Reversal of Cognitive Decline

Disclaimer: 
    Like most concerns in life, people tend to gravitate toward simple solutions to complex problems. Financial opportunists often seize upon both simplistic solutions and commonsense approaches as if they were wonderful new breakthrough products or miracle cures. The heartbreak of watching a loved one suffer through the cognitive decline of Alzheimer's disease and dementia is a case in point. The disease often motivates families to grasp at whatever straws seem hopeful and spend inordinate time and resources in vain. Especially in our age of misinformation, fake news and Godless ethical anarchy,navigating the information mine field related to cognitive decline presents a daunting task. That said, many have found the research and insights of the doctor/ researchers we cite below to be helpful and hopeful for mitigating the effects of cognitive decline. Personally speaking, I am not an expert or a doctor but I have some experience working with clients in mental health settings and writing on mental health topics.  I have also used most of the supplements and ideas presented here for myself and my family with some success.  I pray that God will guide you in navigating your approach to these potentially life changing possibilities.

Discussion
     Whether cognitive decline is age related, the result of the brain fog of long Covid or stems from congenital disorders like ADHD and epilepsy or even some degree of traumatic brain injury: there are life style changes that we can make right now to improve cognitive functioning and mental efficiency. That is an audacious claim, but evidence based on both anecdotal reporting and emerging epidemiological studies lend support to this claim.
    In 2021 we began to understand that mental confusion was often a symptom  associated with COVID-19. Four years later at least 17 million Americans report symptoms of “long Covid”(24), a figure which many say, way understates the scope of the problem. Causes of long Covid are unknown but, “One theory is that the SARS-CoV-2 virus that causes COVID persists in the gut after the acute infection has cleared up...”(19, 1).  Patient symptom descriptions of long Covid include brain fog, poor memory, sluggish thinking, difficulty processing information, headaches, forgetfulness, and an inability to focus, pay attention, or concentrate. Combine these impairments in their mild to serious severity with an aging population now reporting 7 million Americans with Alzheimer's disease plus a reported 60 million mentally ill Americans and terms like mental disorder and cognitive decline take on the dimensions of a new pandemic. Chances are you know someone with these ailments. You may be experiencing loss of mental acuity yourself or be concerned about a loved one. So the important question becomes: “How can we preserve what remains of our once sharp minds, improve mental clarity and the quality of life for ourselves and our families?” 
    What follows is a discussion of cutting edge research focusing on the work of three pioneers in this field and a synthesis of their recommendations for practical, lifestyle, and remedial interventions.
    Often referred to as “metabolic syndrome” step one in a better approach to this problem has been to define the etiology of the syndrome in terms of a useful constellation of specific physiological and psychological factors rather than using catch-all categories like Alzheimer's, long Covid or general dementia. General diagnostic categorizations invite general solutions which have been ineffective in treating dementia and cognitive decline. Everyone it seems, including big pharma, are looking for that magic pill that cures all these ills and earns billions.  The doctors we're focusing upon in this article have taken an approach involving the identification of specific causal factors in cognitive decline and then targeting each one with “multiple modalities designed to achieve metabolic enhancement.”(4)  In reference to neural function, metabolic enhancement may be thought of as improving the efficiency with which cells utilize nutrients and oxygen to produce energy and communicate effectively with each other. These doctors argue convincingly against monotheraputic disease approaches, “there is not a single therapeutic that exerts anything beyond a marginal, unsustained symptomatic effect, with little or no effect on disease progression.”(4)  What follows is a discussion of cutting edge research focusing on the work of three pioneers in this field:  Dr. Dale Bredesen, Dr. Chris Palmer and Dr. Daniel Amen and includes a basic synthesis of their recommendations for practical, lifestyle, remedial interventions.

Doctor Dale Bredesen
    Based on his assessment of thirty-six factors, Dr. Bredesen’s treatment protocol which he characterizes as the MEND (4) (Metabolic Enhancement for Neurodegenerative Diseases) system focuses on the five key areas which several of these researchers have found to be effective in slowing the progression of cognitive decline. Bredesen’s five basic commonsense steps begin with "a plant rich, mildly ketogenic diet" along with intermittent fasting. Also included are nutritional supplements which have been found to improve vascular and mytocondrial-synaptic health and increase blood flow to the brain. The program’s other key interventions include increased exercise, stress reduction, hormonal balance and sleep hygiene.

Doctor Chris Palmer

    Another pioneer in this field is Dr. Chris Palmer.  Doctor Palmer’s focus is on mental illness and treatment modalities for improving  functioning on the cellular level . His work has expanded our understanding of the cell’s mitochondrial functioning.  Mitochondria are small organelles found within the cells responsible for producing the majority of the cell's chemical energy. “Research over the last twenty years has completely shattered that simplistic notion of what mitochondria are.  Let me give you a brief snapshot of what mitochondria do and you’ll begin to understand how it begins to connect to the mental health field. Mitochondria make and they help create, regulate and release neurotransmitters including serotonin, dopamine norepinephrine (and) GABA.”(21)  His practical advice in the opening monologue of his webinars again mention many of the same threads that Bredesen and Amen mention: stress reduction, nutrition and sleep. The important point to know here is the understanding that in recovering and maintaining efficient neural function, there is no time to loose. The effects of age, stress and the built-in daily mind abuse inherent in our western diet and hedonistic, attention robbing entertainment have damaged our minds. The number and strength of mitochondria to power essential synaptic communication are under assault. The definitive summary of Dr. Palmer’s research can be found in this lecture. (21)

Summary Recommendations

1. Nutrition
     Dr.Bredesen's,  “plant rich mildly ketogenic diet" represents a reasonable and accessible approach to nutritional support in improving cognitive function. Dietary modifications that are restrictive or monotonous most often lead to compliance issues.  There is good evidence that a ketogenic diet improves mitochondrial functioning, improves memory and cognition and has been proven effective in controlling seizures in some cases of epilepsy. (17,18,20)  Exclusive meat carnivore diets which exclude fruits and vegetables can be dangerous, especially for the general public who cannot afford the grass fed, pasture raised meat products recommended by proponents of this fad diet. The degree of ketosis and it’s implied benefits to cognitive efficiency are not settled science but the evidence is compelling and rapidly expanding. A highly ketogenic diet is not a one-size-fits-all solution for improving cognitive functioning and can do little to improve cases of advanced Alzheimer's disease but evidence, especially from the work of Dr. Palmer, suggests that it can be effective in treating mental illness. Adopting a ketogenic diet is not as simple as eating low carb and high fat and expecting a miracle. Medical monitoring and a full diagnostic work-up for underlying conditions is imperative in treating serious mental illness.

3. Supplements

     Supplements are recommended by all three of our researchers primarily for increasing blood flow to the brain. Without a strong flow of oxygen and nutrients to the brain, all the other interventions we’ve considered are almost useless. Beware: the FDA has found tremendous variation in quality, purity and concentration of the active ingredients in dietary supplements.  Here are some of the more frequently mentioned supplements to increase blood flow to the brain along with references to reputable source reports: Ginkgo biloba: "Efects of Ginkgo biloba on cerebral blood flow" (14), Vinpocetine (report 13) (warnings 12), Creatine (11)  "A treatment for Memory and Mental Health?" (11), Huperzine NIH report (10) , Curcumin (23), Ashwagandha (3). Do your homework. There can be unintended consequences of combining supplements and cumulative effects over time.  Self medicating can be dangerous.

5. Stimulation

    Novel Stimulation keeps your brain healthy.(7) In a way similar to the benefits of the eye-hand, eye-body coordination required for exercise and sports participation, novel brain stimulation through learning new games, experiencing interesting new concepts or learning a new skill or language activates seldom used areas of the brain. The brain loves novelty. This is why internet content developers like YouTube feed your brain a constant barrage of quick scenes designed to grab your attention. The problem with this kind of stimulation called short form video addiction is that it flashes through your brain quickly activates a sensory pleasure sensor then disappears just as fast. Studies have shown that short form video addiction “poses risks to both physical and mental health of individuals.”(6) These are not the types of brain stimulation these doctors recommend.(5)

References

1. Science direct study finds SARS-CoV-2 S1 subunit produces a protracted priming of the neuroinflammatory, physiological, and behavioral responses to a remote immune challenge: A role for corticosteroids  https://www.sciencedirect.com/science/article/abs/pii/S0889159124005105

2. 5 Foods To Avoid To Prevent Alzheimer's Disease, Dr. Heather Sandison https://www.youtube.com/watch?v=yGfENofBtg4

3. Ashwagandha https://ods.od.nih.gov/factsheets/Ashwagandha-HealthProfessional/

4. Reversal of Cognitive decline https://www.aging-us.com/article/100690?ref=lavieensante.com

5. Brain Stimulation Tips – Bredesen https://www.apollohealthco.com/brain-stimulation/

6. The effect of short-form video addiction... https://pmc.ncbi.nlm.nih.gov/articles/PMC10756502/#:~:text=The%20ability%20to%20control%20their,et%20al.%2C%202010).

7. Novel Stimulation keeps your brain healthy https://www.ciis.edu/news/novelty-keeps-your-brain-healthy

8. CrossFit’s Role in Metabolic Well-Being and Mental Health -Palmer https://www.youtube.com/watch?v=n4Rryo5oqn8

9. Dr. Amen These 5 Physical Activities Improve Brain Health https://www.amenclinics.com/blog/these-5-physical-activities-improve-brain-health/#:~:text=When%20it%20comes%20to%20maintaining,health%20in%20truly%20remarkable%20ways.

10. Huperzine A: Is it an Effective Disease-Modifying Drug for Alzheimer’s Disease? https://pmc.ncbi.nlm.nih.gov/articles/PMC4137276/

11. Creatine Psychology Today https://www.psychologytoday.com/us/blog/the-healthy-journey/202304/creatine-a-treatment-for-memory-and-mental-health#:~:text=Creatine%20may%20help%20our%20minds%20as%20much%20as%20our%20muscles.&text=If%20you've%20ever%20heard,has%20been%20common%20for%20decades.

12. Vinpocetine in Dietary Supplements https://www.fda.gov/food/information-select-dietary-supplement-ingredients-and-other-substances/vinpocetine-dietary-supplements#:~:text=Vinpocetine%20is%20a%20synthetic%20compound,alkaloid%20found%20in%20Voacanga%20seeds.

13. Sloan Kettering on Vinpocetine  https://www.mskcc.org/cancer-care/integrative-medicine/herbs/vinpocetine

14 Ginco and cerebral blood flow  https://pmc.ncbi.nlm.nih.gov/articles/PMC3163160/

15. The ketoflex 12/3 system   https://www.apollohealthco.com/ketoflex-12-3/

16. Fasting as a Therapy in Neurological Disease https://pmc.ncbi.nlm.nih.gov/articles/PMC6836141/#abstract

17. Study shows that keto diet boosts size and strength of aging muscles, improves brain health https://health.ucdavis.edu/news/headlines/study-shows-that-keto-diet-boosts-size-and-strength-of-aging-muscles-improves-brain-health-/2023/02

18. Ketogenic Diets and Mitochondrial Function: Benefits for Aging But Not for Athletes https://pmc.ncbi.nlm.nih.gov/articles/PMC9762714

19 Long COVID Brain Fog: What It Is and How to Manage It https://www.yalemedicine.org/news/how-to-manage-long-covid-brain-fog#:~:text=Estimates%20vary%20as%20to %20exactly,have%20a%20life%2Daltering%20impact.

20. Epilepsy Foundation https://www.epilepsy.com/treatment/dietary-therapies/ketogenic-diet

21 Dr. Palmer’s summary lecture  https://www.youtube.com/watch?v=BUtwr_6sFw4

22. Cognitive Restoration Through Fasting   https://www.apollohealthco.com/cognitive-restoration-fasting/

23. Curcumin   https://www.cancer.gov/about-cancer/treatment/cam/hp/curcumin-pdq#:~:text=Curcumin%20(diarylheptanoid)%20is%20one%20member,application%20in%20traditional%20Asian%20medicine.

24. CDC Science and the Public Health Approach to Long COVID- https://www.cdc.gov/covid/php/long-covid/index.html#:~:text=In%202022%2C%206.9%25%20of%20adults,ever%20reported%20experiencing%20Long%20COVID.&text=While%20Long%20COVID%20can%20occur,risk%20of%20developing%20Long%20COVID.