Introduction

In the book Alzheimer’s Disease: Unravelling the Mystery (2002), Alzheimer’s Disease is defined as an “irreversible, progressive brain disease that slowly destroys memory and thinking skills, eventually even the ability to carry out the simplest tasks” (p. 4).

The disease disrupts each of the three processes that keep neurons healthy: communication, metabolism, and repair. This disruption causes certain nerve cell in the brain to stop working, lose connections with other nerve cells, and finally, die. The destruction and death of nerve cells causes the memory failure, personality changes, problems in carrying out daily activities, and other features of the disease (Alzheimer’s Disease, 2002, p. 20).

Some of the symptoms indicating that a person has Alzheimer’s Disease include significant loss of memory for recent events, significant thinking deficits, and withdrawal from usual interests (Robinson, Saisan, & Segal, 2012).

Until the present, no cure is found for the disease. However, symptoms can be treated. Although there is no assurance that the treatment can prevent the disease from progressing, treatment from early identification may be effective in delaying more debilitating symptoms (Robinson, Saisan, & Segal, 2012). Instead of drug medication, natural or alternative medicine may be used for treatment as it is known to have minimal or none negative effect compared to drug medications. One complimentary alternative medicine that is known to protect patients from developing Alzheimer’s Disease is grape seed extract. Researches claim that grape seed extract has active components effective in the prevention or treatment of Alzheimer’s Disease. In this paper, grape seed extract as a complimentary alternative medicine for treatment or prevention of Alzheimer’s Disease is discussed.

Review of Related Literature

This section discusses the review of related literature on grape seed extract and its role in the treatment or prevention of Alzheimer’s disease.

Grape Seed Extract

Grape seed extract is a “natural plant constituent (bioflavonoid) which strengthens and protects living tissue” (Grape Seed Extract, Grape Seed Extract Benefits Educational Information section, para. 1). According to Frank Mangano (2009), “grape seed extract in supplement form is usually made from the seeds and sometimes the outer skin of red grapes” (p. 42).

Grape Seed Extract and Alzheimer’s Disease

The active components of grape seed extract called Oligomerc Procyanidolic Complexes (OPC) are “50 times stronger than Vitamin E and 20 times stronger than Vitamin C” (Grape Seed Extract, Grape Seed Extract Benefits Educational Information section, para. 1) which, based on the study of Santos, Oliveira, Shenk, Nunomura, Smith, Zhu, and Perry (2008), may lover the risk of Alzheimer’s disease if used in higher doses.

Paul Schacknow and John Samples (2010) said that grape seed has proanthocyanidins. These pronthocyanidins have a “broad spectrum of pharmacological and medicinal properties against oxidative stress” (p. 661) which plays a role in the development and occurs early in the progression of Alzheimer’s Disease. Moreover, proanthocyanidin extract from grape seed “provides excellent protection against free radicals” (Schacknow & Samples p. 661) which also play a role in the pathogenesis of Alzheimer’s disease (Moreira, Santos, Oliviera, Shenk, Nunomura, Smith, Zhu, & Perry, 2008).

Anne Hart in her book Neurotechnology with Culinary Memoirs from the Daily Nutrition & Health Reporter introduced grape seed extract as “designed to possible prevent or reverse the symptoms of Alzheimer’s Disease” (2009, 310). In her book, she cited a study suggesting that “grape seed-derived polyphenolics may be useful agents to prevent or treat Alzheimer’s Disease” (Hart, 2009, p. 311).

Donal O’Mathuna (2006) noted that grape seed extract contains bioflanoids and other components which Professor Jacques Masquelier termed “pycogenols” (p. 367). These components contain Vitamin C from which high doses, along with Vitamin E, may help in the prevention of Alzheimer’s Disease (Landmark as cited in Life Extension, 2012). Anne Hart (2009) mentioned that a study published in the Journal of Neuroscience in 2008 had “implications for the future use…of grape seed extract…to inhibit the development of Alzheimer’s Disease” (p. 310). The study examined the hypothesis that certain molecules contained in red wine which is present in grape seed extract, “might offset disease progression in mice genetically modified to develop Alzheimer’s Disease” (Hart, 2009, p. 310).

David R. Gang (2011) indicated in his book The Biological Activity of Phytochemicals the particular components in grape seed extracts and its activities that aid in the prevention and treatment of Alzheimer’s Disease. According to him “grape seed extract (GSE) is a complex mixture of PA monomers, oligomers, and polymers consisting of (+)-catechin, (-)-epicatechin, and (-)-epicatechin gallate subunits linked by C4   C8 or C4   C6 interflavan bonds” (p. 33). Recent studies indicate that “these compounds have been ascribed a number of potential activities beneficial to health, including protection against ... Alzheimer’s Disease” (Gang, 2011, p. 33).

Furthermore, “grape-derived polyphenolic compounds may inhibit deposition of the beta-amyloid protein in spaces between the nerve cells, a process also called Aβ oligomerization” (Gang, 2011, p. 33). The neurological impact of the process “could provide the missing link that accounts for the poor correlation between Alzheimer’s Disease and amyloid plaques” (Gong, Chang, Viola, Lacor, Lambert, Finch, Krafft & Klein, 2003).

Likewise, studies at Mount Sinai School of Medicine indicated that “dietary grape seed extract significantly reduced Alzheimer’s Disease-type cognitive deterioration in mice by prevention of amyloid formation in the brain (Gang, 2011, p. 33-34). Akhlaq Farooqui and Tahira Farooqui (2012) also demonstrated in their book Oxidative Stress in Vertebrates and Invertebrates: Molecular Aspects of Cell Signalling that other

grape-derived products, namely, a grape seed polyphenolic extract and a purple grape juice, also exert bioactivity at the organism level and significantly interfere with the development of Aβ-related phenotypes in Alzheimer’s Disease mouse models (p. 242). In [this] light of observation that multiple dietary grape products with distinct polyphenolic component composition effectively protect against the onset and progression of Alzheimer’s Disease phenotypes, [they] hypothesize that additional grape-derived products, including other red wines, might also provide beneficial disease-modifying activities in Alzheimer’s Disease (p. 242).

Ray Kurzweil and Terry Grossman (2009) explained in their book Transcend: Nine Steps to Living Well Forever how grape seed extract aids in the treatment or prevention of Alzheimer’s Disease. According to them, grape seed extract is abundant in proanthocyanidins which are “extraordinarily powerful free radical scavengers removing  amyloid, a factor in Alzheimer’s Disease” (p. 39). Moreover, Sun and Cheng (as cited in Benzie & Galor, 2011) said that “a dietary supplement of polyphenols extracted from grape skin and seeds could offer protection against oxidative damage to brain synaptic membranes,” a condition in Alzheimer’s disease (p. 317).

Clinical Use of Grape Seed Extract in Primary Care Settings

Grape seed extract is also used in primary care settings. Dr. Ray D. Strand, a specialist in nutritional and preventive medicine, believed that grape seed extract is a “powerful antioxidant supplement [that] fights free radicals. He uses higher doses than above to treat many diseases... [including] Alzheimer’s disease” (Fee, 2011, p. 132).

Cathy Wong (2012) mentioned that generally, grape seed extract is “well tolerated when taken by mouth” (Is Grape Seed Extract Safe section, para. 1). She also stated that grape seed extract has been used “safely for up to 8 weeks in clinical trials” (Is Grape Seed Extract Safe section, para. 1). However, she advises patients to consult a physician prior to taking grape seed extract considering that it will be used in treatment or prevention of any disease or condition (Wong, 2012).

Side Effects and Controversial Issues

John Heggers, Ph.D presented a study in 2002 at the University of Texas Medical School showing that “grapefruit seed extract at non-toxic concentrations, had a significant ability to inhibit or prevent the growth of 67 individual pathogens” (as cited in Underwood, 2012, Controversy section, para. 1). Therefore it is possible, according to Corrina Underwood (2012), that the “manufactured supplements in previous studies contained unhealthy additives that masked the natural abilities of grapefruit seed extract” (Controversy section, para. 1). She said that the controversy still continues and more studies have to be conducted to resolve the issue (Underwood, 2012).

Frank Minirth, John Claude Krusz, Alan Horewell, and Virginia Neal (2005) enumerated a number of untoward reactions of grape seed extract. According to them, “double-blind clinical studies on the use of grape seed extract in treating or preventing various disease processes are insufficient” (Minirth et al., 2005, p. 300). Gehring (2009) said the common adverse effects of prolonged use of grape seed extract are dry, itchy scalp, nausea, headache, and dizziness.

In addition, Svetlana Konnikova and Anna Maria Clement (2008) mentioned the same side effects previously stated by Gehring but included cough. They further said that potential effects on infants and pregnant and breastfeeding mothers are unclear due to limited information; therefore taking grape seed extract is not advised. Moreover, they asserted that grape seed extract may

increase the effects of drugs, herbs, antioxidants or health supplements, if [individuals] have a bleeding or clotting disorder or if they are taking medicine to prevent blood clots. Grape seed [extract] has not been evaluated by the FDA for safety or potential risks and/or advantages of grape seed may not be known. Additionally there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/health supplements have been sold which were contaminated with toxic metals or other drugs (Konnikova & Clement, 2008, 40).

Conclusion

Grape seed extract was proven to be beneficial in the treatment or prevention of Alzheimer’s Disease. However, it is not advised to use it for medication of the disease without a physician’s recommendation.

Implications for Nurse Practitioner Practice

In the light of the knowledge from the research done, nurse practitioners should not impose patients to take grape seed extract without medical prescription from licensed physicians. Although grape seed extract is widely known for it’s somehow effectivity in the prevention or treatment of Alzheimer’s Disease, it is not only better but even more, important to consult a physician because each individual or patient has different cases. More often than not, grape seed extract may be beneficial for one but not for all. Moreover, if it will be taken for long periods of time and in large doses, the effect will be serious therefore it is crucial to seek a medical instruction prior to any attempt.

On the other hand, nurse practitioners may use or advise their patients to use grape seed extract as a health supplement but not for medication providing that their attending physician is knowledgeable about it to prevent further casualty.

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