The End of Alzheimer's

The Brain and Beyond

Thomas J. Lewis,Clement L. Trempe

• Publisher: Academic Press
• Year: 2017
• ISBN:
  9780128121139
• Edition: 2
• Topic: Medicine
• Subtopic: Geriatrics

The End of Alzheimer's: The Brain and Beyond, Second Edition is the first comprehensive overview on the molecular basis of Alzheimer's outside of the brain, merging the most recent findings within the field into a single book. It aims to educate the reader on the many overlooked aspects of Alzheimer's disease that occur outside the brain.

This book uniquely provides step-by-step, peer-reviewed evidence that the current research model may be misguided and that a new and emerging model is more accurate. It carefully outlines the molecular research in Alzheimer's outside the brain and argues that a more thorough, whole-body diagnosis will provide better answers about its causes and lead to new treatments.

It is beneficial to researchers who need to be apprised of the emerging science on the causes of Alzheimer's, and will hopefully redirect many into new avenues of cellular research and discovery.

• Comprehensive literature-based summary of the current state of molecular Alzheimer's disease research
• Details the shortcomings of the prevailing model and therapeutics in development
• Reviews blood-based biomarkers for Alzheimer's and their link to amyloid- and Tau-independent causes outside the brain
• Describes the tissues outside the brain impacted by Alzheimer's and the underlying molecular causes
• Explains the whole-body risks associated with Alzheimer's, along with concomitant measures to slow or prevent the disease
• Provides a protocol to properly research, evaluate, measure, diagnose, and potentially treat Alzheimer's patients

Chapter 1

Is it Alzheimer’s Disease?

Abstract

“Alzheimer’s” is an inadequate final diagnosis for this multifactorial condition. Hope is often restored when a broader and deeper diagnosis is performed. When such a medical diagnostic process is followed, treatable and often times reversible causes of Alzheimer’s are uncovered. Understanding true causes enables doctors to understand how to prevent the disease. And, when these causes are uncovered in a person with Alzheimer’s, there is a bona-fide possibility that their condition may be slowed, stopped, or even reversed.

Keywords

Alzheimer’s disease

neurodegenerative diseases

dementias

memory loss

differential diagnosis

beta-amyloid

treatable dementias

treatable Alzheimer’s disease

reversible Alzheimer’s disease

Image Credit: A profile of a human head, with a question mark, by EdwardRech (Own work). Available at Wikimedia Commons: https://commons.wikimedia.org/wiki/File:Lost_or_Unknown.svg

If you stop at, and accept, a diagnosis of Alzheimer’s disease (AD), all hope is lost. However, AD does have treatments if you (the patient or family) do not tolerate “Alzheimer’s” as a final diagnosis. Ask healthcare professionals to spend extra time on you or your loved one to obtain a better understanding of the root cause(s) of the disease. You will find that a broader and deeper diagnostic approach, available today but seldom practiced, will yield information about effective treatments for AD. Medical and scientific research, through its nearly $1 trillion annual budget, has already revealed enough information to slow down, halt, or even reverse this disease, even in late stages, but this information is not filtering into the clinic where you are diagnosed and treated.

Everything presented in this book is “evidence-based,” supported by millions (and in some cases, billons) of dollars of medical research, published in prestigious medical journals, from research groups all over the world. This information is intentionally scientific (but still readable) to provide you with the tools to help yourself or your loved one with “Alzheimer’s.” You need the backing of researchers who are part of the medical establishment in your quest for a cure. That is exactly who is referenced and quoted in this book. None of the information is from what might be considered “fringe science”; instead, it’s from researchers at the most prestigious universities like Harvard Medical School, Stanford, MIT, and other top medical universities and research institutes from around the globe.

The goal of this book is to present to you the key research that points to causes of AD as well as possible treatments. We hope you experience an “ah ha!” moment in which you say, “This makes sense!” There are a lot of factors that contribute to this disease and many of these are well studied and published in medical literature. Many of the causes, thus preventions, are within your ability to control. Other factors that contribute to the disease are more complicated, but solutions certainly are within the current knowledge of medicine that your doctor can implement on your behalf. There is hope for all of us!

The term “Alzheimer’s disease” is really for a constellation of symptoms associated with the loss of cognitive function. The label “Alzheimer’s” does not give an indication about the cause(s) of the disease. The purpose of this book is to convince and empower you to go deeper than a diagnosis of Alzheimer’s. We have combed through the medical research literature, and it reveals a clear path to advanced diagnoses and treatments that can stop and reverse so-called “Alzheimer’s disease.”

So why are we stuck at a diagnosis of Alzheimer’s and a belief that the disease is untreatable? This is a complex question whose answer lies in the fact that medicine today is big business. Thought leaders from leading university researchers to the heads of organizations like the Alzheimer’s Association use the media to deluge us with the narrative that AD has no cure nor is there any way to even slow the course of the disease. This statement is part of a marketing strategy, because the Alzheimer’s “industry” is competing against all other medical disciplines for shrinking research dollars and donations. Even researchers within the discipline compete against one another. The more urgent the message, the more likely dollars will flow their way. One could then assume that members of the medical profession do not have an understanding of the causes of this disease. However, as you progress through this book, you will see that researchers from around the world are closing in on real, treatable causes for Alzheimer’s. This is very good news.

Dr. Alois Alzheimer himself (for whom the disease is named) understood the disease well and, if he were alive today, could give valuable guidance to clinicians assigned to diagnose and treat Alzheimer’s patients. Dr. Alzheimer offered an educated guess about the cause in the early 20th century. Current studies are proving him substantially correct. However, medicine today is ignoring the evidence. We provide you with answers to true causes of Alzheimer’s in subsequent chapters, as it is not one simple thing.

There is no disputing that the term “Alzheimer’s” is appropriate because the disease is complex and based on many factors. Thus this “catch-all” disease name is aptly used in honor of Dr. Alzheimer who first characterized a patient with this relatively unknown form of senility or dementia well over 100 years ago. One factor holding back medicine from a cure is that to be paid, doctors must follow the prescriptive diagnostic and treatment codes created by insurance carriers (including Medicare) and their actuaries, accountants, lawyers, and lobbyists. “Alzheimer’s” is an expedient landing point for what should be a much more rigorous diagnostic process. But doctors don’t get paid to go further. Sadly, we have a health system that confuses health insurance with actual health care. They are not synonymous! The health insurance “tail” is wagging the healthcare dog and many of us suffer as a consequence.

Doctors and scientists have less and less input into the design of healthcare delivery as time moves forward. What does this mean to a patient “diagnosed” with AD? They are stuck in a cycle of treatment allowed under the “standard-of-care.” That is, once you are diagnosed, your doctor goes to his or her codebook and determines what are reimbursable procedures and/or medications according to the patient’s insurance. That is what you get regardless of where you go for diagnosis and treatment (almost). And these treatments are the ones you probably already know about. They fulfill the expectations that have been drubbed into us because they do not work. Thus the “Alzheimer’s” diagnosis, from your neurologist within the standard medical delivery model, is a slow and degrading death for the sufferer and an equally slow and miserable emotional and financial decay for caregivers and family.

Does a diagnosis of AD have to be a dead end? No. What is stopping a solution for your loved one who is suffering from Alzheimer’s? My dad (who passed away from Alzheimer’s a decade ago) told me when I was quite young: “Son, if there are things in this world that just do not make any sense, then big money is involved.” Yes, big money is involved in preventing known solutions for AD from being brought to the public. However, this is not necessarily a deliberate or malicious action. It is more a result of a complex system that does not always follow a logical path from brilliant ideas to clinical treatments. Finances all too often override science in this process.

The modern approach to medical development stifles clinical innovation. Dr. Alzheimer stated that outcomes and observations in the clinic should drive medical research. Today, just the opposite is true. Medical research is driven by the development of new drugs, which are first tested on animals that are brought to the clinic. There are many issues with this approach that are discussed in subsequent chapters. Very important points are that clinical discoveries by doctors go relatively unnoticed because these generally involve old drugs (or combinations) that do not have financial sponsors. Drugs have a short (20-year) patent life when the owners, the pharmaceutical companies, have the greatest financial interest to market these medications heavily. This forces “big pharma” (the 10 biggest pharmaceutical and biotech companies, including Pfizer, Merck, GSK, and the other big names we see on TV daily) to constantly produce new drugs that have an “on patent” status. The drug approval process is a critical part of a drug company’s exclusive rights to a new drug, but it presents a tremendous bottleneck to delivery of new drugs and innovation.

There are an enormous number of medication and treatment ideas that never make it into the drug development pipeline. Why? There is a choke point created by cost and resource limitations that control the drug pipeline. Only the 10 big pharmas have the financial and technical resources to spend $1 billion and 10 years developing a drug. Do scientists and doctors have the final say on what candidate drugs will be developed? No. So who has the say? Well, actually, it is you! If you are a shareholder of any of these companies and are watching quarterly earnings reports, then you hold some responsibility for the action of the companies.

The CEOs of the “big pharma” have more to say about drug development projects compared to an individual like you, who owns 100 shares of Pfizer, for example. However, the point is that the scientists and doctors have little say about the drugs that enter into the FDA process. It is a business decision, and many groups within each of the big companies essentially compete for their project to be chosen. In essence, just 10 people determine what new treatments you will get. And they base their decisions on the business of medicine, not the realities of medical development or the best care of patients like you.

The truth about drug development helps define a term that puts our health care and the management of AD into perspective—it’s the “Trillion Dollar Conundrum.” This concept is derived from the nearly $1 trillion spent annually on medical and related research around the globe. One trillion dollars buys us approximately 2 million scientific and medical journal articles each year, at an approximate cost of $500,000 for each. The cost includes research time, professor and researcher salaries, benefits, and all the steps necessary to perform research, assemble the data, write the paper, and get it published. These 2 million ideas worthy of publication funnel down into a bottleneck of drug development that yields tens, not millions, of new treatments. This is the Trillion Dollar Conundrum. It is in essence that some of our (arguably) best medical ideas never leave the research laboratory and are not “translated” to the clinic where they can improve the health of patients suffering with disease. The good news is this overlooked research is published and available to all of us through the Internet.

The Trillion Dollar Conundrum offers a strong message of hope. Why? Because it tells us that medicine is offering us only a tiny fraction of the ideas circulating in the minds (and research articles) of medical researchers. The small percentage that enters into drug development may not even represent the best and brightest of the ideas. Why is that? Many great ideas from history came from clinicians who, while practicing medicine, discovered something beneficial to their patients. These ideas infrequently offer a drug company the patent protection they seek, thus are largely ignored. See Appendix 6 for poignant examples.

This book distills many of the best ideas, some of them theoretical, but many practical, that can, or eventually will, lead you to a health improvement, or even a cure, if you have the affliction currently called “Alzheimer’s disease.”

Neurodegenerative Diseases and Dementia

Alzheimer’s is broadly a neurodegenerative disease and, more specifically, a type of dementia. Neurodegenerative disease is the umbrella term for the progressive loss of structure or function of neurons, including the death of neurons. These diseases include dementias, Parkinson’s, Alzheimer’s, and Huntington’s, to name a few. As research progresses, many similarities appear that relate these diseases to one another on a subcellular level. Discovering these similarities offers hope for therapeutic advances that certainly will ameliorate many diseases simultaneously.

According to the Mayo Clinic, dementia isn’t a specific disease. Instead, dementia describes a group of symptoms affecting intellectual and social abilities severely enough to interfere with daily functioning. Memory loss generally occurs in dementia, but memory loss alone doesn’t mean you have it. Dementia indicates problems with at least two brain functions, such as memory loss and impaired judgment or language. It can make you confused and unable to remember people and names. You...