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Alzheimer's disease

Alzheimer's disease (AD), a neurodegenerative disease, is the most common cause of dementia and characterized clinically by progressive intellectual deterioration together with declining activities of daily living and neuropsychiatric symptoms or behavioral changes. The most striking early symptom is memory loss (amnesia), usually manifest as minor forgetfulness that becomes steadily denser with illness progression, with relative preservation of older memories. more...

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As the disorder progresses, cognitive (intellectual) impairment extends to the domains of language (aphasia), coordinated movement (apraxia), recognition (agnosia) and those functions (such as decision-making and planning) closely related to the frontal lobe of the brain, reflecting extension of the underlying pathological process. This consists principally of neuronal (cell) loss (or atrophy), together with deposition of amyloid plaques and neurofibrillary tangles. Genetic factors are known to be important, and polymorphisms (variations) in three different autosomal dominant genes - Presenilin 1, Presenilin 2, and Amyloid Precursor Protein - have been identified that account for a small number of cases of familial, early-onset AD. For late onset AD (LOAD), only one susceptibility gene has so far been identified - the epsilon 4 allele of the APOE gene. Age of onset itself has a heritability of around 50%.

History

The symptoms of the disease as a distinct entity were first identified by Emil Kraepelin, and the characteristic neuropathology was first observed by Alois Alzheimer, a German psychiatrist, in 1906. In this sense, the disease was co-discovered by Kraepelin and Alzheimer, who worked in Kraepelin's laboratory. Because of the overwhelming importance Kraepelin attached to finding the neuropathological basis of psychiatric disorders, Kraepelin made the generous decision that the disease would bear Alzheimer's name (J. Psychiat. Res., 1997, Vol 31, No. 6, pp. 635-643).

For most of the twentieth century, the diagnosis of Alzheimer's disease was reserved for individuals between the ages of 45-65 who developed symptoms of presenile dementia, which was considered to be a more or less normal outcome of the aging process. In the 1970s and early 1980s, however, the name "Alzheimer's disease" began to be used, within and outside the medical profession, equally for individuals age 65 and older with senile dementia, and was eventually adopted formally for all individuals with the common symptom pattern and disease course in the psychiatric and neurological nomenclature.

Clinical features

The usual first symptom noticed is memory loss which progresses from seemingly simple and often fluctuating forgetfulness (with which the disease should not be confused) to a more pervasive loss of recent memory, then of familiar and well-known skills or objects or persons. Aphasia, disorientation and disinhibition usually accompany the loss of memory. Alzheimer's disease may also include behavioral changes, such as outbursts of violence or excessive passivity in people who have no previous history of such behavior. In the later stages, deterioration of musculature and mobility, leading to bedfastness, inability to feed oneself, and incontinence, will be seen if death from some external cause (e.g. heart attack or pneumonia) does not intervene. Average duration of the disease is approximately 7-10 years, although cases are known where reaching the final stage occurs within 4-5 years, or up to 25 years.

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Anti-inflammatory diet: the right foods can protect you from Alzheimer's, obesity, heart disease, and even premature aging
From Natural Health, 9/1/05 by Mollly Siple

CUT YOUR FINGER SLICING ONIONS and the area will swell, redden, and heat up. This type of acute inflammatory response is the body's reaction to trauma, and it's an essential part of the healing process. But chronic inflammation caused by more subtle forms of trauma can undermine your health every day.

Long-term ailments, highly processed foods, and ongoing exposure to environmental toxins can result in the kind of persistent, low-grade inflammation researchers are linking to premature aging, heart disease, M.S., R.D. diabetes, Alzheimer's, psoriasis, rheumatoid arthritis, and cancer.

Many foods in the standard American diet aggravate inflammation (see our list of fire feeders on page 43), including refined white flour and sugar, red meat, dairy products, fast food, and food additives. "For someone on such a diet, the body can become like a dry field of grass that is waiting for a match," says Jack Challem, author of The Inflammation Syndrome. "Once the match lights, it's hard to put out the fire."

And it's not just your health that gets singed. Chronic inflammation can make you look old before your time. "Low-grade, systemic inflammation drives aging," says Ronald E. Hunninghake, M.D., author of User's Guide to Inflammation, Arthritis, and Aging. "'Inflamaging' is a term coined by Italian researchers to highlight this association."

The good news is that changing your diet can help prevent or even reverse the process. "Our daily diet and the foods we eat are the most effective-and safest--means of preventing inflammation," says Challem. "The body is quite capable of making its own anti-inflammatory compounds as long as we eat the right foods."

put out the fire

A PROTECTIVE MENU is easier to assemble at home, where you can control the ingredients, including cooking oils. Start with the recipes here, and follow our guide to anti-inflammatory foods, especially if you have inflammation risk factors like elevated levels of cholesterol, triglycerides, or C-reactive protein (see "Are You Going Down in Flames?" on page 40).

Polyphenols. These inflammation-dampening phytochemicals are found in colorful kits like blueberries, blackberries, strawberries, and raspberries, which also contain flavonoids called anthocyanins that protect against oxidative damage. Keep no-sugar-added cranberry juice (such as Ocean Spray's 100% Cranberry Blend) on hand, along with jars of sour cherries.

Quercetin. This anti-inflammatory compound and natural histamine inhibitor is the most powerful kind of flavonoid. Excellent sources include red grapes, red and yellow onions, garlic, broccoli, and apples.

Antioxidants. These nutrients protect the body from free radicals, which trigger inflammation. Carrots and orange winter squash supply beta carotene; bell peppers are high in vitamin C; tomatoes are rich in lycopene. Leafy greens, such as spinach and kale, are also abundant in antioxidants.

Omega-3 fatty acids, Thanks to anti-inflammatory properties, omega-3s provide significant benefit to patients with chronic inflammatory diseases, according to a report in the Journal of the American College of Nutrition. The most potent omega-3s are found in seafood, especially coldwater fish like salmon (preferably wild), tuna, and mackerel. Stock your pantry with canned anchovies and sardines and jars of marinated herring to add to meals. Vegetarian sources of omega-3s include flaxseed oil, dark greens, and walnuts.

Oleic acid. Almonds and macadamias (or their oils) contain this omega-9 fatty acid, which helps omega-3s do their job. Olive oil, which contains oleic acid, is best for everyday cooking. If you prefer safflower or sunflower oil, which are normally placed in the pro-inflammatory camp, buy high-oleic versions. "Balanced" oils, such as those from Spectrum Naturals, are available in minimally processed forms, always a better health choice than refined oils. Canola oil, however, is a refined oil that contains a noteworthy amount of omega-3s and oleic acid.

Curcumin. Turmeric, an Indian spice that gives curry its orange-yellow color, contains curcumin, one of the most powerful anti-inflammatory compounds in nature, says Michael T. Murray, N.D., author of Encyclopedia of Natural Medicine. (Other spices with anti-inflammatory properties are ginger and rosemary.)

ARE YOU GOING DOWN IN FLAMES?

How can you tell if you suffer from chronic inflammation? One indicator is an elevated blood level of C-reactive protein, which the body produces in response to inflammation. Researchers at Brigham and Women's Hospital in Boston and Harvard Medical School monitored over 28,000 healthy, postmenopausal women for three years and found that CRP was the strongest predictor of heart disease compared with 11 other links, including LDL cholesterol.

Although not currently part of routine lab work, a high-sensitivity CRP test is in order for anyone with a risk of developing a disease linked to inflammation. "If you have a family history of heart disease, or an inflammatory condition such as gingivitis--especially if you smoke--ask your physician for a CRP test," advises Ronald E. Hunninghake, M.D. "The CRP test is appropriate for people of any age who are at risk."

FOODS THAT FEED THE FIRE

Wheat eggs, milk, soybeans, yeast, and meat are among the most common inflammatory foods. Meat contains inflammation-promoting arachidonic acid; beef has the highest content, double the amount in lamb, pork, or chicken. Eggs and dairy products also contain arachidonic acid, but in lower amounts.

Ironically, well-intentioned advice to consume vegetable oils rather than saturated-fat-rich butter has led to a multifold increase in the intake of omega-6 fatty acids, which promote inflammation. Popular vegetable oils such as sunflower, corn, peanut, soy, cottonseed, and (regular) safflower are high in inflammatory omega-6s.

Choose free-range chicken, turkey, or duck, which receive a natural grass feed rich in anti-inflammatory omega-3 fatty acids. Dairy is fine to eat unless it upsets your system, which could trigger inflammation. Make a point of buying eggs with extra omega-3s. And avoid foods that cause inflammation provoking spikes in blood sugar, such as sugary drinks, refined white flour, and fried potatoes

COPYRIGHT 2005 Weider Publications
COPYRIGHT 2005 Gale Group

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