DEAR DR. MICHELLE,
What about supplements, like Prevagen or CoQ10? Should I be taking those?
The “nutraceutical” industry is not controlled the same way the pharmaceutical industry is, and evidence to support the use of supplements as “brain boosters” is still lacking. Claims about the effectiveness and safety of these products are not necessarily based on scientific research.
Before taking out your wallet, talk to your doctor about the pros and cons of making a supplement part of your cognitive health routine. Some dietary supplements can cause harm by having serious interactions with prescribed medications. And just because something is “natural,” “holistic,” or categorized as a supplement, does not mean that it’s helpful or desirable. Opium, for example, is a naturally derived substance we wouldn’t consider using as part of a healthy lifestyle. Also, because the industry is not carefully monitored, there are no guarantees when it comes to the quality or purity of ingredients – you can’t know, for sure, what you’re taking.
Marketing claims are not scientific facts. If there were a magic pill or miracle cure, we’d all be taking it. Be a smart consumer. Talk with your doctor to make an informed decision about what is best for you.
DEAR DR. MICHELLE,
I’ve heard that you can have Alzheimer’s disease without knowing it, or without having any symptoms. Is this true?
Preclinical Alzheimer’s disease is a term used to describe people who have biomarkers for Alzheimer’s disease without having any symptoms of memory loss or other changes. A biomarker is an observable medical finding characteristic of a particular diagnosis. Plaques and tangles are two typical biomarkers of Alzheimer’s disease. While we were once only able to confirm the presence of plaques and tangles based on autopsy, we now have ways to measure these biomarkers in life. Some measures include specialized brain scans, analysis of cerebrospinal fluid, and blood testing. These techniques are being used in research. Because of this research, we know that plaques and tangles begin forming decades before any symptoms of Alzheimer’s disease are noticed.
Some people who have Preclinical Alzheimer’s disease may not progress to developing symptoms. For others, identifying plaques and tangles early in the process may provide the best opportunity to stop the progression. For this reason, experimental medications thought to slow the progression of Alzheimer’s disease in people with symptoms are now being tested in people with Preclinical Alzheimer’s disease. The SKYLINE study by Roche and the TRAILBLAZER3 study by Eli Lilly are two such studies.
For those considered to be at high risk for developing Alzheimer’s disease or people interested in contributing to research, participation in a Preclinical Alzheimer’s disease study may provide helpful diagnostic information and potential access to a disease modifying drug. Identification of Preclinical Alzheimer’s disease is not considered part of mainstream clinical care and may pose ethical dilemmas. For some, having this information in the absence of a known cure could result in undue distress. For others, it could be a motivating factor to practice healthy brain aging and to be vigilant of new therapeutics and opportunities. For now, Preclinical Alzheimer’s disease is a research agenda that will, hopefully, lead to better diagnosis and treatment options in the future.
*Michelle Papka, Ph.D. is the Founder of The Cognitive and Research Center of New Jersey (The CRCNJ) in Springfield, NJ. The mission of The CRCNJ is to provide no-cost diagnostic, treatment and supportive resources through clinical research opportunities to people affected by Alzheimer’s disease and other cognitive disorders.
