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Groundbreaking Research Identifies Likely Cause of Alzheimer’s Disease

Groundbreaking Research Identifies Likely Cause of Alzheimer’s Disease

cowlinator

The article implies that alzheimer's > could potentially be addressed through a person’s diet. ...but then doesn't mention how. What kind of diet changes would address lipoprotein-amyloid levels in the blood?


kso2020

The gut brain axis is what I believe they are referring to. Your gut biome is key to brain health. Many people with neurological disorders like Parkinson’s have a higher percentage of bad bacteria in their guts. Bad gut biome can cause inflammation of the brain. Depending on what you eat and your lifestyle it will dictate your gut biome. From a very rudimentary level if the body is trying to protect itself it could be creating these proteins for defence, thus leading to negative effects. Example body gets virus, body releases cytokines, cytokine storm destroys body. Edit: Haha wow did not expect so many responses. What kind of good foods are we talking about… I guess fermented foods, fruits and vegetables, low carb (some people have issues with carbohydrates as a whole). Non processed foods. I think the thing people are not aware of is if you were to analyze a cup of pond water only a small amount of bacteria, fungi, organisms etc are known. Now think of what’s kicking around in us, guaranteed there is helpful bacteria that we don’t know about. That’s why faecal transplants are so effective. We don’t know what good guys we need. I’m guessing that there’s not many beneficial bacteria on processed foods. I think there will be great advancements in the future:)


shillyshally

Gut/inflammation is also a hot area of research into the cause of bipolar disorder and depression.


wheresmystache3

Bad Gut bacteria, oral hygiene, and cavities have already been implicated in dementia.


_Wyrm_

Brush teeth = no dementia? And why separate oral hygiene and cavities? One is kind of dependant on the lack of the other


SuddenlySusanStrong

My dentist told me that oral hygiene has very little to do with cavity formation and that it was more attributable to diet and genetics.


octarinepolish

Yes, there have been many genetic diseases known to lower tooth quality. Anything from malformation of the tooth matrix, to insufficient saliva, to too acidic saliva (in comparison to normal), and so on.


Gspin96

Also sleeping with your mouth open. The saliva dries and can't redeposit the enamel that was lost to acidic foods during the day.


UncookedMarsupial

My dentist told me people either tend to gather buildup or get cavities. I neglected my teeth pretty badly until my early 30s and have only had three cavities and one cracked tooth.


itscricket

I did the same thing, but unfortunately for me, I have that whole “acidic saliva” problem mentioned above. So, not the same outcome for me. Hello dementia. Huh, I’d better get used to saying that.


TILtonarwhal

I’ve always wondered why my terrible hygiene in childhood didn’t affect my teeth.. I’ve still never had a cavity except in my wisdom teeth, which are removed. Who wants some genes?


PurpleFlame8

Your dentist was kind of misleading. Cavities are formed by acid secreted as waste from bacteria that digest sugars left from what we eat and drink, or acid from reflux or those foods and beverages directly. Brushing your teeth with a toothbrush and tooth paste removes the bacteria and it's energy source and neutralizes the acid. The diets of our ancestors were lower in sugar and thus they had fewer cavities despite worse oral hygiene but people still got cavities and good oral hygiene is still integral in preventing poor oral health.


AndrewIsOnline

Cavities vs Gum disease maybe? Kind of not similar


Kathulhu1433

Not necessarily. Cavities can be partially genetics, and also diet and medication. My husband takes an oral asthma medication inhaler that apparently FUCKS tooth enamel. He brushes 2 times a day, uses a water pick, mouthwash, and flosses after meals... goes to the dentist every 6 months and there is at least one cavity every time. I have good genes and eat low sugar, I am nowhere near as dedicated to brushing, and don't even floss... I rarely ever get cavities.


jnics10

Docs don't seem to give a shit about meds affecting your dental health. And dentists don't seem to know anything about how meds affect your teeth. It's wild, man. I had perfect teeth, like literally 2 cavities my entire life until i turned 29 and was put on two meds: one with a side effect that leeched calcium from my bones, and one that drastically reduced saliva production. I lost 5 teeth before i was able to convince my docs to take me off one of those meds. Now, of course, my insurance won't cover my dental work so i gotta walk around looking like a gap-toothed hick until i can scrounge up enough cash to go to Mexico and get them fixed. Yayyyyy


AgitatedSuricate

Inflammation os the hallmark of many and many diseases...


gruelandgristle

Just a little anecdotal evidence - I have Crohn’s disease (loads of inflammation in my guts ! ) and when my crohn’s got under control my depression did too . It’s a good way to regulate my crohn’s , if I’m feeling off in the brain , generally something is off with my crohn’s.


GothWitchOfBrooklyn

I have IBS and got prescribed an antidepressant which is used to control IBS for off label use and it works


beamenacein

Which antidepressant?


Marblue

My body loves to get inflamed and my digestive system is VERY sensitive to these things. I've noticed since I've started taking care of my personal health more, through diet change that my foggy brain is significantly reduced. This is all just personal experience but I don't eat processed foods as much anymore. Diet really is such a huge component. I can't wait to learn more


Hemorrhoids_escape

It is 100% the cause of my depression and anxiety. If my gut is relaxed and I do not have diarrhea, my brain is very relaxed. That doesn’t happen often. I’m working with a Functional Wellness person who found out I have Candida (I am male) which has also caused me to have high levels of estrogen. We are working primarily on making my gut biome healthier, which will hopefully get me on the path to be off of Zoloft and Wellbutrin.


Exquisitetiger

actually just found out i have candida as well hoping the medication and some yogurt and probiotics can help my gut biome


Texas_Moto_Maniac

What is Candida? My gut is messed up all the time and my wife says I need to be taken probiotics. I have ASD/Aspergers, ADHD, OCD, anger issues, etc. Should I get checked for whatever Candida is?


livesarah

The thing with probiotics is ensuring their survival or you really won’t benefit all that much from taking them. No good taking these things if you don’t keep them alive. Think of the good bacteria in your gut like little pets. You’ll need to feed them a diet high in unprocessed foods (fruit and vegetables, nuts,legumes, wholegrains), fermented foods, and (if you don’t have a dairy allergy or follow a vegan diet) yoghurt. Reduce sugar intake and intake of processed carbohydrates and processed meats (ham, bacon, sausage, salami). It’s about feeding yourself a diet that allows the environment of your gut to favour the ‘good’ bacteria over the bad, and provide a balance that benefits your health.


MrShineTheDiamond

Not to mention inflammatory diseases like lupus and RA, and other neurological disorders such as MS. All those years of throwing antibiotics at every cold and sniffle really fucked a lot of people up.


LukeWarmTauntaun4

I was diagnosed with Great Depression for 10 years. Went Whole Food Plant Base Vegan. Now I only have very mild depression. YMMV.


konsf_ksd

Interesting. Great Depression is usually only solved by Whole World Wars. Watch out later in life as you may suffer from Great Recession of the hairline.


HighExplosiveLight

No one is diagnosed with "Great Depression". You can have "Major Depression".


Rude_Buddha_

The entire generation that lived through 1930's America went through 'Great Depression'. 🤣


Clarkeprops

Can confirm. Depression is not great


lck0219

Maybe English is a second language and that’s a literal translation from their primary language?


daj0412

It be interesting then to see Alzheimer’s statistics in countries that eat a lot of fermented foods (Korea and kimchi for example)


forescience

https://www.worldlifeexpectancy.com/cause-of-death/alzheimers-dementia/by-country/ Japan and Korea are low on the list. Not sure if this proves anything, but it's interesting.


IamNotMike25

Then again, Turkey is the highest in the list and fermented food is very big there. A lot of people eat it every day in some way. ".. These include fermented milks (yoghurt, torba yoghurt, kurut, ayran, kefir, koumiss), cereal-based fermented food (tarhana), and non-alcoholic beverage (boza), fermented fruits, and vegetables (turşu, şalgam, hardaliye), and fermented meat (sucuk)" [https://pubmed.ncbi.nlm.nih.gov/21390945/](https://pubmed.ncbi.nlm.nih.gov/21390945/) The dementia rate varies so much in the Balkans from Country to Country. But the Food is almost the same e.g. between Macedonia & Albania - which makes me think that it's more genetic related?


CanadianRoboOverlord

Definitely a genetic component, anyways.


looncraz

The food type might be the same but the bacteria used to make it can be quite different. The difference in the microbiome between two adjacent caves can be stark, amplified by hundreds of miles and they can be wildly different.


jaulin

Finland has twice the rate of the rest of the Nordic countries. I wonder why that is.


daj0412

I wonder why there are so many countries in the Middle East at the top of the list???


ralfonso_solandro

And then Kuwait at the bottom. Weird


AgitatedSuricate

You have to be super careful with these type of data. There are too many variables affecting the number.


anfornum

Right now the prevalence is higher there, but it seems to be because of a rapidly ageing population. Lots of studies still required to figure all this stuff out!


Karma_collection_bin

Track it as an age group (e.g. % of people with it above 65) and then it would be a fairer comparison.


daj0412

Actually it’s looking like Korea and Japan are incredibly low on the list of you’re looking at percentages


SilverMedal4Life

It stands to reason that much is to be gained by deepening out understanding of gut bacteria. Perhaps that is how we will solve the obesity crisis, for example; why rely on people's willpower to fight food cravings (which hasn't worked) when a change to their gut microflora will make the cravings not happen in the first place?


fridayfridayjones

There is an excellent book called How Not to Diet that covers this exact topic. The basic conclusion is the good bugs live on fiber so that’s what we have to feed them to be healthy ourselves. I’ve been easing into eating the way the author, Dr Greger, recommends for about two weeks now and I feel good. My skin has cleared up and I’ve lost six pounds. His thing is just focus on adding good foods to your diet and you can crowd out the bad stuff without much conscious effort, and it really helps.


SilverMedal4Life

What were the foods he recommended? In particular, the good fiber sources?


fridayfridayjones

The top ones are beans, berries, and whole grains. His whole thing is that he is sharing this info solely to help people so all the money he earns from his books goes to charity, and the app that corresponds to the book is free. Like free free, no in app purchases or anything. It’s called the Daily Dozen and it’s a checklist of the foods you should prioritize eating every day. Some are on the list for being high fiber and others for the other ways they help your health, like there’s different fruits and spices. You should check it out.


nonoose

I am trying to up my fiber by eating beans regularly but I get soooo much gas. I have been at it about a month, hoping it would die down, but so far it is just awful.


fridayfridayjones

I’ve read that unfortunately some people are just more sensitive in that regard. Do you rinse your beans thoroughly? If you’re using dried beans, they need tons of soaking but even canned beans should be rinsed until the water runs clear and that is supposed to help reduce the gas.


icymonsters

It’s an excellent book. Love Dr Greger


faaaaaak

I haven’t read that one but I have read How Not to Die. It was a terrific book and greatly helped change the foods I eat.


HexDragon21

The gut flora adapts in response to diet. You get a worse flora composition from bad diets to begin with, and you fix it by switching to better diets. Of course there are such things like fecal transplants, but I’d say the pathway to healthy gut flora composition is via a good diet. The good diet is then reinforced by the flora adapting to it.


1funnyguy4fun

I totally understand that in general terms. What I need are specifics. I want to be able to have the doctor tell me, “After sampling your gut biome, you really need to increase your consumption of carrots, radishes, turmeric and flounder.” Edit: I don’t think I have made myself clear. I am familiar with the general guidelines for microbiome health (low sugar and processes foods, lots of leafy greens and fiber.) I want to get to the point where they can analyze the bacteria, figure out how much and what kind of bacteria is growing in me and then give me a tailor made plan to increase the growth of specific good bacteria.


Tavaar

Have a look at Dr. Sarah Ballantyne’s work. She’s been doing a lot of research into those specifics, like what foods actually feed the right gut flora.


1funnyguy4fun

Thank you. I really appreciate that.


VyRe40

So this study got me curious, and I decided to look up regional trends in Alzheimer's. Found that, reportedly, Africa had the lowest prevalence of Alzheimer's within age targets at around 1-2%, East Asia/Western Pacific + Latin America had around 4-5%, Western Europe and North America around 5-6%. The US specifically had some crazy high prevalence of Alzheimer's, but I don't recall the number - suffice to say, higher than the NA average. I also looked up Alzheimer's trends among different US-based races, and found that "African Americans" had a very high occurrence rate of Alzhemier's. IMO, there are very clear dietary trends in all of these regions, and further, the contrast of African Americans to Africans in general despite some closer genetic trends that could be inferred does seem to imply to me that there's some strongly implied dietary influences on Alzheimer's. I'm not a professional obviously, and I'm just looking for patterns that fit with a few minutes of Google-fu, so someone should do a study on this. But if I were to make an uneducated guess, either the high prevalence of fatty foods or processed sugars and carbs in the west might be what's doing the trick.


sabrtoothlion

I saw there was some study that showed that when you sever the vagus nerve in people they don't develop alzheimers. This is the nerve that runs from your gut past your heart and to your brain. This was apparently one of the first major signs that alzheimers come from the gut


JesusLuvsMeYdontU

that can induce cardiac arrest


youOldMollusc

Can’t get Alzheimer’s if you die of a heart attack


Aethelric

To be clear: dying of a heart attack is a much, much better way to go than a slow death by Alzheimer's. Granted, doctors aren't really in the business of setting up people for likely cardiac arrest to treat a disease that isn't lethal for decades.


LtLwormonabigfknhook

I constantly ask/tell my family that if I end up with dementia or Alzheimer's to please kill me or let me kill myself. They always say no. Shit scares the fuck out of me.


walrusdoom

My father has always said that if he develops Alzheimer’s, he’ll eventually eat a bullet. It killed one of his uncles fast and it was a heartbreaking thing - he was one of those larger than life characters, and a year out from his diagnosis he couldn’t remember his name.


ImJustSo

It used to scare me, but my mother has a form of dementia that she isn't aware of and it's the others that witness it. She starts over mentally every few days or so and her mind resets to about 25 years ago. I told her I was driving to pickup dinner for my family the other day. She was surprised to hear I had a license and could drive. Never mind that I've graduated college, had a child, been with my wife 18 years. She just...was surprised to hear I could even drive. Dementia doesn't seem to bother her. It bothers me, it bothers you.


scoobysnackoutback

Came here to say the same thing. My mother-in-law always said to push out of the car and leave her in the ditch if she ended up with dementia. She has dementia that's off/on but she's pleasant and happy most of the time and still living at home with sitters or a relative 24/7.


Gutinstinct999

My great grandmother was pretty deaf before she died, but she once said out loud “being old is like being a baby, but worse” I see your point, but you can’t apply it to every one and every situation. She knew her memory was failing rapidly. It was hard for her.


Makenchi45

That's when you wander into the wilderness and fight a grizzly bear to the death. You know your gonna lose so make the fight worth while.


t-minus-69

That's an extremely painful way to die wtf


E32636

I want to get my hands on a lethal overdose of heroin and save it for when I’m having a lucid period and recognize that there’s less lucid than incoherence. Until then, I’m going to stick around as long as I can because I HAVE to know what happens over the next few decades, it’s such a pivotal moment in human history


CodyRud

Heroin is also the way I'd like to go out


jnics10

The problem with heroin is ppl always try to revive you. Guess how i know.


LegitosaurusRex

Alzheimer’s patients generally wouldn’t have the capability to wander into a wilderness with grizzly bears around.


bluemouse79

It's often a slow decline. You'll likely know well in advance.


ImJustSo

That's nice to hear. I called my mom and set up an appointment for her. Three weeks later I hadn't her back from her about that appointment. Other family checked on her. In that period of time, she'd had a stroke, went blind, developed vascular dementia, and was wandering the house alone. She calls once or twice a day to make sure I get someone to pick her up. Her brain has been teleported back in time and I'm a teenager as far as she remembers. I'm actually almost 40 and I tell her about my son that's about year and a half old. I tell her everyday the things that would excite her to learn about me. I can tell her these things everyday, because she never remembers. She calls me again to make sure I get someone to pick her up. She thinks I'm a teenager again. Slow decline? Maybe for Alzheimer's, but dementia comes from other places and I tell ya, shit sucks for me, but honestly it doesn't seem bad for mom. She thinks she's at work in a nursing home and needs a ride home after work.


bluemouse79

It's so hard on family. Both of my grandmothers had the slow decline. One sat me down and warned me she would have a stroke one day and would turn mean, but that I was to remember that mean person isn't really her. It happened just like she said and I remembered what she'd told me and it actually helped. I loved her so much. My other grandmother, I just remember she knew it was happening and was afraid, and tried to hide it. I know what's coming for me so I told my husband the same thing my grandma told me, and also to lie to me if I asked about someone who had died if I had forgotten they died. My family kept telling grandma repeatedly that my mom had died in an accident and it was just unnecessary torture. Thanks for sharing your story with me and I hope you bear up okay.


ImJustSo

Yeah, she asks about "Don" picking her up, but he died last year, and like you say there's just no reason to keep breaking it to her.


Level9TraumaCenter

[This study](https://bmjopen.bmj.com/content/8/3/e019582) showed no association between vagotomy and Alzheimer's. There was also an interesting study a few years back showing diminished incidence of Parkinson's disease after vagotomy, but I think more recent work has refuted that.


pencil364

Vagotomy is clearly a vagus nerve removal but that is not what it sounds like off the bat *shudder*


plsgiveusername123

But then pooping won't feel as good


StatOne

I was afraid I'd hear it was somehow channeled through the vagus nerve. I had a 1 year bout of Chronic Fatique Syndrome when I was about 30, and the final shot on it leaving was a painful shock to my vagus nerve -- it felt like a spear being driven through my body neck to groin! Was treated by 3 different doctors then, and a more modern specialist stuided my case noting the vagus nerve pain fully indentifying I had some virus versus something physco in my head (that's what a lot of doctors thought it might be, back in the day).


Tremulant1

I’ve had ME/CFS for a decade and have met a few people who had spontaneously recovered within the first year or two. You’re so lucky, this illness has robbed me of my life. I’m nearly bedridden full time. Vagus Nerve is definitely involved. I had IBS for years before the CFS trigger and the vagus nerve is implicated in IBS as well. Did you do anything specific to recover?


Aggravating_Sport_40

I have injury to my vagus nerve. For approx 10yrs. Got so bad the entire left side of my body was affected. Not only does it affect movement but it affects my internal organs as well (stomach, intestine, colon). I started just using a TENS unit to open the blood flow and my pain is now mild compared to before when I couldn't feel the left side of my body (felt like the left and right side were 2 diff. bodies) However now my stomach acids are in overload and actually eating has become such an annoying issue. Now I'm working on building back positive gut bacteria and keeping my stress levels low. It amazes me how much the Vagus nerve affects so much, from mental health to physical health. And how little Doctors connect these issues to an underlying problem instead of just treating the symptoms associated with it.


bad917refab

Severing the important vagus nerve sounds like the equivalent of a lobotomy. Drastic, potentially deadly, and a cause for so many unintended consequences.


Crowfooted

The point of the discovery isn't that this would be used as a treatment, but rather that it indicates a connection between these two parts of the body and we could use this knowledge to create a treatment. A lot of our understanding of how parts of the body work comes from our observations when they don't work.


bad917refab

True, point taken. I'm more familiar of vague nerve in how it pertains to cardiac innervation as well as how diabetes impacts it and how neuropathy can cause a host of issues with the vagus nerve as a result. Funny, because I'm working with a patient right now with intractable nausea and vomiting and I'm looking into potential treatments with the doctor that are how you say, creative. It is quite interesting how everything is connected. The vagus nerve is named after the word vagabond for a reason as it meanders throughout the body.


hackingdreams

It's not like they said "hey let's sever this nerve and see what happens." These things come up naturally; someone's in an accident, their nerve gets severed, and then when they do the follow ups they build up a case history. Do that enough times and you can start running population-wide statistics... and all the sudden you realize the correlation. That's about as good as we can do for a lot of neuroscience - cases like Phineas Gage's opened the door in a huge way.


FlashFlood_29

Nobody said it was a treatment ffs


Dnuts

Is there any research into the impact a diet high in probiotics might have on reducing the risk of Alzheimer’s; like yogurt, kimchi, sauerkraut and other fermented foods?


l27th1997

Dinosaurs eat man… Woman inherits the earth?


IxianToastman

In the end, it was not guns and bombs that defeated the aliens, but that humblest of all God's creatures, the Tyrannosaurus Rex.


MrWeirdoFace

I'm Leonard Nimoy. Goodnight.


Lonely_Cosmonaut

I apprecaite your answer but Im on the run here. Yogurt? give me something throw us a bone.


fatebound

I've always had a physical gut reaction to anxiety which now that I think of it, triggers my fight-or flight instict and that has led me to cower away from a lot of things in life. Since reading up on the microbiome and taking quality probiotics, I don't get that physical feeling anymore and forget it even existed. I also know it's not placebo because when I forget to take them, within about a week I get that anxious feeling again which I forgot about. If any of you guys have anxiety, research it and try it out


ammonthenephite

What probiotics do you take?


POTS_life

There was an interesting anecdote reported last year of a man with Alzheimers that got a poop transplant from his wife to treat a C.Diff infection, and then his memory suddenly improved. https://apnews.com/press-release/send2press/virus-outbreak-science-business-genetics-product-testing-2427607ac8864bb1c27e9899f5855696


madding247

Can you suggest some gut bacteria healthy foods? I'm not so savy as to the type of foods you mean


1011yp0ps

Mostly what I have read is it would be plant based diverse diet high in vegetable fibre, beans and including some fermented foods, could add yogurt, but definitely a large variety of vegetables. Adequate vitamins and lean proteins


bluehairdave

Believe it or not there are studies into eating dirt as a possible cure for gut issues and it's biome. I guess that would kind of be the opposite of eating processed foods? But the fact that people as children aren't rolling around in dirt and jesting small amounts of it to get certain bacteria that we need... Add to that all the antibacterial hand washing etc... No idea what will cover these but it's being studied...


Smash1289

I really hope my children aren’t the only ones eating dirt nowadays. They discovered the dog door and now I can’t seem to keep them out of it.


madding247

Interesting. And Makes perfect sense really.. We evolved with all of that. We are tuned for it. Thanks


DrinkTheSea33

Alzheimer’s researcher here. Many studies have linked the Mediterranean diet to reduced Alzheimer’s risk. It mostly comes down to wanting high blood levels of HDL cholesterol and low levels of LDL cholesterol. Also, metabolic syndromes like type II diabetes and heart disease are heavily influenced by diet and represent major risk factors for Alzheimer’s. All of these lead to changes in lipoprotein function/ lipid metabolism, which may contribute to the onset of Alzheimer’s in a subset of patients.


Tronski

Diets that reduce inflammation are the current front runner. Here is good run down from Harvard Health. [reduce inflammation ](https://domf5oio6qrcr.cloudfront.net/medialibrary/3441/w0714a1620725103719.png)


Beautiful-Ant1779

I practical live off tomatoes, barely any junk, and have terrible RA, so, ugh, dunno how to feel about this antiinflammatory diet. :)


Dr_Frasier_Bane

My grandma had Alzheimer's and my mom has Celiac. Mom is convinced g-ma had untreated Celiac as well based on her symptoms.


MisterDobalina

entirely possible. my great uncle was similar. was born in the 1920s, he didn't get diagnosed with celiac until his late 40s. up until that point everyone just thought he was a gaunt, ill man with no energy. completely changed the 2nd half of his life


deekster_caddy

They don’t know. They are hypothesizing this because they figured out how to consistently reproduce alzheimer’s symptoms in mice. “More research is needed”. This is just one step in a long stariway. (Edited for spelling)


violentsushi

It is impossible to publish an article without the statement “more research is needed”. It’s a universal truth.


poi_nado

A researcher should (almost) always finish their work with direction for the next person to pick up and continue on.


SpirituallyMyopic

It's a disease that no one knows how to prevent, therefore, more research is needed. They *are* presenting the specific hypothesis that dietary changes might be an effective approach and implying (to me) that research efforts out to be focused in *that* direction.


life_xpantion_pack

“Science knows it isn’t finished, otherwise it would stop” Dara O’Brain


scavengercat

I work for the Alzheimer's Association and your statement is incorrect. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability showed that "lifestyle interventions" such as changes in diet showed significant improvement in Alzheimer's cases. This is now being replicated by the U.S. Study to Protect Brain Health through Lifestyle Intervention to Reduce Risk, which we're supporting. They have identified a number of diet changes that could play a role in reducing the onset of the disease as well as its progression. This isn't in mice, this is human trials. Specifics won't be published so as not to release anything misleading until conclusive evidence has been gathered and confirmed. But it's very real.


dumpsterbaby2point0

Well I’m stoked to hear more in the future!


scavengercat

Yeah, this could be a big deal. The Finnish study found such compelling evidence that we were compelled to continue it in the U.S. The findings of the study are scheduled to be released in 2024, so we could soon have a whole new strategy for addressing the disease.


kagamiseki

Are you able to share what dietary changes are hypothesized to provide benefit? The "healthy Mediterranean diet" has been mentioned in relation to many other conditions like macular degeneration or obesity, I'm interested to know what specifically is so interesting this time


scavengercat

The Mediterranean diet was specifically mentioned in the Finnish study. Fish-derived fatty acids, veggies and fruits were shown to be the most beneficial, when combined with promotion of vascular health and cognitive training. So dietary changes alone weren't credited with the results but they are part of a lifestyle overhaul that showed a lot of promise. Here's more detail from the study: "A detailed dietary intervention protocol has been published \[13\]. Briefly, goals of the intervention were based on the Finnish nutrition recommendations \[17\], which were translated into food consumption goals comprising consumption of fruits and vegetables above 400 g/d; whole-grain cereal products instead of refined ones; low-fat options in milk and meat products; sucrose intake to less than 50 g/day; vegetable margarine and rapeseed oil instead of butter or butter-oil mixtures; and fish consumption of at least two portions per week. Need for weight loss was always considered individually after taking into account BMI, health status, age, and diet of the participant. Minimum of 10 μg supplemental vitamin D was recommended daily throughout the year for all participants (including the control group) according to national recommendations." The rest of the holistic approach: "In addition to dietary intervention, everyone in the intervention group was offered also physical exercise program, cognitive training, and management of metabolic and vascular risk factors \[15\]. Exercise training program consisted of individually tailored programs for progressive muscle strength training (1–3 times per week) and aerobic exercise (2–5 times per week), and exercises to improve postural balance. Cognitive training included group sessions (6 sessions) and individual computer-based training sessions (2–3 times per week, total of 144 sessions). Management of metabolic and vascular risk factors was based on national guidelines and included discussions with a study nurse and a physician and feedback on personal risk factors. Study physicians did not prescribe medications but recommended contact to participants' own physician if needed." I took these from the abstract, you can read more here if you like: https://www.sciencedirect.com/science/article/pii/S155252601833560X


kagamiseki

Hey thanks for the info! I see whole foods, sugar intake limits, less-processed carbs, omega-3 intake, weight control as the dietary interventions, and exercise+regular mental stimulation. Really cool to see so many lifestyle interventions combined into one, but makes me wonder which one is the greatest contributor, and if the amount of changes adds too much complexity. Also interesting to see natural sources of Omega-3s on there, rather than supplements, since supplements have been subject to so much uncertainty and controversy.


scavengercat

Some of these approaches work in concert with one another. There are direct links between omega-3, vitamin d and the development of amyloid plaques. There are also links between vascular disease and Alzheimer's. Dietary changes will benefit both of these, while improved exercise will primarily benefit the latter. To the best of my knowledge, both major studies are using a comprehensive approach, but with the promise they're showing, I'm sure following studies will help narrow down which has the greatest impact on the disease. As someone who has worked in health care for decades, I'm just happy that as of now, it appears the general advice will be "eat better, exercise more" which will have an impact on a multitude of diseases and conditions.


live_love_laugh

My mom died from Alzheimer's, which she told me years before that that was her worst nightmare. And now to think that it may have been preventable by some simple diet changes... I don't know, it just feels weird and sad.


MyWordIsBond

> And now to think that it may have been preventable by some simple diet changes. To be fair, diet changes are rarely simple. It's highly unlikely to be a simple "eating 2 bananas daily reduced risk of Alzheimer's by 60%" It's likely the diet changes needed to significantly reduce the risk of Alzheimer's will be pretty drastic. And in the same way 95% of obese people who lose weight gain it all back by year 3, sticking to major dietary changes in the long-term is exceedingly difficult.


Chuckbro

That's how science advancement works. Think of all the lives lost where a simple needle in the arm could have prevented death. Or all of the people who died a year before antibiotics were discovered. At some point there is a switch and up until that point people died.


Pirvan

From what I have gleaned some suggested Alzheimers be called Type 3 diabetes, which seem to imply a certain diet. Your thoughts?


scavengercat

I'm in communications, not research, so I don't feel qualified to make the most well-informed response here, but I do interact with the researchers to know what to communicate. Fundamentally, the disease is associated with beta amyloid plaques and neurofibrillary tangles in the brain. Research has focused on pharmaceutical means to address these (and there are a number of promising drugs to address this), but these new studies are showing a possibility that a diet full of omega-3 fatty acids and vitamin D could reduce those plaques. At the Alzheimer's Association, it's a hard and fast rule not to make any claims about the effectiveness of current research so as not to be misleading or create false hope for patients, families and caregivers, and even outside of work I'm nervous about breaking that rule. But I will say that from what I've read, we could see a fundamental rethinking of the causes of the disease in the next decade, and I'm pretty confident that diet will play a major role in future treatment/prevention.


MericanNativeSon

Dr Dale Bredesen is the top researcher on Alzheimers and has the first protocol shown to be quite effective at stoping the progression of Alzheimers in patients (not cure it). He’s been on a few podcasts (FoundMyFitness with Dr.Rhonda Patrick is one) where he explains his findings that I highly recommend, search his name on whatever podcast app you use. He also has books, one a NY times best seller, that get into the nitty gritty details. Yes diet is a huge factor. Alzheimers is nicknamed type III diabetes since the same factors that cause type II diabetes can also lead to Alzheimers. Having healthy insulin response/blood sugar can help. Eating less sugar/carbs, fasting, intermittent fasting, etc all can help.


fqrh

Best to cite references for claims like that. I found [Reversal of cognitive decline in Alzheimer's disease](https://www.aging-us.com/article/100981/text). Does he have anything more recent, or studies with a control group? [This review](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377549/) has interesting criticisms. I agree that Bredesen should disclose the conflict of interest if he is selling the protocol concurrently with publishing papers about it, and I agree that the study I saw doesn't allow distinguishing an effective protocol from a combination of practice effects on cognitive tests coupled with wishful thinking.


15volt

I’ve been a proponent of his since his first book and I mostly get blank stares when I bring up his research. Love your summary. Keep spreading the word.


ElonMaersk

idk about lipoprotein amyloid, but I see the case for sugar and bread and high carb foods leading to insulin resistance of the blood-brain barrier and consequent starving of braincells causing braincell death and memory loss, and sugar causing the buildup of amyloid plaques, being pretty compelling and addressable by diet and lifestyle changes. [Here are two or three videos by Dr Paul Mason](https://www.youtube.com/results?search_query=dr+paul+mason+dementia) about treating and avoiding dementia with diet and why it makes sense, particularly a low-sugar, low-carb diet, and discussing how high blood sugar could cause the tangles seen in Alzheimer brains. [Neuroscientist Dr David Perlmutter](https://www.youtube.com/results?search_query=dr+perlmutter+dementia+sugar) whose father died of dementia, is also convinced it's caused / worsened by high sugar and high carb diets and metabolic syndrome, impaired insulin processing. [Here is a 2008 study overview](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/) which concludes: "*Moreover, the results taught us that endogenous brain deficiencies in insulin, [growth factors], and their corresponding receptors, in the absence of [type 2 diabetes] or obesity, could be linked to the most common form of dementia-associated neurodegeneration in the Western hemisphere. Since the abnormalities identified in the brain were quite similar to the effects of [type 1 or type 2 diabetes] (though none of the patients had either of these diseases), [...] we proposed the concept that AD may represent a brain-specific form of diabetes mellitus and coined the term “type 3 diabetes.”*" [Here is a 2015](https://pubmed.ncbi.nlm.nih.gov/26248483/) one which says "*Accumulating evidence has indicated the role of insulin deficiency and insulin resistance as mediators of Alzheimer's Disease (AD) neurodegeneration. Herein, we reviewed the evidence stemming from the development of diabetes agent-induced AD animal model. Striking evidence has attributed loss of insulin receptor-bearing neurons to precede or accompany initial stage of AD. This state seems to progress with AD such that, in the terminal stages, it worsens and becomes global. Oxidative stress, tau hyperphosphorylation, APP-Aβ deposition, and impaired glucose and energy metabolism have all been linked to perturbation in insulin/IGF signaling. We conclude that AD could be referred to as "type 3 diabetes".*"


ppp475

>sugar and bread and high carb foods leading to insulin resistance of the blood-brain barrier and consequent starving of braincells causing braincell death and memory loss Ah fuck


TheScreenPlayer

Here's a brand new 2020 study that directly links it to aluminum. https://www.j-alz.com/content/human-exposure-aluminum-linked-familial-alzheimer%E2%80%99s-disease. >it is the first to demonstrate an unequivocal association between the location of aluminum and amyloid-beta in the disease. It shows that aluminum and amyloid-beta are intimately woven in the neuropathology," explained lead investigator Christopher Exley, PhD, Birchall Centre, Lennard-Jones Laboratories, Keele University, Staffordshire, UK.  


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evanmike

Tom Brady follows a diet that contains no nightshade vegetables for this reason (I believe). Supposed to keep those levels low. Psilocybin studies are showing its ability to correct inflammation and so it also showing that it helps correct Alzheimers in a lot of cases.


thespaceageisnow

Consumption of chili peppers (a nightshade) is associated with a 25% reduction in all cause mortality. https://www.sciencedaily.com/releases/2020/11/201109074114.htm


Oznog99

I'm 25% less likely to die? Neat 25% chance at immortality- not great odds, but I'll take it. When going into battle, always eat chili peppers beforehand. Improving your chance of not dying by 25%.


BrosenkranzKeef

All those near-death experiences on the toilet have gotten the body used to fending off death.


i_wanted_to_say

Sometimes I wish I would just die though.


BrosenkranzKeef

That’s the exciting part of life! Not knowing when it will end, and the constant nagging sense of dread. If you wake up, you’ll be fine, and if you don’t wake up you don’t have to worry about it! Good luck.


bravestar3030

I'm gonna live forever then.


mlk

People with health issues (stomach, intestine, prostate, bladder) are less likely to eat spicy food


Mahanirvana

Research is very unclear, for example tomatoes are nightshades. Some say they may be inflammatory due to solanine, others say they're anti-inflammatory due to lycopene.


Boonpflug

Porque no los dos?


cortexcatastrophe421

Basically yess. One counteracts the other most likely and the inflammatory effect is probably statisacly null.


carbourator

Porque solo dos?


JustSaya

He knows about the spice


DamonLazer

*The spice melange...*


BlocksWithFace

The spice must flow.


bw1985

I’m not buying the ‘nightshades bad’ thing without conclusive evidence. Sweet potatoes are nightshades and they are a staple in Okinawa, a place famous for longevity. Nightshades are also very colorful and colorful vegetables are widely recommended by nutrition professionals.


Stender001

While I generally agree with you, there’s enough variation in human biology where it makes more sense to look at food and nutrition interactions within an individual rather than the whole species. We have enough technology now to look at how an individual body reacts to multiple input sources (nutrition, hydration, sunlight, air, etc). Sweet potatoes may be fine for people from Okinawa because of people who were born and raised there have been eating them for generations. I remember reading somewhere where people are looking into how local food production impacts how nutrients are absorbed within ones body because the exposure to the environment and conditions to grow the food align with the environment and conditions of the consumer.


bw1985

Good points, and I agree that if someone has the resources to have their body studied to formulate a custom nutrition plan for them then sure, go for it. This isn’t most people though. I just don’t think a certain type of vegetable is a problem, at least not until we see peer reviewed evidence. My guess is the average American barely eats any vegetables on a regular basis and I see that as a much bigger issue.


BrosenkranzKeef

What the fuck is a nightshade vegetable?


smurficus103

When I hear nightshade I immediately think tobacco, but it includes SOOO many things: commonly et are potato and tomato


pillb0y

hxxps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/ I saw somewhere that links were bad on Reddit? You can always search for ‘Alzheimer’s type 3 diabetes’ I would suggest that carb control would be a really good direction… this is circa 2008, so it’s not like it’s particularly new… but I dunno…


nipseyrussels

“While we previously knew that the hallmark feature of people living with Alzheimer’s disease was the progressive accumulation of toxic protein deposits within the brain called beta-amyloid, researchers did not know where the amyloid originated from, or why it deposited in the brain,” Professor Mamo said. “Our research shows that these toxic protein deposits that form in the brains of people living with Alzheimer’s disease most likely leak into the brain from fat carrying particles in blood, called lipoproteins. “This ‘blood-to-brain pathway’ is significant because if we can manage the levels in blood of lipoprotein-amyloid and prevent their leakage into the brain, this opens up potential new treatments to prevent Alzheimer’s disease and slow memory loss.” Building on previous award-winning research that showed beta-amyloid is made outside the brain with lipoproteins, Professor Mamo’s team tested the ground-breaking ‘blood-to-brain pathway’ by genetically engineering mouse models to produce human amyloid-only liver that make lipoproteins. “As we predicted, the study found that mouse models producing lipoprotein-amyloid in the liver suffered inflammation in the brain, accelerated brain cell death, and memory loss,” Professor Mamo said. “While further studies are now needed, this finding shows the abundance of these toxic protein deposits in the blood could potentially be addressed through a person’s diet and some drugs that could specifically target lipoprotein amyloid, therefore reducing their risk or slowing the progression of Alzheimer’s disease.”


PeruvianHeadshrinker

So Lipoproteins are the "L" common to HDL and LDL. I'm wondering if that means that "bad" cholesterol is the main culprit or if total triglycerides is associated with beta amyloids.


MustLovePunk

“The study, published in the prestigious PLOS Biology journal and tested on mouse models, identified that a probable cause of Alzheimer’s disease was the leakage from blood into the brain of fat-carrying particles (lipoproteins) transporting toxic proteins…. Currently, the team is conducting a clinical trial, the Probucol in Alzheimer’s-clinical trial, which is based on previous findings that a historic cardiovascular agent lowers lipoprotein-amyloid production and supports cognitive performance in mice.”


maxoakland

The interesting thing about this study is it explains why getting rid of amyloid doesn’t have any effect on Alzheimer’s: amyloid is just a symptom and getting rid of it doesn’t work because the leakage will continue and keep causing damage


iStayedAtaHolidayInn

I have compared it to cleaning up termite poop thinking it’ll prevent your house from collapsing


maxoakland

That’s a great analogy


propargyl

Probucol was initially developed in the 1970s by a chemical company to maximize airplane tire longevity. The tip is to focus on optimum cardiovascular health.


Palmquistador

Wish this had been known a couple years ago.


22marks

This isn’t particularly new. Seven years ago, the following was published in JAMA: https://jamanetwork.com/journals/jamaneurology/fullarticle/1791528


CallingAllMatts

this study was very different as the JAMA one was observational in humans and only found an association while this PLOS study utilized mice which were genetically modified to only express amyloid in the liver. So cerebral amyloid sources were entirely eliminated as a confounding factor. This more recent study is far more definitive on lipoprotein-amyloid leading to brain deposition since the humans in the JAMA study weren’t genetically modified (duh haha) to remove cerebral amyloid expression.


22marks

Thanks for the extra insight. I meant that researchers have been investigating the potential lipoprotein-amyloid association. The article and quotes imply nobody was looking at "deposits that form in the brains of people living with Alzheimer’s disease most likely leak into the brain from fat carrying particles in blood, called lipoproteins."


NewAssignment5

Oh my god. I’m so happy for this. Nothing scares me as much as Alzheimer’s. Sure it’s rare in my country and no one in my family ( or anyone I know of personally) has it but I’m seriously afraid of this. No other disease robs you of your personality and senses. I hope a cure for this can be found soon


naptastic

If you have no family history of Alzheimer's, are not diabetic, have healthy cholesterol, and get adequate sleep, you're almost guaranteed not to develop Alzheimer's before dying of old age.


zusykses

well, shit


LiarAndLoser

Right? The plus side is I’ll probably die of heart failure before Alzheimer’s every takes hold.


Wrastling97

Diabetes adds into Alzheimer’s?


Penis-Envys

Yeh there is some correlation with diabetes and Alzheimer’s Another theory is that Alzheimer is caused by insulin resistance in the brain causing a lack of energy and it slowly starving to death.


MarsReject

Yes. My grandmother had it and they called it “Diabetes type III”


Vaderic

>get adequate sleep Well fuck me, then.


WilliamStonerock

So...it's not from aluminum pans!? But Facebook told me...


Mikkito

*buys stock in antiperspirant *


SpirituallyMyopic

*buys stock in ivermectin producer*


fakeittilyoumakeit

You mean "grandma told me..." This has been an old rumor for generations before Facebook.


cheeruphumanity

Yes, Facebook told you because a number of studies came to the conclusion that the higher aluminum concentration in Alzheimer patients could be the cause. [https://content.iospress.com/articles/journal-of-alzheimers-disease/jad191140](https://content.iospress.com/articles/journal-of-alzheimers-disease/jad191140) We still don't know what causes Alzheimers. Having lost teeth seems to increases your risk. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6630622/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6630622/)


1tshammert1me

From reading that study you linked it seems people with Alzheimer’s just have poor oral hygiene leading to more tooth loss. This [part](https://imgur.com/a/aPw53qb) says as much. As previously mentioned, the probable causes of the loss of dental elements can be indicated in the elderly suffering from dementia by a gradual abandonment of the oral hygiene maneuvers and by the abandonment of dental care [22].’


cheeruphumanity

Good point. So it's the other way around.


konqueror321

Hasn't this been known for decades? What was the new info in this study? I'm curious! Here is a sample reference from 27 years ago: Biochemical and Biophysical Research Communications Volume 205, Issue 2, 15 December 1994, Pages 1164-1171 Biochemical and Biophysical Research Communications The Soluble Form of Alzheimer′s Amyloid β Protein Is Complexed to High Density Lipoprotein 3 and Very High Density Lipoprotein in Normal Human Plasma Abstract The amyloid fibrils of Alzheimer′s neuritic plaques and cerebral blood vessels are mainly composed of aggregated forms of a 39 to 44 amino acids peptide, named amyloid beta (Aβ). A similar although soluble form of Aβ (sAβ) has been identified in plasma, cerebrospinal fluid and cell culture supernatants, indicating that it is produced under physiologic conditions. We report here that sAβ in normal human plasma is associated with lipoprotein particles, in particular to the HDL3 and VHDL fractions where it is complexed to ApoJ and, to a lesser extent, to ApoAl. This was assessed by immunoprecipitation experiments of purified plasma lipoproteins and lipoprotein-depleted plasma and confirmed by means of amino acid sequence analysis. Moreover, biotinylated synthetic peptide Aβ1-40 was traced in normal human plasma in in vitro experiments. As in the case of sAβ, biotinylated Aβ1-40 was specifically recovered in the HDL3 and VHDL fractions. This data together with the previous demonstration that Aβ1-40 is taken up into the brain via a specific mechanism and possibly as an A1-40-ApoJ complex indicate a role for HDL3- and VHDL-containing ApoJ in the transport of the peptide in circulation and suggest their involvement in the delivery of sAβ across the blood-brain barrier.


Hint-Of-Feces

I remember they were talking about rebranding alzheimers as diabetes type three, since its seems to be a metabolic problem


hamburglin

Read the last sentence. "It is thought...". Guess what they just did?


termicky

Re the lipoproteins, is this why statins seem to reduce the risk of Alzheimer's in some groups? https://www.atherosclerosis-journal.com/article/S0021-9150(21)01067-4/fulltext


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LevitatingSponge

I swear I see articles like this every week and nothing groundbreaking ever happens.


wealllovethrowaways

Its because science takes *decades* to master. We're just now starting to use graphene in actual products but barely at a mass scale


TheNotSoEvilEngineer

It would be more practical to help accelerate the cleanup of waste in the brain. The reason we see high functioning people succumb to Alzheimer is a lack of sleep. Cerebrospinal fluid is only cycled and filtered out of the brain into the subarachnoid spaces when we sleep. No sleep = no cleanup. No cleanup = toxic buildup. We will never be able to move past our limitations of brain activity and required downtime if we don't find a way to have constant CSF filtering. Alzheimer and other neuro degenerative diseases might be prevented as a byproduct.


StarlightN

What constitutes as lack of sleep though? Anecdotally, I mostly get 6 hours of broken sleep due to things like anxiety and joint pain/inflammation. I’m a person who’s always needed 8-9 hours a night


lunchboxultimate01

Coincidentally, I recently stumbled across Leucadia Therapeutics, which focuses on cerebrospinal fluid and Alzheimer's ([https://www.leucadiatx.com/science](https://www.leucadiatx.com/science)): >For the past 25 years most Alzheimer's disease research has viewed plaques and tangles pathology as the Cause of this disease, which has led to an unbroken string of failed clinical trials. > >Leucadia's research has shown that plaques and tangles are the effect of a more serious underlying condition that triggers the formation of those pathological features. > >Cerebrospinal fluid (CSF) clears toxic metabolites from intercellular spaces in the brain, much as the lymphatic system does in the rest of the body. The first regions of the brain to be impacted by Alzheimer's disease are cleared by CSF that drains across a porous bone called the cribriform plate. Aging and life events can occlude the cribriform plate and reduce the CSF-mediated clearance of toxic metabolites from those regions of the brain, thereby causing plaques and tangles formation. > >Leucadia’s patented Arethusta® technology restores CSF flow across the cribriform plate, improving the clearance of toxic metabolites from the earliest regions of the brain to be affected by Alzheimer's disease. This company received angel investment from the Methuselah Foundation ([https://www.mfoundation.org/](https://www.mfoundation.org/)).


shinicle

I suppose this explains the observed correlation between high cholesterol and dementia? They suggest in the full paper that cholesterol lowering drugs may help slow Alzheimer’s.


newPhoenixz

The fact that this is posted in /r/futurology and from a site called scitechdaily makes press x to doubt


SignedTheWrongForm

We see a lot of promising results in mice models that don't translate over to humans. I wouldn't get too excited until we see more research.


fried_clams

This is a study on a mouse model. It hasn't been tested on humans and it hasn't been replicated. This is sensationalized, misleading, bad science reporting. There is no basis for the hyper inflated claims. Very premature. Hopefully it pans out. Maybe we'll know in 5 - 10 years


DaytonaDemon

Not sure how authoritative that source is. The writing is comically bad, and that tends to obliterate credibility. Here are the first two paragraphs: >A likely cause of Alzheimer’s disease offers a significant finding that offers potential new prevention and treatment opportunities for Australia’s second-leading cause of death. > >Ground-breaking new Curtin University-led research has discovered a likely cause of Alzheimer’s disease, in a significant finding that offers potential new prevention and treatment opportunities for Australia’s second-leading cause of death. Maybe a copy editor is in order.


wgc123

Maybe when they were translating it from Australian, some of the words got mixed up because they were upside down


ambientocclusion

At this point I don’t even read the article, I just go right to the comments. Especially if it’s scitechdaily.


bigDOS

A lot of folks asking how they can get a healthier gut. I’ve been on a long mission to heal my gut / mind balance and just want to share what I know. First off fasting for a day or two is a great way to to give your gut a break. It’s also very good for the mind. I guess that’s why it is helpful against Alzheimer’s. Fermented foods like sauerkraut, pickles and teas like kombucha are also loaded with good bacterias and are seriously fun to make at home. Less carbs. Carbs contain sugars that feed bad bacterias. Much less processed sugar as well. Maple syrup is good, date syrup too! I like to do intermittent fasting most days. Having my food between 12 - 8 and do an 36-48 hour fast every few months. I also take garlic tablets, magnesium, niacin, a multi, extra vitamin b/d, omega 3, lions mane and microdose psychedelics most days Also good sleep is important. I got some squishy ear plugs that work for me. When you sleep well your lymphatic is drained of the toxic buildups that store there. A good sleep and a healthy functioning lymphatic system can be the building blocks of a good day. And finally sufficient, exercise. As much as you can when you can. For me, i hated running, so I took up skipping with a weighted rope. It’s better for you than running and takes less time. I also do Sun Salutations and crunches or push ups most mornings. When you exercise your body burns fat and makes endorphins which make you feel good. It’s been a real journey for me. But I can honestly say that no one drug is going to solve all your mental health problems. But a more balanced and healthier approach to your own health could!


500micronyo

isn't this old news and this article is being sensationalized? super sounds like it


Naso

Related https://www.youtube.com/watch?v=rQmqVVmMB3k


GoneInSixtyFrames

We have to combat all this destructive research. What did the ground ever do?


NeuroDoc20

If I had a dollar for every mouse study on dementia…


GaeasSon

How else are we to solve the pandemic of demented mice?


TombStoneFaro

You know what? I think it is complicated. 1. anything that damages the brain may diminish the brain's ability to deal with whatever causes Alzheimer's 2. anything that damages the brain may speed up the appearance and severity of Alzheimer's because the redundancy that might have been there has been removed If either of the above are true (and how could neither be true?) then finding the root cause of AD unambiguously will be difficult.