welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Monday, August 15, 2022

alzheimers news-i am sure glad i started aricept 12 years ago


12 years ago after i tried to enter the alzheimers study called adni 2 in the normal control group it was found i had memory loss greater than i should have based on my age and my degree of education
i noticed the issues as i was taking my neuropsychological memory test
i told my wife afterwards ive got a problem
i eventually saw a private neurologist and was placed in the mci or mild cognitive impairment group of the adni 2 study
my moca memory test score was around 24 or 25
today my moca memory test score is 30

my score today should have dropped down like in the graph below
it didnt 
it went up

today if i tried to enter the adni2 study and they didnt have my amyloid pet scan which is positive
i would probably be in the normal group of the adni 2 study

aricept or donepezil is usually the first drug thats tried on you when you are diagnosed with alzheimers disease
it is an acetylcholinesterase inhibitor
it prevents an enzyme from breaking down acetylcholine in the nerve endings
the acetylcholine makes the nerve endings fire and transmit impulses from nerve to nerve
if its low the nerve cells or brain cells dont work well
by taking aricept or donepezil you get a higher level of acetylcholine in the nerve endings

this accumulation makes the brain cells work better
it also causes the side effects you can see with aricpet or donepezil

before i saw my new neurologist in 2010 i researched aricept or donepezil and its use in mci and early alzheimers
a study a small one showed that folks put on aricept or donepezil early in their disease seem to have a prolonged benefit over time

after i saw her she said you have mci that probably will turn out to be due to alzheimers disease
she was right
she said that i might benefit from starting it so early in the diagnosis
she was right

later i was on a state committee that was working on recommendations for primary care doctors on how to evaluate folks with memory loss
two neurologists on the committee said that they would not have started me on aricept or donepezil
another neurologist said she would have started me on it
they were wrong
she was right

aricept slows down the symptoms of alzheimers but doesnt stop the disease from progressing in the brain
the disease eventually reaches a point that aricept doesnt  help much

im glad i did it

i knew enough about the side effects to know what to expect and was prepared for them
i knew that i needed to persevere through these side effect since most of them would go away or become tolerable

my worst side effect initially was the nausea and loss of appetite for about a month
that eventually went away
the one side effect that persists is its effect on my sleep as it limits how many hours i sleep
i have very vivid dreams but i tolerate them since they are not usually disturbing
i do now act out my dreams some
that may be the progression of the disease though

i take it in the morning after i eat breakfast and do ok on it
i have occasional leg cramps that make me jump out of bed
i initially had blurred vision and mild vertigo but that resolved the first month
over all
im now tolerating it ok

two years ago when i was sick with what i think was covid i couldnt eat or take my meds
i was off the aricept or donepezil for a month
i noticed a difference when i was off the meds in my memory 
i wish i had done a memory test during that time off the meds

now a new study linked here from nature and very well reviewed by dr daniel gibbs from a tatoo on my brain may be the study that says you should be on aricept or donepezil early in the disease and that it slows down the cognitive decline seen in alzheimers and it also seems to prolong life

now dr gibbs a neurologist has mci due to alzheimers 
he was in the biogen aduhelm or aducanumab study like i am in 
he had to stop the study since he developed a major microbleed from taking the aduhelm or aducanumab
he like me has been on aricept or donepezil for several years

i will do my simple version of the results

to see the scientific article from nature click this link
this one has more scientific info in it
to read dr gibbs blog on this click this link
his is also down to earth but is more scientific than mine

they looked at around 500+ folks with alzheimers disease who took aricept or donepezil
they also looked around 500+ folks with alzheimers disease who did not take aricept of donepezil
they then used their medical records to follow them for around 12 years
the memory testing done was the mmse or mini mental state examination
a memory test commonly used in clinical studies and in doctors offices

now i dont have all my mmse scores but i do have my last one done a month ago
it was 30
i do have my moca or montreal cognitive assessment test
my original one was around 25 in 2010 then it dropped around 24 but now in the last few years the score has been 28-30
my last few moca tests have been normal at 30
the normal range for the moca test is 27-30

so if you look at that graph
the top line is those on aricept or donepezil for 12 years
the bottom line is those not on aricept or donepezil for 12 years

initially most peoples mmse scores were normal ie 27-30

you can see that over the 12 years those folks who took the aricept or donepezil have mmse scores that are 5 pts better than those who didnt take aricept or donepezil
there would be big noticeable differences in what the families see and how well their family members are doing who if they took aricept or donepezil for 12 years

the graph also shows that the treated patients dont really start dropping off in memory scores until after 6 years
the untreated ones dropped off sooner

now if you plotted my scores my graph would start low and go up over the 12 years
making an X with the aricept graph shown above

it was noted and the graphs are shown in the original nature study that those treated patients lived a lot longer than the untreated ones

the results were similar for those with vascular dementia and maybe those with lewy body dementia

so those treated with aricept or donepezil for 12 year had much better memories and they lived longer than those not treated

why am i doing better
why did my graph X that one above

i think starting aricept or donepezil 12 years ago is one reason im better
im glad i didnt listen to those two neurologist
im glad i wasn't the patient of those two neurologists 

also i think its also because i did lifestyle changes to improve my overall health 
control my blood pressure and cholesterol and weight
eat a mind diet
add a nap to get my 7 hours of sleep in
stay active mentally physically and socially 
avoid alcohol abuse
didnt smoke

does aduhlem or aducanumab help
i think it has some effect now since i have been on almost 20 infusions of the drug
thats enough to remove a bulk of the amyloid plaque from my brain 
it should be slowing my decline down by about 20%

add that to what the aricept or donepezil and the healthy living has done
thats probably why my moca scores are 30 and my memory seems to be intact

im glad i started aricept tor donepezil 12 years ago 
im glad i am on the aduhelm or aducanumab infusions

i think all this has made a difference

so if you or your family member or friends are thinking of  whether they need to be on aricept or donepezil when yall get diagnosed with mci and or alzheimers disease
just read this study
it shows it makes a difference
such that 
your family and friends will appreciate it and will enjoy having you around physically and mentally a little longer

ill take that extra time with my family and friends every time

the organicgreen doctor

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