Life for the elderly is looking grim according to a report by Alzheimer’s Disease International. The organization’s World Alzheimer’s Report 2009 estimates that 35 million people worldwide will have Alzheimer’s Disease by next year. In 40 years, that number will triple to 115 million.
These dramatic numbers are used by the report to support a call for equally dramatic action by the World Health Organization and nation states in making Alzheimer’s and other age-related dementias a top priority by spending money on research, treatment, services, and prevention. The report is based on an analysis of research and practices in both rich and poor countries, with the prediction that developing countries will see the worst of it. This is because the estimates are based primarily on an increasing proportion of elderly people: by age 85, the risk of dementia is one of every two people.
Unfortunately, this report is a promotional piece for funding the Alzheimer’s industry. It’s very well-meaning, but quite limited. The first clue as to its role as a promotional piece is how numbers are used: 35 million people growing to 115 million. Big numbers. Sounds like a lot. Sounds a lot more dramatic than a prevalence of 4.7% of people over 60 with Alzheimer’s growing to… Well, the report never actually says what the projected prevalence will be in 40 years. This is shameless manipulation. Big, scary numbers. Give us money.
This is not to say that there isn’t a problem of considerable impact, not least of which is the significant burden of care that falls principally on women. It’s just that I’m offended by the way in which this organization, like so many others, promotes its cause. Big scary numbers. Give us money.
More troubling is the fact that the agenda for treatment is entirely conventional. For example, no mention is made of natural remedies such as curcumin and vitamin B6 that have been shown to promote the assimilation of the peptides implicated in Alzheimer’s.
The agenda for prevention is equally limited. By “prevention,” the report means prevention delivered in the doctor’s office that consists of conventional treatments for so-called risk factors such as high blood pressure, diabetes, and elevated cholesterol.
Some of the report’s own statistics scream for an examination of population-based prevention. For example, the prevalence of dementia in every region of sub-Saharan Africa is significantly lower than every other region of the world. I wonder what role is played by industrialization and the physical and cultural effluvia that industrialization brings in its wake in creating a social and physical environment that promotes dementia in old age. If, as the report says, an increase of aged people is the primary force behind the increase in dementia and, also as the report says, dementia should not be accepted as a normal consequence of aging, then why isn’t there a call in the report for prevention through a reduction in oxidative stress from physical and social sources?
Later this week, Science magazine will publish research on the effects of sleep on Alzheimer’s risk.
Physiologically, Alzheimer’s is caused by the formation of so-called amyloid plaques among neurons in the brain. The building block for these plaques is a peptide (basically, a mini-protein) called amyloid beta. Neurons produce this stuff all the time and dump it off into the fluid surrounding the neurons—the brain interstitial fluid. The body disposes of amyloid beta in the normal course of keeping house. What happens in an aged person is that the disposal mechanisms work with less efficiency or the neurons throw off more amyloid beta or both. When too much amyloid beta builds up in the brain interstitial fluid, amyloid plaques form.
In the Science article, researchers report that normal sleep, but especially non-REM sleep, is the time when amyloid beta that has accumulated over the day is disposed of. Over the course of a day, amyloid beta builds up in the brain fluid, reaching its peak at night. After a night of rest, it’s back to a low level in the morning. Mice that have their sleep-wake cycle disrupted will build up amyloid beta and will form plaques more readily than those allowed to sleep normally. Administering the neuropeptide responsible for wakefulness has the same effect as overt sleep deprivation.
So from the standpoint of personal choice, this research tells me that getting a good night’s sleep will reduce your risk of dementia—along with so much more that healthy sleep patterns provide. And from the standpoint of collective choices, this research and the World Alzheimer’s Report tells me that we should be looking carefully at environmental disruptions that prevent us from getting the rest our bodies need and doing what bodies do so well—care for us.
