“Yes, it’s Alzheimer’s disease.” Those words are arguably the most feared in the English language. To have Alzheimer’s disease suggests that one has become a member of the living dead, existing in a body from which the soul has gradually faded away.

I have observed the process many times. It begins insidiously – intermittently having trouble recalling the names of familiar faces, forgetting appointments or recent events, or having difficulty with simple math problems.

Over time the ability to perform simple tasks becomes compromised. As communication skills deteriorate it becomes progressively more difficult to express one’s thoughts and comprehend what others are saying. Reading and writing become impossible.

As the condition progresses anxiety may become a dominant feature of the individual’s personality. He or she may become violent at times, perhaps in response to inner frustration. A tendency to wander aimlessly often develops, and the victim becomes a danger to himself or herself and others.

While physical deterioration in Alzheimer’s disease lags behind the decline in mental function it does occur. It is not uncommon for loss of bowel or bladder control to occur as the general health of the individual fails. A significant number of those who develop Alzheimer’s disease will become totally incapacitated, and death generally occurs within five to ten years following the onset of symptoms.

Alzheimer’s disease is the most common form of dementia in the elderly. Since it involves the centers for thought, memory, and language the individual so afflicted often becomes a ghost inside a machine, stripped of those characteristics that define being human.

It is important to keep things in perspective, lest one become unduly concerned about the possibility of having early Alzheimer’s disease. Most of us forget names from time to time, and it is not uncommon for to misplace a set of keys or a pair of reading glasses. There is a vast difference between forgetfulness and dementia. Forgetting to stop and pick up spaghetti for supper is one thing; forgetting how to boil the water is another.

It is estimated that 4.5 million people in the United States have the condition. It is rare prior to the age of sixty, but affects approximately 5 % of all individuals in the sixty-five to seventy-four age group. The incidence increases rapidly thereafter, with up to half of those over the age of eighty-five exhibiting symptoms of the disease to some degree.

The disease is named after Dr. Alois Alzheimer, a German physician, who in 1906 found and described clumps (amyloid plaques) & tangles (Neurofibrillary tangles) in brain of a woman who had died of an unusual mental illness. The clumps, which are now called amyloid plaques, and tangles, which are referred to today as neurofibrillary tangles, are the findings that define Alzheimer’s disease and set it apart from other forms of senile dementia.

Alzheimer’s disease cannot be diagnosed in the laboratory. There is no blood test, x-ray, or scan that provides specific evidence that someone has the disorder. It is commonly said, therefore, that Alzheimer’s is a diagnosis of exclusion; its presence is determined by eliminating all other possibilities. Since the characteristic clumps and tangles can only be demonstrated at autopsy, it is not possible to conclusively diagnose the condition prior to the death of the individual who is afflicted by it.

While there is no laboratory test that can confirm the presence of Alzheimer’s disease, I have found a simple drawing exercise to be a reliable indicator of the presence or absence of Alzheimer’s disease is present. In addition, when the disease exists, the exercise can reveal the severity of the condition and provide a means of monitoring its progression.

When I suspect that someone may have Alzheimer’s disease, I simply draw a circle on a blank piece of paper. I then ask the individual to imagine that it is a clock face and direct him or her to place the appropriate numbers on the clock. Having done so, I then ask that hands be placed on the clock indicating that it is three o’clock.

One of the characteristics of Alzheimer’s disease, as opposed to other types of dementia, is the development of spacial disorientation, the loss of the ability to recognize where objects belong in space. It is not difficult for someone with normal spacial orientation skills to place twelve numerals in the appropriate locations in a circle to represent a clock, nor is it difficult to draw a short hand pointing to the number three and a long hand pointing to the number twelve.

Someone who is developing Alzheimer’s disease, however, will find this difficult at first and impossible as the condition progresses. Whereas an individual with mild symptoms will cluster the numbers to the right of the circle, someone with advanced disease will place the numbers completely outside the space provided.

A closely related exercise is to ask the individual to analyze, memorize, and reproduce a simple geometric figure. The accuracy of the reproduction decreases as the severity of the disease process increases.

It is extremely important that other possibilities be considered before accepting a diagnosis of Alzheimer’s disease. While Alzheimer’s is the most common cause of dementia in people over the age of 65, it is not the only cause of mental decline.

Over the counter and prescription drugs often cause an Alzheimer’s-like condition in elderly people. Any non-essential medication should be discontinued to see if the symptoms of dementia clear. The side-effect profile of each medication that cannot be safely discontinued should be reviewed to see if a change in mental function has been noted in people on the drug. Alternatives should be sought if it is found that the drug may be causing a decline in mental ability.

Other causes of senile dementia include B-12 deficiency, atherosclerosis, multiple small strokes, thyroid disease, Parkinson’s disease, brain tumor, head injury, toxicity, depression, alcoholism, & infections. Specific treatments are available for most of these conditions.

While the cause or causes of Alzheimer’s disease are undefined, several risk factors are recognized. A number of nutritional deficiencies have been found to be associated with the onset of the disease. Low levels of B vitamins, particularly B-12, folic acid, and choline increase the risk. Levels of antioxidants such as vitamin A and vitamin E have also been correlated with the disease. Deficiencies in minerals such as zinc and selenium also place people at risk, possibly because trace minerals are needed to protect the body from the toxic effects of heavy metals such as mercury, which has been shown to be present in higher amounts in the brains of those exhibiting the signs of Alzheimer’s disease.

Another metal that is present in high concentrations in the brain in Alzheimer’s disease is aluminum. Autopsies have shown levels of aluminum up to four times the usual amount in the nerve cells of people dying from Alzheimer’s disease. In addition, the British medical journal The Lancet reported in 1989 that the incidence of Alzheimer’s disease was 50 % higher in areas where the drinking water contained aluminum.

I believe that the widespread exposure to aluminum in the United States is a matter of great concern. A very high percentage of U.S. citizens cook in aluminum pans, drink from aluminum cans, and store foods in aluminum foil. They use baking powder that contains aluminum sulfate and consume baked goods that contain up to 50 milligrams of aluminum per serving.

Aluminum is added to processed cheese to enhance its melting properties. In addition, a sizeable number of antacids, antidiarrheals, buffered aspirins, deodorants and shampoos contain significant amounts of aluminum.

The widespread consumption of carbonated beverages from aluminum cans is of double concern. Not only does aluminum leach into the beverages, their high acidity leads to a chronic calcium deficiency, which causes the body to accumulate greater amounts of aluminum than would normally be the case.

Once an individual is found to have Alzheimer’s disease other family members often wonder if they are at an increased risk of developing it as well. There appears to be a familial form of Alzheimer’s disease, but it is not common. Familial Alzheimer’s disease tends to appear early in life, between the ages of thirty-six and forty-five, and progresses very rapidly.

The evidence of a hereditary link in Alzheimer’s disease that develops after the age of sixty-five is limited. Approximately two percent of the population carries two copies of a gene that is responsible for producing a substance that transports cholesterol in the body. Called apolipoprotein E4, its presence is associated with a fifty percent chance of developing Alzheimer’s disease prior to the age of seventy. In the absence of the APO-E4 gene the incidence of Alzheimer’s disease does not reach this level until the age of ninety.

A number of drugs have been introduced in an attempt to slow the progression of the disease. These are aimed at preventing the breakdown of a substance called acetylcholine, which is needed for the transmission of messages within the brain. The earliest recorded use of an acetylcholinesterase inhibiting substance is in the Greek saga of Odysseus, who used daffodil bulbs to enhance his memory. Galantamine, an extract from daffodil bulbs, is sold today as a dietary supplement as well as a prescription drug.

The acetylcholinesterase inhibiting drugs were introduced with a great deal of optimism, but the results have been disappointing, as the disease progression is slowed by months rather than years. Nevertheless, there is hope for individuals found to have Alzheimer’s disease. A number of steps can be taken to help maintain mental acuity over time.

The fact that the incidence of Alzheimer’s disease diminishes as educational level increases is evidence that mental function is a “use it or lose it” skill. A study published several years ago confirmed that the incidence of Alzheimer’s disease was much lower than expected in a population of priests and nuns who remained intellectually active as they aged. People with Alzheimer’s disease should remain mentally active. This can be accomplished by doing word games such as crossword puzzles or word searches or conversing with others about meaningful topics each day.

Evidence also suggests that Alzheimer’s disease progresses more slowly in people who remain physically active. A diagnosis of Alzheimer’s disease should be a call to increase one’s social interaction and level of physical activity rather than a reason to withdraw from the activities of daily living.

Nutrition supplements are also beneficial in providing the tools needed by the body to support mental function over time. A broad-spectrum vitamin/mineral/amino acid preparation should be taken to provide the basic building blocks needed for maintenance and repair. This should provide the antioxidant nutrients required to protect the brain from damaging free radicals.

Providing antioxidant nutrients such as vitamin A, vitamin C, and vitamin E is not enough, however. On their own, these nutrients have difficulty crossing what is called the blood-brain barrier, the wall of protection designed to protect the sensitive central nervous system from toxic substances.

A number of years ago I attended a conference on the subject Parkinson’s disease and Alzheimer’s disease at the University of Oklahoma. One of the nations leading neurological system researchers stated, “If we can ever discover how to get vitamin C into the brain we will have taken a giant leap forward in the prevention and management of these degenerative diseases.”

We now know how to get antioxidant nutrients into the brain. Substances called oligoproanthocyanadins (OPCs) freely cross the blood-brain barrier and carry vitamin E and vitamin C with them as they do. Extracted from such sources as pine bark, grape seeds, and grape skins, OPCs are now readily available as nutritional supplements.

B vitamins and essential fatty acids in the form of omega-3 oils are necessary to maintain efficient nerve function and should be supplemented in Alzheimer’s disease. Additional zinc should also be taken due to the strong link that has been demonstrated to exist between zinc deficiencies and Alzheimer’s disease.

A number of herbal or nutritional substances have been shown to enhance mental activity. Ginkgo biloba is an herb that has been used for centuries for this purpose. Hundreds of scientific studies have been conducted on the use of ginkgo biloba in a variety of conditions. It has been shown to improve circulation, stabilize cell membranes, increase the cellular uptake of oxygen, and act as a powerful antioxidant in protecting cells from free radical damage.

Ginkgo biloba has been demonstrated to improve all levels of mental function in patients diagnosed with Alzheimer’s type senile dementia. In a 1994 study improvement was demonstrated within one month and continued as long as the herb was taken.

I mentioned above that the drugs marketed for use in Alzheimer’s disease are primarily designed to block the activity of acetylcholine esterase, the substance that breaks down the neurotransmitting substance acetylcholine. Phosphatidyl choline, from which acetylcholine is made, freely crosses the blood brain barrier when taken orally and is rapidly converted to acetylcholine. Phosphatidyl choline supplements may be as effective as acetylcholinesterace inhibiting drugs in preventing the progression of Alzheimer’s disease without the side effects associated with those drugs.

Current research is suggesting that Alzheimer’s disease develops because cells in the central nervous system contain toxic substances and have lost their ability to produce energy. This presents exciting possibilities in the management of this devastating disease state. Two substances are known to support cellular energy production and detoxification.

One of these is a South American tree bark extract called pau d’arco, or Taheebo. Lapachol, one of the substances found in pau d’arco, is capable of restoring proper energy production in cells. This in turn allows them to burn toxins that have accumulated over time.

The other is coenzyme Q-10, which has a chemical structure that is similar to that of lapachol. Coenzyme Q-10 is known to be a critical link in the ability of cells to use oxygen effectively and burn toxins.

While unproven at this time, pau d’arco and coenzyme Q-10 should, in theory, support the ability of nerve cells to burn accumulated toxins and return to normal function. Used in combination with other nutritional supplements these substances may hold the key to preventing the progression of, and possibly reversing, the challenge known as Alzheimer’s disease.