There Is Hope for Cognitive Decline

Even in adults the brain can regenerate. The areas of neurogenesis are

  • Subventricular zone of the lateral ventricles
  • Subgranular zone of the hippocampal dentate gyrus
  • PMID: 1553558     PMID: 34453294

Cognitive Decline is Common, but not a Normal Part of Aging

There are things you can do to reverse or prevent cognitive decline

Types of Dementia in North America & Europe

  • Alzheimer’s Dementia 70-80% (twice as common in women than men)
    • 5% Early Onset “Familial” <65 years old, rapid progression
      • 1% related to genetic mutations of APP, presenili, or gamma-secretase
    • 95% Late Onset “Sporadic” >65 years old, slower progression
    • Risk Factors: female, cardiovascular disease, physical inactivity, depression, smoking, obesity, diabetes type 2
  • Vascular Dementia 15-20% (twice as common in men than women)
  • Frontotemporal Dementia 10-20%
  • Lewy Body Dementia 5%
  • Mild cognitive impairment (shows up on testing)
  • Subjective cognitive impairment (you or a loved one notices it)
  • https://doi.org/10.1161/ATVBAHA.119.311908    PMID: 31884487   https://doi.org/10.1152/ajpendo.00008.2021    PMID: 36395147

Check out Dale E. Bredesen’s book “The End of Alzheimer’s” for a terrific blueprint of how to work-up and treat cognitive decline.

The Three Phenotype of Cognitive Decline:

  • Inflammatory – incorrect activation of anti-inflammatory systems – or- over-activation of inflammatory systems
  • Atrophic – lack of necessary nutrients/hormones
  • Toxic – viral, bacteria, mycotoxins, lyme, heavy metal invasion

Systems that Influence Brain Health

  • Ability to methylate
  • Ability to produce and transmit nuerotransmitters
  • Immune system’s ability to effectively fight infections and modulate inflammation
  • Proper vascular flow
  • Ability to produce energy
  • Ability to use energy
  • Ability to have a strong barrier system

Goals for Treatment

  • Identify if blood-brain barrier is sealed or not
  • Identify factors causing brain to defend itself by producing protective amyloid response (i.e the 3 phenotypes: inflammatory, atrophic, toxic)
  • Optimize the aberrant phenotypes
  • Adopt a proneurogenic lifestyle
  • Rebuild synapses

What Is Needed for Normal Brain Function

  • Mental and Physical Exercise
  • Nutritionally Dense Food
  • Social Engagement
  • Avoidance of Pathogens

Abnormal Brain Aging Leads to Brain Degeneration

  • There is a shift from being cortical-based to being spinal cord-based and brainstem-based
  • There is a shift from parasympathetic dominance to sympathetic dominance
  • There is a shift from a system that is more efficient to a system that is less efficient
  • There is a shift from being flexible and adaptable to being hypersensitive and intolerant
  • There is a shift from being extensor dominant (i.e. upright) to being flexor dominant (i.e. stooped)

What Is Neurodegeneration?

Neurodegeneration = Mitochondrial Dysfunction + Protein Misfolding

Amyloid beta plaques are a type of protein midfolding

What is Amyloid Beta

Amyloid beta is produced by

  • Astrocytes
  • Neurons
  • Skin
  • Skeletal muscles
  • Intestinal epithelium
  • Colonized bacteria

The normal function of amyloid beta is

  • Protect from infections
  • Suppress tumor growth
  • Repair leaks in the blood-brain barrier
  • Promote recovery from brain injury, hypoxia, autoimmune disease
  • Regulate glutamatergic & cholinergic synaptic function
  • Contribute to memory consolidation
  • PMID: 29922148

What Causes Amyloid Beta Plaques

  • Incorrect pruning of amyloid pruning protein (APP) by beta secretase or by mutated gamma secretase
  • If an incorrectly pruned APP interacts with chronic inflammation and ApoE amyloid plaque can be formed

What Causes Misfolded Proteins Not To Be Cleaned Up

  • Too much sugar in brain requiring insulin degrading enzyme to break down insulin instead of amyloid beta plaques
  • Inadequate estrogen
  • Too much iron, copper, zinc or other metals in brain

Alzheimer’s = Diabetes of the Brain = Type 3 Diabetes

Inflammatory Phenotype for Cognitive Decline

  • High blood sugar and insulin
  • BMI>25
  • Gluten/Dairy exposure
  • High cortisol
  • Low Zinc: High Copper
  • Low glutathione and selenium
  • Sleep apnea
  • Leaky gut
  • CIRS (chronic inflammatory response syndrome)
  • Brain autoantibodies

Treatment for Cognitive Decline

  • Identify your risk factors and optimize exercise, weight, social engagement, and brain stimulation
  • Identify any underlying biochemical, infectious, inflammatory or toxic issues and treat them
  • Don’t settle for the slippery slope of forgetting words or names
  • Increase your brain game