Is Alzheimer’s really a form of dementia?

Update 5-4-2015
Do we all have Alzheimer’s completely wrong?” “Duke University neurology professor Allen Roses has challenged what for decades has been the prevailing orthodoxy in Alzheimer’s research”

Original Post
I’ve been debating with myself about whether to post a reply to that question. Why? Because very few professionals here in Maine have given the 90+ Study an in-depth thoughtful analysis. They have been asleep at the wheel. The Status Quo reigns supreme.

So here’s my answer – NO. Alzheimer’s is not a form of dementia. That will get some people upset. People don’t like to jump down off their pedestal just because some upstart blogger has done their homework and dares to challenge the professionals. But it seems to me to be all too true. And with all the mystique that some organizations have created around Alzheimer’s, if we viewed Alzheimer’s as merely a unique pathology with no consistent connection to dementia, there is a lot of money at stake that some people want to keep flowing.

After you have read this blog, check out the 3 video’s that I included in the 90+Study blog. You’ll understand why I strongly believe we are missing the boat with Alzheimer’s.

So here’s why. In the 90+ Study, they refer to Alzheimer’s as a pathology which is defined by plaques and tangles (Google them if you want more). They do NOT define Alzheimer’s as dementia, and for good reasons. In their studies, they found a lot of people who had plaques and tangles, the pathology of Alzheimer’s, but who had no signs of dementia, even at age 90+. Think about that a minute. If the pathology always lead to dementia, I could agree that there was a legitimate link between the two illnesses. But that just isn’t the case – even outside of the study.

They also found lots of patients who had dementia but none of the pathology of Alzheimer’s. Of course we know there are dozens of causes for dementia. But for Alzheimer’s, there is only one identifying factor – the plaques and tangles pathology. It can not legitimately be stated that someone with dementia must have Alzheimer’s. It’s just not true.

Nor can it be said that someone with Alzheimer’s has dementia – as shown in the 90+ Study – which included autopsies of brains in great detail.

So if the Alzheimer’s pathology doesn’t always produce dementia, why is it included under the dementia umbrella. It seems that there is Alzheimer’s and then there is dementia, and sometimes they co-exist but not reliably.

There’s another side to this, an expensive side. Scientists around the World receive millions of dollar to study Alzheimer’s. They do so under the assumption that the plaques and tangles lead to dementia, and they believe that if they can halt or alter the “pathology” then they can eliminate the dementia. After all, they believe that the pathology causes dementia. But truth is that it does not cause dementia in all cases. The question is, what exactly does the pathology do? Are we studying something that may do no harm at all (people live quite well when they only have the pathology). Are there two separate illnesses – with the most problematic being the dementia – that may co-exist on occasion?

When you look at some of the publications that have come out of the 90+ Study, there is another point that stands out – at least for this observer. The 90+ points to a strong correlation between dementia and micro-infarcts. Micro-Infarcts are tiny blood vessels that have ruptured in the brain, thus killing the neurons that no longer get a blood supply. If that happens over a long period of time, the loss of neuronal function accumulates and becomes increasingly relevant to your cognition.

On a larger scale, an infarct is called a stroke. Or it can be T.I.A., Trans-Ischemic Attacks. It can also present itself as a multi-infarct event leading to dementia. There’s treatments for these vascular issues. Even micro-infarcts may be treatable the same way we treat stroke – with blood thinners, dietary changes and exercise among many options. It may even be possible that maintenance doses of Aspirin could do for the brain what it does for the heart – keep blood flowing smoothly with minimal clotting.

Let me wrap up by asking again – if Alzheimer’s pathology doesn’t always produce dementia, what does. Maybe I’m way off base here. Hey, I’m no doctor. But common sense overrides training always.

I think we are looking at two separate illnesses that have no direct causal relationship. And if we continue to focus on the pathology, we are just wasting our time looking in all the wrong places for answers to dementia. Vascular issues are well-understood compared to plaques and tangles. My money is on the less acknowledged cause of dementia – micro-infarcts.

Maintaining the Status Quo is fatal.

Kenneth Capron

About Kenneth Capron

Ken Capron comes from a medical background. His Dad was Maine’s 3rd radiologist. His Mom a Mass General nurse. His sister a Physical Therapist in Maryland. His oldest sister was a Resident Manager of a senior housing facility in Maryland. Ken himself was trained as a CPA with a focus on non-profits and healthcare. He worked as Controller at Wentworth-Douglas in Dover and then six years as Director of Accounting at Maine Med. Ken likes to say he’s had 16 different careers – from Real Estate Broker to hobby store owner. Ken also is a Microsoft Certified Systems Engineer. In 2013, Ken founded MemoryWorks to provide support to people with dementia, their caregivers and all the providers that care for PWD.