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Dementias: Alzheimers, Elderly, Middle Age and Pediatric

by Michael Cheikin MD

The terms "dementia" and "Alzheimer's" are often used interchangeably, but they are not the same. Alzheimer's is a specific and common type of dementia, but there are many other types and causes of dementia.  

"Dementia” is the loss of brain cells, either slowly or quickly, at any age. In "Alzheimer’s Disease" or "Alzheimer's dementia" brain cells are killed by the overcrowding of a specific protein named "tau".  Normally occurring with aging, this accumulation of tau protein can begin early in the 30's. Alzheimer’s is diagnosed "by exclusion", meaning that it is assigned after other known causes are ruled out. A direct diagnosis requires a brain biopsy to look for the tau protein, which is rarely indicated.“Senility” occurs with aging--a dementia without cause and without the label of disease. In “encephalopathy”, the brain is misfunctioning without obvious structural changes. 

Loss of brain function is a great fear for all of us, which is why it is always material for comedy. Memory is what connects us to our heritage and legacy; without it we never existed (see separate article on Memory).
Brain Functions
"Mind" can be envisioned as the set of functions of the brain. If so, the mind is like a calculator with several buttons, where the “user” is our consciousness. The various functions, and their dys-functions, are illustrated (but not definitive) in the center table. These functions are used separately or in combination to perform tasks.

Assigning a particular function to a particular region of the brain has limits, since most functions require the coordination of several regions of the brain. Therefore it is rare for one dysfunction to occur in a totally isolated manner.  For example, sleep disturbance, anxiety and stress intolerance often go hand-in-hand. Autism often involves several autonomic dysfunctions as well as the predominant social dysfunction.

Evaluating Dementia
By the time dementia has become evident, it has usually been developing for years. However, some types are rapid and others take decades.

Conventional testing for dementia usually involves an MRI of the brain, blood tests for thyroid, vitamin B12, and syphilis, Lyme, lead, and a few esoteric causes based on age, history or other data. If the lab tests show a reversible cause, one can be optimistic about some improvement, limited by the extent and duration of the problem.

The MRI focuses on structure and will often show shrinkage, or “atrophy” of various regions of the brain.  Atrophy correlates with loss of nerve cells.

Holistic medicine considers the gut-brain connection in the evaluation of dementia, and will look for food allergies, celiac disease, gut infections, and malabsorption of nutrients as potential factors. In addition, special labs offer more extensive testing for infections, toxins, genetics and chemistries that might uncover a reversible, hidden cause.

Treating Dementia
Treating a reversible cause, such as Lyme or lead toxicity can be helpful if only to slow progression. Some pharmaceutical agents that can help with mood, attention, impulsivity, and memory, but with limited effectiveness as well as side effects and cost. 

Not long ago, it was believed that lost neurons are gone forever. However, recent data shows that there are regions of the brain that generate new neurons which can migrate throughout the brain. Certain agents (such as alcohol) are known to damage this area, and therefore not only kill neurons, but their ability to regenerate. However, there also are agents that promote healing and regeneration. Addressing lifestyle factors such as sleep, diet, exercise, stress manage- ment, and modalities such as acupuncture and biofeedback have a strong track record.

Preventing Dementia
Prevention is always better and cheaper than treatment. Preventing dementia requires “brain hygiene”-- taking care of the brain. It needs stimulation, rest, exercise, good nutrients, oxygen and an environment that is free of chemical and spiritual toxins. 

1. This educational material may not be used to influence medical care without supervision by a licensed practitioner.
2. These contents are ©2016 by Michael Cheikin MD and may not be reproduced in any form without express written permission.
3. Dr. Cheikin's website has related articles such as "Memory", "Gut-Brain", "Neurotransmitters" and others.

Michael Cheikin MD is a holistic physician, Board Certified in Physical Medicine and Rehabilitation ("Physiatry"), Pain Management, Spinal Cord Medicine and Electrodiagnostic Medicine and licensed in Medical Acupuncture. Dr. Cheikin has extensively studied yoga, diet and metabolism, Ayurvedic, Chinese and energy medicine and other alternative modalities for over 30 years. He specializes in obscure, chronic and severe problems that have not responded satisfactorily to other methods of healing. www.cheikin.com       

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