Alzheimer’s Disease Frequently Asked Questions with Dr. Fortanasce, Neurologist / Alzheimer’s Expert
Why is Alzheimer’s such a huge concern?
Alzheimer’s disease is a big concern because this mind destroying epidemic is a growing national crisis. The toll is personal, financial and medical. The current cost of Alzheimer’s disease is estimated to be 110 billion dollars and that cost is anticipated to change in the next 10 years. Currently the total Medicare allowance is only 280 billion. Seventy percent of patience with Alzheimer’s disease will be in nursing homes within two years of the diagnosis and then will be there in the nursing home for an average of 7 years. Fifty percent of the households will have a close relative or friend suffering from Alzheimer’s.
Dr. Fortanasce, your breakthrough book offers a science-proven plan to prevent or delay the onset of Alzheimer’s disease. In The Anti-Alzheimer’s Prescription, you offer a 4-step plan that can begin at any age. What are the crucial steps we should all take now?
First is to understand why we fail. We fail due to a loss of will power. Remember, without will power, there is no power. Will power depends on two neurotransmitters: serotonin and dopamine. The formula to succeeding on any lifestyle plan is simple: increase serotonin and dopamine and you will be on your way to preventing the onset of Alzheimer’s disease. In fact the average 50 year old has begun 100 diets and lifestyle changes, while the average 70 year old, 200. Without taking the crucial steps to control stress and sleep, we will begin diet and lifestyle plan 101 at 50 and 201 at 70 and by 80 have a 50% chance of having Alzheimer’s disease. The second thing is to have a science-proven plan. The Anti-Alzheimer’s Prescription gives the unique yet simple 4-step DEAR plan – D for diet, E for exercise, A for accentuating the brain’s reserve, and R for rest and relaxation techniques. This will prevent Alzheimer’s disease in 70% and delay it in the rest. Finally, never give up, have hope. This is a marathon, not a series of 100 yard dashes.
Why do you believe that so many are at risk to suffer from Alzheimer’s, to the point you fear 78 million Baby Boomers could become part of an Alzheimer’s epidemic that can cripple families and our healthcare system?
First, our health care system has failed us. Though in the last 100 years our life span has increased 35 years, our brain span has not increased a single day and we have no magic bullet on the medical horizon. We are given false hope. This has left us with a fate worse than death- Alzheimer’s disease. Alzheimer’s is a disease of affluent societies. It is a result of a SAD lifestyle. S stands for sedentary (1 in 4 after 50 exercise more than once a week), sleeplessness (the average American sleeps 6.5 hours – in 1926 we slept 9.5 hours), and stressful (70% of Americans feel they are overwhelmed at least weekly). Finally, D is for our diet that is full of transfats (tenfold increase since 1954). The FDA and its titanic food pyramid incorrectly told us, in 1970, to eat carbohydrates and reduce fat and protein when science, even back then, said that was wrong. A class action suit should be made to help all those with diabetes, insulin resistant diabetes and obesity that is epidemic today and has increased Alzheimer’s disease risk by up to six-fold. The very governmental department the FDA organized to protect us has given us advice that I believe is at the base of the Alzheimer’s epidemic. It is equivalent to the FDA saying “smoke some cigarettes.”
Is Alzheimer’s really something individuals have control over in terms of prevention or is it inevitable with age or genetic predisposition?
The real problem is that are we capable of doing something about it but don’t. Clearly, Alzheimer’s disease is within our control and can be prevented for 70% of us but 30% of us have a genetic predisposition but can delay its onset by 10-15 years. Remember, Alzheimer’s disease is lifestyle induced and begins in childhood. For the child who is sedentary, sleepless and has a poor diet, studies show that children and adolescents who are obese at 18 years old have a 70% chance of being obese (with a predisposition to hypertension), diabetes, and suffering vascular disease at 50. Parents and grandparents can help or hinder their children’s future brain longevity. What you do today will effect their brain tomorrow. We need to start the Anti-Alzheimer’s Prescription with our children. For adults, the prescription is mandatory.
What are the chief risk factors for developing Alzheimer’s?
The chief risk factors are what I call the sentinel risk factors. Sentinel means “watchman.” If we watch our sleep and handle our stress correctly we can maintain a diet, an exercise program and have time to rest, meditate, and be happy. We simply can’t deal with stress by eating. Stressed spelled backwards is desserts.
What events caused you to pursue a cure for Alzheimer’s disease?
How did you discover a plan for preventing or delaying the onset of the memory-robbing disease? First, I experienced Alzheimer’s disease with my father. I denied my father had Alzheimer’s disease and rationalized it to be due to a heart valve problem until I returned to his birthplace in Italy. There, in 2005, I found long-lost relatives, three of whom died of Alzheimer’s disease in their 70’s. I could no longer deny my susceptibility. Secondly, it was my self-realization of the double damage that we in the medical profession cause. First, we give patient’s false hope that the medication will delay the onset or progression of the disease. We make them incur debts that can bring them to bankruptcy. When I realized medicine had no magic bullet, I knew I had to do something. I then reviewed over 200 studies that clearly showed Alzheimer’s disease could be prevented by a lifestyle change that is included in the 4-step DEAR method.
Are there any medical treatments showing success for Alzheimer’s?
With new drugs or stem cell research are we on the verge of a cure? People like fairy tales. People want to believe a cure is right around the corner. One of the cruelest tales was told to Nancy Reagan. It said by adding stem cells they could cure Alzheimer’s. Recently, the American Academy of Neurology said there is no cure around the corner after a phase III study on tramiprosate failed. To make people believe that we are on the verge of a cure is like believing we can protect our children from life’s hardships. We cannot. We can only prepare them to deal with life’s trials and tribulations. With Alzheimer’s, we cannot hide from it or deny it. It will attack us. We can only learn to prevent it, and that takes determination and a plan. It is a scientifically proven plan that I give in The Anti-Alzheimer’s Prescription.
As a well-respected neurologist and rehabilitation director in Southern California, you have treated thousands of individuals over several decades, including celebrities, politicians, high-powered, stress-filled people such as Pope John Paul II, former Dodgers manager Tommy Lasorda, etc. Are such people more vulnerable to developing Alzheimer’s? Why?
Yes. One thing that I realized was those I would least likely believe would get Alzheimer’s disease were doctors, lawyers, and policemen. But I found a higher rate of Alzheimer’s in physicians than any other profession. The same with Ronald Reagan. All intelligent, determined and constantly using their minds, so what do they all have in common? Why were they vulnerable? Stress and sleeplessness – what I call the sentinel risk factors. Stress skyrockets our aging hormones, while sleeplessness suppresses our youthful hormones and causes carbohydrate binges that cause insulin to peak. Why is that bad? Binging on carbs is like smoking cigarettes each time we do it; it leaves a residual “amyloid” deposit on the brain like a cigarette leaves tar on the lungs. This starts 30 years before the first signs of Alzheimer’s. You know the signs if you are over 50. It’s on the “tip of your tongue” – that name, that word, your keys. You can have a high-profile job and a lot of stress but if you manage it right you can avoid Alzheimer’s disease. The Anti-Alzheimer’s Prescription gives you the tools to do it.
What exactly is Alzheimer’s, how long can people live with it, and why is it so feared?
Alzheimer’s disease is a slow progressive disease of the brain that robs us of our memory, our independence and makes us a burden on those we love. First it causes memory loss, then behavioral changes including hallucinations, combative behavior, embarrassing sexual behavior, and finally, loss of the ability to control one’s bowels, bladder, and even the ability to walk. It is of epidemic proportions with 5.4M with it today in the USA. The question to ask is why has it increased tenfold in those over 65 and 24-fold in those under 65 in the past 50 years, despite our standard of living tripling over the same time. It is feared because people live an average of nine years with it. Most horrifying is that 30% are placed in nursing homes within one year, 70% in two years, where they are imprisoned for another 7 years alone, separated from family, friends, and home. Don’t tell me they don’t know what is happening to them, because many do. It is The Great American Tragedy.
How are you promoting an Anti-Alzheimer’s Diet?
By the Harmonic Diet. It tells you what to eat, in what order, and in what proportions. Foods to have include: Fish, an anti-inflammatory, such as salmon; nuts and berries – the darker the better; vegetables; carbs; whole grains; and snack pack with almonds. Foods to avoid: Jet carbs; pastas, and refined breads; transfats – especially in cookies, cakes, hamburgers. You must avoid “Brain-Busting” snacks: chocolate and candy. We need to understand the Hormonal Symphony and its conductor – insulin. Insulin-peaking occurs with the “Jet-Carbs”. Cigarettes are to the lungs as insulin is to the brain. Cigarettes leave tar and increases lung disease. High insulin leaves amyloids and Alzheimer’s disease. To avoid this, eat protein and fats first.
What role does sleep play?
What electricity is to keeping our world going, sleep is to keeping our brain going. What electricity is to lighten up our home, sleep is to brightening our mind. Sleep, especially during stage 3-4 and REM sleep, is when we replenish dopamine and serotonin, the 2 neurotransmitters responsible for feelings of well-being and giving us self control. Sleep increases GH and testosterone and estrogen; dopamine decreases ghelin and increases leptin, turns off cortisol and so decreases our appetite and decreases anxiety.
What are some sleep myths?
- We don’t need that much sleep. The smartest people need less than 6 hours. Wrong: the major reason for carb craving, anxiety disorders, obesity, DM is a lack of sleep.
- Losing sleep never hurt anyone. Wrong: it does.
- Snoring means you’re deep-sleeping. Wrong: it is a clear sign of sleep apnea, a major cause of Alzheimer’s disease. It is often associated with obesity, hypertension, and dementia. It is epidemic in male and females over 50 who are overweight and who snore. If you have sleep apnea, you are at very high risk for Alzheimer’s disease, heart attacks, and cancer. Sleep apnea is as treatable as high blood pressure.
What types of mental exercises are proven as brain boosters?
Brain Boosters are the mind of the Anti-Alzheimer’s Prescription. Remember the brain is an interest-baring account. To get that interest, three elements are needed – novelty, earning it, and depositing it. Novel – something new or not often done. Earning it – active participation, not just listening but singing, not just reading, but speaking. Retrieval – practice bares interest. To build brain reserve, you must open new bank accounts, not keep filling the same one. What you can do now: Eat or write with your non-dominant hand. Change your routines – taxi cab drivers have a low incidence of Alzheimer’s disease. Learn new words or another language and use them. Memorize the streets on your way to work or your credit card numbers, the extension numbers of your fellow workers or commonly called customers, birthdays, anniversaries, etc. Your boss will be impressed and your spouse will be amazed!!!
What part does exercise play in preventing Alzheimer’s disease?
Exercise is the heart of The Anti-Alzheimer’s Prescription. It is essential for many reasons. First, exercise reduces stress and balances one’s hormones. It puts the hormonal symphony back in balance by increasing growth hormone, testosterone, thyroid and estrogen which plummet as we age. Next, it reduces the aging and fat producing stress hormone cortisol. It stimulates dopamine, providing a runner’s high. Second, brawn increases brain cells. Memory is stored in the cell connections called dendrites. An important nerve growth factor is produced when we exercise, that increases the number of cells and its connections in the hippocampus, where the memory and learning in the brain take place. Third, exercise increases lean muscle mass and decreases fat mass. Lean muscle burns three-five times the calories that fat does. Yes, those good-looking muscular men and women burn calories just by looking good to the chagrin of the couch potatoes. An increase in abdominal fat causes a vicious fat cycle. Fat cells stimulate insulin production that stimulates carbohydrate craving. Fat cells give off inflammatory that injure the brain and blood vessels, a reason why obese women are especially susceptible to Alzheimer’s disease.
When is the best and worst time to exercise?
- Heavy strengthening exercises and moderate aerobic exercises are best to be done before dinner. This decreases carbohydrate cravings and one’s appetite by stimulating leptin, a satiating hormone, and turning of the stress hormone cortisol.
- After dinner, lunch or breakfast, do a light workout (i.e. brisk walk after eating burns carbs and prevents insulin-peaking.
- The worst time to exercise is before going to sleep. It interferes with the sleep cycle and the hormones and neurotransmitters needed to initiate sleep.
How can we encourage parents to realize they can help their children develop healthy habits that will help delay or prevent Alzheimer’s 60, 70 or 80 years from now?
The flowers of tomorrow are in the seeds we plant today. Our parents must take charge and recognize what they do with their children today will affect the rest of their lives. While the parents are learning their new lifestyle, the 4-step AAP, they must establish a healthy lifestyle for their children.
Take these four steps.
- Diet– Only healthy foods should be stored at home. Take time to eat with your children and do not overfeed. For dessert, try berries and nuts.
- Exercise– Let them be your partners, they love it. Remember, from ages 5-12, the sun rises and sets on you the parent. Once they become teenagers, you’re nothing but a dark cloud over their head. In these pre-adolescent years you can teach them to love, to exercise. Take them on walks. Take them to the gym. Make exercise a bonding experience and part of their lifestyle, one that includes you.
- Limit passive and stressful activity. Limit TV, telephone time and computer game time. Don’t put TV’s in their rooms. Make cell phones off-limits at home. Make sure video games are not played two hours prior to bedtime. They are major stressors. Encourage learning, music, a new language. Watch things like National Geographic and the History Channel with them. Make dinner a family time to talk.
- Sleep and stress– You can’t hide your child from stress; you can only prepare them to deal with it.
- Make sure they set up a homework schedule and check to see if it is done. Don’t do homework prior to bedtime. Best is a scheduled regular time after school or one hour after dinner.
- Demand a “light’s out” policy and keep it even on the weekends. Also demand a wake-up policy.
- Make your children feel needed. Give them chores and be consistent. Make sure they finish the job. Don’t go for the “other parents” trick. I.E. “My friend’s parents don’t make them do that.”
- Reward them with positive regard when they behave. Do not give them praise when they don’t deserve it. Don’t reinforce poor work, diet, and exercise habits. Don’t be afraid to be a pest. It is a parent’s job to be one. (See Life Lessons from Little League)
How is the obesity epidemic amongst teenagers going to impact their ability to stave off Alzheimer’s
It is estimated that 50% of children and teenagers are overweight or obese. The number of overweight and obese children has doubled since 1980. 70% of obese teenagers will be obese as adults. Obesity is a major risk factor for Alzheimer’s disease. Obese women have three times the incidence of Alzheimer’s disease. At 70 years old, 20% of women have significant memory loss. This may be 60% in those who are obese at the same age. Fat begets fat. Fat cells in the abdomen omentum are alive. They stimulate insulin production; insulin stimulates glucose conversion to fat and turns off two longevity genes, causing ageing. Fat causes inflammation and destroys brain cells. On the contrary, lean muscle burns three to six times the calories as fat. Muscle use stimulates growth hormone and testosterone. Yes, couch potatoes; there is another reason to be one of those lean, good-looking people. They lose weight just by looking good. In case you’re wondering how doctors add up in the obesity department, a recent AMA survey shows that more than 50% of physicians are overweight. Too much stress, too little sleep. Too much carbohydrate binging.
What should one consider when seeking a doctor to confirm an Alzheimer’s diagnosis?
- Determine: Is he/she qualified in this area? Neurologists specialize in Alzheimer’s disease. If you have a loved one who has increasing mental deterioration more than three months, a consultation with a neurologist is highly recommended. Though some other doctors can treat Alzheimer’s disease, I will assure you that if anyone in their family or they themselves have a problem, they will visit a board certified neurologist and no one else.
- Does he/she order tests or evaluate your medications?
- If you see a doctor and complain of memory problems,
- Does the doctor do a complete mental status exam? It takes 5 minutes or more.
- Does the doctor take your complaints seriously?
- Does the doctor spend adequate time with you?
- Does the doctor or his/her staff return your call when you call them?
- Does the doctor make you feel you’re important?
- Does your doctor resent your request to see a specialist?
- Does the doctor check your vibratory function in your legs? Fifth, does the doctor test for frontal lobe release signs? Does he do lab tests? At a minimum, get these tests done: TSH, CRP, B12, & Folic Acid.
Before seeing your doctor, if you are worried about your memory, what are some things you can do?
Write down your concerns. Always bring in a close friend or family member. Remember you’re complaining about your memory. Never forget to bring in a list of your medications and supplements. Many can cause memory problems like the STATINS used for cholesterol, sleep aides, anxiety meds. Some sleep supplements can be dangerous – ginkgo biloba and others cause bleeding. Chondroitin sulfate for joints can cause insulin-resistant diabetes.
Never forget to tell them if you snore or have sleep difficulties.
Are there some spices that are particularly important for the brain? What are some brain foods?
Yes, turmeric, rosemary, and ginger. I’d like to see, along with the heart symbol on restaurant menus, a brain symbol to advise of brain-healthy selections.
What lab test(s) should your doctor order regarding detection or predisposition to Alzheimer’s disease?
CRP; Homocysteine 4.7x; Thyroid; and B12 & folate levels.
What supplements should you use?
Fish oil; Folic acid; B1-6 & 12, Vitamin E; and BriteShield (which contain resveratrol & turmeric).
What advice do you have for those about to retire or who are already retired?
When you leave your place of employment you must find a new job at the gym, lifting weights, and making new friends and finding new interests.
NOTE: The opinions expressed in this publication are those of the authors. They do not purport to reflect the opinions or views of SeniorCareHomes.Com or its members. The designations employed in this publication and the presentation of material therein do not imply the expression of any opinion whatsoever on the part of the SeniorCareHomes.Com.