Category: Primary Care

Consult your medical provider for a comprehensive evaluation to identify which of the following conditions you have. Research recommends that early screening and treating any three of the conditions could prevent Alzheimer’s disease.

Consult your medical provider for a comprehensive evaluation to identify which of the following conditions you have. Research recommends that early screening and treating any three of the conditions could prevent or cure Alzheimer’s disease.

1. Depression
   • Screen for depression using clinical assessments.
   • Treatment: Avoid selective serotonin reuptake inhibitors (SSRIs) due to their association with increased dementia risk. If needed, fluoxetine may be preferred as it increases TGF-β, which benefits neuroprotection.
2. Diabetes and Insulin Resistance
   • Check fasting blood glucose and HbA1c levels.
   • Treatment: Optimize diabetes management with insulin or glucose-lowering medications. Consider intranasal insulin therapy to improve cerebral glucose metabolism.
3. Dyslipidemia
   • Measure cholesterol and triglyceride levels.
   • Treatment: Use statins (lipophilic or hydrophilic) to reduce dementia risk.
4. Hypertension
   • Monitor blood pressure regularly.
   • Treatment: Beta-blockers and diuretics are most effective in reducing dementia risk.
5. Inflammation
   • Measure C-reactive protein (CRP) to detect systemic inflammation.
   • Treatment: NSAIDs (e.g., ibuprofen) may lower AD risk. Gut microbiome modulation (probiotics or antibiotics) can reduce neuroinflammation.
6. Vascular Abnormalities
   • Screen for cerebrovascular disease (stroke history, carotid ultrasound, or MRI).
   • Treatment: Manage vascular health through antiplatelet therapy, lifestyle interventions, and hypertension control.
7. Nutritional Deficiencies
   • Test for Vitamin D, folate, and niacin levels.
   • Treatment: Supplement with Vitamin D, folate, and a Mediterranean diet to slow cognitive decline.
8. Mitochondrial Dysfunction
   • Assess for chronic fatigue and metabolic indicators.
   • Treatment: Lithium therapy can restore mitochondrial function. Valproate may enhance mitochondrial energy production.
9. Transforming Growth Factor Beta (TGF-β) Deficiency
   • Measure TGF-β levels in plasma.
   • Treatment: Fluoxetine increases TGF-β and may aid in neuronal repair.
10. Wnt/β-Catenin Deficiency
    • Screen for cognitive decline progression.
    • Treatment: Doxycycline therapy has been shown to increase Wnt signaling and enhance neuroprotection.
11. Metabolic Syndrome
    • Identify obesity, insulin resistance, and hypertension.
    • Treatment: Address hypertriglyceridemia, high waist circumference, and hypertension.
12. Circadian Rhythm Disturbances
    • Assess sleep patterns and actigraphy data.
    • Treatment: Melatonin therapy, bright light exposure, and photobiomodulation therapy (near-infrared light therapy) can improve circadian function and cognitive health.
13. Underweight and Malnutrition
    • Monitor BMI and dietary intake.
    • Treatment: Increase caloric intake, protein-rich diets, and short-chain fatty acid (SCFA) supplementation to promote neuroprotection.

Sources of research evidence:

1. Fessel J. Formulating Treatment to Cure Alzheimer’s Dementia: Approach #2. Int J Mol Sci. 2024;25(6):3524. doi:10.3390/ijms25063524.

2. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413-446. doi:10.1016/S0140-6736(20)30367-6.
   • Supports multimodal interventions, including vascular risk factor management, lifestyle modifications, and cognitive training in preventing and reversing cognitive decline.
3. Cummings J, Lee G, Nahed P, et al. Alzheimer’s disease drug development pipeline: 2022. Alzheimers Dement (N Y). 2022;8(1):e12295. doi:10.1002/trc2.12295.
   • Discusses the failure of single-drug approaches in AD treatment and the need for personalized medicine, aligning with Fessel’s multimodal approach.
4. Jack CR Jr, Bennett DA, Blennow K, et al. NIA-AA research framework: Toward a biological definition of Alzheimer’s disease. Alzheimers Dement. 2018;14(4):535-562. doi:10.1016/j.jalz.2018.02.018.
   • Provides evidence that Alzheimer’s pathology is driven by multiple interacting factors, necessitating individualized treatment strategies.
5. Espeland MA, Rapp SR, Manson JE, et al. Long-term effects of lifestyle interventions to prevent diabetes on cognitive function: Action for Health in Diabetes study. J Am Geriatr Soc. 2021;69(3):698-708. doi:10.1111/jgs.16948.
   • Demonstrates that aggressive diabetes management improves cognitive function, supporting the inclusion of diabetes treatment in AD intervention strategies.
6. Walker KA, Gottesman RF, Wu A, et al. Systemic inflammation during midlife and cognitive change over 20 years: The ARIC Study. Neurology. 2019;92(11):e1256-e1267. doi:10.1212/WNL.0000000000007094.
   • Confirms the role of inflammation in cognitive decline and supports the recommendation to target systemic inflammation as part of a curative strategy for AD.