Readers here may want to read How to avoid dementia DR. MALCOLM KENDRICK The paper Dr Kendrick is discussing is available online
HERE

It may also be worth pointing out B vitamins (along with some other vitamins) are made for us by our gut microbiota.

Bacteria as vitamin suppliers to their host: a gut microbiota perspective

Diet-Microbiota Interactions and Their Implications for Healthy Living

We should all be making more effort to restore our natural gut flora particularly after using antibiotics. We should also be aware that older people who may be on a restricted diet and may be vulnerable to repeat UTI infections may require and alternative source of B Vitamins if their gut microbia is subject to regular antibiotic exposures. There are plenty of B Vitamin complex supplements to choose from I use Thorne Research, B-Complex #12, 60 Veggie Caps If you use this code WAB666 you can get an introductory discount at IHERB.

I have posted a couple of comments to this article Coconut oil for Alzheimer’s – separating fact from fiction The first comment of mine stated.

Early decline in glucose transport and metabolism precedes shift to ketogenic system in female aging and Alzheimer's mouse brain It's reasonable to suppose the same happens in human brains. Therefore, it seems unnecessarily cruel to deny those whose brains have a reduced capacity for metabolising glucose, an alternative fuel source. Human milk is rich in medium chain triglyceriedes, so as we know developing brains naturally thrive on MCT rich foods. It's an established fact Ketogenic diets are safely used by children with epilepsy. It's therefore reasonable to suppose brains with damaged glucose regulation/metabolism may also improve when provided with fuel source they can use. It's simply common sense for people with the early signs of dementia or indeed diabetes in any disease where impaired glucose metabolism is a factor, to want to benefit from the potential neuroprotective potential of a ketogenic diet. Eventually there will be sufficient numbers of case history's available for the disconnect between the reality of what actually happens in practice, in real life situations, when compared to big pharma funded research to become obvious to all, except perhaps those with vested interests.

The editor then replied with the usual platitudes to which I replied

The fact there is currently little or no evidence regarding the neuroprotective potential of a ketogenic diet only reflects the current bias present medical research funded by big pharma and published in journals dependant on drug industry advertising for their revenue stream. See, Ben Goldacre's "Bad Pharma", Peter C Gøtzsche (Cochrane database director) "Deadly Medicines and Organised Crime: How big pharma has corrupted healthcare" or search for David Healy's blog or book "Pharmageddon" A relatively quick summary of methods used by big pharma to bias the evidence base is set out in this You Tube Lecture How we have been lied to by Big Pharma Given the role of Neuroinflammation and Brain Functional Disconnection in Alzheimer’s Disease we should perhaps remind readers human DNA evolved without access to grains or grain fed meats at a latitude where anti-inflammatory Vitamin D from Sunlight and anti-inflammatory melatonin (better circadian rhythm ~ no electric light) levels were higher. As the ability to naturally create Vitamin D and melatonin declines with age, it is simply common sense to ensure 25(OH)D levels are kept optimal (115nmol/l is the level of equilibrium of humans living as DNA evolved) and time-release melatonin is available. For someone with a damaged metabolism a balanced diet would have to avoid pro-inflammatory omega 6 vegetable oils and intensively produced omega 6 rich meats. Grassfed pastured meat have higher omega 3 and lower omega 6 levels. Farmed fish also may be grain fed and thus pro-inflammatory omega 6 high. The over-processed nature of the western diet results in low level chronic acidosis that leaches magnesium from our bodies. Restoring magnesium status also improves our ability to create and use vitamin D3 and adds to vitamin D3's anti-inflammatory potential, as does the omega 3 DHA which, like curcumin, is a nutritional vitamin d receptor ligand. Given the current rise in incidence of conditions related to dysfunctional glucose metabolism, (Diabetes, heart disease, cancer, and dementia) it is surely time to end the disastrous low fat diet experiment and recommend diets based on those foods available throughout the evolution of human DNA. An example of current research showing how quickly Western Diet damages the brain is here Short exposure to a diet rich in both fat and sugar or sugar alone impairs place, but not object recognition memory in rats. Cakes biscuits and sweetened beverages are driving appetite and inflammation and lard from industrially produce pork will add to the inflammation. Calorie consumption reduces on a paleo style low carbohydrate diet given availability of pasture raised omega 3 rich meats. Continuing to recommend pro-inflammatory refined carbohydrates, sugars, and omega 6 vegetable seed oils to those with damaged metabolisms is surely tantamount to medical negligence.

The Toxicity of Amyloid β Oligomers

Posting this link to a free full text paper as I may forget it.

There is a useful section on the way curcumin helps prevent aggregation.

I think you also need to be aware that  Alzheimer’s Disease Linked to Diabetes

New Biomarker in the Blood May Help Predict Alzheimer’s Disease

New Biomarker in the Blood May Help Predict Alzheimer’s Disease
This new research is interesting as we've known for some time that the earliest signs of Alzheimer's can be detected up to 25yrs prior to diagnosis and it can lay dormant for most of that time.

This new research, linking earlier onset to higher ceramide levels, gives us the chance to see if lowering ceramides may delay onset.

MAGNESIUM deficiency INCREASES ceramide production.
There are lots of online calculators enabling you to check your diet at least meets the RDA for magnesium for your age/sex.

Magnesium absorption from food/water is less in vitamin D deficient people.
CityAssays Vitamin D Blood Spot test £25 enables you to check if 1000iu/daily/D3 per 25lbs weight raises your vit d3 status to 125nmol/l ~ 50ng/ml the level at which Vitamin D is most effective as an effective anti-inflammatory agent.

Ceramides are potent proinflammatory agents so people with higher vitamin D, magnesium, omega 3 and melatonin levels will be better able to deal with them.

If indeed it turns out to be the case that higher inflammatory ceramides are the driving force for Alzheimer's oneset then maintaining an effective reserve of natural anti inflammatory agents is simply common sense.

Preventing Alzheimer’s Disease?

I was motivated to write this reply to this post on another blog Preventing Alzheimer’s Disease?
which was written in response to the post by Mercola.

Astaxanthin: A Rising Star in Alzheimer's Prevention

I'll deal with what I think are the most likely strategies to preventing or delaying the onset of demetia in the next blog probably in response to Susan Graig's next post.

Well I hope the next post is a little more constructive and helpful to people who come to this blog hoping to find some sensible evidence based suggestions that may enable them to delay the onset of Alzheimer's or other dementias.

Mercola has provided a link to his source of statistics and I while using the upper figures from the ranges provided isn't distorting them unduly. Bear in mind Mercola has had several previous run ins with the FDA and doesn't have many friends in consensus medical opinion so ALL his online statements HAVE to be checked by his legal team before he can write anything. Only AFTER they have been double checked to see if they would stand up to legal scrutiny is he permitted to post. 

I think the one in four people being affected by Alzheimer's includes the relatives carer's and other close family. I'm sure everyone with an Alzheimer's relative is affected by that and the stress it imposes on the family and friends. 

I think your claim that we are living longer healthier lives is mistaken. Sure we may at the moment be living longer but surely not healthier lives. I don't know how many people you know aged 70 but try asking how many medications they are taking and what side effects they are experiencing? Sure I know a lot of blokes my age with Prostate cancer and while they certainly are still alive it's not the same quality of life that they experienced before treatment. Try asking how many are on statins and what the side effects of those are and any reasonable person would question if the trade off between the claimed risk reduction and the actual side effects they are experiencing is actually worth it is certainly debatable. Early detection of many conditions now doesn't necessarily lead to any reduction in all cause mortality but certainly leads to increased medical costs, treatments and other  iatrogenic consequences.  

While it is true that 10% of Alzheimer's is attributed to genetic predisposition I think it would have been better if you had pointed out this is mainly through the maternal DNA so people whose fathers but not mothers had AD can ignore that potential risk factor. While it may be different in the USA, in the UK I'm not sure that most people appreciate that the genetic predisposition for AD is generally through the maternal side. While genes certainly load the gun it's still environmental/dietary factors that pull the trigger, so even if your mother did get AD and you have had your DNA checked and found you  carried the risk that still does not mean there is absolutely nothing you could try to prevent or delay onset of AD. 

You will have to apply a bit of common sense and have an element of luck but I think it's simply untrue to state that 90% of Alzheimer’s cases are sporadic, meaning the disease occurs for no apparent reason. 

We know what the basic risk factors for AD are and we know roughly (though I accept not all the dots are as yet connected) how this impacts on disease initiation therefore I contend that most of the suggestions Mercola makes are sufficiently evidence based to be worthy of investing some time examining the evidence he uses and which are also supported by papers listed at Pubmed. 

We have to take Alzheimer's incidence very seriously in the light of the explosion in obesity and diabetes. These conditions predispose people to increased risk of dementia so it shouldn't be hard to work out that AD incidence will inevitably also increase.

Therefore to do everything possible to reduce hyperglycaemia and conditions that result from raised levels of inflammation is simply common sense.  

There was a recent report of a 68 yr old woman on being given an Alzheimer's diagnosis immediately walking in front of a train, irrespective of whether this was a direct result of knowing the diagnosis or just a consequence of the condition (obviously we'll never know)  we should not give people the impression an Alzheimer's diagnosis is a fate worse than death and that pharmaceutical drugs are the only or even the best way of managing this dreadful condition. We ought be talking about The Myth of Alzheimer's, What You Aren't Being Told About Today's Most Dreaded Diagnosis  Aging with Dignity; Aging with Hope

Resolving controversies on the path to Alzheimer’s therapeutics

Resolving controversies on the path to Alzheimer’s therapeutics
The full text of this article is available at the link.
It's interesting to see how the research has progressed and where it may be going.

I found the time line of Alzheimer's research interesting as well as chart showing the Hypothetical time course of AD with the stages at which interventions Clinical trials are applicable. Confirms my opinion we need to act before symptoms of any kind are apparent and the distinction between normal ageing and Alzheimer's is not as clear cut as some would like to portray.

Mitochondria, Amyloid β, and Alzheimer's Disease

Mitochondria, Amyloid β, and Alzheimer's Disease
Nice free full text online paper that fits in with much of what I've been thinking about.

for those who are interested in learning how to ensure an ongoing supply of new healthy mitochondria this paper has some practical suggestions.
Mitochondrial Energetics and Therapeutics

Melatonin in Mitochondrial Dysfunction and Related Disorders

I should perhaps give a warning that these are quite heavy going papers so don't expect to understand every word initially.