How Gait Analysis Can Be Used to Diagnose Dementia Type

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Like autism among children, Alzheimer’s among seniors has reached epidemic proportions, currently affecting an estimated 5.8 million Americans.1 Alzheimer’s disease, which is the most common form of dementia, eventually leads to the inability to carry out even the most basic of bodily functions, including walking.

Now, researchers claim they’ve discovered that gait analysis can in fact be used as a quick way to identify the type of dementia an individual has.2,3,4 This tool can be quite useful for clinicians trying to reach a diagnosis to work out a treatment plan.

Gait Analysis Helps Diagnose Dementia Type

The research,5 published in the journal Alzheimer’s & Dementia, shows patients with Alzheimer’s disease and Lewy body dementia — two conditions that are difficult to differentiate in their early stages — have distinct gait patterns that relate to the subtle yet unique neurological differences between the two conditions.

As noted by lead researcher Ríona McArdle, a postdoctoral researcher at Newcastle University’s Faculty of Medical Sciences,6 “The way we walk can reflect changes in thinking and memory that highlight problems in our brain, such as dementia.”

Importantly, Lewy body dementia can be a sign of Parkinson’s disease, and the earlier a correct diagnosis is made, the sooner a patient can receive appropriate treatment.

By analyzing 16 different gait characteristics of 110 participants — 29 who did not have a neurological problem, 36 diagnosed with Alzheimer’s and 45 diagnosed with Lewy body dementia — they discovered those with Lewy body dementia vary the step length more than do people with Alzheimer’s, and have greater step time asymmetry.

The irregularity of their walking pattern puts patients with Lewy body dementia at increased risk for falls. While the gait of Alzheimer’s patients was more regular and symmetrical than those with Lewy body dementia, it was still more impaired in terms of pace and step variability than that of healthy controls. According to the authors:7

“Executive dysfunction explained 11% of variance for gait variability in LBD [Lewy body dementia], whereas global cognitive impairment explained 13.5% of variance in AD [Alzheimer’s disease]; therefore, gait impairments may reflect disease-specific cognitive profiles.”

As reported by Science Daily:8

“Scientists found that analyzing both step length variability and step time asymmetry could accurately identify 60% of all dementia subtypes — which has never been shown before …

It is a first significant step towards establishing gait as a clinical biomarker for various subtypes of the disease and could lead to improved treatment plans for patients … Further work will aim to identify how these characteristics enhance current diagnostic procedures, and assess their feasibility as a screening method … “

Gait Disorders Are Common in Dementia

This wasn’t the first time the idea that gait differences might serve as a diagnostic tool has been flouted. A study9 published in the journal Neuropsychiatric Diseases and Treatment in 2008 discussed the potential of gait analysis, stating:

“Gait disorders are more prevalent in dementia than in normal aging and are related to the severity of cognitive decline. Dementia-related gait changes (DRGC) mainly include decrease in walking speed provoked by a decrease in stride length and an increase in support phase.

More recently, dual-task related changes in gait were found in Alzheimer’s disease (AD) and non-Alzheimer dementia, even at an early stage. An increase in stride-to-stride variability while usual walking and dual-tasking has been shown to be more specific and sensitive than any change in mean value in subjects with dementia.

Those data show that DRGC are not only associated to motor disorders but also to problem with central processing of information and highlight that dysfunction of temporal and frontal lobe may in part explain gait impairment among demented subjects.

Gait assessment, and more particularly dual-task analysis, is therefore crucial in early diagnosis of dementia and/or related syndromes in the elderly. Moreover, dual-task disturbances could be a specific marker of falling at a pre-dementia stage.”

Other Telltale Signs of Dementia and Alzheimer’s

Aside from changes in gait, other early warning signs of Alzheimer’s disease include:10

Memory loss that disrupts daily life — One example includes repeatedly asking the same question

Finding it challenging to plan and problem solve

Having trouble completing familiar tasks such as navigating to a well-known location

Confusion with time and/or place — For example, forgetting how you got to where you are

Vision problems and difficulty judging spatial relationships or distance

Having trouble following conversations and/or struggling with vocabulary, such as not being able to name a known object

Misplacing items and being unable to retrace steps

Declining judgment — For example, exhibiting poor financial judgment or ignoring personal grooming

Withdrawing from social contact

Mood and personality changes — Examples include increased confusion, suspicion, depression, fearfulness and anxiety

Understanding the Cause of Alzheimer’s

While there is no conventional cure for Alzheimer’s, a number of lifestyle strategies show promise for preventing and slowing down its progression. Dr. Dale Bredesen, director of neurodegenerative disease research at the UCLA School of Medicine, discusses these alternatives in his book, “The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline.”

If you missed my interview with him, I highly recommend viewing it now (for the full interview, see the original article, linked above). Bredesen has identified more than four dozen variables that can have a significant influence on Alzheimer’s, but at the heart of it all is mitochondrial dysfunction.

This makes sense when you consider that your mitochondria are instrumental in producing the energy currency in your body, and without energy, nothing will work properly — especially your brain, being the most energy-demanding organ in your body.

Your mitochondria are also where a majority of harmful free radicals are generated, so when your lifestyle choices produce higher amounts of free radicals, dysfunctions in mitochondria are to be expected. Knowing this, it makes sense that in order for a prevention strategy or treatment to be effective, it needs to address the underlying mitochondrial dysfunction.

Beta-Amyloid Generation Is a Protective Mechanism

A hallmark of Alzheimer’s is the accumulation of beta-amyloid in your brain.11 Importantly, Bredesen’s work sheds light on why amyloid is created in the first place. Amyloid production is actually a protective response to different types of insults, each of which is related to a specific subtype of Alzheimer’s. As explained by Bredesen in our 2017 interview:

“If you’ve got inflammation, you are making amyloid because … it is a very effective endogenous antimicrobial. [I]n that case, it’s not really a disease … [It’s] a falling apart of the system. You’re making amyloid because you’re fighting microbes, because you’re … inflamed, because you are decreased in your trophic support (insulin resistance, and so on) or because [you’re toxic].

Guess what amyloid does beautifully? It binds toxins like metals, mercury and copper. It’s very clear you’re making [amyloid] to protect yourself. It’s all well and good if you want to remove it, but make sure to remove the inducer of it before you remove it. Otherwise, you’re putting yourself at risk.”

The program Bredesen developed is a comprehensive approach that addresses the many variables of Alzheimer’s at their roots. Interestingly, if you have the ApoE4 gene, which increases your risk for Alzheimer’s, you would be wise to implement intermittent fasting or do longer fasts every now and then.

In fact, this gene appears to be a strong clinical indication that you need to fast on a regular basis to avoid Alzheimer’s. The reason for this is because the ApoE4 gene helps your body survive famine. Unfortunately, it also promotes inflammation. Fasting appears to help cancel out this inflammatory proclivity.

Alzheimer’s Screening Tests

Bredesen also recommends a number of screening tests to help tailor a personalized treatment protocol. For example, if you have insulin resistance, you want to improve your insulin sensitivity. If you have inflammation, then you’ll work on removing the source of the proinflammatory effect. If your iron is elevated, you’ll want to donate blood to lower it, and so on.

Alzheimer’s Screening Tests

Test Recommended range

Ferritin

40 to 60 ng/mL

GGT

Less than 16 U/L for men and less than 9 U/L for women

25-hydroxy vitamin D

40 to 60 ng/mL

You can get the test here

High-sensitivity CRP

Less than 0.9 mg/L (the lower the better)

Fasting Insulin

Less than 4.5 mg/dL (the lower the better)

Omega-3 index and omega 6-to-3 ratio

Omega-3 index should be above 8% and your omega 6-to-3 ratio between 0.5 and 3.0

You can get the omega-3 index test here

TNF alpha

Less than 6.0

TSH

Less than 2.0 microunits/mL

Free T3

3.2-4.2 pg/mL

Reverse T3

Less than 20 ng/mL

Free T4

1.3-1.8 ng/mL

Serum copper and zinc ratio

0.8-1.2

Serum selenium

110-150 ng/mL

Glutathione

5.0-5.5 μm

Vitamin E (alpha tocopherol)

12-20 mcg/mL

Body mass index

18-25

ApoE4 (DNA test)

See how many alleles you have: 0, 1 or 2

Vitamin B12

500-1,500

Hemoglobin A1c

Less than 5.5 (the lower the better)

Homocysteine

4.4-10.8 mcmol/L

Preventive Lifestyle Strategies

It’s important to realize that dementia, including Alzheimer’s, is largely a preventable disease, predicated on lifestyle choices that enhance mitochondrial function.

In 2014, Bredesen published a paper that demonstrates the power of lifestyle choices for the prevention and treatment of Alzheimer’s. By leveraging 36 healthy lifestyle parameters, he was able to reverse Alzheimer’s in 9 of 10 patients.

This included the use of exercise, ketogenic diet, optimizing vitamin D and other hormones, increasing sleep, meditation, detoxification and eliminating gluten and processed food. You can download Bredesen’s full-text case paper online, which details the ReCODE program.12

Following are lifestyle-based suggestions — many of which are included in Bredesen’s treatment protocol — that can boost your mitochondrial health and lower your risk of dementia.

Dietary Strategies

As a base, avoid processed foods of all kinds as they contain a number of ingredients harmful to your brain, including refined sugar, processed fructose, grains (particularly gluten), vegetable oils, genetically engineered ingredients and pesticides like glyphosate.

Opting for organic produce and grass fed or pastured animal products will help you avoid synthetic pesticides and herbicides. Opting for grass fed meat may also lower your risk of Alzheimer’s by lowering your risk of eating prion-contaminated meat, which some research suggests can trigger the disease. More details can be found in “Study Claims Alzheimer’s Is a Double-Prion Disorder.”

Ideally, keep your added sugar level to a minimum and your total fructose below 25 grams per day, or as low as 15 grams per day if you already have insulin/leptin resistance or any related disorders. You can learn more about the importance of limiting sugar in “Link Between Sugar and Alzheimer’s Strengthens.”

Most will also benefit from a gluten-free diet, as gluten makes your gut more permeable, which allows proteins to get into your bloodstream where they sensitize your immune system and promote inflammation and autoimmunity, both of which play a role in the development of Alzheimer’s.

As you limit refined carbohydrates, replace the lost calories with healthy fats. Contrary to popular belief, the ideal fuel for your brain is not glucose, but ketones, which are produced when your body converts fat into energy.

Healthy fats to add to your diet include avocados, butter, organic pastured egg yolks, coconuts and coconut oil, grass fed meats and raw nuts such as pecans and macadamia.

Avoid all trans fats or hydrogenated fats that have been modified in such a way to extend their longevity on the grocery store shelf. This includes margarine, vegetable oils and various butter-like spreads.

By avoiding processed foods, you’re also improving your gut microbiome, which is an important piece of the puzzle. To improve it further, be sure to eat traditionally fermented and cultured foods, along with a high-quality probiotic if needed, and avoid antibiotics, antibacterial products and fluoridated water.

Certain nutrients have also been shown to be of particular importance. Among them: marine-based omega-3 fats, choline, phosphatidylserine, acetyl-L-carnitine, vitamin B12 and vitamin D. You can learn more about these in “Top 9 Nutrients for Better Brain Health.”

Research also suggests magnesium threonate has the power to rejuvenate aging brains. Sulforaphane is yet another nutrient (found in broccoli and other cruciferous veggies) shown to help prevent Alzheimer’s, in part by inhibiting the generation and accumulation of amyloid-beta, and in part by reducing oxidative stress and neuroinflammation.

Lastly, intermittent fasting is a powerful tool to jump-start your body into remembering how to burn fat and repair the insulin/leptin resistance that is a primary contributing factor for Alzheimer’s.

Avoid Risky Medicines

While mitochondrial dysfunction is typically caused by a longstanding pattern of poor diet and lifestyle choices, certain medications can also raise your risk of Alzheimer’s rather significantly.

Most flu vaccines contain neurotoxic mercury and aluminum, making them a risky choice for many, especially on an annual basis. Statins and anticholinergic drugs are also known to increase your risk for dementia.

Anticholinergic drugs block acetylcholine, a nervous system neurotransmitter. These drugs include certain nighttime pain relievers, antihistamines, sleep aids, certain antidepressants, medications to control incontinence and certain narcotic pain relievers.

Research13 shows using benzodiazepines such as Valium, Xanax and Ativan for anxiety or insomnia longer than three months raises your risk of dementia by 51%. This is most likely because these drugs actually worsen your sleep quality, which then contributes to Alzheimer’s. You can learn more about this in “Common OTC Drugs Can Cause Dementia.”

Statin drugs are also problematic because they suppress the synthesis of cholesterol, deplete your brain of coenzyme Q10, vitamin K2 and neurotransmitter precursors, and prevent adequate delivery of essential fatty acids and fat-soluble antioxidants to your brain by inhibiting the production of the indispensable carrier biomolecule known as low-density lipoprotein.

Sun and Daily Activity Do Your Brain Good

Research shows people living in northern latitudes have higher rates of death from dementia and Alzheimer’s than those living in sunnier areas, suggesting vitamin D and/or sun exposure are important factors.

Sufficient vitamin D is imperative for proper functioning of your immune system to combat inflammation associated with Alzheimer’s. If you are unable to get sufficient amounts of sun exposure, make sure to take daily supplemental vitamin D3 to reach and maintain a blood level between 60 and 80 nanograms per milliliter.

Sun exposure is also important for reasons unrelated to vitamin D. Your brain responds to the near-infrared light in sunlight in a process called photobiomodulation.

Research shows near-infrared stimulation of the brain boosts cognition and reduces symptoms of Alzheimer’s, including more advanced stages of the disease. Delivering near-infrared light to the compromised mitochondria synthesizes gene transcription factors that trigger cellular repair, and your brain is one of the most mitochondrial-dense organs in your body.

Exercise and daily nonexercise movement are other important puzzle pieces. It’s been suggested that exercise can trigger a change in the way the amyloid precursor protein is metabolized,14 thus, slowing down the onset and progression of Alzheimer’s.

Exercise also increases levels of the protein PGC-1 alpha. Research has shown that people with Alzheimer’s have less PGC-1 alpha in their brains and cells that contain more of the protein produce less of the toxic amyloid protein associated with Alzheimer’s.

Excess sitting is associated with an increased risk of many diseases, including Type 2 diabetes, cardiovascular disease and neurological diseases, so make it a point to stand up and walk as often as possible.

Stress, Sleep and Mental Stimulation

Another factor to address is stress. Researchers have found stress activates neural and endocrine pathways that have negative impacts on neurodegenerative diseases.15 One of my favorite stress-busting tools is EFT (Emotional Freedom Techniques).

Similarly, sleep deprivation can cause brain damage and may accelerate the onset of Alzheimer’s by impeding your brain’s ability to clear out toxins and waste,16 so make sure you’re getting consistently high quality sleep.

Mental stimulation is also important, especially learning something new, such as learning to play an instrument or to speak a new language. Researchers suspect that mental challenge helps to build up your brain,17 making it less susceptible to the lesions associated with Alzheimer’s disease.

Avoid Toxic Exposures

Lastly, you’ll want to avoid toxic exposures, and address any toxicities you may already have. Dental amalgam fillings are some of the major sources of heavy metal toxicity; however, you should be healthy before having them removed.

Once you have adjusted to following the diet described in my optimized nutrition plan, you can follow the mercury detox protocol and then find a biological dentist to have your amalgams removed.

Aluminum is another heavy metal that wreaks havoc on neural health. Common sources of aluminum include antiperspirants, nonstick cookware and vaccine adjuvants.

A lesser-known toxic influence is electromagnetic field (EMF) radiation from cellphones and other wireless technologies.18,19 The primary pathology behind EMF damage is caused by the reactive nitrogen species peroxynitrites,20 which damage your mitochondria.

Increased peroxynitrite generation has also been associated with autonomic hormonal dysfunction and increased levels of systemic inflammation by triggering cytokine storms.

Martin Pall, Ph.D., has published a review21 in the Journal of Neuroanatomy showing how microwave radiation from cellphones, Wi-Fi routers, computers and tablets (when not in airplane mode) is clearly associated with many neuropsychiatric disorders, including Alzheimer’s.

To reduce your risk, limit your exposure to wireless technology. Simple measures include turning your Wi-Fi off at night, not carrying your cellphone on your body and not keeping portable phones, cellphones and other electric devices in your bedroom.

I also strongly recommend turning off the electricity to your bedroom at the circuit breaker every night. This will radically lower electric and magnetic fields while you sleep. This will help you get better, more sound sleep, allowing your brain to detoxify and cleanse itself out each night.



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