Fighting back against dementia

Photo above: The term vitamin E encompasses eight natural compounds: four tocopherols and four tocotrienols. Currently, most available vitamin E supplements in the market contain only mixed tocopherols. However, tocotrienols are beginning to emerge as a superior addition to the Vitamin E family. Palm fruit oil is the richest source of tocotrienols known to mankind. Imagine walking into a room with no recollection of how you got there.

You are surrounded by faces you remember only vaguely, faces you might have known from a different life.

Or is it all in your head?

You grapple about in frustration, unable to reconcile the figments of thoughts and memories you are being confronted with, you struggle for the right words that just wouldn't come.

You forget who you are. You forget where you've been.

In time, you could even forget your own name.

When life's challenges include memory loss or dementia, your perceptions, relationships and priorities take on a convoluting shift.

Dementia is a loss of brain function that occurs with neurodegenerative diseases such as Alzheimer's, Parkinson's and Huntington's diseases.

Most types of dementia are degenerative or non-reversible, meaning that the changes in the brain that are causing dementia cannot be reversed or stopped.

These changes are not part of the normal ageing process and can have severe implications on one's lives.

Because dementia affects memory, thinking, language, judgment or behaviour, there will likely be a noticeable decline in areas like communication, learning, remembering and problem solving.

These changes may occur quickly, or very slowly over time.

Towards the later stages of the condition, a patient affected by dementia may be disoriented in time (not knowing what day of the week or even what year it is), in place (not knowing where they are), and in person (not knowing who they are or others around them).

Losing one's mind is a downright scary prospect.

The good news is, certain types of dementia can be treated if detected in time.

Understanding the difference between dementia and normal memory loss, as well as the causes of cognitive decline, is key to a person's outcome and in preserving their sense of control.

According to Prof Patrizia Mecocci, professor of Gerontology and Geriatrics at the Department of Clinical and Experimental Medicine at the University of Perugia in Italy, vitamin E can have a positive effect on these neurodegenerative diseases.

Neurodegeneration is a term for the progressive loss of structure and function of neurons, including the death of neurons.

Many neurodegenerative diseases, including Alzheimer's and Parkinson's, occur as a result of neurodegenerative processes.

Prof Mecocci, who also heads the School of Specialisation in Geriatrics as well as the Medical School in Speech Therapy at the University of Perugia, explains: "In neurodegenerative diseases, such as Alzheimer's and Parkinson's, the damage promoted by free radicals, in a phenomenon called 'oxidative stress', plays an important role in causing cell injury.

"Oxidative stress is part of the events that lead to the loss of neuronal cells and synapses (which are the connections between neuronal cells), with consequent impairment of brain functions."

Vitamin E, the main non-enzymatic lipophylic antioxidant in the human body, can help protect the brain from damage mediated by free radicals.

The term vitamin E encompasses eight natural forms: four tocopherols and four tocotrienols namely; alpha, beta, delta and gamma.

Most available vitamin E supplements in the market contain only mixed tocopherols, or alpha, beta, delta and gamma tocopherols.

However, these four tocopherols represent only half of the vitamin E family.

Now, alpha, beta, delta and gamma tocotrienols are beginning to emerge as a "superior" component of the vitamin E family that is also necessary to provide the full range of antioxidant properties in vitamin E.

Palm fruit oil is the richest source of tocotrienols known to man.

"All eight vitamin E forms can neutralise free radicals," says Prof Mecocci.

Together, they offer complete antioxidant protection.

In that, it is plausible that vitamin E can help prevent the onset and progression of dementia by regulating events that entail oxidative stress.

Studies have also shown that different vitamin E forms can be relevant in preventing or delaying the onset of neurodegenerative diseases like Alzheimer's, Prof Mecocci indicates.

"Our studies have shown that subjects with mild cognitive impairment (MCI) have reduced blood levels of all natural tocopherols and tocotrienols, compared to individuals with normal cognition.

"MCI often represents prodromal (or the early symptoms of) Alzheimer's, thus different vitamin E forms could be relevant in preventing or delaying the onset of Alzheimer's in individuals with MCI."

Both tocopherols and tocotrienols can be relevant in preventing and treating Alzheimer's, the Professor adds.

"In a Swedish population-based study of elderly subjects aged 80 years and above, it was found that high blood levels of vitamin E are associated with a reduced risk of Alzheimer's," she says.

However, in this context, the protective effects of vitamin E were related to a combination of its different forms, rather than to alpha-tocopherol alone.

Furthermore, a multi-centre European study known as the AddNeuroMed Project has also shown that all eight natural vitamin E forms are reduced in the blood of Alzheimer's and MCI patients compared to cognitively normal (CN) individuals, she points out.

"This study also found that both Alzheimer's and MCI diagnoses are associated with increased blood indices of vitamin E damage due to free radicals.Subjects with MCI have an increased risk of developing dementia."

"Thus, treating the depletion of tocopherols and tocotrienols in individuals with MCI may help prevent or delay the onset of dementia."

However, as each of the eight natural vitamin E compounds has functionally unique and specific biological properties, the question of not just "how much?" but also, "which one?" of the vitamin E compounds can effectively prevent or treat dementia is one that experts are still trying to answer.

Prof Mecocci elaborates: "Even though it is clear that each vitamin E form is functionally unique, alpha-tocopherol is the only vitamin E compound that is currently used to define vitamin E dietary requirements."

"However, while our studies have shown that the protective effects of vitamin E appear to be related to the combination of its different forms, we do not know how much of each vitamin E form we need to consume every day for the prevention and treatment of diseases like Alzheimer's just yet."

Research to determine which vitamin E forms and in what dosages for the prevention or treatment of these degenerative diseases is currently underway.

Dementia is one of the most disabling and burdensome health conditions worldwide, Prof Mecocci notes.

Which is why the necessity of finding effective preventive or therapeutic means is particularly pressing, especially from a public health perspective.

She adds: "Alzheimer's is among the major causes of dementia among adults and its prevalence is increasing at an alarming rate."

According to the World Alzheimer Report, there were 35.6 million people living with dementia worldwide in 2010, a number that will increase to 65.7 million by 2030 and 115.4 million by 2050 unless effective means to reduce the disease's incidence are introduced.

There is hope yet for Alzheimer's patients.

"While no compound has been proven to have the ability to reverse the effects of Alzheimer's once it has been established, studies have shown that all eight compounds of vitamin E may be able to interfere with the cascade of events that lead to brain damage in Alzheimer's," says Prof Mecocci.

"It is hence reasonable to hypothesise that vitamin E compounds can be an effective therapeutic strategy in Alzheimer's."

Prof Mecocci notes the parameters of the current studies: "To date, alpha-tocopherol is the only vitamin E form tested in randomised controlled trials in subjects with Alzheimer's and MCI."

"However, new data from our studies strongly support the need to consider all natural forms of vitamin E when planning therapeutic strategies for Alzheimer's. We will need more randomised controlled trials to prove this."

As the halting adage goes: The mind is a terrible thing to waste. Understanding dementia and its implications is imperative in spotting the disease and stopping it in its tracks as we journey towards the sunset of our lives.

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