Supplements for Patients with Alzheimer’s Disease

Ray Sahelian
Alzheimer’s Disease (AD) is a progressive deterioration in mental
functioning first described by Alois Alzheimer in 1907. The onset most
commonly starts
in one’s 80s, although it has been known to start as early as age 30. One of
the major cognitive problems with AD is the inability to acquire new
knowledge.
Loss of the sense of smell is common, and the mental deterioration proceeds
to affect language and motor skills.


While scientists have not fully determined the actual causes of Alzheimer’s
disease, a number of treatment options have been proposed. These include the
use of antioxidants, blocking the breakdown of acetylcholine, and improving
blood flow to brain cells. There are currently no effective pharmaceutical
drugs for treating AD. If someone you know has AD, I believe it is
worthwhile exploring nutritional therapies.


Vitamins E and C
It’s quite likely that quite a number of different antioxidants are
beneficial. A highly publicized article in The New England Journal of
Medicine reported that the daily use of 1,000 units of vitamin E was
effective in slowing the progression of this disease. Researchers at the
Rush
Alzheimer’s Disease Center, Rush University, in Chicago, Illinois, found
through an epidemiological survey that the use of vitamin E and C
supplements
reduces the risk of developing AD.


Blocking the Breakdown of Acetylcholine
Another approach that has been tried is to prevent the degradation of
acetylcholine, the brain chemical associated with learning and memory. This
can be achieved by providing drugs that block the activity of the enzyme
cholinesterase, which breaks down acetylcholine. Two of these drugs are
tacrine (Cognex) and donezepil (Aricept).


A Chinese herbal extract called huperzine A has been shown in
preliminary studies to block cholinesterase even more potently than tacrine.
Early
studies indicate that huperzine A is much safer than tacrine.


Improving Blood Circulation
Any step taken to reduce atherosclerosis, or hardening of the arteries, is
likely to improve blood circulation to the brain. A study in The Journal of
the American Medical Association had good news about the herb ginkgo biloba.
Therapy with 40 mg of ginkgo three times a day for one year had a positive
effect in patients with AD. There are several compounds in ginkgo that
improve circulation and act as blood thinners and antioxidants.


Combination Therapy
The nutritional approach to treating patients with AD is still very new, and
there are no standards that have been developed. It may take trial and error
to find the ideal regimen for each patient.
In addition to antioxidants, ginkgo, and huperzine, B vitamins at about two
to five times the RDA should be helpful.


Include plenty of fresh fruits and vegetables in order to obtain
important carotenoids and flavonoids. Vitamin E, between 200 and 400 units a
day, preferably of mixed tocopherols, should be taken with a meal. The
dosage for vitamin C is 250 mg once or twice a day.
A 40-mg dose of ginkgo twice daily with breakfast and lunch is recommended.
Huperzine A is an exciting addition to the nutritional armamentarium of
natural therapies for AD. A dosage of 0.02 to 0.05 mg per day can be tried
instead of the standard cholinesterase inhibitors.


Summary
Finding an effective therapy for AD is very challenging. However, with a
great deal of patience, and trial and error, it is likely that a combination
of nutrients can be found that can improve quality of life and cognitive
function. Even though many nutritional options have been presented in this
article, it is important not take all of these supplements at the same time,
but to gradually add one, and then another, in low dosages in order to
determine the effectiveness of each addition. The use of nutrients is
especially appropriate in the treatment of AD since currently there is no
effective pharmaceutical therapy for this condition.


Ray Sahelian, M.D., is the author of the newly published Mind Boosters: A
Guide to Natural Supplements That Enhance Your Mind, Memory, and Mood (St.
Martins Press, $14.95, 2000). For more details, updates, and to ask
questions, see http://www.raysahelian.com.


Le Bars, P.L., et al. 1997. A placebo-controlled, double-blind randomized
trial of an extract of ginkgo biloba for dementia. JAMA 278:1327-1332.

Morris, M.C., et al. 1998. Vitamin E and vitamin C supplement use and risk
of incident Alzheimer disease. Alzheimer. Dis. Assoc.
Disord.Sep;12(3):121-6.

Sano, M., Ernesto, C., Thomas, R.G., et al. 1997. A controlled trial of
selegiline, alpha-tocopherol, or both as treatment for Alzheimer’s disease.
N. Engl. J. Med. 336:1216-1222.

Xu, S.S., et al. 1995. Efficacy of oral huperzine-A on memory, cognition,
and behavior in Alzheimer’s disease. Chung Kuo Yao Li Hsueh Pao
16(5):391-5.

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Ray Sahelian MD Written by Ray Sahelian MD

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