docSamSBH Blog

Choices for Alzheimer’s management: more nursing home beds or medical research?

Before discussing these 2 choices, here are some interesting facts regarding Alzheimer’s that I have come across in my research.

Alzheimer’s ranks as the 6th leading cause of death in the US, surpassing  breast and  prostate cancer deaths combined; currently, someone develops Alzheimer’s every minute (thats 60 new cases every hour, 1440 for each day (24×60) and  525,600  for each year (1440×365). Predictions are that by 2050, this rate will double to a new case of Alzheimer’s developing every 30 seconds doubling the number to over 1 million new cases annually.

The medicare costs today to treat Alzheimer’s in the USA is $236 billion annually, excluding the $5000 that caregivers also spend annually. Based on the increase in the number of people over age 85, it is predicted that these costs will rise to over one trillion dollars annually by 2050.

Canadian picture -just as gloomy: according to Canadian vital statistics for  2013 , Alzheimer’s ranked as the 5th major cause of death behind, cancer, heart disease, stroke, and chronic respiratory disease; because the elderly are currently the fastest growing segment of our population  there are now more people over age 65 than those under age 17 with the prediction that by 2050 half of the elderly will be over age 85.

Since incidence of Alzheimer’s increases with age, only 8% of the Canadian population have some degree of Alzheimer’s at age 65, but by age 85 this incidence increases to 35%.  By the year 2050, with half of the the Canadian population over the age of 85, 35% of them could have Alzheimer’s, an alarming prognosis. It could also become the number one cause of death. The current annual health care costs for Alzheimer’s is around $30 billion,  which could increase to over $300 billion by 2050. It alone could bankrupt our healthcare system in Canada.

We desparetly need a solution now. In the title of this post I suggested there were 2 routes available: more nursing home beds or basic research to find the cause and cure  of Alzheimer’s. As with other pandemics in the past we also had similar 2 choices. For example, in the 1940’s and 50s with the polio epidemic, governments were facing a similar policy decision – should they   invest their resources to build more and better iron lungs and hospitals for the patients who need them? Or should they invest in basic medical research to find a cure for polio? The National Foundation for Infantile Paralysis as it was called in those days chose the latter – a wise decision.

Regarding Alzheimers we have the same 2 choices-more nursing home beds or medical research.  I especially like the comments by Dr. Roy Walford in his book  Maximum Life Span. (pages 17-18):

“… My point is that old age homes and all the vast social support structures continuously accumulating to care for the helpless aged are the iron lungs of gerontology. Improvements in the social, economic and medical support system for the elderly will merely provide symptomatic relief for an expanding problem. …” .

By giving top priority to constructing 1200 more nursing home beds, the province of Manitoba would seem to have made their decision. Of note in  Saskatchewan, the government claims that everyday there are 10 new cases of Alzheimer’s. That’s over 3600 cases each year. If eventually, 25% of these cases require nursing home beds, then the province would need to build over 900 beds annually. In the 19th century, tuberculosis – known also as the white plague – was the leading cause of death, claiming over 35% of the population. Sanatoria like the one in Ninette, Manitoba were quickly constructed and filled. With the discovery of antibiotics which specifically killed the tuberculosis bacterium, patients no longer needed to go to sanatoria to be cured and these buildings soon became museums.

I have become quite fascinated with the advances made in Alzheimer’s research, and will discuss the topics of the role of Vitamin D and the 7 common ways we have to slow the aging process in my future posts.

Criteria when person is officially dead.

I ask this question because of my research experience will behaviour of human lymphocytes in cell culture at the Kidonan Institute of Gerontology- a private non profit research Lab I set up in December 1974 during my early years of Medical practice.

To discuss the  history of this private non profit research Lab you have to go  back to July 1965- actually 1961- the year after I graduated from Medicine from U. of Manitoba in 1960 and had done  a one year rotating internship at St. Boniface General Hospital, Upon completing my rotating internship I was invited by the University of Saskatchewan in Saskatoon to join their newly formed Department of Cancer research as a cell biologist with the rank of Asst. Professor.. At this Cancer Research Lab they had  just hired Dr. Joesph Morgan – from the Connaught Research Lab in Toronto where together with Dr. C Parker they perfected the tissue culture techniques to grow human polio virus in tissue culture and enabled Dr. Salk to developed the polio vaccine for which he received the Nobel Prizefor Medicine..This enabled me to perfect the techniques of tissue culturegrowth of human tissue  Not only did I he esearch LOver the next 4 years I when I set up the Winnipeg Clinic Research Institute  Laboratory at the Winnipeg Clinic on the invitation  by Dr. PHT Thorlakson.  I was invited by theU. of Saskatchewan to work as a cel biologist in their newly established Department of Cancer Research in 1961 to set up a private Research Labmat the Winnipeg Clinic.

Can fingerprint from deceased person be used to unlock their iPhone ?

There are 3 basic ways to open your iPhone: 1)typing in the 4 number password code, 2)using your finger print. 3) using Siri- I haven’t tried Siri but theoretically it should work since you can ask Siri to do many things-all you need is the recording of your voice on file and/or in your “will”. Scenarios where being able to unlock cell phones include where a person dies suddenly and did not leave password and other data in their will or in cases of terrorism where the victims involved are killed by the police, and companies like the recent experience with apple where they refused to unlock the phone of such victims for the police. The idea occurred to me that maybe their fingerprints could be used to open their iPhone devices if they had installed this method to unlock their cell phones . One would easily test this hypothesis by going to a funeral and/or post mortem room and place the thumb of the deceased on the home button of their iPhone – or whichever finger they used for opening their iPhone when they were alive. .If it is not successful, I wonder whether fingerprints found in police files could replace the fingerprint method for opening iPhones or similar devices. Maybe the finger print is altered shorty after death by rigour mortis changes. A note of caution to the police : when killing the suspected terrorists they should try and save the upper extremities especially the fingers and/or thumbs before they blow them up!

transgender vs cis(gender)

Cis(gender)- is defined as the sex you are assigned at birth, while transgender is an umbrella term for people whose gender identity differs from the sex they are assigned at birth.

Recently I have been working on various keynote presentations on the paradigm shift for gerontology, specifically on anti-aging.  To ‘add life to your years and years to your life’,  it seems gerontologists have shifted from pursing life extension strategies to anti-aging.

In that regard I have searched for more information on the biological markers for aging. One of the tests I have found relates to the significant loss of hormone levels, specifically DHEA. According to Roy Walford in his textbook (The 120 year diet ) table 2.2 in males DHEA  declines from 3400 ng./ml of plasma in the 20-30 age group to less than 900 ng/ml by age 60. Corresponding figures for females are 2200 to 800 .

The Fifth edition (2013) of Disease Prevention and Treatment  published by Life Extension Foundation on p. 608 details how DHEA is converted to Androstenediol an intermediate hormone which can then produce either and/or  both– the male and female sex hormones, viz. testosterone and the 3 major estrogens (estrone,, estradiol and estriol).  The hormonal cascade also shows that the enzyme aromatase can convert testosterone to the female sex hormones.

I wonder if an imbalance of this hormonal cascade can produce the increase in transgenders we are witnessing. Maybe by altering these conversions we could preventive the transgender phenomenon.



Clinical types of early dementia

We are all aware of what we call “senior moments”- where we can’t recall the names of people we have known in the past -only to recall the name at a later date – usually before the end of the discussion. Sometimes remembering may take longer, either several hours or after a night’s sleep.

There is another more frustrating type of amnesia where the clinical feature  is a failure to recall or include a constructive idea or thesis, which would offer an excellent solution to the problem under discussion. To the scientist, this is called the “eureka moment”. That is why they say that scientists make their greatest contributions to research in the earlier years of their research career.

Anti-aging therapies and doctor assisted dying

These anti-aging therapies include bio-identical hormonal replacement, management of oxidative stress with anti- oxidants, reduction of chronic inflammation a forerunner of atherosclerosis and heart disease, genetic-restoring telomere length, stem cell therapy to replace senescent cells, etc.

In one of my keynote presentations, I discuss 7 ways to slow the aging process. Hopefully by slowing and/or reversing the aging process, these individuals can also change their biological clock to a period when they did not have these chronic diseases!

Should these breakthroughs materialize, we may even witness the time when people in nursing homes may actually be discharged and return to their homes, much like we now do with patients who are sent home from hospital after recovering from a medical illness or surgical treatment.

Maybe the health status of those individuals requesting “assisted dying” could be enhanced or their delayed if their biological life clock was reversed to an earlier period when they did not have those debilitating symptoms.

The late Dr.Roy Walford. in his book Maximum Life Span relates the history of the government’s approach to the polio epidemic of the 1940’s and 50’s His comment: “… if the government had invested in perfecting better iron lungs we would now have the best designed most comfortable iron lungs imaginable inhabited by thousands of polio victims…” Instead, by investing in basic research and developing a vaccine, epidemics like polio and smallpox have now theoretically been eradicated from our planet.

Regarding nursing homes, Walford comments “…the vast social support structures continuously accumulating to care for the helpless elderly are the iron lungs of Gerontology…”

It should be noted that in the 19th century when Dr. Edward Jenner developed his crude smallpox vaccine, he and the world did not know that smallpox was also caused by a virus. In my view the current knowledge of the causes of the aging process is probably at the same stage when Jenner was experimenting with a smallpox vaccine which he tested on his own son.

We do not really know what causes the aging process that leads to the development of the chronic symptoms and diseases of the elderly, what I like to call the 5 “D’s-disability, depression, discomfort, dementia, chronic diseases, and death. Why do the levels of hormones like DHEA begin to drop after age 30?

Nursing homes as research labs for dementia

The opening statement of the Report entitled “Nutritional Strategies to Combat Alzheimer’s” in the March 2013 issue of Life Extension Magazine, reads as follows:

“Someone in America develops Alzheimer’s every 68 seconds. This rate is projected to more than double by 2053, to one every 33 seconds.”

Since we in Canada have roughly 1/10th of the US population, the corresponding rate for Canada should be roughly one tenth that of USA.

In a recent radio and TV announcement, Canadian health officials outlined the costs of treating Alzheimer’s from the current 30 billion annually to over 300 billion within a couple of decades.

After reading this article, and with my recent attendance at a nursing home meeting where the CEO of that nursing home outlined plans for bed expansion, it occurred to me that nursing homes with their unique resident profile (compared to patients in hospitals or medical offices), might be excellent ‘labs’ to conduct clinical research on Alzheimer’s disease.

When I reviewed my blog, I found a post where I gave some statistics on incidence of dementia, and also my plans for to develop a podcast.

I have experience in the field of genetics and gerontology. I set up 3 private medical research Labs, including the Winnipeg Clinic Research Institute, the Kildonan Institute of Gerontology, and a private Cytogenetic diagnostic Lab. During my research career, I published over 40 scientific papers. Since the mid-1990’s as a medical educator, I have used the information gathered from various sources to develop various tools such as presentations, websites and blogs and videos to share to share my knowledge and interest in research and life extension. Sources I have leveraged include the Life Extension Foundation, Wellness magazine, A4M, etc., as well as my personal library of over 500 volumes, my clinical practice of over 30 years, and more than 20 years of experience treating elderly patients at the Holy Family Nursing Home in Winnipeg, Canada.

Realizing the importance of medical research in 2000, I set up the Semeon Hrushovetz Endowed Fund at the University of Manitoba which purchases books in the area of gerontology and complementary and/or alternative medicine for the Neil John Maclean Health Sciences Library.

Many current investigators, especially those engaged in life extension research, discovered the important role of nutrition in aging (e.g. Vitamin D and Alzheimer’s).

Another area is the field of searching for biological markers for aging and use them to test if anti-aging therapies are valid. Many of these studies, especially those related to biological markers of aging, could very easily be conducted at a nursing home.

I feel the Holy Family Nursing Home with its expansion program provides an excellent opportunity to establish such a unique research centre. I would be interested in an opportunity to discuss this idea with the nursing home’s board or building committee.

Let me begin by referring the reader to my published website specifically the podcasts.
Note: When I view the second podcast the one on Brainpower and click on more, the reader will see the plans I have for this podcast. Let me copy a portion of this podcast.
Your brain directly and indirectly controls the function of every system of your body. Aging of the brain is the number one cause of dementia,discomfort, disability, depression, and death in the elderly. In Canada alone, 8% of people age 65 and 35% of those over the age of 85 are affected by some type of dementia. By the middle of this century (2050), it is estimated that 50% of the elderly (group over age 65) will be older than 85. The medical costs of just treating dementia (estimated around 30 billion in 2014) in the elderly will skyrocket to over 300 billion by 2050 and likely to bankrupt the healthcare system. Prevention is our only savior.
Posted 13th December 2013 by Dr. Semeon B. Hrushovetz
Labels: medical cost of treating dementia podcasts on brain power

Why all the fuss about lowering carbon dioxide in the environment

I recall posting a blog several years ago on the photosynthesis reaction where CO2 in the presence of water and energy (photons) from sunlight is converted to oxygen and glucose- 2 products that the human body cannot make and are therefore classified as essential nutrients.
I still recall the experiment from my 3rd year Honours botany class- a class that I took from Dr. William Leach at the U OF MANITOBA in 1947. This course was one from the 5 year honours program from the university of Manitoba in both combined Botany and Zoology . In this experiment we followed the method outlined by Leach and Stiles in their small book on photosynthesis. At that time the U. of Manitoba had on staff internationally recognized professors. (Names like Buller,Wardle) In the experiment I recall observing bubbles of O2 into a beaker which had some green plants and a source of CO2!- a procedure nature produces with its algae blooms on our lakes.
If we remove CO2 from our atmosphere the trees would not produce glucose which when polymerized in plants becomes our lumbar,or in our garden plants the starchy potato tutors, tomatoes, wheat etc.
Where would we get out supply of oxygen if there was no CO2 in our atmosphere? Have I missed something in this argument?

Sex hormonal imbalance possible role in sexual orientation

According to the textbook by the Life Extension Foundation entitled “Disease Prevention and Treatment ” 5t Edition on page 608, pregnenolone -the “mother hormone”- is synthesized from cholesterol in the adrenal gland, and then through DHEA and the intermediate hormone androstenediol it cascades to produce both the male hormone testosterone and the female hormones collectively called the estrogens. According to the authors the estrogens are a mixture of 3 separate female sex hormones: Estrone,Estradiol, and Estriol in different proportions and with different functions
It occurred to me that maybe the difficulty for some individuals to determine their own gender and sexual behaviour may be the result of shifts in the concentrations of these different hormones.I recall in my own medical practice that I diagnosed a case of Kleinfelter’s syndrome based on the presence of an extra X (sex) chromosome-which incidentally was made in my own private Western Cytogenetic Laboratory.