Part 2; preventing cognitive decline as we age through lifestyle and supplements.
Omega 3. A small Study of 12 patients published in July 15 in The FASEB Journal described in patients with clinical impairments, Omega 3 Fatty acids improved cognitive function by clearing amyloid-beta protein and reduced overall inflammation in neurological tissues(17). The Journal of Alzheimer’s Disease published in 2012 reviewed multiple randomized controlled trails and found that in mild to moderate cognitive declines, omega 3 fatty acids shows an improvement but more long term trails needs to be done in patients with advanced dementia (18). Omega 3 fatty acids also increases BDNF and reduces oxidative damage (19).
Glutamine. Glutamine has been found to be neuroprotective in AD by protecting DNA damage, beta amyloid and h202 stress (20 ). There is a proposed glutamate-glutamine cycle that is associated with AD and therefor a decline in cognitive function. The FDA has approved an ionotropic glutamate receptor antagonist to treat late-stage AD (21).
Ginko Biloba. In a systematic review, Ginko improves cognition when it comes to patients who need help with ADL by improving free radial production(22,23). Ginko improves social and cognitive function in all stages of dementia depending on baseline function. Patients with mild to moderate AD improved more than severe AD (24).
Melatonin. Melatonin helps during REM sleep and in turn decreases risk of Alzheimer’s and Parkinson disease (25). A study show in rats with sleep deprivation determines decreased good quality REM Sleep decreased BDNF increasing AD making one more forgetful (26).
Turmeric Curcumin has been shown to have anti-oxidant, anti-inflammatory, lipophilic action while improving oxidative stress, free radicals improving cognitive functions in patients with AD (27).
Lemon balm (Melissa officinalis ). Lemon Balm is traditional a “calming” herb used to treat anxiety. It has been shown in patients with mild to moderate AD to be help ease agitation and improve cognitive function vs placebo in a 4 month trail in Iran. (28)
Vitamin D. Studies show higher vitamin D intake is associated with a lower incidence of Alzheimer’s (29, 30) In a 2014 study published in Neurology showed in patients low blood levels of vitamin D were more than twice as likely to develop AD compared to those with normal vitamin D levels (31).
Citicoline. Also known a cytidine diphosphate-choline (CDP-Choline) or cytidine 5′-diphosphocholine ; it is an intermediate of phosphatidylcholine from choline. Experimental evidence from animal studies have continually find the multiple biological actions of citicoline in restoring both cell lipid and neutransmistter function improving memory.
Vitamin E (alpha tocopherol). In a 2014 study study published in JAMA in patients with mild to moderated AD Vitamin E was compared to placebo and memantine and results showed Vit E slowed down cognitive decline more than placebo alone (34).
Phosphatidylserine (PS)- 51 patients with AD over a 12 week trail were given PS vs placebo and results showed PS improved cognitive function better than placebo and that in early sates of AD, it may be promising. (35). PS does have blood thinning affect so it should be used cautiously in patients on Coumadin.
Resveratrol. In a Randomized, placebo-controlled trail individuals with mild-moderate AD were given resveratrol vs placebo over 52 weeks and biomarkers of the tau protein were measured. Resveratrol was indicated to be safe, tolerated and had a positive effect on the biomarkers of Alzheimer’s(36).
17.Milan Fiala et EL. Omega-3 Supplementation increases amyloid-β phagocytosis and resolvin D1 in patients with minor cognitive impairment.. The FASEB Journal. July 2015. vol. 29 no. 7 2681-2689.
18. Hooijmans CR et EL. The effects of long-term omega-3 fatty acid supplementation on cognition and Alzheimer’s pathology in animal models of Alzheimer’s disease: a systematic review and meta-analysis. J Alzheimers Dis. 2012;28(1):191-209. doi: 10.3233/JAD-2011-111217.
19. Wu A, Ying Z, Gomez-Pinilla F. Dietary omega-3 fatty acids normalize BDNF levels, reduce oxidative damage, and counteract learning disability after traumatic brain injury in rats. J Neurotrauma. 2004 Oct;21(10):1457-67.
20. Jianmin Chen and Karl Herrup. Glutamine Acts as a Neuroprotectant against DNA Damage, Beta-Amyloid and H2O2-Induced Stress. PLoS One. 2012; 7(3): e33177.
21. Walton HS, Dodd PR. Glutamate-glutamine cycling in Alzheimer’s disease. Neurochem Int. 2007 Jun;50(7-8):1052-66. Epub 2006 Dec 1.
22. Janssen IM et EL. Ginkgo biloba in Alzheimer’s disease: a systematic review. Wien Med Wochenschr. 2010 Dec;160(21-22):539-46. doi: 10.1007/s10354-010-0844-8.
23. Julie Vining Smith and Yuan Luo. Elevation of oxidative free radicals in Alzheimer’s disease models can be attenuated by Ginkgo biloba extract EGb 761. Journal of Alzheimer’s Disease 5 (2003) 287–300 287
24. Le Bars P.L. Et EL. Influence of the Severity of Cognitive Impairment on the Effect of the Ginkgo biloba Extract EGb 761® in Alzheimer ’s disease. Neuropsychobiology 2002;45:19–26
25. V Srinivasan1, SR Pandi-Perumal2, DP Cardinali3, B Poeggeler4 and R Hardeland. Melatonin in Alzheimer’s disease and other neurodegenerative Disorders. Behavioral and Brain Functions 2006, 2:15
26. Sei H et AL. Differential effect of short-term REM sleep deprivation on NGF and BDNF protein levels in the rat brain. Brain Res. 2000 Sep 22;877(2):387-90.
27. Shrikant Mishra and Kalpana Palanivelu. The effect of curcumin (turmeric) on Alzheimer’s disease: An overview. Ann Indian Acad Neurol. 2008 Jan-Mar; 11(1): 13–19.
28. S Akhondzadeh et EL Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer’s disease: a double blind, randomised, placebo controlled trial. J Neurol Neurosurg Psychiatry. 2003 Jul; 74(7): 863–866.
29. Liang Shen and Hong-Fang Ji. Vitamin D deficiency is associated with increased risk of Alzheimer’s disease and dementia: evidence from meta-analysis. Nutrition Journal 2015, 14:76
30. Annweiler C, Rolland Y, Schott AM, et al. Higher vitamin D dietary intake is associated with lower risk of Alzheimer’s disease: A 7-year follow-up. Journals of Gerontology: Medical Sciences 2012;67:1205-1211.
31 . Thomas J. Littlejohns, MSc et AL. Vitamin D and the risk of dementia and Alzheimer disease. August 6, 2014, Neurology 10.1212/WNL
32. Mario Fioravanti and Ann E Buckley. Citicoline (Cognizin) in the treatment of cognitive impairment Clin Interv Aging. Sep 2006; 1(3): 247–251.
33. McDaniel MA, Maier SF, Einstein GO. “Brain-specific” nutrients: a memory cure? Nutrition. 2003 Nov-Dec; 19(11-12):957-75.
34. Dysken MW et EL. Effect of vitamin E and memantine on functional decline in Alzheimer disease: the TEAM-AD VA cooperative randomized trial. JAMA. 2014 Jan 1;311(1):33-44.
35. Crook T et EL. Effects of phosphatidylserine in Alzheimer’s disease. Psychopharmacol Bull. 1992;28(1):61-6.
36. R. Scott Turner et El. A Randomized, double-bling plabebo-controlled trail of resveratrol for Alzhimer Disease. Neurology. Sept 11,2015.