Welcome to the CHE Partnership Call blog. We encourage you to post your questions and comments here. During the Q&A session, we will check the blog for questions. Thank you for participating today!

Has there been major resistance to viewing alzheimers, and other diseases of cognitive decline, as an ecological health issue? Or are people generally amenable to this concept?

Seems to me we have come a long ways from where aging was talked about in terms of "free radical" theory...but that the opportunity still exists to build off the ties to inflammation, pollution, exercise, nutrition, etc. The systems approach is essential because of how we have advanced in the past 60+ years. Comments?

Hi, I have a lot of background noise here, so my phone is muted. I wanted to inform the group that in 2002 I wrote a book entitled Environmental and Chemical Toxins and Psychiatric Illness published by American Psychiatric Press. In this book I reviewed the literature pertaining to environmental exposures and many forms of mental illness including dementias. I agree with Dr. Whitehouse that lead, more than aluminum, is associated with certain mental conditions. A few weeks ago, I also published an endocrine disruption theory of schizophrenia based on the effects of the plasticizer, bisphenol-A. The article is available in Open Access form in the journal, Schizophrenia Bulletin. I wonder if any of the speakers have an opinion of any possible involvement of endocrine disruption in Alzheimer's disease.

Will get your book. Thanks for your comments. Peter

Has the CHE partnership tried to incorporate the whole concept of the precautionary principle into public policy recommendations, statements, and positions?

It needs to. It resonates with the mainstream medical principle of "First Do no Harm." Peter

Is any research being done on animal confinement, by itself, as a source of toxicity in the meat of our factory farmed diet, which can be linked to Alzheimers and the others in this reframing?

Good question, and an important issue. A variety of studies show that animals that are confined and fed grain have an altered fatty acid profile - increased saturated and omega 6 fats - and decreased omega 6s. This appears to be due both to the confinement (inability to graze - ie move about) and to the grain feeding. A separate body of research shows that this altered fatty acid profile makes a substantial contribution to a variety of western diseases (including dementia). Free-ranging animals are clearly healthier, make for a healthier food system, and a healthier environment. As mentioned on the call, the influence of agribusiness on food policy is a driver here that needs to be addressed if we are to put our food production system back onto a healthy and sustainable footing.
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i have two Qs thank you. 1) what do speakers think about the wave of early-onset? is it more likely to be a neuro-degenerative disease related to early env exposures, vs another "kind" of AD more related to normal brain aging? 2) could you comment on testing for environmental exposure re to AD? it's one thing to search and find the best "test" for toxicity in an individual with early cognitive decline, but then what to do with information about toxic burden, and, what treatment could repair neuro damage? thank you.

The "wave" is mainly to do with there being more baby boomers and more hype, not a biologically spreading epidemic. Peter

1) Agree that that both hype and changing demographics contribute to the wave concerns. But in my own view, there is substantial data to suggest there's more going on as well. The "wave" of neurodegenerative disease (late as well as early onset) is no more natural or inevitable than the wave of other chronic epidemic diseases that surround AD. There are clearly identified population-wide factors (diet, exercise, toxics) that are contributing to cardiovascular disease and diabetes. I find the data quite convincing that there are contributing causes that can be addressed that would help undercut the neurodegenerative epidemic as well. 2) i'm not aware of any data to support generic chemical testing in this context. If there are potential exposures suggested by an environmental history (ie tuna consumption->mercury exposure, occupational etc. lead exposure) they should be tested for on that basis. In my view, precautionary measures are worth employing no matter what any blood tests might show. Those measures include good nutrition (AKA Mediterranean type Diet, as discussed on the call), exercise, toxics avoidance, and community engagement.
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Peter (others too) -- Medical research has not been addressed in the healthcare plans of the presidential campaigns. Are there ways we can use Alzheimer's disease as a platform to raise the importance of the role of research and to call for policy changes, in our individual participation in this presidential election?

Have any studies been done that look at Pb and OP pesticide blood levels in patients with cognitive diseases versus a control group? Would such studies be useful?

Good suggestion, Ruth. i'm not aware of such studies, though it's possible they are out there. Snap shots in time, (technically, cross-sectional studies) often come up negative - especially studies of older folks. Part of the reason is that except for lead, we don't have a good way to measure exposure over time. In neurodegenerative diseases - where remote exposures (including fetal) matter a lot - it's challenging to get meaningful exposure data. The ideal study would be long-term and prospective, monitoring chemical exposures as well as nutritional variables, genetic factors etc. starting very early, prenatally if possible. The Faroes Islands mercury cohort is one of the best examples out there of this kind of study design, and it has yielded very important results. The down side is that conclusions are a long time in the making. Even longer for late-life diseases. That's why holistic, precautionary thinking is called for. Even with no further studies, we have enough information to act right now, promoting better environmental & health policies that serve the public interest and the planet-- if only this were the priority of policy makers!
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Effects of environmental changes can be short-term. I'm aware of several such instances: 1. An Alzheimer patient who became violent when exposed to cleaning chemicals and fragrance - no more episodes when triggers removed. 2. A boy with ADHD who went from 2 or 3 right on a quiz to 100% two weeks after his classroom was cleared of chemicals. 3. Another boy diagnosed with autism who was able to get off Ritalin after moving to a school that accommodated him by removing chemical exposures. Liberty Goodwin, Director Toxics Information Project (TIP) Providence, RI www.toxicsinfo.org

Biomonitoring is an essential component of CDC's National Environmental Public Health Tracking Network. The network will go live in September 08 and displays data on environmental hazards, human exposure, and health effects. Could data on Alzheimer's and the environmental link be included? This network will be constantly updated and could help in linking environmnetal contributors to Alzheimers.

I'm not familiar with details of the Public Health Tracking Network, but strongly agree with your suggestion. Expanding the network to include bio(and nutritional) monitoring, and neurological assessments into later life would be a logical - and much needed - use of the Tracking Network.

Just wondering - my mother-in-law, now with severe Alzheimer's, is a retired art teacher who has continued to paint with oils. Seems there is likely a connection - along with a genetic component.

Nor am i aware of studies that address this. Still solvents generically raise some red flags for neurotoxicity. One precautionary approach - which i'd use if my mother were in a similar boat - would be to encourage her to use water-based non-toxic paints instead of oils. But this is a quality of life decision. It's possible painting with oils may mean more to her than living longer without her art. A second option would be to insure that the room is well ventilated when she paints, to minimize the possibility of harmful exposure.

I take a clinical approach: Taking a complete history of your mother-in-law's exposures would be a good start to see what has helped to cause the condition (see How to Take an Environmental History' on the website below). Treatment would be as per an environmental physician (also listed on the site. I have found that a majority of women who paint or refurbish with oils do become chemically sensitive and some develop neurologic problems without sensitivities. This kind of exposure will definitely not be good for her regardless of what initiated her Alzheimer's and could make her more dysfunctional (adding fuel to the fire). Acrylics or water colors would be a good move, or a getting a charcoal air filter (at www.Needs.com). Some of the cognitive damage may be fixed but I personally have seen extraordinary improvement in memory, reading ability, IQ, and social skills in patients with a variety of environmental exposures after treatment. Usually the younger more motivated patient will undergo the complex treatment (vitamins, oxygen, sauna, immune modulation, antigens, and genetic detox assessment and compensation. At her age it may be for naught. www.aaem.com lists treating physicians countrywide. I should be discussing the utility of environmental treatment any day now on Nightline if you want to keep your eye out for it! Lisa Nagy M. D., www.environmentalmedicineinfo.com, Lisa@nagy1.com

Hi, I know of no connections, but there is much we do not know by chemical exposures . The genetic story is a complicated one. Best wishes, Peter