The speakers were very knowledgeable and generally excellent. While some of the lectures were technical and research oriented there were a lot of simple take-home points that if implemented can benefit you right now.
The speakers slides for each lecture, except one, are linked to the titles below. You can scroll through them and pick out information that is of interest to you. I make short commentaries regarding each talk to give my “on-the-spot” recalled impression.
Overview of “Brain Health Summit”
As always the PREVENTION of cognitive decline, memory loss and dementia should be your focus rather than waiting to treat severe cognitive issues once they have become obvious. This takes self-awareness, education and courage to look at yourself and then take action. If you are a spouse, partner or support person it takes courage as well to be honest with your partner and take action.
Listening to all the speakers and some luminaries such as Dr. Dale Bredesen (author of “The End of Alzheimer’s” and “The End of Alzheimer’s Program” “The First Survivors of Alzheimer's: How Patients Recovered Life and Hope in Their Own Words” ), there is so much hope! Someday in the near future Alzheimer’s and other neurodegenerative conditions will be treated as chronic diseases that are to be managed and not feared. As of right now it is important to act SOONER than later!
Cognitive Loss and Alzheimer’s Disease are Different “Animals”
As I have said many times before, memory and cognitive loss are not like heart disease or diabetes where there are medical treatments that can buy you time for years, then you can dramatically reverse these diseases with aggressive lifestyle change. Once you get to a certain point of memory loss or cognitive decline, the ability and resources to institute a complexed, energy intensive, anti-dementia treatment program is generally too overwhelming (and costly) for most individuals and families and sadly is then not implemented effectively…..BUT!…
Two messages were clear from this Conference (Speakers)…
A) There is Much Hope in preventing and in some cases reversing cognitive decline with a multi-modal approach and trying to correct the underlying imbalances that lead to beta amyloid or tau tangle deposition and…
B) Start Right Now!
1) Walk/move every day – 60 minutes total or more…exercise is a freebie for memory and cognitive enhancement!
2) Eat whole, unprocessed foods, mostly plants (that reduce your blood sugar < 90; A1C <5.7; fasting insulin <10 then <6)
3) Get Sleep! (my weak area! 7-9 hrs nightly)
4) Reduce overwhelming stress
5) Live purposeful, enjoyable and challenging lives to retain cognitive function and memory.
There is a lot more but these are the relative "Freebie" basics to cognitive wellness.
Secondary Areas to Work On In Conjunction With the Above Basics…
(Most of these tests are paid for by Medicare or private insurance. Unfortunately, HMOs do not pay for these tests so they are out of pocket for these patients)
Nutritional Deficiencies - Identify & Replace - Vitamins, Minerals, Amino Acids, Fatty Acids, etc.
Hormone Deficiencies - Identify & Replace - Testosterone, Estrogen, DHEA, Pregnenelone, Thyroid
Toxin Identification & Detoxification - Heavy Metals, Mold, Chemicals, etc.
Infection Identification & Treatment - Lyme, Fungus, Viruses - EBV, Herpes, CMV, overgrowth of gut pathogens – may do selective trials of anti-rivals, anti-fungals or antibiotics
When imbalances in these areas (or “holes in the roof” as Dr. Bredesen states) are corrected there is an up-regulation of synaptic organization and neuronal health which results in improved brain function and less production of amyloid plaque and tau tangles, resulting in improved cognition and memory.
Scroll Through These Excellent Slide Presentations from the Speakers at the “Brain Health Summit June 26 & 27, 2021” to understand more about brain health and take action for you and your loved ones. (Speaker Bios)
The 4M’s of he Aging Brain: Memory, Mood, Mobility and Mojo
Sheldon Jordan, M.D. FAAN, UCLA and USC Dept of Neurology, Neurological Associates, The Interventional Group The Regenesis Project, Moderator of conference and practicing neurologist. There is much hope, but you have to act now. Very practical talk. Emphasis was on noticing early memory loss cues and acting on them that involve memory, your mood (i.e. depression, lack of motivation); mobility issues such as falling or difficulty walking and general zest for living (Mojo). Slides (1-25) are excellent and easy to understand. Dr. Jordan’s message is to act now!
A Brain Doctor’s Guide to Healthy Aging Gary Small, MD, Chair of Psychiatry Hackensack University Medical Center, Behavioral Health Physician in Chief, Hackensack Meridian Health, Emeritus Professor of Psychiatry, University of California, Los Angeles
Good “Healthy Aging” lifestyle review from slides 39 on. Practical things you can do. He has a good book worth getting “The Memory Bible.” At DrGarySmall.com there are excellent resources and books.
Mood and the Inflamed Brain, Edward Bullmore, MB, PhD.
Inflammation causing pain can be correlated to depression which inflammation aggravates. Inflammation is one of the causes of Alzheimer’s disease. C-reactive protein (CRP), a marker of vascular and body inflammation, is elevated in treatment resistant depression. His book “The Inflamed Mind” elaborates on this topic. Dr. Bullmore is a professor of neuroscience at the University of Cambridge, UK.
Good Bugs and Bad Bugs of the Nose, Mouth and Gut, Sabine Jordan, MD Gastroenterologist
Excellent talk regarding how important the gut is in mental health, Alzheimer’s disease, and all chronic diseases with an emphasis on the importance of bacterial diversity in our gut for overall health. Dr. Jordan is also an expert in fecal transplantation, it’s benefit in inflammatory diseases and also some illness that effect behavior. She shows the correlation of oral and gut microbes to the occurrences of neurodegenerative disease such as MS, ALS, Parkinson’s disease and Alzheimer’s. She starts the slide show with some thought provoking quotes. “All diseases begin in the gut,” and “Let food be thy medicine and medicine be thy food.” Hippocrates 470-360 B.C. “The Father of Medicine”. Another two were “One of the first duties of a physician is to inform the masses not to take medicine,” William Osler (1849-1919). “The aim of medicine is to prevent disease and prolong life, the ideal of medicine is to eliminate the need of a physician.” William James Mayo (1861-1931). Dr. Jordan also coins a term called “Globesity” and share statistics on the obesity epidemic around the world. Easy slides to look at.
Herbs for Mood, Stress and Sleep Tereza Hubkova, MD
A good review of some herbs, including dosing protocols, that are beneficial for stress, mood and sleep problems which are common problems in those with cognitive issues. Sleep is critical for proper brain function and memory – Ashwagandha, Rhodiola, Holy Basil, St. John’s Wort, Passion Flower, Valerian root, Lavender, Chamomile, Green Tea with L-theanine, Gotu Kola, Bacopa Monnieri, Nervines, Lemon Balm, Turmeric/Curcumin, Lion’s Mane are reviewed with function and doses given.
Chronic Brain Infection: The Brain’s Microbiome and Immuno-Senescence, Neurologist Sheldon Jordan, MD A thoughtful commentary on the reduced immune function that occurs as we age letting dormant virus’s and other infections agents manifest into illness which may effect cognition. Dr. Jordan suggests screening for cytomegalovirus (CMV), herpes viruses, EBV, chlamydia, syphilis, fungus which may be worth treating with medications if antibodies are elevated in many neurological illness from Parkinson’s to Alzheimer’s disease. The old concept that the blood brain barrier (BBB) is impenetrable is not accurate. The BBB is known to leak.
Proteinaceous Toxins Plug Up the Glymphatic System and How Sleep Would Set Them Free, Maiken Necergaard, MD, DMSc
Incredibly powerful, eloquent but very technical presentation with a very simple message. Sleep is vital and directly related to detoxifying the brain because of the brain’s own lymph system (Glymphatic System) which is activated at night and literally cleans the brain of waste. This Glymphatic System is also dependent on a strong, slower pulse rate, a sign of cardiovascular fitness. Sleep, sleep, sleep…is so important for your brain, memory and cognition. You just have to do it if you are concerned about optimizing brain health. Definitely worth reviewing the slides just to reinforce how valuable sleep is for memory and cognition through the detoxification process of this brain lymph system.
Good Oxygen and Bad Oxygen – Mitochondria, Oxidative Stress and Neurodegeneration, Dayan Goodenowe, PhD
Dr. Goodenowe is very smart and reviews “slowly” a very complexed topic of oxidative stress related to chronic diseases, especially neurodegenerative diseases like Parkinson’s, MS and Alzheimer’s diseases. He reviews how oxidative stress effects cell membranes negatively and sets the stage for the role of “plasmalogens” in the treatment of Alzheimer’s and other neurodegenerative diseases. Having adequate amounts of B-vitamins, CoQ10, cysteine by taking N-Acetylcysteine, along with acetyl-L-carnitine and plasmalogen supplementation (omega-9 for white matter/inflammation; omega-3 for neuronal degradation) are beneficial for these conditions. A lot of biochemistry. Very important topic. But not for the lay person unless they love biochemistry.
Good Fat and Bad Fat – Plasmalogens, Membranes, and Brain Function, Dayan Goodenowe, PhD Acetylcholine transmission is key in cognition and memory in general and in Alzheimer’s disease. Plasmalogens are a subclass of phospholipids, mainly found in the cell membranes that are important for optimal release of acetyl-choline from the synapse. Plasmalogens have been found to be low in neurodegenerative disorders and supplementation of different types of plasmalogens have improved cognitive function. Reduced levels of plasmalogen ethanolamine (PlsEtns) in the plasma are associated with Alzheimer’s disease (AD), cardiovascular disease, hypertension, cancer and respiratory disease [1,2,3,4,5,6,7]. Possible mechanisms of action of PlsEtns include helping maintain the membrane physical bilayer properties to facilitating membrane fusion and the signal transduction processes, including cholesterol efflux [8, 9]; preventing oxidative stress; and reducing the inflammatory response [7, 10,11,12,13].
According to Dr. Goodenowe the optimal levels of lipids for brain function are: fasting triglycerides less than 100 with 60-80 being ideal. Triglyceride levels less than 60 suggest malnourishment or excessive exercise. HDL-cholesterol levels should be over 50, ideally 60-70.. Total cholesterol over 200 with an hsCRP <1.0, homocysteine <10, DHA-Plasmalogens > 75th percentile are optimal. These are the bare minimum according to Dr. Goodenowe for a healthy lipid profile. I am excited about these plasmalogens which can be taken as a supplement.
The moderator of this “Brain Health Summit,” neurologist Dr. Sheldon Jordan, M.D., who has used these products in his neurology practice said there has been some remarkable improvement in cognition in his patients and he puts plasmalogens on his “must supplement list” for his Alzheimer’s and neurodegenerative disorder patients. He strongly recommends their use.. Go here to learn more about Dr. Goodenowe’s work with plasmalogens and here to obtain these products. A reasonable therapeutic trial for memory issues is to start with the ProdromeNeuro Oil with a loading dose of 1 ml/20 drops in a teaspoons mixed in 8-10 oz of fluid 3 x day for a week and then 1 ml/20 drops per day for the next 3 weeks to see if you get a response. The product is pricey but if it performs as good as patient anecdotes suggests then it will be well worth it. You should really start with two bottles to be able to give the loading dose of three times per day for the first week. Order by phone (1-951-550-0505) and provide them with this discount code for 25% off (MKWIKER25.) In the near future you will be able to put this code in and order online. So it is still pricey (2 bottles for $300 with discount code vs. $400) but for those with definite cognitive issues give it a try for a solid month. I am trying this product on my cognitive decline patients (and myself) so I will have a better feel for this supplement within the next two months.
Brain Assailants and Shaking the Jello, Neurologist Vernon Williams
Dr. Williams reviews the history of traumatic brain injury from athletics, the military and other traumatic injuries including how to evaluate concussed individuals, the different criteria, physical assessment and how to follow and treat these individuals back to health. One standout point that Dr. Williams emphasizes is for the patient to do vigorous “non-contact” aerobic exercise after being concussed which helps improve and speed recovery.
Staggering, Falling and Hydrocephalus, Neurosurgeon Garni Barkhoudarian, MD Maximizing Memory and Improving Ambulation Through Endoscopic and Traditional Management of Hydrocephalus
Dementia related to normal pressure hydrocephalus, fluid in the ventricles of the brain, can be misinterpreted as dementia. Dr. Barkhoudarian notes when a patient with cognitive issues has symptoms of frequent urination and urgency, falling or loss of balance, and a shuffling gait with difficulty turning around this may be a treatable form of presumed dementia that can be resolved by putting a shunt in place to reduce the pressure in the brain.
Diet for Brain Health: We Are What We Eat
Amylee Amos MS, RDN, IFMCP the founder of the Amos Institute gave an excellent talk on a more Mediterranean style diet, mostly plant-based, rich in colored and green vegetables, berries, and healthy fats and how this can benefit cognitive decline patients. Amylee is a registered dietician who specializes in Alzheimer’s disease treatment with a focus on following the Bredesen protocol emphasizing whole foods, mostly plant-based with healthy fats that create a mild ketosis (or ketoflex) and is individualized to the patient. Amylee offers video conference consultations and programs to help cognitive decline patients follow the Bredesen protocol (Dale Bredesen interview) diet program. Excellent talk and presentation for patients and medical professionals alike.
Riding the Wave of Life, Michael Eselun, BCC (no slides); Oncology chaplain who works cancer patients at UCLA
Chaplain Eselun spoke with no slides off the top of his head for one hour. Very impressive, thought provoking and moving. Here are some “one liners” to think about from his talk…Also I recommending looking at some of his videos and see what grabs you.
Why do you get up in the morning? What is your daily purpose now in the context of your illness?
The language of a chronic illness is the imagery of being at war or in a battle with the illness.
The illness is part of the patient, part of God and one has to love it – spiritual view.
What happens when our faith doesn’t explain our illness?
Agnostic view – a dance with a tiger.
Disease as punishment or it is testing me.
What is my relationship to this spiritual crisis.
Ride the disease like a wave. Enjoy the ride. We may be powerless over the wave (illness). What happens when recognize we can’t control the wave. But we have the power on how we ride the wave. What if it is nobody’s fault? You just come to ride with the wave. Ride the disease like a rip tide. Relax initially. Go with it. Then start to swim back. May we all ride the wave with an open heart and receive the gifts that may come.
Come to peace with powerlessness of getting the disease. Just accepting that we may be powerless on getting the disease. But we have the power on how we respond to the disease (experience).
What is the gift of the cancer? Don’t try and explain it.
Maybe we need the death of a career path..
Patients are many times overwhelmed with love from people they know or don’t know.
Come to be at peace with powerlessness.
We all want to be seen in our life situation.
Always ask open ended questions to patients…What is this situation like for you?
I don’t have any comments except I just enjoyed his lecture. Kind of stops you in your tracks going from one topic to the next. I like the concept of not being able to stop the wave (illness) but we have a choice on how to ride it!
Brain Rejuvenation with Damage Repair, Aubrey de Grey, PhD
Dr. de Grey has a unique view of looking at aging and how to manage it. Page 9 on the slides, The “7 Deadly Things” explains his philosophy on the “damage and maintenance” model of slowing aging.
Brain & Nutrition: Science and Clinical Application of Fasting & FMD (Non-CME)
Rafael Gonzalez, PhD
I am very familiar with the Prolon Fasting Mimicking Diet and think it is a great tool not just for the clinician but for the patient to self-regulate their diet patterns and gain control of their health. Aside from the physiologic benefits of the five day “fast” of central weight loss, lipid, glucose and inflammation reduction, and the stimulation of autophagy (or “self-eating” the body's way of cleaning out damaged cells in order to regenerate newer, healthier cells) and finally stem cell production, is the resetting of dietary habits and cravings, and the recognition that food causes many of our common daily symptoms. In addition the awareness that we don’t need as much food as we think we do makes this program so valuable. If you just do the fast repetitively, at least 3 months in a row (5 days each month) then 3-4 times a year you will gain much better control of the foods you eat and probably most of your health issues will either disappear or be dramatically reduced.
Reversing Neuronal Aging at the Cellular Level, Neurologist Dale Bredesen, MD
His lecture was excellent as usual. I have heard him speak many times. I have taken training under Dale Bredesen, MD twice. Interviewed him on a podcast. My handout here has an in depth summary of his two books and outline of his approach. He will be coming out with a new book in August, 2021 of the personal stories of patients who have reversed their cognitive decline and/or Alzheimer’s disease. Look for it and get it. Reading the personal stories of people who have recovered may be motivating enough to get people to follow his multi-pronged approach. It is not easy. Especially when the individual already has significant cognitive decline. You can assess people and find all the parameters and imbalances that Dr. Bredesen says are of importance and create a plan to implement this approach. But if people don’t realize how much work it is, and continued to work for a lifetime, the plan never gets implemented fully. THE KEY IS TO START EARLY LIVING A HEATLHY LIFESTYLE AND TREATING THE IMBALANCES YOU CAN NOW TO SLOW, STOP OR HOPEFULLY REVERSE THIS CONDITION!
Visualizing the Brain Across the Lifespan, Taylor Kuhn, PhD
Dr. Taylor reviews different imaging techniques for the brain and their use in cognitive issues.
The Grim Reaper Clock Resides in the Hypothalamus and Can Be Reset, Neurologist Sheldon Jordan, MD
Germ cell progenitors are cells that form reproductive cells, gametes
- Oocytes, egg Cell, sperm Cell
Stem cell is a cell capable of either copying itself or differentiating into a somatic cell
Somatic cell is a cell that is differentiated to perform certain specialized functions
- A neuron is a somatic cell of brain that engages in networking required for cognition
- A microglia is a brain resident somatic cell that is a creator and destroyer
- Exosomes are a little packet of instructions, messages released by one cell that may influence the function of another cell
The aging clock is in the hypothalamus. It releases exosomes that effect the pineal gland.
The pineal gland controls the thymus through the secretion of melatonin and other factors which are important factor in the decline of our immune system. The pineal gland’s output of melatonin markedly decreases with age.
Optimizing the microbiome from bacteria, viruses, fungi, parasites from our nose, mouth and gut effect cognition.
Focused ultrasound is a novel treatment for neurologic issues that has promise in cases such as dementia.
Biofilm can seal off infective agents such as spirochetes or porphyromonas gingivalis that may cause dementia that manifest as the immune system declines with age.
Inflammation can be triggered from the gut.
The blood brain barrier can “leak” leading to neurodegeneration, proteinopathy, blockage of Glymphatics and reduce blood flow leading to reduced synaptic function.
Bad fats in cell membranes can lead to cognitive decline. Plasmalogen precursor supplementation can lead to improved cognitive function in Alzheimer’s patients.
Progressive Degeneration of the Brain
Nasal, oral, gastrointestinal biome
Immunosenescence and inflammaging
Dysbiosis in nose and gut
Loss of barrier function, loss of immunocompetency
Brain infection
Inflammation, microglial activation
Neuronal damage
Damage to stem cells, synapses
Sleep disruption
Loss of neurovascular coupling
Energetics and redox stress
Proteinopathy
Disruption of particulate drainage systems
Treatment Strategy in Sequential Order
Evaluate for chronic infections that worsen immunosenescence and inflammaging such as CMV, vituses, fungi, bacteria
Nasal, oral, gastrointestinal biome check
Antibiotics/Antifungals/Anti-virals for possible bacterial, fungal, viral infections
Antitoxin measures for gingipains, mycotoxins...others?
Dental Health, blue light
Nutritional supplementation, diet, fasting, probiotics for nose, mouth and gut, fecal transplantation
Exercise, mobility
Medications for immune support?
Plasmapheresis, autophagy support
Senolytics
Stem cell and exosome with target in delivery
Summary
Alzheimer’s and Parkinson’s disease are multifactorial in causation with immunosenescence likely producing both direct and indirect effects from microbial growth and other sources of inflammation. Inflammation and infection are likely to damage both somatic cells and natural stem cells. Effective treatment will likely require both neutralization of the toxic and damaging effects of immunosenescence as well as targeted delivery of regenerative factors such as stem cells and exosomes.
In Closing…
Truth be told Alzheimer’s disease is 20 or so years in the making by the time MCI (mild cognitive impairment) occurs. That is why for patients of Health Associates Medical group, schedule (916-489-4400) with me a FREE 15 minute appointment to take the MoCA Test (Montreal Cognitive Assessment Test) which is an excellent screen for cognitive decline and pick up my handout on Alzheimer’s Disease and Cognition Prevention and Reversal (or you can print it out here). If you would like me to spend 60 minutes going over the MoCA results with you and outlining a “cognition enhancing” work-up and plan we can do this for $150 which is our half hour Medicare office visit price. We are offering this price because we want everyone to be able to get going on a cognitive prevention and enhancing program right now. If you are a non-established patient I will include the test in our initial new patient office visit charge and spend 90 instead of 60 minutes so I can do the test and get a detailed medical history and outline a cognitive enhancement plan at that time.
In some circles Alzheimer’s disease is considered the third leading cause of death behind Heart Disease (#1) and Cancer (#2). The good news is the preventive diet and lifestyle for the #1 and #2 killers on the planet are very similar to an Alzheimer’s and cognition prevention diet and lifestyle recommendations in “The 30 Day Alzheimer’s Solution (read pages 1-87).” The difference is you can get away with delaying heart disease and cancer to a certain extent because of medical treatments, but with cognitive issues there still isn’t any new medical therapy of significant benefit, even the recently publicized release of the drug Aduhelm (aducanumab), whose mechanism of action is to remove beta amyloid a hallmark of Alzheimer’s disease. Removing beta amyloid, without changing the multi-factorial causes of AD will not result in long-term success.
Make a FREE 15 minute MoCA appointment today. Call 916-489-4400.
Kirk Hamilton PA-C
Health Associates Medical Group
Prescription 2000, Inc.
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 716-2295 (m) / (916) 489-4400 (w)
krhammer@surewest.net
www.KwikerMedical.com
www.HealthyLivingforBusypeople.com
www.StayingHealthyToday.com