Article written by

G. Allen Power, MD is Eden Mentor at St. John’s Home in Rochester, NY, and Clinical Associate Professor of Medicine at the University of Rochester. He is a board certified internist and geriatrician, and is a Fellow of the American College of Physicians / American Society for Internal Medicine. You can follow his blog at www.Changingaging.org/AlPower/

30 Responses

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  1. Aging 200 student
    Aging 200 student at | | Reply

    Alzheimer’s disease involves changes in the brain, typically separation of different functions within its natural order. Hypothetically speaking, if this same separation decreases the electric wavelength of the brain, thus decreasing it’s connectivity, could there be some type of electronic stimulation that could repair the functioning?

  2. Christopher Chung
    Christopher Chung at | | Reply

    I am currently an Aging 200 student at the Erickson School of Aging. I found this post to be very interesting because we covered the topic of dementia previously. I know that Alzheimer’s is a form of dementia. In my studies I found that a possible cause of dementia could be a result of high blood pressure and it was concluded that white matter hyperintensities cause increase stroke. These correlate because high blood pressure can cause strokes.
    I find Occam’s Razor philosophy to be very interesting and true. Sometimes we tend to overcomplicate things and think that there must be multiple causes for something as stated above. With the exceptions of younger people being diagnosed with the disease, most people that are diagnosed with Alzheimer’s are typically older. With that said, I agree with the statement that perhaps it is just a result of people aging. I personally find Alzheimer’s to be a very scary and serious disease but I feel that it really is just a part of aging.

  3. Madeleine Kolb
    Madeleine Kolb at | | Reply

    The Ockam’s Razor principle is quite relevant. I remember reading about a study of Alzheimer’s disease in cloistered nuns. When a nun died, a brain autopsy would be performed. Amyloid plaque was often found and was present in the brain of one very old nun renowned for her remarkable, life-long cognitive abilities. Researchers came up with the concept of “cognitive reserve” to explain the unexpected result. It seems like quite a stretch. I think that Sir William of Ockam would object.

  4. Sushela McDaniel
    Sushela McDaniel at | | Reply

    So if Alheimer’s and dementia are caused by mini-strokes and other vascular changes within the brain and that the drug companies are not going to be able to find a magic pill to cure it, could we not invest in the care of the currently demented and find better ways to involve them and keep them healthy? I currently work on a geri-psych acute care unit. We are always full and the diagnosis of preference is dementia with behavioral dyscontrol. These older people usually reside at nursing homes which are crowded and understaffed. There are few activities or ways to interact with other people. The residents slip farther and farther away from us. Maybe the focus should change from trying to cure it to trying to care for it and making the lives of those who suffer with it better?

  5. Simon
    Simon at | | Reply

    I think we need to think even bigger than this. Vascular disease of any sort is bad for the brain, but the more we study the more we find out that it’s not just vascular disease but also changes in endocrine function (insulin, late life diabetes), our moods (depression and stress), our education, our social connectivity, and so forth. We need to be thinking of brain and body ecosystems!

  6. Laura Bowley
    Laura Bowley at | | Reply

    I completely agree Al. I wish we could take even a fraction of the money given to research for a (possibly dead-end) cure and spend it instead on dealing with the fallout: supporting people who, for whatever reason, are dealing with a cognitive disability.

    Here are some random thoughts.

    At the very least, I would like to see EVERY person who is suspected of having cognitive loss being tested first for strokes. Automatic testing; do not pass GO. I know this sounds simplistic, but I’m not a doctor so I don’t even know the process of testing, but it seems very counterproductive, even knowing what we know now, to give someone a memory test, a diagnosis of Alzheimer’s, and send them home with a prescription, when all the while they may have a vascular condition that is only going to continue to make matters worse and probably, eventually, kill them.

    I’m speaking from experience. My mother had vascular dementia that went undiagnosed and was ignored by her doctor. She had mild cognitive loss until a major and final stroke landed her in memory care, paralyzed. If the signs of minor strokes had not been ignored, things could have turned out much differently.

    In fact, if “Alzheimer’s” becomes associated with and known as a heart condition, perhaps some of the stigma will diminish as well, and we can begin to take a more rehabilitative approach.

  7. Martha Stettinius (@InsideDementia)
    Martha Stettinius (@InsideDementia) at | | Reply

    Thank you, Dr. Al–this is a very powerful and thought-provoking piece. And I’m always glad to hear someone remind us that the presence of amyloid plaques in the brain does not necessarily mean that one will develop dementia. This is not well known, given the focus of so much research on amyloid, and given the new PET scan that identifies amyloid plaques.

    I agree that prevention is key. I write about some lesser-known risk factors, such as sleep apnea and pre-diabetes, in the appendices to my book “Inside the Dementia Epidemic: A Daughter’s Memoir.”

    Will share this piece on my book’s FB page and Twitter feed.

  8. Rayne Stroebel
    Rayne Stroebel at | | Reply

    AMEN.

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