We all know that the brain is the seat of our consciousness—it contains our thoughts, memories, emotions, problem solving skills, and artistry. In DaVinci’s brain, there lived the Mona Lisa, and in Harper Lee’s brain it turns out that To Kill a Mockingbird was stored. You could not love your children, watch a movie, tie your shoes, or blow out the candles on your birthday cake if you didn’t have a brain. But we forget sometimes that our brain is a physical organ in which things can go wrong. Any change in brain function has a significant, sometimes even profound, impact on every downstream activity, whether it is our ability to communicate, care for ourselves, learn new tasks, or remember the faces of our family.
Yet despite its critical importance, we often don’t think about brain health until we start to see warning signs that things are not quite right. Maybe it is forgetfulness, or changes in judgment, a sudden inability to complete an easy task, even getting lost. For my beloved grandmother, who was 98 years old at the time, it was making her spectacular Christmas cookies—which we looked forward to every year—but forgetting certain ingredients and mismeasuring so the cookies tasted terrible. It was a heart-breaking moment, but we never told her there was a problem and gave her our usual hugs and kudos.
Changes in brain function are increasingly common as we age. A 2022 study published in JAMA Neurology found that about one-third of people over 65 years old have either dementia (about 10 percent) or mild cognitive impairment (about 22 percent).
There are many reasons why brain changes are occurring. One may be polypharmacy, meaning too many prescription medications with too little oversight. Recent research has identified that people with dementia are more likely to be taking three or more medications during the five-year period prior to diagnosis. Patients taking multiple medications increased from 5.5 percent 16 to 20 years prior to diagnosis, to more than 80 percent three to five years before diagnosis. The medications included those for respiratory and urinary infections, cardiovascular diseases, and musculoskeletal conditions.
Another concern is the long-term use of acid reflux drugs, which may also play a role in the development of dementia. People who took proton pump inhibitors (PPIs) for over 4.4 years were 33 percent more likely to develop dementia when compared to those who did not take PPIs. Proposed mechanisms include vitamin B12 deficiency, changes in amyloid metabolism in the brain, and disruptions to the gut microbiome.
Anticholinergic drugs, and there are over a hundred, both OTC and prescription drugs, deplete choline which in turn depletes acetylcholine, increasing dementia risk by well over 50 percent with long term use.
Metabolic syndrome—the cluster of high blood pressure, high blood pressure, cholesterol imbalance, and often, abdominal obesity, is on the rise and a huge risk factor. A Korean study found that people with metabolic syndrome had an 11-times higher risk of developing Alzheimer’s disease versus people without metabolic syndrome.
Blood sugar is a significant culprit in developing brain changes as we age, so diet plays a crucial role in the longevity of our brain function.
There are also supplements that can make a big difference. Some you may be familiar with, and some may be quite new to you.
Bacopa monnieri
Bacopa is an herb the use of which dates back more than 1,400 years. It was considered (rightly so) a rejuvenator for the brain and nervous system. Science has since discovered that key compounds, called bacosides, enhance antioxidant status in regions of the brain like the hippocampus, frontal cortex and striatum.
In addition to being an antioxidant, bacopa increases brain blood flow and preserves acetylcholine, an important neurotransmitter associated with cognitive function.
A human clinical study showed that giving 320 mg of bacopa extract for 12 weeks produced significant improvements in verbal learning, early memory processing and memory strengthening,
In another study, it improved cognition based upon shortened time to complete standardized assessment for evaluating working memory, visual processing, visuospatial skills, selective and divided attention, processing speed and psychomotor coordination. The study also found improvements in reaction time, which can be lifesaving when it comes to driving especially.
This makes bacopa an excellent choice for both preserving and improving brain health and cognition. However, recent research has found that it works even better when partnered with the herb Sideritis scardica, better known as Greek mountain tea.
Greek Mountain Tea
Greek mountain tea has been used in folk medicine in the Mediterranean for centuries. Greek mountain tea is a shrub native to the Balkan peninsula. Other names include Shepherd’s tea and Ironwort. Traditional uses include bronchitis, asthma, upper respiratory tract infections, prevention of anemia, and as a general tonic. More recently, Greek mountain tea’s impacts on the central nervous system have been explored. Research has found that Greek mountain tea can modulate neurotransmitter production (serotonin, dopamine, norepinephrine), enhance cognition, reduce beta-amyloid aggregation and reduce neuroinflammation.
In a recent human study of mild cognitive impairment (MCI) using both Greek mountain tea and bacopa in a blend, the results were even more interesting. The researchers found that after using the combination, participants had significant electroencephalogram changes associated with activity in areas of the brain associated with memory creation, storage, and retrieval. Participants saw improvements in tests of concentration, arithmetic calculations and memory. It is important to note that even though it is called a tea, the herb does not contain caffeine.
Curcumin
Curcumin has an enormous body of research on cognitive health. In fact, the electronic database of the National Institutes of Health (NIH) lists over 1,900 studies specifically on curcumin and brain.
In Alzheimer’s disease, MCI, vascular dementia, and post-stroke cognitive changes, we see higher levels of inflammation and oxidative stress. Since curcumin is a powerful and proven anti-inflammatory, as well as a potent antioxidant, curcumin addresses both these issues. However, there are other curcumin activities that make it a critical medicine for anyone with brain changes.
Research has shown that curcumin is able to significantly increase brain derived neurotropic factors, or BDNF, levels, which can be 20-40 percent lower in people with Alzheimer’s disease. Low BDNF levels are also associated with depression and other mental health disorders.
Curcumin has also demonstrated positive effects on Parkinson’s disease through its activation of the BDNF and other signaling pathways.
Other research has identified that curcumin can help reduce the consequences of traumatic brain injury (TBI) through its ability to reduce neuroinflammation.
In an animal model, curcumin was able to protect the brain from ischemic stroke. Curcumin improved neurological scores, decreased the overall size of stroke-affected area, protected regions of the brain associated with higher function (like the hippocampus), and upregulated proteins that preserved the integrity of the blood-brain barrier.
Last, but certainly not least, curcumin has been shown in animal models of Alzheimer’s disease to significantly reduce beta amyloid plaque in the brain, a hallmark of AD.
Not all curcumin performs the same. Be sure your product is standardized curcumin, not turmeric which has very little curcumin. Make sure it has been used in published human studies. One form, a curcumin enhanced with turmeric essential oil was found to cross the blood-brain barrier 14 times better than a standard curcumin. Plus, the curcumin with turmeric essential oil was able to protect against the neurotoxic effects of aluminum through reducing damage to lipids and hippocampus cells and increasing the levels of protective compounds like glutathione. With curcumin, it is important to do your homework.
Omega-3 Fatty Acids
The two most studied omega-3 fatty acids for brain health are EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), generally found in cold water fish like tuna and salmon.
Omega-3s have been shown to improve the brain structure of people in their 40s and 50s. A higher omega-3 index (EPA + DHA levels) was associated with larger hippocampal volumes, the region of the brain closely associated with learning and memory. Another interesting study of people who are APOE4 carriers showed that folks with a higher omega-3 index had fewer cases of small-vessel disease, which commonly leads to cognitive impairment. There were worse overall health outcomes in the people with the lowest consumption of omega-3 fatty acids.
In fact, in healthy individuals (without cognitive impairment) with coronary artery disease, supplementation with EPA and DHA slowed cognitive aging by 2.5 years. That is a very significant improvement. Overall, having higher blood levels of omega-3s can equate to an extra five years of life.
Vitamin D
For so many years, vitamin D was discussed mostly with regard to its impact on the strength of our bones, but research has shown that vitamin D can have a dramatic impact on brain health as well. In a 12-month clinical trial on vitamin D supplementation (800 IU/day) in elderly patients with MCI, significant improvements were found in intelligence, vocabulary and overall cognitive function. Some of mechanisms identified included reductions in oxidative stress and preservation of telomere length—an indicator of longevity.
Unfortunately, it is estimated that vitamin D deficiency may affect 30 percent to 50 percent of the global population. Deficiency has been implicated in various neurodegenerative and neuropsychiatric conditions, including dementia, mood disorders, schizophrenia, ADHD, and psychosis. Choose vitamin D3, cholecalciferol, as this is a form that is better utilized by the body.
Magnesium
Magnesium may seem like a simple mineral, but it is also a very powerful nutrient for protecting the brain. Higher magnesium intake may help reduce brain shrinkage, especially in women. Researchers found that a 41 percent increase in magnesium intake could help reduce age-related brain shrinkage, resulting in better cognitive function and lowered or delayed risk of dementia in later life. Higher intake would be 550 mg vs around 350 mg. However, different forms of magnesium have different levels of absorption, and poorly absorbed magnesium (like magnesium hydroxide) can cause loose stools and diarrhea. Magnesium that is chelated (attached) to amino acids like glycine are generally the best tolerated when trying to take higher doses of this mineral.
Is There a Cure?
While as yet there are no cures for advanced Alzheimer’s, brain injuries, and other forms of serious brain dysfunction, there is a great deal of hope on the horizon. Clinically studied nutrients can improve function, restore better brain activity, and slow progression.VR
References:
McBurney MI, et al. The American Journal of Clinical Nutrition. 2021 October;114(4):1447-1454.
Welty FK. CurrO pin Lipidol. 2023 Feb;34(1):12-21.
Yang T, et al. J Alzheimers Dis. 2020;78(4):1509-1518.
Manly JJ, et al. JAMA Neurol. 2022;79(12):1242-1249.
Kim E, et al. Aging and Disease. 2023;14(2):548-559.
Northuis CA, et al. Neurology. 2023;101(18).
Kim YJ, et al. Diabetology & Metabolic Syndrome. 2021;13(4).
Ng TKS, et al. Int J Mol Sci. 2019 Jan;20(2):257.
Jin T, et al. Food Chem Toxicol. 2022 Jun:164:113091.
Khayatan D, et al. Biomed Pharmacother. 2022 Oct:154:113621.
Wu S, et al. Exp Ther Med. 2021 Jul;22(1):783.
Banji D, et al. BioMed Res Int. 2021 Jan;1-12.
Satizabal CL, et al. Neurology. 2022 Dec;99(23).
Roy NM, et al. Front Biosci (Landmark Ed). 2021 Jan 1;26(3):566-611.
Alateeq K, et al. European Journal of Nutrition. 2023:62(2039-2051).
Sanmukhani J, Satodia V, Trivedi J. Efficacy and Safety of Curcumin in Major Depressive Disorder: A Randomized Controlled Trial. Phytother Res. 2013 Jul 6. doi: 10.1002/ptr.5025.
Lopresti AL, Maes M, Maker GL, Hood S, Drummond PD. Curcumin and major depression: A randomized, double-blind, placebo-controlled trial investigating the potential of peripheral biomarkers to predict treatment response and antidepressant mechanisms of change. European Neuropsychopharmacology. Dec. 5, 2014 Lopresti AL, Maes M, Maker GL, Hood S, Drummond PD. Curcumin for the treatment of major depression: A randomised, double-blind, placebo-controlled study. J Affect Disord. 2014;167:368-375.
Garcia-Alloza M. Curcumin labels amyloid pathology in vivo, disrupts existing plaques, and partially restores distorted neurites in an Alzheimer mouse model. J Neurochem. 2007;102:1095-1104.
Yang F, Lim GP, Begum AN, et al. Curcumin inhibits formation of amyloid beta oligomers and fibrils, binds plaques, and reduces amyloid in vivo. J Biol Chem. 2005;280(7):5892-901.
Baum L, Lam CW, Cheung SK, et al. Six-month randomized, placebo-controlled, double-blind, pilot clinical trial of curcumin in patients with Alzheimer disease. J Clin Psychopharmacol. 2008 Feb;28(1):110-3.
Wightman EL, Jackson PA, Khan J, et al. The Acute and Chronic Cognitive and Cerebral Blood Flow Effects of a Sideritis scardica (Greek Mountain Tea) Extract: A Double Blind, Randomized, Placebo Controlled, Parallel Groups Study in Healthy Humans. Nutrients. 2018 Jul 24;10(8):955.
Heiner F, Feistel B, Wink M. Sideritis scardica extracts inhibit aggregation and toxicity of amyloid-β in Caenorhabditis elegans used as a model for Alzheimer’s disease. PeerJ. 2018 Apr 30;6:e4683. doi: 10.7717/peerj.4683. PMID: 29736334; PMCID: PMC5933321.
Kongkeaw C, Dilokthornsakul P, Thanarangsarit P, Limpeanchob N, Norman Scholfield C. Meta-analysis of randomized controlled trials on cognitive effects of Bacopa monnieri extract. J Ethnopharmacol. 2014;151(1):528-35. doi: 10.1016/j.jep.2013.11.008. Epub 2013 Nov 16. PMID: 24252493.
Calabrese C, Gregory WL, Leo M, Kraemer D, Bone K, Oken B. Effects of a standardized Bacopa monnieri extract on cognitive performance, anxiety, and depression in the elderly: a randomized, double-blind, placebo-controlled trial. J Altern Complement Med. 2008 Jul;14(6):707-13.
Downey LA, Kean J, Nemeh F, Lau A, Poll A, Gregory R, Murray M, Rourke J, Patak B, Pase MP, Zangara A, Lomas J, Scholey A, Stough C. An acute, double-blind, placebo-controlled crossover study of 320 mg and 640 mg doses of a special extract of Bacopa monnieri (CDRI 08) on sustained cognitive performance. Phytother Res. 2013 Sep;27(9):1407-13. doi: 10.1002/ptr.4864. Epub 2012 Dec 19. PMID: 23281132.
Stough C, Downey LA, Lloyd J, Silber B, Redman S, Hutchison C, Wesnes K, Nathan PJ. Examining the nootropic effects of a special extract of Bacopa monniera on human cognitive functioning: 90 day double-blind placebo-controlled randomized trial. Phytother Res. 2008 Dec;22(12):1629-34. doi: 10.1002/ptr.2537. PMID: 18683852.
McPhee GM, Downey LA, Wesnes KA, Stough C. The Neurocognitive Effects of Bacopa monnieri and Cognitive Training on Markers of Brain Microstructure in Healthy Older Adults. Front Aging Neurosci. 2021 Feb 22;13:638109. doi: 10.3389/fnagi.2021.638109. PMID: 33692683; PMCID: PMC7937913.
Dimpfel W, Biller A, Suliman S, Chiegoua Dipah G.N. Psychophysiological Effects of a Combination of Sideritis and Bacopa Extract (memoLoges®) in 32 Subjects Suffering from Mild Cognitive Impairment. A Double-Blind, Randomized, Placebo-Controlled, 2-Armed Study with Parallel Design. Adv. Alzheimer’s Dis. 2016;5:103–125. doi: 10.4236/aad.2016.53008.
Florent S, Malaplate-Armand C, Youssef I, et al. Docosahexaenoic acid prevents neuronal apoptosis induced by soluble amyloid-beta oligomers. J Neurochem. 2006 Jan;96(2):385-95.
Rondanelli M, et al. Long chain omega 3 polyunsaturated fatty acids supplementation in the treatment of elderly depression: effects on depressive symptoms, on phospholipids fatty acids profile and on health-related quality of life. J Nutr Health Aging. 2011 Jan;15(1):37-44.
Faria R, et al. Alterations in phospholipidomic profile in the brain of mouse model of depression induced by chronic unpredictable stress. Neuroscience. 2014 Jul 25;273:1-11.
Oudshoorn C, Mattace-Raso FU, van der Velde N, Colin EM, van der Cammen TJ. Higher serum vitamin D3 levels are associated with better cognitive test performance in patients with Alzheimer’s disease. Dement Geriatr Cogn Disord. 2008;25(6):539-43.
Annweiler C, Rolland Y, Schott AM, et al. Higher vitamin D dietary intake is associated with a lower risk of Alzheimer’s disease: a 7-year follow up. J Gerontol A Biol Sci Med Sci. 2012;67:1205-11.
Balion C, Griffith LE, Strifler L, et al. Vitamin D, cognition, and dementia: a systemic review and meta-analysis. Neurology. 2012;79:1397-405.
Littlejohns TJ, Henley WE, Lang IA, et al. Vitamin D and the risk of dementia and Alzheimer disease. Neurology. 2014 Sep 2;83(10):920-8.
Masoumi A, et al. 1alpha,25-dihydroxyvitamin D3 interacts with curcuminoids to stimulate amyloid-beta clearance by macrophages of Alzheimer’s disease patients. J Alzheimers Dis. 2009;17(3):703-17.
Eby GA, Eby KL. Rapid recovery from major depression using magnesium treatment. Med Hypotheses. 2006;67(2):362-70. Epub 2006 Mar 20.
Cheryl Myers is an integrative health nurse, author, and an expert on natural medicine. She is a nationally recognized speaker who has been interviewed by the New York Times, Wall Street Journal and Prevention magazine. Her many articles have been published in such diverse journals as Aesthetic Surgery Journal and Nutrition in Complementary Care, and her research on botanicals has been presented at the American College of Obstetrics and Gynecology and the North American Menopause Society. Myers is the head of scientific affairs and education for EuroPharma, Inc.
