Diet and Gut Disorders with Alzheimer's Disease
By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CNPT, CSCS, Cert-DN
Alzheimer's Disease
Physical therapists (PTs) play a crucial role in helping patients and caregivers in the management of Alzheimer's disease (AD). Alzheimer's disease is a chronic neurodegenerative disease that slowly destroys a person's memory, personality, and physical functioning. Currently there is no none cure, so often PTs are left with help patients try to maintain as much physical and cognitive functioning as they can. The costs associated with managing patients with AD are projected to be over $2 Trillion dollars by 2030 -- yes, trillions!
Promising News
While there's much doom and gloom there is also hope: diet and the gut biome. A major, and first of its kind, study out of Edith Cowan University has established a genetic link between AD and several gut-related disorders. In the Nature Communications Biology Paper, the authors analysed large sets of genetic data from AD and several gut-disorder studies – each of about 400,000 people. The results were that people with AD and gut disorders have several genes in common, which could lead to earlier identification of AD and possible gut-brain axis treatments down the road. While gut disorders may not be causal, due to obvious limitations of the study's design, it can prove to be valuable for clinical management and future research.
Cholesterol
One other significant finding from the study was the connection between cholesterol and AD. Prior observational studies has shown a connection between high amounts of dietary and serum cholesterol in the development of AD; however, this study highlights evidence that high cholesterol can transfer into the central nervous system, resulting in abnormal cholesterol metabolism in the brain. Furthermore, the other gut conditions, like H. Pylori infections, can further worsen fat metabolism, which can further worsen cholesterol metabolism in people at risk for AD. The authors of the study state the importance of using statin drugs and dietary modifications as ways to reduce serum cholesterol.
What Should You Expect for the Future
Some people may say: "So what can I do about this?" The answer is fairly simple at this point, as there is more research that needs to be done before we have bedrock clinical research outcomes. First, your physical therapist needs to screen you for gut disorders. As part of our examination we're supposed to do a review of systems -- how many times has your PT asked you about your stomach, bowel, or bladder issues? Getting people to registered dieticians and/or gastroenterology sooner may help them control their irritable bowel syndrome, undiagnosed Crohn's, or GERD. Second, stay on your statins. In an ideal world we should eat a predominantly plant-based or true Mediterranean diet to keep our cholesterol as low as possible; however, sometimes we can't make this change or you may have familial high cholesterol, one of the most common genetic disorders in general practice. As such, your therapist need to discuss your family history, recommend you to stay on statins, and refer you to the primary care physician for continued management of the high cholesterol. Lastly, your PT needs to talk to you more about your diet! They should encourage patients to dump the junk, focus on fruits and vegetables, and limit their saturated fat intake, which comes mostly from excessive animal product consumption. In the end, stopping AD may not be possible, but preserving function and quality life is obtainable.
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Photo by Mikhail Nilov: https://www.pexels.com/photo/man-and-woman-near-the-lake-7698931/https://www.pexels.com/photo/man-and-woman-near-the-lake-7698931/
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