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William H. Waugh, MD

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I am writing in response to the editorial titled "Preventing Cognitive Declines in Usual Aging" by Espeland and Henderson.¹ Prevention of mild cognitive declines preceding diagnosable Alzheimer disease (AD) and declines in AD dementia will probably be most effective when the intervention targets a process closely relevant to the disease pathogenesis.¹ Oxidative stress changes have been shown to precede the cardinal neuropathologic manifestations of AD.² Therapy for AD focuses mainly on the hypotheses that amyloid and the tubular tau proteins are at the core of the disease.

It is prudent to focus on iron overload. The iron burden theory covers both the clinical manifestations and the deposition of the amyloid plaques and the neurofibrillary tangles of AD.³ Goodman³ described numerous deposits of iron in many cerebral gray matter regions with iron deposits in the cytoplasm of neurofibrillary tangle-bearing neurons and with iron staining in amyloid plaques, . . . [Full Text of this Article]

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Preventing Cognitive Decline in Usual Aging
Mark A. Espeland and Victor W. Henderson
Arch Intern Med. 2006;166(22):2433-2434.
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