Dementia Prevention Testing Matters: Part Four

I am not a doctor nor am I responsible for your health! Please consult a physician before implementing any of the suggestions below for dementia prevention eating. If you are already having symptoms of memory loss I strongly recommend you seek help through Dr. Bredesen’s website. (We are not affiliated in any way and he has not endorsed my website.) His company, AHNP uses the latest technology to develop customized plans of the Bredesen protocol for people with SCD (subjective cognitive decline), MCI (mild cognitive impairment) or Alzheimer’s. There are several options based on your cognitive status.

Check out Parts One, Two and Three of dementia prevention testing matters

I strongly recommend that you read Part One, Part Two and Part Three of the series on why dementia prevention testing matters and what it is. It will give you context for this final part and will make it clear why we need to spend so much time on testing.

Sleep Apnea, Toxins, Mitochondrial Function, BMI, Cognitive and Genetic Testing and Imaging

These are the last items that Dr. Bredesen, author of The End of Alzheimer’s wants us to have tested for dementia prevention. For each item I will describe its significance for dementia prevention, the means of testing, Dr. Bredesen’s optimal figures and suggestions if your values are not optimal.

Sleep

There are none among us who do not need a good night’s sleep to function at our best. Yet, as we all know, the pace of modern life creates pressure like we’ve never known before to do anything and everything but sleep. How does it go? Sleep is for lazy people. If you were really devoted to your work, you’d stay up half the night finishing that project. The early bird catches the worm, right? Work environments reward the sleep-deprived–maybe unintentionally, but no matter. The result is the same. We do not get the sound, seven to eight hours of sleep our brains need to do their amazing job of housecleaning.

What does sleep have to do with dementia?

More than we used to believe! More and more scientists are learning a lot about what our brains (and mice brains) actually do while we are asleep. According to recent research, it seems that our brains do serious and systematic housecleaning while we sleep. To put it simply, with the efficiency of a power-washer, the cerebral-spinal fluid circulates among brain cells, flushing out toxins and waste, including amyloid plaque.

Slow cortical network oscillations (delta waves) may contribute to the efficiency of fluid influx into the brain parenchyma and clearance of waste from the brain (5, 9). 

From Increased glymphatic influx is correlated with high EEG delta power and low heart rate in mice under anesthesia
Lauren M. Hablitz¹, Hanna S. Vinitsky¹, Qian Sun¹, et al.
Science Advances
 27 Feb 2019:
Vol. 5, no. 2, eaav5447

In his book, The End of Alzheimer’s on page 139-140 Dr. Bredesen lists the processes which connect sleep and brain function. Included are the power-washing process described above, fasting or lack of food which increases insulin sensitivity (a good thing), cell turnover called “autophagy” by which old, damaged cells are “self-eaten,” and repair of brain cells using increased levels of growth hormones produced during deep sleep. In addition, here’s an informative article on several studies done that examine the relationship between sleep and the removal of tau tangles–one of the earmarks of Alzheimer’s disease.

Testing for sleep apnea

Again, according to Dr. Bredesen, if you snore, are a middle-aged or older male, are overweight, have a short, thick neck, are experiencing cognitive problems, or are chronically tired you should consider investing the several hundred dollars to do a home test for sleep apnea. The measure is the AHI (apnea-hypopnea index)–that is, how many times a person stops or nearly stops breathing during sleep. The optimal figure is 0-5. If your figure is higher than that talk with your dentist about getting a dental appliance or your doctor about using a special machine that regulates air pressure during sleep (a CPAP machine). Remember, dementia prevention testing matters!

Toxins

Surprisingly toxins are turning out to be an important cause of Alzheimer’s disease…. We inhale poisons, we ingest toxins, we absorb toxins through our skin, we produce endogenous toxins as biochemical reaction by-products, we are exposed to toxic electromagnetic fields and radiation. Most of the time we don’t sense these toxins, so we don’t even have a chance to avoid them.

From The End of Alzheimer’s by Dr. Dale Bredesen. p. 151

Biotoxins

As wondrous as our bodies are, they have their limits. Being constantly bombarded with alien substances like molds, Lyme, herpes, and bacteria can cause a chronic stress (inflammatory) response, known as CIRS or chronic inflammatory response syndrome. In this state the body’s innate immune system goes into overdrive and can start attacking itself in the attempt to get rid of the onslaught of invaders. Cognitive decline is just one of the many symptoms of CIRS.

Testing for biotoxins

We are fortunate that science has advanced enough that tests are available! First, have genetic testing done to determine if you are in the 25% of people who are genetically susceptible to CIRS. Here’s an article explaining the significance of mold exposure to health for the genetically susceptible.

There are several tests that will reveal the presence of biotoxins. First, get the genetic blood test for HLA-DR/DQ (Human Leukocyte Antigen). Desired test result: no CIRS propensity. Next, get the blood tests for C4a, TGF-Beta1 and MSH. These are markers of an activated innate immune system. The desired test results: C4a<2830 ng/ml, TGF-Beta1<2380 pg/ml and MSH = 35-81 pg/ml. Finally, you can get a urine test for the most dangerous mycotoxins (molds). Optimal: negative. Dementia prevention testing matters!

What to do if levels are sub-optimal?

If your results do show genetic propensity, or if your levels are sub-optimal on the blood tests or if the urine test comes back positive, it is important that you take immediate action for dementia prevention. Dr. Richard Shoemaker has developed a protocol to specifically address removing bio-toxins. Based on years of extensive research and clinical practice Dr. Shoemaker offers step by step procedures that can be found here. See also The End of Alzheimer’s, pages 204-205 for detailed remediation procedures.

Mitochondrial function

How many of us regularly thank our mitochondria for all they accomplish in our bodies? We should do so daily because these cells perform one of the most essential bodily functions–they convert the fuel (food) and oxygen we take in to the energy that powers all our cells. From The End of Alzheimer’s by Dale Bredesen.

Unfortunately, mitochondria are susceptible to environmental and other damage. Also unfortunately, the list of potentially damaging substances is long. It includes antibiotics, alcohol, L-DOPA (Parkinson’s disease medication), NSAIDS, and AZT (drug used to treat viral infections), to name just a few. This research paper describes a long list of just medication-inducing agents that damage mitochondria. Additionally, research has been done on a broader range of environmental substances with the potential to damage mitochondria.

Testing for mitochondrial damage

Presently, testing for mitochondrial damage is not as simple as having a blood or urine test done. Until there are tests available it is best to simply assess whether or not you have been exposed to agents that might have damaged your mitochondria.

When toxic agents can’t be avoided, improving overall mitochondrial function is possible by including key elements such as CoenzymeQ10, L-carnitine, B Vitamins, antioxidants (Vitamin C, Vitamin E, Alpha-Lipoic Acid, selenium ), and others. Minimizing stress and illness is also important!

From the website mitoaction found here.

Body Mass Index or BMI

An analysis of international data on more than a million people who were followed over time confirms two links between BMI and dementia — one ties midlife obesity to higher risk, and the other ties being underweight near disease onset to higher risk.

From the website Medical News Today found here
By Catharine Paddock, Phd.
Monday, Dec. 4, 2017
Full article
Full original study here

Here is a DIY formula to find your body mass index. Multiply your weight in pounds by 703, divide by your height in inches then divide by your height again. Or find an online calculator such as this one. Optimal value: between 18 and 25. Another important measure is waist size: <35 inches for women or <40 inches for men and visceral fat status.

What to do if my numbers are sub-optimal?

Exercise! And check out Dr. Bredesen’s Ketoflex diet which addresses dementia prevention and weight loss at the same time. Details on a dementia prevention exercise program are on pages 190 to 191. Details on the Ketoflex diet are on pages 179 to 190.

Cognitive testing

One of the most well-used cognitive tests is the MOCA or Montreal Cognitive Assessment test. You can find it here. If you have a printer, it’s easy to print it out and then take it. The scoring is described in detail on this version. Optimal value: 26-30, possible indication of Mild Cognitive Impairment (MCI) is 19-25. Other tests are the MIni-Mental State Examination (MMSE) or SAGE (Self-administered Gerocognitive Examination).

If you feel that your cognitive function is not what is should be, or your values above are not optimal, you might consider tests available from online brain game sites such as BrainHQ or Lumosity. Beyond that, neuropsychologists have more sophisticated (and longer) tests that can be used for follow-up.

Genetic testing

I’m excited to share with all the DIYers out there about how I found out my genetic status for a minimal amount of time and NO charge. But first, let’s look at the genes that we know, so far, play a role in determining your risk for Alzheimer’s. According to Dr. Bredesen (and many others) the ApoE4 gene has been identified as one strongly associated with risk of Alzheimer’s. The ApoE4 gene has two alleles–one that we get from our mother and one from our father. Therefore, many combinations are possible, such as E2, E3, or E3, E3, etc. The highest risk combination is E4, E4. Like all the other testing we’ve talked about, it’s best to have the information so that we can act on it!

So I have discovered that I can participate in clinical studies that often pay me, at least for transportation expenses, and that produce information I need on this journey to a bright mind for life. For example, I signed up for a drug trial at a location in my area. The researchers needed subjects who were ApoE4 positive (E4, E4) so I was given the cheek swab to determine my status. It took several months but I eventually got a call informing me of my ApoE4 status. Fortunately, my status is E3, E3 even though my father had Alzheimer’s and my mother has vascular dementia. (I don’t understand that much about genetics).

If you don’t care to go that route, you can pay for genetic testing. Here is a good website to start with. Dementia prevention testing matters!

Imaging

Dr. Bredesen also recommends having imaging done if other test results indicate higher than average risk for Alzheimer’s or related dementias. Let me tell you my DIY story about getting an amyloid PET scan. This test shows whether or not a person has elevated levels of amyloid in their brain. This newly-developed test is not covered by insurance yet, therefore the cost of around $5,000. makes it prohibitive for most people. However, I found a study that the University of Pennsylvania is doing called the REVEAL study in which researchers needed subjects to have the amyloid PET scan done. They paid me $200. for this. Unbelievable! Dementia prevention testing matters!

I also took many cognitive tests. I will not get the results of those, but the ethics of the study process insure that if any irregularities show up, I will be contacted and connected with UPenn’s Memory Center doctors. Better than free information to speed along my dementia prevention journey!

That’s all for testing!

Now that we’ve been to many labs, we’re ready for Destination Two and what will it be? Keep watching!