Jay S. Cohen M.D.   http://medicationsense.com 1337 Camino Del Mar   Suite C   Del Mar, CA 92014   Phone: 858.345.1760   Fax: 858.509.8944


A Preventative for Alzheimer's Disease?

Another Powerful Study Shows A Markedly Reduced Risk of Alzheimer's with Fish Oils (Omega-3 Oils).  Natural Substances or Prescription Drugs for Alzheimer's Disease?

If a drug company announced that a new drug had reduced the incidence of Alzheimer's disease by 60% in a large, impressive study, the news would create a sensation.  TV news programs and newspaper headlines would broadcast the discovery everywhere.  But what if the discovery wasn't a new drug, but a natural substance: would it get the same attention?

The natural substance is fish oil (omega-3 oils).  A growing number of studies are showing that fish oils may help treat mild Alzheimer's disease and may even prevent Alzheimer's from developing.  The most impressive study I have seen is a prospective study that followed 815 older people over 4 years.  By following the people prospectively, that is, before any illness had developed, the researchers were able to identify the factors associated with the development of Alzheimer's disease in some participants.  The researchers reported:

"Participants who consumed fish once per week or more had 60% less risk of Alzheimer's disease compared with those who rarely or never ate fish.1"

The results were even better for people who ate the most fish.  They had a 70% reduction in the risk of developing Alzheimer's disease.  The positive results also correlated with people who consumed omega-3 fatty acids, particularly DHA (docosahexaenoic acid), a component of fish oils -- and a major component of human brain tissue.

A Series of Impressive Studies
These findings arrived on the shoulders of other impressive studies.  A study published in 2003 found reduced levels of DHA in the blood of people with Alzheimer's disease.2  In 1997, a prospective study of people age 55 and older in the Netherlands found the same thing: an inverse relationship between fish consumption and dementia, especially Alzheimer's disease.3  The more fish people ate, the less the likelihood of Alzheimer's disease.

In 2002, a 7-year study of 1674 people over age 67 found that those who had the greatest fish consumption also had the lowest incidence of dementia.  The authors of this study commented:

"Elderly people who eat fish or seafood at least once a week are at lower risk of developing dementia, including Alzheimer's disease.4"

The authors concluded that fish is beneficial because its omega-3 fatty acids reduce inflammation in the brain and assist the regeneration of nerve cells.4

 A 2006 study found that supplementation with fish oils could slow cognitive decline in people with mild Alzheimer's disease.5

All of these positive findings may be due to the ability of fish oils to reduce inflammation.  Experts believed that much of the degeneration of aging is due to chronic inflammation.  The anti-inflammatory effect of fish oils or other forms of omega-3 fatty acids has been proven in studies of people with inflammatory disorders such as rheumatoid arthritis and osteoarthritis.6-8

Natural Substances vs. Prescription Drugs
People's awareness of the benefits of fish and fish oils is rising, but it has taken many years to accomplish this, and many people still have not heard.  Many doctors still do not recommend fish or fish oils to patients.  There is no national public health initiative to spread the word.  Yet, if a drug is ever developed that reduces Alzheimer's risk by 60%, it will receive the full treatment.  Headlines.  Interviews on television.  Full-page print advertisements and unrelenting television ads.  Thousands of drug sales reps will inundate doctors' offices, touting the drug's benefits so enthusiastically that they might forget to mention the inevitable side effects and exorbitant cost.

Good alternatives are available today.  Fish oils,1-4 folic acid,9,10 alpha lipoic acid,11 curcumin and L-acetyl carnitine12 are believed to offer some benefit for Alzheimer's disease.  The evidence is not complete, but it is promising, more promising than many of the drugs that are frequently prescribed today.  Moreover, coenzyme Q10 has shown benefit in Parkinson's disease.13

Moreover, a recent study has shown that people who eat a Mediterranean diet have a substantially reduced risk of developing Alzheimer's disease.14  In addition, a Mediterranean diet provides other benefits: reduced cholesterol levels, reduced incidence of heart attacks and hypertension, improved glucose metabolism.

Additional Benefits of Fish Oils
There are other reasons to get enough fish oils in your diet.  Studies have demonstrated convincingly that fish oils reduce the risk of sudden cardiac death, which kills 250,000 Americans a year, by 40%-80%.15-17  For this reason, experts recommend that people should eat fish at least once a week or take fish oil supplements (1 gram of omega-3 fatty acids) daily.

Additional benefits of fish oils include reduction of triglyceride levels, improved glucose metabolism, improved vascular flexibility, and reduced blood pressure.  Fish oils many also help prevent some cancers.  Fish oils also have antithrombotic effects, that is, they cause a slight thinning of the blood.  People with bleeding disorders or taking Coumadin (warfarin) or other blood thinners, or even aspirin, should check with their doctors before taking fish oils.

References
1.  Morris, MC, et al.  Consumption of fish and n-3 fatty acids and risk of incident Alzheimer's disease.  Archives of Neurology 2003;60:940-946.
2.  Tully, AM, et al.  Low serum cholesteryl ester-docosahexaenoic acid levels in Alzheimer's's disease: a case-control study.  British Journal of Nutrition 2003;89:483-489.
3.  Kalmijn, S, et al.  Dietary fat intake and the risk of incident dementia in the Rotterdam study.  Annals of Neurology 1997;42:776-82.
4.  Barberger-Gateau, P, et al.  Fish, meat, and risk of dementia: cohort study.  British Medical Journal 2002;325:932-933.
5.  Freund-Levi Y, Eriksdotter-Jonhagen M, et al.  O-3 fatty acid treatment in 174 patients with mild to moderate Alzheimer's disease.  Archives of Neurology 2006;63:1402-1408.
6.  Cleland L, James M, Proudman S.  The role of fish oils in the treatment of rheumatoid arthritis.  Drugs 2003;63(9):845-53.
7.  Kremer, JM, et al.  Effects of high-dose fish oil on rheumatoid arthritis after stopping nonsteroidal antiinflammatory drugs.  Arthritis and Rheumatism 1995;38(8):1107-14.
8.  Lau, CS, Morley, KD, Belch, JJ.  Effects of fish oil supplementation on non-steroidal anti-inflammatory drug requirement in patients with mild rheumatoid arthritis--a double-blind placebo controlled study.  British Journal of Rheumatology  1999;32(11):982-9.
9.  Seshadri, S, Beisir, A, Selhub, J, et al.  Plasma homocysteine as a risk factor for dementia and Alzheimer's disease.  New England Journal of Medicine, Feb. 14, 2002;346:476-483.
10.  Rydlewicz, A, Simpson, JA, Taylor, RJ, et al.  The effect of folic acid supplementation on plasma homocysteine in an elderly population.  QJM 2002;95(1):27-35.
11.  Hager K, Marahrens A, Kenklies M, Riederer P, Munch G.  Alpha-lipoic acid as a new treatment option for Azheimer type dementia.  Journal of Gerontology and Geriatrics 2001;32:275-282.
12.  Spagnoli A, Lucca U, Menasce G, et al.  Long-term acetyl-L-carnitine treatment in Alzheimer's disease.  Neurology 1991;41(11):1726-32. 
13.  Shults, CW, Oakes, D, Kieburtz, K, et al.  Effects of coenzyme Q10 on early Parkinson's disease: evidence of slowing of the functional decline.  Archives of Neurology 2002;59:1541-1550.
14.  Scarmeas N, Stern Y, et al.  Mediterranean diet, Alzheimer's disease, and vascular mediation.  Archives of Neurology 2006;63:published online 10/9/06, www.archneur.ama-assn.org/cgi/content/full/63.12noc16109.
15.  de Lorgeril, M, Salen, P, Defaye, P, et al.  Dietary prevention of sudden cardiac death.  European Heart Journal 2002;23:277-285.
16.  Albert, CM, Campos, H, Stampfer, MJ, et al.  Blood Levels of Long-Chain N-3 Fatty Acids and the Risk of Sudden Death.  New England Journal of Medicine 2002;346(15):1113-18.
17.  Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial.  Lancet 1999;354(9177):447-55.





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