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Checklist of Treatments for Alzheimer's Disease
Part 3 of 8
3. Three Antioxidants: ginko biloba, selenium, grape seed extract. There are numerous antioxidants available to combat free radicals in the bloodstream of Alzheimer's patients. The best antioxidants are foods, such as blueberries. However, because of the expense and limitations on getting dietary antioxidants, the Alzheimer's patients may need to take supplements.
I give my mother ginko biloba extract, two 120 mg capsules per day. A neurologist informed me that ginko may be useful in the early stages of the disease. Based on this advice, I took her off ginko when she progressed to the moderate stages of the disease. However, once I realized that ginko's antioxidant properties would help Alzheimer's patients regardless of what stage they were in for the disease progression, then I put her back on the supplement.
At first I was skeptical that ginko biloba was doing any good. But two facts changed my mind. First, one of my mathematical analyst colleagues at the Tennessee Valley Authority told me that he takes ginko and found that it significantly improved his ability to concentrate. He does not suffer from Alzheimer's or any other disability, but ginko has a true beneficial effect for him.
Second, ginko affects the blood chemistry of the person taking the supplement. For example, ginko enhances the anticoagulation effects of the drug Coumadin (Warfarin). Because ginko affects the blood chemistry, we have reason to suspect it might impact the blood supplied to the brain of Alzheimer's disease. Evidence has not emerged as to whether ginko biloba can cross the blood-brain barrier that prevents certain chemicals in the blood from reaching the brain. However, ginko produces enough physical manifestations that we do not have to rely on the bogus concept of "if you think it works, then it works. If you don't think it works, then it won't."
Second, my mother takes 200 mcg/day of selenium. Selenium has a number of wonderful properties, but the most useful for Alzheimer's patients is its antioxidant property. Writing in the May 23, 2005 issue of the magazine Nation's Restaurant News, nutritionist Mary Tabacchi writes " A diet full of antioxidants can help ward off oxidation, which weakens arterial, heart, skin, kidney and gastrointestinal tract cells. As a result, oxidation likely hastens the aging process and increases one's risk for autoimmune diseases, including arthritis, muscular dystrophy, lupus and Alzheimer's disease. Oxidation occurs when oxygen pulls electrons from electron-rich molecules, such as fatty acids. That sparks the creation of free radicals, which assault cellular and intracellular membranes. As a result, cells are damaged or destroyed and immune functions are inhibited. However, antioxidants can help strengthen and repair cells, making them less susceptible to disease.
Anthocyanin antioxidants--which often come in the crayon colors of bright blue, purple and red--are best known for combating cancer. They can be found in blueberries, blackberries, black raspberries, red cabbage, beets and eggplant skins--and they protect against heart disease to boot.
Plant-based Vitamin C helps to fortify skin and bones and plays a special role in holding cells together. And grain germs, nuts, olives and avocados are chock full of Vitamin E, which protects against heart disease and helps prevent scarring. Whole grains and meats are full of selenium, also a combatant of heart disease."
The December 1, 2004 issue of Better Nutrition, in an article captioned "The Big 10: Top Health News for 2004," reports that selenium has a positive synergistic effect when taken with (natural) Vitamin E, and thus the two should be taken simultaneously to maximize their antioxidant properties.
Third, Alzheimer's patients should consider taking grape seed extract, 100 mg/day. I had trouble finding out about antioxidant supplements from medical doctors. Apparently, in four years of medical school, doctors may take one course in nutrition, or they may skip the course and just get a 3-hour lecture on the subject. It turns out few doctors can speak authoritatively on which supplements offer the most antioxidant effect to remove free radical oxygen molecules from the blood stream. Through independent research, I discovered that grape seed extract was thought to be even more potent as an antioxidant than Vitamin E. The interested reader is advised to search on the Internet for "grape seed extract" and "antioxidant" to learn more about this supplement.
The June 2005 issue of Better Nutrition has this recommendation: "[T]here's reasonable proof flint antioxidants retard cardiovascular decline. Consider pycnogenol, grape seed extract, ginkgo biloba and coenzyme Q10." Grape seed extract has been praised for blocking the Helicobacter pylori human pathogen linked to peptic ulcer and now to cardiovascular diseases. See Cranberry synergies for dietary management of Helicobacter pylori infections. Process Biochem, 2005;40(5):1583-1592. A press release from the food manufacturing concern Kikkoman states "Manufacturers who would like to raise the antioxidant level of their product may be interested in an antioxidant-laden grape seed extract. Kikkoman's Gravinol[R] is a natural antioxidant specially formulated for use in functional bars, cereals, beverages and pasta products. The ingredient harnesses naturally occurring antioxidants extracted from grape seeds, and offers three distinct levels: Gravinol-N, Regular Grade (40% purity); Gravinol-T, Beverage Grade (28% purity); and Gravinol-S, Premium Grade (95% purity). These antioxidants contain proanthocyanidins and have proven to have a positive health benefit."
Finally, at the 2005 meeting of the Royal Society of Medicine in London, Roger Corder of the William Harvey Research Institute in London looked at research exploring the actions of wine and grape polyphenols on vascular function. Over the past 15 years, he said, diets with high flavanoid content have been linked to reduced incidence of coronary heart disease. Many actions of flavanoids are attributed to their antioxidant properties, but recent research has cast doubt on this as the mechanism that underlies these effects according to Corder. Still he noted that grape seed extract represents a suitable product for use in clinical trials to investigate the therapeutic potential of procyanidins to improve vascular function. Thus, more and more people are coming to recognize the important antioxidant properties of grape seed extract, although your local doctor has probably never heard of this research, because most doctors would not take the time to research issues like a Ph.D. would.
Ongoing research is needed to determine if the antioxidant agents in grape seed extract can cross the blood-brain barrier and thereby protect the brain sells of Alzheimer's patients from damage caused by free radicals. One preliminary study using rat brains found that the proteins in these mammalian brains "mediated" the effect of grape seed extract. See "ALZHEIMER DISEASE: Rat brain proteins may mediate neuroprotective actions of grape seed extract," Health & Medicine Week (March 7, 2005).
This article is formatted with bold and italics at http://riskmgmt.biz/economist/pharmecon/threeantiox.htm
"Michael A. S. Guth performs pharmaceutical economics research and outcomes research on drugs for the treatment of Alzheimer's disease, hyperlipidemia, hypertriglyceridemia, bone mineral density, and osteoporosis. The following web site contains links to dozens of articles he has written as well as summaries of work in progress: http://riskmgmt.biz/economist/pharmecon /pharmecon.htm

Comment by Gary Chaison Prof. of Industrial Relations, Clark University

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