How to keep a healthy brain
Keeping a healthy brain includes maintaining thought tasks or cognitive function. Cognitive function is a reflection of a person’s overall health and wellness, including a decline.
Normal cognitive decline consists of mild changes in the rate of information processing and new learning, as well as mild changes in memory.
- Mild Cognitive Impairment (MCI) is a decrease in cognitive function while still being able to function in daily life.
- Dementia, now called Major Neurocognitive Disorder (MND), is when loss of cognitive function impacts a person’s ability to function independently. Dementia, or MND, is postulated to affect 5% of people 65 years of age, and increases to as high as 50% in people 85 years of age and older.1
CAUSES OF DEMENTIA
Dementia can be reversible, or it can be irreversible and progressive. Reversible dementia can be traced to etiologies such as depression, stroke, traumatic brain injury, or medications. Some of the major irreversible and progressive dementias include: Alzheimer’s disease, dementia with Lewy bodies, vascular dementia, frontotemporal dementia, and Parkinson disease with dementia.2
Drugs that are thought to impair cognition include antihistamines, chemotherapy, anticonvulsants, analgesics, sedative-hypnotics, psychotropics, anticholinergics, muscle relaxants, and statin drugs. While some sources name marijuana as a contributing agent to impaired cognition, a THC derivative (a secondary metabolite) has been studied and shown to be a probable molecule for targeting/inhibiting acetylcholinesterase, which would support cognitive health.3
Dementia has been linked to genetic predispositions, eg, the APOE-4 genotype, which has been associated with increased risk. Diminished blood flow, including diminished oxygenation of brain cells due to cardiovascular disease and anemia (there’s different types of anemia- only 1 has need for iron supplementation), can be a predisposing factor. High blood sugar, insulin resistance and diabetes, sometimes referred to as Type 3 Diabetes when combined with cognitive impairment, can increase the risk of hippocampal brain shrinkage; diabetics are twice as likely to develop MND as non-diabetics. High cortisol levels due to chronic stressors and inflammation are another contributor to hippocampal dysfunction.
LIFESTYLE & NUTRITIONAL CONSIDERATIONS
No matter what name or categorization dementia is given, prevention throughout life is optimal, with a focus on good nutrition, stabile blood labs, optimal brain and nerve pathway activation, regular aerobic exercise, adequate and rejuvenating sleep, and an active engagement in life, mentally and socially.
There are many nutritional supplements to consider. Some that have been highlighted in the literature are omega-3 fatty acids, including higher %’s of DHA, blood sugar stabilizing agents and anti-inflammatory supplements such as turmeric and resveratrol.
There is much to be said about the supplementation of amino acids in the prevention and treatment of cognitive dysfunction. Each has its individual contribution, and various combinations of amino acids are worthy considerations in the treatment of MCI and MND. Some of the more commonly used amino acids include acetyl-L-carnitine (or L-carnitine), phosphatidylserine, phosphatidylcholine, inositol, N-acetylcysteine, S-adenosylmethionine, L-glutamine, and L-tyrosine.
Huperzine A, an alkaloid isolated from Huperzia serrata, can increase mental alertness and improve memory.8
This may be partly attributed to the fact that huperzine A appears to have better penetration through the BBB, higher bioavailability, and longer duration of acetylcholinesterase inhibitory action than donepezil, tacrine, and rivastigmine.8 Mechanisms of action include attenuation of oxidative stress, protection of mitochondria, upregulation of nerve growth factor and its receptors, and interference with amyloid protein metabolism.8 Huperzine A has shown no hepatotoxicity and only minimal peripheral cholinergic side effects.8
In the treatment of dementia including Alzheimer’s disease, curcumin has demonstrated inhibition of Ap-1 (activator protein-1) and NFKB (NF-Kappa B) which has the effect of inhibiting activation of the proinflammatory cytokines. Curcumin is lipophilic, so it crosses the Blood Brain Barrier and binds to plaques, decreasing the amount of amyloid plaque formation. 9
Curcumin has been shown in animals to prevent the aggregation of amyloid peptides and to increase brain-derived neurotrophic factor (BDNF), which stimulates and controls neurogenesis.10 BDNF is important for long-term memory.11
A brief systematic review,12 however, found only 3 clinical trials on curcumin and treatment of Alzheimer’s disease that fit their criteria for review, and all had negative or inconclusive outcomes. There may be issues of absorption contributing to these outcomes.12
Using a Turmeric supplement with black pepper extract has shown to increase the absorption of turmeric. (21)
Turmeric has been shown to help decrease blood sugar levels and HbA1c levels as well, which directly effect the markers for diabetes (type 3 as well!)- so good in fact that one of our diabetic patients was told by their MD to stop taking it because it was lowering their blood sugar and HbA1c too quickly otherwise they would have to stop taking their medication! (Call me crazy but isn’t that the point?)
It’s well known that Ginkgo biloba increases blood flow to the brain and the periphery. Many clinical trials have been conducted on Ginkgo and cognitive function. Some have demonstrated efficacy of Ginkgo in enhancing memory and cognition; however, the question remains as to whether this also applies to the elderly and people who have been diagnosed with MCI or MND. One study looked at 76 patients, age 50-80, with mild-to-moderate dementia. They were randomized to Ginkgo biloba (160 mg/d), donepezil (5 mg/d), or placebo. The conclusion was a lack of evidence of significant differences in the efficacy of EGb761 (Ginkgo extract) and donepezil in treatment of mild-to-moderate dementia; ie, both agents were effective.15
Resveratrol – from grape skins, blueberries, bilberries, mulberries, peanuts, and Japanese Knotweed – increases cerebral blood flow. Its action of increasing deoxyhemoglobin suggests enhanced oxygen extraction and therefore utilization. There are many studies looking at resveratrol and its implications in overall cognitive function. In one study examining cognitive function and its relationship to elevated glucose levels in 46 healthy older adults, 23 were given 200 mg/d resveratrol, and 23 were given placebo for 26 weeks. Assessment was conducted through memory tasks, neuroimaging, blood testing, and body fat measurements. Significant improvements were seen in the resveratrol group, in terms of word retention, increases in hippocampal functional connectivity, decreases in HbA1C, reductions in body fat, and increases in leptin.18
Panax ginseng, Panax quinquefolius, and Eleutherococcus senticosis are 3 of the ginsengs to keep in mind when working with cognitive function.
In conclusion, here are 2 key concepts in addressing cognitive health and function: The first is to have in place the basic lifestyle habits of adequate rest and sleep, brain exercise, regular exercise, and a varied and nourishing diet. Starting early in life will provide the best preventative support. The second concept is that each person is a unique individual, will manifest their dis-ease uniquely, and will respond differently to different interventions. Functional Neurology, Chiropractic Neurology and Functional Medicine has many options for supplementation that can be effective for slowing down progression or even repairing some of the neurological damage related to MCI and even MND. A combination of herbal remedies, amino acids, and other supplemental support will provide the possibility for the best outcomes, both short- and long-term, for each individual patient.
- Diseases & Conditions: Dementia. Cleveland Clinic Web site. https://my.clevelandclinic.org/health/diseases_conditions/hic_Types_of_Dementia. Accessed September 15, 2015.
- Dementia: Causes. November 22, 2014. Mayo Clinic Web site. http://www.mayoclinic.org/diseases-conditions/dementia/basics/causes/con-20034399. Accessed September 15, 2015.
- Seniya C, Khan GJ, Uchadia K. Identification of potential herbal inhibitor of acetylcholinesterase associated Alzheimer’s disorders using molecular docking and molecular dynamics simulation. Biochem Res Int. 2014;2014:705451.
- Tierra L. Healing with the Herbs of Life. Berkeley, CA: Crossing Press; 2003.
- Sarkar S, Davies JE, Huang Z, et al. Trehalose, a novel mTOR-independent autophagy enhancer, accelerates the clearance of mutant huntingtin and alpha-synuclein. J Biol Chem. 2007;282(8):5641-5652.
- Liu R, Barkhordarian H, Emadi S, et al. Trehalose differentially inhibits aggregation and neurotoxicity of beta-amyloid 40 and 42. Neurobiol Dis. 2005;20(1):74-81.
- Guerin M, Huntley ME, Olaizola M. Haematococcus astaxanthin: applications for human health and nutrition. Trends Biotechnol. 2003;21(5):210-216.
- Wang R, Yan H, Tang XC. Progress in studies of superzine A, a natural cholinesterase inhibitor from Chinese herbal medicine. Acta Pharmacol Sin. 2006;27(1):1-26.
- Mishra S, Palanivelu K. The effect of curcumin (turmeric) on Alzheimer’s disease: An overview. Ann Indian Acad Neurol. 2008;11(1):13-
- Wu A, Ying Z, Gomez-Pinilla F. Dietary curcumin counteracts the outcome of traumatic brain injury on oxidative stress, synaptic plasticity, and cognition. Exp Neurol. 2006;197(2):309-317.
- Bekinschtein P, Cammarota M, Katche C, et al. BDNF is essential to promote persistence of long-term memory storage. Proc Natl Acad Sci U S A. 2008;105(7):2711-2716.
- Brondino N, Re S, Boldrini A, et al, Curcumin as a therapeutic agent in dementia: a mini systematic review of human studies. ScientificWorldJournal. 2014;2014:174282.
- Khalsa KP, Tierra M. The Way of Ayurvedic Herbs: A Contemporary Introduction and Useful Manual for the World’s Oldest Healing System. Twin Lakes, WI: Lotus Press; 2008.
- Calabrese C, Gregory WL, Leo M, et al. Effects of a standardized Bacopa monnieri extract on cognitive performance, anxiety, and depression in the elderly: a randomized, double-blind, placebo-controlled trial. J Altern Complement Med. 2008;14(6):707-713.
- Mazza M, Capuano A, Bria P, Mazza S. Ginkgo biloba + donepezil: a comparison in the treatment of Alzheimer’s dementia in a randomized placebo-controlled double-blind study. Eur J Neurol. 2006;13(9):981-985.
- Mori K, Obara Y, Hirota M, et al, Nerve growth factor-inducing activity of Hericium errancies in 1321N1 human astrocytoma cells. Biol Pharm Bull. 2008;31(9):1727-1732.
- Mori K, Inatomi S, Ouchi K, et al. Improving effects of the mushroom Yamabushitake (Hericium erinaceus) on mild cognitive impairment: a double-blind placebo-controlled clinical trial. Phytother Res. 2009;23(3):367-372.
- Witte AV, Kerti L, Margulies DS, Floel A. Effects of resveratrol on memory performance, hippocampal functional connectivity, and glucose metabolism in healthy older adults. J Neurosci. 2014;34(23):7862-7870.
- Pengelly A, Snow J, Mills SY, et al. Short-term study on the effects of rosemary on cognitive unction in the elderly population. J Med Food. 2012;15(1):10-17.
- Xue JY, Liu GT, Wei HL, Pan Y. Antioxidant activity of two dibenzocyclooctene lignans on the aged and ischemic brain in rats. Free Radical Biol Med. 1992;12(2):127.