Maintaining a healthy brain

Transcription

1 -guide Your free 20 page e-guide Maintaining a healthy brain How to ensure your mind stays sharp in your 60s and beyond In this issue: Eating to boost your brain health and delay cognitive decline Alzheimer s disease: The risk factors you need to know about The early signs of Alzheimer s to watch for in your loved ones Living with Alzheimer s: A couple s story The revolutionary drink for people with early Alzheimer s and mild cognitive impairment on page 15

2 Eating to boost your brain health and delay cognitive decline Just as there are many ways to keep your body in tip-top shape as you get older, your brain can benefit from some special treatment too. Research has linked several foods with staving off cognitive decline, and even slowing the rate of decline in people diagnosed with Alzheimer s and mild cognitive impairment. The Harvard Medical School s health website, for example, says foods rich in omega-3 fatty acids, B vitamins and antioxidants contribute to better brain health. Some of the big providers of omega-3 fatty acids are fish such as salmon, cod or tuna, which contain unsaturated fats that can lower blood levels of proteins that form lumps in the brain lumps that are thought by some researchers to cause Alzheimer s disease. The medical school recommends eating fatty fish twice a week to maintain strong cognitive function. Harvard also says walnuts have a kind of omega-3 fatty acid that has been linked to improved brain health scores, while other research has found that consuming nuts on a regular basis can strengthen brainwave frequencies linked with memory, learning, healing and cognitive functions. Studies by Rush University Medical Centre, meanwhile, found that eating one serve 2

3 of leafy green vegetables a day can be an effective way of promoting brain health. Study participants who ate the most leafy green vegetables showed a slower rate of decline when it came to memory and thinking skills, compared to those who ate fewer leafy greens. A serve a day has the potential to slow the brain ageing process by 11 years, the researchers found. Another well-known foodbased method of maintaining brain health is the so-called Mediterranean diet, which is rich in fruits, vegetables, olive oil, beans, wheat and rice and limited in red meats and poultry. A Mediterranean diet from early adult life onwards has been associated with a decrease of overall dementia, Associate Professor David Darby, a behavioural neurologist at Melbourne Cognitive Services explains. Research by the American Academy of Neurology found that people aged between who followed a Mediterranean diet over three years retained more brain volume than people who didn t follow the diet. While these dietary habits have been linked to decreasing the Maintaining a healthy brain 3

4 risk of cognitive decline, further studies have found that people already showing symptoms of cognitive decline, particularly in cases of Alzheimer s disease, can slow the rate of decline with specific nutrients. Results from the LipiDidiet study the first clinical trial to investigate the effects of a medicinal food in patients with prodromal Alzheimer s disease found that medical nutrition drink Souvenaid improved everyday thinking and functional ability and memory performance in the people who drank it every day for two years. That s because people with Alzheimer s are typically lacking the right levels of omega 3 fatty acids, uridine monophosphate, choline and B-vitamins, which are essential in maintaining nerve cell junctions called synapses that help deliver electrical and chemical messages to different parts of the brain. A 125-millilitre bottle of Souvenaid which provides the same nutrients as eating eight tins of tuna, 1 kilogram of tomatoes, 100 grams of minced beef, four eggs, 1.2kg of broccoli, 710g of spinach, one orange and a handful of Brazil nuts each day helped to bring the nutrient levels in the Alzheimer s patients to the normal levels, something that would ve been near-impossible to do by consuming food due to the quantities involved. The bottle contains a concentrate of really, effectively, a Mediterranean diet, Associate Professor Darby says of Souvenaid. It has fish oil and things like choline and various vitamins and UMP (uridine monophosphate). All of these things are important if you re going to make new membranes in the brain. If you just take fish oil, for example, you re not going to have the other chemicals which are needed to help the fish oil be incorporated into membranes. It s turned out that fish oil doesn t seem to work by itself in other trials, but Souvenaid appears beneficial. The LipiDiDiet study confirmed Souvenaid was the only product available so far to offer the key nutrients in the right combination and at the right levels to support synapse function. But researchers are continuing to investigate whether other diets can slow or even reverse memory loss or cognitive impairment. For example, University Health News notes that a ketogenic diet high-fat, adequateprotein and low-carbohydrate produces compounds in the body called ketones that typically produce energy but have also been found to be neuroprotective in that they help the brain ward off the damage that s commonly linked to mild cognitive impairment and dementia, including Alzheimer s disease. 4

5 Work up a sweat Aerobic exercise undertaken for 30 minutes, three to four times a week at a minimum, has been shown to slow the rate of decline in people with mild memory problems. That means working up a sweat and increasing your heart rate if your doctor advises that that s safe by riding an exercise bike or rowing machine, swimming or jogging. Break out your dance moves Researchers found that weekly dance training that involved learning a routine boosted the part of the brain associated with learning and memory in older adults. Undertaking interval fitness training had the same effect when both exercises routines were continued over 18 months, but only dancing also helped the study volunteers improve their balance capabilities. Get your shut-eye A good night s sleep can also be vital to cognitive health, even beyond the impact that a sleep-disturbing condition such as sleep apnoea may have on memory. Many sleep conditions cause lower oxygen levels in the blood, which in turn cause the brain s temporal lobes to shrink, with scientists positing that this could be linked to the development of dementia later. How to ensure your mind stays sharp in your 60s and beyond Get into brain training Cognitive training working on your reasoning, problem-solving, memory and processing skills has long been thought to delay or slow aged-related cognitive decline. At least one trial showed that interactive, long-term brain training can indeed improve long-term cognitive functioning in older adults, even allowing them to maintain their independence longer by helping them continue to carry out everyday tasks. Maintaining a healthy brain 5

6 Alzheimer s disease: The risk factors you need to know about When most people have a forgetful moment, they may joke, or even worry, that it s the start of Alzheimer s disease or the cognitive decline that can come with age. 6

7 300,000 Australians currently diagnosed 12,625 Deaths in 2015 But fewer people know in detail how Alzheimer s disease occurs and functions, how it s related to mild cognitive impairment and why it s vital that early signs of both are recognised so treatment can be most helpful. What is Alzheimer s and mild cognitive impairment? Alzheimer s is the most common form of dementia, with almost 300,000 Australians currently diagnosed with the condition. According to the latest statistics, dementia, including Alzheimer s, is Australia s second-leading cause of death, killing 12,625 people in 2015 alone. A person is usually said to have early onset Alzheimer s when they develop the condition in their 20s and by their 40s are severely affected by their symptoms. But Alzheimer s more commonly appears in older adults, with the risk of developing the condition doubling every five years after the age of 60. The symptoms can include a loss of shortterm memory and other cognitive functions including language, problem-solving, orientation or even attention. Mood swings, depression and a complete loss of motor function or language can occur in the later stages of the condition. Symptoms can vary from person to person and can be difficult to identify in earlier stages. A common theme is the existence of memory problems, particularly when recent events are in question. People with Alzheimer s symptoms can appear vague during conversation and can become less enthusiastic about activities they used to enjoy. Some take longer to complete tasks that were once easy for them, while others struggle to identify people or places. Mild cognitive impairment shouldn t be confused with Alzheimer s, although symptoms of mild cognitive impairment can also emerge early in life. People with mild cognitive impairment do, however, have a higher risk of developing Alzheimer s or other forms of dementia later. The most common form of mild cognitive impairment is a condition that significantly impacts memory, but without significant loss of other Maintaining a healthy brain 7

8 cognitive functions as there is with Alzheimer s. For example, a person with mild cognitive impairment might forget names, conversations or appointments, but can typically continue their basic day-to-day tasks unaided. Their judgment may be affected, in that they re less able to make sound decisions, or their navigational ability or visual perception may decline. Most things that cause dementia have a stage where the person is initially affected mildly, so they would all fit under mild cognitive impairment, Associate Professor David Darby explains. How Alzheimer s works Our brains contain tens of billions of neurons, which are special cells that transmit information to different parts of the brain and body using electrical and chemical signals. In people with Alzheimer s, this information transfer and process is disrupted because the disease halts communication that should happen between the neurons through tiny gaps called synapses. The disease can also prevent chemicals and nutrients from breaking down within the cells, due to a lack of oxygen and glucose, and this results in neurons being damaged and even dying. Neurons within the memory parts of the brain are typically most affected during the early stages of Alzheimer s disease, while the destruction of neurons in the areas that impact social behaviour, language and reasoning develops at a later stage. At the same time, the synapses that make up the brain s communications networks may also break down. Research indicates that people with mild cognitive impairment show the same, but less severe, types of damage to the brain that is seen in people with Alzheimer s. In most cases, it will be a family member or loved one who picks up on the symptoms of Alzheimer s or mild cognitive impairment, rather than the person self-identifying them. Specialists usually conduct cognitive testing (for example, one known as the MMSE) and brain imaging such as an MRI or CT scan to help make a diagnosis. What causes Alzheimer s and mild cognitive impairment? About three per cent of people with Alzheimer s disease developed the condition due to single gene that runs in their family. Other Alzheimer s cases can be traced back to lifestyle factors it s been associated with some preventable health issues or simply due to advanced age. Associate Professor Darby explains that health issues involving blood vessels can increase the risk of developing Alzheimer s. 8

9 What we call vascular risk factors - like high blood pressure, diabetes, high cholesterol, family history and obstructive sleep apnoea - increase wear and tear of blood vessels in the brain and can lead to blood vessel changes, which then lead to cognitive changes, he says. The causes of mild cognitive impairment are, like Alzheimer s, not yet fully understood, but some experts believe the risk factors are the same as those of Alzheimer s: old age, a family history of mild cognitive impairment, Alzheimer s or dementia, and the prior existence of vascular conditions. The development of Alzheimer s and mild cognitive impairment has also been linked to a build-up of what s called amyloid protein in the brain and in the blood vessels of the head, and to another protein called tau that can form abnormal clumps in the brain. These build-ups or clumps collect between the neurons and disrupt cell functions. Some people have genes that increase their amyloid protein, and all people over the age of 75 have clumps of tau protein present in the temporal lobes of their brain (the part of the brain the processes sensory inputs). In the presence of excess amyloid protein, these tau clumps can spread into other parts of the brain correlated with progression of symptoms such as making decisions, using language causing word-finding difficulty and hesitations, or with spatial function, causing problems such as getting lost. Associate Professor Darby says. Researchers are now working with patients who aren t yet showing Alzheimer s symptoms in the hope they can remove amyloid proteins to prevent the onset of Alzheimer s, but this research is at an early stage. In patients who are already showing symptoms, being diagnosed as soon as possible could help prevent their condition from deteriorating further. If someone has no symptoms, then there s no recommended treatment at the moment, Associate Professor Darby explains. We would recommend that if people somehow find out they ve got amyloid in the brain, they try and get involved in some trials to see if some of the experimental treatments might work. If they do have mild symptoms and their doctor thinks it s related to Alzheimer s disease in an early stage, there are trials of promising therapies and we re very actively seeking people for these. Maintaining a healthy brain 9

10 In fact, even more serious and longer-term issues with concentration or recall aren t uncommon. That sort of memory problem is an inefficiency often associated with a retrieval pattern of memory problems, Associate Professor David Darby explains. It has lots of causes, but generally not Alzheimer s. Those causes can include specific medications, a lack of sleep and psychological or medical conditions. The memory of people with Alzheimer s disease, however, is more fundamentally affected. Unlike people with normal lapses in memory, those with Alzheimer s simply can t retain information, even when prompted. Their memory issues can t be reversed by a change of medication, more sleep or other treatment. Instead, their memory progressively worsens and the condition starts to affect other cognitive functions, such as language and reasoning. In most cases, it s not the person who may be showing symptoms of Alzheimer s that notices the changes in 10

11 The early signs of Alzheimer s to watch for in your loved ones We all sometimes walk into a room and forget why we re there, or have a word on the tip of our tongue but struggle to get it out - that s normal. their memory, but their loved ones. Very early on they might notice it, but most of the time they don t, Associate Professor Darby says. We d say less than 20 per cent of people are aware they ve got a significant memory problem. So, how to differentiate between normal memory lapses and what could be early signs of Alzheimer s disease in your loved ones? Sometimes people just develop mild memory problems that are a bit more than what you d expect from the retrieval memory pattern impairment, Associate Professor Darby says. For example, if they misplace things and hunt for them frequently, if they repeat questions or repeat stories and aren t aware they are doing this, or if they forget the details of conversations, these can be early Alzheimer s symptoms, he adds. Difficulty with decisionmaking is another key early Alzheimer s symptom to be aware of. Sometimes people will have difficulty making decisions, where before they would have been fine, Associate Professor Darby says. Maintaining a healthy brain 11

12 Sometimes they have trouble with technological things, whereas before they wouldn t have had as much trouble. Problem-solving ability can also be affected, while judgement and reasoning also becomes impaired as the condition worsens. This means people with early symptoms of Alzheimer s can become, for example, more susceptible to the approaches of telemarketers or make riskier financial decisions than previous. As the disease progresses, people close to the person with Alzheimer s may also notice difficulties with language, in that the person hesitates more during conversations, pauses more frequently or can t complete sentences or find the right words. For this reason, conversations can become more repetitive or disjointed, and the person can appear to find it harder than usual to start or join in discussions. For some, forgetting places they know very well is an early Alzheimer s symptom. In the earlier stages, this disorientation doesn t usually happen in familiar settings 12

13 like home, though, but in holiday destinations or other locations the person doesn t visit regularly. Often the earliest symptoms are just subtle problems with navigation in someone who was previously very good at finding the way around, Associate Professor Darby says. We often hear the story that five or 10 years before the person had clear memory problems, they became a bit confused on a trip overseas. Uncharacteristically for them, they actually got lost and couldn t find their way back to the hotel. There might be some very subtle symptoms like that, which resolved when they got back home again. Depression can be a factor that contributes to the development of Alzheimer s, but it can also be a symptom, particularly if it s something a loved one hasn t experienced before. They can also have some more personality changes and become more irritable, particularly when confronted with their memory problem, Associate Professor Darby says. They can get frustrated if someone says I ve already told you that because they really don t remember being told. If you notice a family member or partner showing these signs, it s important to assist them to see their doctor as soon as possible. That s in part because early diagnosis of the condition enables health specialists to put in place treatments that won t stop the disease from progressing but will potentially slow its progression. Aside from treatment, there are many other good reasons for seeking an early diagnosis of Alzheimer s disease, not least because it s easiest to make an accurate diagnosis while the person is still able to respond clearly to questions and express their concerns. It also allows them more time to plan legally, financially and emotionally for when their condition declines, and to most actively participate in treatment trials and make use of the support systems available. The subtle warnings signs of Alzheimer s If you notice any of these symptoms in yourself or a loved one, see your doctor. Early detection of Alzheimer s disease gives you the best opportunity to explore therapies that can alleviate symptoms and help you maintain your independence longer. Memory problems Forgetfulness that impacts daily life. Misplacing familiar items Frequently losing everyday items. Difficulty with judgement and decisions Struggling to make decisions, solve problems or undertake tasks that would previously have been easy. Speech changes Difficulties with language and conversation. Location confusion Disorientation in unfamiliar places. Changes in mood and personality Becoming confused, depressed, anxious, fearful or frustrated more often. Maintaining a healthy brain 13

14 The revolutionary drink for people with early Alzheimer s and mild cognitive impairment 14

15 If you re caring for a loved one in the early stages of Alzheimer s disease or with mild cognitive impairment, or you have the condition yourself, you ll know that the diagnosis can be difficult to come to terms with. While symptoms may not be as noticeable when a person is first diagnosed, you know that it s a progressive disease with no cure, and that managing changes in your loved one s condition is key to ensuring they have the best quality of life. That s why it s important to know that regular aerobic exercise and a diet rich in certain nutrients are believed by researchers to decrease the severity of symptoms associated with the condition and even delay the onset of symptoms. One easy way of ensuring your partner or family member is getting the optimum nutrition is by using medical nutrition drink Souvenaid, which a two-year study has shown can assist people with early stage of Alzheimer s manage and even delay the progression of their symptoms. In fact, Souvenaid is the only medical nutrition product currently on the market that is proven to be effective in delaying symptoms associated with early Alzheimer s disease and mild cognitive impairment. It contains FortasynTM Connect, a unique, patented combination of nutrients that support synapse formation in the brain to delay memory loss and a decline in dayto-day functioning. Souvenaid is backed by 10 years of clinical data, supported by an extensive ongoing research program and has robust demonstration of memory benefit. How Souvenaid works Synapses are the connections that communicate electrical or chemical messages to the right parts of the brain. The synapses are damaged and replaced throughout our lives, and what we consume plays an important part in the process because the brain needs key nutrients omega-3 fatty acids, choline, uridine monophosphate and B vitamins in the right combination and at the right level to replace the synapses. While a healthy brain can replace the synapses as quickly as they re required, this doesn t occur in someone with Alzheimer s. Instead, the synapses become damaged at a faster rate than they can be replaced, causing memory loss and the decline of other cognitive functions. Because nutrients are so important in this process of synapse replacement, eating plans such as the Mediterranean diet rich Maintaining a healthy brain 15

16 in in fruits, vegetables, olive oil, beans, wheat and rice but limited in red meats and poultry have been found to assist brain health in older adults. And while scientists don t have a definitive answer to why synapses aren t replaced at the right rate in people with Alzheimer s, it s known that those in the early stages of the condition typically have low levels of those key nutrients, even if they eat a normal diet. Souvenaid fits into this picture by providing Alzheimer s patients with these nutrients, in a way they could never achieve simply by eating. Souvenaid includes all the components needed to make new synapses, and is designed to be taken once a day. How to use Souvenaid Souvenaid isn t a quick fix and it needs to be taken daily for at least three months to show some effect. Some patients have reported improvement in mood, an increased ability to socialise and even to complete dayto-day tasks that may have been becoming more difficult prior to taking the medical food. Some patients, however, may not notice any change as Souvenaid acts to delay the deterioration of the condition rather than improve it. It takes a while for the body to respond to the nutrients it provides, which is why taking one bottle of Souvenaid once a day for at least three months is recommended. Studies have proven the longer-term positive effect of consuming Souvenaid daily, so patients are recommended to stay on it as per their healthcare professional s advice. 16

17 In the trial that was done, they looked at people who were most compliant versus those who were not as compliant and by compliant, I mean taking the medication every day, which is recommended, Associate Professor Darby says. Those that were compliant had a better result, with less decline than those that were not as compliant. The implication is that if you do take it every day, you re likely to have a better result. Souvenaid doesn t replace meals or other medication, but rather should be taken in addition to a regular diet. For the best results, it should be taken around the same time each day, although it doesn t need to be consumed with a meal. Souvenaid is safe to use with an array of other standard medications, but it s important to first discuss using it with a healthcare professional. Associate Professor Darby also notes that there is anecdotal evidence that symptoms can return when his patients have stopped taking Souvenaid. In some of my patients who have stopped it, their family notice within two weeks or so that they are not as bright and clear in their thinking, he says, adding that it s not clear whether that is a placebo effect. And then they have said that when they restart it, they can notice that they improve again. Souvenaid needs to be recommended by a healthcare professional and can be purchased online or from selected pharmacies. Maintaining a healthy brain 17

18 I can see the difference Souvenaid makes in my mum Sophia s memory for her most beloved recipes is legendary in her family, particularly given the 84-year-old can t read well in either English or her native language. 18

19 The outbreak of World War II meant Sophia had only basic primary school reading skills when she immigrated to Australia, and although she worked in a factory as an adult and learnt to speak excellent English, she never picked up written English. But Sophia had a razorsharp memory, relying on it to remember the many friends she made in the community and at work, perfect the second language she d learnt and whip up delicious meals for her family. And she s still cooking those meals from memory, even though she was diagnosed with dementia a broad collections of symptoms caused by disorders affecting the brain, with Alzheimer s disease being one of the most common five years ago by her geriatrician. He suggested she try medical nutrition drink Souvenaid, which Sophia s been drinking regularly ever since. My mum s never used a recipe book, Sophia s daughter Anna says. It s all from memory, so that s really fascinating. It tends to be the things she always cooked, but she never was one to go out and use a recipe book, partly because of her reading. Anna says her mother s memory for the friends made during her working years remains just as fresh. She met lots of friends from all different backgrounds and I ve been making a point of reconnecting with all those people, Anna says. She remembers them clearly and she has lots of fun, talking about the past with them and talking about the present and what their situation is, how their children and their families are. It s wonderful for her and wonderful for me to observe her happiness. Anna believes the fact Sophia continues to remember her recipes and to speak English with her friends and family is down to Souvenaid. When you get to that advanced level of dementia the things they learnt more recently in their life, languages like English, tend to go and they just remember their original language, Anna says. [But] my mum speaks English as well as I remember before she was diagnosed. Anna goes as far as to say that her mother s condition seems to have remained close to stable since she had been taking Souvenaid. She s 90 per cent of the mum I always knew and it seems to be 90 per cent for the past few years, Anna says. It seems to me it must be working. Maintaining a healthy brain 19

20 Souvenaid Clinically proven to improve memory in early Alzheimer s disease 1,2 Available in selected Pharmacies or visit Souvenaid is a Food for Special Medical Purposes for the dietary management of the early stages of Alzheimer s disease. Souvenaid must be used under medical supervision. You must seek advice from your doctor, nurse or pharmacist if you are unsure of your condition or diagnosis or if you would like to use Souvenaid. References: 1. Scheltens P, et al. Alzheimer s & Dementia. 2010;6: Scheltens P, et al. J Alzheimer s Dis. 2012;31: NUT872