by Lynn Hinderliter CN, LDN

Everyone who is getting older and can’t remember where they left their glasses knows that this question isn’t really funny. I am constantly having to remind myself that I have always been absent-minded, otherwise I might also be tempted to worry that senility is setting in: nobody wants to live a long life, if the price is loss of mental function. Memory

I came across a reassuring assessment the other day:  an expert was saying that everybody sometimes forgets what they did with the car keys.  It’s when you can’t remember what car keys are for that you have to begin worrying!  Memory

Fortunately, we can take steps to make it more likely that we will have active and alert brains into our 9th and perhaps even 10th decades. I know that some people feel that they are sitting on a time bomb, because a family member has suffered in this way: I like to quote Dr. Ronald Hoffman, who says in one of his books “while newly discovered genetic factors may cause a problem for some people, environmental factors clearly influence the expression of heredity, and ….  preventive measures can slow, halt or even reverse the ravages of this condition.” Memory

  • Exercise lowers the risk of dementia by approximately 45%*

  • Controlling inflammation lowers ones risk of dementia* Memory

  • Moderate drinking is beneficial*

  • Adding lecithin to your supplementation may help raise levels of acetylcholine in the brain *- many medications for AD are designed to inhibit the breakdown of ACh

  • Adding fish oil high in DHA can lower the risk of dementia by 47%* Memory

The most common cause of mental confusion is poor blood flow to the brain: maintaining adequate cerebral and carotid circulation is crucial to proper mental function, which means cholesterol control – preferably not through medication,  but through a preventative diet – and exercise. Memory

The second most common cause is an inadequate supply of certain nutrients, due either to a faulty diet, or impaired absorption. One of my very favorite nutritional physicians, Dr. Jonathan Wright, cites the case of an older woman whose confusion, depression and forgetfulness had caused her to be referred to a psychiatrist: but who responded 100% to injections of B12. He tells of a study of 228 residents in a nursing home, with an average age of 87. Despite good diets, and supplementation, 39% were deficient in one or more vitamins: most commonly B6, followed by Niacin and B12. Memory

Some drugs affect memory, in particular medication for high blood pressure.

C and E, important as antioxidants, taken together, may prove to be extremely effective at protecting the brain against Alzheimer’s.  Research to this effect was published in the journal Archives of Neurology. The researchers found that taking a combination of vitamin E and C seemed to have a protective effect, with people taking both vitamins 78% less likely to show signs of Alzheimer’s than those not taking the combination. Recent studies also suggest that Vitamin E is more absorbable if taken with food, and a chewable version may be the best way to combine the two effects. Memory

Surgery, particularly for weight loss, heart bypass or anything brain related, can lead to short term memory loss.  Sometimes this can prove permanent.  Some experts suggest that monitoring/ng peripheral oxygen levels during surgery is an inadequate measure of oxygenation, and that cerebral oxygenation should be monitored instead.  If I were to have surgery of ANY type, this is a question I would definitely pose to my surgical team beforehand! Memory

Interestingly, a new study (Am.J of Clin. Nutr., Apr. 2000) shows a connection between low folic acid levels in women & Alzheimer’s disease.  I say interestingly, because women also apparently have a high need for folic acid for reproductive health (consider the connection between Folate & birth defects, and Folate & cervical dysplasia).  I probably should restate this for accuracy:  what the study showed was that in a group of nuns suffering from Alzheimer’s, low blood levels of folic acid  were common.  A factor here is degeneration of the capacity to absorb nutrients as one ages, refer to my article on Digestion for more information. There is also an increased risk from a strict vegetarian diet,  since the best sources of B12 are animal – i.e. meat, fish, eggs and milk. Memory

Would the threat of Alzheimer’s become less frightening if a cause were found?  And a treatable one at that? I  think so!  This new and fascinating study finds a connection between a bacterium called Chlamydia pneumoniae, consequent inflammation,  and the dreaded brain plaque. Memory

Read the report at Memory

Vitamin B-12 plays an important role in maintaining nerve cells, and some research has linked low blood levels of the vitamin to Alzheimer’s and mental decline. Few studies have looked at whether there is such a connection between Alzheimer’s and folate, a B vitamin key to the production and maintenance of body cells.  However, in a study of 370 men and women aged 75 and older,  (Neurology,  May 8, 2001;56:1188-1194)  investigators found that those with low levels of either vitamin were twice as likely as those with normal levels to develop Alzheimer’s over a 3-year period. Surprisingly, the link was even stronger among study participants who performed well on mental tests at the start of the study.  The reason for the link is unclear, but low blood levels of B-12 and folate can lead to elevations in the amino acid homocysteine, which may in turn damage nerve cells, the authors note.  Vegetarians are frequently deficient in vitamin B-12. Memory

In view of the truly astonishing number of people who are taking antacids, this research is of great importance: as we know, many elderly people are being diagnosed with mental deterioration, when a B12 deficiency should be suspected.

Keywords: HEARTBURN, ACID REFLUX, STOMACH ULCERVitamin B12, B12 Deficiency, Proton-Pump Inhibitors, PPI, Histamine(2) Receptor Antagonists, H2 Blockers
Reference: “Do Acid-lowering agents affect vitamin B12 status in older adults?” Dharmarajan TS, Norkus EP, et al, J Am Med Dir Assoc, 2008; 9(3): 162-7. (Address: Department of Medicine, Our Lady of Mercy Medical Center, Bronx, NY, USA. E-mail: ).
Summary: In a cross-sectional study involving 659 elderly subjects, aged 60-102 years, results indicate that prolonged use of proton-pump inhibitors (PPI) may be associated with a significant decline in serum vitamin B12 levels. Patient demographics, serum B12 levels, use and duration of use of histamine(2) receptor antagonists (H2 blockers) and PPIs, and oral vitamin B12 supplementation were assessed. Acid-lowering agents (H2 blockers and PPIs) were used by 54% of the participants, where the average duration of use was 18.2 months. No association was observed between the use of H2 blockers and serum vitamin B12 levels. On the other hand, PPI use was associated with diminished vitamin B12 levels. Additionally, oral vitamin B12 supplementation (RDA) during PPI use was observed to slow the decline in B12 status, but not prevent it. Thus, the authors of this study conclude, “B12 status declines during prolonged PPI use in older adults, b ut not with prolonged H2 blocker use; supplementation with RDA amounts of B12 do not prevent this decline. This report reinforces that B12 deficiency is common in the elderly and suggests that it appears prudent to monitor periodically B12 status while on prolonged PPI use, to enable correction before complications ensue.”

B12 Status Declines during Prolonged Use of Proton-Pump Inhibitors (Acid-Lowering Agent)

Folate occurs naturally in foods such as: Memory
leafy green vegetables
dried beans and peas
citrus fruits
many cereals are fortified with folic acid, the synthetic form of folate. Memory

Alzheimer’s is the most common form of dementia, affecting an estimated 4 million Americans. The exact cause remains elusive, but scientists believe genetics and environmental factors conspire to trigger the onset of the disease. Memory

Third, there has been some interesting research linking senility, and particularly Alzheimer’s, to problems with toxic metals such as aluminum, mercury and lead.  Last October, a Report by the National Institutes of Environmental Heath Sciences (NIEHS) acknowledged that fluoride has been observed to have synergistic effects on the toxicity of aluminum, complexing with the mineral in the water. They acknowledge that most drinking water is high in fluoride/aluminum complexes, which enhance neurotoxicity. Other studies have shown that cooking with fluoridated water leaches the aluminum out of the aluminum cooking pots,  with different amounts being released depending on the foods being cooked, whereas cooking with non-fluoridated water resulted in no release of aluminum from the pans.  Leaching of up to 600 ppm occurred with prolonged boiling!  Some food additives have also been mentioned as having a possible role , including aspartame and glutamates, as well as alcohol, tobacco, and certain prescription drugs. If I felt myself at risk, I would certainly avoid these things where possible. Look into Silica as a protective agent against aluminum.  Certain sea vegetable and algae substances have chelating properties:  consider chlorella, kelp and algae as supplements also. Memory

Fourth, very new (2003) research is finding a connection between inflammation and Alzheimer’s.   The abstract  of the study states ” Over the past fifteen years, evidence has been accumulating that there is a chronic inflammatory reaction in areas of the brain affected by Alzheimer’s disease. Chronic inflammation, which arises in reaction to an underlying pathology, represents a threat in its own right, wherever it may occur, and can in fact surpass primary affronts upon tissues. The brain, however, is particularly vulnerable because neurons are generally irreplaceable. In the case of Alzheimer’s disease, inflammatory processes thus have the potential for turning a relatively slowly progressing condition into one characterized by rapid neurodegeneration.” For the full text, see RESOURCES. Memory

What this means nutritionally is that it would be extremely wise to avoid that which causes inflammation of any kind, since inflammation in one place usually means inflammation system wide:  and where inflammation exists, to use dietary means and supplementary means to fight it.  Turmeric is found in curry powder, and ginger is part of many Chinese dishes:  an excellent argument for extending your culinary reach! Memory

There can be no argument that trace minerals, despite a name which suggests they are of no importance, have effects far in excess of their presence in the diet.  The National Institute of health has printed research suggesting a link between LITHIUM and ALZHEIMER’S – of course, they suggest that it will form the basis for future medicines, rather than suggesting use of the natural mineral. Memory

According to a study published in the May 22 issue of the British journal Nature, when given to mice with Alzheimer’s, lithium blocked the buildup of abnormal proteins called amyloid plaque, as well as clusters of malformed nerve cells called neurofibrillary tangles. Memory

“The identification of a widely prescribed, relatively safe drug with the potential to slow or prevent the onset of AD is significant,” said lead study author Dr. Peter Klein. “Our current study, combined with earlier work, shows that the two processes associated with the progression of Alzheimer’s disease — the build-up of protein deposits known as amyloid plaques and neurofibrillary tangles — can be inhibited with lithium. Our findings have interesting implications for the potential use of lithium in preventing or disrupting the growth of these plaques and tangles in patients, since lithium is known to be relatively safe in humans when administered properly.” Memory

Lithium Orotate can be found here Memory

The Omega 3 fatty acids DHA and EPA are critical for proper brain function. Partly because of their role as precursors for hormone-like substances that act as messenger molecules in the brain (and elsewhere),  namely  prostaglandins, leukotrienes, thromboxanes, and other eicosanoids but also because the Omega-3 fatty acids  are essential to the very structure of each cell.  It is also conjectured that they improve blood flow to the brain. Last but not least, by their influence on leukotrienes and prostaglandins, they regulate inflammation. Memory

A 2003 study in Archives of Neurology showing that people older than age 65 who ate omega-3-rich fish at least once a week were 60% less likely to develop Alzheimer’s compared with those who rarely ate these fish. A 2004 study showed that DHA protects against the development of the brain lesions of Alzheimer’s EVEN WHEN THEY WERE ALREADY PRESENT! Memory

Consider also this study:

Essential fatty acids and the brain: possible health implications.Youdim KA, Martin A, Joseph JA. Laboratory of Neuroscience, United States Department of Agriculture, Jean Mayer Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.

Int J Dev Neurosci 2000 Jul-Aug;18(4-5):383-99

Linoleic and alpha-linolenic acid are essential for normal cellular function, and act as precursors for the synthesis of longer chained polyunsaturated fatty acids (Peas) such as arachidonic (AA), eicosapentaenoic (EPA) and docosahexaenoic acids (DHA), which have been shown to partake in numerous cellular functions affecting membrane fluidity, membrane enzyme activities and eicosanoid synthesis. The brain is particularly rich in PUFAs such as DHA, and changes in tissue membrane composition of these PUFAs reflect that of the dietary source. The decline in structural and functional integrity of this tissue appears to correlate with loss in membrane DHA concentrations. Arachidonic acid, also predominant in this tissue, is a major precursor for the synthesis of eicosanoids, that serve as intracellular or extracellular signals. With aging comes a likely increase in reactive oxygen species and hence a concomitant decline in membrane PUFA concentrations, and with it, cognitive impairment. Neurodegenerative disorders such as Parkinson’s and Alzheimer’s disease also appear to exhibit membrane loss of PUFAs. Thus it may be that an optimal diet with a balance of n-6 and n-3 fatty acids may help to delay their onset or reduce the insult to brain functions which these diseases elicit.

The new interest in Vitamin D research has turned up a connection between Vitamin D status, and Alzheimer’s: higher levels of Vitamin D were associated with better scores on the Mini-Mental State Examination.  Oudshoorn C, Mattace-Raso FU, et al, Dement Geriatr Cogn Disord, 2008; 25(6): 539-43.

Vitamin D deficiencies are very common in the elderly. Memory

A herbal extract called Ginkgo Biloba has very positive effects on circulation to the brain, and is suggested by Dr. Hoffman along with specific nutrients such as B12, Thiamine, Choline,  CoQ10. and N-Acetyl-Carnitine. A study in Italy evaluated the latter, using 150mg of Carnitine daily on 481 subjects for 3 months. Significant improvement was found, and no side effects. The form used was Acetyl-L-Carnitine, which forms part of the system transporting energy to the mitochondria of the cell. There are reports that it improves oxygen transport, enhances dopamine activity, and increases production of nerve growth factor.  This could, in my opinion, make it a very valuable nutrient to both guard against and help recovery from, stroke. . Perhaps the most interesting nutrient to have been researched recently is Phosphatidyl Serine : 25 human studies have been done in the US and Europe, most of them involving patients with existing measurable memory loss: the results of these studies were highly positive. In an Italian study, 125 patients age 65 to 93 all improved scores on memory and learning, but perhaps even more encouraging, they became less withdrawn and apathetic. Memory

Another nutritional hope for Alzheimer’s comes from a traditional Chinese source, a moss called Qian Ceng Ta. Its active ingredient is an alkaloid compound called Huperzine A, which inhibits the action of acetyl cholinesterase: this enzyme breaks down Acetylcholine, but higher concentrations of it are helpful to Alzheimer patients – as mentioned previously, it is actually supplemented by some in an effort to help! In the studies, doses of 30 to 900 mcg per day were used, most commonly 30 to 200 mcg, and memory enhancement was shown even at the lower doses. There are medications ( Cognex and Aricept are two examples) which work along the same lines as Hup A, and they should not be taken with it. It should also be used with caution by people with heart arrythmias or asthma, and perhaps by those taking anticholinergic medications. Bagchi and Barilla’s book, Boost Your Brain Power cites research by Ashani ( Molecular Pharmacology) on the importance of Acetylcholine synthesis and its importance in eye function. They feel that Huperzine- A may be more effective against glaucoma than such drugs as physostigmine, neostigmine or tacrine. ( ET Better Nutrition, letter to Ed. April 99) Memory

Two other herbs recently studied are Vinpocetine and  Cat’s Claw: the latter  has been found to interfere in the formation of the amyloid plaque found in the brains of Alzheimer’s patients both in the test tube and using rats. The research, which was presented early in 1999 at a meeting of the Federation of American Societies for Experimental Biology in Washington D.C. used Cat’s Claw blended with other herbs, including Rosemary, Ginkgo Biloba and Gotu Kola. Human trials should begin soon. Vinpocetine is an extract of the lesser periwinkle plant, and appears to help energy production in the brain significantly through number of actions – increased blood flow, glucose metabolisation, production of ATP (Adenosine Tri-Phosphate, the energy molecule in the cell), and more efficient burning of oxygen. It’s effects seem to be similar to those of Ginkgo, but while GBE is safe it does occasionally have side effects and its influence on the blood is sometimes problematic:  Vinpocetine, on the other hand, has no recorded side effects and does not interact (as far as I know) with any other medications. Memory

Ayurvedic Medicine has used a herb called Bacopa Monnieri for over a thousand years to combat problems with the central nervous system, such as epilepsy, poor  memory, faulty cognition and also anxiety.  A 1980 open study in India (Singh, J. Res. Ayur Siddha 1:133-148) demonstrated improvement in patients anxiety levels, concentration and memory spans, and as a side benefit also improved instances of palpitations, insomnia, headaches and irritability.  I have personally seen it have a very beneficial effect on some of the children whose parents come to me for help with ADD/ADHD.  However, if you are taking calcium channel blockers, it might be wise not to use this herb. Memory

Recent research suggests that Isoflavones in dietary soy may help protect against Alzheimer’s disease in postmenopausal women, according to the findings from an animal model of ovariectomized monkeys. Dr. Helen Kim from the University of Alabama in Birmingham presented the results of a 3-year study  on Tuesday April 3rd 2001 at the 221st National Meeting of the American Chemical Society. Dr. Kim was surprised that the same protective effects were not seen in the monkeys that received Premarin. “The effects that we saw may be due to the fact that isoflavones are strong antioxidants,” she said. Memory

I want to emphasize that there are things we can do to stay mentally young: not least among them, an active life-style and on-going mental and physical challenges!

Lecithin consumption affects acetylcholine levels in brain –

Survival signalling in Alzheimer’s Disease –

Alcohol consumption, cognitive impairment and progression to dementia –

Exercise is associated with reduced risk for dementia –

Just moderate exercise has been linked to fewer memory problems, and protection against Alzheimer’s disease.

Exercise delays Alzheimer symptoms –

Early inflammation and dementia –

Multifunctional Activities of Green Tea Catechins in Neuroprotection –

Find the recommended supplements here

B12 deficiency in the elderly – a detailed report –

How technology can help with severe memory problems –

A new study – Kirtan Kriya and Alzheimer’s –

An invaluable e-book for dealing with being a successful care-giver.
Alzheimer’s Tips by a Professional Memory Loss Educator.

Research Updates on Alzheimer’s –

Synthetic Hormones DOUBLE risk of Alzheimer’s –

Inflammation and Alzheimer’s Disease –

Fun and Games to improve your Memory –

GABA, Monkey Business and Memory –

The Impact of Fatty Acids  on the Brain –

Flu shots and Alzheimer’s – a disturbing report –

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