Change Your Brain Every Day - The 5 Different Types of Alzheimer’s Disease, with Dr. Dale Bredesen

Episode Date: August 12, 2020

Like most brain health diagnoses, Alzheimer’s disease is not just one thing. In fact, this week’s guest Dr. Dale Bredesen has identified 5 major subtypes for Alzheimer’s disease, and they all have different causes and different treatment recommendations. In the third episode of a series with Dr. Bredesen, he defines the characteristics of each of these subtypes and identifies how and why they manifest in the brain. 

Welcome to the Brain Warriors Way podcast. I'm Dr. Daniel Amen. And I'm Tana Amen. In our podcast, we provide you with the tools you need to become a warrior for the health of your brain and body. The Brain Warriors Way podcast is brought to you by Amen Clinics, where we have been transforming lives for 30 years using tools like brain spec imaging to personalize treatment to your brain. For more information, visit amenclinics.com. The Brain Warriors Way podcast is also brought to you by BrainMD, where we produce the highest quality nutraceuticals to support the health of your brain and body. To learn more, go to BrainMd.com. Welcome back, everybody. We are here with our friend and colleague, Dr. Dale Bredesen, who is the author of The End of Alzheimer's and his new book,

The End of Alzheimer's Program, to really help you take a deep dive. I mean, how you can really apply it in your own life. And we just adore him and grateful for his work. Let's talk about the different types of Alzheimer's. You know, ever since I started imaging in 1991, I'm also a child psychiatrist. My expertise was on ADD or ADHD. And there was this study from NIH and it showed decreased activity in the prefrontal cortex when you try to concentrate. And so in my mind, oh, well, that's what ADD is until I scanned a couple of hundred ADD patients.

And I'm like, oh, it's not one thing. Some people have the classic pattern. A lot of people have other patterns. And ultimately I described seven types of ADHD and all psychiatric illnesses are not single or simple disorders. They all have multiple types. And the same thing is true for Alzheimer's disease. So talk a little bit about how you came to that conclusion. And what are the different types of Alzheimer's disease? Yeah, you made a great point there. So when you start to ask, okay, why?

As you know, 20th century medicine was about what is it? What's the diagnosis? 21st century medicine is about why. Why do you have this? What are the factors that are driving this abnormal biochemistry? And when you look at this thing we call Alzheimer's, which is just a pathology, it can be driven, as you said earlier, by different factors. And they all, they have a final common pathway, but they can come in from different places.

And so what we found is when we begin to measure these things, just as you said, you've got to look, you've got to measure. It is so helpful to do so. one. And they may have a leaky gut. You were talking about gingivitis and periodontitis, as they're now calling it leaky gums. So you got leaky gut, leaky gums, things like this, where you're now having this inflammatory process, maybe herpes. Which caused leaky brain. I love that. Leaky gut, leaky gums, leaky brain. That's exactly right. And of course, the blood brain barrier abnormalities are very, very early in Alzheimer's disease. So that's type one or inflammatory or hot Alzheimer's disease. And the typical person is kind of a 65 year old man who's doing all the wrong things and has an HSCRP of eight, you know, that sort of thing. They have an inflammatory profile. Then there's type two, very different story. You've gotten to the same pathology, but you've come in this case, not because you're pushing on it with inflammation, but because you cannot support the network.

So you have a low vitamin D or thyroid, pregnenolone, progesterone, all these things we had talked about before, estradiol, you know, testosterone, all these things are critical nerve growth factor, brain derived neurotrophic factor, vitamin D, all these things are critical to support that 500 trillion plus neuron network, or synapse network. So it's a tremendous network that you're supporting there. And if you're low in these things, you simply cannot afford that network. And so you now downsize and Alzheimer's results from that story. That's type two. That is atrophic or cold Alzheimer's. And I should say the Ayurvedic physicians thousands of years ago came to the same conclusion that there are these different subtypes of dementia. Then there's type 1.5, which has renamed it that way because it has features of both. It's glycotoxic. It is sweet Alzheimer's disease. And it is because you've got

on the one hand, glycation of these various proteins. And so they now change their shape. They change their function as well as their form. And you they now change their shape, they change their function as well as their form, and you respond to them, they are now abnormal. Of course, we measure it as hemoglobin A1c. But there are lots of other proteins that are glycated, just like remoras on a shark. And so on the other hand, it has some features of type two, because it creates insulin resistance, you can literally measure the phosphorylation change on IRS 1, which is part of the signaling pathway from the insulin receptor. You're shutting down your response to insulin, which is an important growth factor for the brain. So that's type 1.5

or sweet Alzheimer's. Then there's type 3, which is toxic. And as you know, the toxins come in three groups, metals like mercury and other inorganics, air pollution, things like that. As you know, there was a study out of Mexico City, severe air pollution, showing a child that had Alzheimer's changes in the brain, just really scary. And then you've got, so it's the metals and the other inorganics. Then it's the second group organics. Amazing. We're finding people who have high levels of propylene oxide, acrolein, glyphosate, all these various organics that again, people don't typically check for that can contribute to cognitive decline. And then the third group in there, of course, is the biotoxins,

things like trichothecines and ocrotoxin A, mold-related toxins. So that's type three, which is toxic Alzheimer's. Type four is vascular. And of course, vascular component, so important. And this is a critical area for the future because so many people aren't checking, they're not checking their oxygenation at night. They're not getting their blood flow up. They're not doing appropriate exercise. They're often having big glucose swings that they don't know about until they actually do CGM, the continuous glucose monitoring, all these critical for the vascular status. And then the fifth one, of course, is one where you are a real expert, which is traumatic, and which, as you know, contributes so commonly to this problem. So these are the different ones. And it's helpful, of course, to know what are all the contributors,

because then you can go after them. And I should say, we're in the middle of the first trial in history for Alzheimer's. I'm very enthusiastic about this because, as you know, all the trials in the past have been where you have to say, here's our predetermined treatment for this problem. It's going to be this drug or it's going to be this lifestyle change or what have you. In this one, we're saying the opposite. We're saying for each person who comes in, we're going to measure all these different variables and then we're going to address the ones that are contributing to the decline. I think moving forward, that's what we're all starting to do. That's rational. You're going to target treatment based on the vulnerability they have. I'm looking at this thinking about my types, infectious alzheimer's there was an editorial in the journal

of alzheimer's but but there's other infections so like lyme i bet covet 19 is going to become part of the future because there is we scanned our first covet-19 positive brain with cognitive symptoms. It was terrible. The scan was terrible. Do you think at some point there may be an infectious type? Oh, absolutely. And this is part of, right now, this is part of type one, the inflammatory type, because the infections typically drive the inflammation.

But I absolutely agree. Many, many people have Alzheimer's in association with infections. Again, HSV-1, Professor Ruth Itzaki has spent her career looking at this. And you're absolutely right about COVID-19. It's really concerning because you go back to post-encephalitic Parkinson's from 100 years ago. Are we going to have post COVID Alzheimer's disease. And one of the most concerning things I heard recently was from someone on the front line saying that a lot of the people who are coming off the ventilators, and no anesthesia, no hypoxia, but just not waking

up the way they should, which really suggests a significant amount of brainstem pathology. And even though they then ultimately do wake up, what's their concern down the road? Where are they going to stand? And I'd be interested, Daniel, in your scans on COVID-19, do you see brainstem changes? Yeah, we'll have to look. We're just starting that work. But like with Lyme, for example, initially, because there are a lot of COVID-19 people without symptoms or they just have mild flu-like symptoms.

But if you're losing your sense of smell, that's great. How do you know if you're having climate changes? And that will we see something later on like Lyme? You actually put a map of the United States with the highest incidence of schizophrenia. It's the Northwest, the North Midwest, and the West Coast. And then you overlay the highest incidence of Lyme in the United States.

It's almost identical. And so I think, and like your subtypes for Alzheimer's, I think it's also true for serious psychiatric illnesses. It's just curious. We're going to be paying attention really closely to COVID-19. And quite frankly, it's one of the reasons I don't want it. I know there's a lot of controversy in society. They're having COVID-19 parties. It's like, you know, I just don't think that's the smart thing. The smart thing is wash your hands and avoid it if you can. Yes, I'll pass this time around.

Thank you. Yeah, exactly. Oh, my goodness. i love these types and and i think one that's often overlooked is your type five is the having a traumatic brain injury and i think tan and i had this discussion when we first met you know i asked her if ever had a brain injury because that's part of my dating ritual. Okay, but in my defense, I'm a neurosurgical ICU nurse. What do you think we think a brain injury looks like?

Yeah, of course. You've got a brain drain. You've got a skull flap. So I've never had that. I walked away from a car accident. I walked away. And what happened? We rolled two and a half times at 75 miles an hour, but I walked away. And what happened? We rolled two and a half times at 75 miles an hour,

but I walked away. That's a great pickup line. Have you ever had a brain injury? Best pickup line ever. Can I see your naked brain? That's different than the chemist's pickup line is, tell me if this smells like chloroform. Right, exactly. But really, when he brought that up, and he really, he pointed out, he just stared at me when I mentioned the car accident. Because he had to ask me over and over and over, and he's like, ever been in a car accident? I'm like, yeah, but I walked away from it. And he just kept staring at me. And then I had to think about it.

I'm like, you know, I am a nurse. Shaken baby syndrome is a thing, right? So basically that's what I had was probably shaken baby syndrome, right? Well, you got to stay. The book is called The End of Alzheimer's Program Bill Bredesen, groundbreaking.

You should buy this book and then you should buy it for people you love because get your brain right this book and then you should buy it for people you love. That's good. Because get your brain right. Yes, your memory will be better, but your mood will be better. Your focus will be better. Your relationships will be better because ultimately that's brain function.

Stay with us. When we come back, we're going to talk about uh more ways than else stay with us if you're enjoying the brain warriors way podcast please don't forget to subscribe so you'll always know when there's a new episode and while you're at it feel free to give us a review or five star rating as that helps others find the podcast. If you're considering coming to Amen Clinics or trying some of the brain healthy supplements from BrainMD, you can use the code podcast10 to get a 10% discount on a full evaluation at amenclinics.com or a 10% discount on all supplements at brainmdhealth.com. For more information, give us a call at 855-978-1363.