Can You Prevent Dementia And Should We Be Using Statins For High Cholesterol?

Intro

david you want cholesterol drugs or do you want dementia you can take your topic i don’t care no i don’t i i took and you took you know horses lions no no no no i’ll take dimensions because i’m speaking about cholesterol drugs tomorrow but do i want cholesterol drugs or dementia no no but thank you for asking i wanted you to read into it what you wanted to read into it

Can You Prevent Dementia

um can you prevent dementia was basically the question um yeah and i’m not a neurologist but one has to be familiar well read and we are all concerned about our memory and where we left our car in the parking lot

um there was a splash about three four years ago uh a scientist uh out of the buck institute of san francisco and then a book called the end of alzheimer’s that was embraced very quickly by the functional medicine community of which i’m a member but i don’t agree eye to eye with all the idea that there are 36 holes in the roof of your house if you’re starting to lose your memory that’s the analogy

and you can plug each and every one of them some with fitness some with diet that favors a ketogenic diet in this approach and a whole lot of supplements from huperzine to vin positive and on and on it quickly became a franchise and the author of the book profited quite nicely

he did publish a scientific paper but it’s not alzheimer’s it’s at best something called mci mild cognitive impairment that may progress on but may not progress on to the clinical diagnosis of alzheimer’s nine of ten patients showed some improvement uh and then there was a business and there hasn’t been much follow-up publication

a number of my friends in the detroit community did train in this kind of franchise of brain health they basically have all abandoned it it was very expensive for patients it was very complex and there really hasn’t been a good foundation to show that it actually prevented alzheimer’s

on the other hand within a few months out came the scherz-eyes alzheimer’s solution you may have known that book i think it’s a wonderful book with the neuro program of nutrition and exercise and optimized mind body and other features there some mind games but they certainly do not claim that they prevent dementia

in fact most reasonable scientists don’t believe at this point we actually know that anybody can prevent it there is a inherited risk called apoe i have a practice full of people who’ve inherited a rather adverse apoe4 for that 20 years earlier in life than on average you may start to have some memory issues

and there seems to be an advantage to a low saturated fat diet which is perhaps our community and lower alcohol consumption but these are trends we don’t really know that all for sure

um you know the general trend is that a lot of cognitive impairment is cardiovascular impairment it’s microcirculation it’s vascular dementia and certainly the theme out of the chicago healthy aging project and other is that optimal blood pressure optimal blood sugar optimal blood cholesterol regular fitness good sleep avoidance of smoking

and i would say embracing a whole food diet largely of plants would be wise but i think there’s science to come before we say we you know have certainly beat down alzheimer’s i don’t think anybody really claims that yet

Should We Be Using Statins

i’ll say just tying in the question we didn’t do the general data statins don’t cause alzheimer’s if anything they’re neutral and may have a slight advantage if your cholesterol is 300 and there’s no other mechanism to bring it down uh the latest meta-analysis are fairly you know reassuring

okay i’m gonna ask six more questions um in this case yes yes um joe how much uh glucose dysregulation have you seen with statins because i i’ve seen the fair a fair amount in in clinic

yeah so there’s you know good question and there is um no direct understanding why there’s been an observation it may be a mitochondrial toxin is the common statement whether simvastatin is the most glycemic of statins used to be called zocor and some of the others are more favorable as mentioned

whether coenzyme q10 at least in one lab study protected the mitochondria and this response has been mentioned but there’s very little data on it actually

i mean there’s the databases that suggest if you’re a healthy person and you’re placed in a statin the likelihood you’re going to see a major shift in your insulin sensitivity and actually develop diabetes is very low

but if your hemoglobin a1c is 6.2 and your waistline is 43 inches and your diet is not optimal it may push you a couple points up on measures and you will fulfill criteria of type 2 diabetes offset by what i’ll talk about tomorrow at least some data to suggest it prevents the number one killer men and women in high-risk subsets like previous heart attacks and post bypass and such

in my own clinic i’m concerned i’m not a aggressive statin user but they need to be pulled out now and then um and i have stopped people’s statins and you always can for a couple months repeat the hemoglobin a1c it wanders down i won’t say it’s you know amazingly potent intervention to stop and reassess

but i will and and uh you know very often three four times a week reintroduce it and you get pretty adequate balance between cardiovascular risk reduction and not elevating the blood sugar i think it’s a real deal though