Unlocking Brain Health: Natural Strategies to Combat Dementia

Consciousness binds us to the world, giving us a sense of place and identity. The thought of losing this connection, of failing to remember or recognise the people and places that ground us, is unsettling. Dementia affects more than memories; it alters cognitive function, judgment, communication, and, most poignantly, the essence that once defined an individual. For those experiencing dementia, the experience is frequently disorienting and distressing. For their loved ones, witnessing this transformation is a reminder of how delicate the threads that connect us are. We hope that Unlocking Brain Health: Natural Strategies to Combat Dementia may give you food for thought and action.

With average life expectancy increasing, the prevalence of conditions like Alzheimer’s disease is increasing and poses a major public health problem. What can be done about it? Is dementia a natural, inevitable part of ageing? Or are there actions we can take to slow or prevent it? In Unlocking Brain Health: Natural Strategies to Combat Dementia, we’ll navigate the landscape of dementia, pinpointing risk factors and interventions. In particular, we will explore whether alternative therapies, dietary strategies, and modern medical treatments offer hope for maintaining a healthy, functioning mind.

Dementia

The word dementia is an umbrella term. Although dementia has become synonymous with Alzheimer’s disease, the term covers a range of conditions that includes Alzheimer’s as well as several others. Mixed dementia, where different types overlap with additive effects, is also common. Generally speaking, dementia is marked by a gradual, irreversible loss of cognitive function to the degree that it begins to affect everyday living. It can manifest as memory loss but also impaired judgment, communication, and motor function. Let’s explore the most common causes of dementia.

Alzheimer’s Disease

Alzheimer’s disease is the most common cause of dementia, accounting for 70-80% of all cases. It is characterized by the abnormal build-up of proteins in and around brain cells called amyloid plaques and tau fibrils. Initial signs may be as mild as forgetting names, but with disease progression, profound memory loss ensues, and the ability to complete simple tasks diminishes. Established risk factors for developing Alzheimer’s disease include age, genetics, smoking, obesity, high cholesterol, high blood pressure and diabetes. Risk for Alzheimer’s disease and related dementias is partially attributable to environmental factors. The heavy metals Lead, Cadmium, Manganese and Mercury (vapour) are widespread and persistent in our environments.

Vascular Dementia

Vascular dementia is the second most common, accounting for 15-20% of cases. It is caused by a reduction in blood flow to the brain, leading to a loss of cognitive function. While a stroke or multiple mini-strokes (TIAs) can cause vascular dementia, other conditions that damage blood vessels and reduce circulation such as atherosclerosis are also significant. Conditions like diabetes, high blood pressure, high cholesterol, and smoking can increase your risk of developing vascular dementia as they increase the risk of heart disease and stroke. Atherosclerosis, in particular in the carotid arteries, is related to a higher risk of dementia and cognitive decline. Carotid artery calcification (CAC) is a well-known marker of atherosclerosis, just like the coronary artery calcium (CAC) score is a warning for heart attack.

Dementia with Lewy Bodies

Dementia with Lewy Bodies (DLB) is a poorly understood condition with features that significantly overlap with Alzheimer’s disease. As such, is thought to be underdiagnosed and studies have suggested that it accounts for 20-30% of all dementia cases. DLB is characterised by fluctuating attention, visual hallucinations, and motor symptoms akin to Parkinson’s disease. It involves abnormal deposits of the protein alpha-synuclein, called Lewy bodies. Age, positive family history, Parkinson’s disease and male sex are all associated with an elevated risk for DLB.

Frontotemporal Dementia

Named because it affects the front and sides of the brain, frontotemporal dementia (FTD) is characterised by behavioural and personality changes as well as communication difficulties. These can include seemingly rude or insensitive behaviour, impulsiveness and reduced inhibition coupled with difficulties with vocabulary and speaking. Unlike other forms of dementia, FTD tends to affect younger people between the age of 45-65. The risk factors for FTD aren’t fully understood, but a strong familial association has been identified.

Is dementia a normal part of ageing?

Though age itself is a risk factor for dementia and is closely related to high blood pressure and heart disease, dementia is not an inevitable consequence of the ageing brain. One in eleven people over the age of 65 have dementia in the UK, meaning that 10 in eleven people reach old age without dementia. What does that 10-group do that the 1-group doesn’t? While it is impossible to completely negate the risk of dementia in later life, there are actions we can take to dramatically reduce our chances of developing it. Additionally, naturally occurring supplements and compounds may also hold promise in preventing the onset of dementia. To find out more about natural remedies and strategies for reducing your dementia risk, read on.

Is there a natural remedy for dementia?

Natural compounds are increasingly favoured due to their user-friendly nature, minimal side effects, and broad safety margin. Furthermore, they present a cost-effective approach for managing chronic ailments like dementia. In recent years, the popularity of herbal remedies and dietary supplements has surged, with an estimated 80% of the global population leveraging some form of herbal medicine. Despite some concerns over their safety, efficacy, and quality, the limited pharmacological interventions [i.e. prescribed medication]  available for dementia —none of which halt its onset or progression— make naturally derived neuroprotective agents a promising research avenue. Let’s explore some natural remedies that show potential in delaying or preventing dementia progression.

Boswellia Sacra

Boswellia, also known as frankincense, comes from the gum resin in the bark of Boswellia trees, common in places like India, North Africa and Oman where the jewel in the crown of Al-Hojari Boswellia Sacra comes from. This natural extract has been used for ages in traditional medicines for its inflammation-fighting benefits. This is important because inflammation, brain ageing, and Alzheimer’s are closely connected. Boswellia Sacra oil is lipid soluble, enabling small molecules within them to cross the blood-brain barrier (Tisserand & Young 2013). Researchers believe that Boswellia might improve cognitive function by calming age-related inflammation. Its key component, Boswellic acid, is thought to block several pathways that contribute to the development of Alzheimer’s. (link) Animal studies have shown Boswellia can boost memory and even decrease the problematic protein build-ups in the brain related to Alzheimer’s. (link) Some human trials have also shown promising results. For instance, a study with 60 people observed improved memory and attention after taking a Boswellia-based herbal blend. (link) Another study with 85 participants found that using a Boswellic acid supplement for 6 months helped improve dementia symptoms and lowered inflammation markers in the blood. (link)

Fulvic Acid

Fulvic acid is a compound that can be found in soil, sediment, and aquatic environments. It is derived from the decomposition of organic materials, such as plants, and is a crucial element in the formation of humic substances. Fulvic acid may have beneficial effects on the course of Alzheimer’s disease in two ways:
Reduction of tau fibrils – In addition to amyloid plaques, the formation of proteins into tau fibrils is closely related to a loss of brain mass and the progression of dementia symptoms. Compounds that can prevent the formation of tau fibrils or promote their breakdown may be useful treatments for Alzheimer’s disease. In one pre-clinical study, Fulvic acid inhibited the clumping of tau proteins and even broke down those that had already formed. (link)

Heavy metal reduction – Some evidence has pointed toward the involvement of heavy metals such as copper, mercury and iron in the development of AD. Metals such as copper and iron have been associated with the development of free radicals which are implicated in brain cell damage, while copper and zinc have been associated with abnormal amyloid and tau proteins that are found in the brains of people with Alzheimer’s disease. Fulvic acid has a high affinity for heavy metals, pulling them from their binding sites on human cells and aiding their removal from the body.

Resveratrol

Ever heard that a daily glass of red wine could fend off dementia? This came from a study which found that drinking moderate amounts of red wine was associated with a reduction in the frequency of dementia. (link)  While it’s tempting to toast to that new, alcohol consumption can harm cognitive functions such as memory. Thankfully, it wasn’t the wine that was responsible for the effect but resveratrol, a compound found in grapes and raspberries. It has anti-oxidative and anti-inflammatory properties which could explain its role in preventing the onset of dementia. Animal studies have shown resveratrol can guard against vascular dementia, likely due to its antioxidant power. (link). In humans, a year-long trial involving 119 patients with mild-to-moderate Alzheimer’s Disease found resveratrol was associated with the maintenance of a blood and spinal fluid marker that normally drops as Alzheimer’s progresses to more advanced stages. Evidence suggests that resveratrol may also lead to improved brain blood flow. A study on patients type 2 diabetes patients revealed that resveratrol improved blood flow responsiveness in the brain. A subsequent 14-week study on post-menopausal women linked these vasodilator benefits to enhanced cognitive function, underlining resveratrol’s potential in addressing cognitive decline.

Alpha Lipoic Acid (ALA)

Alpha lipoic acid (ALA) is a naturally occurring antioxidant that is water- and fat-soluble, allowing it to function throughout the body. Naturally produced by the body and also found in certain foods, ALA neutralizes free radicals and reduces oxidative stress implicated in dementia and Alzheimer’s disease. Additional evidence suggests that like fulvic acid, ALA can also bind heavy metals. Pre-clinical studies have suggested that a combination of ALA and exercise may benefit learning and memory. However, no definitive clinical study has proven any benefit in dementia. Small population-based studies have suggested that ALA therapy can slow the progression of cognitive decline or stabilise cognitive function in patients with AD and associated dementias. (link link)
In one study of patients with AD and diabetes, ALA supplementation over 16 months was associated with improved clinical measures of cognitive function. (link)

In Alzheimer’s you must eliminate vegetable oils, take large doses of lipid-soluble-antioxidant vitamin E (e.g. 800 IU) and Selenium (total tolerable upper intake level is 400 μg/day for adults – please note that Se obtained from food averages about 100 μg/day for adults). Selenium plays a role against Alzheimer’s disease by minimizing amyloid β aggregation, hyperphosphorylation of tau protein, and preventing neuronal death. To dramatically increase the efficacy of vitamin E, add 3,000 mg/day water-soluble vitamin C (present in the cytosolic compartment of the cell) to serve as an electron donor to vitamin-E-radicals (which is what vitamin E becomes after dealing with oxidative stress in fatty tissue). Eat real-free-range-on-good-soil (raw*) eggs because they are rich in essential amino acids, unsaturated fatty acids, all B vitamins, folate, fat-soluble vitamins, and minerals (Phosphorus, Selenium, Iron, Iodine, Zinc), Choline, Lecithin, Lutein, Zeaxanthin, all have been reported to have a positive impact on cognition. Go for a brisk walk every day (perhaps with spouse or a helper). Note that consumption of one egg per day increases serum lutein and zeaxanthin concentrations in older adults without altering serum lipid and lipoprotein cholesterol concentrations [J Nutr. 2006 Oct;136(10):2519-24. doi: 10.1093/jn/136.10.2519]. *Gently drop one egg into a glass of water: if it sinks to the bottom and lays on its side, it should be fresh and ready to eat – if it floats all the way to the top, the egg may be spoiled so do not eat. Beyond such shoestring remedies, consider (ask us about) a liposomal complex that includes phosphatidylcholine (PC) for memory, phosphatidylethanolamine (PE) for mitochondrial function and phosphatidylinositol (PI) supportive of brain health via neurotransmission support.

Can diet and exercise help prevent dementia?

Yes, they can. As the greatest risk factors for dementia include diabetes, high cholesterol, high blood pressure and cardiovascular disease, diet and exercise have a vital role to play in (every) disease prevention. Diet and exercise have been associated with the increase of proteins that have a protective effect on brain cells. (link, link) To find out more about different diets that may improve brain function and reduce the onset of dementia symptoms, read on.

DASH Diet (Dietary Approaches to Stop Hypertension)

Originally intended for hypertension, the DASH diet promotes nutrients believed to combat high blood pressure. Emphasizing fruits, vegetables, whole grains, lean meats, and low-fat dairy, while limiting sodium, red meat, and sweet food, the DASH diet supports cardiovascular health but may offer benefits for cognitive maintenance. A study of 160 sedentary patients without dementia but with impaired cognitive functioning, found that regular aerobic exercise 3 times/week over a period of six months led to significantly improved performance on cognitive tests. When the DASH diet was combined with exercise, there appeared to be an additive effect, with greater benefits than those who dieted or exercised alone. (link)

MIND Diet (Mediterranean-DASH Intervention for Neurodegenerative Delay)

The MIND diet, a fusion of the Mediterranean and DASH diets, was designed to reduce Alzheimer’s disease risk by targeting cardiovascular factors and bolstering neuroprotection. Brain health is maintained with antioxidant and anti-inflammatory nutrients found in leafy greens, berries, whole grains, nuts, olive oil, fish, and poultry. Heart health is promoted through the reduced consumption of red meats, butter, margarine, cheese, pastries, sweets, and fried or fast foods. A scientific review found that adherence to the MIND diet is linked to a reduced risk of dementia, with a direct relationship between adherence level and benefit. It also found that the MIND diet promotes mood improvements, daily activity performance, and cognitive resilience in elderly people. (link)

KETO Diet (Ketogenic Diet)

The keto diet is a high-fat, low-carbohydrate diet which puts the body into a state of ketosis. In ketosis, the body burns fat for energy and produces ketones. The brain uses these ketones as a major energy source when glucose levels drop. There is emerging evidence to suggest that the ketogenic diet might offer neuroprotective benefits, potentially lowering the risk of cognitive decline and certain neurodegenerative diseases. Moreover, the diet has been used historically to treat epilepsy, further hinting at its advantages in neurological diseases. However, according to Dr. Daroowala, it’s worth noting that long-term adherence to the Keto diet can pose cardiovascular risks due to its high-fat content, which might counteract the benefits for some individuals. Han takes a somewhat opposing view because the commonest disease process precursor is hyperinsulinaemia leading to insulin resistence, micro-inflammations(!), visceral fat… A EUROASPIRE study (24 European countries) measured glucose levels (perturbations): 76% of cardiac patients of all ages were essentially type II diabetic. People with type 2 diabetes often have no symptoms at first, hence 8 in 10 not knowing they have it and a keto diet could turn this around for them. By keeping your TC/HDL ratio below 4, diastolic BP between 80-85 and insulin away from prediabetes, you are going to be much less susceptible to dementia.

The above video is an intesting but somewhat technical interview with Dr. Bredesen who earned his MD from Duke University Medical Center and served as Chief Resident in Neurology at the University of California, San Francisco (UCSF), before joining Nobel laureate Stanley Prusiner’s laboratory at UCSF as an NIH Postdoctoral Fellow.

Exercise and physical activity prevent cognitive decline.

Physical activity, characterized by muscle movement and increased energy use, is linked to improved cognitive function and potential protection against dementia. Although specifics like the optimal amount and type of exercise remain ambiguous due to variations in studies and potential influences like diet, increase social benefits and improved quality of life, a distinct benefit is evident for those who engage in exercise versus those who don’t. Studies have shown that engaging in aerobic exercise for 30 minutes multiple times per week, consistently over the course of a year, can have positive impacts on both cardiovascular and cognitive health. It’s recommended to establish a healthy exercise routine as early in life as possible. Exercise promotes healthy blood pressure and cardiovascular health, which in turn benefits brain health, possibly by reducing age-related vascular changes in the brain, enhancing oxygen circulation, and protecting brain cells.

Prescription Drugs for cognitive function: Balancing Benefits and Risks

Several prescription medications can be used to treat patients with Alzheimer’s Disease, Dementia with Lewy Bodies and Parkinson’s Disease dementia. Vascular dementia and FTD cannot be treated with these medications. It’s important to note that these medications do not halt the progression or reduce cognitive decline, but they can temporarily improve cognitive performance, reduce symptoms and improve quality of life for dementia patients.

Cholinesterase Inhibitors

Donepezil, Rivastigmine and Galantamine are cholinesterase inhibitors, meaning they increase levels of Acetylcholine, a neurotransmitter, which can help to alleviate symptoms of the disease by boosting neural function, improving memory, alertness, and the ability to function. The main side effects of these medications include gastrointestinal upset, nausea, vomiting, diarrhoea and loss of appetite. Less common but serious side effects include weakness, dizziness and heart rhythm disturbances.

Glutamate Inhibitors

Unlike other drugs, memantine is a glutamate inhibitor. The brains of people with Alzheimer’s disease produce excessive levels of glutamate, which can further damage brain cells. Memantine protects the brain and nerve cells by blocking the action of glutamate. Because it works differently, memantine may be combined with other dementia drugs in patients with advanced-stage dementia. The main side effects of memantine include dizziness, confusion, headache, and constipation. Unlike the previous drugs, it doesn’t generally cause gastrointestinal issues. More serious side effects can include liver failure, heart failure, pancreatitis and psychosis.

Conclusion

Our quest for mental health and stability in later years beckons a deeper understanding of the brain, early diagnosis of potential risks, and an integrated approach. As dementia symptoms become more apparent in society, our knowledge of natural treatments, preventative strategies and medical advancements may pave the path toward a future where cognitive decline is a relic of the past.

Unlocking Brain Health: Natural Strategies to Combat Dementia was written by Dr. Remy Daroowala MBBS, BSc, MRCP(UK); editing and video by Han van de Braak BSc LicAc MCSP MBAcC (Retd.)