Alzheimer’s Disease
Definition
Western
Alzheimer’s Disease is one of the most common forms of dementia. This is characterised by the slow progressive loss of mental and social abilities leading to the interference with daily functioning. Healthy brain tissues degenerate, causing steady decline in memory and impairment of reasoning, planning, language and perception over time. Patients generally display emotionless facial expression, decline in verbal expression, forgetfulness and often lose their sense of direction. In more severe instances, patient is adverse towards communication, shuns people away including his family and friends, speaks incoherently, exhibits aggression and unpredictable mood swings or may not even be able to take care of his daily needs.
Traditional Chinese Medicine (TCM)
Alzheimer’s Disease generally affects the whole body due to the dysfunction of mainly the brain, along with the Heart and Kidney systems. In TCM, the weakened functioning of the brain and kidneys, together with the poor blood and water circulation in the body give rise to hindrance in the transportation of nutrients to the brain. Over time, this poor circulation will affect the control of brain functions and the Heart system for the governing of the mind and memory.
Symptoms Displayed / Classifications / Types
In TCM, Alzheimer’s Disease can be classified into 4 main types:
Old age
Mainly affects the elderly with deterioration to the vital organ systems in the body. Symptoms displayed include the loss of abstract thinking, planning abilities and memory loss, and at the same time, language problems displayed include decrease in speech fluency. Patient may also experience frequent dizzy spells, ringing in the ears or fatigue.
Low Emotional Profile
Emotions are governed by the Liver system, according to the TCM theories. Patients with low emotional profile typically display certain emotionless facial expressions or show aversion to communicating with others. There is certain loss of memory capacity, coherent speech, appetite and muscle strength. One would also experience shortness of breath and weak pulse.
Poor Blood Circulation
Patient is slow to respond and possesses a lack of spoken fluency. Patient is also easily alarmed and quick in forgetting recent facts. Patient has dry, scaly complexion with dull eyes and often feel thirsty but is averse to drinking water to quench thirst. According to TCM theories, the Heart and Liver systems might be accounted for this poor blood circulation to provide enough nutrients and oxygen to sustain the brain functions.
Poor Water Circulation
TCM referred that poor water circulation might be a primary sign of the deterioration of the functions in the Kidney system. Patient displays dull facial expression, decrease in intellectual abilities accompanied by lack of appetite and usually experience bloated abdominal region. Patient may also experience drooling and heaviness in the head.
Causes
Beta-Amyloid Protein Plaques
Mounting evidence suggested that aggregation of normally harmless proteins might lead to cell nerve death [1], however the ultimate cause of neuron death in Alzheimer’s Disease is still unknown
Old Age
Advancing age may be the primary risk factor for the disease.
Other diseases
When affected by other diseases such as strokes or giddy spells for prolonged period of time, the circulation in the body will be impeded, thus depriving the brain of essential nourishment. This will inevitably lead to degeneration of the brain tissues.
Risk Factors
Age
As the age increases, the risk of acquiring the disease may increase significantly.
Lifestyle
Cardiovascular risk factors [2-3] such as high blood pressure, high cholesterol and diabetes may increase the likelihood of developing Alzheimer's disease.
Mental activities
Individuals, who remain mentally active throughout their lives, especially in their later years, may face reduced risk of Alzheimer's disease [4].
Genetics
Most patients develop Alzheimer’s disease at old age but there is a small portion of population who develop this in the fourth or fifth decade of their life. This type of individuals was found to inherit gene mutations associated with Alzheimer’s disease [5]. There may also a possible genetic risk for late onset cases; however no specific gene risk has been identified at this point in time [6].
Treatments
Herbs commonly used in prescriptions:
1. Shu Di Huang – 熟地黄
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English/ Common name
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Rehmannia root
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Latin species
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Rehmannia glutinosa Libosch
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Park of plant used
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Underground roots
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Action/s
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Helps to improve memory [7] and protects cells from aging [8].
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Precaution/s
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Individuals with poor digestive system should use with caution.
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2. Ren Shen – 人参
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English/ Common name
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Chinese Ginseng
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Latin species
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Panax ginseng C.A.Mey
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Park of plant used
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Underground roots
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Action/s
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Helps to improve memory [9-10] and cognitive performance [11].
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Precaution/s
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Individuals with blood disorders should use with caution. Not to be used with Veratrum nigrum L.
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3. Shi Chang Pu – 石菖蒲
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English/ Common name
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Grassleaf Sweetflag
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Latin species
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Acorus tatarinowii Schott
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Park of plant used
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Underground roots
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Action/s
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Helps to manage cognitive impairment [12].
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Precaution/s
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Use in small amounts to prevent toxicity.
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4. Gou Qi Zi – 枸杞子
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English/ Common name
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Wolfberries, Lycium berry
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Latin species
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Lycium barbarum L
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Park of plant used
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Fruit
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Action/s
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Believe to have neuroprotective and anti-aging effects [13-14].
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Precaution/s
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Individuals with blood disorders should use with caution.
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5. Yuan Zhi – 远志
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English/ Common name
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Milkwort root, snake root
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Latin species
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Polygala tenuifoilia Willd or Polygala sibirica L.
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Park of plant used
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Roots
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Action/s
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Helps to improve cognitive functions [15] and enhance memory [16-17]
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Precaution/s
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Gastric ulcer patients should use with caution.
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6. Jiang Huang – 姜黄
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English/ Common name
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Curcuma
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Latin species
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Curcuma longa L.
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Park of plant used
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Underground Roots
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Action/s
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Believe to help decrease the amyloid pathology of Alzheimer’s Disease [18] and fight against neurodegenerative diseases [19].
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Precaution/s
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Individuals with bleeding disorders should use with caution
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Tests & Diagnosis
Neuropsychological testing
Extensive assessment to individual’s thinking and memory skills to detect symptoms of Alzheimer’s Disease.
Brain scans
Include Magnetic resonance imaging (MRI), Computerised tomography (CT), and Positron emission tomography (PET) that help reveal areas of the brain that may be less active or are not functioning properly.
Home Remedies
Ginseng + Wolfberries + Chicken
a) Put all ingredients in a cooking pot and pour enough water to fill half the pot.
b) Bring to boil for 10 minutes.
c) Simmer for a further 60 minutes.
d) Remove from heat. Serve warm.
References
1. Bernstein SL, Dupuis NF, Lazo ND, Wyttenbach T, Condron MM, Bitan G, Teplow DB, Shea JE, Ruotolo BT, Robinson CV, Bowers MT. Amyloid-beta protein oligomerization and the importance of tetramers and dodecamers in the aetiology of Alzheimer’s disease. Nat Chem. 2009 Jul 1;1(4):326-331.
2. Christopher Patterson, John W. Feightner, Angeles Garcia, G.-Y. Robin Hsiung, Christopher MacKnight, and A. Dessa Sadovnick, Diagnosis and treatment of dementia: 1. Risk assessment and primary prevention of Alzheimer disease. CMAJ. 2008 February 26; 178(5): 548–556.
3. CliveRosendorff; Michal S.Beeri; Jeremy M.Silverman, Cardiovascular Risk Factors for Alzheimer's Disease. Am J Geriatr Cardiol. 2007 May-Jun;16(3):143-9.
6. Donix M, Burggren AC, Suthana NA, Siddarth P, Ekstrom AD, Krupa AK, Jones M, Martin-Harris L, Ercoli LM, Miller KJ, Small GW, Bookheimer SY. Family History of Alzheimer’s Disease and Hippocampal Structure in Healthy People. Am J Psychiatry. 2010 Aug 4.
9. Feng Chen, Elizabeth A. Eckman and Christopher B. Eckman. Reductions in levels of the Alzheimer’s amyloid β peptide after oral administration of ginsenosides.FASEB J. 2006 Jun;20(8):1269-71. Epub 2006 Apr 24
10. Zhao H, Li Q, Zhang Z, Pei X, Wang J, Li Y. Long term ginsenoside consumption prevents memorloss in aged SAMP8 mice by decreasing oxidative stress and up-regulating the plasticity-related proteins in hippocampus. Brain Res. 2009 Feb 23; 1256:111-22. Epub 2008 Dec 24.
12. Geng Y, Li C, Liu J, Xing G, Zhou L, Dong M, Li X, Niu Y. Beta-asarone improves cognitive function by suppressing neuronal apoptosis in the Beta-amyloid hippocampus injection rats. Biol Pharm Bull. 2010; 33(5):836-43.
13. Yu MS, Leung SK, Lai SW, Che CM, Zee SY, So KF, Yuen WH, Chang RC. Neuroprotective effects of anti-aging oriental medicine Lycium barbarum against beta-amyloid peptide neurotoxicity. Exp Gerontol. 2005 Aug-Sep; 40(8-9):716-27.
14. Ho YS, Yu MS, Yang XF, So KF, Yuen WH, Chang RC. Neuroprotective effects of polysaccharides from wolfberry, the fruits of Lycium barbarum, against homocysteine-induced toxicity in rat cortical neurons. J Alzheimers Dis. 2010; 19(3):813-27.
15. Lv J, Jia H, Jiang Y, Ruan Y, Liu Z, Yue W, Beyreuther K, Tu P, Zhang D. Tenuifolin, an extract derived from tenuigenin, inhibits amyloid-beta secretion in vitro. Acta Physiol (Oxf). 2009 Aug;196(4):419-25. Epub 2009 Feb 5.
19. Bharat B. Aggarwal and Kuzhuvelil B. Harikumar. Potential Therapeutic Effects of Curcumin, the Anti-inflammatory Agent, Against Neurodegenerative, Cardiovascular, Pulmonary, Metabolic, Autoimmune and Neoplastic Diseases. Int J Biochem Cell Biol. 2009; 41(1): 40–59.