P. Murali Doraiswamy
Image: Les Todd, Duke Photography
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P. Murali Doraiswamy is the head of biological psychiatry at Duke University and is a Senior Fellow at Duke’s Center for the Study of Aging. He’s also the co-author of The Alzheimer’s Action Plan, a guide for patients and family members struggling with the disease. Mind Matters editor Jonah Lehrer chats with Doraiswamy about recent advances in Alzheimer’s research and what people can do to prevent memory loss.
LEHRER: What do you think are the biggest public misconceptions of Alzheimer's disease?
DORAISWAMY: The two biggest misconceptions are “It’s just aging” and “It’s untreatable, so we should just leave the person alone.” Both of these misconceptions are remnants of an outdated view that hinders families from getting the best diagnosis and best care. They were also one of the main reasons I wanted to write this book.
Although old age is the single biggest risk for dementia, Alzheimer’s is not a normal part of aging. Just ask any family member who has cared for a loved one with Alzheimer’s and they will tell you how different the disease is from normal aging. Alzheimer’s can strike people as young as their forties; there are some half a million individuals in the United States with early-onset dementia. Recent research has pinpointed disruptions in specific memory networks in Alzheimer’s patients, such as those involving the posteromedial cortex and medial temporal lobe, that appear distinct from normal aging.
The larger point is that while Alzheimer’s is still incurable it’s not untreatable. There are four FDA-approved medications available for treating Alzheimer symptoms and many others in clinical trials. Strategies to enhance general brain and mental wellbeing can also help people with Alzheimer’s. That’s why early detection is so important.
LEHRER: Given the rapid aging of the American population - by 2050, the Alzheimer's Association estimates there will be a million new cases annually - what are the some preventative steps that people can take to prevent or delay the onset of the disease?
DORAISWAMY: Unfortunately, there isn’t yet a magic bullet for prevention. You can pop the most expensive anti-aging pills, drink the best red wine, and play all the brain games that money can buy, and you still might get Alzheimer’s. While higher education is clearly protective, even Nobel Laureates have been diagnosed with the disease, although it’s likely their education helped them stave off the symptoms for a little bit.
My approach is more pragmatic - it’s about recognizing risks and designing your own brain health action plan. The core of our program is to teach people about the growing links between cardiovascular markers (blood pressure, blood sugar, body weight and BMI, blood cholesterol, C-reactive protein) and brain health. A population study from Finland has developed a fascinating scale that can predict 20-year risk for dementia – sort of a brain aging speedometer. Obesity, smoking, lack of physical activity, high blood pressure, and high cholesterol are some of the culprits this study identified. So keeping these under control is crucial.
Depression is another risk factor for memory loss, so managing stress and staying socially connected is also important. B vitamins may prevent dementia in those who are deficient and there are some simple blood tests that can detect this. For the vast majority of people, however, there are no prescription medications that have been proven to prevent dementia. This means that a brain-healthy lifestyle is really our best bet for delaying the onset of memory loss.
In the near future we will likely have prevention plans that are personalized based on genetic, metabolic and neurological information. In familial Alzheimer’s disease, pre-implantation genetic diagnosis has already been used to successfully deliver babies free of a deadly Alzheimer causing mutation—though only time will tell if deleting such dementia risk genes in humans has other consequences.
LEHRER: Your book talks about a new technique that allows doctors to image amyloid plaques in the brain. How will these change the diagnosis of the disease?
DORAISWAMY: Amyloid PET scans are in the late stages of validation testing to see if they can improve the accuracy of clinical diagnosis. The Alzheimer’s brain is defined by beta-amyloid plaques and tangles but, at present, these can only be definitively diagnosed with an autopsy. If an amyloid PET scan is “plaque negative” that will tell a doctor that Alzheimer’s is unlikely to be the diagnosis and help reassure the family. Early findings suggest that people who carry risk genes are more likely to have plaque positive scans even before they develop symptoms - suggesting that the scans could possibly be useful for predicting future risk. If true, this might eventually lead to a change in diagnostic terminology where “preclinical” Alzheimer’s is diagnosed purely based on biomarker and scan findings long before memory symptoms start. Therapies to treat Alzheimer’s by blocking amyloid plaques are already in trials but are currently given blindly to patients without knowing their brain plaque status—raising their risk for side effects and treatment failure. So this scan may also help drug development by helping select the most appropriate subjects for treatment and then monitoring treatment effects. Amyloid accumulation with aging is seen in many animal species and the scan offers us a tool to study what role plaque plays in normal brain aging. So this could do for the brain what colonoscopy did for the gut!
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20 Comments
Add CommentThis is an excellent interview with lots of useful information.
Reply | Report Abuse | Link to thisMost people do not spend time thinking about how their lifestyle and eating habits can effect their brain in the long run.
The author asks: "what are the some preventative steps that people can take to prevent or delay the onset of the disease?" The answer is important.
Every baby boomer should obtain and read a copy of the Alzheimer's Action Plan.
Bob DeMarco
http://alzheimersreadingroom.com
At present, nearly 2.7 million Americans over age 85 have the disease. However, it is estimated that with the first wave of baby boomers reaching 85 in 2031 3.5 million will have AD. It is presently the sixth leading cause of death for citizens of the US and the fifth leading cause in those over age 85. Indeed, death attributed to AD has increased by 47% between 2000 and 2006.
Reply | Report Abuse | Link to thisThis is an enormous social issue as we must secure more funding for the treatment and care of those with AD. Lifestyle factors must be taken more seriously and financial and other incentives should be used to promote proactive brain health lifestyles. At present, the United States is not prepared to manage the disease given the demographic shift.
Dr. Paul Nussbaum
www.fitbrains.com
When a elderly person starts having to make a lot of trips to the bathroom the first thing they do is reduce is their fluid (water) intake and when they do that they are reducing their neuron, cellular conductivity. What percentage of memory loss is caused by the bodies low water level, toxins in the body and poor circulation.
Reply | Report Abuse | Link to thisWhen a elderly person starts having to make a lot of trips to the bathroom the first thing they do is reduce is their fluid (water) intake and when they do that they are reducing their neuron, cellular conductivity. What percentage of memory loss is caused by the bodies low water level, toxins in the body and poor circulation.
Reply | Report Abuse | Link to thisHogwash.
Reply | Report Abuse | Link to thisThis sounds like a good question, to me... low water = a host of other problems. We (livinging beings)require water. It may be another type of what is deemed "mental illness," but if someone is not comsuming enough water, it seems very possible that there is a practical, physical, physiological possibility that there's a connection. What connection does/can this have? Do we distinguish between people who have a "defined mental illness" and those who do not give themsleves the practical nourishment that they need? Do we just roll them into the same category... i.e. mental illness or NOT?
Reply | Report Abuse | Link to thisToxins in the body accumulate over the years,as one ages.Water can wash out these.But there are other very effective detoxifying agents,that are also good for diabetics,and people with heart and kidney problems.These are herbal based ,and very common in our sorroundings,some of which are mentioned in traditional medicine literature of the region.Previously they used to be included in the diet.But now that practice has declined,or almost stopped.Drinking a lot of water can be stressful to the kidney.So drink moderately,and add these herbals ,to ensure detoxification.Using chemicals and phytoceuticals that are synthesised from these or so extracted may not have the synergic effwect that the whole plant provides.So revive some of these traditional dietary habits and foods.
Reply | Report Abuse | Link to thisSURESHKUMAR,SCIENTIST AND ADVISER,NIIST,CSIR
Amyloid PET scans are very exciting! Even though we're still not sure why these protein aggregates go haywire, early diagnosis (before any onset of symptoms) is always crucial for any disease.
Reply | Report Abuse | Link to thisWhere is the science? There is no evidence to suggest that this is anything other than brain aging. One of the most prominent Alzheimer's researchers has written a book "The myth of Alzheimer's", admitting that there is no objective clinical test for the disease, even post-mortem. Even the infamous plaques and tangles are found in completely asymptomatic autopsies, though there is some correlation with AD. To suggest one can "cure" aging is ridiculous. The brain ages like any other organ, and some people live long enough that their brains deteriorate. AD is just a name that we apply to this. Sure, some people age faster, and in different ways than others. Is that a disease? The only people supporting the disease myth, are the families that are tragically affected who need a cause to explain their loss, along with the huge industry of doctors, drug companies and researchers that benefit financially. Where is the science?
Reply | Report Abuse | Link to thisMy colleague, Professor Toshimitsu Musha, emeritus director of the Brain Functions Laboratory, Tokyo, Japan has developed a number of exercises that, when applied to AD patients diagnosed very early, can sometimes reverse the symptoms. One such device is a specially designed "Jaccuzzi" (my terminology) in which the patient is immersed in five feet of water a standing position. While holding on to a stationary bar, strong jets of water pummel the patients anterior body surfaces ........ and in my opinion this action greatly enhances lymphatic drainage resulting in substantial detoxification from all adipose tissue. Other exercises involv patients in unfamiliar activites such as painting, music, etc. Reports from Japanese hospitals indicate remarkably favorable outcomes. In my more limited experience, a Japanese nutraceutical, raffinee-a, can defer the decline of an AD patient for years. This substance is a vasodilator, and perhaps the enhancement of circulation acts to combat high blood pressure and other problems deemed contributory to causing AD.
Reply | Report Abuse | Link to thisExcellent Article.
Reply | Report Abuse | Link to thisApparently there are many things we can do to try and reduce the impact of Alzheimer's.
It is always better to be prepared whether for yourself or when caring for a parent or other loved one.
Amit
www.OurParents.com
i am curious to know whether there is any chance of getting effected with Alzheimers disease if he or she is depressed and frustrated with his or her work for a long time (say 1 year)
Reply | Report Abuse | Link to thisIt is a good article but as the good doctor says, diagnosis may improve faster than treatment and thus patients and families may get even more depressed and stressed with that. Being from main stream medicine, he does not obviously refer to the holistic / alternative systems of treatment including Homeopathy, Acupuncture and Reiki etc.
Reply | Report Abuse | Link to thisIn principle, there is a cure for Alzheimer's, i. e. to replenish the lost nerve cells by neurogenesis which can be achieved by activating the dormant neural stem cells in the brain. We still have quite a number of dormant neural stem cells at old age. These stem cells can be activated and induced to differentiate into neurons. The survival of neurons and their growth of neurites can be enhanced by neurotrophic or neurotropic factors. Our laboratory isolated and tested a few compounds which do have such activities. The preliminary clinical trial looks promising.
Reply | Report Abuse | Link to thisIn principle, there is a cure for Alzheimer's, i.e., to replenish the lost nerve cells via neurogenesis. We still have a number of dormant neural stem cells at old age which can be activated and induced to produce neurons. Our laboratory isolated and tested a few compounds from natural source to have such activities. The preliminary clinical trial looks promising.
Reply | Report Abuse | Link to thisMemory loss
Reply | Report Abuse | Link to thisWater is the bodies #1 ingredient, the base, the foundation and the bodies conductor.
This is out there, but I have heard our memory is not in our bodies and our complete body acts as a transmitter and receiver.
If a person can not transmit because of poor cellular conductivity then there is nothing out there to receive (short term).
If the person can not receive because of poor cellular conductivity then they can not receive the data that is out there (long term).
When I look out there I see sparkling data banks.
I am just throwing my thoughts out there.
Water makes up on average
Reply | Report Abuse | Link to this60 percent of your body weight.
My total body weight is 200 lbs.
200 lbs x 60 % = 120 lbs
A gallon of water weighs 8.33 pounds
120 lb divided by 8.33 lb = 14.40
There is 14.40 gallons of water in my body
There is 128 oz in a gallon
128 x 14.40 = 1843 ounces
There is 1843 ounces of water in my body
if my calculating is correct.
How long does it take me to exchange the
water in my body?
To keep it from becoming stagnate, inactive.
This subject gets my neurons all fired up and I have to throw my thoughts out there.
Reply | Report Abuse | Link to thisIs water a factor in Alzheimer's?
Or I should say, Is lack of water a factor in Alzheimer's?
First let me point out I am not pushing bottled water, or a additive.
I drink filtered city water, a large amount through out the day and keep my electrolytes within range.
As a person ages and starts having to make more and more trips to the bathroom because of urgency and frequency issues, the first thing they do is
reduce their fluid (water) intake and when they do that they are reducing their neuron, cellular conductivity.
What percentage of memory loss is caused by the bodies low water level, toxins in the body and poor circulation?
I am not talking about lack of fresh water for days, weeks or months, I am talking about years, persons through out there entire life not replenishing the body with new, fresh, wholesome, conductive water.
I have read that Alzheimer's disease is characterized by a build-up of proteins in the brain. I understand food is a big supplier of water but if a person thinks they are getting enough water from their food only, then that is why there is a build-up of proteins in the brain because you need more water to dilute the solution that is circulating in the blood stream. That build up of proteins accumulated over many years of a solution that could have been diluted by drinking a sufficient amount water. Has tests been done to persons in there 40s and 50s to see it the accumulation was starting to build?
Today there are a lot more people drinking water through out the day then there was 30 years ago. If my thoughts are correct there will be less health problems in 30 years compared to today. But they still have to keep their electrolytes in range.
Blood is like a cargo ship carrying oxygen and nutrients to and carbon dioxide, and waste from tissue in different parts of the body. Blood is 8% of your body weight. Blood is 80 to 95% water.
My uncle is not remembering everything he should and I ask him are you drinking enough water and he says yes, I sip water. I can not get him to understand the importance of water. He would rather sip water a few times a day and he thinks that will reduce his chances of having a embarrassing accident but in reality it is worsening his urgency and frequency issues.
Im sorry folks but sipping water is not enough to keep the water in your body from becoming stale, stagnate, toxic, a poor conductor, inactive.
I know more water is not what a caregiver wants to hear but Im sorry, I feel positive increasing water intake will be beneficial. Foley catheters and external catheters are a alternative methods of control and by increasing water intake it will help reduce the chances of a UTI.
It may be that, the older a person gets, the more water they have to drink.
Not , the older a person gets, the less water they have to drink
The fountain of youth may be just a sufficient supply of water.
I dont think just drinking a lot of water is going to cure Alzheimer's disease. I think years of not drinking enough water contributed to the onset and I think it
is going to take years of drinking a sufficient amount of water to rejuvenate the damaged cells, neurons.
Drinking a sufficient amount of water maybe the best precaution a person can do to prevent Alzheimer's disease.
Water is the bodies #1 ingredient, the base,
the foundation and the bodies conductor.
Water makes up on average
70% percent of your body weight.
I will use my uncle for a example
his total body weight is 150 lbs.
150 lbs x 70 % = 105 lbs
A gallon of water weighs 8.33 pounds
105 lb divided by 8.33 lb = 12.60
There is 12.60 gallons of water in his body
There is 128 oz in a gallon
128 x 12.60 = 1612 ounces
There is 1612 ounces of water in his body
That is 201, 8 ounce glasses of water in his body.
Again using my uncle as the example
And he drinks a cup of coffee for breakfast
A can of soda for lunch and a can of soda at dinner
(1st that is to much caffeine for him, reducing his blood
flow and caffeine alters brain function, and not for the better)
and maybe 2 cups of water through out the day (if that much)
All of that equals maybe 6, 8 ounce glasses of fluid +
maybe a additional 2 cups of water that is in his food for the day.
How long does it take him to exchange the 201, 8 oz cups or 1612 ounces of water in his body? To keep wholesome, to keep it from becoming stale, stagnate, toxic, a poor conductor, inactive.
I think lack of water is a factor in, some types of strokes, multiple sclerosis, Alzheimer's disease, Parkinson's disease, ALS, Cancer and other health problems.
I am not saying lack of water triggered all of those, but lack of water aided the onset and increases the progression of the dis ease.
Dont forget the valves in arteries and veins that control blood flow, they are located throughout the complete body and the organs like the liver, kidneys etcetera are made up of that same 70% water. Poor conductive water can make the whole body malfunction.
The brain is amazing and can make a vast number of tailor made prescriptions for what ever ails you, but they mix with the bodies #1 ingredient, water and if that water is stale, stagnate, toxic, a poor conductor, inactive, you will not get the maximum effect of the prescription.
Has studies been done to rule out, that lack of water is a contributing factor in those dis eases?
I think a person should have there water level, ph, water conductivity checked first before any treatment starts to get a accurate reading.
Water is the human body's most important nutrient.
I am not a doctor, scientist, I am a troubleshooter by trade, I look at the basics first. It is all I know about in this field. Basics
These notes are my thoughts and opinions and you should always consult with your physician before changing your regimen. Make a copy of this and ask your doctor if my notes are true.
To me lack of water is the most logical explanation on many health problems.
A person with a correct water level, fresh, wholesome, conductive water is like a well oiled precision machine and will get a extended workable life.
This is out there but
I have heard our memory is not in our bodies and our complete body acts as a transmitter and receiver. (this may explain young child prodigies that are concert pianists, etcetera) (that data came from some where)
if this is true
If a person can not transmit because of poor cellular conductivity then there is nothing being sent out there to receive back (short term memory loss).
If the person can not receive because of poor cellular conductivity then they can not receive the data that was stored out there years ago when they were healthier and younger (long term memory loss).
They can not even transmit the request for the data. A double hit.
When I look out there I see sparkling data banks.
I am just throwing my thoughts out there.
(ramm)
"Can Alzheimer's Be Cured?"
Reply | Report Abuse | Link to thisCan Alzheimers Be Prevented?
This subject is really getting my neurons all fired up and I have to throw my thoughts out there. Again
Revised
Is water a factor in Alzheimer's?
Or
I should say,
Is lack of water a factor in Alzheimer's?
Or better yet
I should say,
Is lack of water a factor in Alzheimer's, Dementia, memory loss, loss of motor control, loss of muscle control, muscle weakness?
First let me point out I am not pushing bottled water, or an additive.
I drink filtered city water, a large amount through out the day and keep my electrolytes within range.
As a person ages and starts having to make more and more trips to the bathroom because of urgency and frequency issues, the first thing they do is reduce their fluid (water) intake and when they do that they are reducing their neuron, cellular conductivity.
What percentage of Alzheimer's, Dementia, memory loss, loss of motor control, muscle weakness is caused by the bodys low water level, insufficient water exchange, toxins in the body and poor circulation?
I am not talking about lack of fresh water for days, weeks or months, I am talking about years. Persons through out there entire life not replenishing the body with new, fresh, wholesome, conductive water.
I have read that Alzheimer's disease is characterized by a build-up of proteins in the brain. I understand food is a big supplier of water but if a person thinks they are getting enough water from their food only, then that is why there is a build-up of proteins in the brain because you need more water to dilute the solution that is circulating in the blood stream. Those build up of proteins accumulated over many years of a solution that could have been diluted by drinking sufficient amount water. Has tests been done to persons in there 40s and 50s to see it the accumulation was starting to build?
Today there are a lot more people drinking water through out the day then there was 30 years ago. If my thoughts are correct there will be less health problems in 30 years compared to today. I think by drinking more water will reduce a lot of health problems. But they still have to keep their electrolytes in range.
Blood is like a cargo ship carrying oxygen and nutrients to tissue in different parts of the body and picks up carbon dioxide, and waste from tissue in different parts of the body. Blood is 8% of your body weight. Blood is 80 to 95% water.
My uncle is not remembering everything he should and I ask him are you drinking enough water and he says yes, I sip water. I can not get him to understand the importance of water. He would rather sip water a few times a day and he thinks that will reduce his chances of having an embarrassing accident but in reality it is worsening his urgency and frequency issues.
Im sorry folks but sipping water is not enough to keep the water in your body from becoming stale, stagnate, toxic, a poor conductor, inactive.
I know more water is not what a caregiver wants to hear but Im sorry, I feel positive increasing water intake will be beneficial. Foley catheters and external catheters are alternative methods of control and by increasing water intake it will help reduce the chances of a UTI.
It may be that, the older a person gets, the more water they have to drink.
Not, the older a person gets, the less water they have to drink
The fountain of youth may be just a sufficient supply of water.
Now think about that. When someone says they found the fountain of youth somewhere, people rush there and they start drinking large amounts of water for days and they start to feel better and take some home to drink and even have the fountain of youth water shipped to them. Time passes and they feel better than before they started drinking the fountain of youth water but they are not getting that neuron, cellular firing rush like they did when they first started drinking the fountain of youth water. And they slowly start reducing there water intake again.
I dont think just drinking a lot of water is going to cure Alzheimer's disease but it will be beneficial. I think years of not drinking enough water contributed to the onset, and I think it is going to take years of drinking a sufficient amount of water to help rejuvenate the damaged cells, neurons.
Drinking a sufficient amount of water maybe the best precaution a person can do to prevent Alzheimer's disease.
Water is the bodies #1 ingredient, the base,
the foundation and the bodys conductor.
Water makes up on average
70% percent of your body weight.
I will use my uncle for a example
his total body weight is 150 lbs.
150 lbs x 70 % = 105 lbs
A gallon of water weighs 8.33 pounds
105 lb divided by 8.33 lb = 12.60
There is 12.60 gallons of water in his body
There is 128 oz in a gallon
128 x 12.60 = 1612 ounces
There is 1612 ounces of water in his body
That is 201, 8 ounce glasses of water in his body.
Again using my uncle as the example
And he drinks a cup of coffee for breakfast
A can of soda for lunch and a can of soda at dinner
(1st that is too much caffeine for him, caffeine reduces his blood
flow and caffeine alters brain function, and not for the better)
and maybe he sips 2 cups of water through out the day (if that much)
All of that equals maybe 6, 8 ounce glasses of fluid +
maybe an additional 2 cups of water that is in his food for the day.
So 8 cups x 8 ounces = 64 ounces
And there is 1612 ounces of water in his body.
64 ounces is 1/ 25th of the 1612 ounces of water in his body.
So if you lined up 25, 64 ounce pitchers of water,
now move one over two spaces. What do you see?
How long does it take him to exchange the water in those 24, 64 ounce pitchers of water with the one that was separated. The one that one drinks daily if they drink all 64 ounces. To keep the water wholesome, to keep it from becoming stale, stagnate, toxic, a poor conductor, inactive.
Do not forget when he drinks a 8 ounce glass of water it blends with the existing
201, 8 once glasses of water in his body.
Now, what if he is not telling me the truth and he only drinks half that much. And half of his fluid intake for day contained caffeine.
When he was in the hospital for tests I remember my brother saying he would not eat his lunch but he drank his cup of coffee
I think lack of water is a factor in, some types of strokes, multiple sclerosis, Alzheimer's disease, Parkinson's disease, ALS, Cancer just to name a few and contributes to other health problems.
I am not saying lack of water triggered all of those, but lack of water aided the onset and increases the progression of the dis ease.
Dont forget the valves in arteries and veins that control blood flow, they are located throughout the complete body and the organs like the liver, kidneys etcetera are made up of that same 70% water. Poor conductive water can make the whole body malfunction.
The brain is amazing and can make a vast number of tailor made prescriptions for what ever ails you, but they mix with the bodies #1 ingredient, water and if that water is stale, stagnate, toxic, a poor conductor, inactive, you will not get the maximum effect of the prescription.
Has studies been done to rule out, that lack of water is a contributing factor in those dis eases?
I think a person should have there water level, ph, water conductivity checked first before any treatment starts to get an accurate reading.
Water is the human body's most important nutrient.
I am not a doctor or a scientist, I am a service technician, a troubleshooter by trade, and I look at the basics first.
These notes are my thoughts and opinions and you should always consult with your physician before changing your regimen. Make a copy of this and ask your doctor if these notes are true.
To me lack of water is the most logical explanation on many health problems.
A person with a correct water level, fresh, wholesome, conductive water is like a well lubricated precision machine and will get an extended workable life.
This is out there but
I have heard our memory is not in our bodies and our complete body acts as a transmitter and receiver. (This may explain young child prodigies that are concert pianists, etcetera) (That knowledge, data came from somewhere)
If this is true
If a person can not transmit because of poor cellular conductivity then there is nothing being sent out there to receive back (short term memory loss).
If the person can not receive because of poor cellular conductivity then they can not receive the data that was stored out there years ago when they were healthier and younger (long term memory loss).
They can not even transmit the request for the data. A double hit.
When I look out there I see sparkling data banks.
I am just throwing my thoughts out there.
I would like some answers.
He passed away.
A contractor would not start to renovate a house
if the foundation was not a good base.
(ramm)
This is a really interesting article. I really liked what Dr. P. Murali Doraiswamy said about your own brain plan. That, I think is very crucial when it comes to beating Alzheimer's. There are many ways that people combat their Alzheimer's, some people think that they are better in a <a href="http://palmshadevilla.net">assisted living</a> home, others want to be at home. It is good to talk about it and see what you would want to do if that situation arose.
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