A: To tailor treatments now for preventing possible future dementia - if you can pay for it.
Disclaimer: This post contains information and opinions from someone with no background in medicine or science (proceed with extreme caution). Always consult with your own trusted medical and legal practitioners before making any decisions about diagnosis, treatment, estate planning, and outcomes for dementia or any other condition. I receive no paid endorsements from any post.
A pandemic caused by Covid-19 and dementia were never supposed to happen at the same time as our most vulnerable residents are already helpless against an invisible foe and they are dying as we debate about whether or not to wear masks (or to get a vaccine) to help prevent its spread. Such a sinister and selfish place we find ourselves today without help from those who could make a difference if they would each look a moment beyond their own needs and beyond a paranoia that is worse than any I have seen caused by Alzheimer's Disease.
Let me start by saying how upset I am that we're living in a country where it's still a debate on whether or not we need an Affordable Care Act. Right now, dementia treatment options (and all medical care) is available to those who can pay for it along with having health insurance because having one without the other is worthless except for the wealthiest few among us including corporations that paid no taxes on their U.S. profits in 2018.
Imagine how the US could help people had these hoarded profits been used for supplementing every single person without health insurance (for starters). This gross imbalance is killing people each day whether we ever meet them or not. They are waiting in the Emergency Room for many hours beyond those with insurance because they have no insurance. They are dying from cancer and other chronic conditions because they cannot pay and have no insurance. They are dying from dementia because they do not know there is a better way toward treatment; or, even if they know, then it's beyond their ability to pay without insurance much less longer office visits, DNA tests, and custom supplements.
I'm not sure how to write about DNA testing without also talking about its inequities since I cannot solve these problems nor can society begin to resolve them until we acknowledge that it's unacceptable for anyone to die in the United States because this person has no health insurance.
When dad died from Alzheimer's Disease complications on June 30, 2017, we each thought that there was nothing we could do since every medical visit with multiple doctors was the same: No cure, but we can write him a prescription to slow its progress.
Why would anyone want to live longer with dementia?
If dad had a lengthy appointment, then we might get an hour with a specialist (neurologist or opthalmologist) but never more than 15 minutes with the primary care doctor.
Through it all, we thought we were the lucky ones since we had health insurance combined with Medicare so he paid nothing out of pocket. With every visit, he would get his usual meds but another to prevent any hallucinations caused by what the neurologist thought was Lewy Bodies Dementia (the same affliction that caused beloved talent Robin Williams to kill himself.) Dad's care also seemed better than the antipsychotic meds given to my grandfather for his paranoid delusions which made him still like a seashell bound to concrete from what we would later learn was Alzheimer's when he died in 1986. At the time, with the internet almost a decade away, our only assurance that we were not alone in this suffering was a compassionate and thoughtful book preparing us for"the long goodbye" called The 36-Hour Day by Nancy Mace and Peter Rabins, MD (now in its sixth printing).
Imagine our surprise a few months after dad's memorial when we go to Costco and find Dr. Dale Bredesen's book: The End of Alzheimer's which details case studies from patients helped by his early dementia intervention which has often prevented their future brain destruction from ongoing attention to diet, exercise, and supplements.
For years, I have been fortunate to have health insurance as well as compassionate and knowledgeable primary care doctors who have each been outpaced every day by time. Most health conditions (even simple ones) are complex and cannot be treated in 15-20 minutes but this is our system and we accept this each day because what choice do we have without money and insurance? The answer is: None. After observing from afar as health care professionals care for people in our community with low income and simultaneously learning about own risk for dementia, I became convinced that there must be a better way for everyone. It's the medical care that we all need but cannot receive until the entire system is redesigned around an equity model to give people what they need which can NEVER be done in a 15-20 minute visit. Any change like this would require a complete overhaul for the insurance and health care systems and these are problems beyond what I can offer with own puny knowledge; but, let me give you a glimmer to hope: Functional Medicine. Some may call it concierge care (a term I don't like because it sounds exclusive) and because it's what we each MUST have to thrive.
Just think about this a moment. For everyone out there right now who is struggling with dementia for themselves or a loved one: They get a 15-20 minute visit with the doctor who wants to help. How many think this is enough time?
In general, here's one way that Functional Medicine (Concierge Care) works based upon the Bredesen model for dementia prevention. All listed fees are estimates and may vary by provider and location:
For a yearly fee, typically $2,500, you join a health care provider practice that specializes in dementia prevention
Upon joining, you may choose to get a DNA Test (for an extra $1,200) and doing so will get you extensive results that will be analyzed by your doctor for supplements and treatments based upon what you actually need - not guesswork - but rather the latest studies (research) from the National Institutes of Health (NIH) among other sources
Each regular visit is at least an hour (maybe longer as needed)
You can schedule a separate appointment with an onsite dietician
All office visits are covered both through private pay and health insurance
You can call or email the doctor and staff at any time with any questions or by using their online health care portal - no wait and no extra charge unless medications or additional services are needed. After hours on-call visits are also available for urgent request
You are seen in a small and private clinic environment with a handful of patients at a time in a cozy waiting room that feels more like a hotel than a medical office.
What Fool Takes This Many Supplements a Day? Hint: I do!
Before you go down to the local store and buy all these: PLEASE DON'T because you would be defeating the purpose of helping your own brain through tailored genetic testing from a health care provider (board certified medical doctor) who is trained and licensed to do so. Plus, this industry is ENTIRELY unregulated so any pills you take are always buyer beware. Most people may look at these pills and see a fool and her money are soon parted but it's a chance I'm willing to take since I carry a higher genetic risk for Alzheimer's due to own family history but in no way do I feel my efforts are being wasted. Toxicity, Supplements, & DNA Testing Dr. Bredesen says that trying to repair dementia is like trying to fix a leaky roof with 36 holes and each one represents damage to the brain which can lead to dementia with toxicity being among them. His book goes into much greater depth on how to approach this problem but for starters, please consider having your DNA tested by a health care provider that specializes in his methods which began more than 20 years ago and continue now as the Bredesen protocol. Having this DNA test will allow this trained provider to analyze your DNA pathways to best determine what supplements will work best based upon your results and takes the guesswork from choosing supplements which can cause more harm than good since the entire supplement industry is not regulated in the United States. See also: September 2020 Consumer Reports article: The Safest Ways to Take Supplements as well as their January 2020 article.