"The
Dementia Epidemic- Economic Impact and Positive Health Solutions
for Australia" was prepared for Alzheimer's Australia by Access
Economics Pty Ltd in March 2003. The report found that dementia
was currently costing Australia $5.6 billion in real economic costs.
That expenditure was set to rise with more than half a million people
suffering from the disease by 2040. Alzheimer's Australia states
that "dementia costs more years of health span than any of
the national health priority areas.
Strangely, [this] has not yet been acknowledged in national policy
making."(1)
Orthodox treatment
of Alzheimer's disease tends to focus on acetyl cholinesterase
inhibitors in the brain (8) with
drugs such as physostigmine. The side effects can often outweigh
the benefits of the drug. (2)
Prevention
tends to be a better known area than the treatment of Alzheimer's
disease.
Complementary medicines, particularly antioxidants, offer exciting
developments in both the treatment and the prevention of Alzheimer's
disease.
The John Hopkins
University School of Public Health in Baltimore, USA performed
a study involving over 4700 participants. The study observed whether
people over the age of 65 years developed Alzheimer's disease
as well as other forms of dementia.
Assessment took place between 1995 and 1997, and again between
1998 and 2000.
It was found that those individuals who took over 400iu of vitamin
E and 500mg of vitamin C daily had the least incidence of developing
Alzheimer's disease.
Taking less than these amounts, say in a multivitamin supplement,
did not seem to provide protection from the prevalence or incidence
of Alzheimer's disease. (3)
The lead investigator,
Dr. Peter P. Zandi, concluded that the study results warrant the
need for further research into the effect of antioxidant supplements
on the primary prevention of Alzheimer's disease.
He suggests
that there may be a biological reason that the two antioxidants
produce a combined benefit related to the duration of their antioxidant
effects.
Vitamin E, being fat-soluble, stays in the tissues longer than
vitamin C which is water-soluble and excreted more rapidly.
He suggests that vitamin C may "recharge" vitamin E
and boost its antioxidant effect.
Other studies
support the findings of Dr. Zandi et al.
An Italian study found that the antioxidants vitamin A, C and
carotenoids were significantly lower in those with Alzheimer's
disease.
In the study of 141 people, 63 had Alzheimer's disease, 25 had
mild cognitive impairment and 53 people were controls.
The authors suggested that an increased intake of antioxidants
could assist in lowering the conversion of mild cognitive impairment
to dementia or Alzheimer's disease. (5)
Vitamin E
has also been shown to be of benefit when combined with pharmaceutical
drugs.
Ohio State University Department of Neurology performed a study
into the long term use of vitamin E in combination with donepezil
(a drug used for the treatment of Alzheimer's disease).
The daily dose of vitamin E given was at least 1000 IU whilst
the daily dose of donepezil was at least 5 mg. The results showed
a significant reduction in the rate at which patients developed
Alzheimer's disease. (4)
Apart from
vitamin antioxidants, herbal antioxidants and other natural food
chemicals have provided evidence of benefit in preventing Alzheimer's
disease.
Ginkgo biloba
is a herb with a significant potential preventative role in dementia,
particularly in Alzheimer's disease.
The herbs main active ingredients are flavone glycosides, and
terpene lactones.
A combined American/Chinese study, using a standardized extract
labeled EGb761 from the Ginkgo bilobatree, showed that the extract
inhibited the formation of amyloid- Beta (A Beta) fibrils.
The scientists (Yuan Luo et al.) suggested that Ginkgo bilobacould
be used both in the prevention and the treatment of Alzheimer's
disease. (9)
The World
Health Organization accepted Ginkgo biloba to be effective as
an antidementia drug in January 2000 and included the herb in
its ATC-Classification Index.
The herb was found to be as effective as orthodox pharmaceutical
drugs with the same clinical action, however, the Ginkgo biloba
was found to be safer with "an additional drug safety benefit".
(8)
Resveratrol,
an antioxidant compound found in red wine, has been found by Swiss
scientist Dr. Egemen Savaskan of the University of Basel, to protect
cells from oxidative stress caused only by beta-amyloid. This
means that Resveratrol may protect against Alzheimer's disease.
As in the case of most initial research, Dr. Savakan says "we
need more research on those substances". (6)
Like red wine,
fish rich in omega-3 fatty acids have also been found to protect
the consumer from developing Alzheimer's disease when consumed
on a weekly basis.
Morris et al from the Rush Institute for Healthy Aging in Chicago
studied a total of 815 residents from a select geographical area
with a high risk for dementia.
After 2.3 years, 181 individuals developed Alzheimer's disease.
The researchers found that those participants who developed dementia
had a significant 60% lower risk of developing Alzheimer's disease.
(7)
There seems
to be an interesting link between some natural substances which
have been found to protect against heart disease (such as vitamin
E, red wine, deep sea fish) and also protect against Alzheimer's
disease.
The evidence
that natural products contribute to the prevention of Alzheimer's
disease is strong and with the Australian population of over 50
year olds growing so rapidly, this promises to be an opportunity
for government to start reducing the escalating cost of healthcare.
Government needs to fund more research in this area as a priority-
they would be dollars well invested.
(1) www.alzheimers.org.au
(2) Murray and Pizzorno, The Encyclopedia of Natural Medicine
(3)"Reduced Risk of Alzheimer's Disease in Users of Antioxidant
Vitamin Supplements- The Cache County Study". Zandi, P. et
al. Arch Neurol. Vol.61, Jan 2004
(4)"Combination therapy of donepezil and vitamin E in Alzheimer's
disease". Klatte ET, et al. Alzheimer Dis Assoc Disord 2003
Apr-Jun; 17(2):113-6
(5)"Plasma antioxidants are similarly depleted in mild cognitive
impairment and in Alzheimer's disease." Rinaldi P, et al.
Neurobiol Aging. 2003 Nov; 24(7): 915-9
(6)"Red wine ingredient resveratrol protects from beta-amyloid
neurotoxicity". Savaskan E et al.Gerontology. 2003 Nov-Dec49
(6) 380-3.
(7)"Consumption of fish and n-3 fatty acids and risk of incident
Alzheimer's disease." Morris MC et al. Arch Neurol. 2003
Jul; 60(7): 940-6.
(8)"Value of Ginkgo biloba in treatment of Alzheimer dementia."
Loew D. Wien Med Wochenschr. 2002; 152(15-16):418-22
(9)"Proof of efficacy of the Ginkgo biloba special extract
EGb761 in outpatients suffering from mild to moderate primary
degenerative dementia of the Alzheimer type or multi-infarct dementia."
Kanowski S. Pharmacopsychiatry.1996 Mar 29(2):47-56
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