Alzheimer - In search of the truth E-Book

Thomas Meier

• Herausgeber: novum pro Verlag
• Kategorie: Gesellschafts- und Liebesromane
• Sprache: Englisch
• Veröffentlichungsjahr: 2023

Seitenzahl: 271

Beschreibung

Alzheimer's is a distressing disease that causes numerous fears and difficulties for those affected and their relatives. At the same time, it poses a great mystery to medicine and raises questions that have not yet been answered unequivocally. Although Alzheimer's tends to be regarded in our population as a disease of the older generation, Thomas Meier was already affected by the symptoms at a young age. He struggles with health problems that cause, among other things, memory difficulties. After a number of unsuccessful visits to various doctors, he begins to search for solutions against the mental decline himself in a lengthy process. He presents his experiences and the results of his research in detail in this book.

Leseprobe

Introduction

In a total of 99.9 percent of the time that mankind has inhabited this planet, the average life expectancy has been only 30 years. Even though this is hardly conceivable for all of us in this day and age, this was reality for a long time and growing old was the absolute exception. If our ancestors were not eaten by lions for breakfast, they often died at a young age as a result of a bacterial infection or a viral disease. Nowadays it is hard to imagine that even at the beginning of the 20th century a simple wound infection could mean death. But in fact, only those who had the strongest immune system survived back then. Today, on the other hand, even people with weak immune systems can live to a respectable age. Medicine, technology, hygiene and all that man has come up with over time to combat plague, cholera and other diseases have given mankind additional decades. We are getting older and older. In the past one hundred years, statistically speaking, our life expectancy has almost doubled. But we are paying a high price for it. Our efficiency decreases with every year of life gained and everything becomes harder for us. Everyday things that came naturally to us in our younger years eventually become impossible or very difficult to do. Also the mind fades with increasing age more and more and suddenly it does not work any more. The human being - nursing case. This phenomenon is undoubtedly one of the greatest horrors for each of us and therefore it is not surprising that we like to push it far away from us.

My mother first developed Parkinson's disease, and later Alzheimer's disease. Anyone who has ever accompanied a relative with dementia knows what this diagnosis means. The language of those with the disease is usually limited to only a few words or dries up completely. Dementia patients are dependent on help from other people for most of the tasks of daily life. Preparing meals, combing hair or taking a bath are often no longer possible independently. This can be compounded by other limitations such as difficulty chewing, swallowing and breathing, as well as stiffening of the limbs. These are all typical Alzheimer's symptoms that occur in the late stages.

Particularly in the last phase of the disease, those affected are in great need of care. They regress to the state of a baby and have to wear diapers again, for example. For those persons who assist the affected persons during this time, it is difficult to accept what happens to the relatives.

Statistically, the probability of developing dementia doubles every five years after the age of 60. 90 percent of dementia patients are older than 75. This suggests that age is the greatest risk factor for dementia. However, even though the number of dementia cases increases steadily with age, there are definitely people who develop dementia at a young age. Between 20,000 and 24,000 people in Germany are already affected by this disease between the ages of 45 and 65. According to Wikipedia, the youngest Alzheimer's patient fell ill at the age of 27 and died a few years later at the age of 33. In fact, however, even children are affected. In Germany, about 700 boys and girls are said to suffer from childhood dementia.

Dr. Richard Taylor was a psychology professor and 58 years old when he was diagnosed with Alzheimer's disease in 2001. In 2011, four years before his death, he said of his disease, "For the past ten years, I have lived with a diagnosis of dementia, probably of the Alzheimer's type. At least that's what a doctor told me ten years ago. And although neither my wife, nor my brother, nor myself can remember to this day what else he said besides those life-changing words, I'm pretty sure he didn't tell me that his words would mark the beginning of long life for me. I'm also pretty sure he didn't say that Alzheimer's disease will steal my soul. I'm pretty sure he didn't say I was going to die twice. I'm pretty sure he didn't say I'll become a shell of my former self as I near the end of my life. I'm pretty sure he didn't say I would turn into a turtle that was burned and whose shell was left to dry, safely tucked away in a wheelchair, waiting for the winds of time to turn my shell into a pile of dust so it could be buried." 1

Alzheimer's disease is a disease that leads to death. The time span between diagnosis and death can range from three to twenty years. In general, the later in life the disease occurs, the shorter the Alzheimer's course.

Auguste Deter was the first Alzheimer's patient. She was only 51 years old. Her husband took her to the insane asylum in 1901 because of mysterious symptoms. In 1906, she died miserably of emaciation. When her brain was examined after her death, protein deposits were discovered there. These protein deposits are characteristic of the "disease of forgetfulness" to this day.

I have been dealing with the topic of memory loss for over 20 years, at first occasionally and now intensively for 10 years. Since I myself had problems with my memory as a child and in my early 30s my memory performance declined rapidly, I began to investigate this topic. Like probably everyone, I first went the way of conventional medicine. Since they could not (would not) help me, I became active myself. Among other things, I looked into brain-relevant nutrition and took all kinds of nutritional supplements. I made experiences in particular with hormones, whose effect was amazing. Hormones are known to run out in humans with increasing age. Therefore, it is these little helpers that ultimately cause us to "wilt" when they are missing. This was already proven in 1990 by Dr. Rudman. By administering growth hormone to older men, he was able to show that this hormone has an absolutely rejuvenating effect.

What are hormones? They are the generals in metabolism and the key to everything that happens in our body. They are chemical messengers that give orders. They go to a cell, log into its receptor and tell the cell what to do. The term hormone comes from the Greek and means to drive or excite.

Hormones have a performance-enhancing effect. Ask professional cyclists, cross-country skiers or professional swimmers about this - they know exactly. And why do you think it is becoming increasingly difficult for older people to climb stairs? The older generation in particular likes to talk about how their old bones don't want to go up the stairs the way they used to.

I have experienced lack of strength so many times in my life that I can say quite clearly that it is not only age itself that lowers our performance.

Our life begins with a single cell, the fertilized egg cell. Through constantly repeated cell division, nearly 100 trillion body cells are eventually created. Cells organize themselves into specific tissues, organs and body systems. Regardless of how long we have been alive, our body cells are on average no older than ten years. After only three to four years, almost the entire cell stock of a human being has been renewed once. Consequently, a - at least molecularly - renewed human being is created. How can one speak of being old in this context?

Every second, the organism builds 10 million new cells from the building materials of food. Every five days, for example, the stomach lining is completely renewed by this process. Fatty tissue is replaced every three weeks. Red blood cells last for three months and a skin cell lives for a maximum of 14 days. Bone cells, on the other hand, take a little longer. They need a full 25 - 30 years for their renewal. Our muscle cells never get older than 15 years. 2

A muscle cell does what it can throughout its life, it contracts. It doesn't matter how old it is. To function, cells need energy from food, oxygen and a command (stimulus). In order for our cells to do their job, they need messenger substances called neurotransmitters or hormones. Without them, nothing works.

Messenger substances are involved in the formation of our feelings.

According to current knowledge, whether we feel joy or are happy or unhappy is largely dependent on four messenger substances: Serotonin, adrenaline, noradrenaline and dopamine.

I certainly haven't found the "Holy Grail of Youth" through my research and experiences over the years, but I have experienced that we are by no means hopelessly at the mercy of physical and mental decline.

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The brain

Our brain contains about 100 billion brain cells. These brain cells are linked to each other via about 100 trillion contact points - the so-called synapses.

The basic principle: A nerve cell (neuron) consists of three basic elements. The first is the cell body. It forms the "control center" of the neuron. There are two types of projections on the cell body, the dendrites and the axon. A neuron has many dendrites, but only a single axon. The dendrites receive electrical impulses from other nerve cells and transmit them to the cell body. The impulses contain information that is processed in the cell. The cell body then generates output signals, which are transmitted via the often widely branched "output cable", the axon. Along its entire length, the axon functions mainly as a kind of electrical cable with the function of relaying the signal. Once the electrical signal reaches the end of the axon, the synapse, neurotransmitters are released. Neurotransmitters are the messenger substances of the nervous system. They dock onto receptors of other neurons and have either an excitatory or inhibitory effect there. Through this process, they stimulate further neurons. Colloquially, this is also referred to as a nerve cell firing. It can do this up to 500 times in one second.

Over 100 different neurotransmitters are now known. Each receptor is specialized for a particular neurotransmitter, like a key and a matching lock. Hundreds to thousands of synapses of other nerve cells can be docked to a neuron. The synapses are thus the central switching points for the transmission of information in the brain. A total of almost 100 billion neurons must communicate with each other continuously so that we can feel, act and think. In milliseconds, complex chemical and electrical processes take place at thousands of cells - for a single (meaningful) action. During learning processes, the number of receptors between the nerve cells involved increases even further. The transmission of information is thus increasingly strengthened and new connections are formed in the brain. In short, everything that has to do with learning or brain development is based on an increase in receptors and a growth or change in the connections between the nerve cells.

Did you know that the first thing to be destroyed in Alzheimer's disease is the synapses? The nerve cells themselves only perish much later. At the beginning of the disease, the synapses are not immediately completely destroyed, but are initially only battered. They are empty and flabby because no more information reaches them. As the disease progresses, the connections between the neurons are lost first, and later entire nerve cells die. Without information, cells cannot survive. In severe cases of Alzheimer's, the brain can shrink to a third of its original volume.

Are there means available today that make it possible to halt or even reverse mental decline? If this were the case, Alzheimer's research would surely have already discovered or even researched this.

In 2020, the ambassador of the Alzheimer Forschung Initiative e.V., explained in a lecture that there are no success stories in Alzheimer's disease. There is not a single survivor. With Alzheimer's, there is no one who says, look here, I had a bad time, I went through a tough therapy, but today I'm fine again and I can enjoy a few more years of my life.3 From the point of view of conventional medicine, this may also be true. Medication has not yet succeeded in counteracting memory loss. But I say clearly, it is possible. With today's knowledge it is possible to stop a mental decline and to a certain extent to reverse it. The basic prerequisite for this is that our brain is supplied with all brain-relevant substances. Since I can say from my own experience that certain molecules are not examined during a visit to the doctor, I would like to discuss this in the following.

Magnesium

Magnesium plays a key role in the regulation of messenger substances that influence our mood. It has a calming effect on nerve cells and prevents nervousness, among other things. Magnesium is also important for energy production and supply in the brain. In high doses, it stimulates the formation of new brain connections and activates signal molecules that are crucially involved in the learning process. Magnesium also has a positive effect on blood vessels. It ensures that they remain elastic and stretchable. Numerous studies prove the connection between magnesium deficiency and dementia. 4

Iron

Iron is one of the most important substances for a good energy supply. Without this trace element, oxygen transport to the brain does not function smoothly. In addition, iron is involved in the formation of nerve messengers. If iron is not available during this process, immediate effects on our thinking and behavior become apparent.

Zinc

Zinc plays an important role in sugar, fat and protein metabolism, in the formation of genetic material and in cell growth. It is indispensable for the function of the immune system and various hormones. Since this trace element cannot be stored in the body, a regular and sufficient supply is very important. Depression, aggressiveness as well as anxiety can be serious consequences if zinc is not present in the brain in sufficient quantities. This fact has been known for 50 years. Scientists at the Max Planck Institute for Brain Research in Frankfurt have discovered what exactly zinc does in the brain. Zinc ions help regulate nerve signals at the synapses. They ensure that the body can process commands or reflexes from the brain without error.5

LipiDiDiet

According to an EU study, dietary supplements in particular could play an important role in the good health of the aging population. The LIPIDIET project, which was completed in March 2015, investigated whether the course of Alzheimer's disease can be delayed at an early stage by taking a special mixture of nutrients.

For this purpose, scientists recruited Alzheimer's patients who were in the early stages of the disease to test the efficacy of a liquid diet called "Souvenaid". This nutrient mixture is designed to promote the formation of new synapses in the brain. The nutrient combination consists of long-chain omega-3 fatty acids, phospholipids, choline, B vitamins (B6, B12 and folic acid), vitamins C and E, selenium and uridine monophosphate. After three years of treatment, there were widespread differences between the study participants and the control group. In the patients who took the nutrient mixture, the brains of the subjects affected by Alzheimer's shrank by 20 percent less than in the comparison group. The process of change in the brain was thus clearly slowed down. An even more important finding was that brain performance declined between 40 and 70 percent less during the three years than in the non-treated participants. The positive effect of the treatment was particularly evident in those patients who were able to start treatment at a very early stage of Alzheimer's disease.

Nutrients thus appear to play a central role in reducing the neurodegenerative process in AD. This suggests a special nutritional need in individuals suffering from Alzheimer's disease.6

What are studies of this kind done for? And above all, what of it reaches the doctors' offices? The S3 guideline "Dementias" states about this dietary supplement: "Souvenaid is not reimbursed by health insurance companies. The safe evaluation of the efficacy of Souvenaid on memory functions in mild Alzheimer's dementia cannot yet be made based on the current studies. Evidence for efficacy on everyday functions or efficacy in moderate dementia is not found."7

Protein

An important, if not the most important component of food is protein. Although our body cannot produce energy from protein, this substance is the beginning of all life. In order to live, our body must constantly produce new cells that replace the old and used ones. Protein is the building material for this process. For the process of cell formation, the genetic apparatus receives the command to produce new cells. Hormones enter the cells, attach themselves to the DNA and command it to divide. For this process, the genetic material must be exactly duplicated. Without protein, i.e. without building material, the formation of a new cell is not possible. Protein maintains our immune system. In addition, most hormones are formed from this substance.

Protein itself is also composed of various building blocks, the amino acids. They are the central building blocks of our body and metabolism. Amino acids are particularly valuable for the brain because they play an important role in nerve cell communication and allow new connections to form between them. Our brain does not function without amino acids.

In the human body, 21 amino acids have been identified. Of these, 13 can be produced by the body itself. Eight, in turn, are considered essential. Their formation is not possible for our organism, which means that we have to take them in with food.

Glutamine

Glutamine is a non-essential amino acid for humans. The body can form this amino acid itself. In case of an existing deficiency, glutamine can additionally be taken in through food. Glutamine stimulates the release of growth hormone. It thus supports the regeneration of the body - especially during sleep. In addition, glutamine is needed for the build-up of messenger substances in the brain.

Phenylalanine

The essential amino acid phenylalanine is involved in the formation of neurotransmitters. Phenylalanine is first converted to tyrosine, then to dopamine and later to norepinephrine, before it is finally converted to epinephrine. Norepinephrine is considered "fertilizer for the brain" because dendrites and synapses can grow faster under the influence of this hormone. Researchers have shown that people with high levels of adrenaline in their blood can absorb and store information more quickly.8

Threonine

This amino acid acts on the blood vessels and keeps them open. Thus, threonine plays a decisive role in ensuring that the vessels do not "calcify" into old age and that the blood flow is not restricted.

Proline - Lysine

The amino acid proline can be produced by the human organism from glutamic acid. It is therefore not considered- essential. Proline protects our cells from stress, UV radiation, cold and toxic heavy metals. Together, the amino acids lysine and proline are regulators and stabilizers of the genomic profile, i.e. the genetic information in the cell. In addition, these two protein building blocks are fuels for the cells of the connective tissue. Proline connects the neurons of the brain with the so-called glia cells of the brain. Together, they form the glia-neuron brain.

However, the body's own proline synthesis is not always sufficient, especially in the case of protracted diseases and in old age. In the case of a proline deficiency, communication between these areas is disturbed. This in turn has an effect on the brain's dopamine and serotonin systems.

Histidine

Histidine is important for building the red blood pigment that transports oxygen. The more histidine present, the more efficient the body and mind.

Glycine

In the central nervous system, glycine serves as a neurotransmitter. Glycine is consequently involved in the regulation of movement processes. In the brain, glycine acts as a co-agonist at glutamate receptors and therefore has a positive influence on memory and attention disorders. Glycine is involved in numerous detoxification reactions and has an antioxidant effect. It has a positive effect on the pituitary gland by promoting the formation of growth hormones.

Carnitine

Carnitine performs numerous functions in the body. It serves as a mood enhancer, supports many brain functions and provides increased stress resistance. Carnitine contributes significantly to energy production by transporting fatty acids into the "power plants" of the cells (mitochondria). Thus, carnitine can improve the energy supply of brain cells.

Arginine

The amino acid arginine is the starting substance for the formation of nitric oxide (NO). In the central nervous system, NO is involved in the formation of synapses and long-term memory.

BCAAs

BCAAs are three essential amino acids: leucine, isoleucine and valine. They are the building material of the muscles and therefore important to build new muscles or to protect the existing ones from degradation. They have insulin-stimulating effects, which not only lowers the blood sugar level, but also accelerates the absorption of amino acids into the muscle cells. This has positive effects on muscle building and additionally lowers the release of the stress hormone cortisol.

Amino acids pass the blood-brain barrier and enter the brain this way. Here they provide the energy supply. Some of them also have a positive effect on the release of growth hormone. At this point it is important to know that it is possible to be well supplied with proteins and still have a deficiency of individual amino acids. It always depends on the food source.

Although it is a fact that there can be a deficiency of amino acids in the human body, the picture in the doctor's office is quite different. If you suffer from memory problems, talk to your doctor about amino acids. You will find out very quickly that this deficiency does not exist in conventional medicine. I have experienced it myself. Nevertheless, it is possible at one's own expense to have the vital amino acids determined by a laboratory and to discuss the values with a doctor. It is often useless, because as unbelievable as it may sound, your doctor will usually have no idea about amino acids. In the evaluation, doctors are guided by the measured laboratory values and evaluate on the basis of the reference values. And what do the reference values look like? Here are three examples:

Arginine<22

Methionine<6

Phenylalanine<27

The amino acids should therefore be as low as possible. The optimum here would then be zero and that means: They are dead.9 This is the only way to explain the fact that a real undersupply of L-arginine is not known.

Myelin

Approximately 50 percent of the brain consists of millions of long connecting cables, the axons. They play a key role in ensuring that the brain functions and that all learning, thinking and memory processes can take place in the brain. Axons transmit the signals of the nerve cells as if through a cable. To ensure that the electrical communication between the nerve cells functions smoothly, they are covered with an insulating layer (myelin). How quickly nerve cells interact with each other depends on the health of the myelin in the central nervous system. Myelin is made up of 70 percent fats (a quarter of which is cholesterol) and 30 percent proteins. This is also referred to as the "white matter." 10

What does the body need for the electrical communication of the nerve cells to function smoothly? The electrical communication of the nerve cells cannot be influenced by medication.11 Therefore, taking tablets, for example, cannot be effective. One of the most important factors to build up the myelin layer and thus to ensure a functioning electrical communication of the nerve cells is restful sleep. Myelin is formed by the so-called oligodendrocytes. Cells that develop into oligodendrocytes are formed particularly strongly during REM sleep.

Omega-3 (precisely DHA) promotes the growth of axons and controls electrical currents. This substance is found massively in the neural network. Conversely, a lack of DHA means that signal transmission into the cell is reduced and eventually the life span of the neurons is shortened.

Vitamin D and vitamin K2 also have a positive effect on myelin. For example, studies have shown that the vitamin D receptor can increase the production of oligodendrocytes and vitamin K is involved in increasing so-called "sulfatides". This is a component of the myelin membrane layer. 12

Various scientific studies have established a close connection between nutrition and brain performance. According to these, more than 40 substances are involved in cognitive abilities, memory and learning capacity. The brain is dependent on essential substances and only functions properly if it is supplied with sufficient nutrients.13 At this point, a problem becomes apparent, because older people in particular are enormously susceptible to a vital substance deficiency, since the body can no longer utilize food components as well at an older age. In older people, a deficiency can have such a serious effect that the brain's function is severely impaired.

Over the last century, research has shown that anxiety, fatigue, insomnia, psychosis, hallucinations, paranoia, or severe depression can be a simple vitamin B3 deficiency. Thiamine (vitamin B1) deficiency is also associated with neurological problems. Thiamine deficiency has been associated with impaired cognition for decades. Vitamin B1 deficiency is now even blamed for the development of Alzheimer's disease because the brain needs thiamine to use glucose for energy. In addition, the brain needs thiamine to produce acetylcholine, the most important neurotransmitter that is deficient in patients with Alzheimer's disease.

Acetylcholine is crucially involved in learning processes and memory formation. Decreased concentrations of thiamine have been found in the brains of patients with Alzheimer's dementia. Thiamine is reduced by about one third in the plasma of Alzheimer's dementia patients.

More than one million people in Germany appear to have Alzheimer's disease. But in reality, this number could be significantly lower, because it is frighteningly common for doctors to make the wrong diagnosis. Over 40 percent are misdiagnoses. This is the alarming conclusion of the IDEAS (Imaging Dementia-Evidence for Amyloid Scanning) study conducted by the University of San Francisco. The study involved several thousand patients with mild cognitive impairment, as well as dementias such as Alzheimer's disease. All participants were examined using positron emission tomography (PET). This is an imaging procedure that makes so-called amyloid plaques in the brain visible. If these deposits are detectable, it does not necessarily mean that the affected person is suffering from dementia. The person may even be mentally fit and remain so.

If, on the other hand, no plaques can be seen on a person, it can be clearly assumed that this person does not have Alzheimer's disease. The study showed that around 40 percent of supposed dementia patients received a false diagnosis and did not have Alzheimer's disease. 14

Vitamin B12

Without this vitamin, myelin sheaths cannot be formed. It is therefore essential for the protection of the neuronal connections of the brain and plays a fundamental role in the synthesis of messenger substances. Among other things, it influences acetylcholine. Vitamin B12 deficiency can lead to schizophrenia, paranoia, psychosis or depression. A severe deficiency of vitamin B12 can even result in permanent loss of nerves, brain mass and neuronal connections.

It is known from studies and analyses that 24 percent of people over 65 with cognitive deficits have a vitamin B12 deficiency. So dementia with vitamin B12 deficiency is by no means a rare occurrence.15 Surprisingly, the S3 guideline "Dementias" even recommends determining vitamin B12 levels in patients with suspected dementia. This is surprising because the prevailing opinion in Germany is that there is no vitamin deficiency. The prerequisite for this examination is that a vitamin B12 deficiency is detected and treated as early as possible.

The therapeutic potential for vitamin B12 is apparently limited, as there seems to be only a small period of time during which vitamin B12 intake can still halt cognitive decline. Various studies have shown that this time window is about 6-12 months after the onset of the first symptoms. After this period has elapsed, it seems that the damage can no longer be repaired, at least not by vitamin B12. 16

Homocysteine

It has been known for over 20 years that the endogenous metabolite homocysteine is a risk factor for dementia. Homocysteine is a toxic waste product that is formed in protein metabolism. Since it is harmful to the body, it is quickly broken down by B vitamins.

If these vitamins are not present in sufficient quantities, homocysteine cannot be broken down. An elevated serum homocysteine level is not uncommon in old age. People with a concentration of more than 14 micromoles per liter of homocysteine in their blood serum have up to twice the risk of developing dementia compared to people with a low concentration of homocysteine in their blood serum. If both vitamin B12 levels are conspicuous (< 400 pg/ml) and homocysteine levels are elevated (≥ 15 µmol/l), the risk of Alzheimer's is even around 30 times higher, according to one study. The S3 Dementia Guideline also states that, in addition to vitamin B12, the levels of homocysteine, vitamin B6 and folic acid should be determined in cases of suspected diagnosis. Some dementia diseases could be prevented by a timely compensation of the deficiency. 17,18

Folic acid

The human organism can only store a small amount (approx. 5 to 10 mg) of folic acid (vitamin B9). Since this amount is only sufficient for a few weeks and the body cannot produce folic acid itself, a constant supply through food is essential. Folic acid is sensitive to heat. It is almost completely destroyed during a cooking process. If the folic acid level in the brain drops, a feeling of listlessness can quickly develop. A severe folic acid deficiency can lead to depression. A quarter of all depressions are affected by this. 19

In France, the Three-City Study (3C Study) was conducted from 1999 to 2012. A total of 1321 subjects aged 65 and older participated. Blood samples and neuropsychological tests were taken, and the subjects' food intake was recorded in a precise 24-hour log. The subjects were followed for an average of 7.4 years. The result was that the subjects who consumed the most folic acid had a 50 percent lower risk of dementia than the participants whose diets contained the least amount of folic acid. 20

In 2007, data from 965 elderly people were published. This showed that people who ate a diet rich in folic acid and also took folic acid in the form of dietary supplements developed Alzheimer's disease significantly less than the rest of the population. 21

It can be assumed that a substantial body of data exists when even the dementia guideline indicates that this vitamin should be investigated. Nevertheless, folic acid deficiency is the most common vitamin deficiency found in Western industrialized countries. In Germany, 79 percent of men and 86 percent of women do not reach the recommended daily intake of this vitamin. 22

Vitamins play a significant role in brain performance. They are important in the conversion of carbohydrates into glucose, of fatty acids into healthy brain cells and of amino acids into neurotransmitters. They are important for cell division and protect neurons in the brain from oxidative destruction.

With this enormous importance, it should be assumed that these essential substances are examined during a visit to the doctor. However, the reality in German medical practices is unfortunately different. The diagnostics in the practice generally looks more like the experience I have made. The patient is asked, for example, to count backwards in steps of 7, starting with the number 100, or to draw a clock. Nothing more is examined. This or something similar is what a detailed medical history interview looks like these days. I am not an isolated case. Hardly any elderly person who is confused or forgetful is thoroughly examined. Studies have already shown this.23 A doctor is only paid eight minutes to make a diagnosis. If he takes more time, this is done on a voluntary basis and without compensation.