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Alzheimer’s Disease Non-Conventional Approaches

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Alzheimer’s Disease Non-Conventional Approaches

Non-Conventional Approaches

The drug therapies available for management of AD usually focus on either improving memory or the behavioral symptoms. It is clearly known that there is no definitive treatment that can cure or prevent the progression of disease.

Recently there is an increased interest in the Complementary and Alternative medicine (CAM) in the treatment of various chronic illnesses. These non-conventional interventions are an important addition especially for behavior management and memory loss in AD.

Many people with dementia, and those who care for them, are interested in using CAM therapies as these are believed to be associated with minimum risks and complications. Since age, genetic makeup and familial risks factors cannot be altered, healthy lifestyle and stress reduction strategies, such as diet, exercise, and meditation may be used to prevent or delay disease and maintain health.

The non-conventional approaches described below aim to provide social stimulation and improve the cognitive skills, thus increasing the person’s sense of self-control.

AD has no cure; however, management strategies do exist that that can help you cope up with the symptoms

 

CAM Scoring for AD: Your guide for choosing the best CAM treatment option

On the basis of available evidence of efficacy, safety, comparison to the conventional therapies and convenience or availability, ICMH has developed a proprietary rating system. This rating system may be used as a guide for choosing the appropriate CAM therapy after consultation with your health care provider (HCP).

Dietary Supplements

Research suggests that high consumption of diet rich in trans-unsaturated (hydrogenated) fats increases the risk of AD. Instead, consumption of vitamin-rich vegetables, fruits, legumes, cereals, and food items that are rich in omega-3 fatty acids (e.g. fish) may reduce your risk of suffering from dementia and eventually AD.

Acetyl-L-Carnitine (ALC,★★★)

ALC plays a role in energy and lipid metabolism, and may modify enzyme and hormone activity in the body. After consumption, ALC gets converted to acetylcholine. On the basis of this, it has been investigated in AD.

One study published in Neurology reported that one-year treatment with oral ALC in AD patients showed improvement in long-term verbal memory and selective attention.

In another study it was found that treatment with ALC (2 g/day orally for 3 months) along with donepezil or rivastigmine showed improvement in response rate. ALC use was associated with improvement in cognitive functions, functional status, and behavioral symptoms.

Effect on cognitive/behavioral function:

Improvement of cognitive functions, functional status, and behavioral symptoms

How it works?:

ALC gets converted to a neurotransmitter acetylcholine, which is responsible for maintaining cognitive function

Side effects and drug interactions:

No severe side effects have been reported in clinical studies

Omega-3 Fatty Acids (★★★)

Omega-3 fatty acids provide docosahexaenoic acid (DHA), which are important for growth and function of nerve cells in the brain. Decrease in DHA is associated with impairments in cognitive and behavioral performance.

Therefore, consumption of fish or supplements containing omega-3 fatty acid may prove beneficial for delaying the cognitive impairment in people suffering from dementia who are at high risk of AD.

One clinical study reported that daily intake of 1.7 g of DHA and 0.6 g of eicosapentaenoic acid (omega-3 fatty acids) for six months showed improvement of cognitive behavior in people diagnosed with very mild cognitive dysfunction. Unfortunately, the study did not document any effect in patients with mild to moderate AD.

Another study reported that people who consumed fish once in a week or more had 60 percent less risk of developing AD than people who rarely or never ate fish.

Effect on cognitive/behavioral function:

Improvement of cognitive behavior

How it works?:

Omega-3 fatty acids facilitate growth and function of nerve cells in the brain. A 2012 study in Neurology showed that patients who consume omega3s have less beta-amyloid levels (a protein associated with AD) in their blood

Side effects and drug interactions:

No severe side effects have been reported in clinical studies

Vitamins(★★)

Data from some clinical studies demonstrate that fruit and vegetable consumption may have a role against cognitive decline, dementia, and AD. One recent clinical study reports that vitamin B supplementation can slow the shrinkage of cells in brain regions that are a key component of the AD process and that are associated with cognitive decline.

Some studies also suggest a link between reduced levels of Vitamin D and risk for dementia. A recent study reported that reduced plasma25-hydroxyvitamin D showed increased risk of AD.

The observational studies suggests that low serum 25-hydroxyvitamin D has been associated with increased risk for cardiovascular diseases, diabetes mellitus, depression, dental caries, osteoporosis, and periodontal disease, all of which are considered risk factors for dementia. Animal studies reveal that vitamin D has a role in neuroprotection and reducing inflammation.

Vitamin B Effect on cognitive/behavioral function:

Improvement of cognitive behavior

How it works?:

Vitamin B supplementation slows the shrinkage of cells in brain regions. In 2011 a study in Neurology demonstrated that higher levels of B12 in the blood was associated with a lower risk of AD

Side effects and drug interactions:

No severe side effects have been reported in clinical studies

Vitamin D Effect on cognitive/behavioral function:

Since lower vitamin D concentrations are associated with poorer cognitive function, vitamin D supplementation may improve cognitive behavior in people with AD

How it works?:

Vitamin D may prove neuroprotective due to its antioxidative action, enhanced nerve conduction and detoxification mechanisms. A 2012 study published in Current Alzheimer Research demonstrated that lower vitamin D levels are associated with AD

Side effects and drug interactions:

No major side effects have been reported

Dietary Guidelines for AD

The seven dietary guidelines prepared by physicians committee for Responsible Medicine (PCMR) are listed below. These guidelines were presented recently at the International Conference on Nutrition and the Brain in Washington on July 19 and 20, 2013.

Seven Dietary Guidelines For Reducing The Risk Of Alzheimer’s Disease

1. Reduce Intake of Saturated and Trans Fat

  • Saturated Fats: Found primarily in dairy products, meats, and certain oils (coconut and palm oils)
  • Trans Fat: Found in pastries and fried foods
2. Increase consumption of Vegetables, legumes (beans, peas, and lentils), fruits, and whole grains
3. Consume one ounce (handful) of nuts or seeds daily as they are a rich source of vitamin E. Other healthy sources of omega 3s include salmon and other cold water fish.
4. Take supplements of vitamin B12 or consume fortified foods that have added vitamins and minerals
5. When selecting multiple vitamins, choose those without iron and copper. Ask your physician before taking iron supplements
6. Avoid using cookware, antacids, baking powder, or other products that contribute dietary aluminum
7. In addition to healthy diet, indulge in aerobic exercise – such as running, brisk walking, or step-aerobics for at least 120 minutes in a week

 

 

Herbal Medicines

Herbal drugs have been used for treatment of dementia and related disorders for several years. However, these are very rarely used as a single agent. Clinical research has identified few herbs, which show promising results in terms of their cognitive benefits.

 

Ginkgo biloba(★★★)

Ginko biloba is one of the oldest trees known to humans. Ginkgo is generally taken as an extract (GbE), and has been used for treatment of asthma, vertigo, fatigue, and memory problems. It is thought to show favorable effects on cerebral blood flow and neurotransmitter systems.

Clinical evidence suggests that Ginkgo improves activities of daily living, cognition and accompanying psychopathological symptoms in people with AD. Some studies that have evaluated the safety of this herbs, report it to be safe treatment that can improve the cognitive performance and social functioning of AD patients for six months to one year.

Effect on cognitive/behavioral function: Improves cognitive performance and social functioning of AD patients

How it works?: It is thought to show favorable effects on cerebral blood flow and neurotransmitter systems

Side effects and drug interactions: No severe side effects have been reported in clinical studies

 

Huperzine A (★★★)

Huperzine A is extracted from the herb called Serrate Clubmoss. It is considered to be a potent, reversible and selective inhibitor of acetylcholinesterase. Clinical evidence suggests that Huperzine A shows beneficial effects on general cognitive function, behavioral disturbance, and functional performance in patients with AD.

One study reported that an eight weeks of treatment with 0.2 mg (4 tablets) of huperzine-A showed improvements in the memory, cognitive, and behavioral functions in people with AD. Huperzine A appears to be a promising, safe and effective medicine, for improvement of the cognition, behavior, daily activities, and mood of AD patients.

Effect on cognitive/behavioral function: Huperzine A shows improvement in cognitive and behavioral function in people with AD

How it works?: The herb is believed to cause reduction in oxygen free radicals, which contribute to the pathogenesis of AD. The herb is also considered to be an inhibitor of acetylcholinesterase

Side effects and drug interactions: No severe side effects have been reported in clinical studies

 

Panax Ginseng (★★)

The beneficial effects of Panax ginseng in AD are attributed to its active principle known as panaxsaponin. Ginseng is known to improve brain cholinergic function, reduce the level of beta amyloid plaque and repair the damaged neuronal networks.

In one clinical study the researchers found that treatment with Panax ginseng powder (4.5 g/day) for 12 weeks, showed improvement in the cognitive function and mental status of AD patients.

Effect on cognitive/behavioral function: Panax ginseng improves cognitive function and mental status of AD patients

How it works?: The herb is believed to reduce beta amyloid plaques, which is an important contributor to AD pathology

Side effects and drug interactions: No significant side effects have been reported in clinical studies

 

Salvia officinalis (★★)

Commonly known as ‘Sage,’ Salvia officinalis has been used as herbal medicine for many centuries. It is known to show positive outcome in improving problems related to memory. In one clinical study, patients with mild to moderate AD aged between 65 and 80 years were randomly treated with either extracts of Salvia officinalis or placebo for four months.

The researchers noted that Salvia officinalis extract produced a significant better outcome on cognitive functions than placebo. In addition, the herbal drug showed no adverse effects. The study also found that Salvia officinalis did not cause agitation that was seen in placebo-treated patients.

Effect on cognitive/behavioral function: Improves problems related to memory

How it works?: The herb is believed to have acetylcholinesterase inhibitory activity

Side effects and drug interactions: No significant side effects have been reported in clinical studies

 

Aromatherapy (★★★)

Aromatherapy uses essential oils obtained from various herbs, flowers, seeds, etc. to improve health and general feeling of wellness. Aromatherapy requires you to respire the aromatic oils through oily gauze that is placed under your nostrils or sometimes the oils are massaged onto the skin.

Aromatic herbs such as lavender, eucalyptus, black pepper, ginger, daisy, licorice, rosemary, and myrrh are used commonly in aromatherapy.

In one clinical study the researchers found that lavender aromatherapy (hand massage) showed improvement in emotions and aggressive behavior in elderly people with memory loss due to AD.

In another study aromatherapy that used essential oils, such as rosemary, lemon lavender, and orange was found to be effective in improving cognitive function in AD patients.

Effect on cognitive/behavioral function: Improvement in emotions and aggressive behavior

How it works?: The essential oils used in aromatherapy stimulate your brain and influence physical, emotional, and mental health

Side effects and drug interactions: No severe side effects have been reported in clinical studies

 

Meditation (★★)

Mediation is a mind-body practice that reduces your emotional sensation of stressful events by withdrawing your attention away from the unpleasant feelings. Meditation is generally practiced to increase calmness and physical relaxation.

It helps to improve psychological balance, to cope with illness, or to enhance overall health and well-being.Scientists believe that meditation technique has the potential for improving memory and lowering levels of stress, depression, and anxiety.

One study investigated the role of meditation in improving memory loss in people who were diagnosed with mild age-associated memory impairment, mild cognitive impairment or, moderate impairment with a diagnosis of AD. The participants were subjected to ‘KirtanKriya meditation’ performed for 12 minutes daily over an 8-week period of time.

KirtanKriya meditation is a form of stress-reduction exercise that involves chanting, breath work, and finger poses. The scientists found that meditation program showed an improvement in cognitive function in people with memory loss.

Another study reported that, 11 minutes of meditation done twice daily for eight weeks showed improvement in sleep and mood in people with a diagnosis of mild cognitive impairment or early-stage AD. Meditation also reduced stress in these people.

The clinical evidence thus supports the role of meditation in reducing perceived stress and improving sleep, mood, and memory in adults with symptoms of AD.

Effect on cognitive/behavioral function: Improvement in sleep and mood, and reduction of stress

How it works?: Meditation distracts your mind from negative thoughts, increases calmness and physical relaxation

Side effects and drug interactions: No severe side effects have been reported in clinical studies

 

Massage (★★)

People suffering from AD appear frustrated and anxious because they cannot communicate verbally. The agitated behavior of these individuals often remains untreated with medications. Research suggests that physical expressions of agitation, such as pacing, wandering, and resisting can be reduced using slow-stroke massage.

Since stress is the major reason for agitated behavior in people with AD, use of stress management interventions, massage and therapeutic touch can help them relax.

Effect on cognitive/behavioral function: Reduces agitation and aggressive behavior

How it works?: Massage stimulates the release of certain chemicals in the body, such as serotonin or endorphins and therefore helps to relax the body and mind

Side effects and drug interactions: No severe side effects have been reported in clinical studies

 

Music Therapy (★★)

Music has the power to improve mood, reduce stress-induced agitation, stimulate positive interactions, and facilitate cognitive function in people with AD. The ability to engage in music, particularly rhythm playing and singing does not depend on intact cognitive functioning. Therefore people in advanced stage of AD too can benefit from music therapy.

Recent research reveals that music is closely associated with sex hormones. Secretion of estrogen and testosterone, hormones that are believed to have preventive effects on AD, is significantly increased by music therapy.

People with AD show aging-related reductions in sex hormones, especially estrogen, which protects the nerve cells. Moreover, estrogen also decreases the beta amyloid peptide content, which is an important hallmark in the pathogenesis of AD.

In one study the researchers tried to investigate the effects of sung or spoken lyrics of unfamiliar children’s songs, on people with AD. The outcomes were compared with healthy older adults.

The researchers noted that healthy older adults found no difference in the lyrics whether sung or spoken. However, people suffering from AD showed better recognition accuracy for the lyrics that were sung than spoken.

Effect on cognitive/behavioral function: Improves cognitive function and attention

How it works?: Music therapy increases the secretion of hormones, such as estrogen which decreases the beta amyloid peptide content

Side effects and drug interactions: No severe side effects have been reported in clinical studies

 

Physical Activity (★★★)

Exercise releases ‘endorphins,’ a kind of chemical, which is known to improve mood. Therefore, any kind of physical activity can improve mood and generate feeling of well-being in people suffering from AD.

Physical activity may promote the maintenance of grey matter brain volume and slow the rate of cognitive decline. Regular physical activity is also believed to protect the brain cells and tissues from oxidative stress, which is involved in pathogenesis of AD.

According to one clinical study people who are regularly involved in physical activity (walking, swimming, aerobic dancing, jogging etc.) are at much lower risk of developing AD compared to those who are physically inactive.

Effect on cognitive/behavioral function: Improves mood and generate feeling of wellness

How it works?: Physical activity may promote maintenance of grey matter brain volume and slow the rate of cognitive decline

Side effects and drug interactions: No severe side effects have been reported in clinical studies

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