Cognition, Aging & Nutrient Protocols

As a natural process of aging, humans experience a progressive decline in overall cognitive (brain) function. This causes us to lose our ability to store and retrieve from short-term memory, employ abstract reasoning and easily learn new information. Many neurological diseases are also directly related to aging.

Aging negatively influences cognitive function in several ways, including:

• Free-radical damage in the brain accumulates throughout life
• Changes in lifestyle, diet, and nutrient absorption causes important nutrient deficiencies
• Levels of key hormones begin to decline significantly by the age of 40
• Diminished oxygen available to brain cells (atherosclerosis or heart disease, smoking, drinking in excess, drug abuse, limited exercise, poor diet, or stress)
• Declining energy output of brain cells.

Thousands of published studies have been evaluated substantiating that a decline of cognitive function can be controlled. Some of these studies demonstrate that prevention will help maintain optimal brain function, while others show measurable benefit in reversing cognitive impairment caused by normal aging or by a specific disease of aging, such as stroke.

Models of Cognitive Impairment

Age-associated neurological impairment may manifest itself in a variety of forms, including memory loss, senility, alzheimer’s disease and dementia. Dementia includes those diseases involving nerve cell deterioration and is defined as a loss in at least two areas of complex behavior. These include language, memory, visual & spatial abilities, and judgment. Impairment must be severe enough to interfere with a person’s normal, daily ability to function. Dementia is the most serious form of age-associated mental impairment and is often a slow, gradual process that may take months or even years to become noticeable. Symptoms vary depending on which areas of the brain are affected.

It is important to distinguish normal, age-associated mental impairment from conditions such as dementia which identifies a disease process. Not all memory difficulties or cognitive complaints indicate the presence of dementia, Alzheimer’s disease or any mental disorder. Many memory changes are temporary and are linked to environmental factors such as stress, chemical exposure and/or poor diet rather than to physiological processes.

Significantly, serious cognitive difficulties should not be dismissed as unavoidable consequences of aging. A helpful guideline is that many people with serious mental impairment do not recognize or will not admit that they have a problem, although it is obvious to those around them.

Specific Causes

Conditions that affect the brain and result in intellectual, behavioral, and psychological dysfunction include the following:

• Medication side effects - Adverse side effects can result from too high or too low a dosage of medications, unusual reactions to medications, or combinations of medications. It is especially common in the elderly for individuals to be taking many different medications prescribed by different doctors, in addition to over-the-counter drugs. Be certain that your primary physician is aware of all prescription and nonprescription medications that you take.
• Substance abuse - Abuse of drugs (legal or illegal) and alcohol in excess can cause mental impairment. Older people are less able to tolerate and recover from the use of such substances. Excess alcohol consumption also causes liver damage, increasing the risk of liver disease, which often leads to dementia.
• Metabolic disorders - Thyroid dysfunction, anemia, and nutritional deficiencies, are common in older people who have less appetite and less energy to cook and shop. Nutrient malabsorption will have a further negative impact on mental function. These problems may go undetected in older people when symptoms are attributed to “simply the aging process”.
• Neurological disorders - Multiple sclerosis and normal pressure hydrocephalus (increased fluid in the brain) are examples of two neurological conditions that impact mental function.
• Infections - The brain is susceptible to viral, bacterial, and fungal infections. One extremely rare infection of the brain that causes dementia is Creutz-feldt-Jakob disease, transmitted by a special protein (prion) that damages tissue as it replicates (Mad-Cow disease). Other more common pathogens are also known to cross the blood brain barrier and cause cerebral infection.
• Trauma - Head trauma can result in transient (concussion) or long-term mental impairment. Trauma is obvious in most cases based on history and examination. One type of head trauma frequent in older people, however, is not always obvious. It is called a subdural hematoma, which is the condition of blood leaking into brain cell tissues. This type of injury can occur after very minimal trauma, and its onset can be very gradual if the leak is small. Symptoms are headache, confusion, and lethargy and are often nonspecific.
• Toxic factors - Exposure to substances such as carbon monoxide, aluminum, mercury, lead, cadmium, arsenic, nickel, airborne molds and methyl alcohol cause mental impairment.
• Hormonal changes - The hormonal changes that accompany aging are only recently being clearly identified. A sudden drop in the hormones estradiol and progesterone, for example, lead to menopause at about age 50. In addition to symptoms such as hot flashes, decreased bone density, & vaginal dryness, symptoms of altered mental function such as mood swings, foggy thinking, and fatigue are common. In men, testosterone levels decrease gradually over time, leading to decreased muscle tissue & bone density, increased abdominal fat & cholesterol, deteriorating heart function, and psychological & sexual changes which can impact mental function. In both sexes, the level of the hormone dehydroepiandrosterone (DHEA-S) falls precipitously with age.
• Tumors - Abnormal tissue growth (tumors) in the brain can be eit her primary (originating in the brain itself) or metastatic (“seeds” of tissue that originated in a tumor in another part of the body, and have crossed the blood-brain-barrier). Metastatic tumors are more common. While approximately 70% of brain tumors are benign they, nevertheless, contribute to cognitive dysfunction.

Depression

Depression, stress, and grief are common causes of mental impairment that are transient and treatable. Depression in older people is often overlooked because symptoms are confused with those of a medical illness.

Depression is also considered a normal part of aging: the National Mental Health Association reports that over 58% of older adults believe depression accompanies aging. Although older adults may have difficult experiences such as changes in health status, relocation, or loss of loved ones, if the sadness that follows one of these life changes lingers for a long period of time, it may be diagnosed as clinical depression. Late-life depression affects about 6 million people, most of them women, however, only about 10% of them ever receive treatment for their condition.

Depression has serious consequences. It takes the pleasure out of daily life, aggravates other medical conditions by compromising immune function, and can even lead to suicide. In fact, older adults are considered the group most at risk for suicide. (the suicide rate in older adults is more than 50% higher than the rate for the nation as a whole).

Circulatory Disorders

Ischemic Stroke – Circulatory disorders, such as heart problems or stroke can restrict the oxygen available to brain cells by reducing blood flow. Also, many people who feel fine may have a buildup of plaque in their arteries (atherosclerosis), which can eventually limit the oxygen supply to the brain. The most common type of stroke is called an ischemic stroke, which is the result of a blood clot that has traveled to the brain and has lodged in a vessel or capillary. The result is that brain cells die from lack of oxygen.

Transient Ischemic Attacks (TIAs) are miniature strokes caused when blood flow is blocked to a variable extent for a few hours or a day but is then restored, causing no permanent damage. TIAs are an important warning signal that treatment is necessary to prevent a more serious stroke, such as..

Hemorrhagic Stroke When this type of stroke occurs, a capillary gradually becomes fragile and bursts, flooding brain cells with blood.

• Strokes occur most often in older people, 3/4th occur in people over age 65. Symptoms depend on the part of the brain affected, but can include difficulty moving, speech synthesis, and thinking.
• Normal aging creates a perfusion (circulation) deficit in the brain, so nutrients that improve circulation to the brain are of critical importance to even healthy humans as they age. The recommendations contained in these protocols have been shown to improve long-term recovery of mental function, specifically, short-term memory, speech synthesis, concentration, and learning.
• A 30-year study of male twins showed that elevated blood pressure in mid-life predisposed men to accelerated brain aging and an increase in stroke later in life. Men with even mildly elevated blood pressure 25 years before showed smaller brain volumes and more strokes compared to their twin brothers who did not have the elevation in blood pressure. This study, published in the journal, Stroke (1999;30), emphasized the importance of aggressively treating elevated blood pressure even if it is not exceptionally high.

Behavioral Treatments

Taking steps to improve overall health is highly recommended to prevent or minimize age-associated mental impairment. Regular exercise, abstinence from tobacco, and monitoring blood lipid levels can reduce the risk of stroke and heart disease by keeping arteries open and thus supplying the brain with ample oxygen and nutrients.

Regular exercise improves some mental functions by an average of 20 to 30%. Abstaining from excess alcohol or drug use, or minimizing it, can also help preserve mental function. Since people tend to eat less food as they age, the use of low-fat, nutrient-rich foods is beneficial. A nutrient-rich diet will help prevent cognitive deficiencies, and make a meaningful contribution toward the reversal of pre-existing conditions.

Nutrient Protocols for an Aging Brain

While the following nutrient protocols have been demonstrated to help age-associated mental impairment of any form or cause, significant impairment arising from diseases such as stroke should be treated with the help of medical professionals.

1. Phosphatidylserine is a phospholipid – the main constituent (70%) of brain cell membranes. There are 23 published studies with humans which conclude that PS makes the cell membrane more permeable to cell nourishment and enhances cell-to-cell communication of neurotransmitters. As a natural process of aging (starting at age 40) Phosphatidylserine levels in cell membranes decline and brain cell membranes become brittle. This restricts cell membrane permeability, thereby, inhibiting electro-chemical communication within the brain. Useful in early stages of Alzheimer’s disease, PS levels can be restored to youthful levels with regular supplementation. Brain-aging is, therefore, the leading cause of disability in the elderly and in young people who consume a diet high in animal fats on a daily basis.
2. Acetyl L-Carnitine 100% pure Acetyl-L-Carnitine absorbs more completely than L-Carnitine. It is also an important anti-oxidant that effectively scavanges a very damaging free-radical called the “super-oxide anion radical” which damages membrane lipids. It also increases muscle mass and converts body fat into energy bymetabolizing energy in the cell mitochondria. Acetyl-L-Carnitine has been demonstrated to preserve brain neuron function, and can improve mood, memory and cognition. Also, useful in early stages of Alzheimer’s disease, Acetyl-L-Carnitine is a very important brain function stimulant that also boosts immune function. In the heart it facilitates cellular energy by assisting in the transport of fatty acids through and within the cell to increase cardiac output. Acetyl-L-Carnitine is important as an immune enhancer, for converting fat to energy, for kidney disease prevention, for preventing congestive heart disease and as a primary nutrient for slowing and reversing neurological aging.
3. Stabilized CDP-Choline (cytidine 5’ diphosphocholine) – This is a naturally occurring water-soluble biological compound that is an essential intermediate for the synthesis of phosphatidylcholine. It promotes brain metabolism by enhancing the synthesis of acetylcholine, restores phospholipid content in the brain and regulates neuronal membrane excitability & osmolarity (osmosis). This is accomplished by its effect on ATP-dependent sodium and potassium pumps. It is a precursor to the chemical neurotransmitter acetylcholine, the most abundant brain neurotransmitter. Because acetylcholine is crucial for brain cells to communicate with each other, it plays an important role in learning and memory. Acetylcholine deficiency can predispose a person to a wide range of neurological diseases. CDP-Choline is also metabolized to yield the free nucleotide cytidine and Choline. more information…
4. Ginko Phytosome – strengthens cerebral capillaries preventing them from becoming fragile and helps transport oxygen to all regions of the brain. (As a consequence of aging, blood vessels supplying the brain narrow, reducing oxygen AND nutrient supply. They also become thin, prone to rupture and a resulting stroke).
5. Co-Q10 – prevents oxidation of the cell membrane and mitochondria within the cell, thereby preserving youthful neurological function. Co-Q10 also stimulates the production of ATP. ATP serves as the major energy source within cells, driving such biological processes as photosynthesis, muscle contraction, and protein synthesis.
6. Proanthocyanidins (grape seed extract) are potent free-radical scavenger bioflavonoids that prevent lipofuscin (cellular waste material) formation in the brain & heart and protect oxidation of cell membranes. Lipofuscin kills brain neurons. The brain contains more fat than any other organ and so is very predisposed to free-radical damage.

Note: The orange dots represent the multiple synapses on a single neuron