Why Has Dementia Become One of the Biggest Causes of Death in the Western World?

In recent years dementia has taken the spot as the 2nd biggest cause of deaths in Australia. In the UK it has gone one better and become the leading cause of death. With heart disease still on the rise and cancer too, it made me wonder what has changed in recent years to send neurodegenerative diseases to this level. We can certainly speculate, but it's probably a better idea to look at the research first.

What first got me thinking on this topic was when my daughter, who's work is currently in Parkinson's research, mentioned that pesticides are a trigger for neurodegenerative diseases. At the time I didn't think about it much more than as further confirmation to eat organic as much as possible. Then I noticed a sign one day about dementia having become the second leading cause of death in Australia and wondered again if our pesticide use could account for it. After all, here in Australia our summers come with plenty of flies and mosquitoes so it's not unusual to see those automated aerosol sprayers located throughout houses setting off jets of insecticide periodically.

Sadly, as is often the case, it's not such a simple answer. If it were then we could just eat organic foods and go back to using fly swats. It seems that there are a multitude of toxins that can trigger these diseases and over the last century and more they've been increasing in our environments. Likely since the industrial age. In addition, it's not just our environment that's changed, but our lifestyles and what we're eating too.

But aren't neurodegenerative diseases hereditary and dependant on your genetics? I certainly thought this was the case for a long time. Again the answer isn't so simple, it's a bit of both and science still doesn't have all the answers either.

There are genetic mutations that can give one person a higher chance of getting a neurodegenerative disease over another, but they don't absolutely determine that they will get the disease. Then there is apparently one genetic mutation which almost guarantees you will get the disease at some point in your life. This mutation seems to be very rare, however, and it's quite likely that environmental factors will still determine whether dementia is triggered earlier or later in life. Professor Michael Lardelli, now retired, has some interesting videos on his Alzheimer's Disease and Childhood Dementia Substack which delve into the genetics for these diseases which are free to watch and no subscription is need.

^{Image courtesy of @derangedvisions}

What do we know so far?

With the current epidemic of dementia only a very small percentage seem to actually have any hereditary form of the disease; some doctors have said as few as 5%. At the turn of the last century neurodegenerative diseases were largely unheard of. They were so rare that very little study was even done on them. Could it be that the cases that did happen were caused by that rare gene which inevitably causes the disease?

I'm just speculating at this point, so let's get back to what the factors are that trigger dementia. It seems that they are environmental and lifestyle factors. So things as basic as not getting enough sleep, inactivity and a shoddy diet seem to be the biggest drivers of this recent rise in dementia, with some forms having more of a connection to toxins in our environment. In addition to pesticides, other toxins that have been indicated in triggering dementia are heavy metals such as mercury and aluminium. One doctor cited a patient in the early stages of Alzheimer's who led a pretty healthy lifestyle. It took them a while to realise that it was his regular consumption of tuna that was putting him into contact with mercury at levels that were triggering the disease.

Having established that there isn't necessarily a single trigger for dementia, but that it's more likely a combination of environment and lifestyle factors, my question had to be if there was anything that could be done to prevent the onset of these diseases; after all prevention is better than cure and the reality is that they have made next to no headway on cures and the drugs developed have very little affect on symptoms or even slowing the progression of the disease. In fact some studies have found that ketogenic diets have given better results than any medication currently available. Possibly due to the focus on amyloid plaques disovered in Alzheimer's patients which has had researchers barking up the wrong tree or at least only seeing part of the picture for years and a 2006 research paper in this area was found to have been a least partially fabricated. Sadly it seems it's not been an uncommon theme in the last few decades with the publish or perish environment making some researchers desperate.

Alzheimer's is the most common form of dementia so it's generally the most discussed and easiest to find information on. Interestingly it's being referred to as type 3 diabetes
by some in the field, which hints at more recent discoveries of the cause being linked to an energy or fuel shortage in the brain.

The discovery of amyloid plaques in the brains of deceased with Alzheimer's disease was made in 1892 and subsequent research was focused around these findings. Further discoveries emerged from this research including finding the beta amyloid protein which makes up the plaques. Drugs created to treat Alzheimer's were geared at attempting to break down these plaques. However, more recent findings suggest that the plaques are the brain attempting to protect itself rather being the cause.

Research doesn't seem to have reached a point where they can definitively say what the cause of Alzheimer's is, but with the trajectory of research now changing it's hopeful that in the coming years we'll be seeing more come to light on it. Much of the literacy still says that the build up of amyloid plaques are the cause, but now that they are starting to be recognised as a symptom rather than the cause the question becomes what causes the plaques to build up or what are they trying to protect the brain from? Is it inflammation, a lack of fuel to the cells, toxins or all of the above?

The reality is there is still so much to discover about neurological degenerative diseases across the board, but there does seem to be some headway being made on lifestyle factors that can help with prevention and reduction of symptoms. There are even suggestions that these lifestyle changes may reverse the disease in early stages.

If we go back to the label of type 3 diabetes for Alzheimer's then we can see why most of the drug interventions that have developed so far aren't really helping much. They seem to have been geared towards trying to clear out the amyloid plaques, which doesn't get to the root of the problem. Recent research has found that in Alzheimer's patients the brain's ability to use glucose is impacted, but its ability to use ketones remains the same as in someone without any cognitive impairment. Studies in this area have found that getting ketones to the brain leads to good outcomes for all neurodegenerative diseases.

Preventative Measures

By the time someone has enough symptoms to be diagnosed with a neurodegenerative disease the damage to the brain has likely been happening for over a decade. This is probably why it's so hard to reverse the damage and small improvement or slowing progression might be the only thing that they can hope for, with a small potential for reversal in the very early stages. That said, Dr Mary Newport saw huge improvements in her husband's dementia years down the line after introducing ketones into his diet.

Keeping in mind that prevention is always better than cure, many are trying to raise awareness for prevention and there is plenty to be said on that. It's basically the same three pronged approach as for all the metabolic diseases: sleep, diet and exercise.

Sleep always gets talked about first, particularly deep sleep because this is when your brain detoxes, flushing out the build up gathered through the day, including those afore mentioned beta amyloids. With our modern lifestyles we are often sleep deprived and things like shift work will disrupt our circadian rhythm. Also snoring and sleep apnea can disrupt our sleep which is common when we get overweight and over tired.

Exercise and regular movement is critical for entire body health and the brain is no exception. It can help to make new connections and even repair some structures of the brain. Aerobic exercise has been shown as being particularly good in this regard.

It's also notable that regular movement throughout the day is better for levelling out glucose spikes than than big bursts of exercise once a day. Less glucose spiking means less insulin spiking which brings us back again to the description of type 3 diabetes for describing Alzheimer's. Once again we can see how modern lifestyle often plays a big role in us being much more sedentary. More and more jobs have us sitting for hours as machines take over the physical jobs; at home we sit in front of TVs or even sit and scroll on phones. It even occurred to me as I was changing gears in my manual car, pushing that clutch down and moving the gear stick, that our cars have us moving less while driving now they are mostly automatic.

Then a lot is said about the effects the food we eat can have on the brain. I've already written about some of the problems that modern ultra processed foods cause us, but something that seems to stand out particularly with regards the brain is the imbalance it gives us in the Omega fats. Our brain needs both Omega-6 and Omega-3 in balance order function. Ideally we should be ingesting a ratio of about four Omega-6 to one Omega-3 fatty acids at the highest (one to one is even better), but the ultra processed oils contain only Omega-6. Omega-6 is inflammatory while Omega-3 is anti-inflammatory. While we need both an over supply of Omega-6 can lead to chronic inflammation which leads to chronic illness. As you can imagination, inflammation in the brain is not going to be a good thing.

Not mentioned as often is a fourth factor with regards neurodegenerative diseases, likely because it's a harder factor for us to control. Environmental toxins such as heavy metals, pesticides, fungicides and herbicides can trigger these diseases, either alone or in combination. We can try to limit our exposure to them, but because they permeate through just about everything organic around us we can't really avoid them completely.

Some finishing thoughts

I'll leave this here as I continue to delve into the subject and further research. While I haven't personally experienced seeing family members with neurodegenerative diseases, I currently work with families who are dealing with this. It's a terrible disease for everyone involved. From the distress of the one who realises their decline is happening and having no control over it, to the family members who grieve multiple times as they lose their loved ones first mentally, then eventually physically.