What is Traumatic Alzheimer's Disease?by Justin Perr, M.S. Candidate, Dietetic InternNews
Most people know that a concussion is something they do not want. However, few people know that traumatic brain injuries can contribute towards the development of Alzheimer’s disease. While it is different for each person, the consequences of these injuries may extend long after the initial symptoms subside.
So, what is traumatic Alzheimer’s? **Traumatic Alzheimer’s is the fifth subtype of Alzheimer’s disease that is characterized by a history of head trauma and a subsequent, often earlier, onset of Alzheimer’s disease. While not all head injuries lead to Alzheimer’s, traumatic Alzheimer’s symptoms usually do not appear until many years or decades after the traumatic event. **
Causes of Traumatic Alzheimer’s
Traumatic Alzheimer's disease is perhaps the subtype of Alzheimer's disease with the least amount of research. This does not mean that traumatic Alzheimer's disease does not exist, but rather that there's still much for us to learn. The categorization of traumatic Alzheimer's disease came about after recognizing that the majority of people who suffered a mild to moderate traumatic brain injury during their lives had plaque in their brain upon autopsy, regardless of the cause of death . That being said, the rate of Alzheimer's disease in those that suffered a traumatic brain injury was only modestly higher than those who did not . This left a big question mark in the world of Alzheimer's disease research. We know that a traumatic brain injury can cause similar disease patterns to those of Alzheimer's disease, but why don't all of these people become symptomatic?
For the most part, this is a question that largely remains. However, some early research is beginning to paint a picture that explains how traumatic Alzheimer’s works, and how we can treat it. It appears that the act of sustaining a traumatic brain injury causes an acute stress to the brain and surrounding vasculature . Whether this is a one-time injury from an accident, or a repeated trauma from playing sports, the brain becomes inflamed and the integrity of the blood-brain barrier begins to break down . These two reactions are very similar to the disease processes explained in our articles on inflammatory Alzheimer's disease and vascular Alzheimer's disease. While this acute reaction may subside in some people, it appears to kick-start the pathology of Alzheimer's disease in others. These are typically people that have an ApoE4 allele or have a predisposition towards inflammatory Alzheimer's disease or vascular Alzheimer's disease. For these people, a traumatic brain injury may expedite the onset of Alzheimer's Disease by 2 to 3 years . When this occurs, the condition is classified as traumatic Alzheimer's disease.
Signs and Symptoms of Traumatic Alzheimer’s
Signs and symptoms of traumatic Alzheimer’s will vary heavily from one person to the next. The most obvious sign would be a history of one or more traumatic brain injuries. Other than that, the signs and symptoms would depend on whether the brain injury is vascular or inflammatory in nature.
Inflammatory Signs and Symptoms
- High C-reactive protein (CRP)
- Values should be below 0.9 mg/L
- Low albumin to globulin ratio
- Values should be 1.8:1 or greater
- High interleukin-6 (IL-6)
- Values should be less than 3 pg/mL
- High tumor necrosis factor (TNFa)
- Values should be less than 6.0 pg/mL
- Insulin resistance is another common finding
Vascular Signs and Symptoms
- Values should be less than 20 mg/dL
- Values should be less than 60 u/L
- Values should be less than 7 umol/L
- Values should be less than 90 mg/dL
- Omega-6/Omega-3 ratio
- Values should be 0.5-3
- C-reactive protein
- Values should be less than 0.9 mg/L
- Blood brain barrier antibodies
- Value should be Negative
Treatment of Traumatic Alzheimer’s
There are two phases to treating traumatic Alzheimer’s. The first phase would be implemented directly after the traumatic brain injury has occured. The goal of this phase is to quell inflammation and support the brain through recovery. The second phase would be dependent on the success of the first phase. If the first phase is executed in a timely manner, then the goal of the second phase would be to continue to support the recovery and stability of the brain’s health. If the first phase is skipped or unsuccessful, the second phase would be to reverse damage caused from the traumatic brain injury. This would depend on whether the Alzheimer’s is vascular or inflammatory in cause.
Phase One Interventions
Treat the injury:
This is perhaps the most important step in treating traumatic Alzheimer’s. If the brain trauma can be kept under control, there is a lower chance of triggering the onset of both vascular or inflammatory Alzheimer’s. The first step in treating a brain injury is going to a doctor. The doctor may want to perform scans or prescribe medicine to help with swelling. This is incredibly important for both acute and long term safety. Brain injuries can be deadly and it is important to get quality care following a traumatic event. The second half of treating a brain injury is to promote brain healing and to lower inflammation. There are many strategies that can help with the step, so it is important to work with a professional to know which will be safe and effective for you.
Support the brain:
There are many ways to support your brain with both lifestyle and diet. Lifestyle interventions like getting more sleep and increasing aerobic exercise have been shown to be supportive of brain health following a traumatic brain injury. Additionally, increasing food sources of omega-3 fatty acids can be an effective way to lower inflammation in the brain while also providing the essential fatty acids to repair any damage . However, it is very important to speak to your doctor about implementing these strategies since it can be dangerous to exercise or perform other tasks too soon after a brain injury.
Phase Two Interventions
Support the brain:
Supporting the brain will be very similar to the strategies discussed in phase one. At this point, it would be important to meet with a trained professional to develop a lifestyle plan to support brain health over a long period of time. This would be different for everyone and would ideally blend into a normal life.
Treat other subtypes of Alzheimer’s:
If there begins to be a noticeable change in cognition, it is important to meet with a professional trained in the Bredesen protocol and functional medicine to help identify whether or not another subtype of Alzheimer’s disease has been triggered by the traumatic brain injury. If the onset of Alzheimer's is suspected, typically inflammatory or vascular, these will be treated accordingly.
Like all other subtypes of Alzheimer’s, traumatic Alzheimer’s is a condition that must be taken seriously and treated appropriately. While most doctors can handle the acute phase of traumatic brain injury, it can be harder to find a specialist who can identify and treat the onset of traumatic Alzheimer’s. If you suspect you might have traumatic Alzheimer’s, it is important to work with a doctor and dietitian who are trained in both the Bredesen protocol and can make a functional diagnosis of your symptoms. Contact the Amos Institute today to make an appointment with a dietitian trained in the Bredesen Protocol and functional medicine.