breakdown with a positive ApoE4 status being highly correlated with vascular Alzheimer’s. 

TYPE 5

Type 5’s primary characteristic is brain damage.

Traumatic brain injuries can contribute to the development of Alzheimer’s disease. While it is different for each person, the consequences of these injuries may extend long after the initial symptoms subside. Traumatic Alzheimer’s is the fifth subtype of Alzheimer’s disease and is characterized by a history of head trauma.  Often leading to an earlier onset of Alzheimer’s disease. While not all head injuries lead to Alzheimer’s, traumatic Alzheimer’s symptoms usually do not appear until many years or decades after the traumatic event. 

Causes of Traumatic Alzheimer’s

The categorization of traumatic Alzheimer's disease came about after recognizing that the majority of people who suffered a mild to moderate traumatic brain injury during their lives had plaque in their brain upon autopsy, regardless of the cause of death.

Early research is beginning to explain how traumatic Alzheimer’s works, and how we can treat it. It appears that experiencing a traumatic brain injury causes acute stress to the brain and surrounding vasculature. Whether this is a one-time injury from an accident or a repeated trauma from playing sports, the brain becomes inflamed and the integrity of the blood-brain barrier begins to break down. While this reaction may subside in some people, it appears to kick-start the pathology of Alzheimer's disease in others. These are typically people who have an ApoE4 allele or have a predisposition towards inflammatory Alzheimer's disease or vascular Alzheimer's disease. For these people, a traumatic brain injury may expedite the onset of Alzheimer's Disease by years. When this occurs, the condition is classified as traumatic Alzheimer's disease. 

SIGNS AND SYMPTOMS OF TRAUMATIC ALZHEIMER’S

Signs and symptoms of traumatic Alzheimer’s will vary heavily from one person to the next. The most obvious sign would be a history of one or more traumatic brain injuries. Other than that, the signs and symptoms would depend on whether the brain injury is vascular or inflammatory. 

MISSION

The primary mission of Alzheimer’s Survivor is to communicate to everyone that there are treatments available for people experiencing Alzheimer’s Disease. 

  • There are Research solutions available for every stage of the disease
  • There are FDA-approved pharmaceuticals for every stage of the disease
  • There are Integrative Medicine solutions available for every stage of the disease

Gone are the days when there was nothing you could do to treat Alzheimer’s Disease. It is up to each individual and their family to decide what option best fits your need. 

Next week, we will begin to discuss treatments that are available to treat Alzheimer’s Disease.

Here are the links to purchase the books on Amazon and the link to Dr. Bredesen’s website.

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 AnyAge Paperback – September 6, 2022

LINK:

https://amzn.to/3xNcrct

Dr. Bredesen’s Website

LINK: https://www.apollohealthco.com/

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Growing older comes with outward signs of aging that you might find difficult to accept. Spotty skin, graying hair, and an achy body arent exactly perks of aging. But changes are unavoidable, even when it comes to your brain.Did you realize that your brain shrinks with age? This process begins as early as your 30s and 40s. This shrinkage also affects your learning and memory center, known as the hippocampus. Age-related decline also decreases blood flow to your brain while increasing inflammation. Communication between nerve cells (neurons) becomes less effective as you age.While you might not look or feel as well as you once did, your brain is also experiencing changes. While this might all seem bleakits just a normal part of aging most of the time. Age-related cognitive decline happens gradually for most people.Sometimes neurodegenerative changes arent arent so normal in older adults. Cognitive screens at the right time can help you catch declines early and even address underlying causes to slow or reverse these negative changes.What Is Mild Cognitive Impairment (MCI)?MCI is an early stage of declining cognitive (thinking) function. It usually involves some degree of memory or language loss that is greater than expected at someone's age or health. When you have MCI, you can function in daily life without help, but symptoms can progress until theyre no longer mild. You may eventually require assistance with daily tasks.Although MCIs exact cause isnt known, its apparent that certain processes in the brain trigger toxic clumps of proteins to collect, allowing other toxic proteins to damage and kill neurons. For some, this decline is connected to the early stages of dementia or Alzheimers, which are considered more advanced cognitive impairment that includes functional impairment (or loss of abilities).Of course, age increases your risk of MCI but so does a genetic predisposition to Alzheimers. Other medical conditions like high blood pressure, diabetes, and depression are also MCI risk factors.The Benefits of Cognitive ScreeningEarly detection can be key to stopping or reversing neurodegeneration. Cognitive screening can help you catch negative changes before they cause serious problems. Often, abnormal cognitive decline has underlying causes that can be addressed, such as medication side effects or nutritional deficiencies. And both lifestyle changes and new medications can slow the progression of dementia if detected in the early stages.What Is Cognitive Screening?Cognitive screening includes testing assesses different aspects of your mental functions with the purpose of detecting any problems with thinking, memory, problem solving, language, and other cognitive abilities.This type of screening is usually brief, like a questionnaire. But its not used to diagnose a condition and is instead a means of determining if you need further evaluation to make a diagnosis. It's evaluating whether youre experiencing difficulty with mental functions before you or those close to you notice there is a problem. Think of it as a pre-assessment or preliminary step.When Is the Best Time for Cognitive ScreeningBest rule of thumb: dont wait. Once youre noticing memory problems that are disrupting your life, youre already past the screening stage. At that point, its time for diagnostic testing to determine the specific cause and treatment. You should get a screening to make you aware of what is not yet noticeable, something that might be lurking but correctable, something to be addressed to prevent further decline.You might wonder when to get your first assessment. Its reasonable and worthwhile to get one at age 65 when you enroll in Medicare. It should be included in your annual wellness checkup, but be sure to confirm this or ask your doctor. This is especially if you havent had any symptoms prior to age 65. But if youre in tune with your body and feel like something is off, even without obvious symptoms, its reasonable to get screened prior to 65.Your primary care physician can perform a cognitive screening if there is no reason why you should see a specialist.What Is the Cognitive Screening Process?Its typically about 10 minutes or less and covers three assessments:Montreal Cognitive AssessmentMini-Mental State ExamSaint Louis University Mental State ExamYou can expect to be asked brief questions without any prior preparation. For example, during the Mini-Mental State Exam, you will be given three words and are asked to repeat them after a few minutes. You will also need to draw a circular clock and position the hands at a specified time. Other tests assess your orientation to ensure you know the date, your name, and where you are. These tests include questions to evaluate your:Attention spanShort-term learning abilitiesBoth short- and long-term memoryConcentrationLanguage abilitiesThese screenings are designed to assess different areas of brain function.Can You Do Online Screenings at Home?The most reputable, do-it-yourself, online cognitive screening is the Self-Administered Gerocognitive Exam (SAGE). Its a short, written exam that can be taken at home and doesnt require a trained professional to administer. It takes about 10-15 minutes to complete. It measures a range of abilities like reasoning, memory, language, and orientation.However, you dont get immediate results, because you dont determine the results yourself. There is no answer key or way to score it on your own. Its designed to be completed and given to your primary care physician who will score it and interpret the results. It will be up to your doctor to determine if you need further examination.What Happens After Cognitive Testing?For many people, cognitive testing yields positive results and requires no further evaluation. But you may need further testing if the screening indicates a degree of cognitive impairment. If this is you, dont panic. Not everyone with mild cognitive impairment (MCI) has or will develop dementia.According to the Mayo clinic, only about 10-15% of people with MCI later develop dementia. Many underlying causes can be addressed, like thyroid problems, sleep issues, and vitamin deficiencies like B12. When you treat these causes, your brain impairment is likely to improve.Sometimes a brain scan is necessary to determine if you have inflammation, tumors, or small strokes. It can also detect infection and structural problems in the brain.What Does an MCI Diagnosis Mean?If you get an MCI diagnosis, you can think of it as the stage between normal cognitive decline (due to aging) and more concerning decline like dementia. But remember, MCI doesnt mean that dementia is inevitable. As mentioned previously, most people with MCI dont move into the more serious state of cognitive decline, known as dementia.But its not easy to distinguish between MCI and the typical effects of aging on the brain. Its not uncommon for doctors to completely miss an MCI diagnosis. While having MCI is a risk factor for dementia or Alzheimers disease, these conditions arent inevitable. Its possible for your MCI symptoms to remain the same or improve.Talk to your doctor about lifestyle changes that can help slow declining mental function.Recommended Lifestyle Changes for Improved Brain HealthBoosting brain health means taking steps that improve your health in general. In fact, youve probably heard most of these recommendations before.Quality and sufficient sleepExerciseNutritious dietSocializationThis is not headline news, but adopting these healthy habits can have a notable impact on your cognitive health. For instance, sleep is crucial, because during this time your body removes toxins from your brain, which is key to preventing dementia and Alzheimers.Concerning diet, experts recommend a Mediterranean-style diet for brain function. This would include diets like the original Mediterranean Diet, the MIND Diet, and the Mediterranean-DASH Intervention for Neurodegenerative Delay). These eating plans involve less red meat and more produce. People who eat according to these plans have fewer signs of Alzheimers according to a study sponsored by the National Institute on Aging.Despite the importance of all these lifestyle factors, the addition of exercise has the strongest evidence for improving various cognitive functions. This is according to a review of 65 research studies.What If You Need Medication for MCI?Sometimes, it takes more than lifestyle changes to effectively battle MCI and stave off early on-set Alzheimers disease. Medications can help slow both MCI and Alzheimers, but this is a decision for you to make with your doctor.Medication to consider include:aducanumab (Aduhelm)lecanemab (Leqembi)donanemab (likely to be approved soon)You and your doctor can weigh the benefits of medication against the side effects.Cognitive Screening Is a Tool Worth UsingWhen you turn 65 and are enrolled in Medicare you can take advantage of cognitive screening during your annual wellness visit. The cost should be included in the annual exam. But not all seniors get their annual physical and miss this free cognitive screening. And some who do get an annual physical through Medicare claim they never got the screening. Be sure to ask about cognitive screening when you schedule your annual physical with your Medicare plan.You can be proactive in preventing mild cognitive impairment and the onset of dementia but there are no guarantees. Cognitive conditions like dementia and Alzheimers have a genetic component that you cannot change. But you may be able to delay the onset with good lifestyle habits like regular exercise, good sleep, socialization, and a Mediterranean-style diet.TYE Medical offers premium incontinence products in a variety of sizes and absorbency levels. Shop our online store for free and discreet shipping on all orders!