by Ramona Richard
The concept of a state of cognitive impairment intervening between normal aging and very early dementia has been in the literature for many years. The term Mild Cognitive Impairment (MCI) has been proposed to define an early, but abnormal state of cognitive impairment intervening between normal cognition and probable Alzheimer’s disease (AD). Studies report that from 6% to 25% of MCI patients transition to AD.
There is a fuzzy line between what is considered “normal” aging and MCI. In the end, the definition of MCI reduces down to: patient or someone familiar with the patient reports memory complaint or other cognitive impairment. Other activities of daily living are not generally affected.
Risk factors fall into two categories: those you can change and those you can’t. Age and the presence of the genetic marker for Alzheimer’s (the APOE 4 gene) are two risk factors you cannot change. The rest you can intervene to help prevent:
- High blood pressure
- Systemic inflammation
- Imbalanced blood sugar: insulin resistance/Metabolic Syndrome/Type II Diabetes
- Elevated homocysteine
- Nutritional deficiencies: B12, folate, omega 3, antioxidants
- Lifestyle: smoking, chronic stress, lack of exercise
- Toxicities: pesticides, heavy metals
- Preventing Brain Aging
Diet: eating a Mediterranean-style, whole-foods diet with lots of olive oil, fresh fruits and vegetables, with high quality fish and poultry has been shown to be protective. Beyond this baseline, your diet must keep your blood sugar in check. Poor blood sugar control is highly damaging to the brain. Avoid the whites: white sugar, white flour, white rice. Always eat carbohydrates with a protein and a good fat (which slows down their glycemic index). If you are not diabetic, then 100 – 175 grams of carb a day would be a ballpark goal. For Type II diabetics, 60 – 100 grams a day is more appropriate.
In order to get optimal antioxidants in your diet, eat the rainbow. Choose highly colored fruits and veggies – the color pigments carry the antioxidants. Eat all berries, cherries, bright yellow and orange foods and leafy greens in abundance.
If you have reason to think that you have a body burden of mercury, lead or other heavy metal, it would be worth checking. A hair analysis can reveal whether or not you may have high levels of heavy metals. Also, choosing green products for around your home and organic foods for your plate will help relieve the body of chemical toxicities. Pesticides, for instance, kill because they are neurotoxins. According to Dr. David Perlmutter, they promote free radical damage and inflammation, thereby contributing to dementia.
Cortisol elevates during stress. It is the stress hormone that prepares the body for fight or flight. When it stays high, it damages the hippocampus, the short-term memory center of the brain. If you are stuck in a stressful situation, it is best to practice meditation, deep breathing, Tai Chi or whatever calms you. Herbs like holy basil and ashwagandha also help to lower cortisol.
Many nutrients have shown efficacy in preventing memory loss and brain atrophy. Omega 3 oils or eating cold-water fish several times a week is a must. The brain requires omega 3 for healthy neuron membranes and nerve signal conduction. Omega 3 oils have been shown to reduce both inflammation and beta-amyloid deposition. Studies show optimal supplemental levels are around 2 grams daily.
Folate, a B-vitamin, is also shown in studies to prevent memory loss. It is best to use the active form: 5-methyltetrahydrofolate. Together with methylcobalamin (B12) and vitamin B6, 5-methyl folate reduces high homocysteine, an independent risk factor for dementia. Methylcobalamin, at 1 mg daily, has been shown to improve cognition on its own as well.
Curcumin, the active element in the spice turmeric, is a powerful antioxidant that can cross the blood-brain barrier and protect neurons. It has been shown to stimulate nerve regeneration and to control inflammation. Curcumin would be an especially good choice if you also suffer from inflammatory conditions such as arthritis or autoimmune issues.
Phosphatidylserine or “PS” enhances the brain’s use of energy, increases memory, and facilitates neurotransmission. There are likely more studies showing the efficacy of PS to enhance memory than for any other nutrient. Minimum dose is 100 mg.
Other supplements can also be useful: acetyl-l-carnitine, alpha GPC, Vitamins C & D, alpha lipoic acid, NAC, and astaxanthin all have scientific support for brain health and memory support.
A study done at the Mayo Clinic found that ANY frequency of moderate exercise performed at midlife or late life reduced the risk of having MCI. Exercise has been shown to reduce the genetic risk, the vascular risk (e.g., stroke), the deposition of amyloid plaques and brain atrophy.
Mental exercise is also necessary. The brain is a use-it-or-lose-it organ. Learn something new; use the computer, play challenging card games or Sudoku. Study a foreign language, or sign up for on-line brain gyms: Lumosity or Brain HQ, for example.
Summary, three steps to keep your brain sharp:
- Eat to maintain good blood sugar control
- Supplement with fish oil, vitamin D, antioxidants and “smart” nutrients
- Exercise both your body and your mind.