Alzheimer's: Stopping Alzheimer's Before it Starts (cont.)

MEMBER QUESTION:
So are you saying that there is not a set amount of these vitamins to take and it could be different for everyone? What kind of doctor should I see to set this vitamin regimen?

SHANKLE:
There probably isn't a doctor that can tell you what to take. This is why we have developed, as a companion to Preventing Alzheimer's , an automated online prevention program that tailors the treatment to each person based on a comprehensive review of his or her risks. Once you have that knowledge you can go to your doctor and they can look at what medications you're taking and see if they are safe to take as the prevention treatment. That's why Dr. Amen and I worked so hard to create a quality book to give people the kind of evidence they need to really reduce their risks.

For those who are interested, the prevention program that complements what the book provides, and tailors a prevention program, is preventad.com.

MEMBER QUESTION:
What about ginkgo biloba?

SHANKLE:
Ginkgo has been rather widely studied, and it shows benefits in areas of heart disease and in diabetes, and most of the studies show that it reduces the progression of memory loss in various causes of dementia, such as Alzheimer's and other conditions. It's not clearly established like vitamin E, though, for example.

MEMBER QUESTION:
I was reading in a Time magazine recently that inflammation is one cause or sign of Alzheimer's. My grandmother on my Dad's side has Alzheimer's. My dr. informed me that my hips and sternum were inflamed and that I just needed to do yoga to stop the pop, pop, popping. Basically I want to stop it before it happens to me. What can I do?

SHANKLE:
Inflammation is not an early change of Alzheimer's; it is a late change. When the plaques of Alzheimer's start to appear in the brain, it attracts inflammatory cells, and that is the inflammation people speak of. But that is a later change rather than an earlier change

AMEN:
Inflammation from any cause is not helpful to brain function, but ibuprofen and aspirin calm inflammation. So taking care of the inflammation in your body is useful, probably for your brain, as well.

SHANKLE:
It's interesting, to amplify that point, that the anti-inflammatory medications reduce the risk of Alzheimer's by about 50 to 75 percent. But the effect is not due to reducing inflammation, because the doses required are so low that they don't exert an anti-inflammatory effect in the brain. We know, for example, that ibuprofen, which is also known as Motrin or Advil, blocks the production of the beta-amyloid, which is one of the primary causes of Alzheimer's. So even though inflammation is a pathological process, a disease process itself, the anti-inflammatories are protecting against Alzheimer's in some other way.

It's also very interesting that in general the studies show that aspirin reduces the risk of Alzheimer's by about 33 percent. But there is a group of people where aspirin doubles the risk of Alzheimer's in persons who do not have the apo-lipo protein E4 gene. That gene, the E4 gene, is the major genetic risk for the most common form of Alzheimer's disease, and yet in people without the E4 gene, if they take aspirin the risk of Alzheimer's doubles. That's a very recent study, and it points out the importance of truly knowing your risks so you can select the proper treatment

MEMBER QUESTION:
Do you advise taking a gene test?

AMEN:
Yes, we do. We think that people should know their apo E genotype; if they have the E4 gene they are at two-and-a-half times the risk for getting Alzheimer's disease. If they have two copies of it, because we get one copy from our mom and one from our dad, they are at five to 10 times the risk.

Having the E4 gene does not necessarily mean that you're going to get Alzheimer's disease, but it means that you're at greater risk and you should take prevention more seriously.

MEMBER QUESTION:
What does a gene test entail, and what kind of doctor does them and reads them?

AMEN:
It's just a blood test your family doctor can have done at any lab. They then send it off to a special lab. It's becoming more and more common.

"Having the E4 gene does not necessarily mean that you're going to get Alzheimer's disease, but it means that you're at greater risk and you should take prevention more seriously."

MEMBER QUESTION:
Tell us more about the online prevention program. Is it a study or experiment?

AMEN:
At preventad.com people can take an online screening test that is highly sensitive to uncovering early memory loss, and then based on the test and questions it will help you assess your risk and give you specific things to do about it.

MEMBER QUESTION:
I have been struggling with anxiety and depression for the last three years and since then have been taking different antidepressants. Does this mean I will have a higher risk of getting Alzheimer's disease as I get older?

AMEN:
Great question. It is really untreated depression that increases people's risk, not only for Alzheimer's disease, but also for heart disease. So getting the anxiety and depression treated is absolutely critical to continued mental health and cognitive health.

MEMBER QUESTION:
With the recent release of information indicating a tie between diabetes and Alzheimer's, I am concerned with my situation. I'm a 46 year old with diabetes on insulin treatment for 11 years now. I was in the Army then and allowed to be retained until 2002. In Nov. of 2001 I had a serious memory loss episode. It started with short-term memory and got to the point where my family took me to the hospital for treatment when I woke up crying because I couldn't remember how much insulin to take. The hospital wrote it off as out of control diabetes and released me when my memory began to improve. What is your opinion?

AMEN:
Diabetes does increase the risk for Alzheimer's disease, and doing everything you can to get it under control is critical. In addition, it's important to do the prevention strategies we outline in the book so you can work to keep your brain healthy as you age. The right diet, exercise, and supplements that are appropriate to you are all very important. It also means since diabetes increases the risk, it means you have to work closely with your doctor to get the diabetes under control for you.

MEMBER QUESTION:
What is the difference between memory loss and signs of Alzheimer's?

AMEN:
I don't really want people to think about "regular" memory loss, because it's a little bit of a myth that we lose our memories as we age. In the studies we've done of older people, when you start to lose your memory, your brain is becoming significantly less active and putting you at risk for greater problems. Alzheimer's disease is a progressive loss of memory, so if you notice, or people in your family notice, because they often notice first, that your memory is getting worse and worse, that's the point to be concerned and to get an evaluation.

MEMBER QUESTION:
Is there a test to determine if you have Alzheimer's? My mother had it; are my chances greater than others? I have some memory problems now.

AMEN:
If your mother had it you are at greater risk to get it. We know having a family history of Alzheimer's disease or other forms of severe memory loss increases one's risk. A good evaluation is essential. Start with the checklist in the book or go to preventad.com and do the test.

In my four clinics across the country we do a study called Brain SPECT imaging that looks at blood flow and activity patterns on the brain. We use it to help us diagnose people with Alzheimer's disease and other forms of dementia.

MEMBER QUESTION:
Where are your clinics located and does insurance cover costs?

AMEN:
My four clinics are located in Newport Beach and Fairfield, CA,
Tacoma, WA, and Reston, VA.

It's hard to say about insurance, because there are so many types of companies it's variable. I often recommend if you're going to get screened for the E4 gene and screened for Alzheimer's disease that you pay for it yourself. It's possible that you could be discriminated against with the information, so I recommend people pay for it themselves.