ALZHEIMER'S DISEASE (AD)

What is Alzheimer’s disease?

AD is a neurodegenerative disorder characterized by progressive central nervous system degeneration and cognitive impairment, presenting features such as memory deficits, cognitive dysfunction, language difficulties, executive dysfunction, as well as personality and behavioral changes. 

Many studies suggest that Alzheimer’s disease is caused by a mutation of the Central Nervous System(CNS). Lesions of brain cells that produce accumulation of abnormal substances (eg, amyloid beta (Aβ), hyperphosphorylated Tau protein in cells), can lead to accelerated apoptosis of brain cells and neurons. This results in brain atrophy, consequently affecting brain functions such as memory, cognitive abilities (including learning, comprehension, language usage, spatial orientation, and judgment), as well as emotional regulation.

Three Stages of Alzheimer’s disease

• Early Stage: Memory decline, low mood, difficulty expressing thoughts, loss of interest in things.
• Middle Stage: Reduced sense of direction and time, increased irritability, agitation, and paranoia, diminished initiative, and even hallucinations or delusions of persecution.
• Late Stage: Loss of self-care abilities, requiring prolonged bed rest, loss of speech and comprehension abilities, and more.

Chinese Medicine’s perspective on Alzheimer’s disease

According to Traditional Chinese Medicine(TCM), Alzheimer’s disease falls within the realm of “chidai” (dementia). The term “chidai” was first mentioned in the Eastern Han Dynasty’s “Hua Tuo’s Secret Medical Formulas for Treating Dementia.”TCM believes that the kidneys produce marrow, which gathers in the brain. Emotional imbalances, chronic illnesses, and aging lead to the decline of kidney qi, resulting in the depletion of marrow, dysfunction of the spirit, and ultimately the manifestation of this disease. The primary affected organ is the brain, with kidneys being the main internal organ involved, also linked to the heart and spleen. The pathological mechanism primarily involves deficiencies in qi, blood, and kidney essence, marked by the presence of turbid phlegm and stagnant blood.

In TCM treatment, it is mainly to tonify the kidneys and nourish the marrow, with phlegm-resolving as a supplementary approach. This is generally achieved through internal consumption of herbal medicine and acupuncture.

In the “Internal Medicine of Traditional Chinese Medicine,” Alzheimer’s disease is categorized into four types based on the etiology and pathogenesis: insufficiency of marrow sea, spleen-kidney deficiency, phlegm obscuring the orifices, and blood stasis obstructing the interior. The treatment strategies using Chinese herbal medicine for these four types are as follows:

• For insufficiency of marrow sea, the focus is on tonifying kidney yang and nourishing marrow. Herbs like Epimedium, Psoralea, Morinda, Cistanche, Eucommia are used to tonify kidney yang, while herbs like Ligustrum, Lycium, and Rehmannia nourish kidney yin. Dragon bone, Polygala, and sour jujube seed are added to calm and nourish the spirit.
• For spleen-kidney deficiency, the emphasis is on tonifying the kidneys and invigorating the spleen. Qi-boosting herbs like Ginseng, Astragalus, and White Atractylodes are added to the formula.
• For phlegm obscuring the orifices, the goal is to disperse phlegm and clear the orifices. Herbs like Pinellia, Acorus, Poria, and Coix Seed are incorporated.
• For blood stasis obstructing the interior, the treatment aims to promote blood circulation and open the orifices. Blood-moving herbs like Rehmannia, Angelica sinensis, Ligusticum, Salvia, and Polygonum are included.

These treatments are tailored based on the specific pattern and condition of the patient and their underlying TCM diagnosis.

Acupuncture 

Acupuncture is considered a safe therapeutic method for treating Alzheimer’s disease. Researchers have pointed out that “acupuncture treatment for AD has important clinical significance for improving cognitive function.” Acupuncture can potentially improve AD symptoms through various mechanisms, such as upregulating silent information regulator factor 1 (SIRT1) to counteract and inhibit amyloid-beta (Aβ) formation, promoting the expression of axon growth guidance factors to aid neural reconstruction, and facilitating neurofunctional recovery.

Laboratory results suggest that acupuncture has a beneficial effect on brain health and can protect the brain from Alzheimer’s disease pathology. A study published in the journal “Neural Regeneration Research” indicated that both electroacupuncture and moxibustion could protect brain structures. MRI scans showed that acupuncture enhanced brain activity in Alzheimer’s disease patients. Researchers pointed out that “since AD is related to cognitive impairment, stimulating specific acupuncture points can regulate cerebral blood flow and enhance hippocampal connectivity in AD patients.”

Common acupuncture points used for treating Alzheimer’s disease include “Baihui (DU20),” “Shenshu (BL23),” and “Zusanli (ST36).” Stimulating these points has been shown to have varying degrees of impact on the brain’s pathological structure and related protein expression in animal models of AD. Acupuncture treatment has also demonstrated improvements in behavioral changes and cognitive memory abilities in these animals to different extents.

Learn more: How to Treat Alzheimer’s Disease with Acupuncture?

Prevention of Alzheimer’s disease

Currently, the predominant approaches for treating Alzheimer’s disease involve medication and cognitive and physical training to slow down its progression. Alzheimer’s disease can also be prevented through various strategies:

• Cognitive Activities: Keep the mind active by engaging in cognitive challenges such as learning a new language, playing word games, and participating in mentally stimulating activities like mahjong.
• Physical Activities: Maintain a moderate level of physical exercise, such as running, swimming, dancing, to promote blood circulation, enhance overall health, and positively impact brain health.
• Stress Management: Employ stress-relief techniques like exercise, yoga, meditation, and ensuring adequate sleep, along with practices like diaphragmatic breathing, to reduce the impact of chronic stress on the brain and maintain emotional balance.
• Healthy Diet: Adopt a balanced diet that includes antioxidant-rich fruits and vegetables, while limiting the consumption of greasy, fried, and high-sugar foods, to support both overall health and brain health.

Preventing Alzheimer’s disease involves a comprehensive approach that combines various lifestyle adjustments to lower the risk of developing the condition and maintain healthy brain function. If you have concerns or need more specific TCM methods, please make an consultation at Shanghai Medical Clinic by phone or online booking.

TCM Treatment case for Alzheimer’s disease

Patient: Female, 54 years old

Chief Complaint: Memory decline and mental symptoms for 2 years

Initial Consultation Date: May 24, 2015 (Patient accompanied by her son and he provided the information)

After the patient went through menopause at around 50-51 years old, she experienced severe emotional fluctuations, often feeling anxious, stressed, and depressed. Since then, her memory had been continuously deteriorating. About a year ago, she was diagnosed with Alzheimer’s disease by Western medicine practitioners and started taking one tablet of Ebixa (memantine) daily. However, her condition did not improve and actually worsened over time. When her son brought her to Shanghai Medical Clinic, she needed assistance with daily activities such as cooking and dressing, and she had difficulty engaging in normal conversations. Therefore, the initial consultation was conducted mainly through her son’s description. She experienced severe depression about once a week, becoming agitated and tearful due to forgetting things. She also had left-sided migraines and lower back pain (around GV4 and BL23). She had poor physical endurance, felt easily fatigued, had a good appetite, normal bowel movements, experienced thirst, and drank a large amount of water (though she was unaware of exactly how much). She generally preferred warmth over cold, sweated easily, and had night sweats. Her sleep was generally good but accompanied by vivid dreams. She was overweight, weighing 108 kg with a height of 155 cm. Her face had a reddish hue and her eyes lacked luster. Pulse examination revealed a slippery pulse on the right guan and a deep pulse on both chi positions. Her tongue was red with a slightly yellow and thick greasy coating, and the tip of the tongue was red.

The TCM diagnosis was phlegm-heat and deficiency of both kidney yin and yang. Treatment involved weekly acupuncture sessions along with herbal medicine. Acupuncture points used included Baihui (DU20), Sishen Cong (extra point), Zusanli (ST36), and Fenglong (ST40), among others. The herbal prescription was a modified version of Wendan Decoction, with additions of Yuanzhi (Radix Polygalae) and Shichangpu (Rhizoma Acori Tatarinowii). During the second consultation one week later, the patient’s son reported that after the first treatment, her mood had improved significantly. She was less prone to anxiety and stress, and her speech became more fluent and coherent. Subsequent treatments followed a similar pattern with slight adjustments based on her condition. Her condition improved significantly after each treatment session. Both of her sons took turns bringing her to the clinic, and they were all very pleased with the progress made through acupuncture and herbal medicine treatments.