by Dharma Singh Khalsa, M.D.
Prevention of Alzheimer’s Disease
with Integrative Medicine
Captures Attention of U.S. Congress
For the past 10 years the Alzheimer’s
Prevention Foundation International
(APFI) has been raising awareness about
an integrative medical approach to
Alzheimer’s prevention, educating consumers,
caregivers, health care providers and associations,
payors and academicians nationwide.
This past spring the foundation’s efforts
reached a significant milestone.
On May 7, the U.S. House of Representatives
Appropriations Subcommittee on Labor, Health
and Human Services and Education convened
to explore funding for federal health care programs
in fiscal year 2004. As part of this exploration,
I was invited by congress to testify on
the need to redesign the research agenda at the
National Institute on Aging (NIA). On this
historic day, for the very first time, congress
heard about the promise of integrating conventional
and natural medicine in preventing
Alzheimer’s disease.
As readers of totalhealth might know, I
have been speaking out about brain longevity
through integrative medicine for the past 10
years. I founded the APFI in 1993 as a catalyst
to disseminate information and resources
about this platform, which suggests that combining
diet, nutritional supplementation,
stress management and exercise, and medications
and hormone therapy all form a powerful
strategy for preventing Alzheimer’s.
A decade ago, as might be surmised, I was
met with great hostility when I traveled across
the globe sharing this message of hope. The
words “prevention” and “Alzheimer’s” were
never uttered in the same sentence, and the
academic medical community was skeptical, if
not outright antagonistic. Thankfully, modern
medical research is finally catching up, and
this is evident by the growing body of data
indicating that there are effective preventive
interventions. Today research on vitamin E
and memory, along with the impact of omega-3
fatty acids on brain health, reveals that the
onset of Alzheimer’s can, in fact, be delayed.
Although this research offers great promise, it
is this single-intervention approach that I
criticized in my appearance before the
congressional subcommittee.
Over the past several years the NIA has
made significant progress in Alzheimer’s
research. Advanced imaging techniques have
enabled researchers to better understand an
individual’s risk potential for developing the
disease by focusing on the minute subregions
of the hippocampus, the portion of the
brain that controls memory. Other research
sponsored by the NIA to test specific interventions
for enhancing family caregiving
also holds promise. However, while the NIA
has shown leadership by ranking Alzheimer’s
research among its hallmark initiatives, I am
deeply concerned that the prevention
research activities sponsored by the NIA continue
to be one-dimensional. For example, it
has been shown that estrogen, a hormone
produced by the ovaries during a woman’s
reproductive years, affects the memory
center of the brain. The NIA has sponsored
research testing the efficacy of estrogen on
cognition and blood flow to the brain but
only on individuals who have already been
diagnosed. While there are a few promising
trials underway to test the impact of
estrogen use on memory among normally
aging women, the isolated approach, or what
I would call a “magic bullet” intervention, is
just scratching the surface of an integrative
approach.
Similarly, the NIA is sponsoring research on
the impact of anti-inflammatory agents on
brain inflammation. Much effort is being
made, through NIA-sponsored research, to test
the impact of non-steroidal anti-inflammation
drugs, or NSAIDs (such as naproxen) on brain
inflammation. While it appears that there
could be a measurable connection between
these drugs and anti-inflammation, NSAIDs
are highly toxic, contributing to stomach
bleeding and, in some cases, death.
The APFI believes that no single drug or
intervention will ever prevent or cure
Alzheimer’s disease. The only effective way
that we have found to combat this disease
is to apply an integrative prevention
program.
This is a public service to which the APFI is committed and
a service from which tens of millions will one day benefit.
Diet
The modern American diet is high in saturated,
hydrogenated and trans fats, all of which are
harmful to the brain. A dietary approach to
Alzheimer’s prevention recommends monounsaturated
oils like olive oil, foods rich in omega-
3 fatty acids, such as salmon, and fruits and
vegetables that have high levels of antioxidants.
Nutritional Supplementation
Nutritional supplementation protects the
brain from oxidative damage. An Alzheimer’s
prevention program would include a good
multiple vitamin, as well as nutrients such as
CoQ10, vitamin E, phosphatidylserine and
ginkgo biloba. Together, and only together,
these and other nutrients play a critical role in
the production of energy in the mitochondria
(the brain’s power plant), the prevention of
free radical damage, and provide the necessary
building blocks for the health of brain cells.
Stress Management and Exercise
The APFI believes that balancing stress is a key
part of an Alzheimer’s prevention strategy.
Chronic stress increases the amount of the
stress hormone cortisol produced in the body.
This is one of the main causes of memory loss
and brain cell death. Relaxation techniques,
such as proper breathing, meditation and
others, have been shown to lower cortisol
levels, lower blood pressure and improve
memory. In addition, physical exercise is
absolutely essential for brain health, as it augments
brain blood flow and increases growth
factors. Mental exercise has also been scientifi-
cally shown to enhance cognitive function.
Pharmaceutical Medications and Hormones
Optimum levels of certain hormones are
essential for brain health. Some pharmaceutical
medications also show promise when
used together with natural therapies such as
Aricept™, Exelon™ and Reminyl™, and
natural compounds such as huperzine A,
vinpocetine and galantamine.
Given this context, I formally urged congress
to concentrate one percent of the NIA’s
annual budget of $1 billion, just $10 million,
on genuine integrative research that explores
lifestyle influences on Alzheimer’s. As our population
ages we are on the brink of an epidemic,
and we owe it to the growing
community of sufferers and potential sufferers
to make prevention a priority.
I also urged congress to support a national
education and outreach campaign designed to
inform the public on the benefits of an integrative
approach to Alzheimer’s prevention. I
believe that this campaign would be best
implemented through a public-private partnership
among the United States
Administration on Aging (USAOA), the states’
Area Agencies on Aging and national nonprofit
organizations with a history of experience
in integrative medicine and aging
outreach.
I recognize that Rome was not built in day.
Whether congress will embrace this message at
this stage in the national dialogue over
Alzheimer’s disease, is still in question. But
with its history of persistence and perseverance,
the APFI and its international network of
advocates will continue to make a significant
impact in the conversation. This is a public
service to which the APFI is committed and a
service from which tens of millions will one
day benefit.
Dharma Singh Khalsa, M.D. is the president/
medical director of The Alzheimer’s
Prevention Foundation International, in
Tucson, Arizona and a leading voice in the
field of integrative medicine. In May 2003,
Dr. Khalsa was invited to testify before congress
on his work on integrative medicine and
Alzheimer’s prevention. He is also the author
of four critically acclaimed books. To discover
more about his work please log onto
drdharma.com
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